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The Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (ACSI-CCCD) Project is a primary health care activity that focuses on antenatal care, immunization, diarrhoeal disease control, and malaria control in children under 5 years of age. In order to gauge progress made in the project, a community-based health interview survey to measure simultaneously several prevention and treatment indicators was carried out in 1986 in Conakry, Guinea. A sample of 1415 caretakers and their 2048 children aged under 5 years was visited using a cluster sampling technique. The survey documented the levels of literacy and health education awareness of the caretakers, measured the vaccination coverage levels for children and women of childbearing age, and determined treatment practices for diarrhoea and malaria. Of the 637 women who reported having given birth in the previous 12 months, 96% had visited an antenatal clinic, but only 49% had had two or more doses of tetanus toxoid, and 13% took weekly chemoprophylaxis against malaria. The vaccination coverage for measles was 16% for children aged 12-23 months. Oral rehydration therapy (ORT) was given to 16% of children with diarrhoea; however, only 43% of those who were administered ORT at home were treated according to standard guidelines. Of children with diarrhoea, 51% were given antidiarrhoeal or antimicrobial drugs by caretakers. Fever was treated at home for 79% of the febrile children, and 43% of those with fever also visited health units. The use of injectable antimalarials and prolonged treatments with chloroquine were common. Combining findings from a population-based community study with an assessment of practices in health facilities can provide reliable information for the implementation and monitoring of selective components of primary health care.
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PMID:Monitoring selective components of primary health care: methodology and community assessment of vaccination, diarrhoea, and malaria practices in Conakry, Guinea. ACSI-CCCD team. 263 83

A study was conducted to determine the knowledge and attitude about breast feeding (BF) amongst child development project officers (CDPOs) working in Integrated Child Development Services Scheme. A semi structured pretested questionnaire was administered. It was found that majority of respondent had correct knowledge about feeding of colostrum, age of initiation of breast feeding and introduction of semi-solid foods. Majority of CDPOs had the knowledge that consumption of dry fruits, milk and desi ghee would increase that breast milk secretion. The percentage of subjects who were aware that BF should be discontinued if mother is suffering from illness like breast cancer (48%) tuberculosis (57%), malaria (67%) and Diarrhoea (84%). There is need of continuing education of CDPOs for updating their knowledge.
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PMID:Knowledge and attitude among child development project officers towards breast feeding. 263 80

A 27-year-old man was admitted to the hospital with a seven-day history of fever, nausea, vomiting, diarrhea, and pruritic rash. He was not diagnosed as having malaria until a history was obtained of Plasmodium falciparum malaria two years previous to this admission, and a review of the peripheral blood smear confirmed the diagnosis. The patient was admitted for inpatient therapy. He responded well and was discharged on the fourth hospital day to complete the remainder of the therapy as an outpatient. This case is a somewhat atypical presentation and reemphasizes several key points in the prophylaxis, diagnosis, and treatment of malaria.
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PMID:It's not a viral syndrome, it's malaria. 264 81

In a 5-month study of Salmonella septicaemias in Kenyan children carried out during the annual peak infection period, Salmonella typhimurium septicaemias occurred seven times more frequently than typhoid or other non-typhoid infections. Salmonella typhimurium infections were predominantly community acquired, malnourished infants from rural malaria endemic areas with poor water supply were especially vulnerable. Typical clinical features of fever, diarrhoea, and severe anaemia resembled P. falciparum malaria which often co-existed. Mortality was 18 per cent. Isolates exhibited a wide range of multidrug resistance. Typhoid affected older children, was less severe and drug sensitive.
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PMID:Salmonella septicaemias in Kenyan children. 265 90

The fact that economic progress has a bearing on health can be seen in most developing countries where widespread poverty causes poor health and high mortality. Childhood mortality is highest in Africa and in Southern Asia. The rate of decline in mortality has decreased in these areas since the 1950s. In Sri Lanka, approximately 5% of the children 5 years old die, yet yearly 1/3 of the children 5 Afghanistan and a few West African countries die. In less developed countries, adult mortality is high: in places where the life expectancy of a 15-year-old is under 50 years, 30-40% will die before age 60. 80-90% of the deaths from water and food borne diseases are accounted for by diarrhea and dysentery, and 60-70% of the deaths from airborne diseases by pneumonia and bronchitis. Present estimates from 4 localities indicate that measles, malaria, tetanus, and acute respiratory infection account for more than 90% of all child mortality. Various estimates suggest that there are 100-300 million cases of malaria and 1-2 million malaria-related deaths annually. Estimates indicate a ratio of abortions varying between 9/1000 live births in East Africa to 325/1000 live births in Latin America. 1986 WHO data indicate that induced abortion is responsible for 7-50% of all maternal deaths in developing countries. More than 90 countries now that operational diarrheal disease control programs, 47 countries are producing oral rehydration solutions, 8450 health personnel have been trained in diarrhea program supervisory skills, and oral rehydration use rates are slowly rising.
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PMID:Identifying health problems and health research priorities in developing countries. 266 49

The increased availability of time and resources has made travel attractive to many elderly patients. Both healthy and chronically ill geriatric patients can travel safely and without medical complications in many circumstances. Many of these patients, however, have special health needs that call for specific advice from practitioners. Patients with medical problems, such as chronic obstructive pulmonary disease, cardiovascular disease, thrombotic disease, sinus conditions, or diabetes, should be aware of possible complications involved in travel. In addition, medical advice regarding vaccinations, traveler's diarrhea, jet lag, and malaria prophylaxis should be tailored to this population. Such a prescribed regimen may make travel safe and feasible for many geriatric patients.
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PMID:Assuring safe travel for today's elderly. 267 33

