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PubMed2004

Factors associated with reported diarrhoea episodes and treatment-seeking in an urban slum of Kolkata, India.

In an urban slum in eastern Kolkata, India, reported diarrhoea rates, healthcare-use patterns, and factors associated with reported diarrhoea episodes were studied as a part of a diarrhoea-surveillance project. Data were collected through a structured interview during a census and healthcare-use survey of an urban slum population in Kolkata. Several variables were analyzed, including (a) individual demographics, such as age and educational level, (b) household characteristics, such as number of household members, religious affiliation of the household head, building material, expenditure, water supply and sanitation, and (c) behaviour, such as hand-washing after defecation and healthcare use. Of 57,099 study subjects, 428 (0.7%) reported a diarrhoea episode sometime during the four weeks preceding the interview. The strongest independent factors for reporting a history of diarrhoea were having another household member with diarrhoea (adjusted odds ratio [OR]=3.8; 95% confidence interval [CI] 3.3-4.4) and age less than 60 months (adjusted OR=3.7; 95% CI 3.0-4.7). The first choice of treatment by the 428 subjects was as follows: 151 (35%) had self- or parent-treatment, 150 (35%) consulted a private allopathic practitioner, 70 (16%) went directly to a pharmacy, 29 (7%) visited a hospital, 14 (3%) a homoeopathic practitioner, 2 (0.5%) an ayurvedic practitioner, and 12 (3%) other traditional healers. The choices varied significantly with the age of patients and their religion. The findings increase the understanding of the factors and healthcare-use patterns associated with diarrhoea episodes and may assist in developing public-health messages and infrastructure in Kolkata.

Adolescent↗
PubMed2005

Asymptomatic cryptosporiosis in a periurban slum setting in Kolkata, India--a pilot study.

We report the results of a prospective study conducted among asymptomatic children of slum dwellers in Kolkata, eastern India, to assess the prevalence of Cryptosporidium parvum during the period of October 2002 to July 2003. Of the 609 fecal samples examined, C. parvum was detected in 14 (2.3%). The study indicated that poor sanitary conditions may be cofactors for the cryptosporidial disease burden among slum dwellers. The implications of asymptomatic infections have been discussed.

Animals↗
PubMed2006

Prevalence of anti-cysticercus antibodies in slum, rural and urban populations in and around Union territory, Chandigarh.

A comparative analysis for the prevalence of anti-cysticercus antibodies was carried out in urban, rural and slum population in & around Union territory of Chandigarh. Prevalence of anti-cysticercus antibodies in different population groups was found to be 17.3% with highest prevalence (24%) reported from slum areas followed by that of rural areas (20%) and least in the urban organized sectors (8%). Only 8% of the seropositive individuals had history suggestive of neurocysticercosis. Overall, females showed the highest anti-cysticercus response of 20.4%.

Adolescent↗
PubMed2005

Comparative analysis of intestinal parasitic infections in slum, rural and urban populations in and around union Territory, Chandigarh.

A study was conducted in and around the union Territory, Chandigarh, India to estimate the prevalence of intestinal parasitic infections in different population groups. The stool samples from a total of 600 subjects selected by cluster sampling technique were examined by direct microscopy. The prevalence of intestinal parasitic infections was found to be 14.6% with highest prevalence of 19% from the slum area. Children were the most commonly affected group (18%) with those from slums showing the highest prevalence (24.6%). The most common parasite was Giardia (5.5%) followed by H. nana and Ascaris (2.8% and 2.7% respectively).

Age Factors↗
PubMed2006

Newborn care practices in an urban slum of Delhi.

