| 1. 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 |
| 2. Title: Estimating HIV-1 incidence using the serologic testing algorithm for recent HIV infections at HIV counseling and testing centers in the city of Sao Paulo, Brazil. Author: Bassichetto KC; Bergamaschi DP; Veras MA; Sucupira MC; Mesquita F; Diaz RS Source: Brazilian Journal of Infectious Diseases. 2009 Feb;13(1):9-12. Abstract: The network of HIV counseling and testing centers in Sao Paulo, Brazil is a major source of data used to build epidemiological profiles of the client population. We examined HIV-1 incidence from November 2000 to April 2001, comparing epidemiological and socio-behavioral data of recently-infected individuals with those with long-standing infection. A less sensitive ELISA was employed to identify recent infection. The overall incidence of HIV-1 infection was 0.53/100/year (95% CI: 0.31-0.85/100/year): 0.77/100/year for males (95% CI: 0.42-1.27/100/year) and 0.22/100/ year (95% CI: 0.05-0.59/100/year) for females. Overall HIV-1 prevalence was 3.2% (95% CI: 2.8-3.7%), being 4.0% among males (95% CI: 3.3-4.7%) and 2.1% among females (95% CI: 1.6-2.8%). Recent infections accounted for 15% of the total (95% CI: 10.2-20.8%). Recent infection correlated with being younger and male (p = 0.019). Therefore, recent infection was more common among younger males and older females. Language: English Keywords: BRAZIL | RESEARCH REPORT | ESTIMATION TECHNIQUES | STATISTICAL STUDIES | CLIENTS | HIV TESTING | HIV INFECTIONS | INCIDENCE | LABORATORY PROCEDURES | EPIDEMIOLOGY | PREVALENCE | TIME FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Measurement | Public Health | Population Dynamics | Demographic Factors | Population Document Number: 342655 |
3.  Peer Reviewed Title: Lack of evidence for frequent heterosexual transmission of human herpesvirus 8 in Zimbabwe. Author: Campbell TB; Borok M; Ndemera B; Fiorillo S; White IE; Zhang XQ; Machekano RN; Katzenstein D; Gwanzura L Source: Clinical Infectious Diseases. 2009 Jun 1;48(11):1601-8. Abstract: BACKGROUND: There is conflicting evidence about the contribution of heterosexual transmission to the spread of human herpesvirus 8 (HHV-8) in southern Africa. This study evaluated the hypothesis that HHV-8 infection is associated with risk factors for human immunodeficiency virus type 1 (HIV-1) and other sexually transmitted infections among Zimbabwean men. METHODS: HHV-8 seroprevalence was determined for 2750 participants in the Zimbabwe AIDS Prevention Project cohort of male factory workers in Harare, Zimbabwe. Potential associations of HHV-8 antibody detection with risk factors for HIV-1 infection were examined by univariate analysis. Variables with [Formula: see text] in the univariate analysis were included in a multivariate logistic regression model. HHV-8 seroprevalence was also determined among 297 heterosexual couples. RESULTS: Prevalence of HHV-8, HIV-1, and HHV-8 and HIV-1 coinfection was 28.5% (95% confidence interval [CI], 26.8%-30.2%), 19.5% (95% CI, 18.0%-20.9%), and 6.5% (95% CI, 5.6%-7.5%), respectively. Detection of HHV-8 antibodies was independently associated with older age and HIV-1 infection but not with number of recent sex partners, marital status, education, condom use, prior sexually transmitted infections, payment for sex, chronic hepatitis B infection, or incident HIV-1 infection. HHV-8 seroprevalence was 31.7% (95% CI, 26.3-37.0) among wives in the couples tested, but HHV-8 infection of wives was not associated with HHV-8 infection of husbands (odds ratio, 1.08; 95% CI, 0.62-1.88; P = .8). CONCLUSIONS: HHV-8 and HIV-1 infection did not have common sexual risk factors among urban Zimbabwean men. Sexual transmission does not explain the high prevalence of HHV-8 in this population. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | STATISTICAL STUDIES | HETEROSEXUALS | HERPES GENITALIS | TRANSMISSION | HIV INFECTIONS | RISK FACTORS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Behavior | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Health Document Number: 341676 |
| 4. Title: Daily trimethoprim-sulfamethoxazole prophylaxis rapidly induces corresponding resistance among intestinal Escherichia coli of HIV-infected adults in Kenya. Author: Chiller TM; Polyak CS; Brooks JT; Williamson J; Ochieng B; Shi YP; Ouma P; Greene C; Hamel M; Vulule J; Bopp C; Slutsker L; Mintz E Source: Journal of the International Association of Physicians in AIDS Care. 2009 May-Jun;8(3):165-9. Abstract: BACKGROUND: Trimethoprim-sulfamethoxazole (TMP-SMZ) has been recommended by World Health Organization (WHO) as daily prophylaxis for Africans with AIDS to prevent opportunistic infections. Daily TMP-SMZ may reduce its susceptibility to commensal intestinal Escherichia coli (E coli), increasing the burden of TMP-SMZ-resistant pathogens. METHODS: Participants received either daily TMP-SMZ (CD4 <350 cells/mm(3)) or daily multivitamins (MVIs; CD4 > or =350 cells/mm(3)) for 6 months. Stool was collected at baseline, 2 weeks, 2 months, and 6 months. A random E coli was tested for susceptibility. RESULTS: Baseline prevalence of TMP-SMZ resistance ranged from 71% to 81% and was not different across CD4 strata. At 2 weeks, prevalence of TMP-SMZ-resistant E coli increased significantly from 78% to 98% (P < .001) among persons taking daily TMP-SMZ and did not change among persons taking MVIs. CONCLUSIONS: Daily prophylaxis with TMP-SMZ induced in vivo resistance to the drug after 2 weeks. Empiric therapy for diarrhea with agents other than TMP-SMZ should be considered for HIV-infected persons receiving daily TMP-SMZ prophylaxis. Language: English Keywords: KENYA | RESEARCH REPORT | STATISTICAL STUDIES | PERSONS LIVING WITH HIV/AIDS | ADULTS | BACTERIAL AND FUNGAL DISEASES | ANTIBIOTICS | DRUG RESISTANCE | PREVALENCE | DIARRHEA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 342456 |
