DOCSLIB.ORG

GLOBAL TUBERCULOSIS REPORT 2018 Global Tuberculosis Report 2018

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

global TUBERCULOSIS REPORT 2018 GLOBAL TUBERCULOSIS REPORT 2018 Global Tuberculosis Report 2018 ISBN 978-92-4-156564-6 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY- NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. Global tuberculosis report 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. Designed by minimum graphics Cover designed by Irwin Law Printed in France WHO/CDS/TB/2018.20 Contents Abbreviations iv Acknowledgements v Executive Summary 1 Chapter 1. Introduction 7 Chapter 2. Global commitments to end TB and multisectoral accountability 9 Chapter 3. TB disease burden 27 Chapter 4. Diagnosis and treatment: TB, HIV-associated TB and drug-resistant TB 67 Chapter 5. TB prevention services 103 Chapter 6. Financing for TB prevention, diagnosis and treatment 113 Chapter 7. Universal health coverage, social protection and social determinants 131 Chapter 8. TB research and development 149 Annexes 1. The WHO global TB database 165 2. Country profiles for 30 high TB burden countries 171 3. Regional and global profiles 233 4. TB burden estimates, notifications and treatment outcomes 243 GLOBALTUBERCULOSIS REPORT 2018 iii Abbreviations aDSM active TB drug-safety monitoring and management MDR/RR-TB multidrug-resistant TB or rifampicin-resistant TB AIDS acquired immunodeficiency syndrome MDR-TB multidrug-resistant TB AMR antimicrobial resistance M:F male to female (ratio) ART antiretroviral therapy MIC minimal inhibitory concentration BCG bacille Calmette-Guérin mRNA messenger RNA BPaMZ bedaquiline, pretomanid, moxifloxacin and NACO National AIDS Control Organization pyrazinamide NCD noncommunicable disease BRICS Brazil, Russian Federation, India, China and South NFC near-field communication Africa NGO nongovernmental organization CAD computer-aided detection NHI national health insurance CFR case fatality ratio NHIF National Health Insurance Fund CHOICE CHOosing Interventions that are Cost-Efective NHIS National Health Insurance Scheme (WHO) NIAID National Institute of Allergy and Infectious Diseases CHW community health worker NIH National Institutes of Health CI confidence interval NTLD National Tuberculosis, Leprosy and Lung Disease CRS creditor reporting system Programme CV community volunteer NTP national TB programme CXR chest X-ray OECD Organisation for Economic Co-operation and DALY disability-adjusted life-year Development DST drug susceptibility testing PanACEA Pan-African Consortium for the Evaluation of EBA early bactericidal activity Antituberculosis Antibiotics EDCTP European and Developing Countries Clinical Trial PCR polymerase chain reaction Partnership PEPFAR President’s Emergency Plan for AIDS Relief EECA Eastern Europe and Central Asia PLHIV people living with HIV FIND Foundation for Innovative New Diagnostics PMDT programmatic management of drug-resistant TB GDG Guideline Development Group P:N prevalence to notification (ratio) GDP gross domestic product PPM public–public and public–private mix GHCC Global Health Cost Consortium ReSeqTB Relational Sequencing TB Knowledgebase Global Fund The Global Fund to Fight AIDS, Tuberculosis and RNA ribonucleic acid Malaria RNTCP Revised National TB Control Programme GPW General Programme of Work (WHO) RR rifampicin-resistant GRADE Grading of Recommendations Assessment, RR-TB rifampicin-resistant TB Development and Evaluation RT-qPCR reverse transcriptase quantitative PCR HBC high-burden country SDG Sustainable Development Goal HDC Health Data Collaborative SHA System of Health Accounts HIV human immunodeficiency virus SRL supranational reference laboratory HLM high-level meeting SSI Statens Serum Institut ICD-10 International classification of diseases (10th edition) TB tuberculosis IER Department of Information, Evidence and Research TB Alliance Global Alliance for TB Drug Development (WHO) TBTC TB Trial Consortium IGRA interferon gamma release assay TNF tumour necrosis factor IHME Institute of Health Metrics and Evaluation UCSR Unit Cost Study Repository ILO International Labour Organization UHC universal health coverage LAM lipoarabinomannan UN United Nations LEAP Livelihood Empowerment Against Poverty UNAIDS Joint United Nations Programme on HIV/AIDS LF-LAM lateral flow lipoarabinomannan assay US United States LPA line probe assay USA United States of America LTBI latent TB infection USAID US Agency for International Development MAMS-TB multi-arm, multi-stage TB VR vital registration MBLA molecular bacterial load assay WHO World Health Organization MDG Millennium Development Goal WRD WHO-recommended rapid diagnostic GLOBALTUBERCULOSIS REPORT 2018 MDR multidrug-resistant XDR-TB extensively drug-resistant TB iv Acknowledgements This global TB report was produced by a core team of Chapter 4 (Diagnosis and treatment: TB, HIV-associated 17 people: Laura Anderson, Annabel Baddeley, Hannah TB and drug-resistant TB) was prepared by Hazim Monica Dias, Katherine Floyd, Inés Garcia Baena, Nebiat Timimi, Yinyin Xia and Matteo Zignol, with contributions Gebreselassie, Christopher Gilpin, Philippe Glaziou, Irwin from Laura Anderson, Annabel Baddeley, Hannah Monica Law, Nobuyuki Nishikiori, Molebogeng Rangaka, Andrew Dias, Dennis Falzon, Katherine Floyd, Ernesto Jaramillo, Siroka, Charalambos Sismanidis, Lana Syed, Hazim Thomas Joseph, Irwin Law, Charalambos Sismanidis and Timimi, Yinyin Xia and Matteo Zignol. The team was led Lana Syed. For the box on the national inventory study in by Katherine Floyd. Overall guidance was provided by the Indonesia, which measured the level of underreporting of Director of the Global TB Programme, Tereza Kasaeva. detected TB cases in the country and is the largest study The data collection forms (long and short versions) of its kind to date globally, special thanks are due to the were developed by Philippe Glaziou and Hazim Timimi, study team for allowing WHO to feature the results and with input from staf throughout the WHO Global TB lessons learned in this report. The study team comprised Programme. Hazim Timimi led and organized all aspects the National TB Programme (Asik Surya, Sitti Ganefa, of data management. The review and follow-up of data Sulistyo, Syarifah Khadijah), the National Institute of was done by a team of reviewers that included Laura Health Research and Development (Agus Suprapto, Feri Anderson, Annabel Baddeley, Anna Dean, Hannah Monica Ahmadi, Dina Bisara Lolong, Oster Suriani Simarmata, Dias, Dennis Falzon, Inés García Baena, Giuliano Gargioni, Felly Philipus Senewe, Kristina Tobing), the National TB Medea Gegia, Ernesto Jaramillo, Thomas Joseph, Alexei Expert Committee (Muhammad N Farid, Pandu Riono) and Korobitsyn, Tomáš Matas,
Recommended publications
  • Mozambique Zambia South Africa Zimbabwe Tanzania

