Articles: disease.
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Randomized Controlled Trial Clinical Trial
Randomised controlled trial of clinical outcome after chest radiograph in ambulatory acute lower-respiratory infection in children.
When available, chest radiographs are used widely in acute lower-respiratory-tract infections in children. Their impact on clinical outcome is unknown. ⋯ Chest radiograph did not affect clinical outcome in outpatient children with acute lower-respiratory infection. This lack of effect is independent of clinicians' experience. There are no clinically identifiable subgroups of children within the WHO case definition of pneumonia who are likely to benefit from a chest radiograph. We conclude that routine use of chest radiography is not beneficial in ambulatory children aged over 2 months with acute lower-respiratory-tract infection.
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This descriptive study systematically described the quality and intensity of adolescents' pain during the progression of labor. The Gaston-Johansson Pain-o-Meter was administered to 33 adolescents during the three labor phases (2-4 cm, 5-7 cm, and 8-10 cm) following a contraction. The most frequently selected sensory words were cramping in Phase I and pressing in Phases II and III. ⋯ At-test of independent samples found that quality and intensity pain scores for primiparous and multiparous adolescent participants were not significantly different during the progression of labor. The findings of the study illustrate the value of using objective measures, such as the Gaston-Johansson Pain-O-Meter and the Gaston-Johansson Pain-O-Meter Visual Analogue Scale, to assess pain during labor. The study also demonstrated that nurses can use these tools with minimal training.
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To examine rates of HIV-1 and sexually transmitted disease (STD) among pregnant and postpartum women in urban Malawi, Africa. ⋯ Among urban childbearing women in Malawi, incidence of HIV is highest among young women while, currently, prevalence is highest among older women. Recent declines in STD prevalence suggest that HIV prevention programs are having an impact either through improved STD diagnosis and treatment or reduced risk behaviors. Sequential cross-sectional STD prevalence measures may be useful in monitoring effectiveness of STD and HIV prevention activities.
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To assess the effects of HIV-1 and other sexually transmitted infections on pregnancy, we undertook cross-sectional and prospective studies of a rural population in Rakai district, Uganda. ⋯ Pregnancy prevalence is greatly reduced in HIV-1-infected women, owing to lower rates of conception and increased rates of pregnancy loss. HIV-1 surveillance confined to pregnant women underestimates the magnitude of the HIV-1 epidemic in the general population.
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Bull. World Health Organ. · Jan 1998
Approaches to control sexually transmitted diseases in Haiti, 1992-95.
Despite major obstacles, activities to control sexually transmitted diseases (STDs) were initiated in Haiti in 1992 in collaboration with local nongovernmental organizations. The approaches included review of available local data, assessment of STD case management practices and constraints, and development of specific STD control activities at the primary health care level, such as systematic screening of all pregnant women for syphilis and improved comprehensive syndrome-based STD case management. The activities included conduct of local studies, presentation and dissemination of results to key audiences, training of health care providers, improvement of local capacities, and consensus-building on implementation of STD control approaches. ⋯ Lessons learned included the importance of local data generation and of communication and collaboration with various institutions for consensus-building, the need for continued training, and field supervision to ensure behaviour change among STD care providers. A national STD control programme should be implemented as soon as possible in both the public and private sector. External funding will remain critical to control this important public health problem in Haiti.