Abstract:
Objective:To assess the outcomes of children diagnosed with hearing impairment 3 years earlier in terms of referral uptake, treatment received and satisfaction with this treatment, and social participation. Methods:We conducted a population-based longitudinal analysis of children with a hearing impairment in two rural districts of Malawi. Key informants within the community identified the cohort in 2013 (baseline). Informants clinically screened children at baseline, and by questionnaires at baseline and follow-up in 2016. We investigated associations between sociodemographic characteristics and outcomes by multivariate logistic regression. Results:We diagnosed 752 children in 2013 as having a hearing impairment and traced 307 (40.8%) children of these for follow-up in 2016. Referral uptake was low (102/184; 55.4%), more likely among older children (odds ratio, OR: 3.5; 95% confidence interval, CI: 1.2-10.2) and less likely for those with an illiterate caregiver (OR: 0.5; 95% CI: 0.2-0.9). Few of the children who attended hospital received any treatment (33/102; 32.4%) and 63.6% (21/33) of caregivers reported satisfaction with treatment. Difficulty making friends and communicating needs was reported for 10.0% (30/299) and 35.6% (107/301) of the children, respectively. Lack of school enrolment was observed for 29.5% (72/244) of children, and was more likely for older children (OR: 28.6; 95% CI: 10.3-79.6), girls (OR: 2.4; 95% CI: 1.2-4.8) and those with an illiterate caregiver (OR: 2.1; 95% CI: 1.0-4.1). Conclusion:More widespread and holistic services are required to improve the outcomes of children with a hearing impairment in Malawi. Objectif:Évaluer la situation des enfants chez lesquels une déficience auditive a été diagnostiquée 3 années plus tôt, en matière de consultation d'un spécialiste, de traitement reçu et de satisfaction quant à ce traitement, ainsi que de participation sociale. Méthodes:Nous avons réalisé une analyse longitudinale dans la population des enfants présentant une déficience auditive dans deux districts ruraux du Malawi. Des informateurs clés de la communauté ont défini la cohorte en 2013 (point de référence). Ils ont pratiqué un examen clinique chez les enfants à cette date, et ont eu recours à des questionnaires à cette époque et lors du suivi en 2016. Nous avons étudié les associations entre certaines caractéristiques sociodémographiques et la situation des enfants à l'aide d'une régression logistique multivariée. Résultats:Nous avons diagnostiqué une déficience auditive chez 752 enfants en 2013 et avons fait le suivi de 307 (40,8%) d'entre eux en 2016. Le taux de consultation d'un spécialiste était faible (102/184; 55,4%), plus fréquent chez les enfants les plus âgés (rapport des cotes, RC: 3,5; intervalle de confiance de 95%, IC: 1,2–10,2) et moins fréquent chez ceux à charge d'une personne analphabète (RC: 0,5; IC 95%: 0,2–0,9). Parmi les enfants qui se sont rendus à l'hôpital, peu ont reçu un traitement (33/102; 32,4%) et 63,6% (21/33) des accompagnateurs se sont dits satisfaits du traitement. Des difficultés à se faire des amis et à communiquer ses besoins ont été rapportées respectivement par 10,0% (30/299) et 35,6% (107/301) des enfants. L'absence de scolarisation a été observée pour 