Morbidity in general practice in Barbados

From September 1977, 11 general practitioners took part in a survey of 12 months' duration in which they recorded morbidity at every doctor-patient encounter. 35,143 patients made 53,094 encounters and a total of 62,932 problems were identified. The most common reason for going to the doctor was for examination with no disease detected. Acute upper respiratory tract infections, hypertension and pregnancy were the 3 most common specific problems with which the doctors dealt. The results demonstrated some features of general practice such as the abundance of the common diseases, the need to be alert to the infrequent occurrence of wide range major disease, pre-symptomatic screening of the healthy "at risk" patient and the problems of the ill-defined conditions. Comparisons with other surveys show some similarities in general practice morbidity, but also important differences that can be related to prevailing local conditions (AU)

Rheumatic fever and rheumatic heart disease in Barbados - abstract

This paper is a preliminary report based on the first 12 months of a rheumatic fever programme which is being carried out in Barbados. Data are presented on the natural history of the disease, the load of the disease on the community, the effectiveness of a programme of secondary prophylaxis and the prevalence of rheumatic heart disease among school children aged 5-11 years. In February, 1970, a rheumatic fever clinic was started at the Queen Elizabeth Hospital, to which patient diagnosed as having had rheumatic fever were referred. At the same time twice weekly visits to the paediatric ward to identify cases of rheumatic fever and weekly visits to primary schools were made. Sixty-one (61) patients were registered as having had documented evidence of previous acute rheumatic fever. Thirty-seven (37) of these had a residual valvulitis of which 23 were aged 12 years or less. The major valve affected was the mitral which was incompetent in 19 of 37 patients. Seventy-four (74) patients received monthly injection of penicillin. Information which is available on 71 of these patients showed that after 1 year 533 patient/month injections were received out of a possible total of 547. Nineteen (19) patients were admitted to the paediatric ward with definite first attack of acute rheumatic fever and 6 patients were admitted with a second or more attack. Prevalence of rheumatic heart disease among 3,882 primary school children aged 5-11 years was found to be per 1000. Preliminary analysis demonstrates the high degree of effectiveness of a recently instituted programme of secondary prophylaxis, the presence of chronic rheuamatic heart disease among children and the significant morbidity produced by rheumatic fever and rheumatic heart disease (AU)

Rheumatic fever and rheumatic heart disease in Barbados: detection and prophylaxis

The objectives of this study were to improve our methods of secondary prophylaxis of rheumatic fever and rheumatic heart disease in Barbados, to estimate the overall prevalence of these diseases and the relative load imposed by them on available health services, and to measure the yield, feasibility, and effectiveness of mass programmes for the detection and prophylactic management of rheumatic heart disease in schoolchildren. Improved methods of surveillance and follow up resulted in 97 percent adherence to therapy by patients on prophylactic penicillin. Thirty-four children, 27 with a first attack, were admitted with acute rheumatic fever, representing a 7 percent occupancy of children's medical beds during a twelve month period of the study. Out of a possible 3,942 schoolchildren aged 5-11 years, 3,882 (98 percent) were screened for rheumatic heart disease. Four cases (about 1 per 1,000) were discovered. (Summary)