    Mozambique Zambia South Africa Zimbabwe Tanzania

    UNITED NATIONS MOZAMBIQUE Geospatial 30°E 35°E 40°E L a k UNITED REPUBLIC OF 10°S e 10°S Chinsali M a l a w TANZANIA Palma i Mocimboa da Praia R ovuma Mueda ^! Lua Mecula pu la ZAMBIA L a Quissanga k e NIASSA N Metangula y CABO DELGADO a Chiconono DEM. REP. OF s a Ancuabe Pemba THE CONGO Lichinga Montepuez Marrupa Chipata MALAWI Maúa Lilongwe Namuno Namapa a ^! gw n Mandimba Memba a io u Vila úr L L Mecubúri Nacala Kabwe Gamito Cuamba Vila Ribáué MecontaMonapo Mossuril Fingoè FurancungoCoutinho ^! Nampula 15°S Vila ^! 15°S Lago de NAMPULA TETE Junqueiro ^! Lusaka ZumboCahora Bassa Murrupula Mogincual K Nametil o afu ezi Namarrói Erego e b Mágoè Tete GiléL am i Z Moatize Milange g Angoche Lugela o Z n l a h m a bez e i ZAMBEZIA Vila n azoe Changara da Moma n M a Lake Chemba Morrumbala Maganja Bindura Guro h Kariba Pebane C Namacurra e Chinhoyi Harare Vila Quelimane u ^! Fontes iq Marondera Mopeia Marromeu b am Inhaminga Velha oz P M úngu Chinde Be ni n è SOFALA t of ManicaChimoio o o o o o o o o o o o o o o o gh ZIMBABWE o Bi Mutare Sussundenga Dondo Gweru Masvingo Beira I NDI A N Bulawayo Chibabava 20°S 20°S Espungabera Nova OCE A N Mambone Gwanda MANICA e Sav Inhassôro Vilanculos Chicualacuala Mabote Mapai INHAMBANE Lim Massinga p o p GAZA o Morrumbene Homoíne Massingir Panda ^! National capital SOUTH Inhambane Administrative capital Polokwane Guijá Inharrime Town, village o Chibuto Major airport Magude MaciaManjacazeQuissico International boundary AFRICA Administrative boundary MAPUTO Xai-Xai 25°S Nelspruit Main road 25°S Moamba Manhiça Railway Pretoria MatolaMaputo ^! ^! 0 100 200km Mbabane^!Namaacha Boane 0 50 100mi !\ Bela Johannesburg Lobamba Vista ESWATINI Map No.

