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1.
Title: HIV Infection--Guangdong Province, China, 1997-2007.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Apr 24;58(15):396-400.
Abstract: In 2007, an estimated 700,000 persons in China were living with human immunodeficiency virus (HIV) infection. An estimated 50,000 new HIV infections and 20,000 deaths related to acquired immunodeficiency syndrome (AIDS) occurred in 2007, and an estimated 71% of persons with HIV infection were unaware of their HIV status. In 2007, 40.6% of those living with HIV had been infected through heterosexual transmission and 38.1% through injection-drug use. Guangdong Province in southeastern China is the country's most populous province, with an estimated 75.6 million permanent residents and 16.5 million migrants; the province has undergone rapid economic development. Since 1986, a case-based surveillance system (CBSS) in China has collected data on persons infected with HIV, including demographic characteristics and transmission categories. To assess recent trends in HIV infection in the province, the Guangdong Center for Disease Control, with technical assistance from CDC, analyzed CBSS data for the period 1997--2007. The results of that analysis indicated that the number of HIV cases increased from 102 in 1997 to 4,593 in 2007, although this increase resulted, in part, from expanded testing and surveillance. Among males classified by HIV transmission category, 82.1% of newly diagnosed infections were attributed to injection-drug use. Among females classified by HIV transmission category, 53.7% engaged in high-risk heterosexual conduct. Despite substantial methodologic limitations, these results can be useful to Guangdong public health agencies in targeting and evaluating HIV prevention, care, and treatment programs.
Language: English
Keywords:
CHINA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | PREVALENCE | HIV INFECTIONS | SEX FACTORS | RISK BEHAVIOR | SEX BEHAVIOR | INTERNET | AGE FACTORS | HUMAN GEOGRAPHY | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Measurement | Population Characteristics | Demographic Factors | Information Networks | Communication | Geography | Social Sciences | Science | Sociocultural Factors
Document Number: 331260

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Peer Reviewed

Title: Opportunity for natural selection among the Indian population: secular trend, covariates and implications.
Author: Gautam RK
Source: Journal of Biosocial Science. 2009 Jul 23;:1-41.
Abstract: Crow's index is widely used for indirect quantitative estimation of natural selection using birth and death rates. The present investigation is based on 179 studies among 144 different endogamous communities belonging to nineteen states and six geographical regions of India, categorized into six social groups. These studies appeared in 33 different years over six decades (1956 to 2007). The secular trend in Crow's index (It) and its mortality and fertility components (Im and If) shows a gradual decline in It and radical shift in the relative contributions of Im and If. Before 1990 the opportunity for natural selection was mainly determined by differential pre-reproductive mortality (Im), whereas after 1990 it has been determined by differential fertility (If). To find out the covariates of It, Im and If sixteen socio-demographic variables were considered, and nine were found to be significantly correlated with It: total dependency ratio, decadal growth rate 1991-2001, young age dependency ratio, crude death rate, total fertility rate, child mortality rate, under-5 mortality rate, old age dependency ratio and decadal growth rate 1981-1991. On the basis of multivariate stepwise regression analysis, female literacy emerged as one of the most important predictors of It. The declining trend of It, Im and If shows that the Indian population is passing through the demographic transition.
Language: English
Keywords:
INDIA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | DATA COLLECTION | STATISTICAL REGRESSION | TRIBES | MOTHERS | CASTE | POPULATION GENETICS | FERTILITY | MORTALITY | DEPENDENCY BURDEN | SOCIOCULTURAL FACTORS | DEMOGRAPHIC TRANSITION | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Data Analysis | Cultural Background | Population Characteristics | Demographic Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Genetics | Biology | Population Dynamics | Microeconomic Factors
Document Number: 342293

Peer Reviewed

Title: Epidemiologic study of human immunodeficiency virus (HIV) Infection in the patients referred to health centers in Hamadan province, Iran.
Author: Ghannad MS; Arab SM; Mirzaei M; Moinipur A
Source: AIDS Research and Human Retroviruses. 2009 Mar;25(3):277-83.
Abstract: Acquired immunodeficiency syndrome (AIDS) is one of the most important infectious diseases threatening the world's population today. The main aim of this study was to assess the epidemiologic features of HIV/AIDS from January 1989 to March 2007 in Hamadan province, Iran. In a cross-sectional study, epidemiodemographic characteristics of HIV/AIDS-positive patients during a period of 17 years were collected from health centers in Hamadan province. This study showed that about 1.8% of HIV/AIDS cases in Iran involved people who lived in Hamadan province. Further study is needed to determine the reasons for this. From January 1989 to March 2007, 285 individuals including 275 males and 10 females were infected with HIV in this province. The study showed that 88% of patients lived in urban areas while 12% involved a rural population. Hamadan city had the highest rate of HIV/AIDS infection and death with 191 and 33 individuals, respectively. The main transmission route was intravenous drug use with 78%. From 28 patients who were entered into the AIDS phase, only 10 patients returned to health centers to be covered under definite treatment. The establishment of the Triangular Clinic can be presented as the starting point in the organization of infected people to detect HIV/AIDS. Altogether, efforts in reducing the impact of HIV in this province to date can be considered beneficial. Continuous laboratory diagnostic strategies may lead in time to therapeutic approaches that result in appropriate outcomes.
Language: English
Keywords:
IRAN | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | IV DRUG USERS | PREVALENCE | HIV INFECTIONS | SEX FACTORS | RISK BEHAVIOR | HIV TESTING | Middle East | Developing Countries | Geographic Factors | Population | Research Methodology | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Drug Use and Abuse | Behavior | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 331235