BACKGROUND: Despite efforts by government and other agencies, neonatal morbidity and mortality continues to be high in India. Among other reasons, newborn care practices are major contributors for such high rates. AIMS: To find out the newborn care practices including delivery practices, immediate care given after birth and breast-feeding practices in an urban slum of Delhi. SETTINGS AND DESIGN: Community based, cross-sectional survey in a resettlement colony (a type of urban slum). MATERIALS AND METHODS: Semi-structured, pre-tested schedule was used to interview 82 mothers of newborns in the study area. STATISTICAL ANALYSIS: Data was analyzed using Epi - info version 6.04. Fischer exact test and chi2 test were applied. A P value of less than 0.05 was considered significant. RESULTS AND CONCLUSION: More than half i.e. 26 (56.1%) of home deliveries, which were mostly conducted by dais (24, 91.3%) or relatives in 4 (8.7%) of home deliveries. Bathing the baby immediately after birth was commonly practiced in 38 (82.6%) of home deliveries. Finger was used to clean the air passage in most of the home deliveries (29, 63%). About 61% (28) of home delivered newborns were not weighed at birth. Rooming in was practiced in majority of the cases. A few of home delivered neonates (12) were given injection tetanus toxoid by unqualified practitioners. Use of clip, band or sterile thread to tie the cord and no application to the cord was significantly higher in institutional deliveries. Breast milk as the first feed was significantly more in institutional deliveries. There is an urgent need to reorient health care providers and to educate mothers on clean delivery practices and early neonatal care.

Cross-Sectional Studies↗
PubMedDate not supplied

[Cidade Leonor slum, São Paulo. III. Environmental contamination and natural feeding practice].

In this study the authors report the high rate of environmental contamination to which children living in slum areas are exposed. The authors performed a bacteriologic and parasitologic survey in children with acute diarrhea and in controls. Feeding habits were also recorded. The feeding habits revealed that 176 out of 520 children (33.8%) were never breast fed, whereas the remaining 344 (66.7%) were breast fed for an average of 2.2 months. The parasitologic survey was positive in 89% of the stool samples obtained from 83 children, mostly with multiple infections. The bacteriologic survey revealed the presence of enteropathogens and, in particular, invasive E. coli and Campylobacter in 46.7% of the children with acute diarrhea, and in 32.5% of the children in the control group. These findings allow the authors to state that environmental conditions of slum areas directly predispose to the appearance of the diarrhea-malnutrition binomial.

Brazil↗
PubMedDate not supplied

Prevalence of leprosy in slums in Bombay including a leprosy colony.

Transmission of leprosy which is related directly to the total quantum of infection in the community as a whole is decided by the existence of patients suffering from progressive and infectious forms of leprosy and their movement from place to place. This information is of great importance in cities like Bombay to identify the priority areas as targets towards which control efforts should be directed. In this presentation an attempt has been made to compare the leprosy survey figures from three different situations in the city. Selection is arbitrary, not made on statistical basis. The data of particular importance is from a leprosy colony located in North Bombay representing a hyperendemic situation and a normal slum adjacent to this colony, movement of population between these two colonies being free. Age specific prevalence rates of leprosy after examining more than 80% of population from these colonies are compared with data derived from normal slums situated elsewhere in the city. The figures reveal varying prevalence rates marked by an increasing trend in the prevalence figures, leprosy colony representing the largest pool of infection. These figures indicate that wider statistically planned investigations on similar lines in urban areas may provide epidemiological data useful for planning control measures on a more rational basis.

Adolescent↗
PubMed1982

Comparison of slum survey, school survey and health education as methods of detection of leprosy cases in urban area.

The present study includes the analysis of different methods of survey adopted by the Shram Mandir Trust in its urban leprosy control unit of Baroda. The results are obtained from the work of the Trust of the last decade (i.e. from 1972 to 1982). It reveals that Slum Survey (1.90/1000) has better results as compared to school survey (0.29/1000). 91 cases were detected in one year from 1-4-1981 to 31-3-1982; 38 were through slum survey (41.76%) and 37 were through health education (40.66%). (School Survey was not carried.) Thus health education has a very important place in case detection.

Adolescent↗
PubMedDate not supplied

Dietary patterns and selected anthropometric indices in reproductive age women of a slum in urban: Kurnool.

Dietary intake in pregnant, lactating and non-pregnant nonlactating women of an urban slum in Kurnool, A.P. are about 30% less than the ICMR recommended daily allowances. Heights and weights of the subjects are similar to the National Nutrition Monitoring Bureau's values for slum women and some inter-religious difference is observed in the anthropometry of the subjects.

Adolescent↗
PubMed1993

Situation of hypertension in some Bangkok slums.

