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1
Lopes, Maria de Fátima Costa. "Tracoma: situação epidemiológica no Brasil." Programa de pós-graduação em saúde coletiva, 2008. http://www.repositorio.ufba.br/ri/handle/ri/10292.
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O tracoma é uma cerato-conjuntivite crônica transmitida pela bactéria Chlamydia trachomatis. É a principal causa de cegueira evitável do mundo. O objetivo deste estudo é conhecer a extensão e distribuição do tracoma no Brasil. Foram analisados dados do inquérito de tracoma realizado pelo Ministério da Saúde em 18 estados e no Distrito Federal, no período de 2002 a 2007. Foi selecionada uma amostra de escolares, em municípios com Índice de Desenvolvimento Humano–Municipal menor que a média nacional. Foi realizado exame ocular externo com lupa (2,5X) para detecção de casos de tracoma segundo critérios da OMS. Foram examinados 119.837 alunos, distribuídos em 2.200 escolas localizadas em 1.130 municípios e detectados 5.851 casos de tracoma ativo (TF/TI), obtendo-se a prevalência de 4,9%. Não foi encontrada diferença significativa entre os sexos. A maior prevalência de tracoma por faixa etária foi verificada nos menores de 5 anos de idade (10,4%), com diferença significativa entre as faixas etárias (X2 de tendência= 35,06, p <0,01). A prevalência de tracoma por zona urbana foi de 4,2% e por zona rural de 6,0% com diferença significativa, com mais risco de ocorrer o tracoma entre moradores de zona rural (X2 = 177,688 - p <0,01). Foram detectados casos em 888 municípios (78,6% da amostra), em todas as regiões do país, contradizendo a expectativa de que a endemia estaria controlada no país. Este estudo demonstra que o tracoma é um importante problema de saúde pública no Brasil
Salvador
2
Ferraz, Lucieni Cristina Barbarini [UNESP]. "Tracoma em crianças do Ensino Fundamental do município de Bauru - Estado de São Paulo, Brasil." Universidade Estadual Paulista (UNESP), 2006. http://hdl.handle.net/11449/102328.
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ferraz_lcb_dr_botfm.pdf: 1272413 bytes, checksum: e6358f733b6708125fc92291189f5991 (MD5)Tendo em vista que o Tracoma é causa de cegueira e que há cinco anos não havia nenhum caso notificado no Município de Bauru - São Paulo, foi realizado o presente estudo que teve por objetivo determinar a prevalência de tracoma e as características de seus portadores, assim como estabelecer um programa de controle da doença para Bauru. Material e método: foi realizado um estudo transversal, aleatorizado, nas escolas estaduais de Bauru, São Paulo. Foram examinadas 1749 crianças do ensino fundamental, de 6 a 14 anos, durante o ano de 2005. As escolas foram escolhidas por sorteio, de acordo com o número de estudantes e de acordo com a localização dentro do setor da cidade (centro, região intermediária e periferia). O diagnóstico dos casos foi clínico, seguindo as normas da Organização Mundial de Saúde, confirmado laboratorialmente em três pacientes que apresentavam o diagnóstico de Tracoma folicular, pelo método da imunofluorescência indireta para detecção de Chlamydia trachomatis. A associação entre presença de doença e características dos portadores foi feita usando o teste de Goodman, teste não-paramétrico de Kruskal-Wallis e estatística descritiva. Todos os casos foram tratados com azitromicina oral, em dose única, e foram acompanhados periodicamente. Resultados: A prevalência de Tracoma inflamatório foi de 3,77%, tendo sido diagnosticado Tracoma folicular em 3,71% e Tracoma intenso em 0,06% das crianças examinadas. As crianças com Tracoma moravam principalmente na região intermediária e periférica da cidade, áreas onde o fornecimento de água pode ser descontínuo e o tratamento do esgoto pode estar ausente. Meninos e meninas foram acometidos de forma semelhante. Prurido e ardor ocular foram sintomas que estavam relacionados com a presença da doença. Foram detectados 175 comunicantes com o diagnóstico...
Trachoma is one of cause of blindness. The last five years there were no cases detected in Bauru, São Paulo. The purpose of this study aimed to determine the prevalence of trachoma in schoolchildren in Bauru and to establish a control program of this disease in Bauru. Material and methods: A transversal random study was carried out in state schools of Bauru, São Paulo. One thousand seven hundred and forty nine children were examined at fundamental classes, between six to fourteen years old during the year 2005. The schools were chosen by random, according to the number of scholar children and the school region and it was represented by section of the city (downtown, middle and periphery). The diagnosis of the cases was clinical, it was according to the World Health Organization protocol, and three patients with clinical follicular trachoma had laboratory confirmation. The laboratory technique chosen was direct smear fluorescent antibodies cytology for Chlamydia trachomatis. The association study among trachoma and relatives variables was done by Goodman test, Kruskal-Wallis test and descriptive statistics. All cases were treated with Azitromycin orally and they had followed up periodically. Results: The sample was composed of 1749 children and the trachoma prevalence was 3,77%. Follicular trachoma was diagnosed in 3,71% of children, and intense trachoma in one child (0,06%). The children with trachoma were living mainly in the middle and periphery region of the city, regions with discontinuous water supply and absent sewerage system. Itching and burning were complains more related to trachoma. One hundred and seventy five contacts were found and were clinic diagnostic with the disease. Conclusion: The Trachoma prevalence in Bauru - São Paulo State is 3,77%. A control program is development to treat ant detect the contacts. This way, there was a bauruense community mobilization to prevent Trachoma blindness in the municipal district.
3
Luna, Expedito Jose de Albuquerque. "A epidemiologia do tracoma no Estado de São Paulo." [s.n.], 1993. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310518.
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Orientador : Luis Jacintho da SilvaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: o tracoma foi introduzido no Estado de São Paulo pela imigração européia, que se intensifica a partir da segunda metade do século XIX. Nas primeiras décadas do século XX já havia tornado-se endêmico, sendo uma das doenças de maior prevalência, à época, não só em São Paulo, como em todo o pais. A partir da década de trinta, inicia-se em São Paulo, a instalação de uma rede de serviços especializados em tracoma. Já a partir da segunda metade da década de cinquenta, esta rede de serviços começa a detectar uma diminuição da ocorrência e gravidade do tracoma no Estado, que foi por fim considerado erradicado ao inicio da década de setenta. No entanto, na década seguinte, novos casos de tracoma voltam a ser detectados na região oeste do Estado, e posteriormente em outras regiões. Até o momento, constatou-se a ocorrência de tracoma endêmico em mais de 150 municípios do Estado. Demonstrou-se ainda que, na realidade, o tracoma nunca chegou a ser erradicado, e que a sua ocorrência concentra-se majoritariamente em determinados agrupamentos sociais marginalizados dos benefícios do desenvolvimento socioeconômico. o tracoma de hoje difere do tracoma endêmico causador de cegueira do passado. Verifica-se uma tendência à diminuição da gravidade dos casos, sendo a maioria deles assintomáticos e detectados através de busca ativa. Discute-se se esta mudança relaciona-se apenas à diminuição da prevalência ou a outros fatores relacionados ao agente etiológico, ou ainda à disseminação do uso de drogas antimicrobianas. Postula-se que os níveis de prevalência já detectados em São Paulo justificam a intensificação das atividades de vigilância epidemiológica, aliada ao necessário aprofundamento das investigações, com o objetivo de melhor conhecer o problema e viabilizar o seu controle.
Abstract: Trachoma was introduced in the State of São Paulo with the increasing European immigration, starting in the second half of XIX century. In the first two decades of xx century it had become endemic, not only in São Paulo, but in the whole country, being one of the most prevalent diseases in those years. During the thirties, a specialized trachoma services network was established in the State. In the late fifties those services begun to detect a decrease in the number, as well as in the severity of trachoma cases. Trachoma was finally considered to be eradicated from São Paulo in early seventies. But in the following decade new trachoma cases started being detected, at first in the West and later in other regions of the State. At the moment, endemic trachoma has already been detected in more than 150 cities within the State. It has been proved that trachoma was never actually eradicated, and that its occurrence is concentrated mainly among certain social groups which stayed aside from the benefits of socio-economic development. Today's trachoma is different from the past blinding endemic trachoma. It has been observed a tendency towards decreasing severity of the disease. The majority of new cases are asymptomatic and detected in surveys. It is being discussed whether such new features of the disease are related only with low prevalence or whether factors related to the bacteria or either the widespread use of anti-microbial drugs also play a role in determining it. The present study assumes that the prevalence rates detected in São Paulo justify the need of intensifying the surveillance of the disease, as well as the scientific investigation, in order to better understand and control it.
Mestrado
Mestre em Saude Coletiva
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Alves, Fábia Alexandra Pottes. "Tracoma em Pernambuco: análise das intervenções e dos fatores individuais e ambientais associados à ocorrência da doença." Centro de Pesquisas Aggeu Magalhães, 2014. https://www.arca.fiocruz.br/handle/icict/13908.
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Previous issue date: 2014Fundação Oswaldo Cruz. Centro de Pesquisas Aggeu Magalhães. Recife, PE, Brasil
O tracoma é a principal causa de cegueira prevenível, principalmente nos países em desenvolvimento. Atinge populações sob-risco social, com baixas condições de vida. O objetivo do estudo foi descrever o panorama do tracoma no estado de Pernambuco, identificar as estratégias norteadoras do programa de controle no Estado e analisar a associação das variáveis socioeconômicas, demográficas e de saúde, nos níveis individual e ecológico, com as taxas de prevalência da doença com base em dados de inquéritos de 2006 e 2012. O estudo divide-se em duas partes. Na primeira foi realizado um estudo ecológico descritivo com os 79 municípios avaliados na etapa de Pernambuco do inquérito Nacional do Tracoma realizada em 2006 e nos 22 municípios prioritários para o tracoma segundo o inquérito conduzido pelo Programa SANAR no ano de 2011/2012. Na segunda parte foram selecionados os municípios de Poção e Barra de Guabiraba dentre os 22 analisados. Realizou-se um estudo transversal aninhado com um estudo caso controle. Os casos eram os escolares com diagnóstico de tracoma e os controles, os sem tracoma. Fizeram parte também da amostra as 16 escolas de Poção e 12 de Barra de Guabiraba. Utilizou-se os softwares SPSS versão 8.0 e R v. 3.1.1 e para o ajuste do modelo misto, o glmer. O pequeno número de examinados em 2006 resultou em estimativas imprecisas de prevalência fragilizando metodologicamente a escolha dos 22 municípios considerados prioritários pelo SANAR. Não se pode comprovar a real diminuição da prevalência do tracoma na maioria desses municípios. Apenas 5, dentre os 22, apresentaram essa diminuição. No modelo multinível multivariado para ocorrência de tracoma verificou-se associações significantes com sexo e turma, onde os escolares do sexo feminino apresentam 38 por cento de chance a mais de ter tracoma e os alunos que estudam no ensino fundamental 1 tem 97 por cento de chance a mais de ter tracoma, enquanto os que encontram-se no pré-escolar, apresentam 70 por cento de chance a mais de ter tracoma. Investigações de base populacionais deverão ser executadas no Estado e as ações de controle deverão ser repensadas já que o formato das investigações ainda é baseado em campanhas com ações pontuais, sem o desenvolvimento de outras mais contínuas e efetivas reduzindo as formas ativas da doença, para assim alcançar a meta de eliminação do tracoma com causa de cegueira até 2015 no Brasil
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Ferraz, Lucieni Cristina Barbarini. "Tracoma em crianças do Ensino Fundamental do município de Bauru - Estado de São Paulo, Brasil /." Botucatu : [s.n.], 2006. http://hdl.handle.net/11449/102328.
