In a retrospective study, the impact of breast-feeding on the survival probabilities of children born to women in hospitals in Cairo, Egypt, is estimated. The analysis shows that early cessation of breastfeeding is associated with higher mortality and the effects are more severe the lower the education level of the mother.

The spiked Lippes loop was inserted in 53 women and the standard loop in 55 women immediately following the delivery of the placenta after normal vaginal delivery. A group of 50 recently delivered women with no IUD was studied as a control. The cases were followed up for 1 year. Ultrasonic scanning was performed during the 6th week after insertion for 47 cases with the spiked loop and 43 cases with the standard loop. All loops were correctly positioned within the uterine cavity except in two cases; one using the spiked and the other using the standard loop. The loops were found displaced downwards and as there was excessive bleeding, the devices were removed. Regarding the effect of the IUD on uterine involution, it was found that the fundus to internal os length for the cases with IUDs was shorter than that among the controls, also this length among the standard loop users was significantly shorter than that of the controls (P less than 0.01). Postplacental IUD insertion did not delay uterine involution, on the contrary, it helped involution. Regarding the effect of lactation, the fundus to internal os length for the fully lactating women either using a loop or not, was found to be significantly shorter than that of the non-lactating cases (P less than 0.002).

Vaginal delivery may predispose to bacteriuria, as it entails repeated vaginal examination, compression of the bladder and sometimes urethral catheterization. One hundred and forty pregnant women were studied. Three samples of urine were used for cultures; the first at start of labor, the second 24 h after labor, and the third 14 days later. Culture plates were examined for total colony count, which was multiplied by 10 to give an estimate of the number of organisms/ml. Type of organism was identified. Nine of 112 women (8%) developed bacteriuria for the first time after labor. Of these, premature rupture of membranes occurred in four, prolonged labor in two, and cervical and vaginal tears in two others. Detection and treatment of postpartum bacteriuria could decrease the incidence of urinary tract infection.

In preparation for a study on the effect of bed net use on malaria, this article describes febrile morbidity and malaria expenditures in a sub-Saharan area (Benin) of hyperendemic malaria. The 325 randomly selected households were visited weekly between April 1994 and March 1995 to determine febrile morbidity and household expenditures for prevention and treatment. The results indicate that rural children had two febrile episodes annually compared with 0.3 episodes among children living in the city. There was no difference in mean annual febrile episodes between adults and children (adults 1.5, children 1.5; P 0.48) and in the expenditures per febrile episode In addition to being a major cause of mortality and morbidity in developing countries, malaria also has economic consequences for the afflicted population. These consequences include considerable direct (medical consultations, hospitalizations, laboratory tests, and medications) and indirect (work days lost) costs for households that are already socioeconomically disadvantaged. 1-4 Chloroquine chemopro-phylaxis, mosquito coils, insecticide sprays and bed nets are the principal malaria prevention methods used. The per-methrin insecticide-treated bed net (PITN), in particular, can reduce mortality and malaria morbidity by 30-45%. 5-7 There is considerable variation in the price of a PITN, an item with an approximate lifespan of five years. Although in theory, it may cost US$6-7, 5,6 in reality its price is closer to US$12, taking into account size, local duties, transportation, taxes, and other costs. Studies have shown that a PITN treated with a permethrin concentration of 200-500mg/m 2 works effectively for a six-month period, after which a new permethrin treatment is necessary. 5 The cost of each treatment is estimated at US$1.43, for an average annual use cost of US$7.79, as estimated by Brinkmann and Brinkmann. 8 By decreasing the malaria attack episodes, the use of the PITN also reduces the expenses associated with the illness. Therefore , over time, the cost of the initial investment in the PITN is many times less than the treatment expenses. In effect, the cost of the PITN is amortized in only two years following its acquisition, a phenomenon that is often accompanied as well by a reduction in spending on chloroquine treatment and prophylaxis, insecticide sprays, and mosquito coils. 8-12 This article describes a continuous analysis of the PITN that is locally produced and used in a operational research setting in the Republic of Benin in west Africa. 13 This article (the first in a two-part series) presents the study methodology , the collection and analysis of the principal characteristics of the study population, and their febrile morbidity and malaria-related expenditures. The second article concentrates on the effect of bed net use and other determinants of febrile episodes and expenditures associated with malaria. METHODOLOGY A project to promote the use of PITNs through a strategy that included the local production, marketing and sale of PITNs w...

SummaryThis study was carried out in four adjacent villages in Lower Egypt with a combined population of 24,000. A team of social workers and physicians worked together to introduce the injectable contraceptive depomedroxyprogesterone acetate as a post-partum long-acting contraceptive to the community leaders and the villagers at several meetings. Postpartum women who agreed to use the drug were defined as acceptors (591) and those who did not were defined as rejectors (715). The incidence of polygamy was higher among the rejectors, and rejectors' husbands had more children from their other wives. Acceptors had more previous pregnancies and children of both sexes than rejectors. The interval between the last two pregnancies was shorter among the rejectors. A greater percentage of acceptors had previously used another contraceptive. The commonest reasons for rejection were desire for further pregnancy (69%), health problems (11%) and desire for another method of contraception (8%). Religious factors figured in only 3% of cases.