Articles: health.
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Comparative Study
Factors affecting immunization coverage levels in a district of India.
Immunization coverage is measured to assess the performance of the Expanded Programme on Immunization. In 1988 we conducted a coverage survey among 12-23 month-old children in the North Arcot District (population 5,007,746) in southern India. In each of the 12 towns a 30-cluster sample survey was conducted. ⋯ In the towns, 25, 66, 67 and 59% of BCG, DPT, OPV and measles vaccines had been provided by private agencies showing that availability of vaccines throughout the week and easy access even in payment terms played an important role in achieving higher levels of coverage compared with rural areas where all vaccines are given by Government agencies, free of charge. In the rural areas, significantly large variations in coverage were seen among panchayats--large and peri-urban panchayats had significantly better coverage than small and more rural panchayats. Within any given block (the population unit consisting of 30-40 panchayats served by a Primary Health Centre), there were large variations in the levels of immunization coverage between panchayats.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
Reduced childhood mortality after standard measles vaccination at 4-8 months compared with 9-11 months of age.
To evaluate the impact on mortality of standard Schwarz measles immunisation before 9 months of age. ⋯ Standard measles vaccination before 9 months is not associated with higher childhood mortality than is the currently recommended strategy of immunising from 9 months, and it may reduce mortality. This has implications for measles immunisation strategy in developing countries.
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Acta Obstet Gynecol Scand · Nov 1993
Iron status in Danish women aged 35-65 years. Relation to menstruation and method of contraception.
Iron status was assessed by serum (S-) ferritin and hemoglobin (Hb) in a population survey comprising 883 non-gravid Danish women in age cohorts of 35, 45, 55, and 65 years. Premenopausal women (n = 676) had lower S-ferritin, median 42 micrograms/l, than postmenopausal women (n = 207), median 80 micrograms/l (p < 0.0001). Of premenopausal women, 12.1% had S-ferritin < or = 20 micrograms/l (i.e. depleted iron stores), and 35.6% S-ferritin of 21-40 micrograms/l (i.e. small iron stores). ⋯ Women (n = 64) using hormonal contraceptives (the pill) had menstrual bleeding of shorter duration than those (n = 511) not using pills or intrauterine devices (IUD), who in turn had bleeding of shorter duration than those (n = 101) using IUD. Median S-ferritin in pill users was 62 micrograms/l, in those not using pills or IUD 42 micrograms/l, and in IUD users 36 micrograms/l. S-ferritin values < 40 micrograms/l (i.e. small and depleted iron stores) were seen in 25% of pill users, in 48% of those not using pills or IUD, and in 61% of IUD users.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Divergent mortality for male and female recipients of low-titer and high-titer measles vaccines in rural Senegal.
The female/male mortality ratio among unimmunized children and children vaccinated with standard or high-titer measles vaccines was examined for all children born in the period 1985-1991 in a rural area of Senegal. The female/male mortality ratio from 9 months to 5 years of age for unvaccinated children was 0.94 (95% confidence interval (CI) 0.75-1.19), significantly different from the ratio of 0.64 (95% CI 0.48-0.85) for recipients of the Schwarz standard measles vaccine (p = 0.040). ⋯ Hence, the Schwarz standard and high-titer measles vaccines have divergent sex-specific effects on mortality throughout childhood. Further studies of the underlying mechanisms are needed.