1.  Peer Reviewed Title: Presentation and survival of patients with AIDS-related Kaposi's sarcoma in Jos, Nigeria. Author: Agaba PA; Sule HM; Ojoh RO; Hassan Z; Apena L; Mu'azu MA; Badung B; Agbaji OO; Idoko JA; Kanki P Source: International Journal of STD and AIDS. 2009 Jun;20(6):410-3. Abstract: AIDS-related Kaposi's sarcoma (AIDS-KS) remains a significant cause of morbidity and mortality. We describe the pattern of presentation and survival in Jos, Nigeria. We identified 48 HIV-positive patients with AIDS-KS and matched them for age and sex with an equal number of HIV-positive patients without AIDS-KS. We compared their clinical, immunological, virological characteristics and survival. They were similar in age and body mass index profile but patients with AIDS-KS had more tuberculosis co-infection (P, 0.02), lower median CD4 count (P, 0.003) and higher mortality (P, 0.002). Surprisingly, patients with AIDS-KS had lower levels of median viral load (29,347 copies/mL) compared with controls (80,533 copies/mL). We recommend specific AIDS-KS therapy in addition to highly active antiretroviral therapy in order to improve survival. Language: English Keywords: NIGERIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | AIDS | SIGNS AND SYMPTOMS | ANTIRETROVIRAL THERAPY | LIFE EXPECTANCY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | HIV | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 342440 |
| 2. Peer Reviewed Title: Expanding antiretroviral options in resource-limited settings--a cost-effectiveness analysis. Author: Bendavid E; Wood R; Katzenstein DA; Bayoumi AM; Owens DK Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):106-13. Abstract: BACKGROUND: Current World Health Organization (WHO) guidelines for treatment of HIV in resource-limited settings call for 2 antiretroviral regimens. The effectiveness and cost-effectiveness of increasing the number of antiretroviral regimens is unknown. METHODS: Using a simulation model, we compared the survival and costs of current WHO regimens with two 3-regimen strategies: an initial regimen of 3 nucleoside reverse transcriptase inhibitors followed by the WHO regimens and the WHO regimens followed by a regimen with a second-generation boosted protease inhibitor (2bPI). We evaluated monitoring with CD4 counts only and with both CD4 counts and viral load. We used cost and effectiveness data from Cape Town and tested all assumptions in sensitivity analyses. RESULTS: Over the lifetime of the cohort, 25.6% of individuals failed both WHO regimens by virologic criteria. However, when patients were monitored using CD4 counts alone, only 6.5% were prescribed additional highly active antiretroviral therapy due to missed and delayed detection of failure. The life expectancy gain for individuals who took a 2bPI was 6.7-8.9 months, depending on the monitoring strategy. When CD4 alone was available, adding a regimen with a 2bPI was associated with an incremental cost-effectiveness ratio of $2581 per year of life gained, and when viral load was available, the ratio was $6519 per year of life gained. Strategies with triple-nucleoside reverse transcriptase inhibitor regimens in initial therapy were dominated. Results were sensitive to the price of 2bPIs. CONCLUSIONS: About 1 in 4 individuals who start highly active antiretroviral therapy in sub-Saharan Africa will fail currently recommended regimens. At current prices, adding a regimen with a 2bPI is cost effective for South Africa and other middle-income countries by WHO standards. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | THEORETICAL MODELS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | ADMINISTRATION AND DOSAGE | COST EFFECTIVENESS | MONITORING | WHO | IMMUNOLOGICAL EFFECTS | LIFE EXPECTANCY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Evaluation Indexes | Quantitative Evaluation | Evaluation | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Immunity | Immune System | Physiology | Biology | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 342908 |
| 3. Peer Reviewed Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population. Author: Deboosere P; Gadeyne S; Oyen HV Source: European Journal of Population. 2008 May;25(2):175-196. Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level. Language: English Keywords: BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics Document Number: 340174 |
| 4. Title: Early motherhood, high mortality, and HIV/AIDS rates in Sub-Saharan Africa. Author: Gant L; Heath KM; Ejikeme GG Source: Social Work In Public Health. 2009 Jan-Apr;24(1-2):39-46. Abstract: Despite billions of dollars devoted to HIV/AIDS prevention since 1990, rates of infection continue to climb worldwide, primarily through heterosexual contact, and Sub-Saharan Africa is the worst case scenario (UNAIDS, 2004). Traditional intervention programs based on the ABCs (abstinence, being faithful, and condom use) of safe sex practices have shown mixed success. Engaging in risky sexual behavior (behaviors not adhering to the ABCs of safe sex practices) continues to escalate the HIV/AIDS epidemic. Although research abounds with correlates to HIV/AIDS rates, few studies have addressed the basis of sexual behavior. Here we show that not only are HIV/AIDS rates significantly higher in Sub-Saharan Africa than in the rest of the world but also infant mortality rates and teenage birth rates are higher as well. Based on these findings, we argue that engaging in risky sexual behavior, in many circumstances associated with deplorable living conditions and high mortality, is the only viable option for avoiding reproductive failure: dying without leaving surviving descendents. We suggest that initiatives that improve overall health and living conditions in the at-risk populations are necessary before traditional intervention programs can effectively combat the spread of HIV/AIDS in Sub-Saharan Africa. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | STATISTICAL STUDIES | HIV INFECTIONS | AIDS | PREVALENCE | MORTALITY | LIFE EXPECTANCY | INFANT MORTALITY | AGE SPECIFIC FERTILITY RATE | ADOLESCENT PREGNANCY | SEX BEHAVIOR | Africa | Developing Countries | Studies | Research Methodology | Viral Diseases | Diseases | Measurement | Population Dynamics | Demographic Factors | Population | Length of Life | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Reproductive Behavior | Behavior Document Number: 341955 |
| 5. Title: Evaluating the President's Emergency Plan for AIDS Relief: time to scale it up [editorial] Author: Gross R; Bisson G Source: Annals of Internal Medicine. 2009 May 19;150(10):727-8. Abstract: This editorial examines the President's Emergency Plan for AIDS Relief (PEPFAR) and measures the effects of the program by comparing trends in AIDS-related death rates and HIV prevalence rates. It also discusses PEPFAR's achievement of some of its goals but will have to meet a higher standard and document impact by gathering credible evidence in the future and note which aspects of the program are working and which are not. Language: English Keywords: UNITED STATES OF AMERICA | DEVELOPING COUNTRIES | SUMMARY REPORT | EVALUATION | AIDS PREVENTION | HIV PREVENTION | LIFE EXPECTANCY | GOVERNMENT PROGRAMS | PROGRAM EVALUATION | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | AIDS | HIV Infections | Viral Diseases | Diseases | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Programs | Organization and Administration Document Number: 341603 |