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Orientador: Silvana Artioli SchelliniBanca: Marino Scarpi
Banca: Norma Helen Medina
Banca: Ivete Dalben
Banca: Carlos Roberto Padovani
Resumo: Tendo em vista que o Tracoma é causa de cegueira e que há cinco anos não havia nenhum caso notificado no Município de Bauru - São Paulo, foi realizado o presente estudo que teve por objetivo determinar a prevalência de tracoma e as características de seus portadores, assim como estabelecer um programa de controle da doença para Bauru. Material e método: foi realizado um estudo transversal, aleatorizado, nas escolas estaduais de Bauru, São Paulo. Foram examinadas 1749 crianças do ensino fundamental, de 6 a 14 anos, durante o ano de 2005. As escolas foram escolhidas por sorteio, de acordo com o número de estudantes e de acordo com a localização dentro do setor da cidade (centro, região intermediária e periferia). O diagnóstico dos casos foi clínico, seguindo as normas da Organização Mundial de Saúde, confirmado laboratorialmente em três pacientes que apresentavam o diagnóstico de Tracoma folicular, pelo método da imunofluorescência indireta para detecção de Chlamydia trachomatis. A associação entre presença de doença e características dos portadores foi feita usando o teste de Goodman, teste não-paramétrico de Kruskal-Wallis e estatística descritiva. Todos os casos foram tratados com azitromicina oral, em dose única, e foram acompanhados periodicamente. Resultados: A prevalência de Tracoma inflamatório foi de 3,77%, tendo sido diagnosticado Tracoma folicular em 3,71% e Tracoma intenso em 0,06% das crianças examinadas. As crianças com Tracoma moravam principalmente na região intermediária e periférica da cidade, áreas onde o fornecimento de água pode ser descontínuo e o tratamento do esgoto pode estar ausente. Meninos e meninas foram acometidos de forma semelhante. Prurido e ardor ocular foram sintomas que estavam relacionados com a presença da doença. Foram detectados 175 comunicantes com o diagnóstico... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Trachoma is one of cause of blindness. The last five years there were no cases detected in Bauru, São Paulo. The purpose of this study aimed to determine the prevalence of trachoma in schoolchildren in Bauru and to establish a control program of this disease in Bauru. Material and methods: A transversal random study was carried out in state schools of Bauru, São Paulo. One thousand seven hundred and forty nine children were examined at fundamental classes, between six to fourteen years old during the year 2005. The schools were chosen by random, according to the number of scholar children and the school region and it was represented by section of the city (downtown, middle and periphery). The diagnosis of the cases was clinical, it was according to the World Health Organization protocol, and three patients with clinical follicular trachoma had laboratory confirmation. The laboratory technique chosen was direct smear fluorescent antibodies cytology for Chlamydia trachomatis. The association study among trachoma and relatives variables was done by Goodman test, Kruskal-Wallis test and descriptive statistics. All cases were treated with Azitromycin orally and they had followed up periodically. Results: The sample was composed of 1749 children and the trachoma prevalence was 3,77%. Follicular trachoma was diagnosed in 3,71% of children, and intense trachoma in one child (0,06%). The children with trachoma were living mainly in the middle and periphery region of the city, regions with discontinuous water supply and absent sewerage system. Itching and burning were complains more related to trachoma. One hundred and seventy five contacts were found and were clinic diagnostic with the disease. Conclusion: The Trachoma prevalence in Bauru - São Paulo State is 3,77%. A control program is development to treat ant detect the contacts. This way, there was a bauruense community mobilization to prevent Trachoma blindness in the municipal district.
Doutor
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CARVALHO, Raimunda Marques de. "Detecção laboratorial de Chlamydia trachomatis em escolares da rede pública do estado do Pará com diagnóstico clínico de tracoma." Universidade Federal do Pará, 2012. http://repositorio.ufpa.br/jspui/handle/2011/3949.
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O tracoma como principal causa de cegueira prevenível no mundo, é uma doença negligenciada relacionada a baixas condições socioeconômicas e locais sem saneamento básico. Presente principalmente nos países subdesenvolvidos traz grandes prejuízos aos cofres públicos com a perda de produtividade e a deficiência visual. Com a criação da Aliança para Eliminação Global de Tracoma em 1997 (GET2020), o Estado do Pará, com apoio do Ministério da Saúde do Brasil, realizaram em 2006 o inquérito epidemiológico do tracoma em escolares de 1ª a 4ª série da rede oficial de ensino, nos municípios com índice de desenvolvimento humano inferior a média nacional, para conhecer a prevalência da doença. Os dados obtidos no inquérito comprovaram que a doença não foi erradicada, revelando 35 municípios paraenses prioritários e prevalências acima de 5%. Uma sub-amostra da conjuntiva de escolares clinicamente positivos foi coletada para a confirmação diagnóstica por Imunofluorescência direta (IFD). O presente estudo utilizou 52 amostras crio conservadas obtidas durante o inquérito, para serem analisadas pelos métodos de IFD e de biologia molecular, na identificação laboratorial da Chlamydia trachomatis. Foram encontradas as frequências de 26,92% (14/52) e 49% (24/49) de resultados positivos pelas técnicas de IFD e reação em cadeia da polimerase (nested-PCR), respectivamente. Considerando as 49 amostras analisadas pelas duas metodologias, as sensibilidades para a detecção do agente etiológico, por IFD e PCR foram de 28,57% (14/49) e 48,98% (24/49), respectivamente (p = 0,0127). As duas técnicas juntas confirmaram a infecção em 57,14% (n=28) das amostras, onde 50% (n=14) foram positivas apenas pela PCR, 35,72% (n=10) para ambas as técnicas e 14,28% (n=4) somente pela IFD. A análise de sete sequências nucleotídicas demonstrou homologia para isolados de C. trachomatis genótipo L1. Este estudo é pioneiro no Brasil, pois além de confirmar a presença de C. trachomatis em amostras oculares de escolares clínicamente positivos para tracoma, validou protocolo de obtenção de DNA a partir de lâminas de IFD crioconservadas, demonstrou a maior sensibilidade do método molecular frente à IFD e identificou o genótipo L1 presente nas amostras.
Trachoma as a leading cause of preventable blindness in the world is a neglected disease related to low socioeconomic conditions and locations without basic sanitation. Present mainly in developing countries brings great harm to public coffers in lost productivity and visual impairment. With the creation of the Alliance for the Global Elimination of Trachoma in 1997 (GET2020) the State of Pará, with support from the Ministry of Health of Brazil, held in the 2006 epidemiological survey of trachoma in school 1st to 4th grades of the official network of education in municipalities with the human development index of less than national average, to discover the prevalence of the disease. Data from the survey proved that the disease was not eradicated, revealing 35 priority municipalities in Pará and prevalence above 5%. A sub-sample of the conjunctiva of clinically positive students was collected to confirm the diagnosis by direct immunofluorescence (DIF). The present study used 52 cryopreserved samples obtained during the epidemiological survey to be analyzed by the methods of DIF and molecular biology to laboratorial identification of Chlamydia trachomatis. We found frequencies of 26.92% (14/52) and 49% (24/49) of positive results by DIF techniques and polymerase chain reaction (nested-PCR), respectively. Considering the 49 samples analyzed by two methods, the sensitivities for detection of the etiologic agent, by FAT and PCR were 28.57% (14/49) and 48.98% (24/49), respectively (p = 0,0127). The two techniques together confirmed 57.14% (n = 28) of samples with infection, where 50% (n = 14) were positive only by PCR, 35.72% (n = 10) for both technical and 14, 28% (n = 4) only by the IFD. The nucleotide sequence analysis of seven isolates showed homology to C. trachomatis genotype L1. These studies is a pioneer in Brazil, as well as confirm the presence of C. trachomatis in samples from ocular school clinically positive for trachoma, validated protocol for obtaining DNA from cryopreserved sheets DIF, showed the highest sensitivity of the molecular method front DIF and identified the genotype L1 in the sample of the conjunctiva of clinically positive students.
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Meneghim, Roberta Lilian Fernandes de Sousa [UNESP]. "O Tracoma no Município de Botucatu - Estado de São Paulo: medidas de Detecção, Educação em Saúde, Prevenção e Tratamento." Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/138394.
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000858293.pdf: 2497641 bytes, checksum: 7003c9d5f09c9aba9b7ab05f3c28f684 (MD5)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
O tracoma ainda figura entre as grandes causas de cegueira do mundo, sendo a principal causa de cegueira evitável e a principal causa de cegueira corneana. No Brasil, por vários anos, acreditou-se que a doença havia sido erradicada, o que impediu seu ensino nas escolas médicas e diminuiu a busca ativa, aumentando o número de pessoas não tratadas e portadoras da doença. Além disso, os fatores que mantém a doença no meio ambiente precisam ser detectados para melhor controle da mesma. Diante destes fatos, desenvolveu-se este estudo com os objetivos de promover educação em saúde; prevenir a cegueira por tracoma detectando e tratando os casos da doença; descrever o perfil socioeconômico dos portadores da doença no município de Botucatu; pesquisar a presença de vetores da doença e da bactéria causadora de tracoma nesses vetores. Material e Métodos: Estudo transversal conduzido na cidade de Botucatu, estado de São Paulo - Brasil no ano de 2010. Um grupo composto por oito estudantes do curso de graduação em Medicina ou Enfermagem e duas agentes de saúde foi treinado por dois oftalmologistas para detectar e tratar o tracoma na população, segundo as recomendações da Organização Mundial de Saúde (OMS). Após treinamento, foi realizado trabalho de campo, com exame de uma amostra aleatorizada de 3568 crianças, calculada baseando-se nos dados históricos da prevalência de tracoma em Botucatu e no número de crianças matriculadas no ensino fundamental das escolas municipais. A unidade primária de amostra foi a classe, examinado-se todas as crianças da classe sorteada. O diagnóstico foi clínico, com eversão palpebral à procura de folículos em conjuntivas tarsais superiores usando-se lupa binocular de 2,5 vezes de aumento e iluminação artificial (lanterna). As crianças com tracoma inflamatório foram tratadas com Azitromicina, 20 mg/kg de peso e visitadas em suas casas para aplicação de um questionário...
