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WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1995; (857):i-vi, 1-91.In 1993, the World Health Organization (WHO) Study Group on Vector Control for Malaria and other Mosquito-Borne Diseases convened in Geneva to develop well-defined guidelines for implementing the vector control component of the Global Malaria Control Strategy. Goals and objectives of the control strategy, vector control, and the study group as well as those concerning use of the insecticide DDT are addressed in the meeting's published report. A review of the global status and trends in malaria and other mosquito-borne diseases follows. Malaria status and experiences, priorities, and trends in vector control in the various WHO regions are examined. One section reviews objectives of vector control, considerations in planning and implementation, selectivity and sustainability, information systems management, stratification of malarious areas by eco-epidemiological criteria, and priority geographical areas and risk groups. Indoor residual spraying, personal protection measures, larviciding and biological control, and environmental management are also discussed. The next section examines the role of vector control in malaria epidemics and drug-resistant malaria. Another section examines indicators of operational and entomological impact and of impact on disease and integrated use of control methods under the context of monitoring and evaluation of vector control efforts. Entomological parameters and techniques discussed include detection and monitoring of insecticide resistance, bioassays, adult density, resting indices, mosquito age and survival rates, human-vector contact, mosquito infection rates, entomological inoculation rate, and measurement of malaria transmission as well as choice of parameters and design for evaluating interventions. Other topics include the role of entomological services in malaria control, managerial aspects of malaria vector control and entomological services, comprehensive vector-borne disease control, capacity building, role of communities and other sectors in vector control, cost-effectiveness in vector control, research in vector control, and policy issues related to vector control.
The biochemistry and microbiology of the female and male genital tracts: report of a WHO Scientific Group.
Geneva, World Health Organization, 1965. (World Health Organization Technical Report Series No. 313.) 15 p.A WHO Scientific Group on the Biochemistry and Microbiology of the Female and Male Genital Tracts met in Geneva on April 20-26, 1965. It was the sixth of a series of meetings giving detailed consideration to the biology of human reproduction. Topics investigated included: 1) the chemistry and enzymology of the uterus; 2) sperm transport; 3) capacitation and the acrosome reaction; 4) nidation and placentation; 5) the chemistry and enzymology of semen; 6) the effects of cadmium, zinc, and selenium compounds on reproduction; and 7) microbiology. The Group considered that many of the subjects discussed required further investigation. The discussions repeatedly indicated the need for more broadly based comparative studies in the physiology of reproduction. They also underlined the need for more extensive studies in primates, particularly with a view to determining the time of ovulation and the reaction of uterine tissues to the changing stages of the cycle and of pregnancy. The importance of viewing the male and female components in reproduction as an integrated whole rather than as isolated events was stressed.
EARTH TIMES. 1996 Oct 16-31; 9(18):8.Vitamin A, iodine, and iron are widespread, cheap, available, and needed in small quantities by the human body in order to remain healthy. Many people, however, especially women and children, do not consume adequate quantities of these micronutrients. Indeed, vitamin deficiency affects more than 200 million children worldwide, and a lack of vitamin A supplementation could be the cause of 1-3 million child deaths per year. The problem remains particularly serious in 76 countries. Vitamin A affects vision and the immune system such that deficiency can cause blindness, delay recovery from diarrhea, and cause an episode of measles to be more severe. Vitamin A deficiency is more likely to be found in arid regions, among the poor, and in areas without a historical pattern of eating vitamin A-rich foods. Supplementation readily corrects the problem. The author notes that the United Nations Children Fund (UNICEF) has helped make countries aware of the problem of micronutrient deficiencies.
Hunger and malnutrition: the determinant of development: the case for Africa and its food and nutrition workers.
