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Title: Male circumcision: a cancer prevention strategy?
Source: Lancet Oncology. 2009 May;10(5):431.
Abstract: Given that less than 20% of males are circumcised in many developing countries, and that male circumcision is relatively simple and reduces viral infection, might this practice be more widely used as a preventive measure against cancer? In developing countries, male circumcision could have a vital role in specific segments of the population depending on the answers to specific scientific and infrasturcture related questions. Discussions around male circumcision strategies should be encouraged within the context of cancer prevention, and these should include local communities alongside assessments of current capacities, measurable targets, cost analyses and modelling, and the development of practicable guidelines, so as to place male circumcision within the possible options available for disease prevention.
Language: English
Keywords:
UGANDA | SUMMARY REPORT | PREVALENCE | MEN | MALE CIRCUMCISION | CANCER | PREVENTION AND CONTROL | HIV PREVENTION | STANDARDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Neoplasms | Diseases | HIV Infections | Viral Diseases
Document Number: 341199

3.
Title: HIV Infection--Guangdong Province, China, 1997-2007.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Apr 24;58(15):396-400.
Abstract: In 2007, an estimated 700,000 persons in China were living with human immunodeficiency virus (HIV) infection. An estimated 50,000 new HIV infections and 20,000 deaths related to acquired immunodeficiency syndrome (AIDS) occurred in 2007, and an estimated 71% of persons with HIV infection were unaware of their HIV status. In 2007, 40.6% of those living with HIV had been infected through heterosexual transmission and 38.1% through injection-drug use. Guangdong Province in southeastern China is the country's most populous province, with an estimated 75.6 million permanent residents and 16.5 million migrants; the province has undergone rapid economic development. Since 1986, a case-based surveillance system (CBSS) in China has collected data on persons infected with HIV, including demographic characteristics and transmission categories. To assess recent trends in HIV infection in the province, the Guangdong Center for Disease Control, with technical assistance from CDC, analyzed CBSS data for the period 1997--2007. The results of that analysis indicated that the number of HIV cases increased from 102 in 1997 to 4,593 in 2007, although this increase resulted, in part, from expanded testing and surveillance. Among males classified by HIV transmission category, 82.1% of newly diagnosed infections were attributed to injection-drug use. Among females classified by HIV transmission category, 53.7% engaged in high-risk heterosexual conduct. Despite substantial methodologic limitations, these results can be useful to Guangdong public health agencies in targeting and evaluating HIV prevention, care, and treatment programs.
Language: English
Keywords:
CHINA | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | PREVALENCE | HIV INFECTIONS | SEX FACTORS | RISK BEHAVIOR | SEX BEHAVIOR | INTERNET | AGE FACTORS | HUMAN GEOGRAPHY | Asia, Eastern | Asia | Developing Countries | Geographic Factors | Population | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Measurement | Population Characteristics | Demographic Factors | Information Networks | Communication | Geography | Social Sciences | Science | Sociocultural Factors
Document Number: 331260

4.
Title: Impact of new WHO growth standards on the prevalence of acute malnutrition and operations of feeding programs - Darfur, Sudan, 2005-2007.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 5;58(21):591-4.
Abstract: Acute malnutrition among children aged 6-59 months is a key indicator routinely used for describing the presence and magnitude of humanitarian emergencies. In the past, the prevalence of acute malnutrition and admissions to feeding programs has been determined using the growth reference developed by the World Health Organization (WHO), CDC, and the National Center for Health Statistics (NCHS). In 2006, WHO released new international growth standards and recommended their use in all nutrition programs. To evaluate the impact of transitioning to the new standards, CDC analyzed anthropometric data for children aged 6-59 months from Darfur, Sudan, collected during 2005-2007. This report describes the results of that analysis, which indicated that use of the new standards would have increased the prevalence of global acute malnutrition on average by 14% and would have increased the prevalence of severe acute malnutrition on average by 100%. Admissions to feeding programs would have increased by 56% for moderately malnourished children and by 260% for severely malnourished children. For programs in Darfur, this would have resulted in approximately 23,200 more children eligible for therapeutic feeding programs. For the immediate future, the prevalence of acute malnutrition in children should be reported using both the old WHO/CDC/NCHS reference and the new WHO standards. More research is needed to better ascertain the validity of the admission criteria based on the new WHO standards in predicting malnutrition-related morbidity and mortality.
Language: English
Keywords:
SUDAN | SUMMARY REPORT | WHO | STANDARDS | PREVALENCE | CHILD DEVELOPMENT | GROWTH | MALNUTRITION | NUTRITION PROGRAMS | EVALUATION | Developing Countries | Africa, North | Africa | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Measurement | Biology | Nutrition Disorders | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health
Document Number: 341622

Title: [Global Burden of Diseases, Injuries and Risk Factors Study] operations manual. Final draft.
Author: Harvard University; University of Washington. Institute for Health Metrics and Evaluation; Johns Hopkins University; University of Queensland; World Health Organization [WHO]
Source: [Cambridge, Massachusetts, Harvard University, 2009 Jan 20 142 p.
Abstract: The final draft of the Global Burden of Diseases, Injuries and Risk Factors Study Operations Manual is intended to serve as a guide for the Expert Groups working on the GBD Study. There are opportunities to provide input and feedback, and instructions to do so are included in the operations manual. The new Global Burden of Diseases, Injuries, and Risk Factors Study (the GBD 2005 Study), which commenced in the spring of 2007, is led by a consortium including Harvard University, the Institute for Health Metrics and Evaluation at the University of Washington, Johns Hopkins University, the University of Queensland, and the World Health Organization WHO). It is the first major effort since the GBD 1990 Study to carry out a complete systematic assessment of the data on all diseases and injuries, and produce comprehensive and comparable estimates of the burden of diseases, injuries and risk factors for two time periods, 1990 and 2005. By November 2010 the project will produce a final set of estimates. (Excerpts)
Language: English
Keywords:
GLOBAL | MANUAL | DATA ANALYSIS | ESTIMATION TECHNIQUES | DISABLED PERSONS AND DISABILITIES | DISEASES | ACCIDENTS AND INJURIES | MORTALITY | RISK FACTORS | EPIDEMIOLOGY | INCIDENCE | PREVALENCE | RISK ASSESSMENT | BIAS | Research Methodology | Population Characteristics | Demographic Factors | Population | Health | Population Dynamics | Public Health | Measurement | Evaluation | Error Sources
Document Number: 331797

