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At least 865 records · Page 48Linked to original sources
PubMed2002

Childcare practices of commercial sex workers.

OBJECTIVE: To determine the childcare practices of commercial sex workers (CSWs). DESIGN: A descriptive cross-sectional survey was conducted between July and December 2000 during which a structured questionnaire was administered. SETTING: Kibera slum, Nairobi, Kenya. SUBJECTS: Three hundred eighty five CSWs and four focus group discussions (FGDs) held. Health cards from 126 under five years old children belonging to the respondents were reviewed for immunization status and regularity of growth monitoring. RESULTS: The mean age of the 385 CSWs surveyed was 32 +/- 7 years and mean duration of sex work was 6 +/- 4 years. The mean number of living children was 3.4 +/- 2 and 81.2% of the mothers lived with their children. Three quarters of the CSWs practised prostitution at home. The most common daily childcare activities by the mothers were food preparation (96.2%) and washing children's clothes (91.3%). Overall 96.8% of their under-five years old children were fully immunized and 80% of their under one year old children had their growth monitored monthly. About three quarters of the mothers with adolescent children educated them on HIV/STDs. Health seeking behaviour for the children was hampered by health care cost (71.4%) and consumption of alcohol by the mothers. Like other mothers, the CSWs encouraged their adolescent children to take up some adult roles such as maintaining a clean house (93.3%). However only 2.0% took time to converse or counsel the children. Focus group discussions (FGDs) with the CSWs showed that children were left unattended at night while the mothers went out in search of clients. Efforts to provide better education for the children were undermined by lack of funds (52.2%) and truancy (46.6%). One third of the study population had invested for the future maintenance of their children. CONCLUSION: There was more emphasis on physical, rather than psychological aspect of childcare. The practice of living with the children ensured that earnings from the sex trade were used for the immediate needs of the children such as food. However this practice had a negative influence on the children as the majority of the respondents conducted their sexual business at home with little or no privacy. Health seeking behaviour for the children was hampered by lack of funds and to some extent alcohol consumption by the mothers. Efforts to invest in the education of their children were undermined by lack of funds and truancy.

Adolescent↗
PubMed2003

Daily versus weekly iron supplementation and prevention of iron deficiency anaemia in lactating women.

OBJECTIVE: To demonstrate the effectiveness and social feasibility of weekly versus daily iron supplementation in preventing and treating iron deficiency anaemia among anaemic mothers. DESIGN: A longitudinal in nature. SETTING: Seven urban slum communities in Teklehaimanot Wereda, Addis Ababa, Ethiopia. SUBJECTS: Two hundred seven eligible mothers were assigned to the daily supplementation, weekly supplementation or control groups following randomisation between March and May 2001. The daily supplemented groups (n=71) received 60 mg of elemental iron containing 300 mg ferrous sulphate and 400 microg folic acid from Monday to Friday. The weekly group (n=68) received one tablet once a week every Monday supervised while the control group (n=68) was advised to take no medications without the knowledge of the investigators until the completion of the study. To eliminate a major source of variation, subjects participating in the study were de-wormed at the beginning of the study. MAIN OUTCOME MEASURES: Haemoglobin and serum ferritin concentrations were compared before and after the intervention among the groups. RESULTS: The mean haemoglobin (Hgb), and serum ferritin concentration (SFC) at baseline were practically similar among the groups. Haemoglobin levels significantly increased at the end of the study in all the groups and the proportion of anaemia decreased from 6.9% to 1.6% in the daily, 6.7% to 1.7% in the weekly supplemented and 6.7% to 6.1% in the control groups. The difference noted between the daily and weekly supplemented groups was not significant. The improvement of SFC concentration was better in the daily than the weekly group but not statistically significant. Daily supplementation schedule caused more side effects and lower compliance level than the weekly supplementation schedule. CONCLUSION: Weekly supplementation is simple, comparable to daily supplementation and economically advantageous. Thus, it is recommended to adopt the strategy for controlling anaemia. Further because of higher compliance rate and lower side effects, it is deemed to be socially feasible.

Adolescent↗
PubMed2003

Vitamin A deficiency among Kenyan children as detected by conjunctival impression cytology.

