Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cities”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed2006

Endotoxin in inner-city homes: associations with wheeze and eczema in early childhood.

BACKGROUND: An inverse association between domestic exposure to endotoxin and atopy in childhood has been observed. The relevance of this aspect of the hygiene hypothesis to US inner-city communities that have disproportionately high asthma prevalence has not been determined. OBJECTIVES: To measure endotoxin in the dust from inner-city homes, evaluate associations between endotoxin and housing/lifestyle characteristics, and determine whether endotoxin exposure predicted wheeze, allergic rhinitis, and eczema over the first 3 years of life. METHODS: As part of an ongoing prospective birth cohort study, children of Dominican and African-American mothers living in New York City underwent repeated questionnaire measures. Dust samples collected from bedroom floors at age 12 or 36 months were assayed for endotoxin. RESULTS: Among the samples collected from 301 participants' homes, the geometric mean endotoxin concentration (95% CI) was 75.9 EU/mg (66-87), and load was 3892 EU/m2 (3351-4522). Lower endotoxin concentrations were associated with wet mop cleaning and certain neighborhoods. Endotoxin concentration correlated weakly with cockroach (Bla g 2: r = 0.22, P < .001) and mouse (mouse urinary protein: r = 0.28; P < .001) allergens in the dust. Children in homes with higher endotoxin concentration were less likely to have eczema at age 1 year (odds ratio, 0.70 [0.53-0.93]) and more likely to wheeze at age 2 years (odds ratio, 1.34 [1.01-1.78]). These associations were stronger among children with a maternal history of asthma. CONCLUSION: Endotoxin levels in this inner-city community are similar to those in nonfarm homes elsewhere. In this community, domestic endotoxin exposure was inversely associated with eczema at age 1 year, but positively associated with wheeze at age 2 years. CLINICAL IMPLICATIONS: Endotoxin exposure in the inner-city community may be related to wheeze in the early life; however, given the inverse association seen with eczema, the long-term development of allergic disease is still in question.

Allergens↗
PubMed2006

Perceptions of inner city parents about early behavioral and violence prevention counseling.

OBJECTIVES: (1) Identify how receptive inner city parents of young children are to routine anticipatory guidance about behavior at well child care visits. (2) Determine whether inner city parents correlate early behavior problems with a risk of later behavior problems. (3) Determine whether inner city parents believe that physician-provided anticipatory guidance about behavioral issues and violence prevention can help their child avoid future violence-related problems. METHODS: A convenience sample of parents of children < or =5 years old attending an inner city pediatric teaching clinic were invited to complete a self-administered survey including questions about behavior, parenting, and physician-provided behavior and violence counseling. RESULTS: One hundred and ninety-five participants completed surveys; most were African-American (81%) mothers (92%). In response to T/F questions, 84% of parents responded "False" to "Bad behavior in kids cannot be prevented" (95% CI; 78.8, 89.1), 97% responded "False" to "[Bad behavior in kids] cannot be changed" (95% CI; 94.5, 99.3), and 67% responded "True" to "My child's doctor can help me protect my child from violence" (59.8, 73.6). A majority of parents indicated that doctors should routinely ask about behavior and discuss parenting even if the parent was not worried about their child's behavior. CONCLUSIONS: Inner city parents believe that bad behavior in children can be changed and prevented. They welcome physician-provided guidance about behavior and believe physicians can help their children avoid violence.

Adolescent↗
PubMed2006

Testosterone levels in women and men who are single, in long-distance relationships, or same-city relationships.

Research points to an association between testosterone (T) and partnering in some women and men, and this association has been interpreted as an effect of either relationship status (i.e. differences in relationship status lead to differences in T) or relationship orientation (i.e. T is associated with the likelihood of entering relationships). To address whether physical partner presence was associated with decreased T, we examined T levels in people (72 women; 49 men) who were single, in long-distance relationships, or in same-city relationships. No participants were using exogenous hormones, including hormonal contraceptives. Participants provided a saliva sample and responded to questions about their relationship status. Single men had higher T than long-distance and same-city partnered men, which supports the relationship orientation interpretation. In contrast, same-city partnered women had lower T than single women and women in long-distance relationships, which supports the relationship status interpretation. We conclude that physical partner presence is not necessary to see an association between partnering and hormones in men (since same-city and long-distance partnered men had similar T levels), but may be necessary in women (since same-city partnered women had lower T than long-distance partnered women).

