1.  Peer Reviewed Title: Mortality of HIV-infected patients starting antiretroviral therapy in sub-Saharan Africa: comparison with HIV-unrelated mortality. Author: Brinkhof MW; Boulle A; Weigel R; Messou E; Mathers C; Orrell C; Dabis F; Pascoe M; Egger M Author: International Epidemiological Databases to Evaluate AIDS (IeDEA) Source: PLoS Medicine. 2009 Apr 28;6(4):e1000066. Abstract: BACKGROUND: Mortality in HIV-infected patients who have access to highly active antiretroviral therapy (ART) has declined in sub-Saharan Africa, but it is unclear how mortality compares to the non-HIV-infected population. We compared mortality rates observed in HIV-1-infected patients starting ART with non-HIV-related background mortality in four countries in sub-Saharan Africa. METHODS AND FINDINGS: Patients enrolled in antiretroviral treatment programmes in Cote d'Ivoire, Malawi, South Africa, and Zimbabwe were included. We calculated excess mortality rates and standardised mortality ratios (SMRs) with 95% confidence intervals (CIs). Expected numbers of deaths were obtained using estimates of age-, sex-, and country-specific, HIV-unrelated, mortality rates from the Global Burden of Disease project. Among 13,249 eligible patients 1,177 deaths were recorded during 14,695 person-years of follow-up. The median age was 34 y, 8,831 (67%) patients were female, and 10,811 of 12,720 patients (85%) with information on clinical stage had advanced disease when starting ART. The excess mortality rate was 17.5 (95% CI 14.5-21.1) per 100 person-years SMR in patients who started ART with a CD4 cell count of less than 25 cells/microl and World Health Organization (WHO) stage III/IV, compared to 1.00 (0.55-1.81) per 100 person-years in patients who started with 200 cells/microl or above with WHO stage I/II. The corresponding SMRs were 47.1 (39.1-56.6) and 3.44 (1.91-6.17). Among patients who started ART with 200 cells/microl or above in WHO stage I/II and survived the first year of ART, the excess mortality rate was 0.27 (0.08-0.94) per 100 person-years and the SMR was 1.14 (0.47-2.77). CONCLUSIONS: Mortality of HIV-infected patients treated with combination ART in sub-Saharan Africa continues to be higher than in the general population, but for some patients excess mortality is moderate and reaches that of the general population in the second year of ART. Much of the excess mortality might be prevented by timely initiation of ART. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | DEATH RATE | EXCESS MORTALITY | RISK FACTORS | Africa | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Mortality | Population Dynamics | Demographic Factors | Population | Health Document Number: 341677 |
| 2. Peer Reviewed Title: Saving the lives of South Africa's mothers, babies, and children: can the health system deliver? Author: Chopra M; Daviaud E; Pattinson R; Fonn S; Lawn JE Source: Lancet. 2009 Sep 5;374(9692):835-46. Abstract: South Africa is one of only 12 countries in which mortality rates for children have increased since the baseline for the Millennium Development Goals (MDGs) in 1990. Continuing poverty and the HIV/AIDS epidemic are important factors. Additionally, suboptimum implementation of high-impact interventions limits programme effectiveness; between a quarter and half of maternal, neonatal, and child deaths in national audits have an avoidable health-system factor contributing to the death. Using the LiST model, we estimate that 11,500 infants' lives could be saved by effective implementation of basic neonatal care at 95% coverage. Similar coverage of dual-therapy prevention of mother-to-child transmission with appropriate feeding choices could save 37,200 children's lives in South Africa per year in 2015 compared with 2008. These interventions would also avert many maternal deaths and stillbirths. The total cost of such a target package is US$1.5 billion per year, 24% of the public-sector health expenditure; the incremental cost is $220 million per year. Such progress would put South Africa squarely on track to meet MDG 4 and probably also MDG 5. The costs are affordable and the key gap is leadership and effective implementation at every level of the health system, including national and local accountability for service provision. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | ESTIMATION TECHNIQUES | ECONOMIC MODEL | EXCESS MORTALITY | CAUSES OF DEATH | HIV INFECTIONS | INTERVENTIONS | IMPLEMENTATION | HEALTH POLICY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PRIMARY HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | PERFORMANCE IMPROVEMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Theoretical Models | Mortality | Population Dynamics | Demographic Factors | Population | Viral Diseases | Diseases | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Health Services | Delivery of Health Care | Health | Management Document Number: 342802 |
3.  Title: Excess mortality and risk factors for mortality among a cohort of TB patients from rural south India. Author: Kolappan C; Subramani R; Kumaraswami V; Santha T; Narayanan PR Source: International Journal of Tuberculosis and Lung Disease. 2008 Jan;12(1):81-86. Abstract: OBJECTIVES: To estimate the excess general mortality among tuberculosis (TB) patients in a rural area (Tiruvallur) and identify risk factors for TB-related mortality. SETTING: The study population consisted of all TB patients aged >or=15 years who were registered under the Revised National Tuberculosis Control Programme (RNTCP) during the years 2000 to 2003 at Velliyur TB unit (TU) in south India. DESIGN: This is a retrospective cohort study of 3405 patients treated under the DOTS strategy, followed up from the date of start of treatment till the date of interview (for the survivors) or the date of death (for those who died). RESULTS: There were 2710 (79.6%) survivors and 695 (20.4%) deaths. The excess general mortalities for the cohort, expressed as standardised mortality ratio (SMR), was 4.2 (95%CI 3.9-4.5). High SMR values were obtained for patients belonging to the 15-44 years age group (12.1), patients on Category II regimen (9.3), treatment failures (9.1) and defaulters (7.8). The adjusted hazards ratios (aHR) were high for patients aged 45-59 years (1.9), >or=60 years (3.1) and with incomplete treatment due to default or failure (6.4). CONCLUSION: TB is one of the main causes of mortality in the younger age group. Among TB patients, the major risk factors for mortality are old age (>or=45 years) and incomplete treatment. Language: English Keywords: INDIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | COHORT ANALYSIS | RETROSPECTIVE STUDIES | RURAL POPULATION | TUBERCULOSIS | RISK FACTORS | EXCESS MORTALITY | MORTALITY DETERMINANTS | SURVIVORSHIP | AGE FACTORS | USER COMPLIANCE | ANTIBIOTICS | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Biology | Mortality | Population Dynamics | Length of Life | Behavior | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325807 |