The mean annual rate of decline of the probability of dying 5 years of age in developing countries is 2.5%. Nevertheless disease accounts for a considerable proportion of premature deaths. The leading causes of death in these countries, in order, include respiratory disease, diseases of the circulatory system, low birth weight, diarrhea, measles, injuries, malnutrition, and neoplasms. These conditions represent diseases of poverty and affluence. Respiratory infections are common among 5-year old children and cause a high proportion of child deaths. Circulatory diseases tend to be limited to adults. Control of hypertension, diet, smoking prevention, and exercise can prevent circulatory diseases. The risk of dying in infancy and childhood and of developmental disabilities is higher among low birth weight infants than those who weigh 2500 gm. In Bangladesh, 50% of infants weight 2500 gm. Low birth weight is the underlying cause of death for many infants who die of respiratory infections and diarrhea. Oral rehydration can successfully treat most diarrhea cases. Malnutrition and diarrhea tend to occur together and feed off each other. In fact malnourished people are more susceptible to all infections. Malnourished children suffer from disabilities in development and growth. The greatest sufferers of measles are infants and malnourished children. Immunization of all =or 9-month old infants would eradicate measles. Children and young adults are at the highest risk of injuries. Lung cancer is on the rise in developing countries due to the increase of tobacco smoking. Various means of controlling malaria are use of mosquito nets, antimalarial drugs, reduction of mosquito breeding places, and pesticides. The new infectious disease, AIDS, has emerged as a considerable health problem in developing countries. High priority research areas are vaccines for Streptococcus pneumonia, Plasmodium app., rotavirus, Salmonella typhi (Ty21a), and Shigella spp.
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PMID:Disease problems in the Third World. 269 79

The effectivity of intramuscular Delagil therapy with that of oral treatment in malaria patients are compared. On the basis of the therapeutic results of 8 malaria patients each it has been concluded that the cessation of fever and parasitaemia occur within a somewhat shorter time in the intramuscularly treated patients than in the orally treated ones. Finally, the usefulness of intramuscular Delagil therapy as an antimalarial medication has been assessed. According to the opinion of the author oral treatment has to be preferred in general in uncomplicated malaria cases. The indication fields of intramuscular Delagil therapy are the following: 1. Unconsciousness, cerebral or other complications. 2. High fever, poor general condition requiring rapid action; in the latter two cases the above-mentioned frequent application of lower doses is recommended. 3. Relatively good general condition but abundant vomiting and/or diarrhoea.
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PMID:Intramuscular delagil therapy in malaria. 269 17

Infant mortality statistics in developing African countries are reviewed. According to the World Health Organization (WHO) surveys, there was an overall decrease in infant mortality from 1960-1986, although the infant mortality rate in the African region remains higher than in other WHO regions (119.4, compared with 40.6 in the European region, 11.8 in the Eastern Mediterranean region, 110.2 in the South- Eastern Asia, 49.7 in the American Region, and 44.5 in the Western part of the Pacific ocean). In infants younger than 28 days old, mortality is associated with pregnancy and labor complications, congenital birth defects, and birth trauma. In Algeria, Sierra Leone, Nigeria, Mozambique, Malawi, and Zimbabwe, 70-90% of all deaths were caused by tetanus (70-80% of African women give birth at home without any medical help). In a 1 month to 1 year old age group, the leading cause of mortality is diarrhea (52% in Sudan, 29.2% in Sierra Leone); other causes of death are measles (15.8%), acute respiratory diseases (14.3%), malaria (8.5%), and infectious meningitis (6%). In a 1-4 years old age group, leading cause of mortality is nutritional deficiencies (9%). In addition to medical causes, infant mortality is also associated with a number of socioeconomic factors: insufficient nutrition of mothers, heavy physical work during pregnancy, young age of mothers and short interval between pregnancies, lack of proper medical care during pregnancy and labor, and early switching to infant formula not following proper hygienic recommendations.
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PMID:[Child mortality in the developing countries of Africa]. 271 15

In 1985, the US Peace Corps developed a computerized epidemiological surveillance system to monitor health trends in over 5500 Peace Corps Volunteers working in development projects in 62 countries worldwide. Data on 31 health conditions and events are collected monthly from each country; quarterly and annual incidence rates are then calculated, and the analysed data are distributed. In 1987, the most commonly reported health problems were diarrhoea (unclassified), 48 cases per 100 volunteers per year; amoebiasis, 24 per 100 volunteers per year; injuries, 20 per 100 volunteers per year; bacterial skin infections, 19 per 100 volunteers per year; and giardiasis 17 per 100 volunteers per year. Tracking each of these common problems, as well as other selected health conditions, guides design of more specific studies and disease control efforts. Health problems with very low rates (less than 1.0/100 volunteers/year) include hepatitis, schistosomiasis, non-falciparum malaria, and filariasis. The epidemiological surveillance system provides the health data needed to plan, implement, and evaluate health programmes for Peace Corps Volunteers, and provides a model for surveillance in other groups of temporary and permanent residents of developing countries.
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PMID:Epidemiological surveillance in Peace Corps Volunteers: a model for monitoring health in temporary residents of developing countries. 272 68


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