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2.
Peer Reviewed

Title: New methods for estimating the tuberculosis case detection rate in high-HIV prevalence countries: the example of Kenya.
Author: Mansoer J; Scheele S; Floyd K; Dye C; Sitienei J; Williams B
Source: Bulletin of the World Health Organization. 2009 Mar;87(3):186-92, 192A-192B.
Abstract: OBJECTIVE: To develop new methods for estimating the sputum smear-positive tuberculosis case detection rate (CDR) in a country where infection with HIV is prevalent. METHODS: We estimated the smear-positive tuberculosis CDR in HIV-negative and HIV-positive adults, and in all adults in Kenya. Data on time trends in tuberculosis case notification rates and on HIV infection prevalence in adults and in tuberculosis patients were used, along with data on tuberculosis control programme performance. FINDINGS: In 2006, the estimated smear-positive tuberculosis CDR in HIV-negative adults was 79% (95% confidence interval, CI: 64-94) and in HIV-positive adults, 57% (95% CI: 26-88), giving a weighted mean of 68% (95% CI: 49-87). The separate estimate for all smear-positive tuberculosis cases was 72% (95% CI: 53-91), giving an overall average for the three estimates of 70% (95% CI: 58-82). As the tuberculosis CDR in 1996 was 57% (95% CI: 47-67), the estimated increase by 2006 was 13 percentage points (95% CI: 6-20), or 23%. This increase was accompanied by a more than doubling of the resources devoted to tuberculosis control in Kenya, including facilities and staff. CONCLUSION: Using three approaches to estimate the tuberculosis CDR in a country where HIV infection is prevalent, we showed that expansion of the tuberculosis control programme in Kenya led to an increase of 23% in the CDR between 1996 and 2006. While the methods developed here can be applied in other countries with a high prevalence of HIV infection, they rely on precise data on trends in such prevalence in the general population and among tuberculosis patients.
Language: English
Keywords:
KENYA | RESEARCH REPORT | ESTIMATION TECHNIQUES | ADULTS | TUBERCULOSIS | INCIDENCE | TRANSMISSION | HIV INFECTIONS | PREVALENCE | EPIDEMICS | COMMUNICABLE DISEASE CONTROL | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Measurement | Viral Diseases | Health Services | Delivery of Health Care | Health
Document Number: 342352

Peer Reviewed

Title: Potential impact of nanotechnology on the control of infectious diseases.
Author: Allaker RP; Ren G
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Jan;102(1):1-2.
Abstract: Nanotechnology encompasses those technologies used to fabricate materials, including sphere, cubic and needle-like nanoscaled particles (approximately 5-100 nm), and near-nanoscaled devices (up to micrometres). In comparison, mycoplasma are approximately 200nm in length, and a nanometre is 10-9 of a metre. The field of nanotechnology is experiencing rapid growth, with many and diverse potential applications being explored in the biomedical field, including the control of infectious diseases. Nanotechnology not only has the potential to offer improvements to current approaches for immunisation, drug design and delivery, diagnostics and cross-infection control, but is also unexpectedly delivering many new tools and capabilities. (author's)
Language: English
Keywords:
UNITED KINGDOM | CRITIQUE | TECHNOLOGY | COMMUNICABLE DISEASE CONTROL | EXAMINATIONS AND DIAGNOSES | IMMUNIZATION | VACCINES | LABORATORY PROCEDURES | ANTIBIOTICS | ADMINISTRATION AND DOSAGE | METALS | Developed Countries | Europe, Western | Europe | Economic Factors | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Primary Health Care | Laboratory Examinations and Diagnoses | Drugs | Treatment | Vitamins and Minerals | Physiology | Biology
Document Number: 322620

Peer Reviewed

Title: Multi drug resistant tuberculosis: a challenge in the management of tuberculosis.
Author: Amukoye E
Source: African Journal of Health Sciences. 2008 Jan-Mar;15(1-2):6-13.
Abstract: Multi drug resistant tuberculosis (MDR-TB) will not usually respond to short course chemotherapy. Unless the individual infected with this bug is treated appropriately, they can continue spreading resistant strains in the community and further fuel the tuberculosis epidemic. Diagnosis requires drug sensitivity testing and the capability to do this is not widely available. Multi drug resistant tuberculosis has been reported all over Africa but the prevalence is still low. The treatment is not only expensive but also quite prolonged and compliance cannot be overemphasized. The recent outbreaks of extensive drug resistant TB further complicate the management and control of the disease. This is a perspective on challenges of managing MDR TB and its effect on the control program the information presented is gathered from published data.
Language: English
Keywords:
AFRICA | LITERATURE REVIEW | CRITIQUE | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | TUBERCULOSIS | DRUG RESISTANCE | LABORATORY EXAMINATIONS AND DIAGNOSES | ECONOMIC FACTORS | TIME FACTORS | USER COMPLIANCE | MANAGEMENT | COMMUNICABLE DISEASE CONTROL | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | Developing Countries | Research Methodology | Infections | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Population Dynamics | Demographic Factors | Population | Behavior | Organization and Administration
Document Number: 323096

Title: Overcoming the limits of tuberculosis prevention among foreign-born individuals: Next steps toward eliminating tuberculosis [editorial]
Author: Cain KP; Mac Kenzie WR
Source: Clinical Infectious Diseases. 2008 Jan 1;46(1):107-109.
Abstract: From 1993 through 2006, the number of TB cases in the United States decreased by 45%, from 25,108 to 13,767. However, the decrease has occurred disproportionately among the US-born population, in which the number of cases has decreased by 66%. Over the same interval, the number of foreign-born TB cases in the United States actually increased by 5%. In 2006, 57% of all TB cases reported were among foreign-born persons. If current trends continue, this proportion will continue to grow, and we could reach a point at which TB is nearly eliminated among US-born persons but is still a major problem among foreign-born individuals. Similar trends have been noted in other countries with a low burden of TB; in several European countries, greater than 50% of TB cases occur among foreign-born persons. These trends raise a fundamental question: why do current TB-control strategies have such limited impact on the foreign-born population? The article by Walter et al. complements previously published evidence to provide some answers to this question and to guide future efforts to control and eliminate TB. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | EPIDEMIOLOGIC METHODS | FOREIGNERS | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | CONTACTING CLIENTS | TESTING | GENETICS | SCREENING | TIME FACTORS | Developed Countries | North America | Americas | Research Methodology | Nationality | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Health Services | Delivery of Health Care | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Clients | Program Activities | Programs | Organization and Administration | Biology | Population Dynamics
Document Number: 325752

