Search

Objective To describe tools used for the assessment of maternal and child health issues In humanitarian emergency settings. Methods We systematically searched MEDLINE, Web of Knowledge and POPLINE databases for studies published between January 2000 and June 2014. We also searched the websites of organizations active in humanitarian emergencies. We included studies reporting the development or use of data collection tools concerning the health of women and children In humanitarian emergencies. We used narrative N synthesis to summarize the studies. Findings We identified 100 studies: 80 reported on conflict situations and 20 followed natural disasters. Most studies (76/100) focused on the health status of the affected population while 24 focused on the availability and coverage of health services. Of 17 different data collection tools identified, 14 focused on sexual and reproductive health, nine concerned maternal, newborn and child health and four were used to collect information on sexual or gender-based violence. Sixty-nine studies were done for monitoring and evaluation purposes, 18 for advocacy, seven for operational research and six for needs assessment. Conclusion Practical and effective means of data collection are needed to inform life-saving actions in humanitarian emergencies. There are a wide variety of tools available, not all of which have been used In the field. A simplified, standardized tool should be developed for assessment of health issues in the early stages of humanitarian emergencies. A cluster approach is recommended, in partnership with operational researchers and humanitarian agencies, coordinated by the World Health Organization. Objectif Decrire les outils utlllses pour evaluer les problemes en matlere de sante maternelle et Infantile dans les situations d'urgence humanitaire. Methodes Nous avons recherche de facon systemique, dans les bases de donnees Medline, Web of Knowledge et Popline, les etudes publiees entre janvier 2000 et juin 2014. Nous avons egalement fait des recherches sur les sites Internet dbrganisations intervenant dans les situations d'urgence humanitaire. Nous avons inclus les etudes qui se rapportaient au developpement ou a l'utilisation d'outils de collecte de donnees concernant la sante des femmes et des enfants dans des situations d'urgence humanitaire. Nous avons resume ces etudes par unesynthese narrative. Resultats Nous avons retenu 100 etudes: 80 portaient surdes situations de conflit et 20 faisalent suite a des catastrophes naturelles. La plupart de ces etudes (76/100) s'interessaient a la situation sanltalre des populations affectees tandis que 24 d'entre elles s'interessaient a la disponibllite de services de sante et a leur couverture. Sur 17 outils de collecte de donnees identifies, 14 concernaient la sante sexuelle et genesique, neuf la sante de la mere, du nouveau-ne et de l'enfant, et quatre servalent a recueilllr des informations sur la violence sexuelle ou exercee a l'egard des femmes. Soixante-neuf etudes avaient ete reallsees a des fins de sulvi et devaluation, dlx-huit de sensibilisation, sept pour la recherche operationnelle et six pour evaluer les besoins. Conclusion Des moyens pratiques et efficaces de collecte de donnees sont necessalres pour orlenter les actions permettant de preserver des vies humaines dans les situations d'urgence humanitaire. II existe une grande variete d'outils disponibles, dont tous n'ont pas ete employes sur le terrain. II faudralt developper un outil simplifie et standardise pour evaluer les problemes sanitaires des les premieres phases des urgences humanitaires. II est recommande d'adopter une approche groupee, en partenariat avec les chercheurs operationnels et les agences humanitaires, sous la coordination de l'Organisation mondiale de la Sante. Objetivo Describir las herramientas utilizadas para evaluar los problemas de salud materna e infantil en entornos de emergencias humanitarias. Metodo Se realizaron busquedas sistematicas en las bases de datos de Medline, Web of Knowledge y Popline para encontrar estudios publicados entre enero de 2000 y junio de 2014. Tambien se realizaron busquedas en paginas web de organizaciones activas en emergencias humanitarias. Se incluyeron estudios que informaban sobre el desarrollo o el uso de herramientas de recopilacion de datos relacionadas con la salud de las mujeres y los ninos durante emergencias humanitarias. Se utilizo la sintesis narrativa para resumir los estudios. Resultados Se identificaron 100 estudios: 80 informaban sobre situaciones de conflicto y 20 sobre desastres naturales. La mayoria de los estudios (76/100) se centraban en el estado de la salud de la poblacion afectada, mientras que 24 lo hacian en la disponibilidad y cobertura de los servicios de salud. De las 17 herramientas de recopilacion de datos diferentes identificadas, 14 se centraban en la salud reproductiva y sexual, nueve trataban sobre salud maternal, neonatal e infantil y cuatro se utilizaban para recopilar informacion sobre violencia sexual o basada en el genero. 69 estudios se habian realizado con fines de supervision y evaluacion, 18 para promocion, siete para investigaciones operacionales y seis para la evaluacion de necesidades. Conclusion Se necesitan medios practicos y efectivos de recopilacion de datos para informar de acciones para salvar vidas en emergencias humanitarias. Existe una amplia variedad de herramientas disponibles, y no todas se han utilizado en este campo. Se deberia desarrollar una herramienta simplificada estandar para evaluar los problemas de salud en las primeras etapas de emergencias humanitarias. Se recomienda un enfoque por grupos en cooperacion con investigadores operacionales y agencias humanitarias, coordinados por la Organizacion Mundial de la Salud., Introduction Humanitarian emergencies are natural disasters, man-made events or a combination of both that represent critical threats to the health, safety, security or wellbeing of a community. (1) Humanitarian emergencies [...]