Title: Cesarean section deliveries in the occupied Palestinian territory (oPt): An analysis of the 2006 Palestinian Family Health Survey.
Author: Abdul-Rahim HF; Abu-Rmeileh NM; Wick L
Source: Health Policy. 2009 Aug 10;
Abstract: OBJECTIVE: Against the backdrop of a rise in cesarean section deliveries from 6.0% in 1996 to 14.8% in 2006, the objective of this study was to investigate socio-demographic, clinical and service-related factors associated with cesarean sections in the occupied Palestinian territory. METHODS: Data from the Palestinian Family Health Survey 2006 were used to examine last births in the 5 years preceding the survey to women aged 15-49 years. Bivariate and multivariate associations between type of delivery (dependent variable) and selected factors were analyzed using logistic regression. Selected maternal outcomes were also investigated with type of delivery as the independent variable. RESULTS: Cesarean section deliveries were significantly associated with maternal age (35+ years), primiparity, low birth weight and residence area in the West Bank and Gaza. There was no significant difference in the prevalence of cesarean deliveries by sector in the West Bank, but in Gaza, they were significantly more common in the governmental sector. CONCLUSIONS: There is a need for detailed audits of cesarean section deliveries, nationally and at the facility level, in order to avoid unnecessary interventions in the context of high fertility, rising poverty and fragmented health services. Variations by governorate should be studied further for focused interventions.
Language: English
Keywords:
MIDDLE EAST | DEVELOPING COUNTRIES | PREVALENCE | HEALTH SURVEYS | WOMEN | CESAREAN SECTION | HEALTH SERVICES | DELIVERY OF HEALTH CARE | Measurement | Research Methodology | Health | Demographic Factors | Population | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine
Document Number: 342538

10.

Peer Reviewed

Title: Intended postpartum contraceptive use among pregnant and puerperal women at a university teaching hospital.
Author: Adegbola O; Okunowo A
Source: Archives of Gynecology and Obstetrics. 2009 Mar 26;
Abstract: OBJECTIVE: To assess the intention to use postpartum contraceptives and factors influencing use. METHOD: A total of 423 consecutive consenting women attending the pregnancy and puerperal clinics at a university teaching hospital were interviewed using structured questionnaire. RESULTS: The prevalence of previous contraceptive use was 35.5%. Fifty-four percent of the respondents intended to use contraceptives after delivery, though 3% were yet to decide. Condoms (38.3%) followed by intrauterine contraceptive device (IUCD) 11.5%, were the most preferred choice of postpartum contraceptives. However, spermicide (0.4%) was the least preferred. Advanced age and high parity significantly predicted intention to use postpartum contraceptives (P = 0.02 and 0.01, respectively). Also high level of respondent's education and family planning counseling by doctors and nurses increased the intention to use postpartum contraceptives (P = 0.03 and 0.01, respectively). CONCLUSION: Family planning counseling and education play a vital role in increasing the use of contraceptives in the postpartum period.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | PREVALENCE | POSTPARTUM WOMEN | PREGNANT WOMEN | CONTRACEPTIVE USAGE | FAMILY PLANNING | ATTITUDES | Measurement | Research Methodology | Puerperium | Reproduction | Population Characteristics | Demographic Factors | Population | Contraception | Psychological Factors | Behavior
Document Number: 330850

11.

Peer Reviewed

Title: Premarital sexual behavior among male college students of Kathmandu, Nepal.
Author: Adhikari R; Tamang J
Source: BMC Public Health. 2009 Jul;9(241):1-9.
Abstract: A cross-sectional survey of male college students in Kathmandu was conducted between April and May 2006. A self-administered questionnaire was completed by 573 male students. Association between premarital sex and the explanatory variables was assessed. Despite the religious and cultural restrictions, about two-fifths of survey respondents (39%) reported that they had had premarital sex. The study also showed that substantial proportions of students indulge in sexual activities as well as risky sexual behavior. Sex with commercial sex workers and multiple sex partners, and inconsistent use of condoms with non-regular partners were common among the students. Less than two in five male students (57%) had used condoms at first sexual intercourse. Students aged 20 and above were more likely to have had premarital sex compared with younger students ages 15-19. Students who believe in Hindu religion were more than two times more likely to have premarital sex compared with those who follow other religions. Participants who had close unmarried friends who experienced premarital sexual intercourse were eight times more likely to be sexually active than those who did not have such sexually active friends. School- or college-based sexuality education could benefit out-of-school youths as well, because their partners often are students.
Language: English
Keywords:
NEPAL | RESEARCH REPORT | STUDENTS | MEN | PREMARITAL SEX BEHAVIOR | CONDOM USE | PREVALENCE | ATTITUDES | RELIGIOUS ASPECTS | AGE FACTORS | SEX EDUCATION | Developing Countries | Asia, Southern | Asia | Education | Demographic Factors | Population | Sex Behavior | Behavior | Risk Reduction Behavior | Measurement | Research Methodology | Psychological Factors | Religion | Sociocultural Factors | Population Characteristics
Document Number: 339893