Title: Global tuberculosis control: surveillance, planning, financing. WHO report 2008.
Author: Dye C; Floyd K; Uplekar M
Source: Geneva, Switzerland, World Health Organization [WHO], 2008. [300] p. (WHO/HTM/TB/2008.393)
Abstract: This report is the twelfth annual report on global control of tuberculosis (TB) published by the World Health Organization (WHO) in a series that started in 1997. It is based on data reported to WHO via its standard data collection form by 202 out of 212 countries and territories in 2007, and on the series of data collected from these countries and territories annually since 1996. Using these data, we present our latest assessment of the epidemiological burden of TB as well as progress towards targets for global TB control that have been established within the context of the Millennium Development Goals (MDGs) and by the World Health Assembly (WHA) and Stop TB Partnership. The impact targets are to halt and reverse incidence by 2015 (MDG 6 Target 6.C) and to halve prevalence and death rates by 2015 compared with 1990. The outcome targets are to detect at least 70% of new smear-positive cases and to successfully treat 85% of those cases that are detected. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | PROGRESS REPORT | EPIDEMIOLOGIC METHODS | TARGET POPULATION | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | PLANNING | FINANCIAL ACTIVITIES | NOTIFICATION | INCIDENCE | ANTIBIOTICS | ADMINISTRATION AND DOSAGE | SCREENING | DRUG RESISTANCE | HIV INFECTIONS | Research Methodology | Program Design | Programs | Organization and Administration | Infections | Diseases | Health Services | Delivery of Health Care | Health | Economic Factors | Political Factors | Sociocultural Factors | Measurement | Drugs | Treatment | Medical Procedures | Medicine | Examinations and Diagnoses | Viral Diseases
Document Number: 325473

Peer Reviewed

Title: Tuberculosis control in vulnerable groups.
Author: Figueroa-Munoz JI; Ramon-Pardo P
Source: Bulletin of the World Health Organization. 2008 Sep;86(9):733-735.
Abstract: Tuberculosis (TB) remains an important public health problem in industrialized countries. The majority of cases occur in minority groups, particularly recently arrived immigrants from countries with high endemicity who often congregate in deprived communities within wealthy cities. In the United Kingdom of Great Britain and Northern Ireland, people from the Indian subcontinent and sub-Saharan Africa living in inner cities have higher rates of TB than the general population; particularly during the first years after arriving in the country. The HIV/AIDS epidemic has had a disproportionate impact among ethnic minorities in large industrialized cities. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | MIGRANTS | REFUGEES | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | BORDER CROSSING | INTERNATIONAL MIGRATION | HOMELESS PERSONS | POVERTY | BEST PRACTICES | Research Methodology | Migration | Population Dynamics | Demographic Factors | Population | Infections | Diseases | Health Services | Delivery of Health Care | Health | Residence Characteristics | Population Distribution | Geographic Factors | Socioeconomic Factors | Economic Factors | Programs | Organization and Administration
Document Number: 328068

Peer Reviewed

Title: Adapting the DOTS framework for tuberculosis control to the management of non-communicable diseases in sub-Saharan Africa.
Author: Harries AD; Jahn A; Zachariah R; Enarson D
Source: PLoS Medicine. 2008 Jun;5(6):e124.
Abstract: In sub-Saharan Africa, management standards for NCDs in public health services are poor. With the growing burden of NCDs, now is the time to develop and implement standardised NCD management protocols and systems for diagnosis, treatment, monitoring, and reporting. DOTS has been the framework for tuberculosis control for over a decade, allowing structured and well monitored services to be delivered to millions of tuberculosis patients in some of the poorest countries of the world. The DOTS model has been successfully adapted for the scale-up of ART in Malawi, allowing long-term, structured treatment to be given to thousands of patients. This paper discusses why the DOTS paradigm should be adapted for NCDs, and, with the "DOTS five-point policy package" as a template, shows how this could be implemented and rolled out in resource-poor countries, with special reference to sub-Saharan Africa. (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | CRITIQUE | RECOMMENDATIONS | EVALUATION | TARGET POPULATION | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | ANTIBIOTICS | STANDARDIZATION | TREATMENT | ANTIRETROVIRAL THERAPY | PUBLIC HEALTH | HEALTH POLICY | DISEASE TRANSMISSION CONTROL | Developing Countries | Africa | Program Design | Programs | Organization and Administration | Infections | Diseases | Health Services | Delivery of Health Care | Health | Drugs | Medical Procedures | Medicine | Data Adjustment | Research Methodology | HIV | HIV Infections | Viral Diseases | Policy | Political Factors | Sociocultural Factors | Prevention and Control
Document Number: 327410

Title: India's Revised National Tuberculosis Control Programme: Looking beyond detection and cure.
Author: Kelkar-Khambete A; Kielmann K; Pawar S; Porter J; Inamdar V
Source: International Journal of Tuberculosis and Lung Disease. 2008 Jan;12(1):87-92.
Abstract: SETTING: Pune District, Maharashtra State, India. OBJECTIVES: To examine delays experienced by patients in accessing directly observed treatment. DESIGN: Data were collected from 117 new sputum-positive patients using a semi-structured interview schedule. RESULTS: Patient delays as well as diagnostic and treatment delays, which reflect the performance of a National TB Programme, were minimal. Provider delays, however, contributed significantly to delayed entry into India's Revised National TB Control Programme (RNTCP). Patients had to resort to multiple contacts with providers due to limitations of these providers in diagnosing or directing patients to the RNTCP. Patients who consulted a private provider participating in the public-private mix (PPM) were more likely to be suspected (OR 2.63, 90% CI 1.04-6.64) and referred (OR 6.8, 95%CI 2.08-22.21) to the RNTCP. Once the patients entered the RNTCP, the response of the system was rapid, with diagnosis offered and treatment initiated within on average 7 days. CONCLUSION: Interventions aimed at providers to encourage early suspicion and referral to the RNTCP, such as the PPM, are more important in improving patient access to TB care than those focusing on reducing patient delays.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | TARGET POPULATION | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | GOVERNMENT PROGRAMS | USER COMPLIANCE | UTILIZATION OF HEALTH CARE | ANTIBIOTICS | LABORATORY EXAMINATIONS AND DIAGNOSES | HEALTH SERVICES EVALUATION | REFERRAL AND CONSULTATION | TIME FACTORS | PROGRAM ACCESSIBILITY | Developing Countries | Asia, Southern | Asia | Research Methodology | Program Design | Programs | Organization and Administration | Infections | Diseases | Health Services | Delivery of Health Care | Health | Behavior | Drugs | Treatment | Medical Procedures | Medicine | Examinations and Diagnoses | Program Evaluation | Program Activities | Population Dynamics | Demographic Factors | Population
Document Number: 325806

10.

