The national prevalence survey of nosocomial infections in Belgium, 1984.

A national one-day prevalence survey of nosocomial infections was carried out in March 1984 in 106 Belgian acute-care hospitals involving 8723 patients of whom 6130 had undergone surgery. Three infections were studied: surgical wound infection, bacteraemia and urinary-tract infection. One or more of these three infections was recorded in 9.3% of all patients and in 11.8% of surgical patients. Prevalences increased with increasing duration of hospital stay and with higher ages, but the association of HAI with age was no longer significant after correction for duration of hospital stay. Prevalences varied considerably in different specialties. After adjustment for age and duration of stay, there was no association between perioperative antibiotic prophylaxis and the prevalence of the infections studied, but bias due to selection of higher risk patients in the antibiotic group was probable. Larger hospitals had a higher overall prevalence, but populations differed according to the size of the hospital. Bacteraemia was strongly associated with the presence of an intravenous catheter, and urinary-tract infection with a urinary catheter.

Epidemiological surveillance of measles through a network of sentinel general practitioners in Belgium.

Measles morbidity data were collected during 1982-1983 through a network of sentinel general practitioners. The annual incidence rate of the disease in the country was 80.3 per 1000 population with most of the cases seen between 2 and 6 years of age. Complications were encountered in 13.8% of all cases. Emphasis is put on developing a strategy for immunization against measles on a nationwide scale.

Maternal mortality in developing countries.

PIP: The author stresses that uncritical reliance on the institutional maternal mortality rates in developing countries will provide spurious indications of improvement in this area. There appears to bean an important, although imprecisely known, differential in coverage between deliveries and maternal deaths. In 1 area, the institutional maternal mortality rate was 10 times higher among unbooked than among booked deliveries. Moreover, caution should be used in transposing maternal mortality estimates based on life table data from Europe and North America from the early 20th century to present-day Africa. Health statistics should be used to monitor health status; analyzed reduction in maternal mortality should be analyzed carefully to ensure they are valid.^ieng

Maternal mortality in developing countries.

PIP: The authors of this letter respond to earlier letters prepared in response to their article on maternal mortality in developing countries. It is conceded that maternal mortality is high in India and Bangladesh; however, statistics from Gambia are based on small populations and are therefore inconclusive. It is noted that a 7-year survey of 4000 households in Machakos, Kenya, where 73% of deliveries occurred at home, yielded a maternal mortality rate of only 0.8/1000 deliveries. Finally, it is asserted that the measurement traditionally used in estimating maternal mortality for many African countries (ratio of recorded maternal deaths to recorded deliveries) is misleading. Maternal deaths are more likely than deliveries to be recorded. In Niger, the number of maternal deaths increased from 1980 (374) to 1982 (484). The ratio of maternal deaths to expected live births also increased from 135 to 166/100,000, whereas the traditionally calculated maternal mortality rate decreased from 519 to 420/100,000 due to changes in the denominators. It is recommended that health authorities of African countries such as Niger consider setting an absolute number of maternal deaths below which they would try to bring the current toll.^ieng

Seasonal variations in nutrition among a group of nomadic pastoralists in Niger.

To identify the most critical period in a normal year for nomadic Sahelian pastoralists, 54 families of Wodaabe herders in Niger were visited every 3 months for a year. At each visit an average of 366 herders were interviewed with a standard questionnaire and anthropometric measurements were made. A cohort of 32 adult men lost a mean 3.1 kg between February and May, the peak of the dry season, and 30 adult women lost a mean 2.4 kg during the same period. Both men and women regained weight progressively over the months until the next February. Children under 5 years not only stopped gaining weight between February and May but on average lost 113 g; after May normal rates of weight gain resumed. This weight loss caused an increase in the proportion with acute malnutrition (less than 80% reference median weight-for-height) to 17% in May from 7% in November.