| 5. Peer Reviewed Title: Modeling CD4+ cell count increase over a six-year period in HIV-1-infected patients on highly active antiretroviral therapy in Senegal. Author: De Beaudrap P; Etard JF; Diouf A; Ndiaye I; Gueye NF; Gueye PM; Sow PS; Mboup S; Ndoye I; Ecochard R; Eric D Author: ANRS 1215/90 Study Group Source: American Journal of Tropical Medicine and Hygiene. 2009 Jun;80(6):1047-53. Abstract: To assess the extents and determinants of long-term CD4 cell increases after initiation of antiretroviral therapy (ART), changes in CD4 cell counts were analyzed in a cohort of HIV-1-infected Senegalese using a mixed-effects model. After a median follow-up of 54 months, an average of 483 CD4 cells/mm3 (95% confidence interval [CI] = 331; 680) was reached. The average asymptote level was approximately 421 cells/mm3 (95% CI = 390; 454) in patients with < 200 cells/mm3 at baseline and approximately 500 cells/mm3 in patients with > 200 cells/mm3. The independent predictors of long-term CD4 cell reconstitution were the baseline CD4 cell count and the monthly average viral load over the entire follow-up. This good long-term immune reconstitution, optimal in subjects with low average viral loads and > 200 CD4 cells/mm3 at baseline, argues in favor of the earliest possible access to ART and underlines the importance of strict compliance with the treatment. Language: English Keywords: SENEGAL | RESEARCH REPORT | STATISTICAL STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | IMMUNOLOGICAL EFFECTS | TIME FACTORS | HEMATOLOGIC TESTS | USER COMPLIANCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Immunity | Immune System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior Document Number: 341762 |
| 6. Peer Reviewed Title: Stress, needs, and quality of life of family members caring for adults living with HIV/AIDS in Taiwan. Author: Feng MC; Feng JY; Chen TC; Lu PL; Ko NY; Chen YH Source: AIDS Care. 2009 Apr;21(4):482-9. Abstract: The stress, needs and quality of life (QoL) of family members of people living with HIV/AIDS (PLWHA) are critical to explore in Taiwan where home care projects are not available to help the PLWHA families. We examined the extent of stress, needs, QoL and its correlates that family caregivers of PLWHA experienced with structural questionnaires survey. A total of 50 family caregivers of PLWHA visiting a medical center in Taiwan participated in the study from October 2005 to August 2006. Family caregivers felt most stressful on disclosure and stigma issues, and most worried about patients' interpersonal relationships. The most important needs were care-related needs including knowledge of the disease progression, methods of examination and treatment, and the related side effects. The level of stress significantly positively correlated with needs, and negatively correlated with QoL. Availability of alternative manpower to care PLWHA and being PLWHA's parents were two significant factors affecting family caregivers' QoL. In conclusion, family members of PLWHA experienced high level of stress, enormous caring needs, and poor QoL. A family-centered care for PLWHA and their families in the community is crucial to improve quality of care and to prevent family's overload, particularly for families with no alternative manpower and for those being PLWHA's parents. Language: English Keywords: TAIWAN | RESEARCH REPORT | STATISTICAL STUDIES | FRIENDS AND RELATIVES | PERSONS LIVING WITH HIV/AIDS | CARE AND SUPPORT | INTERPERSONAL RELATIONS | STRESS | QUALITY OF LIFE | NEEDS | STIGMA | INTERVIEWS | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Behavior | Psychological Factors | Social Welfare | Economic Factors | Social Problems | Data Collection Document Number: 341833 |
| 7. Peer Reviewed Title: Rates of serious infection after changes in regimens for medical abortion. Author: Fjerstad M; Trussell J; Sivin I; Lichtenberg ES; Cullins V Source: New England Journal of Medicine. 2009 Jul 9;361(2):145-51. Abstract: BACKGROUND: From 2001 through March 2006, Planned Parenthood health centers throughout the United States provided medical abortion (abortion by means of medication) principally by a regimen of oral mifepristone followed 24 to 48 hours later by vaginal misoprostol. In response to concern about serious infections, in early 2006 Planned Parenthood changed the route of misoprostol administration from vaginal to buccal and required either routine provision of antibiotics or universal screening and treatment for chlamydia; in July 2007, Planned Parenthood began requiring routine treatment with antibiotics for all medical abortions. METHODS: We performed a retrospective analysis assessing the rates of serious infection after medical abortion during a time when misoprostol was administered vaginally (through March 2006), as compared with rates after a change to buccal administration of misoprostol and after initiation of additional infection-reduction measures. RESULTS: Rates of serious infection dropped significantly after the joint change to buccal misoprostol from vaginal misoprostol and to either testing for sexually transmitted infection or routine provision of antibiotics as part of the medical abortion regimen. The rate declined 73%, from 0.93 per 1000 abortions to 0.25 per 1000 (absolute reduction, 0.67 per 1000; 95% confidence interval [CI], 0.44 to 0.94; P<0.001). The subsequent change to routine provision of antibiotics led to a further significant reduction in the rate of serious infection - a 76% decline, from 0.25 per 1000 abortions to 0.06 per 1000 (absolute reduction, 0.19 per 1000; 95% CI, 0.02 to 0.34; P=0.03). CONCLUSIONS: The rate of serious infection after medical abortion declined by 93% after a change from vaginal to buccal administration of misoprostol combined with routine administration of antibiotics. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | STATISTICAL STUDIES | ABORTION | RU-486 | MISOPROSTOL | ADMINISTRATION AND DOSAGE | STANDARDS | INFECTION PREVENTION | ANTIBIOTICS | MONITORING | Developed Countries | North America | Americas | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins, Synthetic | Prostaglandins | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Diseases | Evaluation Document Number: 342147 Notification |
| 8. 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 |
| 9. Peer Reviewed Title: Sex ratio at birth and family composition in sub-saharan Africa: inter-couple variations. Author: Garenne M Source: Journal of Biosocial Science. 2009 May;41(3):399-407. Abstract: In this study, sex ratios at birth (male/female births) were found to vary according to family composition. Using Demographic and Health Survey (DHS) maternity histories from sub-Saharan Africa, the study shows that the sex ratio at birth increases with the number of previous male births and decreases with the number of previous female births. For families with only males, the sex ratio increases from 1.046 for the first birth to 1.083 for the 8th birth. For families with only females, the sex ratio decreases from 1.046 for the first birth to 0.942 for the 8th birth. The differences were highly significant when tested with a linear logistic model (p=0.018 for males; p=1.85 x 10(-11) for females). The effect was not symmetrical, and was found to be significantly stronger for females. These effects could be reproduced assuming a strong heterogeneity between couples. The distribution of sex ratios was fitted with an asymmetrical log-gamma function, which revealed a wide range of variation in the sex ratio between 0.50 and 1.30, and a peak around 1.14. The results and their implications are discussed in the light of former findings in France and in the United States of America. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | STATISTICAL STUDIES | COUPLES | SEX RATIO | FAMILY CHARACTERISTICS | BIRTH HISTORY | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Family and Household | Sociocultural Factors | Sex Distribution | Sex Factors | Population Characteristics | Pregnancy History | Fertility Measurements | Fertility Document Number: 341403 |
