PubMed · 15452951
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Clare Kapp. Hazard or help?. https://doi.org/10.1016/s0140-6736(04)17122-5
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This article reviews what is known about the incidence, aetiology, presentation, bacteriology and management of septic arthritis in children. It compares where possible the different presentations and characteristics of this condition in the Western and sub-Saharan African regions.
Diagnosis and treatment of endemic infectious disease is crucial for productivity of cattle in rural sub-Saharan Africa, but shortages of trained veterinary professionals necessitate support for less well-trained cadres of animal health worker. A Delphi survey of veterinary experts provided quantitative information on key clinical signs associated with eight endemic bovine diseases, then heuristics and dendrogram analysis identified a reduced sign set to be incorporated in a diagnostic decision support tool implemented as a simple colour-banded card. One hundred and seventy disease-sign questionnaire returns were obtained from 32 veterinary research scientists and 14 veterinary practitioners. Preliminary validation of the decision support tool for 16 prototypical cases resulted in 'correct' diagnosis over 90% of the time. The card potentially serves as a training aid and aide-mémoire, and could improve the diagnostic competence of animal healthcare providers.
The integration of preventive chemotherapy programs (PCPs) targeting multiple neglected tropical diseases (NTDs) with similar strategic approaches offers opportunities for enhanced cost-effectiveness. To estimate the potential cost savings and health outcomes of integrated programs, the data available for five NTDs (lymphatic filariasis, onchocerciasis, intestinal helminthiasis, schistosomiasis and trachoma) can be used to define eligible target populations, the probable overlap of at-risk populations, and the cost per person treated in stand-alone and integrated programs. If all targets for 2006 in sub-Saharan Africa are met, then savings of 26-47% can be projected from such integration (a cost of US dollar 58-81 million versus dollar 110 million for stand-alone PCPs). These first estimates can be refined as empirical data become available from integrated PCPs in the future.