| 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. Peer Reviewed Title: Emergence of a peak in early infant mortality due to HIV/AIDS in South Africa. Author: Bourne DE; Thompson M; Brody LL; Cotton M; Draper B; Laubscher R; Abdullah MF; Myers JE Source: AIDS. 2009 Jan 2;23(1):101-6. Abstract: OBJECTIVES: South Africa has among the highest levels of HIV prevalence in the world. Our objectives are to describe the distribution of South African infant and child mortality by age at fine resolution, to identify any trends over recent time and to examine these trends for HIV-associated and non HIV-associated causes of mortality. METHODS: A retrospective review of vital registration data was conducted. All registered postneonatal deaths under 1 year of age in South Africa for the period 1997-2002 were analysed by age in months using a generalized linear model with a log link and Poisson family. RESULTS: Postneonatal mortality increased each year over the period 1997-2002. A peak in HIV-related deaths was observed, centred at 2-3 months of age, rising monotonically over time. CONCLUSION: We interpret the peak in mortality at 2-3 months as an indicator for paediatric AIDS in a South African population with high HIV prevalence and where other causes of death are not sufficiently high to mask HIV effects. Intrauterine and intrapartum infection may contribute to this peak. It is potentially a useful surveillance tool, not requiring an exact cause of death. The findings also illustrate the need for early treatment of mother and child in settings with very high HIV prevalence. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | RETROSPECTIVE STUDIES | LINEAR REGRESSION | INFANT | PERSONS LIVING WITH HIV/AIDS | INFANT MORTALITY | AIDS | CAUSES OF DEATH | CHILD MORTALITY | VITAL STATISTICS | MOTHER-TO-CHILD TRANSMISSION | DEATH RATE | AGE SPECIFIC DEATH RATE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Statistical Regression | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Mortality | Population Dynamics | Population Statistics | Transmission | Infections Document Number: 330334 |
3.  Title: [Trends in sex ratio at birth according to parental social positions: results from vital statistics birth, 1981-2004 in Korea] Author: Chun H; Kim IH; Khang YH Source: Journal of Preventive Medicine and Public Health. 2009 Mar;42(2):143-50. Abstract: OBJECTIVES: South Korea has experienced unprecedented ups and downs in the sex ratio at birth (SRB), which has been a unique phenomenon in the last two decades. However, little is known about socioeconomic factors that influence the SRB. Employing the diffusion theory by Rogers, this study was undertaken to examine the trends in social variations in the SRB from 1981 to 2004 in Korea. METHODS: The data was taken from Vital Birth Statistics for the period from 1981-2004. We computed the annual male proportion of live births according to the parental education (university, middle/high school, primary) and occupation (non-manual, manual, others). Logistic regression analysis was employed to estimate the odds ratios of male birth according to social position for the equidistant three time periods (1981-1984, 1991-1994, and 2001-2004). RESULTS: An increased SRB was detected among parents with higher social position before the mid 1980s. Since then, however, a greater SRB was found for the less educated and manual jobholders. The inverse social gradient for the SRB was most prominent in early 1990s, but the gap has narrowed since the late 1990s. The mother's socioeconomic position could be a sensitive indicator of the social variations in the sex ratio at birth. CONCLUSIONS: Changes in the relationship of parental social position with the SRB were detected during the 1980-2004 in Korea. This Korean experience may well be explained by diffusion theory, suggesting there have been socioeconomic differences in the adoption and spread of sex-detection technology. Language: Korean Keywords: DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA | RESEARCH REPORT | VITAL STATISTICS | SEX RATIO | SOCIOECONOMIC FACTORS | Developing Countries | Asia, Eastern | Asia | Population Statistics | Research Methodology | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Economic Factors Document Number: 341819 |
| 4. Peer Reviewed Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population. Author: Deboosere P; Gadeyne S; Oyen HV Source: European Journal of Population. 2008 May;25(2):175-196. Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level. Language: English Keywords: BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics Document Number: 340174 |
5.  Title: Births: preliminary data for 2007. Author: Hamilton BE; Martin JA; Ventura SJ Source: National Vital Statistics Reports. 2009 Mar 18;57(12):1-23. Abstract: Objectives-This report presents preliminary data for 2007 on births in the United States. U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother. Data on marital status, cesarean delivery, preterm births, and low birthweight are also presented. Methods-Data in this report are based on 98.7 percent of births for 2007. The records are weighted to independent control counts of all births received in state vital statistics offices in 2007. Comparisons are made with 2006 data. Results-The preliminary estimate of births in 2007 rose 1 percent to 4,317,119, the highest number of births ever registered for the United States. The general fertility rate increased by 1 percent in 2007, to 69.5 births per 1,000 women aged 15-44 years, the highest level since 1990. Increases occurred within all race and Hispanic origin groups and for nearly all age groups. The birth rate for U.S. teenagers 15-19 years rose again in 2007 by about 1 percent, to 42.5 births per 1,000. The birth rate for teenagers 15-17 and 18-19 years each increased by 1 percent in 2007, to 22.2 and 73.9 per 1,000, respectively. The rate for the youngest group, 10-14 years, was unchanged. Birth rates also increased for women in their twenties, thirties, and early forties between 2006 and 2007. The 2007 total fertility rate increased to 2,122.5 births per 1,000 women. All measures of childbearing by unmarried women rose to historic levels in 2007, with the number of births, birth rate, and proportion of births to unmarried women increasing 3 to 5 percent. The cesarean delivery rate rose 2 percent in 2007, to 31.8 percent, marking the 11th consecutive year of increase and another record high for the United States. The rate of preterm births (infants delivered at less than 37 weeks of gestation) decreased 1 percent in 2007, to 12.7 percent, with the decline predominately among infants born late preterm (at 34-36 weeks). The rate of low birthweight (less than 2,500 grams) also declined slightly in 2007, to 8.2 percent. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | VITAL STATISTICS | BIRTH RATE | INFANT HEALTH | FERTILITY RATE | MATERNAL HEALTH | FERTILITY MEASUREMENTS | Developed Countries | North America | Americas | Population Statistics | Research Methodology | Fertility | Population Dynamics | Demographic Factors | Population | Child Health | Health Document Number: 341885 |
