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The Child, Measles and the Eye
Slide Set and Training Manual
1994, 47 pages + 20 colour slides [E, F]
WHO/EPI/TRAM/93.5 / WHO/PBL/93.31
Sw.fr. 30.-/US $27.00; in developing countries: Sw.fr. 21._
Order no. 1930044
A training manual, supported by twenty colour slides, focused on the links between childhood measles and damage to the eye, and explaining what can be done to protect sight and save lives, whether through preventive measures or the emergency management of severe infections. Noting that measles continues to blind some 250,000 children each year, the training package emphasizes the many things that can be done, at the primary health care level, using just a few medicines and simple equipment. Information is suitable for the training of workers in immunization, eye care programmes, nutrition education, and maternal and child health. Information ranges from the steps to follow when examining the eye, through schedules for the administration of medicines, to advice on what to do when measles breaks out in a refugee camp. Since vitamin A deficiency greatly increases the risk of eye and other complications, the package also includes information on nutrition support.
The manual has four parts, each supported by colour slides. The first illustrates and explains essential features of measles, concentrating on preventable factors that place children at increased risk. Part two, on measles and the eye, moves from a description of the normal eye to depict the different signs of eye involvement and the best methods of treatment. In the third part, which covers sight-saving measures, health workers learn how to perform a simple examination of the eye, provide primary eye care, administer vitamin A supplements, and give advice on the best protective foods. The training package concludes with guidance on immunization against measles and the other vaccine-preventable diseases of childhood.
Management of Cataract in Primary Health Care Services
1996, vi + 34 pages + 14 colour plates [E, F, S*]
ISBN 92 4 154499 6
Sw.fr. 13.-/US $11.70 ; in developing countries: Sw.fr. 9.10
Order no. 1152344
Outlines a comprehensive strategy for bringing sight-restoring surgical services to the world's estimated 15.8 million persons who are needlessly blind due to cataract. Noting the need for a public health approach to this growing problem, the book presents compelling arguments for the use of primary health care services as the framework for case-finding, diagnosis, referral, and follow-up. Arguments take their force from the availability of safe and effective surgical treatments suitable for use on a mass scale.
Recommended lines of action respond to the magnitude of the "cataract backlog" seen in many developing countries, the woefully poor access to surgical services, and the obstacles posed by limited staff and equipment. With these needs in mind, the book offers abundant advice on ways to expand surgical output through better organization, management, and training, and appropriate choice of therapies. Now in its second edition, the book has been revised in line with newer techniques for cataract surgery and the recent availability of low-cost, high-quality intraocular lenses in developing countries.
The book opens with an introduction to the clinical features of cataract, supported by fourteen colour plates. Subsequent sections focus on practical questions that can help health planners understand what an expansion of services to include cataract management will mean in terms of demands on staff, facilities, and equipment. The advantages of the new microsurgical techniques of extracapsular cataract extraction, together with the implantation of an intraocular lens behind the iris, are carefully weighed against the speed and simplicity of intracapsular cataract extraction, followed by the provision of aphakic spectacle lenses.
Prevention of Childhood Blindness
1992, vii + 51 pages + 8 colour plates [C, E, F, S]
ISBN 92 4 156151 3
Sw.fr. 15.-/US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1150378
Describes and explains the actions that can be taken to prevent or treat each of the main causes of childhood blindness. Taking a public health approach, the book encourages its readers to understand the many new possibilities for prevention opened up by striking recent advances in knowledge and technology. Strategies for prevention, which are relevant to developed as well as developing countries, take their focus from the growing conviction that much childhood disability can now be prevented.
The opening chapter summarizes the global prevalence and epidemiology of childhood blindness, noting that each year an estimated half a million children become blind. The second chapter provides a detailed explanation of the many complex factors that influence some 20 causes of blindness occurring during the prenatal period, the neonatal period, and childhood. Each cause of blindness is discussed in terms of factors influencing occurrence and severity, prevalence, clinical features, and measures for prevention and treatment. Seven colour plates illustrate the most prevalent blinding diseases.
