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《Malawi medical journal : the journal of Medical Association of Malawi》2009,21(3):123-159
Background
Tackling Severe Acute Malnutrition (SAM) is critical to achieving child survival targets, such as Millennium Development Goal 4. Most feeding programmes treating SAM report patient outcomes on discharge from the programme. Research on whether children subsequendy remain alive and well is currendy limited, particularly in settings where HIV is prevalent.Aims
To describe long term outcomes following an episode of SAMMethods
We followed up on all surviving children discharged from a large urban NRU-based malnutrition programme one year after completion of a probiotic RCT (with no overall effect). HIV patients started cotrimoxazole prophylaxis and were referred for ARVs if meeting WHO (2005) HIV staging criteria.Results
From July 2006 to March 2007, 1024 patients contributed to 1187 admission episodes for treatment of SAM. 697/1024(68.1%) had oedematous malnutrition, 459/1024(45%) were HIV seronegative, and 445/1024(43%) were seropositive. HIV status was unknown in 120/1024(12%).There were 238/1024(23.2%) inpatient deaths: 42/459(9.2%) among HIV seronegative children, 126/445(28.3%) among seropositives, and 70/120(58.3%) among those not tested. Overall programme nutrition cure (weight-for-height>80% on 2 consecutive outpatient visits) was 471/1024(46.0%): 310/459(67.5%) among seronegatives and 155/445(34.8%) among seropositives.Long-term 1-year-outcomes were identified for 900/1024(87.9%) children. 365/471(77.5%) of children discharged as cured were alive and 37/471 (7.8%)were reported dead. 28/37(75.6%) of these late deaths in the year since discharge were HIV-positive. Total cumulative programme deaths had risen to 428/1024(41.8%):; 77/459(16.7%) among HIV seronegative children; 274/445(61.6%) among known seropositives.Conclusions
In this study, the majority of children discharged cured from a programme treating SAM were still alive 1 year after discharge. Overall programme mortality was high, however; HIV and failure to achieve cure were major underlying factors. Routine, short-term programme reporting systems would have underestimated this long-term post-SAM mortality. More studies are needed to explore long-term outcomes from other approaches to SAM treatment (notably in Community Management of Acute Malnutrition, CMAM programmes). Future analyses of variables in our programme will also play a role in understanding and addressing factors underlying positive or negative long-term outcomes. 2009 Sep; 21(3): 123–159.Mortality a Year After Admission with HIV and Severe Acute Malnutrition (SAM) in Malawi: A Cohort Study
J Bunn, G Chagaluka, and M Kerac Copyright and License information DisclaimerCopyright notice 相似文献3.
第十四届欧洲卒中会议(14th European Stroke Conference)于2005年5月25—28日在意大利博洛尼亚市召开。来自欧、美、亚洲和澳洲各国的1500名代表参会,其中我国20余名专家出席了大会。现就该届大会上有关卒中的危险因素、基因遗传、治疗、预后等热点问题概述如下。 相似文献
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19世纪的德国精神病学 总被引:1,自引:0,他引:1
李亚明 《Zhonghua yi shi za zhi (Beijing, China : 1980)》2005,35(2):114-117
19世纪是德国精神病学的黄金时期。在此期间,德国精神病学不仅在世界范围内占据优势地位,而且基本完成了其自身的职业化过程。因此,了解这一阶段的历史对于认识精神病学的历史和本质具有重要意义。通过论述形而上学观念的变迁、学术的进步以及精神病收容所的兴衰这三个层面的内容论述,将19世纪德国精神病学的面貌完整的展现出来。 相似文献
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第四届全国生命伦理学学术会议于2010年8月6日至8日在云南昆明召开,100多名来自国内及香港、台湾地区的与会学者对生命伦理学的一些重要问题展开了热烈而富有建设性的探讨. 相似文献
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Introduction
Severe malarial anaemia requiring blood transfusion is a major cause of in-hospital childhood morbidity and mortality in sub-Saharan Africa. Previous follow-up studies from high malaria transmission areas in southern Malawi and western Kenya have shown that transfused children with severe malarial anaemia are also at high risk of dying after discharge from the hospital. We hypothesize that failure to clear the initial malaria infection due to ineffective antimalarial treatment and the acquisition of new infections after discharge, negate the initial improvements in haemoglobin concentrations that result from the blood transfusion. The study aims to compare the efficacy of a single treatment course with lumefantrine artemether (Coartem®) at discharge to three treatment courses with Coartem® given at discharge, 1 and 2 months (IPTpd) in the post-discharge management of children who have recovered from severe malarial anaemiaMethods
This is a randomised double-blind placebo controlled trial in which children aged between 4–59 months will be randomised to receive IPTpd with Coartem or with placebo. Children are followed up for a period of 6 months with the primary efficacy endpoint being the incidence of recurrent severe anaemia or death.Results
The study recruitment and follow-up is complete and data is being analysed.Discussion and Conclusion
This study showing that preventing recurrent severe anaemia and death in this vulnerable group of children would lead to important policy recommendations. At the conference, we shall present important preliminary results 2010 Sep; 22(3): 82–104.Preliminary Results of Prevalence of Human Birth Defects in Five Referral Hospitals in Malawi
K Bultemeier,1 A Mwakikunga,2 J Mwale,3 K Chimwemwe,4 M Chirwa,5 and F Mgawedere6K Bultemeier
1University of Malawi/KCN/Blantyre, MalawiFind articles by K BultemeierA Mwakikunga
2University of Malawi/COM/Blantrye, MalawiFind articles by A MwakikungaJ Mwale
3University of Malawi/College of Health Sciences/Zomba, MalawiFind articles by J MwaleK Chimwemwe
4St. John''s College of Nursing/Mzuzu, MalawiFind articles by K ChimwemweM Chirwa
5University of Malawi/KCN/Lilongwe, MalawiFind articles by M ChirwaF Mgawedere
6University of Malawi/KCN/Lilongwe, MalawiFind articles by F MgawedereAuthor information Copyright and License information Disclaimer1University of Malawi/KCN/Blantyre, Malawi2University of Malawi/COM/Blantrye, Malawi3University of Malawi/College of Health Sciences/Zomba, Malawi4St. John''s College of Nursing/Mzuzu, Malawi5University of Malawi/KCN/Lilongwe, Malawi6University of Malawi/KCN/Lilongwe, MalawiCopyright notice 相似文献13.
中华医院管理学会病案管理专业委员会 《中国病案》2001,2(4):12-13
中华医院管理学会第十次全国病案管理学术会议于2001年11月7日-10日在上海市召开。会议主题会“新世纪病案信息管理科室的规范化建设”,会议收到论文255篇,论文水平比过去普遍有所提高,为方便与会代表讨论,会议制定并印发了《病案信息管理科室设置、任务、技术规范》和《病案书写规范》(讨论稿)文件。参加会议的代表240名,来自全国30个省、市、自治区,这是历次会议各省、市、参加会议最全的一次盛会。上海市医院管理学会林发雄会长在会议开幕式上代表上海学会,对大会在上海召开表示欢迎,并预祝会议圆满成功,中华医院管理学会江耘秘书长代表总会对会议的召 相似文献
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Canadian medical journalism in the 19th century. 总被引:1,自引:1,他引:0
C. G. Roland 《Canadian Medical Association journal》1983,128(4):449-51,454-5,458-9
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Thengo Kavinya 《Malawi medical journal : the journal of Medical Association of Malawi》2009,21(4):185-204