| 6. Title: Strong association between birth month and reproductive performance of Vietnamese women. Author: Huber S; Fieder M Source: American Journal of Human Biology. 2009 Jan-Feb;21(1):25-35. Abstract: Epidemiological studies on premodern and modern Western societies indicate that birth season may influence female reproduction. Nothing is known, however, about this effect in developing economies. Many of the latter are characterised by tropical climates with a rainy season associated with lower food availability and a greater prevalence of infectious diseases. We therefore predict that an association between birth month and reproductive output, if it exists, should be related to the rainy season. To test this prediction, we analysed census data of Vietnam obtained from IPUMS-International (Vietnam 1999 Population and Housing Census). Based on 493,853 women born between 1950 and 1977 and thus aged 22 to 49 years, we found that the time series of mean offspring count per month of birth has a highly significant period of 12 months (power = 46.871, P < 0.00001). Our results further indicate that the 12-month periodic signal has a maximum in July and a minimum in January. Accordingly, the peak corresponds to birth during the rainy season, the low if the third pregnancy month concurs with the rainy season. The month of birth is therefore clearly associated with the later reproductive performance of Vietnamese women, strongly supporting the assumption that environmental and maternal conditions during early development exert long-term effects on reproductive functioning. Provided the rainy season adversely affects developmental processes due to inadequate food and/or high infection risk, the association reported here points to a critical period of reproductive development during early pregnancy. Language: English Keywords: VIETNAM | RESEARCH REPORT | EPIDEMIOLOGY | CENSUS | WOMEN | REPRODUCTIVE BEHAVIOR | TIME FACTORS | SEASONAL VARIATION | CLIMATE | CHILDBIRTH | FOOD SECURITY | Asia, Southeastern | Asia | Developing Countries | Public Health | Health | Population Statistics | Research Methodology | Demographic Factors | Population | Fertility | Population Dynamics | Environment | Pregnancy Outcomes | Pregnancy | Reproduction | Food Supply | Natural Resources Document Number: 330492 |
| 7. Peer Reviewed Title: Verbal autopsy of maternal deaths in two districts of Pakistan--filling information gaps. Author: Jafarey SN; Rizvi T; Koblinsky M; Kureshy N Source: Journal of Health, Population, and Nutrition. 2009 Apr;27(2):170-83. Abstract: In Pakistan, the vital registration system is weak, and population-based data on the maternal mortality ratio are limited. This study was carried out to collect information on maternal deaths from different existing sources during the current year-2007 (prospective) and the past two years--2005 and 2006-(retrospective), identify gaps in information, and critically analyze maternal deaths at the community and health-facility levels in two districts in Pakistan. The verbal autopsy questionnaire was administered to households where a maternal death had occurred. No single source had complete data on maternal deaths. Risk factors identified among 128 deceased women were low socioeconomic status, illiteracy, low-earning jobs, parity, and bad obstetric history. These were similar to the findings of earlier studies. Half of the women did seek antenatal care, 34% having made more than four visits. Of the 104 women who died during or after delivery, 38% had delivered in a private facility and 18% in a government facility. The quality of services in both private and public sectors was inadequate. Sixty-nine percent of deaths occurred in the postpartum period, and 51% took place within 24 hours of delivery. The study identified gaps in reporting of maternal deaths and also provided profile of the dead women and the causes of death. Language: English Keywords: PAKISTAN | RESEARCH REPORT | MATERNAL MORTALITY | CAUSES OF DEATH | RISK FACTORS | AUTOPSY | DEATH RECORDS | SOCIOECONOMIC STATUS | PREGNANCY COMPLICATIONS | PREGNANCY OUTCOMES | UTILIZATION OF HEALTH CARE | Developing Countries | Asia, Southern | Asia | Mortality | Population Dynamics | Demographic Factors | Population | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Vital Statistics | Population Statistics | Research Methodology | Socioeconomic Factors | Economic Factors | Diseases | Pregnancy | Reproduction Document Number: 341936 |
| 8. Peer Reviewed Title: Birth records from Swiss married couples analyzed over the past 35 years reveal an aging of first-time mothers by 5.1 years while the interpregnancy interval has shortened. Author: Kalberer U; Baud D; Fontanet A; Hohlfeld P; de Ziegler D Source: Fertility and Sterility. 2009 Jul 14; Abstract: Although the general trend for delaying childbearing is generally viewed as causing infertility, its consequences on the interpregnancy interval have been unknown. A study of birth records for Swiss married women from 1969 to 2006 revealed that the woman's age at first birth has increased from 25.0 to 30.1 years, whereas calculated theoretical interpregnancy intervals after the first and second child decreased from 23.2 to 13 and from 22.4 to 7.9 months, respectively. Language: English Keywords: SWITZERLAND | SUMMARY REPORT | COUPLES | CURRENTLY MARRIED | DELAYED CHILDBEARING | DEMOGRAPHIC AGING | FERTILITY | BIOLOGICAL AGING | BIRTH RECORDS | FIRST BIRTH | AGE FACTORS | FIRST BIRTH INTERVALS | Developed Countries | Europe, Central | Europe | Family Characteristics | Family and Household | Sociocultural Factors | Marital Status | Nuptiality | Demographic Factors | Population | Reproductive Behavior | Population Dynamics | Physiology | Biology | Vital Statistics | Population Statistics | Research Methodology | Pregnancy History | Fertility Measurements | Population Characteristics | Birth Intervals Document Number: 342041 |
| 9. Peer Reviewed Title: Global patterns of mortality in young people: a systematic analysis of population health data. Author: Patton GC; Coffey C; Sawyer SM; Viner RM; Haller DM; Bose K; Vos T; Ferguson J; Mathers CD Source: Lancet. 2009 Sep 12;374(9693):881-92. Abstract: BACKGROUND: Pronounced changes in patterns of health take place in adolescence and young adulthood, but the effects on mortality patterns worldwide have not been reported. We analysed worldwide rates and patterns of mortality between early adolescence and young adulthood. METHODS: We obtained data from the 2004 Global Burden of Disease Study, and used all-cause mortality estimates developed for the 2006 World Health Report, with adjustments for revisions in death from HIV/AIDS and from war and natural disasters. Data for cause of death were derived from national vital registration when available; for other countries we used sample registration data, verbal autopsy, and disease surveillance data to model causes of death. Worldwide rates and patterns of mortality were investigated by WHO region, income status, and cause in age-groups of 10-14 years, 15-19 years, and 20-24 years. FINDINGS: 2.6 million deaths occurred in people aged 10-24 years in 2004. 2.56 million (97%) of these deaths were in low-income and middle-income countries, and almost two thirds (1.67 million) were in sub-Saharan Africa and southeast Asia. Pronounced rises in mortality rates were recorded from early adolescence (10-14 years) to young adulthood (20-24 years), but reasons varied by region and sex. Maternal conditions were a leading cause of female deaths at 15%. HIV/AIDS and tuberculosis contributed to 11% of deaths. Traffic accidents were the largest cause and accounted for 14% of male and 5% of female deaths. Other prominent causes included violence (12% of male deaths) and suicide (6% of all deaths). INTERPRETATION: Present global priorities for adolescent health policy, which focus on HIV/AIDS and maternal mortality, are an important but insufficient response to prevent mortality in an age-group in which more than two in five deaths are due to intentional and unintentional injuries. FUNDING: WHO and National Health and Medical Research Council. Language: English Keywords: GLOBAL | RESEARCH REPORT | DATA ANALYSIS | YOUTH | MORTALITY | CAUSES OF DEATH | VITAL STATISTICS | GEOGRAPHIC FACTORS | MATERNAL MORTALITY | ADOLESCENT HEALTH | ACCIDENTS AND INJURIES | SUICIDE | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Population Statistics | Health Document Number: 342865 |
