Search

Background: The first few years of life is the most crucial period of life as this age is known for accelerated growth and development. Various studies in India have shown that respiratory and gastrointestinal tract infections are the leading cause of morbidity in infants. These infectious diseases are affected by several sociodemographic factors such as birth weight, gestational age, birth order, immunization status, day care attendance and socio-economic status of the family.Methods: A cross sectional study was conducted in the urban field practice area of department of community medicine MRMC, Kalaburagi from June 2016-October 2016. House to house survey using pre-structured and pretested questionnaire method was done.Results: Out of 104 infants in the present study it was found that majority 53% were females and 49% were males. Majority 61.5% of the infants belonged to low socioeconomic class and majority 54.8% of them were from nuclear families, most 62.5% of the infants had 1-2 siblings in the family and 34.6% had no siblings, 51% of the mothers were illiterate and majority 54.8% of the fathers were literate. Among all the morbidities majority 36.50% had fever. No significant association was found between various social factors.Conclusions: Though no significant association was found between morbidity and socio-demographic factors, but the socio demographic factors which showed more prevalence of morbidity among infants were females, number of siblings in the family and lower socio economic class. As these infants are the future citizens of the country hence their health should be the utmost priority for us and their health needs should be properly addressed.

The nonlinear optical properties of a plasma due to the relativistic electron motion in an intense laser field are of fundamental importance for current research and the generation of brilliant laser-driven sources of particles and photons1-15. Yet, one of the most interesting regimes, where the frequency of the laser becomes resonant with the plasma, has remained experimentally hard to access. We overcome this limitation by utilizing ultrathin carbon nanotube foam16 (CNF) targets allowing the strong relativistic nonlinearities at near- critical density (NCD) to be exploited for the first time. We report on the experimental realization of relativistic plasma optics to spatio-temporally compress the laser pulse within a few micrometers of propagation, while maintaining about half its energy. We also apply the enhanced laser pulses to substantially improve the properties of an ion bunch accelerated from a secondary target. Our results provide first insights into the rich physics of NCD plasmas and the opportunities waiting to be harvested for applications., Comment: 11 pages+5 pages (supplementary information), 4 figures+ 2 figures (supplementary information)

Relativistic electrons are prodigious sources of photons. Beyond classical accelerators, ultra-intense laser interactions are of particular interest as they allow the coherent motion of relativistic electrons to be controlled and exploited as sources of radiation. Under extreme laser conditions theory predicts that isolated free relativistic electron sheets (FRES) can be produced and exploited for the production of a new class of radiation - unipolar extreme ultraviolet(XUV) pulses. However, the combination of extremely rapid rise-time and highest peak intensity in these simulations is still beyond current laser technology. We demonstrate a route to isolated FRES with existing lasers by exploiting relativistic transparency to produce an ultra-intense pulse with a steep rise time. When such an FRES interacts with a second, oblique target foil the electron sheet is rapidly accelerated ('kicked'). The radiation signature and simulations demonstrate that a single, nanometer thick FRES was produced. The experimental observations together with our theoretical modeling suggest the production of the first unipolar (half-cycle) pulse in the XUV - an achievement that has so far only been realized in the terahertz spectral domain., Comment: 10 pages, 3 figures