| 10. Title: Use of family planning services in Darfur, Sudan. Author: Haggaz A; Ahmed S; Adam I Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):247-8. Abstract: High fertility rates and inadequate spacing between births can lead to high maternal and infant mortality. An estimated 600 000 maternal deaths occur worldwide each year, and the vast majority take place in low-income countries. The World Health Organization estimates that 13% of these deaths are due to unsafe abortions. Worldwide, where approximately 50 million women resort to induced abortion, this frequently results in high rates of maternal morbidity and mortality. Family planning and adequate spacing between births are important methods to help avoid these deaths. Little published data are available regarding the use of family planning services in Sudan-the largest country in Africa, with 40 million inhabitants-although high maternal mortality and inadequate utilization of prenatal care in Darfur have been reported previously. In Alfasher, the area considered in the present study, the Sudanese Family Planning Association has an office that provides services such as contraceptive pills and intrauterine contraceptive devices free of charge. A community-based cross-sectional household survey was conducted in Alfashar, in April and June 2008, to investigate the use of and factors associated with family planning services. (excerpt) Language: English Keywords: SUDAN | RESEARCH REPORT | STATISTICAL STUDIES | WOMEN | FAMILY PLANNING PROGRAMS | UTILIZATION OF HEALTH CARE | AGE FACTORS | EDUCATIONAL STATUS | PARITY | FAMILY PLANNING EDUCATION | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Demographic Factors | Population | Family Planning | Health Services | Delivery of Health Care | Health | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Education Document Number: 341389 |
| 11. Title: Education, prenatal care, and poor perinatal outcome in Khartoum, Sudan. Author: Hassan AA; Abubaker MS; Radi EA; Adam I Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):66-7. Abstract: Perinatal outcome is an important indicator of obstetric care and health status. Reducing the incidence of low birth weight neonates by at least one third between 2000 and 2010 is one of the major goals of the United Nations resolution "A World Fit for Children" and is an important contribution toward Millennium Development Goal (MDG) 4 which is to reduce child mortality by two thirds by 2015. Local surveillance and basic epidemiology can more accurately assess perinatal outcome and identify areas to which interventions should be targeted. The aims of the present study were to identify and quantify the risk factors for low birth weight neonates and perinatal mortality in Sudan, and to assess the role of sociodemographic factors. Language: English Keywords: SUDAN | RESEARCH REPORT | STATISTICAL STUDIES | MOTHERS | ANTENATAL CARE | LOW BIRTH WEIGHT | RISK FACTORS | EDUCATIONAL STATUS | ANTHROPOMETRY | PREGNANCY OUTCOMES | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Birth Weight | Body Weight | Physiology | Biology | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Measurement | Pregnancy | Reproduction Document Number: 341386 |
| 12. Peer Reviewed Title: Can the outcome of the next pregnancy be predicted at the time of induced abortion? Author: Heikinheimo O; Gissler M; Suhonen S Source: Human Reproduction. 2009 Apr;24(4):820-6. Abstract: BACKGROUND: Factors predicting the outcome of the next pregnancy following termination of pregnancy (TOP) are poorly known. METHODS: A cohort of 1269 women undergoing medical TOP between 2000 and 2002 were followed up until the next pregnancy or until the end of 2006, using registers of induced abortion, births and hospital discharges. Factors associated with repeat TOP, delivery and failed pregnancy were analysed. RESULTS: During the mean (+/-SD) follow-up period of 4.2 +/- 1.5 years, 446 (35%) women had at least one subsequent pregnancy. Of these, 207 (46%) resulted in delivery, 169 (38%) in repeat TOP and 16% in failed pregnancy. In multivariate analysis, parity [hazard ratio (HR) 3.42, 95% confidence interval (CI) 1.70-6.91] and history of TOP (HR 1.60, 95% CI 1.10-2.33) were risk factors of repeat TOP. Age above 25 years (HR < or = 0.46) and the use of intrauterine contraception (HR < or = 0.45) were associated with reduced risks of repeat TOP. However, only age between 25 and 29 years was associated with an increased probability of delivery (HR 2.44, 95% CI 1.45-4.11). CONCLUSIONS: Risk factors of repeat TOP are more clearly defined than factors associated with delivery. An increased focus on young women, those with a history of TOP and parous women, might be effective in reducing repeat TOP. Language: English Keywords: FINLAND | RESEARCH REPORT | COHORT ANALYSIS | STATISTICAL STUDIES | ABORTION | PREGNANCY OUTCOMES | RISK FACTORS | CONTRACEPTIVE USAGE | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Health | Contraception Document Number: 341660 |
| 13. Peer Reviewed Title: The role of biological fertility in predicting family size. Author: Joffe M; Key J; Best N; Jensen TK; Keiding N Source: Human Reproduction. 