OBJECTIVE: To determine the prevalence of Xerophthalmia among Kenyan children aged four to seven years in high risk using Conjuctival Impression Cytology and transfer. DESIGN: A cross sectional community based study. SETTING: Mathare slum in Nairobi and Tiva/Ithiani area of Kitui. SUBJECTS: Children aged four to seven years residing in the above areas were assessed for both clinical and cytological features of vitamin A deficiency. RESULTS: Of the 342 children included in this study, 316 (92.0%) were normal, five (1.5%) had XN, 19 (5.9% had XIA and two (0.6%) had XIB. No signs of corneal Xerophthalmia were seen in this study. Conjuctival impression cytology and transfer (CICT) was used to asses for squamous metaplastic changes associated with Vitamin A deficiency (VAD). Seventy five (23.1%) of the children were normal by CICT while 249 (76.9%) were abnormal. In comparing the two areas of study, only 13.2% of the children in Mathare had normal CICT compared to 50% in Kitui. For each of the age groups studied there was significant difference between the two areas with children from Mathare being more deficient than those from Kitui. CONCLUSION: VAD is a significant health problem in the high risk areas assessed by CICT in this study.

Age Distribution↗
PubMed2004

Potential pathogens in the lower genital tract at manual vacuum aspiration for incomplete abortion in Korle Bu Teaching Hospital, Ghana.

OBJECTIVES: To determine the carriage rates of potential pathogens in the lower genital tract and factors associated with colonization among women with incomplete abortion. DESIGN: A cross-sectional study. SETTING: The Manual Vacuum Aspiration room of the Korle-Bu Teaching Hospital, Accra, Ghana. SUBJECTS: Two hundred women undergoing Manual Vacuum Aspiration at the Korle-Bu Teaching Hospital. METHODS: Eligible patients were screened for the presence of organisms in the lower genital tract by microscopy and culture of high vaginal and endocervical swabs. RESULTS: Nearly two-thirds of the patients (64.2%) had potential pathogens in the lower genital tract. Bacterial vaginosis alone was present in 47% and a combination of bacterial vaginosis and Candida albicans was present in 17.2%. Residence in an urban slum showed a significant association with the presence of potential pathogens (Odds ratio 2.6; p-value 0.04). CONCLUSION: Organisms responsible for bacterial vaginosis were the most frequently isolated potential pathogens in the cervical canal of patients with incomplete abortion at the Korle-Bu Teaching Hospital. Management of these patients should therefore include antibiotic prophylaxis against bacterial vaginosis.

Abortion, Incomplete↗
PubMed2005

Epidemiology of intestinal nematodes in school-age children of the Kumba Urban Area, south west Cameroon.

BACKGROUND: The urban slums, poorly disposed garbage and inadequate toilet facilities in many homes, coupled with the high temperatures, rainfall and humidity that characterise the Kumba urban area, favour the development and transmission of helminth parasites in the area. School-age children are particularly at risk of infection. OBJECTIVE: To determine the pattern of soil-transmitted nematode infections in the Kumba urban area as affected by seasonal changes. DESIGN: Longitudinal study. SETTING: Ten primary schools in the Kumba urban area. SUBJECTS: Five hundred and eighty seven randomly selected pupils aged between four and fifteen years of both sexes. RESULTS: Significantly (P<0.005) more children were infected towards the end (69%) than in the early months (38.3%) of the rainy season. The infection rate recorded in December/January (dry season) was significantly reduced in April/May (early months of the rainy season) in male and female (P<0.01) children of different age groups (P<0.005) and classes (P<0.05). Then after, the rate increased significantly (P<0.005) in all the groups to reach a peak in October/November (last months of the rainy season). The intensity of infection more or less followed the same pattern as prevalence, except in hookworms where prevalence increased progressively and significantly (P>0.05) from 10.7% in December/January to 19.4% in October/November, while the worm load decreased. Single and mixed species infections constituted 50.8% and 49.2% respectively of the infections investigated, with Ascaris lumbricoides accounting for the highest number of infections. The most common combination of mixed species infections was Ascaris/Trichuris. CONCLUSION: The study has revealed that, in general, progressively more school-age children are infected with soil-transmitted nematodes in the course of the rainy season while acquisition of infections in the dry season progressively reduce to the low levels observed in the early months of the rainy season.

Adolescent↗
PubMedDate not supplied

Vaginal flora of first time urban family planning attendants in Accra, Ghana.

