Your search found 95 Results

  1. 1
    Peer Reviewed

    Antiretroviral therapy needs: the effect of changing global guidelines.

    Stanecki K; Daher J; Stover J; Beusenberg M; Souteyrand Y; Garcia Calleja JM

    Sexually Transmitted Infections. 2010 Dec; 86 Suppl 2:ii62-6.

    BACKGROUND: In 2010 the WHO issued a revision of the guidelines on antiretroviral therapy (ART) for HIV infection in adults and adolescents. The recommendations included earlier diagnosis and treatment of HIV in the interest of a longer and healthier life. The current analysis explores the impact on the estimates of treatment needs of the new criteria for initiating ART compared with the previous guidelines. METHODS: The analyses are based on the national models of HIV estimates for the years 1990-2009. These models produce time series estimates of ART treatment need and HIV-related mortality. The ART need estimates based on ART eligibility criteria promoted by the 2010 WHO guidelines were compared with the need estimates based on the 2006 WHO guidelines. RESULTS: With the 2010 eligibility criteria, the proportion of people living with HIV currently in need of ART is estimated to increase from 34% to 49%. Globally, the need increases from 11.4 million (10.2-12.5 million) to 16.2 million (14.8-17.1 million). Regional differences include 7.4 million (6.4-8.4 million) to 10.6 million (9.7-11.5 million) in sub-Saharan Africa, 1.6 million (1.3-1.7 million) to 2.4 million (2.1-2.5 million) in Asia and 710 000 (610 000-780 000) to 950 000 (810 000-1.0 million) in Latin America and the Caribbean. CONCLUSIONS: When adopting the new recommendations, countries have to adapt their planning process in order to accelerate access to life saving drugs to those in need. These recommendations have a significant impact on resource needs. In addition to improving and prolonging the lives of the infected individuals, it will have the expected benefit of reducing HIV transmission and the future HIV/AIDS burden.
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  2. 2
    Peer Reviewed

    Implications of adopting new WHO guidelines for antiretroviral therapy initiation in Ethiopia.

    Konings E; Ambaw Y; Dilley K; Gichangi P; Arega T; Crandall B

    Bulletin of the World Health Organization. 2012 Sep 1; 90(9):659-63.

    OBJECTIVE: To assess the implications of implementing the World Health Organization (WHO) 2010 guidelines for antiretroviral therapy (ART) initiation in adults and adolescents with human immunodeficiency virus (HIV) infection, which recommend initiating ART at a CD4+ T lymphocyte (CD4+) threshold of 200 but
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  3. 3

    WHO prequalification of male circumcision devices. Public report. Product: PrePex. Number: PQMC 0001-001-00. Version 1.0.

    World Health Organization [WHO]

    [Geneva, Switzerland], WHO, 2013 May. [15] p. (PQMC 0001-001-00)

    PrePex with product codes DW0201, DW0202, DW0203, DW0204 and DW0205, manufactured by Circ MedTech Limited, CE-marked regulatory version, was accepted for the WHO list of prequalified male circumcision devices and was listed on 31 May 2013. PrePex is a single use, disposable device; indicated for circumcision of adult men, defined as circumferential excision of the foreskin or prepuce at or near the level of coronal sulcus, with minimal amount of preputial skin remaining. The device should not be used if the package has been compromised. Use by trained personnel only. All device components should not be reused at the risk of cross contamination. The device is intended for adults only and is not applicable for males under the age of 18. The device should be used only in settings where suitable surgical facilities and skills are available within a short time frame (6-12 hours) in order to manage potentially serious complications resulting from device displacements. Device displacement when wearing the device, may lead to the risk of adverse events. Informing the patient of safe behavior when wearing the device is critical. PrePex includes the following items: 1. Placement Ring 2. Elastic Ring 3. Inner Ring 4. Verification Thread Accessories: The PrePex Sizing Plate (PSP) is intended for single use for selecting an appropriate device size. The use of PrePex requires additional tools and materials which are not supplied with PrePex. For Placement: examination gloves, antiseptic solution, skin marker, gauze, 5% anesthetic cream and nurse utility scissors. For Removal: examination gloves, antiseptic solution, sterile harvey wire scissors, sterile forceps, sterile spatula, sterile scalpel, 2 wound dressings, nurse utility scissors and a cutter. Storage: The test kit should be stored at -10 to 55 °C. Shelf-life: 3 years.
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  4. 4

    From paper to practice. Implementing the World Health Organization’s 2010 Antiretroviral Therapy Recommendations for Adults and Adolescents in Zambia.

