Articles: disease.
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Bull. World Health Organ. · Jan 1993
Syphilis-associated perinatal and infant mortality in rural Malawi.
In Mangochi District, a rural area of Malawi, the prevalence of active syphilis was 3.6% among 3591 women who had singleton births and who were negative for human immunodeficiency virus (HIV). Compared with non-syphilitic women, those with active syphilis (positive Venereal Disease Research Laboratory/rapid plasmin reagin tests (titre > or = 1:8) and a reactive microhaemagglutination assay) were more likely to experience stillbirths as well as the early and late neonatal deaths and even postneonatal deaths of their children. ⋯ The potential for a programme to prevent congenital syphilis in the perinatal, neonatal, and post-neonatal periods is evident. In considering resource allocation to child survival programmes in areas where the prevalence of syphilis is high, officials need to include antenatal syphilis screening, using rapid tests and treatment at the first contact of the mother with the health care system.
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A system has been established to document births and deaths in children in a large, rural, West African population, using community reporters. Causes of death in children under the age of 5 years were investigated using post-mortem questionnaires completed by field assistants. There was a marked seasonal incidence of all major causes of death with peak rates in the rainy season. ⋯ Other major causes of death were malaria, acute gastro-enteritis and chronic diarrhoea with malnutrition. Mortality from all the major causes of death decreased with increasing village size. Our findings have implications for interventions against childhood mortality.
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Heterosexual transmission is one factor involved in the spread of the human immunodeficiency virus (HIV) within the injection drug use (IDU) population and between IDU and non-IDU individuals. Insufficient information is currently available to reduce this heterosexual transmission. As a basis for designing a questionnaire aimed at the IDU population, we conducted 5 focus groups to collect information on knowledge of and attitudes toward safe sex as held by male and female IDUs in methadone treatment. ⋯ We also found gender-based differences in knowledge and learning style. Also, while individuals felt a responsibility to prevent HIV transmission, they lacked sufficient control to do so. The wide range of responses on questions concerning sexually transmitted diseases (STDs), condoms, reproductive decisions, and methods of promoting safe sex provides a basis for developing a questionnaire designed to identify and target specific subgroups for educational intervention.