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PubMed1989

The influence of individual, social group and household factors on the distribution of Ascaris lumbricoides within a community and implications for control strategies.

The distribution of Ascaris lumbricoides within a community was examined at an initial mass anthelmintic treatment programme (January 1984) and following an 11-month period of reinfection (November 1984). Similar patterns of the negative binomial parameter kappa (an inverse measure of parasite aggregation) and the proportion of parasites within the most heavily infected quartile of the community were recorded at the two dates. The pattern of parasite aggregation within individuals, measured by parameter k, appears to be a stable characteristic of this host-parasite relationship. Significant variation in the intensity of infection was observed between households in the community. The number of family members living in the house strongly influenced the mean Ascaris burden and proportion of relatively heavy infections within adults and children. This finding suggests that the density of people in a house positively influences the frequency of exposure to infective stages of Ascaris, which in turn plays a major role in determining which individuals will harbour heavy infections. Positive correlations were recorded between the initial and reinfection burdens of individuals, relative to others in the community. The correlations were strongest in the youngest and oldest age groups and were more frequently significant among age-stratified groups of females, compared to males. A comparative examination of hypothetical treatment strategies suggests that for Ascaris infections in this community, targetting age groups with anthelmintic treatment would probably be more cost-effective in the long term in reducing the abundance of this parasite than selective treatment of individually identified heavy infections.

Adolescent↗
PubMed1996

Incidence of dog bites in Milwaukee, wis.

Dogs are everywhere. The incidence of and injuries caused by dog bites have grown to such epidemic proportions in certain parts of the United States that they are now considered a major public health concern. Playful Rover is no longer a harmless pet. Uncontrolled, he now can be considered a public nuisance. In this study, we evaluated the epidemiology of dog bites recorded in Milwaukee, for calendar years 1989-1991. This assessment included anatomical location of bites, victims' ages, behavioral antecedents, leading up to the bite incidents, season of the year, and animal ownership. The evaluation also measured the correlation coefficient between the frequency of dog bite incidents and median household income distribution within the city. During the 3-year period, a total of 3,926 animal bites, including 3,244 (83%) dog bites, were reported to the City of Milwaukee Department of Health. Of all the dog bites reported, 60% were on the upper extremities. Children less than 15 years old sustained 44% of the injuries, mostly to the head and face. Provocation by the victim accounted for 19% of the cases. The majority of the incidents (67%) occurred during the spring and summer months. In 49% of all cases, the victims families or neighbors owned the animals involved in the biting. Researchers also observed a significant negative correlation between bites and median household income distribution. Study results suggest a need to educate the public about the magnitude of dog-bite problems, enforce leash laws and impound stray dogs as an integral part of prevention programs.

Adolescent↗
PubMed2006

Spatial clustering of ocular chlamydial infection over time following treatment, among households in a village in Tanzania.

PURPOSE: To observe the spatial distribution of households with high loads of ocular chlamydia infection in children, before and after mass treatment with azithromycin to determine whether there exists spatial clustering of households with high loads of infection and the spatial scale of the clustering. METHODS: All residents of a village in Tanzania were invited to participate in the study. A global positioning system unit recorded the location of each house. Mass treatment with azithromycin was offered, with participation above 80%. Active trachoma and swab samples of the conjunctiva were assessed at baseline and at 2, 6, 12, and 18 months after treatment. A k-function analysis was performed to detect clustering of households with high loads of ocular chlamydia in children younger than 8 years. RESULTS: A total of 1055 villagers were examined during the study; of these, 374 (35.4%) were children younger than 8 years. The total number of households was 215, with 182 (84.6%) households having at least one child. K-function analysis showed clustering of households with high loads of ocular chlamydia at distances up to 2 kilometers (km) at baseline; at 6 months, slight clustering existed within 0.5 km. At 12 and 18 months, high load households clustered at distances up to 1.3 km. CONCLUSIONS: This analysis suggests that infection spreads between households with children or that nearby households share the same risk factors for infection. Mass treatment has value in lowering infection prevalence within the community, and clustering of households with infection takes up to 1 year to reemerge at the same level as baseline. Re-treatment at yearly intervals may interrupt spread of infection.

