| 1. Title: Impact of new WHO growth standards on the prevalence of acute malnutrition and operations of feeding programs - Darfur, Sudan, 2005-2007. Author: Centers for Disease Control and Prevention (CDC) Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 5;58(21):591-4. Abstract: Acute malnutrition among children aged 6-59 months is a key indicator routinely used for describing the presence and magnitude of humanitarian emergencies. In the past, the prevalence of acute malnutrition and admissions to feeding programs has been determined using the growth reference developed by the World Health Organization (WHO), CDC, and the National Center for Health Statistics (NCHS). In 2006, WHO released new international growth standards and recommended their use in all nutrition programs. To evaluate the impact of transitioning to the new standards, CDC analyzed anthropometric data for children aged 6-59 months from Darfur, Sudan, collected during 2005-2007. This report describes the results of that analysis, which indicated that use of the new standards would have increased the prevalence of global acute malnutrition on average by 14% and would have increased the prevalence of severe acute malnutrition on average by 100%. Admissions to feeding programs would have increased by 56% for moderately malnourished children and by 260% for severely malnourished children. For programs in Darfur, this would have resulted in approximately 23,200 more children eligible for therapeutic feeding programs. For the immediate future, the prevalence of acute malnutrition in children should be reported using both the old WHO/CDC/NCHS reference and the new WHO standards. More research is needed to better ascertain the validity of the admission criteria based on the new WHO standards in predicting malnutrition-related morbidity and mortality. Language: English Keywords: SUDAN | SUMMARY REPORT | WHO | STANDARDS | PREVALENCE | CHILD DEVELOPMENT | GROWTH | MALNUTRITION | NUTRITION PROGRAMS | EVALUATION | Developing Countries | Africa, North | Africa | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Measurement | Biology | Nutrition Disorders | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 341622 |
2.  Peer Reviewed Title: Where the most private becomes public: policy making for sexual health. Author: PLoS Medicine Editors Source: PLoS Medicine. 2009 May 26;6(5):e1000082. Abstract: Language: English Keywords: GLOBAL | CRITIQUE | HEALTH POLICY | REPRODUCTIVE HEALTH | REPRODUCTIVE RIGHTS | SEXUALITY | IPPF | GOALS | ABORTION | CONTRACEPTIVE AVAILABILITY | NEEDS | SAFER SEX | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | Policy | Political Factors | Sociocultural Factors | Health | Human Rights | Personality | Psychological Factors | Behavior | International Agencies | Organizations | Planning | Organization and Administration | Fertility Control, Postconception | Family Planning | Contraception | Economic Factors | Sex Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 342315 Notification |
3.  Title: Expert Group Meeting to Assess the Progress in the Implementation of the Plan of Action on Population and Poverty Adopted at the Fifth Asian and Pacific Population Conference, 3-5 February 2009, Bangkok. Report. Author: United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]; United Nations Population Fund [UNFPA] Source: Bangkok, Thailand, ESCAP, 2009. 38 p. Abstract: The Expert Group Meeting to Assess the Progress in the implementation of the Plan of Action on Population and Poverty adopted at the Fifth Asian and Pacific Population Conference was held at the United Nations Conference Centre, Bangkok from 3 to 5 February 2009. The Expert Group Meeting was organized by the Social Policy and Population Section, Social Development Division, ESCAP in collaboration with the UNFPA Asia and the Pacific Regional Office. The meeting benefited from background papers and country reports prepared by resource persons and representatives of governments. Language: English Keywords: ASIA | OCEANIA | CONFERENCES AND CONGRESSES | ESCAP | POPULATION | SUSTAINABLE DEVELOPMENT | POVERTY | REPRODUCTIVE HEALTH | MATERNAL-CHILD HEALTH SERVICES | GENDER ISSUES | MIGRATION | HIV INFECTIONS | AIDS | IMPLEMENTATION | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Economic Development | Economic Factors | Socioeconomic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Population Dynamics | Demographic Factors | Viral Diseases | Diseases | Programs | Organization and Administration Document Number: 331854 |
| 4. Title: Expanding access to injectable contraceptives. Author: United States. Agency for International Development [USAID] Source: [Washington, D.C.], USAID, [2009]. [2] p. Abstract: A technical consultation, co-sponsored by the World Health Organization (WHO), USAID, and Family Health International (FHI), was held June 15-17, 2009, at the WHO in Geneva to review the evidence and programmatic experience for community-based provision of injectable contraceptives. Thirty technical and program experts from countries and organizations reviewed the scientific evidence and experiences from programs that provided injectable contraceptives through community-based health workers (CHWs). This evidence and programmatic experience came from Africa, Asia, and Latin America and focused on depotmedroxyprogesterone acetate (DMPA). The evidence consistently showed that given appropriate training, CHWs can screen clients effectively, provide DMPA injections safely, and counsel on side effects appropriately, demonstrating competence equivalent to higher level facility-based providers of DMPA. Continuation of use of DMPA by clients of CHWs was as long as those of clients receiving injections at clinics. In addition, the vast majority of clients expressed satisfaction with CHW provision of DMPA. The Consultation concluded that sufficient evidence existed for national policies to support the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives, especially DMPA. Provision of DMPA by CHWs will expand choice for underserved populations and contribute to reducing the unmet need for family planning. Operational guidelines for family planning should therefore reflect that appropriately trained CHWs can safely initiate use of DMPA and provide reinjection. (Excerpt) Language: English Keywords: GLOBAL | SUMMARY REPORT | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | COUNSELING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Public Health | Contraceptive Usage | Training Programs | Education | Clinic Activities | Program Activities | Programs | Organization and Administration | Population Policy | Social Policy | Policy Document Number: 331839 |
