Articles: mortality.
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Comparative Study
HIV infection and breast-feeding: policy implications through a decision analysis model.
(1) To develop a comprehensive decision analysis model to compare mortality associated with HIV transmission from breast-feeding with the mortality from not breast-feeding in different populations and (2) to perform sensitivity analyses to illustrate critical boundaries for guiding research and policy. ⋯ Based on available data, the model supports current World Health Organization and Centers for Disease Control recommendations on HIV infection and breast-feeding. Given the importance of breast-feeding and the global impact of HIV infection, more research is needed, especially to clarify the range of HIV transmission rates from breast-feeding and to expand specific assessments of relative risks for different areas of the world.
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Wkly. Epidemiol. Rec. · Nov 1992
Expanded programme on immunization (EPI). Safety of high titre measles vaccines.
Unexpected results suggesting decreased survival when compared with standard titre vaccine administered at 9 months of age have been found in some field studies evaluating the performance of high titre measles vaccine. Analytical difficulties have arisen because the studies were not specifically designed to measure survival. Nonetheless, careful analysis of the results from all of the high titre vaccine trials showed decreased survival of high titre vaccine recipients, in areas with high background mortality rates, compared with recipients of standard measles vaccines at 9 months. ⋯ The panel recommended that high titre measles vaccine derived from the original Edmonston measles vaccine isolate should no longer be recommended for use in immunization programmes. Further post-licensure field studies of new measles vaccines should take into account the results of these studies. Additional detailed epidemiological studies in populations that have received high titre vaccines and their controls were encouraged.
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As Asia becomes increasingly urbanized the effect of new industrial development on child mortality becomes of increasing interest. In India, considerable investment has been made in the social infrastructure of industrial new towns. This survey of Durgapur steel town in West Bengal shows that although the average level of child mortality in the working class population is favourable in comparison with other Indian cities, considerable differentials, that can be related to social, economic and environmental differences within the population, have arisen since the creation of the city in the late 1950s. The paper argues that the undertaking of selective sanitary interventions to improve access to drinking water (in particular) would be administratively feasible in these industrial new towns, of immediate impact, and indeed necessary if the differentials in mortality are to be eliminated.
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The increasing trends of mortality from diabetes mellitus in Taiwan are becoming a public health concern. The age-adjusted death rate for diabetes was 3.7 per 100,000 population in 1960, which increased to 23.2 per 100,000 in 1988, a 6.3-fold increase over the past 30 years. The mortality data for diabetes in Taiwan from 1960 to 1988 for both sexes are presented and analysed using an age-period-cohort model in order to gain a better understanding of the possible determinants of the time trends of this disease. ⋯ Significant cohort effects were found which peaked in the birth-cohort 1910-1917. This declined thereafter for females but has levelled since then for males. Further study is necessary to assess the aetiological implications of diet and urbanization on time trends of diabetes.