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Biomedical subjects

W Van Damme

Publications and source records attributed to W Van Damme.

At least 19 recordsLinked to original sources
PubMed2004

Fake antimalarials in Southeast Asia are a major impediment to malaria control: multinational cross-sectional survey on the prevalence of fake antimalarials.

OBJECTIVE: To assess the prevalence of counterfeit antimalarial drugs in Southeast (SE) Asia. DESIGN: Cross-sectional survey. SETTING: Pharmacies and shops selling antimalarial drugs in Myanmar (Burma), Lao PDR, Vietnam, Cambodia and Thailand. MAIN OUTCOME MEASURES: Proportion of artemisinin derivatives or mefloquine containing drugs of substandard quality. RESULTS: Of the 188 tablet packs purchased which were labelled as 'artesunate' 53% did not contain any artesunate. All counterfeit artesunate tablets were labelled as manufactured by 'Guilin Pharma', and refinements of the fake blisterpacks made them often hard to distinguish from their genuine counterparts. No other artemisinin derivatives were found to be counterfeited. Of the 44 mefloquine samples, 9% contained <10% of the expected amount of active ingredient. CONCLUSIONS: An alarmingly high proportion of antimalarial drugs bought in pharmacies and shops in mainland SE Asia are counterfeit, and the problem has increased significantly compared with our previous survey in 1999-2000. This is a serious threat to public health in the region.

Antimalarials↗
PubMed2000

Epidemics and fear.

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Communicable Disease Control↗
PubMed1999

Safe motherhood.

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Female↗
PubMed1998

Effects of a refugee-assistance programme on host population in Guinea as measured by obstetric interventions.

BACKGROUND: Since 1990, 500000 people have fled from Liberia and Sierra Leone to Guinea, west Africa, where the government allowed them to settle freely, and provided medical assistance. We assessed whether the host population gained better access to hospital care during 1988-96. METHODS: In Guéckédou prefecture, we used data on major obstetric interventions performed in the district hospital between January, 1988, and August, 1996, and estimated the expected number of births to calculate the rate of major obstetric interventions for the host population. We calculated rates for 1988-90, 1991-93, and 1994-96 for three rural areas with different numbers of refugees. FINDINGS: Rates of major obstetric interventions for the host population increased from 0.03% (95% CI 0-0.09) to 1.06% (0.74-1.38) in the area with high numbers of refugees, from 0.34% (0.22-0.45) to 0.92% (0.74-1.11) in the area with medium numbers, and from 0.07% (0-0.17) to 0.27% (0.08-0.46) in the area with low numbers. The rate ratio over time was 4.35 (2.64-7.15), 1.70 (1.40-2.07), and 1.94 (0.97-3.87) for these areas, respectively. The rates of major obstetric interventions increased significantly more in the area with high numbers of refugees than in the other two areas. INTERPRETATION: In areas with high numbers of refugees, the refugee-assistance programme improved the health system and transport infrastructure. The presence of refugees also led to economic changes and a "refugee-induced demand". The non-directive refugee policy in Guinea made such changes possible and may be a cost-effective alternative to camps.

Adult↗
PubMed1995

Change in undergraduate medical education.

Undergraduate medical education didn't undergo major changes since the Flexner report in the beginning of this century and has since been copied without important modifications worldwide. The bulk of the medical education is given by subject specialists and general practice is only marginally covered. The result is that the training of medical doctors has become inappropriate and that a change is urgently needed. The aim is on the one hand to improve the clinical skills of doctors, on the other hand to prepare doctors for enhanced roles and to have some community perspective. Innovations such as problem-based learning and community-oriented education took mainly place in new medical schools. The need to change medical education is however greater in established medical schools, but innovation seems more difficult to reach there, although some successful experiences are described. Most innovations failed to tackle reform of the health system in which new graduates will function. This is probably one of the main reasons for their limited results. Five presentations to the Colloquium illustrate the difficulties and possible successes of change in undergraduate medical education.

Curriculum↗
PubMed1995

Clinical training for tropical doctors in the nineties.

Together with economic causes, the declining belief in the relevance of clinical skills, the omission of the hospital from the health system, and the erroneous generalisation of a complaint centred approach enhanced the decline in clinical medicine in several developing countries over the last decades. Despite a growing interest and important efforts in continuous education, basic training remains generally knowledge-directed. Clinical training should start from a realistic job description, and aim at acquiring skills instead of knowledge. Basics of clinical epidemiology can help refine clinical logic both at the health centre and the hospital level. the district hospital should be awarded a key role in pre-graduate and continuous clinical training. Awaiting a revival of the economy in most tropical countries, and especially in tropical Africa, an effective way for improving clinical practice is to invest in training, at all levels, with an emphasis on continuous medical training.

Clinical Competence↗
PubMed1992

Local application of diminazene aceturate: an effective treatment for cutaneous leishmaniasis?

In a controlled clinical trial we tested the effect of diminazene aceturate (Berenyl, Bayer) in local application against cutaneous leishmaniasis. The study was performed among schoolchildren in Nyala, West-Sudan in 1988 during a major outbreak of cutaneous leishmaniasis in this region. Sixty-six schoolchildren with cutaneous leishmaniasis were enrolled in the study. The children were randomly assigned to either diminazene aceturate (Berenil) or cetrimide 15% + chlorhexidine 1.5% (Savlon) treatment. The study results show a significant faster healing of the ulcers in the children treated with diminazene aceturate (chi-square 7.31, p less than 0.01). We conclude that diminazene aceturate should be considered as a potential topical drug in the treatment of cutaneous leishmaniasis.

Antiprotozoal Agents↗