Trachoma still ranks among the major causes of blindness in the world, being the leading cause of preventable blindness and the leading cause of corneal blindness. In Brazil, for several years, it was believed that the disease had been eradicated, which prevented the searching and the teaching of the disease in medical schools and decreased the active search, increasing the number of untreated people and affected by the disease. Furthermore, the maintenance factors of the disease in the environment must be detected for its better control. Based on these facts, this study was developed with the objectives of promoting health education; prevent blindness from trachoma detecting and treating cases of the disease; describe the socioeconomic profile of disease carriers in Botucatu; search for the presence of vectors of the disease and for the bacterium which causes trachoma in these vectors. Methods: A cross-sectional study was conducted in the city of Botucatu, state of São Paulo - Brazil in 2010. A group of eight students from the graduation course in Medicine or in Nursing and two health workers was trained by two ophthalmologists to detect and how to treat trachoma in the population, according to the recommendations of the World Health Organization (WHO). After training, a fieldwork was conducted by the exam of a random sample of 3568 children, calculated based on historical data of the prevalence of trachoma in Botucatu and on the number of children enrolled in primary education in municipal schools. The primary unit of the sample was the class, and all children from the selected class were examined. The diagnosis was clinical, with eyelid eversion looking for follicles on the superior tarsal conjunctiva by using a 2.5-fold increase binocular magnifier lenses and artificial light (flashlight). Children with inflammatory trachoma were treated with Azithromycin, 20 mg/kg of weight and visited at home for a socioeconomic questionnaire ...
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Meneghim, Roberta Lilian Fernandes de Sousa. "O Tracoma no Município de Botucatu - Estado de São Paulo : medidas de Detecção, Educação em Saúde, Prevenção e Tratamento /." Botucatu, 2015. http://hdl.handle.net/11449/138394.
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Orientador: Silvana Artioli SchelliniBanca: Antônio Augusto Velasco e Cruz
Banca: Norma Helen Medina
Banca: Lucieni Cristina Barbarini Ferra
Banca: Edson Nacib Jorge
Resumo: O tracoma ainda figura entre as grandes causas de cegueira do mundo, sendo a principal causa de cegueira evitável e a principal causa de cegueira corneana. No Brasil, por vários anos, acreditou-se que a doença havia sido erradicada, o que impediu seu ensino nas escolas médicas e diminuiu a busca ativa, aumentando o número de pessoas não tratadas e portadoras da doença. Além disso, os fatores que mantém a doença no meio ambiente precisam ser detectados para melhor controle da mesma. Diante destes fatos, desenvolveu-se este estudo com os objetivos de promover educação em saúde; prevenir a cegueira por tracoma detectando e tratando os casos da doença; descrever o perfil socioeconômico dos portadores da doença no município de Botucatu; pesquisar a presença de vetores da doença e da bactéria causadora de tracoma nesses vetores. Material e Métodos: Estudo transversal conduzido na cidade de Botucatu, estado de São Paulo - Brasil no ano de 2010. Um grupo composto por oito estudantes do curso de graduação em Medicina ou Enfermagem e duas agentes de saúde foi treinado por dois oftalmologistas para detectar e tratar o tracoma na população, segundo as recomendações da Organização Mundial de Saúde (OMS). Após treinamento, foi realizado trabalho de campo, com exame de uma amostra aleatorizada de 3568 crianças, calculada baseando-se nos dados históricos da prevalência de tracoma em Botucatu e no número de crianças matriculadas no ensino fundamental das escolas municipais. A unidade primária de amostra foi a classe, examinado-se todas as crianças da classe sorteada. O diagnóstico foi clínico, com eversão palpebral à procura de folículos em conjuntivas tarsais superiores usando-se lupa binocular de 2,5 vezes de aumento e iluminação artificial (lanterna). As crianças com tracoma inflamatório foram tratadas com Azitromicina, 20 mg/kg de peso e visitadas em suas casas para aplicação de um questionário...
Abstract: Trachoma still ranks among the major causes of blindness in the world, being the leading cause of preventable blindness and the leading cause of corneal blindness. In Brazil, for several years, it was believed that the disease had been eradicated, which prevented the searching and the teaching of the disease in medical schools and decreased the active search, increasing the number of untreated people and affected by the disease. Furthermore, the maintenance factors of the disease in the environment must be detected for its better control. Based on these facts, this study was developed with the objectives of promoting health education; prevent blindness from trachoma detecting and treating cases of the disease; describe the socioeconomic profile of disease carriers in Botucatu; search for the presence of vectors of the disease and for the bacterium which causes trachoma in these vectors. Methods: A cross-sectional study was conducted in the city of Botucatu, state of São Paulo - Brazil in 2010. A group of eight students from the graduation course in Medicine or in Nursing and two health workers was trained by two ophthalmologists to detect and how to treat trachoma in the population, according to the recommendations of the World Health Organization (WHO). After training, a fieldwork was conducted by the exam of a random sample of 3568 children, calculated based on historical data of the prevalence of trachoma in Botucatu and on the number of children enrolled in primary education in municipal schools. The primary unit of the sample was the class, and all children from the selected class were examined. The diagnosis was clinical, with eyelid eversion looking for follicles on the superior tarsal conjunctiva by using a 2.5-fold increase binocular magnifier lenses and artificial light (flashlight). Children with inflammatory trachoma were treated with Azithromycin, 20 mg/kg of weight and visited at home for a socioeconomic questionnaire ...
Doutor
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Silva, Evanildo Jos? da. "Ocorr?ncia do tracoma em escolares e o impacto do treinamento de habilidades cl?nicas para profissionais de sa?de em Turmalina, MG, Brasil." UFVJM, 2014. http://acervo.ufvjm.edu.br/jspui/handle/1/824.
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O Tracoma, tido equivocadamente como erradicado em nosso meio, encontra-se na lista de doen?as negligenciadas. Trata-se da maior causa de cegueira evit?vel do mundo, sendo encontrado predominantemente nos pa?ses subdesenvolvidos. Diversos trabalhos t?m demonstrado que esta doen?a se faz presente em todas as regi?es do Brasil atualmente, o que evidencia que tanto o governo (nas esferas federal, estadual e municipal) quanto a academia devem continuar a considerar o Tracoma entre as causas de cegueira em nosso meio. A necessidade de maior qualifica??o e capacita??o dos profissionais de sa?de para um melhor atendimento aos usu?rios do Sistema ?nico de Sa?de ? SUS tem feito com que sejam tentadas diferentes alternativas para atingir este objetivo. Diversas experi?ncias t?m sido efetivadas em nosso meio, com resultados exitosos. Neste trabalho procurou-se levantar a frequ?ncia de Tracoma entre os escolares de sete a quinze anos da rede p?blica do munic?pio de Turmalina, MG bem como verificar a efetividade de uma estrat?gia de educa??o permanente denominada Treinamento de Habilidades Cl?nicas ? THC na detec??o desta doen?a. A pesquisa foi realizada neste munic?pio, situado no Vale do Jequitinhonha, tendo em vista um levantamento pr?vio que demonstrou que nos ?ltimos cinco anos n?o tinha ocorrido nenhum encaminhamento de usu?rio da Aten??o Prim?ria para o servi?o de oftalmologia do munic?pio com hip?tese diagn?stica de Tracoma. Considerando que no munic?pio existem regi?es com popula??es em situa??o de alta vulnerabilidade social, portanto com caracter?sticas prop?cias para o surgimento da doen?a, suspeitou-se que os casos n?o estavam sendo diagnosticados. Participaram da pesquisa quatro m?dicos e oito enfermeiros das ESF e ainda tr?s enfermeiros que atuavam na gest?o, mas tamb?m ocasionalmente nas ESFs. Inicialmente foi feito um diagn?stico situacional visando avaliar o n?vel de conhecimento dos profissionais das ESFs de Turmalina, MG, acerca do Tracoma quando os profissionais de sa?de responderam a um question?rio a respeito do tema. Em seguida foi realizado um m?dulo de capacita??o e ap?s esta etapa foi realizado o THC. Posteriormente os profissionais de sa?de realizaram o exame de 635 estudantes sob a supervis?o do pesquisador. Os estudantes com diagn?stico de Tracoma foram submetidos ? raspagem de conjuntiva com swab e o material enviado para an?lise laboratorial. Todos os escolares diagnosticados com Tracoma foram tratados gratuitamente no SUS e suas fam?lias convidadas para que os demais membros pudessem ser examinados. Para finalizar, os profissionais responderam novamente ao question?rio que continha quest?es a respeito do tema. Os dados coletados foram analisados com aux?lio do software Statistical Package for Social Sciences, IBM Inc., USA ? SPSS, vers?o 20.0. Ao comparar a quantidade de acertos nos question?rios pr? e p?s-capacita??o, observou-se que no segundo a pontua??o foi significativamente maior que no primeiro. Entre os escolares foi encontrada uma frequ?ncia do Tracoma de 4,7%, com predom?nio nas ?reas rurais. Todas as fam?lias dos estudantes diagnosticados com Tracoma foram convidadas a realizar exames, sendo identificadas, at? o momento, 27 pessoas como portadores de Tracoma ativo. Todas foram submetidas ao tratamento custeado pelo SUS. Conclui-se ent?o que o treinamento teve impacto positivo no conhecimento dos profissionais, contribuindo para uma maior habilidade para o diagn?stico ou suspei??o diagn?stica da doen?a. Pode-se afirmar ainda que a educa??o permanente ? uma importante ferramenta a ser utilizada visando melhorar o desempenho destes.
Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2014.
ABSTRACT The Trachoma, had been mistakenly known as eradicated in our country is on the list of neglected diseases. It is the leading cause of preventable blindness in the world, being found predominantly in underdeveloped countries. Several studies have shown that this disease is present in all regions of Brazil today, which shows that both the government (federal, state and municipal) as the academy must continue to treat Trachoma among the causes of blindness in our midst. The need for more advanced training capable health professionals to improve the service for the National Health System ? SUS users has made different alternatives to achieve this goal . Several experiments have been effected in our midst, with successful results, highlighting the importance of this methodology. This paper sought to raise the frequency of trachoma among school children from seven to fifteen years of public network of the city of Tourmaline, MG and verify the effectiveness of a strategy of continuing education called Skills Training Clinics in the detection of this disease. The survey was conducted in this city, situated in the Valley of Jequitinhonha, considering an earlier survey that showed that in the last five years had been no referral of Primary User for the ophthalmology service of the city with a diagnosis of trachoma. Whereas in the city there are regions with populations that have high social vulnerability, with so conducive to the emergence of disease characteristics, it was suspected that the cases were not being diagnosed. Participants were four doctors and eight nurses FHT and three nurses who worked in management, but also occasionally in the FHS. Initially it was made ??a situational analysis to assess the level of knowledge of the professionals of the ESFs Tourmaline - MG, about Trachoma when health professionals completed a questionnaire on the subject. Then a training module where the theme was worked and after this step, the training of clinical skills was conducted. Later health professionals conducted the examination of 635 students, under the supervision of the researche. Students diagnosed with Trachoma underwent scraping conjunctival swabs and material sent for laboratory analysis. All students diagnosed with trachoma were treated free on the National Health System and their families were contacted so they could also be examined. Finally, practitioners responded to the questionnaire again which contained questions on the subject. The collected data were analyzed using software Statistical Package for Social Sciences, Inc. IBM, USA - SPSS, version 20.0. marital status. Comparing the amount of correct answers in the pre and post-training questionnaires, it was observed that the second score was significantly higher than the first. Among students a frequency of 4.7% Trachoma was found, predominantly in rural areas. All families of these children diagnosed with trachoma were invited to conduct examinations, 27 were identified as having active trachoma. All of them were subjected to treatment funded by the National Health System and are in a camping. The conclusion is that training had a positive impact on the knowledge of professionals, as well as the ability for the diagnosis or diagnostic suspicion of the disease. It can even be said that continuing education is an important tool to be used to improve the performance of these.