Childhood diarrhoea still claims nearly 2 million lives each year and remains responsible for 18% of all child deaths [1,2]. Regardless of this, research interest in this disease has been [...]

Objective The major objective of this study is to provide estimates of diarrhoea mortality at country, regional and global level by employing the Child Health Epidemiology Reference Group (CHERG) standard. Methods A systematic and comprehensive literature review was undertaken of ali studies published since 1980 reporting under-5 diarrhoea mortality. Information was collected on characteristics of each study and its population. A regression model was used to relate these characteristics to proportional mortality from diarrhoea and to predict its distribution in national populations. Findings Global deaths from diarrhoea of children aged less than 5 years were estimated at 1.87 million (95% confidence interval, CI: 1.56-2.19), approximately 19% of total child deaths. WHO African and South-East Asia Regions combined contain 78% (1.46 million) of ali diarrhoea deaths occurring among children in the developing world; 73% of these deaths are concentrated in just 15 developing countries. Conclusion Planning and evaluation of interventions to control diarrhoea deaths and to reduce under-5 mortality is obstructed by the lack of a system that regularly generates cause-of-death information. The methods used here provide country-level estimates that constitute alternative information for planning in settings without adequate data. Objectif Le principal objectif de cette etude est de fournir des estimations de la mortalite par diarrhee aux niveaux mondial, regional et national, en utilisant la norme du Groupe de reference pour l'epidemiologie de la sante de l'enfant (CHERG). Methodes Une revue systematique et exhaustive de la litterature a ete realisee sur l'ensemble des etudes publiees depuis 1980 et traitant de la mortalite par diarrhee des moins de cinq ans. Des informations ont ete recueillies sur les caracteristiques de chaque etude et de sa population. Un modele par regression a ete utilise pour relier ces caracteristiques a la mortalite proportionnelle par diarrhee et pour predire sa distribution dans les populations nationales. Resultats A l'echelle mondiale, le nombre de deces par diarrhee chez les moins de cinq ans a ete estime a 1,87 million (intervalle de confiance a 95 %, IC : 1,56-2,19), soit approximativement 19 % du nombre total de deces d'enfants. La Region africaine et la Region de l'Asie du Sud-est de l'OMS totalisent 78 % (1,46 millions) des deces par diarrhee se produisant chez les enfants du monde en developpement et 73 % de ces deces se concentrent dans 15 pays en developpement seulement. Conclusion La planification et l'evaluation des interventions pour endiguer la mortalite par diarrhee et pour reduire la mortalite des moins de cinq ans se heurtent a l'absence de systeme generant regulierement des donnees sur les causes de deces. Les methodes utilisees dans cette etude fournissent des estimations nationales, qui constituent des donnees de substitution pour la planification dans les pays ne disposant pas de donnees appropriees. Objetivo El principal objetivo de este estudio fue aportar estimaciones de la mortalidad por diarrea a nivel de pais, regional y mundial aplicando los criterios del Grupo de Referencia en Epidemiologia de la Salud Infantil (CHERG). Metodos Se llevo a cabo una revision sistematica y detallada de la bibliografia para identificar todos los estudios publicados desde 1980 en los que se notificaran cifras de la mortalidad por diarrea entre los menores de cinco anos. Se reunio informacion sobre las caracteristicas de cada estudio y la poblacion estudiada, y seuso un modelo de regresion para relacionar esas caracteristicas con la mortalidad proporcional por diarrea y predecir su distribucion en la poblacion de cada pais. Resultados La mortalidad mundial por diarrea entre la poblacion menor de cinco anos se estimo en 1,87 millones (intervalo de confianza del 95%: 1,56-2,19), lo que supone aproximadamente e119% de la mortalidad total en la ninez. Las regiones de Africa y Asia Sudoriental de la OMS acumulan entre ambas el 78% (1,46 millones) de todas las muertes por diarrea registradas entre los ninos en el mundo en desarrollo; y el 73% de estas defunciones se concentran en solo 15 paises en desarrollo. Conclusion La planificacion y evaluacion de las intervenciones encaminadas a controlar la mortalidad por diarrea y reducir la mortalidad de los menores de cinco aros se ve dificultada por la falta de un sistema que genere informacion sobre las causas de mortalidad de manera regular. Los metodos aqui utilizados aportan estimaciones a nivel de pais a modo de informacion alternativa para las actividades de planificacion en los entornos que carecen de datos suficientes., Introduction The Millennium Development Goals (MDGs) were adopted in 2000 with the aim of reducing the severe gaps between rich and poor populations. Most countries have endorsed Goal 4 of [...]

