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Gender differences in health and health care utilisation in various ethnic groups in the Netherlands: a cross-sectional study
Annette AM Gerritsen, Walter L Devillé
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-109
Abstract: Data from the second Dutch National Survey of General Practice (2000–2002) were used. A total of 7,789 persons from the indigenous population and 1,512 persons from the four largest migrant groups in the Netherlands – Morocco, Netherlands Antilles, Turkey and Surinam – aged 18 years and older were interviewed. Self-reported health outcomes studied were general health status and the presence of acute (past 14 days) and chronic conditions (past 12 months). And self-reported utilisation of the following health care services was analysed: having contacted a general practitioner (past 2 months), a medical specialist, physiotherapist or ambulatory mental health service (past 12 months), hospitalisation (past 12 months) and use of medication (past 14 days). Gender differences in these outcomes were examined within and between the ethnic groups, using logistic regression analyses.In general, women showed poorer health than men; the largest differences were found for the Turkish respondents, followed by Moroccans, and Surinamese. Furthermore, women from Morocco and the Netherlands Antilles more often contacted a general practitioner than men from these countries. Women from Turkey were more hospitalised than Turkish men. Women from Morocco more often contacted ambulatory mental health care than men from this country, and women with an indigenous background more often used over the counter medication than men with an indigenous background.In general the self-reported health of women is worse compared to that of men, although the size of the gender differences may vary according to the particular health outcome and among the ethnic groups. This information might be helpful to develop policy to improve the health status of specific groups according to gender and ethnicity. In addition, in some ethnic groups, and for some types of health care services, the use by women is higher compared to that by men. More research is needed to explain these differences.Gender differences in h
Provision and need of HIV/AIDS services in the City of Tshwane Metropolitan Municipality, 2010
Annette AM Gerritsen, Janine S Mitchell, Brenda White
South African Medical Journal , 2012,
Abstract: Objectives. To determine the need for HIV/AIDS service provision in the City of Tshwane Metropolitan Municipality (CTMM), especially in municipal areas. Methods. The Foundation for Professional Development initiated the Compass Project. Using a questionnaire, data were collected during May - June 2010 from organisations providing HIV/AIDS services in the CTMM (organisational information and types of HIV/AIDS services). The need for HIV counselling and testing (HCT), antiretroviral treatment (ART), prevention of mother-tochild transmission (PMTCT), and care for orphans and vulnerable children (OVC) was estimated using data from various sources. Results. A total of 447 service providers was included in the study: 72.3% non-governmental organisations (NGOs); 18.1% in the public sector; 5.1% in the private sector; and 4.5% faithbased organisations. The majority of the prevention- (70.2%) and support-related services (77.4%) were provided by NGOs, while the majority of treatment-related services originated from the public sector (57.3%). Service need estimates included: HCT – 1 435 438 adults aged 15 - 49 years (11 127/service provider); total ART – 75 211 adults aged 15+ years (1 213/service provider); ART initiation – 30 713 adults aged 15+ years (495/service provider); PMTCTHCT – 30 092 pregnant women (510/service provider); PMTCTART – 7 734 HIV+ pregnant women (221/service provider); and OVC care – 54 590 children (258/service provider). Conclusions. Service gaps remain in the provision of HCT, PMTCT-ART and OVC care. ART provision must be increased, in light of new treatment guidelines from the Department of Health. S Afr Med J 2012;102:44-46
Malaria incidence in Limpopo Province, South Africa, 1998–2007
Annette AM Gerritsen, Philip Kruger, Maarten van der Loeff, Martin P Grobusch
Malaria Journal , 2008, DOI: 10.1186/1475-2875-7-162
Abstract: Routinely collected data on diagnosed malaria cases and deaths were available through the provincial malaria information system. In order to calculate incidence rates, population estimates (by sex, age and district) were obtained from Statistics South Africa. The Chi squared test for trend was used to detect temporal trends in malaria incidence over the seasons, and a trend in case fatality rate (CFR) by age group. The Chi squared test was used to calculate differences in incidence rate and CFR between both sexes and in incidence by age group.In total, 58,768 cases of malaria were reported, including 628 deaths. The mean incidence rate was 124.5 per 100,000 person-years and the mean CFR 1.1% per season. There was a decreasing trend in the incidence rate over time (p < 0.001), from 173.0 in 1998–1999 to 50.9 in 2006–2007. The CFR was fairly stable