RESUMO
Thika District, Kenya, is the site of an operational research study on the provision of comprehensive post-rape care, including the free provision of HIV post-exposure prophylaxis (PEP). It is a typical rural Kenyan district in terms of resources and patient throughput. The high rate of children attending for post-rape services was unexpected and had significant programming implications. An age-disaggregated analysis of existing quantitative data from the first 8 months of service provision was conducted. Ninety-four case records were reviewed, of whom 48 (51%) were in the age range 1.5-17 years inclusive. All three cases of male rape were in children. Children were more likely to know their assailant than adults and were more likely to be HIV-negative at baseline. The majority (86%) of children presented in time for PEP, with adherence and completion rates similar to adults but lower rates of 6-week follow-up. The use of weight bands to determine drug dosages greatly simplified the appropriate and early administration of paediatric PEP. The high rates of childhood rape and demand for post-rape services were an enormous challenge for service providers and policy-makers.
Assuntos
Fármacos Anti-HIV/administração & dosagem , Abuso Sexual na Infância , Infecções por HIV/prevenção & controle , Lamivudina/administração & dosagem , Estupro , Zidovudina/administração & dosagem , Adolescente , Adulto , Peso Corporal , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Lactente , Quênia , Masculino , Projetos Piloto , Guias de Prática Clínica como Assunto , Fatores de Risco , Saúde da População Rural , Infecções Sexualmente Transmissíveis/prevenção & controleRESUMO
Fine structural abnormalities in seven-day-old broilers reared at high altitude are described. Tissue changes were seen in the heart, kidney and lung that resembled those previously reported in four-week-old broilers reared at altitude with an ascitic syndrome. Almost half of the hearts examined had myofibril disorganisation and mitochondrial hyperplasia. Renal changes occurred principally in tubule morphology and the lungs showed capillary congestion as well as engorged parabronchi. Increased levels of cartilaginous and osseous nodules in the lungs of 28-day-old ascitic birds reared at high altitude supported observations from a previous study conducted at low altitude. The observations in this study of seven-day-old chicks, may indicate that the embryo is at greater risk of developing abnormalities following exposure to low oxygen tension.
