[afro-nets] New publication: Randomized Controlled Trials in child health in developing countries 2007-2008

Attached [*] is a small booklet which summarizes some of the latest research on child health in developing countries: evidence derived from all the randomized trials published over the last year. The aim is to make this information widely available to paediatricians, child health nurses, students and administrators in places where up-to-date health information is hard to find. It is hoped that such information will be helpful in reviewing treatment guidelines, clinical practice and public health strategies, and in teaching about paediatrics and evidence-based medicine. Some of the important findings this year include:

- Outpatient treatment of WHO-defined severe pneumonia was shown to be safe and effective in children without any danger signs and in areas that are not HIV endemic [**]
- Giving zinc and ORS to children with diarrhoea improves prescribing of ORS, and reduces subsequent morbidity from acute respiratory infections, so zinc for diarrhoea treatment also has a preventative effect In HIV-affected infants in Zambia, mortality was higher when there was abrupt weaning from breast milk at 4 months of age. - Giving mothers nevirapine or nevirapine and zidovudine for 14 weeks has a strong protective effect against HIV transmission through breast milk.
- Home-based antenatal and neonatal care visits by community health workers reduced neonatal mortality in Bangladesh
- In Kenya there has been sustained benefit on child survival of insecticide treated bed-nets; it was estimated that 7 deaths were averted for every 1,000 bed-nets distributed.
- Topically applied sunflower oil improved survival rates among preterm hospitalized infants in Bangladesh.
- Rectally administered quinine is effective for the treatment of severe malaria, as has been shown with dihydroartimisinin and artesunate; useful where intravenous access is not possible or the child is vomiting IV phenytoin, IV valproate or buccal midazolam are effective and safe for the treatment of status epilepticus. Diazepam should not be given as an IV infusion.
- Artimisinin derivatives have important effects on schistosomal infections.

This is the 6th edition of this booklet. It is part of a project supported by WHO and many international partners, which critically appraises the evidence behind WHO's treatment guidelines. Previous editions (2003-2007) and further reviews of WHO guidelines are available at http://www.ichrc.org

If you have a laser printer, the document may be printed out as a small booklet form to save trees. After clicking on "Print" go to "Properties" and select: "Print to both sides"; Booklet layout "Left edge binding"; Pages per sheet "two pages per sheet". Printing this way will use only 30 sheets. Then fold the A-4 pages in half to form a booklet.

Please feel free to make as many copies as you like or pass this document on to anyone who may find it useful.

Kind regards,

Trevor

--
Trevor Duke, MD FRACP
Associate Professor
Director, Centre for International Child Health
Department of Paediatrics, University of Melbourne
Parkville, Vic 3052, Victoria, Australia

Adjunct Professor of Child Health
School of Medicine
University of PNG
mailto:trevor.duke@rch.org.au