3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Primaquine sensitivity: Some epidemiological and biochemical aspects(1962-09) Charlton, R. W.Plasmoquine (piasmochin, paiuaquin) was the first synthetic antimalarial drug, and it aroused a great deal of interest when it became available in 1926. Dixon (1933) estimated that at least 415 papers relating to plasmoquine hid appeared in the first 4 years following iti introduction, thereafter the volume of communications decreased somewhat,until fresh interest was stimulated by the Second world <.ar and the horean »,ar with fighting in maiariou. areasItem Internal Migration Reconciliation for the Kintampo HDSS Core Datasets using Probabilistic Record Linkage Techniques(2018) Adda, Robert AwiahInternal migration reconciliation involves the tracking of internal migrants to link their places of origin and destination for each movement within a given Health and Demographic Surveillance Area (HDSS) site. This involves several related activities adopted to account for the time the person moves from one location to the other but, remaining under the HDSS surveillance. This poses a major challenge for longitudinal studies particularly Kintampo HDSS site, where manual data capture modality is still being used. For most HDSS sites, all data related operations rely much on an individual unique personal identifier which is issued to identify a resident member during registration. The identifier enables the data system to keep track of resident members over an extended period of time to enable an accurate estimation of the population under surveillance. Movement of resident members within the geographical boundaries of the surveillance areas must be tracked based on these personal identifiers. However, residents’ records may not be linked to each other in the event of multiple movements when the personal identifier cannot be recorded or is wrongly recorded. The effort in reconciling such cases of inconsistencies resulting from internal migration involves the printing of mismatched records for field supervisors to trace back to original locations to ascertain the identity of migrants. This process is very expensive as a full-time field supervisor is required and the reconciliation process is time demanding. In this project, we explored alternative automatic and cheaper method of reconciling all categories of discrepancies that exist in the internal migration datasets using the probabilistic record linking techniques.A theoretical foundation for probabilistic record linkage technology was provided and the sequential order was followed.The EM algorithm was used in the estimation of parameters. This research report demonstrate clearly that the probabilistic record linkage frame work by Fellegi and sunter is useful for HDSS internal migration reconciliation. The EM algorithm showed an improved performance in terms of linked records compare to the probabilistic framework. However, more work needs to done to explore other parameter estimation algorithm such as the Frequency-based EM algorithm. Such results can be compared to the results in this report.Item The epidemiology and management of traumatic facial fractures in children under the age of 15 years recorded in a Johannesburg General hospital over a period of 5 years(2017) Fouche, GerhardAim: This study aim was to determine the prevalence of traumatic facial fractures in children under the age of 15 years who presented at the Charlotte Maxeke Johannesburg Academic Hospital (Department of Maxillofacial and Oral surgery, Wits Oral Health Centre and Department of General Surgery) over a period of 5 years from 2011 to 2015. Objective: This study objective was to determine the prevalence of facial bone fractures, the age and gender mostly affected, the place and cause of facial fracture, the type and distribution of facial fractures, the prevalence of associated injuries as well as the management of facial fractures. Materials and methods: This is a retrospective study based on data retrieved from patient records. Four thousand and forty-four files were used for the analysis of this study. Data collected from existing patient records included: department of admission; date of admission; age; gender; who accompanied the patient to hospital; ethnicity; medical history; number of days between date of injury and date of arrival; place of injury; cause of fracture; site of fracture; type of fracture; teeth affected; associated facial injuries; ophthalmic or globe involvement; associated bodily injuries; specialized consultation; radiographs; management and treatment of injuries. The results: Cases numbering 171 children under the age of 15 years with facial bone fractures were retrieved from patient records. Majority of the patients were males. Mean age of patients was 6.45 ± 3.47 years. Most common places of injury included the home, school and other places which refer to any other environment, surrounding area or public place in the home or school. Most common causes of paediatric facial fracture injury are pedestrianvehicle accidents (PVAs), motor vehicle accidents (MVAs) and falls, with a significant association between the cause of fracture and the age of the patients. Two hundred and forty