2009 Aug;24(8):1999-2006. Abstract: BACKGROUND: It is plausible that a couple's ability to achieve the desired number of children is limited by biological fertility, especially if childbearing is postponed. Family size has declined and semen quality may have deteriorated in much of Europe, although studies have found an increase rather than a decrease in couple fertility. METHODS: Using four high-quality European datasets, we took the reported time to pregnancy (TTP) as the predictor variable; births reported as following contraceptive failure were an additional category. The outcome variable was final or near-final family size. Potential confounders were maternal age when unprotected sex began prior to the first birth, and maternal smoking. Desired family size was available in only one of the datasets. RESULTS: Couples with a TTP of at least 12 months tended to have smaller families, with odds ratios for the risk of not having a second child approximately 1.8, and for the risk of not having a third child approximately 1.6. Below 12 months no association was observed. Findings were generally consistent across datasets. There was also a more than 2-fold risk of not achieving the desired family size if TTP was 12 months or more for the first child. CONCLUSIONS: Within the limits of the available data quality, family size appears to be predicted by biological fertility, even after adjustment for maternal age, if the woman was at least 20 years old when the couple's first attempt at conception started. The contribution of behavioural factors to this result also needs to be investigated. Language: English Keywords: EUROPE | RESEARCH REPORT | DATA ANALYSIS | STATISTICAL STUDIES | COUPLES | FERTILITY DETERMINANTS | FAMILY SIZE, COMPLETED | FAMILY SIZE, DESIRED | FIRST PREGNANCY INTERVALS | CONTRACEPTION FAILURE | REPRODUCTIVE BEHAVIOR | MATERNAL AGE | TOBACCO USE | Developed Countries | Research Methodology | Studies | Family Characteristics | Family and Household | Sociocultural Factors | Fertility | Population Dynamics | Demographic Factors | Population | Family Size | Pregnancy Intervals | Fertility Measurements | Contraceptive Usage | Contraception | Family Planning | Parental Age | Age Factors | Population Characteristics | Behavior Document Number: 342795 |
| 14. Peer Reviewed Title: Multilevel analysis of HIV related risk behaviors among heroin users in a low prevalence community. Author: Li H; Goggins W; Lee SS Source: BMC Public Health. 2009;9:137. Abstract: BACKGROUND: Injecting drug users (IDU) are at increased risk of human immunodeficiency virus (HIV) infection. Their HIV prevalence however varies from place to place and may not be directly linked with the level of individual risk. This study explores the relative importance of individual and community level characteristics in the practice of HIV-related risk behaviors in IDU in Hong Kong where the HIV prevalence has remained low at below 1%. METHODS: Methadone clinics were used as the channel for accessing drug users in Hong Kong. HIV-related risk factors in drug users attending these clinics were retrieved from a questionnaire routinely administered to newly admitted and readmitted clients, and assessed using logistic regression and multilevel analyses. RESULTS: Between 1999 and 2005, a total of 41,196 person-admissions were recorded by 20 methadone clinics. Male gender, older age and new admissions in bigger clinics located in districts with older median age were more likely to have engaged in HIV related risk behaviors including heroin injection, needle sharing, unprotected sex and having multiple sex partners (p < 0.05). CONCLUSION: Multilevel analysis is a useful adjunct for determining the association between risk behaviors and both individual and community factors in IDUs, which can be demonstrated even in low HIV prevalence settings. Language: English Keywords: HONG KONG | RESEARCH REPORT | STATISTICAL STUDIES | IV DRUG USERS | SOCIAL NETWORKS | HIV INFECTIONS | RISK BEHAVIOR | SEX BEHAVIOR | AGE FACTORS | Developed Countries | Asia, Eastern | Asia | Studies | Research Methodology | Drug Use and Abuse | Behavior | Friends and Relatives | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population Document Number: 341405 |
| 15. Title: Need for syphilis screening and counselling in HIV counselling and testing centres: a curtain raiser study from north India. Author: Nag VL; Dash NR; Pathak A; Agarwal SK Source: Australian Journal of Rural Health. 2009 Apr;17(2):102-6. Abstract: BACKGROUND: Voluntary counselling and testing centres (VCTC) are important HIV screening points for the population with suspicion or apprehension for HIV, because of high-risk exposures. Theoretically, these are also at the risk of having co-infections, commonest being syphilis. The present short-term study was aimed at knowing the sero-reactivity of syphilis among a study cohort attending the VCTC in King George's Medical University, Lucknow, India. METHOD: During a 2.5-month period, 49 HIV-positive and 171 HIV-negative sera were tested for venereal disease research laboratory (VDRL). The positive sera were further tested for treponema pallidum haemagglutination (TPHA). RESULT: Eleven (22.4%) HIV-positive sera and 104 (60.8%) HIV-negative sera were VDRL-reactive (>or=1:8 dilutions). Of these, TPHA was reactive in three (27.3%) and four (3.9%), respectively. CONCLUSION: The result might suggest the need for routine screening and counselling for syphilis at VCTC. Studies from other centres on larger population are required. Language: English Keywords: INDIA | RESEARCH REPORT | STATISTICAL STUDIES | SYPHILIS | SCREENING | INCIDENCE | HIV INFECTIONS | VOLUNTARY COUNSELING AND TESTING | CLINIC ACTIVITIES | LABORATORY PROCEDURES | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Viral Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Program Activities | Programs | Organization and Administration Document Number: 341687 |
| 16. Title: Trans fatty acids and fatty acid composition of mature breast milk in turkish women and their association with maternal diet's. Author: Samur G; Topcu A; Turan S Source: Lipids. 2009 May;44(5):405-13. Abstract: The aim of this study was to determine the fatty acid composition and trans fatty acid and fatty acid contents of breast milk in Turkish women and to find the effect of breastfeeding mothers' diet on trans fatty acid and fatty acid composition. Mature milk samples obtained from 50 Turkish nursing women were analyzed. Total milk lipids extracts were transmethylated and analyzed by using gas liquid chromatography to determine fatty acids contents. A questionnaire was applied to observe eating habits and 3 days dietary records from mothers were obtained. Daily dietary intake of total energy and nutrients were estimated by using nutrient database. The mean total trans fatty acids contents was 2.13 +/- 1.03%. The major sources of trans fatty acids in mothers' diets were margarines-butter (37.0%), bakery products and confectionery (29.6%). Mothers who had high level of trans isomers in their milk consumed significantly higher amounts of these products. Saturated fatty acids, polyunsaturated fatty acids and monounsaturated fatty acids of human milk constituted 40.7 +/- 4.7%, 26.9 +/- 4.2% and 30.8 +/- 0.6% of the total fatty acids, respectively. The levels of fatty acids in human milk may reflect the current diet of the mother as well as the diet consumed early in pregnancy. Margarines, bakery products and confectionery are a major source of trans fatty acids in maternal diet in Turkey. Language: English Keywords: TURKEY | RESEARCH REPORT | STATISTICAL STUDIES | MOTHERS | BREASTFEEDING, EXCLUSIVE | LIPIDS | DIET | HUMAN MILK | LABORATORY PROCEDURES | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Physiology | Biology | Lactation | Maternal Physiology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 342185 |
