| 1. Title: Progress toward the 2012 measles elimination goal--Western Pacific Region, 1990-2008. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 26;58(24):669-73. Abstract: In 2003, the World Health Organization (WHO) Regional Committee of the Western Pacific Region (WPR) formally declared a measles elimination goal, and in 2005, the committee established a target date of 2012 for regional measles elimination. Key strategies recommended by WHO for achievement of measles elimination include 1) very high (>or=95%) vaccination coverage with 2 doses of measles-containing vaccine (MCV1 and MCV2) through routine vaccination and/or supplemental immunization activities (SIAs); 2) high-quality case-based measles surveillance; and 3) access to an accredited measles laboratory network for testing of suspected measles cases and identification of measles virus genotypes. This report describes progress toward measles elimination in the WPR through 2008. Measles likely has been eliminated or nearly eliminated in 24 of the 37 countries and areas in the WPR (referred to in this report as countries). However, large numbers of measles cases continue to be reported from several countries. During 2008, a total of 131,441 confirmed measles cases (98.4 per million population) were reported from China and 11,015 cases (86.1 per million population) from Japan, two countries that account for 82% of the region's population and >97% of its confirmed measles cases. Intensified efforts by WPR countries, particularly China and Japan, will be required to achieve the 2012 goal. Language: English Keywords: OCEANIA | SUMMARY REPORT | INCIDENCE | MEASLES | VACCINES | IMMUNIZATION | PREVENTION AND CONTROL | MONITORING | SCREENING | Developing Countries | Measurement | Research Methodology | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care | Evaluation | Examinations and Diagnoses Document Number: 341752 |
2.  Peer Reviewed Title: Assessment of childhood immunisation coverage [letter] Author: Aaby P; Benn CS Source: Lancet. 2009 Apr 25;373(9673):1428. Abstract: Stephen Lim and colleagues scrutinise coverage with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) in 193 countries. With donor emphasis on DTP3 coverage, it is not surprising that the national estimates might be inflated. Still, there is little doubt that DTP3 coverage has increased in recent decades. But maybe we should be more concerned about the health implications of this trend than about the accuracy of the estimate. From a public health perspective, the fact that DTP3 coverage is now higher than measles vaccine coverage in most African countries is of questionable value. Numerous studies have shown that measles vaccine is beneficial for child survival, but there are conflicting data about the effect of DTP. DTP has frequently been associated with increased mortality in situations with herd immunity. Furthermore, as a result of the drive to increase the DTP3 coverage, more children receive DTP simultaneously with or after measles vaccine. We have found consistently that DTP given simultaneously with measles vaccine (table) or after it is associated with increased mortality compared with having measles vaccine alone as the most recent vaccine. In a study from Bangladesh, children who received DTP/BCG after the age of measles vaccine administration had around threefold higher mortality than unvaccinated children. These observations have not been contradicted. If they are true, the drive to boost the DTP3 coverage could lead to increased child mortality. Current policy is based on the assumption that receiving three DTP vaccines is associated with decreased child mortality. It should be a major priority to determine whether this assumption is correct. (full-text) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGIC METHODS | CHILDREN | IMMUNIZATION | PERTUSSIS | TETANUS | DIPHTHERIA | Comparative Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Bacterial and Fungal Diseases | Infections | Diseases Document Number: 341150 |
| 3. Peer Reviewed Title: Faith and child survival: the role of religion in childhood immunization in Nigeria. Author: Antai D Source: Journal of Biosocial Science. 2009 Jan;41(1):57-76. Abstract: This study assessed the role of mother's religious affiliation in child immunization status of surviving children 12 months of age and older in Nigeria, using data from the 2003 Nigeria Demographic and Health Survey (NDHS). Guided by two competing hypotheses--the 'characteristics hypothesis' and the 'particularized theology hypothesis'--variations in the risks of child immunization in Nigeria were examined using logistic regression analysis. The results indicate that religion plays a role in the risk of non-immunization; religion was not associated with the risk of partial immunization; however, religion was significantly associated with the reduced risk of full immunization. Language: English Keywords: NIGERIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | MOTHERS | CHILDREN | IMMUNIZATION | RELIGION | UTILIZATION OF HEALTH CARE | BELIEFS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Primary Health Care | Health Services | Delivery of Health Care | Health | Culture Document Number: 330568 |
| 4. Title: Factors predicting BCG immunization status in northern Nigeria: a behavioral-ecological perspective. Author: Babalola S; Lawan U Source: Journal of Child Health Care. 2009 Mar;13(1):46-62. Abstract: This study examines the predictors of Bacille Calmette-Guerin (BCG) immunization status among infants in northern Nigeria using a behavioral-ecological model. The findings show only 37.3 percent of the children had received BCG vaccine, and reveal that BCG immunization status in northern Nigeria is influenced by multiple layers of factors, including child's characteristics, parental or household factors, community characteristics, vaccine supply and the policy environment. At the child's level, place of birth and ownership of an immunization card are the two most significant predictors. The parental and household predictors of BCG immunization status include maternal use of antenatal care, maternal knowledge about immunization, maternal exposure to child health information, social influence and paternal approval of immunization. Both the regularity of vaccine supply to the health facility and the state of residence are associated independently with BCG immunization status. These findings stress the need for interventions at multiple levels in order to increase BCG immunization status. Language: English Keywords: NIGERIA | RESEARCH REPORT | ACTION RESEARCH | INFANT | INFANT HEALTH | IMMUNIZATION | SOCIOECONOMIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Health | Health | Primary Health Care | Health Services | Delivery of Health Care | Economic Factors Document Number: 341722 |
