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September 2003 Insights
Health Issue #4
Hitting the mark
Can under five mortality be cut by two thirds?
In 2000, the nations of the world pledged to achieve the Millennium
Development Goals. These ambitious targets included a commitment over
the period 1990 to 2015 to:
- eradicate extreme poverty and hunger (50% reduction in the numbers
of people living on less than US$1/day)
- reduce under five mortality rate by two thirds
- reduce maternal mortality rates by 75%.
As the World Bank estimates and projections for progress show, the
goals for reduction in child mortality will be achieved in only a few
countries.
More...
Other articles in this issue:
Many children die in developing countries without ever reaching a health
facility. What stops caregivers from accessing medical services? Why
are they accessed late? Are caregivers able to spot the symptoms and
signs of severe illnesses? Research by the London School of Hygiene and
Tropical Medicine tackles this question in rural Ghana.
With one third of mother-to-child transmission of HIV (MTCT) occurring
through breast-feeding, advice not to breast-feed appears sensible, and
is standard practice in well-resourced countries. However in poorly resourced
environments breast-feeding offers substantial advantages to all infants
in protecting against infectious diseases such as gastrointestinal infection,
meningitis, sepsis and bronchiolitis.
The mother-to-child transmission of HIV through breast feeding (MTCT)
is a major problem for child health, especially in high HIV prevalence
areas, such as sub-Saharan Africa. However, MTCT is preventable: taking
issue with WHO recommendations, research suggests that HIV infected mothers
should not breast-feed and should offer artificial milk to their infants.
Fits are dramatic events. They frighten onlookers, particularly parents.
Recurrent fits, epilepsy, have profound and broad implications for the
sufferer and their family: they not only interfere with everyday activities,
but also social functioning and job prospects. Furthermore, in some parts
of Africa, epilepsy and convulsions are often thought to be caused by
supernatural forces. Seizures are common in malaria endemic areas, particularly
in sub-Saharan Africa.
Since the introduction of a market economy in China in the early 1980s,
many areas have moved from a situation of food scarcity to wide choice
in diet in less than a generation. But the changes have been unevenly
distributed. While the increase in the number of overweight adults in
certain cities between 1982 and 1991 has been described as among the
most rapid ever documented, rates of underweight adults in urban and
rural areas fell by just 1% over the same period.
In 1992, the WHO stopped recommending the high-titre measles vaccine
(HTMV) after studies showed raised death rates in girls. What caused
this increase? Research by the Danish Epidemiology Science Centre showed
that a change in the sequence of vaccinations, rather than HTMV itself,
may lead to higher female mortality.
Acute respiratory infections (ARI) are the most frequent cause of death
in children in the developing world. Although it is now well accepted
that bacteria such as pneumococcus and haemophilus and viruses, especially
Respiratory Syncytial Virus (RSV), are among the main causes of ARI,
it is not known what other factors contribute to a significant number
of these episodes.
Further web resources.
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