Anti-Bacterial Agents↗
PubMed1997

Wealth inequality among older Americans.

Using the AHEAD study, this article examines the wealth distribution among American households with a member at least 70 years old. Household wealth is quite unevenly distributed among older American households. Those households in the top 10th percentile of the wealth distribution have 2,500 times as much wealth as those at the lowest 10th percent. This sharp wealth disparity relative to income dispersion is the dominant reason why older minority households have accumulated so little wealth compared to White households. Wealth varies by a factor of seven to one when both spouses are in poor health compared to when they say that they are in excellent health. Finally, AHEAD data on bequest intentions suggest a bifurcated bequest motive. Most older households plan to bequeath a modest financial inheritance, but about one-quarter expect to leave inheritances worth $100,000 or more.

Aged↗
PubMed1988

[The distribution of microorganisms in household kitchens. I. Problems, experiments, results].

Epidemiological investigations have demonstrated that insufficient hygiene in households results in increasing health hazards. In order to be able to recommend ways to disrupt infection chains it was necessary to explore the most important pathways of cross-contamination. Housewives without special training were instructed to prepare a complete meal, in the kitchen of a modern, vacant apartment. Among the raw products provided was minced meat, contaminated with Sarcinae (unbeknown to the housewives) in a quantitative manner. When cooking and cleaning procedures were completed we analysed household utensils and surfaces by Rodac impressions and swabs. The test organisms could be detected on all inspected surfaces and on the dining-table with albeit different frequencies. The following locations showed an especially high degree of cross-contamination: a) working-surfaces, especially boards of wood and plastics. b) cutting-machines, c) kitchen-machines. These results agree with literature data. By careful disinfection, i.e. by application of a 0.5% solution of hypochlorite, the contaminations could be removed. We assessed this when arranging the kitchen for the next test. Since it is impossible to practise disinfection procedures in a household kitchen on the same scale as in an operating room, we tried to achieve at least a limited disinfection by household cleansers with germicidal properties. In our opinion a minimum reduction of five log stages, demanded in the medical area, can not be achieved in a household kitchen and indeed it is not necessary. A reduction of the microbial counts to 10% of the original value would already be useful, as toxic levels of microbial counts will be reached later especially when there is simultaneous refrigeration. Correct dosage proved to be one of the main practical problems because a discrepancy exists between the low concentration of tensids, necessary for cleaning, and the relatively high dose necessary for germ-killing compounds. Diluted DOMESTOS proved to be a cleaning agent and germicide, but was, however, blamed for chlorine odour, especially when diluted with warm water. A greater acceptance level was reached with a peroxide-containing cleanser, which, however, was not sufficiently germicidal, when applied in diluted form. The concentrated formulation was more effective in everyday experience, but for this housewives had to wear rubber gloves. This was reported to be complicated and uncomfortable, and indeed the search for better formulations must be continued. (In communication II comparisons with the bibliography and hygienic consequences will be published.)

Cooking and Eating Utensils↗
PubMed1988

[The distribution of microorganisms in household kitchens. II. Evaluation of results and hygienic inferences].

The very high morbidity rates of Enteritis infectiosa diseases demand improved prophylactic measures. An important indication of the source of these illnesses is the fact that infections in private households are about three times more frequent than in canteens. Indeed, the rise in morbidity is undoubtedly caused by inadequate treatment of raw products, of meal rests and by insufficient heating processes. Furthermore, in household kitchens no efforts are made to interrupt infection chains, and disinfections are considered as superfluous and housewives are content if their kitchens appear to be clean. The aim of our study performed in a normal household kitchen, was to investigate cross-contamination caused by pathogens, introduced into the kitchen from outdoors. A further aim was to establish the main sources of contamination in order to be able to recommend practical disinfection procedures. The main fields of contamination discovered when 55 meals prepared were: a) working surfaces (including boards of wood and plastics) b) kitchen- and cutting-machines. The amount of test organisms (Sarcinae), introduced into the kitchen (unbeknown to the housewives) by experimentally contaminated minced meat was only reduced by common cleaning procedures, in sofar as nearly half of the original contaminations could be demonstrated to be still present. However, when the normal cleanser was replaced by one containing hypochlorite, and with retention of the same working routines, about 90% bacteriologically clean surfaces were determined. In this way it could be demonstrated that infection chains can be interrupted. It is, however, not correct to compare the efficiency of these procedures with the efficiency of disinfection, according to the Federal Infectious Diseases Act (Bundesseuchengesetz). On practical application of these experiences it must be borne in mind that housewives should not be forced to apply medical disinfection procedures: indeed, traditional and practised cleaning methods should be retained, as far as possible. We recommend therefore that manufacturers supply household cleansers with an anti-bacterial additive, after its application in the kitchens working surfaces and machines are bacteriologically clean. Additionally housewives should be appropriately informed about the necessity of these manipulations. We consider minimization of toxicity and a thorough environmental compatibility of formulations to be self-evident.

Cooking and Eating Utensils↗
PubMedDate not supplied

How the number of living sons influences contraceptive use in Menoufia Governorate, Egypt.

Couples in rural areas of many Arab societies, including Egypt, have consistently reported strong preferences for having sons. However, these reported preferences are not always reflected in reproductive behavior. In 38 rural villages in Menoufia Governorate in Egypt, women's responses to a community-based contraceptive distribution program were examined, taking into consideration both the number of living children and the number of living sons each women reported having. Controlling for number of living children, women with more sons were more likely to be using contraception before the distribution program began. Among women not using contraception before the program, those with more sons were more likely to initiate contraceptive use and were more likely to continue use for a nine-month period following the distribution. These findings imply that in addition to obstacles related to contraceptive availability, there are several cultural, social, and economic factors that influence fertility behavior and exert considerable pressure on married couples to have large families, including several sons. Unless the pressure exerted by these factors is changed or reduced, the impact of family planning programs is likely to reach a plateau at a relatively low prevalence level.

Adolescent↗
PubMed1981

Sex disparities in the distribution of food within rural households.

The findings of a recent nutritional survey in rural Bangladesh suggest that within rural households, food is inequitably divided among household members in relation to their nutritional requirements. Women and girls are disadvantaged in comparison to men and boys. This leads to a higher incidence of severe malnutrition among women and girls and excess female infant mortality. These findings suggest that in order to eradicate malnutrition, it may not be enough to increase the supply of food available to households among the rural poor, unless at the same time steps are taken to ensure a more equitable distribution of food within the household by enhancing the perceived economic value of females in rural society.

Age Factors↗
PubMed1981

The East Baltimore study. II. Familial aggregation of plasma lipid levels in juveniles in a black inner-city population.

Familial aggregation of plasma lipid levels among 676 black juveniles, aged less than 20 years and residing in 202 households in East Baltimore, Maryland, was assessed by the intraclass correlation coefficient of residuals from sex-specific cubic regressions on age. Significant aggregation of both plasma cholesterol (r = 0.23, p less than 0.005) and plasma triglyceride (r = 0.27, p less than 0.005) levels were found. In addition, no effect on familial aggregation was found for each of several measures of family structure: number of juvenile household members, closeness in age, all children over 9 years of age, or shared surname. Two methods of classifying juvenile household size were compared. An association between classification method and juvenile household size was demonstrated (p less than 0.005) for the distributions of households and of children. The intraclass correlation coefficients for plasma cholesterol and plasma triglyceride for households classified by number of juveniles were higher than the coefficients for the house grouped by the number of juveniles admitted to the study, when compared for each classification number, 2 through 4. Evidence for an effect on familial aggregation of the socioeconomic status was shown by a comparison of intraclass correlation coefficients from households in East Baltimore with those from white and black households from the Columbia Medical Plan which have higher levels of occupation and education. Higher correlations were shown for the groups with higher socioeconomic status, regardless of race.

Adolescent↗
PubMed1988

American Indian household structure and income.

We use the 1980 Public-Use Microdata Sample to consider the relationship between household structure and economic well-being among American Indians. We focus on the total U.S. Indian population and on the residents of 19 "Indian states" where there has been relatively little growth in the Indian population by means of changes in racial self-identification. Using Sweet's (1984) scheme of household types, we find that the prevalence among Indians of female-headed households with children is intermediate between that among blacks and whites, but the prevalence of couple-headed households with children is highest among Indians. Racial differences in the distribution of household types and differences in average household size are important determinants of black-white and Indian-white differences in average household income.

Adult↗
PubMed2002

Hygiene measures considering actual distributions of microorganisms in Japanese households.

AIMS: Effective household hygiene measures require that sources of bacterial contamination and the places to which contamination spreads be carefully identified. Therefore, a study was performed to examine the distribution of microorganisms throughout ordinary households in Japan, which has its own unique customs of daily life and food preparation. METHODS AND RESULTS: Using the stamping method, samples were taken from 100 different places and items in each of 86 households. This study found kitchens/dining rooms to have the greatest level of microbial contamination and bathrooms, the next highest level. Toilets (water closets) were found to have an unexpectedly low level of bacterial contamination. The largest bacterial counts were found on items such as drain traps, dish-washing sponges, counter towels, sinks, dish-washing tubs, and bathroom sponges. CONCLUSIONS: It is necessary to carefully identify both the items that can become instruments for spreading bacterial contamination and the places that easily become subject to secondary contamination, and then to take timely and effective disinfection/sanitizing measures. SIGNIFICANCE AND IMPACT OF THE STUDY: The data gathered in this study will be very valuable for anticipating the pathways over which bacteria are transported and prioritizing disinfection targets, to make effective disinfection possible.

Activities of Daily Living↗
PubMed1995

[From minimal household units to household projections: an application to Canadian data].

"The headship rate method for household projections has been criticised for its silence concerning household composition, while alternative models have yet to resolve how to estimate households from the distribution of individuals by household status projected by their models. By combining an indicator of household composition with an indicator of headship, the method proposed here attempts to remedy these problems. The application to Canadian households could be viewed as an adaptation of the headship rate method, but would ideally serve as the second step of a model more representative of the household formation process." (SUMMARY IN ENG AND SPA)

Americas↗
PubMed2002

Social capital and health (plus wealth, income inequality and regional health governance).

This article describes an empirical exploration of relationships among aspects of thirty health districts in Saskatchewan, Canada. These aspects include social capital, income inequality, wealth, governance by regional health authorities and population health, the primary dependent variable. The social capital index incorporated associational and civic participation, average and median household incomes served as proxies for wealth, the degree of skew in the distribution of household incomes assessed income inequality while the model for effective governance by District Health Boards (DHBs) focused on reflection of health needs, policy making and implementation, fiscal responsibility and the integration and co-ordination of services. I found no evidence of a relationship between social capital in health districts and the performance of DHBs. Among the determinants of health, wealth appeared unrelated to age-standardised mortality rates while income inequality was positively and social capital was negatively related to mortality. Income inequality was not as strongly related to age-standardised mortality after controlling for social capital. and vice versa, suggesting the two may be comingled somehow when it comes to population health, although they were not significantly related to one another. Of the predictors of social capital the distribution of age in districts appeared to be the most salient; of the predictors of age-standardised mortality rates the gender composition of a district was most salient.

Adolescent↗
PubMed2001

Intrahousehold food distribution: a case study of eight provinces in China.