seven facial bone fractures were detected. Most common site of facial fracture was the frontal bone followed by the orbital bone. Fifty six paediatric patients had multiple facial bone fractures. Forty nine children had an associated tooth injury. Of the 435 facial soft tissue injuries (STIs) detected, 91.0% were extra orally. Most common STIs were lacerations, abrasions and soft tissue swellings. Seventy four of the 117 paediatric patients with associated bodily injuries, had multiple bodily injuries. Twelve patients with facial bone fractures showed results of ophthalmic or globe involvement. One hundred and nine (63.7%) patients with facial bone fractures were managed conservatively, whilst management of 58 (34.0%) patients included surgical intervention. Four (2.3%) patient records did not indicate any treatment. Conclusion: Most facial bone fractures were recorded in children under the age of 10 years and male gender was most affected. Aetiology of facial fractures seems to be more similar in male and female children at a younger age, whereas more variation in aetiology occurs in gender during adolescence. This study suggests that the school is the safest place for children. The seasonal variance in terms of paediatric facial fracture prevalence is most likely related to an increased outdoor activity during the months of summer. Possible reasons that contribute to home and other places as high-risk areas for facial fractures in children could either be lack of parental supervision and responsibility, or the absence of safety measures. More children were involved in PVAs than MVAs. The negligence of drivers, lack of road safety awareness, insufficient pedestrian safety measures or inadequate parental control is potential factors to contribute to the high prevalence of MVAs and PVAs as a major aetiological factor amongst children in these affected communities. From this study, it seems that the mechanism of injury and stage of facial development shows a noticeable influence on the type and site of the bone fracture and that the frequency of aetiological factors changes with age. Management and treatment of paediatric facial fractures should be with a good understanding of the patterns of anatomical growth and stages of skeletal development.Item The background of congenital abnormalities in general, and especial consideration of rubella (German Measles), its epidemiology, symptomatology and teratology: A review of the literature(1951-01) Fasser, E.Every morbid condition, occurring in Medicine is based fundamentally on the genetic constitution of the individual, but only diseases whloh are significantly related to hereditary factors are regarded as hereditary diseases. In the thesis presented by the writer, an attempt is made to show how the environment affects the development and expression of factors genetical in origin. The first part of this work is really only a sketchy introduction to the genetic processes involved, and is presented as a background on which to paint the picture of certain conditions regarded as slgnifioantally environmental in origin,. Hence the early chapters cannot be regarded as being vety complete or detailed, but an attempt has been made to present the basic genetic laws, and to Interpret various morbid processes in the foetus and newborn In the light of these laws. Some of these pathological conditions have only recently been understood, and a few are enumerated In the hope of producing an over-all picture. Some are touched upon as being of some practical importance either . at the present date, or possibly in the near future, This brings us to the conception of "prenatal paediatrics." There is a tendency at the present time for a closer relationship to develop between obstetrician and paediatrician Just because of the newer knowledge regarding the reciprocal relationship between maternal and foetal status. Maternal nutri- Importance* Obstetricians, today, in introducing newer and safer procedures, operations, and analgaesic methods for delivering their patients, consider more and more, the management of labour in terms of the effect upon the foetus. Psychological, as well as physiological care of the pregnant woman must be instituted beoause psychological disturbances may significantly affect the actual physiology of pregnancy and parturition. Paediatric attention, initiated early in pregnancy, is therefore not necessarily an impractical procedure. As the genetlo constitution cannot be Varied the aim of “prenatal paediatrics” must be directed towards modification of adverse environmental factors. One of the great aims of Eugenics is to prevent the action of adverse genetio factors, but the scope of eugenics at.the present time Is limited in its application. There appears to be a tendency, as the centuries roll on, for balanced genetical systems to evolve, whioh seem to be resistant to change. Whether the future use of atomic radiation, either in Peace or in War, may change this, remains to be seen. The effects of maternal rubella, as described in the second part of this work, appear to be so diverse in different instances, that the operation of co-existent genetical background factors oannot entirely be excluded. It is essential to obtain