1. Kennedy, Maureen Shawn MA, RN

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The Marburg hemorrhagic fever outbreak in Angola.

The Marburg virus has killed 255 of its 275 victims, at least a dozen of them nurses, and according to an April report by the World Health Organization (WHO), the Angola outbreak is the largest and deadliest on record. Infection with the virus, which is closely related to the Ebola virus, begins with severe headache and malaise, high fever, vomiting, and diarrhea and quickly progresses to debilitation; death usually occurs from blood loss and shock. Transmission is through close contact with infected bodily fluids, putting family caregivers and clinicians at high risk. The current outbreak was first reported in Uige Province (population 500,000), which has remained the epicenter; more than 95% of the cases have occurred there. The WHO is leading international efforts to contain the disease and to provide training and equipment. It's especially concerned that the disease will continue to spread through family members who care for stricken relatives at home, without protective clothing or knowledge of isolation measures.


Is U.S. influence thwarting AIDS prevention in Uganda?

According to a recent report by Human Rights Watch, Uganda, which saw its HIV-AIDS rate drop from 15% in 1992 to 6% in 2002 thanks to sex education and condom distribution programs, has recently embraced abstinence-until-marriage campaigns, funded largely by an $8 million annual grant from the United States. Ugandan president Yoweri Museveni and the country's first lady, Janet Museveni, have both spoken out in favor of abstinence and against condoms (which they say are ineffective and unreliable), and information on HIV and AIDS, condoms, safer sex, and the risk of HIV in marriage has been removed from primary school curricula. The full report, The Less They Know, the Better: Abstinence-Only HIV/AIDS Programs in Uganda, can be found at


A road map for decreasing global neonatal mortality rates.

Every year, according to a four-part series of studies published in the Lancet, about 4 million newborns (defined as infants in the first four weeks of life) worldwide die, 99% of them in poor countries. The most common direct causes are severe infection, preterm birth, and asphyxia. Many of these deaths can be prevented, with such interventions as tetanus toxoid immunization, along with syphilis screening and treatment for pregnant women, ensuring that the delivery area is clean, and administering antibiotics for preterm rupture of membranes. Combining interventions in small bundles, or "packages," say the researchers, will make prevention more efficient and cost effective. But to achieve long-term results, local governments and international organizations must create policies that will help mothers have healthier pregnancies as well as deliveries and will ensure that infants receive the care they need during those crucial first weeks of life. To read the complete series, go to (registration is required but free) and search for "neonatal survival series."

FIGURE. Namuddu Flor... - Click to enlarge in new windowFIGURE. Namuddu Florence, who is HIV positive, receives free medical treatment in Kampala, Uganda. After its HIV-AIDS rates dropped 9% in a decade, Uganda is now seeing an increase in such rates, which may be the result of less sex education and condom distribution.