| 5. Title: Reaching every district - development and testing of a health micro-planning strategy for reaching difficult to reach populations in Mongolia. Author: Enkhtuya B; Badamusuren T; Dondog N; Khandsuren L; Elbegtuya N; Jargal G; Surenchimeg V; Grundy J Source: Rural and Remote Health. 2009 Apr-Jun;9(2):1045. Abstract: CONTEXT: Since the 1990s, Mongolia has undergone a rapid social and economic transition with migration to the urban areas of the national capital Ulaanbaatar. The main reasons for the migration are social sector decline in rural areas and the potential for employment opportunities in urban areas. There are also new internal patterns of migration in rural and remote areas relating to recent developments in the economic sector. Despite recent innovations in health system management in Mongolia, in some urban and rural and remote locations health services are not sufficiently accessed by the most socially and economically disadvantaged populations. These concerns provided the motivation for the Ministry of Health of Mongolia and development partners to attempt to access the most difficult to reach populations through the development of a micro-planning process referred to as the 'Reaching Every District strategy' (RED). This article describes and analyses RED micro-planning processes and content, and highlights the lessons learned. The main source of data for this planning system development was in the development and testing of the micro-planning process in Byanzurkh District, Ulaanbaatar in June 2008. INTERVENTION: The principal intervention developed and trialed was a health micro-planning strategy for improved access to immunization and maternal and child health services for difficult to reach populations. The planning methodology was a problem-solving approach progressing from health mapping to barrier analysis, to activity planning and costing and finally to monitoring and evaluation. LESSONS LEARNED: Main success factors in the development of the planning methodology were the use of barrier analysis and mapping approaches for data analysis and problem solving at the local level, and re-orientation of management approaches from 'inspection' to supportive supervision. Additionally, although the RED strategy is intended to be an immunization-specific intervention internationally, evidence from the development and trial of the process in Mongolia indicates its potential for wider health systems applications. This is particularly so for detecting and responding to the maternal and child health service needs of the more difficult to reach sub-populations. Language: English Keywords: MONGOLIA | RESEARCH REPORT | CHILDREN | CHILD SURVIVAL | CHILD HEALTH | IMMUNIZATION | HEALTH SERVICES | PLANNING | MONITORING | Developing Countries | Asia, Northern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Survivorship | Length of Life | Mortality | Population Dynamics | Health | Primary Health Care | Delivery of Health Care | Organization and Administration | Evaluation Document Number: 341537 |
| 6. Peer Reviewed Title: [Impact of immunization measures by the Family Health Program on infant mortality from preventable diseases in Olinda, Pernambuco State, Brazil] Impacto das acoes de imunizacao pelo Programa Saude da Familia na mortalidade infantil por doencas evitaveis em Olinda, Pernambuco, Brasil. Author: Guimaraes TM; Alves JG; Tavares MM Source: Cadernos de Saude Publica. 2009 Apr;25(4):868-876. Abstract: This article analyzes the impact of the Family Health Program (FHP) on infant health in Olinda, Pernambuco State, Brazil, evaluating immunization and infant mortality from vaccine-preventable diseases. A time-series study was conducted with data from the principal health information systems, analyzing indicators before and after implementation of the FHP in 1995. The independent variable was year of birth, related to degree of population coverage by the FHP. Three periods were analyzed: 1990-1994 (prior), 1995-1996 (implementation phase: 0 to 30% coverage), and 1997-2002 (intervention: coverage of 38.6% to 54%). Trends in the indicators were analyzed by simple linear regression, testing significance with the t test. During the implementation period there was an increase in all the vaccination coverage rates (176% BCG, 223% polio, 52% DPT, 61% measures) and a decrease in infant mortality from preventable diseases (12.7 deaths/year), even without a decrease in absolute poverty in the municipality or an increase in either coverage by the public health care system or the sewage system. Improvement in the indicators demonstrates the effectiveness of FHP actions in the municipality. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | IMPACT | IMMUNIZATION | INFANT MORTALITY | DISEASE PREVENTION | PREVENTION AND CONTROL | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Communication | Primary Health Care | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population | Diseases | Programs | Organization and Administration Document Number: 341866 |
| 7. Peer Reviewed Title: Community response to intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in five African settings. Author: Gysels M; Pell C; Mathanga DP; Adongo P; Odhiambo F; Gosling R; Akweongo P; Mwangi R; Okello G; Mangesho P; Slutsker L; Kremsner PG; Grobusch MP; Hamel MJ; Newman RD; Pool R Source: Malaria Journal. 2009 Aug 10;8(1):191. Abstract: ABSTRACT: BACKGROUND: IPTi delivered through EPI has been shown to reduce the incidence of clinical malaria by 20-59%. However, new health interventions can only be effective if they are also socially and culturally acceptable. It is also crucial to ensure that attitudes to IPTi do not negatively influence attitudes to and uptake of immunization, or that people do not misunderstand IPTi as immunization against malaria and neglect other preventive measures or delay treatment seeking. METHODS: These issues were studied in five African countries in the context of clinical trials and implementation studies of IPTi. Mixed methods were used, including structured questionnaires (1,296), semi-structured interviews (168), in-depth interviews (748) and focus group discussions (95) with mothers, fathers, health workers, community members, opinion leaders, and traditional healers. Participant observation was also carried out in the clinics. RESULTS: IPTi was widely acceptable because it resonated with existing traditional preventive practices and a general concern about infant health and good motherhood. It also fit neatly within already widely accepted routine vaccination. Acceptance and adherence were further facilitated by the hierarchical relationship between health staff and mothers and by the fact that clinic attendance had a social function for women beyond