PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “AFRICA, EASTERN”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2003

A systematic and critical review of the process of translation and adaptation of generic health-related quality of life measures in Africa, Asia, Eastern Europe, the Middle East, South America.

In recent years there has been a worldwide increase in demand for subjective measures of health-related quality of life (HRQL). Researchers have the choice of whether to develop a new measure or whether to adapt an existing measure in another language. This review evaluates the processes used in translating and adapting nine generic HRQL instruments (15D, Dartmouth COOP/WONCA Charts, EuroQol, HUI, NHP, SIP, SF-36, QWB, WHOQOL) for use in Africa, Asia, Eastern Europe, the Middle East, and South America. The review adopts a universalist model of equivalence, outlined by Herdman, Fox-Rushby, and Badia (Qual. Life Res. 7 (1998) 323), to judge the 58 papers reviewed. Research spans 23 countries and is dominated by research in the East Asia and Pacific region and the SF-36. Results are reported for conceptual, item, semantic, operational, measurement and functional equivalence. It is argued that currently there is a misguided pre-occupation with scales rather than the concepts being scaled and too much reliance on unsubstantiated claims of conceptual equivalence. However, researchers using the WHOQOL approach are more likely to establish reliable conclusions concerning the equivalence of their instrument across countries. It is a key conclusion of this review that research practice and translation guidelines still need to change to facilitate more effective and less biased assessments of equivalence of HRQL measures across countries.

Culture↗
PubMed2005

Refugia, dispersal and divergence in a forest archipelago: a study of Streptocarpus in eastern South Africa.

We describe a scenario of plant speciation across a relict forest archipelago in South Africa involving Pleistocene habitat expansion-contraction cycles, dispersal and adaptation to lower temperatures. This is the first population level study using molecular data in South African forests and has significant implications for conservation efforts in this area. Populations of the mesophytic forest floor herbs Streptocarpus primulifolius sensu lato and Streptocarpus rexii were sampled throughout their range in the naturally fragmented forests of eastern South Africa in order to investigate population genetic and phylogenetic patterns within the species complex, using nuclear microsatellites, nuclear ribosomal ITS (internal transcribed spacer) sequences and chloroplast genome sequences. S. primulifolius harbours high levels of genetic diversity at both the nuclear (mean HE = 0.50) and the chloroplast level (each population fixed for a unique haplotype). This is consistent with populations of these coastal species being Pleistocene relicts. In contrast, populations of S. rexii in cooler habitats at higher altitudes and lower latitudes harbour little or no nuclear genetic diversity (mean HE = 0.09) and most share a common chloroplast haplotype. The split of S. rexii from populations intermediate between the two species (S. cf. primulifolius) occurred between 0 and 0.44 million years ago according to the calibrated ITS phylogeny of the taxa. The low genetic diversity and homogeneity of S. rexii is congruent with this species having reached its current range during the Holocene. We found no evidence of monophyly of any of the taxa in this study, which we consider a consequence of recent evolution in a fragmented habitat.

Conservation of Natural Resources↗
PubMed2006

Divergent haplotypes and human history as revealed in a worldwide survey of X-linked DNA sequence variation.

The population genetic history of a 10.1-kbp noncoding region of the human X chromosome was studied using the males of the HGDP-CEPH Human Genome Diversity Panel (672 individuals from 52 populations). The geographic distribution of patterns of variation was roughly consistent with previous studies, with the major exception that 1 highly divergent haplotype (haplotype X, hX) was observed at low frequency in widely scattered non-African populations and not at all observed in sub-Saharan African populations. Microsatellite (short tandem repeat) variation within the sequenced region was low among copies of hX, even though the estimated time of ancestry of hX and other sequences was 1.44 Myr. The estimated age of the common ancestor of all hX copies was 5,230 years (95% consistency index: 2,000-75,480 years). To further address the presence of hX in Africa, additional samples from Chad and Tanzania were screened. Five additional copies of hX were observed, consistent with a history in which hX was present in Africa prior to the migration of modern humans out of Africa and with eastern Africa being the source of non-African modern human populations. Taken together, these features of hX-that it is much older than other haplotypes and uncommon and patchily distributed throughout Africa, Europe, and Asia-present a cautionary tale for interpretations of human history.

Chromosomes, Human, X↗
PubMed2005

The pattern of genetic diversity of Guinea-race Sorghum bicolor (L.) Moench landraces as revealed with SSR markers.