| 10. Peer Reviewed Title: Malaria has no effect on birth weight in Rwanda. Author: Rulisa S; Mens PF; Karema C; Schallig HD; Kaligirwa N; Vyankandondera J; de Vries PJ Source: Malaria Journal. 2009 Aug 10;8(1):194. Abstract: ABSTRACT: BACKGROUND: Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall, the incidence decreased over the last six years (2002-2007). Therefore, the impact of malaria on birth outcomes is also expected to vary over time and space. METHODS: Obstetric indicators (birth weight and pregnancy outcome) and malaria incidence were compared and analyzed to their association over time (2002-2007) and space. Birth data from 12,526 deliveries were collected from maternity registers of 11 different primary health centers located in different malaria endemic areas. Malaria data for the same communities were collected from the National Malaria Control Programme. Associations were sought with mixed effects models and logistic regression. RESULTS: In all health centres, a significant increase of birth weight over the years was observed (p < 0.001) with a significant seasonal fluctuation. Malaria incidence had no significant effect on birth weight. There was a slight but significant decreasing effect of malaria incidence on the occurrence of premature delivery (p-value 0.045) and still birth (p-value 0.009). Altitude showed a slight but significant negative correlation with birth weight. Overall, a decrease over the years of premature delivery (p = 0.010) and still birth (p=0.036) was observed. CONCLUSION: In Rwanda, birth weight and pregnancy outcome are not directly influenced by malaria, which is in contrast to many other studied areas. Although malaria incidence overall has declined and mean birth weight increased over the studied period, no direct association was found between the two. Socio-economic factors and improved nutrition could be responsible for birth weight changes in recent years. Language: English Keywords: RWANDA | RESEARCH REPORT | INCIDENCE | BIRTH RECORDS | MALARIA | BIRTH WEIGHT | NUTRITION | PROGRAM EVALUATION | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Vital Statistics | Population Statistics | Parasitic Diseases | Diseases | Body Weight | Physiology | Biology | Health | Programs | Organization and Administration Document Number: 342541 |
| 11. Title: Forensic considerations of pregnancy-related maternal deaths: an overview. Author: Sharma BR; Gupta N Source: Journal of Forensic and Legal Medicine. 2009 Jul;16(5):233-8. Abstract: During the 20th century, risks to women associated with childbirth in developed countries have been dramatically reduced on account of many factors that include technological advancements in obstetrical care, greater access to health services and fewer births occurring at the extremes of women's reproductive age span. However, pregnancy-related maternal deaths continue to be a major health concern in developing countries. In the year 2005, an estimated 536,000 women died of maternal causes worldwide of which 86% occurred in sub-Saharan Africa and South Asia and less than 1% in more developed countries. The large regional differences in maternal deaths demonstrate that most of these deaths are preventable. It is nevertheless important to monitor patterns of pregnancy-related mortality and serious morbidity and to be sensitive to what observed patterns or changes may tell us in order to continue to safeguard women during this critical period and the monitoring process must begin with ascertainment of the accuracy of routine reporting of deaths associated with pregnancy and childbirth. We examine the pregnancy-related maternal deaths with a forensic view point. Language: English Keywords: DEVELOPING COUNTRIES | CRITIQUE | MEASUREMENT | MATERNAL MORTALITY | DEATH RATE | CAUSES OF DEATH | RISK FACTORS | PREGNANCY COMPLICATIONS | VITAL STATISTICS | MONITORING | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Health | Diseases | Population Statistics | Evaluation Document Number: 342792 |
| 12. Peer Reviewed Title: DOES FAMINE HAVE A LONG-TERM EFFECT ON COHORT MORTALITY? EVIDENCE FROM THE 1959-1961 GREAT LEAP FORWARD FAMINE IN CHINA. Author: Song S Source: Journal of Biosocial Science. 2009 Mar 23;41:469-491. Abstract: SummaryUsing retrospective individual mortality records of three cohorts of newborns (1954-1958, 1959-1962 and 1963-1967) from a large national fertility survey conducted in 1988 in China, this paper examines the effect of being conceived or born during the 1959-1961 Great Leap Forward Famine on postnatal mortality. The results show strong evidence of a short-term (period) effect of the famine, caused directly by starvation or severe malnutrition during the period of the famine. After controlling for period mortality fluctuation, however, the famine-born cohort does not show higher mortality than either the pre-famine or the post-famine cohort. Aggregate-level cross-temporal comparisons using published cohort population counts from China's 1982 Census, 1990 Census, 1995 micro-Census, 2000 Census and 2005 micro-Census lead to the same conclusion. The relevance of these new findings for the 'fetal origins' hypothesis and the selection effect hypothesis is discussed. Language: English Keywords: CHINA | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | FERTILITY SURVEYS | LONGITUDINAL STUDIES | POPULATION | POLITICAL SYSTEMS | FAMINE | LONGTERM EFFECTS | MORTALITY | DEATH RATE | CENSUS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Studies | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Political Factors | Sociocultural Factors | Food Supply | Natural Resources | Environment | Time Factors | Population Statistics Document Number: 341482 |