Childhood pneumonia is the leading single cause of mortality in children aged less than 5 years. The incidence in this age group is estimated to be 0.29 episodes per child-year in developing and 0.05 episodes per child-year in developed countries. This translates into about 156 million new episodes each year worldwide, of which 151 million episodes are in the developing world. Most cases Occur in India (43 million), China (21 million) and Pakistan (10 million), with additional high numbers in Bangladesh, Indonesia and Nigeria(6 million each). Of all community cases, 7-13% are severe enough to be life-threatening and require hospitalization. Substantial evidence revealed that the leading risk factors contributing to pneumonia incidence are lack of exclusive breastfeeding, undernutrition, indoor air pollution, low birth weight, crowding and lack of measles immunization. Pneumonia is responsible for about 19% of all deaths in children aged less than 5 years, of which more than 70% take place in sub-Saharan Africa and south-east Asia. Although based on limited available evidence, recent studies have identified Streptococcus pneumoniae, Haemophilus influenzae and respiratory syncytial virus as the main pathogens associated with childhood pneumonia. La pneumonie est la principale cause simple de mortalite chez les enfants de moins de 5 ans. L'incidence dans cette tranche d'age est estimee a 0,29 episode/enfant/an dans les pays en developpement et a 0,05 episode/enfant/an dans les pays developpes. Il en resulte environ 156 millions de nouveaux episodes de pneumonie chaque annee dans le monde, dont 151 millions dans les pays en developpement. La plupart des cas se produisent en Inde (43 millions), en Chine (21 millions), au Pakistan (10 millions) et egalement en grands nombres au Bengladesh, en Indonesie et au Nigeria (6 million pour chacun de ces pays). Parmi l'ensemble des cas communautaires, 7 a 13 % sont assez graves pour menacer le pronostic vital et necessiter une hospitalisation. De nombreux elements ont fait apparaitre comme facteurs de risque principaux pour l'incidence de la pneumonie l'absence d'allaitement au sein exclusif, la denutrition, la pollution de l'air interieur, le petit poids a la naissance, le surpeuplement et le manque de couverture par la vaccination antirougeoleuse. La pneumonie est responsable d'environ 19 % des deces d'enfants de moins de 5 ans, dont plus de 70 % se produisent en Nrique sub-saharienne et en Asie du Sud-est. Bien que reposant sur les donnees disponibles limitees, les etudes recentes ont identifie Streptococcus pneumonia, Haemophilus influenzae et le virus respiratoire syncytial comme les principaux agents pathogenes associes a la pneumonie de l'enfant. La neumonia es la principal causa Onica de mortalidad entre los menores de cinco anos. Se estima que la incidencia en ese grupo de edad es de 0.29 episodios por nino y ano en los paises en desarrollo y de 0.05 episodios por nino y ano en los paises desarrollados. Ello se traduce en unos 156 millones de episodios nuevos cada ano en todo el mundo, de los cuales 151 millones se registran en el mundo en desarrollo. La mayoria de los casos se dan en la India (43 millones), China (21 millones), el Pakistan (10 millones), y tambien presentan cifras altas Bangladesh, Indonesia y Nigeria (6 millones cada uno). De todos Ios casos comunitarios, un 7%-13% son lo bastante graves para poner en peligro la vida y requerir hospitalizacion. Numerosos datos demuestran que Ios principales factores de riesgo de la incidencia de neumonia son la falta de lactancia materna exclusiva, la desnutricion, la contaminacion del aire en locales cerrados, el bajo peso al nacer, el hacinamiento y la falta de inmunizacion contra el sarampion. La neumonia provoca aproximadamente un 19% de todas las defunciones entre Ios ninos menores de cinco anos, y mas del 70% de esas muertes se producen en el Africa subsahariana y en Asia sudoriental. Aunque la evidencia disponible es aun limitada, estudios recientes senalan a Streptococcus pneumoniae, Haemophilus influenzae y el virus sincitial respiratorio como Ios principales agentes patogenos asociados a la neumonia en la ninez. [TEXT NOT REPRODUCIBLE IN ASCII], Introduction In the early 1970s Cockburn & Assaad (1) generated one of the earliest estimates of the worldwide burden of communicable diseases. In a subsequent review, Bulla & Hitze (2) [...]