A longitudinal survey of health and nutrition in China was undertaken in eight provinces (Liaoning, Jiangsu, Shandong, Henan, Hubei, Hunan, Guangxi, Guizhou). Data were collected in 1989, 1991, 1993 and 1997. The 1991 and 1993 data were used to investigate factors affecting intrahousehold food distribution. The discrepancy score and the ratio of food share to energy share were used to describe food distribution within households. Findings indicated that, in most cases, males had a higher proportion of nutrient intake than females, particularly in the young adult group where men presented with a higher discrepancy score than women for energy and all nutrients observed. The food and nutrient distribution tends to be more favourable to the middle-aged group, although the youngest group, while accepting relatively smaller amounts of cereals, ate much bigger amounts of meat, dairy products and fruits. Household members with higher incomes are more favoured in terms of food consumption and nutrient intake. Household leaders accepted a higher share of energy and nutrients in comparison with other members of the household across all age and sex groups. Administrators and people working in service or trade industries in rural areas are favoured in terms of food distribution relative to farmers and manual workers. Well-educated people accepted a better food allocation than others and those in employment received more nutrients than the unemployed. The 'contribution rule' (individuals who make a greater contribution to the family receive a larger share of the family's food) is discussed and deemed to be applicable in explaining the discrepancy in food distribution and nutrient intake among household members.

Adolescent↗
PubMedDate not supplied

Household health expenditures in Morocco: implications for health care reform.

The purpose of this study was to investigate the level and distribution of household health care expenditures in Morocco, and to compare the level of health care funds provided by households with the levels provided by the government and international donors. In addition, the reliance of poor and non-poor households on both public and private providers was investigated. The study was based on data collected in the 1995 Demographic and Health Survey, which included a special supplement on health care expenditures. Descriptive statistics are presented on utilization of out-of-pocket expenditures for antenatal and obstetric care, chronic care, and non-chronic care associated with illness and injury, by urban/rural status and by socio-economic status. The results indicate that government health care providers are an important source of modern health care not only for poor households, but for better-off households as well. While individuals who use private health care providers incur substantially higher costs than those who use public providers, an unexpected finding of the study is the degree to which public clients pay for health care services, despite the fact that public care is nominally priced in Morocco. We conclude by discussing the implications of our results on the design and implementation of health care reform policies.

Child↗
PubMed1995

The urban household pattern of daytime population change.

"A matrix representation of places of residence and places of commuting destination in a metropolis, is coupled with evidence regarding spatio-temporal change in average household size. This approach allows the average number of persons per household who commute to be hierarchically ordered in a square matrix which shows attributes associated with a well-known class of matrices. Based on these attributes it is shown that any given spatial distribution of households implies a bounded range of vectors representing the spatial distribution of commuters.... The proposed methodology is applied to thirty four subareas throughout the city of Saskatoon, Saskatchewan."

Americas↗
PubMed1999

Lot quality assurance sampling (LQAS) for monitoring a leprosy elimination program.

In a statistical sense, prevalences of leprosy in different geographical areas can be called very low or rare. Conventional survey methods to monitor leprosy control programs, therefore, need large sample sizes, are expensive, and are time-consuming. Further, with the lowering of prevalence to the near-desired target level, 1 case per 10,000 population at national or subnational levels, the program administrator's concern will be shifted to smaller areas, e.g., districts, for assessment and, if needed, for necessary interventions. In this paper, Lot Quality Assurance Sampling (LQAS), a quality control tool in industry, is proposed to identify districts/regions having a prevalence of leprosy at or above a certain target level, e.g., 1 in 10,000. This technique can also be considered for identifying districts/regions at or below the target level of 1 per 10,000, i.e., areas where the elimination level is attained. For simulating various situations and strategies, a hypothetical computerized population of 10 million persons was created. This population mimics the actual population in terms of the empirical information on rural/urban distributions and the distribution of households by size for the state of Tamil Nadu, India. Various levels with respect to leprosy prevalence are created using this population. The distribution of the number of cases in the population was expected to follow the Poisson process, and this was also confirmed by examination. Sample sizes and corresponding critical values were computed using Poisson approximation. Initially, villages/towns are selected from the population and from each selected village/town households are selected using systematic sampling. Households instead of individuals are used as sampling units. This sampling procedure was simulated 1000 times in the computer from the base population. The results in four different prevalence situations meet the required limits of Type I error of 5% and 90% Power. It is concluded that after validation under field conditions, this method can be considered for a rapid assessment of the leprosy situation.

Computer Simulation↗