Title: Decentralizing Kenya's health management system: an evaluation. January 2009. Based on further analysis of the 2004 Kenya Service Provision Assessment Survey.
Author: Ndavi PM; Ogola S; Kizito PM; Johnson K
Source: Calverton, Maryland, Macro International, MEASURE DHS, 2009 Jan. [37] p. (USAID Contract No. GPO-C-00-03-00002-00Kenya Working Papers No. 1)
Abstract: Kenya's Ministry of Health (MOH) commitment to address the inherent constraints in the health sector has included deliberate decentralization efforts aimed at strengthening the effective implementation of activities at the district level, and fostering closer coordination and collaboration amongst the line ministries, donors, organizations, and other stakeholders. Among these efforts, local District Health Management Boards (DHMBs) and District Health Management Teams (DHMTs) gradually assumed responsibilities for the operation of the facilities under their jurisdiction through a single line grant, annual work plans, and procurement plans. To assess the current effectiveness of the district health management systems in meeting their responsibilities, we analyze data from a special District Health Management module of the 2004 Kenya Service Provision Assessment Survey to discern the degree to which the DHMTs and DHMBs meet norms and standards in the areas of governance and management, human resource development and management, commodity management, infrastructure development, health care financing, budgeting and management, and performance monitoring. Notably, data on DHMTs and DHMBs were missing for 20 percent of the districts. This level of nonresponse has the potential to weaken the validity of the findings, particularly when the excluded DHMTs are in provinces with some of the worst health indicators in the country. Their exclusion was due to difficult terrain and insecure environment, both of which imply that the right of the population to health care services is compromised. The results of this descriptive analysis indicate that although most of the DHMTs hold meetings frequently, the unavailability of the guidelines on the functioning of the DHMTs made it difficult to determine compliance of DHMTs with any existing norms and standards. The survey missed the opportunity to assess the activities and achievements of the HFMCs and HCMTs, which are important for decentralization. Although most of the DHMTs had documented plans for improving reproductive health, less than a quarter reported implementing their plans on time. Lack of funds and transport were the most cited reasons for failure by DHMTs to meet their supervision targets despite the near universal existence of documented supervision plans. In terms of support of human resources, continuing professional development is an accepted norm in the districts, but there is urgent need to strengthen and expand the scope of updates to serving staff through the establishment of district health training committees and regular monitoring of their activities. An assessment of available infrastructure indicated that repair and maintenance units existed in most districts, with nearly all of the districts contracted with the provincial workshop for repair and maintenance work. Communication facilities between most district hospitals and close to three quarters of the health centers with referral facilities under government management had capacity to communicate easily by telephone or two-way radio with a referral facility to arrange transport during emergencies. The situation was much better for NGO/mission-run facilities. Regarding financing issues, despite existence of both recurrent and development funds, funding for medicines, equipment, and maintaining buildings was inadequate for most districts. Sources for funding for district health services included central government funding supplemented by local government, revolving funds, and other sources. Increased annual budgetary allocations to the agreed 15 percent to ministries of health, in agreement with the Abuja accord, may increase financial resources required for medicines, equipment, and maintenance of buildings.
Language: English
Keywords:
KENYA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | HEALTH SURVEYS | ADMINISTRATIVE PERSONNEL | POLICYMAKERS | HEALTH PERSONNEL | GOVERNMENT AGENCIES | DECENTRALIZATION | HEALTH SERVICES EVALUATION | DELIVERY OF HEALTH CARE | QUALITY OF HEALTH CARE | MONITORING | PERFORMANCE IMPROVEMENT | GOVERNMENT FINANCING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Health | Organization and Administration | Organizations | Political Factors | Sociocultural Factors | Program Evaluation | Programs | Evaluation | Management | Financial Activities | Economic Factors
Document Number: 329888

Peer Reviewed

Title: Patterns and distribution of HIV among adult men and women in India.
Author: Perkins JM; Khan KT; Subramanian SV
Source: PloS One. 2009;4(5):e5648.
Abstract: BACKGROUND: While the estimated prevalence of HIV in India experienced a downward revision in 2007, the patterning and distribution of HIV in the population remains unclear. We examined the individual and state-level socioeconomic patterning of individual HIV status among adult men and women in India as well as the patterning of other individual demographic and behavioral determinants of HIV status. METHODOLOGY/PRINCIPAL FINDINGS: We conducted logistic regression models accounting for the survey design using nationally representative, cross-sectional data on 100,030 women and men from the 2005-2006 India National Family Health survey which, for the first time, provided objective assessments of HIV seroprevalence. Although there was a weak relationship between household wealth and risk of being HIV-positive, there was a clear negative relationship between individual education attainment and risk of being HIV-positive among both men and women. A 1000 Rupee change in the per capita net state domestic product was associated with a 4% and 5% increase in the risk for positive HIV status among men and women, respectively. State-level income inequality was associated with increased risk of HIV for men. Marital status and selected sexual behavior indicators were significant predictors of HIV status among women whereas the age effect was the most dominant predictor of HIV infection among men. CONCLUSIONS/SIGNIFICANCE: Although the prevalence of HIV in India is low, the lack of strong wealth patterning in the risk of HIV suggests a more generalized distribution of HIV risk than some of India's high-risk group HIV prevention policies have assumed. The positive association between state economic development and individual risk for HIV is intriguing and requires further scrutiny.
Language: English
Keywords:
INDIA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ADULTS | HIV INFECTIONS | RISK FACTORS | SOCIOECONOMIC STATUS | AGE FACTORS | MARITAL STATUS | CONDOM USE | SEX BEHAVIOR | INEQUALITIES | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Health | Data Analysis | Research Methodology | Population Characteristics | Demographic Factors | Viral Diseases | Diseases | Socioeconomic Factors | Economic Factors | Nuptiality | Risk Reduction Behavior | Behavior
Document Number: 342161

7.
Title: Prevalence of HIV/AIDS among jail inmates in Sindh.
Author: Safdar S; Mehmood A; Abbas SQ
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Feb;59(2):111-2.
Abstract: There is currently an ongoing epidemic of HIV/AIDS in Sindh Province. The Sindh Government has established a program for delivering HIV/AIDS prevention services to jail inmates. The objective of this study was to establish baseline HIV prevalence in Sindh jails. Anonymous unlinked volunteer testing was offered to 15000 jail inmates across nine jails in six cities of Sindh, of which 4987 (33%) agreed to be tested, using Abbot Determine rapid testing kit for HIV. Final analysis was done on 4897 samples. Majority of HIV+ve cases were from Karachi (0.7%, n = 32), followed by Sukkur (0.14%, n = 7), Larkana (0.08%, n = 4), Hyderabad (0.06%, n = 3), Shikarpur (0.04%, n = 2) and Khairpur (0.02%, n = 1) jails. Among women prisoners, only three foreigners were found HIV+ve. The overall HIV prevalence was 1% (n = 49) in the study sample. This study establishes the presence of HIV among jail inmates in Sindh and further necessitates detailed behavioural study for risk assessment in this subpopulation.
Language: English
Keywords:
PAKISTAN | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | BASELINE SURVEYS | PRISONERS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | HIV INFECTIONS | VOLUNTARY COUNSELING AND TESTING | HUMAN GEOGRAPHY | SEX FACTORS | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Research Methodology | Surveys | Sampling Studies | Studies | Crime | Social Problems | Sociocultural Factors | Viral Diseases | Diseases | Measurement | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Geography | Social Sciences | Science | Population Characteristics | Demographic Factors
Document Number: 330907