Objective Clinical pneumonia (defined as respiratory infections associated with clinical signs of pneumonia, principally pneumonia and bronchiolitis) in children under five years of age is still the leading cause of childhood mortality in the world. In this paper we aim to estimate the worldwide incidence of clinical pneumonia in young children. Methods Our estimate for the developing world is based on an analysis of published data on the incidence of clinical pneumonia from community-based longitudinal studies. Among more than 2000 studies published since 1961, we identified 46 studies that reported the incidence of clinical pneumonia, and 28 of these met pre-defined quality criteria. Findings The estimate of the median incidence from those studies was 0.28 episodes per child-year (e/cy). The 25-75% interquartile range was 0.21-0.71. We assessed the plausibility of this estimate using estimates of global mortality from acute respiratory infections and reported case-fatality rates for all episodes of clinical pneumonia reported in community-based studies or the case-fatality rate reported only for severe cases and estimates of the proportion of severe cases occurring in a defined population of community. Conclusion The overlap between the ranges of the estimates implies that a plausible incidence estimate of clinical pneumonia for developing countries is 0.29 e/cy. This equates to an annual incidence of 150.7 million new cases, 11-20 million (7-13%) of which are severe enough to require hospital admission. In the developed world no comparable data are available. However, large population-based studies report that the incidence of community-acquired pneumonia among children less than five years old is approximately 0.026 e/cy, suggesting that more than 95% of all episodes of clinical pneumonia in young children worldwide occur in developing countries. Keywords Pneumonia/epidemiology/mortality; Bronchiolitis/epidemiology/mortality; Child, Preschool; Incidence; Longitudinal studies; Meta-analysis; Developing countries (source: MeSH, NLM). Mots cles Pneumonie/epidemiologie/mortalite; Bronchiolite/epidemiologie/mortalite; Enfant age pre-scolaire; Incidence; Etude longitudinale; Meta-analyse; Pays en developpement (source: MeSH, INSERM). Palabras clave Neumonia/epidemiologia/mortalidad; Bronquiolitis/epidemiologia/mortalidad; Preescolar; Incidencia; Estudios longitudinales; Meta-analisis; Paises en desarrollo (fuente: DeCS, BIREME)., Resume Estimation de l'incidence mondiale de la pneumopathie clinique chez les enfants de moins de cinq ans Objectif La pneumopathie clinique (definie comme l'ensemble des infections respiratoires associees a des [...]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries yet updated estimates of diarrhea incidence by age for these countries are greatly needed. We conducted a systematic literature review to identify cohort studies that sought to quantify diarrhea incidence among any age group of children 0-59 mo of age. Methods We used the Expectation-Maximization algorithm as a part of a two-stage regression model to handle diverse age data and overall incidence rate variation by study to generate country specific incidence rates for low- and middle-income countries for 1990 and 2010. We then calculated regional incidence rates and uncertainty ranges using the bootstrap method, and estimated the total number of episodes for children 0-59 mo of age in 1990 and 2010. Results We estimate that incidence has declined from 3.4 episodes/child year in 1990 to 2.9 episodes/child year in 2010. As was the case previously, incidence rates are highest among infants 6-11 mo of age; 4.5 episodes/child year in 2010. Among these 139 countries there were nearly 1.9 billion episodes of childhood diarrhea in 1990 and nearly 1.7 billion episodes in 2010. Conclusions Although our results indicate that diarrhea incidence rates may be declining slightly, the total burden on the health of each child due to multiple episodes per year is tremendous and additional funds are needed to improve both prevention and treatment practices in low- and middle-income countries.

