Prevention vs cure in developing countries.
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Delivery of Health Care↗
Biomedical subjects
R Tonglet
Publications and source records attributed to R Tonglet.
Efficacy of low oral doses of iodized oil in the control of iodine deficiency in Zaire.
BACKGROUND: About one billion people worldwide are at risk for iodine deficiency. Despite existing programs of prophylaxis, the prevention of iodine deficiency is still a challenge throughout the developing world. We studied the efficacy of low doses of iodized oil in an area of severe iodine deficiency in Zaire. METHODS: Seventy-five subjects with visible goiter were randomly assigned to receive a single oral dose of placebo or either 0.1 or 0.25 ml of iodized oil, corresponding to 0, 47, and 118 mg of iodine, respectively. The mean ages of the subjects in the three groups were 23, 22, and 22 years, respectively, and the ratios of males to females were 0.25, 0.32, and 0.19. Efficacy was assessed by evaluating goiter size and measuring urinary iodine and serum thyroid hormone concentrations for 12 months. RESULTS: Goiter size decreased in most of the subjects who received either dose of iodized oil. Their urinary iodine concentrations were normal for six to nine months and their serum thyroxine and thyrotropin concentrations were nearly all normal throughout the study period. There were no side effects, even in subjects whose serum thyroxine concentrations had initially been low. In the placebo group, neither goiter size nor any of the biochemical values changed. CONCLUSIONS: The oral administration of a single small dose of iodized oil is capable of correcting iodine deficiency for about a year. This method of supplementation is likely to be more effective, efficient, and acceptable than the administration of either intramuscular or large oral doses of iodized oil.
Administration, Oral↗
[Community health workers are capable of determining reliably the target population for health programs].
The target population is a key concept for the planning and evaluation of health services. However, in developing countries, health professionals in the field are often uneasy with the determination of the population denominator. In Zaire, where reliable demographic data are hardly available, we make use of two different methods aimed to the determination of the size of the target population: (1) an exhaustive population based survey performed by trained interviewers, and (2) a rapid census of the target population performed by community health workers. This paper presents both the results of a demographic survey organized in 1984, and two consecutive census performed by community health workers in 1986 an 1988, in the same area (Northern-Kivu, Zaire). Our results suggest that community health workers under close supervision are able to perform rapidly and at low cost a reliable collection of the demographic data needed for the implementation and monitoring of health programmes at the local level.
Adolescent↗
The causal model approach to nutritional problems: an effective tool for research and action at the local level.
Reported are the results of a case study from Kirotshe rural health district, Northern Kivu, Zaire, where a workshop on the causal model approach to nutrition was organized in 1987. The model has since been used in the field for research design, training of health professionals, nutrition intervention, and community development. The rationale behind this approach is reviewed, the experience accumulated from Kirotshe district is described, and the ways in which the causal model contributes to comprehensive health and nutrition care are discussed. The broad range of possible policy implications of this approach underlines its usefulness for future action.
Child, Preschool↗
The reduction of the leprosy endemicity in northeastern Zaire 1975/1989.
The leprosy endemy in Uele, North Eastern region of Zaire has declined considerably since the 1950's, particularly since 1975. The hypothesis is advanced that the most important causal factor has been the distribution of dapsone for many years, through a vertical programme. The gradual increase of dapsone resistance has been taken care of by the introduction of combined, multidrug therapy in the 1980's. The cost per patient detected and treated rises in inverse proportion to the decline in endemy; therefore, the time has come for the integration of a leprosy control in the primary health care strategy. However, central specialized teams financed by voluntary organisations should be maintained to assure training of personnel, to give advice in diagnosis, prevention and treatment of complications, to provide drugs and to assist in rehabilitation.
Dapsone↗
[The evaluation of an anti-leprosy program in Uélés (1975-1989)].
Foperda, who took over and continued the work initiated in 1924 by the Congo Red Cross, is responsible for the programme of fight against leprosy in the Ueles region (Zaire). Important results have been obtained since 1975 in the framework of a specialised medical service. These results are exposed and discussed herebelow. The evolution of the endemic leprosy in the region under survey allows to contemplate new trends for the pursuit of the programme in the coming years (controlled integration within polyvalent health services).
Democratic Republic of the Congo↗