| 5. Title: Reducing health inequities through action on the social determinants of health. Author: World Health Assembly (62nd: 2009: Geneva) Source: Geneva, Switzerland, World Health Assembly, 2009 May 22. 5 p. (WHA62.14) Agenda item 12.5 Abstract: The Sixty-second World Health Assembly calls upon the international community, including United Nations agencies, intergovernmental bodies, civil society and the private sector: (1) to take note of the final report of the Commission on Social Determinants of Health and its recommendations; (2) to take action in collaboration with WHO's Member States and the WHO Secretariat on assessing the impacts of policies and programmes on health inequities and on addressing the social determinants of health; (3) to work closely with WHO's Member States and the WHO Secretariat on measures to enhance health equity in all policies in order to improve health for the entire population and reduce inequities; (4) to consider health equity in working towards achievement of the core global development goals and to develop indicators to monitor progress, and to consider strengthening international collaboration in addressing the social determinants of health and in reducing health inequities. (Excerpts) Language: English Keywords: GLOBAL | CONFERENCES AND CONGRESSES | WHO | HEALTH | INEQUALITIES | SOCIOECONOMIC FACTORS | HEALTH POLICY | SOCIAL POLICY | GOALS | INTERNATIONAL COOPERATION | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Economic Factors | Policy | Planning | Organization and Administration Document Number: 331421 |
| 6. Title: Community-based health workers can safely and effectively administer injectable contraceptives: Conclusions from a technical consultation. Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI] Source: Research Triangle Park, North Carolina, FHI, 2009. 4 p. Abstract: In June 2009, a technical consultation held at the World Health Organization (WHO) in Geneva concluded that evidence supports the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives. The group of 30 technical and programme experts reviewed scientific and programmatic experience, which largely focused on the progestin-only injectable, depot-medroxyprogesterone acetate (DMPA). The experts found that community-based provision of progestin-only injectable contraceptives by appropriately trained community health workers (CHWs) is safe, effective, and acceptable. Such services should be part of a family planning programme offering a range of contraceptive methods. (Excerpt) Language: English Keywords: GLOBAL | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | NEEDS | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | MONITORING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Economic Factors | Public Health | Contraceptive Usage | Training Programs | Education | Evaluation | Population Policy | Social Policy | Policy Document Number: 331834 |
| 7. Title: WHO / USAID / FHI Technical Consultation: Expanding Access to Injectable Contraception, 15-17 June 2009, Room M405, WHO, Geneva. Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI] Source: [Unpublished] 2009. 5 p. Abstract: The agenda for the consultation is presented. The objectives of the consultation were: To review systematically the evidence and programmatic experience on interventions designed to expand access to / provision of contraceptive injectables, focusing on non clinic-based services and programs; To reach conclusions on issues: (a) for which evidence is consistent and strong; (b) for which evidence is mixed; and (c) for which evidence is marginal or entirely lacking and, thus requires additional research; To document discussions and conclusions of the Consultation, including policy and program implications, and to disseminate these widely. Language: English Keywords: GLOBAL | TABLES AND CHARTS | CONFERENCES AND CONGRESSES | WHO | USAID | INJECTABLES | CONTRACEPTIVE AVAILABILITY | INTERVENTIONS | NEEDS | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTION CONTINUATION | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Government Agencies | Contraceptive Methods | Contraception | Family Planning | Programs | Organization and Administration | Economic Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Contraceptive Usage Document Number: 331853 |
| 8. Peer Reviewed Title: Evidence behind the WHO guidelines: hospital care for children: what is the evidence that BCG vaccination should not be used in HIV-infected children? Author: Bannister C; Bennett L; Carville A; Azzopardi P Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):78-82. Abstract: The World Health Organization has produced guidelines for the management of common illnesses in hospitals with limited resources. This series reviews the scientific evidence behind WHO's recommendations. The WHO guidelines, and more reviews are available at: http://www.ichrc.org. This review addresses the question: What is the evidence that BCG vaccination should not be used in HIV-infected children? The limited evidence currently available has been the basis of the WHO recommendation that BCG vaccination should not be used in HIV-positive children, as severe complications appear more commonly in HIV-infected individuals [8]. This decision is supported by the findings from the Fallo [13] and Hesseling [18, 20] studies. Although the WHO have suggested that HIV-infected infants should not be vaccinated this is obviously difficult in countries where BCG vaccination is administered before HIV status can be detected. Many high HIV-burden countries do not have viral-specific testing (such as PCR) routinely available to adequately assess the infection status of every new born infant. More research needs to be undertaken in this area to clarify the situation, and treating clinicians need to be made aware of this issue with all its complexity. The WHO recommendation highlights the need for viral-specific testing to be widely available in developing countries. This will ensure HIV-infected infants are not exposed to BCG which may be potentially dangerous and HIV-exposed but uninfected infants are not denied this important vaccine. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | WHO | STANDARDS | CHILDREN | HOSPITALS | DELIVERY OF HEALTH CARE | VACCINES | HIV INFECTIONS | Oceania | Developed Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Facilities | Health | Medical Procedures | Medicine | Health Services | Viral Diseases | Diseases Document Number: 341013 |
| 9. Peer Reviewed Title: Expanding antiretroviral options in resource-limited settings--a cost-effectiveness analysis. Author: Bendavid E; Wood R; Katzenstein DA; Bayoumi AM; Owens DK Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):106-13. Abstract: BACKGROUND: Current World Health Organization (WHO) guidelines for treatment of HIV in resource-limited settings call for 2 antiretroviral regimens. The effectiveness and cost-effectiveness of increasing the number of antiretroviral regimens is unknown. METHODS: Using a simulation model, we compared the survival and costs of current WHO regimens with two 3-regimen strategies: an initial regimen of 3 nucleoside reverse transcriptase inhibitors followed by the WHO regimens and the WHO regimens followed by a regimen with a second-generation boosted protease inhibitor (2bPI). We evaluated monitoring with CD4 counts only and with both CD4 counts and viral load. We used cost and effectiveness data from Cape Town and tested all assumptions in sensitivity analyses. RESULTS: Over the lifetime of the cohort, 25.6% of individuals failed both WHO regimens by virologic criteria. However, when patients were monitored using CD4 counts alone, only 6.5% were prescribed additional highly active antiretroviral therapy due to missed and delayed detection of failure. The life expectancy gain for individuals who took a 2bPI was 6.7-8.9 months, depending on the monitoring strategy. When CD4 alone was available, adding a regimen with a 2bPI was associated with an incremental cost-effectiveness ratio of $2581 per year of life gained, and when viral load was available, the ratio was $6519 per year of life gained. Strategies with triple-nucleoside reverse transcriptase inhibitor regimens in initial therapy were dominated. Results were sensitive to the price of 2bPIs. CONCLUSIONS: About 1 in 4 individuals who start highly active antiretroviral therapy in sub-Saharan Africa will fail currently recommended regimens. At current prices, adding a regimen with a 2bPI is cost effective for South Africa and other middle-income countries by WHO standards. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | THEORETICAL MODELS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | COST EFFECTIVENESS | MONITORING | WHO | IMMUNOLOGICAL EFFECTS | LIFE EXPECTANCY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Evaluation Indexes | Quantitative Evaluation | Evaluation | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Immunity | Immune System | Physiology | Biology | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 342908 |
| 10. Title: Placing learning needs in context: distance learning for clinical officers in Tanzania. Author: Brigley S; Hosein I; Myemba I Source: Medical Teacher. 2009 Apr;31(4):e169-76. Abstract: BACKGROUND: Poor public health indicators in Tanzania have led to the upgrading of nursing and clinical personnel who currently have just core training. Clinical officers (COs) have 3 years training in basic and applied medicine and are responsible for healthcare of large and dispersed rural populations. AIMS: UNESCO-Wales has funded colleagues in Wales (UK) to assist the upgrade of COs. An inquiry into their learning needs and the Tanzanian context has produced a framework for design of a module for COs on sexually transmissible infections and HIV & AIDS by distance learning. METHODS: Face-to-face discussions were held with the Ministry of Health, healthcare workers, educators and administrators in Tanzania; a review of training documents was carried out; and a follow-up questionnaire issued to COs. RESULTS: The discussions and review highlighted teacher-centred approaches, and management, infrastructure and resources obstacles to curriculum change. Principal learning needs of COs around STIs were: counselling, syndromic management, drugs management, laboratory diagnosis, health education, resources, staffing and service morale. CONCLUSIONS: Placing learning needs in context in dialogue with Tanzanian colleagues was an advance on simple transfer of educational technologies and expertise. The inquiry resulted in a draft study guide and resources pack that were positively reviewed by Tanzanian tutors. Management and resources issues raised problems of sustainability in the module implementation. Language: English Keywords: TANZANIA | SUMMARY REPORT | HEALTH PERSONNEL | DISTANCE EDUCATION | TRAINING PROGRAMS | NEEDS | UNESCO | CURRICULUM | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | AIDS | TREATMENT | OBSTACLES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Delivery of Health Care | Health | Education | Economic Factors | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Organization and Administration Document Number: 341949 |
| 11. Peer Reviewed Title: Antiretroviral resistance patterns and HIV-1 subtype in mother-infant pairs after the administration of combination short-course zidovudine plus single-dose nevirapine for the prevention of mother-to-child transmission of HIV. Author: Chalermchockcharoenkit A; Culnane M; Chotpitayasunondh T; Vanprapa N; Leelawiwat W; Mock PA; Asavapiriyanont S; Teeraratkul A; McConnell MS; McNicholl JM; Tappero JW Source: Clinical Infectious Diseases. 2009 Jul 15;49(2):299-305. Abstract: BACKGROUND: World Health Organization guidelines for prevention of mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) recommend administration of zidovudine and single-dose nevirapine (NVP) for HIV-1-infected women who are not receiving treatment for their own health or if complex regimens are not available. This study assessed antiretroviral resistance patterns among HIV-infected women and infants receiving single-dose NVP in Thailand, where the predominant circulating HIV-1 strains are CRF01_AE recombinants and where the minority are subtype B. METHODS: Venous blood samples were obtained from (1) HIV-infected women who received zidovudine from 34 weeks' gestation and single-dose NVP plus oral zidovudine during labor and (2) HIV-infected infants who received single-dose NVP after birth plus zidovudine for 4 weeks after delivery. HIV-1 drug resistance testing was performed using the TruGene assay (Bayer HealthCare). RESULTS: Most mothers and infants were infected with CRF01_AE. NVP resistance was detected in 34 (18%) of 190 women and 2 (20%) of 10 infants. There was a significantly higher proportion of NVP mutations in women with delivery viral loads of >50,000 copies/mL (adjusted odds ratio, 8.5; 95% confidence interval, 2.2-32.8, [Formula: see text] for linear trend) and in those with subtype B rather than CRF01_AE infections (38% vs. 16%; adjusted odds ratio, 3.6; 95% confidence interval, 1.1-11.8; P = .038). CONCLUSIONS: The lower frequency of NVP mutations among mothers infected with subtype CRF01_AE, compared with mothers infected with subtype B, suggests that individuals infected with subtype CRF01_AE may be less susceptible to the induction of NVP resistance than are individuals infected with subtype B. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | WHO | MANUAL | STANDARDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | MOTHERS | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV | DRUG RESISTANCE | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | TREATMENT | LABORATORY PROCEDURES | HIV TESTING | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Disease Transmission Control | Prevention and Control | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 342429 |
| 12. Peer Reviewed Title: A global fund for the health MDGs? Author: Cometto G; Ooms G; Starrs A; Zeitz P Source: Lancet. 2009 May 2;373(9674):1500-2. Abstract: The world is off track to achieve the health-related targets of the Millennium Development Goals (MDGs) by 2015. Maternal mortality has stagnated for two decades, child mortality is not declining fast enough, HIV/AIDS still infects people faster than the pace of antiretroviral treatment roll-out, and inequalities are widening within and across countries. Addressing these crises will require increased funding and more efficient spending. The next Board meetings of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance, scheduled for May and June, respectively, present an opportunity to tackle these issues. We propose that the exceptional approach created for the fight against AIDS should be expanded: the entire global health agenda must adopt a rights-based approach, which in some countries requires challenging the model of national financial autonomy. We therefore recommend that the Global Fund and the GAVI Alliance gradually move towards becoming a global fund for all the health MDGs, which will require substantially greater resources to address the broader mandate. As a first step the next Global Fund and GAVI Alliance board meetings should expand the review of their architecture to provide greater support to national health plans, including co-financing non-disease-specific human resources for health. A global fund for the health MDGs would eventually allow the delivery of prevention and treatment services for specific diseases through revamped general health services, reducing transaction costs and streamlining the global health architecture. Such radical, yet rational, action is our best chance of meeting-or at least making significant progress toward-the health-related MDG targets by 2015. Language: English Keywords: DEVELOPING COUNTRIES | RECOMMENDATIONS | EVALUATION | POLICYMAKERS | GOALS | DEVELOPMENT POLICY | HEALTH POLICY | FUNDS | FOREIGN AID | INTERNATIONAL COOPERATION | COORDINATION | WHO | Administrative Personnel | Organization and Administration | Planning | Policy | Political Factors | Sociocultural Factors | Financial Activities | Economic Factors | UN | International Agencies | Organizations Document Number: 341099 |
