1.  Peer Reviewed Title: Determinants of perceived morbidity and use of health services by children less than 15 years old in rural Bangladesh. Author: Alam N; van Ginneken JK; Timaeus I Source: Maternal and Child Health Journal. 2009 Jan;13(1):119-29. Abstract: This study examined the association of a number of social and economic and other factors with perceived morbidity and use of health services by children in rural Bangladesh, using the data of a health and socioeconomic survey conducted in Matlab, Bangladesh in 1996. One of the factors of interest was women's social position measured with indicators such as their education, domestic autonomy, social networks and social prestige. Other factors of interest were economic in nature and included the availability of high-quality primary health care (PHC) facilities in one part of the study area. A total of 52% of the 3,793 children below 15 had an episode of an acute illness in the month preceding the interview. The medical care sought for acute illnesses was grouped into four categories: medical doctors, paramedics, traditional and untrained village doctors (including drug sellers) and homeopaths. A total of 55% of the children who were sick in the past month consulted any type of health provider. Logistic regression was used to estimate the effects of the various independent variables on the two dependent variables: perceived morbidity of under-15 children and health service use for under-15 sick children. The results revealed that age of the child was the most important factor influencing perceived morbidity while social and economic variables were in general not related to perceived morbidity. Prolonged and severe illnesses and illnesses of young and male children were more likely to be treated by health providers, particularly by physicians. While women's education and social network influenced visits to any health providers socioeconomic indicators influenced visits to physicians. Availability of PHC facilities in one part of the study area also led to more use of modern medical care. The findings highlight that improvement of women's education and of social and economic status in general, in combination with more availability of high-quality PHC will in Bangladesh lead to better health care of children. Language: English Keywords: BANGLADESH | RESEARCH REPORT | CHILDREN | MORBIDITY | INFECTIONS | UTILIZATION OF HEALTH CARE | BEHAVIOR | MATERNAL HEALTH | EDUCATION | SOCIAL NETWORKS | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Health Services | Delivery of Health Care | Health | Friends and Relatives | Family and Household | Sociocultural Factors Document Number: 330857 |
| 2. Title: Virologic and immunologic responses to antiretroviral therapy among HIV-1 and HIV-2 dually infected patients: case reports from Abidjan, Cote d'Ivoire. Author: Borget MY; Diallo K; Adje-Toure C; Chorba T; Nkengasong JN Source: Journal of Clinical Virology. 2009 May;45(1):72-5. Abstract: In four of five HIV-1 and HIV-2 dually infected patients treated with efavirenz-based therapy, viral load was undetectable for HIV-1 only, with limited increase in CD4+ counts. Both viral loads were undetectable and CD4+ counts increased in one patient treated with protease inhibitor regimen. Specific guidelines for treating HIV-dually infected patients are needed that should avoid the use of non-nucleoside reverse transcriptase inhibitors. Language: English Keywords: COTE D'IVOIRE | RESEARCH REPORT | CASE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV | INFECTIONS | ANTIRETROVIRAL THERAPY | CONTRACEPTIVE USE-EFFECTIVENESS | LABORATORY PROCEDURES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Contraceptive Effectiveness | Contraception | Family Planning | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342661 |
| 3. Peer Reviewed Title: The HIV-exposed, uninfected African child. Author: Filteau S Source: Tropical Medicine and International Health. 2009 Mar;14(3):276-87. Abstract: The increasing success of prevention of mother-to-child HIV transmission programmes means that in Africa, very large numbers of HIV-exposed, uninfected (HIV-EU) children are being born. Any health problems that these children may have will thus be of enormous public health importance, but to date have been largely neglected. There is some evidence that HIV-EU African children are at increased risk of mortality, morbidity and slower early growth than their HIV-unexposed counterparts. A likely major cause of this impaired health is less exposure to breast milk as mothers are either less able to breastfeed or stop breastfeeding early to protect their infant from HIV infection. Other contributing factors are parental illness or death resulting in reduced care of the children, increased exposure to other infections and possibly exposure to antiretroviral drugs. A broad approach for psychosocial support of HIV-affected families is needed to improve health of HIV-EU children. High quality programmatic research is needed to determine how to deliver such care. Language: English Keywords: AFRICA | CRITIQUE | LITERATURE REVIEW | EVALUATION | CHILDREN | PERSONS LIVING WITH HIV/AIDS | ORPHANS AND VULNERABLE CHILDREN | BREASTFEEDING | TIME FACTORS | CHILD HEALTH | GROWTH | DEFICIENCY DISEASES | CHILD MORTALITY | ANTIRETROVIRAL DRUGS | INFECTIONS | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Population Dynamics | Child Development | Biology | Nutrition Disorders | Mortality | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 330961 |
| 4. Peer Reviewed Title: Stuips, spuits and prophet ropes: the treatment of abantu childhood illnesses in urban South Africa. Author: Friend-du Preez N; Cameron N; Griffiths P Source: Social Science and Medicine. 2009 Jan;68(2):343-51. Abstract: With a paucity of data on health-seeking behaviour for childhood illnesses in urban South Africa, a mixed method approach was used to investigate the treatment of abantu childhood illnesses in Johannesburg and Soweto between March and June 2004. In-depth interviews were held with caregivers (n=5), providers of traditional (n=6) and Western (n=6) health care, as well as five focus groups with caregivers. A utilisation-based survey was conducted with 206 black African caregivers of children under 6 years of age from one public clinic in Soweto (n=50), two private clinics in Johannesburg (50 caregivers in total), two public hospitals from Johannesburg and Soweto (53 caregivers in total) and two traditional healers from Johannesburg and Orange Farm (53 caregivers in total), an informal settlement on the outskirts of Johannesburg. The symptoms of several childhood abantu health problems, their treatment with traditional, church and home remedies, and influences on such patterns of resort are described. Despite free primary health care for children under 6 years, the pluralistic nature of health-seeking in this urban environment highlights the need for community and household integrated management of childhood illnesses and a deeper understanding of how symptoms may be interpreted and treated in the context of the local belief system. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | URBAN POPULATION | TRADITIONAL MEDICINE | CHILD HEALTH | INFECTIONS | TREATMENT | BELIEFS | BEHAVIOR | PRIMARY HEALTH CARE | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Medical Procedures | Culture | Sociocultural Factors Document Number: 331180 |
