Bulletin of the World Health Organizationhttps://scielosp.org/feed/bwho/2011.v89n10/2016-01-01T00:02:00ZUnknown authorVol. 89 No. 10 - 2011WerkzeugUnknow titleS0042-968620110010000012016-01-01T00:02:00Z2001-01-28T00:08:00ZGlobal action on social determinants of healthS0042-968620110010000022016-01-01T00:02:00Z2001-01-28T00:08:00ZMarmot, Michael
<em>Marmot, Michael</em>;
<br/><br/>
Social determinants of health: practical solutions to deal with a well-recognized issueS0042-968620110010000032016-01-01T00:02:00Z2001-01-28T00:08:00ZKrech, Rüdiger
<em>Krech, Rüdiger</em>;
<br/><br/>
Public health round-upS0042-968620110010000042016-01-01T00:02:00Z2001-01-28T00:08:00ZBehind the "Glasgow effect"S0042-968620110010000052016-01-01T00:02:00Z2001-01-28T00:08:00ZTackling social factors to save lives in IndiaS0042-968620110010000062016-01-01T00:02:00Z2001-01-28T00:08:00ZA decade towards better health in ChileS0042-968620110010000072016-01-01T00:02:00Z2001-01-28T00:08:00ZDealing with the big picture in AustraliaS0042-968620110010000082016-01-01T00:02:00Z2001-01-28T00:08:00ZBrazil calls for pact on social factors to improve healthS0042-968620110010000092016-01-01T00:02:00Z2001-01-28T00:08:00ZGlobal mesothelioma deaths reported to the World Health Organization between 1994 and 2008S0042-968620110010000102016-01-01T00:02:00Z2001-01-28T00:08:00ZDelgermaa, VanyaTakahashi, KenPark, Eun-KeeLe, Giang VinhHara, ToshiyukiSorahan, Tom
<em>Delgermaa, Vanya</em>;
<em>Takahashi, Ken</em>;
<em>Park, Eun-Kee</em>;
<em>Le, Giang Vinh</em>;
<em>Hara, Toshiyuki</em>;
<em>Sorahan, Tom</em>;
<br/><br/>
OBJECTIVE: To carry out a descriptive analysis of mesothelioma deaths reported worldwide between 1994 and 2008. METHODS: We extracted data on mesothelioma deaths reported to the World Health Organization mortality database since 1994, when the disease was first recorded. We also sought information from other English-language sources. Crude and age-adjusted mortality rates were calculated and mortality trends were assessed from the annual percentage change in the age-adjusted mortality rate. FINDINGS: In total, 92 253 mesothelioma deaths were reported by 83 countries. Crude and age-adjusted mortality rates were 6.2 and 4.9 per million population, respectively. The age-adjusted mortality rate increased by 5.37% per year and consequently more than doubled during the study period.The mean age at death was 70 years and the male-to-female ratio was 3.6:1.The disease distribution by anatomical site was: pleura, 41.3%; peritoneum, 4.5%; pericardium, 0.3%; and unspecified sites, 43.1%.The geographical distribution of deaths was skewed towards high-income countries: the United States of America reported the highest number, while over 50% of all deaths occurred in Europe. In contrast, less than 12% occurred in middle- and low-income countries. The overall trend in the age-adjusted mortality rate was increasing in Europe and Japan but decreasing in the United States. CONCLUSION: The number of mesothelioma deaths reported and the number of countries reporting deaths increased during the study period, probably due to better disease recognition and an increase in incidence. The different time trends observed between countries may be an early indication that the disease burden is slowly shifting towards those that have used asbestos more recently.Excess child mortality after discharge from hospital in Kilifi, Kenya: a retrospective cohort analysisS0042-968620110010000112016-01-01T00:02:00Z2001-01-28T00:08:00ZMoïsi, Jennifer CGatakaa, HellenBerkley, James AMaitland, KathrynMturi, NeemaNewton, Charles RNjuguna, PatriciaNokes, JamesOjal, JohnBauni, EvasiusTsofa, BenjaminPeshu, NorbertMarsh, KevinWilliams, Thomas NScott, J Anthony G
<em>Moïsi, Jennifer C</em>;
<em>Gatakaa, Hellen</em>;
<em>Berkley, James A</em>;
<em>Maitland, Kathryn</em>;
<em>Mturi, Neema</em>;
<em>Newton, Charles R</em>;
<em>Njuguna, Patricia</em>;
<em>Nokes, James</em>;
<em>Ojal, John</em>;
<em>Bauni, Evasius</em>;
<em>Tsofa, Benjamin</em>;
<em>Peshu, Norbert</em>;
<em>Marsh, Kevin</em>;
<em>Williams, Thomas N</em>;
<em>Scott, J Anthony G</em>;
<br/><br/>