Adolescent↗
PubMed2004

The cardiovascular health of residents in selected metropolitan cities in China.

BACKGROUND: To better understand the cardiovascular health and leisure-time physical activity of residents in major metropolitan cities in China, 2196 subjects (39.0 +/- 10.7 years) who lived in Beijing, Shanghai and Hong Kong were investigated. METHODS: During the months of January to June 2001, residents of the three cities who went through annual medical examinations at participating hospitals and exercise physiology laboratories were recruited as subjects, with a target of 800-900 subjects per city. Data on their behavior and health-related cardiovascular heart disease (CHD) risk factors were assessed. RESULTS AND CONCLUSIONS: It was found that over 80% of the subjects were sedentary (participating less than 90 min/week in leisure physical activity). The percentages of subjects having three or more cardiovascular heart disease risk factors were highest in Beijing (72.2%), followed by Shanghai (53.5%) and then Hong Kong (29.3%), suggesting that the cardiovascular health of Hong Kong residents was the best. It was noted that while all cities have similar health problems, there were significant differences in CHD risk factor due to geographical differences: Beijing residents smoked, drank, had high serum cholesterol and did not exercise; Shanghai residents had high blood pressure and drank; and Hong Kong residents were overweight and had lower HDL level. It was found that as subjects grew older, their cardiovascular health became worse. Gender differences were also observed-female subjects have generally fewer CHD risk factors and thus better health than male subjects. A model to examine the effects of age and behavior-related factors on health was developed for each city. Implications on planning strategies and primary prevention programs of CHD were discussed, in light of intervening identified risk factors.

Adult↗
PubMed2006

Prevalence of cigarette and bidi smoking among rickshaw pullers in Dhaka city.

OBJECTIVE: Rickshaw pullers in Dhaka city, Bangladesh are exposed to severe air pollution due to their long stay on city roads. In addition, smoking could further jeopardize their health status. The objective of this study is to estimate the prevalence of cigarette and bidi smoking among the rickshaw pullers in Dhaka city. METHODS: One thousand rickshaw pullers (100 from each of the 10 blocs of Dhaka city) were randomly chosen and underwent interviewer administered questionnaire survey during August-October 2003. Data on demographics, education, rickshaw-pulling, smoking status, duration, and daily consumption were collected by 4 trained interviewers using pre-tested questionnaire. Prevalence of cigarette and bidi smoking, and their sociodemographic correlates were examined using bivariate and multivariate analyses. RESULTS: The overall prevalence of current smoking was 75.9%, while the prevalence of cigarette, bidi and both smoking were 39.2%, 15.7% and 20.9%, respectively. Multinomial logistic regression analysis showed that those who were older, had lower mean schooling years and smoked more sticks per day are more likely to be bidi or both smokers. CONCLUSION: The prevalence of smoking among rickshaw pullers is very high compared to that in general population. Immediate intervention programs are warranted to reduce the future burden of smoking related morbidity among them who are already exposed to tremendous pollution on city roads.

Adolescent↗
PubMed2001

Analysis of fatal pedestrian injuries in Mexico City, 1994-1997.

Currently, in Mexico City, 57% of deaths from traffic crashes are pedestrian injuries. The purpose of this study was to identify and analyse the magnitude, trends, risks, and geographic distribution of fatal pedestrian injuries during the period 1994-1997. A cross-sectional study design was used, based on the death certificates of persons who were in Mexico City during 1994-1997 and died due to pedestrian injuries. Mortality rates, trend analysis, standard mortality ratios (SMRs), and potential years of life lost index (PYLLI) were calculated by gender, age groups and region (these correspond to "delegations", which are political divisions of the city). Rates were derived according to place of occurrence and place of residence. A total of 3687 pedestrian fatalities were reported, and 71% of these were to Mexico City residents. The rate for males was 10.6/100000 with a slight decrease in rate from 1994 to 1997. For females, the rate was 4.0/100000, with an increase in rate during the same years. The present study allowed identification of the target population as well as regions with a high risk of fatal pedestrian injuries. From these data we have developed or recommended specific interventions for prevention and control of fatal pedestrian injuries in Mexico City.