The third chapter, on strategies for prevention, features a seven-page tabular outline of measures that can be taken, at primary, secondary, and tertiary levels, in order to prevent each of the main causes of childhood blindness. Requirements in terms of human resources, training, facilities and supplies are also specified. Other chapters, concerned with programme implementation, list the major areas that can be tackled by blindness prevention programmes and discuss the special contribution that can be made by nongovernmental organizations. The book concludes with an agenda for future research based on 14 specific priority areas.
"... compulsive reading ... an eminently
informative text with good colour plates..."
Preventing Trachoma: A Guide for Environmental Sanitation and Improved Hygiene
S.P. Mariotti and A. Prüss
2000, 72 pages [E/F]
Sw.fr. 15./US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1930179
An illustrated guide to a range of measures involving environmental sanitation and improved hygiene that can help communities prevent blinding trachoma. Addressed to health workers in poor rural and peri-urban areas, the manual uses line drawings, colour photographs, and simple text to explain how relatively simple changes can have a major impact on both trachoma and several other diseases transmitted by flies. Although chemical and physical methods of fly control are covered, emphasis is firmly placed on environmental sanitation as the best way to achieve sustainable, community-wide reductions in trachoma.
The manual opens with advice on trachoma assessment, including a concise summary of causes, consequences, symptoms, treatment, and prevention. The next section, on transmission, explains the role of flies and describes their breeding habits. Other diseases transmitted by flies are also briefly described in order to illustrate the broad benefits of environmental improvements. Against this background, the main section explains and illustrates specific measures for fly control in the areas of human excreta disposal, solid waste management, food hygiene, disposal of animal excreta, and location of animals. Details range from line drawings illustrating the construction of latrines, to measures for eliminating breeding zones in dung heaps. Physical and chemical methods of fly control are also briefly discussed. The final section describes several relatively simple measures of personal and domestic hygiene, including hygiene education in schools, that can reduce the risk of transmission.
Strategies for the Prevention of Blindness in National Programmes
A Primary Health Care Approach
1997, vii + 104 pages [E, F*, S*]
ISBN 92 4 154492 9
Sw.fr. 28._/US $25.20; in developing countries: Sw.fr. 19.60
Order no. 1152223
A comprehensive guide to the development of well-planned national programmes for the prevention of blindness. Addressed to health planners and decision-makers in developing countries, the book responds to the very large number of people who have been either blinded or significantly visually impaired by conditions that are easily prevented or cured. National programmes, based on a primary health care approach, are put forward as the best strategy for reaching the many people who can benefit from simple, inexpensive, and effective measures delivered by trained health care workers.
The book has four parts. Part one introduces the concept of avoidable blindness and explains how well-planned activities, originating at the national level and incorporating systematic community-based action, can do much to eliminate avoidable vision loss. The essential components of national programmes are discussed in the second part. Part three, on primary eye care, helps planners understand what a national programme entails in terms of essential clinical activities, personnel and training, supplies and equipment, and training material. The most extensive part provides detailed advice on ways to combat each of the major blinding conditions: trachoma, blinding malnutrition, onchocerciasis, cataract, ocular trauma, glaucoma, and diabetic retinopathy. Though recommended measures draw on the state-of-the-art in technical knowledge, emphasis is firmly placed on simple activities easily carried out at the primary health care level.
Vitamin A Deficiency and its Consequences
A Field Guide to Detection and Control
1995, vii + 69 pages + 32 colour plates [C, E, F, R, S]
ISBN 92 4 154478 3
Sw.fr. 17.-/US $15.30; in developing countries: Sw.fr. 11.90
Order no. 1153050
A practical guide, now in its third edition, to the detection, treatment, and prevention of vitamin A deficiency and its consequences, including associated mortality, infectious morbidity, and xerophthalmia. Addressed to clinicians, nurses, and public health officials, the text has been thoroughly revised to reflect recent advances in knowledge. These include growing recognition of the importance of adequate vitamin A intake for normal child health and survival, and evidence that milder degrees of deficiency may have severe consequences, including increased mortality, before xerophthalmia becomes apparent in a population. In line with these advances, the guide offers advice on the detection and treatment of subclinical or marginal degrees of deficiency as well as on the emergency management of xerophthalmia and measles.
