Aksel Schreiner

AIDS education for primary school children in Tanzania: an evaluation study.

Objective:To test the effects of an HIV/AIDS education program. Design:A quasi-experimental, nested cross-sectional design including baseline and 6-month follow-up surveys. Schools, stratified according to location, were randomly assigned to intervention (n = 6) or comparison conditions (n = 12). Setting:Public primary schools in Arusha and Kilimanjaro regions, Tanzania. Participants:A total of 2026 sixth and seventh grade pupils (average age, 14.0 years) participated at baseline (85%) and 1785 at follow-up. Intervention:The program was designed to reduce childrens risk of HIV infection and to improve their tolerance of and care for people with AIDS. Local teachers and health workers attended a 1-week training workshop before implementing the program over a 2–3-month period (averaging 20 school hours per class). Main outcome measures:Self-reported exposure to AIDS information, communication regarding AIDS; AIDS knowledge, attitudes towards people with AIDS, attitudes towards having sexual intercourse, subjective norms regarding sexual intercourse, and intention to engage in sexual intercourse. Results:Following this program, intervention pupils reported significantly higher scores for the following outcome measures than pupils attending the comparison schools: AIDS information (13.1 versus 10.5; P= 0.0001), AIDS communication (10.9 versus 7.8; P= 0.0001) AIDS knowledge (14.5 versus 11.5; P= 0.0001), attitudes towards people with AIDS (9.0 versus 6.7; P= 0.0008), subjective norms (45.5 versus 43.9; P= 0.011), and intention (1.3 versus 1.4; P= 0.020). No program effect was seen for attitudes towards sexual intercourse (47.0 versus 46.3, P=0.44). Conclusions:These results indicate that it is feasible and effective to provide AIDS education for Tanzanian primary school children.

Bacteriology of acute lower respiratory tract infections

Summary Based on cultures of transtracheal aspirates in hospitalised patients, the bacteriology in acute pneumonia ( n = 323) was found to be dominated by pneumococci (46·5 per cent of cases with pure culture), followed by Haemophilus influenzae (23·6 per cent). Neisseria spp. were also involved (10·7 per cent). In acute exacerbation of chronic bronchitis ( n = 87), H. influenzae prevailed (35 per cent), followed by pneumococci (20.6 per cent). In this infection Neisseria spp.—including N. meningitidis —were even more prominent (17·5 per cent). In nonpulmonary disease ( n = 121), and in pulmonary embolism ( n = 38), the demonstration of bacteria reflecting the oropharyngeal flora in approximately 10 per cent indicated that the broncho-tracheal clearing mechanism may be impaired in some of these patients.

Absorption, Distribution and Elimination of Cefazolin in Patients with Normal Renal Function

Cefazolin was given intramuscularly in a dosage of 1.0 g to 13 bed-ridden patients during treatment for various infections, and the pharmacokinetics evaluated in each subject. In 9 patients the mean serum half-life was 2.7 h, whereas in 4 patients--all over 60 years of age--it was significantly above this value. Impaired renal fuction could not explain the prolonged excretion time in the last group.

Pathogenicity Of Branhamella Catarrhalis

Branhamella catarrhalis--a Gram-negative diplococcus--differs biochemically from other Neisseriaceae and possesses a specific protein with antigenic properties. Although scattered cases of meningitis and endocarditis have been reported since 1907, B. catarrhalis has been considered a non-pathogenic, pharyngeal commensal. However, relatively recent reports have shown B. catarrhalis to play a significant role in the etiology of otitis media and bronchopulmonary infections. Some reports also indicate a pathogenic role in sinusitis and longstanding cough in children, and in acute laryngitis in adults. B. catarrhalis is susceptible to co-trimoxazole, erythromycin, cephalosporins and tetracyclines. Most strains are also susceptible to penicillin, but the frequency of beta-lactamase producing B. catarrhalis has increased from 4% to 25% during the last six years (Sweden). First choice antibiotics in infections with penicillin-resistant strains would be erythromycin and co-trimoxazole.

Therapy of Infections with Parenteral Cephalexin

14 patients with lower respiratory tract infections, 6 with postoperative Staphylococcus aureus infections, 5 with erysipelas, 4 with septicemia, and 1 with Diplococcus pne

Therapy of Infections with Cefazolin

16 patients with acute urinary tract infections, 6 with acute lower respiratory tract infections and 3 with miscellaneous infections were treated with 1 g cefazolin parenterally 3 times daily. All patients, except one in whom therapy was discontinued, were cured. Both intramuscular and intravenous administration resulted in high-peak serum levels, and concentrations after 8 h were still inhibitory to relevant pathogens. The drug was well tolerated and caused, after intramuscular injection, probably less pain than does cephalotin. Cefazolin is a rational choice of therapy in severe cases of acute urinary, respiratory, and other infections.

Therapy of Infections with Oral Cephalexin

11 patients with postoperative wound infections and 11 with septicemia caused by penicillinase producing Staphylococcus aureus, 22 patients with lower respiratory tract infections and 6 with erysipelas were treated with 1 g cephalexin orally 4 times daily. The septicemia patients received initial intravenous therapy with 1 g cephalexin, 4–6 times daily for 1–4 days. 44 patients were cured and 3 improved; 2 patients with pneumonia, 1 caused by Staphylococcus aureus and the other by Hemophilus influenzae, and 1 septicemia patient failed to respond to therapy. 8 patients developed minor side-effects. Oral cephalexin is useful in the treatment of lower respiratory tract and soft tissue infections. It is also useful in the treatment of Staphylococcus aureus septicemia which initially has been controlled by parenteral antibiotics.