Gene/Protein Disease Symptom Drug Enzyme Compound
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The World Health Organization (WHO) convened a Scientific Group to adapt its program in virus diseases to recent progress in virology. The program consists of (a) general activities, such as reference services and the supplying of reagents by the WHO Collaborating Centres and (b) specific activities to solve problems-including the promotion of necessary research-caused by certain diseases of public health importance. The Group reviewed problems caused by influenza and other respiratory viruses, enteroviruses, gastroenteritis viruses (for which types A and B have been proposed as a convenient nomenclature), viral hepatitis, viruses in water and sewage, arboviruses, arenaviruses and Marburg virus, measles and rubella vaccination, smallpox, rabies, chronic infections, herpesviruses, oncogenic viruses, congenital infections, nosocomial infections, chlamydial and rickettsial infections, and mycoplasma infections.
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PMID:The new program of the World Health Organization in medical virology. 18 63

The parents of 200 malnourished childred referred and admitted over the July-December 1976 period to the nutrition wing of the Children's University Teaching Hospital, Zambia, were interviewed in an effort to understand the home environment of malnourished children in Lusaka, Zambia. The 1974 incidence of malnutrition in Zambia was about 23% with higher prevalences of marasmus and moderate malnutrition. There were 9.4% severly malnourished children admitted in 1976 as compared with less than 1% in 1971. Many of these children were admitted very late in a hypothermic shocked state which is directly responsible for the increasing incidence of mortality over these years. Plasma or blood transfusion is a standard procedure in all shocked cases of kwashiorkor, yet many of the children still die within 24 hours of admission. Malnutrition incidence was found to be closely linked to the rise in price index. The majority of the children were admitted from the rainy months November to March, the time associated with a higher incidence of gastroenteritis, respiratory infections, and measles. 88% of the children were between 1-3 years old. Marasmus (33.5%) and marasmic kwashiorkor (40.5%) were more frequent. 63% of the malnourished childred had attended the child health clinics in their infancy and were immunized but discontinued attendance one vaccination was completed. The problem of malnutrition was in the toddler age group. 86% of the childred came from urban slums and periurban areas; 83% were from unitary families, living in 1 or 2 bedroom houses with no separate provision for a kitchen. Rural families (14%) were living as joint families. 32% of the children were from large families. 52% of the parents were employed as casual laborers and earning under US $35 per month. There were only 10 families with earnings in excess of US $125 per month and only 8 had good sources of income from farms. As many as 68.5% children were experiencing 1 or more adverse factors which contributed to their present condition. Almost half of the mothers were pregnant or carrying a young child. An alcoholic family, divorce, or separation of parents was frequently observed. Separation from the mother was marked by a deterioration in the health of the children. Only 4 divorced mothers were working to support the family. The remainder were dependent on their parents. 53% of mothers were favorable to family spacing if properly motiavated. A social rehabilitation program should meaningfully involve the family unit. Parental responsibilities must be propagated. Family spacing with health education programs is vital in the improvement of child care.
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PMID:A study of malnourished children in children's hospital Lusaka (Zambia). 26 Jul 44

Tabulation of monthly reports of infectious diseases from 19 countries and territories in the South and Central Pacific for the years 1973 through 1975 indicated that influenza-like illness, dengue, dysentery, measles, and gonorrhoea were the greatest problems. Reports of the leading causes of hospitalisation from 11 areas indicated that infectious respiratory disease, gastroenteritis and accidents were the most common problems requiring hospitalisation in most Pacific countries. The leading causes of death showed a different pattern with striking differences between traditional and modernised areas. It appeared that the major causes of death were changing from infectious diseases in the traditional areas to chronic diseases such as cardiovascular disease and cancer in the modernised areas.
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PMID:Current health problems in the South and Central Pacific. 27 17