| 6. Peer Reviewed Title: Changing health status and health expectancies among older adults in China: gender differences from 1992 to 2002. Author: Gu D; Dupre ME; Warner DF; Zeng Y Source: Social Science and Medicine. 2009 Jun;68(12):2170-9. Abstract: Numerous studies document improvements in health status and health expectancies among older adults over time. However, most evidence is from developed nations and gender differences in health trends are often inconsistent. It remains unknown whether changes in health in developing countries resemble Western trends or whether patterns of health improvement are unique to the country's epidemiologic transition and gender norms. Using two nationally representative samples of non-institutionalized adults in China aged 65 years and older, this study investigates gender differences in the improvements in disability, chronic disease prevalence, and self-rated health from 1992 to 2002. Results from multivariate logistic regression models show that all three indicators of health improved over the 10-year period, with the largest improvement in self-rated health. With the exception of disability, the health of women improved more than men. Using Sullivan's decomposition methods, we also show that active life expectancy, disease-free life expectancy, and healthy life expectancy increased over this decade and were patterned differently according to gender. Overall, the findings demonstrate that China experienced broad health improvements during its early stages of the epidemiologic transition and that these changes were not uniform by gender. We discuss the public health implications of the findings in the context of China's rapidly aging population. Language: English Keywords: CHINA | RESEARCH REPORT | MULTIVARIATE ANALYSIS | ADULTS | GENDER ISSUES | LIFE EXPECTANCY | DISEASES | LIFE STYLE | QUALITY OF LIFE | DEMOGRAPHIC AGING | Asia, Eastern | Asia | Developing Countries | Data Analysis | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Length of Life | Mortality | Population Dynamics | Behavior | Social Welfare | Economic Factors Document Number: 342740 |
| 7. Title: Life expectancy and welfare in Latin America and the Caribbean. Author: Soares RR Source: Health Economics. 2009 Apr;18 Suppl 1:S37-54. Abstract: This paper analyses the recent evolution of life expectancy in Latin American and Caribbean countries, and evaluates how much it has contributed to the overall improvements in welfare. We argue that increases in life expectancy between 1960 and 2000, which were largely independent of income, represented gains in welfare comparable to the ones derived from income growth. For countries in the region, estimates of welfare improvements accounting for health increase the numbers obtained from income alone by 40% on average. The available evidence suggests that improvements in public health infrastructure - such as provision of treated water and sewerage services - and large-scale immunization programs may have been the key factors behind the mortality reductions observed in the period. Language: English Keywords: CARIBBEAN | LATIN AMERICA | CRITIQUE | LIFE EXPECTANCY | SOCIAL WELFARE | PUBLIC HEALTH | IMMUNIZATION | WATER QUALITY | SANITATION | INCOME | INEQUALITIES | MORTALITY DECLINE | Developing Countries | Americas | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Economic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Water | Natural Resources | Environment | Socioeconomic Factors Document Number: 341985 |
| 8. Title: When to start antiretroviral therapy in resource-limited settings. Author: Walensky RP; Wolf LL; Wood R; Fofana MO; Freedberg KA; Martinson NA; Paltiel AD; Anglaret X; Weinstein MC; Losina E Author: CEPAC (Cost-Effectiveness of Preventing AIDS Complications)-International Source: Annals of Internal Medicine. 2009 Aug 4;151(3):157-66. Abstract: BACKGROUND: The results of international clinical trials that are assessing when to initiate antiretroviral therapy (ART) will not be available for several years. OBJECTIVE: To inform HIV treatment decisions about the optimal CD4 threshold at which to initiate ART in South Africa while awaiting the results of these trials. DESIGN: Cost-effectiveness analysis by using a computer simulation model of HIV disease. DATA SOURCES: Published data from randomized trials and observational cohorts in South Africa. TARGET POPULATION: HIV-infected patients in South Africa. TIME HORIZON: 5-year and lifetime. PERSPECTIVE: Modified societal. INTERVENTION: No treatment, ART initiated at a CD4 count less than 0.250 x 10(9) cells/L, and ART initiated at a CD4 count less than 0.350 x 10(9) cells/L. OUTCOME MEASURES: Morbidity, mortality, life expectancy, medical costs, and cost-effectiveness. RESULTS OF BASE-CASE ANALYSIS: If 10% to 100% of HIV-infected patients are identified and linked to care, a CD4 count threshold for ART initiation of 0.350 x 10(9) cells/L would reduce severe opportunistic diseases by 22,000 to 221,000 and deaths by 25,000 to 253,000 during the next 5 years compared with ART initiation at 0.250 x 10(9) cells/L; cost increases would range from $142 million (10%) to $1.4 billion (100%). Either ART initiation strategy would increase long-term survival by at least 7.9 years, with a mean per-person life expectancy of 3.8 years with no ART and 12.5 years with an initiation threshold of 0.350 x 10(9) cells/L. Compared with an initiation threshold of 0.250 x 10(9) cells/L, a threshold of 0.350 x 10(9) cells/L has an incremental cost-effectiveness ratio of $1200 per year of life saved. RESULTS OF SENSITIVITY ANALYSIS: Initiating ART at a CD4 count less than 0.350 x 10(9) cells/L would remain cost-effective over the next 5 years even if the probability that the trial would demonstrate the superiority of earlier therapy is as low as 17%. LIMITATION: This model does not consider the possible benefits of initiating ART at a CD4 count greater than 0.350 x 10(9) cells/L or of reduced HIV transmission. CONCLUSION: Earlier initiation of ART in South Africa will probably reduce morbidity and mortality, improve long-term survival, and be cost-effective. While awaiting trial results, treatment guidelines should be liberalized to allow initiation at CD4 counts less than 0.350 x 10(9) cells/L, earlier than is currently recommended. PRIMARY FUNDING SOURCE: National Institute of Allergy and Infectious Diseases and the Doris Duke Charitable Foundation. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | COST BENEFIT ANALYSIS | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | LIFE EXPECTANCY | MORBIDITY | MORTALITY | TIME FACTORS | ANTIRETROVIRAL THERAPY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Quantitative Evaluation | Evaluation | Clinical Research | Research Methodology | Viral Diseases | Diseases | Length of Life | Population Dynamics | Demographic Factors | Population | HIV Document Number: 342686 |
