Institution
World Health Organization
Government•Islamabad, Pakistan•
About: World Health Organization is a government organization based out in Islamabad, Pakistan. It is known for research contribution in the topics: Population & Public health. The organization has 13330 authors who have published 22232 publications receiving 1322023 citations. The organization is also known as: World Health Organisation & WHO.
Topics: Population, Public health, Health care, Health policy, Global health
Papers published on a yearly basis
Papers
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TL;DR: The worldwide distribution of protein-energy malnutrition is described, based on nationally representative cross-sectional data gathered between 1980 and 1992 in 79 developing countries in Africa, Asia, Latin America, and Oceania, to confirm that more than a third of the world's children are affected.
Abstract: Using the WHO Global Database on Child Growth, which covers 87% of the total population of under-5-year-olds in developing countries, we describe the worldwide distribution of protein-energy malnutrition, based on nationally representative cross-sectional data gathered between 1980 and 1992 in 79 developing countries in Africa, Asia, Latin America, and Oceania. The findings confirm that more than a third of the world's children are affected. For all the indicators (wasting, stunting, and underweight) the most favourable situation--low or moderate prevalences--occurs in Latin America; in Asia most countries have high or very high prevalences; and in Africa a combination of both these circumstances is found. A total 80% of the children affected live in Asia--mainly in southern Asia--15% in Africa, and 5% in Latin America. Approximately, 43% of children (230 million) in developing countries are stunted. Efforts to accelerate significantly economic development will be unsuccessful until optimal child growth and development are ensured for the majority.
604 citations
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TL;DR: The results of the first comparison, involving 6708 births with information on NTDs and other infant outcomes, show a protective effect of daily folic acid supplementation (alone or in combination with other vitamins and minerals) in preventing N TDs compared with no interventions/placebo or vitamin and minerals without folic Acid.
Abstract: Background
It has been reported that neural tube defects (NTD) can be prevented with periconceptional folic acid supplementation. The effects of different doses, forms and schemes of folate supplementation for the prevention of other birth defects and maternal and infant outcomes are unclear.
Objectives
This review aims to examine whether periconceptional folate supplementation reduces the risk of neural tube and other congenital anomalies (including cleft palate) without causing adverse outcomes in mothers or babies. This is an update of a previously published Cochrane review on this topic.
Search methods
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2015). Additionally, we searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (31 August 2015) and contacted relevant organisations to identify ongoing and unpublished studies.
Selection criteria
We included all randomised or quasi-randomised trials evaluating the effect of periconceptional folate supplementation alone, or in combination with other vitamins and minerals, in women independent of age and parity.
Data collection and analysis
Two review authors independently assessed the eligibility of studies against the inclusion criteria, extracted data from included studies, checked data entry for accuracy and assessed the risk of bias of the included studies. We assessed the quality of the body of evidence using the GRADE approach.
Main results
Five trials involving 7391 women (2033 with a history of a pregnancy affected by a NTD and 5358 with no history of NTDs) were included. Four comparisons were made: 1) supplementation with any folate versus no intervention, placebo or other micronutrients without folate (five trials); 2) supplementation with folic acid alone versus no treatment or placebo (one trial); 3) supplementation with folate plus other micronutrients versus other micronutrients without folate (four trials); and 4) supplementation with folate plus other micronutrients versus the same other micronutrients without folate (two trials). The risk of bias of the trials was variable. Only one trial was considered to be at low risk of bias. The remaining studies lacked clarity regarding the randomisation method or whether the allocation to the intervention was concealed. All the participants were blinded to the intervention, though blinding was unclear for outcome assessors in the five trials.
The results of the first comparison involving 6708 births with information on NTDs and other infant outcomes, show a protective effect of daily folic acid supplementation (alone or in combination with other vitamins and minerals) in preventing NTDs compared with no interventions/placebo or vitamins and minerals without folic acid (risk ratio (RR) 0.31, 95% confidence interval (CI) 0.17 to 0.58); five studies; 6708 births; high quality evidence). Only one study assessed the incidence of NTDs and showed no evidence of an effect (RR 0.07, 95% CI 0.00 to 1.32; 4862 births) although no events were found in the group that received folic acid. Folic acid had a significant protective effect for reoccurrence (RR 0.34, 95% CI 0.18 to 0.64); four studies; 1846 births). Subgroup analyses suggest that the positive effect of folic acid on NTD incidence and recurrence is not affected by the explored daily folic acid dosage (400 µg (0.4 mg) or higher) or whether folic acid is given alone or with other vitamins and minerals. These results are consistent across all four review comparisons.
