Evaluation of methods for the laboratory diagnosis of malaria in Guyana

When 297 blood samples taken from patients attending a fever clinic in Georgetowm Public Hospital were examined microscopically, after thick and thin blood films had been stained with Giemsa, one hundred and forty-two (47.8 per cent ) were microscopically positive for malaria. After processing the patients' serum samples by the Indirect Fluourescent Antibody (IFA) technique, specific IgG and IgM antibodies were detected in 239 (81.3 per cent ) and 179 (60.1 per cent ), respectively, of the sera. Based on the microscopical findings, the IFAT gave positive and negative values of 54.4 per cent and 81.8 per cent (IgG), and 57.5 per cent and 67.8 per cent (IgM), suggesting that the IgM would be more useful than the IgG in the diagnosis of current malaria. An odds ratio analysis showed that the presence of symptoms, IgG or IgM antibodies, as well as visits to endemic regions, could be good indicators of current malaria. Age and occupation are not. The microscopical method will continue to be the gold standard - the best available criterion for the validation of our tests - for our diagnosis of acute malaria.

Political economy of health care in Jamaica an historical analysis 1962-1983

Examines the approaches and policies of successive governments to health care from 1962 to 1983, and the effects of these policies within the constraints of social and economic factors. Contends that developmental policies in Jamaica failed to acknowledge the important contribution of health to development. Presents an historical review of the development of health care in colonial Jamaica with the responsibility for health care passing from the hands of planters to charitable institutions and later to government institutions. Discusses the first independence five year plan in which priority was given to increasing hospital capacity but little attention paid to primary health care. Contends that expenditure on health care was only six percent of total government expenditure despite the buoyancy in economic expansion. Attributes the slow progress in some areas to government's tendency of equating health care with expensive hospital services. Discusses the 1978 to 1982 Five Year Plan with its slogan that health care is a fundamental right. Comments on the programmes stress on more effective use of existing workers and the redefinition of roles and extensive inservice training and on the improvement in nutrition and the increased number of health centres. Points to the neglect in maintaining existing infrastructure and to the attrition among the health personnel. Comments on the adverse effects of structural adjustment policies of the 1980s on health and on recent policies which seem to reflect a departure from those of 1978-1982. Concludes that, in the short run, present policies will impact negatively on health, which in turn will affect the human resources and inhabit the country's growth potential.