Bulletin of the World Health Organization
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Bull. World Health Organ. · Jan 1991
Prevention and control of haemophilia: memorandum from a joint WHO/WFH meeting (World Federation of Haemophilia)
Haemophilia, the commonest hereditary bleeding disorder, arises because of the absence of, decrease in, or deficient functioning of plasma coagulation factor VIII or factor IX. With rare exceptions, exclusively males are affected. This Memorandum summarizes the discussions and recommendations for the prevention and control of haemophilia made by participants at a joint WHO/World Federation of Haemophilia Meeting, held in Geneva on 26-28 March 1990.
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Observations made during the epidemics in Côte d'Ivoire (1982), Burkina Faso (1983), Nigeria (1986 and 1987) and Mali (1987), together with studies conducted in the last 10 years, particularly in Côte d'Ivoire, now make it possible, without calling into question the dynamics of yellow fever virus circulation in space and time, to redefine some features of the pattern suggested in 1977 and refined on a number of occasions up to 1983. The endemicity area is still the region of epizootic and enzootic sylvatic circulation, and contains the natural focus and the endemic emergence zone. --The natural focus is no longer confined to the forest alone, now that transovarial transmission has been demonstrated. --The endemic emergence zone is tending to become conterminous with the endemicity area on account of increasing deforestation. Emergence in forest regions, due to Aedes africanus, is still few and isolated, unlike that observed in savanna regions where A. furcifer is the major vector. ⋯ These epidemics can only occur in the endemicity area. --Sylvatic epidemics occur in villages, but only involve the sylvatic vectors. They result from a conjunction of a very large number of emergences for which A. furcifer is almost always mainly responsible, and occur in the endemicity area, usually close to the emergence front. Transmission is never strictly interhuman, as the same vector populations are responsible for epizootic and epidemic transmission.(ABSTRACT TRUNCATED AT 400 WORDS)