  • The T-SPOT.TB Test Frequently Asked Questions

    General tuberculosis information T-SPOT.TB Test description and Frequently asked performance questions T-SPOT.TB Test performance characteristics T-SPOT.TB advantages over tuberculin skin test T-SPOT.TB test results T-SPOT.TB methodology Screening control programs Contact investigations References References Table of contents General tuberculosis information Tuberculosis: Definition, infection and disease 1. What is the scale of the TB problem? 2. How is TB spread? 3. What is TB infection (Latent Tuberculosis Infection “LTBI” or “latent TB”)? 4. What is TB disease (“active TB”)? 5. Are certain groups of individuals at an increased risk of exposure to Mycobacterium tuberculosis? 6. Are certain individuals at an increased risk of progressing from latent TB infection to TB disease? 7. How important is treatment for TB disease? 8. Why is the treatment period for TB disease so long? 9. How important is treatment for TB infection (“LTBI” or “latent TB”)? TB detection 10. Is there a test for the detection of TB infection (“LTBI” or “latent TB”)? • Tuberculin Skin Test (TST) • Interferon-Gamma Release Assays (IGRA) 11. Is there a test for the detection of TB disease (“active TB”)? 12. What are the limitations of the TST? Bacille Calmette-Guérin (BCG) vaccination 13. What is the BCG vaccination? T-SPOT.TB test description and performance 14. What is the intended use of the T-SPOT.TB test? 15. Why does the T-SPOT.TB test measure interferon-gamma? 16. Does the T-SPOT.TB test differentiate between latent TB infection and TB disease? 17. What data is there to support the T-SPOT.TB test in clinical use? 18.
  • Pediatric Tuberculosis in India

    Pediatric Tuberculosis in India

    Current Medicine Research and Practice 9 (2019) 1e2 Contents lists available at ScienceDirect Current Medicine Research and Practice journal homepage: www.elsevier.com/locate/cmrp Editorial Pediatric tuberculosis in India Tuberculosis (TB) was first called consumption (phthisis) by endemic in India, children are constantly exposed to tubercular Hippocrates because the disease caused significant wasting and antigens. Data on prevalence of environmental mycobacteria in loss of weight. India has the largest burden of TB in the world, India are also absent. Both these exposures can continue to and more than half the cases are associated with malnutrition.1,2 increased positivity to TST. Therefore, TST results in India can Stefan Prakash Eicher, born in Maharashtra, India, made this oil often be false positive. No data on these issues are available in In- painting “What Dreams Lie Within” of an emaciated patient with dia so far. TB seen on the streets of New Delhi (Image 1).3 This author conducted a study of skin test responses to a host of mycobacteria in BCG-vaccinated healthy Kuwaiti school children.5 BCG was routinely given to all children at the age of 5 yrs (school-going age). A multiple skin test survey on 1200 children aged 8e11 yrs and on 1228 children aged 12e16 yrs was conducted. All (except 15 children) had taken Japanese BCG vaccine 5 yrse9 yrs before the study was conducted. Tuberculin positivity was 90% in both the groups. This was associated with very high responsiveness to many other environmental mycobacterial antigens as well. It was proposed that such high TST positivity several years after BCG vaccination may be due to responsiveness to group II antigen pre- sent in all slow-growing species.
  • Operation Update Report Southern Africa: Drought (Food Insecurity)