Accidents, Traffic↗
PubMed2000

Background levels of atmospheric mercury in Kagoshima City, and influence of mercury emission from Sakurajima Volcano, Southern Kyushu, Japan

Vapor phase mercury concentration was determined daily for 1 year (Jan. 1996-Jan. 1997) in order to present the levels of atmospheric mercury in Kagoshima City and to estimate the influence of mercury emission from Sakurajima Volcano, southern Kyushu, Japan. The atmospheric mercury was collected on a porous gold collector at Kagoshima University and was determined by cold vapor atomic absorption spectrometry; Kagoshima University of Kagoshima City is located approximately 11 km west of Sakurajima Volcano. The mercury concentration obtained was in the range 1.2-52.5 ng m(-3) (mean 10.8 ng m(-3), n = 169). The atmospheric concentration varied from season to season; the concentration was high in summer and lower in winter. A linear relation was obtained by plotting ln[Hg/ng m(-3)] vs. 1/T for the north, south and west winds with correlation coefficients of -0.76, -0.79 and -0.83, respectively, but no such dependency was found for the east wind (r = -0.035). When the wind is blowing from the east, Kagoshima City is on the leeward side of the volcano. The impact of the fumarolic activity of the volcano on ambient air in the city was evident in the disappearance of temperature dependency with the appearance of the east wind. Atmospheric mercury concentration except for the east wind was considered to be background levels of Kagoshima City. As background levels, 8.1 +/- 5.3 ng m(-3), 14.8 +/- 7.9 ng m(-3), 13.9 +/- 11.7 ng m(-3) and 4.4 +/- 1.6 ng m(-3) (mean +/- S.D.) were obtained for spring, summer, autumn and winter, respectively.

Journal Article↗
PubMed2002

Use of medical resources, complications and long-term outcome in patients hospitalized with acute chest pain. A comparison between a city university hospital and a county hospital.

OBJECTIVE: The primary aim was to test the hypothesis that there is a difference in long-term outcome after hospital discharge among patients hospitalized with acute chest pain in a university hospital and a county hospital. Secondary aims were to compare these two hospitals with regard to use of medical resources, occurrence of complications and risk indicators for death. PATIENTS: All patients hospitalized at Sahlgrenska University Hospital in Göteborg (with a catchment population of 706 inhabitants/km(2)) and Uddevalla County Hospital (with a catchment population of 34 inhabitants/km(2)) due to symptoms of acute chest pain during a period of 6 months. RESULTS: Complications, use of medical resources and mortality during the subsequent 2 years after discharge were compared among 1,592 hospitalizations in a city hospital and 822 in a county hospital due to acute chest pain. Angina pectoris after the first event, congestive heart failure and various arrhythmias were more frequently reported in the county hospital. The use of medical resources differed. Thus, the use of betablockers, heparin, antiarrhythmics, diuretics and nipride was more frequent in the county hospital, whereas the use of nitrates, digitalis, coronary angiography, percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) was more frequent in the city hospital. Despite these differences, the mortality 2 years after hospital discharge was similar (14.7% in the city hospital and 12.8% in the county hospital, P=0.26). Two factors, intravenous digitalis in hospital and a prescription of insulin at discharge, were significantly more associated with death in the county hospital compared with the city hospital. CONCLUSIONS: When comparing a city university hospital with a county hospital with regard to patients admitted with chest pain, major differences in terms of complications and use of medical resources were found. Thus, various complications were reported more frequently in the county hospital. The use of medical resources varied, some being used more frequently in the county hospital, whereas others were used more frequently in the university hospital. Despite these differences the mortality 2 years after hospital discharge was similar in the two cohorts.

Acute Disease↗
PubMed2004

[Mortality due to asthma in the city of Barcelona (1983-1993)].

