Journal of the New Zealand Medical Association, 12-August-2005, Vol 118 No 1220
This Issue in the Journal
Prevalence and risk factors for Chlamydia trachomatis infection in female New Zealand university students
M Baker, J Ortega-Benito, N Garret, C Bromhead, K Leslie, J MacDonald, A McNicholas
Chlamydia is the most commonly diagnosed sexually transmitted infection in New Zealand. This research offered Chlamydia testing, using a urine specimen, to female students aged 18–25 years attending a university student health service in 2003. It found that 2.7% (19 out of 715) were infected with this bacteria without knowing it. It also found that a majority (60%) of students were willing to participate in this screening programme. This study provides more evidence that New Zealand needs an adequately resourced and evidence-based Chlamydia control strategy. This strategy should contain guidelines on screening in a range of settings, including universities, as well as approaches for preventing Chlamydia infection.
Low birth weight and cardiovascular risk factors in Auckland adolescents: a retrospective cohort study
B Daly, R Scragg, D Schaaf, P Metcalf
The proposal, that poor fetal development (such as low birth weight) is associated with increased cardiovascular disease risk later in life, was examined in 855 hospitals-born Auckland adolescents. We found that blood pressure, blood cholesterol, and blood glucose levels were unrelated to low birthweight but positively associated with current adolescent weight. These results indicate that prevention of cardiovascular risk factors in adolescence should focus on lowering current weight rather than trying to achieve higher births weights among at-risk populations.
Coeliac disease diagnosed at Starship Children’s Hospital: 1999–2002
E Westerbeek, S Mouat, A Wesley, S Chin
Coeliac disease is a condition caused by an inability to digest gluten, which often results in bowel symptoms, weight loss, or failure to gain weight. It is relatively common in New Zealand. Our study reviewed the clinical presentation and testing of children diagnosed with coeliac disease at Starship Children’s Hospital over a 4-year period between January 1999 and December 2002; 48 patients were studied (range 1.6 to 15.7 years). Older (>5 years) children mostly presented to hospital with abdominal pain, while younger children mostly presented with ‘failure to thrive’; children are mostly being first diagnosed at an older age. Anti-endomysial and tissue transglutaminase antibodies are reliable tests for coeliac disease. However, in younger patients or if there is a high clinical index of suspicion of coeliac disease, small bowel biopsy should be performed, even if the anti-endomysial and tissue transglutaminase antibody tests are negative.
Sore throat management in New Zealand general practice
M Kljakovic, P Crampton
Rheumatic fever is an important sequel of throat infections in some areas of New Zealand, particularly for at-risk Maori or Pacific Island children aged 5–14 years. This study found that sore throat remains one of the top-10 symptoms patients present to their GP over the last decade. It was encouraging that more at-risk patients attended their GP with sore throat than had been observed 10 years previously. The perceived urgency of visit to the GP was greatest in parents worried about their young children. However, a wait for over a week with a sore throat among the at-risk group of 5–14 years may influence the attack rate of rheumatic fever. Most GPs were certain of their diagnoses; however, fewer GPs explicitly stated viral causes of sore throat than might be expected given the higher prevalence of viral related sore throats in the community. 61% of sore throat patients were prescribed an antibiotic and 6.6% had a throat swab. Overall, GPs appeared to have different management policies for patients with sore throat who come from different ethnic backgrounds, as there was less swabbing of the throat and more prescribing of antibiotics for Maori and particularly Pacific Island patients compared to European patients.
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