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Macharelli, Carlos Alberto [UNESP]. "Aspectos epidemiológicos do tracoma em crianças do ensino fundamental do minicípio de Bauru-SP: a utilização do geoprocessamento na priorização de recursos do setor saúde." Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/102325.
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O tracoma ainda é um importante problema de saúde pública, causando morbidade, deficiência visual e cegueira em diversos países subdesenvolvidos ou em desenvolvimento. Em 2006 foi realizado um estudo transversal nas escolas estaduais na de Bauru, estado de São Paulo, que revelou uma prevalência de 3,7% de tracoma no município. O presente estudo tem como objetivo analisar o comportamento espacial da ocorrência dos casos de tracoma detectados na cidade de Bauru pelo referido estudo, a fim de utilizar as informações apuradas para definir áreas prioritárias para a otimização dos recursos do setor Saúde. Para atingirmos nossos objetivos lançamos mão de uma ferramenta que é o geoprocessamento em saúde ‐ uma das maneiras de se conhecer mais detalhadamente as condições de saúde da população através de mapas que permitem observar a distribuição espacial de situações de risco e dos problemas de saúde. A quantificação dos fenômenos observados pode ser feita de várias formas, sendo a estimativa de Kernel uma delas. Esse procedimento permite filtrar a variabilidade de um conjunto de dados, sem alterar as suas características locais. Os casos de tracoma foram georreferenciados com uso do GPS e depois as coordenadas transformadas em latitudes e longitudes decimais, com o auxílio do TCGeo. As análises espaciais foram feitas com o TerraView, utilizando‐se os pontos dos casos, das escolas, e dados do censo IBGE 2000, contidos nos CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002. O protocolo empregado possibilitou que todas as crianças detectadas pelo estudo de Ferraz (2006) fossem visitadas pela equipe executora do presente e georeferenciadas usando aparelho de GPS. As crianças que fizeram parte da amostra apresentavam média de idade de 8.5 anos, eram na sua maioria do sexo masculino e...
Trachoma still is an important issue for public health; it increases morbidity, causing visual deficiency and blindness in several underdeveloped or developing countries. In 2006, a transversal study was carried out among public schools in Bauru, São Paulo state. The study revealed a prevalence of 3.7% of trachoma in the town. This study aims at analyzing the spatial behavior of the cases detected in Bauru by the 2006 research, in order to define areas that should have priority when improving the municipal health system. We used health geoprocessing – which is done by maps that show the spatial distribution of risk situations and health problems, allowing to know details about the population health. The phenomena observed can be quantified in different manners – Kernel estimation is one of them, and the one we used, because it permits to filter the variability of a set of data without altering its local features. Trachoma cases were georeferenced with a GPS and their coordinates were converted with TCGeo into decimal latitudes and longitudes. Spatial analyses were carried out with TerraView, using points of cases and schools, and data from IBGE 2000 census found in the CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002 (Information database on each censual sector. Demographic census 2000, Universal Results. Bauru. IBGE, 2002). The procedures allowed our team to visit and georeference all the children detected by Ferraz (2006). The children are mostly males, with a mean age of 8.5 years and presenting uni or bilateral trachoma. Geoprocessing was important for it facilitates the process of spatial localization through Google Earth (2007) – which allowed us to notice a concentration of cases in regions with low income. We could also observe that individuals with low income are not concentrated on the ...(Complete abstract click electronic access below)
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Macharelli, Carlos Alberto. "Aspectos epidemiológicos do tracoma em crianças do ensino fundamental do minicípio de Bauru-SP : a utilização do geoprocessamento na priorização de recursos do setor saúde /." Botucatu : [s.n.], 2010. http://hdl.handle.net/11449/102325.
Full textAbstract:
Orientador: Silvana Artioli SchelliniBanca: Ivete Dalben Soares
Banca: Luciene Cristina Barbarini Ferraz
Banca: Paula Araújo Opromolla
Banca: Norma Helen Medina
Resumo: O tracoma ainda é um importante problema de saúde pública, causando morbidade, deficiência visual e cegueira em diversos países subdesenvolvidos ou em desenvolvimento. Em 2006 foi realizado um estudo transversal nas escolas estaduais na de Bauru, estado de São Paulo, que revelou uma prevalência de 3,7% de tracoma no município. O presente estudo tem como objetivo analisar o comportamento espacial da ocorrência dos casos de tracoma detectados na cidade de Bauru pelo referido estudo, a fim de utilizar as informações apuradas para definir áreas prioritárias para a otimização dos recursos do setor Saúde. Para atingirmos nossos objetivos lançamos mão de uma ferramenta que é o geoprocessamento em saúde ‐ uma das maneiras de se conhecer mais detalhadamente as condições de saúde da população através de mapas que permitem observar a distribuição espacial de situações de risco e dos problemas de saúde. A quantificação dos fenômenos observados pode ser feita de várias formas, sendo a estimativa de Kernel uma delas. Esse procedimento permite filtrar a variabilidade de um conjunto de dados, sem alterar as suas características locais. Os casos de tracoma foram georreferenciados com uso do GPS e depois as coordenadas transformadas em latitudes e longitudes decimais, com o auxílio do TCGeo. As análises espaciais foram feitas com o TerraView, utilizando‐se os pontos dos casos, das escolas, e dados do censo IBGE 2000, contidos nos CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002. O protocolo empregado possibilitou que todas as crianças detectadas pelo estudo de Ferraz (2006) fossem visitadas pela equipe executora do presente e georeferenciadas usando aparelho de GPS. As crianças que fizeram parte da amostra apresentavam média de idade de 8.5 anos, eram na sua maioria do sexo masculino e ...(Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Trachoma still is an important issue for public health; it increases morbidity, causing visual deficiency and blindness in several underdeveloped or developing countries. In 2006, a transversal study was carried out among public schools in Bauru, São Paulo state. The study revealed a prevalence of 3.7% of trachoma in the town. This study aims at analyzing the spatial behavior of the cases detected in Bauru by the 2006 research, in order to define areas that should have priority when improving the municipal health system. We used health geoprocessing - which is done by maps that show the spatial distribution of risk situations and health problems, allowing to know details about the population health. The phenomena observed can be quantified in different manners - Kernel estimation is one of them, and the one we used, because it permits to filter the variability of a set of data without altering its local features. Trachoma cases were georeferenced with a GPS and their coordinates were converted with TCGeo into decimal latitudes and longitudes. Spatial analyses were carried out with TerraView, using points of cases and schools, and data from IBGE 2000 census found in the CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002 (Information database on each censual sector. Demographic census 2000, Universal Results. Bauru. IBGE, 2002). The procedures allowed our team to visit and georeference all the children detected by Ferraz (2006). The children are mostly males, with a mean age of 8.5 years and presenting uni or bilateral trachoma. Geoprocessing was important for it facilitates the process of spatial localization through Google Earth (2007) - which allowed us to notice a concentration of cases in regions with low income. We could also observe that individuals with low income are not concentrated on the ...(Complete abstract click electronic access below)
Doutor
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Kajbaf, Mohammad Javad. "Immunology of trachoma." Thesis, University of Southampton, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.236213.
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Ngondi, Jeremiah Muriithi. "The epidemiology of trachoma and evaluation of trachoma control in southern Sudan." Thesis, University of Cambridge, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.613394.
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Hawkins, James David. "Computer simulation of trachoma." Thesis, University of Southampton, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.255761.
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Blake, Isobel M. "Transmission dynamics and control of trachoma." Thesis, Imperial College London, 2010. http://hdl.handle.net/10044/1/5605.
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Trachoma continues to be the leading cause of infectious blindness. Mass administration of antibiotics is part of the current control effort, an approach which is costly when drugs are not donated. Trachoma has been shown to cluster by household and therefore this unit could be a means to target treatment. This thesis shows that active inflammatory disease is a more sensitive marker of infection within an individual’s household than just in that individual. The potential impact of a more efficient, targeted treatment of households with at least one member with active disease depends on the relative contributions of community and household transmission of infection. A mathematical model of the household transmission of ocular Chlamydia trachomatis was fitted to detailed demographic and prevalence data from four endemic populations, two in The Gambia and two in Tanzania. Maximum likelihood estimates of the household and community transmission coefficients were obtained. The estimated household transmission coefficient exceeded both the community transmission coefficient and the rate of clearance of infection by individuals in three of the study populations, indicating persistent transmission of infection within households. Allowing children and adults to have a different duration of infection improved the fit of the model to the data in three populations. For a given level of treatment coverage, targeting antibiotics to households with active disease was predicted to have similar post‐treatment dynamics to those observed after mass treatment but to be much more drug sparing. Using available cost data this approach was shown to be more cost effective when antibiotics are not donated. If targeting increases treatment coverage of diseased households, it was found to be more effective and more cost‐effective than mass treatment even if antibiotics are donated. Further work is now required to explore the feasibility of incorporating household targeted treatment into trachoma control programmes.
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Buchan, John Cameron. "Surgical aspects of the management of trachoma : evaluation of the National Trachoma Control programmes of five African countries." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429950.
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Bailey, Robin Leslie. "Studies on the epidemiology and immunology of human ocular chlamydial infection." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244730.
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Emerson, Paul Michael. "Ecology and control of the trachoma vector Musca sorbens." Thesis, Durham University, 2001. http://etheses.dur.ac.uk/3995/.
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The work described in this thesis was conducted In rural Gambia and builds a body of evidence Incriminating the fly Musca sorbens as a vector of the blinding disease, trachoma, which is caused by ocular infection with Chlamydia trachomatis. Literature on hygiene promotion, environmental change and flies and trachoma is reviewed in the context of the SAFE strategy for trachoma control advocated by the World Health Organization M. sorbens was present throughout the year in trachoma endemic communities; was responsible for the majority of fly-eye contacts; C. trachomatis DNA was found on it; and trachoma transmission dropped when they were removed from the environment. In a large cluster-randomised trial communities receiving fly control with insecticide for six months had a mean reduction in trachoma prevalence of 56% (95% Cl 19-93%; P=0.01) compared to controls and 37% (4-70%; P=0.068) fewer new prevalent cases of trachoma. Breeding media choice experiments showed that isolated human faeces were the preferred larval medium for M. sorbens and were capable of supporting the production of large numbers of adults. However, other animal faeces were also able to support M. sorbens development. This suggested that a community-based strategy to reduce the quantity of human faeces on the soil surface by providing latrines would have the effect of reducing the population of M. sorbens, and hence reduce fly-eye contact and trachoma transmission. The provision of latrines gave encouraging results, which were not statistically significant; 30% less active trachoma than controls after six months (-22-81%; P=0.210) and 28% (-5-60%; P=0.146) fewer new prevalent cases. Provision of latrines warrants further investigation as a method to control trachoma, particularly when used in conjunction with other control methods. The potential role of fly control in the SAFE strategy for trachoma control is discussed.
