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In: Disease and mortality in Sub-Saharan Africa, edited by Richard G. Feachem, Dean T. Jamison. Oxford, England, Oxford University Press, 1991. 31-6.This article is an overview of 4 chapters of part I of the 1991 World Bank publication entitled Disease and Mortality in Sub-Saharan Africa. It discusses what the health community currently knows about the levels, trends, and patterns of mortality in Sub-Saharan Africa. In fact, it points out that only limited data are currently available. Demographic techniques have evolved to overcome data limitations, however. These chapters also identify important information gaps that must be filled to plan interventions. These chapters reveal that mortality levels are higher in Sub-Saharan Africa than in other developing regions. Mortality of children <5 years old has decreased since the 1940s in most Sub-Saharan African countries, except for countries who have experienced war and civil unrest. Further Sub-Saharan Africa exhibits a specific mortality pattern: higher levels of infant, young child, and adult mortality exist in western Africa than in eastern or southern Africa. Nevertheless adult mortality in western Africa fell considerably between the 1950s-late 1970s, but it did not fall much in eastern African countries (their levels were lower initially though). This article suggests that donors could greatly contribute to developing planning ability in Sub-Saharan Africa by supporting the establishment of a vital registration system. Health planners often have access to hospital record and community survey data, however, but these data are biased. Further these chapters show that interventions to reduce mortality do not necessarily result in a reduction in morbidity. Rapid population growth and high fertility pose further problems for health planners.
BULLETIN OF THE INTERNATIONAL UNION AGAINST TUBERCULOSIS AND LUNG DISEASE. 1990 Dec; 65(4):75.WHO estimates of pediatric AIDS cases are 400,000 by September 1990, not including 300,000 who have already died. WHO projects that 10 million or more infants and children will have HIV infections by 2000, in addition to 25-30 million adults. The primary mode of transmission in most countries is heterosexual contact, resulting in a rapidly increasing prevalence in women of childbearing age. WHO predicts that pediatric AIDS will be a major, and in some countries the predominant, cause of death in children in the 1990s. Even though child survival programs have made progress recently, by immunization and diarrhea control, the fruits of these efforts are expected to be reversed. The world's cumulative total of HIV infected women is about 3 million. In the U.S., 20,000 infants have been born to infected mothers. In contrast, in Eastern Europe, about 1000 children are infected, mostly from unscreened blood transfusions and unsterilized needles and syringes. The impact of childhood AIDS is expected to be an increase in child mortality by 50% in many developing countries. Serious social repercussions for children also stem from projected 10 million uninfected children orphaned by AIDS, mostly in sub-Saharan Africa. The only way to lessen this tragedy is for people to protect themselves by practicing safe sex and having sexually transmitted diseases treated.