| 9. Peer Reviewed Title: Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Author: Antiretroviral Therapy Cohort Collaboration Source: Lancet. 2008 Jul 26;372(9635):293-299. Abstract: Background: Combination antiretroviral therapy has led to significant increases in survival and quality of life, but at a population-level the effect on life expectancy is not well understood. Our objective was to compare changes in mortality and life expectancy among HIV-positive individuals on combination antiretroviral therapy. Methods: The Antiretroviral Therapy Cohort Collaboration is a multinational collaboration of HIV cohort studies in Europe and North America. Patients were included in this analysis if they were aged 16 years or over and antiretroviral-naive when initiating combination therapy. We constructed abridged life tables to estimate life expectancies for individuals on combination antiretroviral therapy in 1996-99, 2000-02, and 2003-05, and stratified by sex, baseline CD4 cell count, and history of injecting drug use. The average number of years remaining to be lived by those treated with combination antiretroviral therapy at 20 and 35 years of age was estimated. Potential years of life lost from 20 to 64 years of age and crude mortality rates were also calculated. Findings: 18 587, 13 914, and 10 854 eligible patients initiated combination antiretroviral therapy in 1996-99, 2000-02, and 2003-05, respectively. 2056 (4.7%) deaths were observed during the study period, with crude mortality rates decreasing from 16.3 deaths per 1000 person-years in 1996-99 to 10.0 deaths per 1000 person-years in 2003-05. Potential years of life lost per 1000 person-years also decreased over the same time, from 366 to 189 years. Life expectancy at age 20 years increased from 36.1 (SE 0.6) years to 49.4 (0.5) years. Women had higher life expectancies than did men. Patients with presumed transmission via injecting drug use had lower life expectancies than did those from other transmission groups (32.6 [1.1] years vs 44.7 [0.3] years in 2003-05). Life expectancy was lower in patients with lower baseline CD4 cell counts than in those with higher baseline counts (32.4 [1.1] years for CD4 cell counts below 100 cells per µL vs 50.4 [0.4] years for counts of 200 cells per µL or more). Interpretation: Life expectancy in HIV-infected patients treated with combination antiretroviral therapy increased between 1996 and 2005, although there is considerable variability between subgroups of patients. The average number of years remaining to be lived at age 20 years was about two-thirds of that in the general population in these countries. (author's) Language: English Keywords: EUROPE | NORTH AMERICA | RESEARCH REPORT | COHORT ANALYSIS | LIFE TABLE METHOD | PERSONS LIVING WITH HIV/AIDS | QUALITY OF LIFE | ANTIRETROVIRAL THERAPY | TREATMENT | LIFE EXPECTANCY | Developed Countries | Americas | Research Methodology | Demographic Analysis | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Social Welfare | Economic Factors | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 327889 |
10.  Title: Population and HIV / AIDS 2007. [Wallchart]. Author: United Nations. Department of Economic and Social Affairs. Population Division Source: New York, New York, United Nations, Department of Economic and Social Affairs, Population Division, 2008 Mar. [2] p. (ST/ESA/SER.A/270) Abstract: The AIDS epidemic remains one of the greatest challenges confronting the international community. In countries with a large number of people living with HIV, all population and development indicators are affected by the epidemic. Governments often cite HIV/AIDS as their most significant demographic concern. For more than two decades, the rapidly expanding HIV/AIDS epidemic has triggered a wide array of responses at the national, regional and global levels. The goals established by the United Nations General Assembly in the 2000 Millennium Declaration and through the adoption of the 2001 Declaration of Commitment on HIV/AIDS reflect widely-held concerns about the impact of the epidemic on development and human well-being. More recently, at the 2006 High Level Meeting on AIDS, Member States adopted a Political Declaration focusing on how to attain universal access to comprehensive HIV/AIDS prevention programs, treatment, care and support by 2010. (excerpt) Language: English Keywords: GLOBAL | TABLES AND CHARTS | UN | PERSONS LIVING WITH HIV/AIDS | HIV | AIDS | PREVALENCE | LIFE EXPECTANCY | GOVERNMENT PROGRAMS | CONDOM USE | ANTIRETROVIRAL THERAPY | MORTALITY | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Measurement | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Programs | Organization and Administration | Risk Reduction Behavior | Behavior Document Number: 326399 |
| 11. Title: Socio-demographic variables associated with AIDS epidemic: evidence from the Organization for Economic Cooperation and Development and the African countries. Author: Al-Asfahani AM; Girvan JT Source: African Journal of Food, Agriculture, Nutrition and Development. 2008 Sep;8(1):1-16. Abstract: The Human Immunodeficiency Virus (HIV) has been spreading rapidly worldwide for the past two decades, causing a variety of symptoms known as the Acquired Immune Deficiency Syndrome (AIDS), which has killed millions of people, and which looks likely to kill millions more. Generally, HIV infection rates are currently decreasing in several countries, but globally the number of people living with HIV/AIDS continues to rise both geographically and among specific demographic groups. For example, despite the remarkable efforts that are being made throughout Africa to avert the spread of HIV and reduce its impact, the HIV/AIDS pandemic in Africa continues to spread obstinately. Among the vexing issues related to the AIDS epidemic are the insufficient provisions of planners, policy makers and the public in general in curbing its devastating consequences to the health sector, households, schools, workplaces, economies and the quality of life as a whole. This paper presents information on the association between socio-demographic variables and AIDS prevalence in some African and the Organization for Economic Cooperation and Development (OECD) countries. The studied variables included size of population; population density; urbanization; average life expectancy; average female life expectancy; average male life expectancy; literacy; female and male literacy; population increase; infant mortality; average daily calorie intake; gross domestic product (GDP) per capita; religion; fertility rates; death rates; and AIDS-rate. Several parametric and nonparametric statistical techniques were adopted including Kruskal-Wallis, Mann-Whitney and Chi-square tests. Insignificant difference in the means of AIDS-rates between the OECD countries and the African group was found, but the difference was significant when the USA was excluded from the analysis. As initially expected, life expectancy in the OECD countries was significantly higher than that of the African group while the average rates of infant mortality, population growth, fertility, and death were significantly higher within the African group. Significant association between AIDS-rate and life expectancy was only found for African males, while association with fertility, infant mortality, population density, and calorie intakes was statistically insignificant. No clear difference between urban and rural areas with respect to AIDS-rates was discerned. Communities of Muslims were less subject to the AIDS problem. In conclusion, future studies should devote more attention toward impacts on HIV/AIDS prevalence of other equally important variables such as access to social and health care services, cultural norms, ethnic diversity, and educational facilities. Language: English Keywords: AFRICA | RESEARCH REPORT | MULTIVARIATE ANALYSIS | HIV INFECTIONS | HIV TRANSMISSION | POPULATION DENSITY | URBANIZATION | LIFE EXPECTANCY | LITERACY | INFANT MORTALITY | POPULATION DYNAMICS | QUALITY OF LIFE | RISK FACTORS | Developing Countries | Data Analysis | Research Methodology | Viral Diseases | Diseases | Population Distribution | Geographic Factors | Population | Urban Population Distribution | Length of Life | Mortality | Demographic Factors | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Social Welfare | Biology Document Number: 322509 |
