FAPRI 1998 World Agricultural Outlook

The Food and Agricultural Policy Research Institute (FAPRI) prepares in the late fall of every year a preliminary baseline based on agricultural production, consumption, and trade. This is followed by an extensive outside review, re-evaluation of projections, and completion of the final baseline in January. The baseline assumes continuation of current agricultural and trade policies by world governments and assumes normal weather in the future. Macroeconomic assumptions on world general economic activity are derived from both Project LINK and the WEFA Group projections

Clinical predictors of bacterial meningitis in infants and young children in The Gambia.

BACKGROUND: Bacterial meningitis is an important cause of childhood morbidity and mortality world-wide. In the developing world, where the burden of acute meningitis and its long-term sequelae are especially high, staff with limited training at primary health care facilities must be able to recognize the symptoms and signs of meningitis, so that suspected cases can be referred urgently to hospitals. METHODS: Children who presented with possible invasive bacterial infection to health facilities in The Gambia, West Africa, between 1993 and 1995 were investigated in a standardized manner and clinical findings were documented. Bacterial meningitis was defined as the growth of bacteria from the cerebrospinal fluid. Clinical findings were compared between cases of meningitis and other children. RESULTS: Of 2097 children between 2 months and 3 years of age investigated, 51 had a confirmed diagnosis of bacterial meningitis. In multivariate analysis using a model adjusting for age but not including respiratory signs, the variables associated independently with meningitis were appearance of being very sick (odds ratio for meningitis vs. no meningitis or no lumbar puncture performed (OR) 4.1, 95% CI 1.5-11.1), being lethargic or unconscious (OR 5.2, 95% CI 2.1-13), a stiff neck (OR 29.3, 95% CI 12.2-70.3), a bulging fontanel (OR 3.2, 95% CI 1.2-8.5) and reduced feeding as a prompted complaint (OR 2.9, 95% CI 1.3-6.7). A combination model of a history of convulsions, or being lethargic or unconscious, or having a stiff neck, as used in the WHO-Integrated Management of Childhood Illness (IMCI) guidelines, had a sensitivity of 98% and a specificity of 72% to predict meningitis. CONCLUSIONS: A combination of a limited number of signs is sufficient to predict meningitis with high sensitivity, without a large number of children who do not have meningitis being unnecessarily referred

FAPRI 1998 World Agricultural Outlook

The Food and Agricultural Policy Research Institute (FAPRI) prepares in the late fall of every year a preliminary baseline based on agricultural production, consumption, and trade. This is followed by an extensive outside review, re-evaluation of projections, and completion of the final baseline in January. The baseline assumes continuation of current agricultural and trade policies by world governments and assumes normal weather in the future. Macroeconomic assumptions on world general economic activity are derived from both Project LINK and the WEFA Group projections.</p