26
Tropical Doctor, January 1992
AIDS awareness among students and teachers in primary and secondary schools in Kabarole District, Uganda W Kipp MO OTM + HI H Mpuga OipPW
Figure 4. Massive injection requiring amputation. Handfunction willremainimpairedjollowingsurgery surgical emergency - in some cases a special type of compound fracture - that needs urgent referral to hospital. The application and administration of local drugs may also lead to delay in hospital attendance. In our series, only one patient attended on the day the bite occurred. The mean delay was 3 weeks but for a few patients the delay was several months. In these patients the finger infection was extremely severe, with involvement of the deep palmar spaces, exposed and necrotic tendons, necrotic phalanges and multiple ulcers (Figure 4). Late presentation could be explained, at least partially, by the social stigma of the bite itself, especially for men attacked with such 'love bites' by their wives. On admission, while the history is being taken, a man will usually try to hide the real cause of his finger infection, especially if a love tangle is the reason behind it. Finger infections complicating human bites show clinical characteristics that make them rather different from infections of other aetiology (eg post thorn prick). There is much tissue destruction, and sepsis is difficult to control, spreading quickly along the tendineous sheaths towards the palm. Irregularity in the supply and availability of broad spectrum antibiotics make the institution of appropriate treatment even more difficult: both the peripheral health units and the hospitals are usually short of them. Many health workers are unaware of how serious a human bite can be. A bitten finger requires immediate and thorough medical attention.
'Deutsche Gesellschqft fuer Technische, Zusammenarbeit (07Z). Box 27, Fort Portal, Uganda 2Ministry of Health, Kabarole District. Uganda TROPICAL DOCTOR,
1992, 12, 26-27
The main objective of this study, (conducted in April, 1990), was to assess students' and teachers' knowledge about AIDS in Kabarole District, Uganda. HIV seroprevalence in the district was reported to be 6.0% in 19871• Six urban and six rural schools were selected by stratified random sampling. Sixty pupils in primary school, 240 secondary school students, and 84 teachers from 100 90 80
70 60
50 40 30 20 10 O...J.L.L.L...L..:...:.......:...L.:::...:~L-.IL...4~.:..:...:....:.....L:~>..L
p
S Urban
Schools REFERENCE
1 Kroeger AV, Vicher EE. Microbiology. In: Laskin OM, ed. Oral and maxillofacial surgery. C.V. Mosby Company, 1980:108-78
E M Kwered MSc'
T
p
T S Rural Schools
Figure I. A verage percentage oj correct responses about AIDS, by type ojschool. P, primary pupils; S, secondary pupils; T, teachers
Tropical Doctor, January 1992 12 schools completed anonymously a true-false questionnaire about AIDS. For each question, a score of correct responses exceeding 750/0 was regarded as satisfactory. That AIDS is a fatal disease with no cure was more known among teachers (970/0) than students (88%). While 91 % of the students from rural schools recognized that AIDS is not confined to the urban rich population; only 80% of the youths in urban schools were aware of this. Regarding HIV transmission, 82% of all students and 86% of all teachers knew that transfusion with untested blood is a risk factor. That injection with unsterilized needles can spread HIV was least known by students from rural schools (71 %). As also noted in Zimbabwe', many students (65%) seem to fear that mosquitoes might transmit HIV. It was mainly urban students (21%) who felt that HIV can be transmitted by the sharing of drinking cups. Thirty per cent of students think that if a healthy person has coitus only once with someone who is HIV seropositive, there is no chance of being infected. Also, 28% of all students and 4% of all teachers believe that washing sexual parts after having sex greatly reduces the risk of HIV infection. These beliefs could promote high risk sexual practices. Sixty per cent of the students and 78% of teachers appreciate that using condoms reduces the risk of HIV infection. But many (46%) students feel that condoms protect only men against HIV. This false view is also shared by one quarter (25%) of teachers in rural schools. Over 80% of all respondents knew that many HIV-seropositive persons look quite healthy; however, 33% of students in rural schools were ignorant of this. That AIDS is a curse from God and impossible to avoid was reported by 46% of all students. These beliefs might lead to a state of helplessness and to risky behaviour. As Figure 1 indicates, the percentage of correct answers by students increased with their level of education. Overall, teachers performed significantly better than students: average scores were 91 % and 75%, respectively. Pupils aged below 15 years scored least (64%). However, there was no significant association between location of a school (ie urban, rural), and the level of AIDS awareness among students or their teachers. This may suggest a fair distribution of AIDS education activities in schools in all parts of the district. Also, AIDS knowledge was not significantly associated with the presence of co-education, and the level of knowledge was similar in males and females.