| 5. Title: Seropositivity for Listeria monocytogenes in women with spontaneous abortion: a case-control study in Iran. Author: Jamshidi M; Jahromi AS; Davoodian P; Amirian M; Zangeneh M; Jadcareh F Source: Taiwanese Journal of Obstetrics and Gynecology. 2009 Mar;48(1):46-8. Abstract: OBJECTIVE: There are many studies supporting the role of certain asymptomatic infections such as Listeria monocytogenes (L. monocytogenes) in spontaneous abortion. In some cases, latent listeriosis may complicate the pregnancy, and serologic tests can, therefore, be used to detect the disease. This study was designed to assess the relationship between seropositivity for L. monocytogenes and spontaneous abortion. MATERIALS AND METHODS: A total of 250 women with previous spontaneous abortion and a control group of 200 women with normal full-term deliveries entered the study as case and control groups, respectively. Demographic characteristics were recorded for each subject, and serum samples were obtained from all participants. All serum samples were examined using the indirect immunofluorescence antibody test for L. monocytogenes antibody. Data was analyzed using Chi-squared and t tests. RESULTS: The average age of participants was 25.6 +/- 7.6 years in cases and 25.3 +/- 6.5 years in controls. Eighty-nine (35.6%) of the cases with abortion and 35 (17.5%) of the control group were positive for L. monocytogenes antibody (p = 0.001). No relationship was observed between the number of pregnancies and infection with L. monocytogenes (p = 0.4), or between the number of previous abortions and L. monocytogenes seropositivity (p = 0.2). CONCLUSION: We suggest monitoring L. monocytogenes seroprevalence in pregnant women at high risk of threatened abortion, and further microbiological assessment of symptomatic women for detection of L. monocytogenes and insidious infection. Language: English Keywords: IRAN | RESEARCH REPORT | CASE STUDIES | WOMEN | ABORTION, SPONTANEOUS | PREGNANCY | MONITORING | INFECTIONS | TESTING | Middle East | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Pregnancy Complications | Diseases | Reproduction | Evaluation | Measurement Document Number: 342081 |
| 6. Peer Reviewed Title: Probiotics and prebiotics for severe acute malnutrition (PRONUT study): a double-blind efficacy randomised controlled trial in Malawi. Author: Kerac M; Bunn J; Seal A; Thindwa M; Tomkins A; Sadler K; Bahwere P; Collins S Source: Lancet. 2009 Jul 11;374(9684):136-44. Abstract: BACKGROUND: Severe acute malnutrition affects 13 million children worldwide and causes 1-2 million deaths every year. Our aim was to assess the clinical and nutritional efficacy of a probiotic and prebiotic functional food for the treatment of severe acute malnutrition in a HIV-prevalent setting. METHODS: We recruited 795 Malawian children (age range 5 to 168 months [median 22, IQR 15 to 32]) from July 12, 2006, to March 7, 2007, into a double-blind, randomised, placebo-controlled efficacy trial. For generalisability, all admissions for severe acute malnutrition treatment were eligible for recruitment. After stabilisation with milk feeds, children were randomly assigned to ready-to-use therapeutic food either with (n=399) or without (n=396) Synbiotic2000 Forte. Average prescribed Synbiotic dose was 10(10) colony-forming units or more of lactic acid bacteria per day for the duration of treatment (median 33 days). Primary outcome was nutritional cure (weight-for-height >80% of National Center for Health Statistics median on two consecutive outpatient visits). Secondary outcomes included death, weight gain, time to cure, and prevalence of clinical symptoms (diarrhoea, fever, and respiratory problems). Analysis was on an intention-to-treat basis. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN19364765. FINDINGS: Nutritional cure was similar in both Synbiotic and control groups (53.9% [215 of 399] and 51.3% [203 of 396]; p=0.40). Secondary outcomes were also similar between groups. HIV seropositivity was associated with worse outcomes overall, but did not modify or confound the negative results. Subgroup analyses showed possible trends towards reduced outpatient mortality in the Synbiotic group (p=0.06). INTERPRETATION: In Malawi, Synbiotic2000 Forte did not improve severe acute malnutrition outcomes. The observation of reduced outpatient mortality might be caused by bias, confounding, or chance, but is biologically plausible, has potential for public health impact, and should be explored in future studies. FUNDING: Department for International Development (DfID). Language: English Keywords: MALAWI | RESEARCH REPORT | DOUBLE-BLIND STUDIES | CHILDREN | MALNUTRITION | NUTRITION PROGRAMS | FOOD AND BEVERAGE | ANTHROPOMETRY | HIV INFECTIONS | ANTIBIOTICS | INFECTIONS | MORTALITY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Nutrition | Measurement | Viral Diseases | Drugs | Treatment | Medical Procedures | Medicine | Population Dynamics Document Number: 342331 |
| 7. Peer Reviewed Title: Patterns of soil-transmitted helminth infection and impact of four-monthly albendazole treatments in preschool children from semi-urban communities in Nigeria: a double-blind placebo-controlled randomised trial. Author: Kirwan P; Asaolu SO; Molloy SF; Abiona TC; Jackson AL; Holland CV Source: BMC Infectious Diseases. 2009;9:20. Abstract: BACKGROUND: Children aged between one and five years are particularly vulnerable to disease caused by soil-transmitted helminths (STH). Periodic deworming has been shown to improve growth, micronutrient status (iron and vitamin A), and motor and language development in preschool children and justifies the inclusion of this age group in deworming programmes. Our objectives were to describe the prevalence and intensity of STH infection and to investigate the effectiveness of repeated four-monthly albendazole treatments on STH infection in children aged one to four years. METHODS: The study was carried out in four semi-urban villages situated near Ile-Ife, Osun State, Nigeria. The study was a double-blind placebo-controlled randomised trial. Children aged one to four years were randomly assigned to receive either albendazole or placebo every four months for 12 months with a follow-up at 14 months. RESULTS: The results presented here revealed that 50% of the preschool children in these semi-urban communities were infected by one or more helminths, the most prevalent STH being Ascaris lumbricoides (47.6%). Our study demonstrated that repeated four-monthly anthelminthic treatments with albendazole were successful in reducing prevalence and intensity of A. lumbricoides infections. At the end of the follow-up period, 12% and 43% of the children were infected with A. lumbricoides and mean epg was 117 (S.E. 50) and 1740 (S.E. 291) in the treatment and placebo groups respectively compared to 45% and 45% of the children being infected with Ascaris and mean epg being 1095 (S.E. 237) and 1126 (S.E. 182) in the treatment and placebo group respectively at baseline. CONCLUSION: Results from this study show that the moderate prevalence and low intensity of STH infection in these preschool children necessitates systematic treatment of the children in child health programmes. Language: English Keywords: NIGERIA | RESEARCH REPORT | PREVALENCE | CHILDREN | CHILD NUTRITION | GASTROINTESTINAL EFFECTS | INFECTIONS | VITAMINS AND MINERALS | DEFICIENCY DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Physiology | Biology | Diseases | Nutrition Disorders Document Number: 330549 |