| 12. Peer Reviewed Title: Income inequality and population health: Correlation and causality. Author: Babones SJ Source: Social Science and Medicine. 2008 Apr;66(7):1614-1626. Abstract: A large literature now exists on the cross-national correlation between income inequality and population health, but existing studies suffer from sparse data, poor operationalization of income inequality, and the use of low-power statistical models. This paper sets out to estimate the ecological correlation between income inequality and indicators of population health in a very broad panel of countries, to demonstrate that this relationship is largely non-artifactual, and to test whether this relationship might be causal. Gini coefficients of national income inequality in 1970 and 1995 are correlated with life expectancy, infant mortality rates, and murder rates, controlling for national income per capita. In cross-sectional analyses, inequality is significantly correlated with life expectancy, infant mortality, and (inconsistently) the murder rate. The health correlations are shown to be not primarily due to the "convexity effect" of the non-linear relationship between individual income and individual health, which seems to account for no more than one-third of the relationship between inequality and health, and likely much less. Change in inequality 1970-1995 is significantly related to change in life expectancy and infant mortality, suggesting a causal relationship, but these correlations are not robust with respect to sample or controls. It can be concluded that there is a strong, consistent, statistically significant, nonartifactual correlation between national income inequality and population health, but though there is some evidence that this relationship is causal, the relative stability of income inequality over time in most countries makes causality difficult to test. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | CORRELATION STUDIES | POPULATION | HEALTH | INEQUALITIES | INCOME DISTRIBUTION | LIFE EXPECTANCY | INFANT MORTALITY | Statistical Studies | Studies | Research Methodology | Socioeconomic Factors | Economic Factors | Income | Length of Life | Mortality | Population Dynamics | Demographic Factors Document Number: 324204 |
| 13. Peer Reviewed Title: An integrated approach to cause-of-death analysis: cause-deleted life tables and decompositions of life expectancy. Author: Beltran-Sanchez H; Preston SH; Canudas-Romo V Source: Demographic Research. 2008 Jul 25;19(35):1323-1350. Abstract: This article integrates two methods that analyze the implications of various causes of death for life expectancy. One of the methods attributes changes in life expectancy to various causes of death; the other method examines the effect of removing deaths from a particular cause on life expectancy. This integration is accomplished by new formulas that make clearer the interactions among causes of death in determining life expectancy. We apply our approach to changes in life expectancy in the United States between 1970 and 2000. We demonstrate, and explain analytically, the paradox that cancer is responsible for more years of life lost in 2000 than in 1970 despite the fact that declines in cancer mortality contributed to advances in life expectancy between 1970 and 2000. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | LIFE TABLE METHOD | CAUSES OF DEATH | LIFE EXPECTANCY | CANCER | DEATH RATE | MORTALITY | Developed Countries | North America | Americas | Research Methodology | Demographic Analysis | Population Dynamics | Demographic Factors | Population | Length of Life | Neoplasms | Diseases Document Number: 327870 |
| 14. Title: Cost-effectiveness of HIV monitoring strategies in resource-limited settings: a southern African analysis. Author: Bendavid E; Young SD; Katzenstein DA; Bayoumi AM; Sanders GD Source: Archives of Internal Medicine. 2008 Sep 22;168(17):1910-8. Abstract: BACKGROUND: Although the number of infected persons receiving highly active antiretroviral therapy (HAART) in low- and middle-income countries has increased dramatically, optimal disease management is not well defined. METHODS: We developed a model to compare the costs and benefits of 3 types of human immunodeficiency virus monitoring strategies: symptom-based strategies, CD4-based strategies, and CD4 counts plus viral load strategies for starting, switching, and stopping HAART. We used clinical and cost data from southern Africa and performed a cost-effectiveness analysis. All assumptions were tested in sensitivity analyses. RESULTS: Compared with the symptom-based approaches, monitoring CD4 counts every 6 months and starting treatment at a threshold of 200/muL was associated with a gain in life expectancy of 6.5 months (61.9 months vs 68.4 months) and a discounted lifetime cost savings of US $464 per person (US $4069 vs US $3605, discounted 2007 dollars). The CD4-based strategies in which treatment was started at the higher threshold of 350/microL provided an additional gain in life expectancy of 5.3 months at a cost-effectiveness of US $107 per life-year gained compared with a threshold of 200/microL. Monitoring viral load with CD4 was more expensive than monitoring CD4 counts alone, added 2.0 months of life, and had an incremental cost-effectiveness ratio of US $5414 per life-year gained relative to monitoring of CD4 counts. In sensitivity analyses, the cost savings from CD4 count monitoring compared with the symptom-based approaches was sensitive to cost of inpatient care, and the cost-effectiveness of viral load monitoring was influenced by the per test costs and rates of virologic failure. CONCLUSIONS: Use of CD4 monitoring and early initiation of HAART in southern Africa provides large health benefits relative to symptom-based approaches for HAART management. In southern African countries with relatively high costs of hospitalization, CD4 monitoring would likely reduce total health care expenditures. The cost-effectiveness of viral load monitoring depends on test prices and rates of virologic failure. Language: English Keywords: AFRICA, SOUTHERN | RESEARCH REPORT | COST BENEFIT ANALYSIS | COST EFFECTIVENESS | HIV | MONITORING | SIGNS AND SYMPTOMS | LIFE EXPECTANCY | PRICES | Africa, Sub Saharan | Africa | Developing Countries | Quantitative Evaluation | Evaluation | Evaluation Indexes | HIV Infections | Viral Diseases | Diseases | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Commerce | Macroeconomic Factors | Economic Factors Document Number: 328592 |
