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Journal of Human Ecology. 2005; 17(3):223-228.This study examined the chemical composition /quality of Well water in Ede Area of Southwestern Nigeria with a view to determine their suitability for human consumption. The pH, total dissolved solids (TDS) and cations concentration such as calcium (Ca/2t), sodium (Na+), magnesium (Mg/2+) and potassium (K+) of 21 well water samples were determined using pH meter, Electronic Conducting (EC) meter and Atomic Absorption Spectrometer respectively. The results of this study shows that potassium (K+) was the most abundant dissolved cation in the well water sampled in the area. All the dissolved cations such as Ca/2t, mg/2+ , Na+ , K+ and generally conformed with the recommendation of W.H.O maximum limits. However, since most of the inhabitants of the area depend on well water supply for drinking, the authors of this study recommended that waste disposal facilities should be sited in the outskirts of the towns. In this regard, the site of the well should be at least thirty meters away from any source of contamination. (author's)
[Unpublished] 1990. , 18 p. (GPA/GCA(3)/90.11)The member of the Global Commission on AIDS (GCA) convened on March 22-23, 1990 to explore the issue of drug use and HIV infection, review prevention activities, and identify critical issues for AIDS prevention and control in the early 1990s. This document provides a full account of each session including the names of the presenters, the information shared, and the discussions that followed. In the session about drug use and HIV infection, the problem was identified as being "truly global" because the sharing of injection equipment occurs everywhere. Some of the reasons cited for sharing equipment are initiation into intravenous drug use, social bonding, and practicality. Rapid spread of HIV has been seen in New York City, several Italian cities, Edinburgh, and Bangkok. Characteristically, it has taken only 3-5 years after the introduction of HIV for about 50% of injecting drug users (IDU) to be infected. Several studies have demonstrated that behavior change can lower the risk of transmission and infection rates. Amsterdam, Innsbruck, Seattle, and Stockholm had all achieved stabilization of their prevalence of HIV among IDUs at levels between 10-30%. It was emphasized that the means for behavior change must be provided for education to have an impact. The discussion of prevention activities featured the use of education, information, and communication (IEC) programs to execute mass campaigns, focus interventions, and provide monitoring and evaluation. Specific prevention activities discussed were condom usage, outreach to persons with sexually transmitted diseases, and blood safety. There were separate presentations on the status of blood transfusion programs and vaccine development. 10 issues were identified by the GCA that warrant priority attention in the early 1990s. These critical issues are research, complacency and abatement of a sense of urgency, preservation and protection of human rights and legal issues, equity of access, human sexuality, women and AIDS, AIDS as a disease affecting families, HIV/AIDS and drug use, economic and social implications of HIV/AIDS, and the collation and improvement of data.
Global Blood Safety Initiative. Use of plasma substitutes and plasma in developing countries, Geneva, 20-22 March 1989.
[Unpublished] 1989. , 5 p. (WHO/GPA/INF/89.17; WHO/LAB/89.9)Health care practitioners should treat hypovolemia with plasma substitutes rather than plasma since it carries the risk of transmitting infections. They can use plasma to manage hemostasis and sometimes acute plasma protein loss, however. Crystalloid, a plasma substitute, spread swiftly from the capillaries into the interstitial fluid space. Therefore health care practitioners must administer 3 volumes of crystalloid for each volume of blood or plasma lost. This phenomenon may bring about tissue edema which is unacceptable for high risk patients. Another set of substitutes are synthetic colloids which serve to retain circulatory water and volume. They include gelatin solutions, dextran 70, and hydroxyethyl starch (HES). The gelatins function as osmotic diuretics and therefore must be supplemented with 1-2 liters of crystalloid solutions. Dextran and HES draw fluid into the intravascular areas from the surrounding extravascular spaces. Depending on the synthetic colloid, side effects consist of circulatory overload, anaphylactoid reactions, red cell aggregation, platelet and factor VIII interference, and hemostatic interference. Albumin and plasma protein fraction make up the 3rd set of substitutes. Since sophisticated manufacturing techniques and strict quality control are required, they are costly for developing countries to import. They must be pasteurized to inactivate HIV, hepatitis, and other viruses. wpossible side effects are circulatory overload, hypotension, and anaphylactoid reactions. WHO has identified >10 guidelines for managing bleeding, e.g. starting an IV if the pulse rate climbs to >100/minute or systolic blood pressure falls to <90 mm Hg. It also has addressed the need for training for nonphysicians who use plasma substitutes.