OBJECTIVE: To determine the vaginal flora of first time urban Family Planning clients at Korle-Bu Teaching Hospital and to assess its implications for the contraceptive choices made. DESIGN: A cross sectional study. METHODS: A standardized questionnaire surveying the sociodemographic characteristics and the choice of Family Planning method was administered to 100 clients at the Korle Bu Teaching Hospital between March and September 2001. High vaginal and endocervical swabs were also taken during the inspection of the vagina and cervix using a sterile bivalve speculum. The specimens were transported in Amies transport medium to the Microbiology laboratory for processing. RESULTS: The age range of the clients was 19-48 years with a modal age of 28 years. Ninety-six percent of them were married while 86% lived in urban slums. Sixty-three percent were sure of their last menstrual period. Potential pathogens were isolated from culture in 56% of the clients. Organisms causing bacterial vaginosis were the most prevalent in their genital tract. The intrauterine contraceptive device (IUCD) was the most common Family Planning method chosen, followed by the Norplant and the Depo-Provera injections. Potential pathogens were isolated from culture in 50% of those who chose the IUCD. CONCLUSION: Potential pathogens were isolated from culture in 56% of these first-time clients and organisms causing bacterial vaginosis were the most prevalent in the genital tract. It is suggested that Family Planning clients who screened positive for potential pathogens and opt for the IUCD should be considered for prophylactic antibiotics at insertion.

Adult↗
PubMed1999

[Blood lead levels in children of Cordoba City].

Exposure to environmental lead is a major hazard to public health. International Environmental Agencies have assessed that blood lead concentrations of 10.0-15.0 micrograms/dl or even lower may be a risk factor for children. This survey focussed on environmental lead contamination and tried to provide information about blood lead levels in the children population of Cordoba City. A total of 172 children between 6 months and 9 years of age assisted in health centers and hospitals from December 1995 to December 1996 were surveyed. Lead assessment was performed by atomic absorption spectrophotometry with graphite furnace. Results revealed that 73.3% of the children population studied exhibited blood lead levels lower than 10.0 micrograms/dl; 19.2% evidenced risk concentration levels (10.0-14.9 micrograms/dl) and 7.6% showed concentrations higher than 15.0 micrograms/dl. It was confirmed that children with elevated concentrations lived in areas where numerous car repair shops are located. Three of the subjects lived in slums. From the group with low blood lead levels (< 10.0 micrograms/dl), 25 children lived downtown or near main avenues of heavy traffic and belonged to middle class families. Our survey showed a high occurrence of children with lead levels higher than 15.0 micrograms/dl (7.6%) whose etiology risk factors have been identified. Prevention should be able to cut down this occurrence through a safe control of environmental lead sources.

Argentina↗
PubMed1999

Mass vaccination with a two-dose oral cholera vaccine in a refugee camp.

In refugee settings, the use of cholera vaccines is controversial since a mass vaccination campaign might disrupt other priority interventions. We therefore conducted a study to assess the feasibility of such a campaign using a two-dose oral cholera vaccine in a refugee camp. The campaign, using killed whole-cell/recombinant B-subunit cholera vaccine, was carried out in October 1997 among 44,000 south Sudanese refugees in Uganda. Outcome variables included the number of doses administered, the drop-out rate between the two rounds, the proportion of vaccine wasted, the speed of administration, the cost of the campaign, and the vaccine coverage. Overall, 63,220 doses of vaccine were administered. At best, 200 vaccine doses were administered per vaccination site and per hour. The direct cost of the campaign amounted to US$ 14,655, not including the vaccine itself. Vaccine coverage, based on vaccination cards, was 83.0% and 75.9% for the first and second rounds, respectively. Mass vaccination of a large refugee population with an oral cholera vaccine therefore proved to be feasible. A pre-emptive vaccination strategy could be considered in stable refugee settings and in urban slums in high-risk areas. However, the potential cost of the vaccine and the absence of quickly accessible stockpiles are major drawbacks for its large-scale use.

Administration, Oral↗
PubMed2000

The role of son preference in reproductive behaviour in Pakistan.

The sex of surviving children is an important determinant of reproductive behaviour in South Asia in general and Pakistan in particular. This cohort study evaluates the role of the sex of children on reproductive intentions and subsequent behaviour of women in urban slums of Karachi, Pakistan. The analysis is based on two rounds of surveys conducted in 1990-91 and 1995 of a cohort of married women aged 15-49 years. The results show that pregnancies became increasingly unwanted as the number of surviving sons increased. The sex of surviving children was strongly correlated with subsequent fertility and contraceptive behaviour. However, rather than an exclusive son preference, couples strove for one or more sons and at least one surviving daughter. The policy implications of the link between overt son preference and low status of women are discussed.

Adolescent↗
PubMed2000

The relationship between rainfall and human leptospirosis in Florianópolis, Brazil, 1991-1996.

