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At least 19 recordsLinked to original sources
PubMed1995

Interaction of condom design and user techniques and condom acceptability.

In 1991, the source of public sector condom supplies in an African country changed from USAID to WHO. Following a complaint, the two types of condoms were sampled and compared. Laboratory tests indicated that the new-style condoms were of adequate quality, but a number of differences were noted between the two types. Complaints that the condoms were short and broke frequently could not be reconciled with measurements. Lubricant quantities on the WHO-supplied condoms were found to be lower than on the USAID condoms, but still within the range found on the commercial market. Also, the WHO condoms were marginally narrower and thicker. WHO asked the authors to conduct field interviews to seek reasons for the reported problems. These revealed that the relative dissatisfaction with the WHO condoms was largely confined to a group of sex workers in a follow-up programme conducted by two educators funded by a European agency. The instructions for use being given by the educators magnified the risk of incorrect application of the condom. Design changes to the WHO condoms (regarding lubricant, size and thickness) were subsequently made to minimise the chance of wrong use.

Africa↗
PubMed1980

Malaria control and long-term periodicity of the disease in Pakistan.

The classic investigations of the malaria epidemics in the Punjab led to the conclusion that in this most populous and most malarious province of the present-day Pakistan, epidemics occurred regularly at intervals of approximately eight years. Against this background, the results of a Malaria Control Programme launched in 1975 are examined. The Programme, supported by USAID and WHO, represents in economic terms the greatest effort made against malaria in the country. Malathion, the main attack weapon of the Programme, was used on an unprecedented scale. This created logistic and--unexpectedly--toxicity problems among the spraying workers. Despite these difficulties, an over-all reduction of 76% in the slide positivity rate was observed in the first two years of operations of the Programme. The authors warn against measures which may curtail the activities of the Programme when, according to the cyclical periodicity of malaria in the Punjab, an epidemic wave can be expected in 1980-81, with inevitable repercussions all over the country.

Disease Outbreaks↗
PubMed1993

Children's nutritional status in female-headed households in the Dominican Republic.

A national representative household survey of food consumption, income, and expenditure was conducted in the Dominican Republic in 1986 by Tufts University School of Nutrition in cooperation with USAID Office of Nutrition [1: Rogers B. L. and Swindale A. Determinants of Food Consumption in the Dominican Republic. USAID/S & T/Nutrition, Washington, DC, 1988]. Out of 1440 families surveyed 706 had children under 6 years of age. Anthropometric indicators of height and weight were collected for all 1251 children in the sample in a follow-up study conducted from December 1986 to January 1987 by Tufts with USAID/Santo Domingo Mission funding. Anthropometric measurements were converted to standard deviation scores using NCHS standards; nutritional status was thus measured by height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ). Earnings in families with children having males as heads-of-household were roughly one-third greater than in those with females as household head; total income was also greater in these families, though not significantly. More calories and protein per adult equivalent were available in male-headed families as well. In spite of this superior economic and dietary situation, there was a trend throughout the entire sample for children of female-headed households to be taller and heavier for their age than those of two parent homes; all three anthropometric measures showed differences in the same direction. In the lowest expenditure quartile, WAZ and WHZ were significantly greater for children in female-headed households than their counterparts in male-headed households (WAZ: P = 0.01, WHZ: P = 0.00).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Changes in use of health services in a rural health zone in Zaire.