East African Medical Journal. 1992 Aug; 69(8):424-7.Hunger and malnutrition in Africa have been on the increase since the 1960s. During the 1970s, it is estimated that 30 million people were directly affected by famine and malnutrition. About 5 million children died in 1984 alone. In Mozambique during the 1983-84 famine, about 100,000 people perished. In Ethiopia, Sudan, Somalia, Liberia, and Angola armed conflicts compound the problem. Ethiopia alone had 9 million famine victims in 1983. The most common form of malnutrition in Africa is protein energy deficiency affecting over 100 million people, especially 30-50 million children under 5 years of age. Almost another 200 million are at risk. Iron deficiency, commonly called anemia, also affects 150 million people, mostly women and children. Iodine deficiency leads to disorders like mental retardation, cretinism, deafness, abortion, low resistance to disease, and goiter and this affects 60 million with about 150 million more at risk. Vitamin A deficiency causes blindness and low resistance to disease and affects about 10 million. Protein energy deficiency is treated by using donated foods in hospitals, rehabilitation centers, day care centers, and feeding centers. There are no community programs for anemia, or vitamin A or iodine deficiencies. Vaccines for preventing and drugs for treating diseases that cause malnutrition are imported. Therefore, African food and nutrition professionals met in 1988 and created the Africa Council for Food and Nutrition Sciences (AFRONUS) to eliminate famine and malnutrition in Africa. Activities have started in: 1) developing contacts between the workers in food and nutrition; 2) assessing the situation of food and nutrition in Africa; 3) developing an action plan; 4) implementing the plan; and 5) monitoring progress. Food and Nutrition Policy Guidelines have also been prepared by AFRONUS for food and nutrition workers. Africa has enough natural resources to solve the problem of hunger and malnutrition, but these resources have to be harnessed.
[Geneva, Switzerland], WHO, 1987.  p. (GEMS: Global Environment Monitoring System)The Global Environment Monitoring System (GEMS) is a system for compiling and analyzing the health of the environment globally, to improve and coordinate measurement methodologies between countries, to increase the validity and accuracy of measurements, and to support the development of national monitoring programs. This report summarizes the levels and trends in environmental quality from 1975-84. The number of countries and the number of measurement points is limited due to unavailability of the data. The measurements are gross measures rather than precise measures. Monitoring of air pollution begin in 1973, of water pollution in 1977, of food contamination in 1976, and biological monitoring of human lead, cadmium, and organochlorine pesticides and PCBs in 1979. The following topics are considered for discussion: air pollution (general level of severity of sulfur dioxide (SO2), trends, and estimation of populations exposed); water quality, pollution by sewage, nutrients in the water, chemicals in the water, and trends; and food contamination, pesticides in foods, industrial chemicals in foods, natural toxins in food; and trends in biological monitoring and the onset of assessment of human exposure begun in 1984. The GEMS air monitoring system, for example, includes 170 urban monitoring sites in 50 countries, which provide broad coverage of different climatic conditions, levels of development, and pollution situations. measurements are for average values for 1980-84 and the 98th percentile of SO2 and suspended particulate matter (SPM); recent data unavailable for this report include nitrogen dioxide and lead. Cities with concentrations of >50 micrograms/cubic meter of SO2 were Milan, Italy; Shenyang, China; Tehran, Iran; Seoul, Korea; and Rio de Janeiro, Brazil. SPM averages >100 were present between 1980-84 in Kuwait; Shenyang and Xian, China; New Delhi, India; Beijing, China; Calcutta, India; Tehran, Iran; Jakarta, Indonesia;' and Shanghai and Guangzhou, China. SO2 levels >60 micrograms/cubic and SPM >90 are considered harmful to health; these levels should not be exceeded >2% of the time or 7 days/year. For SO2, 20 cities have acceptable levels affecting 35% a population of 1.8 billion, 11 cities are marginal (30% of the population), and 23 (35% of the population) are unacceptable; for SPM, 10 (20%) are acceptable, 9 (10%) marginal, and 22 (70%) unacceptable. The greatest improvements are seen in European and North American cities.
