Articles: disease.
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Information on the cost-effectiveness of malaria control is needed for the WHO Roll Back Malaria campaign, but is sparse. We used mathematical models to calculate cost-effectiveness ratios for the main prevention and treatment interventions in sub-Saharan Africa. ⋯ Cost-effective interventions are available. A package of interventions to decrease the bulk of the malaria burden is not, however, affordable in very-low-income countries. Coverage of the most vulnerable groups in Africa will require substantial assistance from external donors.
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A case of uterine perforation which occurred two months after the insertion of a Gynefix, a frameless filiform copper intrauterine device fixed into the fundal myometrium is described. Laparoscopic removal of the device had to be performed. The incidence of this complication is unknown. The appropriateness or need of assessing echo-graphically the myometrial thickness before the insertion and of controlling its correct position after the insertion remains uncertain.
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Prevalence of malnutrition among pre-school children can be used to determine the need for nutrition surveillance, nutritional care, or appropriate nutritional intervention programmes. Such data also indicate the target groups and where interventions are required. ⋯ These results show that malnutrition is still a serious public health problem in Kenya and requires urgent attention. The problem since the first survey in 1977 shows an upward trend, suggesting deterioration over the years. Well thought out and targeted intervention programmes are long overdue. The results of this survey and others emphasize the importance of having a well established surveillance system which would ensure necessary and timely action.
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The Institute of Medicine has proposed that the amount of disease-specific research funding provided by the National Institutes of Health (NIH) be systematically and consistently compared with the burden of disease for society. ⋯ The amount of NIH funding for research on a disease is associated with the burden of the disease; however, different measures of the burden of disease may yield different conclusions about the appropriateness of disease-specific funding levels.
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Severely malnourished children have high mortality rates. Death commonly occurs during the first 48 h after hospital admission, and has been attributed to faulty case-management. We developed a standardised protocol for acute-phase treatment of children with severe malnutrition and diarrhoea, with the aim of reducing mortality. ⋯ Compared with non-protocol management, our standardised protocol resulted in fewer episodes of hypoglycaemia, less need for intravenous fluids, and a 47% reduction in mortality. This standardised protocol should be considered in all children with diarrhoea and severe malnutrition.