| 15. Peer Reviewed Title: The modal age at death and the shifting mortality hypothesis. Author: Canudas-Romo V Source: Demographic Research. 2008 Jul 8;19(30):1179-1204. Abstract: The modal age at death is used to study the shifting mortality scenario experienced by low mortality countries. The relations of the life table functions at the modal age are analyzed using mortality models. In the models the modal age increases over time, but there is an asymptotic approximation towards a constant number of deaths and standard deviation from the mode. The findings are compared to changes observed in populations with historical mortality data. As shown here the shifting mortality scenario is a process that might be expected if the current mortality changes maintain their pace. By focusing on the modal age at death, a new perspective on the analysis of human longevity is revealed. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LIFE TABLE METHOD | MORTALITY CHANGES | LIFE EXPECTANCY | Demographic Analysis | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Length of Life Document Number: 327676 |
| 16. Peer Reviewed Title: Perturbation analysis of nonlinear matrix population models. Author: Caswell H Source: Demographic Research. 2008 Mar;18(3):59-116. Abstract: Perturbation analysis examines the response of a model to changes in its parameters. It is commonly applied to population growth rates calculated from linear models, but there has been no general approach to the analysis of nonlinear models. Nonlinearities in demographic models may arise due to density-dependence, frequency-dependence (in 2-sex models), feedback through the environment or the economy, and recruitment subsidy due to immigration, or from the scaling inherent in calculations of proportional population structure. This paper uses matrix calculus to derive the sensitivity and elasticity of equilibria, cycles, ratios (e.g., dependency ratios), age averages and variances, temporal averages and variances, life expectancies, and population growth rates, for both age-classified and stage-classified models. Examples are presented, applying the results to both human and non-human populations. (author's) Language: English Keywords: MASSACHUSETTS | METHODOLOGICAL STUDIES | THEORETICAL STUDIES | MATHEMATICAL MODEL | DEMOGRAPHIC ANALYSIS | POPULATION | POPULATION THEORY | POPULATION GROWTH ESTIMATION | ENVIRONMENT | MACROECONOMIC FACTORS | AGE FACTORS | TIME FACTORS | LIFE EXPECTANCY | Developed Countries | United States of America | North America | Americas | Theoretical Models | Research Methodology | Demography | Social Sciences | Science | Sociocultural Factors | Estimation Techniques | Economic Factors | Population Characteristics | Demographic Factors | Population Dynamics | Length of Life | Mortality Document Number: 325250 |
| 17. Peer Reviewed Title: Constant global population with demographic heterogeneity. Author: Cohen JE Source: Demographic Research. 2008 May 27;18(14):409-436. Abstract: To understand better a possible future constant global population that is demographically heterogeneous, this paper analyzes several models. Classical theory of stationary populations generally fails to apply. However, if constant global population size P(global) is the sum of all country population sizes, and if constant global annual number of births B(global) is the sum of the annual number of births of all countries, and if constant global life expectancy at birth e(global) is the population-weighted mean of the life expectancy at birth of all countries, then B(global) e(global) always exceeds P(global) unless all countries have the same life expectancy at birth, in which case B(global) e(global) = P(global). (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | THEORETICAL MODELS | POPULATION STABILIZATION | POPULATION SIZE | POPULATION CHARACTERISTICS | INTERNATIONAL MIGRATION | LIFE EXPECTANCY | Research Methodology | Population Dynamics | Demographic Factors | Population | Migration | Length of Life | Mortality Document Number: 326903 |
| 18. Peer Reviewed Title: Preconception care: a clinical case of "think globally, act locally". Author: Curtis MG Source: American Journal of Obstetrics and Gynecology. 2008 Dec;199(6 Suppl 2):S257-8. Abstract: In 1900, the life expectancy for a woman in the United States was 48.3 years; by 2004, that life expectancy had risen to 80.4 years.1 Most of the increase is attributable to improvements in nutrition, sanitation, and other public health efforts that are focused at the population level; however, medical advances in secondary and tertiary prevention efforts that target individual patients also played a significant role. Despite evidence of the synergy between medicine and public health, the full integration of these disciplines has never been realized. This dichotomy has fostered the perception that medicine cares for individuals and that public health cares for populations. At the clinical level, health care practitioners often struggle with how to "translate" population-based risk data to the individual who is seated in front of them. To paraphrase the vernacular, "think global, act local" health care providers are grappling with the challenge to "think population, treat individual." The concept and practice of preconception care epitomizes the difficulty, and concurrent simplicity, of translating population- based primary prevention data to individual patient care. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | WOMEN | WOMEN'S HEALTH | LIFE EXPECTANCY | DIET | OBESITY | NUTRITION | DIABETES | PREGNANCY | REPRODUCTIVE HEALTH | TREATMENT | Developed Countries | North America | Americas | Demographic Factors | Population | Health | Length of Life | Mortality | Population Dynamics | Body Weight | Physiology | Biology | Diseases | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 329642 |
| 19. Peer Reviewed Title: Health and economic impact of HPV 16 and 18 vaccination and cervical cancer screening in India. Author: Diaz M; Kim JJ; Albero G; de Sanjose S; Clifford G Source: British Journal of Cancer. 2008 Jul 22;99(2):230-8. Abstract: Cervical cancer is a leading cause of cancer death among women in low-income countries, with approximately 25% of cases worldwide occurring in India. We estimated the potential health and economic impact of different cervical cancer prevention strategies. After empirically calibrating a cervical cancer model to country-specific epidemiologic data, we projected cancer incidence, life expectancy, and lifetime costs (I$2005), and calculated incremental cost-effectiveness ratios (I$/YLS) for the following strategies: pre-adolescent vaccination of girls before age 12, screening of women over age 30, and combined vaccination and screening. Screening differed by test (cytology, visual inspection, HPV DNA testing), number of clinical visits (1, 2 or 3), frequency (1 x , 2 x , 3 x per lifetime), and age range (35-45). Vaccine efficacy, coverage, and costs were varied in sensitivity analyses. Assuming 70% coverage, mean reduction in lifetime cancer risk was 44% (range, 28-57%) with HPV 16,18 vaccination alone, and 21-33% with screening three times per lifetime. Combining vaccination and screening three times per lifetime provided a mean reduction of 56% (vaccination plus 3-visit conventional cytology) to 63% (vaccination plus 2-visit HPV DNA testing). At a cost per vaccinated girl of I$10 (per dose cost of $2), pre-adolescent vaccination followed by screening three times per lifetime using either VIA or HPV DNA testing, would be considered cost-effective using the country's per capita gross domestic product (I$3452) as a threshold. In India, if high coverage of pre-adolescent girls with a low-cost HPV vaccine that provides long-term protection is achievable, vaccination followed by screening three times per lifetime is expected to reduce cancer deaths by half, and be cost-effective. Language: English Keywords: INDIA | RESEARCH REPORT | COST BENEFIT ANALYSIS | HPV | CERVICAL CANCER | VACCINES | SCREENING | PREVENTION AND CONTROL | LIFE EXPECTANCY | Developing Countries | Asia, Southern | Asia | Quantitative Evaluation | Evaluation | Viral Diseases | Diseases | Cancer | Neoplasms | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 328470 |