| 8. Peer Reviewed Title: Prevalence and risk factors for HIV, syphilis, hepatitis B, hepatitis C, and HTLV-I/II infection in low-income postpartum and pregnant women in Greater Metropolitan Vitoria, Espirito Santo State, Brazil. Author: Lima LH; Viana MC Source: Cadernos De Saude Publica. 2009 Mar;25(3):668-76. Abstract: Sexually transmitted infections during pregnancy pose a major risk to the fetus due to vertical transmission. The study's objective was to determine the prevalence of HIV, syphilis, hepatitis B and C, and HTLV-I/II infection among low-income postpartum and pregnant women treated in Greater Metropolitan Vitoria, Espirito Santo State, Brazil, and the risk factors associated with these infections. A cross-sectional study was conducted from February to October 1999 assessing postpartum and pregnant women from the maternity ward of the Vitoria Mercy Hospital and the Carapina Outpatient Referral Unit in the Municipality of Serra, respectively. Patients were systematically interviewed and had blood samples drawn for serological tests (HIV 1&2, VDRL, HbsAg, anti-HCV, and HTLV-I/II). A total of 534 patients (332 postpartum and 202 pregnant women) were assessed. Seroprevalence rates for the target infections in postpartum and pregnant women and the overall sample were as follows, respectively: HIV 0.9%, 0%, and 0.6%; syphilis 2.1%, 3.6%, and 2.7%; HBV 1.2%, 1%, and 1.1%; HCV 1.8%, 0.6%, and 1.4%; and HTLV-I/II 1.7%, 0.6%, and 1.3%. Factors associated with the various infections are presented and analyzed in light of other research findings from the literature. Language: English Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | PREGNANT WOMEN | POSTPARTUM WOMEN | LOW INCOME POPULATION | PREGNANCY | MOTHER-TO-CHILD TRANSMISSION | SEXUALLY TRANSMITTED DISEASES | INFECTIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Measurement | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Transmission | Diseases | Reproductive Tract Infections Document Number: 342666 |
| 9. Title: Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome? Author: Mazor-Dray E; Levy A; Schlaeffer F; Sheiner E Source: Journal of Maternal - Fetal and Neonatal Medicine. 2009 Feb;22(2):124-8. Abstract: OBJECTIVE: This population-based study was aimed to determine whether there is an association between urinary tract infections (UTI) during pregnancy, among patients in whom antibiotic treatment was recommended, and maternal and perinatal outcome. METHODS: A retrospective population-based study comparing all singleton pregnancies of patients with and without UTI was performed. Multiple logistic regression models were performed to control for confounders. RESULTS: Out of 199,093 deliveries, 2.3% (n = 4742) had UTI during pregnancy and delivery. Patients with UTI had significantly higher rates of intra-uterine growth restriction (IUGR), pre-eclampsia, caesarean deliveries (CD) and pre-term deliveries (either before 34 weeks or 37 weeks of gestation). Although controlling for possible confounders such as maternal age and parity, using multivariable analyses, the significant association between UTI and IUGR, pre-eclampsia, CD and preterm deliveries persisted. In contrast, no significant differences in 5-min Apgar scores less than 7 or perinatal mortality were noted between the groups (0.6% vs. 0.6%; p = 0.782, and 1.5% vs. 1.4%; p = 0.704, respectively). CONCLUSION: Maternal UTI is independently associated with pre-term delivery, pre-eclampsia, IUGR and CD. Nevertheless, it is not associated with increased rates of perinatal mortality compared with women without UTI. Language: English Keywords: ISRAEL | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | UROGENITAL EFFECTS | INFECTIONS | PREGNANCY OUTCOMES | RISK FACTORS | PREMATURE BIRTH | INTRAUTERINE GROWTH RETARDATION | PREECLAMPSIA | CESAREAN SECTION | Developed Countries | Middle East | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Urogenital System | Physiology | Biology | Diseases | Pregnancy | Reproduction | Health | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Pregnancy Complications | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 341696 |
| 10. Title: Expectant management of incomplete abortion in the first trimester. Author: Pauleta JR; Clode N; Graca LM Source: International Journal of Gynaecology and Obstetrics. 2009 Mar 28; Abstract: OBJECTIVE: To evaluate the effectiveness and acceptability of expectant management of induced and spontaneous first trimester incomplete abortion. METHODS: A prospective observational trial, conducted between June 2006 and November 2007, of 2 groups of patients diagnosed with an incomplete abortion: 66 patients who had received misoprostol for an induced abortion (group 1) and 30 patients who had had a spontaneous abortion (group 2). Transvaginal ultrasound was performed weekly. The success rate (complete abortion without surgery), time to resolution, duration of bleeding and pelvic pain, rate of infection, number of unscheduled hospital visits, and level of satisfaction with expectant management were recorded. RESULTS: The incidence of complete abortion was 86.4% and 82.1% in groups 1 and 2 respectively at day 14 after diagnosis, and 100% in both groups at day 30 (two group 2 patients underwent curettage and were excluded from the analysis). Both groups reported 100% satisfaction with expectant management, although over 90% of the women reported feeling anxious. CONCLUSION: Expectant management for incomplete abortion in the first trimester after use of misoprostol or after spontaneous abortion may be practical and feasible, although it may increase anxiety associated with the impending abortion. Language: English Keywords: PORTUGAL | RESEARCH REPORT | PROSPECTIVE STUDIES | CLINICAL RESEARCH | PREGNANT WOMEN | ABORTION | PREGNANCY, FIRST TRIMESTER | ABORTION, SPONTANEOUS | MISOPROSTOL | ULTRASONICS | TIME FACTORS | BLEEDING | PAIN | INFECTIONS | Developed Countries | Europe, Southwestern | Europe | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Signs and Symptoms Document Number: 341468 |
| 11. Peer Reviewed Title: Infectious complications of pregnancy termination. Author: Rahangdale L Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):198-204. Abstract: Infectious complications are a significant source of morbidity and mortality associated with pregnancy termination worldwide. However, in areas where abortion practices are legal, the risk of infection is very low. Proper technique, prophylaxis, and initial management of septic abortion have led to a significant decrease in risk of serious complications such as sepsis and death. Clinical features, management, and prevention of postabortal infection will be reviewed in the setting of legalized abortion. Language: English Keywords: GLOBAL | UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | ABORTION | ENDOMETRIOSIS | INFECTIONS | Developed Countries | North America | Americas | Demographic Factors | Population | Pregnancy Complications | Diseases Document Number: 342244 Notification |
