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PubMed1988

Risk factors for breast cancer in Chinese women in Shanghai.

Five hundred thirty-four histologically confirmed incident cases of breast cancer in Chinese women of Shanghai and an equal number of age and sex-matched population controls were interviewed as part of an epidemiological study of breast cancer risk factors. Early age at menarche was positively associated with breast cancer risk whereas early age at first full term pregnancy, high parity, and long duration of nursing were each negatively associated. We found high average body weight to be a risk factor, especially among women over age 60. Use of oral contraceptives after age 45 also was a risk factor, but use in general was not. Personal history of benign breast disease and history of breast cancer in first degree female relatives both increased risk. Multivariate analysis showed that each of these risk (or protective) factors was independently related to breast cancer. In addition to confirming most of the breast cancer risk factors of Western populations in a low risk developing Asian country, this study demonstrates a clear beneficial effect on breast cancer risk of lactation in a population characterized by a long cumulative duration of nursing in the majority of women. Finally, this study supports several other recent reports of a residual and beneficial effect of parity on breast cancer risk after controlling for age at first full term pregnancy.

Abortion, Spontaneous↗
PubMed1988

Recent decline in gonorrhea incidence in Israel: possible association with the AIDS pandemic.

The effect of the AIDS pandemic on the sexual behavior of the general population has not been clearly established. Since trends in the incidence of other sexually transmitted diseases may be a good marker of such behavioral changes, gonorrhea incidence in the civilian and military populations in Israel was examined during the period 1963-87. In the civilian population, the rates were relatively stable until 1967, when they increased to a peak in 1970 and then declined to the earlier levels. In 1982 a further decline began, which accelerated considerably in 1986 when the rates declined by 38%. During 1987 the decline was even more dramatic, with a drop of 60% compared with the rate of the previous year. A similar trend has been noted in the military population. The recent sharp decline in gonorrhea incidence may be related, at least partly, to a change in sexual behavior associated with the fear of AIDS. If so, its magnitude suggests that such changes have not been restricted to high-risk groups.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Cancers of the cervix uteri and breast: changes in incidence rates in Bombay over the last two decades.

The age-adjusted incidence rate of cervical cancer in Bombay has decreased over the last 20 years, whereas over the same period that of breast cancer increased slightly. Studies indicate that the incidence of cervical cancer is lower in successively later-born cohorts, but no cohort effect has been observed for breast cancer. Age at marriage is an important factor in the etiology of both these cancers, and it is plausible that the decrease in cervical cancer has resulted from the increase in age at marriage of women over the last 20 years in the city. The changing pattern of incidence of cancer for women in Bombay, among whom the incidence of breast cancer is the highest of all forms of cancer, indicates that, from a long-term perspective, cancer control programmes in India as a whole should aim at minimizing the risk of both cervical and breast cancer.

Adult↗
PubMed1987

Lactation and reproduction in Western Australian women.

There has been an increase in the incidence of breast-feeding in industrial areas, particularly in Western Australia, where one in four infants is breast-fed into the second year of life. Most of this increase in the incidence of breast-feeding is found in the higher socio-economic groups, pointing to a need to collect data on milk yield in such women. The levels of milk yield in women with infants between 1 and 6 months ranged from a mean of 1.13-1.24 kg/24 h. This is a higher level of milk production than the generally accepted range of 0.7-0.9 kg/24 h. However, this difference is due, in part, to a failure of previous test weighing methods to correct for the evaporative water losses in either the infant or mother. There was no relationship between the introduction of solids and a return to fertility in 38 women breast-feeding on demand. The return of the ovulatory menstrual cycle in women resulted in two acute changes in milk composition. These changes were characterized by a rise in the concentration of sodium and chloride and a fall in the concentration of potassium, glucose and lactose in breast milk. The first change occurred five to six days before ovulation, and the second occurred six to seven days after it. Following the cessation of breast-feeding, the concentration of lactose in breast milk gradually declined, but the concentrations of anti-bacterial proteins (IgA and lactoferrin) gradually increased to high levels over a period of 30-40 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Australia↗
PubMedDate not supplied

Trends in sexually transmitted disease incidence in Papua New Guinea.

