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PubMedDate not supplied

Enzyme polymorphisms in Ascaris lumbricoides in Bangladesh.

Fourteen enzymes of Ascaris lumbricoides were analysed electrophoretically on cellulose acetate plates; 8 stained well and 3 were found to be polymorphic. Allelic and genotypic frequencies at the 3 polymorphic enzyme loci, Mpi, Pgi and 6-Pgd, were determined in a sample of 117 worms from 8 children living in different houses in an urban slum in Bangladesh. Allele frequencies in samples of parasites from the different children were compared to test for the possibility of non-random distribution of parasite genotypes between people. No strong evidence of differences was found. Diploid genotype frequencies did not deviate significantly from those expected from the Hardy-Weinberg equilibrium. Significant linkage disequilibrium was observed in one of 3 pairs of enzyme loci tested, which might suggest that some genetic subdivision exists in the local A. lumbricoides population, although no strong interference should be made from this single result. Overall, the results suggest that the worms sampled formed part of a single population which appears to be randomly mating.

Alleles↗
PubMedDate not supplied

Household aggregation of Strongyloides stercoralis infection in Bangladesh.

Strongyloides stercoralis infections were shown to be aggregated in households in an urban slum community in Dhaka, Bangladesh. Parasitological data on 880 residents living in 280 households were analysed statistically using 3 different tests, each of which yielded significant evidence of household aggregation of S. stercoralis infection. One test was applied to the data after stratification for 4 variables were previously shown to be independently associated with infection. Evidence of household aggregation of infection remained after stratification, suggesting that aggregation is due not only to shared risk factors, but also to either familial genetic predisposition to infection or close contact person to person transmission of infection within households.

Adolescent↗
PubMed1991

Treatment of tuberculosis by private general practitioners in India.

Early detection and optimal treatment constitute the most important measures in the control of tuberculosis. This study of prescriptions for tuberculosis recommended by 102 private doctors, practising in the slums of Bombay, shows a lack of awareness among doctors who treat tuberculosis patients in their own clinics about the standard drug regimens for treatment of tuberculosis recommended by national and international agencies. While there are a few standard, efficient, recommended regimens, 100 private doctors prescribed 80 different regimens, most of which were both inappropriate and expensive. The study highlights the need for effective communication between those implementing national tuberculosis programmes and the practising private doctors, continuing education of these doctors for updating their knowledge and their active participation in at least those national disease programme for which their curative functions could contribute significantly to control of a disease.

Antitubercular Agents↗
PubMed1991

Studies of blood lead levels in children by proton-induced X-ray emission (PIXE).

Blood lead levels of children admitted to Sion Hospital, Bombay (India), from the adjoining Dharavi slum areas have been determined by proton-induced X-ray emission (PIXE). Blood samples were collected from 36 children with suspected lead poisoning and from 20 control children. The analysis showed that the lead concentration of the patients varied from 0.1 to 6.0 micrograms ml-1. In addition to lead, K, Ca, Fe, Cu, Zn, Se, Br and Rb were also detected simultaneously, of which the concentrations of Fe, Cu, Zn, Se, Rb and Pb were determined. The high blood lead levels of the children from this area may be ascribed to environmental pollution due to heavy vehicular traffic and industrial sources.

Anemia, Hypochromic↗
PubMed1985

Child labor in Bombay.

Of the world's largest child labor force in India, Bombay has over 30,000 working children, most of them migrants. In a prospective study of 73 working children from a part of Dharavi, the biggest slum in Asia, 68% were working as hotel boys; 22% had started working before their 10th birthday, a large number doing so to increase the family income, but earning less than Rs. 100 ($11) per month. Forty percent worked more than 12 hours a day and only 16% continued schooling. Two-thirds depended entirely on their employers for food which was adequate and no child in the study was malnourished. Overall incidence of anemia and vitamin deficiency was 10% each. Only 7% had ailments related to their occupation. Because this was a cross-sectional study no conclusions can be drawn regarding long term and residual effects. Preventing children from working is likely to make worse their own as well as their families' problems unless substitute sources of income or welfare are available. Legal protection and other services near their working places are essential for those who have to work.

