Estimating the Incidence of Typhoid Fever and Other Febrile Illnesses in Developing Countries

To measure the incidence of typhoid fever and other febrile illnesses in Bilbeis District, Egypt, we conducted a household survey to determine patterns of health seeking among persons with fever. Then we established surveillance for 4 months among a representative sample of health providers who saw febrile patients. Health providers collected epidemiologic information and blood (for culture and serologic testing) from eligible patients. After adjusting for the provider sampling scheme, test sensitivity, and seasonality, we estimated that the incidence of typhoid fever was 13/100,000 persons per year and the incidence of brucellosis was 18/100,000 persons per year in the district. This surveillance tool could have wide applications for surveillance for febrile illness in developing countries

Commentary on: ‘Pacifiers Use in Term Infants and Breastfeeding: Caution with the Cochrane Results’

This is a commentary of Cochrane review, published in this issue of EBCH, first published as: Jaafar SH, Jahanfar S, Angolkar M, Ho JJ. Pacifier use versus no pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database of Systematic Reviews 2011, Issue 3. Art. No.: CD007202. DOI: 10.1002/14651858.CD007202.pub2

Midwives' reported practice supporting the first breastfeed

10.1111/j.1740-8709.2008.00173.xMaternal and Child Nutrition54334-34

Predictors of death from severe pneumonia among children 2-59 months old hospitalized in Bohol, Philippines: implications for referral criteria at a first-level health facility

Objective To determine predictors of death among children 2 - 59 months old admitted to hospital with severe pneumonia. methods Prospective observational study from April 1994 to May 2000 to investigate serious infections in children less than 5 years old admitted to a tertiary care government hospital in a rural province in central Philippines. The quality of clinical and laboratory work was monitored. The WHO classification for severe pneumonia was used for patient enrolment. Results There were 1249 children with severe pneumonia and no CNS infection. Thirty children died. Using univariate analysis, the following factors were significantly associated with death: age 2 - 5 months, dense infiltrates on chest radiography and presence of definite bacterial pathogens in the blood. Stepwise logistic regression analysis revealed the following independent predictors of death: age 2 - 5 months, weight for age z- score less than) 2 SD, dense infiltrates on chest radiography and definite pathogens isolated in the blood. When the results of chest radiographs and blood cultures were not included to mimic facilities available at first- level facilities, age 2 - 5 months and weight for age z- score less than) 2 SD remained independent predictors of death. Conclusion When resources are limited, children with lower chest wall indrawing ( severe pneumonia) who are 2 - 5 months old or moderately to severely malnourished should be referred for immediate higher- level care