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  1. 1
    181185

    Africa struggles for global attention. Concern that Iraq focus will be at continent's expense.

    Mutume G

    Africa Recovery. 2003 Jul; 17(2):10-11.

    Concern is growing among governments, policymakers and civil society groups that the international community is sidelining African priorities as it focuses on the crisis in Iraq. "My appeal to the main donors is that while they should attend to the reconstruction of Afghanistan and Iraq, Africa is also in dire need of resources to get rid of poverty, to be able to get safe water, to get education and so on;' Ugandan Finance Minister Gerald Ssendaula said during a recent visit to Washington, DC. UN Deputy Emergency Relief Coordinator Carolyn McAskie rein- forced these concerns at a New York press conference in May. Drawing attention to Africa's "forgotten emergencies," she recalled that last year international donor focus was on Afghanistan, before that Kosovo and now Iraq. (excerpt)
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  2. 2
    182587

    The new lepers. HIV-positive people are treated as social outcasts while the government fails to cope.

    Osokina A

    London, England, Institute for War and Peace Reporting [IWPR], 2003 Aug 8. 3 p. (Belarus Reporting Service No. 28)

    More and more people in Belarus are finding themselves in her position – 50 or 60 new HIV cases are recorded every month. At the beginning of August, the number of people carrying the virus reached 5,150, and experts fear that the figure will be more than double that in 2005. More worryingly, some say the recorded figures should be multiplied by a factor of three or more since they fail to capture drug users who have not been seen by the health authorities. Although HIV and AIDS are advancing rapidly, neither the government nor society in general appear able to come to terms with it. A survey conducted jointly by the United Nations and the Centre for Sociological and Political Research in Minsk found that three quarters of the people polled thought people with HIV should not be allowed to care for their own children, and more than 40 per cent said they should not be allowed to travel around the country or choose where they want to live. (excerpt)
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  3. 3
    134846

    Global tuberculosis control: WHO report 1998.

    World Health Organization [WHO]. Global Tuberculosis Programme

    Geneva, Switzerland, WHO, Global Tuberculosis Programme, 1998. vi, 163 p. (WHO/TB/98.237)

    This annual compilation of data by the World Health Organization (WHO) tuberculosis surveillance and monitoring project was based on information provided to WHO in 1997 by 181 countries, covering 97% of the global population. A total of 3.81 million cases of tuberculosis were reported in 1996, of which 1.29 million were smear-positive. These figures represent case detection rates of 39% and 51%, respectively. Between 1995 and 1996, case notifications increased in all regions except the Americas and the Eastern Mediterranean. 57% of registered cases were reported to have been treated successfully. Directly observed treatment, short-course (DOTS) programs reported more new pulmonary cases to be smear-positive (67% vs. 30% in non-DOTS control programs) and achieved higher treatment success rates (78% vs. 45%). Despite the advantages of DOTS, only 32% of the world's population had access to this treatment strategy by the end of 1996. In 1996, out of 96 countries (63%) that used DOTS, only 26 (carrying 6% of estimated global incidence) had case detection and cure rates that approach WHO targets. Nine of the 22 highest-burden countries have not yet adopted DOTS or have failed to provide data on case detection and/or treatment success. Progress in these high-incidence countries is the key to global tuberculosis control.
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  4. 4
    074583

    Some clinical aspects of HIV infection in Africa.

    Harries A

    AFRICA HEALTH. 1992 Jul; 14(5):10-1.

    An update on clinical aspects of HIV in africa highlights new proposed clinical definitions of adult AIDS and of tuberculosis in HIV+ adults, and staging of adult HIV infection. The 1986 WHO clinical definition of AIDS has been widely used in Africa, but now research suggests that this definition has several limitations: the definition will pick up several unrelated diseases such as diabetes mellitus and renal failure. It does not ascertain cases of AIDS marked by nonopportunistic infections. Most persons with pulmonary tuberculosis may be wrongly diagnosed with AIDS by this definition. The study showed that the WHO clinical definition has good specificity and positive predictive value for HIV+ people, but its positive predictive value fell to 30% in identifying people with AIDS in Africa. New definitions should take into account any serious morbidity, tuberculosis, neurological disease, both endemic localized Kaposi's, and aggressive typical Kaposi's sarcoma, and HIV serological testing. Tuberculosis is a problem because few HIV+ people suspected of having pulmonary TB (sputum-negative TB) actually have it based on bronchoscopy, while HIV+ persons with TB experience high mortality, often from pyogenic bacteremia. HIV+ persons with TB suffer high rates of relapse, possibly related to insufficient drug treatment or reinfection. 1 study showed that 6 months of isoniazid significantly improved incidence of TB over 30 months of follow-up. Staging of AIDS in Africa based on degree of immunosuppression was proposed as: 1) clinically inapparent HIV infection marked by pulmonary TB, soft tissue infections, and community acquired pneumonia; 2) lymphadenopathy, oral thrush, widespread pruritic maculopapular rash, herpes zoster, enteric illness, dysentery, and Kaposi's sarcoma; and 3) HIV wasting syndrome, chronic pulmonary disease, meningitis, and fever of unknown origin.
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  5. 5
    068551

    USAID steps up anti-AIDS program.

    USAID HIGHLIGHTS. 1991 Fall; 8(3):1-4.

    This article considers the epidemic proportion of AIDS in developing countries, and discusses the U.S. Agency for International Development's (USAID) reworked and intensified strategy for HIV infection and AIDS prevention and control over the next 5 years. Developing and launching over 650 HIV and AIDS activities in 74 developing countries since 1986, USAID is the world's largest supporter of anti-AIDS programs. Over $91 million in bilateral assistance for HIV and AIDS prevention and control have been committed. USAID has also been the largest supporter of the World Health Organization's Global Program on AIDS since 1986. Interventions have included training peer educators, working to change the norms of sex behavior, and condom promotion. Recognizing that the developing world will increasingly account for an ever larger share of the world's HIV-infected population, USAID announced an intensified program of estimated investment increasing to approximately $400 million over a 5-year period. Strategy include funding for long-term, intensive interventions in 10-15 priority countries, emphasizing the treatment of other sexually transmitted diseases which facilitate the spread of HIV, making AIDS-related policy dialogue an explicit component of the Agency's AIDS program, and augmenting funding to community-based programs aimed at reducing high-risk sexual behaviors. The effect of AIDS upon child survival, adult mortality, urban populations, and socioeconomic development in developing countries is discussed. Program examples are also presented.
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  6. 6
    270489

    Local Area Monitoring (LAM).

    Kirsch TD

    WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1988; 41(1):19-25.

    Routine surveillance of the incidence of vaccine-preventable diseases has not proved sensitive enough to demonstrate the impact of the Expanded Program on Immunization (EPI) in many countries. In order to document progress since the start of the EPI in 1979, data are needed for several years prior to that. In most developing countries these can be found only in major cities or large hospitals. Therefore a system of sentinel surveillance, the Local Area Monitoring Project (LAM), is being set up in selected institutions in the major cities of the developing world. The primary goal of the LAM project is to provide disease-incidence data of sufficient quality to evaluate more fully the global impact of the EPI on the 6 target diseases--diptheria, pertusis, tetanus, poliomyelitis, measles, and tuberculosis. The goal is to include the major city of each of the 25 largest developing countries, with a total population of 115 million. These 25 countries together account for 85% of all births in the developing world. The program and coverage information is used to assess the impact of individual EPI programs on disease trends. Preliminary analysis of the 12 cities with the best data suggests that the impact of the EPI on the incidence of the target diseases has been greater than previously shown by the routine system. The LAM information is useful for global and regional analysis of program impact, but for the countries themselves its utility may be even greater. It is hoped that the project will help to improve a country's surveillance system by encouraging the use of sentinel reporting as a means of supplementing routine data. The information on the impact of the EPI may further increase political and public support for a program. (Summaries in ENG, FRE)
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