WHO Recent publications

/Recent publications WHO-OMS /Publications retcen-tes Bulletin of the World Health Organization, 65 (5): 759-767 (1987) © World Health Organization 1987 Chemical toxicology, carcinogenicity Ammoniaa Geneva, 1986, 210 pages (Environmental Health Criteria, No. 54). ISBN 92 4 154194 6 Price: Sw.fr. 18.-/US$ 9.00 This book provides an expert assessment of the effects of ammonia on human health and the en- vironment. Prepared by a 14-member task group, the book bases its evaluation on more than 600 published reports of epidemiological, laboratory and clinical investigations, including controlled studies in human beings. The opening sections summarize the properties of ammonia, describe sampling and analytical methods, and identify sources of human and en- vironmental exposure resulting from both natural processes and industrial activities, including cer- tain types of intensive farming. Other sections provide details on mechanisms of environmental transport, distribution, and transformation, and assess the effects which different ammonia con- centrations in different components of the en- vironment can have on humans and farm animals. The most extensive sections of the book are devoted to the effects of ammonia in the aquatic and terrestrial environments where, as a result of urbanization, industry, and farming and as a result of deposition in the environment, significant toxic effects may arise. Readers will find especially detailed assessments of the effects on aquatic animals and those on cattle, swine and poultry resulting from continuous exposure under con- fined housing conditions. Information on the kinetics and metabolism of ammonia and on its effects on experimental animals and in vitro systems is also presented. As with other volumes in this series, the book will serve as a complete and authoritative record of what is currently known about the hazards for the environment, for humans, and for aquatic and farm animals posed by ammonia. Kelevana Geneva, 1986, 32 pages (Environmental Health Criteria, No. 66). ISBN 92 4 154266 7 Price: Sw.fr. 6.-/US$ 3.00 Kelevan is a chlordecone derivative used in a number of countries as an insecticide, mainly for the control of the potato beetle and the banana root borer. Kelevan is metabolized in the mam- malian body and in the environment back to chlor- decone. Though kelevan, which is moderately toxic, is degraded quite rapidly to other caged structure products, its major metabolite is known to persist in the soil for several years. This report assesses available data on the risks for human health and the environment posed by kelevan. The opening sections summarize what is known about the properties of kelevan, sources of exposure, environmental transport and distri- bution, biotransformation and degradation, levels in the environment, and kinetics and metabolism. A section devoted to the effects of kelevan on organisms in the environment concentrates on the findings from a very limited number of studies conducted in rainbow trout, honey bees, domestic hens, and soil microarthropods. In view of the sparsity of data on kelevan, the report bases its recommendations on what is known about the toxicity of chlordecone. It con- cludes that, unless kelevan is indispensable, it should not be used. A separate monograph on chlordecone is avail- able as No. 43 in the Environmental Health Criteria series. a Published byWHO under the joint sponsorship of the United Nations Environment Programme, the International Labour Organisation, and WHO (International Programme on Chemical Safety-IPCS). -759- 760 RECENT PUBLICATIONS Tetradifona Geneva, 1986, 47 pages (Environmental Health Criteria, No. 67). ISBN 92 4 154267 5 Price: Sw.fr. 7.-/US$ 3.50 Tetradifon is a white crystalline solid used in formulation as an acaricide in agriculture and horti- culture. This book evaluates data on the chemical properties of tetradifon, methods for its deter- mination, levels in the environment, sources of exposure, and associated risks for the environment and the general population. Data from experi- mental studies in animals and short-term in vitro tests are also used to assess toxicity, mutagenicity, and carcinogenicity. Because of the uses of tetra- difon, particular attention is given to questions of residues in soil and in food, adverse effects on terrestrial plants, birds, fish, aquatic crustacea, and bees, and risks associated with exposure for workers spraying crops. On the basis of available data, the report con- cludes that there are no indications that the normal recommended use of tested tetradifon products as an acaricide causes any health or safety hazards for the general population, exposed workers, or the environment. The report also notes the importance of following recommended application rates and recommended standards for the control of product quality. Communicable diseases Basic principles for control of acute respiratory infections in children in developing countries A joint WHO/UNICEF statement Geneva, 1986, 18 pages ISBN 92 4 156094 0 Price: Sw.fr. 3.