The Guinea-race of sorghum [Sorghum bicolor (L.) Moench] is a predominantly inbreeding, diploid cereal crop. It originated from West Africa and appears to have spread throughout Africa and South Asia, where it is now the dominant sorghum race, via ancient trade routes. To elucidate the genetic diversity and differentiation among Guinea-race sorghum landraces, we selected 100 accessions from the ICRISAT sorghum Guinea-race Core Collection and genotyped these using 21 simple sequence repeat (SSR) markers. The 21 SSR markers revealed a total of 123 alleles with an average Dice similarity coefficient of 0.37 across 4,950 pairs of accessions, with nearly 50% of the alleles being rare among the accessions analysed. Stratification of the accessions into 11 countries and five eco-regional groups confirmed earlier reports on the spread of Guinea-race sorghum across Africa and South Asia: most of the variation was found among the accessions from semi-arid and Sahelian Africa and the least among accessions from South Asia. In addition, accessions from South Asia most closely resembled those from southern and eastern Africa, supporting earlier suggestions that sorghum germplasm might have reached South Asia via ancient trade routes along the Arabian Sea coasts of eastern Africa, Arabia and South Asia. Stratification of the accessions according to their Snowden classification indicated clear genetic variation between margeritiferum, conspicuum and Roxburghii accessions, whereas the gambicum and guineënse accessions were genetically similar. The implications of these findings for sorghum Guinea-race plant breeding activities are discussed.

Africa↗
PubMed1997

Use of bovine somatotropin in the tropics: the effect of sometribove on milk production in western, eastern, and southern Africa.

Seven field studies conducted in western, eastern, and southern Africa to determine the effect of a prolonged-release formulation of bovine somatotropin (bST) administered at 14-d intervals on milk production of indigenous, crossbred, and purebred cows are described. Studies in Gambia showed that 334 mg of a prolonged-release formulation of bST increased milk production of N'Dama cattle by 205 ml/d, which represented a 22% increase in milk production, and increased the body weight gain of calves. In small dairy units in Zimbabwe, 500 mg of a prolonged-release formulation of bST increased milk production of crossbreds from 8.0 to 10.0 kg/d. Milk production response of crossbred cows in Kenya increased 2.5 kg/d after the lower dose rate (334 mg); no further increases were observed when the dose rate was increased to 500 mg. A study with Holsteins showed that delaying treatment of 500 mg of a prolonged-release formulation of bST from 90 to 120 or 150 d postpartum resulted in similar milk production responses of 3.5, 3.4, and 3.2 kg/d, respectively. The milk production response (6.1 kg/d) recorded in another study with Holsteins was attributed to an excellent plane of nutrition and delayed treatment initiation. For nonpregnant cows that were classified to be culled, the prolonged-release formulation of bST was efficacious and could potentially be used to extend lactation.

Africa, Eastern↗
PubMed2006

Guide to blackflies of the Simulium damnosum complex in eastern and southern Africa.

At least 26 members of the Simulium damnosum Theobald complex (Diptera: Simuliidae) are known from eastern Africa, most of which are assumed to be non-anthropophilic and some are restricted to small areas of endemicity. Their discovery was based on polytene chromosome inversion polymorphisms and since then they have been cited as cytological entities, but, in many cases, with inadequate descriptions (e.g. without illustrations of the chromosomes). The present distribution, taxonomy and vector identity have been re-evaluated during the last decade in conjunction with ongoing onchocerciasis control programmes. Here, a summary of the relevant data is presented, integrating results of cytotaxonomic, morphotaxonomic and molecular investigations into a guide that provides a comprehensive system of identification for the cytoforms 'Kagera', 'Kasyabone', 'Kibwezi', 'Kisiwani', 'Kisiwani E', 'Kulfo', 'Linthipe', 'Mombo', 'Mutonga', 'Njombe', 'Nkusi', 'Nkusi SA', 'Nkusi SW', 'Nyika', 'Pienaars', 'Sanje', 'Sebwe', 'Turiani', Simulium damnosum sensu stricto, Simulium kaffaense Hadis et al., Simulium kilibanum Gouteux, Simulium kipengere Krueger, Simulium latipollex (Enderlein), Simulium pandanophilum Krüger, Nurmi & Garms, Simulium plumbeum Krueger, Simulium thyolense Vajime et al. and for five newly recognized molecular forms of 'Nkusi' and S. kilibanum. All taxa except S. pandanophilum are assigned to one of five subcomplexes (damnosum, Ketaketa, Kibwezi, Sanje, squamosum) within the S. damnosum complex. The guide encompasses anthropophilic and non-anthropophilic segregates for the whole of eastern and southern Africa, and is not restricted to larval chromosome criteria; in many cases it also allows the typing of adult flies.