Peer Reviewed

Title: Voluntary HIV counselling and testing among men in rural western Uganda: implications for HIV prevention.
Author: Bwambale FM; Ssali SN; Byaruhanga S; Kalyango JN; Karamagi CA
Source: BMC Public Health. 2008;8:263.
Abstract: BACKGROUND: Voluntary HIV counselling and testing (VCT) is one of the key strategies in the prevention and control of HIV/AIDS in Uganda. However, the utilization of VCT services particularly among men is low in Kasese district. We therefore conducted a study to determine the prevalence and factors associated with VCT use among men in Bukonzo West health sub-district, Kasese district. METHODS: A population-based cross-sectional study employing both quantitative and qualitative techniques of data collection was conducted between January and April 2005. Using cluster sampling, 780 men aged 18 years and above, residing in Bukonzo West health sub-district, were sampled from 38 randomly selected clusters. Data was collected on VCT use and independent variables. Focus group discussions (4) and key informant interviews (10) were also conducted. Binary logistic regression was performed to determine the predictors of VCT use among men. RESULTS: Overall VCT use among men was 23.3% (95% CI 17.2-29.4). Forty six percent (95% CI 40.8-51.2) had pre-test counselling and 25.9% (95%CI 19.9-31.9) had HIV testing. Of those who tested, 96% returned for post-test counselling and received HIV results. VCT use was higher among men aged 35 years and below (OR = 2.69, 95%CI 1.77-4.07), the non-subsistence farmers (OR = 2.37, 95%CI 2.37), the couple testing (OR = 2.37, 95%CI 1.02-8.83) and men with intention to disclose HIV test results to sexual partners (OR = 1.64, 95%CI 1.04-2.60). The major barriers to VCT use among men were poor utilization of VCT services due to poor access, stigma and confidentiality of services. CONCLUSION: VCT use among men in Bukonzo West, Kasese district was low. In order to increase VCT use among men, the VCT programme needs to address HIV stigma and improve access and confidentiality of VCT services. Among the more promising interventions are the use of routine counselling and testing for HIV of patients seeking health care in health units, home based VCT programmes, and mainstreaming of HIV counselling and testing services in community development programmes.
Language: English
Keywords:
UGANDA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | FOCUS GROUPS | KAP SURVEYS | STATISTICAL REGRESSION | MEN | RURAL POPULATION | VOLUNTARY COUNSELING AND TESTING | HIV TESTING | HIV PREVENTION | UTILIZATION OF HEALTH CARE | AGE FACTORS | STIGMA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Research Methodology | Data Collection | Surveys | Sampling Studies | Studies | Data Analysis | Demographic Factors | Population Characteristics | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Social Problems | Sociocultural Factors
Document Number: 328553

11.

Peer Reviewed

Title: Integrating health interventions for women, newborn babies, and children: a framework for action.
Author: Ekman B; Pathmanathan I; Liljestrand J
Source: Lancet. 2008 Sep 13;372(9642):990-1000.
Abstract: For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management skills. Furthermore, districts need to be supported by national strategies and policies, and, in the case of the least developed countries, also by international donors and other partners. If packages for maternal, newborn and child health care can be integrated within a gradually strengthened primary health-care system, continuity of care will be improved, including access to basic referral care before and during pregnancy, birth, the postpartum period, and throughout childhood.
Language: English
Keywords:
DEVELOPING COUNTRIES | ADMINISTRATIVE DISTRICTS | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CHILDREN | ADMINISTRATIVE PERSONNEL | INTEGRATED PROGRAMS | COST EFFECTIVENESS | DELIVERY OF HEALTH CARE | SOCIAL PROTECTION | COMMUNITY HEALTH SERVICES | HEALTH EDUCATION | ANTENATAL CARE | Geographic Factors | Population | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Youth | Age Factors | Organization and Administration | Programs | Evaluation Indexes | Quantitative Evaluation | Health | Political Factors | Sociocultural Factors | Primary Health Care | Health Services | Education | Maternal Health Services | Maternal-Child Health Services
Document Number: 328496

12.

Title: Promotion and protection of all human rights, civil, political, economic, social and cultural, including the right to development. Report of the Special Rapporteur on violence against women, its causes and consequences, Yakin Erturk. Addendum: Mission to the Democratic Republic of the Congo. Advance edited version.
Author: Erturk Y
Source: [Geneva, Switzerland], United Nations, Office of the High Commissioner for Human Rights [OHCHR], Human Rights Council, 2008 Feb 28. 26 p. (A/HRC/7/6/Add.4) Human Rights Council, Seventh Session, Agenda item 3.
Abstract: Sexual violence has been a defining feature of the Democratic Republic of the Congo's recent armed conflicts. Women, in areas of armed conflict, still suffer sexual violence committed by the Forces armees de la Republique democratique du Congo (FARDC), the Police nationale congolaise (PNC), armed groups and, increasingly, civilians. The situation is particularly dramatic in South Kivu, where non-State armed groups, including foreign militia, commit sexual atrocities that aim at the complete physical and psychological destruction of women with implications for the entire society. Given the multitude of actors involved in the conflict and the continuation of these crimes, the international community, in cooperation with the Congolese authorities, has a responsibility to take all necessary measures to ensure that women in South Kivu are protected. Sexual violence extends beyond eastern Congo. In Equateur Province, PNC and FARDC have carried out systematic reprisals against the civilian population, including mass rape. Soldiers and police who commit these acts amounting to crimes against humanity are rarely held accountable by the commanding officers. Some of the perpetrators have been given commanding positions in the State security forces, which further aggravates the situation. (excerpt)
Language: English
Keywords:
DEMOCRATIC REPUBLIC OF THE CONGO | ADMINISTRATIVE DISTRICTS | PROGRESS REPORT | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | WOMEN'S RIGHTS | WOMEN'S STATUS | DOMESTIC VIOLENCE | RAPE | WAR | SOCIAL POLICY | SOCIAL PROTECTION | INSTITUTION BUILDING | PREVENTION AND CONTROL | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Geographic Factors | Population | Economic Development | Economic Factors | Human Rights | Political Factors | Sociocultural Factors | Socioeconomic Factors | Crime | Social Problems | Policy | Program Sustainability | Programs | Organization and Administration | Diseases
Document Number: 326335

13.