    Bolton C; Topp S; Rossi V; Ojikutu B

    Arlington, Virginia, John Snow [JSI], AIDS Support and Technical Assistance Resources [AIDSTAR-One], 2011 May. [12] p. (USAID Contract No. GHH-I-00-07-00059-00; AIDSTAR-One Case Study Series)

    After the 2009 release of WHO’s Rapid Advice for HIV treatment in adults and adolescents, Zambia launched a broad-based effort to update its national treatment protocols. The Ministry of Health succeeded in creating an efficient and inclusive review and revision process for the guidelines, which they began implementing in 2011.
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  5. 5
    Peer Reviewed

    Male circumcision: towards a World Health Organisation normative practice in resource limited settings.

    Hargreave T

    Asian Journal of Andrology. 2010; 12(5):628-638.

    There is now grade 1 evidence that male circumcision (MC) reduces the risk of a man acquiring HIV. Modelling studies indicate MC could in the next 10 years save up to 2 million lives in those African countries with high HIV prevalence. Several African countries are now scaling up public health MC programmes. The most effective immediate public health MC programmes in Africa will need to target 18-20 years old men. In the longer term there is a need for infant circumcision programmes. In order to implement more widespread MC there is a need to make the surgical procedures as simple as possible so that safe operations can be performed by paramedical staff. The WHO Manual of Male Circumcision under local anaesthetic was written with these objectives in mind. Included in the manual are three adult techniques and four paediatric procedures. The adult procedures are the dorsal slit, the forceps guided and the sleeve resection methods. Paediatric methods included are the plastibell technique, the Mogen and Gomco shield method and a standard surgical dorsal slit procedure. Each method is described in a step by step manner with photographic and line drawing illustrations. In addition to the WHO manual of surgical technique a teaching course has been developed and using this course it has been possible in one week to train a circumcision surgeon who has had no or minimal previous surgical experience. Further scaling will require training of circumcision surgeons, monitoring performance, training the trainer workshops as well as advocacy at national, international and government meetings. In addition to proceeding with standardised methods work is in progress to assess novel techniques in adults such as stay on ring devices and policies are being formulated as to how to assess new devices. Also work is in progress to explore efficiencies in surgical processing by task sharing. Proper informed consent and safety remain paramount and great care has to be taken as programmes in Africa scale up. In continental China where the HIV epidemic is at a much earlier stage there may be a case for considering infant circumcision but great care will be needed to ensure that there is no harm.
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  6. 6

    Rapid advice: antiretroviral therapy for HIV infection in adults and adolescents.

    World Health Organization [WHO]. Department of HIV / AIDS

    Geneva, Switzerland, WHO, 2009 Nov. 25 p.

    Based on the latest scientific evidence, the World Health Organization (WHO) has released new recommendations on HIV treatment and prevention and infant feeding in the context of HIV. WHO now recommends earlier initiation of antiretroviral therapy for adults and adolescents, the delivery of more patient-friendly antiretroviral drugs (ARVs), and prolonged use of ARVs to reduce the risk of mother-to-child transmission of HIV. For the first time, WHO recommends that HIV-positive mothers or their infants take ARVs while breastfeeding to prevent HIV transmission.
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  7. 7
    Peer Reviewed

    Increase in clinical prevalence of AIDS implies increase in unsafe medical injections.

    Reid S

    International Journal of STD and AIDS. 2009 May; 20(5):295-9.

    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.
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  8. 8
    Peer Reviewed

    The Spectrum projection package: improvements in estimating mortality, ART needs, PMTCT impact and uncertainty bounds.

    Stover J; Johnson P; Zaba B; Zwahlen M; Dabis F; Ekpini RE

    Sexually Transmitted Infections. 2008; 84(Suppl 1):i24-i30.

