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Epidemiology of measles in the central region of Ghana: a five-year case review in three district hospitals.
East African Medical Journal. 2003 Jun; 80(6):312-317.Objective: As part of a national accelerated campaign to eliminate measles, we conducted a study, to define the epidemiology of measles in the Central Region. Design: A descriptive survey was carried out on retrospective cases of measles. Setting: Patients were drawn from the three district hospitals (Assin, Asikuma and Winneba Hospitals) with the highest number of reported cases in the region. Subjects: Records of outpatient and inpatient measles patients attending the selected health facilities between 1996 and 2000. Data on reported measles eases in all health facilities in the three study, districts were also analysed. Main outcome measures: The distribution of measles eases in person (age and sex), time (weekly, or monthly, trends) anti place (residence), the relative frequency, of eases, and the outcome of treatment. Results: There was an overall decline in reported eases of measles between 1996 and 2000 both in absolute terms and relative to other diseases. Females constituted 48%- 52% of the reported 1508 eases in the hospitals. The median age of patients was 36 months. Eleven percent of eases were aged under nine months; 66% under five years and 96% under 15 years. With some minor variations between districts, the highest and lowest transmission occurred in March and September respectively. Within hospitals, there were sporadic outbreaks with up to 34 weekly eases. Conclusion: In Ghana, children aged nine months to 14 years could be appropriately targeted for supplementary, measles immunization campaigns. The best period for the campaigns is during the low transmission months of August to October. Retrospective surveillance can expediently inform decisions about the timing and target age groups for such campaigns. (author's)
Importation and circulation of poliovirus in Bulgaria in 2001. [Importation et circulation du poliovirus en Bulgarie en 2001]
Bulletin of the World Health Organization. 2003 Jul; 81(7):476-481.Objective: To characterize the circumstances in which poliomyelitis occurred among three children in Bulgaria during 2001 and to describe the public health response. Methods: Bulgarian authorities investigated the three cases of polio and their contacts, conducted faecal and serological screening of children from high-risk groups, implemented enhanced surveillance for acute flaccid paralysis, and conducted supplemental immunization activities. Findings: The three cases of polio studied had not been vaccinated and lived in socioeconomically deprived areas of two cities. Four Roma children from the Bourgas district had antibody titres to serotype 1 poliovirus only, and wild type 1 virus was isolated from the faeces of two asymptomatic Roma children in the Bourgas and Sofia districts. Poliovirus isolates were related genetically and represented a single evolutionary lineage; genomic sequences were less than 90% identical to poliovirus strains isolated previously in Europe, but 98.3% similar to a strain isolated in India in 2000. No cases or wild virus isolates were found after supplemental immunization activities were launched in May 2001. Conclusions: In Bulgaria, an imported poliovirus was able to circulate for two to five months among minority populations. Surveillance data strongly suggest that wild poliovirus circulation ceased shortly after supplemental immunization activities with oral poliovirus vaccine were conducted. (author's)
The impact of HIV / AIDS on Southern Africa's children: poverty of planning and planning of poverty.
Pretoria, South Africa, Human Sciences Research Council, Southern African Regional Poverty Network, 2002. , 26 p. (Save the Children UK: Southern Africa Scenario Planning Paper)In the initial discussion of this paper the terms of reference began: “Save the Children has not been adept at managing its programme planning processes in the region. Country based strategic planning has often been a tortuous business which has alienated our staff because of the abstract language used. It has been a time consuming and often disjointed process leaving most participants dissatisfied with the final planning document”. Save the Children (SCF) is not alone in this. HIV/AIDS is changing the environment in which we operate. It will have effects as serious as the plague in medieval Europe and we do not know how to deal with it. In effect there is a complete poverty in planning which will result in considerable impoverishment and misery in much of Southern Africa. One new way to assess the situation would be to through developing scenarios. HEARD has some experience in this having been part of a team working with Shell South Africa on developing scenarios for their Southern African region. We therefore agreed to prepare a draft paper, and this was discussed with SCF staff. We did not agree to follow the terms of reference exactly but rather to prepare the paper with scenarios. The first draft was completed and sent for comment on 21st June with a deadline for comment of 27th June (Alan Whiteside was away from 27th June). The first draft showed up one major problem. SCF must be part of the brainstorming. We know what HIV/AIDS means in broad terms, we have some ability at developing broad scenarios but we do not know what SCF does or what these will mean for them. In effect while HEARD’s work is nearly complete that of SCF is only just beginning. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 1991. vi, 96 p.WHO published this manual on the prevention and control of hookworm infection and anemia primarily for community health workers. The manual addresses the epidemiology, diagnosis, and management of these conditions. Its annexes provide details of appropriate examination techniques for hookworm and hookworm anemia surveys and sample survey considerations. It emphasizes the importance of thorough population surveys. The worldwide prevalence of infection with Ancylostoma duodenale and Necator americanus is about 25%. It occurs predominantly in developing countries, where prevalence may be as high as 80% in some areas. It is a major cause of iron deficiency anemia. Its presence indicates deficiencies in sanitation and health education. Many persons, including public health officials, are not interested in national control of hookworm infection, probably because it induces low mortality and it is technically difficult to measure and quantify hookworm-related morbidity. Control of hookworm infection and hookworm-related anemia is uncomplicated and effective. It consists of health education, effective sanitation, and treatment with antihelminthics and iron supplements. The manual's seven chapters cover the following: hookworms infecting humans; clinical pathology of hookworm infection; hookworm infection as a cause of anemia; epidemiology of hookworm infection; principles of prevention and control; assessing the situation; and practical prevention and control.