Tropical medicine & international health : TM & IH
-
Trop. Med. Int. Health · May 1999
Randomized Controlled Trial Clinical TrialEvaluation of the SPf66 vaccine for malaria control when delivered through the EPI scheme in Tanzania.
Malaria control programmes need to protect young children, who bear the brunt of malaria disease and death in Africa. The development of a vaccine is a priority if improved and sustained malaria control is to be achieved. The best use of a vaccine in Africa will be achieved if it can be delivered through the expanded programme of immunization (EPI). We conducted a trial designed to evaluate the efficacy of SPf66 vaccine for malaria control when delivered through the EPI scheme in Tanzania. ⋯ This has been the first trial of a malaria vaccine among very young infants. It provides information on the safety of peptide vaccines administered at this early age as well as their capacity to induce immune responses without negatively interacting with EPI vaccines. Given the modest protection previously documented in older age groups and the lack of efficacy in younger infants, this vaccine in its current alum-based formulation does not appear to have a role in malaria control in sub-Saharan Africa. The lack of efficacy found in this trial also raises concerns about potential difficulties of inducing protective immune responses against malaria through immunization in infants.
-
Trop. Med. Int. Health · Jun 1998
Multicenter StudyVerbal autopsies for adult deaths: their development and validation in a multicentre study.
Verbal autopsy (VA) has been widely used to ascertain causes of child deaths, but little is known about the usefulness of VA for adult deaths. This paper describes the process used to develop a VA tool for adult deaths and the results of a multicentre validation of this tool. ⋯ VAs by a panel of physicians performed better than an opinion-based algorithm. The validity of VA diagnosis was highest for AFI, direct maternal causes, TB/AIDS, tetanus, rabies and injuries.
-
Trop. Med. Int. Health · Apr 1998
Attacking poverty and improving health: a report on the WHO/State of Maryland International Health Congress, Baltimore, September 1997.
An international meeting, 'Investment Strategies for Healthy Urban Communities', in Baltimore in September 1997 called on the the business community, city authorities and the health professions to reduce poverty and its adverse health consequences, especially in urban areas, in both the industrialized and developing world. In addition to issuing the Baltimore Charter on partnership for a healthy urban future, the meeting had two main outcomes: the innovative concept of Business for Health, championed by progressive business leaders from Australia, Europe and the United States, to promote business principles to reduce poverty, create enterprises and improve people's health, especially in developing countries; and the establishment by health professionals of an information network between cities and countries on poverty and ill-health. Two follow-up meetings in London in December 1997 resulted in an action plan to create networks of health professional groups and representatives of the business community.
-
To study the quality of diagnostic practice in rural Burkina Faso. ⋯ The low diagnostic quality of the outpatient consultations in the studied area indicates that this issue has been neglected in national public health initiatives. But examination skills are good and diagnostic guidelines may have had a positive effect on the diagnostic quality.
-
Trop. Med. Int. Health · Oct 1997
Comparative StudyPoverty and mortality among the elderly: measurement of performance in 33 countries 1960-92.
This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960-92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. ⋯ High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.