Peer Reviewed

Title: Plasmodium vivax resistance to chloroquine in Dawei, southern Myanmar.
Author: Guthmann JP; Pittet A; Lesage A; Imwong M; Lindegardh N
Source: Tropical Medicine and International Health. 2008 Jan;13(1):91-98.
Abstract: The objective was to assess the efficacy of chloroquine in the treatment of Plasmodium vivax malaria in Dawei District, southern Myanmar. Enrolled patients at Sonsinphya clinic greater than 6 months of age were assessed clinically and parasitologically every week for 28 days. To differentiate new infections from recrudescence, we genotyped pre- and post-treatment parasitaemia. Blood chloroquine was measured to confirm resistant strains. Between December 2002 and April 2003, 2661 patients were screened, of whom 252 were included and 235 analysed. Thirty-four per cent (95% CI: 28.1-40.6) of patients had recurrent parasitaemia and were considered treatment failures. 59.4% of these recurrences were with a different parasite strain. Two (0.8%) patients with recurrences on day 14 had chloroquine concentrations above the threshold of 100 ng/ml and were considered infected with chloroquine resistant parasites. 21% of failures occurred during the first 3 weeks of follow-up: early recurrence and median levels of blood chloroquine comparable to those of controls suggested P. vivax resistance. Plasmodium vivax resistance to chloroquine seems to be emerging in Dawei, near the Thai-Burmese border. While chloroquine remains the first-line drug for P. vivax infections in this area of Myanmar, regular monitoring is needed to detect further development of parasite resistance. (author's)
Language: English
Keywords:
MYANMAR | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | EPIDEMIOLOGIC METHODS | CHILDREN | MALARIA | DRUG RESISTANCE | PARASITE CONTROL | PREVALENCE | BORDER CROSSING | Asia, Southeastern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Treatment | Public Health | Measurement | International Migration | Migration | Population Dynamics
Document Number: 324685

14.

Peer Reviewed

Title: Ascertainment of childhood vaccination histories in northern Malawi.
Author: Jahn A; Floyd S; Mwinuka V; Mwafilaso J; Mwagomba D
Source: Tropical Medicine and International Health. 2008 Jan;13(1):129-138.
Abstract: The objective was to assess factors related to recorded vaccine uptake, which may confound the evaluation of vaccine impact. Analysis of documented vaccination histories of children under 5 years and demographic and socio-economic characteristics collected by a demographic surveillance system in Karonga District, Malawi. Associations between deviations from the standard vaccination schedule and characteristics that are likely to be associated with increased mortality were determined by multivariate logistic regression. Approximately 78% of children aged 6-23 months had a vaccination document, declining to less than 50% by 5 years of age. Living closer to an under-5 clinic, having a better educated father, and both parents being alive were associated with having a vaccination document. For a small percentage of children, vaccination records were incomplete and/or faulty. Vaccination uptake was high overall, but delayed among children living further from the nearest under-5 clinic or from poorer socio-economic backgrounds. Approximately 9% of children had received their last dose of DPT with or after measles vaccine. These children were from relatively less educated parents, and were more likely to have been born outside the health services. Though overall coverage in this community was high and variation in coverage according to child or parental characteristics small, there was strong evidence of more timely coverage among children from better socio-economic conditions and among those who lived closer to health facilities. These factors are likely to be strong confounders in the association of vaccinations with mortality, and may offer an alternative explanation for the non-specific mortality impact of vaccines described by other studies. (author's)
Language: English
Keywords:
MALAWI | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | DEMOGRAPHIC ANALYSIS | MULTIVARIATE ANALYSIS | CHILDREN | IMMUNIZATION | SOCIOECONOMIC FACTORS | DEMOGRAPHIC FACTORS | EDUCATIONAL STATUS | DISTANCE EDUCATION | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Research Methodology | Data Analysis | Youth | Age Factors | Population Characteristics | Primary Health Care | Health Services | Delivery of Health Care | Health | Economic Factors | Socioeconomic Status | Education
Document Number: 324760

15.

Peer Reviewed

Title: Estimates of HIV prevalence in a highly endemic area of China: Dehong Prefecture, Yunnan Province.
Author: Jia Y; Sun J; Fan L; Song D; Tian S; Yang Y; Jia M; Lu L; Sun X; Zhang S; Kulczycki A; Vermund SH
Source: International Journal of Epidemiology. 2008 Dec;37(6):1287-1296.
Abstract: Background: Dehong Prefecture in Yunnan Province, China, borders Myanmar. Its proximity to the 'Golden Triangle', one of the world's largest illicit drug production and distribution centre, contributes to drug trafficking and ready availability of heroin. Dehong's 1.1 million people confront a serious HIV problem fuelled by injection drug use. The aim of this study is to improve the 2005 estimates of the true status of the HIV/AIDS epidemic in Dehong Prefecture. Methods: We estimated the HIV prevalence by synthesizing the results from several data sources (HIV/AIDS case reports, surveys, surveillance activities and epidemiological studies). We applied three different statistical procedures for estimations: (i) The Workbook method, adapted to meet the estimation needs in Dehong Prefecture; (ii) An estimate based on antenatal clinical data; and (iii) a dynamic model based on the local epidemic pattern. Results: We estimated that the population prevalence for HIV infections in Dehong Prefecture is 1.3% (likely range from low/high of three estimates: 0.9-1.7%) such that 13 500 people were living with HIV/ AIDS in Dehong Prefecture (likely range: 8200-18 300) in 2005. Infections remain concentrated among injection drug users, female sex workers and their clients with an uneven geographical distribution of estimated cases. Conclusion: More reliable estimates of HIV prevalence can be made by synthesizing multiple data sources using several procedures. Current HIV prevention, care and treatment challenges are judged substantial in Dehong Prefecture, regardless of what modelling strategy is used.
Language: English
Keywords:
CHINA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | INDIRECT ESTIMATION TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | SEX WORKERS | WOMEN IN DEVELOPMENT | PREVALENCE | HIV INFECTIONS | ANTENATAL CARE | HUMAN GEOGRAPHY | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Estimation Techniques | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Sex Behavior | Economic Development | Economic Factors | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Geography | Social Sciences | Science | Sociocultural Factors
Document Number: 328758

16.

Peer Reviewed

Title: District-based malaria epidemic early warning systems in East Africa: perceptions of acceptability and usefulness among key staff at health facility, district and central levels.
Author: Jones C; Abeku TA; Rapuoda B; Okia M; Cox J
Source: Social Science and Medicine. 2008 Jul;67(2):292-300.
Abstract: Malaria epidemics represent a significant public health problem in the highlands of Africa. Many of these epidemics occur in low resource settings, where the development of an effective system for malaria surveillance has been a key challenge. Between 2001 and 2006, the Highland Malaria Project (HIMAL) established a programme to develop and test a district-based surveillance system for the early detection and control of malaria epidemics in four pilot districts in Kenya and Uganda. An innovative feature of the programme was the devolution of responsibility for the detection of epidemics from the central Ministry of Health to District Health Management Teams. The implementation of the programme offered the opportunity to test both the technical aspects of the system and to examine the practical issues relating to the operation of the programme in the context of the existing health system. To investigate the attitude of key staff towards the programme, and their perceptions of its impact on their working practices, interviews were carried out among 52 health staff at district level and in the Ministries of Health in Kenya and Uganda. The transfer of responsibility for the early detection of epidemics to the districts had resulted in perceptions of individual empowerment among district-based staff. This, together with improved support supervision, was a key factor in sustaining motivation and improved surveillance. The enhanced support supervision also produced capacity benefits that extended beyond improved malaria surveillance. However, these improvements occurred in the context of increased logistical support (the provision of transport, fuel and travel allowances) which the participants believed was essential to the functioning of an effective system. With this proviso, the district-based malaria early warning system was perceived to be manageable, effective and sustainable in the context of the current health system.
Language: English
Keywords:
KENYA | UGANDA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | KAP SURVEYS | HEALTH PERSONNEL | GOVERNMENT AGENCIES | MALARIA PREVENTION | EPIDEMICS | EPIDEMIOLOGY | DECENTRALIZATION | ATTITUDES | CAPACITY BUILDING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Research Methodology | Surveys | Sampling Studies | Studies | Delivery of Health Care | Health | Organizations | Political Factors | Sociocultural Factors | Malaria | Parasitic Diseases | Diseases | Public Health | Psychological Factors | Behavior | Program Sustainability | Programs | Organization and Administration
Document Number: 328859

