Children in Burkina Faso who are protected by insecticide-treated materials are able to clear drug-resistant parasites better than unprotected children.

Background: It has been suggested that reducing exposure to malaria by vector control might impair the development of naturally acquired immunity to malaria. It is also thought that an individual's ability to clear drug-resistant malarial parasites after treatment is enhanced by acquired immunity.

Methods: To investigate the hypothesis that insecticide-treated materials may affect the acquisition of immunity to malaria, we compared the ability of children living in villages in which insecticide-treated curtains (ITCs) had been used for 6-8 years to clear resistant parasites after treatment with chloroquine (CQ) with that of children living in unprotected villages.

Sustained use of insecticide-treated curtains is not associated with greater circulation of drug-resistant malaria parasites, or with higher risk of treatment failure among children with uncomplicated malaria in Burkina Faso.

The impact of vector control measures on the evolution of antimalarial drug resistance is an important issue for malaria control programs. We investigated whether the in vivo efficacy of chloroquine (CQ) in children aged 6-59 months with uncomplicated malaria differed in 9 villages that had benefited from long-term use of insecticide-treated curtains (ITCs) and in 9 nearby non-ITC villages. We also compared the prevalence of genetic markers of resistance to CQ and sulfadoxine-pyrimethamine (SP) between the two groups of villages.

Safety and immunogenicity of the Plasmodium falciparum merozoite surface protein-3 long synthetic peptide (MSP3-LSP) malaria vaccine in healthy, semi-immune adult males in Burkina Faso, West Africa.

Unlabelled: The merozoite surface protein-3 long synthetic peptide (MSP3-LSP) comprises the amino acid sequence 186-276 of the Plasmodium falciparum protein MSP3. It is currently in development as an erythrocytic stage (blood stage) malaria vaccine candidate. We report here the first data on the safety, reactogenicity and immunogenicity of three doses of MSP3-LSP, adjuvanted with aluminium hydroxide, in healthy male adults living in a malaria endemic area.

[Knowledge, attitude and practices (KAP) of community health center staff on birth asphyxia in Kolokani (Mali)].

Most newborn deaths are associated with birth asphyxia (40%), low birth weigt and prematurity (25%) and infections (20%). In Mali, in the Community Health Centers (CSCOM) exercises a staff composed of the nurse chief of health centers (ICPM) assuring the supervision of the matrons that is charged in pregnancy and the newborn. An investigation KAP (Knowledge, Attitudes and Practises) initiated in order to assess the knowledge and the practices of the community health centers agents on birth asphyxia.

Effect of beta radiation on success of glaucoma drainage surgery in South Africa: randomised controlled trial.

Objective: To evaluate whether beta radiation may offer a practical method of improving surgical success for glaucoma drainage surgery in South Africa.

Design: Double blind, randomised controlled trial.

Setting: Three public hospitals in South Africa.

Methodological issues in the assessment of antimalarial drug treatment: analysis of 13 studies in eight African countries from 2001 to 2004.

The objectives of these analyses were to assess the feasibility of the latest WHO recommendations (28-day follow-up with PCR genotyping) for the assessment of antimalarial drug efficacy in vivo and to examine how different statistical approaches affect results. We used individual-patient data from 13 studies of uncomplicated pediatric falciparum malaria conducted in sub-Saharan Africa, using chloroquine (CQ), sulfadoxine/pyrimethamine (SP), or amodiaquine (AQ). We assessed the use effectiveness and test performance of PCR genotyping in distinguishing recurrent infections.

Estimating the causes of 4 million neonatal deaths in the year 2000.

Background: Information on cause-of-death is lacking for 98% of the world's 4 million neonatal deaths that occur in countries with inadequate vital registration (VR). Our aim was to estimate, by country for the year 2000, the distribution of neonatal deaths across programme-relevant causes including: asphyxia, preterm birth, congenital abnormalities, sepsis/pneumonia, neonatal tetanus, diarrhoea, and 'other'.

Methods: Two sources of neonatal cause-of-death data were examined: VR datasets for countries with high coverage (>90%), and published and unpublished studies identified through systematic searches.

Risk factors for variant Creutzfeldt-Jakob disease: a case-control study.

Objective: To investigate the potential risk factors for variant Creutzfeldt-Jakob disease (VCJD) in the United Kingdom.

Methods: Definite and probable vCJD cases (n = 136) were residing in Great Britain at disease onset, and were referred between May 1995 and November 2003. Control subjects (n = 922) were recruited between 2002 and 2003, from 100 randomly selected geographical clusters sampled to represent the geographical distribution of vCJD.

