Objective: Most infections occur during childhood, but the health effects of childhood infection are poorly understood. We investigated whether growth decreases in the 2 months after acute seroconversion.

Methods: We performed a nested case-control study among children 6 months to 12 years of age in a community on the outskirts of Lima, Peru. Health interviews were completed daily. Anthropometric measurements were taken monthly. Sera were collected every 4 months and tested for immunoglobulin G. Two-month height and weight gains of seroconverters were compared with gains of sex, age, and size-matched seronegative controls.

Results: In the 2 months after infection, 26 seroconverters gained a median of 24% less weight than 26 matched controls (interquartile range, 63% less to 21% more). In multivariate analysis, infection attenuated weight gain only among children aged 2 years or older. This decrease was not explained by increased diarrhea.

Conclusions: Seroconversion is associated with a slowing of weight gain in children aged 2 years or older. Reasons for this finding merit additional study.

Background: Cohort and case-crossover studies were conducted to evaluate whether new Helicobacter pylori infections are followed by increased diarrhea.

Methods: Participants were 6-month-old to 12-year-old shantytown residents living near Lima, Peru. Baseline data were collected from community households. Health interviews were completed daily, and sera, drawn every 4 months, were tested for H pylori immunoglobulin G. Diarrhea rates among newly H pylori-infected (seroconverting) children were compared with rates among persistently uninfected and infected children using cohort and case-crossover analyses.

Results: Sera were obtained from 345 children from January 1, 1995, through September 1, 1997. H pylori incidence was 12% per year (36 H pylori infections in 109 866 seronegative days). In adjusted cohort analyses, seroconverters had more diarrhea days (rate ratio: 2.0; 95% confidence interval: 1.6-2.4), episodes, and sick days in the year after infection than did uninfected children; and more diarrhea days and sick days than did persistently infected children. This effect was strongest in the first 2 months. Case-crossover analyses supported these findings.

Conclusion: Preventing H pylori infection may help reduce pediatric diarrheal disease.

How can external actors - governments, regional organizations, the United Nations, financial institutions, nongovernmental organizations - affect the process of democratic transition and consolidation? In Beyond Sovereignty, leading scholars and policy experts examine the experiences of a variety of Latin American nations and the relevant characteristics of intergovernmental and nongovernmental organizations to draw lessons that can be applied globally.

The contributors begin by discussing evolving views of sovereignty, democracy, and regional security. They review the past efforts and present capacity of various international organizations - the United Nations, the Organization of American States, external financial institutions, and transnational nongovernmental organizations - to further efforts to deepen democracy. They also offer case studies of how these organizations related to democratic development in Chile, El Salvador, Haiti, and Peru.

The last section applies lessons learned to two problematic regimes: Cuba and Mexico. This timely and useful collection will be of interest to all who study democratic transition and consolidation, comparative politics, Latin American politics, international organizations, and international relations more generally.

Contributors: Domingo E. Acevedo, Larry Diamond, Jorge I. Dominguez, Denise Dresser, Stephanie J. Eglinton, Patricia Weiss Fagen, Tom Farer, David P. Forsythe, Alicia Frohmann, Claudio Grossman, Anita Isaacs, Anthony P. Maingot, Joan M. Nelson, David Scott Palmer, Karen L. Remmer, Kathryn A. Sikkink, and Fernando R. Tesón.

From the Introduction:

"Concern over democracy's uncertain prospects inspired the project that culminates in this volume. Two assumptions shaped the collective effort of its contributors: one, that external actors can contribute to the defense and enhancement of democracy, and two, that tolerance for such external action has increased dramatically--even measures that would once have been widely condemned as impermissible intervention are acquiring a remarkable aura of legitimacy. An increase in tolerance is least marked, however, for unilateral action of a coercive nature, which in the Western Hemisphere usually means action that the Unites States has taken on its own initiative."