12.
Title: Evaluation of transmitted HIV drug resistance among recently-infected antenatal clinic attendees in four Central African countries.
Author: Aghokeng AF; Vergne L; Mpoudi-Ngole E; Mbangue M; Deoudje N; Mokondji E; Nambei WS; Peyou-Ndi MM; Moka JJ; Delaporte E; Peeters M
Source: Antiviral therapy. 2009;14(3):401-11.
Abstract: BACKGROUND: The rapid expansion of antiretroviral treatment in resource-limited settings is raising concerns regarding the emergence and transmission of HIV drug resistance (HIVDR). We evaluated the extent of transmission of drug-resistant HIV strains in four Central African countries: the Republic of Congo, Central African Republic, Chad and Cameroon. METHODS: The World Health Organization (WHO) HIVDR threshold survey was implemented in major treatment areas in each country. Pregnant women who were aged <25 years, who were at first pregnancy and who were HIV type-1-positive were enrolled at each site in 2006-2007 for genotyping. HIVDR prevalence was categorized using the WHO threshold survey binomial sequential sampling method. RESULTS: The prevalence of HIVDR in Brazzaville and Bangui sites could not be classified because the eligible sample number was not reached. HIVDR prevalence was low (<5%) in N'Djamena for all drug classes. In Yaounde, we found one individual with the D67D/N mutation and two with K103N. HIVDR prevalence was categorized as low (<5%) for protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs), and moderate (> or =5-< or =15%) for non-NRTIs (NNRTIs). HIVDR prevalence in Douala was low for PIs and NNRTIs, and moderate for NRTIs as we identified one individual with M184V plus K101E plus G190A mutations and a second with D67D/N. CONCLUSIONS: The moderate HIVDR prevalence found in Yaounde and Douala indicate that efforts should be made in Cameroon to prevent HIVDR; however, additional surveys are needed to confirm this trend. This study highlighted challenges presented by the WHO methodology, such as additional costs, workload, difficulties in acquiring even small sample numbers and the necessity for better quality assurance of HIV testing and record keeping at antenatal clinics.
Language: English
Keywords:
CAMEROON | CENTRAL AFRICAN REPUBLIC | CHAD | REPUBLIC OF THE CONGO | RESEARCH REPORT | SAMPLING STUDIES | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | PREVALENCE | ANTENATAL CARE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Africa, Central | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care
Document Number: 342346

13.

Title: Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India.
Author: Ahmad A; Khan AU
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2009 May;144(1):68-71.
Abstract: OBJECTIVES: The objectives were to determine the frequency of Candida species in women of different age groups as well as to suggest the criteria for the diagnosis of vulvovaginal candidiasis (VVC). STUDY DESIGN: A prospective study of vulvovaginal candidiasis was carried out using laboratory diagnosis, with the estimation of vaginal pH and the direct microscopic and biochemical examination of vaginal discharge/secretions. Vaginal cultures for Candida species were collected from 1050 women with vulvovaginal symptoms. RESULTS: Out of 1050 women, 215 (20.47%) were positive for Candida species. Of 215 women, 172 (80%) had pH within the normal range and 167 (77.67%) were showing yeast cells and mycelia on direct microscopic examination. Candida albicans accounted for 46.9% of cases, Candida glabrata 36.7%, Candida parapsilosis 10.2%, Candida tropicalis 2.8%, Candida krusei 1.4%, and Candida kiefer 1.9%. The frequency of culture positivity was related to pregnancy (P<0.001), an increase in parity (P<0.001), and use of oral contraceptives (P<0.001) and antibiotics (P<0.001). The most common signs and symptoms in 215 women with positive cultures were pruritus with or without vaginal discharge and vaginal erythema. CONCLUSION: Our study suggests that vulvovaginal candidiasis can only be diagnosed by using clinical criteria in correlation with vulvovaginal symptoms and Candida cultures.
Language: English
Keywords:
INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | CANDIDIASIS | RISK FACTORS | PREVALENCE | LABORATORY EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | PRURITUS | VAGINITIS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Bacterial and Fungal Diseases | Infections | Diseases | Health | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Dermatitis | Vaginal Abnormalities
Document Number: 342002

14.

Title: Breastfeeding and obesity among Kuwaiti preschool children.
Author: Al-Qaoud N; Prakash P
Source: Medical Principles and Practice. 2009;18(2):111-7.
Abstract: OBJECTIVES: To determine if breastfeeding and its duration are associated with a reduced risk of obesity among Kuwaiti preschool children. SUBJECTS AND METHODS: The sample consisted of 2,291 (1,092 males and 1,199 females) preschool children (3-6 years of age) and their mothers. The data were collected from September 2003 to June 2004. Height and weight measurements were used for defining weight status while other data were collected by questionnaire. RESULTS: There was no significant association of breastfeeding or its duration with either overweight or obesity among preschool children after adjusting for effects of the confounders. The child's gender, age and birth weight were the significant factors influencing current weight. Girls were at 32% higher risk of becoming obese than boys. Children aged 4-5 years were at nearly 3 times higher risk of overweight and obesity than children of less than 4 years. Children with higher birth weight (>or=4 kg) had double the risk of obesity than those of normal birth weight (>or=2.5 to <4.0 kg). Maternal obesity was a strong predictor of obesity in the children. A child with an obese mother had nearly 2 times higher risk of being overweight (BMI between the 85th the 95th percentiles) and 3 times of being obese (BMI >or=95th percentile) compared to a child born to a mother with a normal body weight. CONCLUSION: Breastfeeding and its duration are not associated with obesity status. However, there is a positive association between child and maternal obesity.
Language: English
Keywords:
KUWAIT | RESEARCH REPORT | PREVALENCE | CHILDREN | BREASTFEEDING | OBESITY | BODY WEIGHT | CHILD HEALTH | Middle East | Developed Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Physiology | Biology
Document Number: 341031

15.