-/US$ 1.50 This booklet outlines measures that can be intro- duced to reduce the high rates of childhood mor- tality and morbidity caused by acute respiratory infections.b Concerned exclusively with the needs of developing countries, the booklet concentrates on the basic steps necessary to make better use of what is already known about these diseases and the most effective measures for their treatment and control. The importance of developing control programmes within the context of primary care is stressed throughout. The booklet opens with a brief review of statis- tics useful in assessing the magnitude of problems b A note on global mortality from acute respiratory infections among children aged below 5 years appeared in the Bulletin of the World Health Organization, 65 (1): 114-116 (1987). caused by acute respiratory infections. Basic in- formation on etiological agents is provided in a second section, which characterizes the different pathogens in terms of their relevance to effective case management. The most extensive section of the booklet is devoted to a discussion of the various control methods that can be implemented at the community and first-referral health care levels. These include immunization, nonspecific preventive measures, and a strategy of case man- agement that incorporates the correct identification of the severity of the clinical condition, the appro- priate use of antimicrobial drugs, adequate sup- portive treatment at the primary care level, and knowledge of when a case requires referral. For health planners and educators in developing countries, the booklet will serve as a useful state- ment of principles and priorities for improving the control of acute respiratory infections. Education, training Guidelines for training community health workers in nutrition Second edition Geneva, 1986, vii + 121 pages ISBN 92 4154210 1 Price: Sw.fr. 16.-/US$ 9.60 In this task-oriented manual for the training of community health workers in nutrition, infor- mation and instructions are presented in two main parts. The first features chapters introducing the purpose and uses of the guidelines, the skills necessary to make the trainer a more effective teacher, and the basic facts about foods and nutrition which the health worker should be taught. The second part reproduces nine training modules. Focused on a single topic, each of these modules includes information on associated tasks, learning objectives, basic training content, and the various training methods appropriate for that module. Each module concludes with a set of practical train- ing exercises that can be used for either the prac- tising of skills or the assessment of how well these skills have been mastered. Common teaching aids and teaching methods are presented in tabular form together with information on their advan- tages, limitations, and specific applications. In this second edition, the book has been revised and expanded in keeping with lessons learned from extensive field testing of the first edition. The modular approach, which encourages adaptation to local nutrition needs, makes this work an es- pecially useful training and reference manual for RECENT PUBLICATIONS 761 primary health care workers and their supervisors or instructors. Environmental engineering Standard model designs for rural water supplies Copenhagen, 1986, 235 pages, including 131 illustrations. ISBN 92 890 1030 4 Price: Sw.fr. 60.-/US$ 36.00 This book presents well over 100 technical draw- ings and plans developed to assist engineers and local authorities in the design and construction of rural water supply systems. Intended for use in communities at a middle level of development, the book introduces a series of standard equipment, installation, and construction designs that can serve as models for the engineering of water schemes adapted to local conditions and needs. These designs, which were prepared forWHO by a firm of consulting engineers, are the outgrowth of a four-year project involving field investigations, topographic surveys, and design work in a pro- vince of Yugoslavia. The first part of the book gives design details for 13 standardized structural components of a water supply system. Each structural unit is intro- duced in terms of its function, main design con- siderations, and requirements for operation and maintenance. The book then presents 38 model designs illustrating all details necessary to con- struct, engineer, or equip each of these structures. The second part of the book shows how these flexible designs were applied and combined to prepare water schemes for 12 rural communities in Yugoslavia selected as representing a wide range of hydrogeological, topographic, and source con- ditions. The solutions worked out for these com- munities are depicted in 98 detailed drawings, which serve to illustrate both the application of model designs and the extent to which use of standard drawings for standardized components can simplify the work of engineers. Epidemiology, statistics World health statistics annual 1986 Geneva, 1986, 692 pages ISBN 92 4 067861 1 Price: Sw.fr. 90.