印度、尼泊尔结核病控制项目考察报告

福建省世界银行贷款／英国赠款结核病控制项目自2002年4月24日正式启动以来,已做了大量的工作。为学习国外先进经验,更好地完成项目管理工作,省卫生厅组织有关项目人员一行8人于2003年12月11～23日赴印度和尼泊尔考察。先后听取了加尔格达西部班哥结核病院、阿格拉胸科医院、I．R．S结核病呼吸道疾病研究所和尼泊尔KALIMATI肺科医院的介绍,并现场参观了医院的相关科室。现将考察情况报告如下：     

尼泊尔的婚姻、生育和计划生育情况

<正>尼泊尔位于喜马拉雅山脉南侧,北面与中国毗邻,东、南和西面与印度接壤,面积147 181平方公里。人口26 427 399,其中男性13 240 233,女性13 187 166;平均寿命男性为62.9岁,女性为63.7岁。人种基本上为两大类:藏缅语人和印度雅利安人。全国分为三个     

尼泊尔卫生健康体制

该文对尼泊尔卫生健康体制进行了介绍与分析。对该国卫生管理体制、组织结构与设施、医疗卫生状况及现行健康政策进行了剖析与研究。     

印度医疗器械监管概述

1政治,卫生及市场1.1政治印度是一个联邦,是一个主权独立的、政教分离的、具有议会制政府的民主共和国。政体为联邦共和制。印度的国家机构由议会、总统、政府、司法机构组成。议会实行两院制,由联邦院（上院）和人民院（下院）组成。人民院中占有多数席位政党的领袖,出任政府总理。     

尼泊尔与中国的卫生资源比较分析

目的:通过对比分析尼泊尔和中国卫生资源,寻找共性与特点、成就与经验,为尼泊尔的卫生事业发展提供相应的对策和建议。方法:通过数据收集、文献阅读等途径了解尼泊尔卫生状况并比较探究其与中国在卫生方面的差距及其原因。结果:基于现有数据,尼泊尔的卫生资源总量不足,城乡分布极其不均匀,卫生人力极为短缺。结论:新中国成立以来的卫生工作经验可为尼泊尔逐步改善当前的卫生状况提供借鉴。     

中国和印度对尼泊尔卫生发展援助模式的比较

目的：通过比较中国和印度对尼泊尔卫生发展援助模式的异同和引起差异的原因,探讨印度值得中国学习的援助策略.方法：利用文献综述和关键人深入访谈法实施研究.通过中国、印度和尼泊尔提供和接受援助的部门网站和官员,获取文献资料;以滚雪球式的寻找方式,对中国和印度在尼泊尔卫生发展援助项目的知情人进行个人深入访谈.结果：中国和印度具有共同的援助基本原则,但在实施政策时存在差异,印度的卫生发展援助同其整体援助目标更相关.中国和印度对卫生发展援助的组织管理机构不同、决策层不同,援助协调性有所差异.结论：南亚的地缘政治和历史因素影响到援助模式的选择,中国对尼泊尔的卫生发展援助同领域两部门管理的现状导致了援助协调问题.     

尼泊尔孕产妇在家生产的影响因素

ＡｌｉｓｏｎＢｏｌａｍ等在ＨＥＡＬＴＨＰＬＣＨＡＮＤＰＬＡＮＮＩＮＧＶＳ ＦＮ １９９８年第２期上撰文，讨论在泥泊尔加德满都地区孕妇在家生产的影响因素。该文对了解发展中国家产科服务的提供及利用现况有一定参考价值。对发国家 产科服务的发展趋势也提供了可借鉴的建议。     

尼泊尔男女街边洗澡

尼泊尔人似乎和水有着天然的亲近感,然而据了解,在加德满都却没有一家室内的公共浴池,原因是收费太高,尼泊尔百姓承受不起,他们大多选择在街边的水池或者喷泉边洗澡。     

法国：国民议会批准临终关怀法案

法国国民议会2月17日通过了一项关于临终病人陪护补助金的议案。     

Capacity building in environmental health research in India and Nepal

The Fogarty International Training and Research Program in Environmental and Occupational Health at UC Berkeley concentrates on two major environmental health issues in the Indian subcontinent: arsenic in drinking water in West Bengal, India, and indoor air pollution in India and Nepal. Local trainees and researchers have had the opportunity to work on related research. Concerning arsenic in drinking water, projects included studies of skin lesions, pulmonary effects, reproductive outcomes, and child development, as well as mitigation approaches to reduce exposures. Activities in the indoor air pollution project have emphasized quantifying exposures to smoke from cooking and heating as well as their associations with tuberculosis and eye disease. Training has focused on developing skills necessary to address these problems. The training emphasizes in-country mentoring of trainees related to their research projects, and intensive short courses at partner institutions. The focus of capacity building in environmental health research in countries in economic and environmental transition should be on country-based research projects with embedded training efforts.     