Title: Prevention of low birthweight.
Author: Alam DS
Source: Nestle Nutrition Workshop Series. Paediatric Programme. 2009;63:209-21; discussion 221-5, 259-68.
Abstract: Globally an estimated 20 million infants are born with low birthweight (LBW), of those over 18 million are born in developing countries. These LBW infants are at a disproportionately higher risk of mortality, morbidity, poor growth, impaired psychomotor and cognitive development as immediate outcomes, and are also disadvantaged as adults due to their greater susceptibility to type 2 diabetes, hypertension and coronary heart disease. Maternal malnutrition prior to and during pregnancy manifested by low bodyweight, short stature, inadequate energy intake during pregnancy and coexisting micronutrient deficiency are considered major determinants in developing countries where the burden is too high. LBW is a multifactorial outcome and its prevention requires a lifecycle approach and interventions must be continued for several generations. So far, most interventions are targeted during pregnancy primarily due to the increased nutritional demand and aggravations of already existing inadequacy in most women. Several individually successful interventions during pregnancy include balanced protein energy supplementation, several single micro-nutrients or more recently a mix of multiple micronutrients. Nutrition education has been successful in increasing the dietary intake of pregnant women but has had no effect on LBW. The challenge is to identify a community-specific intervention package. Current evidence supports intervention during pregnancy with increased dietary intakes including promotions of foods rich in micronutrients and micronutrient supplementation, preferably with a multiple micronutrient mix. Simultaneously a culturally appropriate educational component is required to address misconceptions about diet during pregnancy and childbirth including support for healthy pregnancy with promotion of antenatal and perinatal care services. While further research is needed to identify more efficacious interventions, an urgent public health priority would be to select and implement an optimal mix of interventions to avert the immediate adverse consequences of LBW and to prevent the impending epidemic of type 2 diabetes, hypertension and coronary heart disease which are negatively associated with LBW.
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | LOW BIRTH WEIGHT | PREVALENCE | INTERVENTIONS | INTRAUTERINE GROWTH RETARDATION | MATERNAL NUTRITION | FOOD SUPPLEMENTATION | VITAMINS AND MINERALS | DIET | Birth Weight | Body Weight | Physiology | Biology | Measurement | Research Methodology | Programs | Organization and Administration | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Nutrition | Health | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341347

16.

Peer Reviewed

Title: Diarrhoeagenic Escherichia coli are not a significant cause of diarrhoea in hospitalised children in Kuwait.
Author: Albert MJ; Rotimi VO; Dhar R; Silpikurian S; Pacsa AS; Molla AM; Szucs G
Source: BMC Microbiology. 2009;9:62.
Abstract: BACKGROUND: The importance of diarrhoeagenic Escherichia coli (DEC) infections in the Arabian Gulf including Kuwait is not known. The prevalence of DEC (enterotoxigenic [ETEC], enteropathogenic [EPEC], enteroinvasive [EIEC], enterohemorrhagic [EHEC] and enteroaggregative [EAEC]) was studied in 537 children < or = 5 years old hospitalised with acute diarrhoea and 113 matched controls from two hospitals during 2005-07 by PCR assays using E. coli colony pools. RESULTS: The prevalence of DEC varied from 0.75% for EHEC to 8.4% for EPEC (mostly atypical variety) in diarrhoeal children with no significant differences compared to that in control children (P values 0.15 to 1.00). Twenty-seven EPEC isolates studied mostly belonged to non-traditional serotypes and possessed beta and theta intimin subtypes. A total of 54 DEC isolates from diarrhoeal children and 4 from controls studied for antimicrobial susceptibility showed resistance for older antimicrobials, ampicillin (0 to 100%), tetracycline (33 to 100%) and trimethoprim (22.2 to 100%); 43.1% of the isolates were multidrug-resistant (resistant to 3 or more agents). Six (10.4%) DEC isolates produced extended spectrum beta-lactamases and possessed genetic elements (blaCTX-M, blaTEM and ISEcp1) associated with them. CONCLUSION: We speculate that the lack of significant association of DEC with diarrhoea in children in Kuwait compared to countries surrounding the Arabian Gulf Region may be attributable to high environmental and food hygiene due to high disposable income in Kuwait.
Language: English
Keywords:
KUWAIT | RESEARCH REPORT | CONTROL GROUPS | CHILDREN | BACTERIAL AND FUNGAL DISEASES | DIARRHEA | DIARRHEA, INFANTILE | PREVALENCE | ANTIBIOTICS | DRUG RESISTANCE | Middle East | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Measurement | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341689

17.
Title: High prevalence of HIV infection among injection drug users (IDUs) in Hyderabad and Sukkur, Pakistan.
Author: Altaf A; Saleem N; Abbas S; Muzaffar R
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Mar;59(3):136-40.
Abstract: OBJECTIVE: To estimate size of injection drug users (IDU), determine their high risk behaviours and assess the prevalence of HIV. METHOD: As part of second generation surveillance (SGS), we investigated specific demographic and behavioural characteristics of IDUs in Hyderabad and Sukkur in 2005. It was a cross sectional study. The survey was preceded by geographic mapping to determine size estimation and to define sampling procedures prior to integrated behavioural and biological survey (IBBS). A sample size of at least 400 was calculated for each city. Besides calculating frequencies, chi square was used for comparing variables among HIV positive and negative IDUs like time elapsed as IDU, number of injections, sharing needles and self perception of acquiring HIV infection. RESULTS: A total of 800 (Hyderabad 398; Sukkur 402) questionnaires and DBS samples were collected. The estimated number of IDUs in both cities was 3,225 (Hyderabad 975 and Sukkur 2250 respectively). Average age of IDUs in Hyderabad was 36.5 years and 34.6 years in Sukkur. Sharing of injection equipment for last injection was reported by 34 (8.5%) in Hyderabad and 135 (33.6%) in Sukkur. In both cities behaviours such as injecting drugs for more than 10 years (p = 0.00) and injecting four or more times in a day (p = 0.11) were significantly associated with seropositivity of HIV infection. In Hyderabad the seroprevalence of HIV was 25.4% (101/398) and in Sukkur it was 19.2% (77/402). CONCLUSION: The burden of HIV among IDUs in Hyderabad and Sukkur is extremely high and can play a significant role in transmitting the infection to other vulnerable groups.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | IV DRUG USERS | URBAN POPULATION | PREVALENCE | HIV INFECTIONS | RISK BEHAVIOR | HUMAN GEOGRAPHY | NEEDLE SHARING | SELF-PERCEPTION | RISK ASSESSMENT | DEMOGRAPHIC FACTORS | Developing Countries | Asia, Southern | Asia | Research Methodology | Viral Diseases | Diseases | Drug Use and Abuse | Behavior | Population Characteristics | Population | Measurement | Geography | Social Sciences | Science | Sociocultural Factors | Perception | Psychological Factors | Evaluation
Document Number: 330915

18.