29,5% (72/244) des enfants, plus fréquemment chez les plus âgés (RC: 28,6; IC 95%: 10,3-79,6), les filles (RC: 2,4; IC 95%: 1,2-4,8) et les enfants à charge d'une personne analphabète (RC: 2,1; IC 95%: 1,0-4,1). Conclusion:Il est nécessaire de proposer des services plus complets et généralisés pour améliorer la situation des enfants présentant une déficience auditive au Malawi. Objetivo:Evaluar los resultados de los niños diagnosticados con hipoacusia hace tres años con respecto a la asimilación de la remisión, el tratamiento recibido y la satisfacción con este tratamiento, y la participación social. Métodos:Se realizó un análisis longitudinal basado en la población de niños con discapacidad auditiva en dos distritos rurales de Malawi. Los informantes clave dentro de la comunidad identificaron a la cohorte en 2013 (inicio del estudio). Los informantes examinaron clínicamente a los niños y aplicaron cuestionarios desde el inicio, y luego el seguimiento se realizó en 2016. Se investigaron las asociaciones entre las características sociodemográficas y los resultados mediante la regresión logística multivariada. Resultados:En 2013, diagnosticamos a 752 niños con discapacidad auditiva y en 2016 seguimos el rastro de 307 (40,8 %) de ellos para su seguimiento. La asimilación de la remisión fue baja (102/184; 55,4 %), más probable entre los niños mayores (razón de momios, OR: 3,5; intervalo de confianza del 95 %, IC: 1,2-10,2) y menos probable entre los que tenían un cuidador analfabeto (OR: 0,5; IC del 95 %: 0,2-0,9). Pocos de los niños que asistieron al hospital recibieron tratamiento (33/102; 32,4 %) y 63,6 % (21/33) de los cuidadores informaron satisfacción con el tratamiento. La dificultad para hacer amigos y comunicar las necesidades fue reportada para el 10.0 % (30/299) y 35.6 % (107/301) de los niños, respectivamente. La falta de escolarización se observó en el 29,5 % (72/244) de los niños, y fue más probable en los niños mayores (OR: 28,6; IC del 95 %: 10,3-79,6), las niñas (OR: 2,4; IC del 95 %: 1,2-4,8) y los que tenían un cuidador analfabeto (OR: 2,1; IC del 95 %: 1,0-4,1). Conclusión:Se necesitan servicios más amplios y holísticos para mejorar los resultados de los niños con discapacidad auditiva en Malawi. الغرض:تقييم للنتائج الخاصة بالأطفال الذين تم تشخيص إصابتهم بضعف السمع منذ 3 سنوات، فيما يتعلق بالحصول على فرصة للإحالة، وتلقى العلاج، والرضا عن هذا العلاج، والمشاركة الاجتماعية. الطريقة:قمنا بإجراء تحليلاً طولانياً على أساس السكان من الأطفال الذين يعانون من ضعف السمع في اثنين من المناطق الريفية في ملاوي. يمثل المبلغون الرئيسيون في المجتمع مجموعة الأتراب في عام 2013 (خط الأساس). قام المبلغون بفحص الأطفال سريرياً عند خط الأساس، ومن خلال الاستبيانات عند الأساس والمتابعة في عام 2016. وقمنا بفحص الارتباطات بين الخصائص الاجتماعية الديموغرافية ونتائج التحوف اللوجستي متعدد المتغيرات. النتائج:لقد قمنا بتشخيص 752 طفلًا في عام 2013 على أنهم يعانون من ضعف في السمع، وقمنا بتتبع 307 طفلاً (40.8%) منهم للمتابعة في عام 2016. كانت نسبة الحصول على فرصة الإحالة منخفضة (102/184؛ 55.4%)، وكانت أكثر احتمالية بين الأطفال الأكبر سناً (نسبة الاحتمالات: 3.5؛ فاصل الثقة 95%: 1.2 إلى 10.2)، واحتمالية أقل لهؤلاء الأطفال ممن يخضعون لرعاية شخص أُمي (نسبة الاحتمالات: 0.5؛ بفاصل ثقة 95%: 0.2 إلى 0.9). عدد قليل من الأطفال الذين تلقوا الرعاية في المستشفى، وحصلوا