OBJECTIVE: To explore excess paediatric mortality after discharge from Kilifi District Hospital, Kenya, and its duration and risk factors. METHODS: Hospital and demographic data were used to describe post-discharge mortality and survival probability in children aged < 15 years, by age group and clinical syndrome. Cox regression models were developed to identify risk factors. FINDINGS: In 2004-2008, approximately 111 000 children were followed for 555 000 person-years. We analysed 14 971 discharges and 535 deaths occurring within 365 days of discharge. Mortality was higher in the post-discharge cohort than in the community cohort (age-adjusted rate ratio, RR:7.7; 95% confidence interval, CI: 6.6-8.9) and declined little over time.An increased post-discharge mortality hazard was found in children aged < 5 years with the following: weight-for-age Z score <-4 (hazard ratio, HR:6.5); weight-for-age Z score >-4 but <-3 (HR:3.4); hypoxia (HR:2.3); bacteraemia (HR:1.8); hepatomegaly (HR:2.3); jaundice (HR:1.8); hospital stay >13 days (HR:1.8).Older age was protective (reference <1 month): 6-23 months, HR:0.8; 2-4 years, HR:0.6. Children with at least one risk factor accounted for 545 (33%) of the 1655 annual discharges and for 39 (47%) of the 83 discharge-associated deaths. CONCLUSION: Hospital admission selects vulnerable children with a sustained increased risk of dying. The risk factors identified provide an empiric basis for effective outpatient follow-up.Childhood and adult mortality from unintentional falls in IndiaS0042-968620110010000122016-01-01T00:02:00Z2001-01-28T00:08:00ZJagnoor, JagnoorSuraweera, WilsonKeay, LisaIvers, Rebecca QThakur, JSGururaj, GopalkrishnaJha, Prabhat
<em>Jagnoor, Jagnoor</em>;
<em>Suraweera, Wilson</em>;
<em>Keay, Lisa</em>;
<em>Ivers, Rebecca Q</em>;
<em>Thakur, Js</em>;
<em>Gururaj, Gopalkrishna</em>;
<em>Jha, Prabhat</em>;
<br/><br/>
OBJECTIVE: To estimate fall-related mortality by type of fall in India. METHODS: The authors analysed unintentional injury data from the ongoing Million Death Study from 2001-2003 using verbal autopsy and coding of all deaths in accordance with the International statistical classification of diseases and related health problems, tenth revision, in a nationally representative sample of 1.1 million homes throughout the country. FINDINGS: Falls accounted for 25% (2003/8023) of all deaths from unintentional injury and were the second leading cause of such deaths. An estimated 160 000 fall-related deaths occurred in India in 2005; of these, nearly 20 000 were in children aged 0-14 years. The unintentional-fall-related mortality rate (MR) per 100 000 population was 14.5 (99% confidence interval, CI: 13.7-15.4). Rates were similar for males and females at 14.9 (99% CI: 13.7-16.0) and 14.2 (99% CI: 13.1-15.4) per 100 000 population, respectively. People aged 70 years or older had the highest mortality rate from unintentional falls (MR: 271.2; 99% CI: 249.0-293.5), and the rate was higher among women (MR: 281; 99% CI: 249.7-311.3). Falls on the same level were the most common among older adults, whereas falls from heights were more common in younger age groups. CONCLUSION: In India, unintentional falls are a major public health problem that disproportionately affects older women and children. The contexts in which these falls occur and the resulting morbidity and disability need to be better understood. In India there is an urgent need to develop, test and implement interventions aimed at preventing falls.Risk factors for Mycobacterium tuberculosis infection among children in GreenlandS0042-968620110010000132016-01-01T00:02:00Z2001-01-28T00:08:00ZSøborg, BoletteAndersen, Aase BengaardMelbye, MadsWohlfahrt, JanAndersson, MikaelBiggar, Robert JLadefoged, KarinThomsen, Vibeke OstergaardKoch, Anders
<em>Søborg, Bolette</em>;
<em>Andersen, Aase Bengaard</em>;
<em>Melbye, Mads</em>;
<em>Wohlfahrt, Jan</em>;
<em>Andersson, Mikael</em>;
<em>Biggar, Robert J</em>;
<em>Ladefoged, Karin</em>;
<em>Thomsen, Vibeke Ostergaard</em>;
<em>Koch, Anders</em>;
<br/><br/>