| 4. Peer Reviewed Title: The environment's impact on health. Source: Lancet. 2007 Jun 23;369(9579):2052. Abstract: With its release of each country's profile of environmental factors and their impact on health last week, WHO has made a first, very important step towards facilitating more joined-up thinking by policymakers when planning interventions that have the greatest effect at a population level. The profiles make grim reading in some parts of the world and show stark inequalities. In Sierra Leone, one of the worst affected countries, an estimated 316 healthy years of life are lost per 1000 inhabitants due to preventable environmental factors compared with only 14 healthy years of life lost per 1000 in Iceland. Worldwide an estimated 13 million deaths could be prevented each year in a healthier environment. In 23 countries, more than 10% of these deaths are due to just two factors: lack of clean water and the effects of indoor air pollution caused by a high proportion of households that use solid fuel, such as wood, for cooking and heating. Many of these factors have the greatest effect on young children, and without tackling the most important environmental impacts on health, there is little hope of substantial progress towards Millennium Development Goal 4: reducing under-5 child mortality by two-thirds by 2015. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | POLICYMAKERS | POPULATION AT RISK | ENVIRONMENTAL POLLUTION | WATER SUPPLY | INDOOR AIR POLLUTION | EXCESS MORTALITY | PUBLIC HEALTH | Administrative Personnel | Organization and Administration | Research Methodology | Environmental Degradation | Environment | Natural Resources | Mortality | Population Dynamics | Demographic Factors | Population | Health Document Number: 318051 |
| 5. Title: Good choice: the right to sexual and reproductive health. Author: Panos. RELAY Source: London, United Kingdom, Panos, 2007. [6] p. (Panos Media Toolkit on Communicating Research No. 4) Abstract: The right to health is a universal human right and this includes sexual and reproductive health. To guarantee these rights, people must be treated according to their needs and work against prejudices which limit access to healthcare. While married people need access to good sexual and reproductive health services, so too do teenagers, gay men, disabled people, sex workers, drug users and people having sex outside marriage. Good sexual and reproductive health services enhance public health and improve quality of life. They can reduce the risk of disability, disease or death from sexually transmitted infections (STIs), harmful traditional practices and HIV and AIDS. And having a choice about how many children a woman has, and when, makes pregnancy, childbirth and abortion safer. Despite the obvious gains, improving access to these health services is often contentious. Medical developments such as female condoms, abortion pills, screening for STIs and making antiretroviral drugs available can bring public health policy into conflict with religious ideologies and traditional practices. Lack of funding, changes in legislation or simple government inaction can create barriers to universal access to services. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | PROVIDERS WITH CLIENTS | GOVERNMENT | NONGOVERNMENTAL ORGANIZATIONS | REPRODUCTIVE HEALTH | EXCESS MORTALITY | FUNDS | DELIVERY OF HEALTH CARE | INFORMED CHOICE | PROGRAM ACCESSIBILITY | POLITICAL FACTORS | Health Services | Health | Sociocultural Factors | Organizations | Mortality | Population Dynamics | Demographic Factors | Population | Financial Activities | Economic Factors | Contraceptive Usage | Contraception | Family Planning | Program Evaluation | Programs | Organization and Administration Document Number: 324280 |
| 6. Peer Reviewed Title: The burden of malaria in Sudan: Incidence, mortality and disability --adjusted -- life -- years. Author: Abdalla SI; Malik EM; Ali KM Source: Malaria Journal. 2007 Jul 28;6(1):97. Abstract: Estimating the burden of malaria in Sudan is important for evidence-based planning of malaria control. Estimates of malaria burden in terms of DALYs (Disability Adjusted Life Years) were not developed locally. This study synthesized information from different sources to calculate malaria incidence, mortality and DALYs lost in Sudan in 2002. A search for local studies and reports providing epidemiological data on malaria in Sudan was conducted. Preliminary estimates of incidence rate, case fatality rate and mortality rate were developed from the data found. The preliminary estimates were processed in the disease modelling computer software, DisMod II, to produce internally consistent mortality and incidence rates, which were used to calculate DALYs lost due to malaria. Malaria incidence in Sudan was estimated to be about 9 million episodes in 2002 and the number of deaths due to malaria was about 44,000. 2,877,000 DALYs were lost in Sudan in 2002 due to malaria mortality, episodes, anaemia and neurological sequelae. Children under five years of age had the highest burden. Males had the highest incidence and mortality, but females lost more DALYs. Formal health system data underestimated malaria burden. The burden estimates can be useful in informing decision making, although uncertainty around them needs to be quantified. Epidemiological research is needed to fill data gaps and update the estimates. (author's) Language: English Keywords: SUDAN | RESEARCH REPORT | ESTIMATION TECHNIQUES | CLIENTS | MALARIA | PREVENTION AND CONTROL | INCIDENCE | EXCESS MORTALITY | Developing Countries | Africa, North | Africa | Research Methodology | Program Activities | Programs | Organization and Administration | Parasitic Diseases | Diseases | Measurement | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 318926 |
| 7. Title: Decreases in male and female mortality and missing women in Bangladesh. Author: Alam N; Van Ginneken J; Bosch A Source: In: Watering the neighbour's garden: The growing demographic female deficit in Asia, edited by Isabelle Attane and Christophe Z. Guilmoto. Paris, France, Committee for International Cooperation in National Research in Demography [CICRED], 2007. :161-181. "Chapters in this volume originate from papers presented at an international seminar organized by the authors in Singapore on 5-7 December 2005". Abstract: In Bangladesh, parents have a preference for a balance in sex composition of children; most couples want two sons and one daughter (Chowdhury and Bairagi, 1990). There is a debate over whether the pro-son bias is the result of economic structure or due to sociocultural reasons. The social institutions that shape norms and values prevailing in a number of Asian countries dispose parents and other caretakers to treat boys and girls differently on the ground of their sex, which does not imply deliberate discrimination. Parents do not engage in conscious discrimination between sons and daughters, but sex discrimination is embodied in cultural beliefs (Waldron, 1987). The differential treatment on the ground of sex often leads to poor health and survival of girls. For this reason the 1994 Cairo International Conference of Population and Development placed special emphasis on the need to improve the health, welfare and survival of girls. The objectives of this study are to examine whether discrimination against girls persists in Bangladesh or has shifted over time and to identify the behavioural mechanisms involved in these changes. This study will focus on male/female differentials in mortality of infants and children aged 1-4 years and male/female differences in nutritional status of children aged 1-4 years old. Sex differentials in use of child health services are also considered as well as changes in patterns of enrolment in education for girls versus boys. (excerpt) Language: English Keywords: BANGLADESH | RESEARCH REPORT | NUTRITION SURVEYS | HEALTH SURVEYS | DEMOGRAPHIC SURVEYS | INFANT | CHILD, FEMALE | SEX RATIO | SEX DISCRIMINATION | EXCESS MORTALITY | DIFFERENTIAL MORTALITY | CHILD SURVIVAL | CHILD MORTALITY | CHILD NUTRITION | CHILD HEALTH | Developing Countries | Asia, Southern | Asia | Nutrition | Health | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Child | Sex Distribution | Sex Factors | Social Discrimination | Social Problems | Sociocultural Factors | Mortality | Survivorship | Length of Life Document Number: 308899 |
