Articles: disease.
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The complexities of current societal trends impose a daunting challenge to providers of maternal child health services. Demographers, anthropologists, sociologists, policy makers, and health care providers struggle to grasp the multiple issues in an effort to create useful strategies for the 21st century. ⋯ Legislative and policy efforts have focused new and much-needed attention on women as recipients and providers of health care. The realities of mothers in the work force, the epidemic of adolescent pregnancy, the swelling ranks of women and children in poverty, the increasing number of women with acquired immune deficiency syndrome, the new advances in reproductive technology, and the effect of population and immigration trends greatly influence the childbearing client of the future and create enormous pressures for critical problem solving.
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One hundred and three children (1% of seriously ill children referred to the Korle Bu Teaching Hospital in Accra) were admitted with bacterial meningitis over a 17 month period. 43 of these children had been ill for more than 4 days before arrival at our centre. The main causative organisms were S. pneumoniae (47.9%), Neisseria meningitides (38.4%) and Haemophilus influenzae (9.6%). All bacterial isolates were highly sensitive to ceftriaxone. ⋯ No significant difference was noted among the three treatment regimens of ceftriaxone alone, penicillin plus chloramphenicol, and ceftriaxone alone for 48 hours followed by penicillin/chloramphenicol combination. Our overall outcome would have been better if patients had been started on appropriate antibiotic treatment within the earlier hours of the infection. Furthermore, the latter generation cephalosporins, including ceftriaxone, must be given consideration as antibiotics of first choice world wide.
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A total of 675 male and female adolescents, aged 10 to 19 years, who were attending the adolescent antenatal clinic at the Kenyatta National Hospital and the Special STD and Skin Disease Clinic in Nairobi, between April 1, 1991 and July 31, 1991, were interviewed by means of partially structured questionnaire, to determine their level of awareness on sexually transmitted diseases, HIV infection, AIDS and contraception with its relationship to their sexual behaviour and contraceptive practice. Adolescents formed 27.6% of people attending the STD and Skin diseases clinic, of whom 52.9% were females and 41.2% were males. Majority of them were not in any formal employment. ⋯ They were involved with many and different partners, some of whom belonged to the high risk groups for HIV infection as well as STD's. As a reflection of their low awareness on AIDS, most of these sexually active adolescents had not changed their sexual behaviour, nor were they using any protective measure against STD's or HIV infection. The implications of these findings are discussed and possible remedial measures suggested.
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Even though hypoxia is a major risk factor for death in children with acute respiratory infection in developing countries, oxygen is not part of first line treatment. Because oxygen is not readily available in developing countries it tends to be given to the most seriously ill children, whose outcome is poor. ⋯ A simple oximeter would make detection easier, and oxygen concentrators are more cost effective than bottled oxygen. Ideally oxygen should be given to children in the early stages of clinical pneumonia to prevent deterioration.