على أي علاج (33/102؛ بنسبة 32.4%) وأعربت نسبة 63.6% (21/33) من مقدمي الرعاية عن رضاهم عن العلاج. تم الإبلاغ عن صعوبة في تكوين الصداقات، واحتياجات التواصل لنسبة 10.0% (30/299)، و35.6% (107/301) من الأطفال، على الترتيب. تمت ملاحظة نقص في الالتحاق بالتعليم لنسبة 29.5% (72/244) من الأطفال، وكانت أكثر احتمالية بالنسبة للأطفال الأكبر سناً (نسبة الاحتمالات: 28.6؛ بفاصل ثقة 95%: 10.3 إلى 79.6)، والبنات (نسبة الاحتمالات: 2.4؛ بفاصل ثقة 95%: 1.2 إلى 4.8)، وهؤلاء الأطفال ممن يخضعون لرعاية شخص أُمي (نسبة الاحتمالات: 2.1؛ بفاصل ثقة 95%: 1.0 إلى 4.1). الاستنتاج:هناك حاجة إلى خدمات أكثر انتشاراً وشمولية لتحسين نتائج الأطفال المصابين بضعف السمع في ملاوي. 目的:从转诊率、接受治疗情况、对治疗的满意程度及社会参与度等方面对 3 年前确诊为听力障碍儿童的治疗结果进行评估。. 方法:我们对马拉维两大农村地区中患有听力障碍的儿童进行了一项基于人口的纵向分析。我们确定了 2013 年社区内关键受访者群组(基准值)。受访者在 2016 年通过基准值调查问卷和随访的形式对儿童进行了临床筛查。我们采用多变项逻辑回归法对社会人口特征与结果之间的关系进行了研究。. 结果:我们在 2013 年诊断出 752 名儿童患有听力障碍,并在 2016 年对其中的 307 名儿童 (40.8%) 进行了随访。转诊率较低(102/184;55.4%),且多见于年龄较大的儿童(比值比,OR: 3.5;95% 置信区间,CI:1.2-10.2),而其看护人未受过教育的儿童转诊率更低(比值比,OR:0.5;95% 置信区间,CI:0.2-0.9)。只有极少数在医院就诊的儿童接受了治疗(33/102;32.4%),其中 63.6% (21/33) 的看护人对治疗表示满意。报告表明,10.0% (30/299) 的儿童交友困难,35.6% (107/301) 的儿童有沟通障碍。据悉,儿童失学率达到 29.5% (72/244),其中年龄较大的儿童(比值比,OR:28.6;95% 置信区间,CI:10.3-79.6)、女孩(比值比,OR:2.4;95% 置信区间,CI:1.2-4.8)以及其看护人未接受过教育的儿童(比值比,OR:2.1;95% 置信区间,CI:1.0-4.1)的失学率更高。. 结论:马拉维仍需要一系列更广泛的服务来改善患有听力障碍儿童的治疗结果。. Цель:Оценка результатов вмешательства у детей, у которых за три года до этого были диагностированы нарушения слуха, применительно к использованию направлений к врачам-специалистам, полученному лечению и удовлетворенности его результатами, а также социальному участию. Методы:Авторы провели популяционное лонгитюдное исследование детей с нарушениями слуха в двух сельских районах Малави. Основные информанты в сообществе определили когорту в 2013 году (базовые данные). Информанты провели клинический скрининг детей в момент сбора базовых данных, а также анкетирование в момент сбора базовых данных и повторно в 2016 году. Авторы исследовали взаимосвязь между социодемографическими характеристиками и результатами вмешательства с использованием множественной логистической регрессии. Результаты:Диагноз нарушений слуха был поставлен 752 детям в 2013 году, из них 307 детей (40,8%) участвовали в последующем контроле в 2016 году. Использование направлений к специалистам было низким (102 из 184; 55,4%). Вероятность обращения к врачу была выше для детей старшего возраста (отношение шансов, ОШ: 3,5; 95%-й ДИ: 1,2–10,2) и ниже в том случае, если осуществляющее уход лицо было неграмотным (ОШ: 0,5; 95%-й ДИ: 0,2–0,9). Немногие из детей, посетивших больницу, прошли курс лечения (33 из 102; 32,4%), а 63,6% (21 из 33) лиц, осуществлявших уход за детьми, сообщили о том, что они довольны лечением. Сложность в приобретении друзей и проблемы в общении отмечались у 10,0% (30 из 299) и 35,6% (107 из 301) детей соответственно. Недостаточная посещаемость школы отмечалась у 29,5% (72 из 244 детей) и была выше у детей старшего возраста (ОШ: 28,6; 95%-й ДИ: 10,3–79,6), девочек (ОШ: 2,4; 95%-й ДИ: 1,2–4,8) и в случаях, когда осуществляющее уход лицо было неграмотным (ОШ: 2,1; 95%-й ДИ: 1,0–4,1). Вывод:Для улучшения результатов лечения детей с нарушениями слуха в Малави необходима система повсеместного и комплексного медицинского обслуживания.