A cross-sectional epidemiologic survey was undertaken in slums in the catchment areas of two health centers in Bangkok. Two hundred and sixty representative households were randomly selected. All adults (993) aged 20 years and over who lived in the households were asked to participate. The results were, however, based on 809 subjects (89%) who responded and whose data were completed. It was found that prevalence of hypertension (blood pressure > or = 160/95 mmHg) was 14 per cent with a 95 per cent confidence interval of 11.8 and 16.4 per cent. Nearly half of the hypertensives were found to be mild cases (diastolic blood pressure = 95-105 mmHg). Less than half of the hypertensives were aware of their condition. Even a lower proportion was under treatment and had their blood pressure controlled. The results confirmed earlier studies that slum inhabitants seem to be at high risk of hypertension. Furthermore, the status of hypertensives in terms of awareness, treatment and control was unacceptably poor. This prompts a need to develop community programmes to cope with the problems.

Adult↗
PubMedDate not supplied

Effect of age and helminthic infection on IgE levels in slum children.

Helminthic infections can cause an IL-4-dependent polyclonal synthesis of IgE, which is the major cause of the elevated serum levels of this immunoglobulin in tropical populations. In the present study, we measured the IgE levels in the serum of children of different ages in slum areas of Caracas, Venezuela, where intestinal helminths are endemic. As would be expected, in children over 5 years of age, the IgE levels were highly elevated, and in addition, the cord blood serum levels were higher than those reported for populations where parasitic infections are uncommon. However, the IgE levels measured in the sera of children under 5 years of age were relatively low, and within the generally accepted normal ranges. This was surprising because the latter children were infected by parasites and had high IgG antibody levels against helminths. We found, however, that whereas older children had detectable IL-4 levels in their sera, the younger children did not. These results suggest that, despite infection of these slum children by common intestinal helminths, a polyclonal stimulation of IgE synthesis did not occur, possibly due to a lack of IL-4 production by an immature immune system.

Adolescent↗
PubMedDate not supplied

Iodine deficiency in adolescents from Bombay slums.

BACKGROUND: Iodine deficiency may be associated with endemic goitre, lowered levels of circulating thyroid hormone and suboptimal brain function. We studied iodine deficiency, thyroid status and scholastic performance in 866 (416 girls and 450 boys) adolescents from the slums of Bombay. METHODS: We examined 866 adolescents (416 girls and 450 boys) to determine the presence of goitre. Circulating levels of T3 and T4 were estimated by radioimmunoassay and of thyroid stimulating hormone by the immunoradiometric assay technique. Their scholastic performance was assessed by the average marks obtained in the last examination. RESULTS: The prevalence of goitre was 56% in both boys and girls. The visible goitre rate was also similar in boys (9.8%) and girls (10.6%). We found no significant difference in the mean urinary iodine excretion and urinary iodine to creatinine ratio between boys and girls, but the mean serum T3 and T4 levels were lower in girls than in boys, while the thyroid stimulating hormone levels were higher. The mean thyroid hormone levels were consistent with normal thyroid function. With an increase in the size of goitre, there was a decrease in urinary iodine excretion, urinary iodine to creatinine ratio, T3 and T4 levels while the thyroid stimulating hormone levels increased. The scholastic performance of the adolescents with goitre was poor. Forty-eight per cent of them obtained less than 50% marks and their academic grades showed a significant association with thyroid stimulating hormone levels. CONCLUSION: Goitre has a high prevalence among adolescents in the slums of Bombay. This can be attributed partly to the increasing demand for iodine at puberty which cannot be satisfied with the limited amounts available in food. The children also show a poor scholastic performance. Mild iodine deficiency can be easily controlled by encouraging the use of iodized salt in adolescents.

Achievement↗
PubMed1997

Symptoms and problems of menopausal women in Klong Toey slum.

This study was conducted to assess the symptoms and problems of postmenopausal Thai women in Klong Toey slum. The interview was randomly performed according to the home number by well-trained social workers and a standardized questionnaire was used. One hundred and nineteen postmenopausal women were eligible for the study. The women were of low socioeconomic and educational background. Their mean age was 58.9 +/- 6.9 years. The mean time since menopause was 7 years. The prevalence of the climacteric symptoms was as follows: vasomotor symptoms 72.3 per cent, urological symptoms 80.7 per cent, genital symptoms 87.4 per cent and psychological symptoms 98.3 per cent. However, the prevalence of severe vasomotor, urological, genital and psychological symptoms which these women recognized as problems was 29.4 per cent, 19.3 per cent, 15.1 per cent and 75.6 per cent, respectively. In conclusion, the prevalence of climacteric symptoms of postmenopausal women in Klong Toey slum were high but the symptoms which these women recognized as problems were low. These women probably perceived these symptoms as a natural change of life.

