Articles: disease.
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Bull. World Health Organ. · Jan 1996
ReviewPerformance and potency of tetanus toxoid: implications for eliminating neonatal tetanus.
Neonatal tetanus (NT) is a major cause of mortality in developing countries, with over 400,000 deaths estimated to occur annually. WHO has adopted the goal of eliminating NT worldwide, and a major strategy for its prevention is the administration of at least two properly spaced doses of tetanus toxoid (TT) to women of childbearing age in high-risk areas to protect passively their newborns at birth. In certain countries the locally produced TT vaccine has been shown to be subpotent, while other countries have reported NT among infants born to vaccinated women. ⋯ Of these, 15 lots from eight manufacturers in seven countries had potency values below WHO requirements. TT potency can also be compromised by improper vaccine handling. To eliminate neonatal tetanus worldwide requires assurance that all doses of TT meet WHO production and quality requirements and that the field effectiveness of TT is monitored through systematic NT case investigations and assessment of coverage.
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Tuberculosis (TB) has remained the 5th leading cause of death in Thailand for several years. There has been a slight change in the total number of TB cases notified since 1985 when the first case of HIV infection was reported. Although there is an increase in the incidence of TB in HIV-infected cases, the percentage of multidrug-resistant tuberculosis (MDR-TB) in this group is the same as in the HIV-negative group (2.7%). ⋯ A prospective study showed a success rate of 67% with no adverse effects. The current Bangkok multicenter trials on ofloxacin 600 mg daily combined with pyrazinamide, p-aminosalicylate, amikacin and ethambutol are ongoing. Good organization of ambulatory TB management combined with directly observed therapy will probably help to reduce the incidence of MDR-TB.
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Rev. Inst. Med. Trop. Sao Paulo · Jan 1996
Aerobic bacteria, Chlamydia trachomatis, Pneumocystis carinii and Cytomegalovirus as agents of severe pneumonia in small infants.
The authors studied 58 infants hospitalized for pneumonia in a semi-intensive care unit. Age ranged from 1 complete to 6 incomplete months. The infants were sent from another hospital in 20 cases and from home in a further 38. ⋯ The investigation was carried out prospectively on the etiological agents associated with respiratory infection to look for evidence of aerobic bacteria (blood cultures), Chlamydia trachomatis and Cytomegalovirus (serology), and Pneumocystis carinii (direct microscopy of tracheal aspirated material). The following infectious agents were diagnosed in 21 children (36.2%): Aerobic bacteria (8), Chlamydia trachomatis (5), Pneumocystis carinii (3), Cytomegalovirus (3), Cytomegalovirus and Chlamydia trachomatis (1), Aerobic bacteria and Cytomegalovirus (1). Seven cases of infection by Chlamydia trachomatis and/or Cytomegalovirus were diagnosed out of the 12 cases with pulmonary interstitial involvement.
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HIV-1 infection, initially described as "slim disease", was first recognized in Uganda in 1982, and is now a predominant health problem. Approximately 1.5 million Ugandans are now infected, largely through heterosexual transmission. In many areas half of adult deaths are now caused by HIV. ⋯ Mother to child transmission of HIV accounts for about 10% of total cases, with a transmission rate of 26% in two studies. Epidemiological and clinical research programs are well developed in Uganda, especially in areas of tuberculosis, maternal and paediatric HIV infection and sexually transmitted infections. Societal openness, a multisectoral approach by the government and innovative programmes, including large-scale HIV testing and counselling and the pioneering work of The AIDS Support Organization (TASO), distinguish the Ugandan response to the epidemic.
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To identify factors associated with failure to return for HIV post-test counselling in pregnant women in Kigali (Rwanda). ⋯ Innovative approaches for HIV testing and counselling programs are needed and the importance of psychosocial and cultural factors associated with HIV testing should be emphasized in African populations.