Abstract:
:Acute respiratory infections (ARI) are a leading cause of childhood morbidity and mortality in Pakistan. The National ARI Control Programme was launched in 1989 in order to reduce the mortality attributed to pneumonia, and rationalize the use of drugs in the management of patients with ARI. WHO's standard ARI case management guidelines were adopted to achieve these objectives. The medical staff at the Children's Hospital, Islamabad, were trained in such management in early 1990; further training sessions were conducted when new staff arrived. Data on outpatients were obtained from special ARI abstract registers, which have been maintained in the outpatient department since January 1990. Details on inpatients who were admitted with ARI were obtained from hospital registers. During the period 1989-92, the use of antibiotics in the outpatient department decreased from 54.6% to 22.9% (P < 0.0001). The case fatality rate (CFR) in children admitted with ARI fell from 9.9% to 4.9% (P < 0.0001), while the overall case fatality rate fell from 8.7% to 6.2%. Our results from a tertiary health care facility show that standard ARI case management reduced both antibiotic use and expenditure on drugs. Although the ARI case management criteria, which are more sensitive than the conventional diagnostic criteria of auscultation and radiography, led to more admissions, we believe that this strategy contributed to a significant reduction in the ARI case fatality rate. :Acute respiratory infection (ARI) is the leading cause of death among children in Pakistan. The Government's National ARI Control Program seeks to reduce pneumonia-related mortality in children under 5 years, standardize clinical assessment, and rationalize the use of drugs in case management. To assess the impact of this protocol on ARI case fatalities and antibiotic use, the registries of ARI patients presenting to Children's Hospital in Islamabad in 1989-92 were reviewed. Staff training in ARI case management was initiated in 1990. ARI admissions more than doubled from 776 in 1989 to 1673 in 1992. Many children admitted in 1990-92 would not have been admitted if the 1989 criteria, based on clinical auscultation and radiologic diagnosis, had been followed. Use of antibiotics decreased significantly from 54.6% of ARI outpatient cases in 1989 to 30.2% in 1992 as a result of no longer providing medication to children with viral ARI. The case fatality rate for all hospital admissions decreased by 28% during the study period (from 8.7% in 1989 to 6.2% in 1992), while that for ARI decreased by 50.5% (from 9.9% to 4.9%). The elimination of inappropriate antibiotic therapy associated with this protocol has the potential to save RS 39.8 million (US$1.2 million) from Pakistan's public health budget each year as well as to reduce both ARI and overall child mortality.
journal_name
Bull World Health Organjournal_title
Bulletin of the World Health Organizationauthors
Qazi SA,Rehman GN,Khan MAsubject
Has Abstractpub_date
1996-01-01 00:00:00pages
501-7issue
5eissn
0042-9686issn
1564-0604journal_volume
74pub_type
杂志文章abstract::Paula Radcliffe tells Gary Humphreys about her journey from athlete to clean air advocate and her hopes for a clean air initiative launched by the International Association of Athletics Federation. ...