Africa, Eastern↗
PubMedDate not supplied

HIV prevalence and trends in sub-Saharan Africa: no decline and large subregional differences.

BACKGROUND: Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to the size of the AIDS epidemic. However, only analysis of surveillance data from the same populations over time can provide insight into trends of HIV prevalence. We have used data from the same antenatal clinics to document recent empirical trends. METHODS: We collated data from antenatal clinics on HIV prevalence between 1997 and 2003. Data were obtained from 140?000 pregnant women attending more than 300 antenatal clinics in 22 countries in sub-Saharan Africa. Additionally, long-term trend data are available for 57 urban areas and provinces. FINDINGS: Median HIV prevalence in 148 antenatal clinic sites in southern Africa increased from 21.3% (IQR 11.5-28.2%) in 1997/98 to 23.8% (15.6-29.2%) in 2002. At more than half the sites (58%) an increase of at least one-tenth was noted, but at a fifth of sites, prevalence dropped by at least one-tenth. In eastern Africa, median HIV prevalence decreased from 12.9% (7.0-16.9%) in 1997/98 to 8.5% (5.3-13.0%) in 2002, with prevalence rising in four (7%) sites, but falling at 25 (43%) sites. In west Africa, median HIV prevalence was 3.5% (2.2-5.9%) and 3.2% (2.3-6.1%) for 1997/98 and 2002, respectively, with reductions and increases in prevalence being noted in equal proportions. The long-term trends in urban areas in sub-Saharan Africa show a similar pattern, with increasing evidence of stabilisation during the past 2-3 years compared with the previous decade. INTERPRETATION: Evidence from surveillance of mostly urban antenatal clinic attendees indicates that the growth in the AIDS epidemic in sub-Saharan Africa has levelled off since the late 1990s but only eastern Africa shows a decline in HIV prevalence. Very large differences persist between subregions. Workers planning a response to the AIDS epidemic must take more careful consideration of these variations to allow locally appropriate responses to the epidemic.

Adolescent↗
PubMedDate not supplied

Childbearing in Malawi, Africa.

Malawi is a small, landlocked country in South Eastern Africa that faces many challenges in providing health care to childbearing women. Through a partnership between the faculty of the University of Pennsylvania, School of Nursing, faculty of the Kamuzu College of Nursing in Malawi, and the Malawi Ministry of Health and Population, an ongoing collaboration has led to research and demonstration projects designed to improve the health of women and children in Malawi. To underscore the cultural context within which childbearing occurs, care of the childbearing family in Malawi is described, as is research that has documented some of the similarities and differences between childbearing in Malawi and the United States.

Cultural Diversity↗
PubMed2001

A seroprevalence study of human herpesvirus type 8 (HHV8) in eastern and Central Africa and in the Mediterranean area.

Human herpes virus type 8 (HHV8) is the major determinant of Kaposi's sarcoma (KS), a neoplasm with wide geographic variations in incidence rates. To assess the prevalence of HHV8 infection among populations with differing rates of KS, we used sera from 1,402 persons (Central Africa: Cameroon, n = 293, age range: 5-40; eastern Africa: Uganda, n = 315, age range: 1-64: Mediterranean area: Egypt, n = 236, age range: 13-19: Italy, blood donors n = 134, age range: 20-67: Italy. HIV seroconverters n = 424, age range: 16-65). Serum samples were tested for antibodies to lytic and latent antigens of HHV8 using two immunofluorescence assays. HHV8 prevalence was evaluated according to geographic area, gender and age groups. Overall, the highest prevalence of HHV8 lytic antigens (47.5%) was recorded among children and adults in Africa. Approximately 40% of children and adolescents from Egypt and of Italian HIV-positive persons (39.9%) were HHV8 seropositive. In eastern and Central Africa and in Egypt, no differences emerged between males and females for both types of HHV8 antibodies. Conversely, Italian females were at lower HHV8 risk than their male counterparts. Moreover the prevalence of HHV8 infection tended to increase with age. This investigation partially confirms that HHV8 infection mirrors incidence rates of KS. The high prevalence of HHV8 infection in newborns, children and adolescents in Egypt, in eastern and in Central Africa strongly suggests the existence of transmission modes other than sexual.