    The approach to national and global estimates of HIV/AIDS used by UNAIDS starts with estimates of adult HIV prevalence prepared from surveillance data using either the Estimation and Projection Package (EPP) or the Workbook. Time trends of prevalence are transferred to Spectrum to estimate the consequences of the HIV/AIDS epidemic, including the number of people living with HIV, new infections, AIDS deaths, AIDS orphans, treatment needs and the impact of treatment on survival. The UNAIDS Reference Group on Estimates, Modelling and Projections regularly reviews new data and information needs and recommends updates to the methodology and assumptions used in Spectrum. The latest update to Spectrum was used in the 2007 round of global estimates. Several new features have been added to Spectrum in the past two years. The structure of the population was reorganised to track populations by HIV status and treatment status. Mortality estimates were improved by the adoption of new approaches to estimating non-AIDS mortality by single age, and the use of new information on survival with HIV in non-treated cohorts and on the survival of patients on antiretroviral treatment (ART). A more detailed treatment of mother-to-child transmission of HIV now provides more prophylaxis and infant feeding options. New procedures were implemented to estimate the uncertainty around each of the key outputs. The latest update to the Spectrum program is intended to incorporate the latest research findings and provide new outputs needed by national and international planners.
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  9. 9

    Women, ageing and health: a framework for action. Focus on gender.

    World Health Organization [WHO]. Department of Gender, Women and Health

    Geneva, Switzerland, WHO, 2007. 55 p.

    The concepts and principles in this document build on the World Health Organization's active ageing policy framework, which calls on policy-makers, practitioners, nongovernmental organizations and civil society to optimize opportunities for health, participation and security in order to enhance quality of life for people as they age. This requires a comprehensive approach that takes into account the gendered nature of the life course. This report endeavors to provide information on ageing women in both developing and developed countries; however, data is often scant in many areas of the developing world. Some implications and directions for policy and practice based on the evidence and known best practices are included in this report. These are intended to stimulate discussion and lead to specific recommendations and action plans. The report provides an overall framework for taking action that is useful in all settings. Specific responses in policy, practice and research is undoubtedly best left to policy-makers, experts and older people in individual countries and regions, since they best understand the political, economic and social context within which decisions must be made. (excerpt)
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  10. 10

    Are a past history of tuberculosis and WHO clinical stage associated with incident tuberculosis in adults receiving antiretroviral therapy? [letter [reply]

    Ouattara E; Messou E; Gabillard D; Seyler C; Anglaret X

    AIDS. 2007 Jan; 21(3):389-390.

    In two recent excellent articles, Lawn and colleagues [1,2] reported the incidence and risk factors for active tuberculosis among HIV-infected adults receiving antiretroviral therapy (ART) in South Africa. In both studies, they found contradictory results regarding the association between the baseline World Health Organization (WHO) clinical stage and the occurrence of incident tuberculosis during follow-up, and contradictory trends towards an association between a past history of tuberculosis at enrolment and a lower (first study) or higher (second study) incidence of tuberculosis during follow-up. (excerpt)
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  11. 11

    Adult literacy programs and socio-economic transformation among the rural poor: Lessons from a local NGO in Arua district, Uganda.

    Ngaka W; Ngaka J; Eleru Y

    Art'ishake. 2006 Summer; (3):22-25.

    In this paper, we examine the role of adult literacy programs in transforming the lives of the rural poor in Uganda. Based on the work of a local NGO--the Uganda Rural Literacy and Community Development Association (URLCODA), operating in Arua district--we argue that participating in literacy activities lays a solid foundation for continuing education/training, social development, and active participation in democratic processes. URLCODA's project therefore complements the global efforts to achieve some of the UN's Millennium Development Goals. The challenges faced in maximizing the benefits of literacy to participants and possible remedies are highlighted. (author's)
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  12. 12
    Peer Reviewed

    The added value of a CD4 count to identify patients eligible for highly active antiretroviral therapy among HIV-positive adults in Cambodia.

    Lynen L; Thai S; De Munter P; Leang B; Sokkab A

    Journal of Acquired Immune Deficiency Syndromes. 2006 Jul; 42(3):322-324.

