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PubMed1998

The World Health Organization Multinational Study of Breast-feeding and Lactational Amenorrhea. II. Factors associated with the length of amenorrhea. World Health Organization Task Force on Methods for the Natural Regulation of Fertility.

OBJECTIVE: To determine the relation between infant feeding practices (and other factors) and the duration of postpartum amenorrhea, and to establish whether there are real differences in the duration of postpartum amenorrhea for similar breast-feeding practices in different populations. DESIGN: Prospective, nonexperimental, longitudinal follow-up study. SETTING: Five developing and two developed countries. PATIENT(S): Four thousand one hundred eighteen breast-feeding mothers and their infants. INTERVENTION(S): Breast-feeding women collected ongoing information about infant feeding and family planning practices, plus the return of menses. Fortnightly follow-up occurred in the women's homes. MAIN OUTCOME MEASURE(S): A multivariate analysis explored the association between the risk of menses return and 16 infant feeding variables and 11 other characteristics. RESULT(S): Ten factors (in addition to center effects) were significantly related to the duration of amenorrhea. Seven of these were infant feeding characteristics and the remaining three were high parity, low body mass index, and a higher frequency of infant illness. CONCLUSION(S): The breast-feeding stimulus is strongly linked to the duration of postpartum amenorrhea. Cross-cultural effects also are extremely important and may have caused the variations in feeding, the variation in amenorrhea, or both.

Adult↗
PubMed1998

[The 50th anniversary of the World Health Organization].

In the 1998, the World Health Organization celebrates its 50th anniversary. The creation of the WHO in 1948 has terminated long-lasting efforts in the development of the international organization which can promote, support and coordinate improvement in the international health. In the paper, the history of the WHO, its present structure and functions, budget, main areas of activity, achievements and problems are discussed. The WHO's contribution in the improvements in the world's public health and especially in the control of infectious diseases is essential. However, to meet new challenges of the coming XXI century, and to catalyse, encourage and support needed reforms, the WHO itself has to reorganize its structure and to discuss its strategical concepts.

History, 20th Century↗
PubMed1998

The World Health Organization Multinational Study of Breast-feeding and Lactational Amenorrhea. I. Description of infant feeding patterns and of the return of menses. World Health Organization Task Force on Methods for the Natural Regulation of Fertility.

OBJECTIVE: To detect differences between populations in both infant feeding practices and the duration of lactational amenorrhea, if they exist. DESIGN: Prospective, nonexperimental, longitudinal follow-up study. SETTING: Five developing and two developed countries. PATIENT(S): Four thousand one hundred eighteen breast-feeding mothers and their infants. INTERVENTION(S): Breast-feeding women collected ongoing information about infant feeding and family planning practices, plus the return of menses. Fortnightly follow-up occurred in the women's homes. MAIN OUTCOME MEASURE(S): Breast-feeding frequency by day (and by night); 24-hour breast-feeding duration, percent of all infant feedings that were milk/milk-based (and solid/semisolid foods); time until the end of full breast-feeding; time until regular supplementation; and time until the end of lactational amenorrhea. RESULT(S): Differences between the centers in the duration of amenorrhea were substantial, ranging from a median of 4 months in New Delhi (India) to 9 months in Chengdu (China). Women in developed countries (but also women in Chengdu) were more likely to delay supplementation (for up to 5 months), whereas women in Santiago (Chile), Guatemala City (Guatemala), and Sagamu (Nigeria) started supplements much earlier, sometimes as early as 1 week after birth. CONCLUSION(S): Both breast-feeding behavior and the duration of lactational amenorrhea vary markedly across settings, indicating that breast-feeding promotion and family planning advice should be site- and culture-specific.

Adult↗
PubMed1992

Making the World Health Organization work: a legal framework for universal access to the conditions for health.

Improving global health conditions has been one of the most important and difficult challenges for the world community. Despite concerted efforts by international organizations, like the World Health Organization, great disparities in health conditions remain between developed and developing countries, as well as within those countries. The World Health Organization has achieved some successes through its Health for All strategy; however, it can and should encourage member nations to enact national and international laws to protect and promote the health status of their populations. A comparison to the lawmaking efforts in other areas by international organizations indicates that WHO may have the authority and the means to institutionalize efforts to improve global health conditions.