| 8. Peer Reviewed Title: Cerebrospinal fluid and serum biomarkers of cerebral malaria mortality in Ghanaian children. Author: Armah HB; Wilson NO; Sarfo BY; Powell MD; Bond VC Source: Malaria Journal. 2007 Nov 12;6:147. Abstract: Plasmodium falciparum can cause a diffuse encephalopathy known as cerebral malaria (CM), a major contributor to malaria associated mortality. Despite treatment, mortality due to CM can be as high as 30% while 10% of survivors of the disease may experience short- and long-term neurological complications. The pathogenesis of CM and other forms of severe malaria is multifactorial and appear to involve cytokine and chemokine homeostasis, inflammation and vascular injury/repair. Identification of prognostic markers that can predict CM severity will enable development of better intervention. Postmortem serum and cerebrospinal fluid (CSF) samples were obtained within 2-4 hours of death in Ghanaian children dying of CM, severe malarial anemia (SMA), and non-malarial (NM) causes. Serum and CSF levels of 36 different biomarkers (IL-1beta, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12 (p70), IL-13, IL-15, IL-17, Eotaxin, FGF basic protein, CRP, GCSF, GM-CSF, IFN-y, TNF-alpha, IP-10, MCP-1 (MCAF), MIP-1alpha, MIP-1beta, RANTES, SDF-1alpha, CXCL11 (I-TAC), Fas-ligand [Fas-L], soluble Fas [sFas], sTNF-R1 (p55), sTNF-R2 (p75), MMP-9, TGF-beta1, PDGF bb and VEGF) were measured and the results compared between the 3 groups. After Bonferroni adjustment for other biomarkers, IP-10 was the only serum biomarker independently associated with CM mortality when compared to SMA and NM deaths. Eight CSF biomarkers (IL-1ra, IL-8, IP-10, PDGFbb, MIP-1beta, Fas-L, sTNF-R1, and sTNF-R2) were significantly elevated in CM mortality group when compared to SMA and NM deaths. Additionally, CSF IP-10/PDGFbb median ratio was statistically significantly higher in the CM group compared to SMA and NM groups. The parasite-induced local cerebral dysregulation in the production of IP-10, 1L-8, MIP-1beta, PDGFbb, IL-1ra, Fas-L, sTNF-R1, and sTNF-R2 may be involved in CM neuropathology, and their immunoassay may have potential utility in predicting mortality in CM. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | MALARIA | CEREBROVASCULAR EFFECTS | EXCESS MORTALITY | RISK FACTORS | AUTOPSY | IMMUNOLOGICAL EFFECTS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Physiology | Biology | Mortality | Population Dynamics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunity | Immune System Document Number: 322718 |
| 9. Title: Sex ratio at birth and excess female child mortality in India: trends, differentials and regional patterns. Author: Arokiasamy P Source: In: Watering the neighbour's garden: The growing demographic female deficit in Asia, edited by Isabelle Attane and Christophe Z. Guilmoto. Paris, France, Committee for International Cooperation in National Research in Demography [CICRED], 2007. :49-72. "Chapters in this volume originate from papers presented at an international seminar organized by the authors in Singapore on 5-7 December 2005". Abstract: The region comprising the northern and western states of India, where evidence of stronger son preference is well documented, has the history of most imbalanced sex ratio. The corresponding link between adverse female/male child mortality differentials and the recent sharp rise in child sex ratios, related to foetal mortality, constitutes the main focus of this analysis. Set in this context, this chapter assesses the evidence of trends and regional patterns in sex bias against female children. It explores the dynamics of gender bias in terms of two proximate determinants of sex ratio, namely, sex ratio at birth and excess female child mortality. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | DEMOGRAPHIC ANALYSIS | CHILD, FEMALE | SEX RATIO | CHILD MORTALITY | SEX DISTRIBUTION | HUMAN GEOGRAPHY | EXCESS MORTALITY | DIFFERENTIAL MORTALITY | SEX DISCRIMINATION | AMNIOCENTESIS | ULTRASONICS | ABORTION | Developing Countries | Asia, Southern | Asia | Health | Research Methodology | Child | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Factors | Mortality | Population Dynamics | Geography | Social Sciences | Science | Sociocultural Factors | Social Discrimination | Social Problems | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Fertility Control, Postconception | Family Planning Document Number: 308894 Notification |
| 10. Title: Estimation of excess in context of AIDS deaths and the probable causes: 1994-2002. Author: Bhattacharya M; Neogi S; Sogarwal R Source: [Unpublished] 2007. Presented at the Population Association of America 2007 Annual Meeting, New York, New York, March 29-31, 2007. [10] p. Abstract: Estimating the number of deaths due to AIDS is an ever-growing challenge across the globe. Dynamics of HIV spread is known to vary from region to region. India with its huge population size would yield a large number of AIDS deaths even with a slight increase in the HIV sero-prevalence rate. It is therefore prudent to try estimating the contribution of HIV/AIDS to overall mortality. In this study, we present estimates of excess deaths in four states of India (Maharashtra, Karnataka, Andhra Pradesh and Tamil Nadu) from 1994 to 2002. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | ESTIMATION TECHNIQUES | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | STATISTICAL REGRESSION | MATHEMATICAL MODEL | DEMOGRAPHIC SURVEYS | PERSONS LIVING WITH HIV/AIDS | ADULTS | EXCESS MORTALITY | AIDS | MORTALITY DETERMINANTS | DEATH RATE | SEX DISTRIBUTION | Asia, Southern | Asia | Developing Countries | Research Methodology | Studies | Data Analysis | Theoretical Models | Population Dynamics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Age Factors | Population Characteristics | Mortality | Sex Factors Document Number: 317857 |
| 11. Peer Reviewed Title: The demographic impact of the HIV / AIDS epidemic in Papua New Guinea, 1990-2030. Author: Hayes G Source: Asia-Pacific Population Journal. 2007 Dec;22(3):11-30. Abstract: The first case of human immunodeficiency virus (HIV) infection in Papua New Guinea was detected in the capital in 1987. After a relatively short period during which the epidemic was concentrated in certain "high-risk" groups, the disease spread throughout the country and by 2005 had become a "generalized epidemic" - with a 1 per cent HIV prevalence rate among adults aged 15-49. The most recent (2007) estimates suggest that the adult prevalence rate has risen to 1.6 per cent, confirming that the epidemic is continuing to grow rapidly. The scale of the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic in the country has reached the point where future demographic patterns are likely to be affected, possibly severely. Among the demographic impacts to be expected based on the experience of other countries with generalized epidemics are an increase in the number of deaths, particularly among young adults leading in turn to reduced life expectancy. The rate of population growth will drop as a higher death rate reduces the rate of natural increase. The number of births can also be expected to decline owing to the impaired fecundity of HIV positive women. Changes to the age structure follow from the concentration of excess AIDS mortality in the young adult age groups. (excerpt) Language: English Keywords: PAPUA NEW GUINEA | RESEARCH REPORT | ESTIMATION TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | PREVALENCE | EXCESS MORTALITY | DEMOGRAPHIC IMPACT | Developing Countries | Oceania | Research Methodology | Viral Diseases | Diseases | Measurement | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 326114 |