    In a retrospective study of 648 persons with HIV infection in Cambodia, we determined the sensitivity, specificity, and accuracy of the 2003 World Health Organization (WHO) criteria to start antiretroviral treatment based on clinical criteria alone or based on a combination of clinical symptoms and the total lymphocyte count. As a reference test, we used the 2003 WHO criteria, including the CD4 count. The 2003 WHO clinical criteria had a sensitivity of 96%, a specificity of 57%, and an accuracy of 89% to identify patients who need highly active antiretroviral therapy (HAART). In our clinic, with a predominance of patients with advanced disease, the 2003 WHO clinical criteria alone was a good predictor of those needing HAART. A total lymphocyte count as an extra criterion did not improve the accuracy. Nine percent of patients were wrongly identified to be in need of HAART. Among them, almost 50% had a CD4 count of more than 500 cells/KL, and 73% had weight loss of more than 10% as a stage-defining condition. Our data suggest that, in settings with limited access to CD4 count testing, it might be useful to target this test to patients in WHO stage 3 whose staging is based on weight loss alone, to avoid unnecessary treatment. (author's)
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  13. 13

    A global priority: education for all.

    Bolton S

    UN Chronicle. 2005 Dec; [2] p..

    Adult literacy rates continue to be a major obstacle to achieving the six Education for All (EFA) goals and overall poverty reduction, according to the EFA Global Monitoring Report 2006--Literacy for life. The report, launched by the United Nations Educational, Scientific and Cultural Organization (UNESCO) in London on 9 November 2005, focuses on the world's 771 million adults living without minimal literacy skills. This global challenge predominantly affects developing regions, although highly developed countries were also found to have significant numbers of young people and adults with weak literacy skills. Findings are based on data from the 2002/2003 school year, reporting on change since 1998. Across the board, progress over the five years was found to be steady but insufficient to reach, or come close to reaching, the EFA goals. In the area of early childhood care and education, enrolment ratios are rising rapidly and the gender gap is slowly closing across sub-Saharan Africa, South and West Asia, and the Arab States; however, this sector continues to be a low public policy priority. Progress towards universal primary education has been slow overall, with the world's net enrolment ratio increasing by only one percentage point, from 83.6 per cent in 1998 to 84.6 in 2002. While significant advances have been made in least developed countries, access to primary schools, the quality of teaching and charging of fees for primary education pose major barriers to further progress. (excerpt)
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  14. 14

    Niger: a famine foretold. Early UN appeals met only a belated reaction from donors. [Le Niger : la prédiction d'une famine. Face à l'appel lancé par les Nations Unies, la réaction de la part des donateurs a été fort tardive]

    Fleshman M

    Africa Renewal. 2005 Oct; 19(3):3.

    The seasonal rains returned to southern Niger in June, coaxing the green millet stalks from the dry earth and signalling an end, hopefully, to a food shortage that has left some 2.4 million Nigeriens — including 800,000 children — vulnerable to malnutrition. International relief workers have also started to arrive to distribute the emergency rations needed until the harvest is in. But neither the millet nor the aid came soon enough for Fassoma Abdoulsalam. The one-year-old died on 10 August, one of some two dozen children to succumb to malnutrition in the village of Birgi Dangotcho in the hard-hit Zinder region. It was not an uncommon tragedy in a country where malnutrition, child mortality and poverty rates are high even in good times. What distinguished her death was that the world knew it was coming almost from the moment of her birth, yet failed to prevent it. (excerpt)
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  15. 15

    Cross-country access to antiretroviral treatment. [Acceso al tratamiento antirretroviral en distintos países]

    Nattrass N

    AIDS Bulletin. 2005 Sep; 14(3):20-22.

    The launch of the $15 billion United State's President's Emergency Plan for AIDS Relief (PEPFAR) and the announcement on World AIDS Day 2003 by the World Health Organisation and UNAIDS of a concrete plan to provide HAART to three million people gave a tremendous boost to national and international efforts to expand access to antiretroviral treatment. As can be seen in Table 1, there has been a major increase in the numbers of people on highly active antiretroviral therapy (HAART) in developing and transitional economies between June and December 2004. National policy clearly also plays a central role in determining country-level access to HAART. This is illustrated vividly by the contrasting cases of three high HIV prevalence neighbouring southern African countries at similar levels of development: Botswana (adult HIV prevalence of 37 percent), Namibia (21 percent) and South Africa (22 percent). Whereas by the end of 2004, Botswana had succeeded in providing HAART to 50 percent of those estimated to need it, and Namibia had reached 28 percent respectively, South Africa had provided HAART to a mere seven percent of those living with AIDS. AIDS prevention and treatment policies are political priorities in Botswana and Namibia, but are mired in confusion and political dissembling in South Africa. (excerpt)
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  16. 16

    Introduction of a new hypo-osmolar oral rehydration solution to routine use in the treatment of diarrhoeal disease: a phase IV clinical trial.