OBJECTIVE: To find asthma mortality in the city of Barcelona. DESIGN: Descriptive study of mortality. SETTING: City of Barcelona. MAIN MEASUREMENTS: Deaths due to asthma in the city of Barcelona in the period 1983-1993 were studied through the register of mortality at Barcelona's Municipal Institute of Health, which in turn is supplied by the Statistical Gazette of Deaths. Rates of mortality per 100,000 inhabitants were calculated, overall and broken down by sex and by age. The ratio of mortality comparing city districts and the place and season of decease was also worked out. RESULTS: There were 716 deaths due to asthma (overall rate of 3.82/100,000 inhabitants; 3.3 in men and 4.33 in women). Almost two-thirds of deaths occurred in people over 65. Mortality was stable in the entire period except in the over-65s, in which a downwards trend was discerned (beta=-0.63; P=.037). For the 5-34 year old group, the rate oscillated between 0.1 and 0.6/100,000 inhabitants. The number of deaths in the over-65s was greater in winter (31.7%; 95% CI, 27.8-35.7). 56.2% of deaths occurred at home. Hospital deaths were more common among women (P<.001) and the under-65s, and their trend is upwards (P=.004). CONCLUSIONS: Asthma mortality in the city of Barcelona was stable during the period studied. Its rate for the 5-34 year-old age group was higher than for Spain and slightly greater than in similar nearby countries.

Adolescent↗
PubMed2004

[The impact of air pollution on health. The "Programme de Surveillance Air et Santé 9 villes" (Air and Health surveillance program in 9 cities)].

OBJECTIVES: To quantify the short term effects of air pollution on mortality and hospitalisation for cardiovascular or respiratory disorders in the nine French cities (Bordeaux, Le Havre, Lille, Lyon, Marseille, Paris, Rouen, Strasbourg and Toulouse) of the Surveillance Air et Santé program. METHODS: Data were available on mortality and hospitalisation were available, respectively, from 1990 to 1997 and 1995 to 1999. Exposure data were the concentrations of sulphur dioxide, particles with a diameter of less than or equal to 10 mm, black smoke, nitrogen dioxide, ozone, and carbon monoxide. The analysis assessed the relationships, in each of the cities, between the daily numbers of deaths and hospitalisations and the daily levels of polluting agents, taking into account confounding factors. A combined relative risk was calculated for all the cities. The number of deaths and hospitalisations attributable to air pollution was then estimated for each of the cities, based on the relative risk. RESULTS: Significant relationships were found for mortality, from whatever cause, and for hospitalisations for respiratory disorders in children aged under 15. If the levels of air pollution were reduced to 10 microg/m3 in the nine cities, 2800 premature deaths and 750 hospitalisations for respiratory disorders in children would be avoided, every year. CONCLUSION: Today, it is possible to assess the benefits of reducing air pollution in terms of health in the short term. These analyses would provide a sanitary dimension to the strategies for the reduction of urban pollution on local and European level.

Adolescent↗
PubMed2002

Fine particulate air pollution and all-cause mortality within the Harvard Six-Cities Study: variations in risk by period of exposure.

PURPOSE: We used Poisson regression methods to examine the relation between temporal changes in the levels of fine particulate air pollution (PM(2.5)) and the risk of mortality among participants of the Harvard Six Cities longitudinal study. METHODS: Our analyses were based on 1430 deaths that occurred between 1974 and 1991 in a cohort that accumulated 105,714 person-years of follow-up. For each city, indices of PM(2.5) were derived using daily samples. Individual level data were collected on several risk factors including: smoking, education, body mass index (BMI), and occupational exposure to dusts. Time-dependent indices of PM(2.5) were created across 13 calendar periods (< 1979, 1979, 1980, em leader, 1989, >/= 1990) to explore whether recent or chronic exposures were more important predictors of mortality. RESULTS: The relative risk (RR) of mortality calculated using Poisson regression based on average city-specific exposures that remained constant during follow-up was 1.31 [95% confidence interval (CI) = 1.12-1.52] per 18.6 microg/m(3) of PM(2.5). This result was similar to the risk calculated using the Cox model (RR = 1.26, 95% CI = 1.08-1.46). The RR of mortality was attenuated when the Poisson regression model included a time-dependent estimate of exposure (RR = 1.19, 95% CI = 1.04-1.36). There was little variation in RR across time-dependent indices of PM(2.5). CONCLUSIONS: The attenuated risk of mortality that was observed with a time-dependent index of PM(2.5) is due to the combined influence of city-specific variations in mortality rates and decreasing levels of air pollution that occurred during follow-up. The RR of mortality associated with PM(2.5) did not depend on when exposure occurred in relation to death, possibly because of little variation between the time-dependent city-specific exposure indices.