Adolescent↗
PubMed1982

The home environment of the malnourished-deprived child.

The extent of childhood malnutrition-deprivation throughout the world is indicated and its nature and the forms it takes are described. An account is given of several studies carried out by the author and his colleagues in Lebanon. An investigation of failure to thrive in young children revealed that in an apparently homogeneous low socioeconomic group there was a wide spectrum of physical growth which correlated closely with a number of home environment variables. Another study of the mental development of some of these children carried out over several years showed that children with even mild growth failure had a statistically significant impairment of mental development as compared with their apparently healthy siblings, also living in a home environment characterized by deprivation. The far reaching consequences are emphasized. In a third study which investigated the formal education of mothers, their nutritional knowledge and practices and the growth of their children, the indices were found to be interrelated to some extent. Finally, a small study gave some indication, perhaps contrary to general belief, that the rapid social change undergone by families who migrate from the country to an urban slum may be associated with an improvement in nutrition of the children.

Child↗
PubMed1984

Persistence of social and health problems in the welfare state: a Danish cohort experience from 1948 to 1979.

A cohort of 1112 pre-school children who lived in Copenhagen around 1950 was reidentified three decades later. A historical body of information regarding living conditions during childhood was supplemented with information from public registries concerning adult life experiences of the very same individuals. Childhood conditions were analysed in relation to later occurrences of hospitalization, delinquency and unemployment in adult life. A group of individuals whose childhoods were characterized by unfavourable conditions in the slum clearance sections of Copenhagen in the fifties later experienced a substantial accumulation of health and social problems in adult life. The housing conditions during childhood turned out to be a powerful predictor of later occurrences of somatic as well as psychiatric hospitalization, and furthermore of conviction for criminal offences. The fundamental importance of living conditions for the development of social and health problems permeates the population experience of the highly developed Danish welfare state, in full agreement with its basic properties as a class society.

Adolescent↗
PubMed1987

An educational intervention for altering water-sanitation behaviours to reduce childhood diarrhoea in urban Bangladesh: formulation, preparation and delivery of educational intervention.

The formulation, preparation and delivery of an educational intervention previously shown to alter hygienic practices and reduce rates of childhood diarrhea in 25 slum communities in Dhaka, Bangladesh is described in detail. Successful aspects of the program included involvement of community members in goal determination, involvement of community members and women as trainers, focusing conflict into positive actions and utilization of informal training techniques. The failures included inadequate transfer of technical aid to communities and insufficient involvement of volunteer-trainers in curriculum development. We suggest possible explanations for these successes and failures and suggest that these hypotheses should, if possible, be subjected to formal evaluation.

Audiovisual Aids↗
PubMed1993

Primary health workers in north east Brazil.

One approach to providing primary health care in developing countries is to implement programs which rely on minimally trained primary health workers (PHWs). Originally, such programs were primarily designed for rural areas with intact social structures--where a community--based PHW could easily establish a link between the community and the conventional health services (delivery programs). However, faced with increasing migration of the rural population to urban centers in developing countries, the present need for elementary health care in urban slums raises the question of whether PHWs can also provide health assistance to the population there. This paper deals with the issue of whether PHWs in North East Brazil can improve health care delivery and the health situation of the poor population in rural and urban areas. The investigations covered both PHWs and the population. Questionnaire-guided interviews and participant observation were used as research tools. The conclusion is drawn that the PHW-program there has succeeded, if the PHWs have increased the coverage of the health service delivery and also the level of health-related knowledge, attitudes and practices (KAP) in the population--although with significant differences between rural and urban areas (higher coverage and higher KAP in rural areas). The quality of training and supervision and the characteristics of the area and local framework were also found to influence the quality of the work (performance) of the PHWs.

Brazil↗
PubMed1994

Sexual behaviour in Kenya: implications for sexually transmitted disease transmission and control.