Contains fulltext : 81616.pdf (Publisher’s version ) (Open Access) BACKGROUND: A Phase Ia trial in European volunteers of the candidate vaccine merozoite surface protein 3 (MSP3), a Plasmodium falciparum blood stage membrane, showed that it induces biologically active antibodies able to achieve parasite killing in vitro, while a phase Ib trial in semi-immune adult volunteers in Burkina Faso confirmed that the vaccine was safe. The aim of this study was to assess the safety and immunogenicity of this vaccine candidate in children aged 12-24 months living in malaria endemic area of Burkina Faso. METHODS: The study was a double-blind, randomized, controlled, dose escalation phase Ib trial, designed to assess the safety, reactogenicity and immunogenicity of three doses of either 15 or 30 microg of MSP3-LSP adsorbed on aluminum hydroxide in 45 children 12 to 24 months of age randomized into three equal groups. Each group received 3 vaccine doses (on days 0, 28 and 56) of either 15 microg of MSP3-LSP, 30 microg of MSP3-LSP or of the Engerix B hepatitis B vaccine. Children were visited at home daily for the 6 days following each vaccination to solicit symptoms which might be related to vaccination. Serious adverse events occurring during the study period (1 year) were recorded. Antibody responses to MSP3-LSP were measured on days 0, 28, 56 and 84. RESULTS: All 45 enrolled children received three MSP3 vaccine doses. No serious adverse events were reported. Most of the adverse events reported were mild to moderate in severity. The only reported local symptoms with grade 3 severity were swelling and induration, with an apparently dose related response. All grade 3 adverse events resolved without any sequelae. Both MSP3 doses regimens were able to elicit high levels of anti-MSP3 specific IgG1 and IgG3 antibodies in the volunteers with very little or no increase in IgG2, IgG4 and IgM classes: i.e. vaccination induced predominantly the isotypes involved in the monocyte-dependent mechanism of P. falciparum parasite-killing. CONCLUSION: Our results support the promise of MSP3-LSP as a malaria vaccine candidate, both in terms of tolerability and of immunogenicity. Further assessment of the efficacy of this vaccine is recommended. TRIAL REGISTRATION: ClinicalTrials.gov NCT00452088.

To assess the possible impact of insecticide treated curtains (ITC) on the composition of a Plasmodium falciparum population in a rural area of Burkina Faso, blood samples were collected during the rainy season of 1997 from 226 children aged 3-6 years, from 4 villages equipped with ITC and 2 control villages without ITC. The analysis of fragment lengths of 3 highly polymorphic P. falciparum genes (msp-1, msp-2 and glurp) revealed a maximum number of 3 alleles per infected person for each gene. The mean number of clones per infected person was similar in villages with and without ITC.

OBJECTIVES: To determine whether a large, 3-year hygiene promotion programme in Bobo-Dioulasso, Burkina Faso, was effective in changing behaviours associated with the spread of diarrhoeal diseases. The programme was tailored to local customs, targeted specific types of behaviour, built on existing motivation for hygiene, and used locally appropriate channels of communication. METHODS: Two population surveys recorded the coverage of the programme among target audiences (mothers of children aged 0-35 months). Four surveys were carried out: three prior to the programme and one in 1998 (after the programme had been running for 3 years), using structured observation of hygiene behaviours in the participants' homes to document changes in target behaviours. FINDINGS: After the programme had run for 3 years, three-quarters of the mothers targeted had had contact with programme activities. Half could cite the two main messages of the programme correctly. Although the safe disposal of children's stools changed little between 1995 and 1998 (80% pre-intervention, 84% post-intervention), hand-washing with soap after cleaning a child's bottom rose from 13% to 31%. The proportion of mothers who washed their hands with soap after using the latrine increased from 1% to 17%. CONCLUSION: Hygiene promotion programmes can change behaviour and are more likely to be effective if they are built on local research and use locally appropriate channels of communication repeatedly and for an extended time.

