Health Systems for the Millennium Development Goals: Country Needs and Funding Gaps

by Akinola B Ajayi, Charles Nwabuisi, Abiodun P Aboyeji, Nanji S Ajayi, Adeola Fowotade, Olurotimi O Fakeye, Agersew Alemu, Feleke Moges, Yitayal Shiferaw, Ketema Tafess, Afework Kassu, Belay Anagaw, Abebe Agegn, Smart Enoch Amala, Easter Godwin Nwokah, Kani Yamuna Aminu, Umar Usman Aliyu, G Andabati, J Byamugisha, A N E W Antibiotic, Original Article, Annie Rajaratnam, Neha Maria Baby, Santhosh Machado, Suzanne L. August, Michael J. de Rosa, S Avraham, F Azem, D Seidman, Scott A Beatson, Nouri L Ben Zakour, Makrina Totsika, Brian M Forde, Filiz Bilir, Nermin Akdemir, Selcuk Ozden, A Serhan Cevrioglu, Cemil Bilir, Mohammad Ali Boroumand, Leila Sam, Seyed Hesameddin Abbasi, Mojtaba Salarifar, Ebrahim Kassaian, Saeedeh Forghani, Edward J Boyko, Stephan D Fihn, Delia Scholes, Linn Abraham, Barbara Monsey, Great Britain, M Campbell-Brown, I R McFadyen, D V Seal, M L Stephenson, L Association Medicale Canadienne, CA. Careno, EF. Funai, Sevki Celen, Ayla Sargin Oruç, Rana Karayalçin, Sibel Saygan, Serpil Unlü, Belgin Polat, Nuri Danişman, Lata R Chandel, Anil Kanga, Kamlesh Thakur, Kiran K Mokta, Anuradha Sood, Smriti Chauhan, Katharine L Cheung, Richard A Lafayette, Seong Jin Choi, Sang Won Soon Deok Park, In Ho Jang, Young Uh, Anna Lee, Farhana Chowdhury, Kumkum Sarkar, Angela Branche, Juliette Kim, Philip Dwek, Angelica Nangit, David Tompkins, Ernest Visconti, Dezful City, Marziyeh Amiri, Zohreh Lavasani, Reza Norouzirad, Reza Najibpour, Tazebew Demilie, Getenet Beyene, Selabat Silabat Melaku, Wondewosen Tsegaye, M Dietrich, A A Hoosen, J Moodley, S Moodley, Tazebew Emiru, Getenet Beyene, Wondewosen Tsegaye, Selabat Silabat Melaku, Stéphane Emonet, Stephan Harbarth, Christian van Delden, Kalantar Enayat, Farhadifar Fariba, Nikkho Bahram, David B Evans, Tessa Tan-Torres Edejer, Taghreed Adam, Stephen S Lim, Sebastian Faro, S M Garland, N Kelly, a M Ugoni, Paulo César Giraldo, Edilson D. Arajo, José Eleutério Junior, Rose Luce Gomes Do Amaral, Mauro R L Passos, Ana Katherine Gonaçlves, C S Goodwin, A E Stewart, J C Graham, J B Leathart, S J Keegan, J Pearson, A Bint, D L Gally, Courtney a Gravett, Michael G Gravett, Emily T Martin, Jeffrey D Bernson, Sadaf Khan, David S Boyle, Sophia M R Lannon, Janna Patterson, Craig E Rubens, Matthew S Steele, The Lancet Publishing Group, Sarah Racelis Macfarlane Mary Multi-Musiime, Florence, Valerie T Guinto, Blanca De Guia, Mario R Festin, Therese Dowswell, Elisabet Guiral, Emma Sáez-López, Jordi Bosch, Anna Goncé, Marta López, Sergi Sanz, Jordi Vila, Sara M. Soto, Hamdan Z Hamdan, Abdel Haliem M Ziad, Salah K Ali, Ishag Adam, Siti Hanna, Siti Nur, Hajah Roselina, Samad Hazhir, Maureen Henderson, George Entwisle, Matthew Tayback, J. a. Ives, G. D. Abbott, R. R. Bailey, Vaishali Jain, Vinita Das, Anjoo Agarwal, Amita Pandey, K S Joseph, K N Brahmadathan, Sulochana Abraham, Abraham Joseph, Kerbala Journal, Pharmaceutical Sciences Number, Received August, Accepted Nov, Birgul Kacmaz, Ozenc Cakir, Altan Aksoy, Aydan Biri, A L KAITZ, George Kasyan, Tatiana Y Berketova, Anton K Rogozin, Dmitry Y Pushkar, Brenda M Kazemier, Caroline Schneeberger, Esteriek De Miranda, Aleid Van Wassenaer, Patrick M Bossuyt, Tatjana E Vogelvang, Frans J L Reijnders, Friso M C Delemarre, Corine J M Verhoeven, Martijn A Oudijk, Jeanine A Van Der Ven, Petra N Kuiper, Nicolette Feiertag, Alewijn Ott, Christianne J M De Groot, Ben Willem J Mol, Suzanne E Geerlings, Aderemi O Kehinde, Kayode S Adedapo, Christopher O Aimaikhu, Akin-Tunde A Odukogbe, Oladapo Olayemi, Babatunde Salako, Sadaf Khan, M Sc, M Sc, P Singh, M Sc, Z Siddiqui, Nada Khazal, Kadhim Hindi, Shaimaa O Hasson, Shatha Khazal, Niddk-funded George M O Brien Kidney, Peter Aronson, Jean-philippe Lavigne, Adeline Boutet-dubois, Dorsaf Laouini, Christophe Combescure, Nicole