Richard C. Brown

Traditional intravaginal practices and the heterosexual transmission of disease: a review.

Objective: To review reports on the use and effects of traditional intravaginal substances and practices. Method: The medical and social science literature of the past 50 years regarding use and effects of traditional intravaginal substances and practices is reviewed. Results: Traditional intravaginal practices have been described in 11 countries of sub‐Saharan Africa, and also in Qatar, Indonesia, Thailand, Haiti, the Dominican Republic, and the United States. Womens reasons for the practices include personal hygiene, disease prevention or treatment, and enhancement of sexual experience. Few studies document damage to the vaginal epithelium or changes in vaginal flora due to these practices. No prospective studies link these practices to disease transmission. Conclusion: The determination of how these practices affect disease transmission will require precise definition of independent variables, which is difficult because of the diversity of the practices. It is appropriate to search for intervening variables; specifically, the effects on the vaginal pH, flora, and epithelium.

Nutrition surveillance by QUAC stick.

The QUAC stick method of nutrition assessment was used as an indicator of change in a nutrition surveillance system in Zaire. The method is quick, simple and can be done by primary school teachers. Results of QUAC stick measurements are reproducible and easy to report.

Characteristics of contraceptive acceptors in rural Zaire.

Almost 15% of the women of childbearing age accepted modern contraception during the 1st 2 years of a program of contraceptive education and services in a remote rural area of Zaire. Family planning team members were widely known residents of the area. Their personal contact strongly influenced the acceptance and method of contraception chosen by local women. The acceptors averaged 7 pregnancies and 5 living children and generally wanted a total of 6 or 7 children.

Clinical treatment of tuberculosis in rural Africa.

Tuberculosis is one of the most serious health problems of rural Africa (WHO 1972). It is possibly the greatest single cause of death among adults. In children, tuberculosis is seen as a frequent complication of malnutrition. The physician who is charged with the management of a tuberculosis programme in rural Africa is confronted with the same problems as any physician in advanced countries. But, in addition, he is faced with the limitations imposed by lack of funds, shortages of staff, and patients who live in extreme poverty and ignorance of their disease. From a practical point of view this situation can be expressed by three basic concerns of the physician:

A simple system of nutrition surveillance for African communities.

A nutrition surveillance is proposed to demonstrate short-term trends of protein-energy malnutrition in African communities. This proposal can be utilized by members of the community and employs 4 indicators: rainfall market prices birth weights and pre-school weight-for-age. Basically it entails rainfalls effect on food production which in turn influences local food prices. Local food prices are also influenced by external prices.. Both food production and local food prices have an impact on household food availability which determines the communitys nutritional status. Variations in the nutritional status can be assessed by birth weight and pre-school weight-for-age. By measuring rainfall recording market prices of selected items collecting birth weights and measuring pre-school childrens weight the nutritional status of a community can be appraised. 3 examples of employing this strategy are described. It is concluded that determining the nutritional situation in a community will aid in the reduction of nutritional problems.

An evaluation of nutrition centre effectiveness by measurement of younger siblings

Thirty children were measured when they entered nutrition centres. Their younger siblings were later measured at the same age. Over the same period, a matched group of control children and their siblings were measured. The younger siblings of Centre participants showed the same growth patterns as the younger siblings of control children. Centre teaching had evidently not affected the way mothers fed their younger children, and thus it had no effect on their growth.