| 17. Title: Cost-effectiveness of misoprostol and prenatal iron supplementation as maternal mortality interventions in home births in rural India. Author: Sutherland T; Bishai DM Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):189-93. Abstract: OBJECTIVE: To determine the cost-effectiveness of prenatal iron supplementation and misoprostol use as interventions to prevent maternal mortality in home births in rural India. METHODS: A cost-effectiveness analysis depicted three hypothetical cohorts of 10,000 pregnant women delivering at home in rural India: one with no intervention, one receiving standard prenatal iron supplements, and 1 receiving 600 microg of misoprostol in the third stage of labor. RESULTS: Misoprostol used to prevent postpartum hemorrhage resulted in a 38% (95% CI, 5%-73%) decrease in maternal deaths, while prenatal iron supplementation resulted in a 5% (95% CI, 0%-47%) decrease. Misoprostol cost a median US $1401 (IQR US $1008-$1848) prenatal iron supplementation cost a median US $2241 (IQR No Lives Saved-$3882) per life saved compared with the standard care outcome. CONCLUSION: Misoprostol is a cost-effective maternal mortality intervention for home births. Iron supplementation may be worthwhile to improve women's health, but it is uncertain whether it can prevent mortality after hemorrhage. Language: English Keywords: INDIA | RURAL AREAS | RESEARCH REPORT | STATISTICAL STUDIES | PREGNANT WOMEN | MATERNAL MORTALITY | INTERVENTIONS | MISOPROSTOL | IRON | FOOD SUPPLEMENTATION | COST EFFECTIVENESS | ANEMIA | Asia, Southern | Asia | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Population Characteristics | Demographic Factors | Mortality | Population Dynamics | Programs | Organization and Administration | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Metals | Vitamins and Minerals | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation | Diseases Document Number: 341385 |
| 18. Title: Effect of free treatment and surveillance on HIV-infected persons who have tuberculosis, Taiwan, 1993-2006. Author: Tseng SH; Shyong-Jiang DD; Hoi HS; Lo HY; Hwang KP Source: Emerging Infectious Diseases. 2009 Feb;15(2):332-4. Abstract: In 1997, Taiwan made highly active antiretroviral therapy (HAART) available without cost to HIV-infected persons; in 2001, a national web-based surveillance system was implemented. Healthcare workers use the system to monitor patients' conditions and can intervene when necessary. Free HAART, coupled with the surveillance system, appears to have increased survival rates of HIV-infected persons with tuberculosis in Taiwan. Language: English Keywords: TAIWAN | RESEARCH REPORT | STATISTICAL STUDIES | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | TUBERCULOSIS | MONITORING | INTERNET | MORTALITY CHANGES | RISK FACTORS | USER COMPLIANCE | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Infections | Evaluation | Information Networks | Communication | Mortality | Population Dynamics | Demographic Factors | Population | Health | Behavior Document Number: 341839 |
| 19. Title: Human population growth and temperature increase along with the increase in urbanisation, motor vehicle numbers and green area amount in the sample of Erzurum city, Turkey. Author: Yilmaz S; Toy S; Demircioglu Yildiz N; Yilmaz H Source: Environmental Monitoring and Assessment. 2009 Jan;148(1-4):205-13. Abstract: In the study, main purpose was to determine the effect of population growth along with the increase in urbanisation, motor vehicle use and green area amount on the temperature values using a 55-year data set in Erzurum, which is hardly industrialised, and one of the coldest cities with highest elevation in Turkey. Although the semi-decadal increases, means of which are 0.1 degrees C for mean, minimum and maximum temperatures, are not clear enough to make a strong comment even in the lights of figures or tables, it was found as the result of the statistical analysis that population growth and increases in the number of vehicles, the number of buildings and the green area amount in the city have no significant effect on mean temperatures. However, the relationships between population growth and maximum temperature; and the number of vehicles and minimum temperature were found to be statistically significant. Language: English Keywords: TURKEY | RESEARCH REPORT | STATISTICAL STUDIES | URBANIZATION | POPULATION GROWTH | TRANSPORTATION | Developing Countries | Europe, Southeastern | Europe | Studies | Research Methodology | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Population Dynamics | Demographic Factors | Economic Factors Document Number: 330493 |
20.  Title: HIV and AIDS education in emergencies. Author: Joint United Nations Programme on HIV / AIDS [UNAIDS]. Inter-Agency Task Team on Education Source: Paris, France, UNESCO, 2008. [2] p. (Advocacy Briefing NoteED/UNP/HIV/2008/IATT-ABN3) Abstract: The relationship between HIV and AIDS and humanitarian crisis is complex: conflict increases vulnerability, especially among women and children, as sexual violence increases (e.g. through the use of rape as a weapon of war), and social networks and institutions that usually provide support and regulate behavior break down. At the same time, there is evidence that in some situations, instability can also play a "protective" role vis-a-vis HIV infection, by limiting population mobility to high prevalence areas (often urban) and isolating communities. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | PROGRESS REPORT | STATISTICAL STUDIES | PERSONS LIVING WITH HIV/AIDS | REFUGEES | SEX WORKERS | WOMEN IN DEVELOPMENT | DISASTER RELIEF | HIV PREVENTION | WAR | RAPE | RESIDENTIAL MOBILITY | BORDER CROSSING | ADVOCACY | SEX EDUCATION | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Sex Behavior | Behavior | Economic Development | Economic Factors | Financial Activities | Political Factors | Sociocultural Factors | Crime | Social Problems | Residence Characteristics | Population Distribution | Geographic Factors | International Migration | Communication | Education Document Number: 326776 |