Sexual behaviour in Kenya in relation to STD transmission was investigated with a view to forming a basis for the more rational design of STD/HIV control interventions. Questionnaires were administered to a sample of 762 men and women attending eight health facilities in two urban centres. Equal numbers of STD patients (cases) and non-STD related clinic attenders (clinic controls) were selected, matched by gender and clinic. Another sample of 427 men and women was obtained from a random sampling of households in a slum area in Nairobi (community controls). Male STD patients who were unmarried, or married but living apart from their wives, reported a higher mean number of sex partners in the previous three months than did male clinic or community controls. Unmarried female STD patients reported a higher mean number of sex partners in the previous three months than did unmarried female clinic or community controls. Both male and female STD patients were more likely to report having been involved in commercial sex transactions in the previous three months than clinic or community controls. Considerable heterogeneity in sexual behaviour was apparent. In multivariate analysis, the most important predictor of STD acquisition for both men and women was the number of reported sex partners in the previous three months. In addition, for men only, marital status (unmarried, or married but living apart from their wives) and purchasing sex were significant predictors of being an STD patient. These data confirm the importance of commercial sex in STD transmission, and suggest that men play a bridging role between female sex workers and the general population of women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Public health crises of cities in developing countries.

During the decade and a half after Alma Ata hundreds of projects were started in developing countries to implement the principles of PHC and start community based health care programs in the rural areas of developing countries. Until the past five years urban health was not seen as a special health problem. Population pressure in the rural areas has created shortages of land, food and employment opportunities. These forces have generated major population movements to the urban centres. The population movements have encouraged unprecedented expansion of urban centres. This sudden concentration of large populations in small geographical areas has resulted in the urban health crises of the developing world. The poor who live in the slum areas have no access to adequate health services, they experience frequent epidemics of communicable diseases like cholera, they live within a heavily polluted environment, and their children have very poor health because they are not immunized and are malnourished. The paper agrees with approaches which have been championed by development agencies to address the urban health crises. These approaches propose the reorientation of urban health systems to include adoption of PHC for urban health programs, intersectoral collaboration and extra budgetary support. The paper argues for further strengthening of the reorientation approach by adjusting the development planning model. It is proposed that the urban plan be integrated into the national development plan so that emerging urban health crises can receive special attention in resource allocation.

Adult↗
PubMed1996

"I'm not dog, no!": cries of resistance against cholera control campaigns.

Popular reactions toward government efforts to control the recent cholera epidemic in Northeast Brazil are evaluated. Intensive ethnographic interviews and participant-observation in two urban slums (favelas), reveal a high level of resistance on the part of impoverished residents towards official cholera control interventions and mass media campaigns. "Non-compliance" with recommended regimens is described more as a revolt against accusatory attitudes and actions of the elite than as an outright rejection of care by the poor. "Hidden transcripts" about "The Dog's Disease," as cholera is popularly called, voices a history of social and economic inequity and domination in Northeast Brazil. Here, cholera is encumbered by the trappings of metaphor. Two lurid cultural stereotypes, pessoa imunda (filthy, dirty person) and vira lata (stray mutt dog) are used, it is believed, to equate the poor with cholera. The morally disgracing and disempowering imagery of cholera is used to blame and punish the poor and to collectively taint and separate their communities from wealthy neighborhoods. The authors argue that metaphoric trappings have tragic consequences: they deform the experience of having cholera and inhibit the sick and dying from seeking treatment early enough. Controlling cholera requires eliminating "blaming the victim" rhetoric while attacking the social roots of cholera: poverty, low earning power, female illiteracy, sexism, lack of basic sanitation and clean water supplies, medical hegemony, etc. For health interventions to be effective, it is necessary to take into account people's "hidden transcripts" when designing action programs.

Adult↗
PubMed1987

The problems and prevention of burns in developing countries.