    Alam NH; Yunus M; Faruque AS; Sattar S; Parvin S

    Dhaka, Bangladesh, International Centre for Diarrhoeal Disease Research, Bangladesh [ICDDR,B], Centre for Health and Population Research, [2005]. 14 p. (USAID Development Experience Clearinghouse DocID / Order No. PN-ADD-051)

    In May 2002, following the recommendations made at a meeting of experts held in New York in July 2001, WHO and UNICEF recommended the use of a new, low sodium, low glucose, low osmolarity oral rehydration salts (ORS) solution in place of the previous formulation for use in the treatment and prevention of dehydration due to diarrhoea in all age groups and for all causes. Although the safety data in patients with cholera, while limited, was reassuring, it was recommended that the safety of this new formulation be monitored in a post-marketing surveillance study, measuring the incidence of symptomatic (seizure/altered consciousness) hyponatraemia (serum sodium <130 mmol/L) during treatment with the new formulation of ORS. The objective was to measure the incidence of symptomatic hyponatraemia (seizure/altered consciousness) during treatment of diarrhoea with the newly recommended ORS formulation. The study was conducted at the ICDDR, B hospitals in Dhaka and in Matlab over a complete year (from December, 2002 to November 2003 in Dhaka hospital and from February, 2003 to January 2004 in Matlab hospital). In the two hospitals, a total of 53,280 patients were admitted to the rehydration ward with uncomplicated watery diarrhoea to be treated with the new ORS solution for at least for 8 hours. Patients with associated severe illnesses, or patients directly admitted to the special care unit of the hospitals were excluded from the study. During treatment in the rehydration ward, patients developing symptoms (seizure/altered consciousness) were immediately transferred to the special care unit for treatment and clinical and laboratory investigations to identify the cause of the symptoms. Patients’ records were analysed to find out if the symptoms were associated with hyponatraemia, and if the development of hyponatraemia was due to intake of the new ORS. As this study was not a controlled clinical trial, we reviewed also the records of the Dhaka hospital for the corresponding previous year (from December, 2001 to November, 2002) to compare our findings with the situation when the old ORS formulation was the only ORS solution in use. In both hospitals, a total of 53,280 patients were monitored (22,536 were less than 60 months old, 6,093 were 6 to 15 years of age, and 24,651 were more than 15 years old). In patients less than 60 months of age, on admission 51% had signs of some dehydration and 10% signs of severe dehydration. In patients 6 to 15 years old, 46% had signs of some dehydration and 46% had signs of severe dehydration. Finally, among patients older than 15 years of age, 48% had signs of some dehydration, while 45% had signs of severe dehydration. No single adult patient experienced any symptoms (seizure/altered consciousness) associated with hyponatraemia. A total of 31 patients less than 60 months of age experienced seizure/altered consciousness during treatment with the new ORS formulation. Among those, 24 presented symptoms (seizure/altered consciousness) associated with hyponatraemia (serum sodium <130 mmol/L). Overall the incidence rate of symptomatic hyponatraemia was 0.05% per year in the Dhaka hospital, and 0.03% per year in the Matlab hospital. The review of the hospital records from the Dhaka hospital showed that the incidence rate of symptomatic hyponatraemia was 0.09% per year (47 cases of symptomatic hyponatremia) for the year prior to the initiation of this study. Concerns about the safety of the new reduced osmolarity ORS centers on its use in patients with cholera especially adults. As no single adult diarrhoea patients experienced symptoms (seizure/altered consciousness) associated with hyponatraemia, this finding should be reassuring for the clinicians, policy makers and producers of ORS. In addition, the results of this study demonstrates that the occurrence of seizure/altered consciousness associated with hyponatraemia in patients treated with the new ORS formulation is rare and that the incidence rate of symptomatic hyponatremia associated to the use of the new ORS is less than the incidence rate observed with the old ORS formulation. Based on the results of this study, we can conclude that the new reduced osmolarity oral rehydration salts solution recommended by WHO and UNICEF is safe and that it can be used for the treatment of acute diarrhoea of all etiologies and in all age groups. (author's)
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  17. 17
    Peer Reviewed

    The challenge of measuring global fruit and vegetable intake.