| 21. Title: State of the world's mothers 2008. Closing the survival gap for children under 5. Author: Save the Children Source: Westport, Connecticut, Save the Children, 2008. [56] p. Abstract: Worldwide, more than 200 million children under age 5 do not get the basic health care they need. This contributes to nearly 10 million children dying needlessly every year from highly preventable or treatable ailments such as diarrhea and pneumonia. A disproportionate number of the children without health care come from the poorest and most marginalized families in developing countries. While there has been significant progress in reducing the overall death toll among children under 5 in recent decades, death rates among the poorest of the poor have not improved nearly so well, and in some countries they have gotten worse. These widening health care inequities unfairly condemn millions of the world's poorest children to early death or a lifetime of ill health. This year's State of the World's Mothers report shows which countries are succeeding - and which are failing - to deliver basic health care to the mothers and children who need it most. It examines where the health care gaps between the poorest and best-off children are widest, and where they are smallest. It also looks at the survival gaps between the rich and poor children in developing countries, and shows how millions of children's lives could be saved by ensuring all children get essential, low-cost health care. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | PROGRESS REPORT | CROSS-CULTURAL COMPARISONS | STATISTICAL STUDIES | CHILDREN | WOMEN IN DEVELOPMENT | MATERNAL HEALTH | CHILD SURVIVAL | HEALTH STATUS INDEXES | POVERTY | INDUSTRIALIZATION | FUNDS | FOREIGN AID | CHILD HEALTH SERVICES | Comparative Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Health | Survivorship | Length of Life | Mortality | Population Dynamics | Socioeconomic Factors | Financial Activities | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care Document Number: 326320 |
| 22. Title: The state of the world's children 2009. Maternal and newborn health. Author: UNICEF Source: New York, New York, UNICEF, 2008 Dec. [168] p. Abstract: This report examines critical issues in maternal and newborn health, underscoring the need to establish a comprehensive continuum of care for mothers, newborns and children. It also outlines the latest paradigms in health programming and policies for mothers and newborns, and explores policies, programmes and partnerships aimed at improving maternal and neonatal health. Africa and Asia are a key focus for this report, which complements the previous year's issue on child survival. Language: English Keywords: DEVELOPING COUNTRIES | PROGRESS REPORT | EVALUATION INDEXES | STATISTICAL STUDIES | CHILDREN | INFANT | PREGNANT WOMEN | MOTHERS | WOMEN IN DEVELOPMENT | HEALTH STATUS INDEXES | MATERNAL HEALTH | CHILD HEALTH | INFANT HEALTH | MATERNAL-CHILD HEALTH SERVICES | NEONATAL DISEASES AND ABNORMALITIES | Quantitative Evaluation | Evaluation | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Diseases Document Number: 329170 |
| 23. Title: World contraceptive use 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 Jan. [2] p. (ST/ESA/SER.A/273) Abstract: At the 2005 World Summit, Governments committed themselves to "achieving universal access to reproductive health by 2015, as set out at the International Conference on Population and Development" (A/RES/60/1). This wall chart presents the latest data available on key dimensions of reproductive health, including two of the indicators for the Millennium Development Goals, namely, contraceptive prevalence relative to the use of any method (indicator 5.3) and unmet need for family planning (indicator 5.6). The wall chart shows that universal access to reproductive health is still far from being attained since, at least in terms of unmet need for family planning, in at least 43 countries over 20 per cent of the women of reproductive age who are married or in union have not met their need for contraception. Nevertheless, contraceptive use continues to increase. At the world level, 63 per cent of women of reproductive age who are married or in union are currently using a contraceptive method for a total of 716 million worldwide. (excerpt) Language: English Keywords: GLOBAL | TABLES AND CHARTS | STATISTICAL STUDIES | CROSS-CULTURAL COMPARISONS | CONTRACEPTIVE PREVALENCE SURVEYS | POPULATION | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS CHOSEN | Studies | Research Methodology | Comparative Studies | Family Planning Surveys | Family Planning | Contraceptive Usage | Contraception Document Number: 326747 |
| 24. Peer Reviewed Title: Complexity of the msp2 locus and the severity of childhood malaria, in south-western Nigeria. Author: Amodu OK; Oyedeji SI; Ntoumi F; Orimadegun AE; Gbadegesin RA Source: Annals of Tropical Medicine and Parasitology. 2008;102(2):95-102. Abstract: As the genetic diversity of Plasmodium falciparum infections in humans is implicated in the pathogenesis of malaria, the association between P. falciparum diversity at the merozoite surface protein-2 (msp2) locus and the severity of childhood malaria was investigated in Ibadan, in south-western Nigeria. The 400 children enrolled had acute uncomplicated malaria (144), cerebral malaria (64), severe malarial anaemia (67) or asymptomatic infections with P. falciparum (125). Nested PCR was used to investigate the msp2 genotype(s) of the parasites infecting each child. In terms of the complexity of infection and frequency of polyinfection, the children with asymptomatic infection were significantly different from those with uncomplicated malaria or severe malaria. The median number of FC27 alleles detected was higher in the asymptomatic children than in the symptomatic. After controlling for age and level of parasitaemia (with 'asymptomatic infection' as the reference category), a child in whom no FC27 alleles were detected was found to be at five-fold greater risk of uncomplicated malaria, and a child without polyinfection was found to have a three-fold increased risk of severe malarial anaemia and a six-fold increased risk of cerebral malaria. It therefore appears that msp2 genotypes are associated with asymptomatic carriage and that children with mono-infections are more likely to develop severe malaria than children with polyinfections. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL TRIALS | STATISTICAL STUDIES | CHILD | MALARIA | POPULATION GENETICS | PARASITIC DISEASES | SIGNS AND SYMPTOMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Genetics | Biology Document Number: 325067 |