    Operation Update Report Southern Africa: Drought (Food Insecurity)

    Operation Update Report Southern Africa: Drought (Food Insecurity) Emergency appeal n°: MDR63003 GLIDE n°: __ Operation update n° 3: 15 February 2021 Timeframe covered by this update: September 2020 – December 2020 Operation start date: 11 December 2019 Operation timeframe and end date: 17 months, 31 May 2021 Funding requirements: CHF 7.4 million DREF amount initially allocated: CHF 768,800 N° of people targeted: Botswana: 7,750 - Eswatini: 25,000 - Lesotho: 23,000 - Namibia: 18,000 Total: 73,750 people (14,750 households) Red Cross Red Crescent Movement partners currently actively involved in the operation: American Red Cross, British Red Cross; Canadian Red Cross; Finnish Red Cross; Netherlands Red Cross; Spanish Red Cross; Swedish Red Cross Other partner organizations actively involved in the operation: Governments of Botswana, Eswatini, Lesotho and Namibia; Government of Japan. Swedish International Development Cooperation Agency (Sida), United States Agency for International Development (USAID); World Food Programme (WFP); Food and Agricultural Organisation (FAO); GIZ; and UNICEF. <Please click here for the budget and here for the contacts> Summary: This operation update reflects the current situation and information available since the last operation update published in September 2020. The operation timeframe will be extended by one month to end on 31 May 2021 to allow for a final evaluation to be completed. Simultaneously, as needs persist and the funding gap in 2020 allowed to reach less than half of the targeted people in many places, extending the operation further beyond May is being discussed. Following discussions with the National Societies and estimates of needs and possible activities, a new operation update may be published to extend the timeframe or the Emergency Appeal may be revised should a change of activities be foreseen.
  • 2020 09 30 USG Southern Africa Fact Sheet #3

    2020 09 30 USG Southern Africa Fact Sheet #3

    Fact Sheet #3 Fiscal Year (FY) 2020 Southern Africa – Regional Disasters SEPTEMBER 30, 2020 SITUATION AT A GLANCE 10.5 765,000 5.4 1.7 320,000 MILLION MILLION MILLION Estimated Food- Estimated Confirmed Estimated Food-Insecure Estimated Severely Estimated Number Insecure Population in COVID-19 Cases in Population in Rural Food-Insecure of IDPs in Southern Africa Southern Africa Zimbabwe Population in Malawi Cabo Delgado IPC – Sept. 2020 WHO – Sept. 30, 2020 ZimVAC – Sept. 2020 IPC – Sept. 2020 WFP – Sept. 2020 Increasing prevalence of droughts, flooding, and other climatic shocks has decreased food production in Southern Africa, extending the agricultural lean season and exacerbating existing humanitarian needs. The COVID-19 pandemic and related containment measures have worsened food insecurity and disrupted livelihoods for urban and rural households. USG partners delivered life-saving food, health, nutrition, protection, shelter, and WASH assistance to vulnerable populations in eight Southern African countries during FY 2020. TOTAL U.S. GOVERNMENT HUMANITARIAN FUNDING USAID/BHA1,2 $202,836,889 For the Southern Africa Response in FY 2020 State/PRM3 $19,681,453 For complete funding breakdown with partners, see detailed chart on page 6 Total $222,518,3424 1USAID’s Bureau for Humanitarian Assistance (USAID/BHA) 2 Total USAID/BHA funding includes non-food humanitarian assistance from the former Office of U.S. Foreign Disaster Assistance (USAID/OFDA) and emergency food assistance from the former Office of Food for Peace (USAID/FFP). 3 U.S. Department of State’s Bureau of Population, Refugees, and Migration (State/PRM) 4 This total includes approximately $30,914,447 in supplemental funding through USAID/BHA and State/PRM for COVID-19 preparedness and response activities.
  • Malawi Program Highlights