27
The results of this study will be used to modify and improve the on-going AIDS information programme, which needs to focus more on younger students in future. REFERENCES
I
Report of the Uganda national HIV serosurvey. Ministry of Health, Entebbe, 1987 2 Wilson D, Greenspan R, Wilson C. Knowledge about AIDS and self-reported behaviour among Zimbabwean secondary school pupils. Soc Sci Med 1989;28:957-61
Gastric carcinoma-a study of 100 cases in Northern Pakistan Manzoor Ahmed FRPS Adnan Manssor MBBS FCPS Amir H Khan MBBS MPhii Javed Iqbal MBBS MCPS Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan TROPICAL DOCTOR,
1992,22,27-29
SUMMARY
We describe 100 consecutive patients with histologically proven gastric carcinoma who were admitted to various hospitals in Northern Pakistan. Twenty-six per cent of patients were under 40 years of age. In a majority of patients the tumour was of a morphological type associated with poor prognosis. In most cases the disease was already at an advanced stage at the time of diagnosis, and most patients died within one year. INTRODUCTION
Gastric carcinoma shows geographical variations in its incidence, morphology and mortality. Epidemiological studies have shown high and low risk areas in various parts of the world". Environmental factors may be responsible for this variation, and diet is the focus of attention for most workers". Control of some environmental factors is believed to have led to the declining incidence of this cancer in developed countries", Information on stomach cancer in Pakistan is not available. Analysis of data on the general pattern
Tropical Doctor, January 1992
AIDS awareness among students and teachers in primary and secondary schools in Kabarole District, Uganda W Kipp MO OTM + HI H Mpuga OipPW
Figure 4. Massive injection requiring amputation. Handfunction willremainimpairedjollowingsurgery surgical emergency - in some cases a special type of compound fracture - that needs urgent referral to hospital. The application and administration of local drugs may also lead to delay in hospital attendance. In our series, only one patient attended on the day the bite occurred. The mean delay was 3 weeks but for a few patients the delay was several months. In these patients the finger infection was extremely severe, with involvement of the deep palmar spaces, exposed and necrotic tendons, necrotic phalanges and multiple ulcers (Figure 4). Late presentation could be explained, at least partially, by the social stigma of the bite itself, especially for men attacked with such 'love bites' by their wives. On admission, while the history is being taken, a man will usually try to hide the real cause of his finger infection, especially if a love tangle is the reason behind it. Finger infections complicating human bites show clinical characteristics that make them rather different from infections of other aetiology (eg post thorn prick). There is much tissue destruction, and sepsis is difficult to control, spreading quickly along the tendineous sheaths towards the palm. Irregularity in the supply and availability of broad spectrum antibiotics make the institution of appropriate treatment even more difficult: both the peripheral health units and the hospitals are usually short of them. Many health workers are unaware of how serious a human bite can be. A bitten finger requires immediate and thorough medical attention.