Peer Reviewed

Title: Predictors of pneumocystosis or tuberculosis in HIV-infected Asian patients with AFB smear-negative sputum pneumonia.
Author: Le Minor O; Germani Y; Chartier L; Lan NH; Lan NT; Duc NH; Laureillard D; Fontanet A; Sar B; Saman M; Chan S; L'Her P; Mayaud C; Vray M
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Aug 15;48(5):620-7.
Abstract: OBJECTIVES: To identify predictors of Pneumocystis jiroveci pneumonia (PCP) or pulmonary tuberculosis (TB) in acid-fast bacillus smear-negative HIV-infected patients and to develop clinical prediction rules. DESIGN: A cohort study conducted in consecutive hospitalized Asian patients. METHODS: Multivariate analyses were performed on the Cambodian sample to determine clinical, radiological, and biological predictors of PCP or TB at hospital admission. The Vietnamese sample was kept for independent validation. RESULTS: In Cambodia, the gold standard technique for TB and PCP were fulfilled in 172 (27 cases) and 160 (84 cases) patients, respectively. For TB, independent predictors included the following: headache [odds ratio (OR) 3.0; 95% confidence interval (CI) 1.04 to 8.6], localized radiological opacity (OR 5.8; 95% CI 1.9-17.9), and mediastinal adenopathy (OR 10.1; 95% CI 3.5 to 29.0); and for PCP: resting oxygen saturation <90% (OR 3.3; 95% CI 1.3 to 8.5 for resting arterial oxygen saturation >or=80%; and OR 9.1; 95% CI 1.8 to 44.5 for resting arterial oxygen saturation <80%), trimethoprim-sulphamethoxazole prophylaxis (OR 0.1; 95% CI 0.04 to 0.6), and diffuse radiological shadowing (OR 7.0; 95% CI 2.7 to 18.6). PCP risk predicted by a score based on these 3 factors ranged from 3% to 92% (Cambodia). When tested on Vietnamese patients (n = 69, 38 with PCP), the score maintained correct predictive ability (c-index = 0.72) but with poor calibration. CONCLUSIONS: The PCP score could provide a useful clinical tool to identify PCP among acid-fast bacillus smear-negative pneumonia and start specific therapy.
Language: English
Keywords:
VIETNAM | CAMBODIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | MULTIVARIATE ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PNEUMONIA | TUBERCULOSIS | AIDS | HIV INFECTIONS | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | HEADACHE | COMMUNICABLE DISEASE CONTROL | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Data Analysis | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Pulmonary Effects | Physiology | Biology | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 328291

11.

Peer Reviewed

Title: China's health system performance.
Author: Liu Y; Rao K; Wu J; Gakidou E
Source: Lancet. 2008 Nov 29;372(9653):1914-23.
Abstract: We created a comprehensive set of health-system performance measurements for China nationally and regionally, with health-system coverage and catastrophic medical spending as major indicators. With respect to performance of health-care delivery, China has done well in provision of maternal and child health services, but poorly in addressing non-communicable diseases. For example, coverage of hospital delivery increased from 20% in 1993 to 62% in 2003 for women living in rural areas. However, effective coverage of hypertension treatment was only 12% for patients living in urban areas and 7% for those in rural areas in 2004. With respect to performance of health-care financing, 14% of urban and 16% of rural households incurred catastrophic medical expenditure in 2003. Furthermore, 15% of urban and 22% of rural residents had affordability difficulties when accessing health care. Although health-system coverage improved for both urban and rural areas from 1993 to 2003, affordability difficulties had worsened in rural areas. Additionally, substantial inter-regional and intra-regional inequalities in health-system coverage and health-care affordability measures exist. People with low income not only receive lower health-system coverage than those with high income, but also have an increased probability of either not seeking health care when ill or undergoing catastrophic medical spending. China's current health-system reform efforts need to be assessed for their effect on performance indicators, for which substantial data gaps exist.
Language: English
Keywords:
CHINA | CRITIQUE | EVALUATION INDEXES | RURAL POPULATION | URBAN POPULATION | HEALTH STATUS INDEXES | QUALITY OF HEALTH CARE | EXPENDITURES | COMMUNICABLE DISEASE CONTROL | HYPERTENSION | PROGRAM ACCESSIBILITY | DELIVERY OF HEALTH CARE | INEQUALITIES | HUMAN GEOGRAPHY | ECONOMIC FACTORS | Asia, Eastern | Asia | Developing Countries | Quantitative Evaluation | Evaluation | Population Characteristics | Demographic Factors | Population | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Financial Activities | Health Services | Vascular Diseases | Diseases | Socioeconomic Factors | Geography | Social Sciences | Science | Sociocultural Factors
Document Number: 329368

12.