| 12. Title: Priorities in emergency obstetric care in Bolivia--maternal mortality and near-miss morbidity in metropolitan La Paz. Author: Roost M; Altamirano VC; Liljestrand J; Essen B Source: BJOG. 2009 Aug;116(9):1210-7. Abstract: OBJECTIVE: To document the frequency and causes of maternal mortality and severe (near-miss) morbidity in metropolitan La Paz, Bolivia. DESIGN: Facility-based cross-sectional study. SETTING: Four maternity hospitals in La Paz and El Alto, Bolivia, where free maternal health care is provided through a government-subsidised programme. POPULATION: All maternal deaths and women with near-miss morbidity. METHODS: Inclusion of near-miss using clinical and management-based criteria. MAIN OUTCOME MEASURES: Maternal mortality ratio (MMR), severe morbidity ratio (SMR), mortality indices and proportion of near-miss cases at hospital admission. RESULTS: MMR was 187/100,000 live births and SMR was 50/1000 live births, with a relatively low mortality index of 3.6%. Severe haemorrhage and severe hypertensive disorders were the main causes of near-miss, with 26% of severe haemorrhages occurring in early pregnancy. Sepsis was the most common cause of death. The majority of near-miss cases (74%) were in critical condition at hospital admission and differed from those fulfilling the criteria after admission as to diagnostic categories and socio-demographic variables. CONCLUSIONS: Pre-hospital barriers remain to be of great importance in a setting of this type, where there is wide availability of free maternal health care. Such barriers, together with haemorrhage in early pregnancy, pre-eclampsia detection and referral patterns, should be priority areas for future research and interventions to improve maternal health. Near-miss upon arrival and near-miss after arrival at hospital should be analysed separately as that provides additional information about factors that contribute to maternal ill-health. Language: English Keywords: BOLIVIA | URBAN AREAS | RESEARCH REPORT | OBSTETRICS | EMERGENCY SERVICES | HOSPITALS | MATERNAL MORTALITY | MORBIDITY | PREGNANCY COMPLICATIONS | INFECTIONS | MATERNAL HEALTH SERVICES | REFERRAL AND CONSULTATION | Developing Countries | South America, Central | South America | Latin America | Americas | Geographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Mortality | Population Dynamics | Demographic Factors | Diseases | Maternal-Child Health Services | Primary Health Care | Program Activities | Programs | Organization and Administration Document Number: 342832 |
| 13. Peer Reviewed Title: Nosocomial Sepsis Risk Score for Preterm Infants in Low-resource Settings. Author: Rosenberg RE; Ahmed AN; Saha SK; Chowdhury MA; Ahmed S; Law PA; Black RE; Santosham M; Darmstadt GL Source: Journal of Tropical Pediatrics. 2009 Jul 21; Abstract: Sepsis is a leading cause of mortality for neonates in developing countries; however, little research has focused on clinical predictors of nosocomial infection of preterm neonates in the low-resource setting. We sought to validate the only existing feasible score introduced by Singh et al. in 2003 and to create an improved score. In a secondary analysis of daily evaluations of 497 neonates Language: English Keywords: BANGLADESH | RESEARCH REPORT | INFANT | PREMATURE BIRTH | LOW BIRTH WEIGHT | INFECTIONS | HEMATOLOGICAL EFFECTS | SCREENING | VALIDITY | SIGNS AND SYMPTOMS | JAUNDICE | RESPIRATORY INSUFFICIENCY | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Diseases | Hemic System | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology | Pulmonary Effects Document Number: 342294 |
14.  Title: Fatal neglect: How health systems are failing to comprehensively address child mortality. Author: Ross I; Cumming O Source: New York, New York, WaterAid America, 2009 May. 21 p. Abstract: The aid system is not responding to the causes of child mortality in a targeted manner. The Millennium Development Goal to reduce by two-thirds the number of children dying before their fifth birthday by 2015 (MDG 4) is seriously offtrack. In Sub-Saharan Africa, on current trends, it will not be met until 2064. The international health agenda is failing to mobilize the required response to critical causes of child deaths. This paper assesses how and why the international aid system is overlooking diarrhea, the second-biggest killer of under-fives after acute respiratory infections. (Excerpts) Language: English Keywords: AFRICA | SUMMARY REPORT | CHILDREN | CHILD HEALTH | DIARRHEA | INFECTIONS | SANITATION | MALARIA PREVENTION | PROGRAM EVALUATION | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Diseases | Public Health | Malaria | Parasitic Diseases | Programs | Organization and Administration Document Number: 331383 |
| 15. Title: Breast-feeding practices in relation to HIV in India. Author: Shankar AV Source: Advances In Experimental Medicine and Biology. 2009;639:299-311. Abstract: The benefits of breast-feeding on infant and child health are both well established and substantial. Breast-feeding provides complete nutrition for the newborn for at least 6 months and can provide a significant proportion of nutritional needs up to 1 year of life. Breast-feeding also confers significant protection against infectious morbidity and mortality from gastrointestinal infections lower respiratory infections, and otitis media due to the presence of numerous immunological factors in breast-milk. Breast-feeding is especially important in developing countries where use of replacement foods is not advisable due to poor sanitation, unsuitable preparation and prohibitive costs. Recent studies confirm the impact of breast-feeding on morbidity and mortality. A pooled analysis of 6 studies in developing countries revealed that mortality rates were significantly higher in non-breast-fed infants through the first 8 months of life, with the greatest protection in disadvantaged populations with lower education. Deaths from diarrhea were 10 times higher in infants who were never breast-fed or where breast-feeding was stopped. With regard to morbidity in resource poor settings, risks of both diarrheal and acute respiratory illness are associated with type of infant feeding. Infants who were not breast-fed had a 17-fold increased risk of hospitalisation for pneumonia compared to breast-fed infants. Over the past several decades countries throughout the world have put tremendous effort into promoting breast-feeding within the population. In developing countries, during the 1990s (based on 37 countries with trend data) continued improvements were made in exclusive breast-feeding (see definitions below) for the first four months of life, with rates increasing from 48% to 52%. Estimates show that amongst infants aged six months or younger in the developing world, the prevalence of no breast-feeding was around 5%. The prevalence of continued breast-feeding was 86% and 68% for infants and children aged 6-11 and 12-23 months, respectively. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | INFANT | CHILDREN | MOTHERS | BREASTFEEDING | INFANT HEALTH | INFECTIONS | PREVENTION AND CONTROL | INFANT NUTRITION | HIV INFECTIONS | IMPACT | Asia, Southern | Asia | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Nutrition | Health | Child Health | Diseases | Viral Diseases | Communication Document Number: 330898 |
