Persisting high hospital and community childhood mortality in an urban setting in Guinea-Bissau.

Aim: To describe paediatric hospitalization in a West African capital in relation to overall childhood mortality in the community and to evaluate the potential impact of improved management at the hospital.

Methods: Hospital data on child admissions in a 6-year period were linked to information in a community-based longitudinal surveillance system. Paediatric hospitalization rates, risk factors for hospitalizations, community mortality, in-hospital mortality and the proportion of deaths occurring at hospital were examined.

Breast milk reduces the risk of illness in children of mothers with cholera: observations from an epidemic of cholera in Guinea-Bissau.

Background: A protective effect of breastfeeding against cholera has been demonstrated in areas endemic of cholera. To assess the protection offered by breast milk from mothers living in an area that had been free from cholera for 7 years, we investigated mothers with cholera and their children during an epidemic with Vibrio cholerae El Tor in the capital of Guinea-Bissau.

Methods: Eighty mothers with clinical cholera and their children were identified, and interviewed.

HIV-1 infection prevalence and incidence trends in areas of contrasting levels of infection in the Kagera region, Tanzania, 1987-2000.

This study aimed at assessing the extent to which decline in HIV infection prevalence reflects decline in incidence in 3 areas with contrasting initial exposure to the HIV epidemic in the Kagera region of Tanzania. A population sample was recruited for the baseline study in 1987 through a multistage cluster sampling technique to determine HIV prevalence. Seronegative individuals identified in the baseline and subsequent studies were followed up for 3 years to yield trends in incidence that were compared for the 3 areas.

Childhood mortality after oral polio immunisation campaign in Guinea-Bissau.

Though previous studies have suggested a non-specific beneficial effect of oral polio vaccine (OPV), there has been no evaluation of the mortality impact of national polio immunization days. On the other hand, studies examining the effect of OPV and diphtheria-tetanus-pertussis (DTP) vaccines, which are usually administered together in routine immunisation programmes in low-income countries, have found no beneficial or even a negative effect on infant survival. In 1998, we used the opportunity of two national immunisation days to examine the impact of OPV administered alone on survival for the 6103 children less than 5 years of age in the Bandim Health Project's study area in Guinea-Bissau.

The social situation of motherless children in rural and urban areas of Guinea-Bissau.

With the increasing prevalence of HIV infection and the high maternal mortality, orphans are a rapidly growing problem in Africa. However, few studies describe the social conditions of these children. Our study focuses on motherless children in urban and rural areas of Guinea-Bissau.

Tuberculosis in Bissau: incidence and risk factors in an urban community in sub-Saharan Africa.

Background: Despite the long history of tuberculosis (TB) research, population-based studies from developing countries are rare.

Methods: In a prospective community study in Bissau, the capital of Guinea-Bissau, we assessed the impact of demographic, socioeconomic and cultural risk factors on active TB. A surveillance system in four districts of the capital identified 247 adult (>or=15 years) cases of intrathoracic TB between May 1996 and June 1998.

Maternal mortality: only 42 days?

Objective: A maternal death is defined by WHO as 'the death of a woman while pregnant or within 42 days of termination of pregnancy em leader '. The origin of the 42 days is no longer clear. In developing countries, the burden imposed by pregnancy and birth on a woman's body may extend beyond 42 days as pregnancy-related anaemia can persist for longer and vaginal haemorrhaging and risk of infections are not necessarily over after six weeks.

Treatment of children with Plasmodium falciparum malaria with chloroquine in Guinea-Bissau.

Children with symptomatic malaria in Bissau, Guinea-Bissau were randomly assigned to treatment with a 25 mg/kg total dose of chloroquine as recommended by the National Malaria Program or with a higher total dose of 50 mg/kg. Sixty-seven and 62 children, respectively, completed the treatment and were then followed once a week for five weeks. Treatment with a dose of 50 mg/kg was significantly more effective than treatment with 25 mg/kg in preventing recrudescence.

Application of Lime ( Citrus aurantifolia ) Juice to Drinking Water and Food as a Cholera-Preventive Measure.

The protective activity of lime juice against cholera was suggested in a recent case-control study from Guinea-Bissau, On the basis of these findings, we investigated the vibriocidal properties of juice from lime ( Citrus aurantifolia ) fruits added to well water, tap water, and food samples. Well-water samples showed initial pH values from 3.5 to 4,9 whereas water samples from municipal or private taps showed initial pH values between 7.