| 20. Title: A careful look at "A re-look at recent statistics on mortality in the context of HIV/AIDS with particular reference to South Africa". Author: Dorrington R; Moultrie TA Source: Current HIV Research. 2008 Jun;6(4):279-85. Abstract: An article recently published in this journal argues that the life expectancies (and other mortality statistics) produced by models of the HIV/AIDS epidemic in Southern Africa are inconsistent, and questions their reliability. To demonstrate the argument, the author of that paper derived empirical estimates of several mortality statistics from three different sources of data and, on the grounds that the estimates of life expectancy for 2001 and 2006 are somewhat higher than is typically estimated by projection models, concludes that the empirical evidence supports the theoretical view outlined in that paper. If correct, the reasoning (and its empirical demonstration) could be construed as a strong challenge to a dominant orthodoxy surrounding the estimation of mortality statistics in an era of HIV/AIDS and offering some comfort to governments with low Human Development Indices because of the index's dependence, inter alia, on estimates of life expectancy at birth derived from such models. This paper shows how, on theoretical, methodological and empirical grounds, the reasoning and estimates in the paper are severely flawed, and thus that the conclusions drawn in that paper are unjustified. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | ESTIMATION TECHNIQUES | RELIABILITY | INFANT MORTALITY | MORTALITY | HIV | LIFE EXPECTANCY | EVALUATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Measurement | Population Dynamics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Length of Life Document Number: 329836 |
| 21. Title: [Survival analysis of 530 HIV infected former unsafe commercial blood and plasma donors] Author: Dou ZH; Yu L; Zhao HX; Ma Y; Peng GP; Lu LX; Li ZH; Fu JH; Zhang FJ Source: Zhonghua Yu Fang Yi Xue Za Zhi / Chinese Journal of Preventive Medicine. 2008 Dec;42(12):879-83. Abstract: OBJECTIVE: To investigate HIV survival time and it's influencing factors among former commercial blood and plasma donors engaged in unsafe blood donation practices in China. METHODS: HIV/AIDS cases from 8 counties (districts) in 4 provinces confirmed prior to January 24, 2006 related with former commercial blood and plasma donors were selected and data regarding infection, AIDS progression, death, and influencing factors were retrospectively collected. RESULTS: In 530 cases of HIV infection, 334 (63.0%) cases had developed AIDS, 168 (50.3%) had received antiretroviral therapy (ART), and 152 (29.0%) had died. For the 530 cases, there was an average (10.1 +/- 1.8) years of observation from time of infection. Among 166 AIDS patients not receiving ART, average survival was 9.1 years (95% CI: 9.1 - 9.4), with an 8 year survival rate of 52.0%. Among 168 AIDS patients receiving ART, average survival was 12.1 years (95% CI: 11.9 - 12.3), with a 12-year survival rate of 80.0%. In 3 years of ART, average survival was longer in the treatment group as compared to the no treatment group with a hazard ratio for death of 12.2. Univariate analysis showed a significant difference (P < 0.05) in AIDS patient average survival based on gender, age, location, ART status, and baseline CD(4)(+) T cells count. Results from multivariate COX-regression showed that highly active ant iretroriral therapy (HAART) was the strongest protective factor for prolonging AIDS patients' survival (HR = 13.3, P = 0.00). CONCLUSION: Although there are many factors influencing AIDS patients survival, intervention with HAART is the principle measure to prolong survival and decrease the risk of death. Language: Chinese Keywords: CHINA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | BLOOD DONORS | AIDS | CAUSES OF DEATH | MORTALITY | ANTIRETROVIRAL THERAPY | LIFE EXPECTANCY | INTERVENTIONS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Viral Diseases | Diseases | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Demographic Factors | Population | HIV | Length of Life | Programs | Organization and Administration Document Number: 341964 |
| 22. Title: [Retrospective research on proportion of HIV related death causes in nine counties in China] Author: Gao X; Wang N; Wang L; Qin QQ; Wang LY; Li DM; Wang L; Wang YH; Ding GW; Ding ZW Source: Zhonghua Yu Fang Yi Xue Za Zhi / Chinese Journal of Preventive Medicine. 2008 Dec;42(12):884-7. Abstract: OBJECTIVE: To investigate the proportion of HIV related death cause, and its years of potential life lost (YPLL) and work years of potential life lose (WYPLL) in project counties. METHOD: According to the protocol of the third national death causes surveillance and HIV related death causes surveillance, retrospective study was implemented including baseline investigation of deaths' name list, demography information, door-to-door interview and death causes deduction in Gejiu, Ruili and Longchuan county in Yunnan province, Yangdong county in Guangdong province, Luzhai county in Guangxi zhuang Autonomous Region, Weishi and Zhecheng county in Henan province, Xishui county in Hubei province and Gu'an county in Hebei province. RESULTS: The study was conducted among nine counties located in seven provinces. A total of 118 719 cases were included, raw mortality was 5.83 per thousand, 2002 death cases were related to HIV, which contributed 1.67% of total deaths. The average age of HIV death was 38.03 yearsow, which was earlier than the non-HIV-related life-span (63.10 years). The YPLL and WYPLL of HIV death was 33.80 years and 20.50 years, respectively, which had contributed the second highest average YPLL. CONCLUSION: HIV has an important proportion among all death causes, and has contributed severe average YPLL and WYPLL. Language: Chinese Keywords: CHINA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | CAUSES OF DEATH | HIV INFECTIONS | AGE FACTORS | DEATH RATE | LIFE EXPECTANCY | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Viral Diseases | Diseases | Mortality | Population Dynamics | Demographic Factors | Population | Population Characteristics | Length of Life Document Number: 341963 |