The relationship between serologically confirmed cases of leptospirosis and the amount of rainfall in greater Florianôpolis, in southern Brazil, was studied retrospectively for the period 1991 to 1996. Maximum daily and total monthly rainfall for present and previous months were statistically significant predictors of the number of cases of leptospirosis in Poisson regression models. However, daily maximum rainfall data showed a much better model fit than total monthly rainfall. For each millimeter increase in maximum daily rainfall for the month above the average for the period studied, there was an increase of 0.55% in the number of leptospirosis cases relative to the period average. For the past month's daily maximum, this increase was 0.21%. Maximum daily rainfall during the month is a sensitive indicator of large amounts of rain falling in a brief period of time. This may cause flash floods and, thus, disseminate pathogenic Leptospira among the human population, particularly in densely populated areas with large rodent populations and without adequate drainage. This situation is typical for the association of tropical rainstorms and the spread of leptospirosis among slum dwellers.

Antibodies, Bacterial↗
PubMed2000

Clinical trial with Secnidazole in a single dose in Venezuelan children infected by Giardia intestinalis.

The aim of this work was to evaluate in an open, noncomparative study the use of secnidazole in oral suspension given to Venezuelan children infected with Giardia intestinalis, from a community in Carapita, a slum area in Caracas. Seventy children from 2 to 11 years old (38 males and 32 females) were treated with a single oral dose of secnidazole (30 mg/Kg of body weight), after clinical and parasitological evaluation to make the diagnosis of active giardiasis. The effectiveness of treatment was determined by clinical examination and parasitological evaluation of feces samples 15 days after treatment. The results showed 95% of clinical cure with a significant decrease of the frequency of gastrointestinal symptoms. The parasitological cure was 98%, there were 4 failures at the end of treatment. Side effects observed after treatment were of mild intensity, lasting only few hours. These results show that a simple dose of secnidazole in an oral suspension is an effective, safe and well tolerated treatment for giardiasis in children and that this drug may be used as a mass treatment in risk populations.

Administration, Oral↗
PubMed2000

User-fees for family-planning methods: an analysis of payment behaviour among urban contraceptors in Bangladesh.

The study was carried out to review the experience with the existing user-fee (pricing) strategies and examine the socioeconomic and demographic factors associated with payment behaviour among contraceptors in urban Bangladesh for selected contraceptive methods, such as injectables, pill, and condom. Data for the study were drawn from a survey of more than 5,000 married women of reproductive age in Zone 3 of Dhaka city, Bangladesh, within the sample frame of the Urban Panel Survey of the ICDDR,B's former Urban MCH-FP Extension Project. The findings of the study showed that most (80%) urban contraceptors have been paying for selected family-planning services. This indicates the existence of a notable demand for contraceptives which suggests that there is scope for improved financial sustainability of the family-planning programme through charging appropriate user-fees for contraceptives with proper analyses of willingness-to-pay among the contraceptors and price elasticities of demand. Higher socioeconomic status of households, marked by higher levels of education and house rent, and location of residence in non-slum areas, is predictive of paying for contraception. Households having 1-3 living child(ren) are also more likely to make payment for the selected contraceptive services.

Adult↗
PubMedDate not supplied

Body iodine status in school children and availability of iodised salt in Calcutta.

Success of Universal Salt Iodization (USI) programme depends on availability of iodised salt to consumers, which should be reflected in their body iodine status. From a monitoring study in Calcutta, it was found that all packed salts were iodised and most of them (98.1% at household level and 93.6% at retailers' outlets) had iodine at a level of > or = 15 ppm. Of the loose salts, 34.6% at household level and 19.9% at retailers' outlet had iodine level < 15 ppm. A few number (0.5% at household level and 1.0% at retailers' outlets) of salts had no iodine. To ascertain the impact of consumption of iodised salt iodine excreted in urine (UIE) was measured in school children of age between 8-12 years of south, east, west, north and central parts of Calcutta. 22.95% of male children and 31.81% of female children had urinary iodine level less than 50 micrograms/l, which is cut off figure of public health concern. Children from poor slum areas were found to be at greater risk.

Child↗
PubMed2001

Sustaining our rivers in crisis: setting the international agenda for action.