    Pomerleau J; Lock K; McKee M; Altmann DR

    Journal of Nutrition. 2004 May; 134(5):1175-1180.

    The WHO recently conducted, within its Global Burden of Disease 2000 Study, a Comparative Risk Assessment (CRA) to estimate the global health effect of low fruit and vegetable intake. This paper summarizes the methods used to obtain exposure data for the CRA and provides estimates of worldwide fruit and vegetable intakes. Intakes were derived from 26 national population-based surveys, complemented with food supply statistics. Estimates were stratified by 14 subregions, 8 age groups, and gender. Subregions were categorized on the bases of child mortality under age 5 y and 15- to 59-y-old male mortality (A: very low child and adult mortality; B: low child and adult mortality; C: low child, high adult mortality; D: high child and adult mortality; E: high child, very high adult mortality). Mean intakes were highest in Europe A [median = 449 g/(person • d)] and the Western Pacific Region A. They were lowest in America B [median = 192 g/(person • d)], and low in Europe C, the South East Asian Regions B and D, and Africa E. Children and elderly individuals generally had lower intakes than middle-aged adults. SDs varied considerably by region, gender, and age [overall median = 223 g/(person • d)]. Assessing exposure levels for the CRA had major methodological limitations, particularly due to the lack of nationally representative intake data. The results showed mean intakes generally lower than current recommendations, with large variations among subregions. If the burden of disease attributable to dietary factors is to be assessed more accurately, more countries will have to assess the dietary intake of their populations using comparable methods. (author's)
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  18. 18

    World Health Organization integrated guidelines for ART in the context of primary health care.

    World Health Organization [WHO]. Department of HIV / AIDS

    Geneva, Switzerland, WHO, 2003. [2] p. (WHO/HIV/2003.20)

    What are the IMAI modules ? IMAI is the Integrated Management of Adolescent and Adult Illness. The World Health Organization (WHO) has coordinated the development of the IMAI guidelines and training materials, based on a working group involving 22 HQ Departments and AFRO plus a large international working group. These simplified and standardized WHO guidelines support the delivery of ARV therapy within the context of primary health care, based at first-level health facilities or in district clinics. IMAI provides tools (standardized guidelines and training courses to teach these guidelines) for rapid country adaptation and use in their efforts to achieve the 3 by 5 goals. The modules cover chronic HIV care with ARV therapy, acute care (including the management of opportunistic infections and when to suspect HIV, linking to testing and counselling), palliative care (symptom management at home), and general principles of good chronic care (to support the health system transition from acute to chronic care). Each module can be used alone or as an integrated package. (excerpt)
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  19. 19

    Parents providing care to adult sons and daughters with HIV / AIDS in Thailand. UNAIDS case study.

    Saengtienchai C; Knodel J

    Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2001 Nov. [132] p. (UNAIDS Best Practice Collection; UNAIDS Case Study; UNAIDS/01.72E; National Institute on Aging Grant No. AG15983)

    This study provides a qualitative analysis of the circumstances and consequences of parental caregiving to adult children with AIDS in Thailand based on open-ended interviews, primarily with parents of adult children who died of AIDS. The results reveal the circumstances that lead to parental caregiving, the tasks involved and the stress they created, how parents coped with this stress, and the consequences for their emotional, social and economic well-being. The results make clear that routine caregiving to those with AIDS often requires extensive time from the main caregiver. Caregiving assistance is especially needed in the final stage of illness when the AIDS-afflicted person often requires help with even basic bodily needs and functions. Financial demands can also accumulate to the point where the adult son/daughter’s and parents’ own resources are exhausted. Such a situation can be overwhelming for anyone, but it is particularly so for an older person. With varying degrees of success, Thai parents often solicit the help of other family members in caregiving, paying expenses and providing emotional support. In addition, viewing their role in terminal-stage caregiving as part of the responsibility that parents have for their children (regardless of age), refusing to view the child as a burden, and avoiding blaming their son/daughter for becoming infected, all help Thai parents cope with the emotional stress of caring for their terminally ill son or daughter. (excerpt)
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  20. 20

    Physical status: the use and interpretation of anthropometry. Report of a WHO expert committee.