Burns are rapidly assuming greater importance as a cause of ill health in the developing nations. The major factors include gross ignorance of fire prevention, the quick spread of slums and the persistence of old traditional customs and beliefs. One hundred and forty-one new cases of burns were treated at the University of Calabar Teaching Hospital (UCTH) in a 2-year period from January 1984 to December 1985. A large proportion of the patients (91, or 64.5 per cent) were minor burns, while 40 (28.4 per cent) were serious burns, and 10 patients (7.1 per cent) suffered major burns. Thirteen patients (9.2 per cent) left hospital against medical advice or absconded without completing their treatment. There were six deaths (4.3 per cent), most of the deaths occurred in the major burns group. Lack of drugs and intravenous fluids, delay in bringing the patients to hospital, ignorance, superstition and old cultural and traditional beliefs contributed to the morbidity and mortality. Most of the burn injuries were caused by domestic accidents and were therefore preventable.

Adolescent↗
PubMed1996

Epidemiology of adults hospitalized with burns in Karachi, Pakistan.

Burns are a leading cause of adult death in Karachi slums, therefore we reviewed 1 year's logged experience (November 1992 to October 1993) at Karachi's two adult burn units for patient age, sex, burn severity and outcome. Also 47 inpatients were interviewed regarding their circumstances of injury. We grouped these using Haddon's Matrix. The log identified 832 patients. Females (57 per cent) outnumbered males and were younger on average (25.1 vs 27.6 years, P = 0.002). Females had more severe burns than males (57 per cent vs 50 per cent total body surface area (TBSA) burn, P = 0.002). At the unit with outcome data (n = 556), the case fatality was 56 per cent. The estimated adult mortality due to burns in Karachi was 10.2/100 000, 6.8/100 000 and 14.1/100 000 for men and women, respectively. Burns of interviewed patients were most often associated with flames (33/47), but stove bursts caused the most severe injury (52 per cent TBSA). These patients were predominantly young uneducated female houseworkers, clothed in loose attire who were injured during daylight at home around a floor-level stove, unaware of fire safety, and who received no first aid. It was concluded that the high burn severity and case fatality rates demand: (1) preventive measures, such as kitchen sand buckets, safer stove design and placement and education on fire safety and first aid, and (2) risk factor analysis to refine interventions.

Accidents, Home↗
PubMed1993

Characteristics of menopause in three socioeconomic urban groups in Karachi, Pakistan.

To determine age, symptoms and treatment choices in Pakistani women with spontaneous menopause, three groups in Karachi were interviewed using a structured questionnaire. The groups consisted of 250 poor slum dwellers, 250 middle class clinic attenders and 150 wives of retired military officers. Interviews were carried out in 1989 and 1990 by members of a team from the Aga Khan University consisting of a gynaecologist, a community health physician and two senior medical students. All interviewees had natural menopause at least 12 months previously. The results showed a mean age of 47 years for menopause in all groups. One in five women were symptomatic in the poorest group but one in two were in the other groups. Treatment was sought by 6% in the poor group, 26% of the middle class group and 38% of the most privileged group. Age at menopause was 4 years earlier than in most reports and fewer women had menopausal symptoms. These urban women may not represent the situation across the country but, as life expectancy in Pakistan is rising (now 56.4 years for women), menopausal problems may increase.

Adult↗
PubMed2003

Development and initial validation of a scale to measure emotional abuse among school children aged 13-15 years in Sri Lanka.

OBJECTIVE: To develop a scale to measure emotional abuse among school children aged 13-15 years in Sri Lanka that can be used in field settings. METHOD: Emotional abuse was defined based on available literature. Review of literature and discussions with a panel identified 85 items indicating abusive behaviors. Content validity and social acceptability were achieved by getting the views of this same panel and parents, respectively. Item analysis and assessment of validity were carried out based on the responses to the draft instrument by 105 children aged 13-15 years attending a school in an urban slum area. The test-retest reliability of the scale was assessed using the responses from 144 students from a different school. Criterion validity was established by comparing the independent assessments of a psychiatrist for the presence or absence of emotional abuse with the respective scores of the children on the scale. RESULTS: The scale developed to assess emotional abuse included 46 items having a Cronbach alpha of .89. The test-retest reliability was .73. A cutoff score of 95 was identified at a sensitivity of 76.9% and a specificity of 51.4%. CONCLUSIONS: A scale that had a satisfactory level of reliability and validity was socially acceptable, which could be used in school settings in Sri Lanka was developed to enable identification of emotional abuse among school children aged 13-15.

