[Global eradication of dracunculiasis is a reality nowadays].

Global efforts to eradicate dracunculiasis have continued to progress with only 542 cases reported in 2012 versus almost 1 million cases in the 1980s when the initiative was launched. The disease is still endemic, but in only four countries: South Sudan (541 cases), Chad (10 cases), Mali (4 cases), and Ethiopia (4 cases). The International Commission for the Certification of Dracunculiasis Eradication declared that 180 countries were free of the disease by 2013. Dracunculiasis was first eradicated in the former USSR in 1931 when its last case was registered due to the successful implementation of a package of appropriate measures (case detection and management, vector control, and health education, including water filtration from open water sources and behavioral changes). These approaches were actively taken into account when developing the global strategy for dracunculiasis. The World Health Organization has set a goal to eradicate the disease by 2015. However, despite the fact that the global situation looks very optimistic, the time for completing the program will be most likely postponed due to a few operational challenges remaining in the still endemic countries, in South Sudan in particular.

[Russian experience with international health cooperation at early stages of its development].

It is a historical review of the development of international health cooperation and participation of Russia at its early stages. Detailed information is presented concerning joint work for control of malaria and other parasitic infections with WHO, CMEA countries, developed and developing states. The important role of E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine in combating infections and in health protection at large is emphasized. Current collaboration and its prospects are briefly discussed.

Immunization of 6 and 9 month old infants with AIK-C, Edmonston-Zagreb, Leningrad-16 and Schwarz strains of measles vaccine.

BACKGROUND: Measles kills more than 1 million infants per year and is particularly lethal in infants < 1 year old in developing countries. Recent reports have suggested that measles vaccines of different strains and titre differ in their immunogenicity in young infants. We sought to identify strains and titres of measles vaccines which would be effective in 6 and 9 month old infants. METHODS: We conducted a randomized trial of AIK-C, Edmonston-Zagreb (EZ), Leningrad-16 and Schwarz strains of measles vaccine at different titres in 1202 6 month old and 1250 9 month old infants. Antibody levels were measured by haemagglutination inhibition assay. Seroconversion was defined as a change from seronegative to seropositive or a fourfold rise in titre above the expected level after antibody decay (assumed antibody half-life = 6 weeks). Chi-square tests were used to compare seroconversion rates and rates of adverse reactions among the groups. Comparison of geometric mean titres (GMT) was done by the Student's t-test. RESULTS: No severe or unusual adverse reactions occurred during the 6 weeks after vaccination. All strains induced high seroconversion rates in 9 month old infants. In 6 month olds, medium- and standard-titre AIK-C induced the highest rates of seroconversion. Antibody titres at 6 weeks after vaccination were highest in recipients of Schwartz vaccine and lowest for EZ vaccine recipients. CONCLUSIONS: Standard-titre AIK-C may be more effective than other measles vaccine strains for early measles immunization and should be evaluated further for efficacy, long-term immunogenicity, and long-term safety.

EUROHEALTH Programme.

The countries of central and eastern Europe (CCEE) and the newly independent states (NIS) of the former USSR are undergoing rapid and profound change, and assistance from the international community has lacked a common focus. In late 1990, the WHO Regional Committee for Europe created the EUROHEALTH programme to try to meet the urgent and medium-term needs of the CCEE/NIS for technical, managerial and material resources within the framework of the long-term regional strategy for health for all. The programme's strategy includes making collaborative agreements with each of the CCEE/NIS, raising funds and coordinating tripartite assistance with a wide variety of international organizations. The Regional Office for Europe has changed to support the EUROHEALTH programme by establishing a Country Health Development department, and an information clearing-house to track assistance to the NIS so it can be provided more efficiently. The programme's work has created a flow of information and better coordination of cooperation between all the organizations working in the health sector in the CCEE/NIS. The most important EUROHEALTH activities in 1992-1993 have focused on: relieving shortages of vaccines and medical equipment, developing health policy and developing programmes on such issues as health service reform, human resources, noncommunicable diseases, maternal and child health, AIDS and environment and health. The EUROHEALTH programme is a pragmatic and highly appropriate approach to the CCEE/NIS; its main need is for more funding to enable it to meet countries' needs more precisely and to cooperate more effectively with other organizations.

[The cluster method in conducting epidemiological research]. / Klasternyi metod v provedenii épidemiologicheskikh issledovanii.

The Expanded Programme on Immunization (EPI) whose goal is to reduce morbidity and mortality by providing children with immunizations against diphtheria, pertussis, tetanus, poliomyelitis, measles, and tuberculosis continually faces the problem of documenting immunization coverage rates. Therefore the EPI seeks simple, effective, and inexpensive methods of evaluation which could be implemented in different countries. An example of such a method is a simplified cluster sampling technique of estimation of immunization coverage through the examination of 210 children, selected randomly as 30 groups of 7 children each. In 1978-1984 more than 1000 immunization coverage surveys were performed all over the world, mainly in developing countries. In a modified way this method is also used to collect data on morbidity and mortality of certain EPI target diseases as well as diarrhoeal diseases.

[Experience with the expanded WHO program on immunization against tetanus]. / Opyt rasshirennoi programmy VOZ po immunizatsii protiv stolbniaka.

PIP: According to (WHO) statistics, over 1 million infants in the developing countries die each year from tetanus. The estimated annual occurrence of tetanus in the 3rd World exceeds 2.5 million cases, including approximately 1.3 million newborn infants. In 1974, WHO began an expanded program for the systematic immunization of infants against tetanus and certain other diseases. The program uses 2 approaches for preventing tetanus: 1) immunization of infants under 1 year of age with the AKDS vaccine; and 2) immunization of pregnant women or, if possible, all women, with tetanus anatoxin. The 2nd approach is more effective, especially when 2 doses of tetanus anatoxin are administered within a minimum interval of 4 weeks. The anatoxin has no harmful effects on the fetus and can be used during any stage of pregnancy. The program strives to reduce infant mortality caused by tetanus to less than 1 case in 1000 by 1990, and to 0 by 2000. To attain these goals, systematic immunization should be combined with drastic improvements in delivery techniques and hygiene in developing countries. Specialized surveys indicate that initial steps toward implementation of the program resulted in a significant reduction of infant mortality caused by tetanus. Experience with the expanded WHO program shows that elimination of tetanus in infants is a realistic and attainable goal.^ieng