-/US$ 54.00 In over 600 pages of maps, diagrams, tables, and interpretive text, this book presents a wealth of statistical information useful in monitoring health trends throughout the world. Information ranges from demographic data on more than 200 countries and territories to statistics on age- and sex-specific death rates, by country and by cause. Topics covered in the 1986 volume include rates of child- hood death before the age of five, the relationship between infant mortality and birth weight, the worldwide incidence of addiction to smoking and the associated hazards to health,c the prevalence of blindness, patterns of dental caries and the global distribution of dental manpower, and the preval- ence of mental, neurological and psychosocial dis- orders. As with previous volumes, the 1986 edition will serve as a useful reference tool for all health administrators, planners, and epidemiologists in- terested in monitoring health trends and charting the progress of strategies for improvement. Immunization The Expanded Programme on Immunization in South-East Asia New Delhi, 1986, xiv + 363 pages (SEARO Regional Health Papers, No. 12). ISBN 92 9022 181 X Price: Sw.fr. 20.-/US$ 12.00 This book presents detailed information on the operation and achievements of the Expanded Programme on Immunization (EPI) in the eleven countries of WHO's South-East Asia Region. It marks the most comprehensive progress report on immunization, by country and for each vaccine- preventable disease, ever compiled for the Region. Chapters outlining global and regional efforts to intensify immunization are supplemented by ex- tensive reports on activities within each country. Tables, charts and interpretive text are used to indicate the extent of progress achieved, the im- munization strategies that succeeded or failed, the public information and health education initiatives undertaken, and the types of training and research conducted in the country. The most extensive section of each country report is devoted to the identification and detailed analysis of operational problems. Examples include the shortage of spare parts for the repair of donated refrigerators, the difficulty of transporting vaccination supplies in locally available boats, high drop-out rates be- tween sequential doses of vaccines, and the fre- quent failure to immunize children suffering from c A note on the worldwide trends of smoking and their impli- cations, based on the World health statistics annual, 1986, appeared in the Bulletin of the World Health Organization, 65 (3): 409-410 (1987). 762 RECENT PUBLICATIONS minor ailments. More general problems and needs relating to surveillance systems, maintenance of the cold chain, and local production of vaccines are addressed in separate chapters. The book also includes an important discussion of disease reduc- tion targets set for the Region. Nuclear power Nuclear power: accidental releases- practical guidance for public health action Copenhagen, 1987, 46 pages (WHO Regional Publications, European Series, No. 21). ISBN 92 890 1112 2 Price: Sw.fr. 10.-/US$ 6.00 The disaster at Chernobyl, USSR,d has caused a major crisis of confidence in nuclear safety, and highlighted the need for comprehensive contin- gency planning for-and emergency response to -such accidents. This report gives practical guid- ance on how the authorities should deal with an accident in any type of nuclear installation, whether it involves accidental releases to the air or into water. It is based on principles developed in a pre- vious WHO report published in 1984.e It summarizes the range of accidents for which plans need to be made to protect the public, the measures to be taken and the levels of dose at which they should be applied. It indicates how to measure the levels of exposure and what are the most likely routes of exposure. It then outlines the problems faced by public health authorities and medical practitioners, and the administrative arrangements that will have to be made. The example used is of a standard pressurized light water reactor of the type currently used for elec- tricity generation, but many of the features will be common to other nuclear installations as well. This report is addressed to those organizations and individuals responsible for public health in the event of a nuclear accident. It will also be of use to those medical practitioners who are not adminis- tratively responsible in an accident, but who may need to be aware of the consequences and of the action to be taken in the aftermath of an accident. Coordination is vital between the public health administration and the organizations with direct responsibilities in the event of an accident, and this report is essential reading for them all. d See note on pages 743-744. ' Nuclear power: accidental releases - principles of public health action. Copenhagen, 1984 (WHO Regional Publications, European Series, No. 16). ISBN 92 890 1107 6, 62 pages. Price: Sw.fr. 12.