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Estimation of the incidence and prevalence of sexually transmitted infections. Report of a WHO consultation, Treviso, Italy, 27 February - 1 March 2002.
Geneva, Switzerland, WHO, Department of HIV / AIDS, 2002. 26 p. (WHO/HIV/2002.14; WHO/CDS/CSR/NCS/2002.7)WHO in collaboration with the Office of International and Social Health at the Department of Health, Veneto Region, Italy organized a consultation on the estimation of STI prevalence and incidence on 27 February– 1 March 2002 in Treviso, Italy with the following objectives : to determine the strengths, weaknesses and appropriateness of the current WHO approach to estimating the prevalence and incidence of STIs; to identify the STIs or syndromes that are most appropriate for surveillance and the most appropriate methods for deriving estimates of their incidence and prevalence; to identify structural surveillance needs within countries; to determine the utility and feasibility of using specific STI data as indicators of HIV risk behaviour within the concept of second-generation HIV surveillance; and to make recommendations for how the data collected can best be used to prevent STIs and to improve the care of individuals with STIs or their outcomes. (excerpt)
In: La population du monde: enjeux et problemes, edited by Jean-Claude Chasteland and Jean-Claude Chesnais. Paris, France, Institut National d'Etudes Demographiques [INED], 1997. 435-60. (Travaux et Documents Cahier No. 139)The author clarifies the conceptual framework of the study of populations health in an attempt to understand the notions of demographic transition and epidemiological transition. World Health Organization (WHO) statistics are then noted, followed by the presentation of WHO data on the global health situation. Estimated numbers of all cases of morbidity and mortality worldwide by cause are presented for 1993. Where possible, the prevalence, incidence, and number of long-term handicaps caused by each ailment are presented in addition to the number of deaths caused. According to data collected by WHO, approximately 51 million people died worldwide in 1993, of which almost 24% were in developed countries and 76% were in developing countries. The most important groups of illnesses were infectious and parasitic diseases, and causes of maternal, perinatal, and neonatal mortality, responsible for about 40% of all mortality during the year. 99% of these latter deaths occurred in the developing world. Then, circulatory system diseases, chronic lower respiratory system illness, and cancer were together responsible for about the same number of deaths, with the numbers of such deaths divided almost equally between developed and developing countries. External causes, such as accidents, suicides, and homicides caused near to 4 million deaths, or 8% of the overall total. These causes of morbidity and mortality are discussed, followed by consideration of likely future trends for the world s predominant ailments.
Who Chronicle. 1973 Oct; 27(10):410-7.In recent years the epidemiological pattern of venereal disease and endemic treponematoses has undergone important changes in both developing and developed countries. This discussion outlines the present situation and indicates the role that the World Health Organization (WHO) is playing in efforts to combat these infections. About 15-20 years ago 2 contrasting epidemiological situations confronted health authorities around the world. The developed countries were experiencing the lowest recorded incidence of venereal diseases since World War 2. At the same time in developing countries nonvenereal endemic treponematoses were becoming a major health problem because of their widespread endemicity and their disabling effect on the sufferers, which was causing a serious reduction in manpower resources. By the mid 1950s reports from several countries showed an increase in the incidence of early syphilis and gonorrhea and during the subsequent years the rising trend continued and began to affect most countries of the world. Simultaneously, the prevalence of endemic treponematoses dropped markedly in several developing nations as a result of WHO/UN International Children's Emergency Fund (UNICEF) assisted mass treatment campaigns. There can be little question that the introduction of penicillin for the treatment of venereal diseases and treponematoses made a major contribution to the developments outlined. The marked treponemicidal effect of this drug, its ease of administration, and the low incidence of side effects made it almost ideal for the safe, short-term, ambulatory treatment of both venereal and nonvenereal treponematoses as well as of gonorrhea. The immediate result of intensive antivenereal campaigns in the developed countries at the end of World War 2 as well as of the mass treatment campaigns against endemic treponematoses was excellent. Yet, it led some to believe that these infections could be completely eliminated by treatment alone. Subsequent experience has shown this opinion to be unjustified, because the transmission of venereal diseases and treponematoses is closely dependent upon the socioeconomic structure of the society concerned. It is clear at this time that a new approach is required in the field of endemic treponematoses. The era of mass treatment is most likely nearing its end. The endemic treponematoses will remain a longterm public health problem until the hygiene and socioeconomic conditions of the populations concerned are improved so as to eliminate low level transmission of the disease. In regard to the increase of early syphilis and gonorrhea reported from most countries since 1955-57, it should be noted that national statistics are unreliable. Underreporting is general and the statistics are variously estimated to represent between 10% and 50% of the true number of cases.
