Articles: mortality.
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The hospital records of 62 Zambian children with sickle cell anaemia (SCA) who died during a 3 year period (January 1987 to December 1989) at the Paediatric Wing of the University Teaching Hospital, Lusaka, Zambia, were reviewed retrospectively. The SCA patients accounted for 2.92 percent of the total admissions and the average case fatality was 6.61 percent of the total SCA admissions. ⋯ The common causes of death were infections (29.54%), vasoocclusive crises (22.72%) and splenic sequestration crises (20.45%). The problems of sub-Saharan Africa, like malaria, malnutrition and now the HIV infection also adde to the mortality (15.90%).
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In general females have a lower mortality than males at all ages. Excess female mortality has been documented in certain high mortality situations, in particular in South Asia. However, females may have a higher mortality for certain causes of death. One of the causes of death for which excess female mortality is suspected is measles. ⋯ When pooled together, the results show an excess of female mortality from birth until age 50 years. The excess female mortality appears small at age 0-4 (+4.2%), larger at age 5-14 (+10.9%) and peaks during the female reproductive period, at age 15-44 (+42.6%). This pattern of excess female mortality occurs in all the major regions of the world: Europe, North and South America, Far-East Asia, the Middle East and South Asia. The only noticeable exceptions are the Philippines and Thailand. The validity of the finding is extensively reviewed. Emphasis lies on the statistical power to prove that sex differences in measles mortality do exist, on the critical analysis of a case study in England and Wales, on the comparison with the overall pattern of sex differences and on available data on sex differences in incidence. Possible explanations are reviewed.
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Historical Article
The importance of social intervention in England's mortality decline: the evidence reviewed.
This paper examines the first phase of England's mortality decline, which commenced in the middle of the eighteenth century, and proceeded fitfully down to the end of the nineteenth. It finds that recent research in population history has weakened the explanation known as the McKeown thesis, but that the alternative synthesis, developed by Szreter, does not stand up well to a scrutiny of the evidence on infant mortality and morbidity. ⋯ C. Riley for the second half of the nineteenth century.