Forecasting↗
PubMedDate not supplied

The new program of the World Health Organization in medical virology.

The World Health Organization (WHO) convened a Scientific Group to adapt its program in virus diseases to recent progress in virology. The program consists of (a) general activities, such as reference services and the supplying of reagents by the WHO Collaborating Centres and (b) specific activities to solve problems-including the promotion of necessary research-caused by certain diseases of public health importance. The Group reviewed problems caused by influenza and other respiratory viruses, enteroviruses, gastroenteritis viruses (for which types A and B have been proposed as a convenient nomenclature), viral hepatitis, viruses in water and sewage, arboviruses, arenaviruses and Marburg virus, measles and rubella vaccination, smallpox, rabies, chronic infections, herpesviruses, oncogenic viruses, congenital infections, nosocomial infections, chlamydial and rickettsial infections, and mycoplasma infections.

Arboviruses↗
PubMed2001

One-step disposable chambers for sperm concentration and motility assessment: how do they compare with the World Health Organization's recommended methods?

The World Health Organization suggests that 'one-step' type disposable chambers lack the accuracy and precision of the haemocytometer method for assessing sperm concentration. The purpose of this particular study was to compare sperm concentration measurements and motility using the Neubauer((R)) haemocytometer with those obtained using three 'one-step' methods: the Microcell((R)) slide, Leja((R)) slide and a plain glass slide with a 22x22 mm coverslip. A total of 200 sperm concentration measurements and 100 motility assessments were performed on all chambers. Paired comparisons showed enormous discrepancies between the counts, particularly between the Neubauer((R)) and other chambers (P < 0.0001). This discrepancy was less pronounced in oligozoospermic samples, and samples with low (<30% progression) motility but more pronounced in normozoospermic samples and those with good motility (>50% progression). In addition, concentration assessments from a fresh undiluted and unfixed semen sample on the Microcell((R)) slide were found to be significantly lower than both fixed counts on the same slide (P = 0.011) and the initial laboratory reading on the Neubauer((R)) chamber (P = 0.009). No differences were observed in progressive motility between the different chambers and a plain glass slide. There appears to be little comparison between the haemocytometer and either re-useable or disposable one-step chambers. The unfortunate consequence of this is that diagnostic semen analysis and guidelines for allocation of patients to appropriate treatment groups will vary from centre to centre, depending on the method used and may, on occasion, be erroneous.

Humans↗
PubMed1999

The World Health Organization multinational study of breast-feeding and lactational amenorrhea. IV. Postpartum bleeding and lochia in breast-feeding women. World Health Organization Task Force on Methods for the Natural Regulation of Fertility.

OBJECTIVE: To describe and compare the duration of lochia in seven groups of women; to investigate the occurrence of a possible "end-of-puerperium" bleeding episode; and to determine the frequency of bleeding episodes before postpartum day 56, which applies to the practice of the lactational amenorrhea method of contraception. DESIGN: Prospective longitudinal study with fortnightly follow-up, beginning within 7 days of delivery. SETTING: Five developing and two developed countries. PATIENT(S): Four thousand one hundred eighteen breast-feeding women. INTERVENTION(S): Postpartum lochia and all days of bleeding per vaginam were recorded. MAIN OUTCOME MEASURE(S): Duration of lochia, frequency of an end-of-puerperium bleeding episode, and frequency of postlochia bleeding episodes within 56 days of delivery. RESULT(S): The median duration of lochia was 27 days; it varied significantly among the centers (range, 22-34 days). In 11% of the women, lochia lasted >40 days. An end-of-puerperium bleeding episode around the 40th day postpartum was reported by 20.3% of the women. Bleeding within 56 days of delivery (separated from lochia by at least 14 days) occurred in 11.3% of the women and usually was followed by a confirmatory bleeding episode 21-70 days later. CONCLUSION(S): The duration of lochia varied significantly among the study populations, and long durations were not unusual. The significance of the end-of-puerperium bleeding episode is unknown. Most users of the lactational amenorrhea method will not experience a postlochia bleeding episode before postpartum day 56.

Amenorrhea↗