| 13. Peer Reviewed Title: Comparison of the new World Health Organization growth standards and the National Center for Health Statistics growth reference regarding mortality of malnourished children treated in a 2006 nutrition program in Niger. Author: Dale NM; Grais RF; Minetti A; Miettola J; Barengo NC Source: Archives of Pediatrics and Adolescent Medicine. 2009 Feb;163(2):126-30. Abstract: OBJECTIVE: To compare the National Centre for Health Statistics (NCHS) international growth reference with the new World Health Organization (WHO) growth standards for identification of the malnourished (wasted) children most at risk of death. DESIGN: Retrospective data analysis. SETTING: A Medecins Sans Frontieres (Doctors Without Borders) nutrition program in Maradi, Niger, in 2006 that treated moderately and severely malnourished children. PARTICIPANTS: A total of 53 661 wasted children aged 6 months to 5 years (272 of whom died) in the program were included. INTERVENTIONS: EpiNut (Epi Info 6.0; Centers for Disease Control and Prevention, Atlanta, Georgia) software was used to calculate the percentage of the median for the NCHS reference group, and the WHO (igrowup macro; Geneva, Switzerland) software was used to calculate z scores for the WHO standards group of the 53 661 wasted children. OUTCOME MEASURES: The main outcome measures are the difference in classification of children as either moderate or severely malnourished according to the NCHS growth reference and the new WHO growth standards, specifically focusing on children who died during the program. RESULTS: Of the children classified as moderately wasted using the NCHS reference, 37% would have been classified as severely wasted according to the new WHO growth standards. These children were almost 3 times more likely to die than those classified as moderately wasted by both references, and deaths in this group constituted 47% of all deaths in the program. CONCLUSIONS: The new WHO growth standards identifies more children as severely wasted compared with the NCHS growth reference, including children at high mortality risk who would potentially otherwise be excluded from some therapeutic feeding programs. Language: English Keywords: NIGER | UNITED STATES OF AMERICA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | CLASSIFICATION | RETROSPECTIVE STUDIES | COMPARATIVE STUDIES | EVALUATION INDEXES | CHILDREN | GROWTH | MALNUTRITION | STANDARDS | HEALTH STATUS INDEXES | WHO | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Developed Countries | North America | Americas | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Development | Biology | Nutrition Disorders | Diseases | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 330228 |
| 14. Title: CD4 validation for the World Health Organization classification and clinical staging of HIV/AIDS in a developing country. Author: Edathodu J; Ali B; Alrajhi AA Source: International Journal of Infectious Diseases. 2009 Mar;13(2):243-6. Abstract: OBJECTIVES: To validate the World Health Organization (WHO) clinical staging and classification of HIV/AIDS using CD4+ T-lymphocyte counts in the setting of a developing country. METHODS: This was a retrospective chart review of HIV-infected adults at the national HIV referral clinic in the Kingdom of Saudi Arabia. Four hundred HIV-infected individuals were reviewed. All individuals under the age of 15 years and those who had received antiretroviral therapy were excluded. WHO clinical stage at presentation was determined by a single reviewer. The first CD4+ T-lymphocyte count within 6 months of diagnosis of HIV infection was then abstracted by a different reviewer. The main outcome measure was the comparison of the WHO clinical stages of HIV/AIDS at the time of diagnosis and the CD4+ T-lymphocyte counts. RESULTS: Data were available for 191 individuals, of whom 123 were men and 68 were women. The mean CD4+ T-lymphocyte count was 281/mm(3) in the men and 425/mm(3) in the women. The distribution of individuals at the WHO clinical stages was 110 at stage I, 10 at stage II, 36 at stage III, and 35 at stage IV. Mean CD4+ T-lymphocyte counts were 457, 337, 188, and 86/mm(3) at the respective stages. The difference between the mean CD4+ T-lymphocyte count in patients at stage IV and at each of the other stages was significant; p<0.0001. The correlation between the stages and the mean CD4+ T-lymphocyte counts was -0.65. CONCLUSION: The WHO clinical staging and classification of HIV/AIDS correlates well with CD4+ T-lymphocyte counts. Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | WHO | VALIDITY | HIV | AIDS | TESTING | IMMUNITY | Middle East | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases | Immune System | Physiology | Biology Document Number: 341557 |
| 15. Peer Reviewed Title: Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations. Author: El Mouzan MI; Al Omar AA; Al Salloum AA; Al Herbish AS; Qurachi MM Source: Annals of Saudi Medicine. 2009 Jan-Feb;29(1):20-3. Abstract: BACKGROUND AND OBJECTIVE: The WHO recommends exclusive breastfeeding in the first 6 months of life. Our objective was to evaluate trends in infant nutrition in Saudi Arabia and the degree of compliance with WHO recommendations. SUBJECTS AND METHODS: A nationwide nutritional survey of a sample of Saudi households was selected by the multistage probability sampling procedure. A validated questionnaire was administered to mothers of children less than 3 years of age. RESULTS: Of 5339 children in the sample, 4889 received breast milk at birth indicating a prevalence of initiation of 91.6%. Initiation of breastfeeding was delayed beyond 6 hours after birth in 28.1% of the infants. Bottle feeding was introduced by 1 month of age to 2174/4260 (51.4%) and to 3831/4260 (90%) by 6 months of age. The majority of infants 3870/4787 (80.8%) were introduced to "solid foods" between 4 to 6 months of age and whole milk feedings were given to 40% of children younger than 12 months of age. CONCLUSIONS: The current practice of feeding of Saudi infants is very far from compliance with even the most conservative WHO recommendations of exclusive breastfeeding for 4 to 6 months. The high prevalence of breastfeeding initiation at birth indicates the willingness of Saudi mothers to breastfeed. However, early introduction of complementary feedings reduced the period of exclusive breastfeeding. Research in infant nutrition should be a public health priority to improve the rate of breastfeeding and to minimize other inappropriate practices. Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | NUTRITION SURVEYS | INFANT | HOUSEHOLDS | INFANT NUTRITION | WHO | STANDARDS | BREASTFEEDING, EXCLUSIVE | PREVALENCE | TIME FACTORS | SUPPLEMENTARY FEEDING | AGE FACTORS | BREASTFEEDING | Middle East | Developing Countries | Nutrition | Health | Youth | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | UN | International Agencies | Organizations | Political Factors | Research Methodology | Measurement | Population Dynamics Document Number: 331138 |