over the whole period. The mean incidence rate in males was higher than in females (145.8 versus 105.6; p < 0.001); the CFR (1.1%) was similar for both sexes. The incidence rate was lowest in 0–4 year olds (78.3), it peaked at the ages of 35–39 years (172.8), and decreased with age from 40 years (to 84.4 for those ≥ 60 years). The CFR increased with increasing age (to 3.8% for those ≥ 60 years). The incidence rate varied widely between districts; it was highest in Vhembe (328.2) and lowest in Sekhukhune (5.5).Information from this study may serve as baseline data to determine the course and distribution of malaria in Limpopo province over time. In the study period there was a decreasing trend in the incidence rate. Furthermore, the study addresses the need for better data over a range of epidemic-prone settings.South Africa is at the southern extreme of malaria distribution in Africa. Malaria is endemic in the low-altitude areas of the northern and eastern parts of South Africa along the border with Mozambique and Zimbabwe, with transmission taking place mainly in Limpopo, Mpumalanga and KwaZulu-Natal provinces [1]. Malaria
Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study
Annette AM Gerritsen, Inge Bramsen, Walter Devillé, Loes HM van Willigen, Johannes E Hovens, Henk M van der Ploeg
BMC Public Health , 2004, DOI: 10.1186/1471-2458-4-7
Abstract: The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands.The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose.This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees.In the Netherlands, health surveys are frequently conducted to assess the health of the population and the utilisation of health care services [1,2]. Due to language and cultural problems these surveys often exclude (first generation) immigrants. However, in recent years, much research has focused on the four largest immigrant groups, i.e. people from Surinam, the Netherlands Antilles, Turkey and Morocco [1,3]. Although refugees have been coming to the Netherlands since the eighties, their numbers were not large enough and their backgrounds were too diverse for them to be the subject of large-scale epidemiological research. However, it is important that research also focuses on these grou
Splinting or surgery for carpal tunnel syndrome? Design of a randomized controlled trial [ISRCTN18853827]
Annette AM Gerritsen, Rob JPM Scholten, Willem JJ Assendelft, Herman Kuiper, Henrica CW de Vet, Lex M Bouter
BMC Neurology , 2001, DOI: 10.1186/1471-2377-1-8
Abstract: Patients of 18 years and older, with clinically and electrophysiologically confirmed idiopathic carpal tunnel syndrome, are recruited by neurologists in 13 hospitals. Patients included in the study are randomly allocated to either open carpal tunnel release or wrist splinting during the night for at least 6 weeks. The primary outcomes are general improvement, waking up at night and severity of symptoms (main complaint, night and daytime pain, paraesthesia and hypoesthesia). Outcomes are assessed up to 18 months after randomization.CTS is a compression neuropathy of the median nerve at the wrist. Any condition that reduces the size of the carpal tunnel or increases the volume of its content may cause compression of the median nerve. In the majority of cases the cause of CTS is unknown, referred to as idiopathic CTS. However, there are numerous medical conditions associated with CTS, such as diabetes mellitus, thyroid disease, rheumatoid arthritis and pregnancy. [1] The prevalence of CTS in the Netherlands was found to be 0.6% in men and 9.2% in women (age 25–74 years). [2] The symptoms of CTS include pain, paraesthesias and hypoesthesias in the hand, in the area innervated by the median nerve, and often occur or worsen during the night or early morning, waking the patient up. Furthermore, there may also be loss of sensibility and strength, causing difficulties in performing the activities of daily life and work. The clinical diagnosis of CTS can be confirmed by electrodiagnostic studies, which have been found to be highly sensitive (49% to 84%) and specific (95% or greater). [3] Clinical tests (e.g. assessing thenar atrophy, performing provocative tests, Semmes-Weinstein monofilament testing) have been shown to have little diagnostic value, but are nevertheless still widely used. [4]For the treatment of CTS, several conservative and surgical options are available. The most commonly used conservative treatment options are wrist splinting, injection of corticosteroids
Surgery is more cost-effective than splinting for carpal tunnel syndrome in the Netherlands: results of an economic evaluation alongside a randomized controlled trial
Ingeborg BC Korthals-de Bos, Annette AM Gerritsen, Maurits W van Tulder, Maureen PMH Rutten-van M?lken, Herman J Adèr, Henrica CW de Vet, Lex M Bouter
BMC Musculoskeletal Disorders , 2006, DOI: 10.1186/1471-2474-7-86