Adolescent↗
PubMed2003

African Y chromosome and mtDNA divergence provides insight into the history of click languages.

BACKGROUND: About 30 languages of southern Africa, spoken by Khwe and San, are characterized by a repertoire of click consonants and phonetic accompaniments. The Jumid R:'hoansi (!Kung) San carry multiple deeply coalescing gene lineages. The deep genetic diversity of the San parallels the diversity among the languages they speak. Intriguingly, the language of the Hadzabe of eastern Africa, although not closely related to any other language, shares click consonants and accompaniments with languages of Khwe and San. RESULTS: We present original Y chromosome and mtDNA variation of Hadzabe and other ethnic groups of Tanzania and Y chromosome variation of San and peoples of the central African forests: Biaka, Mbuti, and Lisongo. In the context of comparable published data for other African populations, analyses of each of these independently inherited DNA segments indicate that click-speaking Hadzabe and Jumid R:'hoansi are separated by genetic distance as great or greater than that between any other pair of African populations. Phylogenetic tree topology indicates a basal separation of the ancient ancestors of these click-speaking peoples. That genetic divergence does not appear to be the result of recent gene flow from neighboring groups. CONCLUSIONS: The deep genetic divergence among click-speaking peoples of Africa and mounting linguistic evidence suggest that click consonants date to early in the history of modern humans. At least two explanations remain viable. Clicks may have persisted for tens of thousands of years, independently in multiple populations, as a neutral trait. Alternatively, clicks may have been retained, because they confer an advantage during hunting in certain environments.

Africa, Eastern↗
PubMed1995

Morbillivirus infections in wildlife (in relation to their population biology and disease control in domestic animals).

The three members of the morbillivirus genus that infect wildlife in ecosystems where domestic animals occur are rinderpest, peste des petits ruminants (PPR) and canine distemper. Data on the relative susceptibility of species of the Order Artiodactyla for rinderpest have been obtained from historical records of outbreaks. Rinderpest in wildlife has only occurred in equatorial and eastern Africa since the great pandemic of 1889-1897. The distributions, densities and population dynamics of susceptible species in this region are described. There has only been one recorded outbreak of PPR in wildlife but the possibility of its occurrence in the future now that it is present in many parts of west and eastern Africa is discussed. Wild carnivora are not likely to be important maintenance hosts for canine distemper but the disease is of significance in free-ranging carnivores and particularly in small populations of endangered susceptible wildlife species. It is also of great significance in zoo populations.

Africa↗
PubMed2003

The emerging problem of coronary heart disease in Kenya.

OBJECTIVE: To review the literature on coronary heart disease (CHD) and its electrocardiogram (ECG) manifestations in Eastern Africa and provide medical education by increasing awareness and strengthening recognition skills of myocardial infarction (MI) through discussion of key features from representative ECGs selected from the Moi Teaching and Referral Hospital (MTRH) ECG service in Eldoret, Kenya. DATA SOURCE: Peer reviewed published articles found using a Medline search. ECGs were reproduced with one complex from each of the 12 standard leads, without patient's name or other identifying information. CONCLUSION: CHD and its risk factors are increasing in prevalence in Eastern Africa over recent years. The ECG remains integral to the diagnosis of acute coronary syndromes, including MI. Representative ECGs from MTRH demonstrate the various features of the common anatomical distributions of MI, enabling medical education. Recognition of CHD and its ECG manifestations is one step on the path to decreasing resultant morbidity and mortality.

Coronary Disease↗
PubMed1989

Leishmaniasis in Kenya: description of leishmaniasis of a domestic goat from Transmara, Narok District, Kenya.

Extensive research has been carried out in Eastern Africa for animal reservoirs of both visceral and cutaneous leishmaniasis. The domestic dog has been the only domestic animal so far implicated as a possible reservoir for visceral leishmaniasis. For cutaneous leishmaniasis caused by Leishmania aethiopica, the hyrax and the giant rat are the proven reservoirs of the disease while several species of rodents have been demonstrated to harbor L. major. Recent studies conducted in domestic animals in West Pokot led to the first isolation of leishmanial parasites from a domestic goat, a close associate of man in the vast endemic leishmaniasis foci. Consequent encounter of a clinical case of the disease is the basis for this paper. It is the first autochthonous case in Eastern Africa. The goat originated from the Western escarpments of the Rift Valley which are known to harbor L. aethiopica. Clinical signs included lesions, indurations, and enlargement of lymph nodes. Parasitological and pathological investigations revealed amastigotes in various tissues. Cultures of the affected tissues produced promastigotes.