| 12. Peer Reviewed Title: The Phoenix population: Demographic crisis and rebound in Cambodia. Author: Heuveline P; Poch B Source: Demography. 2007 May;44(2):405-426. Abstract: The study of mortality crises provides an unusual and valuable perspective on the relationship between mortality and fertility changes, a relationship that has puzzled demographers for decades. In this article, we combine nationally representative survey and demographic-surveillance system data to study fertility trends around the time of the Khmer Rouge (KR) regime, under which 25% of the Cambodian population died. We present the first quantitative evidence to date that attests to a one-third decline of fertility during this regime, followed by a substantial "baby boom" after the fall of the KR. Further analyses reveal that the fertility rebound was produced not only by a two-year marriage bubble but also by a surge in marital fertility that remained for nearly a decade above its precrisis level. Our results illustrate the potential influence of mortality on fertility, which may be more difficult to identify for more gradual mortality declines. To the extent that until recently, Cambodian fertility appears to fit natural fertility patterns, our findings also reinforce recent qualifications about the meaning of this core paradigm of demographic analysis. (author's) Language: English Keywords: CAMBODIA | RESEARCH REPORT | DATA ANALYSIS | EXCESS MORTALITY | FERTILITY CHANGES | FERTILITY DETERMINANTS | TOTAL FERTILITY RATE | MARITAL FERTILITY | BABY BOOM | NUPTIALITY | REPRODUCTIVE BEHAVIOR | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Fertility | Fertility Rate | Birth Rate | Fertility Measurements Document Number: 317139 |
| 13. Peer Reviewed Title: "Low" fertility and population replacement in Scotland. Author: MacInnes J; Diaz JP Source: Population, Space and Place. 2007 Jan-Feb;13(1):3-21. Abstract: It has been argued that Scotland faces population ageing and decline that will have potentially serious economic and social consequences, and that the origin of these processes lie in its low and declining fertility rates. After considering alternatives to the total period rate measure of fertility, empirical evidence and theoretical argument about low fertility and its consequences is briefly reviewed. The paper argues that low fertility in general may not be the problem it is often purported to be, that Scotland has relatively high fertility, and that pro-natalist policies are neither desirable nor necessary. It suggests that low fertility and population ageing may be viewed as positive developments, and that within Europe, Scotland is distinguished more by its excess of early deaths than by any shortage of births. (author's) Language: English Keywords: SCOTLAND | LITERATURE REVIEW | POPULATION | DEMOGRAPHIC TRANSITION | FERTILITY DECLINE | SOCIAL CHANGE | DEMOGRAPHY | REPRODUCTIVE BEHAVIOR | POPULATION POLICY | INTERNATIONAL MIGRATION | EXCESS MORTALITY | POPULATION FORECAST | United Kingdom | Europe, Western | Europe | Developed Countries | Population Dynamics | Demographic Factors | Fertility Changes | Fertility | Sociocultural Factors | Social Sciences | Science | Social Policy | Policy | Political Factors | Migration | Mortality | Estimation Techniques | Research Methodology Document Number: 311616 |
| 14. Peer Reviewed Title: The HIV / AIDS tsunami: Perception determines global response. Author: Roberts J Source: Population Review. 2007;46(1):56-58. Abstract: On 26 December 2004, a magnitude 9.0 earthquake struck off the coast of Indonesia, generating a widespread tsunami. The resulting waves, some up to 15 meters high, reached the heavily populated shores of Indonesia, Thailand, Sri Lanka, India and the east coast of Africa, leaving a path of death and destruction in their wake. Because many bodies (including entire families) were swept out to sea, the final death toll may never be known. But it is likely that at least 200,000 people lost their lives on that fateful day. Along with lives lost, the tsunami destroyed countless livelihoods and made millions of people homeless. Soon after the event, in an interview with CNN, UN emergency relief co-coordinator Jan Egeland summarized the situation: "This may be the worst natural disaster in recent history because it is affecting so many heavily populated coastal areas... so many vulnerable communities." (excerpt) Language: English Keywords: GLOBAL | PHILOSOPHICAL OVERVIEW | PERSONS LIVING WITH HIV/AIDS | INFLUENTIALS | MASS MEDIA | NATURAL DISASTERS | EPIDEMICS | DISASTER RELIEF | FOREIGN AID | PERCEPTION | EXCESS MORTALITY | VALUE ORIENTATION | HIV Infections | Viral Diseases | Diseases | Knowledge Sources | Communication | Environment | Financial Activities | Economic Factors | Psychological Factors | Behavior | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 318101 |
| 15. Peer Reviewed Title: Defining and defeating the intolerable burden of malaria III. Progress and perspectives. Author: Sambo LG Source: American Journal of Tropical Medicine and Hygiene. 2007;77 Suppl 6:[1] p. Abstract: The excess of malaria-attributed mortality in the African region is estimated to be well over a million, mainly because of the premature death of children younger than 5 years of age and the adverse consequences during pregnancy. Therefore, children and pregnant women-the most vulnerable segments of society-bear the greatest burden. Malaria is responsible for keeping millions of people in the vicious cycle of ill-health, diminished cognitive capacities among children, and absenteeism from activities of daily living, productivity and income loss, and poverty. Malaria-related mortality, morbidity, and economic loss could be averted if the available effective preventive and treatment interventions were made universally accessible to all those in need. Malaria is a polymorphous disease, and its burden varies among different regions and populations. As such, particular attention needs to be paid to the range of challenges that have been compromising optimal program implementation and preventing most endemic countries from being on track for achieving the internationally agreed targets. These challenges will need to be tackled in a comprehensive and rational manner to accelerate progress toward malaria control. (excerpt) Language: English Keywords: AFRICA | CRITIQUE | POPULATION AT RISK | CHILDREN | PREGNANT WOMEN | MALARIA PREVENTION | EXCESS MORTALITY | INTERNATIONAL COOPERATION | RESEARCH AND DEVELOPMENT | INTERVENTIONS | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Malaria | Parasitic Diseases | Diseases | Mortality | Population Dynamics | Political Factors | Sociocultural Factors | Technology | Economic Factors | Programs | Organization and Administration Document Number: 323429 |