    World Health Organization [WHO]. Expert Committee on Physical Status: the Use and Interpretation of Anthropometry

    Geneva, Switzerland, WHO, 1995. [463] p. (WHO Technical Report Series No. 854)

    The Expert Committee's report is intended to provide a framework and contexts for present and future uses and interpretation of anthropometry. Technical aspects of this framework are presented in section 2, and specific applications of anthropometry appropriate for a particular physical status or for particular age groups are dealt with in subsequent sections. For some groups, such as adolescents and the elderly, there has been little previous research, and the report provides a basis and impetus for future studies. For other age groups, such as infants and children, the report provides a re-evaluation in the light of current research, and allows for an integrated approach to anthropometry throughout life. It is intended to furnish scientists, clinicians, and public health professionals worldwide with an authoritative review, reference data, and recommendations for the use and interpretation of anthropometry that should be appropriate in many settings. (excerpt)
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  21. 21
    Peer Reviewed

    DOTS versus self administered therapy (SAT) for patients of pulmonary tuberculosis: a randomised trial at a tertiary care hospital.

    Tandon M; Gupta M; Tandon S; Gupta KB

    Indian Journal of Medical Sciences. 2002 Jan; 56(1):19-21.

    Tuberculosis is a major public health problem in India, and it is being made worse by poor adherence to and frequent interruption of antitubercular treatment. Directly observed therapy short course (DOTS), is one of the key elements in the WHO global tuberculosis control programme strategy and has been widely publicized as a breakthrough and strongly promoted globally by WHO. However little or no randomised data exists of comparison between DOTS versus self administered therapy (SAT). The present study is an effort in this direction to compare adherence and outcome after random allocation of patients to directly observed therapy (DOTS) or self administered therapy (SAT). (author's)
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  22. 22
    Peer Reviewed

    Gender and HIV / AIDS.

    Turmen T

    International Journal of Gynecology and Obstetrics. 2003 Sep; 82(3):411-418.

    The impact of gender on HIV/AIDS is an important dimension in understanding the evolution of the epidemic. How have gender inequality and discrimination against women affected the course of the HIV epidemic? This paper outlines the biological, social and cultural determinants that put women and adolescent girls at greater risk of HIV infection than men. Violence against women or the threat of violence often increases women’s vulnerability to HIV/AIDS. An analysis of the impact of gender on HIV/AIDS demonstrates the importance of integrating gender into HIV programming and finding ways to strengthen women by implementing policies and programs that increase their access to education and information. Women’s empowerment is vital to reversing the epidemic. (author's)
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  23. 23
    Peer Reviewed

    FIGO and women's health 2000 - 2003.

    Sheth SS

    International Journal of Gynecology and Obstetrics. 2003 Sep; 82(3):357-367.

    The International Federation of Gynecology and Obstetrics – FIGO – has been striving hard to carefully attend to women’s well-being, and respect and implement their rights, the status and their health, which is well beyond the basic obstetric and gynecological requirement. FIGO is deeply involved in acting as a catalyst for the all-round activities of national obstetric and gynecologic societies to mobilise their members to participate in and contribute to, all of their endeavours. FIGO’s committees strengthen these objectives and FIGO’s alliance with WHO provides a springboard. The task is gigantic, but FIGO, through national obstetric and gynecological societies and with the strength of obstetricians and gynecologists as its battalion, can offer to combat and meet the demands. (author's)
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  24. 24
    Peer Reviewed

    A dose escalation study of docetaxel and oxaliplatin combination in patients with metastatic breast and non-small cell lung cancer.

    Kouroussis C; Agelaki S; Mavroudis D; Kakolyris S; Androulakis N

    Anticancer Research. 2003 Jan-Feb; 23(1B):785-791.