acquiring health care. Type of drug and regimen were important, with newer drugs being seen as more effective, but potentially also more dangerous. Single dose infant formulations delivered in the clinic seem to be the most likely to be both acceptable and adhered to. There was little evidence that IPTi per se had a negative impact on attitudes to EPI or that it had any affect on EPI adherence. There was also little evidence of IPTi having a negative impact on health seeking for infants with febrile illness or existing preventive practices. CONCLUSIONS: IPTi is generally acceptable across a wide range of settings in Africa and involving different drugs and regimens, though there is a strong preference for a single dose infant formulation. IPTi does not appear to have any negative effect on attitudes to EPI, and it is not interpreted as immunization against malaria. Language: English Keywords: AFRICA | RESEARCH REPORT | CLINICAL TRIALS | INCIDENCE | INFANT HEALTH | SAFE MOTHERHOOD | MATERNAL HEALTH | MALARIA | IMMUNIZATION | PREVENTIVE HEALTH CARE | PROGRAM ACCEPTABILITY | Developing Countries | Clinical Research | Research Methodology | Measurement | Child Health | Health | Parasitic Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration Document Number: 342542 |
| 8. Peer Reviewed Title: Population immunity to measles virus and the effect of HIV-1 infection after a mass measles vaccination campaign in Lusaka, Zambia: a cross-sectional survey. Author: Lowther SA; Curriero FC; Kalish BT; Shields TM; Monze M; Moss WJ Source: Lancet. 2009 Mar 21;373(9668):1025-32. Abstract: BACKGROUND: Measles control efforts are hindered by challenges in sustaining high vaccination coverage, waning immunity in HIV-1-infected children, and clustering of susceptible individuals. Our aim was to assess population immunity to measles virus after a mass vaccination campaign in a region with high HIV prevalence. METHODS: 3 years after a measles supplemental immunisation activity (SIA), we undertook a cross-sectional survey in Lusaka, Zambia. Households were randomly selected from a satellite image. Children aged 9 months to 5 years from selected households were eligible for enrolment. A questionnaire was administered to the children's caregivers to obtain information about measles vaccination history and history of measles. Oral fluid samples were obtained from children and tested for antibodies to measles virus and HIV-1 by EIA. FINDINGS: 1015 children from 668 residences provided adequate specimens. 853 (84%) children had a history of measles vaccination according to either caregiver report or immunisation card. 679 children (67%) had antibodies to measles virus, and 64 (6%) children had antibodies to HIV-1. Children with antibodies to HIV-1 were as likely to have no history of measles vaccination as those without antibodies to HIV-1 (odds ratio [OR] 1.17, 95% CI 0.57-2.41). Children without measles antibodies were more likely to have never received measles vaccine than those with antibodies (adjusted OR 2.50, 1.69-3.71). In vaccinated children, 33 (61%) of 54 children with antibodies to HIV-1 also had antibodies to measles virus, compared with 568 (71%) of 796 children without antibodies to HIV-1 (p=0.1). INTERPRETATION: 3 years after an SIA, population immunity to measles was insufficient to interrupt measles virus transmission. The use of oral fluid and satellite images for sampling are potential methods to assess population immunity and the timing of SIAs. Language: English Keywords: ZAMBIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | URBAN POPULATION | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | IMMUNIZATION | HIV INFECTIONS | COMPLICATIONS | SEROCONVERSION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Primary Health Care | Health Services | Delivery of Health Care | Health | Immunity | Immune System | Physiology | Biology Document Number: 330988 |
| 10. Peer Reviewed Title: Rich-poor gap in utilization of reproductive and child health services in India, 1992-2005. Author: Mohanty SK; Pathak PK Source: Journal of Biosocial Science. 2009 May;41(3):381-98. Abstract: This paper examines the trends in utilization of five indicators of reproductive and child health services, namely, childhood immunization, medical assistance at delivery, antenatal care, contraceptive use and unmet need for contraception, by wealth index of the household in India and two disparate states, Uttar Pradesh and Maharashtra. The data from three rounds of the National Family and Health Survey conducted during 1992-2005 are analysed. The wealth index is computed using principal component derived weights from a set of consumer durables, land size, housing quality and water and sanitation facilities of the household, and classified into quintiles for all three rounds. Bivariate analyses, rich-poor ratio and concentration index are used to understand the trends in utilization of, and inequality in, reproductive and child health services. The results indicate huge disparities in utilization of these services, largely to the disadvantage of the poor. Utilization of basic childhood immunization among the poorest and the poor stagnated in India, as well as in both states, during 1998-2005 compared with 1992-1998. The use of maternal care services such as medical assistance at delivery and antenatal care remained at a low level among the poor over this period. However, contraceptive use increased relatively faster among the poor, even with higher unmet need. Of all these services, the inequality in medical assistance at delivery is consistently large, while that of contraceptive use is small. The state-level differences in service coverage by wealth quintiles over time are large. Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | HOUSEHOLDS | REPRODUCTIVE HEALTH | CHILD HEALTH SERVICES | UTILIZATION OF HEALTH CARE | SOCIOECONOMIC STATUS | INEQUALITIES | ANTENATAL CARE | NEEDS | IMMUNIZATION | Asia, Southern | Asia | Developing Countries | Health | Family and Household | Sociocultural Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Socioeconomic Factors | Economic Factors | Maternal Health Services Document Number: 341404 |
11.  Title: Nicaragua: Combining demand- and supply-side incentives. Author: Regalia F; Castro L Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :215-235. Abstract: A conditional cash transfer program should incorporate both demand-side and supply-side performance incentives. Significant improvements are seen in immunizations, growth monitoring, and reductions in stunting. Two-phase impact evaluation does not disentangle the individual impacts of demand-side and supply-side incentives, but its results suggest that a well-targeted strategy of supply-side performance incentives could, on its own, be enough to achieve and maintain high levels of health care service use among poor rural populations. Language: English Keywords: NICARAGUA | RESEARCH REPORT | LOW INCOME POPULATION | IMMUNIZATION | DELIVERY OF HEALTH CARE | HEALTH SERVICES | INCENTIVES | POVERTY | PROGRAM ACTIVITIES | MONITORING | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Primary Health Care | Health | Policy | Political Factors | Sociocultural Factors | Programs | Organization and Administration | Evaluation Document Number: 331458 |