    Malawi Program Highlights

    Malawi Program Highlights Cervical cancer is the number one cancer killer of women in sub-Saharan Africa (SSA), with roughly WLHIV on Cervical Cancer Malawi Funding Amount 110,000 women diagnosed annually; of these women, Treatment* Screening Target about 66% will die from the disease. Women living FY19 $5,409,699 449,407 42,179 with HIV (WLHIV) are up to six times more likely to develop persistent precancerous lesions and progress to cervical cancer, often with more aggressive form FY20 $2,199,935 200,136 101,507 and higher mortality. FY21 $3,000,000 378,235 103,671 Launched in May 2018 to address this challenge, Go Further is an innovative public-private partnership * For FY19, this is the number of women aged 30+ estimated to be on treatment; otherwise, between the U.S. President’s Emergency Plan for this is women aged 25-49 on treatment at the end of FYs 18 and 19, respectively. AIDS Relief (PEPFAR), the George W. Bush Institute, (Source: PEPFAR Panorama Spotlight) the Joint United Nations Programme on HIV/AIDS (UNAIDS), and Merck. The partnership collaborates closely with governments to strategize on ways to provide services for women from prevention through the cancer journey. Go Further began working in eight countries (Botswana, Eswatini, Lesotho, Malawi, Mozambique, Namibia, Zambia, and Zimbabwe), and will expand services to four additional countries (Ethiopia, Kenya, Tanzania, Uganda) in fiscal year (FY) 2021. The objectives are to screen all WLHIV on ART between the ages of 25 and 49 for cervical cancer, and to treat pre-invasive cervical cancer lesions to prevent progression to cervical cancer.
  • Swazi Countries Worked: Eswatini, Zambia, Sudan, Kenya, Nigeria, Senegal, Tanzania, Zanzibar and Ethiopia

    Swazi Countries Worked: Eswatini, Zambia, Sudan, Kenya, Nigeria, Senegal, Tanzania, Zanzibar and Ethiopia

    P.O. BOX C970. THE HUB. MANZINI. ESWATINI TEL: +26876025092 EMAIL: [email protected], [email protected] (WORK) Name: Zelda Nompumelelo NHLABATSI Nationality: Swazi Countries worked: Eswatini, Zambia, Sudan, Kenya, Nigeria, Senegal, Tanzania, Zanzibar and Ethiopia Education Jan 2011 to Certificate in Health Management, Foundation for Professional Development, December 2011 South Africa September 1997 to MA, Educational Studies, University of York, United Kingdom October 1998 August 1984 to May Bachelor of Science, University of Eswatini, Eswatini 1988 August 1986 to May Diploma in Education, University of Eswatini, Eswatini 1988 Employment record: 2012-Present Executive Director: Provide Strategic Leadership and management for the Family Life Association of organisation Eswatini (FLAS) 2008-June 2012 Programs Director: to guide and provide technical guidance to FLAS Family Life Association of programs Eswatini September 2002 – Aug 2008 Municipal AIDS Programme Manager: Working with the local AMICAALL 2007 Consultant. Developed a comprehensive HIV & AIDS response framework UNESCO for the Education sector through research and stakeholder consultations. June 2003 - 2007 Consultant: Formulation of Niger Delta Integrated Development Programme UNDP to address the challenges of the Niger Delta region. Orientation of NGOs & Government ministries on CCE-CC in 6 sub-Saharan Africa countries. Development of CCE –CC UNDP Handbook 1999 – August 2002 Head of Research unit: Undertake research studies for schools health SHAPE program. 1999-2000 Training Officer. Provided education and training to students and teachers SHAPE on sexual reproductive health. January 1989 – 1995 Head of Math & Science Department and a Science teacher Mentor. T GOVERNMENT RESEARCH EXPERIENCE 1999: Qualitative & Quantitative Research Methods as part fulfilment for Thesis of the Master of Arts in Educational Studies on Learning science through contexts: helping pupils make sense of everyday situations.
  • Antigua and Barbuda Citizenship-By-Investment Programme: OPTION 1