| 16. Title: Early treatment of HIV: implications for resource-limited settings. Author: Hobbs CV; Essajee SM Source: Current Opinion In HIV and AIDS. 2009 May;4(3):222-31. Abstract: PURPOSE OF REVIEW: We review the current literature supporting adoption of higher CD4 thresholds for initiation of antiretroviral treatment and survey progress in adoption of early treatment policies in resource-limited settings. We highlight some of the challenges and opportunities implementation of early treatment will bring. RECENT FINDINGS: The initial success of combination antiretroviral treatment resulted in the recommendation to treat early all individuals with HIV. However, the gradual realization that antiretroviral treatment was associated with toxicity led to a more tempered approach. Recent cohort studies and some clinical trials have shown that delaying treatment is associated with increased morbidity and mortality. SUMMARY: Early treatment is routinely practiced in developed countries. Now, early treatment is being adopted as a strategy in many resource-limited settings. The implications of this policy shift are not known, but we predict early treatment will have important consequences for the health system, the individual, and the community. Whereas these consequences will bring significant challenges, the increased numbers of HIV-infected individuals on treatment will result in many new opportunities - antiretroviral treatment will become less expensive, systems to deliver chronic care will be strengthened, and the policy shift will focus greater attention on pregnant women and children. Finally, some authors postulate that early treatment may impact HIV transmission. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | HIV INFECTIONS | AIDS | ANTIRETROVIRAL THERAPY | IMPLEMENTATION | OBSTACLES | TIME FACTORS | MORTALITY | IMMUNOLOGICAL EFFECTS | HEALTH POLICY | WHO | Viral Diseases | Diseases | HIV | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population | Immunity | Immune System | Physiology | Biology | Policy | Political Factors | Sociocultural Factors | UN | International Agencies | Organizations Document Number: 342344 |
| 17. Title: Total lymphocyte count and World Health Organization pediatric clinical stage as markers to assess need to initiate antiretroviral therapy among human immunodeficiency virus-infected children in Moshi, Northern Tanzania. Author: Johnson OO; Benjamin DK; Benjamin DK Jr; Schimana W; Gayani Tillekeratne L; Crump JA; Landman KZ; Kinabo GD; Mmbaga B; Msuya LJ; Shao JF; Swai ME; Cunningham CK Source: Pediatric Infectious Disease Journal. 2009 Jun;28(6):493-7. Abstract: BACKGROUND: The World Health Organization (WHO) has recommended the use of clinical staging alone and with total lymphocyte count to identify HIV infected children in need of antiretroviral therapy (ART) in resource-limited settings, when CD4 cell count is not available.METHODS: We prospectively enrolled children obtaining care for HIV infection at the Kilimanjaro Christian Medical Centre Pediatric Infectious Diseases Clinic in Moshi, Tanzania between March 2004 and May 2006 for this cohort study.RESULTS: One hundred ninety two (89.7%) of 214 children met WHO ART initiation criteria based on clinical staging or CD4 cell count. Several low-cost measures identified individuals who met WHO ART initiation criteria to the following degree: WHO stages 3 or 4 had 87.5% (95% CI, 82.8-92.1) sensitivity and, by definition, 100% (CI, 100-100) specificity; WHO recommended advance disease TLC cutoffs: sensitivity = 23.9% (95% CI, 17.3-30.5) specificity = 78.2% (95% CI, 67.3-89.1). Low TLC was a common finding, (50 of 214; 23%); however, it did not improve the sensitivity or specificity of clinical staging in identifying the severely immunosuppressed stage 2 children. Growth failure or use of total lymphocyte counts in isolation were not reliable indicators of severe immunosuppression or need to initiate ART.CONCLUSION: The use of total lymphocyte count does not improve the ability to identify children in need of ART compared with clinical staging alone. Low absolute lymphocyte count did not correlate with severe immunosuppression based on CD4 cell count in this cohort. Language: English Keywords: TANZANIA | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | CHILDREN | ANTIRETROVIRAL THERAPY | NEEDS | IMMUNOLOGIC FACTORS | WHO | STANDARDS | IMMUNOLOGICAL EFFECTS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | Economic Factors | Immunity | Immune System | Physiology | Biology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 342640 |
| 18. Peer Reviewed Title: Low levels of antiretroviral-resistant HIV infection in a routine clinic in Cameroon that uses the World Health Organization (WHO) public health approach to monitor antiretroviral treatment and adequacy with the WHO recommendation for second-line treatment. Author: Kouanfack C; Montavon C; Laurent C; Aghokeng A; Kenfack A; Bourgeois A; Koulla-Shiro S; Mpoudi-Ngole E; Peeters M; Delaporte E Source: Clinical Infectious Diseases. 2009 May 1;48(9):1318-22. Abstract: A cross-sectional study, performed at a routine human immunodeficiency virus (HIV)/AIDS clinic in Cameroon that uses the World Health Organization public health approach, showed low rates of virological failure and drug resistance at 12 and 24 months after initiation of antiretroviral therapy. Importantly, the cross-sectional study also showed that the World Health Organization recommendation for second-line treatment would be effective in almost all patients with HIV drug resistance mutations. Language: English Keywords: CAMEROON | RESEARCH REPORT | SUMMARY REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | DRUG RESISTANCE | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | WHO | MONITORING | STANDARDIZATION | CHROMOSOME ABNORMALITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Measurement | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Evaluation | Data Adjustment | Neonatal Diseases and Abnormalities Document Number: 341154 |
| 19. Title: Circumcision and HIV [letter] Author: Lazarus J Source: South African Medical Journal. 2009 Jan;99(1):12. Abstract: Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | CLINICAL TRIALS | LONGITUDINAL STUDIES | MATHEMATICAL MODEL | MEN | MALE CIRCUMCISION | HEALTH POLICY | HIV PREVENTION | RISK REDUCTION BEHAVIOR | WHO | Africa | Developing Countries | Clinical Research | Research Methodology | Studies | Theoretical Models | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Behavior | UN | International Agencies | Organizations Document Number: 341057 |