Lancet. 1993 Aug 7; 342(8867):360.In May 1993 in France, Doctors without Borders, Epicentre, and INSERM met to develop a practical protocol for treatment of severely malnourished children in refugee camps and to discuss use of WHO's oral rehydration solution (ORS) for treating the children who may be dehydrated. The suggested treatment formula for catch-up growth for severely malnourished children is 80 gm dried skimmed milk; 50 gm sugar; and 60 gm oil, minerals, and vitamins per liter of feed (energy density; 1 kcal/ml). Adequate potassium, magnesium, zinc, copper, selenium, iodine, and each of the vitamins must be part of this diet. (Concentrations adequate for repletion and rapid recovery of malnourished children ingesting 100-200 ml/kg/day are tabulated in the article.) The various vitamins and minerals must be packaged separately to assure stability. During the early treatment stages, refugee workers should give this formula, diluted 3:1, either orally or through a nasogastric tube. They should administer 100 ml/kg/day of the formula (133 ml with water) during the first few days. Once the children regain their appetite, refugee workers should increase the undiluted feed to about 200 ml/kg/day. Refrigeration or lactobacillus fermentation prevent pathogenic contamination of the formula. Fermentation reduces the pH and the risk of lactose intolerance and generates antibacterial products. The potassium concentration of WHO-ORS is too low and the sodium concentration too high for severely malnourished children, especially those with kwashiorkor and marasmic-kwashiorkor. Further, it does not contain the minerals needed to stop diarrhea. Refugee workers can mix 1 WHO-ORS packet, 1 sachet of each mineral used in making the formula, and 50 gm sugar in 2 l of water to make an isotonic rehydration solution. A field trial in refugee camps in Ethiopia showed that this formula and modified WHO-ORS are practical and acceptable. Participants also suggested administering broad-spectrum antibiotic treatment, parenteral vitamin A, and measles vaccine to all children, regardless of HIV status.
NETWORK. 1992 Aug; 13(1):20-3.Researchers are pursuing 2 approaches to developing a male contraceptive drug. 1 approach centers around suppression of sperm production the other around blocking conception. Researchers are looking at introducing hormonal contraceptives into men's bodies via injections or implants to stop sperm production. Both forms of these possible male contraceptives will not be available for many years, however. A WHO study on testosterone enanthate of men in 7 countries reveals total suppression of sperm production occurred in almost all the Asian men, but only about 60% suppression occurred in other ethnic groups. A current WHO study is examining whether a hormonal contraceptive which is not 100% effective can be useful if it would be more effective than barrier methods. The Population Council is conducting research on 2 capsule implants with 1 capsule releasing luteinizing hormone releasing hormone 13 to halt sperm production while the other releases an androgen to maintain sex drive. Animal tests indicate complete contraception with no side effects. The other possible means of suppressing sperm production is administration of a cottonseed oil extract called gossypol which appears to stop sperm production thereby eliminating the need for concurrent androgen administration. Yet it does cause potassium depletion in some men which can result in arrhythmias. An antifertility vaccine comprises the 2nd approach. Several US researchers are exploring an antifertility vaccine to produce antibodies only to the specialized sperm surface needed to attach to the egg. The 1st antifertility vaccine would probably be in pill form and a woman's contraceptive since it is earlier to target the smaller number of sperm in the oviduct than in the testes.
INDIAN JOURNAL OF PUBLIC HEALTH. 1990 Jan-Mar; 34(1):35-7.Oral rehydration therapy (ORT) prevents severe morbidity and death from mild to moderate dehydration from acute diarrhea for all ages and all etiologies. WHO advises ORT fluid to contain 3.5 g sodium chloride, 3.5 g potassium chloride, 2.5 g sodium bicarbonate or 2.9 g trisodium citrate dihydrate, and 20 g glucose all dissolved in 1 1 of water. This fluid does not reduce stool volume or frequency and does not curtail duration thus it is not always acceptable. Improved ORT is needed, however. The glucose concentration cannot be increased above the present 2% since an increased concentration would intensify diarrhea and dehydration. Researchers are working on an improved solution (Super ORS) which would rehydrate the body and actively bring on reabsorption of endogenous secretions in the intestine. Thus this improved ORS would reduce stool volume, shorten duration of diarrhea, and allow early introduction of feeding. Even though some studies demonstrate that fortified ORS with the amino acid glycine decreases stool volume by 49-70% and duration of diarrhea 28-30%, other studies indicate that it induces excess sodium concentrations in the blood. 1 study demonstrates that in comparison with the standard ORS, ORS fortified with the amino acid L-alanine reduced the severity of symptoms and the need for fluid in patients afflicted with cholera and enterotoxigenic Escherichia coli. Further studies reveal that rice powder based ORS (50-80 g/l) reduces stool volume 24-49% and duration of duration 30%. The advantage of using rice is that when it hydrolyzes glucose, amino acids, and oligopeptides emerge. Each 1 of these chemicals facilitate sodium absorption through separate pathways. Disadvantages include the fuel must be used to cook the rice, rice based ORS ferments within 8-24 hours making it useless, and the rice or pop rice needs to be ground.
[Unpublished] 1988. 15 p. (WHO/GPA/DIR/88.9)Following up on a January, 1988, meeting at World Health Organization headquarters, this meeting was held to inform participants about the present status of blood transfusion systems worldwide, study obstacles to developing integrated systems, achieve consensus on the objectives, principles and activities of the Global Blood Safety Initiative and structure of a previously proposed consortium, and to endorse and launch the initiative. Objectives, principles, and consortium activities are presented in the report, followed by discussion of the organization and activities of the consortium secretariat. Evolution of the Global Blood Safety Initiative is also explained in the report, and results largely out of need for safe blood supplies in the face of AIDS. Instead of stressing long-term infrastructure development toward integrated blood transfusion services, priority was placed upon HIV prevention, with care to not link too closely in the public eye AIDS with hopes for strengthened blood transfusion services. Participants were keen to point out that the initiative will not fuel additional bureaucracy, and that patients is paramount in realizing initiative goals. Realistic targets must be set, and steady, gradual improvements should be expected. Where bilateral arrangements are concerned, support to countries should be provided in accordance with the national AIDS plans of each respective country. Linking country needs with available resources, the initiative would be a facilitating, integrating force.