Animals↗
PubMed1999

Comparison of five methods of malaria detection in the outpatient setting.

In eastern Africa where 90% of the malaria is due to Plasmodium falciparum, the accuracy of malaria diagnosis at the outpatient level is becoming increasingly important due to problems of drug resistance and use of alternative, costly antimalarial drugs. The quantitative buffy coat (QBC) technique, acridine orange staining with an interference filter system, and the ParaSight-F test have been introduced as alternative methods to conventional microscopy for the diagnosis of malaria. Two hundred thirteen outpatients were tested using these alternative methods and conventional microscopy by five experienced technologists; two were randomly allocated to read the results of each test. Paired results showed the highest level of agreement with the ParaSight-F test (99%), followed by Field stain (92%). The results of the QBC technique showed the least agreement (73%). Using conventional microscopy as the reference standard, the ParaSight-F test had a sensitivity range of 90-92% and a specificity of 99%, staining with acridine orange had a sensitivity range of 77-96% and a specificity range of 81-98% and the QBC technique had a sensitivity range of 88-98% and a specificity range of 58-90%. All microscopic tests showed lower sensitivities (as low as 20% using staining with acridine orange) in detecting low parasitemias (< or = 320/microl) than the ParaSight-F test (70%). Due to the high cost of the ParaSight-F test, Field-stained blood films remain the most appropriate method for diagnosis of P. falciparum in eastern Africa. The ParaSight-F test may be used in situations where no trained microscopists are available, or where malaria is strongly suspected and the results of microscopy are negative.

Acridine Orange↗
PubMed2001

Surgical output in Kibaale district, Uganda.

BACKGROUND: The output of major surgeries in eastern Africa is low and varies considerably between hospitals and regions. This study in rural Uganda relates surgical output to number of hospital beds, number of in-patient admissions, number of new out-patient visits, estimated catchment area population and number of doctors and nurses. This was to facilitate comparison between institutions and areas and to determine surgical resource needs. OBJECTIVES: To describe the quantitative output of surgery in a Ugandan district and to demonstrate the use of standardised indicators for the purpose of comparison, monitoring, resource needs assessment and planning. DATA SOURCES: Retrospective review and analysis of inpatient and outpatient records at Kagadi district hospital, Kibaale district, Western Uganda, the only hospital providing major surgery in the district. STUDY SELECTION: Data on all recorded major and minor surgical operations in the hospital during two complete calendar years, 1996 and 1997. DATA SYNTHESIS: In 1996 and 1997 there were 331 and 309 major operations performed respectively in Kagadi hospital, Kibaale district. This output corresponded to 3.3 and 3.1 per 100 beds; 270 and 270 per 1,000 in-patient admissions; 328 and 267 per year per 10,000 new out-patient visits; 166 and 155 per 100,000 catchment area population; 83 and 77 per doctor; 27.6 and 25.8 per nurse. Minor surgery output at the same hospital in 1996 and 1997 were 185 and 190 respectively. This corresponded to 183 and 164 per 10,000 new outpatient visits and 93 and 95 operations per 100,000 catchment area population. CONCLUSIONS: The output of surgery in the district was very low in comparison with Europe and North America but within the range common in Eastern Africa. For planning and performance review purposes the most useful indicators are surgical output per 100 beds per year; per 1000 inpatient admissions; per doctor and per nurse per year because they measure workload against available resources. Output per 100,000 estimated catchment area population is useful in relating output to need. These indicators are recommended to be incorporated in district and hospital performance reviews and in annual reports.

Ambulatory Care↗
PubMed1987

[Human intestinal parasites in Subsaharan Africa. I. Eastern Boè and Canhabaque Island (Guinea-Bissau)].