-/US$ 7.20. Pharmaceuticals, biologicals Basic tests for pharmaceutical substances Geneva, 1986, 205 pages ISBN 92 4 154204 7 Price: Sw.fr. 34.-/US$ 17.00 This book presents simplified tests for verifying the identity of pharmaceutical substances and detecting gross degradation. The 321 substances covered represent the majority of drug substances contained in theWHO model list of essential drugsf as well as a number of widely used drug sub- stances. For each, tests have been devised to serve as a simple and readily applicable method of verifi- cation of identity when a fully equipped laboratory is not available. For this reason, the required reagents and equipment have been kept to a mini- mum, and reagents that are unstable, corrosive, expensive, or difficult to obtain have been ex- cluded. Special attention has been given to the techniques used to determine melting character- istics, as these provide a basis not only for confirm- ing the identity of a substance but also for detecting possible contamination, whether arising from poor manufacture, adulteration, cross-con- tamination during storage, or degradation. The book concludes with a list of required equipment and a description of the reagents, test solutions and volumetric solutions mentioned in the basic tests. The procedures for the preparation of test solutions that require special attention are given in detail. The book will serve as a useful component of national programmes for quality assurance in the pharmaceutical supply system. The rational use of drugs Report of the Conference of Experts, Nairobi, 25-29 November 1985 Geneva, 1987, 329 pages ISBN 92 4 156105 X Price: Sw.fr. 52.-/US$ 31.20 This book summarizes the numerous complex issues identified and discussed during an inter- national conference on the rational use of drugs. The meeting represented an unprecedented gathering of more than 100 experts from academic research, the pharmaceutical industry, consumer- protection groups, ministries of health, and national and international regulatory authorities located throughout the world. Virtually all issues related to rational practices in the manufacturing, marketing, f See WHO Technical Report Series No. 722, 1985 (reprinted 1986) (The use of essential drugs (model list of essential drugs, fourth list): second report of the WHO Expert Committee). PUBLICATIONS RECENTES 763 distribution, prescribing, quality control, and reg- ulation of pharmaceuticals were discussed in their full complexity. The book opens with a succinct overview of points debated during the meeting, including the extent of agreement or disagreement surrounding each. The second part provides a topic-by-topic summary of the widely divergent views expressed during the five-day meeting. Points of discussion range from ways of improving information to pre- scribers and consumers, through various mechan- isms for assuring that ethical criteria for advertising are observed, to the difficult question of whether the high price of certain drugs can be attributed to the costs of research and development. The most extensive part of the book reproduces 17 working papers prepared for the conference and designed to clarify ways of making drug use more rational. Topics include the responsibilities of governments, prescribers and dispensers; possible ways of rendering drug information more objective, less biased, and more accessible to prescribers and consumers; suggestions for improving drug mar- keting and for making prescription practices more rational; and proposals for improving distribution schemes. National case studies from six develop- ing and developed countries are used to illustrate some of the ways these suggestions can be put into practice. As a unique record of the views and interests of all parties concerned in the world drug situation, the book will serve as a key source of guidance in the development and planning of actions neces- sary to ensure that drugs are used more rationally throughout the world. Biological substances International standards and reference reagents 1986 Geneva, 1987, 94 pages ISBN 92 4154213 6 Price: Sw.fr. 15.