    Antigua and Barbuda Citizenship-By-Investment Programme: OPTION 1

    INVESTMENT OPTIONS There are two investment options which serve as a qualifier for your ANTIGUA AND application to the Antigua and Barbuda citizenship-by-investment programme: OPTION 1 BARBUDA National Development Fund (NDF) Contribution Main applicant or a family of up to 4: USD 100,000. CITIZENSHIP BY INVESTMENT PROGRAMME For a family of 5 or more: USD 125,000. Global community - Global citizenship OPTION 2 Real Estate Investment ABOUT ANTIGUA AND BARBUDA Approved property: USD 200,000 or 400,000. Antigua and Barbuda is an independent Commonwealth state in the Eastern Caribbean. With GOVERNMENT FEES some 365 beaches of clean turquoise waters, the lush tropical islands of Antigua and Barbuda are an inviting paradise and considered to be one of the most beautiful places in the world. As a NDF: result, tourism is the key driver of Gross Domestic Product (GDP) and generates around 60% of Family up to 4: USD 25,000. the island’s income, with key target markets being the U.S., Canada and Europe. Antigua and Each additonal dependant: USD 15,000. Barbuda is a member of the United Nations, the British Commonwealth, CARICOM and the Real Estate: Organisation of American States (OAS) among many other international organisations. Family up to 4: USD 50,000. Each additional dependent: USD 15,000. WHY ANTIGUA AND BARBUDA TRAVEL WITH EASE PROCESS AND TIMELINE Month 1-2 Sign a retainer agreement and pay the first retainer invoice. The Antigua passport unlocks visa-free travel to over 140 countries including Hong Kong, Preparation Prepare required documentation. Singapore, the UK and the Schengen states.The passport is valid for a period of 5 years and will 10% payment of government fees.
  • Oct-Dec-09.Pdf

    Oct-Dec-09.Pdf

    2009; 11(4) : 311 INDIAN JOURNAL OF IJPP PRACTICAL PEDIATRICS • IJPP is a quarterly subscription journal of the Indian Academy of Pediatrics committed to presenting practical pediatric issues and management updates in a simple and clear manner • Indexed in Excerpta Medica, CABI Publishing. Vol.11 No.4 OCT.-DEC.2009 Dr. K.Nedunchelian Dr. S. Thangavelu Editor-in-Chief Executive Editor CONTENTS FROM THE EDITOR'S DESK 317 TOPICS FROM “IAP-IJPP CME 2009” Fluid management in shock 320 - Indira Jayakumar, Sarfaraz Navaz R Follow- up of the high risk neonates 329 - Kumutha J Treatment of malaria – Recent guidelines 337 - Ravisekar C V Approach to single ring enhancing CT Lesions 342 - Thilothammal N Management of cerebral edema 350 - Abishek Narayanan, Bala Ramachandran Revised national tuberculosis control programme 355 - Gowrishankar N C Acute rheumatic fever – Update 363 - Gnanasambandam S What is new in neonatal resuscitation? 370 - Ratna Kumari TL, Ramkumar S Journal Office and address for communications: Dr. K.Nedunchelian, Editor-in-Chief, Indian Journal of Practical Pediatrics, 1A, Block II, Krsna Apartments, 50, Halls Road, Egmore, Chennai - 600 008. Tamil Nadu, India. Tel.No. : 044-28190032 E.mail : [email protected] 1 Indian Journal of Practical Pediatrics 2009; 11(4) : 312 GENERAL Evaluation and management of hypertension 376 - Aditi Sinha, Arvind Bagga Childhood obesity and risk of cardiovascular disease : Role of pediatrician 398 - Mangla Sood DERMATOLOGY Superficial fungal infections - Tinea corporis 404 - Vijayabhaskar
  • The Decline in Mortality in Philadelphia from 1870 to 1930: the Role of Municipal Services

    The Decline in Mortality in Philadelphia from 1870 to 1930: the Role of Municipal Services

