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Using lot quality assurance sampling to improve immunization coverage in Bangladesh.

OBJECTIVE: To determine areas of low vaccination coverage in five cities in Bangladesh (Chittagong, Dhaka, Khulna, Rajshahi, and Syedpur). METHODS: Six studies using lot quality assurance sampling were conducted between 1995 and 1997 by Basic Support for Institutionalizing Child Survival and the Bangladesh National Expanded Programme on Immunization. FINDINGS: BCG vaccination coverage was acceptable in all lots studied; however, the proportion of lots rejected because coverage of measles vaccination was low ranged from 0% of lots in Syedpur to 12% in Chittagong and 20% in Dhaka's zones 7 and 8. The proportion of lots rejected because an inadequate number of children in the sample had been fully vaccinated varied from 11% in Syedpur to 30% in Dhaka. Additionally, analysis of aggregated, weighted immunization coverage showed that there was a high BCG vaccination coverage (the first administered vaccine) and a low measles vaccination coverage (the last administered vaccine) indicating a high drop-out rate, ranging from 14% in Syedpur to 36% in Dhaka's zone 8. CONCLUSION: In Bangladesh, where resources are limited, results from surveys using lot quality assurance sampling enabled managers of the National Expanded Programme on Immunization to identify areas with poor vaccination coverage. Those areas were targeted to receive focused interventions to improve coverage. Since this sampling method requires only a small sample size and was easy for staff to use, it is feasible for routine monitoring of vaccination coverage.

BCG Vaccine↗

[Princess Eugénie and her work for the benefit of disabled children].

Princess Eugénie was the daughter of the Swedish-Norwegian king Oscar I. She had a very good education; her favourite subjects were art and music. In the Spring of 1852, when she was 22 years old, she was stricken with a severe disease, and she was paralysed in one leg. During her illness she underwent a religious crisis. After recovering, her main interest was to assist poor and incurably ill children. Her name is above all associated with the Home of Eugénie (Eugenia-hemmet) in Stockholm, which was opened in 1886. This home accommodated at this time 45 children, but very soon the number increased. According to the regulations, the Home of Eugénie was to become a real home for these children. They were allowed to stay there until the age of 15, and to get a complete medical attention. They were also to receive an education as well as a vocational training. The princess put down most of her interest and her energy in the home. She knew all the children, started fundraising in aid for them. She herself donated them all her earnings. She even made porcelaine figurines which were spread and sold in big numbers. She died in 1889.

Adolescent↗

Longitudinal development of object permanence in mentally retarded children: an exploratory study.

Monthly testing on a series of Piaget object tasks was carried out on 1- to 6-year-old profoundly, severly, and moderately retarded children. Forty nine subjects were followed for 1 to 1.5 years or to criterion; 18 subjects were followed for shorter periods. Three general patterns occurred among the noncriterion subjects with approximately equeal frequency: (a) little or no change, (b) marked variability, and (c) relatively steady upward change from month to month. Criterion and upward subjects skipped certain substages about one-half of the time. Degree of retardation, CA, and diagnostic concomitants of these observations were discussed.

Abnormalities, Multiple↗

[The epidemic importance of the virological study of sewage for rotaviruses].

The results of correlation of rotavirus circulation indices among apparently normal and sick children and the rates of rotavirus antigen detection in sewage from an orphanage and an infectious ward of children's hospital are presented. It was established that there should be up to 1% of virus excretors for rotaviruses to be detectable in sewage of peripheral collectors of children's institutions. A significant increase in the rate of detection of rotaviruses in sewage may indicate an activation of the epidemic process of rotavirus infection.

Antigens, Viral↗

Project ROSES.

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Child↗