Alberto Narváez

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BACKGROUND We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities. METHODS In our cross-sectional(More)
OBJECTIVE To assess the risks and benefits associated with caesarean delivery compared with vaginal delivery. DESIGN Prospective cohort study within the 2005 WHO global survey on maternal and perinatal health. SETTING 410 health facilities in 24 areas in eight randomly selected Latin American countries; 123 were randomly selected and 120 participated(More)
BACKGROUND Caesarean delivery rates continue to increase worldwide. Our aim was to assess the association between caesarean delivery and pregnancy outcome at the institutional level, adjusting for the pregnant population and institutional characteristics. METHODS For the 2005 WHO global survey on maternal and perinatal health, we assessed a multistage(More)
BACKGROUND Caesarean section rates continue to increase worldwide with uncertain medical consequences. Auditing and analysing caesarean section rates and other perinatal outcomes in a reliable and continuous manner is critical for understanding reasons caesarean section changes over time. METHODS We analyzed data on 97,095 women delivering in 120(More)
Cluster-based studies involving aggregate units such as hospitals or medical practices are increasingly being used in healthcare evaluation. An important characteristic of such studies is the presence of intracluster correlation, typically quantified by the intracluster correlation coefficient (ICC). Sample size calculations for cluster-based studies need(More)
 The compartment syndrome is well recognised as occurring after trauma, but atraumatic acute compartment syndrome is less widely known. We report 3 cases in whom an acute compartment syndrome developed without major injury. Early diagnosis and prompt treatment by decompressive fasciotomy is of vital importance if limb function is to be preserved and(More)
A double-blind randomized placebo-controlled field trial with the SPf66 malaria vaccine was carried out in an endemic area consisting of 14 small villages with exclusive fluvial access, in a rain forest area along the Rosario River, Colombia. A total of 1257 subjects completed the full three dose vaccination schedule on days 0, 30 and 180 (643 vaccinated(More)
OBJECTIVES To determine the impact of a community-based programme of yaws control in Esmeraldas province in Ecuador. METHODS Community health workers provided mass treatment and subsequent surveillance for the detection and treatment of new cases and their contacts over the period 1988 to 1993. Clinical and serological surveys were performed in the study(More)
This study addresses the impact of small-scale gold mining on the environment and communities of the Puyango River basin in the southwest of Ecuador between 1999 and 2001. Our primary objectives were to measure mercury, manganese, and lead in the river, to identify pathways of population exposure, and biological indicators of human exposure. A multi-method(More)
RATIONALE Bedside use of Bayes' theorem for estimating probabilities of diseases is cumbersome. An alternative approach based on five categories of powers of tests from 'useless' to 'very strong' has been proposed. The performance of clinicians using it was assessed. METHODS Fifty clinicians attending a course of tropical medicine estimated powers of(More)