| 16. Peer Reviewed Title: Factors associated with anaemia in HIV-infected individuals in southern India. Author: Subbaraman R; Devaleenal B; Selvamuthu P; Yepthomi T; Solomon SS; Mayer KH; Kumarasamy N Source: International Journal of STD and AIDS. 2009 Jul;20(7):489-92. Abstract: Anaemia accelerates disease progression and increases mortality among HIV-infected individuals. Few studies have characterized this problem in developing countries. Haemoglobin values of adults presenting to an HIV tertiary care center in India between 1996 and 2007 were collected (n = 6996). Multivariate logistic regression analysis was performed to examine associations among anaemia, HIV progression and co-morbidities. Overall, anaemia prevalence was 41%. Twenty percent of patients with CD4 counts >500 cells/microL were anaemic, compared with 64% of those with CD4 counts <100 cells/microL (P < 0.001). In multivariate analysis, CD4 count <100 cells/microL (odds ratio [OR]:5.0, confidence interval [CI]:4.0-6.3), underweight body mass index (OR:4.8, CI:3.6-6.5), female gender (OR:3.1, CI:2.8-3.6) and tuberculosis (TB) (OR:1.6, CI:1.4-1.8) were significantly associated with anaemia. In this setting, management of anaemia should focus on antiretroviral therapy, nutritional supplementation and TB control. The high anaemia prevalence among patients meeting criteria for antiretroviral therapy highlights the need for increased access to non-zidovudine nucleoside reverse transcriptase inhibitors in developing countries. Language: English Keywords: INDIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ANEMIA | PREVALENCE | HEMOGLOBIN LEVEL | IMMUNOLOGICAL EFFECTS | INFECTIONS | BODY WEIGHT | MALNUTRITION | ANTIRETROVIRAL THERAPY | Asia, Southern | Asia | Developing Countries | HIV Infections | Viral Diseases | Diseases | Measurement | Research Methodology | Hemic System | Physiology | Biology | Immunity | Immune System | Nutrition Disorders | HIV Document Number: 342828 |
| 17. Title: Burden of neonatal infections in developing countries: a review of evidence from community-based studies. Author: Thaver D; Zaidi AK Source: Pediatric Infectious Disease Journal. 2009 Jan;28(1 Suppl):S3-9. Abstract: INTRODUCTION: Infections are a major contributor to newborn deaths in developing countries. Majority of these deaths occur at home without coming to medical attention. The Millennium Development Goal for child survival cannot be achieved without substantial reductions in infection-specific neonatal mortality. We describe the burden of neonatal infections in developing countries and discuss the need for community-based management approaches to improve survival from neonatal infections in these countries. METHODS: We reviewed community-based studies published since 1990 from developing countries to estimate the rates of neonatal and young infant infections and infection-specific neonatal mortality. RESULTS: Thirty-two studies reviewed suggest that infections may be responsible for 8% to 80% of all neonatal deaths and as many as 42% of deaths in the first week of life. Eleven reports provided data on incidence of infections in neonates and infants up to 60 days of life. Rates of neonatal sepsis were as high as 170/1000 live births (clinically diagnosed) and 5.5/1000 live births (blood culture-confirmed). CONCLUSIONS: Considerable heterogeneity exists among included studies, and more accurate data and standardized methodologies are required. However, data indicate that a significant proportion of neonatal deaths in developing countries are due to infections. Current recommendations of hospitalization and parenteral therapy for managing neonatal infections are inadequately followed in developing countries. Approaches for detecting and managing serious infections within the community, at home or first-level health facilities, may be more effective options in settings where delays and reluctance to seek care, health system inefficiencies, socioeconomic and cultural, as well as logistic constraints exist. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | STUDY DESIGN | COMMUNITY | INFANT | NEONATAL DISEASES AND ABNORMALITIES | INFECTIONS | NEONATAL MORTALITY | PREVALENCE | CAUSES OF DEATH | STANDARDIZATION | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Diseases | Infant Mortality | Mortality | Population Dynamics | Measurement | Data Adjustment Document Number: 330050 |
| 18. Peer Reviewed Title: Scheduled hysterectomy for second-trimester abortion in a patient with placenta accreta. Author: Tocce K; Thomas VW; Teal S Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):568-70. Abstract: BACKGROUND: As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion. CASE: A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy termination at 15 weeks of gestation. Scheduled hysterectomy was performed to avoid hemorrhage and subsequent complications. The patient did well postoperatively; her course was complicated only by a wound infection treated as an outpatient. Pathology was consistent with placenta increta. CONCLUSION: Placenta accreta has increased 13-fold in the past 30 years. In select patients with evidence of abnormal placentation, scheduled hysterectomy for termination of pregnancy is an option that may be considered. Language: English Keywords: COLORADO | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PREGNANT WOMEN | ABORTION | CESAREAN SECTION | PREGNANCY, SECOND TRIMESTER | PREGNANCY COMPLICATIONS | HYSTERECTOMY | INFECTIONS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy | Reproduction | Diseases | Gynecologic Surgery | Urogenital Surgery Document Number: 330356 Notification |
| 19. Title: Seroprevalence of HIV/HBV coinfection in Malian blood donors. Author: Tounkara A; Sarro YS; Kristensen S; Dao S; Diallo H Source: Journal of the International Association of Physicians in AIDS Care. 2009 Jan-Feb;8(1):47-51. Abstract: A cross-sectional study was conducted to assess the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and their coinfection among blood donors at the National Blood Transfusion Center in Bamako, Mali, from November 2001 to July 2002. Enzyme-linked immunosorbent assay techniques with reagents from Bio-Rad (France) were used to test the blood samples. 11,592 blood donors were tested for HIV and HBV surface antigens. The prevalence of HIV was 4.5% and the prevalence of HBV was 14.9%. The HIV/HBV coinfection rate was only 1.13% in this population. The coinfection rate was unexpectedly low in this blood donor population where monoinfection with HIV or HBV prevalence was high. Language: English Keywords: MALI | RESEARCH REPORT | BLOOD DONORS | HIV INFECTIONS | INFECTIONS | LABORATORY PROCEDURES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 331329 |
