Suchergebnisse

Intro -- Contents -- Acknowledgments -- Introduction: Patterns of Resistance -- PART I: SEROTHERAPY AND THE RISE OF THE SPECIFIC, 1891 - 1930 -- 1 The Advent of Type-Specific Antipneumococcal Serotherapy -- 2 A "Specific" Specific and the Turbid Age of Applied Immunology -- 3 Fundamental Tensions: Clinical "Proof" and Clinical Resistance -- PART II: THE TRANSFORMATION OF PNEUMONIA INTO A PUBLIC HEALTH CONCERN, 1930 - 1939 -- 4 The Massachusetts Experiment and New (York) Tensions -- 5 The New Standard, the New Deal, and the Pneumonia Control Programs -- PART III: RESOLUTION: THE ANTIMICROBIAL "REVOLUTION" AND THE DECLINE OF SEROTHERAPY, 1939 - PRESENT -- 6 Histology of a Revolution -- 7 A "Modern" Revolution: The Limits and Uses of Controlled Clinical Trials -- 8 The Dismantling of Pneumonia as a Public Health Concern -- Conclusion: Overcoming Resistance -- Notes -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W.

Although previous workers have emphasised that venereal disease is rife in many developing countries there are no reliable statistics on the relative incidence of such infections. This dearth of information about these infections in Africa is directly related to economic factors, and the lack of modern diagnostic facilities and medical manpower. The pattern of these diseases was studied over a 30-month period at a hospital clinic serving an African population of about 2 million people. Standard diagnostic methods were used. The age distribution of patients conformed with that in other parts of the world except that more pre-pubertal patients were seen. The male to female ratio was 3:1. Non-specific genital infections were the most common (25·9%) followed closely by post-pubertal gonorrhoea (19·5%). Pre-pubertal gonorrhoea was commoner than reported elsewhere (4·0%) and this may be because the children have been in contact with infected clothing of their parents or members of their family. Most strains of Neisseria gonorrhoeae were sensitive to penicillin by the disc method, but a few were markedly resistant to this and other agents. It is to be expected that the problem of gonococcal drug resistance will increase unless effective legislation is introduced to discourage self-medication with antimicrobial preparations. Venereophobia was common (6·6%) and sociocultural factors may play a dominant role in the incidence of the basically psychiatric condition. Syphilis constituted 2·5% of diagnoses and this can be regarded as an ominous sign in an area where yaws was endemic two decades ago and is now virtually non-existent. Altogether 9·5% of cases had multiple diagnoses making them dangerous sources of multiple infections. Up to 70% of the patients were infected after a promiscuous sexual activity. Such a high level of promiscuity would undoubtedly lead to an even greater dissemination of these infections. It is essential to provide facilities for diagnosis and treatment in every major town in Africa, otherwise it ...