Enhancing access to immunization services and exploiting the benefits of recent innovations in the African region

The African Regional Office of the World Health Organization (WHO AFRO) organized the annual regional conference on immunization (ARCI) from 10 to 12 December 2012 in Dar es Salaam, Tanzania, under the theme, "Innovations, access and the right of all to vaccines". The meeting reviewed the status of immunization in the region and identified all innovations, strategies and technologies available and how these could be fully utilized to enhance the access and the rights of all to vaccines. Over 50 oral presentations were made in plenary and parallel sessions of the conference which was attended by over 200 participants drawn from national immunization programs, academia, public health experts and immunization partners. In addition there were 40 poster presentations. This manuscript summarizes of the meeting, highlighting the innovations in immunization being piloted or scaled-up, their impact and suggesting ways to further improve immunization service delivery for the eradication, elimination and control of vaccine-preventable diseases in the region.

Intradural cervical chordoma without bone involvement. Case report

The authors report a unique case of cervical chordoma in a 37-year-old woman without radiological evidence of bone involvement that was found to be totally intradural at surgery. Chordomas that are entirely extrasseous and intradural are extremely rare and in most of the cases described are located near the clivus. This is the first reported case of an intraspinal intradural chordoma.

Testicular cancer. Adolescent knowledge and attitudes

To study what adolescents know or feel about testicular cancer (TC), 1,364 males, mean age 14.9 years, were given an 85-item pretest questionnaire. Although 28% had heard of TC, none knew how to perform a testicular self-examination (TSE). Analysis of the attitude questions showed that adolescents are afraid of getting TC, are unsure about whether it can be self-diagnosed, and do not know whether recovery is more likely with early diagnosis. Black adolescents were less knowledgeable about and more afraid of getting TC than white adolescents; males of lower socioeconomic status (SES) and males with more contact with cancer were also more afraid of getting TC than higher SES and low-cancer contact groups. Although 75% reported having a complete physical examination by a physician within the previous 15 months, less than 2% reported being taught TSE. Having had a recent physical examination made no difference in the knowledge of or attitudes toward TC.

Takayasu's arteritis. Protean manifestations

An adolescent girl presented with fever, weight loss, and headache. Despite extensive diagnostic studies, the diagnosis of Takayasu's arteritis was made only after she developed bruits and diminished pulses. Although the initial manifestations of Takayasu's arteritis are often protean and confusing, characteristic clinical and radiographic findings develop after the onset of vascular insufficiency. The chest radiograph may provide an early clue to diagnosis, which can be confirmed by arterial digital subtraction aortography. Physicians should consider Takayasu's arteritis in the differential diagnosis of prolonged fever or weight loss in young females because treatment appears to be more effective when started early.