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Lansingh, Van Charles. "Primary health care approach to trachoma control in Aboriginal communities in Central Australia." Connect to thesis, 2005. http://repository.unimelb.edu.au/10187/984.
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This study concerned a primary health care approach to trachoma control in two Central Australian Aboriginal communities. The World Health Organization (WHO) has advocated that the best method to control trachoma is the SAFE strategy (Surgery, Antibiotics, Facial hygiene, and Environmental improvements), and this approach was adopted.The communities, Pipalyatjara and Mimili, with populations slightly less than 300 each, are located in the Anangu Pitjantjatjara (AP) lands of Central Australia, in the northwest corner of the South Australia territory. At Pipalyatjara, a full SAFE-type intervention was undertaken, with the ‘E’ component designed and implemented by the NHC (Nganampa Health Council Inc.). At Mimili, only a SAF-type of intervention was implemented.
Baseline data was gathered for 18 months from March 1999 through September 2000 (five visits to Pipalyatjara and four at Mimili), and included determining trachoma prevalence levels using the WHO system, facial cleanliness, and nasal discharge parameters. A trachoma health program was implemented at the end of this period and a one-time dose of azithromycin was given in September of 2000. The chief focus of the study was children under 15 years of age.
Improvements in road sealing, landscaping, and the creation of mounds were started to improve dust control. Concurrently, efforts were made in the houses of the residents to improve the nine healthy living practices, which were scored in two surveys, in March 1999 and August 2001. Trachoma prevalence, and levels of facial cleanliness and nasal discharge were determined at 3, 6, and 12 months following antibiotic administration.
In children less than 15 years of age, the pre-intervention prevalence level of TF (Trachoma Follicular) was 42% at Pipalyatjara, and 44% at Mimili. For the 1-9 year age group, the TF prevalence was 47% and 54% respectively. For TI (Trachoma Intense), the pre-intervention prevalence was 8% for Pipalyatjara, and 9% for Mimili. The TF prevalence, adjusted for clustering, and using only individuals present at baseline and follow-up (3, 6, and 12 months post-intervention), was 41.5%, 21.2%, 20.0%, and 20.0% at Pipalyatjara respectively. For Mimili, the corresponding prevalence figures were 43.5%, 18.2%, 18.2%, and 30%.
In the 1-9 year age group, a lower TF prevalence existed between the pre-intervention and 12-month post-intervention points at Pipalyatjara compared to Mimili. The TF prevalence after the intervention was also lower for males compared to females, when the cohorts were grouped by gender, rather than community. It is posited that reinfection was much higher at Mimili within this age group, however, in both communities, there appeared to be a core of females whose trachoma status did not change. This is speculated as mainly being caused by prolonged inflammation, though persistent infection C. Trachomatis cannot be ruled out.
Facial cleanliness and nasal discharge continued to improve throughout the intervention at both communities, but at the 3-month post-intervention point no longer became a good predictor of trachoma.
It is not known whether the improvements in the environment at Pipalyatjara were responsible for the reduction in trachoma prevalence 12 months after the intervention, relative to Mimili.
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Pecharatana, Suphut. "The application of molecular technology in the study of human chlamydia trachomatis infections." Thesis, University of Southampton, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295908.
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Wright, Heathcote R. "Trachoma in Australia : an evaluation of the SAFE strategy and the barriers to its implementation /." Connect to thesis, 2007. http://eprints.unimelb.edu.au/archive/00003844.
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Thesis (Ph.D.)--University of Melbourne, Dept. of Opthalmology, 2007.Typescript. SAFE Strategy refers to Surgery for trichiasis, Antibiotics for active infection, Facial cleanliness and Environmental improvements. Includes bibliographical references (leaves 233-253). Also available electronically: http://eprints.unimelb.edu.au/archive/00003844.
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Gardelli, Paolo Enmanuel, and Massimiliano Urbini. "Sulla traccia delle mura urbane." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amslaurea.unibo.it/22070/.
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Unicità e solidità sono proprietà fondamentali alla base dell’idea d’identità utilizzate per la riqualificazione urbana delle aree esaminate. Situate a ridosso della traccia di quella che una volta era la cinta muraria della città, le due aree sono per caratteristica diverse ma unite da uno dei viali più importanti della città. Rappresentano il limite, ad oggi, tra centro storico e zona di espansione,sviluppandosi in una zona di margine che esprime probabilmente una ricchezza maggiore delle aree che separa.
Esibiscono inoltre quello che è l’ultimo resto dei vecchi orti urbani della città, risalenti a prima dell’epoca di Caterina Sforza.
La sfida principale dell’intervento è stata quella di far dialogare queste tre dimensioni: campagna, centro storico e zona di espansione.
A partire dal fronte stradale lungo Viale Italia, il progetto si è evoluto inglobando una consistente fetta del tessuto urbano, con l’idea di definire e dare una nuova immagine ad una parte della città che negli anni è sempre sfuggita alla progettazione dettata dai diversi Piani.
Si tratta di un intervento molto ampio, ma che agisce su punti strategici, creando una connessione costante lungo tutto il Viale, prerogativa che sta alla base di un progetto che risulta così unico e totale.
Il carattere dell’intero sistema viene delineato anche dalla forma delle sue architetture urbane, pensate per legarsi alla tradizione e al tessuto esistente, ma che allo stesso tempo sono uniche, differenziandosi da quello che le circonda.
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Stocks, Nigel. "Trachoma and visual impairment in the Anangu Pitjantjatjara of South Australia /." Title page, contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09MD/09mds865.pdf.
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Harding-Esch, Emma Michele. "Trachoma control and elimination field studies in the Gambia and Sengal." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.536939.
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Sellitri, Francesco <1968>. "Trapianto eterotopico della trachea: studio sperimentale." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2007. http://amsdottorato.unibo.it/447/.
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Yamashita, Masaru. "Regeneration of the larynx and trachea." Kyoto University, 2007. http://hdl.handle.net/2433/135671.
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Longuefosse, Olivier. "Bilan ultrastructural du trachome et perspectives actuelles." Bordeaux 2, 1989. http://www.theses.fr/1989BOR25179.
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Burton, Matthew John. "Studies of the epidemiology, pathogenesis and control of trachoma in the Gambia." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.407979.
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Derrick, T. "The role of epigenetics and type 2 epithelial-mesenchymal transitions in trachoma." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2016. http://researchonline.lshtm.ac.uk/3141182/.
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Trachoma is the leading infectious cause of blindness worldwide and is initiated by repeated infection of the conjunctiva with Chlamydia trachomatis (Ct). In some individuals this causes chronic inflammation and fibrosis that progresses in the absence of Ct. The work presented in this thesis sought to determine the role and contribution of miRNA and epithelial-mesenchymal transition (EMT) in various stages of trachomatous disease. Epithelial cells did not differentially express miRNA at 48 hours post infection with virulent plasmid-competent and avirulent plasmid-free ocular strains of Ct. Expression of inflammatory cytokines and growth factors were increased in response to virulent Ct infection but the induction of EMT was not detected in response to either strain. In a set of 161 samples from children living in a trachoma hyper-endemic region in Guinea-Bissau, miR-155 was upregulated in children with active trachoma and current Ct infection and miR-184 was downregulated in children with active trachoma with and without Ct infection. In a set of 194 samples from adults in The Gambia, miR-1285 and miR-147b were upregulated in inflammatory trachomatous scarring. Differential expression of these miR indicates the regulation of inflammation, wound healing and cell proliferation pathways. Immunohistochemistry was used to study conjunctival biopsies from Tanzanian adults with trachomatous trichiasis and found increased epithelial expression of the pro-inflammatory mediator and antimicrobial peptide S100A7 and connective tissue growth factor. Pro-inflammatory cytokine IL-1β expression was increased in the subepithelium relative to controls. Trichiasis cases had increased disruption of collagen deposition patterns and increased sub-clinical inflammatory cell infiltrates, but no differences in epithelial atrophy and myofibroblasts were detected relative to controls. There was no evidence for the occurrence of EMT in biopsy tissue from trachomatous trichiasis cases. These data suggest that EMT does not have a major role in conjunctival fibrosis and highlight the importance of inflammation in trachomatous pathology.
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Gross, Linda L. "Oromo Ethiopians Perceptions of the Prevalence, Causes, Treatment and Prevention of Trachoma." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7803.
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In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic rural areas of Oromia, all now living in Phoenix, Arizona. Results showed that this sample of former villagers had limited knowledge of the causes, prevention or treatment of trachoma, and could not recognize, or differentiate it from other eye diseases. The participants had some knowledge of governmental and nongovernmental efforts to control trachoma in their home country - through education and pit latrines. They also knew about the limitations of those programs. All reported that people would be willing to attend classes for trachoma prevention if held at a convenient time and place. These results may be useful in preparing a program to prevent trachoma in rural Ethiopia, and reduce blindness in this population, enabling more individuals to become educated and contributing to their community's well-being. Since trachoma is highly infectious, and participants in this study come from a trachoma-endemic area and do not know how to recognize it for themselves, the need for screening for trachoma on arrival in the US should be examined in more detail.
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Tagoh, Selassie. "Prevalence of trachoma and risk factors for disease in Benue State, Nigeria." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29851.
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Background: Trachoma is a common contagious bacterial eye infection caused by Chlamydia trachomatis serovariants A, B, Ba or C. It is the leading infectious cause of blindness worldwide and is responsible for about 3% of global blindness. World Health Organization (WHO) reports suggest that of the 2.2 million people who have been rendered visually impaired worldwide by trachoma, 1.2 million are irreversibly blind while an additional 7.3 million people are suffering from trachomatous trichiasis (TT) and are at risk of developing blindness. According to WHO 2007 reports, globally about 84 million people suffer from active trachoma while an estimated 299 million people still live in trachoma endemic districts. In order to eliminate trachoma as a public health problem, The Global Trachoma Mapping Project (GTMP) was initiated on 23 July 2012 as a first step in generating population-level prevalence estimates of the disease so as to determine the need for intervention. Between 2013 and 2015, the GTMP mapped suspected endemic districts including Benue state of Nigeria. This current study took advantage of this data to generate prevalence information on Trachomatous inflammation Follicular (TF) and Trichiasis for Benue state and to describe the some of the household risk factors associated with the disease. The thesis is structured in three parts 0(Preamble), A (Protocol), B (Literature Review), C (Article) and D (Appendix).
Methods: A two-stage cluster random sampling technique was utilized in a population based prevalence survey to generate estimates for TF and Trichiasis.
