Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Morbidity and mortality due to ascariasis: re-estimation and sensitiviey analysis of global numbers at risk(Blackwell Scientific Publications, 1997) de Silva, N.R.; Chan, M.S.; Bundy, D.A.P.This paper presents estimates of the global numbers of people at risk from morbidity related to infection with Ascaris lumbricoides and the numbers of deaths from this infection. Morbidity is classified into 4 types: deficits in growth and fitness which are contemporaneous with infection, or permanent, overt acute illness of mild to moderate severity, and complications involving hospitalization. The estimation of morbidity is based on theoretical models of parasite distributions developed in previous papers. A sensitivity analysis is carried out in which parameters of the model are varied using a Latin hypercube sampling technique. The results estimate approximately 1300 million infections globally with 59 million at risk of some morbidity. The estimate for acute illness is 12 million cases per year with approximately 10,000 deaths. Most morbidity is in children. Sensitivity analysis suggests that infection estimates will not vary greatly with changes in parameter values but that morbidity estimates may be highly variable.Item Morbidity and mortality due to Ascaris-induced intestinal obstruction(Oxford University Press, 1997) de Silva, N.R.; Guyatt, H.L.; Bundy, D.A.P.We examined epidemiological aspects of Ascaris-induced intestinal obstruction (AI-IO) through analysis of published reports on the subject. In 9 studies of > or = 100 patients admitted to hospital due to ascariasis, intestinal obstruction was the single most common complication and accounted for 38-87.5% of all complications (weighted mean 72%). The proportion of intestinal obstruction caused by ascariasis was identified in 14 studies from 7 countries with varying degrees of endemic ascariasis. Using relevant data on the duration of the study, the number of beds in the reporting hospital, and the number of hospital beds/1000 population in the area, the number of cases of AI-IO/year/1000 population was estimated from 11 studies. Both the proportion of AI-IO (range 0-0.71) and the number of cases of AI-IO/year/1000 population (range 0-0.25) were significantly related, in a non-linear manner, to the local prevalence of ascariasis (range 0.01-0.92). In 12 studies of > or = 30 patients with AI-IO, the case fatality rates ranged from 0 to 8.6% (weighted mean 5.7%). The mean age of patients with AI-IO was < or = 5 years in 6 of 7 studies in which age was specified.