| 12. Peer Reviewed Title: Preventive measures in infancy to reduce under-five mortality: a case-control study in The Gambia. Author: Rutherford ME; Dockerty JD; Jasseh M; Howie SR; Herbison P; Jeffries DJ; Mulholland K; Adegbola RA; Hill PC Source: Tropical Medicine and International Health. 2009 Feb;14(2):149-55. Abstract: OBJECTIVE: To investigate the relationship between child mortality and common preventive interventions: vaccination, trained birthing attendants, tetanus toxoid during pregnancy, breastfeeding and vitamin A supplementation. METHODS: Case-control study in a population under demographic surveillance. Cases (n = 141) were children under five who died. Each was age and sex-matched to five controls (n = 705). Information was gathered by interviewing primary caregivers. RESULTS: All but one of the interventions - whether the mother had received tetanus toxoid during pregnancy - were protective against child mortality after multivariate analysis. Having a trained person assisting at child birth (OR 0.2 95% CI 0.1-0.4), receiving all vaccinations by 9 months of age (OR 0.1; 95% CI 0.01-0.3), being breastfed for more than 12 months (Children breastfed between 13 and 24 months OR 0.1 95% CI 0.03-0.3, more than 25 months OR 0.1 95% CI 0.01-0.5) and receiving vitamin A supplementation at or after 6 months of age (OR 0.05; 95% CI 0.01-0.2) were protective against child death. CONCLUSIONS: This study confirms the value of at least four available interventions in the prevention of under-five death in The Gambia. It is now important to identify those who are not receiving them and why, and to intervene to improve coverage across the population. Language: English Keywords: GAMBIA | RESEARCH REPORT | CASE STUDIES | CHILDREN | CHILD SURVIVAL | BREASTFEEDING | IMMUNIZATION | CHILD MORTALITY | PREVENTION AND CONTROL | INTERVENTIONS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Survivorship | Length of Life | Mortality | Population Dynamics | Infant Nutrition | Nutrition | Health | Primary Health Care | Health Services | Delivery of Health Care | Diseases | Programs | Organization and Administration Document Number: 341034 |
| 13. Peer Reviewed Title: Timeliness and completion rate of immunization among Nigerian children attending a clinic-based immunization service. Author: Sadoh AE; Eregie CO Source: Journal of Health, Population, and Nutrition. 2009 Jun;27(3):391-5. Abstract: To achieve maximal protection against vaccine-preventable diseases, a child should receive all immunizations within recommended intervals. Clinic records of 512 Nigerian children were evaluated for timeliness in receiving vaccines and the completion rates of the schedule. About 30% of the children presented after four weeks of age for their first immunization; 18.9-65% of the children were delayed in receiving various vaccines compared to the recommended ages for receiving the vaccines. Only 227 (44.3%) children were fully immunized. Health education and mass mobilization of the community and health workers are recommended to improve the uptake of vaccines and to encourage timely receipt of vaccines. Language: English Keywords: NIGERIA | RESEARCH REPORT | CHILDREN | IMMUNIZATION | IMMUNIZATION SCHEDULE | TIME FACTORS | CLINIC ACTIVITIES | HEALTH EDUCATION | SOCIAL MOBILIZATION | VACCINES | ADMINISTRATION AND DOSAGE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Population Dynamics | Program Activities | Programs | Organization and Administration | Education | Social Change | Sociocultural Factors | Medical Procedures | Medicine | Drugs | Treatment Document Number: 341923 |
| 14. Title: Measles in Children Younger Than 9 Months in Pakistan. Author: Saleem AF; Zaidi A; Ahmed A; Warraich H; Mir F Source: Indian Pediatrics. 2009 Jul 1; Abstract: Pakistan has one of the highest burden of measles and measles related deaths in the world. We compared the clinical course and outcomes of measles in infants aged <9 months with those < 9 month old amongst children admitted to a tertiary care hospital. Data were collected by a retrospective chart review, and compared between age < 9 months (Group A) and age > 9 months (Group B). Severe malnutrition (P=0.039, AOR=3.02), anemia (P=0.017), leukocytosis (P<0.001, AOR 4.1), and conjunctivitis (P=0.021) were higher in Group A children. All four deaths occurred in Group B. Language: English Keywords: PAKISTAN | RESEARCH REPORT | COMPARATIVE STUDIES | DATA COLLECTION | MEASLES | IMMUNIZATION | EPIDEMICS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Viral Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 342539 |
| 15. Title: Life expectancy and welfare in Latin America and the Caribbean. Author: Soares RR Source: Health Economics. 2009 Apr;18 Suppl 1:S37-54. Abstract: This paper analyses the recent evolution of life expectancy in Latin American and Caribbean countries, and evaluates how much it has contributed to the overall improvements in welfare. We argue that increases in life expectancy between 1960 and 2000, which were largely independent of income, represented gains in welfare comparable to the ones derived from income growth. For countries in the region, estimates of welfare improvements accounting for health increase the numbers obtained from income alone by 40% on average. The available evidence suggests that improvements in public health infrastructure - such as provision of treated water and sewerage services - and large-scale immunization programs may have been the key factors behind the mortality reductions observed in the period. Language: English Keywords: CARIBBEAN | LATIN AMERICA | CRITIQUE | LIFE EXPECTANCY | SOCIAL WELFARE | PUBLIC HEALTH | IMMUNIZATION | WATER QUALITY | SANITATION | INCOME | INEQUALITIES | MORTALITY DECLINE | Developing Countries | Americas | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Economic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Water | Natural Resources | Environment | Socioeconomic Factors Document Number: 341985 |