| 20. Title: Occupational transmission of bloodborne diseases to healthcare workers in developing countries: meeting the challenges. Author: Lee R Source: Journal of Hospital Infection. 2009 Aug;72(4):285-91. Abstract: Healthcare workers have increased chance of acquiring bloodborne pathogens through occupational exposure in developing countries due to a combination of increased risk and fewer safety precautions. As loss of workers can seriously undermine developing health systems, it is important that risks are minimised. A literature search was conducted to investigate the risks of transmission of three pathogens: human immunodeficiency virus, hepatitis B and hepatitis C viruses; and to identify factors that influenced the risk with reference to developing countries. There are many difficulties faced by developing countries in minimising the risk of occupational exposure. Efforts have been made to address the problems both on international and national levels. It is imperative that all healthcare workers are protected in order to prevent the loss of such a crucial component of developing healthcare systems. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | HEALTH PERSONNEL | HIV INFECTIONS | HEPATITIS | OCCUPATIONAL HEALTH | INFECTION TRANSMISSION | RISK FACTORS | NEEDLE PIERCING | SAFETY | UNIVERSAL PRECAUTIONS | WHO | HEALTH POLICY | Delivery of Health Care | Health | Viral Diseases | Diseases | Infections | Risk Behavior | Behavior | Public Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Policy Document Number: 342909 |
| 21. Title: A review of the evidence developed for a technical consultation on expanding access to injectable contraception. Author: Malarcher S Source: [Research Triangle Park, North Carolina], Family Health International [FHI], 2009 Jun. 48 p. Abstract: The document was prepared to facilitate deliberations for the Technical Consultation on Expanding Access to Injectable Contraceptives sponsored by the World Health Organization, the United States Agency for International Development, and Family Health International, scheduled to be held from 15-17 June 2009 in Geneva, Switzerland. This document summarizes the results of a literature review conducted to identify research evidence and program experience relevant to the objectives of the Technical Consultation: To review systematically the evidence and programmatic experience on interventions designed to expand access to / provision of contraceptive injectables, focusing on non clinic-based services and programs; To reach conclusions on issues: (a) for which evidence is consistent and strong; (b) for which evidence is mixed; and (c) for which evidence is marginal or entirely lacking and, thus requires additional research; To document discussions and conclusions of the Consultation, including policy and program implications, and to disseminate these widely. Use of community-based injectable services was significant in all studies reviewed. This evidence suggests that community-based delivery of injectable services by CHW is acceptable in a wide variety of settings. (Excerpts) Language: English Keywords: GLOBAL | LITERATURE REVIEW | WHO | INJECTABLES | DEPO-PROVERA | NEEDS | SAFETY | CONTRACEPTIVE USAGE | PROGRAM ACCESSIBILITY | CONTRACEPTION CONTINUATION | CONTRACEPTIVE AGENTS, SIDE EFFECTS | TRAINING ACTIVITIES | COUNSELING | MONITORING | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Economic Factors | Public Health | Health | Program Evaluation | Programs | Organization and Administration | Training Programs | Education | Clinic Activities | Program Activities | Evaluation Document Number: 331835 |
| 22. Title: Blind optimism: Challenging the myths about private health care in poor countries. Author: Marriott A Source: Oxford, United Kingdom, Oxfam International, 2009 Feb. 55 p. (Oxfam Briefing Paper No. 125) Abstract: 'The realization of the right to health for millions of people in poor countries depends upon a massive increase in health services to achieve universal and equitable access. A growing number of international donors are promoting an expansion of private-sector health-care delivery to fulfil this goal. The private sector can play a role in health care. But this paper shows there is an urgent need to reassess the arguments used in favor of scaling-up private-sector provision in poor countries. The evidence shows that prioritizing this approach is extremely unlikely to deliver health for poor people. Governments and rich country donors must strengthen state capacities to regulate and focus on the rapid expansion of free publicly provided health care, a proven way to save millions of lives worldwide. (Excerpt) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | EVALUATION | POPULATION | PRIVATE SECTOR | HEALTH SERVICES EVALUATION | PROGRAM ACCESSIBILITY | INEQUALITIES | CAPACITY BUILDING | WORLD BANK | GOVERNMENT PROGRAMS | QUALITY OF HEALTH CARE | DELIVERY OF HEALTH CARE | Macroeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration | Socioeconomic Factors | Program Sustainability | International Agencies | Organizations | Political Factors | Sociocultural Factors | Health Document Number: 331349 |
| 23. Peer Reviewed Title: The United Nations Convention on the Rights of the Child and HIV/AIDS [editorial] Author: McMillan AS; Simkiss D Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):71-2. Abstract: The authors provide recommendations to promote children's right to life and survival, children's best interests and children's participation and non-discrimination through sex education. They also outline ideas that may be developed on the issues for children orphaned by HIV to promote the child's right to life. Language: English Keywords: GLOBAL | UN | UNAIDS | CRITIQUE | CHILDREN | HUMAN RIGHTS | HIV INFECTIONS | AIDS | QUALITY OF LIFE | CHILD HEALTH | INTERVENTIONS | PREVENTION AND CONTROL | International Agencies | Organizations | Political Factors | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Social Welfare | Economic Factors | Health | Programs | Organization and Administration Document Number: 341012 |
| 24. Title: Two vs. three sputum samples for microscopic detection of tuberculosis in a high HIV prevalence population. Author: Noeske J; Dopico E; Torrea G; Wang H; Van Deun A Source: International Journal of Tuberculosis and Lung Disease. 2009 Jul;13(7):842-7. Abstract: SETTING: A busy urban hospital in Cameroon. OBJECTIVES: To compare the yield in bacteriologically proven tuberculosis (TB) cases examining two morning vs. three spot-morning-spot sputum specimens (MM vs. SMS) by direct microscopy for acid-fast bacilli (AFB). DESIGN: Repeated temporal cross-over between MM and SMS sampling for successive TB suspects, using culture as gold standard. RESULTS: A total of 799 suspects were screened using the MM strategy, identifying 223 smear-positives, and 808 suspects with the SMS strategy, yielding 236 smear-positives. Of the MM, 256 were culture-positive, of whom 195 (76%) were smear-positive. For SMS, these figures were respectively 281 and 206 (73%), a non-significant difference. The MM and SMS strategies also detected respectively 28 and 30 smear-positive cases not confirmed by culture. No cases were lost to treatment with either strategy. CONCLUSIONS: In this population with a high prevalence of human immunodeficiency virus (HIV) with late case presentation, smear microscopy of two morning specimens detected at least as many positive cases as the classical strategy, and no cases were lost before treatment. Two specimens for initial TB suspect screening can thus be recommended, also without excessive workload. Comparative studies in populations presenting with paucibacillary sputum are needed to determine the equivalent quality and yield of an alternative strategy with two spot specimens at consultation. Language: English Keywords: CAMEROON | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | TUBERCULOSIS | LABORATORY EXAMINATIONS AND DIAGNOSES | HIV INFECTIONS | PREVALENCE | SCREENING | WHO | STANDARDS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Measurement | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 342823 |
