DocumentsDate added
Case study
Mwanri Lillian (FAFPHM)1,* and Benson Jill2,3
Affiliation:-
1Discipline of Public Health, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University
2Discipline of General Practice, University of Adelaide 3Migrant Health Service, SA Health
The name of the department(s) and institution(s) to which the work should be attributed:
Discipline of Public Health, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University
Discipline of General Practice, University of Adelaide Migrant Health Service, SA Health
Corresponding author:-
Dr Lillian Mwanri (MD, PhD, FAFPHM)
Course Coordinator, Master of Health and International Development, Discipline of Public Health, School of Health Sciences, Flinders UniversityLevel2, Health Sciences Building, Registry Road, Bedford Park SA5042.
Tel/Fax: 0872218417/0872218424
Email: lillian.mwanri@flinders.edu.au
Core idea: Cholesteatoma is a serious health condition and can lead to severe complications including meningitis, brain and extradural abscesses and death. While it is not an uncommon in developing countries, the cholesteatoma occurrence is rare in Australia. Many health professionals in Australia have not seen cholesteatoma cases in their practice. This paper analyses the occurrence of a few cases in a newly arrived refugee populations. Findings highlight the need to educate health professionals about the higher than the expected cases in newly refugee populations. The findings are highly transferable to other countries similar to Australia where refugee population from developing countries is increasing.
Authors contribution: Both the author contributed equally to this paper.
Abstract: Purpose: This paper aims to describe the unusually high prevalence of cholesteatoma in refugees, and to advocate for the preparation of health systems including educating clinicians and other health professionals about conditions that are more common in refugee populations.
Methods: An audit of patient records from the Migrant Health Service in Adelaide was conducted from June 2009 to November2011 to identify Chronic Suppurative Otitis Media (CSOM) and cholesteatoma cases.
Results: In the 2.5 year timeframe of the study, 20 patients were diagnosed with CSOM, including 13males (65%) and seven females (35%). Two cases of Cholesteatoma were also identified during the same study period. Details of CSOM have been published elsewhere1. In the current paper, we report two cases of Cholesteatoma in recently arrived refugee populations in South Australia.
Discussion: Both cholesteatomas and CSOM are diseases of poverty and rare conditions in the general Australian population. In the past two decades, Australia has received an increasingly high flow of migrants from across the world with significant proportions arriving with refugee backgrounds. Refugees have multiple risk factors for cholesteatoma: were having commonly been victims of torture, trauma and head injury and mostly coming from a background of severe and long-standing socio-economic disadvantage. Advocacy and education are needed to improve the preparedness of clinicians, other health workers and health systems to address the unique needs of this vulnerable group of people to ensure that they have optimum health as they settle into Australia.
Key words: Recently arrived refugee populations; Cholesteatoma; Medical and health workers’ education; addressing health inequalities.
REFERENCES
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Article citation:-
Mwanri Lillian & Benson Jill. Cases of cholesteatoma in refugee populations in South Australia. Journal of pharmaceutical and biomedical sciences (J Pharm Biomed Sci.) 2013 December; 37(37): 1915-1921. Available at www.jpbms.info
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Source of support: Nil
Original article
Sherwal B L1, Anuradha2,*, Khandekar J3, Rakshit P4, Rajani E5
Affiliation:-
1Director Professor, Department of microbiology, Lady Hardinge medical College, New Delhi,India.
2Assistant Professor, Dr RML Hospital, Department of Microbiology, New Delhi,India
3Professor, Department of Community Medicine, Lady Hardinge medical College, New Delhi,India
4Assistant Director, Department of microbiology, CRI, Kasauli,India.
5Assistant Professor, Department of Microbiology, Mahatma Gandhi Medical College, Sitapura, Rajasthan, India
The name of the department(s) and institution(s) to which the work should be attributed:
Lady Hardinge Medical College, Department of Microbiology, New Delhi,India
*Corresponding author:-
Dr. Anuradha.
H.No 522, phase2, pocket B, sector-13, Dwarka, New Delhi-110075, India
Abstract:
Background: The aim of Tuberculosis (TB) control is to cut the chain of transmission of disease; priority is given to the identification of smear positive pulmonary tuberculosis cases. Early diagnosis of tuberculosis is important for initiating treatment to gain cure. Aims: The present study was undertaken to see the association of initial smear grading with conversion and cure rate. Methods: 200 new pulmonary tuberculosis patients registered from October 2006 to December 2007 were analysed. The data on the smear grading at the start of the treatment and at the end of the intensive phase of the treatment, and the treatment outcomes of the patients were evaluated.
Results: It was observed that out of 200 patients, 169(84.5%) converted at the end of intensive phase and 174(87%) cured at the end of treatment. There was significantly decrease in conversion and cure rate with increase in initial smear grading (P<0.05). It was also seen that maximum number of defaulters (7.8%), deaths (4.4%) and failures (4.4%) belongs to grade 3+. It shows that there is some association of the treatment outcome with the initial smear grading.
Conclusion: Conversion and cure rate were linearly associated with initial smear grading. The patients with higher grade (3+) have low conversion and cure rate as compared to patients with lower grades and also the unfavorable treatment outcome was seen with 3+ grades. More attention needs to be given to the higher grading by motivating the patients to return to regular treatment and sustain commitment in control of tuberculosis.
Key words: Cure Rate; Smear grading; Sputum Conversion; Tuberculosis.
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Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Source of support: Partially funded by Delhi Tapedic Unmulan Samiti.
Article citation:-
Sherwal B L, Anuradha, Khandekar J, Rakshit P, Rajani E. Association of initial smears grading of new pulmonary TB patients with sputum conversion rate. Journal of pharmaceutical and biomedical sciences (J Pharm Biomed Sci.) 2013 December 37(37): 1976-1980. Available at www.jpbms.info.
Copyright © 2013 Sherwal B L, Anuradha, Khandekar J, Rakshit P, Rajani E. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.