Peer Reviewed

Title: Infectious diseases and vaccine sciences: strategic directions.
Author: Luby SP; Brooks WA; Zaman K; Hossain S; Ahmed T
Source: Journal of Health, Population, and Nutrition. 2008 Sep;26(3):295-310.
Abstract: Despite substantial progress, infectious diseases remain important causes of ill-health and premature deaths in Bangladesh. Bangladesh has experienced a > 90% reduction in the incidence of deaths due to childhood diarrhoea over the last 25 years. Further reductions can be achieved through the introduction of effective vaccines against rotavirus and improvements in home hygiene, quality of drinking-water, and clinical case management, including appropriate use of oral rehydration solution and zinc. Pneumonia is now the leading cause of childhood deaths in Bangladesh, and the pneumonia-specific child mortality is largely unchanged over the last 25 years. Reductions in mortality due to pneumonia can be achieved through the introduction of protein conjugate vaccines against Haemophilus influenza type b and Streptococcus pneumoniae, improvements in case management, including efforts to prevent delays in providing appropriate treatment, and the wider use of zinc. Tuberculosis is responsible for an estimated 70,000 deaths each year in Bangladesh. Although services for directly-observed therapy have expanded markedly, improved case finding and involvement of private practitioners will be important to reduce the burden of disease.
Language: English
Keywords:
BANGLADESH | RECOMMENDATIONS | PROGRESS REPORT | EPIDEMIOLOGIC METHODS | CHILDREN | COMMUNICABLE DISEASE CONTROL | INFECTION PREVENTION | IMMUNIZATION | CHILD SURVIVAL | ORAL REHYDRATION | DIARRHEA | ZINC | HYGIENE | PNEUMONIA | TUBERCULOSIS | Developing Countries | Asia, Southern | Asia | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Infections | Diseases | Primary Health Care | Survivorship | Length of Life | Mortality | Population Dynamics | Treatment | Medical Procedures | Medicine | Metals | Vitamins and Minerals | Physiology | Biology | Public Health | Pulmonary Effects
Document Number: 328889

13.
Title: The feasibility and acceptability of a multimedia hepatitis C prevention program for Hispanic HIV-infected persons.
Author: Mayor AM; Fernandez DM; Colon HM; Thomas JC; Hunter-Mellado RF
Source: Ethnicity and Disease. 2008 Spring;18(2 Suppl 2):S2-195-9.
Abstract: INTRODUCTION: Hepatitis C (HCV) and HIV coinfection has emerged as a major health problem in Puerto Rico, particularly among injection drug users (IDUs). We developed and implemented a multimedia educational intervention for HIV-infected IDUs, based on the Health Belief Model and social cognitive theory. METHODS: To evaluate the program's acceptability, a group of 42 participants completed a written questionnaire immediately after each intervention component. RESULTS: Participants were 85% male, the mean age was 41.6 years (standard deviation 9.2 years), and mean educational level was ninth grade. More than 73% of respondents reported that the computer-based program was very easy to operate. More than 83% agreed that the audio and video tools highly facilitated their learning process, and > 71% agreed that the sessions were long enough. Additionally, they reported a high incremental increase in perceived knowledge regarding HIV/HCV co-infection, HCV infection risk behaviors, HCV complications, HCV preventive measures, and HCV diagnosis and therapy. Most of the participants favored the dissemination of this intervention. CONCLUSIONS: The study found a very good acceptability and feasibility of the computerized intervention in the study group. This new technology that includes audiovisual tools in its design kept the participants' attention and interest, while increasing HIV/HCV co-infection knowledge. Subsequent studies will evaluate the efficacy of this intervention, investigating changes in knowledge and risk behaviors among HIV-infected persons.
Language: English
Keywords:
PUERTO RICO | EVALUATION REPORT | KAP SURVEYS | THEORETICAL MODELS | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | PROGRAM ACCEPTABILITY | HEPATITIS | COMMUNICABLE DISEASE CONTROL | HIV INFECTIONS | COMPLICATIONS | COMPUTER PROGRAMS AND PROGRAMMING | SATISFACTION | KNOWLEDGE | AUDIOVISUAL AIDS | Caribbean | Americas | Developed Countries | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Program Evaluation | Programs | Organization and Administration | Health Services | Delivery of Health Care | Health | Information Processing | Information | Psychological Factors | Sociocultural Factors | Educational Methods | Educational Activities | Education
Document Number: 328744

14.
Title: Completion of isoniazid preventive therapy among HIV-infected patients in Tanzania.
Author: Munseri PJ; Talbot EA; Mtei L; Fordham von Reyn C
Source: International Journal of Tuberculosis and Lung Disease. 2008 Sep;12(9):1037-41.
Abstract: SETTING: Isoniazid preventive therapy (IPT) has not been widely implemented due to questions about acceptance, adherence and side effects. OBJECTIVE: To examine factors related to completion of IPT among human immunodeficiency virus (HIV) infected subjects in Tanzania. DESIGN: HIV-infected subjects in the DarDar TB vaccine trial with CD4 cell counts >or=200 cells/mm(3) and a positive tuberculin skin test (TST) were counseled, offered IPT for 6 months and seen monthly. RESULTS: Among 1932 subjects, TST results were positive in 631 (33%): 568 (90%) were offered IPT, 565 (99%) accepted and three (<1%) refused. Of the 565 subjects who accepted IPT, 493 (87%) completed treatment and 72 (13%) did not. Non-completion was physician-initiated in 24 (33%, due to active TB or side effects), patient-initiated in 42 (58%, due to self-cessation or loss to follow-up) and due to death in 6 (8%, unrelated to IPT). Interviews were conducted among 109 completers and 20 non-completers (12 physician- and 8 patient-initiated). Completers were motivated by fear of TB (44%), understanding the importance of IPT (32%) and counseling (22%). Patient-initiated non-completers were dissuaded by stigma (58%), side effects (14%) and travel distance (1%). CONCLUSIONS: HIV-infected subjects provided with counseling, monthly follow-up and travel reimbursement have high rates of IPT completion with minimal side effects.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | USER COMPLIANCE | SIDE EFFECTS | COUNSELING | TREATMENT | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | ANTIBIOTICS | DISTANCE | KNOWLEDGE | FEAR | STIGMA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinic Activities | Program Activities | Programs | Organization and Administration | Infections | Drugs | Geographic Factors | Population | Sociocultural Factors | Emotions | Psychological Factors | Social Problems
Document Number: 329221

15.

Title: U.S. policy options for strengthening coordination between global HIV / AIDS and TB programs. A report of the CSIS Task Force on HIV / AIDS.
Author: Nieburg P; Ramachandran S; Hofler K
Source: Washington, D.C., Center for Strategic and International Studies, 2008 Feb. 6 p.
Abstract: Although some efforts are underway to increase coordination between TB and HIV programs globally, there remains a persistent tendency to view TB and HIV as separate pandemics, leading to a single-disease approach for each one rather than an integrated strategy for both. With only a small number of exceptions, present global control efforts for TB and HIV/AIDS are largely managed in separate silos financially, programmatically, and administratively. This arrangement, if allowed to persist, will implicitly invite higher program costs and lower program efficiencies. Continuing a fragmented approach to global TB and HIV will lead to missed opportunities for program synergy and will undermine past and current investments in both these diseases. In short, the severity and increasing frequency of TB-HIV coinfection, together with the rising global caseload of drug-resistant TB, argues for this issue to become a more urgent U.S. policy priority and for new policy approaches to be pursued. Fortunately, congressional reauthorization of U.S. global HIV/AIDS programs in 2008 provides a good opportunity for the United States to exercise leadership in supporting the development of a comprehensive strategy for addressing TB-HIV coinfection. (excerpt)
Language: English
Keywords:
GLOBAL | UNITED STATES OF AMERICA | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | COMPLICATIONS | INTEGRATED PROGRAMS | HIV INFECTIONS | COORDINATION | HEALTH POLICY | POLICY DEVELOPMENT | Developed Countries | North America | Americas | Administrative Personnel | Organization and Administration | Viral Diseases | Diseases | Infections | Health Services | Delivery of Health Care | Health | Programs | Policy | Political Factors | Sociocultural Factors | Planning
Document Number: 326317

16.

Title: Addressing diarrhea prevalence in the West African Middle Belt: social and geographic dimensions in a case study for Benin.
Author: Pande S; Keyzer MA; Arouna A; Sonneveld BG
Source: International Journal of Health Geographics. 2008 Apr 23;7(17):[17] p.
Abstract: Background: In West Africa, the Northern Sahelian zone and the coastal areas are densely populated but the Middle Belt in between is in general sparsely settled. Predictions of climate change foresee more frequent drought in the north and more frequent flooding in the coastal areas, while conditions in the Middle Belt will remain moderate. Consequently, the Middle Belt might become a major area for immigration but there may be constraining factors as well, particularly with respect to water availability. As a case study, the paper looks into the capacity of the Middle Belt zone of Benin, known as the Oueme River Basin (ORB), to reduce diarrhea prevalence. In Benin it links to the Millennium Development Goals on child mortality and environmental sustainability that are currently farthest from realization. However, diarrhea prevalence is only in part due to lack of availability of drinking water from a safe source. Social factors such as hygienic practices and poor sanitation are also at play. Furthermore, we consider these factors to possess the properties of a local public good that suffers from under provision and requires collective action, as individual actions to prevent illness are bound to fail as long as others free ride. Methods: Combining data from the Demographic Health Survey with various spatial data sets for Benin, we apply mixed effect logit regression to arrive at a spatially explicit assessment of geographical and social determinants of diarrhea prevalence. Starting from an analysis of these factors separately at national level, we identify relevant proxies at household level, estimate a function with geo-referenced independent variables and apply it to evaluate the costs and impacts of improving access to good water in the basin. Results: First, the study confirms the well established stylized fact on the causes of diarrhea that a household with access to clean water and with good hygienic practices will, irrespective of other conditions, not suffer diarrhea very often. Second, our endogeneity tests show that joint estimation performs better than an instrumental variable regression. Third, our model is stable with respect to its functional form, as competing specifications could not achieve better performance in overall likelihood or significance of parameters. Fourth, it finds that the richer and better educated segments of the population suffer much less from the disease and apparently can secure safe water for their households, irrespective of where they live. Fifth, regarding geographical causes, it indicates that diarrhea prevalence varies with groundwater availability and quality across Benin. Finally, our assessment of costs and benefits reveals that improving physical access to safe water is not expensive but can only marginally improve the overall health situation of the basin, unless the necessary complementary measures are taken in the social sphere. Conclusion: The ORB provides adequate water resources to accommodate future settlers but it lacks appropriate infrastructure to deliver safe water to households. Moreover, hygienic practices are often deficient. Therefore, a multifaceted approach is needed that acknowledges the public good aspects of health situation and consequently combines collective action with investments into water sources with improved management of public wells and further educational efforts to change hygienic practices.
Language: English
Keywords:
BENIN | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | EPIDEMIOLOGIC METHODS | CHILDREN | PREVALENCE | DIARRHEA | GEOGRAPHIC FACTORS | CLIMATE | WATER SUPPLY | HYGIENE | COMMUNICABLE DISEASE CONTROL | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Diseases | Environment | Natural Resources | Public Health | Health | Health Services | Delivery of Health Care
Document Number: 327689

17.

Title: Tuberculosis: Infection control / exposure control issues for oral healthcare workers.
Author: Porteous NB; Terezhalmy GT
Source: Journal of Contemporary Dental Practice. 2008 Jan 1;9(1):1-13.
Abstract: AIM: The aim is to present the essential elements of an infection control/exposure control plan for the oral healthcare setting with emphasis on tuberculosis (TB). METHODS AND MATERIALS: A comprehensive review of the literature was conducted with special emphasis on TB infection-control issues in the oral healthcare setting. RESULTS: Currently available knowledge related to TB infection-control issues is supported by data derived from well-conducted trials or extensive controlled observations. In the absence of supportive data the information is supported with the best-informed, most authoritative opinion available. CONCLUSION: Essential elements of an effective TB infection-control plan include a three-level hierarchy of administrative, environmental, and respiratory-protection controls. CLINICAL SIGNIFICANCE: Standard precautions provide the fabric for strategies to prevent or reduce the risk of exposure to bloodborne pathogens and other potentially infectious material. However, standard precautions are inadequate to prevent the spread of organisms through droplet nuclei 1-5 micron in diameter and additional measures are necessary to prevent the spread of Mycobacterium tuberculosis. Oral healthcare settings have been identified as outpatient settings in which patients with suspected or confirmed infectious TB disease are expected to be encountered. Therefore, oral healthcare settings must have a written TB infection-control program.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | RECOMMENDATIONS | CLINICAL RESEARCH | DENTISTS | HEALTH PERSONNEL | DENTAL HEALTH | ORAL EFFECTS | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | BEST PRACTICES | RISK REDUCTION BEHAVIOR | OCCUPATIONAL HEALTH | Developed Countries | North America | Americas | Research Methodology | Delivery of Health Care | Health | Physiology | Biology | Infections | Diseases | Health Services | Programs | Organization and Administration | Behavior
Document Number: 325801

18.

19.

Peer Reviewed

Title: Has donor prioritization of HIV / AIDS displaced aid for other health issues?
Author: Shiffman J
Source: Health Policy and Planning. 2008;23(2):95-100.
Abstract: Advocates for many developing-world health and population issues have expressed concern that the high level of donor attention to HIV/AIDS is displacing funding for their own concerns. Even organizations dedicated to HIV/AIDS prevention and treatment have raised this issue. However, the issue of donor displacement has not been evaluated empirically. This paper attempts to do so by considering donor funding for four historically prominent health agendas-HIV/AIDS, population, health sector development and infectious disease control-over the years 1992 to 2005. The paper employs funding data from the Organization for Economic Cooperation and Development's (OECD) Development Assistance Committee, supplemented by data from other sources. Several trends indicate possible displacement effects, including HIV/AIDS' rapidly growing share of total health aid, a concurrent global stagnation in population aid, the priority HIV/AIDS control receives in US funding, and HIV/AIDS aid levels in several sub-Saharan African states that approximate or exceed the entirety of their national health budgets. On the other hand, aggregate donor funding for health and population quadrupled between 1992 and 2005, allowing for funding growth for some health issues even as HIV/AIDS acquired an increasingly prominent place in donor health agendas. Overall, the evidence indicates that displacement is likely occurring, but that aggregate increases in global health aid may have mitigated some of the crowding-out effects. (author's)
Language: English
Keywords:
DEVELOPING COUNTRIES | CRITIQUE | POLICYMAKERS | FOREIGN AID | HIV PREVENTION | AIDS PREVENTION | TREATMENT | HEALTH POLICY | POPULATION PROGRAMS | COMMUNICABLE DISEASE CONTROL | Administrative Personnel | Organization and Administration | Financial Activities | Economic Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | Population Control | Population Policy | Social Policy
Document Number: 324664

20.

Peer Reviewed

Title: Reaching the limits of tuberculosis prevention among foreign-born individuals: A tuberculosis-control program perspective.
Author: Walter ND; Jasmer RM; Grinsdale J; Kawamura LM; Hopewell PC; Nahid P
Source: Clinical Infectious Diseases. 2008 Jan 1;46(1):103-106.
Abstract: Analysis of whether assiduous implementation of American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America guidelines for targeted testing and treatment of latent tuberculosis infection could have prevented any of 223 cases of active tuberculosis in foreign-born persons in San Francisco during the period 2002-2003. We report that 62% of these cases were not preventable and conclude that a further reduction in the incidence of tuberculosis among foreign-born persons will be modest without modification of current guidelines.
Language: English
Keywords:
CALIFORNIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | FOREIGNERS | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SCREENING | RECORDS | Developed Countries | United States of America | North America | Americas | Research Methodology | Nationality | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Health Services | Delivery of Health Care | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Information Processing | Information
Document Number: 325753

21.

Peer Reviewed

Title: Adapting a generic tuberculosis control operational guideline and scaling it up in China: a qualitative case study.
Author: Wei X; Walley JD; Liang X; Liu F; Zhang X; Li R
Source: BMC Public Health. 2008;8:260.
Abstract: BACKGROUND: The TB operational guideline (the deskguide) is a detailed action guide for county TB doctors aiming to improve the quality of DOTS, while the China national TB policy guide is a guide to TB control that is comprehensive but lacks operational usability for frontline TB doctors. This study reports the process of deskguide adaptation, its scale-up and lessons learnt for policy implications. METHODS: The deskguide was translated, reviewed, and revised in a working group process. Details of the eight adaptation steps are reported here. An operational study was embedded in the adaptation process. Two comparable prefectures were chosen as pilot and control sites in each of two participating provinces. In the pilot sites, the deskguide was used with the national policy guide in routine in-service training and supervisory trips; while in the control sites, only the national policy guide was used. In-depth interviews and focus groups were conducted with 16 county TB doctors, 16 township doctors, 17 village doctors, 63 TB patients and 57 patient family members. Following piloting, the deskguide was incorporated into the national TB guidelines for county TB dispensary use. RESULTS: Qualitative research identified that the deskguide was useful in the daily practice of county TB doctors. Patients in the pilot sites had a better knowledge of TB and better treatment support compared with those in the control sites. CONCLUSION: The adaptation process highlighted a number of general strategies to adapt generic guidelines into country specific ones: 1) local policy-makers and practitioners should have a leading role; 2) a systematic working process should be employed with capable focal persons; and 3) the guideline should be embedded within the current programmes so it is sustainable and replicable for further scale-up.
Language: English
Keywords:
CHINA | METHODOLOGICAL STUDIES | MANUAL | CASE CONTROL STUDIES | CASE STUDIES | QUALITATIVE EVALUATION | OPERATIONS RESEARCH | PILOT PROJECTS | FOCUS GROUPS | PHYSICIANS | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | GROUP PROCESSES | TRAINING PROGRAMS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Evaluation | Program Evaluation | Programs | Organization and Administration | Data Collection | Health Personnel | Delivery of Health Care | Health | Infections | Diseases | Health Services | Treatment | Medical Procedures | Medicine | Social Behavior | Behavior | Education
Document Number: 328461

22.

Title: Avian influenza: Critical program issues.
Author: Yansen S; Safi B; Nuzzo J; Barnett D
Source: Baltimore, Maryland, Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Information and Knowledge for Optimal Health [INFO], 2008 Feb 21. [2] p. (Global Health Technical BriefsUSAID Grant No. GPH-A-00-02-00003-00) http://www.maqweb.org/techbriefs/spanish/stb46avianflu.pdf (Spanish)
Abstract: While the spread of avian influenza (H5N1) virus from person-to-person is currently rare and unsustained, H5N1 continues to pose a significant threat to public health and economies worldwide. All evidence to date indicates that close contact with dead or sick birds is the principal source of human infection with H5N1. Key protective practices endorsed by international agencies include washing (proper hygiene), separating chickens/birds, reporting dead or sick chickens/birds, and cooking poultry properly. Strategic AI communication can effectively increase awareness of AI risks, means of transmission, and promote sustained behavior change when carefully delivered. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | INFLUENZA | COMMUNICABLE DISEASE CONTROL | HYGIENE | INFECTION TRANSMISSION | BEHAVIOR CHANGE COMMUNICATION | ANTIVIRAL DRUGS | VACCINES | POLITICAL FACTORS | USAID | Administrative Personnel | Organization and Administration | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Public Health | Infections | Behavior Change | Behavior | Communication Programs | Communication | Drugs | Treatment | Medical Procedures | Medicine | Sociocultural Factors | Government Agencies | Organizations
Document Number: 326800

23.

Title: [Elimination of measles in the Republic of Korea, 2001-2006. Elimination de la rougeole en Republique de Coree, 2001-2006.
Source: Weekly Epidemiological Record. 2007 Apr 6;82(14):118-124.
Abstract: Before the introduction of measles-containing vaccine, measles was endemic in the Republic of Korea. In early 2001, the Republic of Korea developed a national 5-year plan to eliminate measles. One of the requirements of this plan was that children must have had 2 doses of measles-containing vaccine (MCV2) by the time they start school; the plan also included a measles catch-up vaccination campaign covering a wide age range of children and case-based surveillance with laboratory confirmation of suspected cases of measles. This article describes the progress made towards eliminating measles in the Republic of Korea between 2001 and the end of 2006. Measles-containing vaccine became available in the Republic of Korea in 1965; in 1983, measles-mumps-rubella immunization was included in the National Immunization Programme, with 1 dose administered between the ages of 9-15 months. In 1997, a 2-dose schedule (administered at 12-15 months and 4-6 years) was implemented. A survey in December 2000 demonstrated that MCV2 coverage was 39% among children aged 7 to 9 years. Between January 2000 and July 2001, a measles epidemic occurred during which >55 000 cases (118 cases/100 000 population) and 7 deaths were recorded. The age distribution of cases was bimodal, with children aged < 2 years and those aged 7-15 years comprising the majority of cases. The majority of cases (86%) aged < 2 years had not been vaccinated, and about 80% of school-aged children had received only MCV1. A total of 15 measles virus strains were isolated and identified as genotype H1. (excerpt)
Language: EnglishFrench
Keywords:
REPUBLIC OF KOREA | EVALUATION REPORT | EPIDEMIOLOGIC METHODS | CHILDREN | MEASLES | IMMUNIZATION | CAMPAIGNS | ADMINISTRATION AND DOSAGE | AGE FACTORS | COMMUNICABLE DISEASE CONTROL | SCHOOL-BASED SERVICES | INCIDENCE | PREVALENCE | Developed Countries | Asia, Eastern | Asia | Evaluation | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Communication Programs | Communication | Drugs | Treatment | Medical Procedures | Medicine | Programs | Organization and Administration | Measurement
Document Number: 314968

24.

Peer Reviewed

Title: Financing the fight against AIDS, tuberculosis, and malaria.
Source: Lancet. 2007 Oct 6;370(9594):1190.
Abstract: Last week saw some positive announcements in global health financing. At a meeting in Berlin, Germany, donor countries pledged US$9.7 million over the next 3 years to replenish the coffers of the Global Fund to Fight AIDS, Tuberculosis and Malaria. (PRODUCT) RED announced that it had raised US$45 million for the fund since its launch in 2006. And, Germany and Indonesia became the first countries to take part in the Global Fund's new debtconversion initiative, Debt2Health. Germany has agreed to cancel 50 million of Indonesia's debt if it spends half of this money on domestic Global Fund programmes. Debt2Health is a welcome addition to the growing number of innovative financing mechanisms-such as UNITAID, which mobilises airline tax-revenues to purchase drugs for HIV/AIDS, tuberculosis, and malaria. But such initiatives will not be enough on their own. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | DEVELOPED COUNTRIES | PROGRESS REPORT | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | FINANCIAL ACTIVITIES | FOREIGN AID | HIV PREVENTION | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | MALARIA PREVENTION | GOVERNMENT FINANCING | FUNDS | Administrative Personnel | Organization and Administration | Economic Factors | HIV Infections | Viral Diseases | Diseases | Infections | Health Services | Delivery of Health Care | Health | Malaria | Parasitic Diseases
Document Number: 321850

25.

Title: Inadequate, but not quite hopeless.
Source: Lancet Infectious Diseases. 2007 Jul;7(7):439.
Abstract: The 2007 Group of Eight (G8) summit, which took place in Heiligendamm, Germany, on June 6-8, has been described by John Kirton (G8 Research Group, University of Toronto, Canada) as an "emerging centre of democratic global governance". Like many self-appointed elites, the G8 is an idiosyncratic club. The eight started as six in 1975 with a meeting in Rambouillet, France, of the heads of government of France, West Germany, Italy, Japan, the UK, and the USA-the most economically powerful democratic nations. This annual forum for discussion of matters of mutual interest was joined by Canada in 1976, by the European Union in 1977, and by Russia in 1997. Although the G8 nations account for nearly two-thirds of world economic output, the Russian economy is not among the world's top eight, whereas China with the fourth largest economy remains outside the G8 club. (excerpt)
Language: English
Keywords:
DEVELOPED COUNTRIES | DEVELOPING COUNTRIES | CRITIQUE | INTERNATIONAL AGENCIES | GOVERNMENT | LOW INCOME POPULATION | INTERNATIONAL COOPERATION | GOALS | FOREIGN AID | COMMUNICABLE DISEASE CONTROL | PROGRAM EVALUATION | Organizations | Political Factors | Sociocultural Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Planning | Organization and Administration | Financial Activities | Health Services | Delivery of Health Care | Health | Programs
Document Number: 318069

26.

Title: Communication for Healthy Living's campaign improves response to avian influenza in Egypt.
Author: Johns Hopkins Bloomberg School of Public Health. Center for Communication Programs. Health Communication Partnership
Source: Communication Impact!. 2007 Feb;(22):2 p.
Abstract: Within hours of the confirmation of the first cases of the H5N1 "Avian Influenza" (AI) virus in Egypt on February 17, 2006, all the major state-owned television channels were airing an informative TV spot showing families how to protect themselves from the deadly virus. The Communication for Healthy Living (CHL) Project, whose core partners include the Ministry of Health and Population (MOHP) and the Ministry of Information/State Information Service (MOI/SIS), worked well before any outbreak, under the "Your Health Is Your Wealth" Program, to develop an integrated package of communication interventions. Their goal was to develop a quick, unified and effective response to any outbreak. As a result of this concerted effort, which included broadcast and print materials as well as community outreach activities, 86 percent of the adult population--an estimated 38 million people--were able to recall messages from the campaign. Seventy-eight percent of those--nearly 30 million people--reported taking at least one protective action, including avoiding contact with birds, keeping children and the elderly away from poultry, and washing their hands and utensils more carefully after preparing poultry. (excerpt)
Language: English
Keywords:
EGYPT | SUMMARY REPORT | KAP SURVEYS | GOVERNMENT AGENCIES | CAMPAIGNS | INFLUENZA | INFECTION PREVENTION | BEHAVIOR CHANGE COMMUNICATION | TELEVISION PROGRAM | BROADCAST MEDIA | PRINTED MEDIA | COMMUNITY PARTICIPATION | HOTLINES | INTEGRATED PROGRAMS | COMMUNICABLE DISEASE CONTROL | COMMUNICATION STRATEGY | Developing Countries | Africa, North | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Organizations | Political Factors | Sociocultural Factors | Communication Programs | Communication | Viral Diseases | Diseases | Infections | Behavior Change | Behavior | Television | Mass Media | Organization and Administration | Information | Programs | Health Services | Delivery of Health Care | Health
Document Number: 310008

27.

Title: Improving child health through the Accredited Drug Dispensing Outlet Program: baseline survey from five districts in Tanzania.
Author: Management Sciences for Health [MSH]. Center for Pharmaceutical Management. Rational Pharmaceutical Management Plus; Tanzania. Centre for Enhancement of Effective Malaria Interventions [CEEMI]; Partnership for Child Health Care. Basic Support for Institutionalizing Child Survival [BASICS]
Source: Arlington, Virginia, MSH, Center for Pharmaceutical Management, Rational Pharmaceutical Management Plus, 2007 Sep. [60] p. (USAID Cooperative Agreement No. HRN-A-00-00-00016-00)
Abstract: In Tanzania, diarrhea, malaria, and pneumonia are the main causes of morbidity and mortality in young children. Together, they account for more than 50 percent of all childhood mortality in the country. Integrated Management of Childhood Illness (IMCI), first introduced in Tanzania in 1997, is a strategy to improve child health and ultimately reduce child mortality by addressing these three key common childhood conditions. In more than 60 percent of the health districts in Tanzania health workers have been trained in IMCI, and preliminary results show that the strategy has been effective in improving treatment of sick children. However, because accessibility to public health facilities is limited and essential medicines are frequently out of stock at those facilities, many caregivers of sick children seek medicines outside the public sector, particularly in private pharmacies. The Ministry of Health and Social Welfare (MOHSW) of Tanzania, through the Tanzania Food and Drugs Authority (TFDA) and with support from the U.S. Agency for International Development (USAID) through the Rational Pharmaceutical Management (RPM) Plus Program of Management Sciences for Health (MSH) and with technical support from the Basic Support for Institutionalizing Child Survival (BASICS) project for behavior change communication (BCC), is developing a child health component to integrate into the expanding network of accredited Duka la Dawa Muhimu private drug outlets, also known as the Accredited Drug Dispensing Outlet (ADDO) program. (excerpt)
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | BASELINE SURVEYS | KAP SURVEYS | CHILDREN | USAID | PHARMACY DISTRIBUTION | DISTRIBUTIONAL ACTIVITIES | ANTIBIOTICS | PARASITE CONTROL | CHILD HEALTH SERVICES | DIARRHEA | MALARIA PREVENTION | PNEUMONIA | COMMUNICABLE DISEASE CONTROL | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Nonclinical Distribution | Program Activities | Programs | Organization and Administration | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Maternal-Child Health Services | Primary Health Care | Diseases | Malaria | Parasitic Diseases | Pulmonary Effects | Physiology | Biology
Document Number: 324249

29.

Title: Water, sanitation, and hygiene: Simple, effective solutions save lives.
Author: World Bank. Disease Control Priorities Project
Source: [Washington, D.C.], World Bank, Disease Control Priorities Project, 2007 May. [4] p.
Abstract: While sometimes not considered a public health priority, improvements to water supply, sanitation services, and hygiene promotion greatly reduce the incidence of diarrheal diseases, trachoma, and water-based parasitic diseases. Improvements to services are generally financed by transportation or infrastructure sectors and not part of health expenditures. However there are many steps public health policy makers can take, at low-cost, to ensure that services and benefits are optimized. (excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | PROGRESS REPORT | CROSS-CULTURAL COMPARISONS | POPULATION | WATER SUPPLY | SANITATION | HYGIENE | ECONOMIC FACTORS | COST EFFECTIVENESS | PUBLIC HEALTH | LATRINES | COMMUNICABLE DISEASE CONTROL | INTERVENTIONS | Comparative Studies | Studies | Research Methodology | Natural Resources | Environment | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Health Services | Delivery of Health Care | Programs | Organization and Administration
Document Number: 325122

30.

Peer Reviewed

Title: Barriers to reaching the targets for tuberculosis control: multidrug-resistant tuberculosis.
Author: Blondal K
Source: Bulletin of the World Health Organization. 2007 May;85(5):325-420.
Abstract: The development and expansion of WHO's DOTS strategy was successful, with 83% of the world's population living in countries or parts of countries covered by this strategy by the end of 2004. Treatment success in the 2003 DOTS cohort of 1.7 million patients was 82% on average, close to the 85% target. Treatment success was below average in the African Region (72%), which can be partly attributed to occurrence of HIV co-infection, and in the European Region (75%), partly due to drug resistance. Drug resistance, specifically multidrug resistance and extensive drug resistance, is a serious threat to public health in all countries, especially in the Russian Federation, where the highest rates of multidrug resistance are presently accompanied by a rapid increase in HIV infection. Based on the experience of the first projects approved by the Green Light Committee, the treatment success of patients with multidrug-resistant tuberculosis (MDR-TB) is lower than that of drug-susceptible cases, but nevertheless reaches 70%. The collaborative effort of different organizations, professionals and communities is needed to address the development and spread of multidrug resistance and extensive drug resistance, which combined with the epidemic of HIV infection is one of the barriers to dealing effectively with TB. This effort should be directed towards facilitating the diagnosis and treatment of TB patients, in particular by improving access to drug susceptibility testing and strengthening treatment delivery by rigorous adherence to DOTS as outlined by the Stop TB Partnership. (author's)
Language: English
Keywords:
SWITZERLAND | GLOBAL | SUMMARY REPORT | WHO | LABORATORY EXAMINATIONS AND DIAGNOSES | TUBERCULOSIS |