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Washington, D.C., Program for Appropriate Technology in Health [PATH], 2013.  p.This toolkit provides information about the UN Commission on Life-Saving Commodities (the Commission), 13 priority commodities, and examples of how its ten recommendations to improve access and availability are being applied globally and within countries. It also provides advocacy resources for utilizing the Commission platform to raise awareness and engage stakeholders in addressing commodity-related gaps in policy.
Current Opinion in Gastroenterology. 2010 Sep 10; 26: p.PURPOSE OF REVIEW: To highlight recent advances in our understanding of prolonged episodes of acute diarrhea and persistent diarrhea in children. The focus is on the contribution of these illnesses to the global burden of diarrhea, their impact on childhood growth and development, novel epidemiologic links between prolonged and persistent diarrheal episodes, and strategies for their prevention and management. RECENT FINDINGS: Although less common than acute diarrhea, prolonged and persistent episodes of diarrhea in childhood constitute a significant portion of the global burden of diarrhea. These episodes also play a key role in the vicious cycle of childhood diarrhea and malnutrition in which undernutrition is both a risk factor and an outcome of diarrhea. Increased efforts to provide WHO-recommended zinc therapy for all children with diarrhea in developing countries will significantly reduce morbidity and mortality. In children who develop persistent diarrhea, yogurt-based or amino acid-based diets may accelerate their recovery. SUMMARY: In addition to increased implementation of strategies already known to effectively prevent and manage acute diarrhea, further research is needed to address the recognition, prevention, and treatment of prolonged episodes of acute diarrhea and persistent diarrhea in resource-limited settings.
New York, New York, UNICEF, 2009.  p.This report sets out a 7-point strategy for comprehensive diarrhoea control that includes a treatment package to reduce child deaths, and a prevention package to reduce the number of diarrhoea cases for years to come. The report looks at treatment options such as low-osmolarity ORS and zinc tablets, as well as prevention measures such as the promotion of breastfeeding, vitamin A supplementation, immunization against rotavirus -- a leading cause of diarrhoea -- and proven methods of improving water, sanitation and hygiene practices. Diarrhoea's status as the second leading killer of children under five is an alarming reminder of the exceptional vulnerability of children in developing countries. Saving the lives of millions of children at risk of death from diarrhoea is possible with a comprehensive strategy that ensures all children in need receive critical prevention and treatment measures. (Excerpt)
Zinc treatment to under-five children: applications to improve child survival and reduce burden of disease.
Journal of Health, Population, and Nutrition. 2008 Sep; 26(3):356-65.Zinc is an essential micronutrient associated with over 300 biological functions. Marginal zinc deficiency states are common among children living in poverty and exposed to diets either low in zinc or high in phytates that compromise zinc uptake. These children are at increased risk of morbidity due to infectious diseases, including diarrhoea and respiratory infection. Children aged less than five years (under-five children) and those exposed to zinc-deficient diets will benefit from either daily supplementation of zinc or a 10 to 14-day course of zinc treatment for an episode of acute diarrhoea. This includes less severe illness and a reduced likelihood of repeat episodes of diarrhoea. Given these findings, the World Health Organization/United Nations Children's Fund now recommend that all children with an acute diarrhoeal illness be treated with zinc, regardless of aetiology. ICDDR.B scientists have led the way in identifying the benefits of zinc. Now, in partnership with the Ministry of Health and Family Welfare, Government of Bangladesh and the private sector, the first national scaling up of zinc treatment has been carried out. Important challenges remain in terms of reaching the poorest families and those living in remote areas of Bangladesh.
Implementing the new recommendations on the clinical management of diarrhoea: guidelines for policy makers and programme managers.
Geneva, Switzerland, WHO, 2006. 34 p.WHO and UNICEF have released revised recommendations aimed at dramatically cutting the number of deaths due to diarrhoea. These new recommendations take into account two significant recent advances: demonstration of the increased efficacy of a new formulation for ORS containing lower concentrations of glucose and salt, and success in using zinc supplementation in addition to rehydration therapy in the management of diarrhoeal diseases. Prevention and treatment of dehydration with ORS and fluid commonly available at home, breastfeeding, continued feeding, selective use of antibiotics, and providing zinc supplementation for 10 to 14 days are the critical therapies that will help us achieve these goals. This manual provides policy makers and programme managers with the information they need to introduce and/or scale up a national decision to introduce the new ORS formulation and zinc supplementation as part of the clinical management of diarrhoeal diseases. (excerpt)
BMJ. British Medical Journal. 2005 Feb 12; 330:347-349.Zinc deficiency is one of the ten biggest factors contributing to burden of disease in developing countries with high mortality. Since the problem was highlighted in the World Health Report 2002, calls have increased for supplementation and food fortification programmes. Zinc interventions are among those proposed to help reduce child deaths globally by 63%. Populations in South East Asia and sub-Saharan Africa are at greatest risk of zinc deficiency; zinc intakes are inadequate for about a third of the population and stunting affects 40% of preschool children. Zinc is commonly the most deficient nutrient in complementary food mixtures fed to infants during weaning. Improving zinc intakes through dietary improvements is a complex task that requires considerable time and effort. The case for promoting the use of zinc supplements and for fortifying foods with zinc, especially those foods commonly eaten by young children, therefore seems strong. However, global policies or recommendations for zinc interventions are few. The World Health Organization recommends zinc only as a curative intervention, either as part of the mineral mix used in the preparation of foods for the treatment of severe malnutrition, or more recently in the treatment of diarrhoea. We review current evidence that improving zinc intake has important preventive or curative benefits for mothers and young children and examine the programme implications for achieving this in developing countries. (excerpt)
Geneva, Switzerland, WHO, 2004. 7 p. (WHO/FCH/CAH/04.7; UNICEF/PD/Diarrhoea/01)Though the mortality rate for children under five suffering from acute diarrhoea has fallen from 4.5 million deaths annually in 1979 to 1.6 million deaths in 2002, acute diarrhoea continues to exact a high toll on children in developing countries. Oral rehydration salts (ORS) and oral rehydration therapy (ORT), adopted by UNICEF and WHO in the late 1970s, have been successful in helping manage diarrhoea among children. It is estimated that in the 1990s, more than 1 million deaths related to diarrhoea may have been prevented each year, largely attributable to the promotion and use of these therapies. Today, however, there are indications that in some countries knowledge and use of appropriate home therapies to successfully manage diarrhoea, including ORT, may be declining. (excerpt)
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.