Infection: Controlling Hospital Environments

Infections acquired in health care facilities occur worldwide and affect both developed and resource-poor countries. These infections are among the major causes of death and morbidity among hospitalized patients and a significant burden for both the patient and for public health.

Nearly 90 percent of hospitals in Latin America lack the personnel and proper procedures to prevent and control hospital-acquired infections, despite the elevated rates of these infections and their associated morbidity, mortality, and high cost. Many hospitals do not have adequate laboratories and lack crucial data for determining appropriate antimicrobial therapy and infection control practices. Several countries also lack regulations and policies to compare the true extent of these problems. Little knowledge exists on how these infections affect particularly vulnerable populations, such as indigenous people, premature babies, young children and the elderly.

Health Challenges

• The rates of infection in resource-poor countries tend to be twice as high as in developed countries.
• At any time, over 1.4 million people worldwide suffer from infectious complications acquired in health care facilities; 50% of them are caused by pathogens resistant to common antibiotics..
• The most frequent are urinary tract infections, lower respiratory tract infections, and infections of surgical wounds.
• Infection rates are higher among patients with increased susceptibility because of extremes of age, underlying disease, chemotherapy, surgery or invasive procedures.

Vaccines: Preventing Disease and Protecting Health

A grant from PAHEF supported a vaccination campaign by the Pan American Health Organization for residents of hard-to-reach communities in the Paraguayan Chaco. This remote region of Paraguay is home to more than 55 different native communities that speak several dialects.

As part of the campaign:

• 161 health workers were trained.
• 14,145 vaccinations were given for yellow fever, diphtheria, measles, polio, and neo-natal tetanus.
• Vaccination activities increased by 30 percent over the previous year.
• Vaccine coverage nearly doubled for children under 1 year of age over the previous year.

Education: Providing Textbooks for Health Workers

For nearly 40 years, PALTEX (The Expanded Textbook and Instructional Materials Program), a joint technical cooperation program of PAHEF and PAHO, has provided more than five million books and instruments to students and health professionals (physicians, nurses, dentists, nutritionists, veterinary doctors, etc.) at over 560 institutions in 20 Latin American and Caribbean countries. PALTEX materials emphasize public health, specifically primary health care.

In addition to textbooks for professionals, PALTEX publishes and distributes affordable manuals and other materials focused on the needs of health service personnel at all levels of the health system that are available for Spanish-speaking people in the United States and Canada.

Its Serie PALTEX para Técnicos Medios y Auxiliares consists of practical manuals for front-line health workers in the areas of acute respiratory illness, care of mothers and infants, community health education, principles of epidemiology for disease control, basic laboratory techniques, and many others. Serie PALTEX para Ejecutores de Programas de Salud is a collection of manuals for in-service professionals responsible for project planning and execution covering social aspects of health and planning of community health programs. Areas include community health research methodology; design and execution of community control programs in hypertension, diabetes, diarrheal disease, uterine cancer, HIV disease; child growth and development; adolescent medicine; and special aspects of epidemiology in primary health care. The program also publishes PALTEX Salud y Sociedad 2000, which covers the relationship between social realities and the health status of the population.

Malaria: Testing a New Delivery System

Malaria is the world's most prevalent vector-borne disease, causing over two million deaths per year, half of which are in children under five years of age. It is endemic in 92 countries and over 40 percent of the world's population is at risk.

There is treatment for malaria. But babies, children, and adults who are weakened, ill, or system-compromised, often cannot ingest the drugs.

PAHEF has funded a World Health Organization (WHO) study of a new rectal suppository delivery system for artesunate medications.

The project encompasses registration, behavioral studies, packaging information, clinical trials, and has controlled deployment of drugs in six countries. This delivery modality, still in the study stage, could be life-saving for hundreds of thousands of persons ill with malaria.

In fact, one recent, first-hand account from a health worker in a study area reveals promising results:

"One night, two children came in who had a very high fever and were convulsing. I could not treat them and had to run to the nearest Drug Dispenser who inserted the rectal artesunate suppository. The next day the children were better and I was able to treat them with oral quinine."

– Health Worker, Kiyune Subcountry, Uganda