The history of streams and rivers is as much a social and technological history as it is a scientific one. Rivers are the lifeblood of nations and the control of their waters has been fundamental to the building of human civilisations. The control or regulation of rivers embodied the advancement of institutions, administration and co-ordination; it was a manifestation of military and economic power. Yet the history of human development is also characterised by the degradation of the basic resource--polluted water, increased flooding, and the loss of biological diversity. Many early civilisations collapsed in the face of environmental degradation, manifest by flood, drought, famine and plague. The Industrial Revolution upon which modern societies are founded was based upon a short-term vision that has left rivers in crisis, marked by a legacy of pollution, slums, a loss of confidence in civic life, and a loss of ownership of places and spaces--once seen to be at the heart of civilized society. Within this global or international context of water management, this paper examines the impacts and future of rivers and water within the United Kingdom, establishing some principles for such management in other settings.

Conservation of Natural Resources↗
PubMed2001

[Living conditions and life experiences of working-class groups in Rio de Janeiro: rethinking dengue control and popular mobilization].

Using narratives of an experience with popular mobilization during the 1986-91 dengue epidemic in the city of Rio de Janeiro, the authors discuss the scientific research and technical counseling involving basic sanitation conditions for vulnerable social groups. They present research results on water distribution in the slums from the Leopoldina area of the city. The research stemmed from demands by community leaders at local forums discussing health conditions. Gathering, systematizing, and analyzing the data were based on what they call "shared knowledge construction", resulting by crossing accumulated scientific knowledge with popular knowledge produced as a result of living conditions and life experiences among working-class groups. Finally, the authors comment on the need for local health professionals to be aware of relationships between epidemic and endemic processes and protection of life.

Brazil↗
PubMed2001

[Urbanization and dengue ecology].

Demographic changes occurring in underdeveloped countries due to intense rural-urban migration since the 1960s have resulted in overcrowded cities with multiple deficiencies, particularly in housing and basic sanitation. Some 20% of the population in large and medium-sized cities live in slums or under similar conditions. Lack of regular water supply and public garbage collection foster the proliferation of potential breeding sites for Aedes aegypti (the main mosquito vector for dengue), including precarious reservoirs for potable water and disposable recipients which accumulate water, like used cans and plastic and glass bottles. Modern industries also produce large volumes of disposable materials. Propagation of the dengue virus and the spread of dengue vectors are favored by the high intensity, frequency, and speed of private and public transportation. Such factors can help explain the re-emergence of dengue, the most important arbovirus in the world today, affecting thousands of people each year.

Aedes↗
PubMed2001

Group A streptococcal sore throat in a periurban population of northern India: a one-year prospective study.

OBJECTIVE: To estimate the incidence and risk factors of group A streptococcus (GAS) sore throat among school-aged children living in a periurban slum area of Chandigarh, North India. METHODS: A total of 536 children aged 5-15 years from 261 families identified by a systematic random selection method were enrolled in the study. Episodes of sore throat were recorded through fortnightly home visits over a one-year period. The local vernacular (Hindi) terms gala kharab (bad throat) and khansi jukam (cough and cold) were used to identify symptoms of sore throat, and throat swab specimens were collected from children who had these symptoms on the day of the home visit. Bacterial culture was carried out and the isolation of GAS was confirmed using group-A-specific antiserum. FINDINGS: The incidences of sore throat and GAS sore throat were, respectively, 7.05 and 0.95 episodes per child-year. The incidence was higher in the following situations: among 11-year-olds, during the winter (November to January) and rainy (August) months (a bimodal peak), among children living in houses where there was no separate room for the kitchen, and in homes that included a tobacco smoker. CONCLUSION: The results show that the incidence of GAS sore throat was related to age, season, and indoor air pollution.

Adolescent↗
PubMed2000

[Adiposity distribution in adolescents by conicity index].

Body regional fat distribution has been linked with a metabolic atherogenic risk profile, that starts early in life. Data from a cross-sectional sample of 394 boys and girls, 11 to 16 years, who inhabit a slum sector of Caracas, Venezuela was studied using Conicity Index (C): [equation: see text] by means of Box-plot diagram, Levene, ANOVA, and Scheffé tests. The accepted level of significance was p < 0.05. Results showed significant differences in body fat distribution between age groups. Height and body mass index were used as control variables. C values ranged between (1.02-1.18) in boys and (0.99-1.14) in girls. Boys attained higher mean values. All groups showed variance homogeneity (p value > 0.05) and sexual dimorphism was found at 11, 12 and 13 years, that were removed after controlling for height and body mass index. Differences according to age groups in boys, were removed after controlling for height. Results found conicity index as an alternative method to assess abdominal fat distribution during adolescents years.

Adipose Tissue↗