| 16. Peer Reviewed Title: Traditional birth attendants in rural Nepal: Knowledge, attitudes and practices about maternal and newborn health. Author: Thatte N; Mullany LC; Khatry SK; Katz J; Tielsch JM; Darmstadt GL Source: Global Public Health. 2009 May 8;:1-17. Abstract: Efforts to formalise the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. TBAs' continued attendance at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. Twenty-one trained and untrained TBAs participated in focus groups and in-depth interviews about antenatal care, delivery practices, maternal complications and newborn care. Antenatal care included advice about nutrition and tetanus toxoid (TT) immunisation, but did not include planning ahead for transport in cases of complications. Clean delivery practices were observed by most TBAs, though hand-washing practices differed by training status. There was no standard practice to identify maternal complications, such as excessive bleeding, prolonged labour, or retained placenta, and most referred outside in the event of such complications. Newborn care practices included breastfeeding with supplemental feeds, thermal care after bathing, and mustard seed oil massage. TBAs reported high job satisfaction and desire to improve their skills. Despite uncertainty regarding the role of TBAs to manage maternal complications, TBAs may be strategically placed to make potential contributions to newborn survival. Language: English Keywords: NEPAL | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | RURAL POPULATION | TRADITIONAL BIRTH ATTENDANTS | ATTITUDES | MATERNAL-CHILD HEALTH SERVICES | ANTENATAL CARE | PREGNANCY COMPLICATIONS | TRANSPORTATION | IMMUNIZATION | MATERNAL NUTRITION | HYGIENE | EDUCATIONAL STATUS | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Psychological Factors | Behavior | Primary Health Care | Health Services | Maternal Health Services | Diseases | Economic Factors | Nutrition | Public Health | Socioeconomic Status | Socioeconomic Factors Document Number: 341473 |
| 17. Peer Reviewed Title: Integration of immunization services with other health interventions in the developing world: what works and why? Systematic literature review. Author: Wallace A; Dietz V; Cairns KL Source: Tropical Medicine and International Health. 2009 Jan;14(1):11-9. Abstract: OBJECTIVE: To assess benefits, challenges and characteristics of integrating child and maternal health services with immunization programmes. METHODS: Literature review using journal databases and grey literature. Papers meeting the inclusion criteria were rated for the quality of methodology and relevant information was systematically abstracted. RESULTS: Integrated services were vitamin A supplementation, bednet distribution, deworming tablet distribution, Intermittent Preventive Therapy for infants and referrals for family planning services. Two key characteristics of success were compatibility between interventions and presence of a strong immunization service prior to integration. Overburdened staff, unequal resource allocation and logistical difficulties were mentioned as risks of integration, whereas rapid uptake of the linked intervention and less competition for resources were listed as two key benefits of integration. CONCLUSION: The theoretical strengths of integrating other health services with immunization services remain to be rigorously proved in practice. When additional interventions are carefully selected for compatibility and when they receive adequate support, coverage of these interventions may improve, provided immunization coverage is already high. Evidence for the effectiveness of integration in increasing efficiency of resource use was insufficient and most benefits and challenges were not statistically quantified. More substantive information about the costs of integrated vs. vertical programmes and full documentation of the impacts of integration on immunization services should be published. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CHILDREN | INTEGRATED PROGRAMS | IMMUNIZATION | MATERNAL-CHILD HEALTH SERVICES | VITAMIN A | FOOD SUPPLEMENTATION | BED NETS | DISTRIBUTIONAL ACTIVITIES | PARASITE CONTROL | PREVENTIVE HEALTH CARE | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Public Health | Program Activities Document Number: 330264 |
| 18. Peer Reviewed Title: The 2007 Estimates for People at Risk for and Living With HIV in China: Progress and Challenges. Author: Wang L; Wang N; Wang L; Li D; Jia M; Gao X; Qu S; Qin Q; Wang Y; Smith K Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2009 Apr 1;50(4):414-8. Abstract: OBJECTIVE: To present the methods used for the 2007 estimates for the number of people at risk for and infected with HIV. DESIGN:: Estimation work took place throughout 2007, led by the National Center for AIDS and Sexually Transmitted Disease Control and Prevention in collaboration with United Nations AIDS and the World Health Organization. METHODS: The workbook method was used to process prefecture and county-level surveillance data to generate HIV prevalence by risk group for each prefecture, which was in turn imported into the spectrum model to generate estimates of new infections and HIV-related deaths. RESULTS: The working group estimated that as of 2007, there were 700,000 people living with HIV/AIDS in China, with 50,000 new infections and 20,000 HIV-related deaths in that year. Injection drug use and sexual contact are still primary modes of HIV transmission, with heterosexual contact quickly becoming the dominant route, making up 44.7% of new infections in 2007. The HIV/AIDS epidemic is still highly concentrated in certain areas, with wide variation in prevalence across regions. CONCLUSIONS: The 2007 estimates are based on the most accurate and local-level data available to date, including case reports, sentinel surveillance data, results from mass screening of key target groups, and special epidemiological studies. Language: English Keywords: ZAMBIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | SAMPLING STUDIES | PERSONS LIVING WITH HIV/AIDS | CHILDREN | PREVALENCE | MEASLES | HIV INFECTIONS | COMPLICATIONS | CAMPAIGNS | IMMUNIZATION | IMMUNOLOGICAL EFFECTS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Communication Programs | Communication | Primary Health Care | Health Services | Delivery of Health Care | Health | Immunity | Immune System | Physiology | Biology Document Number: 330986 |
| 19. Title: Attacking inequality in the health sector: a synthesis of evidence and tools. Author: Yazbeck AS Source: Washington, D.C., World Bank, 2009. [330] p. Abstract: The main purpose of this book is to make available the accumulated knowledge of successful policy and analytical tools in this fight to reverse the vicious circle of income-poverty and ill health. The book presents both a practical set of analytical tools for understanding the causes of inequality in the use of health services and a menu of proven pro-poor policy actions. It is based on the evaluation of 14 successful policy changes in low- and middle-income countries in Africa, Asia, and Latin America, and a review of the published literature on inequality in the health sector. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | DATA COLLECTION | LITERATURE REVIEW | LOW INCOME POPULATION | POVERTY | INEQUALITIES | DELIVERY OF HEALTH CARE | HEALTH POLICY | INFANT MORTALITY | FERTILITY | MATERNAL-CHILD HEALTH SERVICES | ANTENATAL CARE | CHILD HEALTH | IMMUNIZATION | CHILD NUTRITION | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Health | Policy | Political Factors | Sociocultural Factors | Mortality | Population Dynamics | Demographic Factors | Population | Primary Health Care | Health Services | Maternal Health Services | Nutrition Document Number: 331451 |