Članak daje pregled teoretskih i praktičnih pristupa postavljanju prioriteta prilikom ulaganja u istraživanje dječjega globalnog zdravlja. Daje i pregled prijašnjih pokušaja razvitka odgovarajućih alata i postupaka u području ulaganja u istraživanja o zdravlju. Napravljen je kratak pregled najvažnijih teoretskih postavki prema kojima bi se trebalo ravnati u postupku određivanja prioriteta. On je pokazao da će se različiti pristupi u postavljanju prioriteta, poput medicinskoga, gospodarskoga, zakonskoga, etičkoga, društvenoga, političkoga, pragmatičnoga, filozofskoga, onoga od poslodavaca i svih drugih nužno sukobiti. Posebno smo raspravili aktualne pravce istraživanja u području globalnoga dječjega zdravlja i njihov odnos prema Milenijskom cilju br. 4 organizacije Ujedinjenih naroda (UN), koji je da se između 1990. i 2015. dječja smrtnost smanji za dvije trećine. Procijenjena su postignuća pristupa koji su bili ranije primjenjivani i prikazane njihove prednosti i mane. Navedeni su razlozi organizacije Inicijativa za dječje zdravlje i prehranu (engl., Child Health and Nutrition Research Initiative) za stvaranje nove metodologije određivanja prioriteta u ulaganju u zdravstvena istraživanja i navedeni su razlozi za njezinu primjenu u području globalnoga dječjega zdravlja. Da bi se mogli obuhvatiti svi kutovi iz kojih je moguće promatrati prioritete ulaganja u istraživanja zdravlja nuždan je interdisciplinarni pristup. Određivanje prioriteta traži da njihovo stvaranje bude javno, jasno i sustavno i da u obzir uzme mnogobrojna gledišta i nastavi se na prednosti prethodnih pristupa., This article reviews theoretical and practical approaches to priority setting in global child health research investments. It also provides an overview of previous attempts to develop appropriate tools and methodologies to define priorities in health research investments. A brief review of the most important theoretical concepts that should govern priority setting processes is undertaken, showing how different perspectives, such as medical, economical, legal, ethical, social, political, rational, philosophical, stakeholder driven, and others will necessarily conflict each other in determining priorities. We specially address present research agenda in glob

Globally 1.3 billion people are at risk of cholera in endemic countries, where nearly 3 million cases occur annually, of which 3 % are fatal. The burden is highest in South-Asia and Sub-Saharan Africa, where diarrhoeal diseases in general are also a leading cause of mortality and morbidity, especially for children under 5. Uvira, the second largest city of South-Kivu province in the eastern part of the Democratic Re-public of the Congo, has been affected by cholera since it reached the region in the late 1970s. Suspected cholera cases have been reported nearly every week since 2004 by the Uvira cholera treatment centre (CTC). This thesis first shows that about 40% of the patients admitted to the CTC test positive for cholera with rapid diagnostic tests, and that infections with other common enteric pathogens are highly prevalent. Two surveys of water-related practices in more than 500 households indicate that tap water is sometimes used by nearly 80% of households for drinking purposes but only systematically by less than 50%, whilst surface water is the main source of domestic water for nearly 40% of households. Tap water access is a predictor of the quality and quantity of domestic water used in households. Time-series regression reveals a 2.5-fold increase in CTC admissions within the 12 days following a 24h interruption in tap water supply. Finally, a multivariable time-series model high-lights the influence of tap water supply variability in time and space on suspected chol-era incidence, especially that attributed to epidemic transmission. By demonstrating the influence of coverage disparities and intermittency of the current tap water supply network on households’ water-related practices and suspected cholera incidence in Uvira, this research establishes a solid base for a much-needed impact evaluation of on-going improvements on suspected cholera in an endemic area.

Background: Diarrhoeal diseases are an important cause of morbidity and mortality in children under five years old in South Asia and Sub-Saharan Africa. Handwashing with soap after contact with faeces is a cost-effective way of preventing diarrhoea. However, handwashing with soap frequencies are low in many settings. Aim: The study aimed to design and evaluate two interventions to increase handwashing with soap after using the toilet, in housing compounds in Koumassi commune, Abidjan, Côte d’Ivoire. Methods: We randomly assigned 75 compounds to one of three arms in a 1:1:1 ratio. One arm received an intervention package comprising disgust-inducing handwashing messages, designed using the Theory of Normative Social Behaviour, and a handwashing station (TNSB); the second arm received only the handwashing station (HWS-only); the third arm served as a control group. The primary outcome was the proportion of occasions when hands were washed with soap after using the toilet, measured at the one-month and five-month post-intervention delivery. Results: One month post intervention, handwashing with soap somewhat increased from a baseline frequency of 3% to 9% in the HWS-only intervention group, and from 7% to 24% in the TNSB-based handwashing intervention group. In the control group, handwashing with soap changed little (from 6% at baseline to 5%). There was strong evidence (P