17.

Title: Development of a quality assurance procedure for reproductive health services for district public health systems: Implementation and scale-up in the State of Gujarat.
Author: Khan ME; Mishra A; Sharma V; Varkey LC
Source: [New Delhi, India], Population Council, Frontiers in Reproductive Health, 2008 Apr. [30] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-00)
Abstract: This project, entitled was carried out in two districts each in Gujarat and Maharashtra states. It confirmed that Quality Assurance (QA) checklists and an implementation manual, developed by the USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council in collaboration with UNFPA/India, are useful and effective tools that the Ministry of Health and Social Welfare (MOHFW) can use to monitor the quality of services provided by health facilities. It also demonstrated that this QA mechanism can be easily institutionalized at the district level management. The QA procedure involves a series of visits to health facilities by a team of three district level health officials, called the Quality Assurance Group (QAG). This team uses the QA checklists to review the readiness of the facility to offer services and the measures the quality of services provided. Before the QAG team leaves the facility, any gaps in readiness or quality identified by the team members are communicated to the Medical Officer in-charge (MO I/C) and actions are suggested for improvement. Further visits are made to the facility every four months, during which progress in addressing the gaps identified previously is assessed. The QA checklists provide easy procedures to provide an aggregated score for each individual facility with respect to input (readiness), process (how the service is delivered) and outcome (performance). (excerpt)
Language: English
Keywords:
INDIA | ADMINISTRATIVE DISTRICTS | EVALUATION REPORT | MANUAL | OPERATIONS RESEARCH | PILOT PROJECTS | ADMINISTRATIVE PERSONNEL | QUALITY CONTROL | REPRODUCTIVE HEALTH | CAPACITY BUILDING | USAID | PROGRAM EVALUATION | PERFORMANCE IMPROVEMENT | INSTITUTION BUILDING | TRAINING PROGRAMS | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Evaluation | Programs | Organization and Administration | Research Methodology | Studies | Health | Program Sustainability | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Management | Education
Document Number: 326783

18.
Title: Tuberculosis incidence and risk factors among patients living with HIV/AIDS in public health service institutions in Brasilia, Federal District.
Author: Lannoy LH; Cortez-Escalante JJ; Evangelista Mdo S; Romero GA
Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2008 Nov-Dec;41(6):549-55.
Abstract: In order to estimate the incidence of and risk factors for developing tuberculosis, the clinical charts of a retrospective cohort of 281 HIV-positive adults, who were notified to the AIDS Program of the Health Department of Brasilia in 1998, were reviewed in 2003. All the patients were treatment-naive regarding antiretroviral therapy at the time of inclusion in the cohort. Twenty-nine patients were identified as having tuberculosis at the start of the study. Thirteen incident tuberculosis cases were identified during the 60 months of follow-up, with an incidence density rate of 1.24/100 person-years. Tuberculosis incidence was highest among patients with baseline CD4+ T-lymphocyte counts < or = 200 cells/microl who were not using antiretroviral therapy (incidence = 5.47; 95% CI = 2.73 to 10.94). Multivariate analysis showed that baseline CD4+ T-lymphocyte counts < or = 200 cells/microl (adjusted hazard ratio [AHR] = 5.09; 95% CI = 1.27 to 20.37; p = 0.02) and non-use of antiretroviral therapy (AHR = 12.17; 95% CI = 2.6 to 56.90; p = 0.001) were independently associated with increased risk of tuberculosis.
Language: English
Keywords:
BRAZIL | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | MULTIVARIATE ANALYSIS | PREVALENCE | RISK FACTORS | HIV INFECTIONS | TUBERCULOSIS | COMPLICATIONS | ANTIRETROVIRAL THERAPY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Research Methodology | Studies | Viral Diseases | Diseases | Data Analysis | Measurement | Health | Infections | HIV
Document Number: 341067

19.
Title: Malaria and mosquito net utilisation among schoolchildren in villages with or without healthcare facilities at different altitudes in Iringa District, Tanzania.
Author: Mboera LE; Kamugisha ML; Rumisha SF; Kisinza WN; Senkoro KP; Kitua AY
Source: African Health Sciences. 2008 Jun;8(2):114-9.
Abstract: BACKGROUND: The endemicity of malaria in Tanzania is heterogenous, mainly associated with physical factors such as topography, climate and socio-economic status. The contributions of these factors in many regions of Tanzania have not been studied in detail. OBJECTIVE: This study was carried out to determine the prevalence and transmission of malaria and mosquito nets coverage among schoolchildren in relation to altitude in villages with or without healthcare facilities in Iringa District,Tanzania. METHODS: A cross-sectional survey of schoolchildren was carried out in six villages in three altitude transects (965-2075 m). In each transect a village with and without a healthcare facility were selected. The villages included Idodi (965m), Makifu (985m), Tosamaganga (1561m) Mangalali (1520m) Lulanzi (1917) and Kilolo (2075m). For the purpose of this study, the villages were categorised as lowlands (Idodi and Makifu), intermediate (Tosamaganga and Mangalali) and highlands (Lulanzi and Kilolo. Healthcare facilities were available at Idodi,Tosamaganga and Kilolo. Each child was asked whether or not slept under a mosquito net during the previous night. Mosquitoes were collected using pyrethrum spray catch technique in ten houses in each study village. RESULTS: Blood smears from a total of 1643 schoolchildren (mean age = 5.9-12.3 years) were examined for malaria infection. Plasmodium falciparum accounted for 93.1% of the malaria parasites. The prevalence of P. falciparum among children in Idodi, Makifu, Mangalali,Tosamaganga, was 51.51%, 73.66%, 22.79%, and 14.83%, respectively. Malaria parasites were not found among children in the highland villages of Lulanzi and Kilolo). The prevalence of malaria parasitaemia, packed cell volume, geometric mean parasite density and spleen rates were higher in children living in villages without healthcare facilities (P<0.001). Of the children, 16.1% (264/1643) slept under a mosquito net during the previous night. About three quarters (253/344) of the schoolchildren who had malaria parasites were not using mosquito nets. Mosquito net coverage was higher in lowland villages, accounting for 61.7% (163/264) of the total net use in the district. The majority (75.5%) of the mosquito net users were from village with health facilities (P<0.001). A total of 228 mosquitoes were collected, with Anopheles gambiae s.l. accounting for the majority (53.5%). Overall, 8.7% of the An. gambiae s.l. were infected with malaria sporozoites. Higher sporozoite rates were observed in mosquitoes collected in the lowlands. CONCLUSION: Communities living in areas without health facilities form the largest proportion of malaria-infected populations in Iringa district. Availability of healthcare service has an influence on mosquito net coverage. The results provide more evidence of the existence of a relationship between altitude variability or accessibility to healthcare services, and the burden of malaria in rural communities of Tanzania.
Language: English
Keywords:
KENYA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | EPIDEMIOLOGIC METHODS | SCHOOL AGE POPULATION | MALARIA PREVENTION | BED NETS | HUMAN GEOGRAPHY | ALTITUDE | PREVALENCE | INSECTS | MALARIA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Geography | Social Sciences | Science | Sociocultural Factors | Environment | Measurement | Disease Transmission Control | Prevention and Control
Document Number: 331272