'Deutsche Gesellschqft fuer Technische, Zusammenarbeit (07Z). Box 27, Fort Portal, Uganda 2Ministry of Health, Kabarole District. Uganda TROPICAL DOCTOR,
1992, 12, 26-27
The main objective of this study, (conducted in April, 1990), was to assess students' and teachers' knowledge about AIDS in Kabarole District, Uganda. HIV seroprevalence in the district was reported to be 6.0% in 19871• Six urban and six rural schools were selected by stratified random sampling. Sixty pupils in primary school, 240 secondary school students, and 84 teachers from 100 90 80
70 60
50 40 30 20 10 O...J.L.L.L...L..:...:.......:...L.:::...:~L-.IL...4~.:..:...:....:.....L:~>..L
p
S Urban
Schools REFERENCE
1 Kroeger AV, Vicher EE. Microbiology. In: Laskin OM, ed. Oral and maxillofacial surgery. C.V. Mosby Company, 1980:108-78
E M Kwered MSc'
T
p
T S Rural Schools
Figure I. A verage percentage oj correct responses about AIDS, by type ojschool. P, primary pupils; S, secondary pupils; T, teachers
Tropical Doctor, January 1992 12 schools completed anonymously a true-false questionnaire about AIDS. For each question, a score of correct responses exceeding 750/0 was regarded as satisfactory. That AIDS is a fatal disease with no cure was more known among teachers (970/0) than students (88%). While 91 % of the students from rural schools recognized that AIDS is not confined to the urban rich population; only 80% of the youths in urban schools were aware of this. Regarding HIV transmission, 82% of all students and 86% of all teachers knew that transfusion with untested blood is a risk factor. That injection with unsterilized needles can spread HIV was least known by students from rural schools (71 %). As also noted in Zimbabwe', many students (65%) seem to fear that mosquitoes might transmit HIV. It was mainly urban students (21%) who felt that HIV can be transmitted by the sharing of drinking cups. Thirty per cent of students think that if a healthy person has coitus only once with someone who is HIV seropositive, there is no chance of being infected. Also, 28% of all students and 4% of all teachers believe that washing sexual parts after having sex greatly reduces the risk of HIV infection. These beliefs could promote high risk sexual practices. Sixty per cent of the students and 78% of teachers appreciate that using condoms reduces the risk of HIV infection. But many (46%) students feel that condoms protect only men against HIV. This false view is also shared by one quarter (25%) of teachers in rural schools. Over 80% of all respondents knew that many HIV-seropositive persons look quite healthy; however, 33% of students in rural schools were ignorant of this. That AIDS is a curse from God and impossible to avoid was reported by 46% of all students. These beliefs might lead to a state of helplessness and to risky behaviour. As Figure 1 indicates, the percentage of correct answers by students increased with their level of education. Overall, teachers performed significantly better than students: average scores were 91 % and 75%, respectively. Pupils aged below 15 years scored least (64%). However, there was no significant association between location of a school (ie urban, rural), and the level of AIDS awareness among students or their teachers. This may suggest a fair distribution of AIDS education activities in schools in all parts of the district. Also, AIDS knowledge was not significantly associated with the presence of co-education, and the level of knowledge was similar in males and females.
27
The results of this study will be used to modify and improve the on-going AIDS information programme, which needs to focus more on younger students in future. REFERENCES
I
Report of the Uganda national HIV serosurvey. Ministry of Health, Entebbe, 1987 2 Wilson D, Greenspan R, Wilson C. Knowledge about AIDS and self-reported behaviour among Zimbabwean secondary school pupils. Soc Sci Med 1989;28:957-61
Gastric carcinoma-a study of 100 cases in Northern Pakistan Manzoor Ahmed FRPS Adnan Manssor MBBS FCPS Amir H Khan MBBS MPhii Javed Iqbal MBBS MCPS Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan TROPICAL DOCTOR,
1992,22,27-29
SUMMARY
We describe 100 consecutive patients with histologically proven gastric carcinoma who were admitted to various hospitals in Northern Pakistan. Twenty-six per cent of patients were under 40 years of age. In a majority of patients the tumour was of a morphological type associated with poor prognosis. In most cases the disease was already at an advanced stage at the time of diagnosis, and most patients died within one year. INTRODUCTION
Gastric carcinoma shows geographical variations in its incidence, morphology and mortality. Epidemiological studies have shown high and low risk areas in various parts of the world". Environmental factors may be responsible for this variation, and diet is the focus of attention for most workers". Control of some environmental factors is believed to have led to the declining incidence of this cancer in developed countries", Information on stomach cancer in Pakistan is not available. Analysis of data on the general pattern