A retrospective study of gonorrhoea and syphilis from Health Department records was carried out in Papua New Guinea. During the ten-year period (1974-1983) 101,636 new cases of gonorrhoea and 34,422 of syphilis were reported among the general population of Papua New Guinea. The incidence of both sexually transmitted disease have significantly (P less than 0.005) increased over the decade despite the introduction and implementation of the National Sexually Transmitted Disease (STD) Control Programme. Some which contribute to the present increase in sexually transmitted diseases are segregation of health and non-health services, insufficient staff training and increased immigration to urban centres.

Adolescent↗
PubMedDate not supplied

Immunization with oral poliovirus vaccine in China.

China began to produce oral, live poliovirus vaccine ( OPV ) in 1960. During 1960-1964, OPV was introduced in major cities only and subsequently was used throughout the country. Since that time the incidence of poliomyelitis has dropped dramatically, and the percentage of the healthy population with antibody has clearly risen. Data from many observations showed a high rate of isolation of other enteroviruses in the healthy population and in individuals with poliomyelitis. These findings indicate that some paralytic cases may be caused by other enteroviruses. Localized outbreaks of poliomyelitis still occur, however, and their elimination will require a campaign to ensure that greater than 90% of susceptible individuals are immunized.

China↗
PubMed1994

Changing scenario of birthweight in south India.

Reducing incidence of low birthweight and increasing mean birthweights are now considered seriously in the national action plans. Comparison of birthweights obtained over two decades from the representative random segments of rural and urban areas of North Arcot Ambedkar district, Tamil Nadu, India, were studied. Although statistically significant (p < 0.001), the mean birthweight shows only a marginal increase of 70 g from 2774.5 g (+/- 500.2) in 1969-73 to 2845.4 g (+/- 451.0) in 1989-93. The mean birthweight stratified by area and gender also revealed similar increase. On the other hand, the proportion of low birthweight (< 2500 g) newborns reduced significantly from 27.2% to 15.9% in rural and 19.1% to 10.8% in urban area over the decades (p < 0.001). The increase in the mean birthweight and the decline in the percentage of low birthweight newborns over the years was greater in rural than the urban community, but the rural newborns continued to weigh lesser than their urban counterparts.

Adolescent↗
PubMed1993

Perinatal mortality in caesarean section: a disturbing picture of unfulfilled expectations.

Indications for caesarean section had been studied in a 2-year period and the incidences were compared to that of the same 15 years back. Though there are more incidences of caesarean section, still perinatal death is a major concern to all. The study included a total of 291 perinatal deaths of which there were 208 early neonatal deaths and 83 stillbirths over a period of 2 years from January, 1990 to December, 1991. Caesarean section is being increasingly performed for foetal interest, but this study reveals that perinatal mortality is still high though cesarean section rate has increased in recent times.

Cesarean Section↗
PubMed1993

A 13-year follow-up of treatment and snail control in an area endemic for Schistosoma mansoni in Brazil: incidence of infection and reinfection.

The incidences of Schistosoma mansoni infection and reinfection were investigated in an endemic area of Brazil (Peri-Peri, State of Minas Gerais) where chemotherapy and snail control had been used for 13 years (1974-87). Two cohorts were followed: the first consisted of 584 individuals with no evidence of infection at entry (infection cohort), and the second comprised 296 individuals who were treated and did not eliminate eggs 8-12 months afterwards (reinfection cohort). The incidence of infection (per 100 person-years) decreased from 7.5 in 1974-77 to 3.6 in 1986-87, and that of reinfection from 21.3 in 1974-77 to 3.7 in 1986-87. Calendar period, age at risk, and sex were independently associated with both infection and reinfection, while a heavy S. mansoni egg count prior to treatment (> or = 500 epg (eggs per gram of stools)) was independently associated with reinfection. The geometric mean number of eggs after treatment among those reinfected (47 epg) was approximately half that among those infected for the first time (81.5 epg). Age at risk had the greatest effect on both infection and reinfection. The rate ratios of infection and reinfection were 3 to 6 times higher among individuals younger than 20 years than among those aged > or = 25 years, even after adjusting for confounders. This suggests the existence of a strong protective effect with increased age (because of biological and/or environmental factors) for both infection and reinfection.