-/US$ 9.00 Tabulates key information on the availability and specifications of international biological standards and international biological reference reagents. Biological standards, which occupy the most ex- tensive part of the book, are established for use in the calibration of the activity of national or working standards and for the expression of their biological activity in international units. Samples of standard preparations are intended for use in laboratory assays only. The book provides an updated list of standards for antibiotics, antibodies, antigens, blood products and related substances, endocrino- logical and related substances, and a miscellaneous group of substances. For each group of substances, standard preparations are listed in alphabetical order under the name and address of the lab- oratory that holds and distributes the substances. Each is identified by name and then characterized in terms of its biological activity, expressed as the total number of international units per ampoule; a weight definition of the unit, where necessary; the form in which the substance is available from the laboratory; the year of establishment of the stan- dard; and pertinent references to the literature. The second main part of the book presents similar information for international biological reference reagents, which are established mainly for the purpose of providing reference materials of high specificity for the identification of microorganisms or their products as well as for the identification of other biological substances of interest in the diag- nosis of disease. A concluding section lists new biological standards under consideration together with biological and pharmaceutical reference materials that have been discontinued. The publication of this authoritative list rep- resents part of WHO's efforts to ensure uniformity throughout the world in the designation of the potency or specificity of biological preparations that are used in the prophylaxis, therapy, or diagnosis of disease. Additifs alimentaires Evaluation de certains additifs alimentaires et contaminants Trentieme rapport du Comite mixte FAO/OMS d'Experts des Additifs alimentaires Geneve, 1987, 61 pages (OMS, Serie de Rapports techniques, NO 751). ISBN 92 4 220751 9 Prix: Fr.s. 9.- Cette publication rend compte des travaux et des recommandations d'un comite d'experts charge d'etablir les normes de qualite et de securite pour les substances chimiques utilisees dans l'in- dustrie alimentaire.9 Le debut du rapport est consacre aux principes a appliquer pour determiner les proprietes toxico- logiques des additifs alimentaires et pour etablir leurs normes d'identite et de purete. Vient ensuite la partie essentielle du rapport, qui est l'evaluation chimique, biologique et toxicologique de 21 com- poses des categories suivantes: antioxygenes, aromatisants, colorants alimentaires, edulcorants, 9 Voir note sur la s6curit6 des produits alimentaires aux pages 755-758. PUBLICATIONS RECENTES epaississants, additifs alimentaires divers, et enfin contaminants. Pour chaque compose, le Comite a etudie si les normes d'identite et de purete exis- tantes etaient satisfaisantes, s'il etait necessaire de fixer, ou de reviser, les doses journalieres acceptables et s'il existait suffisamment de donnees toxicologiques pour juger de la securite au niveau de la consommation par l'homme. Pour faciliter au lecteur un apercu rapide de la question, les donnees sur tous ces composes-doses journalieres admissibles, autres recommandations d'ordre toxicologique et renseignements sur les normes-sont reprises en annexe dans un tableau recapitulatif. Les nouvelles recherches et donnees toxicologiques necessaires ou souhaitables sont egalement indiquees en annexe. Par ailleurs, les risques que font courir aux nourrissons et aux enfants la nourriture, 1'eau et d'autres substances contaminees par du plomb sont evalues en detail. Enfin, une bibliographie o'u figurent plus de 70 rapports ou documents issus des reunions pre- cedentes du Comite mixte FAO/OMS d'Experts des Additifs alimentaires complete le rapport. Ce rapport pr6sente de l'interet tant pour les autorites chargees de la reglementation que pour l'industrie alimentaire en raison des informations qu'il contient sur les normes, criteres et methodes d'analyse necessaires pour proteger les con- sommateurs et assurer la s6curite des produits alimentaires. Maladies transmissibles La trypanosomiase africaine: epidemiologie et lutte Rapport d'un Comite d'Experts de l'OMS Geneve, 1986, 144 pages (OMS, Serie de Rapports techniques, NO 739). ISBN 92 4 220739 X Prix: Fr.s. 16.- Ce rapport presente les constatations et recom- mandations d'un comite d'experts reuni pour evaluer les methodes actuelles de lutte contre la trypanosomiase africaine, ou maladie du sommeil. 11 couvre tous les aspects de la maladie et ex- pose notamment des donnees nouvelles sur les symptomes cliniques et la pathogenie. 