There is no evidence of any preventive or negative effects on cleft palate (RR 0.73, 95% CI 0.05 to 10.89; three studies; 5612 births; low quality evidence), cleft lip ((RR 0.79, 95% CI 0.14 to 4.36; three studies; 5612 births; low quality evidence), congenital cardiovascular defects (RR 0.57, 95% CI 0.24 to 1.33; three studies; 5612 births; low quality evidence), miscarriages (RR 1.10, 95% CI 0.94 to 1.28; five studies; 7391 pregnancies; moderate quality evidence) or any other birth defects (RR 0.94, 95% CI 0.53 to 1.66; three studies; 5612 births; low quality evidence). There were no included trials assessing the effects of this intervention on neonatal death, maternal blood folate or anaemia at term.
Authors' conclusions
Folic acid, alone or in combination with vitamins and minerals, prevents NTDs, but does not have a clear effect on other birth defects.
600 citations
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TL;DR: These two population-based intervention strategies could therefore substantially reduce mortality from chronic diseases, and make a major (and affordable) contribution towards achievement of the global goal to prevent and control chronic diseases.
597 citations
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TL;DR: The incidence of typhoid varied substantially between sites, being high in India and Pakistan, intermediate in Indonesia, and low in China and Viet Nam, and underscore the importance of evidence on disease burden in making policy decisions about interventions to control this disease.
Abstract: Objective To inform policy-makers about introduction of preventive interventions against typhoid, including vaccination. Methods A population-based prospective surveillance design was used. Study sites where typhoid was considered a problem by local authorities were established in China, India, Indonesia, Pakistan and Viet Nam. Standardized clinical, laboratory, and surveillance methods were used to investigate cases of fever of ³ 3 days’ duration for a one-year period. A total of 441 435 persons were under surveillance, 159 856 of whom were aged 5–15 years. Findings A total of 21 874 episodes of fever were detected. Salmonella typhi was isolated from 475 (2%) blood cultures, 57% (273/475) of which were from 5–15 year-olds. The annual typhoid incidence (per 100 000 person years) among this age group varied from 24.2 and 29.3 in sites in Viet Nam and China, respectively, to 180.3 in the site in Indonesia; and to 412.9 and 493.5 in sites in Pakistan and India, respectively. Altogether, 23% (96/413) of isolates were multidrug resistant (chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole). Conclusion The incidence of typhoid varied substantially between sites, being high in India and Pakistan, intermediate in Indonesia, and low in China and Viet Nam. These findings highlight the considerable, but geographically heterogeneous, burden of typhoid fever in endemic areas of Asia, and underscore the importance of evidence on disease burden in making policy decisions about interventions to control this disease.
596 citations
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TL;DR: From the 'Channg Cross and Westminster Medical School London UK IRCCS Maggiore Hospital, Milan Italy, Beth Israel Hospital, Boston USA, and the 'Institute of Thrombosis and Hemostasis Tel Hashomer, Israel.
Abstract: From the 'Channg Cross and Westminster Medical School London UK IRCCS Maggiore Hospital, Milan Italy Beth Israel Hospital, Boston USA, \"University Hospital Leiden The Netherlands Research Centre of Medical Genetics Moscow The Russian Federation, WHO, Switzerland, Chnstian Medical College Hospital Vellore India University of Lund, Malmo Sweden 'Institute of Clinical Genetics Moscow The Russian Federation, Washmgton University, St Louis, USA, \"Institute of Thrombosis and Hemostasis Tel Hashomer, Israel
594 citations
Authors
Showing all 13385 results
Name | H-index | Papers | Citations |
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Christopher J L Murray | 209 | 754 | 310329 |
Michael Marmot | 193 | 1147 | 170338 |
Didier Raoult | 173 | 3267 | 153016 |
Alan D. Lopez | 172 | 863 | 259291 |
Zulfiqar A Bhutta | 165 | 1231 | 169329 |
Simon I. Hay | 165 | 557 | 153307 |
Robert G. Webster | 158 | 843 | 90776 |
Ali H. Mokdad | 156 | 634 | 160599 |
Matthias Egger | 152 | 901 | 184176 |
Paolo Boffetta | 148 | 1455 | 93876 |
Jean Bousquet | 145 | 1288 | 96769 |
Igor Rudan | 142 | 658 | 103659 |
Holger J. Schünemann | 141 | 810 | 113169 |
Richard M. Myers | 134 | 496 | 137791 |
Majid Ezzati | 133 | 443 | 137171 |