Peer Reviewed

Title: HIV prevalence and associated risk factors among individuals aged 13-34 years in rural western Kenya.
Author: Amornkul PN; Vandenhoudt H; Nasokho P; Odhiambo F; Mwaengo D
Source: Plos One. 2009 Jul;4(7):e6470.
Abstract: From a demographic surveillance system, the authors selected a random sample of Asembo, Kenya residents ages 13�34 years, who were contacted at home and invited to a nearby mobile study site. From October 2003 to April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. Of 2,606 eligible residents, 1,822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner or parental objection. Females comprised 53% of 1,762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women ages 25-29 years (36.5%) and men ages 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity.
Language: English
Keywords:
KENYA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | HIV INFECTIONS | HERPES GENITALIS | PREVALENCE | RISK FACTORS | AGE FACTORS | SEX FACTORS | MIGRATION | VOLUNTARY COUNSELING AND TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Health | Population Characteristics | Demographic Factors | Population Dynamics | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 339909

19.

Peer Reviewed

Title: [Prevalence of intimate partner violence and associated factors: a population-based study in Lages, Santa Catarina State, Brazil, 2007] Prevalencia e fatores associados a violencia entre parceiros intimos: um estudo de base populacional em Lages, Santa Catarina, Brasil, 2007.
Author: Anacleto AJ; Njaine K; Longo GZ; Boing AF; Peres KG
Source: Cadernos�de Saude Publica. 2009 Apr;25(4):800-808.
Abstract: The aim of this study was to estimate the prevalence of intimate partner violence and associated factors in Lages, Santa Catarina State, Brazil. A population-based household study included 20-59-year-old women (n = 1,042) living in the urban area. The Conflict Tactics Scales - Form R was used to investigate verbal aggression, minor physical violence, and severe physical violence. A questionnaire covering socioeconomic and demographic variables was applied. Pearson qui-square and linear trend test were used to test associations. Prevalence rates for verbal aggression and minor and severe physical abuse within couples were 79.0%, 14.9%, and 9.3%, respectively. Couples under 30 years of age, with per capita income less than half the minimum wage (approximately U$90/month), and in households with more than two family members per bedroom were more likely to report all types of violence as compared to older couples, those with better incomes, and those living with less crowding, respectively. Preventive programs and qualitative studies could be effective strategies to shed further light on intimate partner violence.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | PREVALENCE | URBAN POPULATION | COUPLES | SEXUAL PARTNERS | WOMEN | AGE FACTORS | VIOLENCE | SOCIOECONOMIC FACTORS | INCOME | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Sex Behavior | Behavior | Economic Factors
Document Number: 341868

20.

Peer Reviewed

Title: Menstrual blood loss in women using the frameless FibroPlant LNG-IUS.
Author: Andrade A; Wildemeersch D
Source: Contraception. 2009 Feb;79(2):134-8.
Abstract: BACKGROUND: This study was conducted to report on a menstrual blood loss (MBL) study and iron stores in women with and without heavy menstrual bleeding using the frameless FibroPlant levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception. STUDY DESIGN: An open, prospective, noncomparative MBL study, using FibroPlant releasing 14 mcg of LNG/day for contraception. MBL was assessed by the quantitative alkaline hematin (QAH) technique. RESULTS: The MBL study was conducted in 40 heavy and normally menstruating Brazilian women seeking contraception. MBL was reduced from a mean baseline menstrual volume of 29.7 mL to a mean volume of 1.5 mL after 24 months, while ferritin values increased from a mean value of 31.1 ng/mL (at baseline) to a mean level of 72.5 ng/mL (after 24 months of use). Differences were highly significant (p<.0005). There were no significant differences between those who had normal menstrual bleeding and the heavy bleeders. The heavy bleeders had comparable MBL to thenormal bleeders 3 months after insertion, and by 24 months post-insertion, their ferritin levels were comparable to those of the normal bleeders. Amenorrhea occurred in 80% of women out of 40 after 24 months of use. No pregnancies were recorded. CONCLUSION: The LNG-IUS is effective in reducing MBL in normally menstruating women as well as in women with heavy menstrual bleeding. The authors agree with the recommendations by the UK National Institute for Clinical Effectiveness and the new Finnish guidelines for heavy menstrual bleeding that the LNG-IUS should be positioned as first-line treatment prior to endometrial ablation or hysterectomy.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | MENSTRUATION | SERUM IRON LEVEL | IUD, HORMONE RELEASING | LEVONORGESTREL | MENORRHAGIA | TIME FACTORS | AMENORRHEA | PREVALENCE | CONTRACEPTIVE EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Hemic System | Physiology | Biology | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Diseases | Population Dynamics | Demographic Factors | Population | Measurement
Document Number: 331016

21.

Peer Reviewed

Title: Increasing the acceptability of HIV counseling and testing with three C's: convenience, confidentiality and credibility.
Author: Angotti N; Bula A; Gaydosh L; Kimchi EZ; Thornton RL; Yeatman SE
Source: Social Science and Medicine. 2009 Jun;68(12):2263-70.
Abstract: Agencies engaged in humanitarian efforts to prevent the further spread of HIV have emphasized the importance of voluntary counseling and testing (VCT), and most high-prevalence countries now have facilities that offer testing free of charge. The utilization of these services is disappointingly low, however, despite high numbers reporting that they would like to be tested. Explanations of this discrepancy typically rely on responses to hypothetical questions posed in terms of psychological or social barriers; often, the explanation is that people fear learning that they are infected with a disease that they understand to be fatal and stigmatizing. Yet when we offered door-to-door rapid blood testing for HIV as part of a longitudinal study in rural Malawi, the overwhelming majority agreed to be tested and to receive their results immediately. Thus, in this paper, we ask: why are more people not getting tested? Using an explanatory research design, we find that rural Malawians are responsive to door-to-door HIV testing for the following reasons: it is convenient, confidential, and the rapid blood test is credible. Our study suggests that attention to these factors in VCT strategies may mitigate the fear of HIV testing, and ultimately increase uptake in rural African settings.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | PREVALENCE | LONGITUDINAL STUDIES | RURAL POPULATION | HIV TESTING | VOLUNTARY COUNSELING AND TESTING | FEAR | Africa | Developing Countries | Measurement | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Emotions | Psychological Factors | Behavior
Document Number: 342741

22.