better statistical Information regarding gene frequencies. Biochemistry, physiology, and Serology should be allied to Clinical and Social Medicine In an attempt to discover v i i i . and diabetes, and also various types of defedtfe fend malformations, such as congenital morbus cordis * deaf-mutism, mental defioienoy, eto. Art Investigation of the relationship between neonatal stattie fend the development of subsequent disease patterns during later childhood, or even adulthood, will undoubtedly » prove to be of the greatest import. In this work reference has been made to the value of epidemiological Btudies as a means of uncovering mechanisms which produce congenital defects. It should be remembered that, due to differences in diet, medical care, and a thousand other factors of changed environment, maternal status today is different to what it was fifty or one hundred years ago, and any effects for good or ill on the foetal population can. be unearthed by careful, prolonged statistical study. It is obvious that the correlated efforts of many branches of Ollnlcal, Experimental and Social Medicine over long.periods, are essential to produoe useful results. For lnstanoe, mongolism occurring in two slbs may not necessarily represent an hereditary condition, as one of the cases may be incidental, or dependant on environmental factors obtaining for both affected sibs. Similarly, many of the less typloal congenital defects, which in late years have been described as appearing in children born after maternal rubella may be incidental, and either represent the risk to the foetal population at large, or may yet be the means of uncovering the operation of other environmental factors as well. Hence we see the need for a oloser follow up of all morbid or abnormal conditions during pregnancy, particularly/*«,. particularly virus infections, with complete reports on the infants subsequently born, whether normal or otherwise. This need becomes clear, when the latter part of this work is consulted. The investigations carried out on maternal rubella as an aetiological factor in the production of congenital defects is presented as a most important step in the understanding and prevention of unfortunate accidents of foetal development. The present thesis is essentially a review of the literature, but several oases are presented on account.of the paucity of reports in the xrorld literature. In this connection, the writer would like to acknowledge case histories given by Doctors D. G. Melle, 0.N..Javett, M. Chitters, W, Tope, M, Epstein and C-. Faerber all of Johannesburg, and Doctors B. Epstein, P. Oosterhagen and J. Rudolph of Pretoria. Valuable assistance and great courtesy has been offered by the Matron, St. Vinoentfs School for the Deaf, Johannesburg, Mr. Wentworth of.the National Council for the Blind, Pretoria, Dr. le Riche of the Union Health Department, Pretoria, Ma.^or Dreisenstock at Defence Headquarters, Pretoria and those most efficient librarians, Miss A.C. Dick.and Miss Krige of the Witwatersrand Medical Library. My thanks are also due to the doctors at Union Health Department, Pretoria who so graciously plaoed their excellent library material at my disposal* Last but not least, I am indebted to Mrs, T. Mellet, Miss E. Marcus and my wife for clerical assistance. X. E„ F. Pretoria, January, 1951.Item Epidemiology of Cassava mosaic disease and molecular characterization of Cassava mosaic viruses and their associated whitefly (Bemisia Tabaci) vector in South Africa(2008-06-19T12:16:54Z) Mabasa, Kenneth GazaCassava mosaic disease (CMD) is caused by whitefly-transmitted geminiviruses and is a major constraint to cassava production in Africa. Field surveys were conducted in three (Bushbuckridge, Mariti and Tonga) cassava growing areas of Limpopo and Mpumalanga provinces in South Africa during two seasons (2004/2005 and 2005/2006). Results showed that a higher percentage (27.1%) of CMD infection was due to the use of infected planting materials compared to whitefly borne-infections (10.4%). Disease symptoms were generally mild. There was no change in disease incidence over the survey period. Molecular characterization of cassava mosaic geminiviruses (CMG’s), using differential primer PCR, restriction fragment length polymorphisms (RFLP’s), phylogenetic and recombination analysis and screening for satellite DNA’s. Differential primer PCR and RFLP’s showed that African cassava mosaic virus (ACMV) was the most prevalent virus in South Africa and that mixed infections were a common occurrence. Phylogenetic analysis and RFLP’s showed the presence of a ‘new’ strain of ACMV in South Africa. EACMV isolates from this study showed more frequent recombination compared to ACMV isolates. None of the samples tested positive for satellite DNA’s. Phylogenetic analysis of Bemisia tabaci using the mitochondrial cytochrome oxidase gene sequences revealed a ‘new’ sister clade of B. tabaci that is closely related to the previously identified southern African clade and the presence of the Q biotype that groups with Q biotypes of North African/Mediterranean origin. Good cultural practices, introduction of resistant cultivars and continuous monitoring are required to reduce the impact of CMD in South Africa.