Effectiveness Of Primary Health Care Research Articles

New Aspects of an old Disease. Plan, Endemic Syphilis and Pinta: the endemic Treponematoses.

Yaws and the other endemic treponematoses (bejel or endemic syphilis, pinta) are resurging in many countries of Africa. Today there are more than 2.5 million cases of these diseases, 75% of them in children. More than 100 million additional children are at risk to these disabling and disfiguring infec- tions which destroy tissue and bone. In the 1950's and 1960's, through concerted efforts and leadership of UNICEF and WHO, more than 50 million individuals in 46 countries were cured and the diseases were brought under control or even eliminated from large parts of the world. Despite this success, endemic foci remained and in the last ten years there has been an alarming resurgence of the endemic treponematoses, in particular in parts of West and Central Africa.Endemic treponematoses control is based on treatment with single-dose penicillin of the entire treponemal reservoir, and of all clinical cases and their contacts presumed to be incubating the disease. No instances of penicillin-resistance have been documented to date and these infections should be eliminated while the organisms still remain sensitive to penicillin. An endemic treponematoses control programme must be fully integrated into the primary health care system. The persistence of endemic treponematoses in an area is an indicator of failing effectiveness of primary health care. From recent consultations with Member States, WHO Collaborating Centres and expert groups, a consensus regarding the fundamental components of endemic treponematoses control has emerged. Effective disease control requires coordinated and complementary activities by WHO and Member States. The interruption of disease transmission is a feasible and realistic objective for renewed control programmes. KEYWORDS: bejel, control programmes, pinta, primary health, yaws

Le Nouveau Visage D’une Vieille Maladie

New Aspects of an Old Disease. Pian, Endemic Syphilis and Pinta: The Endemic Treponematoses Yaws and the other endemic treponematoses (bejel or endemic syphilis, pinta) are resurging in many countries of Africa. Today there are more than 2.5 million cases of these diseases, 75% of them in children. More than 100 million additional children are at risk to these disabling and disfiguring infections which destroy tissue and bone. In the 1950’s and 1960’s, through concerted efforts and leadership of UNICEF and WHO, more than 50 million individuals in 46 countries were cured and the diseases were brought under control or even eliminated from large parts of the world. Despite this success, endemic foci remained and in the last ten years there has been an alarming resurgence of the endemic treponematoses, in particular in parts of West and Central Africa. Endemic treponematoses control is based on treatment with single-dose penicillin of the entire treponemal reservoir, and of all clinical cases and their contacts presumed to be incubating the disease. No instances of penicillin-resistance have been documented to date and these infections should be eliminated while the organisms still remain sensitive to penicillin. An endemic treponematoses control programme must be fully integrated into the primary health care system. The persistence of endemic treponematoses in an area is an indicator of failing effectiveness of primary health care. From recent consultations with Member States, WHO Collaborating Centres and expert groups, a consensus regarding the fundamental components of endemic treponematoses control has emerged. Effective disease control requires coordinated and complementary activities by WHO and Member States. The interruption of disease transmission is a feasible and realistic objective for renewed control programmes.

International health technology exchange. A multidirectional and multidisciplinary road.

The U.S. and developing countries are participating in an international multidirectional and multidisciplinary exchange of health technology to an unprecedented degree. The information flow is not only from greater to lesser developed countries; it occurs between developing nations and from developing nations to industrialized countries as well. Thus techniques and concepts established in African Asian and Latin American countries have been applied directly to solution of rural and urban health problems in the U.S. Successful international health technology exchange principles include: 1) emphasis on prevention; 2) a multidisciplinary and integrated organizational approach; 3) active community participation; 4) a proper mix of professionals and specially trained paraprofessionals; 5) training programs for health care personnel; 6) self-help health education for community members; 7) infrastructure development and program management; 8) evaluation; 9) legislation giving authority for health systems; and 10) coordination and cooperation among assisting organizations. The Gondar Public Health College and Training Center in Ethiopia and the Danfa Comprehensive Rural Health and Family Planning Project in Ghana are cited as organizations which apply these principles. The Gondar project was based on the ideas of training health officers community nurses and sanitarians in the same institution emphasizing the importance of preventive medicine and stressing a teamwork approach in operating rural health centers. The Danfa project which assisted the government in increasing the effectiveness of primary health care also adhered to these principles with special emphasis on training both locally and overseas.