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  1. 1
    038647

    [Effectiveness of the expanded programme on immunization] Efficacite du programme elargi de vaccination

    Keja K; Chan C; Brenner E; Henderson R

    World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1986; 39(2):161-70.

    The Expanded Program on Immunization (EPI) aims at the reduction of morbidity and mortality from vaccine-preventable diseases through the provision of immunization to women and children. Program effectiveness is measured by immunization coverage and by incidence of the target diseases. Information on these 2 indicators is provided by national programs to WHO Regional Offices and forwarded to EPI, Geneva. Although considerable progress has been made in delivering vaccines to the children of the world, the potential impact of immunization remains unfulfilled. In the developing world (excluding China) less than 40% of infants receive a 3rd dose of DPT or polio vaccines, and coverage with measles vaccine remains at only 1/2 of that level. Over 3 million children still die each year from measles, neonatal tetanus and pertussis, while over a 1/4 of a million children are crippled by poliomyelitis. In the European Region the coverage goal of the EPI has been largely achieved. In the American Region dramatic progress has been made since the beginning of EPI. The South-East Asia Region has made steady progress since the start of the EPI. The Western Pacific Region is the most heterogenous within WHO, with countries ranging in size from the smallest to the largest in the world. Levels of socioeconomic development and immunization coverage also differ widely. Nevertheless, satisfactory progress is observed in the majority of countries. In the African Region, the problems of drought, famine and civil unrest are extensive. Despite these problems, progress has been satisfactory and exemplary in a few countries. In the Eastern Mediterranean Region, progress in increasing immunization coverage has been remarkably good. It will be difficult, however, to improve immunization services for the remainder of the decade in a number of countries currently ravaged by drought, famine and civil unrest.
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  2. 2
    268019

    Remarks.

    Heckler MM

    In: Proceedings of the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C., edited by Richard Cash. Washington, D.C., Agency for International Development [AID], Bureau for Science and Technology, 1983. 4-5. (International Conference on Oral Rehydration Therapy, 1983, proceedings)

    The Honorable Margaret Heckler, secretary of Health and Human Services, presents the goal of the conference--discussion of the remarkable potential of oral rehydration therapy and its importance to the health of infants and children throughout the world. The conference celebrates the scientific advances of recent years that give new hope for millions of children every year. Over 500 million episodes of diarrhea afflict infants in developing countries each year; each year, some 5 million children lose their lives to these diseases. In Europe, and in North America as well, diarrhea is the 6th most common cause of death among small children. At the turn of the century, mortality due to cholera was 60%. A scientist in Calcutta and 1 in Manila developed methods of intravenous therapy that reduced mortality dramatically to 20%. Treatment of the disease remained relatively unchanged until the middle of the century when work in Egypt and Asia resulted in a therapy method that reduced mortality for cholera to less than 1%. The crucial discovery of an effective cholera agent occurred in India in 1959. In 1962, scientists in Manila established the vital role of oral glucose in the absorption of sodium and water. The large-scale use of oral rehydration therapy was demonstrated in Dhaka and Calcutta in the 1960s, when 100s of cholera cases were managed under field conditions during a rural epidemic. A massive epidemic during a refugee crisis in 1971 was well-coped with by the Johns Hopkins group in Calcutta by treating 3700 patients over an 8-week period. This was one of the 1st large-scale uses of prepackaged materials for oral hydration, costing only US$750. In Dhaka and Calcutta in the early 1970s the critical discovery that noncholera diarrheal diseases could be treated with the oral rehydration therapy developed for cholera was made. The discovery of the role of glucose in accelerating the absorption of salt and water was underscored in the British journal "Lancet" as being potentially the most important medical advance of this century. A strong coalition of interest exists between governments and scientists of many nations as well as the international organizations to promote oral rehydration therapy. WHO, UNICEF, USAID and other agencies are playing an extremely important part in discovering how oral rehydration therapy can best be incorporated into broader health services, and how to prevent diarrheal diseases from occurring.
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