| 13. Peer Reviewed Title: A prospective key informant surveillance system to measure maternal mortality -- findings from indigenous populations in Jharkhand and Orissa, India. Author: Barnett S; Nair N; Tripathy P; Borghi J; Rath S Source: BMC Pregnancy and Childbirth. 2008 Feb 28;8(6):[22] p. Abstract: In places with poor vital registration, measurement of maternal mortality and monitoring the impact of interventions on maternal mortality is difficult and seldom undertaken. Mortality ratios are often estimated and policy decisions made without robust evidence. This paper presents a prospective key informant system to measure maternal mortality and the initial findings from the system. In a population of 228 186, key informants identified all births and deaths to women of reproductive age, prospectively, over a period of 110 weeks. After birth verification, interviewers visited households six to eight weeks after delivery to collect information on the ante-partum, intra-partum and post-partum periods, as well as birth outcomes. For all deaths to women of reproductive age they ascertained whether they could be classified as maternal, pregnancy related or late maternal and if so, verbal autopsies were conducted. 13 602 births were identified, with a crude birth rate of 28.2 per 1000 population (C.I. 27.7-28.6) and a maternal mortality ratio of 722 per 100 000 live births (C.I. 591-882) recorded. Maternal deaths comprised 29% of all deaths to women aged 15-49. Approximately a quarter of maternal deaths occurred ante-partum, a half intra-partum and a quarter post-partum. Haemorrhage was the commonest cause of all maternal deaths (25%), but causation varied between the ante-partum, intra-partum and postpartum periods. The cost of operating the surveillance system was US$386 a month, or US$0.02 per capita per year. This low cost key informant surveillance system produced high, but plausible birth and death rates in this remote population in India. This method could be used to monitor trends in maternal mortality and to test the impact of interventions in large populations with poor vital registration and thus assist policy makers in making evidence-based decisions. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | METHODOLOGICAL STUDIES | MATERNAL MORTALITY | CAUSES OF DEATH | MEASUREMENT | DATA COLLECTION | VITAL STATISTICS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Population Statistics Document Number: 324224 |
| 14. Peer Reviewed Title: Spread pattern of the first dengue epidemics in the City of Salvador, Brazil. Author: Barreto FR; Teixeira MG; Costa MD; Carvalho MS; Barreto ML Source: BMC Public Health. 2008 Feb 7;8:51. Abstract: The explosive epidemics of dengue that have been occurring in various countries have stimulated investigation into new approaches to improve understanding of the problem and to develop new strategies for controlling the disease. The objective of this study was to evaluate the characteristics of diffusion of the first dengue epidemic that occurred in the city of Salvador in 1995. The epidemiological charts and records of notified cases of dengue in Salvador in 1995 constituted the source of data. The cases of the disease were georeferenced according to census areas (spatial units) and epidemiological weeks (temporal unit). Kernel density estimation was used to identify the pattern of spatial diffusion using the R-Project computer software program. Of the 2,006 census areas in the city, 1,400 (70%) registered cases of dengue in 1995 and the spatial distribution of these records revealed that by the end of 1995 practically the entire city had been affected by the virus, with the largest concentrationof cases occurring in the western region, composed of census areas with a high population density and predominantly horizontal residences compared to the eastern region of the city, where there is a predominance of vertical residential buildings. The pattern found in this study shows the characteristics of the classic process of spreading by contagion that is common to most infectious diseases. It was possible to identify the epicenter of the epidemic from which centrifugal waves of the disease emanated. Our results suggest that, if a more agile control instrument existed that would be capable of rapidly reducing the vector population within a few days or of raising the group immunity of the population by means of a vaccine, it would theoretically be possible to adopt control actions around the epicenter of the epidemic and consequently reduce the incidence of the disease in the city. This finding emphasizes the need for further research to improve the technology available for the prevention of this disease.(author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | CENSUS METHODS | EVALUATION RESEARCH | ESTIMATION TECHNIQUES | URBAN POPULATION | DENGUE | HUMAN GEOGRAPHY | EPIDEMICS | PREVALENCE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Census | Population Statistics | Evaluation Methodology | Evaluation | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Geography | Social Sciences | Science | Sociocultural Factors | Measurement Document Number: 324429 |
| 15. Peer Reviewed Title: Contextual correlates of child malnutrition in rural Maharashtra. Author: Bawdekar M; Ladusingh L Source: Journal of Biosocial Science. 2008 Sep;40(5):771-786. Abstract: This paper examines the role of observed contextual factors like topography, development and literacy on severe malnutrition among social groups in rural Maharashtra based on the Reproductive and Child Health District Level Household Survey (RCH-DLHS) Round II (2002-04) data. Multilevel modelling techniques were applied in order to examine the district-wise variations in severe malnutrition associated with the characteristics of the places (contextual effects), as the relationships with the type of people (compositional effects) have already been well established. The results show that developmental aspects such as road connectivity, community literacy, toilet facilities and household standard of living contribute positively to the status of severe malnutrition. Also, the scheduled tribe, aboriginal underprivileged group are more at risk of severe malnourishment due to a lack of proper development, poor awareness about maintaining and enhancing the nutritional value of food and lack of hygiene and sanitation as compared with the scheduled castes, another aboriginal group. Language: English Keywords: INDIA | RESEARCH REPORT | DATA ANALYSIS | CENSUS | RURAL AREAS | TRIBES | CHILD | MALNUTRITION | LITERACY | AGRICULTURE | POVERTY | STANDARD OF LIVING | HYGIENE | SANITATION | Developing Countries | Asia, Southern | Asia | Research Methodology | Population Statistics | Geographic Factors | Population | Cultural Background | Population Characteristics | Demographic Factors | Youth | Age Factors | Nutrition Disorders | Diseases | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Macroeconomic Factors | Public Health | Health Document Number: 308355 |
| 16. Title: Cancer mortality in a Chinese population exposed to hexavalent chromium in drinking water. Author: Beaumont JJ; Sedman RM; Reynolds SD; Sherman CD; Li LH Source: Epidemiology. 2008 Jan;19(1):12-23. Abstract: In 1987, investigators in Liaoning Province, China, reported that mortality rates for all cancer, stomach cancer, and lung cancer in 1970-1978 were higher in villages with hexavalent chromium (Cr/+6)-contaminated drinking water than in the general population. The investigators reported rates, but did not report statistical measures of association or precision. Using reports and other communications from investigators at the local Jinzhou Health and Anti-Epidemic Station, we obtained data on Cr/+6 contamination of groundwater and cancer mortality in 9 study regions near a ferrochromium factory. We estimated: (1) person-years at risk in the study regions, based on census and population growth rate data, (2) mortality counts, based on estimated person-years at risk and previously reported mortality rates, and (3) rate ratios and 95% confidence intervals. The all-cancer mortality rate in the combined 5 study regions with Cr/+6-contaminated water was negligibly elevated in comparison with the rate in the 4 combined study regions without contaminated water (rate ratio = 1.13; 95% confidence interval = 0.86-1.46), but was somewhat more elevated in comparison with the whole province (1.23; 0.97-1.53). Stomach cancer mortality in the regions with contaminated water was more substantially elevated in comparison with the regions without contaminated water (1.82; 1.11-2.91) and the whole province (1.69; 1.12-2.44). Lung cancer mortality was slightly elevated in comparison with the unexposed study regions (1.15; 0.62-2.07), and more strongly elevated in comparison with the whole province (1.78; 1.03-2.87). Mortality from other cancers combined was not elevated in comparison with either the unexposed study regions (0.86; 0.53-1.36) or the whole province (0.92; 0.58-1.38). While these data are limited, they are consistent with increased stomach cancer risk in a population exposed to Cr/+6 in drinking water. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | CENSUS | WATER QUALITY | CANCER | EXPOSURE | DEATH RATE | GASTROINTESTINAL EFFECTS | Asia, Eastern | Asia | Developing Countries | Population Statistics | Research Methodology | Water | Natural Resources | Environment | Neoplasms | Diseases | Risk Factors | Biology | Mortality | Population Dynamics | Demographic Factors | Population | Physiology Document Number: 326529 |