20.

Title: Land use change and population growth in the Morobe Province of Papua New Guinea between 1975 and 2000.
Author: Ningal T; Hartemink AE; Bregt AK
Source: Journal of Environmental Management. 2008 Apr;87(1):117-124.
Abstract: The relation between human population growth and land use change is much debated. Here we present a case study from Papua New Guinea where the population has increased from 2.3 million in 1975 to 5.2 million in 2000. Since 85% of the population relies on subsistence agriculture, population growth affects agricultural land use. We assessed land use change in the Morobe province (33,933km/2) using topographic maps of 1975 and Landsat TM images of 1990 and 2000. Between 1975 and 2000, agricultural land use increased by 58% and population grew by 99%. Most new agricultural land was taken from primary forest and the forest area decreased from 9.8 ha person/-1 in 1975 to 4.4 ha person/-1 in 2000. Total population change and total land use change were strongly correlated. Most of the agricultural land use change occurred on Inceptisols in areas with high rainfall (greater than 2500mm year/-1) on moderate to very steep slopes (10-56%). Agricultural land use changes in logged-over areas were in the vicinity of populated places (villages), and in close proximity to road access. There was considerable variation between the districts but districts with higher population growth also had larger increases in agricultural areas. It is concluded that in the absence of improved farming systems the current trend of increased agriculture with rapid population growth is likely to continue. (author's)
Language: English
Keywords:
PAPUA NEW GUINEA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | LONGITUDINAL STUDIES | POPULATION | POPULATION GROWTH | LAND AND RESOURCE DEVELOPMENT | AGRICULTURE | FORESTS | HUMAN GEOGRAPHY | GEOGRAPHIC FACTORS | AGRICULTURAL DEVELOPMENT | ECOLOGY | ENVIRONMENTAL DEGRADATION | Developing Countries | Oceania | Studies | Research Methodology | Population Dynamics | Demographic Factors | Rural Development | Economic Factors | Macroeconomic Factors | Natural Resources | Environment | Geography | Social Sciences | Science | Sociocultural Factors
Document Number: 324752

21.

Peer Reviewed

Title: 30 years after Alma-Ata: has primary health care worked in countries?
Author: Rohde J; Cousens S; Chopra M; Tangcharoensathien V; Black R; Bhutta ZA; Lawn JE
Source: Lancet. 2008 Sep 13;372(9642):950-61.
Abstract: We assessed progress for primary health care in countries since Alma-Ata. First we analysed life expectancy relative to national income and HIV prevalence to identify overachieving and underachieving countries. Then we focused on the 30 low-income and middle-income countries with the highest average yearly reduction of mortality among children less than 5 years of age, describing coverage and equity of primary health care as well as non-health sector actions. These 30 countries have scaled up selective primary health care (eg, immunisation, family planning), and 14 have progressed to comprehensive primary health care, marked by high coverage of skilled attendance at birth. Good governance and progress in non-health sectors are seen in almost all of the 14 countries identified with a comprehensive primary health care system. However, these 30 countries include those that are making progress despite very low income per person, political instability, and high HIV/AIDS prevalence. Thailand has the highest average yearly reduction in mortality among children less than 5 years of age (8.5%) and has achieved universal coverage of immunisation and skilled birth attendance, with low inequity. Lessons learned from all these countries include the need for a nationally agreed package of prioritised and phased primary health care that all stakeholders are committed to implementing, attention to district management systems, and consistent investment in primary health-care extension workers linked to the health system. More detailed analysis and evaluation within and across countries would be invaluable in guiding investments for primary health care, and expediting progress towards the Millennium Development Goals and "health for all".
Language: English
Keywords:
DEVELOPING COUNTRIES | ADMINISTRATIVE DISTRICTS | RECOMMENDATIONS | EVALUATION | HEALTH PERSONNEL | COMMUNITY WORKERS | MIDWIVES AND MIDWIFERY | PRIMARY HEALTH CARE | LIFE EXPECTANCY | MATERNAL-CHILD HEALTH SERVICES | HIV INFECTIONS | PREVALENCE | CHILD SURVIVAL | PROGRAM ACCESSIBILITY | HEALTH SERVICES ADMINISTRATION | Geographic Factors | Population | Delivery of Health Care | Health | Health Services | Length of Life | Mortality | Population Dynamics | Demographic Factors | Viral Diseases | Diseases | Measurement | Research Methodology | Survivorship | Program Evaluation | Programs | Organization and Administration | Management
Document Number: 328499

22.