OBJECTIVE: To examine the risk factors for Mycobacterium tuberculosis infection (MTI) among Greenlandic children for the purpose of identifying those at highest risk of infection. METHODS: Between 2005 and 2007, 1797 Greenlandic schoolchildren in five different areas were tested for MTI with an interferon gamma release assay (IGRA) and a tuberculin skin test (TST). Parents or guardians were surveyed using a standardized self-administered questionnaire to obtain data on crowding in the household, parents' educational level and the child's health status. Demographic data for each child - i.e. parents' place of birth, number of siblings, distance between siblings (next younger and next older), birth order and mother's age when the child was born - were also extracted from a public registry. Logistic regression was used to check for associations between these variables and MTI, and all results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Children were considered to have MTI if they tested positive on both the IGRA assay and the TST. FINDINGS: The overall prevalence of MTI was 8.5% (152/1797). MTI was diagnosed in 26.7% of the children with a known TB contact, as opposed to 6.4% of the children without such contact. Overall, the MTI rate was higher among Inuit children (OR:4.22; 95% CI: 1.55-11.5) and among children born less than one year after the birth of the next older sibling (OR:2.48; 95% CI: 1.33-4.63). Self-reported TB contact modified the profile to include household crowding and low mother's education. Children who had an older MTI-positive sibling were much more likely to test positive for MTI themselves (OR:14.2; 95% CI: 5.75-35.0) than children without an infected older sibling. CONCLUSION: Ethnicity, sibling relations, number of household residents and maternal level of education are factors associated with the risk of TB infection among children in Greenland. The strong household clustering of MTI suggests that family sources of exposure are important.Preoperative visual acuity among cataract surgery patients and countries' state of development: a global studyS0042-968620110010000142016-01-01T00:02:00Z2001-01-28T00:08:00ZShah, Shaheen PGilbert, Claire ERazavi, HessomTurner, Elizabeth LLindfield, Robert J
<em>Shah, Shaheen P</em>;
<em>Gilbert, Claire E</em>;
<em>Razavi, Hessom</em>;
<em>Turner, Elizabeth L</em>;
<em>Lindfield, Robert J</em>;
<br/><br/>
OBJECTIVE: To describe the preoperative surgical case mix among patients undergoing cataract extraction and explore associations between case mix, country level of development (as measured by the Human Development Index, HDI) and cataract surgery rates (CSRs). METHODS: Ophthalmologists in 50 countries were invited to join the newly-established International Eye Research Network and asked to complete a web-based questionnaire about their eye hospitals. Those who complied received a data collection form for recording demographic and clinical data on 100 consecutive patients about to undergo cataract surgery. Countries were ranked into five HDI categories and multivariable regression was used to explore associations. FINDINGS: Ophthalmologists at 112 eye hospitals (54% of them nongovernmental) in 50 countries provided data on 11 048 cataract procedures over 9 months in 2008. Patients whose visual acuity (VA) before surgery was < 6/60 in the better eye comprised 47% of the total case mix in poorly developed countries and 1% in developed countries (P < 0.001). Overall, 72% of the eyes undergoing surgery had a VA < 6/60. Very low VA before cataract surgery was strongly associated with poor development at the country level and inversely associated with national CSR. CONCLUSION: The proportion of patients with very poor preoperative VA is a simple indicator that can be easily measured periodically to monitor progress in ophthalmological services. Additionally, the internet can be an effective tool for developing and supporting an ophthalmological research network capable of providing a global snapshot of service activity, particularly in developing countries.Health-care-associated infection in Africa: a systematic reviewS0042-968620110010000152016-01-01T00:02:00Z2001-01-28T00:08:00ZNejad, Sepideh BagheriAllegranzi, BenedettaSyed, Shamsuzzoha BEllis, BenjaminPittet, Didier