| 20. Title: Gastroduodenal opportunistic infections and dyspepsia in HIV-infected patients in the era of Highly Active Antiretroviral Therapy. Author: Werneck-Silva AL; Prado IB Source: Journal of Gastroenterology and Hepatology. 2009 Jan;24(1):135-9. Abstract: BACKGROUND AND AIM: Dyspeptic symptoms are frequently reported by human immunodefficiency virus (HIV)-infected patients under highly active antiretroviral therapy. Whether opportunistic infections are a cause of dyspepsia is still unknown. In this study we prospectively compare the prevalence of gastrointestinal opportunistic infections in dyspeptic versus non-dyspeptic HIV-infected patients with advanced immunodeficiency. PATIENTS AND METHODS: Six hundred and ninety HIV-infected patients under highly active antiretroviral therapy underwent esophagogastroduodenoscopy with mucosal biopsies from the stomach and duodenum. Group 1: 500 patients (161 women, 339 men; mean age 38.8 years; mean CD4 count 154.3 cells/mm(3) with dyspeptic symptoms such as epigastric pain, nausea, vomiting and fullness. Group 2: 190 patients (169 men, 21 women; mean age 40.7 years; mean CD4 count 171.6 cell/mm(3)) with no dyspeptic symptoms. RESULTS: Group 1: Gastrointestinal opportunistic infections were observed in eight (1.6%), and non-opportunistic parasites in two (0.4%), patients. They were: Cytomegalovirus (four patients), Cryptosporidium sp. (two patients), Schistosoma mansoni sp. (one patient), Strongyloides stercoralis (one patient) and Giardia sp. (two patients). In five patients esophagogastroduodenoscopy showed no mucosal lesions. Group 2: Giardia sp. was detected in two patients (1.1%: P = 0.07947). CONCLUSION: Gastrointestinal opportunistic infections were shown in a small number of HIV-infected patients under highly active antiretroviral therapy with advanced immunodeficiency. Although gastrointestinal opportunistic infections were detected exclusively in the dyspeptic patient group, they could not be related to these symptoms, since the number of infected patients was not statistically significant. To correctly diagnose opportunistic infections, multiple biopsy specimens may be necessary even from normal-appearing mucosa. Language: English Keywords: BRAZIL | RESEARCH REPORT | PREVALENCE | PERSONS LIVING WITH HIV/AIDS | GASTROINTESTINAL EFFECTS | HIV INFECTIONS | INFECTIONS | ENDOSCOPY | EXAMINATIONS AND DIAGNOSES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Viral Diseases | Diseases | Physiology | Biology | Physical Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341038 |
| 21. Title: Oral hormonal contraceptives affect the concentration and composition of urinary glycosaminoglycans in young women. Author: Zamboni MJ; Cabral CA; Sampaio FJ; Cardoso LE Source: International Urogynecology Journal and Pelvic Floor Dysfunction. 2009 Jul 4; Abstract: INTRODUCTION AND HYPOTHESIS: Urinary glycosaminoglycans (uGAG) have protective effects against urinary tract disorders. Here we investigated whether oral hormonal contraceptives (OC) affect uGAG excretion. METHODS: Urine specimens were from young women regularly taking: ethinyl estradiol + drospirenone, n = 9; ethinyl estradiol + cyproterone acetate, n = 9; and ethinyl estradiol + gestodene, n = 7. Controls were from ten women not taking OC. Total uGAG was assayed as hexuronic acid/urinary creatinine. Sulfated uGAG species was determined by electrophoresis. RESULTS: Unlike controls, total uGAG in the two halves of the menstrual cycle was similar in the OC groups. Whole cycle uGAG was higher in the OC groups (p < 0.01), especially for ethinyl estradiol + cyproterone acetate (p < 0.005). The three OC produced decreases of ~50% in heparan sulfate (p < 0.02) and dermatan sulfate (p < 0.02), and a ~100% increase in chondroitin sulfate (p < 0.004). CONCLUSIONS: uGAG excretion is changed in women taking OC, and this might enhance the protective effects of these molecules against urinary tract disorders. Language: English Keywords: BRAZIL | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | LABORATORY PROCEDURES | MENSTRUAL CYCLE | UROGENITAL EFFECTS | INFECTIONS | CYSTITIS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Menstruation | Reproduction | Urogenital System | Physiology | Biology | Diseases Document Number: 341973 |
| 22. Title: Protecting health from climate change: World Health Day 2008. Author: World Health Organization [WHO] Source: Geneva, Switzerland, WHO, 2008. [32] p. Abstract: Climate change also brings new challenges to the control of infectious diseases. Many of the major killers are highly climate sensitive as regards temperature and rainfall, including cholera and the diarrhoeal diseases, as well as diseases including malaria, dengue and other infections carried by vectors. In sum, climate change threatens to slow, halt or reverse the progress that the global public health community is now making against many of these diseases. In the long run, however, the greatest health impacts may not be from acute shocks such as natural disasters or epidemics, but from the gradual build-up of pressure on the natural, economic and social systems that sustain health, and which are already under stress in much of the developing world. These gradual stresses include reductions and seasonal changes in the availability of fresh water, regional drops in food production, and rising sea levels. Each of these changes has the potential to force population displacement and increase the risks of civil conflict. (excerpt) Language: English Keywords: GLOBAL | CRITIQUE | EVALUATION | CHILDREN | GLOBAL WARMING | WHO | WORLD HEALTH DAY | NATURAL DISASTERS | HUMAN GEOGRAPHY | HEALTH | PUBLIC HEALTH | INFECTIONS | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Climate | Environment | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | International Cooperation | Geography | Social Sciences | Science | Diseases Document Number: 325696 |
| 23. Peer Reviewed Title: No HIV stage is dominant in driving the HIV epidemic in sub-Saharan Africa. Author: Abu-Raddad LJ; Longini IM Jr Source: AIDS. 2008;22(9):1055-1061. Abstract: The objective was to estimate the role of each of the HIV progression stages in fueling HIV transmission in sub-Saharan Africa by using the recent measurements of HIV transmission probability per coital per HIV stage in the Rakai study. A mathematical model, parameterized by empirical data from the Rakai, Masaka, and Four-City studies, was used to estimate the proportion of infections due to each of the HIV stages in two representative epidemics in sub-Saharan Africa. The first setting represents a hyperendemic HIV epidemic (Kisumu, Kenya) whereas the second setting represents a generalized but not hyperendemic HIV epidemic (Yaounde´, Cameroon). We estimate that 17, 51, and 32% of HIV transmissions in Kisumu were due to index cases in their acute, latent, and late stages, respectively. In Yaounde´, the fractions were 25, 44, and 31%. We found that the relative contribution of each stage varied with the epidemic evolution with the acute stage prevailing early on when the infection is concentrated in the high-risk groups with the late stage playing a major role as the epidemic matured and stabilized. The latent stage contribution remained largely stable throughout the epidemic and contributed about half of all transmissions. No HIV stage dominated the epidemical though the latent stage provided the largest contribution. The role of each stage depends on the phase of the epidemic and on the prevailing levels of sexual risk behavior in the populations in which HIV is spreading. These findings may influence the design and implementation of different HIV interventions. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | MATHEMATICAL MODEL | MEASUREMENT | HIV | HIV TRANSMISSION | TIME FACTORS | INFECTIONS | Developing Countries | Africa | Theoretical Models | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Dynamics | Demographic Factors | Population Document Number: 327153 |