| 25. Title: Madrasas and NGOs: complements or substitutes? Non-state providers and growth in female education in Bangladesh. Author: Asadullah MN; Chaudhury N Source: [Washington, D.C], World Bank, South Asia Region, Human Development Unit, 2008 Feb. 20 p. (Policy Research Working Paper No. 4511) Abstract: There has been a proliferation of non-state providers of education services in the developing world. In Bangladesh, for instance, Bangladesh Rural Advancement Committee runs more than 40,000 non-formal schools that cater to school-drop outs from poor families or operate in villages where there's little provision for formal schools. This paper presents a rationale for supporting these schools on the basis of their spillover effects on female enrollment in secondary (registered) madrasa schools (Islamic faith schools). Most madrasa high schools in Bangladesh are financed by the sate and include a modern curriculum alongside traditional religious subjects. Using an establishment-level dataset on student enrollment in secondary schools and madrasas, the authors demonstrate that the presence of madrasas is positively associated with secondary female enrollment growth. Such feminization of madrasas is therefore unique and merits careful analysis. The authors test the effects of the Bangladesh Rural Advancement Committee primary schools on growth in female enrollment in madrasas. The analysis deals with potential endoegeneity by using data on number of the number of school branches and female members in the sub-district. The findings show that madrasas that are located in regions with a greater number of Bangladesh Rural Advancement Committee schools have higher growth in female enrollment. This relationship is further strengthened by the finding that there is, however, no effect of these schools on female enrollment growth in secular schools. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | STATISTICAL STUDIES | NONGOVERNMENTAL ORGANIZATIONS | FAITH-BASED ORGANIZATION | WOMEN IN DEVELOPMENT | ADOLESCENTS, FEMALE | ISLAM | EDUCATION | WOMEN'S EMPOWERMENT | SCHOOL ENROLLMENT | SECONDARY SCHOOLS | RURAL DEVELOPMENT | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Organizations | Political Factors | Sociocultural Factors | Economic Development | Economic Factors | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Religion | Women's Status | Socioeconomic Factors | Educational Status | Socioeconomic Status | Schools Document Number: 325677 |
| 26. Peer Reviewed Title: Health-risk behaviour in Croatia. Author: Becue-Bertaut M; Kern J; Hernandez-Maldonado ML; Juresa V; Vuletic S Source: Public Health. 2008 Feb;122(2):140-150. Abstract: The objective was to identify the health-risk behaviour of various homogeneous clusters of individuals. The study was conducted in 13 of the 20 Croatian counties and in Zagreb, the Croatian capital. In the first stage, general practices were selected in each county. The second-stage sample was created by drawing a random subsample of 10% of the patients registered at each selected general practice. Methods: The sample was divided into seven homogenous clusters using statistical methodology, combining multiple factor analysis with a hybrid clustering method. Seven homogeneous clusters were identified, three composed of males and four composed of females, based on statistically significant differences between selected characteristics (P less than 0:001). Although, in general, self-assessed health declined with age, significant variations were observed within specific age intervals. Higher levels of self-assessed health were associated with higher levels of education and/or socio-economic status. Many individuals, especially females, who selfreported poor health were heavy consumers of sleeping pills. Males and females reported different health-risk behaviours related to lifestyle, diet and use of the healthcare system. Heavy alcohol and tobacco use, unhealthy diet, risky physical activity and non-use of the healthcare system influenced self-assessed health in males. Females were slightly less satisfied with their health than males of the same age and educational level. Even highly educated females who took preventive healthcare tests and ate a healthy diet reported a less satisfactory self-assessed level of health than expected. Sociodemographic characteristics, life style, self-assessed health and use of the healthcare system were used in the identification of seven homogeneous population clusters. A comprehensive analysis of these clusters suggests health-related prevention and intervention efforts geared towards specific populations. (author's) Language: English Keywords: CROATIA | RESEARCH REPORT | STATISTICAL STUDIES | RISK ASSESSMENT | WOMEN | WOMEN'S HEALTH | SATISFACTION | SOCIOECONOMIC FACTORS | LIFE STYLE | BEHAVIOR | RISK BEHAVIOR | DIET | UTILIZATION OF HEALTH CARE | EDUCATIONAL STATUS | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Evaluation | Demographic Factors | Population | Health | Psychological Factors | Economic Factors | Nutrition | Health Services | Delivery of Health Care | Socioeconomic Status Document Number: 324039 |
| 27. Peer Reviewed Title: Progress and challenges in modelling country-level HIV/AIDS epidemics: the UNAIDS Estimation and Projection Package 2007. Author: Brown T; Salomon JA; Alkema L; Raftery AE; Gouws E Source: Sexually Transmitted Infections. 2008;84(Suppl 1):i5-i10. Abstract: The UNAIDS Estimation and Projection Package (EPP) was developed to aid in country-level estimation and shortterm projection of HIV/AIDS epidemics. This paper describes advances reflected in the most recent update of this tool (EPP 2007), and identifies key issues that remain to be addressed in future versions. The major change to EPP 2007 is the addition of uncertainty estimation for generalised epidemics using the technique of Bayesian melding, but many additional changes have been made to improve the user interface and efficiency of the package. This paper describes the interface for uncertainty analysis, changes to the user interface for calibration procedures and other user interface changes to improve EPP's utility in different settings. While formal uncertainty assessment remains an unresolved challenge in low-level and concentrated epidemics, the Bayesian melding approach has been applied to provide analysts in these settings with a visual depiction of the range of models that may be consistent with their data. In fitting the model to countries with longer-running epidemics in sub-Saharan Africa, a number of limitations have been identified in the current model with respect to accommodating behaviour change and accurately replicating certain observed epidemic patterns. This paper discusses these issues along with their implications for future changes to EPP and to the underlying UNAIDS Reference Group model. Language: English Keywords: DEVELOPING COUNTRIES | METHODOLOGICAL STUDIES | ESTIMATION TECHNIQUES | MATHEMATICAL MODEL | STATISTICAL STUDIES | PERSONS LIVING WITH HIV/AIDS | EPIDEMICS | HIV INFECTIONS | UNAIDS | Research Methodology | Theoretical Models | Studies | Persons Living With HIV/AIDS | Viral Diseases | Diseases | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 323041 |