Air Pollutants↗
PubMed1997

Patterns of smoking among inner-city teenagers: smoking has a pediatric age of onset.

OBJECTIVES: (1) To test the hypothesis that the prevalence of smoking among African-American teenagers is lower than among whites and Hispanic inner-city senior high school students; (2) to assess the patterns of smoking among inner-city teenagers; and (3) to ascertain the relationship between smoking status and their knowledge, attitudes, beliefs, and behaviors. METHODS: All students attending inner-city senior high schools in two cities in New Jersey were included in the survey (n = 8,900). Response Rate was 85%; 89% of respondents were minority teenagers. RESULTS: The overall point prevalence rate of cigarette smoking was 9%. Almost all smoking began before the age of 16 years. The factors that significantly (p < .001) contributed to the initiation of cigarette smoking were: peer influence, self-initiation, and the influence of relatives' cigarette smoking. The factors that were stated to play a major role in progression to regular smoking were: perceptions that smoking relieves stress and feelings of induced pleasure while smoking. In addition, smokers were significantly (p < .0005) less knowledgeable about smoke-related diseases than exsmokers or nonsmokers. Over two-thirds of smokers and exsmokers believed that it is the physician's responsibility to advise patients to quit smoking and the majority of the current smokers contemplated quitting smoking. The data support the hypothesis that smoking prevalence among African-American teenagers is significantly lower than among white and Hispanic teenagers who attended the senior high school and resided in the inner city. CONCLUSION: These data suggest that multidimensional antismoking strategies are needed to address the smoking among predominately minority teenagers. This includes supportive messages from physicians, relatives, friends along with public policy to act as motivating factors to discourage early smoking.

Adult↗
PubMed2006

Asthma risk factor assessment: what are the needs of inner-city families?

BACKGROUND: A complex array of risk factors contributes to sustained high levels of asthma morbidity in inner-city children. OBJECTIVE: To describe risk factors for asthma morbidity in a national sample of inner-city children with persistent asthma. METHODS: This study examined baseline questionnaire results from 1,772 children ages 5 to 11 years old with moderate to severe persistent asthma who enrolled in the Centers for Disease Control and Prevention-funded Inner-City Asthma Intervention between April 2001 and March 2004. Risk for asthma morbidity was assessed in 9 domains using the Child Asthma Risk Assessment Tool. The domains included environmental exposures, parental stress, medication adherence, pessimistic asthma beliefs, smoke exposure, aeroallergen exposure, child psychological well-being, responsibility for medication administration, and medical care. RESULTS: A total of 51% of families demonstrated high risk of asthma morbidity in 3 or more domains. High risk of asthma morbidity was suggested based on household environmental exposures (47.7%), high parental stress (38.5%), poor medication adherence (38.3%), pessimistic asthma beliefs (31.8%), environmental tobacco smoke (24.4%), sensitization to aeroallergens in the home (24.8%), child behavioral or emotional concerns (22.9%), child assigned responsibility for medication administration (21.2%), and poor medical care (20.7%). Allergy testing was completed for 40% of the participating children. Of these children, 61% were exposed to aeroallergens in their home to which they were sensitized. CONCLUSIONS: In this national sample of inner-city children, multiple risk factors for asthma morbidity were identified. Asthma programs that provide multilevel support and intervention are needed to reduce the burden of asthma on inner-city families.