| 24. Peer Reviewed Title: Febrile status, malarial parasitaemia and gastro-intestinal helminthiases in schoolchildren resident at different altitudes, in south-western Cameroon. Author: Achidi EA; Apinjoh TO; Mbunwe E; Besingi R; Yafi C Source: Annals of Tropical Medicine and Parasitology. 2008;102(2):103-118. Abstract: In the many areas where human malaria and helminthiases are co-endemic, schoolchildren often harbour the heaviest infections and suffer much of the associated morbidity, especially when co-infected. In one such area, the Buea district, in south-western Cameroon, two cross-sectional surveys, together covering 263 apparently healthy schoolchildren aged 4-12 years, were recently conducted. The prevalences of fever, malarial parasitaemia and intestinal helminth infections, the seroprevalences of anti-Plasmodium falciparum IgG and IgE and antiglycosylphosphatidylinositol (anti-GPI) IgG, plasma concentrations of total IgE, and the incidence of anaemia were all investigated. The mean (S.D.) age of the study children was 7.56 (1.82) years. Overall, 156 (59.3%) of the children were found parasitaemic, with a geometric mean parasitaemia of 565 parasites/ml. Parasitaemia and fever were significantly associated (P = 0.042). The children who lived at low altitude, attending schools that lay 400-650 m above sealevel, had significantly higher parasitaemias than their high-altitude counterparts (P less than 0.01). At low altitude, the children attending government schools had significantly higher parasitaemias than their mission-school counterparts (P = 0.010). Of the 31 children (11.9%) found anaemic, 22 (70.4%) had mild anaemia and none had severe anaemia. A significant negative correlation (r = -0.224; P = 0.005) was observed between haemoglobin concentration and level of parasitaemia. Infection with Plasmodium appeared to reduce erythrocyte counts (P = 0.045), a condition that was exacerbated by co-infection with helminths (P = 0.035). Plasma concentrations of total IgE were higher in the children found to be excreting helminth eggs than in those who appeared helminth-free, while levels of anti-P. falciparum IgE were higher in the children with low-grade parasitaemias than in those with more intense parasitaemias. Levels of anti-GPI IgG increased with age and were relatively high in the children who lived at lowaltitude and in those who were aparasitaemic. The survey results confirm that asymptomatic malarial parasitaemia frequently co-exists with helminth infections in schoolchildren and indicate links with fever, altitude and school type. Immunoglobulin E may play a role in immune protection against helminthiasis whereas anti-GPI antibodies may be important in the development of antimalarial immunity in such children. In Cameroon, as in other areas with endemic malaria, control programmes to reduce the prevalences of infections with intestinal helminths and malarial parasites in schoolchildren, which may effectively reduce the incidence of anaemia, are clearly needed. (author's) Language: English Keywords: CAMEROON | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CHILD | ALTITUDE | INFECTIONS | MORBIDITY | FEVER | MALARIA | SIGNS AND SYMPTOMS | ANEMIA | LABORATORY EXAMINATIONS AND DIAGNOSES | IMMUNOLOGIC FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Environment | Diseases | Body Temperature | Physiology | Biology | Parasitic Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunity | Immune System Document Number: 325068 |
| 25. Title: Infection control attitudes and perceptions among dental students in Latin America: implications for dental education. Author: Acosta-Gio AE; Borges-Yanez SA; Flores M; Herrera A; Jeronimo J Source: International Dental Journal. 2008 Aug;58(4):187-93. Abstract: Latin American dental schools are at diverse stages in the continuum of implementation of infection control (IC) programmes that comply with evidence-based recommendations. Poor IC training may result in low compliance and negative attitudes against patients infected with blood borne pathogens (BBP). OBJECTIVE: To evaluate students' knowledge on IC and attitudes toward occupational BBP risks, in six dental schools in Latin America. METHODS: This survey was administered to convenience samples of dental students at one school in Costa Rica; four schools in Mexico, and one in Venezuela. The questionnaire included Likert-type scale evaluations of agreement with statements. Study variables included knowledge about and confidence in recommended IC procedures, degree of concern about HIV and HBV transmission in dental settings, and attitudes toward patients infected with BBP. Possible associations between variables were analysed using Pearson's Chi square and Kruskal Wallis tests. RESULTS: Substantial numbers of students had incomplete knowledge and often lacked confidence on IC and procedures; believed that HIV and HBV could be transmitted during clinical procedures; felt worried about occupational exposure to BBP, and held prejudices towards HIV and HBV infected individuals. CONCLUSIONS: Educational efforts are needed to enhance IC teaching and compliance. Diverse educational resources and international networks for research collaboration are available from organisations specialised in IC, hopefully paving the way to harmonising regional standards. Language: English Keywords: LATIN AMERICA | RESEARCH REPORT | STUDENTS | DENTISTS | MEDICAL SCHOOLS | TEACHERS | KNOWLEDGE | AIDS | HEPATITIS | HIV INFECTIONS | INFECTIONS | SAFETY | TRAINING PROGRAMS | OCCUPATIONAL HEALTH | HEALTH EDUCATION | EXPOSURE | BLOOD | Americas | Developing Countries | Education | Health Personnel | Delivery of Health Care | Health | Schools | Sociocultural Factors | Viral Diseases | Diseases | Public Health | Risk Factors | Hemic System | Physiology | Biology Document Number: 329033 |
| 26. Title: Activities of artesunate and amodiaquine against intestinal helminth in children with Plasmodium falciparum malaria in endemic areas. Author: Adedeji AA; Fehintola FA; Olasupo NO; Balogun T; Sowunmi A Source: European Journal of Clinical Microbiology and Infectious Diseases. 2008 Feb 12;:[3] p. Abstract: Malaria and helminthes infections are major causes of morbidity and mortality in children and are a public health problem in endemic areas of sub-Saharan Africa. The prevalence of concomitant infection with intestinal helminthes of malaria is unknown, but the high prevalence of both infections exists in individuals living in Africa and elsewhere in the world where the infections are endemic. Several studies have reported that co-infection with helminthes affects the natural history and progression of malaria; however, the contribution of antimalarial drug treatment on the coinfection is unknown. Artesunate and amodiaquine are effective antimalarial drugs in the treatment of uncomplicated falciparum malaria. Recently, the use of an artemisinine-based combination option was adopted for the new policy on the management of malaria in Nigeria in 2004. One of the most frequently used of these combinations is artemether-amodiaquine, the individual drugs of which are readily available and readily used uncombined. Artemether has been reported to show activity against adult human schistosome parasites, but there is no clear-cut documentation of the effects of this drug, and amodiaquine, a potential artemisinine-based combination candidate, against intestinal helminthes. (excerpt) Language: English Keywords: NIGERIA | RESEARCH REPORT | CHILDREN | MALARIA | PARASITES | GASTROINTESTINAL EFFECTS | INFECTIONS | PREVALENCE | ANTIMALARIAL DRUGS | ADMINISTRATION AND DOSAGE | TREATMENT | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Biology | Physiology | Measurement | Research Methodology | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325313 |
