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In: Disease and mortality in Sub-Saharan Africa, edited by Richard G. Feachem, Dean T. Jamison. Oxford, England, Oxford University Press, 1991. 119-21.This article is an overview of comprehensive up-to-date accounts of the current literature on infective and parasitic diseases and malnutrition found in part II of the 1991 World Bank publication entitled Disease and Mortality in Sub-Saharan Africa. It also points out that the region has a problem with insufficient health information systems and lack of surveillance. Malaria is still a major cause of morbidity and mortality in Sub-Saharan Africa. Further the mosquito vectors become resistant to insecticides and the parasite becomes resistant to drugs. It poses many challenges to epdiemiologists, malariologist, pharmacologists, and immunologists. Yet there are not enough of African malaria scientists to address these problems. Diarrhea remains a leading cause of morbidity and mortality in small children in Sub-Saharan Africa. It includes the dysenteries, typhoid, other salmonella infections, cholera, and intestinal parasitic infections such as hookworm and ascaris. Countries in Sub-Saharan Africa need to emphasize good hygiene, safe excreta disposal, and safe water supply to prevent these conditions. Another major cause of disease and mortality in children is acute respiratory infections (ARIs) such as pneumonia. Antibiotics can treat some of these ARIs. WHO's Expanded Programme on Immunization (EPI) operates in many Sub-Saharan African countries and coverage is often high. For example, the Gambia has reached 80% coverage in children <2 years old with measles, DPT-3, BCG, polio-3, and yellow fever. Yet the 6 disease of EPI continue to afflict children. The AIDS epidemic exacerbates the burden of Sub-Saharan Africa which is already fraught with disease. Children in Sub-Saharan Africa also bear a nutritional burden (40% prevalence of stunting and 9% of wasting). Further many children also suffer from micronutrient deficiencies such as vitamin A. Other health problems in Sub-Saharan Africa include leprosy, meningococcal meningitis, and physical handicaps.
In: Disease and mortality in Sub-Saharan Africa, edited by Richard G. Feachem, Dean T. Jamison. Oxford, England, Oxford University Press, 1991. 31-6.This article is an overview of 4 chapters of part I of the 1991 World Bank publication entitled Disease and Mortality in Sub-Saharan Africa. It discusses what the health community currently knows about the levels, trends, and patterns of mortality in Sub-Saharan Africa. In fact, it points out that only limited data are currently available. Demographic techniques have evolved to overcome data limitations, however. These chapters also identify important information gaps that must be filled to plan interventions. These chapters reveal that mortality levels are higher in Sub-Saharan Africa than in other developing regions. Mortality of children <5 years old has decreased since the 1940s in most Sub-Saharan African countries, except for countries who have experienced war and civil unrest. Further Sub-Saharan Africa exhibits a specific mortality pattern: higher levels of infant, young child, and adult mortality exist in western Africa than in eastern or southern Africa. Nevertheless adult mortality in western Africa fell considerably between the 1950s-late 1970s, but it did not fall much in eastern African countries (their levels were lower initially though). This article suggests that donors could greatly contribute to developing planning ability in Sub-Saharan Africa by supporting the establishment of a vital registration system. Health planners often have access to hospital record and community survey data, however, but these data are biased. Further these chapters show that interventions to reduce mortality do not necessarily result in a reduction in morbidity. Rapid population growth and high fertility pose further problems for health planners.
INTERNATIONAL MIGRATION REVIEW. 1991 Spring; 25(1):60-92.The United Nations has recommended the measurement of types of international migration using demographic criteria, including length of stay and purpose of travel. Information systems at the U.S. Immigration and Naturalization Service (INS) have the potential to provide a basis for documenting these demographic characteristics, in particular, length of stay of temporary migrants to the United States. This article analyzes these characteristics of selected categories of nonimmigrant aliens. The results of the analysis are used to produce series of estimates of alien immigration that conform more closely to the U.N. recommended definitions and better represent demographic concepts of long-term immigration. A strategy for measuring emigration of aliens from the United States using INS information systems is also described. (EXCERPT)