journal_name
Bull World Health Organjournal_title
Bulletin of the World Health Organizationauthors
Mulwafu W,Tataryn M,Polack S,Viste A,Goplen FK,Kuper Hdoi
10.2471/BLT.18.226241subject
Has Abstractpub_date
2019-10-01 00:00:00pages
654-662issue
10eissn
0042-9686issn
1564-0604pii
BLT.18.226241journal_volume
97pub_type
杂志文章abstract::This Memorandum discusses two areas of research into rheumatic disease in which it is considered international cooperation would be valuable. These are: (a) standardization and cooperative evaluation of immunological tests used in diagnosis, clinico-pathological assessment, and epidemiological work; and (b) standardiz...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1974-01-01 00:00:00
abstract::The aim of this study was to obtain information, using a written questionnaire, on the knowledge, smoking behaviour, and attitudes of Costa Rican physicians about smoking as a health issue. A random sample of 650 physicians was chosen from a list of active physicians; 287 of them were covered by survey between August ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:Rubella vaccine is not included in the immunization schedule in Myanmar. Although surveillance for outbreaks of measles and rubella is conducted nationwide, there is no routine surveillance for congenital rubella syndrome (CRS). Therefore, we organized a study to assess the burden of CRS. METHODS:From 1 Dece...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/blt.05.022814
更新日期:2006-01-01 00:00:00
abstract::The relatively recent development of more-effective pulicides has been paralleled by the discovery of more-efficient rodenticides. Eight of the latter-namely, warfarin, pival, red squill, alpha-naphthylthiourea (ANTU), zinc phosphide, arsenic trioxide, thallium sulfate, and sodium fluoroacetate (1080)-are discussed wi...
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::A 7-valent pneumococcal polysaccharide-protein conjugate vaccine (PCV7) was licensed in the United States of America in 2000, but no comprehensive postmarketing review of safety has been carried out. We conducted a systematic review of the safety of PCV7 and other pneumococcal conjugate vaccines. A total of 42 studies...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:10.2471/blt.07.048025
更新日期:2008-05-01 00:00:00
abstract::Previous investigations have shown that in the Lake Region of Sukumaland, Tanganyika, where Schistosoma haematobium is highly endemic, Bulinus (Physopsis) nasutus is responsible for the transmission of that schistosome in small, temporary rain pools. This area is one of low rainfall, and large artificial reservoirs ar...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1964-01-01 00:00:00
abstract:OBJECTIVE:To test the applicability of lot quality assurance sampling (LQAS) for the rapid assessment of the prevalence of active trachoma. METHODS:Prevalence of active trachoma in six communities was found by examining all children aged 2-5 years. Trial surveys were conducted in these communities. A sampling plan app...
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::In March 1990 a study was carried out in the village of Kicheba, United Republic of Tanzania, in which the pyrethroid insecticide lambda-cyhalothrin was sprayed on all the internal surfaces of houses and other shelters at a coverage of about 25 mg of active ingredient per m2. Every day for 6 days, 12 spraymen and 3 sq...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::In this study the efficacy of oral rehydration solution (ORS) was compared with that of intravenous fluid (IVF) in the treatment of moderate and some severe cases of dehydration due to diarrhea in a treatment center in Bangladesh during 1980-81. 10,379 patients with moderate and severe dehydration in 1980 and 9897 in...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::In the early summer of 1993, an outbreak of Rift Valley fever (RVF) was reported among both humans and animals in Aswan Governorate, Upper Egypt. To determine whether RVF infection had spread to the Nile delta region of the country, we carried out a cross-sectional survey of 1181 occupationally exposed abattoir worker...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::The recommended procedures and criteria for T-cell receptor (TCR) designations are described. The officially adopted designations are for the TCR A, B, D and G loci and for V, D, J and C segments. ...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1993-01-01 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::Experimental studies in mice have provided evidence that antibody specific for viral neuraminidase markedly inhibits influenza virus replication in the lungs of animals challenged with virus containing homologous neuraminidase. In contrast to antihaemagglutinin antibody, antineuraminidase antibody does not increase re...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1969-01-01 00:00:00
abstract::Selective population chemotherapy using a single dose of praziquantel (40 mg per kg body weight), which was offered to 29,365 schoolchildren in Abu El Matameer and 40,241 in Abo Homos districts, Beheira governorate in the Nile delta, reduced the prevalence of schistosomiasis from 75.4% to 40.9% (reduction of 45.8%) an...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:Objective:To analyse the demographic and clinical characteristics of people attending physical rehabilitation centres run or supported by the International Committee of the Red Cross in countries and territories affected by conflict. Methods:Of 150 such rehabilitation centres worldwide, 38 use an electronic patient ma...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.19.249060
更新日期:2020-09-01 00:00:00
abstract::In the course of WHO/UNICEF-assisted tuberculosis surveys carried out in a number of African territories, sputa were microscopically examined for the presence of acid-fast bacilli. Since adequate facilities for performing cultures to confirm the diagnosis of tuberculosis and other mycobacterial infections were not ava...