| 25. Peer Reviewed Title: Validation of 2006 WHO prediction scores for true HIV infection in children less than 18 months with a positive serological HIV test. Author: Peltier CA; Omes C; Ndimubanzi PC; Ndayisaba GF; Stulac S; Arendt V; Courteille O; Muganga N; Kayumba K; Van den Ende J Source: PloS One. 2009;4(4):e5312. Abstract: INTRODUCTION: All infants born to HIV-positive mothers have maternal HIV antibodies, sometimes persistent for 18 months. When Polymerase Chain Reaction (PCR) is not available, August 2006 World Health Organization (WHO) recommendations suggest that clinical criteria may be used for starting antiretroviral treatment (ART) in HIV seropositive children <18 months. Predictors are at least two out of sepsis, severe pneumonia and thrush, or any stage 4 defining clinical finding according to the WHO staging system. METHODS AND RESULTS: From January 2005 to October 2006, we conducted a prospective study on 236 hospitalized children <18 months old with a positive HIV serological test at the national reference hospital in Kigali. The following data were collected: PCR, clinical signs and CD4 cell count. Current proposed clinical criteria were present in 148 of 236 children (62.7%) and in 95 of 124 infected children, resulting in 76.6% sensitivity and 52.7% specificity. For 87 children (59.0%), clinical diagnosis was made based on severe unexplained malnutrition (stage 4 clinical WHO classification), of whom only 44 (50.5%) were PCR positive. Low CD4 count had a sensitivity of 55.6% and a specificity of 78.5%. CONCLUSION: As PCR is not yet widely available, clinical diagnosis is often necessary, but these criteria have poor specificity and therefore have limited use for HIV diagnosis. Unexplained malnutrition is not clearly enough defined in WHO recommendations. Extra pulmonary tuberculosis (TB), almost impossible to prove in young children, may often be the cause of malnutrition, especially in HIV-affected families more often exposed to TB. Food supplementation and TB treatment should be initiated before starting ART in children who are staged based only on severe malnutrition. Language: English Keywords: RWANDA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | INFANT | HIV INFECTIONS | HIV TESTING | WHO | EXAMINATIONS AND DIAGNOSES | ANTIRETROVIRAL THERAPY | SIGNS AND SYMPTOMS | MALNUTRITION | TUBERCULOSIS | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV | Nutrition Disorders | Infections Document Number: 342347 |
| 26. Peer Reviewed Title: Pilot testing of WHO child growth standards in Chandigarh: implications for India's child health programmes. Author: Prinja S; Thakur JS; Bhatia SS Source: Bulletin of the World Health Organization. 2009 Feb;87(2):116-22. Abstract: OBJECTIVE: To compare the prevalence of underweight as calculated from Indian Academy of Paediatrics (IAP) growth curves (based on the Harvard scale) and the new WHO Child Growth Standards. METHODS: We randomly selected 806 children under 6 years of age from 45 primary anganwadi (childcare) centres in Chandigarh, Punjab, India, that were chosen through multistage stratified random sampling. Children were weighed, and their weight for age was calculated using IAP curves and WHO growth references. Nutritional status according to the WHO Child Growth Standards was analysed using WHO Anthro statistical software (beta version, 17 February 2006). The chi2 test was used to determine statistical significance at the 0.05 significance level. FINDINGS: The prevalence of underweight (Z score less than -2) in the first 6 months of life was nearly 1.6 times higher when calculated in accordance with the new WHO standards rather than IAP growth curves. For all ages combined, the estimated prevalence of underweight was 1.4 times higher when IAP standards instead of the new WHO standards were used. Similarly, the prevalence of underweight in both sexes combined was 14.5% higher when IAP standards rather than the new WHO growth standards were applied (P < 0.001). By contrast, severe malnutrition estimated for both sexes were 3.8 times higher when the new WHO standards were used in place of IAP standards (P < 0.001). CONCLUSION: The new WHO growth standards will project a lower prevalence of overall underweight children and provide superior growth tracking than IAP standards, especially in the first 6 months of life and among severely malnourished children. Language: English Keywords: INDIA | RESEARCH REPORT | PILOT PROJECTS | SAMPLING STUDIES | CHILDREN | CHILD DEVELOPMENT | GROWTH | WHO | STANDARDS | BODY WEIGHT | CHILD HEALTH SERVICES | MALNUTRITION | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Physiology | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Nutrition Disorders | Diseases Document Number: 341788 |
| 27. Peer Reviewed Title: Increase in clinical prevalence of AIDS implies increase in unsafe medical injections. Author: Reid S Source: International Journal of STD and AIDS. 2009 May;20(5):295-9. Abstract: A mass action model developed by the World Health Organization (WHO) estimates that the re-use of contaminated syringes for medical care accounted for 2.5% of HIV infections in sub-Saharan Africa in 2000. The WHO's model applies the population prevalence of HIV infection rather than the clinical prevalence to calculate patients' frequency of exposure to contaminated injections. This approach underestimates iatrogenic exposure risks when progression to advanced HIV disease is widespread. This sensitivity analysis applies the clinical prevalence of HIV to the model and re-evaluates the transmission efficiency of HIV in injections. These adjustments show that no less than 12-17%, and up to 34-47%, of new HIV infections in sub-Saharan Africa may be attributed to medical injections. The present estimates undermine persistent claims that injection safety improvements would have only a minor impact on HIV incidence in Africa. Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | ESTIMATION TECHNIQUES | ADULTS | WHO | HIV INFECTIONS | PREVALENCE | HIV TRANSMISSION | NEEDLE PIERCING | NEEDLE SHARING | SAFETY | SYRINGE | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Viral Diseases | Diseases | Measurement | Risk Behavior | Behavior | Public Health | Health | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 341816 |