Results: Overall unadjusted prevalence of TF among persons 1-9 years was 2.00% (95% CI: 1.20 – 2.98) and that of trichiasis among persons ≥15 years was 0.11% (95% CI 0.06 – 0.12). Trichiasis was more prevalent among adult women 0.05% (95% CI: 0.03 – 0.07) compared to males 0.03 % (95% CI: 0.02 – 0.05), (p=0.13). LGA-level prevalence of TF and Trichiasis among persons 1-9 years and persons ≥15 years ranged from 0.30% (95% CI: 0.1–0.5) to 5.30% (95% CI: 3.30–7.70) and 0.00% to 0.35% (95% CI: 0.12–0.50) respectively. Two LGAs had trichiasis prevalence above 0.2%. TF prevalence was between 5% and 9.9% in 2 LGAs. The common risk factors identified included age, sex, inaccessibility to water and latrine facility. Adults ≥15 years were 8.94(95%CI: 2.79 – 29.64) times more likely to have trichiasis compared to persons between 1-9 years of age.
Conclusion: Trachoma was found to be a public health problem in 3 LGAs of Benue state. One round of mass antibiotic distribution will be required in 2 LGAs. With an estimated trichiasis backlog of 1,064, about 173 individuals with trichiasis needed to be managed to reduce the prevalence to less than the elimination threshold.
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Sugano, Yoshimi Teresa. "Bronchoskopische Vermessung und dreidimensionale Darstellung der Trachea." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2006. http://dx.doi.org/10.18452/15419.
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Im Rahmen der vorliegenden Arbeit ist ein neues bronchoskopisches Verfahren entwickelt und getestet worden, mit dem eine Längs- und Querschnittsvermessung zentraler Atemwegesstenosen in Echtzeit ermöglicht wird und anschließend eine 3D-Rekonstruktion des untersuchten Abschnitts dargestellt werden kann. Für die Querschnittsflächenbestimmung wird durch den Arbeitskanal des Bronchoskops eine Lasersonde eingeführt und ein Laserlichtring auf die Trachealwand projiziert. Die Abbildung des Lichtrings wird im bronchoskopischen Bild noch während der Untersuchung mit Hilfe einer speziell im Rahmen dieser Arbeit entwickelten Software Endo3D segmentiert und vermessen. Durch Speichern aufeinanderfolgender Querschnittsflächen kann ein 3D-Datensatz erstellt, visualisiert und das Volumen berechnet werden. Experimentell wurde die Methode an Kunststoffmodellen mit bekannten Maßen und Präparaten aus Schweineluftröhren getestet. Die Referenzwerte für die Volumen der Schweineluftröhren wurden durch Wasservolumetrie bestimmt. Klinisch wurde die Methode in einer Pilotstudie getestet. Bei 10 Patienten wurden Querschnitte und Volumen unterschiedlich langer Trachealabschnitte vermessen. Als Vergleichsmethode wurde jeweils eine CT durchgeführt. Die Ergebnisse im experimentellen Teil zeigten bei sehr guter Reproduzierbarkeit eine gute Korrelation zwischen den bronchoskopisch gemessenen Werten und den realen bzw. Referenzwerten. Die Korrelation der klinischen Ergebnisse erwies sich als befriedigend ohne Hinweis auf einen systematischen Fehler. Ein kleiner systematischer Messfehler im experimentellen Teil zeigte sich als irrelevant für die Klinik. Die hier vorgestellte Methode ermöglicht untersucherunabhängige Verlaufsbeschreibungen von Stenosen und erlaubt die Schaffung einer einheitlichen Klassifikation. Darüber hinaus ist damit zukünftig eine individualisierten Stentimplantation sowie Tumorvolumenberechnungen denkbar.In this paper a new bronchoscopic method was developed and tested, that performs measuring both cross-sectional areas and length of central airway stenoses in real-time. Furthemore this method enables to represent a three-dimensional reconstruction of the airway section that was analysed. To measure th cross-section area, a laser probe inserted into the operating channel of a bronchoscope projects a ring of light onto the trachal wall and marks the cross-sectional area. A new software especially developed for this method makes it possible to identify the projected ring of light and measures the cross-sectional area after applying lens distortion correction algorithms. By saving a succession of cross-sections 3D-data is provided for visualizing and volume calculation. The measuring accurracy was first tested employing plastic tubes with known diameters and 17 models of porcine trachea. The cilinical evaluation was realized in a pilot study. Sections of different length of tracheas of 10 patients were analysed by both the new method and by CT. The results of the experimental part showed good correlation between the reference methods and a very good reliability. The correlation between CT and bronchoscopic measuring results was slightly less good than the experimental correlation, but they showed no systematic measuring error. A little systematic error in the experimental evaluation prooved to be irrelevant for clinical results. The new method enabels objective description of stenoses and makes it possible to develop a standardized classification. In future indvidual stent construcions or calculation of tumor volumes are conceivable.
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West, Emily S. "Risk factors for trichiasis recurrence in a trachoma-endemic area of central Tanzania." Available to US Hopkins community, 2002. http://wwwlib.umi.com/dissertations/dlnow/3068228.
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Mwangi, Grace Wangari. "Post-operative Trachomatous Trichiasis in Africa: a systematic review and online survey." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30108.
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Background
High incidence of post-operative trichiasis and other poor outcomes after surgery in most trachoma-endemic settings poses a major challenge to global elimination of trachoma. This systematic review aimed to assess the incidence of post-operative trichiasis and other poor outcomes of trichiasis surgery in Africa, based on findings of observational and interventional studies.
Search methods
We searched PubMed, Academic Search Premier, Africa-Wide Information, CINAHL and Health Source Nursing through EBSCOhost, Web of Science [all databases], and Cochrane Central Register of
Controlled Trials for relevant studies on the subject. We also searched the reference lists of included
studies to identify further potentially relevant studies. We included all observational and interventional studies that measured post-operative trichiasis as one of the primary outcomes. Only studies conducted in Africa were included in this review.
Data collection and analysis
Two reviewers independently screened the titles and abstracts, selected and assessed the articles for inclusion in this review. Any disagreements were resolved through discussion or by consulting a third reviewer. Where necessary, the corresponding authors of included studies were contacted to provide any missing data. Our primary outcome was post-operative trichiasis, which was defined as any eyelash touching the globe at different time points after surgery.
Main results
Thirty-five studies, including 12,943 participants, met the inclusion criteria. A number of the studies included in this review utilized the same data to measure the incidence of post-operative trichiasis and other poor outcomes over different follow-up periods.
Overall, a review of the included studies revealed a pattern of high incidence of post-operative trichiasis and other poor outcomes ranging from 2.3 at 6 weeks to 65% at 7 years. This incidence varied by type of study design, surgical procedure and technique used as well as the follow up period among other factors.
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Hemphälä, Johanna. "Genetic dissection of tubulogenesis in the Drosophila trachea /." Stockholm : Department of Developmental Biology, Wenner-Gren institute, Stockholm University, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-430.
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Khawaja, Aamir Mahmoud. "Inhibition of neurogenic mucus secretion in ferret trachea." Thesis, Imperial College London, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286452.
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Ruiz, Carmona Luz Marcela. "TraceME: Traceability-based Method for Conceptual Model Evolution." Doctoral thesis, Universitat Politècnica de València, 2016. http://hdl.handle.net/10251/64553.
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[EN] Renewing software systems is one of the most cost-effective ways to protect software investment, which saves time, money and ensures uninterrupted access to technical support and product upgrades. There are several motivations to promote investment and scientific effort for specifying systems by means of conceptual models and supporting its evolution. In order to contribute to the requirements engineering field with automated software production methods, we design TraceME to cover the spectrum of activities from requirements to code focusing on organisational evolution. In this sense, the spectrum of activities involves various information system perspectives of analysis that need to be integrated. In this complex setting, traceability and conceptual models are key concepts. Mechanisms to trace software specifications from requirements to code are important to justify evolution processes; versions of information systems should be traced in order to get the connection between old and new specifications. Moreover, it is necessary to find mechanisms to facilitate change specifications, measurement, and interpretation.
To design this thesis we follow Design Science by Roel Wieringa. Design Science gives us the hints on how to conduct the research, be rigorous, and put in practice scientific rules. Besides Design Science has been a key factor for structuring our research, we acknowledge the application of this framework since it has helps us to report clearly our findings.
We build TraceME by making a method engineering effort, which shapes its fragmented nature in chunks. The architecture of TraceME opens a wide window of opportunities for its application in real world situations. To facilitate industrial adoption, we develop open source tools to support the implementation of the TraceME chunks. For example, one case study and one action-research protocols have been executed in two different organisations in Spain.
The validation of TraceME has taken place in laboratory demonstrations, controlled experiments, action research and case study experiences in industry. Thanks to the validations various lessons learnt have been gathered and greatly influenced the maturity of the method. For example: the importance to consider end-users' perceptions for discovering needs to mitigate, and the significance to get knowledge from the application of TraceME in different contexts. The evidences from the validations demonstrate that TraceME is feasible to be applied to support evolution projects. In addition, future research is needed for promoting the implementation of TraceME. We envision short term and future-term work that motivate us to tackle the challenge to support evolution projects.[ES] La evolución de sistemas software es una de las actividades mas importantes que permiten minimizar el tiempo de puesta en producción de actualizaciones y nuevos desarrollos, reducir los costos que implica desarrollar una aplicación desde cero, y además asegura el acceso ininterrumpido de servicios. Existen variadas motivaciones para promover la investigación y desarrollo de soluciones para especificar y evolucionar sistemas de información mediante modelos conceptuales. Para contribuir al campo de la ingeniería de requisitos con métodos automáticos de producción de software, hemos diseñado el método TraceME para cubrir el espectro de actividades desde requisitos a código con un enfoque de evolución organizacional. De este modo, el espectro de actividades involucra diferentes perspectivas de análisis de sistemas de información que necesitan ser integradas. En este escenario tan complejo, la trazabilidad y los modelos conceptuales son conceptos clave. Es necesario disponer de mecanismos para trazar especificaciones de software desde requisitos a código con el fin de justificar procesos de evolución. Las versiones de los sistemas de información deben ser trazables con el fin de establecer la conexión entre especificaciones obsoletas y actuales. Adicionalmente, es necesario encontrar mecanismos para facilitar la especificación del cambio, su medición e interpretación. Para diseñar esta tesis hemos seguido el marco de Design Science de Roel Wieringa. Design Science nos ha proporcionado las claves para conducir esta investigación, ser rigurosos y poner en práctica reglas científicas. Además de que Design Science ha sido un factor clave para estructurar nuestra investigación, reconocemos que la aplicación de este marco nos ha ayudado a reportar claramente nuestros hallazgos. Hemos aplicado ingeniería de métodos para diseñar y construir TraceME. Gracias a esto, la naturaleza de TraceME es conformada mediante fragmentos de método. La arquitectura de TraceME abre una amplia ventana de oportunidades para su aplicación en situaciones de la vida real. Para facilitar la adopción industrial de TraceME, hemos desarrollado herramientas de software libre para dar soporte a los fragmentos de TraceME. Por ejemplo, un caso de estudio y una experiencia de action research han sido ejecutadas en dos organizaciones en España. La validación de TraceME ha sido llevada a cabo mediante demostraciones de laboratorio, experimentos controlados, un caso de estudio y una experiencia de action research en industria. Como resultado, TraceME ha sido mejorado considerablemente; además hemos descubierto investigaciones a realizar a corto, mediano y largo plazo con el fin de implementar TraceME en la industria. Las evidencias obtenidas como resultado de las validaciones demuestra la factibilidad de TraceME para ser aplicado en proyectos de evolución organizacional. El trabajo futuro nos motiva a afrontar los retos que conlleva el soporte de proyectos de evolución de sistemas de información.
