The role of research in a technical assistance agency: the case of the 'German Agency for Technical Co-operation'.

Technical assistance agencies have a sustainable impact on the health systems of the countries they are operating in. As well as policy-makers at the national level, technical assistance agencies see themselves confronted that their interventions should be based on evidence, usually meaning the results of research. This study has the aim to analyse role of research in the implementation of technical assistance. We sent a questionnaire to all health project managers of the 'German Agency for Technical Co-operation' and performed a qualitative case study in one of the health projects. Forty-seven of 80 (58.8%) of the questionnaires were completed and sent back. The managers considered publications of International Organisations (IOs), scientific articles and local research as most important for their work. The case study showed application problems in the daily work. Research use not only depends on the relevance of the data but also on analytical skills, linguistic barriers and technical access to research by the potential users. The role of knowledge and information management has to be clearly defined in an organisation of technical assistance. The specific needs at the different levels have to be analysed so that skills and resources can be allocated adequately.

Training and research for implementation of health care system reform in Cambodia.

One important objective of Technical Co-operation is institutional strengthening. Human resource development is understood as a means of improving the implementation of health care system development and an important factor for sustainability. Health care system reform is also a concern in Cambodia, where it has suffered from a period of war and insecurity previously, and now is beginning to aim for long term development. The implementation of the reform started four years ago with external support. This paper will show how capacity can be built and services developed under the specific circumstances of Cambodia, with technical cooperation and support from neighbouring countries through the SEAMEO TROPMED network. Training courses have been developed and research studies have been conducted to strengthen the role of the National Institute of Public Health and to aim for quality improvement. In addition, impact of training to improve management at provincial/district level was measured.

[Carriage of Streptococcus B in the mother and infant pair at birth. Apropos of 106 cases]. / Portage du streptocoque B dans le couple mère-enfant a la naissance. A propos de 106 cas.

Streptococcus of group B found in the upper respiratory tract, the genito-urinary tract and the intestines of humans and animals is responsible for peri- and neonatal infections with serious outcomes: septicemia, meningitis. In Togo, the high frequency of neo-natal infections brought us to question the importance of streptococcus B in the mother-child couple at birth and to undertake a study conducted simultaneously in two maternities in the city of Lomé. During 8 weeks, from 19 March-19 May we studied 100 mother-child couples and 300 placentas. The following laboratory samples were taken: from the mother a vaginal smear during labor at 5 cm dilatation and rectal swabbing, from the new-born, a swabbing of the outer ear canal and an aspiration of gastric liquid, a fragment of the placenta taken under conditions of surgical asepsis. The results obtained prove that streptococcus B play an important role in the mother-child couple in Togo. The authors propose that more systematic research be conducted on children at birth with regard to this issue.

Reduction of pathological findings in urine and bladder lesions in infection with Schistosoma haematobium after treatment with praziquantel.

Egg output, proteinuria, erythrocyturia, and leukocyturia were quantitatively assessed in six schoolchildren with urinary schistosomiasis due to Schistosoma haematobium on 5 days before and 1-35 and 61-65 days after administration of praziquantel (40 mg/kg). Twenty days after therapy, egg output had decreased from a median of 310 before therapy to less than one egg per 10 ml of urine. This decrease was paralleled by a reduction in proteinuria (1.01 g/liter), erythrocyturia (2,142/microliter), and leukocyturia (803/microliter) to normal values. Between days 31-35 and 61-65, five of the six patients had no detectable viable eggs on five consecutive days. Thickening of the bladder wall and vesical polyps detected by ultrasonography returned to a normal appearance one month after treatment. However, dilatation of the renal collecting system showed no significant reduction.

Morbidity in urinary schistosomiasis: relation between sonographical lesions and pathological urine findings.

213 patients with urinary schistosomiasis were investigated under field conditions in the Peoples Republic of Congo by quantitative parasitological examination, urine analysis and abdominal ultrasonography. The study group consisted mainly of children. Disease related pathological ultrasonographical findings were dependent on the intensity of infection. Sixty patients had bladder wall thickening and 55 patients had vesical polyps. Those with multiple vesical polyps were the only patients with urinary retention and they had a significantly higher proteinuria than those with a singular polyp. Obstructive uropathy of different degrees was encountered in 50 cases. Of these, 21 patients had moderate to severe urinary tract obstruction and in all cases except one also presented concomitant vesical abnormalities. Nine patients revealed bilateral obstructive uropathy. Lesions of the lower urinary tract were a predisposing factor in the development of urinary tract obstruction. Morbidity of study patients was considered to be substantial. A proteinuria of more than one gramme per litre in spontaneously voided midday urine indicated a high probability for the presence of urinary tract obstruction and was considered an urgent indication for antischistosomal treatment.