Air Pollution, Indoor↗
PubMedDate not supplied

The prehospital emergency care system in Mexico City: a system's performance evaluation.

INTRODUCTION: Mexico City has one of the highest mortality rates in Mexico, with non-intentional injuries as a leading cause of death among persons 1-44 years of age. Emergency medical services (EMS) in Mexico can achieve high levels of efficiency by offering high quality medical care at a low cost through adequate system design. OBJECTIVE: The objective of this study was to determine whether the prehospital EMS system in Mexico City meets the criteria standards established by the American Ambulance Association Guide for Contracting Emergency Medical Services (AAA Guide) for highly efficient EMS systems. METHODS: This retrospective, descriptive study, evaluated the structure of Mexico City's EMS system and analyzed EMS response times, clinical capacity, economic efficiency, and customer satisfaction. These results were compared with the AAA guide, according to the soc ial, economic, and political context in Mexico. This paper describes the healthcare system structure in Mexico, followed by a description of the basic structure of EMS in Mexico City, and of each tenet described in the AAA guide. The p aper includesdata obtained from official documents and databases of government agencies, and operative and administrative data from public and private EMS providers. RESULTS: The quality of the data for response times (RT) were insufficient and widely varied among providers, with a minimum RT of 6.79 minutes (min) and a maximum RT of 61 min. Providers did not define RT clearly, and measured it with averages, which can hide potentially poor performance practices. Training institutions are not required to follow a standardized curriculum. Certifications are the responsibility of the individual training centers and have no government regulation. There was no evidence of active medical control involvement in direct patient care, and providers did not report that quality assurance programs were in place. There also are limited career advancement opportunities for EMS personnel. Small economies of scale may not allow providers to be economically efficient, unit hours are difficult to calculate, and few economic data are available. There is no evidence of customer satisfaction data. CONCLUSIONS: Emergency medical services in Mexico City did not meet the AAA requirements for high-quality, prehospital, emergency care. Coordination among EMS providers is difficult to achieve, due, in part, to the lack of: (1) an authoritative structure; (2) sound system design; and (3) appropriate legislation. The government, EMS providers, stakeholders, and community members should work together to build a high quality EMS system at the lowest possible cost.

Efficiency, Organizational↗
PubMed1998

The big cities health inventory, 1997.

This manuscript reports on the publication of a unique document, The Big Cities Health Inventory, 1997: The Health of Urban U.S.A., which was released in July 1997 by the Chicago Department of Public Health (CDPH). The report presents data on 20 important health indicators such as AIDS, cancers, tuberculosis, sexually transmitted diseases, homicide, heart disease, infant mortality and low birthweight. Indicators of morbidity are gathered from participating local health departments and indicators of mortality and maternal and child health are obtained from vital records files provided by the National Center for Health Statistics (NCHS). The data are displayed and analyzed in two sections. The first consists of a series of tables presenting overall rates, gender and race/ethnicity-specific rates and city rankings according to these measures. These rankings provide meaningful comparisons between and within cities for specific demographic characteristics. The second component presents sample analyses which illustrate the possible uses of this information. The report represents an important tool for health professionals, researchers, policy makers and community advocates dedicated to promoting healthier cities. Such array of city-level data, to our knowledge not available from any other source, could indeed begin to lead to public health interventions that will impact the well-being of residents of large urban areas.

Cause of Death↗
PubMed2006

Prevalence of overweight among Baltimore City schoolchildren and its associations with nutrition and physical activity.

OBJECTIVE: To determine the prevalence of overweight and at-risk-for-overweight in schoolchildren from Baltimore City. RESEARCH METHODS AND PROCEDURES: Ten schools within city limits were randomly selected from each tertile of income, using eligibility for free school lunch as a proxy. A total of 209 third grade students from eight public schools in Baltimore City were surveyed in May 2000. Anthropometric data including height, weight, subscapular and triceps skinfold thickness, and percentage body weight from bioelectrical impedance were collected. Nutrition-related knowledge, attitudes, and behaviors were assessed using a validated questionnaire. Physical activity was assessed by questionnaire. RESULTS: Based on International Obesity Taskforce reference values for BMI-for-age, 20.7% of girls and 17.2% of boys were overweight (BMI > 95th percentile) and 15.3% of girls and 14.1% of boys were at-risk-for-overweight (BMI between the 85th and 95th percentiles). The prevalence of overweight and at-risk-for-overweight did not vary by self-reported physical activity levels or by nutrition-related knowledge and behaviors. DISCUSSION: The high prevalence of overweight and at-risk-for-overweight in this sample of inner-city children from Baltimore City highlights a need for targeted preventive and treatment interventions.