| 28. Title: Reproductive and sexual health rights: 15 years after the International Conference on Population and Development [editorial] Author: Serour GI Source: International Journal of Gynaecology and Obstetrics. 2009 May 8;:[2] p. Abstract: For the past 15 years, the World Report on Women's Health has been published in the International Journal of Gynecology and Obstetrics (IJGO) every 3 years to mark the occasion of the FIGO World Congress. The topic of the 2006 World Report was promoting partnerships to improve access to women's reproductive and sexual health. It is fitting that, following the International Conference on Population and Development (ICPD) held in Cairo in 1994, the 2009 World Report addresses reproductive and sexual health rights 15 years after this significant conference took place. Despite some of the progress made in achieving reproductive and sexual health rights in many countries, many agenda items from the ICPD Programme of Action remain unfinished, and these are now emphasized in the health-related Millennium Development Goals (MDGs) 4, 5, and 6. The WHO Reproductive Health Research division has indicated that the core elements for improvement include improving prenatal, delivery, post partum, and newborn care; providing high-quality services for family planning including infertility services; eliminating unsafe abortion; combating sexually transmitted infections including HIV, reproductive tract infections, cervical cancer, and other gynecological morbidities; and promoting sexual health. It identified 6 areas of action including strengthening the capacity of health systems, improving the information base for priority settings, mobilizing political will, creating supportive legislation and regulatory frameworks, and strengthening, monitoring, evaluation, and accountability. The 2009 World Report provides the reader with a comprehensive and concise overview of what has been achieved in women's reproductive and sexual health rights since the ICPD, unmet needs, obstacles, and the feasible actions in the countdown to 2015 as outlined in the ICPD Programme of Action and the health-related MDGs. The July 2008 Summit Declaration of the G8 countries called for reproductive health to be "widely accessible," for closer links between HIV/AIDS and family planning programs, and strengthening of health systems. It is hoped that the latest global economic crisis will not negatively impact the commitments of rich countries to reproductive and sexual health programs in low-resource countries to reduce mortality and improve the quality-of-life of women and newborns around the world. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | CONFERENCES AND CONGRESSES | CRITIQUE | EVALUATION | WOMEN IN DEVELOPMENT | POLICYMAKERS | REPRODUCTIVE RIGHTS | SEXUALLY TRANSMITTED DISEASE PREVENTION | REPRODUCTIVE HEALTH | MATERNAL MORTALITY | DEATH RATE | WHO | HUMAN RIGHTS | HEALTH POLICY | GOALS | Economic Development | Economic Factors | Administrative Personnel | Organization and Administration | Political Factors | Sociocultural Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Health | Mortality | Population Dynamics | Demographic Factors | Population | UN | International Agencies | Organizations | Policy | Planning Document Number: 341456 |
| 29. Title: The WHO/PEPFAR collaboration to prepare an operations manual for HIV prevention, care, and treatment at primary health centers in high-prevalence, resource-constrained settings: defining laboratory services. Author: Spira T; Lindegren ML; Ferris R; Habiyambere V; Ellerbrock T Source: American Journal of Clinical Pathology. 2009 Jun;131(6):887-94. Abstract: The expansion of HIV/AIDS care and treatment in resource-constrained countries, especially in sub-Saharan Africa, has generally developed in a top-down manner. Further expansion will involve primary health centers where human and other resources are limited. This article describes the World Health Organization/President's Emergency Plan for AIDS Relief collaboration formed to help scale up HIV services in primary health centers in high-prevalence, resource-constrained settings. It reviews the contents of the Operations Manual developed, with emphasis on the Laboratory Services chapter, which discusses essential laboratory services, both at the center and the district hospital level, laboratory safety, laboratory testing, specimen transport, how to set up a laboratory, human resources, equipment maintenance, training materials, and references. The chapter provides specific information on essential tests and generic job aids for them. It also includes annexes containing a list of laboratory supplies for the health center and sample forms. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | WHO | HIV PREVENTION | CARE AND SUPPORT | TREATMENT | PRIMARY HEALTH CARE | HEALTH FACILITIES | PROCEDURES | LABORATORY | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | QUALITY CONTROL | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Organization and Administration | Equipment and Supplies | Examinations and Diagnoses | Measurement | Research Methodology Document Number: 341765 |
| 30. Peer Reviewed Title: Improving control of African schistosomiasis: towards effective use of rapid diagnostic tests within an appropriate disease surveillance model. Author: Stothard JR Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Apr;103(4):325-32. Abstract: Contemporary control of schistosomiasis is typically reliant upon large-scale administration of praziquantel (PZQ) to school age children. Whilst PZQ treatment of each child is inexpensive, the direct and indirect costs of preventive chemotherapy for the whole school population are more substantive and, at the national level where many schools are targeted, maximising cost effectiveness and the health impact are essential requirements for ensuring longer-term sustainability (i.e. >5 years). To this end, the WHO has issued a set of treatment guidelines, inclusive of re-treatment schedules, such that, where possible, treatment decisions by school are based upon local disease prevalence as determined by parasitological and/or questionnaire methods. As each diagnostic method has known shortcomings, presumptive treatment of at-risk schools may initially be preferred, especially if the existing infrastructure for disease surveillance is poor. It is against this background of school-based preventive chemotherapy that a rapid diagnostic test (RDT) for schistosomiasis is most urgently needed, not only to improve initial disease surveillance but also to focus drug delivery better through time. In this paper, the development, evaluation and application of selected diagnostic tests are reviewed to identify barriers that impede progress, foremost of which is that a new disease surveillance and evaluation model is required where the in-country price of each RDT ideally needs to be less than US$1 to be cost effective both in the short- and long-term perspective. Language: English Keywords: AFRICA, SUB SAHARAN | TECHNICAL REPORT | SCHISTOSOMIASIS | PREVENTION AND CONTROL | DRUGS | COST EFFECTIVENESS | PREVALENCE | EXAMINATIONS AND DIAGNOSES | ANTIGENS | WHO | OBSTACLES | Africa | Developing Countries | Parasitic Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Measurement | Research Methodology | Immunologic Factors | Immunity | Immune Sys |