bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal home care practices in rural Egypt during the first week of life
Authors: Darmstadt Gary L. , Hussein Mohamed Hassan , Winch Peter J. , Haws Rachel A. , Lamia Mohsen , El‐Said Mohsen A. , Gipson Reginald F. , Santosham Mathuram 
Published: August 2010

SummaryObjective  To provide information about home care practices for newborns in rural Egypt, in order to improve neonatal home care through preventive measures and prompt recognition of danger signs.Method  Survey of newborn home care practices during the first week of life in 217 households in three rural Egyptian Governorates.Results  Many practices met common neonatal care standards, particularly prompt initial breastfeeding, feeding of colostrum and continued breastfeeding, and most bathing practices. However, several practices could be modified to improve neonatal care and survival. Supplemental substances were given to 44% of newborns as pre‐lacteal feeds, and to more than half during the first week. Nearly half (43%) of mothers reported that they did not wash their hands before neonatal care, and only 7% washed hands after diaper changes. Thermal control was not practiced, although mothers perceived 22% of newborns to be hypothermic.Conclusions  The practices we observed, which are critical for newborn survival, could be improved with minor modifications. We provide a framework for communicating behaviour change and setting research priorities for improving neonatal health.
Early exposure to yellow fever vaccine during pregnancy
Authors: Cavalcanti Denise P. , Salomão Maria Antonieta , Lopez‐Camelo Jorge , Pessoto Mônica A. ,   The Campinas Group of Yellow Fever Immunization during Pregnancy
Published: August 2010

SummaryObjective  To investigate the association of Yellow Fever Vaccination (YFV) during pregnancy with the presence of structural defect in exposed babies.Methods  An observed/expected frequencies study, before and after the vaccination campaign against YF was designed. 304 babies exposed to YFV during the prenatal period underwent dysmorphological examinations. The expected frequencies of malformations were obtained from a reference population of 10 691 births occurred in the period immediately prior to the vaccination campaign and born in the same region. These frequencies were evaluated using Poisson distribution model.Results  The major malformation rate found in this study was 3.3% (CI 1.7–6.3%). Minor dysmorphisms, especially naevus, were significantly more frequent (P < 0.001) than in the reference population.Conclusions  The data here presented provide no indication that immunization with YFV early in pregnancy increases the risk of major malformations. However, the association found between YFV during pregnancy and minor dysmorphisms, especially pigmented naevus, seems to be a bias of evaluation. We suggest, nevertheless, that a reproductive risk hypothesis regarding minor dysmorphisms should be considered in future studies involving YFV.
Patient empowerment in tuberculosis control: reflecting on past documented experiences
Authors: Macq Jean , Torfoss Ted , Getahun Haileyesus 
Published: August 2010

SummaryObjectives  To review the available published and non‐published literature on patient empowerment in tuberculosis (TB) control, describe what it entails, identify possible trends and conclusions, and suggest areas both for informing policy makers and for orienting further research.Methods  We searched MEDLINE and PSYCINFO databases, used World Wide Web research tools and included conference abstracts and specific project reports.Results  Experience shows that operational definitions, potential barriers towards empowerment and contextual issues need to be considered. Four types of experiences were reported: (1) enabling patients to take more responsibility for their health, especially regarding adherence to treatment, (2) organizing TB patients into groups and clubs, (3) building patient‐centred care in TB and general health services, and (4) using TB patients’ advocacy skills to improve TB control.Conclusion  Patient empowerment conceptions through interventions and studies should primarily involve TB patients themselves. Patients’ activism – their role, the shape it takes and resulting effects – is insufficiently documented.
Dramatically decreased therapeutic efficacy of chloroquine and sulfadoxine‐pyrimethamine, but not mefloquine, in southern Benin
Authors: Aubouy Agnès , Fievet Nadine , Bertin Gwladys , Sagbo Jean C. , Kossou Hortense , Kinde‐Gazard Dorothée , Kiniffo Richard , Massougbodji Achille , Deloron Philippe 
Published: August 2010

