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CMAJ: Canadian Medical Association Journal. 2004 Apr 13; 170(8):1225.Trachoma is a chronic keratoconjunctivitis caused by repeated infection with the ocular serovars A, B, Ba and C of Chlamydia trachomatis. The name, derived from the Greek word for “rough,” describes the appearance of the lymphoid follicles apparent with trachomatous inflammation when the upper eyelid is everted and the upper tarsal conjunctiva inspected. A single episode of C. trachomatis ocular infection produces a self-limiting mucopurulent conjunctivitis. Repeated infections lead to conjunctival scarring and distortion of the lid margin, which causes the eyelashes to turn inward (entropion) and repeatedly rub against the cornea (trichiasis). The catastrophic outcome is corneal opacification and, ultimately, blindness. Trachoma is second only to cataracts as a cause of blindness and accounts for about 15% of cases of blindness in the world. In 1997 the World Health Organization (WHO) estimated that 146 million people were actively infected, more than 10 million had trichiasis, and about 6 million were blind from corneal scarring. Active disease is most often seen in children, and women more often than men experience the visual loss that results from chronic, untreated disease, probably because of their greater direct contact with children. (excerpt)
Cholera: ancient scourge on the rise. WHO announces global plan for cholera control. (25 April 1991).
WHO FEATURES. 1991 Apr; (154):1-3.Vibrio cholerae spreads quickly via contaminated water and food, especially in areas with a poor health and sanitation infrastructure. Its enterotoxin induces vomiting and huge amounts of watery diarrhea leading to severe dehydration. 80-90% of cholera victims during an epidemic can use oral rehydration salts. A cholera epidemic is now spreading through Latin America threatening 90-120 million people (started in January 1991), particularly those in urban slums and rural/mountainous areas. As of mid April 1991, there were more than 177,000 new reported cases in 12 countries and 78% of these cases and more than 1200 deaths were limited to 5 countries: Brazil, Chile, Colombia, Ecuador, and Peru, WHO's Global Cholera Control Task Force coordinates global cholera control efforts to prevent deaths in the short term and to support infrastructure development in the long term. Its members are specialists in disease surveillance, case management, water and sanitation, food safety, emergency intervention, and information and education. WHO's Director General is asking for the support of the international community in cholera control activities. These activities' costs are considerable. For example, Peru needs about US$ 60 million in 1992 to fulfill only the most immediate demands of rehabilitation and reconstruction of the infrastructure. Costs of infrastructure capital throughout Latin America is almost US$ 5 thousand million/year over the next 10 years. It is indeed an effective infrastructure which ultimately prevents cholera. Cholera is evidence of inadequate development, so to fight it, we must also fight underdevelopment and poverty.
INDIAN JOURNAL OF PEDIATRICS. 1990 Jan-Feb; 57(1):7-14.Problems facing the world's children, development goals for children, and strategies for meeting these goals in the 1990s are abstracted from a UNICEF publication "Strategies for Children in the 1990s". Children face poverty (45% of children under 5 outside China), mortality from diarrhea, preventable diseases, malaria, meningitis and others, disabling diseases, being unplanned, low birth weight, malnutrition, lack of sanitation and education, and 20% are in "especially difficult circumstances" i.e. war, disaster, abandonment of refugee status. Children should be the starting point of development strategy since human capital is the basis of national investment. The UN goals are to reduce infant mortality by 50% in all countries or to 50-70/1000; reduce maternal mortality by 50%, provide safe drinking water, sanitation and universal education and eliminate guinea worm by 1995. Specific goals in maternal and child health are listed. Emphasis should be placed on implementation with today's technology, reaching the hard to reach, giving preferential access to women.