As part of the Combatting Childhood Communicable Diseases (CCCD) project funded by the US Agency for International Development (USAID), the Zairian CCCD programme conducted surveys in the rural health zones of Kingandu and Pai-Kongila, Zaire, in 1984-1985 and 1988-1989 to determine whether a strategy of selective primary health care would affect childhood mortality. This paper describes the changes in the medical care infrastructure and the increasing coverage of selected services. The strategies evaluated were vaccination, oral rehydration therapy, and treatment of febrile episodes with antimalarial drugs for children; and tetanus vaccination and malaria prophylaxis for pregnant women. The health infrastructure in the Kingandu and Pai-Kongila Health Zones expanded considerably from 1984 to 1989, with health centres increasing from 7 to 18. During this period, economic conditions deteriorated moderately, with the nation experiencing nearly 700% inflation. Medical care costs remained stable because of external subsidies. Use of health services was assessed in 1984, 1988, and 1989. Between 1984 and 1989, the proportion of children aged 12-23 months vaccinated against measles increased from 22% to 71%. Coverage with other vaccine antigens increased similarly. Women's knowledge of the correct recipe for the preparation of sugar-salt solution increased from 0% to 61%. Reported treatment at home with sugar-salt or oral rehydration solution increased from 6% to 53%. The proportion of children with febrile episodes who were treated presumptively for malaria with chloroquine remained unchanged (47% in 1984; 44% in 1988). We conclude that, despite a moderate deterioration in economic conditions, Kingandu and Pai-Kongila Health Zones achieved remarkable increases in use of selected health services between 1984 and 1989, especially in vaccination coverage.

Adolescent↗
PubMed1994

Knowledge and use of maternal and child health services by mothers in Papua New Guinea.

A survey was conducted in the coastal area of Morobe Province in Papua New Guinea between March to April 1992 in order to obtain and examine the current health knowledge and practices of mothers with children under two years of age. The purpose of the survey was to gather data for the detailed planning and implementation of a Child Survival Intervention Project funded by USAID. A total of 30 villages in the area were selected utilizing the WHO 30-cluster sampling technique. The results indicated that breastfeeding was a very common practice. However, because nutritional intake was not increased during pregnancy and lactation for many of the women, it is likely that their nutritional intake was insufficient. Although many mothers knew the importance of immunization, they were unclear about the importance of completing immunization series. The utilization of contraceptive methods was very low among women who did not want to have another child within the subsequent two years. The most common methods were injections and pills. The dissemination of health education to isolated rural villages is one of the most important interventions in reducing maternal and infant mortality. As there currently is no health education unit at the Morobe Provincial Department of Health. It is crucial to establish the unit and to emphasize the importance of health education as the tool for disease prevention and health promotion.

Adolescent↗
PubMed1978

Nutrition, development, and foreign aid: a case study of U.S.-directed health care in Colombian plantation zone.

Based on a case study of some aspects of Rockefeller and USAID intervention in the Cauca Valley, Colombia, this article is aimed at drawing attention to the political characteristics and inadequacies of U.S.-sponsored health care planning and research in the Third World, particularly as regards nutrition in rural regions of intensive economic development. By contrasting an historical analysis of the politicoeconomic development of agriculture and nutrition in the southern Cauca Valley with the assumptions guiding U.S. intervention in the health field there, a more complete picture of the causes of malnutrition is obtained, among which should be counted the intervention of the U.S. itself. Inter alia, other approaches to the malnutrition problem are suggested.

Agriculture↗
PubMed1991

Current status of malaria in Taiwan from 1966 to 1990.

Malaria was highly or moderately endemic in about 200 townships among the 360 municipalities in Taiwan before the World War II. During and after the War, annual incidence of malaria was estimated as 1.2 million cases out of 6 million population at that period. In 1952, malaria mortality was reported as 27.5 per 100,000 persons. Malaria Eradication Program in Taiwan was successfully carried out during 1947-1965 through a combined effort made by the Government, WHO, UNICEF and USAID, and by the participation of the community. Since 1966, avoidance of malaria transmission in population centers has been well maintained through the network of malaria surveillance system, both parasitological and entomological, at the ports (sea and air) of entry and by the 383 public health services all over the island. Through this surveillance network, a total of 936 malaria cases and distribution of the vector mosquito Anopheles minimus have been well documented during 1966- June 1990. Of the 936 malaria cases detected, 819 cases were classified as imported from outside the country, 14 cases as relapsing, 17 cases as induced infection through blood transfusion, and 86 cases as the secondary infection originating from the imported cases. These 86 cases were exclusively P. vivax infections which were found concealed in the mountainous area of the northern most of Taiwan during 1968-1973. This small transmission focus was swiftly eliminated without further dissemination to the other parts of the island. Of the 819 imported cases; 250 cases were P. falciparum infection, 516 cases were P. vivax, 19 cases were P. malariae, 18 cases were P. ovale and 16 cases were mixed infection of P. falciparum with other parasite species. among the imported malaria cases with P. falciparum (in total 266), six were reported fatal cases before proper diagnose and treatment. Of the 14 relapsing cases; 13 cases were P. malariae infection, and the remaining one case was P. vivax malaria. All the 17 induced malaria cases were caused by the blood transfusion, exclusively with P. malariae infection. It was quite difficult to prove the positive parasitemia directly under microscopy from the blood donors due to very low parasite density of their blood.

