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A climate‐based prediction model in the high‐risk clusters of the Mekong Delta region,Vietnam: towards improving dengue prevention and control
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Dung Phung Mohammad Radwanur Rahman Talukder Shannon Rutherford Cordia Chu 《Tropical medicine & international health : TM & IH》2016,21(10):1324-1333
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Rosanne W. Wieten Wytze Vlietstra Abraham Goorhuis Michèle van Vugt Caspar J. Hodiamont Tjalling Leenstra Peter J. de Vries Saskia Janssen Pieter P. van Thiel Kees Stijnis Martin P. Grobusch 《Tropical medicine & international health : TM & IH》2012,17(8):1023-1030
Objectives The aim of this study was to assess the applicability and benefits of the new WHO dengue fever guidelines in clinical practice, for returning travellers. Methods We compared differences in specificity and sensitivity between the old and the new guidelines for diagnosing dengue and assessed the usefulness in predicting the clinical course of the disease. Also, we investigated whether hypertension, diabetes or allergies, ethnicity or high age influenced the course of disease. Results In our setting, the old classification, compared with the new, had a marginally higher sensitivity for diagnosing dengue. The new classification had a slightly higher specificity and was less rigid. Patients with dengue who had warning signs as postulated in the new classification were admitted more often than those who had no warning signs (RR, 8.09 [1.80–35.48]). We did not find ethnicity, age, hypertension, diabetes mellitus or allergies to be predictive of the clinical course. Conclusions In our cohort of returned travellers, the new classification system did not differ in sensitivity and specificity from the old system to a clinically relevant degree. The guidelines did not improve identification of severe disease. 相似文献
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Improving survey data on pregnancy‐related deaths in low‐and middle‐income countries: a validation study in Senegal
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Stéphane Helleringer Gilles Pison Bruno Masquelier Almamy Malick Kanté Laetitia Douillot Cheikh Tidiane Ndiaye Géraldine Duthé Cheikh Sokhna Valérie Delaunay 《Tropical medicine & international health : TM & IH》2015,20(11):1415-1423
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Qian Long Tuohong Zhang Ling Xu Shenglan Tang Elina Hemminki 《Tropical medicine & international health : TM & IH》2010,15(10):1210-1217
Objective To investigate factors influencing maternal health care utilisation in western rural China and its relation to income before (2002) and after (2007) introducing a new rural health insurance system (NCMS). Methods Data from cross‐sectional household‐based health surveys carried out in ten western rural provinces of China in 2003 and 2008 were used in the study. The study population comprised women giving birth in 2002 or 2007, with 917 and 809 births, respectively. Correlations between outcomes and explanatory variables were studied by logistic regression models and a log‐linear model. Results Between 2002 and 2007, having no any pre‐natal visit decreased from 25% to 12% (difference 13%, 95% CI 10–17%); facility‐based delivery increased from 45% to 80% (difference 35%, 95% CI 29–37%); and differences in using pre‐natal and delivery care between the income groups narrowed. In a logistic regression analysis, women with lower education, from minority groups, or high parity were less likely to use pre‐natal and delivery care in 2007. The expenditure for facility‐based delivery increased over the period, but the out‐of‐pocket expenditure for delivery as a percentage of the annual household income decreased. In 2007, it was 14% in the low‐income group. NCMS participation was found positively correlated with lower out‐of‐pocket expenditure for facility‐based delivery (coefficient ?1.14 P < 0.05) in 2007. Conclusions Facility‐based delivery greatly increased between 2002 and 2007, coinciding with the introduction of the NCMS. The rural poor were still facing substantial payment for facility‐based delivery, although NCMS participation reduced the out‐of‐pocket expenditure on average. 相似文献
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Using multi‐country household surveys to understand who provides reproductive and maternal health services in low‐ and middle‐income countries: a critical appraisal of the Demographic and Health Surveys
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K. Footman L. Benova C. Goodman D. Macleod C. A. Lynch L. Penn‐Kekana O. M. R. Campbell 《Tropical medicine & international health : TM & IH》2015,20(5):589-606
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Peter Waiswa Stella Nyanzi Sarah Namusoko‐Kalungi Stefan Peterson Goran Tomson George W. Pariyo 《Tropical medicine & international health : TM & IH》2010,15(10):1140-1147
Objective To explore the current care for and perceptions about preterm babies among community members in eastern Uganda. Methods A neonatal midwife observed care of preterm babies in one general hospital and 15 health centres using a checklist and a field diary. In‐depth interviews were conducted with 11 community health workers (CHWs) and also with 10 mothers, six fathers and three grandmothers of preterm babies. Three focus group discussions were conducted with midwives and women and men in the community. Content analysis of data was performed. Results Community members mentioned many features which may correctly be used to identify preterm babies. Care practices for preterm babies at health facilities and community level were inadequate and potentially harmful. Health facilities lacked capacity for care of preterm babies in terms of protocols, health workers’ skills, basic equipment, drugs and other supplies. However, community members and CHWs stated that they accepted the introduction of preterm care practices such as skin‐to‐skin and kangaroo mother care. Conclusion In this setting, care for preterm babies is inadequate at both health facility and community level. However, acceptance of the recommended newborn care practices indicated by the community is a window of opportunity for introducing programmes for preterm babies. In doing so, consideration needs to be given to the care provided at health facilities as well as to the gaps in community care that are largely influenced by beliefs, perceptions and lack of awareness. 相似文献
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Genetic signatures coupled with lineage shift characterise endemic evolution of Dengue virus serotype 2 during 2015 outbreak in Delhi,India
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Manish Chandra Choudhary Ekta Gupta Shvetank Sharma Nadeem Hasnain Pragya Agarwala 《Tropical medicine & international health : TM & IH》2017,22(7):871-880