Tropical and geographical medicine
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High caesarean birth rates are an issue of international public health concern. Determinants of caesarean birth are reviewed in order to formulate strategies to reduce these high rates. ⋯ The risks and safety of caesarean birth differ from place to place in this world. As the relative safety of the procedure is an important factor contributing to the rise of caesarean birth, the fact that this has only been achieved in some parts of the world should restrict the indications to perform the operation in the best interests of pregnant women.
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To assess prevalence of hair dyspigmentation, decurling, thinness and frailty, a random sample of more than 4,000 preschoolers, representative for a large area in Northern Zaire, was examined clinically and anthropometrically. Isolated dyspigmentation, isolated thinness and the combination of both were the most frequent signs (> 5%). Prevalence of hair signs did not differ according to sex or season. ⋯ Isolated dyspigmentation, however, was unrelated to WFA or marasmus. All signs occurred also in children with 'normal' WFA (SD > -2). In these children, hair signs were associated with the presence of clinical muscle wasting.