PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Infant Mortality--prevention and control”

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 19 recordsLinked to original sources
PubMed1992

Pediatric AIDS and perinatal HIV infection in Zaire: epidemiologic and pathologic findings.

HIV infection in women and children is a special problem in Zaire and in other countries where heterosexual transmission is predominant. Nearly half of the cases of HIV infection are in women 15 to 30 years old and as many as seven infected infants may be born each year. Whether or not infected at birth, these children have mothers, and often fathers, who are infected and likely to die while they are still very young. Such orphaned children, as well as those whose families cannot provide adequate food and health care, add to the problematic economies of developing countries. The problems of children of HIV-infected mothers in developing countries may be compounded further by factors directly related to their mother's disease. Infected mothers who are sick may produce insufficient levels of antibodies and be unable to provide their children with adequate natural passive immunity before birth. Their infants may also receive inadequate levels of breast-milk-derived antibodies possibly enhancing their already increased susceptibility to perinatal infections, and lastly, the volume of breast milk produced by these mothers may be inadequate for the nutrition of these infants. All these factors may further compromise the already difficult task of distinguishing those infants of HIV-infected mothers who are ill because they are infected from those who are ill because of their mother's disease. Regardless of the mechanisms accounting for the increased vulnerability of infants of HIV--seropositive and AIDS-afflicted mothers to perinatal infections, infant mortality can be expected to increase significantly as a direct consequence of the progression of the HIV pandemic throughout Africa and possibly other developing countries; this in populations already with a total under five-years-of-age mortality rate exceeding 15%. The association of chorioamnionitis with HIV seropositivity and with the clinical status of the mother seems to suggest that impaired maternal immunity increases the risk of premature birth, its consequent lower birth weight, and to HIV or other perinatally acquired infections. The identification of women at higher risk of chorioamnionitis and their treatment might provide a means to decrease the risk of premature delivery and possibly reduce the rate of HIV transmission to their infants. The pathologic changes in organs of infants and children with HIV infection require in-depth, systematic study to better define the natural history of perinatal HIV disease and infection.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1990

HIV and infant feeding practices: epidemiological implications for sub-Saharan African countries.

In industrialized countries HIV-1-seropositive mothers who are nursing infants are advised to use artificial feeds, whilst HIV-infected women in the developing world are recommended to breast-feed. Current evidence is insufficient even to estimate the attributable risk associated with breast-feeding. There is a possibility that the policy promoted in industrialized societies will eventually become established in urban and peri-urban areas of sub-Saharan Africa. This may be defensible for some elite urban mothers providing safe artificial feeding. However, calculations of the consequence of any population-level change to bottle-feeding indicate that it would result in more deaths from infectious causes, substantially adding to the child deaths directly attributable to HIV-1 infection. These data demonstrate that there is a clear need for policy-makers and health care workers to undertake further promotion of breast-feeding despite the AIDS epidemic.

Africa↗
PubMed1992

Measures to reduce the infant mortality rate in Tanzania.

Tanzanian health problems reflect those in other developing countries where the standard of living is low and housing and sanitation are inadequate. The major cause of infant mortality can be attributed to preventable diseases such as gastroenteritis, acute respiratory infections and malnutrition. In spite of the fact that various efforts have been made to extend primary health care coverage, particularly in rural areas, the scarcity of economic resources impedes the implementation of many health programmes. However, only by maintaining primary health care as a major part of the country's development strategy can the needs of both rural and urban people be met.

Child Health Services↗
PubMedDate not supplied

Nurse-midwifery in rural Pakistan.

Pakistan is a relatively new nation of predominantly Islamic influence. Like many developing countries, it is plagued by extensive communicable diseases, malnutrition, inadequate sewage systems, and illiteracy. Religious beliefs and cultural influences impact heavily on access to health care and on maternal-child health outcomes. This paper examines the major maternal-child health problems encountered, as well as implications for midwifery practice in an Islamic country.

Child↗
PubMed1989

Pediatric mortality: an avoidable tragedy.

The article analyzes the causes of pediatric mortality. One thousand deaths secondary to medical diseases and conditions that occurred at the American University of Beirut Medical Center during 8 years are reviewed. Many deaths could have been avoided. Recommendations are made.

Cause of Death↗
PubMed1989

Cost-effectiveness of routine and campaign vaccination strategies in Ecuador.