The guide has six chapters. Background information is provided in the first two, which describe the biochemistry of vitamin A metabolism and explain the complex relationship between specific serum levels and the physiological consequences of deficiency. The third chapter provides a detailed guide to the clinical classification and diagnosis of xerophthalmia. Recognition of the characteristic signs and symptoms of increasingly severe disease is facilitated through the inclusion of 32 colour plates. A chapter on epidemiology concentrates on the many factors that place children, particularly those from depressed rural communities and urban slums, at risk of vitamin A deficiency.
Of particular practical value is a chapter on assessment, which explains how well-conceived surveys, appropriate to local conditions, can guide the design of efficient and cost-effective interventions. A chapter on treatment provides schedules for vitamin A dosing in the emergency management of xerophthalmia, severe infectious episodes, and severe protein-energy malnutrition, and offers advice on dietary improvement, essential eye care, and the prevention of recurrence. The final chapter, on prevention, describes the wide range of options that can be followed to meet both short-term and long-term programme goals.
"... recommended as a definitive review of the
current knowledge and management of this condition..."
Journal of Nutrition and Environmental Medicine
"... outstanding and very practical ...
essential for all health workers concerned with vitamin A deficiency..."
South African Medical Journal
Vitamin A Supplements
A Guide to their Use in the Treatment and Prevention of Vitamin A Deficiency and Xerophthalmia
1997, vi + 28 pages [E, F*, S*]
ISBN 92 4 154506 2
Sw.fr. 14.-/US $12.60; in developing countries: Sw.fr. 9.80
Order no. 1152303
Provides concise, authoritative advice on the use of high-dose vitamin A supplements for the control of vitamin A deficiency and the emergency treatment of xerophthalmia and other conditions in high-risk groups. Now in its second edition, the guide has been updated and expanded to reflect the latest scientific knowledge, particularly concerning the safety and effectiveness of different dose schedules in different age and population groups. Recommended lines of action also draw on practical experiences gained in the recent international drive to eliminate vitamin A deficiency as a public health problem by the year 2000.
The guide is addressed to programme managers and administrators and aims to answer all practical questions concerning how much vitamin A should be given to different age and population groups, how often, and in what form. Details range from an alert to conditions that should be treated as medical emergencies, through advice on how to calculate procurement requirements, to the simple warning that oil-based preparations should never be injected.
The guide has five sections. The first explains the role of high-dose vitamin A supplements as a proven strategy for controlling xerophthalmia, preventing nutritional blindness and, among deficient populations, reducing the severity and case-fatality rate of certain childhood infections, particularly measles and diarrhoea. Factors influencing the choice of target populations, distribution schemes, and overall programme strategies are also briefly discussed.
Section two presents schedules, for universal and targeted distribution, for the prevention of vitamin A deficiency, xerophthalmia, and nutritional blindness in infants and young children. Questions about safety, side effects, and the potential hazards of overdosing are addressed and clearly answered. Subsequent sections give treatment schedules for xerophthalmia in all age groups and in the special case of pregnant women, and summarize the rationale for supplementation during measles.
Operational issues are discussed in the final and most extensive section, which includes information on the practical and technical advantages of different vitamin A preparations, sources of supplies and their costs, steps to follow in procurement planning, and various options for channelling delivery through existing health care services.
The guide concludes with a list of countries categorized according to the significance of vitamin A deficiency as a public health problem, a summary of the scientific rationale for vitamin A supplementation, and detailed information on the potency retention, at different storage temperatures, of commonly used vitamin A preparations.