[CAT] L'evolució dels sistemes programari és una de les activitats més importants que permeten minimitzar el temps de posada en producció d'actualitzacions i nous desenvolupaments, reduir els costos que involucra desenvolupar una aplicació des de cero, a més d' assegurar l'accés ininterromput de serveis. Existixen diverses motivacions per promoure la investigació i desenvolupament de solucions per a especificar i evolucionar sistemes de informació mitjançant models conceptuals. Per tal de contribuir al camp de l'enginyeria de requisits amb mètodes automàtics de producció de programari, hem dissenyat el mètode TraceME per cobrir l'espectre d'activitats des de requisits a codi en un enfocament d'evolució organitzacional. Així, l'espectre d'activitats involucra diferents perspectives d'anàlisi de sistemes d'informació que necessiten ser integrades. En aquest escenari tan complex, la traçabilitat i els models conceptuals són conceptes clau. És necessari disposar de mecanismes per traçar especificacions de programari des de requisits a codi amb la fi de justificar processos d'evolució. Les versions dels sistemes d'informació deuen ser traçables amb la fi d'establir la connexió entre especificacions obsoletes i actuals. Addicionalment, és necessari trobar mecanismes per facilitar l'especificació del canvi, la seua mesura i interpretació. Per tal de dissenyar aquesta tesi, hem seguit el marc de Design Science de Roel Wieringa. Design Science ens ha proporcionat les claus per conduir aquesta investigació, ser rigorosos i posar en pràctica regles científiques. A més a més, Design Science ha sigut un factor clau per estructurar la nostra investigació, reconeixem que l'aplicació de aquest marc ens a ajudat a reportar clarament els nostres resultats. Hem aplicat enginyeria de mètodes per dissenyar i construir TraceME. Gràcies a açò, la natura de TraceME es conforma mitjançant fragments de mètodes. L'arquitectura de TraceME obri una ampla finestra d'oportunitats per a la seua aplicació en situacions de la vida real. Per facilitar l'adopció industrial de TraceME, hem desenvolupat ferramentes de programari lliure per tal de donar suport als fragments de TraceME. Per exemple, un cas d'estudi i una experiència de action research han sigut executades en dos organitzacions a Espanya. La validació de TraceME ha sigut portada a cap mitjançant demostracions de laboratori, experiments controlats , un cas d'estudi i una experiència de action research en l'industria. Com a resultat, TraceME ha sigut millorada considerablement; a més a més, hem descobert investigacions a realitzar a curt, mig i llarg termini amb la fi d'implementar TraceME a l'industria. Les evidències obtingudes com a resultat de les validacions, demostren la factibilitat de TraceME per ser aplicat en projectes d'evolució organitzacional. El treball futur presenta nous reptes que ens motiven a afrontar el suport de projectes d'evolució de sistemes d'informació.
Ruiz Carmona, LM. (2016). TraceME: Traceability-based Method for Conceptual Model Evolution [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/64553
TESIS
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Hermawan, Vera. "Experimental techniques to determine the Young's Modulus of the trachea thesis submitted in partial fulfilment of the degree of Master of Engineering, Auckland University of Technology, September 2004." Full thesis. Abstract, 2004.
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Amoako, Daniel Kwasi. "Cyclopiazonic acid changes the mode of excitation-contraction coupling in acetylcholine-stimulated bovine tracheal smooth muscle /." Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1865017X.
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Sams, Kelley Cosby. "The Elimination of Blindness: An Ethnographic Exploration of the Fight Against Trachoma in Niger." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4759.
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The goal of this study is to explore specialized and popular cultural models of trachoma, and the interaction between the trachoma elimination program and its target audience in one trachoma hyper-endemic intervention community. Eighty four million people worldwide, mainly children, are infected with active bacterial trachoma. For some, this will lead to painful and progressive corneal opacity and eventual blindness. The disease is most commonly spread by person-to-person contact or by flies, and affects very specific populations living in resource-poor areas such as rural Niger, which has one of the highest prevalence rates worldwide.
The World Health Organization formed an alliance that is working toward the goal of eliminating blinding trachoma globally by 2020 through a strategy that includes behavior change communication, drug distribution, and surgery. The elimination program has been at work in Niger since the late 1990's. Trachoma prevalence in Niger showed a dramatic reduction during the beginning of the elimination program. However, disease prevalence has again increased and, at the time of this study, was nearing pre-intervention levels.
While poverty is closely related to trachoma, the processes by which this economic state becomes translated into health impacts are complex, but rely on behaviors that are directly linked to disease transmission, prevention, and progression. From a social science perspective, these health behaviors can be studied by exploring the influence of both macro- (economics, structural, political), and micro- (cultural, cognitive, meaning-related) level factors. Cultural models are useful in examining the human relationship with infectious disease and how health-related decisions are made. These shared representations are drawn upon to negotiate well-being and disease, and are impacted by the introduction of new ideas or experiences.
This study investigates cultural models of illness and the impact of the trachoma elimination program in one high-prevalence community in rural southern Niger. Using an ethnographic approach, which includes observation, in-depth interviews, and household surveys, data were gathered describing popular representations of the program and the disease in the research community.
The main findings of this study show that the biomedical model of trachoma supported by the elimination program, amadari, has entered popular knowledge. However, this cultural model is not regularly applied to eye disease actually experienced by study households, which is seen to fit in the more general and more natural category of ciwon ido. Although the new treatments introduced for trachoma have been embraced by the intervention community, the use of the treatments has been modified to fit within popular representations of illness.
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Marks, Michael Edward. "Epidemiology of yaws in the Solomon Islands and the impact of a trachoma control programme." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2016. http://researchonline.lshtm.ac.uk/3149251/.
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Yaws is a re-emerging endemic treponemal infection. The Pacific Islands are believed to be a major focus of yaws worldwide. WHO has recently developed a strategy for global yaws eradication based predominantly on community mass treatment with azithromycin at a dose of 30mg/kg (max 2g). Mass treatment with azithromycin is also key to the WHO strategy for trachoma elimination, although the dose used is lower (20mg/kg – max 1g). In areas where trachoma and yaws are co-endemic, mass treatment of populations as part of trachoma control programmes might aid yaws eradication efforts, but could also have negative consequences if drug resistance were to be encouraged. Prior to mass treatment with azithromycin, the prevalence of clinical and serological evidence of yaws in the Solomon Islands was found to be high. Household contact with a seropositive individual was a strong risk factor for infection, especially if the contact also had an active skin lesion. Village level seroprevalence was shown to be the strongest risk factor for infection. Haemophilus ducreyi was identified as the likely cause of a large proportion of ulcerative skin lesions amongst children, which were clinically indistinguishable from those of yaws. A single round of mass treatment with azithromycin at a dose of 20mg/kg significantly decreased the prevalence of both clinical signs of yaws and serological evidence of active infection. This effect was shown to extend to at least 18 months after mass treatment in the absence of any further intervention. Not receiving treatment with azithromycin was the major risk factor for seropositivity following MDA at both 6 and 18 months of follow-up. A rapid diagnostic test for syphilis was shown to also have potential value for use in yaws. The sensitivity of the test was strongly associated with the antibody titre on gold standard testing, suggesting the test may be most appropriate for testing individuals with suspected active yaws where antibody titres are higher. Mathematical modelling data were used to establish the minimum number of rounds and coverage that are likely to be required to interrupt transmission. Consistent with the findings of the post-MDA prevalence surveys, the model predicted that high coverage – ideally above 80% - is likely to be required to interrupt transmission. This PhD has addressed several key questions about the epidemiology of yaws. Even within endemic populations, the disease is highly focal. Integration of rapid diagnostic tests into routine surveillance may help improve data quality and guide yaws elimination efforts at a national level. Given the strong association between coverage of mass treatment and risk of infection, new strategies to increase the reach of yaws eradication strategies are needed. Mathematical modelling may be of use in informing the design of these interventions.
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Ramnarine, Sean Issac. "Neurogenic mucus secretion in ferret trachea : excitatory and inhibitory control." Thesis, Imperial College London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338873.
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Guidi, Silvia. "Traccia banale: Una chiesa povera per i poveri a bogota." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2014. http://amslaurea.unibo.it/8031/.
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Traccia banale, tributo alla correlazione con José Paulo dos Santos, l'edificio sacro è stato progettato a misura d'uomo, dell'uomo del XXI secolo.
Banale, semplice ed elementare, puro e senza fronzoli.
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Lynch, Thomas John. "Adult stem cells in the trachea and tracheal submucosal glands." Diss., University of Iowa, 2016. https://ir.uiowa.edu/etd/6464.
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Breathing is essential for human life, yet tens of millions of people in the U.S. alone suffer from lung diseases. With each breath, lungs are exposed to the external environment. Inhaled air first passes through the trachea, bronchi, and finally the bronchioles before it reaches the alveoli where gases are exchanged. A barrier of epithelial cells protects the airways. In addition, epithelial glands also secrete protein-rich fluids onto the airway surfaces to help maintain sterility. Injury, disease, or other factors can damage these cells, and regiospecific stem cells (SCs) can divide to replace them. However, many important details about lung SCs are still unknown. For example, what processes control SC division? How do region-specific SCs differ from one another? And how does disease or injury impact SC biology? We found that some processes that regulate lung development also control adult SC division following injury. We show that SCs from airway glands give rise to surface epithelial cell types and glandular cell types. In contrast, surface SCs only generated surface cell types. Finally, we identify a type of cell in the glands that can regenerate surface cell types after severe injury. These studies provide new insights into the neighborhoods in which SCs reside in the large airways and processes that control their contribution to airway repair following injury. Overall, this research provides important new insights into adult SC biology and conditions affecting lung health.
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Schémann, Jean-François. "Le trachome et la xérophtalmie en Afrique, deux maladies de société." Bordeaux 2, 2002. http://www.theses.fr/2002BOR21003.
