Can biomedical and traditional health care providers work together? Zambian practitioners' experiences and attitudes towards collaboration in relation to STIs and HIV/AIDS care: a cross-sectional study

Background :The World Health Organization's World health report 2006: Working together for health underscores the importance of human resources for health. The shortage of trained health professionals is among the main obstacles to strengthening low-income countries' health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners' experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. Methods: We conducted a cross-sectional study in two Zambian urban sites; using structured questionnaires. We interviewed 152 biomedical health practitioners (BHPs) and 144 traditional health practitioners (THPs) who reported attending to patients with STIs and HIV/AIDS. Results: The study showed a very low level of experience of collaboration; predominated by BHPs training THPs (mostly traditional birth attendants) on issues of safe delivery. Intersectoral contacts addressing STIs and HIV/AIDS care issues were less common. However; both groups of providers overwhelmingly acknowledged the potential role of THPs in the fight against HIV/AIDS. Obstacles to collaboration were identified at the policy level in terms of legislation and logistics. Lack of trust in THPs by individual BHPs was also found to inhibit collaboration. evertheless; as many as 40of BHPs expressed an interest in working more closely with THPs. Conclusion: There is indication that practitioners from both sectors seem willing to strengthen collaboration with each other. However; there are missed opportunities. The lack of collaborative framework integrating maternal health with STIs and HIV/AIDS care is at odds with the needed comprehensive approach to HIV/AIDS control. Also; considering the current human resources crisis in Zambia; substantial policy commitment is called for to address the legislative obstacles and the stigma reported by THPs and to provide an adequate distribution of roles between all partners; including traditional health practitioners; in the struggle against HIV/AIDS

A Case of Conjoined Twin / 대한주산의학회잡지

Conjoined twins occur when there is imcomplete fission of the inner cell mass later at approximately 13 to 15 days after fertilization. The earlist case in the literat.ure appears to be that of the Biddenden Maids who were born in England in 1100. since then over two hundred cases of successful separation were reported on literature. And also successful separation cases were reported by Seung et al.(1991) in Korea. Conjoined twins occur between one in 50,000 to 100,000 births but real incidence is one in 200,000 because two thirds are stillbirth or died immediately after birth. The conjoined twins are not associated with maternal age, race or family history and 70 % of them are females. We experienced a case of conjoined twins with omphalopagus and performed surgical separation. A brief review of related literatures was done.

Interferon gamma increases survival in murine experimental cryptococcosis

Se evaluo la efectividad del interferon-µ (IFN-µ) recombinante de rata en un modelo experimental de criptococosis desarollado en ratones Balb/C inoculados por via intraperitoneal con la cepa Rivas de Cryptococcus neoformas (C. neoformans). Se tuvieron en cuenta el tiempo de sobrevida de los animales, el aspecto macroscopico de los organos en la autopsia, la presencia de levaduras capsuladas en los tejidos y la siembra masiva de un homogenato de cerebro. El tratamiento con IFN-µ, en dosis diarias de 10.000 UI, no modifico estos parametros cuando la dosis infectante fue de 10 indice 7 levaduras y el tratamiento se retardo 5 dias post-infeccion (media de sobrevida de 21 vs. 23 dias en los grupos de control y tratados con IFN-µ, respectivamente)...