Humans↗
PubMed1995

Administration of 25,000 IU vitamin A doses at routine immunisation in young infants.

OBJECTIVE: To investigate whether monthly administration of vitamin A at routine immunisation produces any side-effects, and to examine the effect of this supplementation on the vitamin A nutrition status of infants. DESIGN: A double-blind randomised placebo-controlled clinical trial. SETTING: Immunisation clinic of a large diarrhoea treatment centre. SUBJECTS: Infants aged 6-17 weeks who will receive their first diphtheria-pertussis-tetanus/oral polio vaccine (DPT/OPV) dose. METHODS: Infants were randomly assigned to receive either 25,000 IU vitamin A or placebo. Three such doses were given with each immunisation dose at monthly intervals. Infants were examined by a physician before and during 24 h after the doses and any signs of toxicity were recorded. Venous blood was drawn at entry and 1 month after the 3rd dose for retinol assay. RESULTS: One hundred and one infants received vitamin A and 98 received placebo. Decreased feeding, irritability, diarrhoea, and vomiting were comparable between the two groups. In the vitamin A group five infants developed bulging fontanelle; three of them developed it once (after 1st, 2nd and 3rd dose respectively), one developed it twice (after both the 2nd and 3rd dose), and the other infant after all three doses. In the placebo group a single child developed bulging fontanelle after the 3rd dose. In all the cases the bulging disappeared within 48 h of onset except in one infant, in whom it subsided at 60 h. The total bulging episodes in the vitamin A and placebo groups were 8 and 1 respectively (RR = 7.7; P < 0.04). However, none of these infants had irritability. At entry fasting retinol level was < 10 micrograms/dl in 35% infants and in 87% infants it was < 20 micrograms/dl. After the third dose fasting retinol level was marginally better in the vitamin A group (mean +/- s.d.: 21.9 +/- 8.2 vs 19.2 +/- 7.8; P = 0.05). However, 47% infants receiving supplementation still had serum retinol level <20 micrograms/dl. CONCLUSION: The results suggest that administration of 25,000 IU of vitamin A in young infants along with routine immunisations, though associated with increased incidence of transient bulging fontanelle without any associated adverse signs or symptoms, may still be inadequate to prevent deficiency in this population. SPONSORSHIP: This study was funded by the United States Agency for International Development (USAID) under grant no. DPE-5986-A-1009-00 with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). The ICDDR,B is supported by countries and agencies which share its concern for the health problems of developing countries.

Double-Blind Method↗
PubMed1995

Variations in estimates of Guatemalan infant mortality, vaccination coverage, and ORS use reported by different sources.

All available estimates of rates of infant mortality, vaccination coverage (for BCG, DPT 3, polio 3, measles, and tetanus toxoid), and ORS use in Guatemala in the 1980s were identified and investigated. A large number of sources and estimates were found. Large discrepancies were also found between the estimates for a given indicator, even when the estimates were reported for the same year by the same source. For instance, reports for 1985 yielded 10 different infant mortality estimates ranging from 56.0 to 79.8 deaths per 1,000 live births; vaccination coverage estimates ranging from 30% to 60.5% for BCG, 3.5% to 34.2% for DPT 3, 3.5% to 33.5% for polio 3, 11% to 58.2% for measles, and 1% to 8.2% for tetanus toxoid; and estimated use rates of oral rehydration solution ranging from 3.5% to 7.2%. In this same vein, three Guatemalan Ministry of Health estimates of infant deaths per 1,000 live births in 1984 ranged from 52.4 to 79.8; four UNICEF estimates for 1985 ranged from 65 to 79.8; and three USAID estimates for 1987 ranged from 59 to 72. The many reasons found for this diversity point to significant problems influencing the reliability of current data.