| 28. Title: Effect of WHO Newborn Care Training on neonatal mortality by education. Author: Chomba E; McClure EM; Wright LL; Carlo WA; Chakraborty H Source: Ambulatory Pediatrics. 2008 Sep-Oct;8(5):300-304. Abstract: Background.-Ninety-nine percent of the 4 million neonatal deaths per year occur in developing countries. The World Health Organization (WHO) Essential Newborn Care (ENC) course sets the minimum accepted standard for training midwives on aspects of infant care (neonatal resuscitation, breastfeeding, kangaroo care, small baby care, and thermoregulation), many of which are provided by the mother. Objective.-The aim of this study was to determine the association of ENC with all-cause 7-day (early) neonatal mortality among infants of less educated mothers compared with those of mothers with more education. Methods.-Protocol- and ENC-certified research nurses trained all 123 college-educated midwives from 18 low-risk, first-level urban community health centers (Zambia) in data collection (1 week) and ENC (1 week) as part of a controlled study to test the clinical impact of ENC implementation. The mothers were categorized into 2 groups, those who had completed 7 years of school education (primary education) and those with 8 or more years of education. Results.-ENC training is associated with decreases in early neonatal mortality; rates decreased from 11.2 per 1000 live births pre- ENC to 6.2 per 1000 following ENC implementation (P <.001). Prenatal care, birth weight, race, and gender did not differ between the groups. Mortality for infants of mothers with 7 years of education decreased from 12.4 to 6.0 per 1000 (P < .0001) but did not change significantly for those with 8 or more years of education (8.7 to 6.3 per 1000, P ¼.14). Conclusions.-ENC training decreases early neonatal mortality, and the impact is larger in infants of mothers without secondary education. The impact of ENC may be optimized by training health care workers who treat women with less formal education. Language: English Keywords: ZAMBIA | URBAN AREAS | RESEARCH REPORT | STATISTICAL STUDIES | NURSES AND NURSING | MIDWIVES AND MIDWIFERY | MOTHERS | EDUCATIONAL STATUS | NEONATAL MORTALITY | WHO | TRAINING PROGRAMS | TRAINING OF TRAINERS | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | UN | International Agencies | Organizations | Political Factors | Education | Program Evaluation | Programs | Organization and Administration Document Number: 340233 |
| 29. Title: Population, health, and environment issues in the Philippines. A profile of Calabarzon (Region 4-A). Author: De La Paz MC; Colson L Source: Washington, D.C., Population Reference Bureau [PRB], Population, Health, and Environment Program, 2008 Oct. 6 p. Abstract: Linking population, health, and environment (PHE) issues is becoming increasingly important for the Philippines, where natural resources and public health and well-being are often negatively affected by factors such as population pressures and poverty. Understanding these connections--including the economic and social context in which they occur--and addressing PHE issues in an integrated manner is critical for achieving sustainable development. This regional PHE profile highlights key population, health, and environment indicators and important development challenges for the Calabarzon Region (Region 4-A). The profile is designed to help educators, policymakers, and community leaders identify key threats to sustainable development and explore possible approaches to addressing them. This profile is part of a series covering select regions of the Philippines, and is intended as a companion publication to the Population Reference Bureau's 2006 data sheet, Making the Link in the Philippines: Population, Health, and the Environment. Language: English Keywords: PHILIPPINES | RESEARCH REPORT | STATISTICAL STUDIES | EVALUATION INDEXES | POPULATION | ENVIRONMENTAL DEGRADATION | SOCIOECONOMIC FACTORS | POPULATION DYNAMICS | POPULATION SIZE | URBANIZATION | FAMILY PLANNING | NATURAL RESOURCES | CONTRACEPTIVE PREVALENCE | POPULATION PROJECTION | HEALTH STATUS INDEXES | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Environment | Economic Factors | Demographic Factors | Urban Population Distribution | Population Distribution | Geographic Factors | Contraceptive Usage | Contraception | Estimation Techniques | Health Document Number: 323137 |
| 30. Peer Reviewed Title: Coverage of cervical cancer screening in 57 countries: Low average levels and large inequalities. Author: Gakidou E; Nordhagen S; Obermeyer Z Source: PLoS Medicine. 2008 Jun;5(6):e132. Abstract: The large declines in cervical cancer mortality in developed countries have been attributed to widespread screening, but it is unclear whether this success can be replicated in the developing world. It is generally assumed that screening coverage in the developing world is low; in this paper we substantiate this claim with evidence from 57 countries, thus contributing to the evidence base for formulation of effective policies. Our analysis of population-based surveys indicates that coverage of cervical cancer screening in developing countries is on average 19%, compared to 63% in developed countries, and ranges from 1% in Bangladesh to 73% in Brazil. Older and poor women, who are at the highest risk of developing cervical cancer, are least likely to be screened. Strategies for improving cervical cancer prevention must be adapted to meet the specific needs of individual countries: expanded screening may be a viable option where sufficient infrastructure and health system access exists, but novel strategies need to be considered in other settings. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | ESTIMATION TECHNIQUES | STATISTICAL STUDIES | WOMEN IN DEVELOPMENT | PAP SMEAR | SCREENING | PROGRAM ACCESSIBILITY | DELIVERY OF HEALTH CARE | AGE FACTORS | POVERTY | PERFORMANCE IMPROVEMENT | PELVIC EXAM | Research Methodology | Studies | Economic Development | Economic Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Health | Program Evaluation | Programs | Organization and Administration | Population Characteristics | Demographic Factors | Population | Socioeconomic Factors | Management | Physical Examinations and Diagnoses Document Number: 327414 |
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