Title: Reproductive and hormonal factors, and ovarian cancer risk for BRCA1 and BRCA2 mutation carriers: results from the International BRCA1/2 Carrier Cohort Study.
Author: Antoniou AC; Rookus M; Andrieu N; Brohet R; Chang-Claude J
Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Feb;18(2):601-10.
Abstract: BACKGROUND: Several reproductive and hormonal factors are known to be associated with ovarian cancer risk in the general population, including parity and oral contraceptive (OC) use. However, their effect on ovarian cancer risk for BRCA1 and BRCA2 mutation carriers has only been investigated in a small number of studies. METHODS: We used data on 2,281 BRCA1 carriers and 1,038 BRCA2 carriers from the International BRCA1/2 Carrier Cohort Study to evaluate the effect of reproductive and hormonal factors on ovarian cancer risk for mutation carriers. Data were analyzed within a weighted Cox proportional hazards framework. RESULTS: There were no significant differences in the risk of ovarian cancer between parous and nulliparous carriers. For parous BRCA1 mutation carriers, the risk of ovarian cancer was reduced with each additional full-term pregnancy (P trend = 0.002). BRCA1 carriers who had ever used OC were at a significantly reduced risk of developing ovarian cancer (hazard ratio, 0.52; 95% confidence intervals, 0.37-0.73; P = 0.0002) and increasing duration of OC use was associated with a reduced ovarian cancer risk (P trend = 0.0004). The protective effect of OC use for BRCA1 mutation carriers seemed to be greater among more recent users. Tubal ligation was associated with a reduced risk of ovarian cancer for BRCA1 carriers (hazard ratio, 0.42; 95% confidence intervals, 0.22-0.80; P = 0.008). The number of ovarian cancer cases in BRCA2 mutation carriers was too small to draw definitive conclusions. CONCLUSIONS: The results provide further confirmation that OC use, number of full-term pregnancies, and tubal ligation are associated with ovarian cancer risk in BRCA1 carriers to a similar relative extent as in the general population.
Language: English
Keywords:
DEVELOPED COUNTRIES | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CROSS-CULTURAL COMPARISONS | CLINICAL RESEARCH | WOMEN | PREVALENCE | RISK ASSESSMENT | OVARIAN CANCER | CHROMOSOME ABNORMALITIES | PARITY | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | TUBAL LIGATION | Research Methodology | Comparative Studies | Studies | Demographic Factors | Population | Measurement | Evaluation | Cancer | Neoplasms | Diseases | Neonatal Diseases and Abnormalities | Fertility Measurements | Fertility | Population Dynamics | Health | Contraceptive Safety | Safety | Public Health | Female Sterilization | Sterilization, Sexual | Family Planning
Document Number: 331025

23.
Peer Reviewed

Title: HIV testing rates and outcomes in a South African community, 2001-2006: implications for expanded screening policies.
Author: April MD; Walensky RP; Chang Y; Pitt J; Freedberg KA; Losina E; Paltiel AD; Wood R
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51(3):310-6.
Abstract: BACKGROUND: Revised World Health Organization recommendations seek to increase HIV testing. We assessed the need for expanded testing in South Africa by examining current testing and treatment trends among a high prevalence population. METHODS: We determined the numbers of adults receiving HIV testing and antiretroviral treatment (ART) during 2001-2006 using testing registers linked to patient records from 2 health care facilities believed responsible for virtually all HIV services available to the population. We evaluated annual population testing rates using census population counts; proportions of clients testing seropositive (yield); CD4 counts and World Health Organization stage at diagnosis; and ART initiation rates. RESULTS: HIV testing rates rose from 4% in 2001 to 20% in 2006 (P < 0.001) and were highest among pregnant females receiving provider-initiated testing. Yield for first-time testers decreased from 47% in 2001 to 28% in 2006; annual incidence of seroconversion among initially HIV-negative retesters was 1.9%. Median CD4 counts and World Health Organization stage distributions for newly diagnosed clients remained stable. HIV-infected clients receiving ART within 6 months of eligibility increased from 0% in 2001 to 68% in 2006 (P < 0.001). CONCLUSIONS: Population testing and ART initiation rates rose dramatically during 2001-2006. Yet, yield remained high, and HIV-infected persons continued to receive late diagnoses. These findings highlight the continuing need for expanded testing and linkage to care.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | DATA LINKAGE | STATISTICAL STUDIES | HIV TESTING | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | SCREENING | HEALTH POLICY | CENSUS | HIV INFECTIONS | PREVALENCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Studies | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors | Population Statistics | Measurement
Document Number: 342149

24.

Peer Reviewed

Title: Effect of male circumcision on the prevalence of high-risk human papillomavirus in young men: results of a randomized controlled trial conducted in orange farm, South Africa.
Author: Auvert B; Sobngwi-Tambekou J; Cutler E; Nieuwoudt M; Lissouba P; Puren A; Taljaard D
Source: Journal of Infectious Diseases. 2009 Jan 1;199(1):14-9.
Abstract: The authors used data from a male circumcision (MC) trial conducted in Orange Farm, South Africa among men aged 18-24 years to investigate the association between male circumcision (MC) and the prevalence of high-risk human papillomavirus (HR-HPV) among young men. Urethral swab samples were collected during a period of 262 consecutive days from participants in the intervention (circumcised) and control (uncircumcised) groups who were reporting for a scheduled follow-up visit. Swab samples were analyzed using polymerase chain reaction. HR-HPV prevalence rate ratios were assessed using univariate and multivariate log Poisson regression. In an intention-to-treat analysis, the prevalence of HR-HPV among the intervention group was 14.8% (94/637) and in the control group was 22.3% (140/627). Controlling for propensity score and confounders (ethnic group, age, education, sexual behavior [including condom use], marital status, and human immunodeficiency virus status) had no effect on the results. This is the first randomized controlled trial to show a reduction in the prevalence of urethral HR-HPV infection after MC. This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLINICAL TRIALS | EPIDEMIOLOGIC METHODS | YOUTH | MULTIVARIATE ANALYSIS | MEN | MALE CIRCUMCISION | HPV | PREVALENCE | RISK FACTORS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Clinical Research | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Data Analysis | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Measurement | Biology
Document Number: 328586

25.