A coprological survey was carried out in 1982-1983 in East Boè and in Canhabaque Island, (Bijagòs Islands), where 289 and 288 specimens of stools, respectively, have been collected. The samples were taken from apparently healthy subjects, of both sexes and of different age groups. The tests were made according to the modified Ritchie technique. The following results were obtained: A) East Boè: 1) Protozoa: E. coli 68.9%, E. nana 24.6%, G. intestinalis 8.7%, I. buetschlii 5.9%, E. histolytica 1.7%, E. hartmanni 0.7%, T. intestinalis 0.7%. b) Helminths: Ancylostomatidae 69.2%, T. trichiura 38.4%, S. stercoralis 6.2%, Taenia sp. 1.7%, H. nana 0.7%, S. haematobium 0.7%, S. mansoni 0.7%, S. fuelleborni 0.7%. B) Canhabaque: a) Protozoa: E. coli 85.1%, I. buetschlii 14.9%, E. nana 12.5%, G. intestinalis 8.3%, C. mesnili 7.3%, E. hartmanni 1.4%, E. histolytica 1.0%, T. intestinalis 0.4%. b) Helminths: Ancylostomatidae 87.9%, T. trichiura 9.4%, S. stercoralis 7.9%, S. fuelleborni 2.8%, Trichostrongylus sp. 1.4%, A. lumbricoides 0.7%, H. nana 0.4%. Eggs of Capillaria sp. probably pseudoparasites, were found in 8.7% of samples. The high prevalence of Ancylostomatidae infections appears to be related to the heavy fecal pollution all over the examined territory. The utilization of antihelminthic drug of popular medicine, which has a specific action on A. lumbricoides, could explain the lack and the low prevalence, respectively, of A. lumbricoides infections in both examined areas. In the past, other authors emphasized the low prevalence of this parasite for other Guinea Bissau regions which have a different geomorfological constitution. The cases of S. fuelleborni and H. nana are the first reported for Guinea Bissau.

Adolescent↗
PubMed2005

Nutritional and clinical status of children admitted to the malnutrition ward, Maputo central hospital: a comparison of data from 2001 and 1983.

Malnutrition is the fourth commonest reason for hospital admission to the paediatric department of the Central Hospital, Maputo and has the second highest death rate (20 per cent). A study from 1995 into mortality at this paediatric department, suggested an increase in severe malnutrition. Recent studies have shown that the global burden of undernutrition in the world is declining; however, data for Eastern Africa shows a deterioration. The current study was aimed at describing and comparing the patients on the malnutrition ward, in 2001 and 1983. The study gathered indices of nutritional status and secondary diagnoses from the notes of all children (aged between 6 months and 5 years) discharged from the malnutrition ward for a period of l year (January-December 2001), and from data (collected in January-December 1983) for the malnutrition ward. Data was entered and analysed using Epi-Info 6 and SPSS statistics package. The ethics committee of the hospital approved the study. Data was collected for 558 children in 2001 and 833 in 1983. There was no gender difference, average age was 21.7 months in 2001 and 23.8 months in 1983 and the average hospital stay was 13.1 and 14.3 days, respectively. In 2001, 33 per cent had kwashiorkor, 26 per cent marasmus, and 28 per cent marasmic kwashiorkor. Three hundred and twenty children (82 per cent) were <2 Z-scores below the median weight-for-age and 252 children (65 per cent) were <3 Z-scores. Forty per cent had malaria, 65 per cent anaemia, 53 per cent bronchopneumonia, 14 per cent TB, 36 per cent diarrhoea, and 12 per cent HIV/AIDS. In 1983, 49 per cent had kwashiorkor, 17 per cent marasmus, and 11 per cent had marasmic kwashiorkor. A total of 494 children (81 per cent) were <2 Z-scores below the median weight-for-age and 335 children (55 per cent) were <3 Z-scores. Eighteen per cent had malaria, 37 per cent anaemia, 28 per cent bronchopneumonia, 6 per cent TB, 8 per cent diarrhoea, and 4.4 per cent measles/post-measles. A comparison between the clinical status of 1983 with that of 2001 shows little difference in age, gender or length of stay. There were fewer admissions in 2001, although a higher percentage of severely underweight children and the 2001 group had more secondary infections, especially malaria, bronchopneumonia and anaemia. Clinical malnutrition at a referral hospital level, in spite of the remarkable Mozambican economic growth, shows signs of following the depressing pattern for much of Eastern Africa. A prospective study including HIV tests and anthropometric data for this and the city's other hospitals is warranted. Discussion needs to be prompted on a local level about malnutrition and the use of guidelines.

Body Weight↗