11 contient une mise a jour de la distribution geographique de la maladie et des questions de sante publique qui se posent, etayee par des cartes et des tableaux montrant les foyers de maladie et la distribution des vecteurs. Les methodes de depistage des para- sites par isolement et conservation sont decrites dans le chapitre consacre a Ia parasitologie; le rapport offre egalement un examen tres complet de l'epidemiologie, de la biologie des vecteurs et du reservoir chez les animaux hotes. La partie la plus importante traite de l'elaboration de programmes de lutte. Un chapitre est consacre aux aspects financiers et economiques et un modele de calcul du cout des programmes natio- naux de lutte est donne en annexe. On trouve egalement des directives pour le choix d'ins- truments de lutte appropries parmi les moyens actuellement disponibles, compte tenu de la situation epidemiologique et des ressources locales. Le role des soins de sante primaires et des conseils de sante de village dans la lutte contre la trypanosomiase est clairement defini. Ce rapport constitue un bilan bien venu, complet et actualise, de toutes les connaissances tech- niques et pratiques necessaires pour ameliorer les strategies de lutte contre la maladie du sommeil. Comite mixte FAO/OMS d'Experts de la Brucellose Sixibme rapport Gen&ve, 1986,145 pages (OMS, Serie de Rapports techniques, NO 740). ISBN 92 4 220740 3 Prix: Fr.s. 18.- Bilan des progres scientifiques et technolo- giques recents en matiere de lutte antibrucellique visant a evaluer l'efficacite des methodes desor- mais disponibles. L'ouvrage commence par un examen des progres accomplis dans le domaine de la recherche bacteriologique sur les micro- organismes du genre Brucella. Au nombre des pro- gres recents: des epreuves plus simples et plus sures d'identification des cultures, une classifi- cation plus precise des brucellaphages, des m'thodes ameliorees de culture et d'isolement et une meilleure comprehension des proprietes de resistance et de survie des Brucella, ce qui pre- sente un interet pour la desinfection. Des mesures de securite biologique precises sont recomman- dees a tous les niveaux. Le chapitre 3, consacre a l'immunologie, passe en revue les connaissances scientifiques concernant la reponse immunitaire a l'infection par les Brucella, et notamment les nom- breux facteurs qui, on le sait maintenant, deter- minent l'amplitude et la duree des reponses immunitaires a mediations humorale et cellulaire. Les avantages et les inconvenients des nouvelles epreuves in vivo et in vitro pour evaluer la reponse immunitaire sont egalement examines. Le chapitre 4 porte sur les vaccins et enumere les caracteris- tiques et les inconvenients de tous les vaccins vivants et tues que l'on peut desormais utiliser pour le betail et chez l'homme. La presentation d'un nouveau vaccin vivant buccal qui serait plus largement applicable dans les regions periphe- riques est l'un des points saillants de cet ouvrage. 764 PUBLICATIONS RtCENTES Les chapitres suivants passent en revue les con- naissances concernant la pathogenie et la trans- mission des Brucella dans chaque espece animale exposee a l'infection et enumerent les principaux reservoirs d'infection pour l'homme en decrivant le mode de transmission. Sur le plan clinique, le chapitre consacr6 au diagnostic et traitement de la brucellose humaine est particulierement interessant. Le lecteur y trouvera des conseils d'experts concernant l'evaluation des symptomes, I'utilisation correcte des epreuves de diagnostic recemment mises au point, les schemas thera- peutiques les plus efficaces et le choix des medi- caments a administrer (par exemple, aux femmes enceintes). Les derniers chapitres portent sur la lutte antibrucellique chez I'animal et contiennent des informations sur les epreuves de diagnostic et l'interpretation des resultats et comprennent une liste de mesures de lutte normalisees apres avoir ete utilisees a plusieurs reprises lors de campagnes d'6radication qui se sont revelees efficaces. Le rap- port decrit egalement des strategies de lutte plus nouvelles reposant sur l'utilisation d'arguments sociaux et economiques en vue de s'adjoindre le concours actif des eleveurs de betail, du personnel travaillant dans les abattoirs, des bergers, des trayeurs et de l'ensemble de la population. Le comite d'experts a recommande d'accorder une attention particuliere aux programmes de lutte reposant sur la participation de la communaute convenablement motivee. Destine aux chercheurs comme aux cliniciens, aux veterinaires et aux professionnels de la sante publique, ce rapport d'experts tres exhaustif fait le point sur les methodes de lutte disponibles et recapitule les mesures necessaires a une mise en ceuvre efficace de la lutte antibrucellique et les domaines oiu la recherche est la plus susceptible de donner des resultats concrets. Lutte contre les parasitoses intestinales Rapport d'un Comite OMS d'Experts Geneve, 1987, 96 pages (OMS, Serie de Rapports techniques, NO 749). ISBN 92 4 220749 7 Prix: Fr.s. 12.