The verbal autopsy (VA) is an epidemiological tool that is widely used to ascribe causes of death by interviewing bereaved relatives of children who were not under medical supervision at the time of death. This technique was assessed by comparison with a prospective survey of 303 childhood deaths at a district hospital in Kenya where medically confirmed diagnoses were available. Common causes of death were detected by VA with specificities greater than 80%. Sensitivity of the VA technique was greater than 75% for measles, neonatal tetanus, malnutrition, and trauma-related deaths; however, malaria, anaemia, acute respiratory-tract infection, gastroenteritis, and meningitis were detected with sensitivities of less than 50%. There may have been unwarranted optimism in the ability of VAs to detect some of the major causes of death, such as malaria, in African children. VA used in malaria-specific intervention trials should be interpreted with caution and only in the light of known sensitivities and specificities.
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PMID:Childhood deaths in Africa: uses and limitations of verbal autopsies. 135 14

Data from 34 studies of the etiology of childhood diarrhoea were compiled in order to investigate the seasonal patterns of rotavirus gastroenteritis and consider their implications for transmission of the virus. Rotavirus was detected in 11-71% of children with diarrhoea, and the median rate of detection (33%) was independent of the level of economic development or geographical region of the study area, as well as of the method of detection used. While rotavirus infections have been called a winter disease in the temperate zones, we found that their incidence peaked in winter primarily in the Americas and that peaks in the autumn or spring are common in other parts of the world. In the tropics, the seasonality of such infections is less distinct and within 10 degrees latitude (north or south) of the equator, eight of the ten locations exhibited no seasonal trend. Throughout most of the world, rotavirus is present all the year round, which suggests that low-level transmission could maintain the chain of infection. The virus is spread by the faecal-oral route but airborne or droplet transmission has also been postulated. The epidemiology of rotavirus--its seasonality in the cooler months, its universal spread in temperate and tropical zones in developed and less developed settings--more closely resembles that of childhood viruses that are spread by the respiratory route (such as measles) than that of common enteric pathogens that are spread predominantly by the faecal-oral route.
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PMID:Global seasonality of rotavirus infections. 169 34

The incidence, mortality and clinical features of measles enteritis were reported among 6484 infants and children admitted to the Pediatric Ward Dr. Pirngadi General Hospital Medan from 1st January 1987 until 31st December 1988. Of these 6484 children, 2685 suffered from gastroenteritis and 82 from measles. There were 31 cases of measles enteritis (1.2% of all gastroenteritis cases or 37.8% of measles cases). Most of measles enteritis cases (74.2%) were in the age group of 6-24 months and no case was found under six months old. The mortality of measles enteritis with bronchopneumonia and encephalitis was 25.0% while the mortality of measles enteritis with bronchopneumonia was 13.3%. There were no deaths in children just with measles enteritis alone. The overall mortality of measles enteritis with or without accompanying disease was 12.9%. The age specific death rate of measles enteritis was highest (23.1%) in the 13-24 month age group.
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PMID:Measles enteritis in infants and children. 179 89

Twenty patients with peripheral arteritis due to an infectious disease were studied with the purpose to detect the etiological agent in the vessels belonging to ischemic areas; to establish the relationship between the onset and evolution of the ischemic lesions and the infectious disease; and to verify the appropriateness of the treatment with anticoagulants. Ten patients had meningococal disease with positive blood culture for Neisseria meningitidis. The meningococci were found in vessel walls of ischemic areas. The cutaneous lesions had sudden onset and a rapid evolution. Five patients had pneumonia or gastroenteritis. No microorganisms were detected in the vessel walls of the ischemic areas. The cutaneous necrotic lesions appeared from two to six days after the infectious disease was diagnosed. Therefore, heparinization was considered appropriate to block the extension of the disseminated intravascular coagulation secondary to the vasculitis. Three patients had, probably, post-streptococcal sensibilization arteritis and two post-measles arteritis. No etiological agent was identified in the vessel walls. The necrotic lesions of the extremities appeared from five to 21 days after the clinical course of the infection. The lesions had the complete evolution in a period from one to four days. It was considered appropriate to start the heparinization in the evolutive period of the peripheral lesions in an attempt to reduce the ischemia by the interruption of the intravascular coagulation related to the vasculitis. In heparinized patients in whom the necrotic lesions did not extend completely in the extremities, the evolution to irreversible gangrene and limb loss did not occur.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Arteritis dependent on infective process: the convenience of heparin use]. 184 98