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::This article provides an overview of managed health care in the USA--what has been achieved and what has not--and some lessons for policy-makers in other parts of the world. Although the backlash by consumers and providers makes the future of managed care in the USA uncertain, the evidence shows that it has had a posi...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract::Previous work on monkeys and on human volunteers led to the development of a schedule of diethylcarbamazine dosage suitable for the chemoprophylaxis of loiasis. In several parts of Africa where this chemoprophylaxis is practised against Loa loa, infections with Onchocerca volvulus are also common. Attempts were theref...
journal_title:Bulletin of the World Health Organization
pub_type: 临床试验,杂志文章
doi:
更新日期:1968-01-01 00:00:00
abstract::Monovalent acetone-inactivated typhoid vaccine and heat-killed TAB caused local reactions in 82-88% of volunteers vaccinated by jet injection, whereas they caused local reactions in only 24% of volunteers injected by means of a conventional syringe. Both vaccines induced a high seroconversion rate to typhoid H antigen...
journal_title:Bulletin of the World Health Organization
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1974-01-01 00:00:00
abstract:OBJECTIVE:To assess the implications of implementing the World Health Organization (WHO) 2010 guidelines for antiretroviral therapy (ART) initiation in adults and adolescents with human immunodeficiency virus (HIV) infection, which recommend initiating ART at a CD4+ T lymphocyte (CD4+) threshold of ≤ 350 cells/mm(3) in...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,多中心研究
doi:10.2471/BLT.11.089599
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of diabetes and prediabetes in Bangladesh using national survey data and to identify risk factors. METHODS:Sociodemographic and anthropometric data and data on blood pressure and blood glucose levels were obtained for 7541 adults aged 35 years or more from the biomarker sample of t...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:10.2471/BLT.13.128371
更新日期:2014-03-01 00:00:00
abstract::The single radial haemolysis reaction has been shown to be suitable for the quantitative assay of specific antibody to West Nile and Sindbis viruses. Only 5 mul of undiluted serum are needed for the test, which can be performed on crude preparations of antigen and without removal of nonspecific inhibitors. It is there...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::In the fight against the HIV/AIDS pandemic different approaches can be distinguished, reflecting professional backgrounds, world views and political interests. One important distinction is between the biomedical and the development paradigms. The biomedical paradigm is characterized by individualization and the concep...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract::To study the association of meningococcal serogroups with the course of disease, we reviewed the case histories of 1221 patients. The meningococci from these patients constituted a sample from isolates collected and serogrouped systematically in the Netherlands since 1959. Of these 1221 isolates, 64% were serogroup B....
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Examination of large numbers of strains of meningococci associated with systemic disease in US Army personnel over a 7-year period has shown a changing pattern of sero-group prevalence and an increasing proportion of sulfadiazine-resistant organisms. These findings underline the failure of sulfadiazine prophylaxis and...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1971-01-01 00:00:00
abstract::The use of BCG vaccine in the prevention of leprosy has been one of the most important subjects of investigation in the field of leprology in the last 25 years. The action of the vaccine was for many years investigated by determining its effect on the lepromin reaction. Field studies were later considered essential to...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1970-01-01 00:00:00
abstract::In the course of a research project on atherosclerosis, an international group of pathologists studied lesions in the aorta and coronary arteries obtained at autopsy from 3174 subjects from Czechoslovakia, Sweden and the USSR in an effort to determine what factors, recognizable in life, might be used to predict the pr...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1965-01-01 00:00:00
abstract::A meeting of an informal working group on immune responses to viral antigens was convened in Amsterdam on 15-18 November 1982 to discuss recent developments in this field and to formulate proposals for international collaborative studies relevant to the needs of the WHO Programme on Vaccine Development. The meeting co...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::The source (species of origin), type, and subgroup (where applicable) of the immunoglobulin chain are indicated prior to the numbers of the first and last amino acid residues comprising the synthesized sequence (stated in parentheses), e.g., human gamma 1 (289-298) or rat epsilon (143-147). Square brackets indicate th...
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::Subjects with sickle cell trait have been known to offer resistance to induced Plasmodium falciparum infection. The resistance to malarial infection in other haemoglobinopathic disorders is not clearly known. Investigations were undertaken to test for resistance to malaria in Hb E thalassaemia disease. Compared to con...
journal_title:Bulletin of the World Health Organization
pub_type: 杂志文章
doi:
更新日期:1964-01-01 00:00:00