| 23. Peer Reviewed Title: The impact of avoidable mortality on life expectancy at birth in Spain: changes between three periods, from 1987 to 2001. Author: Gispert R; Serra I; Bares MA; Puig X; Puigdefabregas A Source: Journal of Epidemiology and Community Health. 2008 Sep;62(9):783-789. Abstract: Objective: To evaluate the impact of avoidable mortality on the changes in life expectancy at birth in Spain. Methods: Standard life table techniques and the Arriaga method were used to calculate and to decompose life expectancy (LE) changes by age, effects and groups of causes of avoidable mortality among three periods (1987-91, 1992-6 and 1997-2001). A list of causes of avoidable mortality reached by consensus and previously published in Spain was used. Main results: Life expectancy increased in all ages and both sexes. The main contribution to the increase of LE at birth was due to people over 50. Mortality in young adults produced a reduction in LE between the first two periods, but there was an important increase in LE between the last two periods; in both cases, this was the result of factors amenable to health policy interventions. The highest improvement in LE was due to non-avoidable causes, but avoidable mortality through health service interventions showed improvements in LE in those younger than 1 year and in those aged 45-75 years. Conclusions: Making a distinction between several groups of causes of avoidable mortality and using decomposition by causes, ages and effects allowed us to better explain the impact of avoidable mortality on the LE of the whole population and gave a new dimension to this indicator that could be very useful in public health. Language: English Keywords: SPAIN | RESEARCH REPORT | LIFE TABLE METHOD | LIFE EXPECTANCY | MORTALITY | AGE FACTORS | CAUSES OF DEATH | DIFFERENTIAL MORTALITY | Europe, Southwestern | Europe | Developed Countries | Demographic Analysis | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Population Characteristics Document Number: 307983 |
| 24. Peer Reviewed Title: Fertility transition and population ageing in the Asian and Pacific region. Author: Gubhaju B Source: Asia Pacific Population Journal. 2008 Aug;23(2):55-80. Abstract: This paper provides a general overview of population ageing in the context of fertility transition in Asia and the Pacific. Focusing on low-fertility countries, it highlights the implications of low fertility for the ageing process. Indicators of population ageing, such as changes in age structure, potential support ratio and the feminization of the elderly population, are presented to provide a better understanding of the overall situation. As the region is home to over 60 per cent of the global population and has been experiencing a rapid decline in fertility, the absolute size of the older population is a cause for major concern. While the overall population growth rate has been declining over time, the number of older persons is increasing at a faster rate. In addition to the increase in the number of older persons, gender disparity in improvements in life expectancy at birth is likely to result in a much higher percent age of females in the older age groups, particularly in the age group 80 years and older. It is therefore important for countries in the region to recognize the significance of ageing problems and to start formulating policies for the elderly given that it takes several decades for Government old-age pension schemes to mature and to operate at full scale. Language: English Keywords: ASIA | OCEANIA | RESEARCH REPORT | OLDER ADULTS | DEMOGRAPHIC TRANSITION | AGE DISTRIBUTION CHANGES | FERTILITY DECLINE | DEMOGRAPHIC AGING | LIFE EXPECTANCY | Developing Countries | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Age Distribution | Fertility Changes | Fertility | Length of Life | Mortality Document Number: 331308 |
| 25. Title: Life expectancy and human capital investments: Evidence from maternal mortality declines. Author: Jayachandran S; Lleras-Muney A Source: Cambridge, Massachusetts, National Bureau of Economic Research, 2008 Apr. 51 p. (NBER Working Paper No. 13947) Abstract: Longer life expectancy should encourage human capital accumulation, since a longer time horizon increases the value of investments that pay out over time. Previous work has been unable to determine the empirical importance of this life-expectancy effect due to the difficulty of isolating it from other effects of health on education. We examine a sudden drop in maternal mortality risk in Sri Lanka between 1946 and 1953, which creates a sharp increase in life expectancy for school-age girls without contemporaneous effects on health, and which also allows for the use of boys as a control group. Using additional geographic variation, we find that the 70% reduction in maternal mortality risk over the sample period increased female life expectancy at age 15 by 4.1%, female literacy by 2.5%, and female years of education by 4.0%. (author's) Language: English Keywords: SRI LANKA | RESEARCH REPORT | THEORETICAL MODELS | VITAL STATISTICS | LIFE EXPECTANCY | MATERNAL MORTALITY | MORTALITY DECLINE | SEX FACTORS | LITERACY | EDUCATION | ECONOMIC FACTORS | INCOME | GEOGRAPHIC FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Statistics | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Population Characteristics | Educational Status | Socioeconomic Status | Socioeconomic Factors Document Number: 326614 |
| 26. Title: Determinants of life expectancy in developing countries. Author: Kabir M Source: Journal of Developing Areas. 2008 Spring;41(2):185-204. Abstract: The paper attempts to examine the socio-economic determinants of life expectancy for 91 developing countries using multiple regression and probit frameworks. Disaggregated probit regression has been applied for three groups of countries with low, medium and high life expectancy. Most of explanatory variables turned out to be statistically insignificant, which imply that relevant socio-economic factors like per capita income, education, health expenditure, access to safe water, and urbanization cannot always be considered to be influential in determining life expectancy in developing countries. Based on the analyses it has been suggested that the countries should formulate and implement appropriate social sector policies and programs to increase physicians' availability, and reduce adult illiteracy and undernourishment so as to improve their life expectancies. (author's) Language: English Keywords: BANGLADESH | DEVELOPING COUNTRIES | RESEARCH REPORT | STATISTICAL REGRESSION | LIFE EXPECTANCY | SOCIOECONOMIC FACTORS | Asia, Southern | Asia | Data Analysis | Research Methodology | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Economic Factors Document Number: 324196 |
| 27. Peer Reviewed Title: Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa. Author: Lawn SD; Harries AD; Anglaret X; Myer L; Wood R Source: AIDS. 2008 Oct 1;22(15):1897-908. Abstract: Two-thirds of the world's HIV-infected people live in sub-Saharan Africa, and more than 1.5 million of them die annually. As access to antiretroviral treatment has expanded within the region; early pessimism concerning the delivery of antiretroviral treatment using a large-scale public health approach has, at least in the short term, proved to be broadly unfounded. Immunological and virological responses to ART are similar to responses in patients treated in high-income countries. Despite this, however, early mortality rates in sub-Saharan Africa are very high; between 8 and 26% of patients die in the first year of antiretroviral treatment, with most deaths occurring in the first few months. Patients typically access antiretroviral treatment with advanced symptomatic disease, and mortality is strongly associated with baseline CD4 cell count less than 50 cells/mul and WHO stage 4 disease (AIDS). Although data are limited, leading causes of death appear to be tuberculosis, acute sepsis, cryptococcal meningitis, malignancy and wasting syndrome. Mortality rates are likely to depend not only on the care delivered by antiretroviral treatment programmes, but more fundamentally on how advanced disease is at programme enrollment and the quality of preceding healthcare. In addition to improving delivery of antiretroviral treatment and providing it free of charge to the patient, strategies to reduce mortality must include earlier diagnosis of HIV infection, strengthening of longitudinal HIV care and timely initiation of antiretroviral treatment. Health systems delays in antiretroviral treatment initiation must be minimized, especially in patients who present with advanced immunodeficiency. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | EVALUATION | PERSONS LIVING WITH HIV/AIDS | MORTALITY | LIFE EXPECTANCY | TIME FACTORS | AIDS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | IMMUNOLOGICAL EFFECTS | DEATH | DEATH RATE | TREATMENT | Africa | Developing Countries | Viral Diseases | Diseases | Population Dynamics | Demographic Factors | Population | Length of Life | HIV | Immunity | Immune System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329337 |
