RESUMEN
In order to identify the factors associated with admission to neonatal care units in a developing country, 1,823 newborns admitted to Jamaica's eight neonatal care units over a 6-month period were compared with 9,563 newborns identified during an island-wide population morbidity study. Maternal sociodemographic characteristics, past obstetric history, infant's growth parameters at birth and mode and place of delivery were investigated. Babies of mothers resident in the two regions of the island where specialist paediatric services were available had increased odds of admission (OR= 1.45, 1.22) compared with those living elsewhere (OR=0.70, 0.80). Maternal history of a previous miscarriage, termination or early neonatal death were associated with subsequent admission, but a previous stillbirth or late neonatal death were not. Very low birthweight infants of gestational age 28-31 weeks were more likely to be admitted than those < 28 weeks with ORs of 1.45 and 0.34 respectively. Factors determining neonatal admission in the developing world may be quite different from those of developed countries. The development of guidelines and support services to ensure wider access to these services for those most in need could contribute to more equitable utilisation of services.
Asunto(s)
Países en Desarrollo , Cuidado Intensivo Neonatal , Admisión del Paciente , Adulto , Parto Obstétrico , Femenino , Muerte Fetal , Humanos , Recién Nacido , Recien Nacido Prematuro , Recién Nacido de muy Bajo Peso , Jamaica , Masculino , Oportunidad Relativa , Derivación y Consulta , Historia Reproductiva , Factores de RiesgoRESUMEN
The heads of 137 white-tailed deer (Odocoileus virginianus) were collected on the opening day of the 1996 Missouri (USA) fire-arms deer season and surveyed for the presence of meningeal worm (Parelaphostrongylus tenuis). Eighteen percent of the deer examined were infected. Mean intensity of infection was 2.0 (range 1-7). There were no significant differences of infection or mean intensity when deer were classified and compared according to sex or age class.
Asunto(s)
Ciervos/parasitología , Metastrongyloidea/aislamiento & purificación , Infecciones por Strongylida/veterinaria , Distribución por Edad , Animales , Femenino , Cabeza/parasitología , Masculino , Missouri/epidemiología , Prevalencia , Distribución por Sexo , Infecciones por Strongylida/epidemiología , Infecciones por Strongylida/parasitologíaRESUMEN
The Jamaican Perinatal Survey included among its objectives the quantification of the island's neonatal mortality rate, the identification of the causes of these deaths (Wigglesworth Classification), and the determination of characteristics of both mother and infant that are associated with increased mortality. A death questionnaire was completed on babies who were born between September 1986 and August 1987, and who died in the neonatal period throughout the island of Jamaica. The neonatal mortality rate was 17.9 per 1000 live births with early and late rates of 16.0 and 1.9 per 1000, respectively. The major contributors to neonatal demise were prematurity and intrapartum asphyxia (74 per cent). Twins had a seven-fold greater risk of dying than singletons. Babies born to mothers under 15 years had a four-fold greater risk of dying than those of mothers 25-29 years. The neonatal mortality rate for Jamaica is high, with room for improvement, particularly in the prevention of perinatal asphyxia.