journal_title:Bulletin of the World Health Organization
pub_type: 面试,新闻
doi:10.2471/BLT.19.030319
更新日期:2019-03-01 00:00:00
abstract::To determine whether there are major differences in the distribution of Streptococcus pyogenes serotypes in different countries and to compare the typing results obtained in different laboratories with the same cultures, an international survey of the distribution of such serotypes was carried out in 1964-65 in 12 lab...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1967-01-01 00:00:00
abstract::In this review of published findings on human immunodeficiency virus (HIV) infection and risk factors among female sex workers, we summarize the results of seroprevalence studies in different countries and discuss the different patterns of transmission among such workers in various geographical regions. The highest ra...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:
更新日期:1993-01-01 00:00:00
abstract::This paper summarizes recent thinking on stimulating industrial research and development (R&D) for neglected infectious diseases and argues that it is critical to enlarge the value of the market for medicines and vaccines through, for example, global purchase funds. The most important economic barriers to R&D are that...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::Low back pain is the leading cause of years lived with disability globally. In 2018, an international working group called on the World Health Organization to increase attention on the burden of low back pain and the need to avoid excessively medical solutions. Indeed, major international clinical guidelines now recog...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.18.226050
更新日期:2019-06-01 00:00:00
abstract::In comparison with other rodents, the mastomys is unique as regards the patterns of neoplastic and non-neoplastic diseases that it develops, some of which may constitute suitable animal models for corresponding diseases of man. Among the spontaneous diseases commonly encountered in necropsies of 600 mastomys maintaine...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Some recent physiological observations made in Afghanistan, Ceylon and Burma on adults of Anopheles culicifacies and A. aconitus are described. The specimens from Ceylon and Burma, in particular, showed a peculiar physiological process in which, at the beginning of the dry season, the coagulated, dark red, and almost ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1958-01-01 00:00:00
abstract::An influenzavirus of swine origin (swine/Taiwan/7310/70) antigenically closely related to the human A/Hong Kong/68 virus readily infected human volunteers. Those infected developed antihaemagglutinin and antineuraminidase antibodies to the human A/Hong Kong/68 virus as well as to the swine/Taiwan virus. The clinical r...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1972-01-01 00:00:00
abstract:OBJECTIVE:To develop a Bayesian hierarchical model for human onchocerciasis with which to explore the factors that influence prevalence of microfilariae in the Amazonian focus of onchocerciasis and predict the probability of any community being at least mesoendemic (>20% prevalence of microfilariae), and thus in need o...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To examine if economic development in China correlates with physical growth among Chinese children and adolescents. METHODS:The height, body weight and physical activity level of children and adolescents aged 18 years and under, as well as dietary data, were obtained from seven large surveys conducted in Chi...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.13.126243
更新日期:2014-08-01 00:00:00
abstract::A test for monkeypox-specific antibodies is described. Monkeypox immune sera can be made type-specific by immunoabsorption with heterotypic poxvirus extracts. Monkeypox-specific antibodies were demonstrated in sera from 9 cynomolgus monkeys (Macaca fascicularis) that had previously been experimentally infected with mo...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To estimate the burden of road traffic injuries and deaths for all road users and among different road user groups in Africa. METHODS:We searched MEDLINE, EMBASE, Global Health, Google Scholar, websites of African road safety agencies and organizations for registry- and population-based studies and reports o...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,meta分析,评审
doi:10.2471/BLT.15.163121
更新日期:2016-07-01 00:00:00
abstract::It is likely that everyone will, at some time, suffer from a problem related to the musculoskeletal system, ranging from a very common problem such as osteoarthritis or back pain to severely disabling limb trauma or rheumatoid arthritis. Many musculoskeletal problems are chronic conditions. The most common symptoms ar...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::An outbreak of spastic paraparesis which mostly affected women and children occurred in a northern province of Mozambique in 1981. The epidemic was related to chronic cyanide intoxication associated with a diet consisting almost exclusively of cassava. A prolonged drought in the area had exhausted all food resources e...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Recent research carried out on kwashiorkor in Kampala, Uganda, is discussed. The first essential in both the treatment and the prevention of this disease being a diet rich in protein (preferably animal protein, to ensure an adequate intake of vitamin B(12) and a satisfactory mixture of amino-acids), methods of incorpo...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1953-01-01 00:00:00
abstract:OBJECTIVE:To determine if higher fertility and lower contraceptive use among the poorer segments of society should be considered an inequality, reflecting a higher desire for large families among the poor, or an inequity, a product of the poor being prevented from achieving their desired fertility to the same degree as...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.06.033829