Peer Reviewed

Title: Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV.
Author: Ayles H; Schaap A; Nota A; Sismanidis C; Tembwe R; De Haas P; Muyoyeta M; Beyers N
Author: Peter Godfrey-Faussett for the ZAMSTAR Study Team
Source: PloS One. 2009;4(5):e5602.
Abstract: BACKGROUND: The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation. METHODS AND FINDINGS: 8044 adults were sampled from 2 sub-districts (wards) in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570-1160/100,000). The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04-31.19). HIV- infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42-3.74) and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05-22.94) and fever (Adj OR 2.04, 95%CI 1.23-3.39), were associated with prevalent tuberculosis, but 8 (10%) individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43%) would have been classified as a TB suspect by current guidelines. CONCLUSIONS: Undiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | SAMPLING STUDIES | ADULTS | TUBERCULOSIS | HIV INFECTIONS | RESPIRATORY INSUFFICIENCY | PREVALENCE | SCREENING | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | PREVENTION AND CONTROL | ANTIBIOTICS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Viral Diseases | Pulmonary Effects | Physiology | Biology | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment
Document Number: 342445

26.

Peer Reviewed

Title: Domestic violence against women in eastern India: a population-based study on prevalence and related issues.
Author: Babu BV; Kar SK
Source: BMC Public Health. 2009;9:129.
Abstract: BACKGROUND: Violence against women is now widely recognised as an important public health problem, owing to its health consequences. Violence against women among many Indian communities on a regularly basis goes unreported. The objective of this study is to report the prevalence and other related issues of various forms of domestic violence against women from the eastern zone of India. METHODS: It is a population-based study covering both married women (n = 1718) and men (n = 1715) from three of the four states of Eastern India selected through a systematic multistage sampling strategy. Interviews were conducted using separate pre-piloted structured questionnaires for women (victimization) and men (perpetration). Women were asked whether their husband or any other family members committed violent acts against them. And men were asked whether they had ever perpetrated violent acts against their wives. Three principle domestic violence outcome variables (physical, psychological and sexual violence) were determined by response to a set of questions for each variable. In addition, data on socio-economic characteristics were collected. Descriptive statistics, bi- and multivariate analyses were done. RESULTS: The overall prevalence of physical, psychological, sexual and any form of violence among women of Eastern India were 16%, 52%, 25% and 56% respectively. These rates reported by men were 22%, 59%, 17% and 59.5% respectively. Men reported higher prevalence of all forms of violence apart from sexual violence. Husbands were mostly responsible for violence in majority of cases and some women reported the involvement of husbands' parents. It is found that various acts of violence were continuing among majority of women who reported violence. Some socio-economic characteristics of women have significant association with the occurrence of domestic violence. Urban residence, older age, lower education and lower family income are associated with occurrence of domestic violence. Multivariate logistic regressions revealed that the physical violence has significant association with state, residence (rural or urban), age and occupation of women, and monthly family income. Similar associations are found for psychological violence (with residence, age, education and occupation of the women and monthly family income) and sexual violence (with residence, age and educational level of women). CONCLUSION: The prevalence of domestic violence in Eastern India is relatively high compared to majority of information available from India and confirms that domestic violence is a universal phenomenon. The primary healthcare institutions in India should institutionalise the routine screening and treatment for violence related injuries and trauma. Also, these results provide vital information to assess the situation to develop public health interventions, and to sensitise the concerned agencies to implement the laws related to violence against women.
Language: English
Keywords:
INDIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | DOMESTIC VIOLENCE | PREVALENCE | PHYSICAL ABUSE | PSYCHOLOGICAL ABUSE | SEXUAL ABUSE | SOCIOECONOMIC STATUS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | Crime | Social Problems | Measurement | Violence | Behavior | Aggression | Socioeconomic Factors | Economic Factors
Document Number: 341406

27.

Peer Reviewed

Title: Systematic review of HIV and HCV infection among drug users in China.
Author: Bao YP; Liu ZM
Source: International Journal of STD and AIDS. 2009 Jun;20(6):399-405.
Abstract: To determine the HIV and hepatitis C virus (HCV) geographical distribution among drug users in China, a systematic literature review of 40 peer-reviewed publications (comprising 15,565 drug users) was conducted. Of the total drug users, 10,724 were found to be injection drug users (IDUs) and 4841 were non-injection drug users (non-IDUs). Various studies identified that among IDUs and non-IDUs, the overall HIV prevalence rates were 12.55% and 1.05%, and the HCV prevalence rates were 66.97% and 18.30%, respectively. The HIV prevalence rate ranged from 0% (Anhui and Inner Mongolia) to 52.51% (Yunnan) among IDUs, and from 0% to 19.80% among non-IDUs correspondingly. The HCV prevalence rate ranged from 11.43% (Shannxi) to 90.77% (Hubei) among IDUs, and from 0% (Anhui) to 40.00% (Fujian) among non-IDUs. Based on the high prevalence of HIV and HCV among drug users, scaling-up harm reduction was required from 'heroin trafficking areas' to other areas in China.
Language: English
Keywords:
CHINA | RESEARCH REPORT | LITERATURE REVIEW | PREVALENCE | IV DRUG USERS | HIV INFECTIONS | HEPATITIS | POPULATION DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Measurement | Research Methodology | Drug Use and Abuse | Behavior | Viral Diseases | Diseases | Geographic Factors | Population
Document Number: 342442

28.

