Bulletin of the World Health Organization
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Bull. World Health Organ. · Jan 1994
Comparative StudyAn evaluation of the HemoCue for measuring haemoglobin in field studies in Jamaica.
The HemoCue system utilizes the principle of oxidation of haemoglobin to hemiglobin by sodium nitrite and the subsequent conversion of hemiglobin to hemiglobinazide by sodium azide. The reagents for these reactions are contained within a small disposable microcuvette of approximately 10 microliters in volume. ⋯ We compared haemoglobin values obtained by the HemoCue system with those from the Coulter Counter S-Plus IV in 366 pregnant women in urban Jamaica, and found a highly significant correlation (r = 0.78, P < 0.01). However, because of the convenience and ease of use of this instrument and considering the relatively high cost, we recommend it for use only as a research tool in field studies where accurate and rapid haemoglobin determinations are required.
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Bull. World Health Organ. · Jan 1994
Design, content and financing of an essential national package of health services.
A minimum package of public health and clinical interventions, which are highly cost-effective and deal with major sources of disease burden, could be provided in low-income countries for about US$ 12 per person per year, and in middle-income countries for about $22. Properly delivered, this package could eliminate 21% to 38% of the burden of premature mortality and disability in children under 15 years and 10-18% of the burden in adults. ⋯ Governments should ensure that, at the least, poor populations have access to these services. Additional public expenditure should then go either to extending coverage to the non-poor or to expansion beyond the minimum collection of services to an essential national package of health care, including somewhat less cost-effective interventions against a larger number of diseases and conditions.
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A meeting of international experts exchanged information on recent activities dealing with new, emerging and re-emerging diseases, discussed ways of responding to this problem and to other communicable disease threats, and reviewed WHO's activities and role in this area. This Memorandum summarizes the various presentations and concludes with the recommendations and specific tasks for action at every level.
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Bull. World Health Organ. · Jan 1994
ReviewNutritional status as a predictor of child survival: summarizing the association and quantifying its global impact.
By pooling the results from five previously published prospective studies, we have obtained estimates of the relative risks of mortality among young children 6-24 months after they had been identified as having mild-to-moderate or severe malnutrition. These risk estimates, along with global malnutrition prevalence data, were then used to calculate the total number of young-childhood deaths "attributable" to malnutrition in developing countries. Young children (6-60 months of age) with mild-to-moderate malnutrition (60-80% of the median weight-for-age of the reference population) had 2.2 times the risk of dying during the follow-up period than their better nourished counterparts (> 80% of the median reference weight-for-age). ⋯ Each year approximately 2.3 million deaths of young children in developing countries (41% of the total for this age group) are associated with malnutrition. The comparability of studies, methods used to derive pooled values, potentially confounding factors that may influence risk estimates, and the validity of the results are discussed. Child survival programmes should assign greater priority to the control of childhood malnutrition.
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Bull. World Health Organ. · Jan 1994
Comparative StudyEvaluation of the alkaline haematin D-575 method for haemoglobin estimation in east Africa.
In many health facilities in east Africa, haemoglobin estimation is performed using visual colour comparison methods. Efforts to establish colorimetric methods face numerous constraints, including the unavailability of standards for quality control. ⋯ The method has a precision of +/-0.3 g/dl (coefficient of variation = (1.8%) for whole blood, and is suitable for use with fixed-wavelength haemglobinometers (lambda = 565 nm) or with colorimeters at lambda = 580 nm. Stable quality control standards could be prepared at provincial, zonal, or reference laboratories and distributed regularly to outlying laboratories.