International journal of epidemiology
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Meningococcal disease is still a serious public health problem in many countries. A vaccine produced by Cuba was the first product against B meningococcus available on a large scale. In an attempt to control the increasing incidence of this serogroup in greater Rio de Janeiro, Brazil, the vaccine was used in 1990 in children aged 6 months-9 years. About 1.6 million children were vaccinated. ⋯ The results suggest that the vaccine produced by Cuba may offer protection against serogroup B meningococcal disease, but its effects may not be homogeneous.
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Acute respiratory infection (ARI) is a major cause of childhood morbidity and mortality in developing countries. Community surveys are used to determine the proportion of children with ARI for whom care is sought by questioning mothers about the signs and symptoms of illness episodes. The validity of this approach has been studied infrequently. ⋯ Maternal reporting of ARI symptoms is non-specific 2 and 4 weeks after diagnosis but may be useful for monitoring trends in the proportion of children with pneumonia who receive medical care. To maximize specificity, ARI programmes should generally use a recall period of 2 weeks.
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Health care in Zimbabwe is provided by both orthodox and traditional care providers. With formal medical services under economic strain it is important to understand the extent of consulting with traditional care providers and their effectiveness. ⋯ While members of the community appear to recognize physical problems and take them to medical care, traditional and orthodox medical consultations appear to be equally effective for non-specific pain or non-specific physical problems. The role of traditional medicine in relation to non-specific physical problems and psychological problems is one which deserves further examination from both clinical and administrative perspectives. Poverty appears to be associated with poorer outcomes; this is a potentially important issue in times of increasing economic hardship.
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The Discontinuity Index (DI), which measures the percentage of infants who were exclusively breastfed (EBF) at the beginning of a given age interval and had abandoned this mode of feeding at its end, and the relative weight of this discontinuation, was introduced and employed in the National Survey on Breast Feeding and Infant Feeding Practices carried out in Cuba in 1990. The aim of this article is to illustrate, through a specific example, the quality of DI as a simple procedure for assessing breastfeeding trends. ⋯ Discontinuity indices are useful complements to prevalence rates in epidemiological studies of breastfeeding. The separate analysis of discontinuation in different periods can be highly useful when comparing trends and in the study of the impact of breastfeeding promotion programmes focused on different age intervals.