Adolescent↗
PubMed1996

Epidemiology of HIV and AIDS in the Asia-Pacific region.

The incidence of new HIV infections in Asia and the Pacific will soon pass that in Africa and is projected to increase into the next century. The AIDS epidemic arising from these infections will have enormous consequences for the health and socioeconomic development of a region encompassing more than half the world's population.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Trends in cervical cancer mortality in the Americas.

This article presents an assessment of cervical cancer mortality trends in the Americas based on PAHO data. Trends were estimated for countries where data were available for at least 10 consecutive years, the number of cervical cancer deaths was considerable, and at least 75% of the deaths from all causes were registered. In contrast to Canada and the United States, whose general populations had been screened for many years and where cervical cancer mortality has declined steadily (to about 1.4 and 1.7 deaths per 100,000 women, respectively, as of 1990), most Latin American and Caribbean countries with available data have experienced fairly constant levels of cervical cancer mortality (typically in the range of 5-6 deaths per 100,000 women). In addition, several other countries (Chile, Costa Rica, and Mexico) have exhibited higher cervical cancer mortality as well as a number of noteworthy changes in this mortality over time. Overall, while actual declining trends could be masked by special circumstances in some countries, cervical cancer mortality has not declined in Latin America as it has in developed countries. Correlations between declining mortality and the intensity of screening in developed countries suggest that a lack of screening or screening program shortcomings in Latin America could account for this. Among other things, where large-scale cervical cancer screening efforts have been instituted in Latin America and Caribbean, these efforts have generally been linked to family planning and prenatal care programs serving women who are typically under 30; while the real need is for screening of older women who are at substantially higher risk.

Adult↗
PubMed1997

Rising HIV infection rates in Ho Chi Minh City herald emerging AIDS epidemic in Vietnam.

OBJECTIVE: To describe the epidemiology of HIV in Ho Chi Minh City in the context of current surveillance data from Vietnam. METHODS: Since the late 1980s, HIV surveillance data have been collected in Ho Chi Minh City from centers for the treatment of venereal disease and tuberculosis, centers for the rehabilitation of injecting drug users and sex workers, prenatal clinics, blood banks and other sites. RESULTS: The first case of HIV infection in Vietnam was identified in 1990 in Ho Chi Minh City. The cumulative number of reported HIV infections in this city at the end of 1996 was 2774, about half of the number of cases in the country; 86% of infections were among men, 86% among injecting drug users, 2.5% among patients with sexually transmitted diseases and 2.5% among sex workers. The first HIV infection among antenatal women was detected in 1994. The prevalence of HIV among injecting drug users rose dramatically from 1% in 1992 to 39% in 1996, compared with 1.2% among sex workers, 0.3% among blood donors and 1.3% among tuberculosis patients in 1996. The populations of injecting drug users and sex workers in Ho Chi Minh City are estimated to be 30000 and 80000, respectively, and rates of sexually transmitted diseases are 2-3 per 1000 persons per year. By the end of December 1996, 42 out of 53 provinces had reported HIV infections, and border areas near China and Cambodia began identifying large numbers of HIV-seropositive people. CONCLUSIONS: Ho Chi Minh City is at the forefront of a new HIV epidemic in Vietnam. This epidemic shows similarities to that in Thailand nearly a decade ago, with rapidly rising HIV rates among injecting drug users and infection already established among sex workers. Prevention efforts should include the targeting of injecting drug users and sex workers outside rehabilitation centers, the availability of sterile needles and condoms, the establishment of anonymous testing sites, the control of sexually transmitted diseases and the coordination of programs within southeast Asia.

Acquired Immunodeficiency Syndrome↗