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Major achievements and experience in filariasis control in the People's Republic of China. National Technical Steering Group for Filariasis Control and Research.

Filariasis control including a preparatory phase in the early 50s and two more extensive campaigns in the late 50s and 70s, has gained remarkable achievements. By the end of 1987, filariasis in 781 (90.4%) of 864 counties/cities was brought under control, i.e., the microfilariasis rate declined to less than 1% in the whole population in every village concerned. At present, there remain about 2,446,000 filariasis cases, accounting for 7.9% of 30,099,400 before nationwide campaigns. Microfilaria carriers among the remaining cases amounted to 1,473,000 and amicrofilaremic but symptomatic, to 973,000. The major experience comprises the integration of the control project into national health program, the mobilization of various sectors, including the community, the investigators and technical personnel in research institutions and control services all to participate and cooperate in problems and difficulties encountered.

Animals↗

[Economic development and health].

The purpose of this work is to examine the relationship between economic development and the population's level of health. Consequently, we will establish a comparison between Mexico and other countries in various stages of development. The interrelationship between economic development and health is a complex problem which is little understood, even though it is acknowledged that at increased levels of economic development the levels of health of a population will also increase. These considerations can be taken into account when we accept the fact that the health conditions in industrialized countries are generally better than the health conditions in non-industrialized countries. In the case of Mexico, the problems relating to social disparities due to the type of economic development are reflected in the country's level of health. Poor health conditions and the deterioration of health services in Mexico, based on international references, are matters that must be resolved by means of a clear political decision accompanied by the appropriate corresponding resources so that the strategies put forth by the National Health Program (1989-1994) can be carried out.

Colombia↗

Control of fraud and abuse in Medicare and Medicaid.

This Comment explores issues concerning the control of fraud and abuse in health programs financed with public funds, specifically the Medicare and Medicaid programs. It summarizes the nature, scope, and possible causes of what some regard as a fraud and abuse "crisis," and points out the difficulties and obstacles facing those who attempt to develop legislative and executive action aimed at controlling fraud and abuse. Recent federal initiatives in fraud and abuse control are examined, and a brief summary of key provisions of H.R. 3 (the Medicare-Medicaid Anti-fraud and Abuse Amendments, which may prove to be a landmark piece of legislation in this area) is provided. The author emphasizes that more effective control of fraud and abuse is necessary if further expansion of government financing of health programs, including national health insurance, is to occur in the near future. At the same time, caution must be taken not to neglect the appropriate use of other mechanisms necessary for reducing the costs of medical care and improving its quality. In addition, it is likely that efforts to stem fraud and abuse will raise important medicolegal and public policy issues that will require careful interdisciplinary consideration.

Crime↗

Nurse-midwifery in the caribbean.

Nurse-midwives provide the bulk of maternal and child health care in the Caribbean Area. Their contribution over the years has been a major one, and as national health programs have become more comprehensive, so too have nurse-midwives' roles and functions.

Child Health Services↗

A community study of gynecological and related morbidities in rural Egypt.

This study assesses the prevalence of gynecological and related morbidity conditions in a rural Egyptian community. A medical examination was conducted on a sample of 509 ever-married, nonpregnant women. For gynecological morbidities, genital prolapse was diagnosed in 56 percent, reproductive tract infections in 52 percent, and abnormal cervical cell changes in 11 percent of the women. For related morbidities, anemia was present in 63 percent of the women, followed by obesity (43 percent), hypertension (18 percent), and urinary tract infection (14 percent). Regression analysis of risk factors demonstrated the contribution of social conditions and medical factors to these diseases. Reproductive tract infections were shown to occur more frequently with uterovaginal prolapse, IUD use, presence of husband (regular sexual activity), and unhygienic behavior. Genital prolapse increased with age and number of deliveries. Age, recent pregnancy, education, socioeconomic class, and workload showed significant associations with related morbidity conditions. This evidence challenges national health programs to go beyond safe motherhood, child survival, and family planning in its services to women, and to consider the social context of health as well.

Adult↗

The oral health care programme of Cartaxo. Assessment of its impact.

The Cartaxo Municipality has been developing a primary oral health care program since 1988. It is based on national programs of oral health promotion and prevention of dental caries (Oral Health Technical Guidelines on Mother & Child Health and Oral Program in Schools) of the Primary Health Care Administration, and includes the application of pit and fissure sealants on the occlusal surface of the first permanent molars of school children aged 6-7 years. The purpose of this study is to divulge the evaluation of the impact of this program on the dental health of the population studied.

Child↗

Cholesterol reduction through low-intensity interventions: results from the Minnesota Heart Health Program.

The National Cholesterol Education Program has underscored the need for health professionals to work together to promote dietary changes and reduce blood cholesterol levels across the population. This article reports the results of an evaluation of several low-intensity intervention programs designed for the general public that could be offered on a larger scale, either through traditional outlets for short courses or on an outpatient basis after physician referral. The interventions were designed as classes, required approximately 8 hr of contact time with the participants, cost approximately $20 per participant, and were taught by nutritionists and dietitians recruited from the community and trained for this program. Results indicated that similar net reductions in total cholesterol of about 4% were achieved at 1-yr follow-up either from a course which focused on changing eating patterns or from one which focused on weight loss and weight-loss management. These results support the hypothesis that cholesterol reduction is possible with inexpensive and simple methods in healthy, low-risk populations.

Adult↗