Search

Interpretation: For these rural women, whose lives depend heavily on their reproductive function, reproductive-organ disease is a large burden. In inadequately resourced rural areas, with poor education, heavy agricultural and domestic labour, and limited access to quality health care, many women are not able to attain and maintain reproductive health and wellbeing. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the maternal and child mortality in Bamyan, Afghanistan focusing on the effort conducted by the government to promote health developments despite threats of terrorism and poverty.

Offers the author's experience with mistakes made in clinical practice in rural Africa. Details of how maternal deaths from relapsing fever caused by Borrelia duttoni was prevented; Suggestion of the author that most mistakes result from not listening properly.

Presents a letter to the editor about the use of the WHO partograph to differentiate between normal and abnormal labor.

Assesses the effect of fly control on public health in Gambian villages. How flies are thought to be vectors for diseases and illnesses; Study tracking rates of diarrhea and trachoma; Background; Methods; Findings; Interpretation.

The article presents a study which examines the effect of bolus-dose vitamin D supplementation on the incidence of pneumonia in children in Kabul, Afghanistan. The study conducts a randomised placebo-controlled trial and compares the difference between the incidence of pneumonia in children administered with oral vitamin D3 supplements and those with placebo. It is found out that vitamin D supplementation fails to reduce the incidence of childhood pneumonia.

SummaryBackground: Resistance to cheap effective antimalarial drugs, especially to pyrimethamine-sulphadoxine (Fansidar), is likely to have a striking impact on childhood mortality in sub-Sharan Africa. The use of artesunate (sodium artesunate) in combination with pyrimethamine-sulphadoxine may delay or prevent resistance. We investigated the efficacy, safety, and tolerability of this combined treatment.Methods: We did a double-blind, randomised, placebo-controlled trial in The Gambia. 600 children with acute uncomplicated Plasmodium falciparum malaria, aged 6 months to 10 years, at five health centres were randomly assigned pyrimethamine-sulphadoxine (25 mg/500 mg) with placebo; pyrimethamine-sulphadoxine plus one dose of artesunate (4mg/kg bodyweight); or pyrimethamine-sulphadoxine plus one dose 4 mg/kg bodyweight artesunate daily for 3 days. Children were visited at home each day after the start of treatment until parasitaemia had cleared.Findings: The combined treatment was well tolerated. No adverse reactions attributable to treatment were recorded. By day 1, only 178 (47%) of 381 children treated with artesunate were still parasitaemic, compared with 157 (81%) of 195 children in the pyrimethamine-sulphadoxine alone group (relative risk 1.7 [95% CI 1.5-2.0], p<0.001). Treatment-failure rates at day 14 were 3.1% in the pyrimethamine-sulphadoxine alone group, and 3.7% in the one-dose artesunate group (risk difference -0.6% [-4.2 to 3.0]) and 1.6% in the three-dose group (1.5 [1.5-4.5], p=0.048). Symptoms resolved faster in children who received artesunate, but there was no additional benefit for three doses of artesunate over one dose. Children given artesunate were less likely to be gametocytaemic after treatment.Interpretation: The combined treatment was safe, well tolerated, and effective. The addition of artesunate to malaria treatment regimens in Africa results in lower gametocyte rates and may lower transmission rates. [ABSTRACT FROM AUTHOR]

Reports on the results of a study to determine the effect of pregnancy on exposure to malaria mosquitoes done on pregnant and non-pregnant women in rural Gambia in Africa. Background information; Methods; Findings; Conclusion.

Reports on the improvements in childhood mortality in Gambia. Trends observed by studying the demographic surveillance data from the United Kingdom Medical Research Council; Impact of the government's Expanded Programme on Immunisation; Contribution of village-based primary health care.