Feature page


A systematic review found a significant global burden of rheumatic fever, rheumatic heart disease and post-streptococcal glomerulonephritis. 2–11


Cryptosporidium parvum causes gastroenteritis epidemics in the Nablus region of Palestine. 12–17

Verbal autopsy

In a comparison of the potential benefit of a single vs. 2 physician coders to assign cause of perinatal death, the rank order, patterns and proportions of deaths were very similar between the two. 18–29

Spina bifida

Quality of life of children with spina bifida in Kenya is not related to the degree of spinal defects. 30–36


It is high-time that CD4 technology be simplified and adapted for low-income countries to change the paradigm of restricted access once and for all. 37–41

Undiagnosed HIV infection is common in children attending primary health care clinics in South Africa, especially children with severe pneumonia and growth faltering, and those requiring urgent referral. 42–52

In Kumasi, Ghana, the prevalence of cryptococcal antigenaemia in patients with advanced HIV infection enrolling in an ART program appears to be low, suggesting that routine testing of outpatients diagnosed with advanced HIV infection may be unnecessary. 53–56

Art therapy can help AIDS orphans to protect their mental health. 57–66


A retrospective evaluation of the microbiological profile of Mycobacterium species isolated from HIV-infected patients in São José do Rio Preto, Brazil, showed that 11% of MT strains were resistant to at least one of the antimycobacterial drugs; 3.1% were multidrug resistant. 39.4% were NTM species. 67–73

In an Indian hospital population the most important risk factor for developing TB was diabetes mellitus. 74–78

A viewpoint challenges widely held assumptions which form current dogma on Mtb latency, isoniazid monotherapy and chemoprophylaxis. 79–83

Health policy

The potential for reproductive health voucher programs appears positive; however, more research is needed to determine cost-effectiveness and population health impacts. 84–96

Health economics

In the economic evaluation of package of care interventions employing clinical guidelines many questions remain to be answered: which measures to use, how multiple measures might be combined, how improvements in one area might be compared with those in another and what value is associated with improvement in health worker practices. 97–104

Low income country health financing and universal coverage problems require an open-minded and evidence-based debate within countries and internationally. Ideological positions should not set the tone. 105–109

In a study measuring unit costs of selected outpatient HIV/AIDS services and total annual costs of ART and PMTCT in Zambia, total costs of services were dominated by drugs, laboratory tests and clinical labor. Costs could be reduced by greater harmonization of care protocols and more intensive use of fixed resources. 110–118

Sleeping sickness

Two new biomarkers, MMP-9 and ICAM-1, are presented. They potentially replace or at least complement white blood cell count for HAT staging. 119–126


The admission tourniquet test has low sensitivity and adds relatively little value to the diagnosis of dengue among Lao adult inpatients with suspected dengue. Although a positive tourniquet test suggests dengue, and that treatment of alternative diagnoses may not be needed, a negative test result does not exclude dengue. 127–133


Aedes aegypti populations sampled in distinct environments from French Guiana, Martinique and Guadeloupe are highly competent to transmit Chikungunya virus, highlighting the risk of outbreaks in this region of America. 134–139