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  1. 1
    344991
    Peer Reviewed

    WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study.

    Nadjm B; Amos B; Mtove G; Ostermann J; Chonya S; Wangai H; Kimera J; Msuya W; Mtei F; Dekker D; Malahiyo R; Olomi R; Crump JA; Whitty CJ; Reyburn H

    BMJ. British Medical Journal. 2010; 340:c1350.

    OBJECTIVES: To assess the performance of WHO's "Guidelines for care at the first-referral level in developing countries" in an area of intense malaria transmission and identify bacterial infections in children with and without malaria. DESIGN: Prospective study. SETTING: District hospital in Muheza, northeast Tanzania. PARTICIPANTS: Children aged 2 months to 13 years admitted to hospital for febrile illness. MAIN OUTCOME MEASURES: Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials. RESULTS: Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum, 341 (9.4%) had invasive bacterial disease, and 142 (3.9%) were seropositive for HIV. The prevalence of invasive bacterial disease was lower in slide positive children (100/2195, 4.6%) than in slide negative children (241/1444, 16.7%). Non-typhi Salmonella was the most frequently isolated organism (52/100 (52%) of organisms in slide positive children and 108/241 (45%) in slide negative children). Mortality among children with invasive bacterial disease was significantly higher (58/341, 17%) than in children without invasive bacterial disease (126/3298, 3.8%) (P<0.001), and this was true regardless of the presence of P falciparum parasitaemia. The sensitivity and specificity of WHO criteria in identifying invasive bacterial disease in slide positive children were 60.0% (95% confidence interval 58.0% to 62.1%) and 53.5% (51.4% to 55.6%), compared with 70.5% (68.2% to 72.9%) and 48.1% (45.6% to 50.7%) in slide negative children. In children with WHO criteria for invasive bacterial disease, only 99/211(47%) of isolated organisms were susceptible to the first recommended antimicrobial agent. CONCLUSIONS: In an area exposed to high transmission of malaria, current WHO guidelines failed to identify almost a third of children with invasive bacterial disease, and more than half of the organisms isolated were not susceptible to currently recommended antimicrobials. Improved diagnosis and treatment of invasive bacterial disease are needed to reduce childhood mortality.
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  2. 2
    308277
    Peer Reviewed

    Contemporary issues in women's health.

    Adanu RM; Hammoud MM

    International Journal of Gynecology and Obstetrics. 2008 Sep; 102(3):223-225.

    The editors of Contemporary Issues in Women's Health solicited reporters and correspondents from throughout the world to make contributions to this feature. Items submitted were stories on breastfeeding, FGM, Saudi women and ban on female drivers, and useful sources for women's health information.
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  3. 3
    327633

    The Millennium Development Goals report 2007.

    United Nations

    New York, New York, United Nations, Department of Economic and Social Affairs, 2007 Jun. 36 p.

    Since their adoption by all United Nations Member States in 2000, the Millennium Declaration and the Millennium Development Goals have become a universal framework for development and a means for developing countries and their development partners to work together in pursuit of a shared future for all. The Millennium Declaration set 2015 as the target date for achieving most of the Goals. As we approach the midway point of this 15-year period, data are now becoming available that provide an indication of progress during the first third of this 15-year period. This report presents the most comprehensive global assessment of progress to date, based on a set of data prepared by a large number of international organizations within and outside the United Nations system. The results are, predictably, uneven. The years since 2000, when world leaders endorsed the Millennium Declaration, have seen some visible and widespread gains. Encouragingly, the report suggests that some progress is being made even inthose regions where the challenges are greatest. These accomplishments testify to the unprecedented degree of commitment by developing countries and their development partners to the Millennium Declaration and to some success in building the global partnership embodied in the Declaration. The results achieved in the more successful cases demonstrate that success is possible in most countries, but that the MDGs will be attained only if concerted additional action is taken immediately and sustained until 2015. All stakeholders need to fulfil, in their entirety, the commitments they made in the Millennium Declaration and subsequent pronouncements. (excerpt)
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  4. 4
    195298

    Jong-Wook Lee sets bold new course at WHO.

    Darby J

    Global HealthLink. 2003 Sep-Oct; (123):[1] p..

    On July 21, 2003, Dr. Jong-Wook Lee took office as director-general of the World Health Organization (WHO). In a world where emerging threats to global health are becoming increasingly encompassing, the individual at the helm of the pre-eminant health organization must be recognized as a major player on the world stage. In his inaugural address to WHO staff, Dr. Lee outlined his vision for the coming years of his tenure. Simply stated, he believes that WHO's work must be guided by three principles: doing the right things, in the right places, in the right way. Foremost among the 'right things' is a scaled up effort to fight HIV/AIDS to be led by a new HIV/AIDS leadership team with a mandate to develop a strategy for ensuring achievement of the "three by five" goal, i.e., providing 3 million people in the developing world with antiretroviral therapy by the close of 2005. WHO departments working on the three major infectious diseases - HIV/AIDS, tuberculosis and malaria - will be unified into one cluster that will be able to work effectively with the Global Fund. Additional 'right things' articulated by Lee include expanded attention to child and maternal health, noncommunicable diseases, tobacco control, nutrition, violence, and mental health as well as the eradication of polio. (excerpt)
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