Articles: mortality.
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J Diarrhoeal Dis Res · Sep 1990
ReviewRole of breast-feeding in the prevention and treatment of diarrhoea.
Recent studies have again shown the beneficial effects of breast-feeding in preventing morbidity and mortality from diarrhoea in infants. A case-control study in Brazil has shown that young infants who are not breast-fed have a 25-time greater risk of dying of diarrhoea than those who are exclusively breast-fed. A longitudinal study in the urban slums of Lima, Peru found that exclusively breast-fed infants have a reduced risk of diarrhoeal morbidity when compared with infants receiving only water in addition to breast-milk. ⋯ Programmes also need to include breast-feeding promotion as a part of their activities. This should comprise hospital practices supporting and ensuring breast-feeding immediately after delivery of the infants and subsequently while they are treated in the hospital: immediate breast-feeding after delivery; Mothers and infants rooming together; On demand breast-feeding; No bottle feedings of water or infant formula; No pre-lacteal feeds. In addition, health professionals need to understand the skills for the management of breast-feeding, so that mothers are given appropriate advice on how to breast-feed and counteract breast-feeding problems.
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Comparative Study
Black/white comparisons of deaths preventable by medical intervention: United States and the District of Columbia 1980-1986.
Blacks in the US experience increased mortality (1113 versus 745 per 100,000 males; 631 versus 411 per 100,000 females) and decreased life expectancy (63.7 years versus 70.7 years for males; 72.3 years versus 78.1 years for females); compared to Whites. In an effort to determine if the excess mortality among Black Americans might be explained by differences in access or quality of health care services, we performed a race-specific analysis of conditions for which mortality is largely avoidable given timely and appropriate medical care. Using methodology proposed by Rutstein and Charlton, mortality due to 12 causes was evaluated including tuberculosis, cervical cancer, Hodgkin's disease, rheumatic heart disease, hypertensive heart disease, acute respiratory disease, pneumonia and bronchitis, influenza, asthma, appendicitis, hernias and cholecystitis. ⋯ The highest relative rates among Blacks compared to Whites were observed for tuberculosis, hypertensive heart disease and asthma. The overall mortality rate in the District of Columbia for the selected causes was 3.7 times the national rate. Compared to national rates, statistically significant elevated rates in the District were observed for tuberculosis, hypertensive heart disease and pneumonia and bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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In industrialized countries HIV-1-seropositive mothers who are nursing infants are advised to use artificial feeds, whilst HIV-infected women in the developing world are recommended to breast-feed. Current evidence is insufficient even to estimate the attributable risk associated with breast-feeding. ⋯ However, calculations of the consequence of any population-level change to bottle-feeding indicate that it would result in more deaths from infectious causes, substantially adding to the child deaths directly attributable to HIV-1 infection. These data demonstrate that there is a clear need for policy-makers and health care workers to undertake further promotion of breast-feeding despite the AIDS epidemic.