Abstract: Patients at 13 neurological outpatient clinics with clinically and electrophysiologically confirmed idiopathic CTS were randomly allocated to splinting (n = 89) or surgery (n = 87). Clinical outcome measures included number of nights waking up due to symptoms, general improvement, severity of the main complaint, paraesthesia at night and during the day, and utility. The economic evaluation was performed from a societal perspective and involved all relevant costs.There were no differences in costs. The mean total costs per patient were in the surgery group EURO 2,126 compared to EURO 2,111 in the splint group. After 12 months, the success rate in the surgery group (92%) was significantly higher than in the splint group (72%). The acceptability curve showed that at a relatively low ceiling ratio of EURO 2,500 per patient there is a 90% probability that surgery is cost-effective.In the Netherlands, surgery is more cost-effective compared with splinting, and recommended as the preferred method of treatment for patients with CTS.Carpal tunnel syndrome (CTS), caused by compression of the median nerve at the wrist. In the Netherlands, the prevalence of electrophysiologically confirmed CTS in the adult general population was found to be 0.6% in men and 3.4% in women [1]. In Sweden, prevalence was 2.1% and 3.0%, respectively [2]. Patients with CTS are often treated with surgery or conservative methods of treatment (e.g. wrist splinting). A systematic review showed that open carpal tunnel release was the most suitable surgical technique [3]. One Cochrane review found that a hand brace and carpal bone mobilisation significantly improved symptoms and ultrasound treatment, oral steroid treatment and yoga significantly reduced pain [4]. Another Cochrane review demonstrated clinical improvement of symptoms of carpal tunnel syndrome at one month following local corticosteroid [5]. Two recent systematic reviews confirmed these findings [6,7]. There is still no consensus on whether s
Randomized controlled trials of malaria intervention trials in Africa, 1948 to 2007: a descriptive analysis
Vittoria Lutje, Annette Gerritsen, Nandi Siegfried
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-61
Abstract: Systematic searches for malaria RCTs were conducted using electronic databases (Medline, Embase, the Cochrane Library), and an African geographic search filter to identify RCTs conducted in Africa was applied. Results were exported to the statistical package STATA 8 to obtain a random sample from the overall data set. Final analysis of trial characteristics was done in a double blinded fashion by two authors using a standardized data extraction form.A random sample of 92 confirmed RCTs (from a total of 943 reports obtained between 1948 and 2007) was prepared. Most trials investigated drug treatment in children with uncomplicated malaria. Few trials reported on treatment of severe malaria or on interventions in pregnant women. Most trials were of medium size (100-500 participants), individually randomized and based in a single centre. Reporting of trial quality was variable. Although three-quarter of trials provided information on participants' informed consent and ethics approval, more details are needed.The majority of malaria RCT conducted in Africa report on drug treatment and prevention in children; there is need for more research done in pregnant women. Sources of funding, informed consent and trial quality were often poorly reported. Overall, clearer reporting of trials is needed.Almost 90% of all malaria cases occur in sub-Saharan Africa, with the major burden on children under five years of age and pregnant women [1]. Current measures to control malaria show some degree of success: more than one-third of malaria-endemic countries, including nine African countries, have reported a reduction of malaria cases of >50% between 2000 and 2008 [2,3]. However, malaria remains a major public health problem in Africa, and more work is needed to evaluate new interventions and those currently in use.Randomized controlled trials (RCTs) provide unbiased estimates of the effects of an intervention [4], and allow formal synthesis of results between trials in systematic revie
Clinical practice guidelines within the Southern African development community: a descriptive study of the quality of guideline development and concordance with best evidence for five priority diseases
Tamara Kredo, Annette Gerritsen, Johan van Heerden, Shaun Conway, Nandi Siegfried
Health Research Policy and Systems , 2012, DOI: 10.1186/1478-4505-10-1
Abstract: We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated.We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline.This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders and transparency of process. A regional guideline support committee could harness local capacity to support context appropriate guideline development.Clinical practice guidelines bridge the gap between policy and practice and should be based on up-to-date, high quality research findings [1,2]. Reducing the burden of disease in resource-poor settings relies on the availability of such evidence-based
Le plaisir de se voir digitalis . Toespraak bij de lancering van neerlandistiek.nl op 14 juni 2001.
Gerritsen, W.P.
Neerlandistiek.nl , 2001,
Het beeld van feodaliteit en ridderschap in middeleeuwse litteratuur
W.P. Gerritsen
BMGN : Low Countries Historical Review , 1974,
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