Child, Preschool↗
PubMed1993

Trends in malaria morbidity and mortality in Sri Lanka.

Trends since 1930 in malaria morbidity and mortality in Sri Lanka were analysed. The Malaria Control Programme, which began in 1945 with DDT spraying, was associated with a 100-fold reduction in morbidity and mortality over the following ten years, and gave way to the Malaria Eradication Programme in 1958. DDT spraying ceased in 1964 and a vivax malaria epidemic in 1968 returned to the island to 1952 morbidity levels, though with little mortality. After the discovery of DDT resistance in 1969, malathion spraying took over in 1973, and USAID-assisted control programme, involving case-detection and treatment, started in 1977. However, morbidity levels comparable to 1952 levels were observed in 1975 and 1986 when falciparum malaria morbidity levels were especially high. Mortality rates since 1960 have however remained lower than at any other previous time.

History, 20th Century↗
PubMed1993

Emergency public health surveillance in response to food and energy shortages--Armenia, 1992.

Living conditions in Armenia have deteriorated since 1988 as a result of an economic blockade related to a territorial conflict between Armenia and a neighboring country. The effects of this blockade--a drastic reduction in available food, heating fuel, gasoline, electricity, health services, drugs, and vaccines--have placed residents of Armenia at increased risk for morbidity and mortality from nutritional deficiencies, infectious diseases, and hypothermia. To assess and monitor the current health and nutritional status of residents of Armenia, the Armenian National Institute of Health, the U.S. Agency for International Development (USAID), and CDC have developed the Emergency Public Health Information Surveillance System (EPHISS). This report summarizes preliminary results for 1992.

Armenia↗
PubMed1995

Risk factors of nutritional blindness and determinants of a successful vitamin A prophylaxis programme.

Data on 7668 children (0-72 months) and their 4621 mothers and 81 Anganwadi Workers (AWWs) collected for the USAID Assisted ICDS Evaluation Surveys were analysed. The results indicated that the major risk factors of nutritional blindness were lack of nutrition and health knowledge among mothers; presence of iron deficiency anemia in the children; and history of the child having had measles in the past one year. Mother's health and nutrition, knowledge and maternal literacy status were the determinants of the success of a vitamin A prophylaxis programme. Factors that determined AWW's performance in vitamin A supplementation were her nutrition and health knowledge, her literacy status and the amount of supervisory assistance she received from Auxillary Nurse Midwife (ANM).

Adult↗
PubMed1997

HIV counseling for behavior change.

The purpose of this paper was to provide a framework for discussion in the working group on HIV Counseling for Behavior Change at the Third USAID HIV/AIDS Prevention Conference. The paper begins with a section defining HIV counseling and describing different types of HIV counseling. Next, points of consensus and controversy regarding the conduct and evaluation of HIV counseling are discussed. This is followed by a section outlining findings to date on the effectiveness of HIV counseling, and a discussion of methodological issues in evaluating counseling outcomes. Finally, the paper includes a list of key issues for further research.

Acquired Immunodeficiency Syndrome↗
PubMed1976

Research and development of unconventional systems for immunization.

The problems raised by the ever expanding world population justify the work of USAID (U.S. Agency for International Development). Continual efforts must be made to develop and efficiently operate methods of control of the microbial and parasitic infections which menace our sources of protein. This programme includes immunization, technical methods in bacterial and viral genetics to obtain attenuated strains, and improvements in production, preservation and distribution of preparations. An example of an unconventional but promising system of application is the pilot study recently begun in the Missouri-Mississippi River region.

Animals↗