No abstract

Smallpox eradication was a result of leadership provided by the World Health Organization headquarters and regional offices, national governments and, not least, national and multilateral aid agencies. The involvement of all these agencies encouraged a series of immunization initiatives and give rise to ambitious new goals for the eradication of diseases. The National Immunization Programs in Brazil and other countries, the WHO Expanded Programme on Immunization and the goal of global polio eradication were some of the more immediate results of successful smallpox eradication. Advances can be acknowledged ; yet, several goals remain unfulfilled. The politics of global health, as well as the design and deployment immunization policies, have become increasingly complex in their various dimensions. This is unsur-prising in a situation where immunization projects have been are populated by new actors, new goals and new vaccines. The past, present and future of these trends are put under scrutiny by a range of historians in this issue of Ciência &Saúde Coletiva. Immunization, in the form of an idealized dream, is a dream come true-a miraculous technological product, in the form of painless and a safe vaccine, ensures that many generations of society are protected from dangerous diseases. Reality, however, is far more complex. Technological products are not always as efficacious as advertised by manufacturers and other advocates. It is also worth noting that there are-and always have been-differing notions about vaccinal safety and effectiveness at any point of time. That some voices are heard-and advertised-more loudly than others is part of a complicated process of political and social negotiation; a point that is ignored or downplayed by those seeking to promote the idea of supposedly value free nature of science. Public health, medicine and all the sciences that underpin them are anything but; conceptions about disease, cures for it and even efforts to advocate the primacy of certain interventions over the others are deeply influenced by a variety of social, political and economic considerations (which are often shifting in nature). Global funding agencies are often swayed by those who insist that ever more effective "magic bullets" can be developed and put into place seamlessly; that should not be reason enough for us to agree with such a view and ignore the social negotiations that are capable of rallying stakeholders for interventions, the effective dissemination of information and the responsible development of ethical norms for field practice. Meaningful policy can only be developed on the back of meaningful commitment to the democratic introduction of health regimes. Democracy involves listening to other, often contrasting viewpoints, no matter the economic or social standing of those making the arguments. Such sensitivity in public health is time-consuming, but this type of investment of effort is always worthwhile, not least as it increases the quality of local stake-holding and also brings in a crucial el...

Objective: To determine the prevalence and pattern of malnutrition among adolescents in senior secondary schools in The Abuja Municipal area council Methods: Study design: this is a cross-sectional study conducted among adolescents (10-19 years) in secondary schools. A multistage sampling technique was employed to select a total of 1700 students from classes in selected schools. All schools in the Abuja Municipal Area council (AMAC) were stratified into urban and rural schools. Eight schools were selected by balloting from a list of schools obtained from the Education centre. A school was selected from each of the four major districts of AMAC and four schools were selected from the rural making a total of 8 schools. Although the consent of the school authorities was obtained, individual subject also consented to the study before being enrolled. The study excluded those adolescents who were physically challenged thus limiting physical activity. Information was obtained via the use of questionnaires that were administered by trained personnel. Subject's height and weight was taken using the floor-type height (H) and weight (W) measuring scale model ZT-120 using Massachusetts department of public health protocol. The nutritional status was determined using the formula: BMI= W/H 2 , where W =weight (in kilograms) and H= height (in meters). The age and sex specific height and BMI percentile for each subject was determined using the 2007 WHO Height and BMI growth charts for age 5-19years. The students were then classified into one of the following categories using previously used standards: normal, stunted, wasted, overweight or obese. Data was analyzed using SPSS version 17 statistical package. Results: The mean age was 14.43±1.94 years; male 688, female 862, M:F ratio 1.1.3. Mean BMI, weight and height were 20.31±3.07kg/m 2 , 51.07± 10.80 kg, and 157.88±9.33 cm. The prevalence of wasting, stunting, overweight and obesity was documented as 1.7% (27/1550), 11.3% (175/1550), 13.2% (205/1550), and 2.6% (41/1550) respectively. Those in urban schools had higher mean BMI (20.91±3.22 kg/m2 versus 19.71±2.78 kg/m2) and height (160.41±9.14 cm versus 155.32±8.81 cm) and p values <0.05. Conclusion: There is a double burden of over-nutrition (overweight and obesity) and under-nutrition (stunting and wasting) among adolescents in Nigeria.

This report of Hereditary anhidrotic ectodermal dysplasia (HAED), a genetic disorder characterized by abnormalities of structures of ectodermal origin, was informed by its rarity, and its import for survival in a tropical environment. The five-year old male was first seen on account of inability to cut the front teeth, and a persistent offensive nasal discharge. He had heat intolerance and inability to perspire from early infancy. Pedigree evaluation revealed that both parents are Nigerians and unrelated, but the maternal front dentition was visibly defective. A 19-year old female sibling needed dentures at 10 years of age, while the father was one of two survivors out of 12 children, eight of whom were males. Findings included hypotrichosis; "saddle-nose" deformity and an offensive nasal discharge; the skin was thin, warm and dry; he had no incisors and canines, but had a single erupted premolar on either side and radiographic evidence of unerupted premolars was found. Genetic counseling and parental anticipatory guidance were offered, as was antimicrobial treatment for the co-morbid atrophic rhinitis. Dentures were deferred on the dentist's advice. This case report of HAED in a Nigerian was aimed at raising the local index of clinical suspicion by highlighting the reality of rarities, even with inadequate diagnostic support. The diagnostic parameters, literature review and the management strategies are discussed.