SummaryObjective  To evaluate the in vivo therapeutic efficacy of chloroquine (CQ), sulfadoxine‐pyrimethamine (SP) and mefloquine (MQ) in children presenting with uncomplicated malaria in Benin.Methods  Drug efficacy was tested according to the WHO in vivo 28‐day protocol. For failures that occurred after 7 days of follow‐up, paired pre‐ and post‐treatment blood samples were genotyped at msp1 and msp2 loci to distinguish new infections and recrudescent strains. Children enrolled were randomly assigned to a therapeutic group (CQ, n = 14; SP, n = 42; MQ, n = 44). The number of CQ treatment was intentionally restricted after 1 month, as its use was considered to constitute a danger for children.Results  Chloroquine and SP showed very high failure rates (85.7% and 50%, respectively), whereas MQ treatment was successful in 97.5%. The molecular tool allowed to re‐evaluate two new infections previously considered as failures.Conclusions  Chloroquine should no longer be used to treat children presenting with Plasmodium falciparum malaria in Benin.
Asymptomatic serum cryptococcal antigenemia and early mortality during antiretroviral therapy in rural Uganda
Authors: Liechty Cheryl A. , Solberg Peter , Were Willy , Ekwaru John Paul , Ransom Ray L. , Weidle Paul J. , Downing Robert , Coutinho Alex , Mermin Jonathan 
Published: August 2010

SummaryObjective  To evaluate the association between a positive serum cryptococcal antigen (CRAG) test at baseline and mortality during the first 12 weeks on antiretroviral therapy (ART). Cryptococcal meningitis is a leading cause of HIV‐related mortality in Africa, but current guidelines do not advocate CRAG testing as a screening tool.Methods  Between May 2003 and December 2004, we enrolled HIV‐1 infected individuals into a study of ART monitoring in rural Uganda. CRAG testing was conducted retrospectively on stored pre‐ART serum samples of participants whose baseline CD4 cell count was <100 cells/μl and who were without symptoms suggestive of disseminated cryptococcal disease at enrolment.Results  Of 377 participants, 5.8% had serum CRAG titre ≥1:2. Of these, 23% died during follow‐up. Controlling for CD4 cell count, HIV‐1 viral load, anaemia, active tuberculosis and body mass index, relative risk of death during follow‐up among those with asymptomatic cryptococcal antigenemia at baseline was 6.6 [95% confidence interval (CI) 1.86–23.61, P = 0.0036]. The population attributable risk for mortality associated with a positive CRAG at baseline was 18% (CI 2–33%), similar to that associated with active tuberculosis (19%, CI 1–36%).Conclusion  Asymptomatic cryptococcal antigenemia independently predicts death during the first 12 weeks of ART among individuals with advanced HIV disease in rural Uganda. Routine screening and provision of azole antifungal therapy prior to or simultaneous with the start of ART should be evaluated for the potential to prevent mortality in this population.
Morbidity and associated factors in rural and urban populations of South Lebanon: a cross‐sectional community‐based study of self‐reported health in 2000
Authors: Sabbah Ibtissam , Vuitton Dominique‐Angèle , Droubi Nabil , Sabbah Sanaa , Mercier Mariette 
Published: August 2010

SummaryObjective  To assess self‐reported morbidity and its determining factors in South Lebanon, with an emphasis on the influence of the habitat location (urban vs. rural) and gender.Methods  Cross‐sectional survey in 2000 among 524 South Lebanon residents ≥14 years sampled from a random sample of households using a multi‐level cluster sampling technique. Data on self‐reported morbidity, lifestyle and socioeconomic status were collected through interviews, using a standardized questionnaire. To evaluate deprivation, a new index was created; the modified ‘Living Conditions Index’. Stepwise logistic regression analysis was performed to test the effect of habitat and gender on self‐reported morbidity.Results  People in one‐fifth of the households lived in precarious conditions. Illiteracy was significantly higher in rural than urban settings. Urban residents reported obesity, varicose veins, anxiety/depression and visual disorders more often. Illiteracy, headaches, lumbar pain, varicose veins and anxiety/depression were more frequently reported by women, whereas ulcers, hearing disorders, cardio‐vascular diseases and their risk factors were more frequently reported by men. Precarious living conditions were associated with headaches, lumbar pains and insomnia. Individuals covered by a health insurance sought care more often than the uninsured.Conclusion  Habitat location had only a minor influence on self‐reported morbidity; women perceived their health as poorer than men and a number of disease conditions were influenced by deprivation. Our study confirms that the epidemiological transition phenomenon had occurred in South Lebanon in 2000. Our community‐based data can serve as a baseline for monitoring changes in health in South Lebanon in the future and especially those because of the war that emerged in July 2006.
Plot and see! Maternal comprehension of growth charts worldwide
Authors: Roberfroid D. , Pelto G. H. , Kolsteren P. 
Published: August 2010

SummaryObjective  To evaluate maternal comprehension of growth charts used in growth monitoring and promotion (GMP), a worldwide programme with important budgets but contrasting results.Methods  Systematic literature review through MEDLINE, POPLINE, Global Health, ERIC and the Cochrane Library with the keywords ‘growth monitoring’ or ‘growth chart’ limited to the title/abstract field and to the 0–5 years age range.Results  Twenty studies from Asia (8), Africa (8) and Latin America/Caribbean (3) were included in the review. The results of the 14 non‐intervention, cross‐sectional studies provide convincing evidence that a third to three‐fourths of carers in developing countries do not understand the growth charts. Literacy had a strong effect on women’s ability to interpret the cards. Appropriate training and educational activities also increased substantially maternal comprehension as demonstrated in five of the six intervention trials.Conclusions  Many carers have poor comprehension of growth charts, but their comprehension increases not only with literacy, but also with training. Activities aimed at improving communication skills of health staff and at empowering parents to practice responsive parenting could greatly improve GMP outcomes.
Clinical and laboratory features of disseminated histoplasmosis in HIV patients from Brazil
Authors: Daher Elizabeth F. , Silva Geraldo B. , Barros Fernando A. S. , Takeda Christianne F. V. , Mota Rosa M. S. , Ferreira Marúsia T. , Oliveira Soraya A. , Martins Julieta C. , Araújo Sônia M.H.A. , Gutiérrez‐Adrianzén Oswaldo A. 
Published: August 2010

SummaryObjectives  To identify the main clinical and laboratory features of disseminated histoplasmosis (DH) in human immunodeficiency virus (HIV) patients and compare them with those of HIV patients with other opportunistic diseases.Methods  Retrospective study of HIV patients comparing the clinical and laboratory data of patients with and without DH. Univariate and multivariate analyses were performed to verify the risk factors related to DH.Results  In total, 378 HIV patients were included, 164 with DH and 214 with other opportunistic diseases. Acute renal failure, respiratory insufficiency and septic shock were more frequent in DH patients, who also had a higher mortality (32%vs. 14%, P < 0.001). Independent risk factors for DH were: acute renal failure [odds ratio (OR) 5.2; 95% confidence interval (CI) 3.2–8.5; P < 0.001], splenomegaly (OR 3.4; 95% CI 1.19–9.9; P < 0.001), respiratory insufficiency (OR 2.7 95% CI 1.5–5.0; P < 0.001), proteinuria (OR 2.7; 95% CI 1.3–5.2; P = 0.03), hypotension (OR 2.5; 95% CI 1.2–5.0; P = 0.008), hepatomegaly (OR 2.4; 95% CI 1.2–4.8; P = 0.01), cutaneous lesions (OR, 1.9; 95% CI 1.0–3.3; P = 0.02) and weight loss (OR 1.8; 95% CI 1.0–3.1; P = 0.03).Conclusion  Our results suggest that DH is a severe opportunistic disease with high mortality rate, which should be promptly recognized in order to provide early specific treatment.
Economic burden of malaria in rural Tanzania: variations by socioeconomic status and season
Authors: Somi Masha F. , Butler James R. G. , Vahid Farshid , Njau Joseph D. , Kachur S. Patrick , Abdulla Salim 
Published: August 2010

SummaryObjective  To determine the economic burden of malaria in a rural Tanzanian setting and identify any differences by socioeconomic status and season.Methods  Interviews of 557 households in south eastern Tanzania between May and December 2004, on consumption and malaria‐related costs.Results  Malaria‐related expenses were significantly higher in the dry, non‐malarious season than in the rainy season. Households sought treatment more frequently and from more expensive service providers in the dry season, when they have more money. Malaria expenses did not vary significantly across socioeconomic status quintiles, but poorer households spent a higher proportion of their consumption in both seasons.Conclusion  Poorer households bear a greater economic burden from malaria relative to their consumption than better‐off households. Households are particularly vulnerable to malaria in the rainy season, when malaria prevalence is highest but liquidity is lower. Alternative strategies to assist households to cope with seasonal liquidity issues, including insurance, should be investigated.
Individual and village‐level study of water contact patterns and Schistosoma japonicum infection in mountainous rural China
Authors: Seto Edmund Y. W. , Lee Yu J. , Liang Song , Zhong Bo 
Published: August 2010

SummaryObjective  To describe the exposure patterns related to schistosomiasis transmission in 10 villages in rural Xichang County, Sichuan, China.Methods  Individual and village‐level study of water contact exposure and Schistosoma japonicum reinfection; after initial infection survey and treatment, reinfection was determined 2 years later for 1604 individuals, of whom 578 also participated in a cross‐sectional survey to assess their water contact behaviours.Results  The highest intensity of reinfection was observed in farmers aged 20–29 years, with no difference between sexes. While water contact measured as m2‐minutes of contact was not associated with reinfection, an exposure metric computed by spatially weighting water contact by cercarial risk was correlated with both infection status and intensity. Village‐level indicators based on snail density, number of infected snails, mouse bioassay data, and averaged individual‐level exposures were associated with village reinfection rates.Conclusion  Age‐acquired immunity may be present in this population, but the study lacked sufficient power to discern differences in the exposure infection relationship with age.
Therapeutic efficacy of sulfadoxine–pyrimethamine and the prevalence of molecular markers of resistance in under 5‐year olds in Brazzaville, Congo
Authors: Ndounga Mathieu , Tahar Rachida , Basco Leonardo K. , Casimiro Prisca N. , Malonga David A. , Ntoumi Francine 
Published: August 2010

SummaryObjective  To test the efficacy of sulfadoxine–pyremethamine (SP) monotherapy and establish the prevalence of mutations in dhfr and dhps in Brazzaville, Congo.Method  We recruited 97 patients aged 6–59 months with uncomplicated malaria who attended Tenrikyo public health centre. Eighty‐three were followed until day 28. SP efficacy was determined by the WHO 28‐day test and analysis of mutations in the Plasmodium falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes.Results  There were seven (8.4%) early treatment failures, 23 late treatment failures (27.7%), nine (10.8%) late parasitological failures and 44 (53%) adequate clinical and parasitological responses (ACPR). After polymerase chain reaction (PCR) analysis of 64 available samples, the corrected results there were 44 (68.8%) ACPR and 19 recrudescent cases (31.2%). Approximately, 97.5% of samples bore the Asn51Ile mutation, 66.2% the Cys59Arg mutation and 98.8% the Ser108Asn mutation. Mutations of dhps at positions 437 (Ala–Gly) and 436 (Ser–Ala) were found in 85% and 12.5% of samples. Quadruple mutations (pfdhfr triple mutations in codons 51, 59 and 108+ pfdhps mutation in 437) were found in 42 samples (52.5%) and associated with treatment failures.Conclusion  This high level of treatment failures and mutations in both genes calls for the urgent application of the new policy for malaria treatment to delay the spread of SP resistance.
Assessing the organisational costs of HIV/AIDS on NGOs in Malawi: results from a pilot study
Authors: James Rick , Wright‐Revolledo Katie , Katundu Brenda 
Published: August 2010

SummaryObjectives  To assess the social and economic costs of HIV/AIDS infection on the organisational capacities of selected non‐government organisations (NGOs) in Malawi.Methods  Sixteen semi‐structured interviews with senior staff of four NGOs to estimate the costs paid by the NGO and the loss of management and staff time over the last 12 months because of HIV/AIDS, plus questionnaires filled in by 48 NGO leaders.Results  Labour costs were an estimated 12.5% higher because of HIV/AIDS, corresponding to a 3% increase in overall budget costs. There was also an estimated 12.4% loss of staff time to address HIV‐related issues such as funerals, sickness and management time.Conclusions  The organisational costs of HIV/AIDS on NGOs in Malawi may be considerable and more serious than perceived by NGOs, who must develop a workplace response. It also has policy implications for donors, who may need to adjust their funding strategies.
Assessing unmet obstetric need in Mtwara Region, Tanzania
Authors: Hunger C. , Külker R. , Kitundu H. , Massawe S. , Jahn A. 
Published: August 2010

SummaryObjective  To evaluate maternity care, the feasibility of collecting the relevant data from hospital records, and to assess the usefulness for district health planning in the Mtwara Region, Tanzania.Method  A prospective study running over 2 years using the unmet obstetric need concept in all four hospitals in the region, covering all women undergoing major obstetric interventions. Data on indications, interventions, and pregnancy outcome were collected. Rates of major obstetric interventions performed for absolute maternal indications among all expected births in the study area were calculated to assess met and unmet need.Results  Of 2404 interventions, 91% were caesarean sections, most commonly indicated by cephalo‐pelvic disproportion (46%). The rate of major obstetric intervention for absolute maternal indications per 100 expected births was 1.8% overall with wide rural–urban disparities (1.4% vs. 3.3%). Based on the estimated need of at least 2% of births requiring of a major obstetric intervention, seven of 20 divisions reached or surpassed this threshold, seven had a level between 1% and 2% and six did not reach 1%. Data were collected as part of the regular activities of the health staff, but external resources were needed for data management and analysis.Conclusion  We found a major unmet obstetric need in rural areas with a clear trend towards fewer interventions with longer distance from a hospital. Geographical mapping of the met obstetric need provided a detailed picture of deficiencies in the provision of maternity care and could be useful for priority setting and monitoring.
Viewpoint: Adapting to new international tuberculosis treatment standards with medication monitors and DOT given selectively
Authors: Moulding Thomas S. 
Published: August 2010

SummaryNew international standards no longer require directly observed therapy for all tuberculosis (TB) patients, but state that practitioners must be capable of assessing adherence and addressing poor adherence. Mass‐produced electronic medication monitors, which record removal of medication from a container, could help overcome the problem of assessing treatment adherence accurately even in poor countries. Both health facilities and community workers could dispense drugs for self‐administered treatment in medication monitors and retrieve the adherence record with inexpensive built‐in displays. These devices could keep the adherence record from the beginning of therapy for managing patients who move. Pharmacists using medication monitors could provide surveillance of self‐administered treatment prescribed by private physicians with less adherent patients referred to the health departments. Less adherent patients could be managed with focused counselling, directly observed therapy when necessary, and extensions in treatment duration. Removal of the directly observed therapy burden would encourage patients to seek free high‐quality supervised pubic care and help expand effective TB treatment services. If resources saved by giving less directly observed therapy were focused on poorly adherent patients, medication monitor‐based programmes could create less acquired drug resistance than overwhelmed treatment programmes that attempt but fail to give uninterrupted directly observed therapy to all patients.
Comparison of the therapeutic efficacy of chloroquine and sulphadoxine‐pyremethamine in children and pregnant women
Authors: Tagbor Harry , Bruce Jane , Ord Rosalynn , Randall Anna , Browne Edmund , Greenwood Brian , Chandramohan Daniel 
Published: August 2010

SummaryObjective  To compare the parasitological failure rates of under‐fives and pregnant women with parasitaemia treated with chloroquine (CQ) or sulphadoxine‐pyrimethamine (SP).Methods  During a clinical trial of CQ, SP, amodiaquine (AQ) and SP plus AQ combination for malaria treatment in pregnant women in Ghana, a parallel study of treatment of children below 5 years of age with symptomatic malaria with CQ and SP was undertaken. Four hundred and fifty pregnant women with malaria parasitaemia and 203 children with malaria parasitaemia were randomized to receive CQ or SP. They were followed up and parasitological failure by days 14 and 28 after the start of treatment was assessed.Results  Polymerase chain reaction (PCR)‐uncorrected parasitological failure rates by day 28 after the start of treatment with CQ were 58.5% (55/94), 38.5% (45/117), 31% (13/42) and 8.2% (4/49) in children, primigravidae, secundigravidae and multigravidae, respectively. For those treated with SP the rates by day 28 were 36.4% (32/88), 27.1% (29/107), 6.1% (3/49) and 3.8% (2/52) in children, primigravidae, secundigravidae and multigravidae, respectively. In both CQ and SP treatment arms, children were twice as likely to experience recrudescence as pregnant women (RR 2.1 [95% CI 1.6–2.6] P < 0.0001) by day 28 after the start of treatment.Conclusions  Parasitological failure rates were significantly lower in asymptomatic pregnant women, particularly in multigravidae, compared with symptomatic children. Reliance on drug sensitivity results observed in children only to decide on antimalarial regimes for pregnant women may not be appropriate.