    Objectives: To determine the maximum tolerated dose (MTD) and the dose-limiting toxicities (DLTs) of docetaxel in combination with oxaliplatin (L-OHP) as first-line treatment of patients with advanced breast (ABC) and non-small cell lung cancer (NSCLC). Patients and methods: Fifty-two patients (26 with NSCLC and 26 with ABC), who had not received prior chemotherapy for metastatic disease, were enrolled. The patients' median age was 64 years, and 42 (71%) had a performance status (WHO) 0-1. Docetaxel was given as a 1-hour infusion after standard premedication on day 1 and L-OHP as a 2 to 6-hour infusion on day 2 every 3 weeks. Doses were escalated at increments of 10mg/m2. Results: The DLT1 was reached at the doses of docetaxel 75mg/m2 and L-OHP 80mg/m2. The addition of rhG-CSF permitted further dose escalation (DLT2: docetaxel 90mg/m2 and L-OHP 130mg/m2). The dose-limiting events were grade 4 neutropenia, febrile neutropenia, grades 3 or 4 diarrhea and grade 3 fatigue. Out of 239 delivered cycles, grades 3 or 4 neutropenia occurred in 22 (9%) cycles with 5 (2%) neutropenic febrile episodes. There was one septic death. Grades 3 or 4 fatigue was observed in seven (13%) patients and grades 3-4 diarrhea in five (10%). Out of 42 patients evaluable for response, seven (27%) patients with ABC and five (19%) patients with NSCLC experienced a partial response. Conclusion: The combination of docetaxel and oxaliplatin is a feasible and well-tolerated regimen. The recommended doses for future phase II studies are 75mg/m2 for docetaxel on day 1 and 70mg/m2 for L-OHP on day 2 without rhG-CSF support and 85mg/m2 and 130mg/m2, respectively, with rhG-CSF support. (author's)
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  25. 25

    The new information technologies and women: essential reflections. [La nueva tecnología de la información y la mujer: reflexiones fundamentales]

    Bonder G

    Santiago, Chile, United Nations, Economic Commission for Latin America [ECLAC], 2003 Jul. 56 p. (CEPAL - SERIE Mujer y Desarrollo No. 39)

    Although in Latin America and the Caribbean there is growing concern to take into account the issue of gender in public policies, this process is still embryonic and fragmented in the case of economic and technological policies. The Women and Development Unit of ECLAC is therefore implementing the project "Institutionalization of gender policies within ECLAC and sectoral ministries". The objective of this project is to strengthen technical policies, strategies, tools and capacities, both within ECLAC and in selected countries of the region, in order to encourage equity between men and women in the process and benefits of development, especially with regard to economic and labour policies. One of the activities of the project, organized by the Women and Development Unit together with the International Trade Division of ECLAC and the Centre for Women's Studies and Social Gender Relations of the University of São Paulo, was a meeting of experts on "Globalization, technological change and gender equity" in the city of São Paulo, Brazil, on 5 and 6 November 2001. The purpose of the meeting was to discuss the most relevant aspects of the opportunities and restrictions imposed by the processes of globalization and technological change, with the aim of proposing areas for research, as well as an agenda of public policies that would help to achieve equity. This document was presented as a background study for the discussion at the meeting of experts. It is clear from the text that the new technologies are taking us into a dizzy time of new exclusions, and that in addition to being a material reality they are also a discursive product with effects on institutions, public policies and individuals. The study reviews an extensive amount of theoretical literature, as well as most of the research concerning the inclusion and relationship of women in connection with the new information technologies and skills. This review identifies the major obstacle to reinforcing the potential positive impacts of the new technologies as the lack of information on how they, and especially computers, can help policies, and also individual women, to achieve their goals. It is also shown that we are dealing with two disconnected concepts: the information society and the information economy, and the gender perspective is presented as a means of linking them. As for the impact on social and gender equity, and the current digital divide, according to this document research is needed on more than access alone. There is patently a need for policies to regulate and democratize the new information and knowledge technologies, and it is important to analyze the collective imaginary that is being constructed around them and the different forms of subjectivity that the Internet is encouraging, within a perspective of the future and of changes in social relations. (author's)
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