Case-control study of indoor cooking smoke exposure and cataract in Nepal and India

BACKGROUND: The prevalence of cataract is higher in developing countries, and in both developed and developing countries more females than males are blind from cataracts. Three epidemiological studies have associated indoor cooking with solid fuels (e.g. wood or dung) and cataract or blindness. However, associations in these studies may have been caused by unmeasured confounding. METHODS: A hospital-based case-control study was conducted on the Nepal-India border. Cases (n = 206) were women patients, aged 35-75 years with confirmed cataracts. Controls (n = 203), frequency matched by age, were patients attending the refractive error clinic at the same hospital. A standardized questionnaire was administered to all participants. Logistic regression analysis involved adjustment for age, literacy, residential area, ventilation, type of lighting, incense use, and working outside. RESULTS: Compared with using a clean-burning-fuel stove (biogas, LPG, or kerosene), the adjusted odds ratio (OR) for using a flued solid-fuel stove was 1.23 [95% confidence interval (CI) 0.44-3.42], whereas use of an unflued solid-fuel stove had an OR of 1.90 (95% CI 1.00-3.61). Lack of kitchen ventilation was an independent risk factor for cataract (OR 1.96; 95% CI 1.25-3.07). CONCLUSION: This study provides confirmatory evidence that use of solid fuel in unflued indoor stoves is associated with increased risk of cataract in women who do the cooking. The association is not likely to be due to bias, including confounding, and strengthens the findings of three previous studies. Replacing unflued stoves with flued stoves would greatly reduce this risk, although cooking with cleaner-burning fuels would be the best option.     

Incidence Rate of Acute Encephalitis Syndrome without Specific Treatment in India and Nepal

Background:

A performance target (PT) for the incidence rate (IR) of acute encephalitis syndrome (AES) was not defined by the World Health Organization (WHO) due to lack of data. There is no specific treatment for ~90% of the AES cases.

Objectives:

(1) To determine the IR of AES not having specific treatment (AESn) in two countries, India and Nepal. (2) To suggest the PT.

Subjects and Methods:

This was a record-based study of the entire population of India and Nepal from 1978 to 2011. The WHO definition was used for inclusion of cases. Cases that had specific treatment were excluded. IR was calculated per 100,000 population per annum. Forecast IR was generated from 2010 to 2013 using time-series analysis.

Results:

There were 165,461 cases from 1978 to 2011, of which 125,030 cases were from India and 40,431 were from Nepal. The mean IR of India was 0.42 (s 0.24) and that of Nepal was 5.23 (σ 3.03). IRs of 2010 and 2011 of India and that of 2011 of Nepal were closer to the mean IR rather than the forecast IR. IR of 2010 of Nepal was closer to the forecast IR. The forecast IR for India for 2012 was 0.49 (0.19-1.06), for 2013 was 0.42 (0.15-0.97) and for Nepal for both 2012 and 2013 was 5.62 (1.53-15.05).

Conclusions:

IRs were considerably different for India and Nepal. Using the current mean IR as PT for the next year was simple and practical. Using forecasting was complex and, less frequently, useful.     

Susceptibility of a yak to influenza A viruses and presence of H3N2 antibodies in animals in Nepal and India

Naturally acquired antibody to H3N2 human influenza antigens was found in a yak—zebu crossbred in Nepal. Serial inoculation of a yak, negative for antibody, produced a response to A/Hong Kong/1/68 (H3N2), A/England/42/72 (H3N2), and A/Prague/1/56 (Heq1 Neq1) influenzavirus strains. Single radial diffusion tests showed that cattle and goats in West Bengal, India, and water buffaloes and cattle in Kathmandu, Nepal, also had antibodies against the H3N2 antigens. Haemagglutination-inhibition antibodies to equine influenzaviruses were not found in human, goat, cattle, chicken, and dog sera, nor were antibodies to avian viruses found in human or equine serum.     

Leptospirosis in Nepal

We present here a case report of a suspected leptospiral infection in a Nepali soldier, and the results of a serological survey of 188 residents of Eastern Nepal that indicate the infection may be common there. This is the first report of leptospirosis in Nepal although it is known to affect man and animals in most of the temperate and tropical regions of the world, and apparently occurs widely in India (Das Gupta, 1938; Khanna & Iyer, 1971).     

Delay in the diagnosis of tuberculosis in Nepal

Background  

Identifying reasons for delay in diagnosis and treatment of tuberculosis is important for the health system to find ways to treat patients as early as possible, and hence reduce the suffering of patients and transmission of the disease. The objectives of this study was to assess the duration of delay in the diagnosis of tuberculosis and to investigate its determinants.