| 17. Peer Reviewed Title: Patterns of malaria: Cause-specific and all-cause mortality in a malaria-endemic area of West Africa. Author: Becher H; Kynast-Wolf G; Sie A; Ndugwa R; Ramroth H Source: American Journal of Tropical Medicine and Hygiene. 2008;78(1):106-113. Abstract: Information on cause-specific mortality is sparse in sub-Saharan Africa. We present seasonal patterns of malaria and all-cause mortality from a longitudinal study with 60,000 individuals in rural northwestern Burkina Faso. The study is based on a demographic surveillance system and covers the period 1999-2003. Overall, 3,492 deaths were observed. Cause of death was ascertained by verbal autopsy. Age-specific death rates by cause and month of death were calculated. Seasonal and temporal trends were modeled with parametric Poisson regression. Infant and children less than 5 years of age mortality was 60.6 (95% CI, 56.2-65.3) and 31.9 (95% CI, 30.4-33.5) per 1,000 for all causes and 23.4 (95% CI, 20.7-26.4) and 13.3 (95% CI, 12.3-14.3) for malaria, respectively. Mortality was significantly higher in the rainy season. It is well described parametrically with a sinusoidal function. In adults, the highest all-cause mortality rates were observed in the dry season. Here, HIV/AIDS has become a leading cause of mortality. (author's) Language: English Keywords: BURKINA FASO | RESEARCH REPORT | LONGITUDINAL STUDIES | VITAL STATISTICS | RURAL AREAS | MALARIA | MORTALITY | CAUSES OF DEATH | HUMAN GEOGRAPHY | DEATH RATE | AGE FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Statistics | Geographic Factors | Population | Parasitic Diseases | Diseases | Population Dynamics | Demographic Factors | Geography | Social Sciences | Science | Sociocultural Factors | Population Characteristics Document Number: 323618 |
| 18. Peer Reviewed Title: Internet death notices as a novel source of mortality surveillance data. Author: Boak MB; M'ikanatha NM; Day RS; Harrison LH Source: American Journal of Epidemiology. 2008;167(5):532-539. Abstract: Concerns about bioterrorism and influenza have focused attention on identifying novel data sources to enhance public health surveillance. The authors evaluated free Pittsburgh Post-Gazette Internet death notices for Allegheny County, Pennsylvania, as a potentially timely source of mortality data. Data abstracted from Internet death notices for 1998-2001 were compared with mortality records from the Pennsylvania Department of Health. Approximately 75% (44,294/60,281) of state records had death notices, and 91% (44,294/48,651) of death notices corresponded to a state record. There was a 2-day median lag from the date of death to online death notice publication. The date of death, gender, age, and name data were nearly 90% accurate and 60-100% complete. Increasing education and age were independently associated with increased Pittsburgh Post-Gazette reporting. Being non-White, female, or a nursing home resident were independently associated with decreased reporting. The Pittsburgh Post-Gazette Internet death notices provided accurate, timely mortality data for nearly three fourths of all Allegheny County deaths. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | DATA COLLECTION | MINORITY GROUPS | NOTIFICATION | DEATH RECORDS | VITAL STATISTICS | INTERNET | MORTALITY | TIME FACTORS | NEWSPAPERS | SEX FACTORS | LENGTH OF LIFE | EDUCATIONAL STATUS | Developed Countries | United States of America | North America | Americas | Research Methodology | Population Characteristics | Demographic Factors | Population | Political Factors | Sociocultural Factors | Population Statistics | Information Networks | Communication | Population Dynamics | Printed Media | Mass Media | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 324948 |
| 19. Peer Reviewed Title: Estimating excess mortality in post-invasion Iraq. Author: Brownstein CA; Brownstein JS Source: New England Journal of Medicine. 2008 Jan 31;358(5):445-447. Abstract: There is no set formula for accurately tallying deaths from humanitarian crises. When a population becomes destabilized, estimation of mortality is likely to be severely challenged. In the case of a sudden traumatic event, such as a natural disaster affecting an otherwise stable population, health and human service agencies, though compromised, may well be able to facilitate an accurate assessment of deaths through the use of prospective registries of vital events. In the event of a military invasion and ongoing war, however, the likelihood of obtaining good demographic data plummets. A death registry is unlikely to be developed or maintained, and as conditions deteriorate, it may become increasingly unlikely that bodies can be counted at all. In Iraq, there is also a strong cultural imperative that bodies be put to rest quickly, which may affect the ability to arrive at accurate estimates. Although sentinel populations are commonly monitored to rapidly estimate mortality in developing countries when a registry is not available, the impossibility of finding reliably representative populations in countries engaged in armed conflict and the absence of an accurate population count make it difficult to extrapolate from the rates at sentinel sites to produce reliable national estimates. (excerpt) Language: English Keywords: IRAQ | CRITIQUE | WAR | VIOLENCE | MORTALITY | MORTALITY DETERMINANTS | MORTALITY CHANGES | DEATH RECORDS | ESTIMATION TECHNIQUES | Middle East | Developing Countries | Political Factors | Sociocultural Factors | Behavior | Population Dynamics | Demographic Factors | Population | Vital Statistics | Population Statistics | Research Methodology Document Number: 324337 |