Adolescent↗
PubMed2004

Evaluation of the concentration of HCH, DDT, HCB, PCB and PAH in the sediments along the lower stretch of Hugli estuary, West Bengal, northeast India.

Detailed analyses of persistent organic pollutants (POPs) such as hexachlorocyclohexane (HCH) isomers (HCHs), dichlorodiphenyltrichloro ethane (DDT) and its metabolites (DDTs), hexachlorobenzene (HCB) and congeners of polychlorinated biphenyls (PCBs) and polycyclic aromatic hydrocarbons (PAHs) in surface sediments from the coastal estuarine environment of West Bengal, northeast India allowed the evaluation of the contamination status, distribution and possible pollution sources. HCH, DDT, HCB, PCB and PAH were identified compounds in all the samples, whereas the concentrations of chlorinated pesticides (trans-eptachlorepoxide, dieldrin, endrin, metaoxychlor and mirex) were below the detection limits and were not of great concern. The pesticides did demonstrate markedly different distributions reflecting different agricultural and domestic usage in the region. The range of concentrations of HCH, HCB, DDT and PCBs in the sediments were 0.11-0.40, <0.05-0.98, 0.18-1.93 and 0.18-2.33 ng/g dry wt, respectively. Overall elevated levels of HCB, DDT and PCB were recorded at Babughat, a very closely located site of the metropolitan megacity Calcutta. Fluoranthene (flu) and pyrene (py), the dominant 4-ring PAHs, also showed an abrupt elevated concentrations at Babughat with values of 214 and 144 ng/g dry wt, respectively. Among the isomers and metabolites of HCH, DDT and PCB, alpha-HCH, pp'-DDT and PCB (101), PCB (118), PCB(153) and PCB (138) were found to be dominant. High ratios of metabolites of DDT to SigmaDDTs reveal recent use of DDT in this coastal environment. Fluoranthene, pyrene, 1,2-benzo(a)anthracene and chrysene formed the dominant congeners out of 19 identified PAHs. The sources of contamination are closely related to human activities such as domestic and industrial discharge, automobile exhausts, street runoff, slum sewage, agricultural chemicals and soil erosion due to deforestation as well as atmospheric transport. This study is compared to other coastal and estuarine environments in India and abroad. The baseline data can be used for regular ecological monitoring, considering the industrial and agricultural growth around this important estuarine ecosystem.

Agriculture↗
PubMed2006

Ecological analysis of the distribution and socio-spatial context of homicides in Porto Alegre, Brazil.

Over the last decade, the number of homicides in Porto Alegre has increased to the point where external causes are now the main group of causes of death in the 5-34-year age group. Preventing these deaths depends fundamentally on identifying factors related to excess violence in population groups. The overall aim of this study is to analyse the spatial distribution of homicide victims by place of residence in Porto Alegre, the capital of the southernmost Brazilian State of Rio Grande do Sul, in 1996, in order to identify and understand the socio-spatial context. Demographic and socioeconomic indicators based on the 1991 census and 1996 population count were used to build a multivariate classification characterizing the 1851 census tracts. Homicides occurring in 1996 were located using the municipality's Geographic Information System. Four socioeconomic groups were identified, mainly differentiated by housing indicators. Small areas on the urban periphery in which slums (favelas) are concentrated presented higher homicide rates. Homicide rates were lower in the two groups with higher income and educational level. The second step was to classify the census tracts according to the homicide indicator. In this case, areas were differentiated by the number of household inhabitants per room, income, schooling, and median age. We conclude that the multivariate socioeconomic classification presents a limited capacity to identify populations exposed to homicides, suggesting that socioeconomic conditions themselves do not determine violent behaviour. On the other hand, the spatial methods allowed us to identify small areas where deaths are concentrated and whose populations should receive special attention in planning measures to prevent violent deaths.

Adolescent↗