| 16. Peer Reviewed Title: Persisting high hospital and community childhood mortality in an urban setting in Guinea-Bissau. Author: Veirum JE; Biai S; Jakobsen M; Sandstrom A; Hedegaard K Source: Acta Paediatrica. 2007 Oct;96(10):1526-1530. Abstract: The aim was to describe paediatric hospitalization in a West African capital in relation to overall childhood mortality in the community and to evaluate the potential impact of improved management at the hospital. Hospital data on child admissions in a 6-year period were linked to information in a community-based longitudinal surveillance system. Paediatric hospitalization rates, risk factors for hospitalizations, community mortality, in-hospital mortality and the proportion of deaths occurring at hospital were examined. Almost 15% of infants and 45% of children less than 5 years of age had been hospitalized, and 24% of all deaths in the community occurred in-hospital. Community infant and under-three mortality rates were 110 and 207 per 1 000 person-years, respectively. In-hospital mortality remained persistently high from 1991 to 1996 and the overall in-hospital mortality was 12%. It was found that wet season, lack of maternal schooling and living in a specific district were significant risk factors for both community and in-hospital death, whereas higher hospitalization rates were associated with better-off families. In populations with high hospitalization rates, even minor improvements in acute case management of sick children attending the hospital would be expected to result in substantial reduction in overall childhood mortality. Persistently high acute in-hospital mortality reflects the need of immediate and appropriate care at the hospital. Treatment should be free of charge, in order to minimize the impact of social inequality. (author's) Language: English Keywords: GUINEA-BISSAU | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CHILDREN | COMMUNITY | URBAN POPULATION | HOSPITALS | CHILD MORTALITY | MANAGEMENT | RISK FACTORS | EXCESS MORTALITY | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Health Facilities | Delivery of Health Care | Health | Mortality | Population Dynamics | Organization and Administration | Biology Document Number: 324848 |
| 17. Title: Population aging in Sub-Saharan Africa: demographic dimensions 2006. Author: Velkoff VA; Kowal PR Source: Washington, D.C., United States Government Printing Office, 2007 Jun. [46] p. (International Population Reports P95/07-1) Abstract: Although the older population makes up a small proportion of the population in most Sub-Saharan African countries, the absolute number of older people is growing. In 2006, 35 million people were aged 60 and older in Sub-Saharan Africa, and this number is projected to increase to over 69 million by 2030. In fact, the sheer number of older people is growing more rapidly in Sub-Saharan Africa than in the developed world. This increase in the number of older people will occur despite the excess mortality due to HIV/AIDS that many Sub-Saharan African countries are currently experiencing. This report focuses primarily on the demographic aspects of aging in Sub-Saharan African countries, with a special section examining the impact of HIV/AIDS on population aging. Older people in Africa are a particularly vulnerable social group, and they have been made more vulnerable because of the HIV/AIDS pandemic that is affecting many of these countries. This report examines the populations aged 50 and over, 60 and over, and 80 and over. The cultural definition of "old" differs greatly between and within countries. Attaching a chronological age to "old" often serves practical or official purposes, and looking at these three age groupings will help to compare and contrast the older populations. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | POPULATION STATISTICS | OLDER ADULTS | PERSONS LIVING WITH HIV/AIDS | DEMOGRAPHIC AGING | LIFE EXPECTANCY | POPULATION DYNAMICS | EXCESS MORTALITY | FERTILITY DECLINE | Developing Countries | Africa | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Length of Life | Mortality | Fertility Changes | Fertility Document Number: 324531 |
| 18. Title: Risk factors in hospital deaths in severely malnourished children in Kampala, Uganda. Author: Bachou H; Tumwine JK; Mwadime RK; Tylleskar T Source: BMC Pediatrics. 2006 Mar 16;6:7. Abstract: Although the risk factors for increased fatality among severely malnourished children have been reported, recent information from Africa, during a period of HIV pandemic and constrained health services, remains sketchy. The aim of this study has been to establish the risk factors for excess deaths among hospitalized severely malnourished children of below five years of age. In 2003, two hundred and twenty consecutively admitted, severely malnourished children were followed in the paediatric wards of Mulago, Uganda's national referral and teaching hospital. The children's baseline health conditions were established by physical examination, along with haematological, biochemical, microbiological and immunological indices. Of the 220 children, 52 (24%) died, with over 70% of the deaths occurring in the first week of admission. There was no significant difference by sex or age group. The presence of oedema increased the adjusted odds-ratio, but did not reach significance (OR = 2.0; 95% CI = 0.8 -- 4.7), similarly for a positive HIV status (OR = 2.6, 95% CI = 0.8 -- 8.6). Twenty four out of 52 children who received blood transfusion died (OR = 5.0, 95% CI = 2 -- 12); while, 26 out of 62 children who received intravenous infusion died (OR = 4.8, 95% CI = 2 -- 12). The outcome of children who received blood or intravenous fluids was less favourable than of children who did not receive them. Adjustment for severity of disease did not change this. The main risk factors for excess hospital deaths among severely malnourished children in Mulago hospital include blood transfusion and intravenous infusion. An intervention to reduce deaths needs to focus on guideline compliance with respect to blood transfusions/infusions. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CHILDREN | RISK FACTORS | CHILD NUTRITION | MALNUTRITION | EXCESS MORTALITY | PREVALENCE | EDEMA | BLOOD TRANSFUSION | DEHYDRATION | CAUSES OF DEATH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Nutrition | Health | Nutrition Disorders | Diseases | Mortality | Population Dynamics | Measurement | Signs and Symptoms | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Metabolic Effects | Physiology Document Number: 306461 |
| 19. Title: Economic growth, education and AIDS in Kenya: a long-run analysis. Author: Bell C; Bruhns R; Gersbach H Source: Washington, D.C., World Bank, 2006 Oct. 47 p. (World Bank Policy Research Working Paper No. 4025) Background paper to the 2007 World Development Report. Abstract: The AIDS epidemic threatens Kenya with a long wave of premature adult mortality, and thus with an enduring setback to the formation of human capital and economic growth. To investigate this possibility, we develop a model with three overlapping generations, calibrate it to the demographic and economic series from 1950 until 1990, and then perform simulations for the period ending in 2050 under alternative assumptions about demographic developments, including the counterfactual in which there is no epidemic. Although AIDS does not bring about a catastrophic economic collapse, it does cause large economic costs - and very many deaths. Programs that subsidize post-primary education and combat the epidemic are both socially profitable - the latter strikingly so, due to its indirect effects on the expected returns to education - and a combination of the two interventions profits from a modest long-run synergy effect. (author's) Language: English Keywords: KENYA | RESEARCH REPORT | ECONOMIC MODEL | PERSONS LIVING WITH HIV/AIDS | ECONOMIC DEVELOPMENT | EDUCATION | HUMAN CAPITAL | EXCESS MORTALITY | INTERVENTIONS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Theoretical Models | Research Methodology | HIV Infections | Viral Diseases | Diseases | Economic Factors | Human Resources | Mortality | Population Dynamics | Demographic Factors | Population | Programs | Organization and Administration Document Number: 319267 |