<em>Nejad, Sepideh Bagheri</em>;
<em>Allegranzi, Benedetta</em>;
<em>Syed, Shamsuzzoha B</em>;
<em>Ellis, Benjamin</em>;
<em>Pittet, Didier</em>;
<br/><br/>
OBJECTIVE: To assess the epidemiology of endemic health-care-associated infection (HAI) in Africa. METHODS: Three databases (PubMed, the Cochrane Library, and the WHO regional medical database for Africa) were searched to identify studies published from 1995 to 2009 on the epidemiology of HAI in African countries. No language restriction was applied. Available abstract books of leading international infection control conferences were also searched from 2004 to 2009. FINDINGS: The eligibility criteria for inclusion in the review were met by 19 articles, only 2 of which met the criterion of high quality. Four relevant abstracts were retrieved from the international conference literature.The hospital-wide prevalence of HAI varied between 2.5% and 14.8%; in surgical wards, the cumulative incidence ranged from 5.7% to 45.8%.The largest number of studies focused on surgical site infection, whose cumulative incidence ranged from 2.5% to 30.9%. Data on causative pathogens were available from a few studies only and highlighted the importance of Gram-negative rods, particularly in surgical site infection and ventilator-associated pneumonia. CONCLUSION: Limited information is available on the endemic burden of HAI in Africa, but our review reveals that its frequency is much higher than in developed countries.There is an urgent need to identify and implement feasible and sustainable approaches to strengthen HAI prevention, surveillance and control in Africa.Estimated global incidence of Japanese encephalitis: a systematic reviewS0042-968620110010000162016-01-01T00:02:00Z2001-01-28T00:08:00ZCampbell, Grant LHills, Susan LFischer, MarcJacobson, Julie AHoke, Charles HHombach, Joachim MMarfin, Anthony ASolomon, TomTsai, Theodore FTsu, Vivien DGinsburg, Amy S
<em>Campbell, Grant L</em>;
<em>Hills, Susan L</em>;
<em>Fischer, Marc</em>;
<em>Jacobson, Julie A</em>;
<em>Hoke, Charles H</em>;
<em>Hombach, Joachim M</em>;
<em>Marfin, Anthony A</em>;
<em>Solomon, Tom</em>;
<em>Tsai, Theodore F</em>;
<em>Tsu, Vivien D</em>;
<em>Ginsburg, Amy S</em>;
<br/><br/>
OBJECTIVE: To update the estimated global incidence of Japanese encephalitis (JE) using recent data for the purpose of guiding prevention and control efforts. METHODS: Thirty-two areas endemic for JE in 24 Asian and Western Pacific countries were sorted into 10 incidence groups on the basis of published data and expert opinion. Population-based surveillance studies using laboratory-confirmed cases were sought for each incidence group by a computerized search of the scientific literature. When no eligible studies existed for a particular incidence group, incidence data were extrapolated from related groups. FINDINGS: A total of 12 eligible studies representing 7 of 10 incidence groups in 24 JE-endemic countries were identified.Approximately 67 900 JE cases typically occur annually (overall incidence: 1.8 per 100 000), of which only about 10% are reported to the World Health Organization. Approximately 33 900 (50%) of these cases occur in China (excluding Taiwan) and approximately 51 000 (75%) occur in children aged 0-14 years (incidence: 5.4 per 100 000). Approximately 55 000 (81%) cases occur in areas with well established or developing JE vaccination programmes, while approximately 12 900 (19%) occur in areas with minimal or no JE vaccination programmes. CONCLUSION: Recent data allowed us to refine the estimate of the global incidence of JE, which remains substantial despite improvements in vaccination coverage. More and better incidence studies in selected countries, particularly China and India, are needed to further refine these estimates.Action on social determinants of health is essential to tackle noncommunicable diseasesS0042-968620110010000172016-01-01T00:02:00Z2001-01-28T00:08:00ZRasanathan, KumananKrech, Rüdiger
<em>Rasanathan, Kumanan</em>;
<em>Krech, Rüdiger</em>;
<br/><br/>