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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↗
PubMed1997

Geographical distribution and dramatic increases in incidences of malaria: consequences of the resettlement scheme in Gambela, SW Ethiopia.

The spatial distribution of malaria results from the interaction between vector, parasite, host, physical and human environments. This basic geographical approach provides an illustration of the geographical distribution of malaria in the world, particularly in the tropical regions. Due to the global climate change and population movements, it is predicted that malaria could have a greater impact on the non-immune or unprepared populations in the Northern Hemisphere in the coming decades. Presently, Sub-Saharan Africa (SSA) is the most adversely affected region in the world. Like any other SSA country, Ethiopia suffers from both epidemic (unstable) and endemic (stable) malaria in the high and lowland regions, respectively. Gambela is one of the areas with stable malaria in the humid tropical region of the country. This study is based on observations, unpublished data, interviews and discussions with settlers and officials in Gambela. It is found that a degree of diverse malaria prevalence is associated with altitudinal, temperature and rainfall variations. Owing to the settlement and land-use changes, unexpected rainfall patterns, temperature increase, unstable political system and poverty, malaria has gone beyond its geographical limits. As a result, the number of malaria affected people has increased in the last 12 years. It is suggested that proper physical and social planning, understanding the geography, entomology, epidemiology, behaviour and life-cycle of malaria parasite, cooperation between the policy-makers, malaria specialists, neighbouring countries and international communities are urgent, if malaria has to be controlled and eradicated.

Altitude↗
PubMed1998

[Female sex hormones increase the risk of breast cancer].

The incidence of breast cancer in women in increasing, partly due to changes in age distribution in the population, and partly due to a real increase in risk. Changes in family patterns may, to some extent, explain the increased risk since giving birth to a first child late in life and bearing few children both increase the risk of breast cancer. The influence of female sex steroids on the breast plays a central role, but the biological mechanism is not clearly understood. There is a certain amount of risk involved in using hormonal medication (oral contraceptives or postmenopausal hormone replacement), but on ceasing to take the medication, risk will revert to the expected rate within a few years. Future epidemiological research on breast cancer will concentrate on events occurring during hormonally potent phases of life, such as growth and development during the fetal period, and sexual and somatic maturation during adolescence. Until now only modest interest has been shown in researching these two particular phases, but both may be important for the natural course of breast cancer.

Adolescent↗