Peer Reviewed

Title: HIV prevalence, risks for HIV infection, and human rights among men who have sex with men (MSM) in Malawi, Namibia, and Botswana.
Author: Baral S; Trapence G; Motimedi F; Umar E; Iipinge S; Dausab F; Beyrer C
Source: PloS One. 2009;4(3):e4997.
Abstract: BACKGROUND: In the generalized epidemics of HIV in southern Sub-Saharan Africa, men who have sex with men have been largely excluded from HIV surveillance and research. Epidemiologic data for MSM in southern Africa are among the sparsest globally, and HIV risk among these men has yet to be characterized in the majority of countries. METHODOLOGY: A cross-sectional anonymous probe of 537 men recruited with non-probability sampling among men who reported ever having had sex with another man in Malawi, Namibia, and Botswana using a structured survey instrument and HIV screening with the OraQuick(c) rapid test kit. PRINCIPAL FINDINGS: The HIV prevalence among those between the ages of 18 and 23 was 8.3% (20/241); 20.0% (42/210) among those 24-29; and 35.7% (30/84) among those older than 30 for an overall prevalence of 17.4% (95% CI 14.4-20.8). In multivariate logistic regressions, being older than 25 (aOR 4.0, 95% CI 2.0-8.0), and not always wearing condoms during sex (aOR 2.6, 95% CI 1.3-4.9) were significantly associated with being HIV-positive. Sexual concurrency was common with 16.6% having ongoing concurrent stable relationships with a man and a woman and 53.7% had both male and female sexual partners in proceeding 6 months. Unprotected anal intercourse was common and the use of petroleum-based lubricants was also common when using condoms. Human rights abuses, including blackmail and denial of housing and health care was prevalent with 42.1% (222/527) reporting at least one abuse. CONCLUSIONS: MSM are a high-risk group for HIV infection and human rights abuses in Malawi, Namibia, and Botswana. Concurrency of sexual partnerships with partners of both genders may play important roles in HIV spread in these populations. Further epidemiologic and evaluative research is needed to assess the contribution of MSM to southern Africa's HIV epidemics and how best to mitigate this. These countries should initiate and adequately fund evidence-based and targeted HIV prevention programs for MSM.
Language: English
Keywords:
MALAWI | NAMIBIA | BOTSWANA | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HIV INFECTIONS | PREVALENCE | RISK FACTORS | EPIDEMIOLOGY | HUMAN RIGHTS | SEX BEHAVIOR | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Behavior | Viral Diseases | Diseases | Measurement | Research Methodology | Health | Public Health | Political Factors | Sociocultural Factors
Document Number: 341820

29.

Title: Postpartum traditions and nutrition practices among urban Lao women and their infants in Vientiane, Lao PDR.
Author: Barennes H; Simmala C; Odermatt P; Thaybouavone T; Vallee J; Martinez-Aussel B; Newton PN; Strobel M
Source: European Journal of Clinical Nutrition. 2009 Mar;63(3):323-31.
Abstract: BACKGROUND/OBJECTIVE: To assess the traditional postpartum practices, mother and child nutritional status and associated factors. SUBJECTS/METHODS: A cross-sectional study in 41 randomly selected villages on the outskirts of Vientiane capital city, Lao PDR (Laos). 300 pairs of infants (< 6 months of age) and their mothers were enrolled. Information was collected about pregnancy, delivery and traditional practices through a standardized questionnaire. Dietary intake and food frequency were estimated using the 24 h recall method, calibrated bowls and FAO food composition tables. Mothers' and infants' anthropometry was assessed and multivariate analysis performed. RESULTS: Contrasting with a high antenatal care attendance (91%) and delivery under health professional supervision (72%), a high prevalence of traditional practices was found, including exposure to hot beds of embers (97%), use of traditional herb tea as the only beverage (95%) and restricted diets (90%). Twenty-five mothers (8.3%) were underweight. Mothers had insufficient intake of calories (55.6%), lipids (67.4%), iron (92.0%), vitamins A (99.3%) and C (45%), thiamin (96.6%) and calcium (96.6%). Chewed glutinous rice was given to infants as an early (mean 34.6, 95% CI:29.3-39.8 days) complementary food by 53.7% of mothers, and was associated with stunting in 10% children (OR=1.35, 95% CI:1.04-1.75). CONCLUSION: The high prevalence of traditional postpartum restricted diets and practices, and inadequate maternal nutritional intake in urban Laos, suggest that antenatal care may be an important opportunity to improve postpartum diets.
Language: English
Keywords:
LAOS | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PREVALENCE | INFANT | CHILDREN | MOTHERS | FOOD AND BEVERAGE | DIET | CHILD NUTRITION | INFANT NUTRITION | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Measurement | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Nutrition | Health
Document Number: 341041

30.

Peer Reviewed

Title: Lack of a decline in HIV incidence in a rural community with high HIV prevalence in South Africa, 2003-2007.
Author: Barnighausen T; Tanser F; Newell ML
Source: AIDS Research and Human Retroviruses. 2009 Apr;25(4):405-9.
Abstract: To understand the dynamics of the HIV epidemic and to plan HIV treatment and prevention programs, it is critical to know how HIV incidence in a population evolves over time. We used data from a large population-based longitudinal HIV surveillance in a rural community in South Africa to test whether HIV incidence in this population has changed in the period from 2003 through 2007. We observed 563 seroconversions in 8095 individuals over 16,256 person-years at risk, yielding an overall HIV incidence of 3.4 per 100 person-years (95% confidence interval 3.1-3.7). We included time-dependent period dummy variables (in half-yearly increments) in age-stratified Cox regressions in order to test for trends in HIV incidence. We first did regression analyses separately for women and men. In both regressions, the coefficients of all period dummy variables were individually insignificant (all p > or = 0.338) and jointly insignificant (p = 0.764 and p = 0.111, respectively). We then did regression analysis using the pooled data on women and men, controlling for sex and interactions between sex and age. Again, the coefficients of the eight period dummy variables were individually insignificant (all p > or = 0.387) and jointly insignificant (p = 0.701). We show for the first time that high levels of HIV incidence have been maintained without any sign of decline over the past 5 years in both women and men in a rural South African community with high HIV prevalence. It is unlikely that the HIV epidemic in rural South Africa can be reversed without new or intensified efforts to prevent HIV infection.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | INCIDENCE | PREVALENCE | RURAL POPULATION | HIV INFECTIONS | HIV PREVENTION | PROGRAM EVALUATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Programs | Organization and Administration
Document Number: 341543


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