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Nous présentons trois cartographies nationales du trachome au Mali, au Burkina Faso et au Sénégal réalisées entre 1994 et 2002 et nous émettons des hypothèses pour expliquer la diminution de l'endémie au Sénégal ainsi que le caractère plus cécitant du trachome des zones les plus humides du sud. L'importance de l'hygiène et de l'accès à l'eau ainsi que le rôle des mouches et de la propreté du milieu sont mis en évidence. La maladie reste fortement liée au bas niveau socio économique et à l'absence d'éducation. Poyur cibler les zones plus touchées nous avons testé une méthode d'appréciation rapide du trachome qui ne devrait être utilisée que dans ce but et non pour des études épidémiologiques. La chirurgie du trichiasis est l'un des éléments de la stratégie "CHANCE" visant à prévenir la cécité due au trachome. La méthode de Trabut reste la technique de référence en Afrique francophone zr doit devenir accessible auu plous grand nombre grâce à une offre de proximité. La distribution d'azithromycine permet de diminuer la prévalence de l'affection. Plusieurs stratégies ont été testées. Avec les taux de prévalence du Mali, la stratégie traitant les femmes et les enfants est aussi efficace que la stratégie de masse. Lorsque les prévalences baisseront, il deviendra moins coûteux de distribuer aux concessions où un enfant est malade. L'amélioration de l'hygiène et de l'environnement doivent impérativement accompagner la pression antibiotique afin d'éviter une réemergence du trachome. Ces mesures sont étroitement dépendantes du développement économique et de l'éducation des femmes. Après avoir décrit la xérophtalmie et ses facteurs de risque, nous rapportons une cartographie de l'affection au Mali et les résultats d'une enquête clinique et biologique au pays Dogon. Une étude d'intervention au même lieu a démontré l'efficacité de la distribution de vitamine A au cours des JNV. Nous avons pu mettre en évidence que la xérophtalmie était un facteur de risque pour le trachomeRésults of trachoma and xerophtalmia surveys in Mali and neibouring countries between 1994 and 2002 are recorded. A brief natural history of the disease and its blinding and disabling consequences is given. A national mapping was performed in Mali, Burkina Faso and Sénégal. Trachoma diminishing in Senegal could be explained by better socio economic conditions. Hypothesis on the more severe blinding consequences of the disease in the southern humid regions are given. A risk factors study emphasises the role of hygiene and water supply. It confirm the effect of flies and domestic cleaneliness. The illness is strongly linked to a bad socio economic conditions and to a low educational level. For targeting places that need to be treated we tested a trachoma rapid assessment method that should not be used for zpidemiological purpose. Trichiasis surgery is one of the arm of the "SAFE" strategy fir preventing trachoma blindness. The Trabut method ; the reference technique in French speaking African countries, should become accessible to all and be offered at the closest level. Azithromycin distribution diminishes trachoma prevalence. Different strategies have been tested. At the Malian prevalence level, treating children and women is so effective as mass treatment. When prevalence will diminish the household targeted strategy will become less costly. Hygien and environment should imperatively be improved when antibiotic will be distributed. If not, a re-emergence of trachoma will be observed. This improvement is strongly linked to economic development and to women education. After describing xerophtalmia and its risk factors we report a mapping study performed in Mali and the results of a clinical and biological study carried out in the Dogon country. Effectiveness of vitamin A distribution during NIDs was demobnstrated by an intervention study in the same place. The diagnostic of xerophtalmia appeared to be associated with active trachoma
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鄧兆庭 and Siu-ting Alvin Tang. "Implementation and evaluation of evidence-based practice guidelines for open endotracheal suctioning in mechanically-ventilated adult patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193027.
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Endotracheal suctioning is a procedure performed on a daily basis in hospitals, and is mostly take place in intensive care units (ICUs). (Annapoorna, 2005; Day et al, 2009). It helps removing sputum or secretion out from patients’ trachea. For patients who are under mechanical ventilation, this procedure is vital to maintain their airway patency when they are intubated with endotracheal tube or tracheostomized (Finucane & Santora, 2003). However, the procedure has its own risk and complications such as hypoxaemia, atelectasis, cardiovascular instability and more (Thomson, 2000). There are in general two types of endotracheal suctioning: open and closed system. As disconnection of mechanical ventilation from patients is needed for open endotracheal suctioning (OES), it has a higher risk of complications. However, the cost for OES is much cheaper compared to the closed system. Although OES is widely used in Hong Kong, there is no evidence-based guideline for nurses to follow. The guideline developed by American Association of Respiratory Care (2010) is lack of specificity on the target population and its recommendations were based on mixed literatures targeting on adult and infant patients. Therefore, the aim of this dissertation is to develop an evidence-based guideline for OES in adult patients under mechanical ventilation in ICU.
To develop a guideline for OES, search was performed in multiple electronic databases (British Nursing Index, CINAHL, Cochrane Library, Ovid MEDLINE, and PubMed) with keywords related to OES and its complications. A total of 457 studies fulfilled the inclusion criteria and 11 of them were selected. The selected studies were evaluated by quality appraisal checklists, which are developed by Scottish Intercollegiate Guidelines Network (SIGN). Data were extracted for developing the guideline.
Evidence have shown that the incidence of post-OES hypoxemia can be reduced by performing hyperoxygenation with 100% oxygen for 4-6 breaths prior and after each open endotracheal suction, accompanying with hyperinflation with 150% of patient’s tidal volume at most 8 breaths/40 seconds delivered by ventilator and prohibiting normal saline instillation into trachea for diluting the sputum. The grades of the recommendations in the guideline were rated with using of the SIGN grading system. The implementation potential was analyzed by the patients’ characteristics, transferability of the findings, feasibility of implementation and cost-benefit ratio.
A 12-month implementation program was developed including communication with stakeholders, 4-week pilot testing, and training of ICU staffs, and implementation of OES guideline. The effectiveness of the guideline will be evaluated based on the primary outcome (i.e. oxygen level in blood) for detecting the incidence of hypoxemia. Also, the acceptability of the guideline, compliance of the guideline, financial cost reduction and better quality of service will be used as other evaluation indicators.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Kurujareon, Jutarat. "Simulation of airflow in the human tracheobronchial network." Thesis, University of Hertfordshire, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391374.
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Moyo, George. "Global burden of trichiasis in women as compared to men: Findings from the Global Trachoma Mapping Project." Master's thesis, Faculty of Health Sciences, 2019. https://hdl.handle.net/11427/31765.
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The secondary analysis undertaken for this MPH dissertation examines the global prevalence of trichiasis in relation to gender in trachoma endemic countries. Part A is the research protocol which outlines the background and the process of this research. This study is a population-based analytical study using data from the Global Trachoma Mapping Project (GTMP). GTMP was a standardized population-based trachoma prevalence survey undertaken to provide trachoma prevalence estimates. GTMP data was collected using the World Health Organisation–recommended population based prevalence survey methodology. Trachoma suspect district were identified for inclusion and multistage random sampling was used to sample households for examination of residents for clinical trachoma. Part B presents the background and highlights the importance of this research by exploring the existing theoretical and empirical literature relevant to the topic. It describes how trachoma is transmitted, its clinical manifestations, and the way it can lead to blindness. Results from previous studies on gender and trichiasis are presented. Part C presents the research project in a format suitable for journal submission. The background of this research project is summarized and the meta-analysis is conducted at the global level, at the country level, the regional level, the state level and at the EU level but all in accordance to prevalence of trichiasis in the EUs. The implications of the findings are discussed and limitations in interpretation presented.
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Butcher, Robert M. R. "Using alternate indicators to define need for public health intervention for trachoma : evidence from the Pacific Islands." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2017. http://researchonline.lshtm.ac.uk/4574556/.
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Introduction: Trachoma is the most common infectious cause of blindness worldwide. The presentation of trachoma in the Pacific small island states varies. This study focuses on Fiji, where the trichiasis prevalence recorded prior to this study was very high, and the Solomon Islands, where the prevalence of trachomatous inflammation – follicular (TF) is high enough to warrant intervention with mass antibiotic treatment, but there is apparently little or no trachomatous trichiasis (TT). This study aims to supplement clinical data with photographic and molecular tools to better characterise presentation and microbiological correlates of disease. Methods: Pre-intervention population-based prevalence surveys for trachoma were carried out independently and in conjunction with the Global Trachoma Mapping Project (GTMP). Additionally, one focused post-intervention survey was performed. Standardised clinical data collection was supplemented with ocular swab, dried blood spot and photograph collection. Quantitative and sequence-based nucleic acid techniques were used for targeted and nontargeted pathogen detection and characterisation. Enzyme immunoassays were used for serological analysis. Clinical data was supplemented with photographs. Results: Within the mosaic pattern of clinical trachoma in the Pacific, the prevalence of TT was found to be very low in Fiji and the Solomon Islands. Prevalence of ocular Chlamydia trachomatis (Ct) infection in these countries was also very low. Further investigations in the Solomon Islands demonstrated Ct isolates found to be most closely related to ocular reference strains. Several pathogens that are known to cause follicular conjunctivitis were found, but neither frequency nor load of infection was associated with TF. Amplification of 16S ribosomal RNA amplicons showed diverse ocular microbial communities but no dominant metagenomic communities associated with TF. There is evidence of accumulation of mild scarring as age increases, but little evidence of severe scarring, or association between any trachoma phenotype and exposure to Ct. Conclusion: In Solomon Island communities studied, no evidence was found of significant burden of Ct infection, Ct transmission, trachomatous inflammation – intense, accumulation of severe scarring in older people or TT. We therefore suspect TF in the Solomon Islands to be of an as-yet unidentified aetiology. The WHO simplified grading system also appeared to lack diagnostic accuracy in Fiji. There are direct implications for implementation of control measures in the Pacific. There are additional connotations worldwide; as the global elimination effort continues and phenotypically similar conditions are unmasked, we suspect the positive predictive value of simplified clinical grading to drop. Use of molecular tools could differentiate communities with a high burden of infection, a key correlate of blinding disease, from those where resources may be better allocated elsewhere.
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Piazza, Nicolas, and Nicola Romagnoli. "La traccia continua. Proposta di musealizzazione del parco archeologico di Galeata." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amslaurea.unibo.it/15582/.
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La città di Galeata, luogo di transito di popoli sin dall’eneolitico, nasconde ancora oggi quelle che sono le tracce degli insediamenti di questo vissuto. In particolare emergono due siti archeologici eminenti, la città romana di Mevaniola e l’area del palazzo di Teodorico.
Il progetto affonda le sue radici nella lettura di questi segni, giunte fino a noi in seguito alle varie modifiche dell’azione del tempo e dell’uomo, e di come si possa stabilire con esse una continuità, proteggendole e musealizzandole.
Nell’area della città di Mevaniola è emersa, a seguito dello studio dell’evulozione dei campi, la traccia di quella che doveva essere la centuriazione della città, rievocata tramite il progetto da una riorganizzazione dell’assetto agricolo in conformità con essa. Qui emergono i resti di un piccolo teatro, la cui volumetria viene riproposta tramite una struttura lignea a partire dalle proporzioni vitruviane degli spazi teatrali.
Nel sito del palazzo di Teodorico, un parco pubblico collega tutti i ritrovamenti dell’area. In particolare il progetto si concentra sulla rievocazione della volumetria e della spazialità del padiglione termale del palazzo, in una situazione in cui il nuovo e l’antico non si toccano e dove l’immagine dell’edificio diventa il risultato della relazione tra il reperto archeologico e il paesaggio circostante.