    The Decline in Mortality in Philadelphia from 1870 to 1930: The Role of Municipal Services HE CHRISTMAS SEASON of 1880 should have been a happy occasion for Charles and Caroline Kautz. Charles, a German T immigrant in his mid-forties, had operated a three-person bakery in the Moyamensing section of Philadelphia over a decade. Caroline, several years his junior and his wife of over fifteen years, had married him during her teens and soon assumed the responsibilities of parenthood. Though Pennsylvania born, Caroline also came from German stock and, with her husband, worshipped at a loc&l German Lutheran church. Caroline and Charles Kautz and their three sons and three daughters must have eagerly anticipated a joyous holiday cele- bration. But it was not their fate to enjoy this Christmas. In three and one-half weeks from late November to mid-December, smallpox took the lives of five of the six Kautz children. Six-year-old Clara died on November 20, followed by Albert (aged 2) two weeks later, then Edward (aged 4) on December 10, Charles (aged 8) on December 11, and Bertha (aged 10) on December 14. Only twelve-year-old Sophia survived. Burial in the Lutheran church cemetery followed each of the deaths in numbing succession. The tragedies that befell the Kautzes over a century ago illustrate in a concrete way part of the enormous gap separating the twentieth and the nineteenth centuries in America. Epidemic diseases, childhood death, and low adult life expectancies dominated life. Indeed, in the space of a decade, the Kautzes had witnessed smallpox epidemics in Philadelphia in 1871-72 and 1876 prior to the 1880-81 epidemic that devastated their family.
  • Eswatini SUSTAINABLE DEVELOPMENT GOAL 7: ENERGY INDICATORS (2017) Renewable Energy (% of TFEC) 60.6 Access to Electricity (% of Population) N.A

    Eswatini SUSTAINABLE DEVELOPMENT GOAL 7: ENERGY INDICATORS (2017) Renewable Energy (% of TFEC) 60.6 Access to Electricity (% of Population) N.A

    ENERGY PROFILE Eswatini SUSTAINABLE DEVELOPMENT GOAL 7: ENERGY INDICATORS (2017) Renewable energy (% of TFEC) 60.6 Access to electricity (% of population) n.a. Energy efficiency (MJ per $1 of GDP) 4.1 Access to clean cooking (% of population) 52 Public flows renewables (2017 USD M) n.a. Per capita renewable capacity (W/person) 150.3 TOTAL PRIMARY ENERGY SUPPLY (TPES) TPES 2012 2017 Total primary energy supply in 2017 Non-renewable (TJ) 15 219 13 390 Oil Renewable (TJ) 31 419 30 516 Total (TJ) 46 639 43 906 27% Gas Renewable share (%) 67 70 Nuclear Growth in TPES 2012-17 2016-17 Non-renewable (%) -12.0 -13.2 Coal + others 70% 4% Renewable (%) -2.9 +9.0 Total (%) -5.9 +1.1 Renewables Primary energy trade 2012 2017 Renewable energy supply in 2017 Imports (TJ) 16 426 17 033 3%0% Exports (TJ) 6 418 11 338 Hydro/marine Net trade (TJ) - 10 008 - 5 695 Wind Imports (% of supply) 35 39 Exports (% of production) 18 31 Solar Energy self-sufficiency (%) 79 84 Bioenergy Net trade (USD million) - 301 - 160 97% Net trade (% of GDP) -6.2 -3.6 Geothermal RENEWABLE ENERGY CONSUMPTION Consumption by source 2012 2017 Renewable energy consumption in 2017 Electricity (TJ) 3 664 4 524 Electricity Heat (TJ) 0 0 Bioenergy (TJ) 8 348 6 537 Heat Solar + geothermal (TJ) 0 0 41% Total (TJ) 12 012 11 061 Bioenergy Electricity share (%) 31 41 59% Consumption growth 2012-17 2016-17 Solar + Renewable electricity (%) +23.5 +9.1 geothermal Other renewables (%) -21.7 -17.0 Total (%) -7.9 -8.0 Industry 13% Consumption by sector 2012 2017 Industry (TJ) 4 063 6 401 Transport
  • Final Evaluation Report for the Utetezi Project

    Final Evaluation Report for the Utetezi Project

    Final Evaluation Report for the Utetezi Project Compiled by: African Regional Executive Committee & Utetezi Secretariat Supported by the BAND Foundation Table of Contents Executive Summary ....................................................................................................................2 1.0 Introduction ......................................................................................................................6 1.1 Background ...................................................................................................................6 1.2 Purpose of the Evaluation..............................................................................................6 1.3 Methodology .................................................................................................................7 2.0 Detailed Evaluation Findings ............................................................................................7 2.1 Relevance of the Project ................................................................................................7 2.2 Effectiveness of the Project ...........................................................................................8 2.2.1 Mauritius ...............................................................................................................8 2.2.2 Zimbabwe ..............................................................................................................8 2.2.3 Zambia...................................................................................................................9