A national household coverage survey of 3697 Ecuadorean children, carried out in July 1986, provided an opportunity for a cost-effectiveness analysis of (1) routine vaccination services based in fixed facilities and (2) mass immunization campaigns. A major purpose of the campaigns was to complement the routine services and to accelerate immunization activities. Based on the coverage survey, the Program for Reduction of Maternal and Childhood Illness (PREMI) and earlier campaigns increased the proportion of children under 5 years who were fully vaccinated from 43% to 64%. In one year, the PREMI campaign was responsible for fully vaccinating 11% of children under one year, 21% of 1-2-year-old children, and 13% of all children under 5 years. The campaign also helped ensure that vaccinations were completed when children were still very young and at greatest risk. The average cost per vaccination dose (in 1985 US$ prices) was approximately $0.29 for fixed facilities and $0.83 for the PREMI campaign. Total national costs were $675,000 and $1,665,000 for routine and campaign services respectively. The cost per fully vaccinated child (FVC) was $4.39 for routine vaccination services and $8.60 for the campaign. The cost per death averted was about $1900 for routine vaccination services, $4200 for the PREMI campaign, and $3200 for the combined programme. Because of Ecuador's lower mortality rates, the costs per death averted in Ecuador from both vaccination strategies are not as low as those from studies of vaccinations in Africa. The campaigns, though less cost-effective than routine services, significantly improved the vaccination coverage of younger children who had been missed by the routine services. The costs per FVC of both the campaign and the routine services compare favourably with such programmes in other countries.

Child↗
PubMed1989

Pattern of preventable diseases in Afghanistan: suggestions to reduce the morbidity and mortality at IGICH.

Over nine years period (1354-1362), 1,39,436 children were admitted in Indira Gandhi Institute of Child Health (IGICH), Kabul. Of these 51,212 (46.8%) children were hospitalised with preventable diseases. Seventy four per cent of patients were under five years of age. Among the infectious diseases, gastroenteritis accounted for nearly 70% of admissions. Tuberculosis, measles, diphtheria and typhoid fever were other common infectious diseases. Malnutrition of varying degree was the core problem among the hospitalised children and was seen in nearly two thirds of admissions. Twenty per cent of them had severe protein energy malnutrition which contributed for higher mortality. Gastroenteritis contributed for half (51.5%) of the mortality. Septicemia, tetanus neonatorum and central nervous system infections were associated with high mortality especially among the neonates. Deaths following 6-target preventable diseases accounted for nearly 1/4th of deaths (20.4-24.6%) over these years.

Afghanistan↗
PubMed1990

Reduction in pneumonia mortality and total childhood mortality by means of community-based intervention trial in Gadchiroli, India.

In a community-based intervention trial to reduce childhood mortality from pneumonia the intervention area included 58 villages (6176 children aged 0-4 years) and the control area 44 villages (3947 children) in Gadchiroli, India. The interventions included mass education about childhood pneumonia and case-management of pneumonia by paramedics, village health workers, and traditional birth attendants (TBAs) who were trained to recognise childhood pneumonia and treat it with co-trimoxazole. Parents sought treatment, and coverage was 76% without active case-detection efforts. The case-fatality rate among the 612 cases treated by health workers was 0.8%, compared with 13.5% in the control area. After a year of intervention pneumonia-specific childhood mortality was significantly lower in the intervention than in the control area (8.1 vs 17.5 deaths per 1000 children under 5 years); the difference between the areas was greatest in children under 1 year. The differences in infant mortality (89 vs 121 per 1000) and total under-5 mortality (28.5 vs 40.7 per 1000) were highly significant. Mortality from other causes remained similar in the two areas but neonatal mortality due to birth injury and prematurity was significantly lower in the intervention area, presumably owing to the combination of better maternal and neonatal care by the TBAs trained in the project and the availability of treatment for pneumonia. The cost of co-trimoxazole was US $0.025 per child per year ($2.64 per child saved).

Administration, Oral↗
PubMed1991

The effect of insecticide-treated bed nets on mortality of Gambian children.

Insecticide treatment of bed nets ("mosquito nets") may be a cheap and acceptable method of reducing the morbidity and mortality caused by malaria. In a rural area of The Gambia, bed nets in villages participating in a primary health-care (PHC) scheme were treated with permethrin at the beginning of the malaria transmission season. Additionally, children aged 6 months to 5 years were randomised to receive weekly either chemoprophylaxis with maloprim or a placebo throughout the malaria transmission season. We measured mortality in children in PHC villages before and after the interventions described, and compared this with mortality in villages where no interventions occurred (non-PHC villages). About 92% of children in PHC villages slept under insecticide-treated bed nets. In the year before intervention, mortality in children aged 1-4 years was lower in non-PHC villages. After intervention, the overall mortality and mortality attributable to malaria of children aged 1-4 in the intervention villages was 37% and 30%, respectively, of that in the non-PHC villages. Among children who slept under treated nets, we found no evidence of an additional benefit of chemoprophylaxis in preventing deaths. Insecticide-treated bed nets are simple to introduce and can reduce mortality from malaria.

Antimalarials↗
PubMed1991

Levels and determinants of early neonatal mortality in Natal, northeastern Brazil: results of a surveillance and case-control study.