| 27. Title: The prevalence of HBV, HCV and HIV infections among blood donors in Izmir, Turkey [letter] Author: Afsar I; Gungor S; Sener AG; Yurtsever SG Source: Indian Journal of Medical Microbiology. 2008 Jul-Sep;26(3):288-9. Abstract: The evaluation of the data of the prevalence of the transfusion transmitted infections (TTIs), Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human immunodeficiency virus (HIV), among blood donors permits an assessment of the acquisition of the infections in the blood donor population and consequently the safety of the collected donations. It also gives an idea for the epidemiology of these infections in the community. [1] Therefore, the purpose of the present study was to determine the prevalence of serological markers of HBV, HCV and HIV in the population of blood donors in Izmir, Turkey. (excerpt) Language: English Keywords: TURKEY | CRITIQUE | PREVALENCE | EVALUATION | HEPATITIS | HIV INFECTIONS | INFECTIONS | BLOOD DONORS | BLOOD TRANSFUSION | LABORATORY PROCEDURES | SCREENING | RISK FACTORS | Developing Countries | Europe, Southeastern | Europe | Measurement | Research Methodology | Viral Diseases | Diseases | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Biology Document Number: 328535 |
| 28. Title: Correlation between clinical features and degree of immunosuppression in HIV infected children. Author: Agarwal D; Chakravarty J; Sundar S; Gupta V; Bhatia BD Source: Indian Pediatrics. 2008 Feb;45(2):140-143. Abstract: We conducted this study to find out correlation of CD4% with clinical status in 102 HIV infected antiretroviral naive children. Mean age of presentation was 4.8 years. Perinatal transmission was the commonest mode of transmission (94%). Fever (53%), chronic diarrhea (36%), and cough (29%) were the commonest presenting symptoms. Protein energy malnutrition was seen in 56.7% of children. 33.3% children were asymptomatic, whereas 45.1% were in WHO clinical stages III and IV at the time of presentation. The most common opportunistic infection was tuberculosis. CD4% correlated significantly with the deterioration of the WHO clinical stages (P less than 0.01) and increasing grades of protein energy malnutrition (P less than 0.05). (author's) Language: English Keywords: INDIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | CHILDREN | IMMUNOLOGICAL EFFECTS | MALNUTRITION | PROTEINS | INFECTIONS | SIGNS AND SYMPTOMS | ANTIRETROVIRAL THERAPY | Developing Countries | Asia, Southern | Asia | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Immunity | Immune System | Physiology | Biology | Nutrition Disorders | HIV Document Number: 325107 |
| 29. Peer Reviewed Title: Acute haemorrhagic pancreatitis in HIV-positive patients. Author: Arif M; Nair V; Khan ZR Source: South African Medical Journal. 2008 Jan;98(1):25-26. Abstract: Acute pancreatitis in HIV-positive patients is less common than alcohol-related pancreatitis. Haemorrhagic pancreatitis is very rare. A 23-year-old HIV-positive woman presented with vague upper abdominal pain of 3 days' duration, pain radiating to the back, and vomiting. There was no history of trauma, alcohol use, recent viral illness or drug treatment. She had a tender epigastrium on deep palpation but no rebound, mass or ascites. A chest radiograph was normal and an abdominal radiograph showed dilated loops of small bowel with air in the rectum. Laboratory results were as follows: full blood count: white cell count 10.7×109/l (neutrophils 85.5%), haemoglobin concentration 12.9 g/dl, platelet count 146×109/l; urea and electrolytes: sodium 130 mmol/l, potassium 3.0 mmol/l, chloride 110 mmol/l, urea 13.9 mmol/l, creatinine 103 µmol/l; liver function tests: all normal; serum amylase 391 U/l. She was admitted for observation and treated symptomatically. Her condition deteriorated, with generalised peritonitis, a very high base excess (-12.5 mmol/l) on arterial blood gas measurement, and a serum amylase level of 341 U/l. An exploratory laparotomy showed free haemorrhagic peritoneal fluid (Fig. 1) (amylase level 3 281 U/l), retroperitoneal blood tracking from the transverse colon to the caecum (Figs 1 and 2), and a grossly inflamed pancreas (Fig. 3). A baseline computed tomography (CT) scan of the abdomen was done on postoperative day 1 (Fig. 4). The CD4 count on postoperative day 3 was 34 cells/µl. The patient improved steadily and was discharged via an antiretroviral (ARV) clinic for follow-up, with no sequelae of acute pancreatitis. A follow-up CT scan of the abdomen on day 20 was normal. What triggered the attack remains obscure. Discussion We found only one citation on acute haemorrhagic pancreatitis in HIV-positive patients,1 with 1 of the 2 patients reported to have survived. CT scan facilities would help in the preoperative diagnosis. If the serum and urine amylase remain normal, diagnosis is difficult. We did not have the facility to measure the serum lipase level, which might have been helpful. The APACHE II score has been suggested as a more reliable means of monitoring these patients in the ICU setting. (full-text) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CASE STUDIES | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | INFECTIONS | COMPLICATIONS | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | SURGERY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment Document Number: 330698 |
| 30. Title: Subclinical mastitis is common among Ghanaian women lactating 3 to 4 months postpartum. Author: Aryeetey RN; Marquis GS; Timms L; Lartey A; Brakohiapa L Source: Journal of Human Lactation. 2008 Aug;24(3):263-267. Abstract: Subclinical mastitis (SCM) is an asymptomatic inflammation of mammary tissue and has been associated with lactation failure, suboptimal growth in early infancy, and increased risk of mother-to-child transmission of HIV via breast milk. A rapid survey was carried out to determine the prevalence of SCM among lactating Ghanaian women between 3 and 4 months postpartum. Bilateral breast milk samples were obtained from 117 lactating women in Manya Krobo, Ghana and analyzed for sodium (Na) and potassium (K). An elevated sodium/potassium ratio (Na/K) above 1.0 was considered indicative of SCM. Overall, SCM prevalence was observed among 45.3% of the women. About 30% of the women had unilateral SCM. Na/K was associated with maternal age. The high SCM prevalence in Manya Krobo suggests the need for lactation support to reduce SCM and the risk of poor infant outcomes. Language: English Keywords: GHANA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | HIV TRANSMISSION | MOTHER-TO-CHILD TRANSMISSION | HUMAN MILK | LACTATION | MAMMARY GLAND EFFECTS | MATERNAL AGE | INFECTIONS | PREVALENCE | BREASTFEEDING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | HIV Infections | Viral Diseases | Diseases | Transmission | Maternal Physiology | Physiology | Biology | Parental Age | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Infant Nutrition | Nutrition | Health Document Number: 308024 |
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