Peer Reviewed

Title: Working with risk: Occupational safety issues among healthcare workers in Kenya.
Author: Taegtmeyer M; Suckling RM; Nguku PM; Meredith C; Kibaru J
Source: AIDS Care. 2008 Mar;20(3):304-310.
Abstract: The objective of this study was to explore knowledge of, attitudes towards and practice of post-exposure prophylaxis (PEP) among healthcare workers (HCWs) in the Thika district, Kenya. We used site and population-based surveys, qualitative interviews and operational research with 650 staff at risk of needlestick injuries (NSIs). Research was conducted over a 5-year period in five phases: (1) a bio-safety assessment; (2) a staff survey: serum drawn for anonymous HIV testing; (3) interventions: biosafety measures, antiretrovirals for PEP and hepatitis B vaccine; (4) a repeat survey to assess uptake and acceptability of interventions; in-depth group and individual interviews were conducted; and (5) health system monitoring outside a research setting. The main outcome measures were bio-safety standards in clinical areas, knowledge, attitudes and practice as regards to PEP, HIV-sero-prevalence in healthcare workers, uptake of interventions, reasons for poor uptake elucidated and sustainability indicators. Results showed that HCWs had the same HIV sero-prevalence as the general population but were at risk from poor bio-safety. The incidence of NSIs was 0.97 per healthcare worker per year. Twenty-one percent had had an HIV test in the last year. After one year there was a significant drop in the number of NSIs (OR: 0.4; CI: 0.3-0.6; p less than 0.001) and a significant increase in the number of HCWs accessing HIV testing (OR: 1.55; CI: 1.2-2.1; p = 0.003). In comparison to uptake of hepatitis B vaccination (88% of those requiring vaccine) the uptake of PEP was low (4% of those who had NSIs). In-depth interviews revealed this was due to HCWs fear of HIV testing and their perception of NSIs as low risk. We concluded that Bio-safety remains the most significant intervention through reducing the number of NSIs. Post-exposure prophylaxis can be made readily available in a Kenyan district. However, where HIV testing remains stigmatised uptake will be limited*particularly in the initial phases of a programme. (author's)
Language: English
Keywords:
KENYA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | KAP SURVEYS | EPIDEMIOLOGIC METHODS | OPERATIONS RESEARCH | FOCUS GROUPS | HEALTH PERSONNEL | OCCUPATIONAL HEALTH | SAFETY | NEEDLE PIERCING | ACCIDENTS AND INJURIES | HIV TESTING | HIV TRANSMISSION | PREVALENCE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Surveys | Sampling Studies | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | Data Collection | Delivery of Health Care | Health | Public Health | Risk Behavior | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | HIV Infections | Viral Diseases | Diseases | Measurement
Document Number: 325502

23.

Peer Reviewed

Title: Prevalence and predictors of herpes simplex virus type 2 infection among female sex workers in Yunnan Province, China.
Author: Wang H; Wang N; Chen RY; Sharp GB; Ma Y; Wang G; Ding G; Wu Z
Source: International Journal of STD and AIDS. 2008 Sep;19(9):635-9.
Abstract: The objective of this study was to determine the seroprevalence of herpes simplex virus type 2 (HSV-2), and to evaluate the relationship between HSV-2 infection and sociodemographic factors and the sexual practices of female sex workers (FSWs) in Kaiyuan city, Yunnan Province, China. This cross-sectional study involved 737 FSWs and was carried out from March to May 2006 with confidential interviews and laboratory tests for HSV-2 and other sexually transmitted infections (STI). HSV-2 was the most common STI (68%), followed by Chlamydia trachomatis (26%), Trichomonas vaginalis (11%), Neisseria gonorrhoeae (8%) and syphilis (7%). Prevalence of HIV-1 was 10.3%. Adjusted odds ratios of HSV-2 seroprevalence were 2.6 (95% CI [confidence interval]: 1.30-5.38) for HIV-1 infection, 2.0 (95% CI: 1.33-3.16) for vaginal douching, 2.0 (95% CI: 0.45-0.86) for condom breaking or falling off during sexual intercourse with the client in the previous week, 1.8 (95% CI: 1.07-3.18) for > or =5 years of commercial sex work, 1.6 (95% CI: 1.08-2.33) for > or =5 clients in the previous week, 0.6 (95% CI: 0.45-0.86) for > or =9 years of education. This study identifies a very high prevalence of HSV-2 infections among FSWs in Yunnan Province, with only a few who reported a prior history of genital herpes. HSV-2 serological screening and suppressive therapy should be considered for study populations. Education on the importance of diagnosis, treatment and prevention may help control the spread of HSV-2 infection.
Language: English
Keywords:
CHINA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | WOMEN IN DEVELOPMENT | SEX WORKERS | PREVALENCE | RISK FACTORS | HERPES GENITALIS | DEMOGRAPHIC FACTORS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK BEHAVIOR | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Economic Development | Economic Factors | Behavior | Measurement | Biology | Reproductive Tract Infections | Infections | Diseases
Document Number: 329279

24.

Title: Preventing malaria in pregnancy through focused antenatal care: Working with faith-based organizations in Uganda. Kasese district, Uganda.
Author: JHPIEGO. Access to Clinical and Community Maternal, Neonatal and Women�s Health Services Program [ACCESS]
Source: [Baltimore, Maryland], JHPIEGO, ACCESS, 2007 May. [4] p.
Abstract: In Uganda, 50% of maternal and child health services are provided through faith-based organizations (FBOs). The ACCESS Program, through IMA World Health (IMA) and JHPIEGO, collaborated on a pilot program in the Kasese District with three FBOs - the Uganda Protestant Medical Bureau - to increase uptake of intermittent preventative treatment (IPT) to prevent malaria in pregnancy (MIP), using the focused antenatal care (ANC) platform. This program was supposed by U.S. Agency for International Development (USAID) East Africa, USAID Africa Bureau and the Malaria Action Coalition. In 2003, before program implementation, the uptake of IPT 1 was at 35%, IPT 2 at 27% and the use of insecticide-treated bed nets (ITNs) was at 5%. Following the World Health Organization's (WHO) three-pronged approach, the pilot study's program objectives were to increase: uptake of IPT; use of ITNs among pregnant women; capacity among providers to deliver focused ANC services; the number of pregnant women coming early (first trimester) for ANC. (excerpt)
Language: English
Keywords:
UGANDA | ADMINISTRATIVE DISTRICTS | PROGRESS REPORT | BASELINE SURVEYS | PILOT PROJECTS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | FAITH-BASED ORGANIZATION | ANTENATAL CARE | MALARIA PREVENTION | ADVOCACY | ANTIMALARIAL DRUGS | ADMINISTRATION AND DOSAGE | USAID | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Economic Development | Economic Factors | Organizations | Political Factors | Sociocultural Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Malaria | Parasitic Diseases | Diseases | Communication | Drugs | Treatment | Medical Procedures | Medicine | Government Agencies
Document Number: 325150

25.

