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T Kirsch

Publications and source records attributed to T Kirsch.

89 records · Page 5Linked to original sources
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A survey of emergency department communicable disease reporting practices.

A group of physicians, nurses, and administrators at all 11 hospitals in the District of Columbia were interviewed to elucidate each hospital emergency department's (ED) system for patient and public health notification of the diagnosis of legally reportable communicable diseases. The hospitals' reporting systems were divided into two groups. Three hospitals (27%) had reporting systems that were centered in the emergency department (EDS). Eight hospitals (73%) had disease reporting systems that depended primarily on extradepartmental personnel (HBS) for disease reporting. The EDS outperformed the HBS in several key areas of system performance. Greater attention needs to be paid by ED directors to assuring that their hospital's system is as accurate as possible and fulfills their jurisdiction's legal requirements for communicable disease reporting.

Communicable Diseases↗
PubMedDate not supplied

Pattern of sexually transmitted diseases in a Malagasy population.

BACKGROUND: Data concerning the spectrum and antimicrobial susceptibility of STDs in Madagascar are scarce. OBJECTIVES: Improvement of STD patient management in Madagascar. GOAL OF THE STUDY: Assessment of the spectrum of STDs and improvement of therapy. STUDY DESIGN: Etiologic study of 400 patients (169 men, 231 women) under consultation at the major STD service in Antananarivo for one or more of the STD syndromes, urethral discharge, cervicovaginal discharge, genital ulcers, or condylomata according to a fixed diagnostic schedule. RESULTS: Of genital ulcers, syphilis accounted for 46%, lymphogranuloma venereum for 24%, chancroid for 16%, and herpes for 1%. Of the syphilis cases, 51% presented as condyloma lata. Discharge was found in 124 men and 210 women. Counting concomitant infections separately, gonorrhea occurred in 69% of the men and 20% of the women with discharges, chlamydia infection in 42% and 52%, trichomoniasis in 9% and 31%, candidiasis in 12% and 30%. Bacterial vaginosis was found in 37% of the women with discharges. In 32% of male and 71% of female gonorrhea cases, there was concurrent chlamydia infection. Infection with HIV 1 or 2 was not detected. Determination of the antibiotic susceptibility of Neisseria gonorrhoea revealed high efficacy of ampicillin, ciprofloxacin, and spectinomycin; but frequent resistance to tetracycline and cotrimoxazole. CONCLUSIONS: High priority should be given to the management of infections with chlamydia and with Treponema pallidum as well as to educational measures to increase awareness of genital ulcer disease.

Adolescent↗