Vitamin a supplementation does not affect infants' immune responses to polio and tetanus vaccines.

It has been suggested that administering vitamin A with the measles vaccine may reduce the vaccine's immunogenicity. This trial examined the effect of supplementing vitamin A during the early months of life on infants' immune responses to tetanus and polio vaccines. Young infants (n = 1085) were enrolled and individually randomized into 1 of 4 groups in a factorial, double-blind, placebo-controlled trial.

Gaps in policy-relevant information on burden of disease in children: a systematic review.

Background: Valid information about cause-specific child mortality and morbidity is an essential foundation for national and international health policy. We undertook a systematic review to investigate the geographical dispersion of and time trends in publication for policy-relevant information about children's health and to assess associations between the availability of reliable data and poverty.

Methods: We identified data available on Jan 1, 2001, and published since 1980, for the major causes of morbidity and mortality in young children.

Neonatal measles immunity in rural Kenya: the influence of HIV and placental malaria infections on placental transfer of antibodies and levels of antibody in maternal and cord serum samples.

Introduction: Young infants are protected from measles infection by maternal measles antibodies. The level of these antibodies at birth depends on the level of antibodies in the mother and the extent of placental transfer. We investigated predictors of levels of measles antibodies in newborns in rural Kenya.

Evidence-based, cost-effective interventions: how many newborn babies can we save?

In this second article of the neonatal survival series, we identify 16 interventions with proven efficacy (implementation under ideal conditions) for neonatal survival and combine them into packages for scaling up in health systems, according to three service delivery modes (outreach, family-community, and facility-based clinical care). All the packages of care are cost effective compared with single interventions. Universal (99%) coverage of these interventions could avert an estimated 41-72% of neonatal deaths worldwide.

4 million neonatal deaths: when? Where? Why?

The proportion of child deaths that occurs in the neonatal period (38% in 2000) is increasing, and the Millennium Development Goal for child survival cannot be met without substantial reductions in neonatal mortality. Every year an estimated 4 million babies die in the first 4 weeks of life (the neonatal period). A similar number are stillborn, and 0.

A case-control study of sporadic Creutzfeldt-Jakob disease in the United Kingdom: analysis of clustering.

Background: The authors investigated whether cases of sporadic Creutzfeldt-Jakob disease (CJD) had lived closer to one another at some time in life than individuals without sporadic CJD. Such a phenomenon would be compatible with some cases resulting from transmission.

Methods: UK sporadic CJD cases occurring from 1990 to 1998 were identified.

Estimating the force of measles virus infection from hospitalised cases in Lusaka, Zambia.

Estimates of the force of infection (the rate at which susceptible individuals acquire infection) are essential for modelling the transmission dynamics of infectious diseases and can be a useful tool in evaluating mass vaccination strategies. Few estimates exist of the force of infection of measles virus in sub-Saharan Africa. A mathematical model was applied to age-specific recorded hospital admissions between September 1996 and September 1999 to estimate the force of measles virus infection in Lusaka, Zambia.

A simple model to predict the sensitivity to change of visual acuity measurements.

Background: Estimates of test-retest variability (TRV) in the form of a 95% range have been suggested as providing a cutoff value (or "change-criterion") against which measured acuity changes can be judged to decide whether they are indicative of a clinically important change. This approach is based on ensuring that the specificity of the procedure is 95% in individuals with no real change. In an earlier article we investigated empirically the ability of the procedure to detect varying degrees of change (its sensitivity).

Obstacles to conducting epidemiological research in the UK general population.

Experiences from a national case-control study of Creutzfeldt-Jakob disease show the tensions between protecting individual patients' confidentiality and the access required for the benefit of public health

Impact of counselling on careseeking behaviour in families with sick children: cluster randomised trial in rural India.

Objective: To assess whether training doctors in counselling improves careseeking behaviour in families with sick children.

Design: Pair matched, community randomised trial conducted in 12 primary health centres (six pairs). Doctors in intervention centres were trained in counselling, communication, and clinical skills, using the integrated management of childhood illness approach.

Crowding: risk factor or protective factor for lower respiratory disease in young children?

Background: To study the effects of household crowding upon the respiratory health of young children living in the city of São Paulo, Brazil.

Methods: Case-control study with children aged from 2 to 59 months living within the boundaries of the city of São Paulo. Cases were children recruited from 5 public hospitals in central São Paulo with an acute episode of lower respiratory disease.