Title: The future population of India. A long-range demographic view.
Author: Population Foundation of India; Population Reference Bureau [PRB]
Source: New Delhi, India, Population Foundation of India, 2007 Aug. 15 p.
Abstract: India's population passed the one billion mark in 2000 and, this year, celebrated its 60th year as an independent country. Its population is likely to pass China's as the world's largest within 20 years. All of this leads quite naturally to the question: how large might the population of the world's largest democracy become? This is the question that the Population Foundation of India and its partner, the Population Reference Bureau, have addressed to project India's population for the long term. In this publication, two scenarios of India's future population are offered. Both assume that fertility will decline continuously to the point where couples average two children each, the goal of India's National Population Policy 2000. The scenarios differ in one respect: one assumes that states with higher current fertility will decline to the "replacement level" of 2.1 children, a common assumption in projections. The second assumes that the decline will continue to 1.85 children, near the level observed in states such as Kerala. The first scenario results in an India of two billion population while the second falls short of that mark and results in eventual population decline. (excerpt)
Language: English
Keywords:
INDIA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | POPULATION STATISTICS | POPULATION | POPULATION PROJECTION | POPULATION POLICY | FAMILY SIZE, IDEAL | TOTAL FERTILITY RATE | MIGRATION | MORTALITY | POPULATION GROWTH | LIFE EXPECTANCY | Developing Countries | Asia, Southern | Asia | Geographic Factors | Research Methodology | Estimation Techniques | Social Policy | Policy | Political Factors | Sociocultural Factors | Family Size | Family Characteristics | Family and Household | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Length of Life
Document Number: 320374

26.

Peer Reviewed

Title: The path to below replacement fertility in the Islamic Republic of Iran.
Author: Abbasi-Shavazi MJ; Hosseini-Chavoshi M; McDonald P
Source: Asia-Pacific Population Journal. 2007 Aug;22(2):91-112.
Abstract: This article aims to review the phenomenal fertility change which occurred in the Islamic Republic of Iran during the period 1972-2003 and to discuss the pathways by which the below replacement-level fertility have been achieved in this country. Mean age at first marriage and age at the first and last birth are analysed. Progression to second and third birth are also examined. Finally, the future prospects for fertility as well as their policy implications are discussed. (excerpt)
Language: English
Keywords:
IRAN | ADMINISTRATIVE DISTRICTS | CRITIQUE | BELOW REPLACEMENT FERTILITY | MARRIAGE AGE | EDUCATIONAL STATUS | DEMOGRAPHIC TRANSITION | REPRODUCTIVE BEHAVIOR | FERTILITY RATE | POPULATION POLICY | Developing Countries | Middle East | Geographic Factors | Population | Population Decrease | Population Dynamics | Demographic Factors | Marriage Patterns | Marriage | Nuptiality | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility | Birth Rate | Fertility Measurements | Social Policy | Policy | Political Factors | Sociocultural Factors
Document Number: 326124

27.

Peer Reviewed

Title: Use of over-the-counter malaria medicines in children and adults in three districts in Kenya: Implications for private medicine retailer interventions.
Author: Abuya TO; Mutemi W; Karisa B; Ochola SA; Fegan G
Source: Malaria Journal. 2007 May 10;6(1):57.
Abstract: Global malaria control strategies highlight the need to increase early uptake of effective antimalarials for childhood fevers in endemic settings, based on a presumptive diagnosis of malaria in this age group. Many control programmes identify private medicine sellers as important targets to promote effective early treatment, based on reported widespread inadequate childhood fever treatment practices involving the retail sector. Data on adult use of over-the-counter (OTC) medicines is limited. This study aimed to assess childhood and adult patterns of OTC medicine use to inform national medicine retailer programmes in Kenya and other similar settings. Large-scale cluster randomized surveys of treatment seeking practices and malaria parasite prevalence were conducted for recent fevers in children under five years and recent acute illnesses in adults in three districts in Kenya with differing malaria endemicity. A total of 12, 445 households were visited and data collected on recent illnesses in 11, 505 children and 19, 914 adults. OTC medicines were the most popular first response to fever in children with fever (47.0%; 95% CI 45.5, 48.5) and adults with acute illnesses (56.8%; 95% CI 55.2, 58.3). 36.9% (95% CI 34.7, 39.2) adults and 22.7% (95% CI 20.9, 24.6) children using OTC medicines purchased antimalarials, with similar proportions in low and high endemicity districts. 1.9% (95% CI 0.8, 4.2) adults and 12.1% (95% CI 16.3,34.2) children used multidose antimalarials appropriately. Although the majority of children and adults sought no further treatment, self-referral to a health facility within 72 hours of illness onset was the commonest pattern amongst those seeking further help. In these surveys, OTC medicines were popular first treatments for fever in children or acute illnesses in adults. The proportions using OTC antimalarials were similar in areas of high and low malaria endemicity. In all districts, adults weremore likely to self-treat with OTC antimalarial medicines than febrile children were to receive them, and less likely to use them in recommended ways. Government health centres were the most common second resort for treatment and were often used within 72 hours. In view of these practices, more research is needed to assess the impact on the popularity of private medicine sellers of strengthened public sector policies on access to malaria treatment and insecticide-treated bed nets. Improved targeting of OTC antimalarials to high risk groups, better communication strategies regarding adult as well as children's dosages, and facilitating more rapid referral to trained health workers where needed are important challenges to private medicine seller programmes. (author's)
Language: English
Keywords:
KENYA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | KAP SURVEYS | CHILDREN | ADULTS | PHARMACISTS | PHARMACY DISTRIBUTION | DRUGS | MALARIA | PRIVATE SECTOR | PARASITE CONTROL | FEVER | GOVERNMENT PROGRAMS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Health Personnel | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Treatment | Medical Procedures | Medicine | Health Services | Parasitic Diseases | Diseases | Macroeconomic Factors | Economic Factors | Public Health | Body Temperature | Physiology | Biology
Document Number: 316430

28.

Title: Effect of a school health programme on ensuring safe environments for primary school children.
Author: Adegbenro CA
Source: Journal of the Royal Society for the Promotion of Health. 2007;127(1):29-32.
Abstract: The school health programme (SHP), which focuses on promoting safe environments for school children, has not been given proper attention in Nigeria. The aim of the study was to assess the impact of SHP on ensuring safe environments for primary school children. The study was conducted in ten primary schools in Ife-Central Local Government Area (IFLGA) of Osun State, Nigeria. The ten schools were those that are used by medical students of Obafemi Awolowo University for their clinical rotation posting in Community Health. Hence, these students were used as research assistants. The study employed experimental design and an observational checklist was used to collect data. The project was carried out over a period of three years from 2002-2005. During this period, the students carried out some aspects of SHP by constantly giving health talks to pupils and school personnel on the promotion of optimum sanitary condition in schools. Data were collected on existing facilities in schools and behavioural practices that can promote safe environments both pre- and post-intervention by the SHP. Comparing the two results showed that a well organized and properly executed SHP can be used to create safe environments for school children. The study recommends that the SHP should be implemented in all primary schools in Nigeria. (author's)
Language: English
Keywords: