1.  Peer Reviewed Title: Unmet need for contraception among HIV-positive women in Lesotho and implications for mother-to-child transmission. Author: Adair T Source: Journal of Biosocial Science. 2009 Mar;41(2):269-78. Abstract: In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26.4%), low knowledge of HIV status and a total fertility rate of 3.5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15-49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIVARIATE ANALYSIS | URBAN POPULATION | WOMEN IN DEVELOPMENT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | KNOWLEDGE | CONTRACEPTION | NEEDS ASSESSMENT | BIRTH SPACING | POVERTY | ATTITUDES | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Population Characteristics | Economic Development | Economic Factors | Disease Transmission Control | Prevention and Control | Diseases | Sociocultural Factors | Family Planning | Evaluation | Socioeconomic Factors | Psychological Factors | Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 331114 |
| 2. 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 |
| 3. 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 |
| 4. Peer Reviewed Title: Impact of the Family Health Project on infant mortality in Brazilian municipalities. Author: Aquino R; de Oliveira NF; Barreto ML Source: American Journal of Public Health. 2009 Jan;99(1):87-93. Abstract: The authors evaluated the effects of the Family Health Program (FHP), a strategy for reorganization of primary health care at a nationwide level in Brazil, on infant mortality at a municipality level. They collected data on FHP coverage and infant mortality rates for 771 of 5561 Brazilian municipalities from 1996 to 2004. They performed a multivariable regression analysis for panel data with a negative binomial response by using fixed-effects models that controlled for demographic, social, and economic variables. The authors observed a statistically significant negative association between FHP coverage and infant mortality rate. After controlling for potential confounders, the reduction in the infant mortality rate was 13.0%, 16.0%, and 22.0%, respectively for the 3 levels of FHP coverage. The effect of the FHP was greater in municipalities with a higher infant mortality rate and lower human development index at the beginning of the study period. The FHP had an important effect on reducing the infant mortality rate in Brazilian municipalities from 1996 to 2004. The FHP may also contribute toward reducing health inequalities. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MATHEMATICAL MODEL | EVALUATION INDEXES | INFANT | URBAN POPULATION | INFANT MORTALITY | AGE SPECIFIC DEATH RATE | PRIMARY HEALTH CARE | HEALTH STATUS INDEXES | INEQUALITIES | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Theoretical Models | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Death Rate | Health Services | Delivery of Health Care | Health | Socioeconomic Factors | Economic Factors Document Number: 328585 |
| 5. Title: Growth and nutritional status of pre-school children in India: rural-urban and gender differences. Author: Bharati P; Bharati S; Pal M; Chakrabarty S; Som S; Gupta R Source: Collegium Antropologicum. 2009 Mar;33(1):7-21. Abstract: This cross-sectional study of growth and nutritional status makes an attempt to find the gender and rural-urban differences among Indian preschool children. This study is based on the data of weight and height of children aged 0-35 months taken from 26 States (total 26,369 children; 13784 boys and 12585 girls). The children are found to be lighter and shorter compared to International standards irrespective of age and sex. Boys are heavier and taller than girls. Urban preschool children are heavier and taller compared to rural counterparts. In the urban area, higher percentages of girls are affected by underweight (37.1%) and stunting (35.0%) than boys. In rural areas, the prevalence of underweight is also higher among girls (47.9%) compared to boys (45.7%), which is found to be much significant (p < 0.01). There is a significant rural-urban as well as gender difference in growth and nutritional status of Indian preschool children. Language: English Keywords: INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | RURAL POPULATION | URBAN POPULATION | CHILDREN | PRIMARY SCHOOLS | GROWTH | CHILD NUTRITION | CHILD DEVELOPMENT | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Schools | Education | Biology | Nutrition | Health Document Number: 341201 |
| 6. Peer Reviewed Title: Prevalence of sexually transmitted infections among men who have sex with men in Zagreb, Croatia. Author: Bozicevic I; Rode OD; Lepej SZ; Johnston LG; Stulhofer A; Dominkovic Z; Vacak V; Lukas D; Begovac J Source: AIDS and Behavior. 2009 Apr;13(2):303-309. Abstract: We used respondent-driven sampling among men who have sex with men (MSM) in Zagreb, Croatia in 2006 to investigate the prevalence of HIV, other sexually transmitted infections and sexual behaviours. We recruited 360 MSM. HIV infection was diagnosed in 4.5%. The seroprevalence of antibodies to viral pathogens was: herpes simplex virus type-2, 9.4%; hepatitis A, 14.2%; hepatitis C, 3.0%. Eighty percent of participants were susceptible to HBV infection (HBs antigen negative, and no antibodies to HBs and HBc antigen). Syphilis seroprevalence was 10.6%. Prevalence of Chlamydia and gonorrhoea was 9.0%, and 13.2%, respectively. Results indicate the need for interventions to diagnose, treat and prevent sexually transmitted infections among this population. Language: English Keywords: CROATIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | KAP SURVEYS | MEN HAVING SEX WITH MEN | URBAN POPULATION | PREVALENCE | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK BEHAVIOR | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Behavior | Population Characteristics | Demographic Factors | Population | Measurement | Reproductive Tract Infections | Infections | Diseases Document Number: 340131 |
| 7. Title: Supportive friendships moderate the association between stressful life events and sexual risk taking among African American adolescents. Author: Brady SS; Dolcini MM; Harper GW; Pollack LM Source: Health Psychology. 2009 Mar;28(2):238-48. Abstract: OBJECTIVE: This study examined whether uncontrollable stressful life events were associated with sexual risk taking among adolescents across a 1-year period, and whether supportive friendships modified associations. DESIGN: Participants were 159 sexually active African American adolescents (57% male; mean age [SD] = 17.0 [1.5] years at baseline). Participants were recruited for in-person interviews through random digit dialing in one inner-city neighborhood characterized by high rates of poverty and crime relative to the surrounding city. MAIN OUTCOME MEASURES: Dependent variables included substance use before sexual activity and inconsistent condom use. RESULTS: Among adolescents who reported low levels of supportive friendships, uncontrollable stressors were associated with greater levels of sexual risk taking over time. In contrast, uncontrollable stressors were not associated with sexual risk taking among adolescents who reported high social support from friends; risk taking was typically moderate to high among these adolescents. CONCLUSION: Different processes may explain sexual risk taking among adolescents with varying levels of social support from friends. Adolescents with low support may be prone to engagement in health risk behavior as a stress response, while adolescents with high support may engage in risk behavior primarily due to peer socialization of risk. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | FRIENDS AND RELATIVES | BLACKS | ADOLESCENTS | PEER GROUPS | URBAN POPULATION | STRESS | SEX BEHAVIOR | RISK BEHAVIOR | DRUG USE AND ABUSE | INTERPERSONAL RELATIONS | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Knowledge Sources | Communication | Psychological Factors | Behavior Document Number: 341117 |
| 8. Peer Reviewed Title: Improvement of the patient flow in a large urban clinic with high HIV seroprevalence in Kampala, Uganda. Author: Castelnuovo B; Babigumira J; Lamorde M; Muwanga A; Kambugu A; Colebunders R Source: International Journal of STD and AIDS. 2009 Feb;20(2):123-4. Abstract: Antiretroviral treatment roll-out programmes in Africa often have difficulties to cope with the increasing number of clients. Based on the findings of a survey carried out in 2005 that showed long waiting times, innovative organizational changes (nurse visits and pharmacy-only refill visits) were introduced in our clinic. In August 2007, the survey was repeated to evaluate the impact of these changes. During both surveys we used the same standardized questionnaire. In 2007, 400 patients visited the clinic on the study day compared to 250 in 2005. The median time spent at the clinic decreased from 157 minutes in 2005 (range 22-426) to 124 minutes (15-314). All the waiting times for different services decreased except the time between the visit to the triage nurse and the doctors' visit. A similar methodology could be used by other health services to evaluate and compare different models of care. Language: English Keywords: UGANDA | RESEARCH REPORT | CLINICAL RESEARCH | SURVEYS | URBAN POPULATION | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | CLINIC VISITS | ANTIRETROVIRAL THERAPY | AIDS PREVENTION | CAPACITY BUILDING | TIME FACTORS | ORGANIZATION AND ADMINISTRATION | WAITING AREAS AND QUEUES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Sampling Studies | Studies | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Service Statistics | Program Activities | Programs | HIV | AIDS | Program Sustainability | Population Dynamics | Workplace | Employment | Macroeconomic Factors | Economic Factors Document Number: 331091 |
| 9. Title: Impact of a peer-group intervention on occupation-related behaviors for urban hospital workers in Malawi. Author: Chimango JL; Kaponda CN; Jere DL; Chimwaza A; Crittenden KS; Kachingwe SI; Norr KF; Norr JL Source: Journal of the Association of Nurses In AIDS Care. 2009 Jul-Aug;20(4):293-307. Abstract: Using a pre- and posttest design with no control group, the authors evaluated the impact of a peer-group intervention on work related knowledge and behavior for health workers at an urban hospital in Malawi. The authors surveyed unmatched random samples of health workers, observed workers on the job, and interviewed clients about hospital services at baseline and at 6 months after the intervention. Universal precautions knowledge, reported hand washing, and reported client teaching were significantly higher at the final evaluation. The outcome differences remained robust in multivariate analyses with controls for demographic factors of age, gender, education, food security, and job category. Observations reported consistently greater use of universal precautions, more respectful interactions, and more client teaching at final evaluation. Patient surveys reported more discussion with health workers about HIV at the final evaluation. Peer-group interventions can prepare health workers in Malawi for HIV prevention and offer a potential model for other African countries. Language: English Keywords: MALAWI | RESEARCH REPORT | SAMPLING STUDIES | URBAN POPULATION | HEALTH PERSONNEL | PEER EDUCATORS | HIV PREVENTION | INTERVENTIONS | HOSPITALS | TRAINING PROGRAMS | UNIVERSAL PRECAUTIONS | KNOWLEDGE | HANDWASHING | INTERPERSONAL RELATIONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Education | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Health Facilities | Safety | Public Health | Sociocultural Factors | Hygiene | Behavior Document Number: 342814 |
| 10. Peer Reviewed Title: Estimating HIV prevalence and risk behaviors among high-risk heterosexual men with multiple sex partners: use of respondent-driven sampling. Author: Chopra M; Townsend L; Johnston L; Mathews C; Tomlinson M; O'bra H; Kendall C Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51(1):72-7. Abstract: OBJECTIVES: To collect HIV data from high-risk men who have multiple, younger, female sex partners in a periurban township in South Africa. DESIGN: Unlinked anonymous cross-sectional survey using respondent-driven sampling. METHODS: Survey conducted among men aged 18 years or older who reported having had sex with more than 1 female partner in the previous 3 months (one of whom was either 3 or more years younger than the participant or below the age of 24) and lived in the area of recruitment. RESULTS: The median age of the 421 recruited men was 28 years (range: 18-62 years). They reported a median of 6 sexual partners (range: 2-39) during the past 3 months, and 51% (confidence interval: 45.0 to 59.6) reported inconsistent condom use with their casual partners. During the 3 months before the survey, 98% of men reported having concurrent sexual relationships. HIV prevalence was 12.3% (confidence interval: 8.3% to 16.9%). Being older than 24 years and not using a condom during the last sexual intercourse with a 1-time sexual partner were significantly associated with HIV infection. CONCLUSIONS: This group of heterosexual urban men practice high levels of risky sexual behavior and are an important group that require more targeted HIV surveillance and prevention interventions. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | HETEROSEXUALS | MEN | URBAN POPULATION | HIV INFECTIONS | PREVALENCE | MULTIPLE PARTNERS | CONDOM USE | RISK BEHAVIOR | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Behavior | Demographic Factors | Population | Population Characteristics | Viral Diseases | Diseases | Measurement | Sexual Partners | Risk Reduction Behavior Document Number: 342370 |
| 11. Peer Reviewed Title: Fertility intentions and reproductive health care needs of people living with HIV in Cape Town, South Africa: implications for integrating reproductive health and HIV care services. Author: Cooper D; Moodley J; Zweigenthal V; Bekker LG; Shah I; Myer L Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S38-S46. Abstract: Tailoring sexual and reproductive health services to meet the needs of people living with the human immuno-deficiency virus (HIV) is a growing concern but there are few insights into these issues where HIV is most prevalent. This cross-sectional study investigated the fertility intentions and associated health care needs of 459 women and men, not sampled as intimate partners of each other, living with HIV in Cape Town, South Africa. An almost equal proportion of women (55%) and men (43%) living with HIV, reported not intending to have children as were open to the possibility of having children (45 and 57%, respectively). Overall, greater intentions to have children were associated with being male, having fewer children, living in an informal settlement and use of antiretroviral therapy. There were important gender differences in the determinants of future childbearing intentions, with being on HAART strongly associated with women's fertility intentions. Gender differences were also apparent in participants' key reasons for wanting children. A minority of participants had discussed their reproductive intentions and related issues with HIV health care providers. There is an urgent need for intervention models to integrate HIV care with sexual and reproduction health counseling and services that account for the diverse reproductive needs of these populations. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | URBAN POPULATION | PERSONS LIVING WITH HIV/AIDS | FERTILITY PREFERENCES | REPRODUCTIVE HEALTH | HEALTH SERVICES | NEEDS | COUNSELING | ANTIRETROVIRAL THERAPY | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | FERTILITY DETERMINANTS | SEX FACTORS | HIV/FP INTEGRATION | INTEGRATED PROGRAMS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Fertility | Population Dynamics | Health | Delivery of Health Care | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | HIV | Disease Transmission Control | Prevention and Control Document Number: 341901 |
| 12. Peer Reviewed Title: Factors associated with low early uptake of a national program to prevent mother to child transmission of HIV (PMTCT): results of a survey of mothers and providers, Botswana, 2003. Author: Creek T; Ntumy R; Mazhani L; Moore J; Smith M; Han G; Shaffer N; Kilmarx PH Source: AIDS and Behavior. 2009 Apr;13(2):356-364. Abstract: In Francistown, Botswana, approximately 40% of pregnant women are HIV positive. PMTCT has been available since 1999, antiretroviral (ARV) therapy since 2001, and 95% of women have antenatal care (ANC) and deliver in hospital. However, in 2002, only 33% of ANC clients were tested for HIV, and not all women with HIV received services. In 2003, we conducted a survey of 504 pregnant and postpartum women to explore reasons for poor program uptake, and interviewed 82 health providers about PMTCT. Most women (95%) believed that all pregnant women should be tested for HIV. In multivariate analysis, factors associated with having an HIV test included being interviewed at an urban site, having a high PMTCT knowledge score, knowing someone receiving PMTCT or ARV therapy, and having a partner who had been tested for HIV. Neither fear of stigma nor resistance from partners were frequent reasons for refusing an HIV test. Providers of HIV services reported discomfort with their knowledge and skills, and 84% believed HIV testing should be routine. Ensuring adequate knowledge about HIV and PMTCT, creating systems whereby HIV-positive women receiving care can educate and support other women, and making HIV testing routine for pregnant women may improve the uptake of HIV testing. Language: English Keywords: BOTSWANA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | SEXUAL PARTNERS | POSTPARTUM WOMEN | URBAN POPULATION | HEALTH PERSONNEL | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | GOVERNMENT PROGRAMS | ANTENATAL CARE | KNOWLEDGE | HIV TESTING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Puerperium | Reproduction | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 340126 |
| 13. Peer Reviewed Title: Insertion of intrauterine contraceptives immediately following first- and second-trimester abortions. Author: Drey EA; Reeves MF; Ogawa DD; Sokoloff A; Darney PD; Steinauer JE Source: Contraception. 2009 May;79(5):397-402. Abstract: BACKGROUND: The study was conducted to assess the continuation and patient satisfaction with intrauterine contraception (IUC) insertion immediately after elective abortion in the first and second trimesters in an urban, public hospital-based clinic. STUDY DESIGN: A cohort of 256 women who elected to have insertion of a copper-T IUC (CuT380a) or a levonorgestrel-releasing IUC (LNG-IUC) were followed postoperatively by phone calls or chart review to evaluate satisfaction and continuation with the method. RESULTS: Of our 256 subjects, 123 had first-trimester abortions and 133 had second-trimester abortions (14 or more weeks). Median time to follow-up was 8 weeks (range 7-544 days). Nineteen discontinuations occurred: eight (6.5%, 95% CI 2.8-12.4%) following first-trimester and 11 (8.3%, 95% CI 4.2-14.3%) following second-trimester abortion (p=.6). Five women reported expulsion; one (0.8%, 95% CI 0.0-4.4%) in the first-trimester group and four (3.0%, 95% CI 0.8-7.5%) in the second-trimester group. (p=.4) Seven infections resulting in discontinuation occurred (2.7%, 95% CI 1.1-5.6%); none were positive for gonorrhea or chlamydia at time of insertion. No perforations occurred. Nearly all (93.8%) of the women were satisfied with IUC. Rates of satisfaction between women after first- and second-trimester abortions were equal. CONCLUSION: In an urban clinic, IUC has high initial continuation and high patient satisfaction when inserted immediately following either first- or second-trimester abortions. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN | URBAN POPULATION | POSTABORTAL PROGRAMS | UTERUS | PREGNANCY, SECOND TRIMESTER | IUD, COPPER RELEASING | CONTRACEPTION CONTINUATION | SATISFACTION | IUD, HORMONE RELEASING | LEVONORGESTREL | PREGNANCY, FIRST TRIMESTER | IUD EXPULSION | Developed Countries | North America | Americas | Family Planning Surveys | Family Planning | Demographic Factors | Population | Population Characteristics | Family Planning Programs | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Pregnancy | Reproduction | IUD | Contraceptive Methods | Contraception | Contraceptive Usage | Psychological Factors | Behavior | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 330942 |
| 14. Peer Reviewed Title: What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya. Author: Fotso J; Ezeh A; Madise N; Ziraba A; Ogollah R Source: Maternal and Child Health Journal. 2009 Jan;13(1):130-7. Abstract: Objectives: The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings. The objective of this paper is to identify the factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and "appropriate" health facilities. Methods: The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either "inappropriate" or "appropriate". Place of delivery is the dependent variable. Ordered logit models were used to quantify the effects of covariates on the choice of place of delivery, defined as a three-category ordinal variable. Results: Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy "wantedness", and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Conclusion: Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | SLUMS | URBAN POPULATION | WOMEN IN DEVELOPMENT | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | CHILDBIRTH | EDUCATIONAL STATUS | PROMOTION | ANTENATAL CARE | MULTIPARITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Economic Development | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Socioeconomic Status | Socioeconomic Factors | Marketing | Parity | Fertility Measurements | Fertility | Population Dynamics Document Number: 308031 |
| 15. Peer Reviewed Title: Stuips, spuits and prophet ropes: the treatment of abantu childhood illnesses in urban South Africa. Author: Friend-du Preez N; Cameron N; Griffiths P Source: Social Science and Medicine. 2009 Jan;68(2):343-51. Abstract: With a paucity of data on health-seeking behaviour for childhood illnesses in urban South Africa, a mixed method approach was used to investigate the treatment of abantu childhood illnesses in Johannesburg and Soweto between March and June 2004. In-depth interviews were held with caregivers (n=5), providers of traditional (n=6) and Western (n=6) health care, as well as five focus groups with caregivers. A utilisation-based survey was conducted with 206 black African caregivers of children under 6 years of age from one public clinic in Soweto (n=50), two private clinics in Johannesburg (50 caregivers in total), two public hospitals from Johannesburg and Soweto (53 caregivers in total) and two traditional healers from Johannesburg and Orange Farm (53 caregivers in total), an informal settlement on the outskirts of Johannesburg. The symptoms of several childhood abantu health problems, their treatment with traditional, church and home remedies, and influences on such patterns of resort are described. Despite free primary health care for children under 6 years, the pluralistic nature of health-seeking in this urban environment highlights the need for community and household integrated management of childhood illnesses and a deeper understanding of how symptoms may be interpreted and treated in the context of the local belief system. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | URBAN POPULATION | TRADITIONAL MEDICINE | CHILD HEALTH | INFECTIONS | TREATMENT | BELIEFS | BEHAVIOR | PRIMARY HEALTH CARE | UTILIZATION OF HEALTH CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Medical Procedures | Culture | Sociocultural Factors Document Number: 331180 |
| 16. Peer Reviewed Title: Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics. Author: Ganatra B; Kalyanwala S; Elul B; Coyaji K; Tewari S Source: Global Public Health. 2009 May 8;:1-12. Abstract: We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed. Language: English Keywords: INDIA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | URBAN POPULATION | ABORTION | PERCEPTION | MOTIVATION | FEAR | EMOTIONS | LOGISTICS | NEEDS ASSESSMENT | DECISION MAKING | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Psychological Factors | Behavior | Management | Organization and Administration | Evaluation Document Number: 341474 |
| 17. Peer Reviewed Title: Epidemiologic study of human immunodeficiency virus (HIV) Infection in the patients referred to health centers in Hamadan province, Iran. Author: Ghannad MS; Arab SM; Mirzaei M; Moinipur A Source: AIDS Research and Human Retroviruses. 2009 Mar;25(3):277-83. Abstract: Acquired immunodeficiency syndrome (AIDS) is one of the most important infectious diseases threatening the world's population today. The main aim of this study was to assess the epidemiologic features of HIV/AIDS from January 1989 to March 2007 in Hamadan province, Iran. In a cross-sectional study, epidemiodemographic characteristics of HIV/AIDS-positive patients during a period of 17 years were collected from health centers in Hamadan province. This study showed that about 1.8% of HIV/AIDS cases in Iran involved people who lived in Hamadan province. Further study is needed to determine the reasons for this. From January 1989 to March 2007, 285 individuals including 275 males and 10 females were infected with HIV in this province. The study showed that 88% of patients lived in urban areas while 12% involved a rural population. Hamadan city had the highest rate of HIV/AIDS infection and death with 191 and 33 individuals, respectively. The main transmission route was intravenous drug use with 78%. From 28 patients who were entered into the AIDS phase, only 10 patients returned to health centers to be covered under definite treatment. The establishment of the Triangular Clinic can be presented as the starting point in the organization of infected people to detect HIV/AIDS. Altogether, efforts in reducing the impact of HIV in this province to date can be considered beneficial. Continuous laboratory diagnostic strategies may lead in time to therapeutic approaches that result in appropriate outcomes. Language: English Keywords: IRAN | ADMINISTRATIVE DISTRICTS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | IV DRUG USERS | PREVALENCE | HIV INFECTIONS | SEX FACTORS | RISK BEHAVIOR | HIV TESTING | Middle East | Developing Countries | Geographic Factors | Population | Research Methodology | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Drug Use and Abuse | Behavior | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 331235 |
| 18. Peer Reviewed Title: Alcohol abuse, sexual risk behaviors, and sexually transmitted infections in women in Moshi urban district, northern Tanzania. Author: Ghebremichael M; Paintsil E; Larsen U Source: Sexually Transmitted Diseases. 2009 Feb;36(2):102-7. Abstract: BACKGROUND: To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexually transmitted infections (STIs). METHODS: Two thousand and nineteen women aged 20 to 44 were randomly selected in a 2-stage sampling from the Moshi urban district of northern Tanzania. Participant's demographic and socio-economic characteristics, alcohol use, sexual behaviors, and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas, and mycoplasma genitalium infections. RESULTS: Adjusted analyses showed that a history of physical (OR = 2.05; 95% CI: 1.06-3.98) and sexual violence (OR = 1.63; 95% CI: 1.05-2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR = 1.66; 95% CI: 1.01-2.73). Women who abused alcohol were more likely to report STIs symptoms (OR = 1.61; 95% CI: 1.08-2.40). Women who had multiple sexual partners were more likely to have an STI (OR = 2.41; 95% CI: 1.46-4.00) compared to women with 1 sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR = 0.86; 95% CI: 0.55-1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners. CONCLUSIONS: The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs. Language: English Keywords: TANZANIA | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | URBAN POPULATION | MULTIPLE PARTNERS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK BEHAVIOR | ALCOHOL USE AND ABUSE | PREVALENCE | RAPE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Reproductive Tract Infections | Infections | Diseases | Measurement | Crime | Social Problems | Sociocultural Factors Document Number: 330387 |
| 19. Title: Contraceptive attitudes among inner-city African American female adolescents: Barriers to effective hormonal contraceptive use. Author: Gilliam ML; Davis SD; Neustadt AB; Levey EJ Source: Journal of Pediatric and Adolescent Gynecology. 2009 Apr;22(2):97-104. Abstract: STUDY OBJECTIVE: To better understand the contraceptive attitudes of low-income, inner-city African American female adolescents. DESIGN: We conducted four focus group sessions with African American female adolescents. SETTING: An urban, community health clinic serving low-income patients on Chicago's south side. PARTICIPANTS: African American female adolescents (n = 15) between 14 and 19 years of age. INTERVENTIONS: Focus group sessions lasting approximately 90 minutes in length were conducted using a pre-determined script with set probes and open-ended questions. MAIN OUTCOME MEASURES: Qualitative analysis was conducted to identify major themes related to adolescents' contraceptive attitudes. RESULTS: Six themes related to the contraceptive attitudes of these adolescents emerged: Concerns About Hormones, Concerns About Privacy, Concerns About Compliance, Limited Awareness of New Methods of Hormonal Contraception (HC), Preference for Condoms, and Acceptability of Emergency Contraception (EC). Overall, adolescents in these sessions expressed skepticism and unwillingness to use continuous methods of HC. For some adolescents, concerns about hormones, privacy, and compliance outweighed their concerns about pregnancy. CONCLUSION: Concerns about perceived side effects and long-term health risks associated HC and privacy in obtaining contraception and reproductive health care, as well as concerns about ability to comply with daily and weekly HC regimens are common among African American female adolescents and may deter consistent HC use. Although condoms and EC appear to be highly acceptable among this group, adolescents also report a number of barriers to their consistent use. Efforts to reduce early, unintended pregnancy among African American youth should focus on addressing adolescents' HC-related concerns, improving access to EC, and helping female adolescents effectively negotiate condom use. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | FOCUS GROUPS | BLACKS | LOW INCOME POPULATION | ADOLESCENTS, FEMALE | URBAN POPULATION | ATTITUDES | CONTRACEPTIVE SAFETY | PRIVACY | CONTRACEPTION CONTINUATION | CONDOM USE | CONTRACEPTIVE METHODS | KNOWLEDGE | EMERGENCY CONTRACEPTION | Developed Countries | North America | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Adolescents | Youth | Age Factors | Psychological Factors | Behavior | Safety | Public Health | Health | Contraceptive Usage | Contraception | Family Planning | Risk Reduction Behavior | Sociocultural Factors Document Number: 330953 |
| 20. Peer Reviewed Title: Lack of utility of risk score and gynecological examination for screening for sexually transmitted infections in sexually active adolescents. Author: Guimaraes EM; Guimaraes MD; Vieira MA; Bontempo NM; Seixas MS; Garcia MS; Daud LE; Cortes RL; Alves Mde F Source: BMC Medicine. 2009;7:8. Abstract: BACKGROUND: Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiania, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination. METHODS: A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both. RESULTS: The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value. CONCLUSION: The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required. Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS, FEMALE | URBAN POPULATION | RISK ASSESSMENT | SEX BEHAVIOR | GYNECOLOGY | CERVICAL EFFECTS | PREVALENCE | CHLAMYDIA | GONORRHEA | SIGNS AND SYMPTOMS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Evaluation | Behavior | Medicine | Health Services | Delivery of Health Care | Health | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases Document Number: 331079 |
| 21. Peer Reviewed Title: Rapidly increasing prevalence of HIV and syphilis and HIV-1 subtype characterization among men who have sex with men in Jiangsu, China. Author: Guo H; Wei JF; Yang H; Huan X; Tsui SK; Zhang C Source: Sexually Transmitted Diseases. 2009 Feb;36(2):120-5. Abstract: OBJECTIVES: To investigate the prevalence of HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis among men who have sex with men (MSM) in 2 cities of Jiangsu, China, and to characterize the HIV-1 subtypes prevalent among this population. METHODS: During September 2006 and July 2007, 296 and 173 MSM were recruited from Nanjing and Yangzhou, respectively. Sera samples were collected and tested for HIV, HBV, HCV, and syphilis infections. The nucleotide sequences of p17 and C2V3 regions were determined by RT-nested-PCR and sequencing. HIV-1 subtypes were characterized by phylogenetic analysis. RESULTS: The prevalence of HIV, HBV, HCV, and syphilis infections among MSM was 5.8%, 11.1%, 0.7%, and 27.7%, respectively. The prevalence of HIV and syphilis was significantly higher in 2006-2007 than in 2003 (P Language: English Keywords: CHINA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | GENETIC TECHNIQUES | MEN HAVING SEX WITH MEN | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | PREVALENCE | HIV INFECTIONS | SYPHILIS | HEPATITIS | GENETICS | CHROMOSOME ABNORMALITIES | Asia, Eastern | Asia | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sex Behavior | Behavior | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Biology | Neonatal Diseases and Abnormalities Document Number: 330373 |
| 22. Peer Reviewed Title: Reproductive and family planning history, knowledge, and needs: A community survey of low-income women in Beijing, China. Author: He H; Ostbye T; Daltveit AK Source: BMC Women's Health. 2009 Aug 10;9(1):23. Abstract: ABSTRACT: BACKGROUND: The reproductive health status of China's low-income urban women is believed to be poor. Therefore, understanding their reproductive history and needs and improving services provision is very important. However, few studies have been done to assess reproductive health status, knowledge and needs in this low-income population. The purpose of this study is to broadly assess reproductive and family planning history, knowledge and health needs among low income urban women with an aim to informing health services interventions. METHODS: 1642 low-income women age 18-49 from Haidian district, Beijing were selected. All were interviewed via a standardized questionnaire in 2006. RESULTS: Most women reported at least one pregnancy and delivery (97.7%, 98.3%). Deliveries in hospitals (97.3%) by medical personnel (98.5%) were commonplace, as was receipt of antenatal care (86.0%). Nearly half had at least one abortion, with most (56.0%) performed in district hospitals, by physicians (95.6%), and paid for out-of-pocket (64.4%). Almost all (97.4%) used contraception, typically IUDs or condoms. Reproductive knowledge was limited. Health needs emphasized by the participants included popularizing reproductive health information, being able to discuss their reproductive health concerns, free reproductive health insurance, examination and treatment. CONCLUSIONS: Among poor urban women in Beijing, antenatal care and contraceptive use were common. However, abortions were also common. Knowledge about reproductive health was limited. There is a need for better reproductive health education, free medical care and social support. Language: English Keywords: CHINA | RESEARCH REPORT | SAMPLING STUDIES | FAMILY PLANNING SURVEYS | LOW INCOME POPULATION | URBAN POPULATION | WOMEN | REPRODUCTIVE HEALTH | PREGNANCY HISTORY | KNOWLEDGE | NEEDS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Family Planning | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | Health | Fertility Measurements | Fertility | Population Dynamics | Sociocultural Factors Document Number: 342493 |
| 23. Peer Reviewed Title: Gender differences in the prevalence and behavioral risk factors on HIV in South African drug users. Author: Hedden SL; Whitaker D; Floyd L; Latimer WW Source: AIDS and Behavior. 2009 Apr;13(2):288-296. Abstract: South Africa continues to be the global epicenter of HIV infection. Further, extensive gender disparities in HIV infection exist with females four times as likely to be infected with HIV/AIDS as males (UNAIDS, AIDS epidemic update, 2006; WHO, Epidemiological fact sheets on HIV/AIDS and sexually transmitted infections, 2006). A cross-sectional collection of drug users recruited in the Pretoria region of South Africa (N = 385) was used to model HIV infection as a function of sexual risk behaviors and drug use as modified by gender. Receiving money from illicit sources and knowing someone with AIDS were loosely associated with HIV. Gender interactions were observed for age, cocaine use and condom use. Gender stratified analyses revealed that males who used condoms, were younger and tested negative for cocaine use were less likely to test positive for HIV. Findings suggest that males may have more control of risk behaviors and support the need for gender specific prevention strategies. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | PREVALENCE | HIV INFECTIONS | RISK BEHAVIOR | SEX BEHAVIOR | DRUG USE AND ABUSE | CRIME | SEX FACTORS | CONDOM USE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Measurement | Behavior | Social Problems | Sociocultural Factors | Risk Reduction Behavior Document Number: 340127 |
| 24. Title: Determinants of low birth weight in urban Pakistan. Author: Janjua NZ; Delzell E; Larson RR; Meleth S; Kristensen S; Kabagambe E; Sathiakumar N Source: Public Health Nutrition. 2009 Jun;12(6):789-98. Abstract: OBJECTIVE: To identify determinants of low birth weight (LBW) in Karachi, Pakistan, including environmental exposures and nutritional status of the mother during pregnancy. DESIGN: Cross-sectional study.ParticipantsFive hundred and forty mother-infant pairs. We interviewed mothers about obstetric history, diet and exposure to Pb. We measured birth weight and blood lead level (BLL). We performed multiple log binomial regression analysis to identify factors related to LBW. RESULTS: Of 540 infants, 100 (18.5 %) weighed Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | URBAN POPULATION | PREGNANCY | LOW BIRTH WEIGHT | ASCORBIC ACID | NUTRITION INDEXES | Developing Countries | Asia, Southern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Vitamins and Minerals | Nutrition | Health Document Number: 342264 |
| 25. Peer Reviewed Title: Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan. Author: Jehan I; Harris H; Salat S; Zeb A; Mobeen N; Pasha O; McClure EM; Moore J; Wright LL; Goldenberg RL Source: Bulletin of the World Health Organization. 2009 Feb;87(2):130-8. Abstract: OBJECTIVE: To evaluate the prevalence, sex distribution and causes of neonatal mortality, as well as its risk factors, in an urban Pakistani population with access to obstetric and neonatal care. METHODS: Study area women were enrolled at 20-26 weeks' gestation in a prospective population-based cohort study that was conducted from 2003 to 2005. Physical examinations, antenatal laboratory tests and anthropometric measures were performed, and gestational age was determined by ultrasound to confirm eligibility. Demographic and health data were also collected on pretested study forms by trained female research staff. The women and neonates were seen again within 48 hours postpartum and at day 28 after the birth. All neonatal deaths were reviewed using the Pattinson et al. system to assign obstetric and final causes of death; the circumstances of the death were determined by asking the mother or family and by reviewing hospital records. Frequencies and rates were calculated, and 95% confidence intervals were determined for mortality rates. Relative risks were calculated to evaluate the associations between potential risk factors and neonatal death. Logistic regression models were used to compute adjusted odds ratios. FINDINGS: Birth outcomes were ascertained for 1280 (94%) of the 1369 women enrolled. The 28-day neonatal mortality rate was 47.3 per 1000 live births. Preterm birth, Caesarean section and intrapartum complications were associated with neonatal death. Some 45% of the deaths occurred within 48 hours and 73% within the first week. The primary obstetric causes of death were preterm labour (34%) and intrapartum asphyxia (21%). Final causes were classified as immaturity-related (26%), birth asphyxia or hypoxia (26%) and infection (23%). Neither delivery in a health facility nor by health professionals was associated with fewer neonatal deaths. The Caesarean section rate was 19%. Almost all (88%) neonates who died received treatment and 75% died in the hospital. CONCLUSION: In an urban population with good access to professional care, we found a high neonatal mortality rate, often due to preventable conditions. These results suggest that, to decrease neonatal mortality, improved health service quality is crucial. Language: English Keywords: PAKISTAN | RESEARCH REPORT | PROSPECTIVE STUDIES | URBAN POPULATION | NEONATAL MORTALITY | RISK FACTORS | PREVALENCE | PREMATURE LABOR | CESAREAN SECTION | CAUSES OF DEATH | MATERNAL-CHILD HEALTH SERVICES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Health | Measurement | Pregnancy Outcomes | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Primary Health Care Document Number: 341787 |
| 26. Peer Reviewed Title: HIV Incidence Rates and Risk Factors for Urban Women in Zambia: Preparing for a Microbicide Clinical Trial. Author: Kapina M; Reid C; Roman K; Cyrus-Cameron E; Kwiecien A; Weiss S; Vermund SH Source: Sexually Transmitted Diseases. 2009 Feb 9; Abstract: OBJECTIVES:: A preparedness study was conducted to evaluate the suitability of sites and populations following the same study procedures intended for a larger scale microbicide efficacy trial. In the process the study evaluated human immunodeficiency virus (HIV) incidence, prevalence, and risk profiles for HIV-acquisition among young women in urban Zambia. METHODS:: Women aged 16 to 49 years were screened for participation in the study that involved HIV/sexually transmitted infection testing and the assessment of sexual behavioral characteristics. Two hundred thirty-nine eligible women were enrolled and followed up for 12 months. RESULTS:: Baseline HIV prevalence at screening was 38.7% (95% CI: 34.2%-43.3%). The highest age-specific prevalence of HIV was 54.1% (95% CI: 46.3%-61.8%) seen in women aged 26 to 34 years. HIV incidence was 2.6% per 100 woman years. Pregnancy rates were high at 17.4 per 100 woman years (95% CI: 12.2-24.1). CONCLUSION:: It was concluded that our general population sample, characterized by high HIV prevalence and ongoing incidence rates despite receiving regular risk reduction counseling and free condoms qualifies for future microbicide studies.A microbicide preparedness study conducted in Lusaka, Zambia found high HIV prevalence and appreciable HIV incidence in a population of women in an urban setting. Language: English Keywords: ZAMBIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL TRIALS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | URBAN POPULATION | PREVALENCE | RISK FACTORS | MICROBICIDES | HIV PREVENTION | HIV INFECTIONS | INCIDENCE | CONDOMS | COUNSELING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Measurement | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Viral Diseases | Diseases | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341501 |
| 27. Peer Reviewed Title: The impact of an urban sewerage system on childhood diarrhoea in Tehran, Iran: a concurrent control field trial. Author: Kolahi AA; Rastegarpour A; Sohrabi MR Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 May;103(5):500-5. Abstract: The stepwise implementation of the Tehran Sewerage Project provided a convenient setting for which health impacts of an urban sewerage system could be examined with appropriate controls. In 2001, Tehran municipal districts 17 and 18 had no sewerage system connections, but areas within these districts had been planned to be connected by 2006. These areas were chosen as an intervention group. Neighbouring areas, with a similar socio-economic status, that had not been planned to connect to the sewerage system by 2006, were chosen as controls. Homes within designated areas were randomized and surveyed twice to determine diarrhoea incidences for children aged 6-60 months, once in 2001, before connection to the sewerage system, and once again in 2006, after the intervention. By 2006, 76% of the homes in the intervention zones were connected to the sewerage system. In the first stage of the study, diarrhoea incidences for intervention and control groups were 18.6 and 16.6%, respectively. In the second stage, incidences decreased to 10.1 and 10.5%, respectively. Data collected from 4179 children demonstrated that the diarrhoea incidence had decreased by 46% in the intervention group, whereas it had decreased by 37% in the controls. Language: English Keywords: IRAN | RESEARCH REPORT | INCIDENCE | URBAN POPULATION | SANITATION | PUBLIC HEALTH | DIARRHEA | WASTE MANAGEMENT | HYGIENE | Middle East | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Health | Diseases | Environment Document Number: 342515 |
| 28. Peer Reviewed Title: Herpes Simplex Virus Type-2 Seropositivity Among Ever Married Women in South and North Vietnam: A Population-Based Study. Author: Le HV; Schoenbach VJ; Herrero R; Hoang Pham AT; Nguyen HT; Nguyen TT; Munoz N; Franceschi S; Vaccarella S; Parkin MD; Snijders PJ; Morrow RA; Smith JS Source: Sexually Transmitted Diseases. 2009 Jul 16; Abstract: OBJECTIVE:: To investigate herpes simplex virus type-2 (HSV-2) seropositivity and associated risk factors in Vietnamese women. METHODS:: Cross-sectional study with personal interviews and gynecological examinations among population-based samples of ever married women, aged 15 to 69 years, living in Ho Chi Minh City (HCMC) and Hanoi in 1997. Type-specific IgG antibodies against HSV-2 were detected using HerpeSelect ELISA (Focus Diagnostics). Adjusted prevalence ratios were estimated with log-binomial regression. RESULTS:: HSV-2 seroprevalence was higher in 1106 women from HCMC (30.8%, 95% CI: 28.1-33.4, age-standardized to 2000 world standard population) than in 1170 women from Hanoi (8.8%, 95% CI: 7.1-10.5). In HCMC, HSV-2 seroprevalence was higher for women who were not married, HPV DNA positive, current hormonal contraceptive users, or had a history of multiple sexual partners or spontaneous abortion. HCMC seroprevalence was inversely associated with educational attainment, age at first intercourse, and age at first pregnancy. In the multivariable model for HCMC, a trend of increasing HSV-2 seroprevalence with age was observed, and prevalence ratios were nearly identical to age-adjusted prevalence ratios for marital status, age at first pregnancy, and HPV DNA positivity. CONCLUSIONS:: HSV-2 was notably less prevalent in Hanoi than HCMC, where it was associated with traditional HSV-2 risk factors. These results are likely explained by socio-cultural, historical, economic, and demographic factors related to urban-rural and regional differences. Future population-based studies should include men and never-married women as a next step toward obtaining a more nearly complete picture of HSV-2 epidemiology in Vietnam. Language: English Keywords: VIETNAM | RESEARCH REPORT | SAMPLING STUDIES | URBAN POPULATION | EVER MARRIED | WOMEN | HERPES GENITALIS | PREVALENCE | LABORATORY PROCEDURES | RISK FACTORS | AGE FACTORS | SEX BEHAVIOR | Asia, Southeastern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior Document Number: 342279 |
| 29. Peer Reviewed Title: Contraceptive use and pregnancy outcome in three generations of Swedish female teenagers from the same urban population. Author: Lindh I; Blohm F; Andersson-Ellstrom A; Milsom I Source: Contraception. 2009 Aug;80(2):163-9. Abstract: BACKGROUND: The primary objective of the study was to describe contraceptive use, reasons for discontinuation of contraception and pregnancy outcome in three generations of female teenagers over a period of 20 years. The secondary objective was to describe the relationship between contraception, smoking, body mass index (BMI) and socioeconomic status (SES). STUDY DESIGN: A cross-sectional comparison of 19-year-old women born in 1962, 1972 and 1982 and living in the city of Gothenburg, Sweden, in 1981, 1991 and 2001 was conducted. Contraceptive use, pregnancy outcome, smoking and weight/height were assessed by a postal questionnaire. RESULTS: Current contraceptive use was unchanged between the 62 (60%) and 72 cohorts (62%) but had increased (p<.01) in the 82 cohort (78%); there was no difference in contraceptive use between SES groups at any time. Condom use alone increased over time (p<.01), and the use of oral contraception and a condom together had increased in the 72 and 82 cohorts compared to the 62 cohort (p<.01). Reasons given for using and discontinuing oral contraceptives in three generations of teenagers were studied over 20 years. In addition to contraception, oral contraception was used to reduce dysmenorrhea and heavy bleeding. Discontinuation due to bleeding disturbances decreased (p<.01) over time, whereas discontinuation due to mental side effects increased (p<.01). The percentage of women who had been pregnant at < or =19 years of age in the 82 cohort (7%) was lower (p<.01) than in the 1962 (11%) and 1972 (13%) cohorts. However, there was a successive increase (p<.001) in the percentage of women who had been pregnant more than once at < or =19 years of age (1962/1972/1982: pregnant more than once, 8%/21%/31%). Smoking decreased over time (p<.01) and was no longer related to SES in the 82 cohort. BMI increased (p<.01) over time. There was no difference in BMI between SES groups in the 62 and 72 cohorts but was higher in the low-SES group in the 82 cohort compared to the middle (p<.01) and high (p<.05) SES groups. CONCLUSIONS: Contraceptive use was higher in the 82 cohort where there was a corresponding reduction in the percentage of women who had been pregnant at < or =19 years of age compared with the 62 and 72 cohorts. Discontinuation of oral contraception due to mental side effects increased over time. The prevalence of smoking decreased and BMI increased, and there were changes in smoking prevalence and BMI in the different SES groups over time. Language: English Keywords: SWEDEN | |