| 20. Title: Validation of neonatal tetanus elimination in selected states -- India, 2007. Source: Weekly Epidemiological Record. 2008 May 23;83(21):185-192. Abstract: In India, the global goal of eliminating neonatal tetanus has been validated for the states of Andhra Pradesh, Haryana, Karnataka, Kerala, Maharashtra, Tamil Nadu and West Bengal; thus, these states have had <1 case of neonatal tetanus (NT)/1000 live births in every district. In November 2007, community-based surveys were carried out to assess whether NT had been eliminated in the states of Goa, Punjab and Sikkim, and the Union Territory of Chandigarh; these surveys were undertaken by the Immunization Division of the Ministry of Health and Family Welfare of the Government of India and the departments of family welfare of the state governments in collaboration with UNICEF, WHO, PATH (the Program for Appropriate Technology in Health), the Indian Council of Medical Research and Immunization Basics. This survey was conducted following a data review in January 2007, during which the union territories of Lakshdweep and Pondicherry were also considered to have eliminated NT. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | MOTHERS | MATERNAL HEALTH | NEONATAL DISEASES AND ABNORMALITIES | TETANUS | PREVENTION AND CONTROL | IMMUNIZATION | IMPLEMENTATION | TRAINING ACTIVITIES | PROGRAM EVALUATION | Developing Countries | Asia, Southern | Asia | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Diseases | Infections | Primary Health Care | Health Services | Delivery of Health Care | Programs | Organization and Administration | Training Programs | Education Document Number: 327264 |
| 21. Peer Reviewed Title: Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventions. Author: Countdown to 2015 Core Group. Countdown Coverage Writing Group Source: Lancet. 2008 Apr 12-18;371(9620):1247-1258. Abstract: The Countdown to 2015 for Maternal, Newborn, and Child Survival initiative monitors coverage of priority interventions to achieve the Millennium Development Goals (MDG) for reduction of maternal and child mortality. We aimed to report on 68 countries which have 97% of maternal and child deaths worldwide, and on 22 interventions that have been proven to improve maternal, newborn, and child survival. We selected countries with high rates of maternal and child deaths, and interventions with the most potential to avert such deaths. We analysed country-specific data for maternal and child mortality and coverage of selected interventions. We also tracked cause-of-death profiles; indicators of nutritional status; the presence of supportive policies; financial flows to maternal, newborn, and child health; and equity in coverage of interventions. Of the 68 priority countries, 16 were on track to meet MDG 4. Of these, seven had been on track in 2005 when the Countdown initiative was launched, three (including China) moved into the on-track category in 2008, and six were included in the Countdown process for the first time in 2008. Trends in maternal mortality that would indicate progress towards MDG 5 were not available, but in most (56 of 68) countries, maternal mortality was high or very high. Coverage of different interventions varied widely both between and within countries. Interventions that can be routinely scheduled, such as immunisation and antenatal care, had much higher coverage than those that rely on functional health systems and 24-hour availability of clinical services, such as skilled or emergency care at birth and care of ill newborn babies and children. Data for postnatal care were either unavailable or showed poor coverage in almost all 68 countries. The most rapid increases in coverage were seen for immunisation, which also received significant investment during this period. Rapid progress is possible, but much more can and must be done. Focused efforts will be needed to improve coverage, especially for priorities such as contraceptive services, care in childbirth, postnatal care, and clinical case management of illnesses in newborn babies and children. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | RESEARCH REPORT | PROGRESS REPORT | SURVEYS | INTERVENTIONS | INFANT HEALTH | CHILD HEALTH | MATERNAL HEALTH | IMMUNIZATION | CHILD SURVIVAL | PROGRAM ACCESSIBILITY | INEQUALITIES | Sampling Studies | Studies | Research Methodology | Programs | Organization and Administration | Health | Primary Health Care | Health Services | Delivery of Health Care | Survivorship | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Program Evaluation | Socioeconomic Factors | Economic Factors Document Number: 325844 |
| 22. Title: Achieving results in antenatal care: Improving maternal and newborn outcomes through integration of services. Author: JHPIEGO. Access to Clinical and Community Maternal, Neonatal and Women’s Health Services Program [ACCESS] Source: [Baltimore, Maryland], JHPIEGO, ACCESS Program, 2008 Jun. [4] p. Abstract: This selection addresses the efforts made and planned by the ACCESS program to improve maternal and newborn outcomes through the integration of services. Efforts made, such as increasing advocacy and global learning, attempting to bring research data into practice, and applying best practices to the country level, are discussed. Language: English Keywords: ETHIOPIA | TANZANIA | RWANDA | AFGHANISTAN | MALAWI | INDIA | NIGERIA | GHANA | SUMMARY REPORT | ANTENATAL CARE | MATERNAL-CHILD HEALTH SERVICES | ANEMIA | MALARIA | TUBERCULOSIS | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | TETANUS | IMMUNIZATION | PREVENTION AND CONTROL | PERFORMANCE IMPROVEMENT | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Central | Asia, Southern | Asia | Africa, Southern | Africa, Western | Maternal Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Diseases | Parasitic Diseases | Infections | Reproductive Tract Infections | Viral Diseases | Management | Organization and Administration Document Number: 331786 |
