Articles: mortality.
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To improve measles control in Kinshasa, Zaire, a project to increase vaccine coverage was begun in 1988, and in 1989, the city vaccination programme changed measles vaccination policy from Schwartz vaccine at age 9 months to medium titre Edmonston Zagreb (EZ) vaccine at age 6 months. We report the impact of the programme on measles incidence and mortality. ⋯ Measles can be controlled in urban areas, although it is difficult to determine how great a contribution vaccination at age 6 months makes over and above the achievement of high coverage.
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Infections may be involved in some cases of sudden infant death syndrome (SIDS). Exposure to such infections is likely to differ considerably between areas depending on rates of population mixing. It is therefore possible that the geography of SIDS will reflect that of population migration. ⋯ It is concluded that geographical variations in SIDS deaths in England and Wales are strongly associated with differences in rates of population mixing as measured by migration. The findings support the hypothesis that population mixing, by its influence on exposure to infections, may be a significant factor in the aetiology of SIDS.
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Comparative Study
Comparison of mortality between villages with and without Primary Health Care workers in Upper River Division, The Gambia.
Health services utilization was analysed in a rural area of the The Gambia. In general, health workers were consulted frequently. ⋯ The relationship between cause specific mortality and the utilization of health services is discussed. Childhood mortality was similar in villages with or without a primary health care worker at the time of the study.
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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.