Bouziges, Pierre Mare, Groupe Hospitalo-universitaire De Care, Groupe Hospitalo-universitaire De Care, Myung Jin Lee, Moonsuk Kim, Nak-Hyun Nam Joong Kim, Chung-Jong Kim, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Ji Hwan Bang, Eu Suk Kim, Sang Won Soon Deok Park, Nak-Hyun Nam Joong Kim, Myoung-don Oh, Hong Bin Kim, Ky Loh, N Sivalingam, Rajeev Mallipeddi, Christopher J Mathias, Joanna Matuszkiewicz-Rowińska, Jolanta Małyszko, Monika Wieliczko, Sau-yee Fong Mbbs, C E Mcgruder, Miles Wilson, George L Mendz, Nadeem O Kaakoush, Julie a Quinlivan, Morike Ngoe Mokube, Julius Atashili, Gregory Edie Halle-Ekane, George M Ikomey, Peter M Ndumbe, and Gideon Koren Monica Lee, Pina Bozzo, Adrienne Einarson, Manal F. Moustafa, Entesar M. Makhlouf, Mandira Mukherjee, Snehashis Koley, Sandipkumar Mukherjee, Shreya Basu, Biplab Ghosh, By Mutasim, Abubakr Mustafa, M B Kartoum, Gilbert N.M., O'Brien V.P., Hultgren S., Macones G., Lewis W.G., Lewis a.L., D Nathaniel, Jeremiah Stamler, Jack Zackler, Samuel L Andelman, Lindsay E. Nicolle, Maral G Nogayeva, A Svetlana, C C Obiora, C C Dim, H U Ezegwui, E E Nwogu-Ikojo, C Okeudo, A N Oli, C I Okafor, E C Ibezim, C N Akujiobi, M C Onwunzo, Fidelis Agwu Onu, Leonard Ogbonna Ajah, Paul Olisaemeka Ezeonu, Odidika Ugochukwu Joannes Umeora, Perpetus Chudi Ibekwe, Monique Iheoma Ajah, J H M Pinkerton, Asemptomatik Bakteriüri Prevalansı, Lorri Puil, John Mail, James M Wright, Acute Pyelonephritis, A P Roberts, Ruth Phillips, Charles N Rudick, Aisha K Taylor, Ryan E Yaggie, Anthony J Schaeffer, David J Klumpp, L. a. Schieve, a. Handler, R. Hershow, V. Persky, F. Davis, J Schnarr, A. R. Schroeder, P. W. Chang, M. W. Shen, E. A. Biondi, T. L. Greenhow, R Schultz, A W Read, J A Straton, F J Stanley, P Morich, Human Services, A Shruthi, R Smither, Royal Society, Medicine Volume, R Sujatha, Manju Nawani, Endale Tadesse, Million Teshome, Yared Merid, Belayhun Kibret, Techalew Shimelis, D G Tincello, D H Richmond, N E Tolkoff-Rubin, R H Rubin, C.A. Turpin, Bridget Minkah, K.A. Danso, E.H. Frimpong, Identical Twins, Single-dose Treatment, Recurrent Urinary, Tract Infections, Indu Verma, Kumkum Avasthi, Vandana Berry, Melissa Whitworth, Siobhan Quenby, Ruth O Cockerill, Therese Dowswell, G L Williams, H Campbell, K J Davies, Deborah A Wing, Pamela J Rumney, Christine W Preslicka, Judith H Chung, World Bank, UNICEF, UNFPA, Partnership for Maternal Newborn and Child Health show all authors
BMJ (Clinical research ed.) ()
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Abstract

In order to compare the performance of leukocyte esterase and nitrite urine dipstick tests with enhanced urinalysis (uncentrifuged urine white blood cell count/mm(3) plus Gram stain) in detecting asymptomatic bacteriuria in obstetric patients, clean-catch midstream urine specimens were collected from 250 consecutive asymptomatic pregnant women. Ten of the women (4.0%) showed urine culture results indicating significant bacteriuria. The nitrite test was the most specific (99.2%) of these tests, however, its sensitivity was found to be the lowest (60.0%). The sensitivity of the leukocyte esterase test was 70.0%, on the other hand, while its positive predictive value was 28.0%. The sensitivity and specificity of enhanced urinalysis were found to be 50.0 and 96.7%, respectively. None of the rapid tests was found to be a reliable alternative for culture screening of all pregnant women. Nitrite tests are useful screening tests for detecting asymptomatic bacteriuria only if their limitations are fully understood, while leukocyte esterase and enhanced urinalysis tests are not suitable for screening for asymptomatic bacteriuria. Our findings support previous conclusions that quantitative urine cultures are required to rule out asymptomatic bacteriuria in pregnant women.

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