Geographical areas in the Cape Province are ranked by their need for resources for child health care as determined by several proxy indicators of child health. Low birthweight and perinatal mortality rates for 1989, infant and age-specific childhood death rates, as well as death rates for tuberculosis, gastroenteritis and measles for 1985 are used as indicators of need. The ten magisterial districts having the highest priority for resources are, in decreasing order of need: De Aar, Colesberg, Uitenhage, Sterkstroom, Gordonia, Prince Albert, Philipstown, Victoria West, Kirkwood and Richmond. Limitations in the data are: wide, unquantifiable confidence limits, non-independence of different indicators, lack of timeliness, and incomplete statistics. Despite these problems with the data there are several reasons for employing them. Firstly, the quality of the data is only likely to be improved if they are actually used, and, secondly, there is no alternative. Areas identified as high priority need investigation in situ because corrective action is required for either the data collection system, or child health. Recommendations for improvements in resource management in child health care are: regionalisation of a unitary health care service, more timely data collection in geographically standardised regions, introduction of management objectives, and resource allocation guided by health status indicators.
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PMID:Priorities for provision of health care services for children in the Cape Province. 194 62

Trends and levels of pediatric deaths in the Children's Emergency Room of the University College Hospital in Ibadan Nigeria, were studied for the years 1978-86 and related to admission diagnoses. Admission records were available only for 1978 and 1981 -86. 17,033 children were admitted during the study years, including 9794 males, 7037 females, and 202 whose sex was not recorded. The sample included 11,076 children whose admission records were completed. Excluded were 3507 patients transferred to the pediatric wards for further care and 2446 children for whom the outcome of admission was unknown. Monthly and yearly mortality trends show a progressive decline except for 1984 when slight increase occurred. The overall decline from 238 deaths/1000 admissions in 1981 to 178 and 179 in 1985 and 1986, respectively, was, however, statistically significant. The lowest average monthly mortality rates were recorded in June-September and the highest in January-April. Neonates accounted for 26.4% of all admissions and children aged 1-12 months for 29.5%. 30.5% of admissions were 1-5 years old and 13.4% were 5-15. The ratio of males to females for all age groups was 1.39:1. 20.6% of neonatal admissions, 24.7% of those 7-12 months old, and 27.2% of those 13-24 months old died. The mortality rate was considerably lower for children 2 and over and 2-6 months. Measles and tetanus ranked 4th and 11th among diagnoses and had the highest fatality rates of 32.6% each. 61.6% of tetanus cases were in neonates, who had a case fatality rate of 36.4%. Measles accounted for 13.1% of all deaths and tetanus for 5%. Malnutrition cases had a fatality rate of 27.3%, and 7.%% of all deaths were due to malnutrition. Jaundice, gastroenteritis, and bronchopneumonia were the 3 leading causes of admission proportion of all deaths due to gastroenteritis and bronchopneumonia declined from 30.7% in the early 1970s to 16% in the series. 10% of all deaths were due to jaundice, although it had a relatively low case fatality rate. Low birth weight had the lowest fatality rate of the 10 leading causes of admission, 6.1%.
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PMID:Mortality pattern at a children's emergency ward, University College Hospital, Ibadan, Nigeria. 211 28

A review of 598 cases of measles admitted to the University of Ilorin Teaching Hospital, (Nigeria) between January 1982 and December 1984, was undertaken. One hundred and fourteen children (19%) had measles by the age of nine months, and the number increased to 298 (49.8%) by 12 months of age. There were 207 (34.6%) cases during the second year of life and only 93 children second year of life and only 93 children (15.5%) were above two years of age. The most prevalent months for measles was found to be February, March and April, when 312 (52.29) of the cases occurred. Overall mortality was 71 (11.9%) with 58 (81.7%) deaths occurring among children two years and below. The commonest complications were bronchopneumonia and gastroenteritis with dehydration. Early immunization and further research, particularly into the optimum age for immunization is advocated.
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PMID:The pattern of measles in Ilorin. 226 64


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