World Health Forum. 1981; 2(2):264-80.This 6th report on the world health situation covers the 1973-1977 period and corresponded to the World Health Organization's (WHO) Fifth General Program of Work. Attention is directed to broad population trends, the socioeconomic situation, poverty, employment, mortality and morbidity, cardiovascular diseases, diseases in developing countries, national mortality projections, special health risks--children, mothers, adolescents--health care delivery infrastructure, reorientation of health services, and awareness of health problems. The population of the world increased in the 1970s at an annual rate of 1.9% and exceeded 4000 million in 1977. By the end of the period under review, the rate of growth seems to have somewhat slowed down. The 1 common feature of recent health trends in all parts of the world appears to be a slow down in progress in the reduction of mortality. Possibly the most interesting recent health trend in the more developed countries concerns the cardiovascular diseases. During recent years, the general trend in the age groups 35 and older has been for mortality from cardiovascular disease to decline. Regarding the many diseases plaguing the developing countries, there appears to have been little or no progress in recent years in reducing either their incidence or their prevalence. Malnutrition is the most widespread condition affecting the health of the world's children, particularly children in the developing countries. In countries that have well developed health care systems and good health statistics, the maternal mortality rate is of the magnitude of 5-30/100,000 live births and is continuously decreasing. The situation is much worse in most of the developing countries.
REVIEWS OF INFECTIOUS DISEASES. 1983 May-Jun; 5(3):452-9.This summary of the worldwide impact of measles discusses epidemiology, reported incidence, clinical severity, community attitudes toward measles, and the impact of immunization programs on measles. Measles, 1 of the most ubiquitous and persistent of human viruses, occurs regularly everywhere in the world except in very remote and isolated areas. Strains of measles virus from different counties are indistinguishable, and serum antibodies from diverse population have identical specificity. Yet, the epidemic pattern, average age at infection, and mortality vary considerably from 1 area to another and provide a contrasting picture between the developing and the developed countries. In the populous areas of the world, measles causes epidemics every 2-5 years, but in the rapidly expanding urban conglomerations in the developing world, the continuous immigration from the rural population provides a constant influx of susceptible individuals and, in turn, a sustained occurrence of measles and unclear epidemic curves. In the economically advanced nations, measles epidemics are closely tied to the school year, building up to a peak in the late spring and ceasing abruptly after the summer recess begins. Maternal antibody usually confers protection against measles to infants during the 1st few months of life. The total number of cases of measles reported to WHO for 1980 is 2.9 million. Considering that in the developing world alone almost 100 million infants are born yearly, that less than 20% of them are immunized against measles, and that various studies indicate that almost all nonimmunized children get measles, less than 3 million cases of measles in 1980 is a gross underestimate. There was adecrease in the global number of reported cases of measles during the 1979-80 period due primarily to the reduction in the number of cases in the African continent and, to a lesser extent, in Europe. It is premature to conclude that such a reported decline is real and that it reflects the beginning of a longterm trend. The contrast between the developed and the developing worlds is most marked in relation to the severity and outcome of measles. Case fatality rates of more than 20% have been reported from West Africa. It has been estimated that 900,000 deaths occur yearly in the developing world because of measles, but data available to WHO indicate that the global case fatality rate in the developing world approaches 2% (in contrast to 2/10,000 cases in the US), and the actal mortality may be greater than 1.5 million deaths per year. The advent of WHO's Expanded Program on Immunization has brought about an awareness of the measles problem. Whenever and wherever measles vaccine has been used effectively on a large scale, a marked reduction in the number of cases has been recorded.