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The management of fever in young children with acute respiratory infections in developing countries.
[Unpublished] 1993. ii, 17 p. (WHO/ARI/93.30)The World Health Organization's (WHO) Programme for the Control of Acute Respiratory Infections (ARIs) has prepared guidelines on the management of fever in young children with ARIs in developing countries. A child with an ARI who has a fever does not necessarily have pneumonia. Fever alone is not an indication for antibiotics. However, fever in an infant aged less than 2 months may indicate a serious bacterial infection or malaria and should be referred to a hospital. A modest increase in body temperature may improve the immune system's ability to fight infection. Adverse effects of fever alone rarely occur and tend to occur in very ill and immunocompromised children (e.g., very severe pneumonia) or in children with a fever greater than 42 degrees Celsius. High fevers or rapid increase in temperature in young children often cause convulsions, which tend to resolve spontaneously and to cause no long-term neurological complications. Antipyretic treatment does not seem to prevent febrile convulsions. Lethargy and reduced appetite often accompany high fevers in children. A 10-15 mg/kg dose of paracetamol every 6 hours is the safest and most effective way to treat fever in children aged 2 months to 5 years. A fever of less than 39 degrees Celsius (rectal) is not an indication for antipyretic treatment among these children. In fact, such treatment would waste health services and family resources. It may be indicated in children experiencing fever-related discomfort, however. Additional fluids, appropriate clothing, and appropriate environmental conditions should be provided for young children with high fever. Tepid sponging does not help febrile children and should not be done. Health workers should tell parents what causes fever and reasons for treatment. They should try to ease parents' fears about their child's fever.
KANGAROO. 1994 Jul; 3(1):67-8.The World Health Organization (WHO) has produced a 1-day training module for health professionals to achieve better thermal control of newborns in health facilities. Hypothermia has long been recognized as a significant contributor to neonatal morbidity and mortality, and recent reports indicate an incidence of 67% among all neonates born outside of a hospital in Ethiopia, 80% of infants born in hospital in Nepal, and 6.7/1000 of infants in a large series of births studied in China. As part of its efforts, WHO has also issued a guide explaining the principles and methods for preventing and treating hypothermia. The guide recommends 1) ensuring a clean, warm, draft-free delivery room; 2) immediate drying of the newborn; 3) wrapping the baby and giving it to the mother immediately after birth; 4) initiating breast feeding immediately after birth; 5) putting a warm cap on the baby's head; 6) covering the baby and the mother together; 7) ensuring warm, safe transport, if necessary; and 8) appropriate training for those involved in births and subsequent newborn care.
Geneva, Switzerland, WHO, 1993. ii, 40 p. (Safe Motherhood Practical Guide; WHO/FHE/MSM/93.2)Under auspices of the World Health Organization, different specialists have compiled existing knowledge on thermal control of the newborn in this manual. The guidelines are designed to help program managers and health workers understand the principles and methods to prevent and treat hypothermia. Following the introduction, the 2nd chapter presents an overview of hypothermia in infants, including its definition, signs, effects, causative factors, general risk factors, distribution and incidence, and prevention. The 3rd chapter covers the species of thermal control of newborn infants. These specifics are heat production, the process of heat loss and heat gain, environmental conditions to prevent hypothermia, thermal control in practice, measuring the temperature of the newborn, special risk factors (e.g., preterm and low-birth-weight infants), and environmental risk factors. Prevention of hypothermia is discussed in chapter 4. Subtopics include the warm chain, training, preparation for home delivery, preventing heat loss at childbirth and during the neonatal period, preparation for delivery in a maternity unit, and transporting the baby. Chapter 5 (Keeping Preterm and Sick Babies Warm) is subdivided into 3 areas: in the home, in the health center, and general management of babies in incubators. The last area addresses monitoring the infant's body temperature, monitoring the incubator air temperature regularly, opening incubators to perform nursing procedures, loss of heat by radiation, effect of direct sunlight on babies in incubators, use of phototherapy, and cleaning of incubators. Chapter 6 presents guidelines on rewarming hypothermic babies at home, in the health center, and in the hospital.
Geneva, WHO,  184 p.This packet of learning materials was developed by the British Life Assurance Trust for Health Education for WHO's Special Programme of Research, Development and Research Training in Human Reproduction. The materials were designed to train natural family planning method trainers. At present, the manual is being tested in field trials organized and supported by WHO. Following evaluation, the revised manual will be widely available. The information in the manual deals with the 2 most commonly used methods based on ovulation detection and periodic abstinence--the ovulation method and the sympto-thermal method. Those wishing to use the basal body temperature method can do so by modifying the facts given for the sympto-thermal method. The manual was based upon learning objectives established after consultation with major natural family programs in 19 countries. The packet consists of 4 modules: 1) fertility awareness; 2) sexuality and responsibility; 3) the ovulation method; and 4) the sympto-thermal method. Each module states its objectives, teaches how to teach as well as what to teach, and provides audiovisual aids to use concurrent with the teaching. Common terminology and evaluative methods are also included.
In: Diczfalusy, E., ed. Regulation of human fertility. (Proceedings of the WHO Symposium on Advances in Fertility Regulation, Moscow, USSR, November 16-19, 1976) Copenhagan, Denmark, Scriptor, 1977. p. 111-134A 6-month regimen for managing infertile men and/or women ideally forms 4 stages: 1) history and examination of the couple; 2) confirmation of ovulation, compatibility of sperm and mucus, and seminology; 3) tests for tubal patency; and 4) detailed endocrine tests for abnormalities found in Stages 1-3. Medical history should include emotional stress and work pressures, if any. Ovulation confirmation requires 2 tests combined from these 4: 1) basal body temperature; 2) endometrial biopsy; 3) blood progesterone levels; and 4) urinary pregnanediol. These procedures are outlined in detail, and figures chart body temperature variations and expected progesterone and pregnanediol levels. Assessment of cervical mucus and measurement of sperm penetration combine in vitro and in vivo tests. The Sims-Huhner test (postcoital test), though not standardized, is used to analyze sperm-mucus interaction by quantitative scoring of sperm count and motility. Other in vitro tests are the sperm-mucus match test and the fractional postcoital test (both described). Tubal patency is investigated by tubal insufflation with CO2, hysterosalpingography, endoscopy, and laparoscopy. Additional Stage 4 tests include vaginal cytology and assessment of estrogen and progesterone effects.
London, International Planned Parenthood Federation, 1983. 60 p. (IPPF Medical Publications)This publication provides comprehensive information and instructions for the various ways of using periodic abstinence for contraception, along with a restatement of the position of the International Planned Parenthood Federation that periodic abstinence cannot be considered an equal alternative to other more effective family planning methods but that it should be offered by family planning associations for couples desiring it for religious or other reasons. The manual describes the historical development of the abstinence methods and reviews the physiology of the menstrual cycle as background for the careful instructions for each variant. The methods covered include the basal body temperature method in which the "3 over 6" rule for identifying the temperature shift is endorsed but others, such as the cervical mucus method, cervical palpation, sympto-thermal method, and calendar method are described. Other chapters discuss the psychological and motivational aspects of use of periodic abstinence methods; identify research issues and present data on effectiveness especially of the cervical mucus and sympto-thermal methods; discuss side effects and advantages and disadvantages of the methods; and consider special problems of use in developing countries.