An institution-based surveillance and nested case-control study was conducted in Natal, Northeastern Brazil to estimate the level and determinants of early neonatal mortality. The early neonatal mortality rate was 25.5 per 1000 live-birth, 75% of early neonatal deaths were premature low birthweight infants, and the mortality rates were 591 and 318 per 1000 respectively, for preterm small for gestational age (PT-SGA) and preterm appropriate for gestational age (PT-AGA) infants. Mortality was 50 per 1000 for term low birthweight, and 8.6 for term normal birthweight AGA infants. In addition to prematurity and low birthweight, the main risk factors associated with early neonatal death were maternal smoking, complications during pregnancy or intrapartum, and inadequate antenatal care. The associations were weaker for prepregnancy factors such as single marital status or low maternal body weight, and no significant associations were observed with socioeconomic status. These findings suggest that in this population, efforts to reduce early neonatal death should focus on improved maternal care and the prevention of prematurity.

Brazil↗
PubMed1989

Prophylaxis of upper gastrointestinal bleeding in intensive care units: a meta-analysis.

A meta-analysis was performed of 15 randomized studies on the prophylaxis with cimetidine and/or ant-acids of upper GI bleeding acquired in the ICU. There were eight comparisons of a group receiving cimetidine with a control group, nine comparisons of a group receiving antacids with a control group, and ten comparisons of a group receiving cimetidine with a group receiving antacids. The incidence of upper GI bleeding ranged from 3.4% to 52.7% among 866 control patients who received either a placebo or no prophylaxis. In five of eight comparisons, cimetidine was significantly more effective than no treatment or a placebo to prevent occult and overt upper GI bleeding; the typical odds ratio was 0.32 (95% confidence interval 0.21 to 0.49). In six of nine comparisons, antacids were significantly more effective than no treatment or a placebo; the typical odds ratio was 0.12 (0.08 to 0.19). Finally, antacids were significantly more effective than cimetidine in two of ten comparisons; the typical odds ratio was 1.61 (0.97 to 2.65). However, weaknesses in the study designs, heterogeneity of treatment effects, the lack of strength of the accumulated evidence, and the fact that no utility has been shown in terms of reducing morbidity (shock, need for transfusion) or mortality, prevent any definitive conclusion in regard to compulsory use of upper GI bleeding prophylaxis for ICU patients.

Antacids↗
PubMed1990

Health beliefs related to diarrhea in Haitian children: building transcultural nursing knowledge.

Regardless of where they live or under what circumstances, mothers throughout the world seem to have a compelling desire to provide the best possible health care for their children (Huston, 1979). Haitian mothers living in the Dominican Republic were no exception. The health beliefs and practices of these mothers related primarily to diarrhea among their children which demonstrated a concern and resourcefulness that is commendable. The results of this study clearly indicate the importance of transcultural nurses conducting culturally relevant research as a basis to develop sound health programs in developing countries. Diarrhea was identified as the single most important threat to a child's health in these communities. That mothers did not know about the correct ingredients and/or proportions for oral rehydration solutions (Western views) was of interest. Although the Dominican government makes some commercial packets of ORS, most of the women interviewed did not have ready access to this product. This finding reflected the need for transcultural nurses to offer to teach mothers how to make ORS using the sugar, salt, and water they had available. Since the mothers' perception that diarrhea was a dangerous threat to their children's health, was verified by childhood mortality statistics in the bateys, it would seem that ORS could make a significant impact on the health status of the children. Breastfeeding also was a major health belief factor associated with the treatment of diarrhea. Even though the majority of mothers believed breast feeding should be continued if a child had diarrhea, a number believed it should be discontinued. Nurses working with CHWs will need to emphasize the importance of breastfeeding and help them to develop creative ways of communicating this information to the mothers. The second most dangerous threat to the child identified by the mothers was respiratory ailments. This suggests a new area of concentration for future research and training of CHWs. A host of new questions related to respiratory problems such as health beliefs, causative factors, course of disease, traditional treatments, mortality rate, etc. need to be investigated. When transcultural nurses plan health care programs for women and children in other cultures, it is important to recognize the concerns mothers have for their children, and their intense desire to nature and care for them. In this study, mothers willingly participated and demonstrated active interest in learning to use methods to improve the health and well being of their children. It is well documented (Lieban, 1977) that established health beliefs are not automatically discarded when new knowledge is made available, but that exploration and incorporation of new information when presented in a culturally relevant framework does occur. An understanding of local beliefs surrounding health is fundamental to the development of appropriate transcultural nursing interventions.

Adult↗
PubMed1992

Birth kits for safe motherhood in Bangladesh.

Tetanus infection remains the leading cause of high neonatal mortality in Bangladesh. Birth kits which instruct and assist in a clean, safe birth are seen as a key measure in reducing the high incidence of neonatal deaths. A multisectoral programme has developed a simple kit and tested its potential for distribution to pregnant women. Initial results are positive and development is continuing.

Adult↗