- Ce rapport decrit les nouvelles methodes de lutte contre les parasitoses intestinales mises au point grace a la decouverte de medicaments efficaces et sans danger, a l'amelioration et a la simplification de certaines methodes de diagnostic et aux progres realises en biologie des populations parasitaires. A partir de donnees nouvelles sur l'impact economique et social de ces infections, il montre qu'il est necessaire et possible de les maitriser. La biologie des differents parasites intestinaux ainsi que la forme et la gravite des maladies qu'ils provoquent varient enormement, aussi le rapport commence-t-il par dresser un profil des principales helminthiases et protozooses qui revetent une importance du point de vue de la sante publique. Ces profils comportent des renseignements sur la prevalence mondiale, les zones d'endemicite, le cycle biologique du parasite, les voies d'infection, les symptomes, la morbidite associee et les con- ditions qui favorisent la transmission. Le chapitre suivant porte sur les coGts associes a l'absence de programme de lutte contre les parasitoses intesti- nales. Les effets sur la nutrition, la croissance et le developpement, le travail et la productivite et sur le cout du traitement medical y sont examines et des exemples de budgets nationaux consacres au traitement d'infections choisies y sont donnes. L'on retiendra pour son utilite pratique le chapitre con- cernant les strategies de lutte. Le lecteur y trouvera exposees les diff6rentes methodes de lutte contre les principales helminthiases et protozooses, les approches les plus appropriees pour atteindre des objectifs a court et a long terme et les facteurs a prendre en consideration pour l'evaluation des priorites, des couts et des avantages. Les mesures a prendre pour lutter contre les epidemies, pour la prise en charge des cas et dans le cadre de projets a visee communautaire y sont egalement enon- cees. Le rapport contient par ailleurs des infor- mations sur les methodes qui conviennent le mieux pour la surveillance, la gestion des donnees, le diagnostic et la chimiotherapie. L'ouvrage s'acheve par un chapitre sur la planification et la mise en ceuvre de programmes nationaux et un autre sur le soutien des programmes. Cet ouvrage tres pratique, tant par son contenu que par sa visee, est un expose convaincant quant a la faisabilite de la lutte contre les parasitoses intestinales et contient en meme temps tout un ensemble de recommandations utiles sur le choix des methodes les plus appropriees et leur application. Medecine radiologique L'utilisation future des nouvelles techniques d'imagerie dans les pays en developpement Rapport d'un Groupe scientifique de l'OMS Geneve, 1986, 72 pages (OMS, S6rie de Rapports techniques, NO 723). ISBN 92 4 220723 3 Prix: Fr.s. 7.- Guide a l'intention des pays en developpement qui envisagent l'introduction et l'utilisation des 765 766 PUBLICATIONS RtCENTES techniques d'echographie et de tomodensito- m'trie. Sensible aux besoins et aux priorit's des pays en developpement, cet ouvrage devrait aider les planificateurs a apprecier les exigences techniques, l'investissement initial, les depenses d'entretien et les ressources en personnel qu'impli- quent ces nouvelles technologies et les avantages et les inconvenients qu'elles presentent pour le patient. Comportant plus de 300 references biblio- graphiques, ce rapport examine egalement les applications cliniques particulieres pour lesquelles le recours a l'echographie ou a la tomodensito- m'trie peut apporter une amelioration substan- tielle du diagnostic et du confort du patient. Nutrition Besoins energetiques et besoins en proteines Rapport d'une Consultation conjointe d'Experts FAO/OMS/UNU Geneve, 1986, 226 pages (OMS, Serie de Rapports techniques, NO 724). ISBN 92 4 220724 1 Prix: Fr.s. 17.- Ce rapport, qui paralt plus de 10 ans apres le hprecedent rapport sur la question, presente les resultats d'une consultation d'experts charges de reviser les niveaux recommandes d'apports pro- teino-energetiques. 11 adopte une approche visant a rapprocher les besoins estimatifs des besoins reels des individus aux differents ages et dans les differentes situations de Ia vie. Les variations des besoins en fonction de l'age, du sexe, du poids corporel, de l'activite physique et du regime alimentaire y sont examinees de meme que les besoins particuliers des enfants pendant la crois- sance, des femmes enceintes ou allaitantes, des personnes agees et des populations habituelle- ment exposees aux infections, dont il faut tenir compte. Les donnees scientifiques et statistiques a partir desquelles ont ete calcules les besoins estimatifs y sont presentees en detail. Cet ouvrage s'adresse aux nutritionnistes, aux economistes et aux planificateurs charges d'elaborer des poli- tiques sanitaires et alimentaires. La surveillance nutritionnelle par J. B. Mason, J.-P. Habicht, H. Tabatabai, & V. Valverde Geneve, 1987, 212 pages ISBN 92 4 256078 2 Prix: Fr.s. 23.- Cet ouvrage analyse le role et les methodes de la surveillance nutritionnelle, laquelle suppose l'ap- h OMS, S6rie de Rapports techniques, NO 522, 1973 (Besoins 6nergetiques et besoins en prot6ines: rapport d'un Comit6 special mixte FAO/OMS d'Experts). preciation de l'etat nutritionnel des populations en tant que moyen de faciliter la planification sanitaire et alimentaire, 1'evaluation des programmes et la prevision des penuries alimentaires. L'ouvrage expose les differents types d'actions qui peuvent etre menees pour ameliorer la nutrition et decrit les differentes donnees qu'exige la mise en place d'un systeme de surveillance nutritionnelle. 