Browsing by Author "Williams, Anthony"

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    Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases
    (BioMed Central Ltd, 2010) Jarvis, Joseph; Meintjes, Graeme; Williams, Anthony; Brown, Yolande; Crede, Tom; Harrison, Thomas
    BACKGROUND: The presentation and causes of adult meningitis in South Africa have changed substantially as a result of HIV. Knowledge of aetiology and laboratory findings in patients presenting with meningitis are important in guiding management. We performed a retrospective study to determine these findings in a setting of high HIV and TB prevalence in Cape Town. METHODS: Patients undergoing lumbar punctures between 1st January 2006 and 31st December 2008 at a public sector referral hospital were studied. Cases were classified by microbiological diagnosis, or in the absence of definitive microbiology as 1) normal CSF (neutrophils [less than or equal to] 1 x 106/L, lymphocytes [less than or equal to] 5 x 106/L, protein [less than or equal to] 0.5 g/dL, glucose [greater than or equal to]1.5 mmol/L), 2) minor abnormalities (neutrophils 2-5, lymphocytes 6-20, protein 0.51-1.0, glucose 1.0-1.49) or 3) markedly abnormal (neutrophils>5, lymphocytes>20, protein>1.0, glucose<1.0). RESULTS: 5578 LPs were performed on 4549 patients, representing 4961 clinical episodes. Of these, 2293 had normal CSF and 931 had minor abnormalities and no aetiology identified. Of the remaining 1737, microbiological diagnoses were obtained in 820 (47%). Cryptococcus accounted for 63% (514) of microbiological diagnoses, TB for 28% (227), bacterial meningitis for 8% (68). Of the remaining 917 who had marked abnormalities, the majority (59%) had a sterile lymphocytic CSF. Of note 16% (81) patients with confirmed Cryptococcus, 5% (12) with TB and 4% (3) with bacterial meningitis had normal CSF cell-counts and biochemistry. CONCLUSIONS: Cryptococcal and tuberculous meningitis are now the commonest causes of adult meningitis in this setting. TB meningitis is probably underdiagnosed by laboratory investigation, as evidence by the large numbers presenting with sterile lymphocytic markedly abnormal CSFs.
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    Energy poverty in South Africa: widening access to basic energy services
    (1993) van Horen, Clive; Afrane-Okese, Yaw; Eberhard, Anton; Trollip, Hilton; Williams, Anthony
    This report contains a description and analysis of the current energy consumption patterns of poor households in South Africa, and proposes a range of policies which can improve significantly the access of the poor to adequate and affordable energy services. It draws on the work of the Energy Policy Research and Training Project, a two-year policy research project involving some twenty person-years of effort, being conducted at the Energy for Development Research Centre (EDRC).
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    Low-smoke fuels as a solution to household air pollutions problems: A synthesis of current research
    (1995) Dickson, Bruce; van Horen, Clive; Williams, Anthony
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    Rural Energy and Development: improving energy supplies for 2 billion people: a World Bank best practice paper (Draft)
    (1996) World Bank
    This paper envisages a renewed commitment by the World Bank to support its member countries' efforts to extend modem energy supplies to populations still without them and to promote the sustainable supply and use of biofuels for as long as they remain important sources of energy. Modem energy is defined to include new forms of renewable energy. The purposes of the paper are threefold. First, it argues why meeting the energy needs of rural-and also unserved urban- populations is a priority for sustainable economic development. Second, it reviews twenty-five years of experience with rural energy programs in developing countries; it finds that notwithstanding some mistakes, in any approaches are working well and provide an excellent basis for a substantial expansion of effort to address rural energy problems. Third, it seeks to disseminate and share these lessons of experience with others on whom much responsibility will fall for the implementation of policies; indeed, the preparation of the paper itself entailed extensive sharing of experiences between representatives of the Bank, industry, and numerous governmental and nongovernmental organizations.