| 20. Title: International migration and educational assortative mating in Mexico and the United States. Author: Choi KH; Mare RD Source: Los Angeles, California, University of California - Los Angeles, California Center for Population Research, 2008 Feb. 40 p. (California Center for Population Research On-Line Working Paper Series CCPR-004-08) Abstract: Using data from the 2000 U.S. and Mexican Censuses, this paper examines the relationship between migration and marriage patterns by describing how the distributions of marital statuses and assortative mating patterns vary by individual and community experiences of migration. In Mexico, migrants and those living in areas with high levels of migration are less likely to marry a spouse with the same level of education. Return migrants from the U.S. to Mexico may use their improved economic position to marry up. In the U.S., Mexican migrants are also less likely to enter into homogamous unions; however, the odds of homogamy do not vary by couple level of migration. Migrants may expand their pool of potential spouses to include non-migrants and nonmigrants tend to be better educated than Mexican migrants. With individual migration experiences, the odds of marrying outside of one's education group increase the most among the least educated. With community level of migration in Mexico, the odds of marrying outside of the group increases the most among the best educated. These findings suggest that preferences for homogamy are disrupted by migration. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MEXICO | RESEARCH REPORT | CENSUS | MIGRANTS | MIGRATION | MARRIAGE PATTERNS | EDUCATIONAL STATUS | Developed Countries | North America | Americas | Developing Countries | Population Statistics | Research Methodology | Population Dynamics | Demographic Factors | Population | Marriage | Nuptiality | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 325784 |
| 21. Peer Reviewed Title: Trends and differentials in child sex ratio in Karnataka: a sub-district level analysis. Author: Deshpande RV Source: Journal of Family Welfare. 2008 Jun;54(1):62-78. Abstract: An attempt has been made in this paper to understand the trends and differentials for the decline in the child sex ratio. The sex ratio of children i.e. number of females per 1000 males has been calculated at state/ district/ sub district level for rural and urban areas for 1991 and 2001, separately using census data on 0-6 population by sex and residence. The sex ratio of children of a particular area say state/district/subdistrict thus calculated for 1991 census was compared with sex ratio of children computed from 2001 census and the trends, patterns and differentials in the sex ratio between the censuses has been analysed. The trend analysis at state/district level revealed that there has been an increase in the overall sex ratio in the state and its districts during 1991-2001, one finds a decline in the child sex ratio of 11 points for the state as a whole. The trend analysis at taluka level revealed that more than three-fourths (76 per cent) of the talukas experienced decline in the CSR, in about one-fifth of the talukas (21 per cent), the CSR has increased and in the remaining talukas the CSR did not change between 1991-2001. The use of contraceptives by couples especially of terminal methods has a direct bearing on the sex ratio. If couples use contraceptives after having a child of a particular sex than the other sex, may lead to imbalance in the sex ratio. Sex determination of fetus has a direct and serious implication on the Child Sex Ratio. Aborting a female fetus is a practice although it is more prevalent in the northern part of the country. An increasing number of women are opting for sex determination test during pregnancy and seek abortion if it is a female in rural and urban areas of Karnataka as well. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | CENSUS | SEX RATIO | SOCIOECONOMIC FACTORS | CHANGES | VALIDITY | Asia, Southern | Asia | Developing Countries | Population Statistics | Research Methodology | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Economic Factors | Social Change | Sociocultural Factors | Measurement Document Number: 340186 |
| 22. Peer Reviewed Title: [Fertility of indigenous women in Minas Gerais State, Brazil: an analysis using the 2000 census] Fecundidade das mulheres autodeclaradas indigenas residentes em Minas Gerais, Author: Dias Junior CS; Verona AP; Pena JL; Machado-Coelho GL Source: Cadernos de Saude Publica. 2008 Nov;24(11):2477-86. Abstract: Indigenous populations living in villages in Brazil have presented high total fertility rates (TFR) that have increased over time in some cases. Meanwhile, data from the Brazilian Institute of Geography and Statistics (IBGE) or National Census Bureau show a decline in the TFR for the total self-declared indigenous population (combining urban, rural, and specific rural residence). The current study uses data from the 2000 Population Census to describe and compare the structure and level of period fertility for the cohort of self-declared indigenous women living in the State of Minas Gerais. We calculated age-specific fertility rates (ASFR), the period TFR for 2000, and the cohort TFR for women 50 years and older. According to the findings, self-declared indigenous women living in Minas Gerais experienced high fertility in the past, regardless of their place of residence. In conclusion, the 2000 Population Census is an important data source for studies on indigenous populations in Brazil, based on the high coverage and wealth of information. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | CENSUS | INDIGENOUS POPULATION | WOMEN | TOTAL FERTILITY RATE | AGE CUMULATIVE FERTILITY RATE | CONTRACEPTIVE USE-EFFECTIVENESS | EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Population Statistics | Research Methodology | Population Characteristics | Demographic Factors | Population | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Population Dynamics | Contraceptive Effectiveness | Contraception | Family Planning Document Number: 342262 |
| 23. Peer Reviewed Title: Adult mortality in a rural area of Senegal: Non-communicable diseases have a large impact in Mlomp. Author: Duthe G; Pison G Source: Demographic Research. 2008 Aug 1;19(37):1419-1448. Abstract: This study provides original estimates of adult mortality in Mlomp, a rural population of Senegal which has been monitored for twenty years. Causes of death are assessed through verbal autopsies which are completed by medical information. Between ages 15 and 60, male mortality is much higher than female mortality. Globally, AIDS mortality does not have the tragic impact observed in other regions of Africa, and maternal mortality is relatively low for a rural area, unlike injuries which are common among men. In Mlomp, non-communicable diseases, especially cancers, are predominant. In addition to behavioural factors, infectious diseases may contribute to this situation. (author's) Language: English Keywords: SENEGAL | RESEARCH REPORT | MORTALITY | DEATH RECORDS | ESTIMATION TECHNIQUES | AUTOPSY | CAUSES OF DEATH | COMMUNITY SURVEYS | SEX FACTORS | DISEASES | NEOPLASMS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Population Dynamics | Demographic Factors | Population | Vital Statistics | Population Statistics | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surveys | Sampling Studies | Studies | Population Characteristics Document Number: 327944 |
