Articles: disease.
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Bull. World Health Organ. · Jan 1993
Assessment of respiratory rate and chest indrawing in children with ARI by primary care physicians in Egypt.
In a baseline study for training purposes, two indicators of acute respiratory infections (the respiratory rate (RR) and chest indrawing) were assessed by Ministry of Health physicians in Egypt using a WHO test videotape. Chest indrawing, as defined by the WHO Acute Respiratory Infections (ARI) programme, was not widely recognized by current health personnel. Viewing a WHO training videotape led to significantly more correct assessments of chest indrawing compared with a group that had not viewed this videotape. ⋯ Rates counted over 60 seconds were more accurate than 30-second counts although the difference between them was not clinically significant. Counting of rates using timers with audible cues was comparable to using watches with second hands. Careful training of primary health workers in the assessment of RR and chest indrawing is essential if these clinical findings are to be used as reliable indicators in pneumonia treatment algorithms.
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Surveillance is the foundation of public health practice. This review examines the experience of surveillance in the Expanded Programme on Immunization (EPI). Surveillance systems include routine reporting, sentinel surveillance, and community-based reporting. ⋯ The surveillance of vaccine-preventable diseases has evolved as programmes mature, to monitor progress towards disease control targets. The establishment of goals to reduce measles cases by 90%, eliminate neonatal tetanus, and eradicate poliomyelitis has put increased emphasis on the need for effective disease surveillance. This opportunity should be taken to promote strengthening of national routine systems for disease surveillance, to make them effective instruments for prevention and control of diseases of public health importance.
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The objective of the study was to assess the prevalence of unclassified hypertension during pregnancy and its consequences on infant's health in an African urban setting: Pikine, a suburb of Dakar, Senegal. A cross-sectional study of a random sample of pregnant women and a prospective study, from the inclusion to seven days after delivery, were performed. 886 women attending the prenatal centers were included in the cross-sectional study. 471 pregnant women were included in the follow-up study. The prevalence of DBP > or = 120 mmHg was 0.7%; 5.7% of the women had DBP > or = 95 mmHg. ⋯ Using 95 mmHg as a cutpoint, the relative risk of adverse outcome associated with a DBP > or = 95 mmHg was 2.5 (CI 95%: 1.4-4.3). This risk was significantly increased among women who reported difficult living conditions. Eight percent of the adverse outcomes of pregnancy, 10% of the low birth weights and 8% of the perinatal mortality were found to be associated with DBP > or 95 mmHg.
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The heterosexual spread of HIV-1 is occurring at different rates in different parts of the world. The transmission probability of HIV-1 per sexual contact is low, but may be greatly enhanced by several cofactors. Sexually transmitted diseases (STD), especially genital ulcers, may be such factors. So far, epidemiological evidence that other STD facilitate HIV-1 transmission is weak. The objective of this study was to determine whether treatable STD enhanced sexual transmission of HIV-1 in a cohort of female prostitutes in Kinshasa, Zaire. ⋯ Non-ulcerative STD were risk factors for sexual transmission of HIV-1 in women, after controlling for sexual exposure. Because of their high prevalence in some populations, non-ulcerative STD may represent a considerable population-attributable risk in the transmission of HIV-1 worldwide. The identification of treatable STD as risk factors for HIV-1 transmission offers an important additional strategy for the prevention of HIV/AIDS.