Baltimore↗
PubMed2002

Genetic differentiation of the dengue vector, Aedes aegypti (Ho Chi Minh City, Vietnam) using microsatellite markers.

Dengue haemorrhagic fever emerged in the 1950s and has become a major public health concern in most Asian countries. In Vietnam, little is known about the intraspecific variation of the vector and its consequences on vectorial capacity. Here we report the use of microsatellite markers to differentiate Aedes aegypti populations in Ho Chi Minh City, a typical, overcrowded Asian city. Six microsatellite loci, with 5-14 alleles per locus, were scored in 20 mosquito samples collected in 1998 in Ho Chi Minh City. We found substantial differentiation among Ae. aegypti populations from the outskirts, whereas populations from the centre of the city showed less differentiation. These results are consistent with the hypothesis that populations of Ae. aegypti in central Ho Chi Minh City are panmictic because there are abundant larval breeding sites and an abundance of humans for adults to feed upon. In contrast, populations on the outskirts become differentiated largely through the processes of genetic drift because larval breeding sites are not as abundant. These findings implicate human activities associated with urbanization, as factors shaping the genetic structure of Ae. aegypti populations.

Aedes↗
PubMed2001

The epidemiological transition in maternal and child health in a Brazilian city, 1982-93: a comparison of two population-based cohorts.

Two studies carried out in 1982 and 1993 in the city of Pelotas, Southern Brazil, provide a unique opportunity for assessing the impact on maternal and child health of the economic and health care changes, which took place in Brazil in this period. The cohorts of mothers and infants of 1982 and 1993 were studied from the time of delivery. In both years, all mothers identified in the city's maternity hospitals answered a standardised questionnaire and their infants were examined. Over 99% of all children born in the city in each of the 2 years were included in the cohorts. Deaths occurring among these children were monitored prospectively, as well as all hospital admissions in the 1993 cohort. In the 1982 study, attempts were made to locate a 25% sample of the children at the mean age of 12 months using the addresses collected at the hospital (82% of the children were located), and all of the cohort children at the mean age of 20 months and 42 months, through a city census (87% were located in both follow-ups). In the 1993 study, 20% of all children plus all low birthweight infants were sought at 12 months of age, using the addresses collected at the hospital, and 95% were successfully traced. There was a 12% fall in the number of births occurring in 1993 (5,304 births), in comparison with 1982 (6,011 births), in spite of the increase in the population of reproductive age in the city during the decade. There was a marked difference in maternal height and weight at the beginning of pregnancy, with women giving birth in 1993 being, on average, 3.4 cm taller and 2.5 kg heavier than those who gave birth in 1982. The proportion of preterm babies (<37 weeks), measured by the date of last menstrual period, increased from 5.6% in 1982 to 7.5% in 1993. The median duration of breast feeding increased from 3.1 months in 1982 to 4.0 months in 1993. At 12 months of age, the prevalence of deficit of weight for age decreased from 5.4% in 1982 to 3.7% in 1993. The prevalence of deficit of height for age, however, increased from 5.3% to 6.1%. The perinatal mortality rate dropped 31%, from 32.2 per 1,000 births in 1982 to 22.1 deaths per 1,000 births in 1993. There was also a marked reduction in the infant mortality rate, from 36.4 per 1,000 livebirths in 1982 to 21.1 per 1,000 livebirths in 1993. The findings of the study indicate that there were improvements in the decade for most of the indicators evaluated, with the exception of birthweight and gestational age. It appears that improvements in perinatal and infant mortality rates are largely due to improvements in the health care sector.

Adult↗