Aged↗
PubMed2000

Diphtheria in urban slums in north India.

We recorded a reappearance of cases of microbiologically confirmed diphtheria in a tertiary care hospital in north India. Poor immunisation coverage, population migrations, and overcrowded urban slums may be contributory factors.

Child↗
PubMed1990

A prospective study of persistent diarrhea among children in an urban Brazilian slum. Patterns of occurrence and etiologic agents.

Persistent diarrhea is a major health problem among children in developing areas of the world. Since few community-based studies have addressed the epidemiology or etiology of this condition, we undertook prospective diarrheal surveillance among a cohort of 175 children less than 5 years of age over a 28-month period in an urban slum in northeastern Brazil. Very high diarrhea illness burdens were found. The children in this cohort had an average of 11 episodes per year and spent 82 days per year with diarrhea. A total of 65% of children had at least one episode of persistent diarrhea (greater than or equal to 14 days duration). These episodes accounted for 50% of all days of diarrhea and 11% of all episodes. The occurrence of at least one episode of persistent diarrhea identified all children who spent at least 15% percent of days with diarrhea. Among children with and without diarrhea, rotavirus was the agent isolated most frequently, followed by Giardia lamblia and enterotoxigenic coliforms. The agents isolated from children with acute and persistent diarrhea were similar, which suggests that other factors must be operative in the development of persistent diarrhea.

Brazil↗
PubMed2000

Developing an interactive STD-prevention program for youth: lessons from a north Indian slum.

An intervention developed to teach young men in the urban slums of Lucknow, India, about sexually transmitted diseases is described in detail. This community-based intervention was designed to impart core educational messages and to address preexisting ideas about sexual health and STD-prevention practices among participants. Indicators of knowledge recorded before and after the intervention are presented and evaluated against the scores of a control group. Levels of sexual activity and factors associated with risky sex are discussed. The intervention was successful in raising the young men's awareness of STDs significantly in all areas except for the length of time that symptoms take to manifest following risky sex and the ineffectiveness of washing one's genitals after sex to avoid acquiring STDs. Lessons learned during the intervention are described as a means of informing future STD-education programs, and issues requiring prompt attention are identified.

Adolescent↗
PubMed1997

Umbanda healers as effective AIDS educators: case-control study in Brazilian urban slums (favelas).

During a 12-month period (November 1994-October 1995), Afro-Brazilian Umbanda healers (Pais-de-Santo) taught 126 fellow healers from 51 Umbanda centres (terreiros) located in seven overcrowded slums (favelas) (population 104-343) in Brazil's northeast, the biomedical prevention of AIDS, including safe sex practices, avoidance of ritual blood behaviours and sterilization of cutting instruments. A face-to-face educational intervention by healers, marginalized in society yet respected by devotees, which blended traditional healing-its language, codes, symbols and images- and scientific medicine and addressed social injustices and discrimination was utilized in this project supported by the Brazilian Ministry of Health, National Program in STDs/AIDS. Significant increases (P < 0.001) in AIDS awareness, knowledge about risky HIV behaviour, information about correct condom use, and acceptance of lower-risk, alternative ritual blood practices and decreases (P < 0.001) in prejudicial attitudes related to HIV transmission were found among mobilized healers as compared to 100 untrained controls. Respected Afro-Brazilian Pais-de-Santo can be creative and effective partners in national HIV prevention programmes when they are equipped with biomedical information about AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Birth practice patterns in urban slums of Dhaka, Bangladesh.

This study describes the patterns of birth related practices amongst women from an urban slum population in Dhaka city during December 1988 to May 1989. A household census identified all resident women of childbearing age in Rajabazar ward of Dhaka city. Of the 1017 women so identified, 289 women who had given birth to their last child over the previous five years were randomly selected for interview using a structured interview schedule. To observe actual birth practices, sixteen women pregnant for six months or more at the time of the census were followed-up to the immediate post-natal period. Eight local traditional birth attendants (TBAs) were interviewed informally to obtain insights about birthing techniques. A case study for a typical 'normal' delivery is presented and discussed.

Adolescent↗