| 20. Title: After 15 years of transition, the Russian population is still in turmoil. Author: Blum A; Lefevre C Source: Population and Societies. 2006 Feb;(420):1-4. Abstract: Since the end of the Soviet era, the population of Russia has fallen substantially. The October 2002 census made it possible to quantify this decrease and to examine the factors involved. Alain Blum and Cecile Lefevre assess the situation and reflect upon the role of social policies. The upheavals of the last 15 years are the latest episode in a turbulent demographic history, and this is highlighted by the deep notches in the Russian population pyramid. (author's) Language: English Keywords: RUSSIA | PROGRESS REPORT | POPULATION STATISTICS | POPULATION | POPULATION DECREASE | HUMAN GEOGRAPHY | POPULATION DISTRIBUTION | BIRTH RATE | RURAL-URBAN MIGRATION | EXCESS MORTALITY | MARRIAGE PATTERNS | FERTILITY RATE | Developing Countries | Asia, Northern | Asia | Research Methodology | Population Dynamics | Demographic Factors | Geography | Social Sciences | Science | Sociocultural Factors | Geographic Factors | Fertility Measurements | Fertility | Migration | Mortality | Marriage | Nuptiality Document Number: 316630 |
| 21. Title: [Time-course of neonatal precocious mortality between 1994 and 2003 at the Dakar University Teaching Hospital] Evolution de la mortalite neonatale precoce entre 1994 et 2003 au CHU de Dakar. Author: Cisse CT; Yacoubou Y; Ndiaye O; Diop-Mbengue R; Moreau JC Source: Journal de Gynecologie Obstetrique et Biologie de la Reproduction. 2006 Feb;35(1):46-52. Abstract: The objective was to evaluate early neonatal mortality at the University Teaching Hospital and assess changes in the rate and causes during the last ten years. We performed a retrospective analysis of neonatal deaths recorded at the Neonatal and Premature Unit (NPU) in 2003. The results were compared with earlier evaluations. Comparison of proportions was used for statistical analysis to eliminate the random element in rate variations. The significance threshold was less than or equal to 5%. We registered 364 neonatal deaths: 243 among 4853 newborns in our maternity ward and 121 among 213 newborns transferred from a referring maternity. Early neonatal mortality rate 45.5 per 1,000 live births. Mortality particularly concerned newborns with a birth weight less than or equal to 2,500 grams (66%) and Apgar scores less than or equal to 6. Early neonatal mortality fell significantly since 1994, while overall mortality remained high among newborns transferred from referring maternities. The most frequent causes were premature birth (49%), acute fetal distress (23%) and neonatal infection (18%). Early neonatal mortality has decreased remains at a high level. It could be improved by limiting the number of premature births, neonatal suffering and neonatal infection. In a parallel direction we recommend organizing a perinatal network in Dakar. (author's) French Abstract: Evaluer revolution des taux et des etiologies de la mortalite neonatale precoce au CHU de Dakar au cours des 10 dernieres annees. II s'agit d'une etude retrospective de tous les deces neonatals enregistres au cours de I'annee 2003. Pour eliminer la part du hasard dans les variations observees pour les differentes periodes etudiees, nous avons utilise comme test statistique la comparaison des proportions avec un seuil de signification inferieur a 5%. Nous avons enregistre 364 deces repartis de la maniere suivante : 243 parmi les 4 853 nouveau-nes accouches au niveau de la malernite (221 en periode neonatale precoce et 23 en periode neonatale tardive) et 121 parmi les 213 nouveau-nes transferes des maternites peripheriques. Le taux de mortalite neonatale precoce est de 45 deces pour 1 000 naissances vivantes. Cette mortalite concernait surtout les nouveau-nes pesant moins de 2 500 grammes a la naissance (66%) et/ou ayant un score d'Apgar inferieur ou egal a 6 a la premiere minute de vie (83%). La mortalite neonatale precoce a connu une baisse significative depuis 1994, mais la mortalite specifique observee chez les nouveau-nes transferes ne cesse d'augmenter (568 pour 1 000). Les principales causes de deces sont la prematurite (49% des cas), la souffrance neonatale (23 %) et I'infection neonatale (18%). L'analyse a montre une baisse significative de la part de la prematurite et de la souffrance neonatale mais une hausse significative de I'infection neonatale. La mortalite neonatale precoce a sensiblement baisse, mais elle reste a un niveau encore trap eleve. Pour consolider cette tendance II faut reduire davantage I'incidence de la prematurite, de la souffrance neonatale et de I'infection et parallelement organiser un reseau de perinatalite a Dakar. (de l'auteur) Language: French Keywords: RESEARCH REPORT | LONGITUDINAL STUDIES | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | RETROSPECTIVE STUDIES | INFANT | INFANT, PREMATURE | NEONATAL MORTALITY | EXCESS MORTALITY | HOSPITALS | UNIVERSITIES | CAUSES OF DEATH | DEATH RATE | LOW BIRTH WEIGHT | INFECTIONS | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Health Facilities | Delivery of Health Care | Health | Schools | Education | Birth Weight | Body Weight | Physiology | Biology | Diseases Document Number: 305233 |
| 22. Peer Reviewed Title: Mortality in the Democratic Republic of Congo: a nationwide survey. Author: Coghlan B; Brennan RJ; Ngoy P; Dofara D; Otto B Source: Lancet. 2006 Jan 7;367(9504):44-51. Abstract: Commencing in 1998, the war in the Democratic Republic of Congo has been a humanitarian disaster, but has drawn little response from the international community. To document rates and trends in mortality and provide recommendations for political and humanitarian interventions, we did a nationwide mortality survey during April-July, 2004. We used a stratified three-stage, household-based cluster sampling technique. Of 511 health zones, 49 were excluded because of insecurity, and four were purposely selected to allow historical comparisons. From the remainder, probability of selection was proportional to population size. Geographical distribution and size of cluster determined how households were selected: systematic random or classic proximity sampling. Heads of households were asked about all deaths of household members during January, 2003, to April, 2004. 19 500 households were visited. The national crude mortality rate of 2.1 deaths per 1000 per month (95% CI 1.6-2.6) was 40% higher than the sub-Saharan regional level (1.5), corresponding to 600 000 more deaths than would be expected during the recall period and 38 000 excess deaths per month. Total death toll from the conflict (1998-2004) was estimated to be 3.9 million. Mortality rate was higher in unstable eastern provinces, showing the effect of insecurity. Most deaths were from easily preventable and treatable illnesses rather than violence. Regression analysis suggested that if the effects of violence were removed, all-cause mortality could fall to almost normal rates. The conflict in the Democratic Republic of Congo remains the world's deadliest humanitarian crisis. To save lives, improvements in security and increased humanitarian assistance are urgently needed. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | SURVEYS | QUESTIONNAIRES | WAR | POLITICAL FACTORS | DISEASES | CAUSES OF DEATH | EXCESS MORTALITY | MALNUTRITION | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Sampling Studies | Studies | Research Methodology | Sociocultural Factors | Mortality | Population Dynamics | Demographic Factors | Population | Nutrition Disorders Document Number: 296382 |