| 23. Peer Reviewed Title: Progress in global measles control and mortality reduction, 2000 -- 2006. Author: MMWR. Morbidity and Mortality Weekly Report Source: JAMA. Journal of the American Medical Association. 2008 Jan 30;299(4):400-402. Abstract: The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) comprehensive strategy for measles mortality reduction is focused on 47 priority countries. Components include (1) achieving and maintaining high coverage (greater than 90%) with the first dose of measles vaccine by age 12 months in every district of each priority country through routine immunization services; (2) ensuring that all children receive a second opportunity for measles vaccination; (3) maintaining effective case-based surveillance and monitoring of vaccination coverage; and (4) providing appropriate clinical management, including vitamin A supplementation. In 2005, the World Health Assembly set a goal for global measles control as part of the Global Immunization Vision and Strategy (GIVS): a 90% reduction in measles mortality by 2010, compared with 2000 levels. In January 2007, WHO/UNICEF reported that implementation of measles mortality reduction strategies had reduced measles mortality by 60%, from an estimated 873,000 deaths in 1999 to 345,000 deaths in 2005. This reduction exceeded the goal of 50% measles mortality reduction by 2005 (compared with 1999 levels) that had been set in 2002. This report updates previous reports by detailing (1) measles mortality reduction activities implemented during 2006 and (2) the impact of activities since 2000 on the global burden of measles and progress toward the GIVS mortality reduction goal for 2010. (author's) Language: English Keywords: GLOBAL | TECHNICAL REPORT | WHO | UNICEF | CDC | CHILDREN | MEASLES | PREVENTION AND CONTROL | IMMUNIZATION | MORTALITY DECLINE | GOALS | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | USPHS | Government Agencies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Planning | Organization and Administration Document Number: 323998 |
| 24. Title: Symposium Proceedings. Health Outcomes Research: How Can It Assist Decision-Making for the Prevention of Cervical Cancer and Other HPV Disease in Asia and the Pacific? Bangkok, Thailand, 12 February 2008. Author: Symposium on Health Outcomes Research: How Can It Assist Decision-Making for the Prevention of Cervical Cancer and Other HPV Disease in Asia and the Pacific? (2008: Bangkok) Source: Bangkok, Thailand, Family Health International [FHI], Asia / Pacific Regional Office, 2008. 50 p. Abstract: While cervical cancer is the second most common cancer worldwide and the most common among women in developing countries, it is among the most preventable and treatable of all cancers. Global guidance on comprehensive programs for cervical cancer control as well as for introduction of HPV immunization has been issued by WHO, and review of the guidance has begun in the Asia-Pacific region. However, initial costs of large-scale HPV immunization have made decision-makers in developing countries of the region reluctant to develop strategies to incorporate HPV immunization vaccines into their programs. Without advocacy efforts and a significant reduction in the price of the vaccine, HPV immunization will not feature prominently on the policy agenda in the region. This report documents the proceedings of an FHI-hosted regional workshop highlighting the role of health outcomes research data and modeling for future decision-making. Language: English Keywords: ASIA | CONFERENCES AND CONGRESSES | CERVICAL CANCER | PREVENTION AND CONTROL | DECISION MAKING | HPV | PREVALENCE | VACCINES | IMMUNIZATION | SCREENING | COST EFFECTIVENESS | FINANCIAL ACTIVITIES | PSYCHOSOCIAL FACTORS | PRODUCT APPROVAL | Developing Countries | Cancer | Neoplasms | Diseases | Behavior | Viral Diseases | Measurement | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care | Examinations and Diagnoses | Evaluation Indexes | Quantitative Evaluation | Evaluation | Economic Factors | Legislation | Political Factors | Sociocultural Factors Document Number: 331754 |
| 25. Title: Poliomyelitis in Nigeria and West / Central Africa. Poliomyelite au Nigeria, en Afrique de l’Ouest et du Centre. Author: World Health Organization [WHO] Source: Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 2008 Jun 27;83(26):233-234. Abstract: Northern Nigeria is currently affected by a new outbreak of wild poliovirus type 1 (WPV1), that has begun to spread internationally. In 2008, a 9-fold increase in new WPV1 cases has been reported compared with the same period in 2007. This new outbreak has the potential to cause major international outbreaks, as occurred in 2003-2006. This year, Nigeria accounts for 86% of WPV1 cases in the world. (excerpt) Language: EnglishFrench Keywords: NIGERIA | POLIO | IMMUNIZATION | INFECTION TRANSMISSION | CAMPAIGNS | INTERVENTIONS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Viral Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Infections | Communication Programs | Communication | Programs | Organization and Administration Document Number: 327498 |
| 26. Title: Progress towards interrupting wild poliovirus transmission worldwide, January 2007 - April 2008. Author: World Health Organization [WHO] Source: Weekly Epidemiological Record. 2008 May 9;83(19):170-176. Abstract: In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Subsequently, the global Polio Eradication Initiative reduced the worldwide incidence of polio associated with wild polioviruses (WPVs) from an estimated 350 000 cases in 1988 to 1997 cases in 2006; it also reduced the number of countries that have never succeeded in interrupting WPV transmission from greater than 125 to 4 (Afghanistan, India, Nigeria and Pakistan). Circulation of type-2 WPV (WPV2) was last observed in October 1999. In February 2007, WHO convened a stakeholders' meeting to agree on making an accelerated eradication effort during 2007-2008 and on milestones to monitor progress. Programmatic strategies implemented in 2007 included expanding the use of type-1 monovalent oral poliovirus vaccine (mOPV1) to preferentially eliminate transmission of type-1 WPV (WPV1) before type-3 WPV (WPV3) and targeting the use of type-3 monovalent OPV (mOPV3) in selected areas. This report summarizes the results of implementing these strategies and indicates the overall progress that has been made towards achieving the 2007 milestones (including a decline in the overall number of WPV cases to 1310 in 2007) and the substantial progress made towards interrupting WPV1 circulation in India (supported by 2008 data). An increase in the number of WPV3 cases in India in 2007 occurred as the result of an outbreak that spread to areas where there was limited immunization against WPV3. (excerpt) Language: English Keywords: GLOBAL | AFRICA | ASIA | EUROPE | SUMMARY REPORT | POLIO | PREVENTION AND CONTROL | TRANSMISSION | INCIDENCE | IMMUNIZATION | Developing Countries | Developed Countries | Viral Diseases | Diseases | Infections | Measurement | Research Methodology | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 326726 |