Summary Background Low birthweight (LBW) of less than 2500 g is an important marker of maternal and fetal health, predicting mortality, stunting, and adult-onset chronic conditions. Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025. Estimates to track progress towards this target are lacking; with this analysis, we aim to assist in setting a baseline against which to assess progress towards the achievement of the World Health Assembly targets. Methods We sought to identify all available LBW input data for livebirths for the years 2000–16. We considered population-based national or nationally representative datasets for inclusion if they contained information on birthweight or LBW prevalence for livebirths. A new method for survey adjustment was developed and used. For 57 countries with higher quality time-series data, we smoothed country-reported trends in birthweight data by use of B-spline regression. For all other countries, we estimated LBW prevalence and trends by use of a restricted maximum likelihood approach with country-level random effects. Uncertainty ranges were obtained through bootstrapping. Results were summed at the regional and worldwide level. Findings We collated 1447 country-years of birthweight data (281 million births) for 148 countries of 195 UN member states (47 countries had no data meeting inclusion criteria). The estimated worldwide LBW prevalence in 2015 was 14·6% (uncertainty range [UR] 12·4–17·1) compared with 17·5% (14·1–21·3) in 2000 (average annual reduction rate [AARR] 1·23%). In 2015, an estimated 20·5 million (UR 17·4–24·0 million) livebirths were LBW, 91% from low-and-middle income countries, mainly southern Asia (48%) and sub-Saharan Africa (24%). Interpretation Although these estimates suggest some progress in reducing LBW between 2000 and 2015, achieving the 2·74% AARR required between 2012 and 2025 to meet the global nutrition target will require more than doubling progress, involving both improved measurement and programme investments to address the causes of LBW throughout the lifecycle. Funding Bill & Melinda Gates Foundation, The Children's Investment Fund Foundation, United Nations Children's Fund (UNICEF), and WHO.

Skilled attendance at delivery is crucial for decreasing maternal and neonatal\ud mortality. My literature review showed that epidemiological research on factors\ud influencing whether women receive skilled attendance has so far been\ud hampered by a lack of data on health service availability, and is often restricted\ud to investigating household and individual factors. Distance to health services,\ud however, is likely to play an important role.\ud The availability of geographic coordinates in both national household survey,\ud population census and health facility census in Zambia provides the opportunity\ud to combine user and provider information on a large scale. These datasets were\ud linked to investigate the influence that distance has on place of delivery, while\ud adjusting for other influential factors such as education, wealth and autonomy in\ud a multilevel model.\ud Classifying Zambian health facilities according to their level of delivery care\ud showed that 88% of facilities are not staffed or equipped to provide even Basic\ud Emergency Obstetric Care (EmOC) and therefore cannot save a mother's life in\ud case of complications. Around half of the Zambian population lives further than\ud 15km from a Basic EmOC facility; less than 10% in urban areas and over 70%\ud in rural areas.\ud Using data from over 3000 rural births, I demonstrate that the odds of delivering\ud in a facility are 4 times higher within 1km of a facility as compared to 20km, and\ud additionally 2.5 times higher if that facility offers Comprehensive EmOC rather\ud than substandard care. If all mothers lived within 5km of Basic EmOC, 16% of\ud home deliveries could be avoided, a population attributable fraction of similar\ud magnitude as for education or wealth.\ud Lack of geographical access to EmOC is a key factor explaining why most rural\ud deliveries in Zambia still occur at home without skilled care; this needs to be\ud addressed to lower maternal and neonatal mortality.