11 envisage ensuite la question de l'organisation d'une evalua- tion initiale de la situation nutritionnelle servant a fixer des priorites. Les deux chapitres suivants sont consacres a l'expose detaille de certains principes qui s'appliquent a tous les buts de la surveillance nutritionnelle. Au nombre de ceux-ci figurent le re- censement des utilisateurs potentiels du systeme, les decisions concernant les structures adminis- tratives qu'il faudra mettre en place, la determi- nation des besoins en matiere de production et le choix des sources de donnees. Le dernier chapitre expose les caracteristiques particulieres des pro- grammes d'alerte et d'intervention rapides qui visent a prevenir des penuries alimentaires aigues, notamment en ce qui concerne l'organisation et les besoins en donnees. Produits biologiques, preparations pharmaceutiques Comite OMS d'Experts de la Standardisation biologique Trente-sixieme rapport Geneve, 1987, 160 pages (OMS, Serie de Rapports techniques, No. 745). ISBN 92 4 220745 4 Prix: Fr.s. 20.- Ce rapport presente les resultats des travaux et les recommandations d'un comite d'experts charge d'etablir les etalons et reactifs de reference internationaux pour les vaccins et autres subs- tances biologiques. Le Comite a divise son rapport en deux grandes parties. La premiere indique les changements intervenus en ce qui concerne 34 substances des categories suivantes: antibiotiques, anticorps, antigenes, produits sanguins et subs- tances apparentees, substances endocriniennes et apparentees, et enfin substances diverses. On y trouve des explications sur 1e'tablissement de nou- velles preparations internationales de reference et la suppression de preparations utilisees jusqu'a present et sur la necessite de disposer de materiels de remplacement et de nouveaux materiels de ref6rence indispensables pour lI'laboration ou la mise a 1'essai de nouvelles substances biologiques. Les etudes collectives, en projet ou en cours, visant a etablir la valeur de preparations proposees PUBLICATIONS RtCENTES comme etalons sont egalement mentionnees. La seconde partie du rapport, qui est aussi la plus importante, donne tous les details sur les normes revisees pour la fabrication et le controle national des tuberculines, du vaccin BCG desseche et des lignees cellulaires continues, accompagnees des protocoles recapitulatifs pertinents; il rend compte egalement des modifications apportees aux normes relatives au vaccin antipoliomyelitique (inactive) et aux normes relatives aux epreuves de sensibilite aux antimicrobiens, et se termine par un historique de la production du lot de semence primaire OMS de virus amaril 17D destine a etre utilise pour la production de vaccin. Comme les precedents rapports de ce comite, cette publi- cation, qui entre dans le cadre de l'action menee par l'OMS pour assurer la production de subs- tances biologiques sures, sans danger et actives, servira d'ouvrage de ref6rence indispensable pour les fabricants et les autorites de controle nationales. Comite OMS d'Experts des Specifications relatives aux Preparations pharmaceutiques Trentieme rapport Geneve, 1987, 53 pages (OMS, S6rie de Rapports techniques, NO 748). ISBN 92 4 220748 9 Prix: Fr.s. 9.- Ce rapport decrit divers projets et activites visant a aider les pays desireux de creer des systemes de contrbole de la qualite des produits pharmaceu- tiques importes ou de fabrication locale. Parmi les principaux points traites figurent le choix des essais et des methodes d'analyse a inclure dans la Pharmacopee internationale, l'importance de l'ap- plication de regles de bonne pratique dans les laboratoires nationaux de controle des medica- ments et Ie'tablissement et l'utilisation des subs- tances chimiques internationales de ref6rence. A ces conditions generales font suite des informa- tions plus detaillees donnees dans trois annexes. La premiere enonce les regIes a suivre pour assurer une gestion et un fonctionnement rationnels des laboratoires nationaux de controle des medica- ments, regIes qui concernent aussi bien la structure organique et le personnel que l'organisation du travail quotidien, y compris du point de vue admi- nistratif, et lIevaluation des resultats des essais. La deuxieme fournit la liste des substances chimiques internationales de reference disponibles et indique comment se les procurer. Enfin, la troisieme decrit un programme modele de formation a l'analyse des medicaments consistant en stages de forma- tion collective a l'intention des nouveaux diplomes des facultes de sciences et de pharmacie et portant sur les aspects pratiques et theoriques de l'analyse des medicaments aux fins de reglementation. 767