更新日期:2007-02-01 00:00:00
abstract::Recombinant proteins directed against the circumsporozoite (CS) protein of Plasmodium vivax were tested for safety, immunogenicity, and efficacy in Saimiri sciureus boliviensis monkeys. The monkeys were immunized 3 times with either alum or muramyl tripeptide as adjuvant, and were challenged with 10,000 sporozoites (P...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The clinical manifestations of acute poisoning by organophosphorus compounds in man are in accord with, initially, the stimulation and, later, the blocking of cholinergic transmission due to acetylcholinesterase inhibition. The manifestations involve mainly the para-sympathetic nerves, the neuromuscular junctions, and...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:
更新日期:1971-01-01 00:00:00
abstract::The total cost of the Expanded Programme on Immunization and of its various components in the Gambia over a period of one year (from July 1980 to June 1981) was investigated, and the costs per immunization dose and per fully immunized child were calculated. The total costs were to a large extent (45%) due to the cost ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:PROBLEM:In 2010, dengue virus (DENV) serotype-4 was detected during a dengue outbreak in the Amazonian city of Boa Vista. At that time Brazil was already endemic for DENV-1, DENV-2 and DENV-3. This was the first time DENV-4 was observed in the country after it was initially detected and eliminated in 1981. APPROACH:To...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.13.119081
更新日期:2014-09-01 00:00:00
abstract::Options for health financing reform are often portrayed as a choice between general taxation (known as the Beveridge model) and social health insurance (known as the Bismarck model). Ten years of health financing reform in Kyrgyzstan, since the introduction of its compulsory health insurance fund in 1997, provide an e...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.07.049544
更新日期:2009-07-01 00:00:00
abstract::Smallpox vaccinations were performed in a well-vaccinated prison population by multiple-pressure technique and by intradermal jet injection using serial dilutions of vaccine. A total of 140 subjects were divided into groups, and each group was vaccinated by the multiple-pressure technique or by jet injection using 1 o...
journal_title:Bulletin of the World Health Organization
pub_type: 临床试验,杂志文章
doi:
更新日期:1969-01-01 00:00:00
abstract::The prevalence of ringworm of the scalp in many countries, and the fact that many of the current measures to control it are inconvenient for mass use, lend particular interest to the account given in this paper of mass treatment of tinea capitis in an Arab village in Israel. A total of 446 cases were treated, on an am...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1960-01-01 00:00:00
abstract::The Purchase price report released in August 2004 by the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) was the first publication of a significant amount of real transaction purchase data for antiretrovirals (ARVs). We did an observational study of the ARV transaction data in the Purchase price rep...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.05.025684
更新日期:2006-05-01 00:00:00
abstract::For several years after the First World War calcium oxide was the main compound used in the control of Oncomelania nosophora in Japan. This was generally replaced in 1944 by calcium cyanamide; since 1952 the prefectural authorities in areas of endemic bilharziasis have increasingly turned to the use of sodium pentachl...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1961-01-01 00:00:00
abstract::The respective vectors of the two forms of bilharziasis in Egypt do not have the same ecological distribution. Bulinus truncatus is most abundant in large canals, and decreases in density as the water approaches and flows into drains. Biomphalaria alexandrina is most abundant in drains, and decreases in density upstre...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1966-01-01 00:00:00
abstract::The author describes the design and operation of an automatic molluscicide dispenser for use in flowing water. The equipment, which consists basically of a measuring weir coupled to a float-activated siphon, was designed for simplicity, low cost, construction with commonly available materials, and operation by untrain...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1956-01-01 00:00:00
abstract::The association between oral leukoplakia and possible etiological factors in patients at a Bombay hospital was analysed by a new multivariate computer analysis based on information theory. It was found that the most important etiological factors were bidi smoking and age. The well known sex-leukoplakia relationship wa...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1972-01-01 00:00:00
abstract:PROBLEM:The potential for misidentification of trial participants, leading to misclassification, is a threat to the integrity of randomized controlled trials. The correct identification of study subjects in large trials over prolonged periods is of vital importance to those conducting clinical trials. Currently used me...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.06.031070
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To test whether relations between economic development, economic inequality, and child and youth homicide rates are sex- and age-specific, and whether a country's wealth modifies the impact of economic inequality on homicide rates. METHODS:Outcome variables were homicide rates around 1994 in males and female...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00