| 23. Peer Reviewed Title: Iraq: time to signal a new era for health in foreign policy. Author: Horton R Source: Lancet. 2006 Oct 21;368(9545):1395-1397. Abstract: In 2004, Johns Hopkins researcher Les Roberts and colleagues reported findings that suggested the risk of death in Iraq was 2.5-fold greater after the military invasion in 2003 than before. They estimated that there were 98 000 more deaths than expected, with violence accounting for most of these casualties. Their work provoked great political controversy, not least because the 95% CI around the 98 000 figure was wide, ranging from 8000 to 194 000 deaths. Despite rigorous methods, critics found this uncertainty hard to take seriously. Since 2004, and especially recently, independent observers have recognised that the security situation in parts of Iraq has deteriorated dramatically. This week, The Lancet publishes a follow-up to the 2004 study by the same research group. Their findings corroborate the impression that Iraq is descending into bloodthirsty chaos. Gilbert Burnham and colleagues completed a mortality survey in over 1800 households in Iraq between May and June this year. The death rate in this sample before the 2003 invasion was 5.5 per 1000 a year, rising to 13.3 per 1000 a year for the entire postinvasion period. Interestingly, and reassuringly, the trajectory of the death rate up until September, 2004, closely matched that of their earlier survey. But now the estimated number of excess deaths has increased by an enormous amount. They calculated that 654 965 excess deaths have taken place as a consequence of the war. The lower 95% CI on this figure is still huge, at 392 979 deaths. Violence-- gunfire and car bombing in particular--remains the main cause of this excess mortality. (excerpt) Language: English Keywords: IRAQ | CRITIQUE | EPIDEMIOLOGIC METHODS | ESTIMATION TECHNIQUES | POPULATION | INTERNATIONAL COOPERATION | WAR | DEATH RATE | EXCESS MORTALITY | PUBLIC HEALTH | Developing Countries | Middle East | Research Methodology | Political Factors | Sociocultural Factors | Mortality | Population Dynamics | Demographic Factors | Health Document Number: 309635 |
| 24. Peer Reviewed Title: Worldwide water crisis is a "silent emergency," UN agency says. Author: Moszynski P Source: BMJ. British Medical Journal. 2006 Nov 11;333(7576):986. Abstract: Unclean water is an "immeasurably greater threat to human security than violent conflict" across the developing world, says the latest annual report from the United Nations Development Programme. The report says, "'Not having access to clean water' is a euphemism for profound deprivation. It means that people walk more than one kilometre to the nearest source of clean water for drinking, that they collect water from drains, ditches or streams that might be infected with pathogens and bacteria that can cause severe illness and death." Each year 1.8 million children die from diarrhoea that could be prevented; 443 million school days are lost to water related illnesses; and almost 50% of all people in poor countries have at any given time a health problem caused by a lack of water and sanitation. (excerpt) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | CRITIQUE | UN | LOW INCOME POPULATION | WATER SUPPLY | SANITATION | ENVIRONMENTAL DEGRADATION | EXCESS MORTALITY | International Agencies | Organizations | Political Factors | Sociocultural Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Natural Resources | Environment | Public Health | Health | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 309170 |
| 25. Title: The demography of large-scale human rights atrocities: Integrating demographic and statistical analysis into post-conflict historical clarification in Timor-Leste. Author: Silva R; Ball P Source: [Unpublished] 2006. Presented at the 2006 Annual Meeting of the Population Association of America, Los Angeles, California, March 30 - April 1, 2006. [5] p. Abstract: During 1975, Timor-Leste transitioned from being a colony of Portugal to being occupied by Indonesia. The occupation was characterized by large-scale political violence, including selective and indiscriminate killings, forced migration, famine-related deaths, tortures and acts of ill-treatment. The authors, formerly advisers to the Commission for Reception, Truth and Reconciliation (CAVR, by its Portuguese acronym), estimated the pattern and magnitude of excess mortality and forced migration during the Indonesian occupation of Timor-Leste between 1975 and 1999. These estimates were based on a combination of qualitative testimony data, a census of public graveyards and a Retrospective Mortality Survey. The data corroborate the eyewitness accounts and qualitative historical analysis of the period. This paper briefly presents the statistical and demographic findings along with the results from survey estimates and capture-recapture methods. A detailed discussion is presented which shows how the demographic analysis contributed to the CAVR's mandate, how the analysis was combined with historical, legal and anthropological findings, and which specific policy questions were informed by the demographic analysis. (author's) Language: English Keywords: INDONESIA | PORTUGAL | HISTORICAL REVIEW | POPULATION | COLONIALISM | HUMAN RIGHTS | VIOLENCE | EXCESS MORTALITY | ESTIMATION TECHNIQUES | HISTORICAL DEMOGRAPHY | Developing Countries | Asia, Southeastern | Asia | Developed Countries | Europe, Southwestern | Europe | Political Systems | Political Factors | Sociocultural Factors | Behavior | Mortality | Population Dynamics | Demographic Factors | Research Methodology | Demography | Social Sciences | Science Document Number: 318939 |
| 26. Peer Reviewed Title: Estimating and projecting HIV prevalence and AIDS deaths in Tanzania using antenatal surveillance data. Author: Somi GR; Matee MI; Swai RO; Lyamuya EF; Killewo J Source: BMC Public Health. 2006 May 3;6:120. Abstract: The Estimations and Projections Package (EPP 2005) for HIV/AIDS estimates and projects HIV prevalence, number of people living with HIV and new HIV infections and AIDS cases using antenatal clinic (ANC) surveillance data. The prevalence projection produced by EPP can be transferred to SPECTRUM, a demographic projection model, to calculate the number of AIDS deaths. This paper presents estimates and projections of HIV prevalence, new cases of HIV infections and AIDS deaths in Tanzania between 2001 and 2010 using the EPP 2005 and SPECTRUM soft-wares on ANC data. For this study we used; the 1985 -- 2004 ANC data set, the 2005 UN population estimates for urban and rural adults, which is based on the 2002 population census, and results of the 2003 Tanzania HIV Indicator Survey. The ANC surveillance sites were categorized into urban and rural areas on the basis of the standard national definitions of urban and rural areas, which led to 40 urban and 35 rural clinic sites. The rural and urban epidemics were run independently by fitting the model to all data and on level fits. The national HIV prevalence increased from 0% in 1981 to a peak of 8.1% in 1995, and gradually decreased to 6.5% in 2004 which stabilized until 2010. The urban HIV epidemic increased from 0% in 1981 peaking at 12.6% in 1992 and leveled to between 10.9% and 11.8% from 2003 to 2010. The rural epidemic peaked in 1995 at 7.0% and gradually declined to 5.2% in 2004, and then stabilized at between 5.1% and 5.3% from 2005 to 2010. New infections are projected to rise steadily, resulting in 250,000 new cases in 2010. Deaths due to AIDS started in 1985 and rose steadily to reach 120,000 deaths in 2010, with more females dying than men. The fact that the number of new infections is projected to increase steadily to reach 250,000 per year in 2010 calls for more concerted efforts to combat the spread of HIV infection particularly in the rural areas where the infrastructure needed for prevention programmes such as counseling and testing, condom accessibility and AIDS information is less developed. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | HIV INFECTIONS | PREVALENCE | AIDS | EXCESS MORTALITY | ANTENATAL CARE | CLINICS | GEOGRAPHIC FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Measurement | Mortality | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Facilities Document Number: 304171 |