| 27. Title: Somalia is again polio-free. Author: World Health Organization [WHO] Source: Weekly Epidemiological Record. 2008 Apr 4;83(14):117-118. Abstract: The Global Polio Eradication Initiative (GPEI) announced on 25 March that Somalia is again free of poliovirus, hailing an historic achievement in global public health. Somalia has not reported a case since 25 March 2007. Against a backdrop of widespread conflict, large population movements and a dearth of functioning government infrastructure, transmission of poliovirus in the country has been successfully stopped. This landmark victory is a result of the efforts of greater than 10 000 Somali volunteers and health workers who repeatedly vaccinated greater than 1.8 million children aged less than 5 years by visiting every household in every settlement multiple times, across a country ranked one of the most dangerous places on earth. The use of innovative approaches tailored to conflict areas was pivotal in stopping polio in the country. These included increased community involvement and the effective use of monovalent vaccines to immunize children in insecure areas with several doses within a shortperiod of time. (excerpt) Language: English Keywords: SOMALIA | SUMMARY REPORT | POLIO | CAMPAIGNS | IMMUNIZATION | PREVENTION AND CONTROL | PROGRAM EFFECTIVENESS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Viral Diseases | Diseases | Communication Programs | Communication | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 325931 |
| 28. Title: Validation of neonatal tetanus elimination in Bangladesh by lot quality-assurance cluster sampling. Validation de l'elimination du tetanos neonatal au Bangladesh a l'aide d'un sondage en grappes pour le controle de la qualite des lots. Author: World Health Organization [WHO] Source: Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 2008 Aug 22;83(34):301-307. Abstract: In the 1980s, Bangladesh, a country of 146 million inhabitants and more than 4 million births annually, had one of the highest neonatal tetanus (NT) mortality rates in the world. Community-based surveys showed that before widespread introduction of immunization, mortality rates from NT were 20-40/1000 live births in some parts of the country. According to these surveys, NT was responsible for 21-56% of all neonatal deaths. After the introduction of vaccination in 1979, NT rates fell sharply: surveys showed that NT rates had fallen from 6 cases/1000 live births in 1994 to 2.3/1000 live births in 2000. In May 2008, the Ministry of Health and Family Welfare, in collaboration with WHO and UNICEF, carried out an evaluation to determine whether NT had been eliminated in Bangladesh. Two community-based surveys were performed in the 2 districts where children were considered to be at the highest risk from NT. (excerpt) Language: EnglishFrench Keywords: BANGLADESH | RESEARCH REPORT | EVALUATION REPORT | COMMUNITY SURVEYS | INFANT | NEONATAL MORTALITY | TETANUS | IMMUNIZATION | INTERVENTIONS | PROGRAM EVALUATION | PROGRAM EFFECTIVENESS | Developing Countries | Asia, Southern | Asia | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Infections | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Programs | Organization and Administration Document Number: 327997 |
| 29. Title: Validation of neonatal tetanus elimination in Zambia by lot quality-assurance cluster sampling. Author: World Health Organization [WHO] Source: Weekly Epidemiological Record. 2008 Apr 4;83(14):119-124. Abstract: Zambia has a population of approximately 12 million. According to estimates from the 2001-2002 Zambia Demographic and Health Survey,1 between 1997 and 2001, the rate of neonatal mortality was 37/1000 births, the infant mortality rate was 95/1000 births and the maternal mortality ratio was 729/100 000 live births. In order to protect mothers and their newborn babies against tetanus, WHO recommends that tetanus toxoid (TT) vaccine be given to all pregnant women; Zambia follows WHO's recommendations. In 2006, 79% of all pregnant women received a protective dose of TT vaccine. A total of 60% of all deliveries took place in hygienic conditions (administrative data). WHO and UNICEF estimate that in 2006, 90% of births were protected against tetanus. (excerpt) Language: English Keywords: ZAMBIA | SUMMARY REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | PREGNANT WOMEN | CHILD | IMMUNIZATION | TETANUS | WHO | RECOMMENDATIONS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Population Characteristics | Youth | Age Factors | Primary Health Care | Health Services | Delivery of Health Care | Health | Infections | Diseases | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 325932 |
| 30. Peer Reviewed Title: Seroprevalence of varicella zoster antibodies among children with malnutrition, malignancies and HIV infection. Author: Admani B; Macharia WM; Were F Source: East African Medical Journal. 2008 Oct;85(10):480-6. Abstract: OBJECTIVE: To determine the seroprevalence of varicella zoster in paediatric patients at a high risk of developing complications. DESIGN: A cross-sectional study. SETTING: Paediatric general wards at Kenyatta National Hospital. SUBJECTS: Children with malignancies, severe malnutrition and were HIV positive. INTERVENTIONS: The sample size was calculated at 147 subjects. Venous samples were tested for varicella zoster virus (VZV) antibodies using enzyme immunosorbent assay (ELISA) technique at Kenya Medical Research Institute (KEMRI) laboratories, The data were analysed using the SPSS software and presented in form of tables and graphs. The prevalence of VZV antibodies was determined and 95% confidence interval computed. RESULTS: The overall seroprevalence of VZV antibodies in the three groups of children studied was 23.6% (95% CI = 17.4, 29.8). The seroprevalence of VZV antibodies in those with malignancies and severe malnutrition was 24.1 and 25.0% respectively. About 22% of HIV positive children had protective levels of VZV antibodies. Though the seroprevalence increased with age, it was not significantly associated with area of residence, size of residence, family size or income. CONCLUSIONS: The low prevalence of protective VZV antibodies among children with severe malnutrition, malignancies and HIV infection children at Kenyatta National Hospital warrants routine immunisation of the high-risk population. Language: English Keywords: KENYA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | CHILDREN | MALNUTRITION | ANTIBODIES | LABORATORY PROCEDURES | IMMUNIZATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care Document Number: 342059 |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |