East African medical journal
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The Sisterhood Method, a community-based survey technique, was used to estimate the Life Time Risk of a woman dying a maternal death in Southern Malawi. With this figure, the maternal mortality ratio for that area was calculated to be 409 deaths per 100,000 live births. ⋯ An in-depth questionnaire was then used to determine that 56% of these deaths occurred outside a health facility, largely due to lack of transportation or poor access to fixed health care facilities; 25% died from excessive hemorrhage; 20% from obstructed labour; 18% from abortion; 13% from sepsis; while eclampsia accounted for only 4% of the maternal deaths. This field experience with the Sisterhood Method technique combined with an in-depth questionnaire for determining causes of maternal deaths has provided useful information in a simple and cost-effective manner for use in planning intervention strategies designed to decrease maternal mortality.
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In 1985 at a World Health Organization (WHO) workshop on AIDS in Bangui, Central African Republic, a clinical case definition of Acquired Immune Deficiency Syndrome (AIDS) was developed for developing countries, such as sub-Saharan Africa, where sophisticated diagnostic equipment is not widely available. A particular cachectic syndrome, the "slim disease", which is highly suggestive of AIDS in Africa, constitutes the substratum for the clinical definition for AIDS. The WHO/Bangui definition in adults has a sensitivity of 60%, a specificity of 90%, and a high predictive value especially in endemic areas. ⋯ Its low sensitivity (about 35%) is in relation to its incapacity to diagnose many of the frequently observed secondary infection for paediatric AIDS according to the CDC criteria. The WHO/Bangui clinical definition for AIDS seems to be convenient for epidemiological surveillance of the HIV epidemic in Africa. Nevertheless, the low sensitivity and the low specificity result in the failure to detect some cases of full blown AIDS.
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A 9-year survey on tuberculosis control at Sololo General Hospital (Marsabit District) is presented. 700 patients were treated and followed up from 1982 to 1990. The paper deals with the major constraints of TB control in a nomadic population on the borderland with Ethiopia; it highlights the need of the short course regimen and the TB manyatta programme to increase the percentage of cured patients.
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Hunger and malnutrition in Africa have been on the increase since 1960's reaching a climax in the 1980's when over 150 million people were affected by one form or another. Methods so far used to solve the problem do not seem to succeed, but the scientists and leaders in Africa could now take the opportunity to consider and act on the problem in their own way. The formation of an African food and nutrition group to work with others on the problems, could give an impetus to this kind of initiative. A call is made to all African food and nutrition workers to combine efforts to harness Africa resources, which have not been fully utilized in solving the problem.
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In a study of 7,631 cases referred to the infectious diseases hospital, Nairobi with a diagnosis of measles, 7,447 cases had the diagnosis confirmed. The overall mortality was 17.5 per 1000 cases with 43.51 of all the deaths occurring in all children less than 12 months of age. A nutritional analysis revealed that children whose weight were below 80 of the Harvard median of weight for age stayed in hospital longest and had the highest mortality rate. Measles continues to offer increasing challenge in spite of the intensive vaccination programme presently being carried out.