| 24. Title: Measuring tuberculosis burden, trends, and the impact of control programmes. Author: Dye C; Basslli A; Bierrenbach AL; Broekmans JF; Chadha VK Source: Lancet Infectious Diseases. 2008 Apr;8(4):233-243. Abstract: The targets for tuberculosis control, framed within the United Nations' Millennium Development Goals, are to ensure that the incidence per head of tuberculosis is falling by 2015, and that the 1990 prevalence and mortality per head are halved by 2015. In monitoring progress in tuberculosis control, the ultimate aim for all countries is to count tuberculosis cases (incidence) accurately through routine surveillance. Disease prevalence surveys are costly and laborious, but give unbiased measures of tuberculosis burden and trends, and are justified in high-burden countries where many cases and deaths are missed by surveillance systems. Most countries in which tuberculosis is highly endemic do not yet have reliable death registration systems. Verbal autopsy, used in cause-of-death surveys, is an alternative, interim method of assessing tuberculosis mortality, but needs further validation. Although several new assays for Mycobacterium tuberculosis infection have recently been devised, the tuberculin skin test remains the only practical method of measuring infection in populations. However, this test typically has low specificity and is therefore best used comparatively to assess geographical and temporal variation in risk of infection. By 2015, every country should be able to assess progress in tuberculosis control by estimating the time trend in incidence, and the magnitude of reductions in either prevalence or deaths. (author's) Language: English Keywords: GLOBAL | SUMMARY REPORT | MEASUREMENT | INCIDENCE | PREVALENCE | TUBERCULOSIS | MORTALITY | DEATH RATE | SCREENING | VITAL STATISTICS | TRANSMISSION | MONITORING | Research Methodology | Infections | Diseases | Population Dynamics | Demographic Factors | Population | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Statistics | Evaluation Document Number: 325523 |
| 25. Title: Aetiology of stillbirths and neonatal deaths in rural Ghana: Implications for health programming in developing countries. Author: Edmond KM; Quigley MA; Zandoh C; Danso S; Hurt C Source: Paediatric and Perinatal Epidemiology. 2008 Sep;22(5):430-437. Abstract: In developing countries many stillbirths and neonatal deaths occur at home and cause of death is not recorded by national health information systems. A community-level verbal autopsy tool was used to obtain data on the aetiology of stillbirths and neonatal deaths in rural Ghana. Objectives were to describe the timing and distribution of causes of stillbirths and neonatal deaths according to site of death (health facility or home). Data were collected from 1 January 2003 to 30 June 2004; 20 317 deliveries, 696 stillbirths and 623 neonatal deaths occurred over that time. Most deaths occurred in the antepartum period (28 weeks gestation to the onset of labour) (33.0%). However, the highest risk periods were during labour and delivery (intrapartum period) and the first day of life. Infections were a major cause of death in the antepartum (10.1%) and neonatal (40.3%) periods. The most important cause of intrapartum death was obstetric complications (59.3%). There were significantly fewer neonatal deaths resulting from birth asphyxia in the home than in the health facilities and more deaths from infection. Only 59 (20.7%) mothers of neonates who died at home reported that they sought care from an appropriate health care provider (doctor, nurse or health facility) during their baby's illness. The results from this study highlight the importance of studying community-level data in developing countries and the high risk of intrapartum stillbirths and infectious diseases in the rural African mother and neonate. Community-level interventions are urgently needed, especially interventions that reduce intrapartum deaths and infection rates in the mother and infant. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | NEONATAL MORTALITY | FETAL DEATH | DEATH RECORDS | AUTOPSY | COMMUNITY SURVEYS | CAUSES OF DEATH | MATERNAL HEALTH | MORBIDITY | COMMUNICABLE DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Infant Mortality | Mortality | Population Dynamics | Demographic Factors | Population | Vital Statistics | Population Statistics | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Surveys | Sampling Studies | Studies | Diseases | Infections Document Number: 327929 |
| 26. Peer Reviewed Title: Evaluation of cause-of-death statistics for Brazil, 2002-2004. Author: Franca E; de Abreu DX; Rao C; Lopez AD Source: International Journal of Epidemiology. 2008 Aug;37(4):891-901. Abstract: Mortality statistics systems with reliable cause-of-death data constitute a major resource for effective health planning; however, many developing countries lack such information systems. Brazil has a long history of registering deaths, and a critical assessment of the quality of current cause-of-death statistics in its five different regions is crucial to identify strengths and weaknesses in the data, and present options for improvement. Quality of cause-of-death data from 2002 to 2004 was evaluated using an assessment framework based on four main attributes: generalizability, reliability, validity and policy relevance. A set of nine criteria: coverage, completeness, consistency of cause patterns with general mortality levels, consistency of cause specific mortality proportions over time, content validity, proportion of ill-defined causes and nonspecific codes, incorrect or improbable age or sex patterns, timeliness, and geographical disaggregation were used to assess the four attributes of data quality. Completeness of death registration varies from 72 to 80% in the northeast regions, compared with 85-90% in the Southeast and Centre-West regions, and 94-97% in the wealthier South region. The proportion of ill-defined deaths is an important problem in reported causes of death from almost all regions. Lack of adequate evidence limits the assessment of content validity of registered causes of death. Coverage, consistency of causes with general level of mortality, consistency over time, age and sex patterns, timeliness and usability of statistics for subnational purposes were judged to be reasonable and increase confidence in using the statistics. There is considerable heterogeneity in the quality of cause-of-death statistics across Brazilian regions, especially for criteria such as completeness and ill-defined causes. These factors can influence generalizability and validity of reported causes of death, and must be considered in the interpretation and use of data for secondary descriptive analyses suchas burden of disease estimation at regional level, with suitable adjustments to account for bias. The differences identified in this study could be a useful guide for defining measures and investments needed to improve data quality in Brazil. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CAUSES OF DEATH | MORTALITY | DATA QUALITY | VITAL STATISTICS | HETEROGENEITY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Population Dynamics | Demographic Factors | Population | Data Analysis | Research Methodology | Population Statistics | Population Characteristics Document Number: 327854 |