Geneva, Switzerland, UNCED, Secretariat, 1992 Apr. , 116 p. (E.92.I.15)The UN Conference on Environmental and Development Preparatory Committee (UNCED) agreed on an action plan of global partnership for sustainable development and environmental protection entitled Agenda 21 to be adopted at the June 1992 UNCED in Rio de Janeiro. The priority actions are a call for action to achieve a prospering, just, and habitable world. These actions also promote a fertile, shared, and clean planet via extensive and responsible public participation at local, national, and global levels. Since most environmental problems originate with the failures and inadequacies of the current development process, the 1st action centers around revitalizing growth with sustainability including international policies to accelerate sustainable development in developing countries and integration of environment and development in decision making. The 2nd action is achieving sustainable living by attacking poverty, changing consumption patterns, and recognizing and acting on the links between population dynamics and sustainability, and providing basic health needs to preserve human health. The 3rd action addresses human settlements including urban water supplies, solid wastes management, and urban pollution and health. The 4th and 7th action plans incorporate the most subtopics. The 4th action plan calls for efficient resource use ranging from land resource planning and management to sustainable agriculture and rural development. The 7th plan is a call for individuals and groups to participate and be responsible for sustainable development. The major identified groups are women, children and youth, indigenous people, nongovernmental organizations, farmers, local authorities, trade unions, business and industry, and the scientific and technological community. The 5th plan addresses global and regional resources including protection of the atmosphere, the oceans and seas, and sustainable use of living marine resources. The 6th plan deals with management of toxic and hazardous chemicals and radioactive wastes.
METHODS AND FINDINGS IN EXPERIMENTAL AND CLINICAL PHARMACOLOGY. 1992 May; 14(4):289-95.UNICEF promotes the use of a very effective, inexpensive treatment of dehydration in developing countries: oral rehydration therapy (ORT), which is oral administration of a solution with equimolar concentrations of sodium and glucose (osmolality of about 300 mosmol). The solution is isotonic with respect to total body water when it reaches the small intestine. It expands the extracellular fluid without changing serum osmolality, thus, brain edema does not occur. Further, metabolic degradation of glucose eventually releases free water. On the other hand, intravenous rehydration with saline solution can be lethal, causing excess free water to expand shrunken cells and, thereby, causing brain swelling, rupture of blood vessels and hemorrhage. Yet, physicians and other health workers in developed countries have been quite sow to accept ORT. Leading conditions of dehydration include insensible loss of water and heat through evaporation from the respiratory tract and skin (common in dry air, hot environment, and fever), sensible loss of water and heat through perspiration (common in hot, humid environment and with warm and absorbent clothing), and irritation of the intestinal mucosa by allergies, infections, toxins, and intolerance to some nutrients, resulting in diarrhea. Diarrhea is indeed the main cause of dehydration. Other causes of dehydration are: failure of the hypothalamus to secrete antidiuretic hormone (ADH), kidney unresponsiveness to ADH, diabetes mellitus, protein-rich nutrition, catabolic states, and brush-border lactase after weaning. Physiological changes in dehydration consist of rigidity of the connective tissue (vascular system and lungs) and intracellular fluid loss to the extracellular spaces, resulting in dry mucous membranes, shrunken muscle cells in the lips and the tongue, soft eyes, and adverse effects to the central nervous system. Children become dehydrated more readily than adults, but they tolerate it better.
[Nairobi, Kenya], United Nations Environment Programme [UNEP], 1990. , 42 p. (UNEP Regional Seas Reports and Studies No. 123)The UN Environment Programme (UNEP) ocean program is studying global marine environments to form a policy to protect the oceans. This report examines the marine environment of the Indian Ocean, Bay of Bengal, the Arabian Sea, and the Andaman Sea. Bacteria and viruses comprise the most important contaminants in the South Asia seas. They enter marine life which humans eat and then develop diarrhea. Pathogens enter the seas through untreated sewage which causes much eutrophication. Zooplankton contain considerable concentrations of heavy metals and pesticides. None of the zooplankton samples drawn from seas around India in 1978, 1981, 1983, and 1985 contained mercury, however. Yet mercury and other heavy metals are present in fish species in at least the Ganges River estuary, Andaman Sea, the Karachi harbor in Pakistan, and seas around Bangladesh. Common chlorinated pesticides found off the coast of India include DDT, aldrin, dieldrin, and BHC. Industrial development is increasing the levels of other contaminants such as solid waste and synthetic detergents. Coastal erosion is common in South Asia. Considerable siltation occurs at the head of the Bay of Bengal. Several urban areas are reclaiming the sea using materials from solid wastes and garbage, but these materials leach which causes public health problems. In India, nuclear power plants operate near the coast where they release 50% of the generated heat to the coastal environment. Dredge materials from harbors in India are dumped offshore which resulted in almost complete depletion of fisheries near these harbors. Tourism poses a threat to coastal environments due to the increase in nonbiodegradable solid waste such as cans, plastics, and empty bottles. Oil tanker disasters, bilge washings, and discharge of ballast water contribute to the sizable amount of oil pollution in the Indian ocean. Exploitation damages coral reefs, mineral deposits, mangroves, and marine life.
