International journal of epidemiology
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Studies examining the associations between short birth spacing and child mortality have often concentrated on the strength of the associations whilst the public health importance of short spacing in specific communities has received less attention. This study re-examines the association between short birth intervals and child mortality in rural Senegal and discusses the potential direct effects of efforts to delay births on child mortality in this community. ⋯ In this community where prolonged breastfeeding causes women to space their births at long intervals, short birth intervals are a consequence rather than a cause of child mortality and the potential direct effects of birth spacing efforts on child mortality are limited. To reduce the high levels of child mortality, efforts will have to be made to ensure effective preventive and curative health services, and to maintain the traditional pattern of breastfeeding.
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Comparative Study
Birthweight outcomes among Asian American and Pacific Islander subgroups in the United States.
Information on birth outcome among the Asian and Pacific Islander populations in the US is limited. This report examines the risks of moderately low (MLBW) and very low birthweight (VLBW) among six Asian subgroups (Chinese, Japanese, Fillipinos, Asian Indians, Koreans, Vietnamese) and three Pacific Islander subgroups (Hawaiians, Guamanians, Samoans) as compared with non-Hispanic whites. ⋯ Marked heterogeneity in birthweight outcome was observed between Asian American and Pacific Islander subgroups. This heterogeneity was not related to traditional demographic risk factors. Additionally, risks of VLBW and MLBW were not always related. These findings suggests that the Asian American and Pacific Islander populations should not be aggregated into a single category, and that traditional measures of risk and birth outcome may not be valid for those groups.
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Inguinal hemia repair is one of the most common operations undertaken in routine surgical practice. It generally carries a very low risk of major adverse sequelae. We analysed profiles, separately, for elective and emergency operations to report on the incidence and major adverse outcomes of inguinal hernia repair in a geographically defined population. ⋯ The lifetime 'risk' of inguinal hernia repair is high: at currently prevailing rates we estimate it at 27% for men and 3% for women. There is significant elevation of mortality after emergency operations. Elective repair of inguinal hernia should be undertaken soon after the diagnosis is made to minimize the risk of adverse outcomes.
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Clinical Trial Controlled Clinical Trial
Child mortality following standard, medium or high titre measles immunization in West Africa.
The World Health Organization (WHO) recommended the use of high titre measles vaccine in 1989. Subsequent long term follow-up of several trials yielded results suggesting higher mortality among children inoculated with medium and high titre vaccines compared to standard titre vaccines, although none of the individual trials found significant differences in mortality. ⋯ The combined analysis showed a decreased survival related to high titre measles vaccine compared with standard titre vaccines, though solely among females. As a result of these studies from West Africa and a study from Haiti, WHO has recommended that high titre measles vaccine no longer be used.
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In general, information on the causes of adult deaths in developing countries is scarce. More specifically, relatively little is known about the effect of HIV-1 associated disease on adult mortality in general populations. In this study we have used a verbal autopsy technique to ascertain whether adult deaths were associated with HIV-1 in a rural population with a prevalence of HIV-1 infection of 8%, and used HIV-1 antibody status to validate the verbal autopsy findings. ⋯ The results of this study suggest that verbal autopsy studies may assist in providing data on HIV-associated mortality in general populations and may be useful as surveillance tools.