| 28. Title: An aging world - demographics and challenges [editorial] Author: Lunenfeld B Source: Gynecological Endocrinology. 2008 Jan;24(1):1-3. Abstract: The world has seen enormous changes over the past century, including historically unprecedented declines in mortality rates and increases in population, followed by equally unprecedented declines in fertility rates. This century will see a new set of demographic challenges, including a mix of falling fertility rates alongside persisting worldwide population growth, and the subsequent aging of populations in both developing and developed countries. The 20th century was the century of population growth; the 21st century will go into the history books as the century of aging. A holistic approach to this new challenge of the 21st century will necessitate a quantum leap in multidisciplinary and internationally coordinated research efforts, supported by a new partnership between industry and governments, philanthropic and international organizations. This collaboration we hope will enrich us with a better understanding of healthy aging, permit us to help to improve quality of life, prevent the preventable, and postpone and decrease the pain and suffering of the inevitable. (author's) Language: English Keywords: GLOBAL | CRITIQUE | INTERDISCIPLINARY STUDIES | OLDER ADULTS | POPULATION | DEMOGRAPHIC AGING | FERTILITY RATE | QUALITY OF LIFE | POPULATION PROJECTION | FERTILITY DECLINE | LIFE EXPECTANCY | ENVIRONMENTAL PROTECTION | LIFE STYLE | RISK REDUCTION BEHAVIOR | PREVENTIVE MEDICINE | Adults | Age Factors | Population Characteristics | Demographic Factors | Population Dynamics | Birth Rate | Fertility Measurements | Fertility | Social Welfare | Economic Factors | Estimation Techniques | Research Methodology | Fertility Changes | Length of Life | Mortality | Natural Resources | Environment | Behavior | Medicine | Health Services | Delivery of Health Care | Health Document Number: 324751 |
| 29. Title: The coming acceleration of global population ageing [letter] Author: Lutz W; Sanderson W; Scherbov S Source: Nature. 2008 Feb 7;451:716-719. Abstract: The future paths of population ageing result from specific combinations of declining fertility and increasing life expectancies in different parts of the world. Here we measure the speed of population ageing by using conventional measures and new ones that take changes in longevity into account for the world as a whole and for 13 major regions. We report on future levels of indicators of ageing and the speed at which they change. We show how these depend on whether changes in life expectancy are taken into account. We also show that the speed of ageing is likely to increase over the coming decades and to decelerate in most regions by midcentury. All our measures indicate a continuous ageing of the world's population throughout the century. The median age of the world's population increases from 26.6 years in 2000 to 37.3 years in 2050 and then to 45.6 years in 2100, when it is not adjusted for longevity increase. When increases in life expectancy are taken into account, the adjusted median age rises from 26.6 in 2000 to 31.1 in 2050 and only to 32.9 in 2100, slightly less than what it was in the China region in 2005. There are large differences in the regional patterns of ageing. In North America, the median age adjusted for life expectancy change falls throughout almost the entire century, whereas the conventional median age increases significantly. Our assessment of trends in ageing is based on new probabilistic population forecasts. The probability that growth in the world's population will end during this century is 88%, somewhat higher than previously assessed. After mid-century, lower rates of population growth are likely to coincide with slower rates of ageing. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | DEMOGRAPHIC AGING | FERTILITY DECLINE | LIFE EXPECTANCY | POPULATION FORECAST | POPULATION PROJECTION | MEASUREMENT | Population Dynamics | Demographic Factors | Population | Fertility Changes | Fertility | Length of Life | Mortality | Estimation Techniques | Research Methodology Document Number: 326160 |
| 30. Title: Maternal fish consumption in the nutrition transition of the Amazon Basin: growth of exclusively breastfed infants during the first 5 years. Author: Marques RC; Dorea JG; Bernardi JV; Bastos WR; Malm O Source: Annals of Human Biology. 2008 Jul-Aug;35(4):363-77. Abstract: BACKGROUND: Changes in fish-eating habits due to rapid urbanization in Western Amazon was used as model to investigate whether maternal fish-intake rate impacts on children's weight and height during the first 5 years. AIM: The study examined the growth of 82 breastfed children, and maternal fish consumption (hair mercury concentrations, HHg) during pregnancy and lactation. SUBJECTS AND METHODS: Fish consumption in mothers and children was estimated through HHg. The children were measured and weighed at birth and at 6 (exclusive breastfeeding), 36 and 60 months. RESULTS: Fish consumption rate (HHg) had no significant impact on children's growth at the specified ages (p = 0.35). After 6 months of exclusive breastfeeding, children had the highest proportion of Z-scores <-1 SD; however, weaning (with extended breastfeeding) had a substantial impact in moving up the attained growth at 3 years. The duration of breastfeeding was significantly correlated with attained Z-scores for weight-for-age (r = 0.26; p = 0.02) and weight-for-height (r = 0.22; p = 0.04) but not for height-for-age. At 3 years most children had improved Z-scores (>-1 SD) for height-for-age (70/82), weight-for-age (74/82) and weight-for-height (74/82). At 5 years, all but one child attained Z-scores >-1. CONCLUSION: The apparently good nutritional status of subjects is more likely due to a well balanced diet composition than to only one dietary protein source--fish. Language: English Keywords: INDIA | RESEARCH REPORT | EVALUATION | COST BENEFIT ANALYSIS | ADOLESCENTS, FEMALE | HPV | CERVICAL CANCER | SCREENING | PREVENTION AND CONTROL | VACCINES | ECONOMIC FACTORS | LIFE EXPECTANCY | Developing Countries | Asia, Southern | Asia | Quantitative Evaluation | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Cancer | Neoplasms | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Length of Life | Mortality | Population Dynamics Document Number: 328398 |
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