| 27. Title: Maternal mortality in South Africa in 2001: From demographic census to epidemiological investigation. Author: Garenne M; McCaa R; Nacro K Source: Population Health Metrics. 2008 Aug 21;6(4):[30] p. Abstract: Maternal mortality remains poorly researched in Africa, and is likely to worsen dramatically as a consequence of HIV/AIDS. The 2001 census of South Africa included a question on deaths in the previous 12 months, and two questions on external causes and maternal mortality, defined as "pregnancy-related deaths". A microdata sample from the census permits researchers to assess levels and differentials in maternal mortality, in a country severely affected by high death rates from HIV/AIDS and from external causes. After correcting for several minor biases, our estimate of the Maternal Mortality Ratio (MMR) in 2001 was 542 per 100,000 live births. This level is much higher than previous estimates dating from pre-HIV/AIDS times. This high level occurred despite a relatively low proportion of maternal deaths (6.4%) among deaths of women aged 15-49 years, and was due to the astonishingly high level of adult mortality, some 4.7 times higher than expected from mortality below age 15 or above age 50. The main reasons for these excessive levels were HIV/AIDS and external causes of deaths. Our regional estimates of MMR were found to be consistent with other findings in the Cape Town area, and with the Agincourt DSS. The differentials in MMR were considerable: 1 to 9.2 for population groups (race), 1 to 3.2 for provinces, and 1 to 2.4 for levels of education. Relationship with income and wealth were complex, with highest values for middle income and middle wealth index. The effect of urbanization was small, and reversed in a multivariate analysis. Higher risks in provinces were not necessarily associated with lower income, lower education or higher proportions of home delivery, but correlated primarily with the prevalence of HIV/AIDS. Demographic census microdata offer the opportunity to conduct an epidemiologic analysis of maternal mortality. In the case of South Africa, the level of MMR increased dramatically over the past 10 years, most likely because of HIV/AIDS. Indirect causes of maternal deaths appear much more important than direct obstetric causes. The MMR appears no longer to be a reliable measure of the quality of obstetric care or a measure of safe motherhood. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CENSUS | MATERNAL MORTALITY | ESTIMATION TECHNIQUES | EPIDEMIOLOGIC METHODS | CAUSES OF DEATH | HIV | AIDS | PREVALENCE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Population Statistics | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Measurement Document Number: 328135 |
| 28. Peer Reviewed Title: Measuring maternal mortality: An overview of opportunities and options for developing countries. Author: Graham WJ; Ahmed S; Stanton C; Abou-Zahr; Campbell OM Source: BMC Medicine. 2008 May 26;6:12. Abstract: There is currently an unprecedented expressed need and demand for estimates of maternal mortality in developing countries. This has been stimulated in part by the creation of a Millennium Development Goal that will be judged partly on the basis of reductions in maternal mortality by 2015. Since the launch of the Safe Motherhood Initiative in 1987, new opportunities for data capture have arisen and new methods have been developed, tested and used. This paper provides a pragmatic overview of these methods and the optimal measurement strategies for different developing country contexts. There are significant recent advances in the measurement of maternal mortality, yet also room for further improvement, particularly in assessing the magnitude and direction of biases and their implications for different data uses. Some of the innovations in measurement provide efficient mechanisms for gathering the requisite primary data at a reasonably low cost. No method, however, has zero costs. Investment is needed in measurement strategies for maternal mortality suited to the needs and resources of a country, and which also strengthen the technical capacity to generate and use credible estimates. Ownership of information is necessary for it to be acted upon: what you count is what you do. Difficulties with measurement must not be allowed to discourage efforts to reduce maternal mortality. Countries must be encouraged and enabled to count maternal deaths and act. (author's) Language: English Keywords: GLOBAL | DEVELOPING COUNTRIES | RESEARCH REPORT | METHODOLOGICAL STUDIES | MATERNAL MORTALITY | VITAL STATISTICS | DATA COLLECTION | MEASUREMENT | ESTIMATION TECHNIQUES | COST EFFECTIVENESS | BIAS | RELIABILITY | Mortality | Population Dynamics | Demographic Factors | Population | Population Statistics | Research Methodology | Evaluation Indexes | Quantitative Evaluation | Evaluation | Error Sources Document Number: 326901 |
| 29. Peer Reviewed Title: Effects of the fertility transition on birth seasonality in the Netherlands. Author: Haandrikman K; Van Wissen LJ Source: Journal of Biosocial Science. 2008 Sep;40(5):655-672. Abstract: Synchronous with the decline in fertility that took place in the post-war period in the Netherlands, patterns of birth seasonality changed as well. In this paper seasonal fluctuations in fertility in the Netherlands are examined using population register data for the period 1952 to 2005. The peak in births has changed from spring to summer and subsequently to August/September, thereby shifting from the European to the American pattern. The seasonal shift can be attributed to parity-specific changes. Before the transition, birth seasonality did not differ much between the different parities. In the transition period from higher to low fertility, differences between parities increased which persist up to today. At present, the overall seasonality pattern is determined by first births. Moreover, birth seasonality varies by maternal age. The findings stimulate the discussion on the role of planning as a cause of birth seasonality. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | POPULATION REGISTER | SEASONAL VARIATION | PARITY | MATERNAL AGE | PLANNING | Developed Countries | Europe, Western | Europe | Population Dynamics | Demographic Factors | Population | Population Statistics | Research Methodology | Fertility Measurements | Fertility | Parental Age | Age Factors | Population Characteristics | Organization and Administration Document Number: 308343 |
| 30. Title: Increasing differential mortality by educational attainment in adults in the United States. Author: Hadden WC; Rockswold PD Source: International Journal of Health Services. 2008;38(1):47-61. Abstract: Economic inequality has increased substantially in the United States since the early 1970s. Inequality in mortality increased from 1960 to 1986. To assess the trend in inequality in mortality the authors calculate age-adjusted mortality rates by educational attainment for 2000 and compare them with rates from 1960 and 1986, using relative and absolute indexes of inequality. Rates are calculated for non-Hispanic white and black adults aged 25 to 64 years, using mortality data from U.S. Vital Statistics and population estimates from the Census Public Use Microdata Sample. The trend toward increasing inequality in mortality between 1960 and 1986 accelerated from 1986 to 2000. Improvements in mortality went disproportionately to those with the most education. Mortality rates for whites with low education, which declined from 1960 to 1986, actually rose from 1986 to 2000. The relative change was greatest for those with only a high school education. This change, however, is largely explained by shifts in the distribution of education, which left those with a high school education in a lower position. The increase in inequality was particularly strong in whites and stronger in men than in women. For black men there was a small decline in absolute inequality between 1986 and 2000. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | ADULTS | ETHNIC GROUPS | DIFFERENTIAL MORTALITY | EDUCATIONAL STATUS | INEQUALITIES | AGE SPECIFIC DEATH RATE | VITAL STATISTICS | CENSUS | SEX FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Cultural Background | Mortality | Population Dynamics | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Death Rate | Population Statistics Document Number: 325212 |
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