| 27. Title: Patterns of mortality across 44 countries among men and women aged 15 -- 44 years. Author: White A; Holmes M Source: Journal of Men's Health and Gender. 2006 Jun;3(2):139-151. Abstract: This epidemiological study is the first to explore patterns of mortality in young men and women (aged 15-44 years) worldwide. Its purpose was to chart differing national/regional patterns to illuminate causal factors of death in young men. Data from the new World Health Organisation Statistical Information Services Mortality Database was analysed for patterns of premature death in men and women aged 15-44 years across 44 countries. Rates of death from all causes were compared between men and women and the number of deaths calculated as a proportion of total deaths for each country. The study focused on six potentially avoidable categories of death: Accidents and Adverse Effects, Suicide, Malignant Neoplasms, Diseases of the Circulatory System, Homicide and Injury Purposely Inflicted by Other Persons, and Chronic Liver Disease & Cirrhosis. Rates of death varied between countries and between men and women. The causes of death for both men and women differed markedly between the age groups 15-34 years and 35-44 years. Men's higher rates of deaths for Accidents and Adverse Effects persisted across all the age groups but deaths resulting from disease processes rose rapidly in the age group 35-44 years. Every country has an excess of male deaths due to potentially avoidable causes. The main causes of death are those that are more or less directly attributable to lifestyle and risk taking. More research is required but policy makers and health practitioners should already start to use the available data to develop better-targeted healthcare services for young men. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | EPIDEMIOLOGIC METHODS | MEN | HUMAN GEOGRAPHY | PREMATURE MORTALITY | CAUSES OF DEATH | HOMICIDE | SUICIDE | ACCIDENTS AND INJURIES | AGE FACTORS | CANCER | VASCULAR DISEASES | EXCESS MORTALITY | Comparative Studies | Studies | Research Methodology | Demographic Factors | Population | Geography | Social Sciences | Science | Sociocultural Factors | Mortality | Population Dynamics | Crime | Social Problems | Health | Population Characteristics | Neoplasms | Diseases Document Number: 321459 |
| 28. Title: Artesunate versus quinine for severe falciparum malaria [letter] Author: Woodrow CJ; Planche T; Krishna S Source: Lancet. 2006 Jan 14;367(9505):110-111. Abstract: The South East Asian Quinine Artesunate Malaria Trial represents the first clinical trial to show an improvement in mortality from severe malaria, a notable achievement that encourages further studies in sub-Saharan Africa. Interestingly, only 3% of patients receiving quinine were seen to become hypoglycaemic after entry. This low rate might represent prevention of hypoglycaemia by appropriate replenishment of glucose, but it is more likely to reflect underdiagnosis for several reasons. As suggested by the investigators, clinical signs of hypoglycaemia are often absent in severe malaria. In comparable studies (table), hypoglycaemia complicated about 25% of severe malaria cases after quinine, suggesting that in SEAQUAMAT quinine-induced hypoglycaemia might have remained undiagnosed and consequently untreated. Under-recognition of this complication could have disproportionately increased mortality in quinine recipients to a potentially significant level. Using predicted rates of postadmission hypoglycaemia of 25% and 10% for severe malaria patients receiving quinine and artesunate, respectively, we calculate that 116 and 45 cases of hypoglycaemia, respectively, could have been undiagnosed (an excess of 71 cases in the quinine group). (excerpt) Language: English Keywords: ASIA, SOUTHEASTERN | CLINICAL TRIALS | ADULTS | MALARIA | DRUGS | TOXICITY | EXCESS MORTALITY | TREATMENT | GLUCOSE METABOLISM EFFECTS | Developing Countries | Asia | Clinical Research | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Mortality | Population Dynamics | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 296386 |
| 29. Peer Reviewed Title: Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of Malawi. Author: Zachariah R; Fitzgerald M; Massaquoi M; Pasulani O; Arnould L Source: AIDS. 2006 Nov 28;20(18):2355-2360. Abstract: Among adults started on antiretroviral treatment (ART) in a rural district hospital (a) to determine the cumulative proportion of deaths that occur within 3 and 6 months of starting ART, and (b) to identify risk factors that may be associated with such mortality. A cross-sectional analytical study set in Thyolo district, Malawi. Over a 2-year period (April 2003 to April 2005) mortality within the first 3 and 6 months of starting ART was determined and risk factors were examined. Results: A total of 1507 individuals (517 men and 990 women), whose median age was 35 years were included in the study. There were a total of 190 (12.6%) deaths on ART of which 116 (61%) occurred within the first 3 months (very early mortality) and 150 (79%) during the first 6 months of initiating ART. Significant risk factors associated with such mortality included WHO stage IV disease, a baseline CD4 cell count under 50 cells/ml and increasing grades of malnutrition. A linear trend in mortality was observed with increasing grades of malnutrition (x/2 for trend = 96.1, P = 0.001) and decreasing CD4 cell counts (x/2 for trend = 72.4, P = 0.001). Individuals who were severely malnourished [body mass index (BMI) < 16.0 kg/m2] had a six times higher risk of dying in the first 3 months than those with a normal nutritional status. Among individuals starting ART, the BMI and clinical staging could be important screening tools for use to identify and target individuals who, despite ART, are still at a high risk of early death. (author's) Language: English Keywords: MALAWI | RURAL AREAS | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | EXCESS MORTALITY | RISK FACTORS | MALNUTRITION | BODY WEIGHT | IMMUNOLOGIC FACTORS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | HIV | Mortality | Population Dynamics | Demographic Factors | Biology | Nutrition Disorders | Physiology | Immunity | Immune System Document Number: 310427 |
| 30. Title: TB cases and deaths linked to HIV alarming in Africa. Source: SAfAIDS News. 2005 Jun;11(2):10-12. Abstract: The Global Tuberculosis Control Report for 2005 finds that global TB prevalence has declined by more than 20% since 1990 and that incidence rates are now falling or stable in five of the six regions of the world. The glaring exception is Africa, where TB incidence rates have tripled since 1990 in countries with high HIV prevalence and are still rising across the continent at a rate of 3-4% annually. In Africa, the case rate is 216 per 100 000. According to SA Health Info, a website focusing on health in southern Africa, the 11 countries of the Southern Africa sub-region contribute approximately 275 000 cases every year to the total caseload of TB in Africa. Almost half of these come from South Africa. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | PERSONS LIVING WITH HIV/AIDS | POPULATION AT RISK | TUBERCULOSIS | EXCESS MORTALITY | DRUG RESISTANCE | DIRECTLY OBSERVED THERAPY SHORT-COURSE (DOTS) | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Research Methodology | Infections | Mortality | Population Dynamics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 305166 |
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