Abstract Background The Global Burden of Disease 2000 (GBD 2000) study starts from an analysis of the overall mortality envelope in order to ensure that the cause-specific estimates add to the total all cause mortality by age and sex. For regions where information on the distribution of cancer deaths is not available, a site-specific survival model was developed to estimate the distribution of cancer deaths by site. Methods An age-period-cohort model of cancer survival was developed based on data from the Surveillance, Epidemiology, and End Results (SEER). The model was further adjusted for the level of economic development in each region. Combined with the available incidence data, cancer death distributions were estimated and the model estimates were validated against vital registration data from regions other than the United States. Results Comparison with cancer mortality distribution from vital registration confirmed the validity of this approach. The model also yielded the cancer mortality distribution which is consistent with the estimates based on regional cancer registries. There was a significant variation in relative interval survival across regions, in particular for cancers of bladder, breast, melanoma of the skin, prostate and haematological malignancies. Moderate variations were observed among cancers of colon, rectum, and uterus. Cancers with very poor prognosis such as liver, lung, and pancreas cancers showed very small variations across the regions. Conclusions The survival model presented here offers a new approach to the calculation of the distribution of deaths for areas where mortality data are either scarce or unavailable.

Abstract Background Mortality estimates alone are not sufficient to understand the true magnitude of cancer burden. We present the detailed estimates of mortality and incidence by site as the basis for the future estimation of cancer burden for the Global Burden of Disease 2000 study. Methods Age- and sex- specific mortality envelope for all malignancies by region was derived from the analysis of country life-tables and cause of death. We estimated the site-specific cancer mortality distributions from vital records and cancer survival model. The regional cancer mortality by site is estimated by disaggregating the regional cancer mortality envelope based on the mortality distribution. Estimated incidence-to-mortality rate ratios were used to back calculate the final cancer incidence estimates by site. Results In 2000, cancer accounted for over 7 million deaths (13% of total mortality) and there were more than 10 million new cancer cases world wide in 2000. More than 60% of cancer deaths and approximately half of new cases occurred in developing regions. Lung cancer was the most common cancers in the world, followed by cancers of stomach, liver, colon and rectum, and breast. There was a significant variations in the distribution of site-specific cancer mortality and incidence by region. Conclusions Despite a regional variation, the most common cancers are potentially preventable. Cancer burden estimation by taking into account both mortality and morbidity is an essential step to set research priorities and policy formulation. Also it can used for setting priorities when combined with data on costs of interventions against cancers.

The worst rates of preventable mortality and morbidity among women and children occur in humanitarian settings. Reliable, easy-to-use, standardized, and efficient tools for data collection are needed to enable different organizations to plan and act in the most effective way. In 2015, the World Health Organization (WHO) commissioned a review of tools for data collection on the health of women and children in humanitarian emergencies. An update of this review was conducted to investigate whether the recommendations made were taken forward and to identify newly developed tools. Fifty-three studies and 5 new tools were identified. Only 1 study used 1 of the tools identified in our search. Little has been done in terms of the previous recommendations. Authors may not be aware of the availability of such tools and of the importance of documenting their data using the same methods as other researchers. Currently used tools may not be suitable for use in humanitarian settings or may not include the domains of the authors' interests. The development of standardized instruments should be done with all key workers in the area and could be coordinated by the WHO. [ABSTRACT FROM AUTHOR]

Causes, diagnosis, and treatment methods for diarrheal diseases in children, which can prove to be fatal, are presented.