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.
WOMEN'S GLOBAL NETWORK FOR REPRODUCTIVE RIGHTS NEWSLETTER. 1991 Jul-Sep; (36):21-2.A meeting in Singapore of principal investigators from 7 countries in a WHO collaborative study on hypertensive disease of pregnancy, also called pre-eclampsia or eclampsia, pointed out women at risk, suggested management guidelines, and summarized operations research projects involving administration of aspirin or calcium supplements. Hypertensive disease of pregnancy may ultimately end in fatal seizures. It is often marked by warning signs of severe headaches and facial and peripheral edema. A survey in Jamaica found that 0.72% of a group of 10,000 pregnant women had eclamptic seizures. These were the cause of almost one-third of all obstetric deaths in the period 1981-1983. 10.4% of the pregnant women had hypertension, and half of these had proteinuria. Associated risk factors were primigravida, age >30, abnormal weight gain, edema, 1+ proteinuria. A phased program of management guidelines for identifying and treating affected women is being instituted in half of Jamaica's parishes. An operations research project involves administration of low-dose aspirin vs. placebo. Another controlled trial, in Peru, is testing calcium supplements. A third trial in Argentina will compare 2 drug regimens.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1985; 38(3):302-16.Tables present data on the prevalence of anemia in the world. Anemia may be defined as a state in which the quantity or the quality of circulating red cells is reduced below the normal level. The most common way to diagnose anemia is by measuring the hemoglobin concentration in the blood which is controlled by a homeostatic mechanism. It varies slightly among normal subjects. In 1959, the World Health Organization (WHO) proposed levels of hemoglobin concentrations for different groups of individuals that could be considered as the lower limits of normality. Subjects with values below these levels were considered to be anemic. The causes of anemia, which are multiple, include a deficiency of hemopoietic factos, genetic disorders causing hemolytic anemias, infections including malaria, and increased losses of blood caused inter alia by infections such as ankylostomiasis or schistosomiasis. A survey of the prevalence of anemia in women in developing countries was published by WHO in 1982. It estimated the prevalence of nutritional anemia in developing countries (other than China) at 60% in pregnant women and 47% in non-pregnant women. The prevalence of anemia in all women of reproductive age was estimated at 49%. It appears that studies on the prevalence of anemia were conducted regularly during the 1960-84 period, with the exception of studies on elderly people most of which were conducted before 1970. Most studies included from 100 to 300 subjects. Studies on adolescents usually covered fewer than 100 subjects. The tables provide no data on the severity of anemia, i.e., the percentage of subjects with a hemoglobin concentration below a specific level. On the basis of the present review, the total prevalence of anemia in the world is most likely about 30%. Expressed in absolute numbers this means some 1300 million people of the estimated world population of 4440 million in 1980. For the developing regions of the world, the prevalence of anemia is probably about 36% or 1200 million people, and for the more developed regions about 8% or just under 100 million people. Young children and pregnant women are the most affected groups with an estimated global prevalence of 43% and 51%, respectively. The regions with the highest overall prevalence of anemia are South Asia and Africa. With the exception of pregnant women, the prospects for the prevention of iron deficiency anemia in a population are poor at the present time. Iron fortification and the daily administration of an iron supplement present great problems in developing countries, and they will not be resolved easily.