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PubMed1990

'Clustering'--real or apparent? Probability maps of childhood cancer in the West Midlands Health Authority region.

The West Midlands Regional Children's Tumour Registry collects detailed information on all cases of childhood cancer in the West Midlands Health Authority Region (WMHAR). The distribution by electoral ward of all cases diagnosed in the WMHAR between 1980 and 1984 has been determined. Analysis has also been performed for leukaemias/non-Hodgkin's lymphomas alone. We suggest that this latter grouping should be universally employed, owing to the difficulty of accurately separating out cases of leukaemia. Both spatial analyses showed several wards with significantly excessive rates on the basis of their cumulative Poison probability. Observed/expected ratios of 3-35 were seen for cases in significant wards, which are similar to the ratios seen in analysis of incidence around nuclear installations. However, further detailed consideration of these individual significance levels in the light of the number of statistically significant wards which would occur by chance alone, due to the multiple use of the test, accounted completely for the number of wards obtained in each of the groups considered. Thus, apparent 'clustering' of cases could be mere statistical artefact. In the WMHAR, therefore, using the technique of probability mapping, no true spatial pattern of incidence was found, other than that which would occur by chance alone. This, in a large area without nuclear installations and an even mix of rural and industrialised regions, could be seen as control data for those studies which have considered cases of childhood leukaemia around nuclear facilities, where the observation of single point clusters associated with suspected sites restricts assessments of spatial pattern in the rest of the area.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

Spatial distribution and registry-based case-control analysis of Campylobacter infections in Denmark, 1991-2001.

Using data from an 11-year period (1991-2001), the authors analyzed available information on location of residence for all registered, laboratory-confirmed, domestically acquired cases of campylobacteriosis in Denmark. Patient data were merged with data from a national register on housing and addresses, and a population density index was constructed using the Danish population register. The study was performed as a register-based case-control study; 15 age-matched controls for each case were selected from the national population register. A total of 22,066 cases were compared with 318,958 controls in logistic regression analysis. Living in types of housing found in rural areas and living in areas with a low population density were both associated with an increased risk of infection. This relation concerned children in particular and explained one third of cases among children in the countryside. Furthermore, in some counties there was an association between infection and type of drinking-water company serving the home. This study indicated that contact with animals or the environment is the source of a substantial proportion of sporadic Campylobacter infections in the Danish countryside, particularly among children.

Adolescent↗
PubMed1982

The impact of demographic changes on income distribution in a developing country.

"A common hypothesis regarding the distribution of income is that it tends to become more unequal in the initial and middle stages of economic development, in part because of demographic changes. However, previous studies of the effect of demographic changes on income distribution are not based on the underlying micro determinants of the income components." In the present paper, "the micro determinants of the probability of receipt and amount received conditional on receipt of four income components are estimated for three regions defined by the degree of urbanization. Five simulations of hypothetical demographic changes are conducted. The simulated effects on some of the regional income component distributions are fairly considerable in regard both to equalizing the distributions and increasing the shares of the poorest. However, the overall effects are regressive in both urban and rural regions."

Demography↗
PubMedDate not supplied

Socioeconomic factors and prevalence of endemic goitre.

The present study was conducted on 2611 school children of a rural area of Meerut, with the objectives to find out the prevalence and distribution of endemic goitre and the socioeconomic variables associated with the distribution of the endemic goitre. Grading of goitre was done as per the criteria laid down by the WHO-1979 (1). The overall prevalence rate of endemic goitre was 50.1%, the prevalence was more among females (55.1%) as compared to males (47.2%). Maximum number of goitre cases were having grade Ia enlargement (46.9%) followed by grade Ib (34.1%), grade 2(15.0%) and grade 3 (4.0%). Prevalence increased with increase in age. Statistically significant differences were found in the prevalence of endemic goitre in relation to different religions and caste groups, different occupations of the parents/guardians of children and types of houses used for the purpose of living.

Adolescent↗
PubMed1993

Socio-demographic structure of Sydney's perimetropolitan region.

"The paper conceptualizes processes driving change in perimetropolitan regions then, using Sydney [Australia] as a case study, analyses population growth rates and internal migration patterns between 1981 and 1991. Next, a set of social and demographic variables derived from the 1986 Census is analysed to derive four key dimensions of socio-spatial structure, namely: disadvantage, rurality, socio-economic status and retirement."

Australia↗
PubMed1978

The incidence of sudden infant death syndrome in North Carolina's cities and counties: 1972--1974.

Between January 1, 1972 and December 31, 1974, 534 Sudden Infant Death Syndrome cases were reported in North Carolina. All but the out-of-state cases were mapped by county and city locations to determine if urban or rural cases predominated. The mapping was also undertaken to see if significant spatial variabilities could be detected between the county and city populations of infants at risk. The state had an overall SIDS rate of 2.06 per thousand live births. The mapping revealed that counties had a range from zero to a high of 6.6 and that cities with populations of over 10,000 had SIDS rates which ranged from zero to a high of 10.6. The proportions of SIDS cases occurring in either urban or rural locations roughly approximated the distribution of the state's population, with neither location accounting for disproportionately more cases. The larger cities, however, reported more cases than did their suburbs and the immediately surrounding rural areas. The largest and smallest cities, when grouped accordingly, had the lowest urban SIDS rates. The summary SIDS rates for whites was 1.23 per thousant live births, for blacks it was 3.75, and for Indians it was 6.56 per thousand live births.

Autopsy↗
PubMedDate not supplied

Factors influencing child mortality levels in rural Bangladesh: evidence from a micro study.

"This paper examines the factors that affect child mortality [in rural Bangladesh] by using a multivariate technique. The results suggest that mother's access to education and health care facilities are important determinants of child mortality. The access to maternal and child health programs and visit by the health workers were also related to low childhood mortality...." (SUMMARY IN FRE AND ITA)

Asia↗
PubMed1996

[Leukemias and other hemoblastoses: description of unusual clustering and difficulties in evaluation. A report on the epidemiology of leukemias and related diseases in rural communities].

The purpose of this study, drawn up as a localised report, was to find out whether the accumulation of notified cases of leukaemia and haemoblastosis over a 40-year observation period, in a restricted region within a small village, can also be found in other localities of the northern Bavarian administration district of Kronach. This region was very out-of-the-way before German reunification. With its static indigenous population, and the retrieval possibilities of respective archives, it offered good conditions for a long-term study over four decades; 13 out of 63 administrative district communities could be randomly selected for research. Between 1950 and 1993, 144 patients who contracted either leukaemia or another type of malignant neoplasm of the lymphoid and haematopoetic tissues were recorded (Pos. C 81-C 96 ICD 10). When these patients' dwellings were charted, a sporadic, inconspicious, temporal-spatial distribution became apparent in seven out of 13 localities. However, in six of the 13 communities there was the same limited local concentration of cases spread over a period of time, as had been observed in the abovementioned village. This cartographically noticeable concentration was termed "cluster"; in these "clusters", both locals and long-term residents were affected. What these "clusters" have in common topographically is that they are noticeably located in moist areas. The study clearly demonstrates the difficulties in assessing these cartographically significant "clusters" from a statistical point of view, i.e. in making a risk quantification for small populations and with insufficient demographic data. Therefore, no statement can be made as to whether the observed "clusters" represent change findings, or rather, an epidemiological, i.e. endemic fundamental pattern of leukaemia and haemoblastoses; one that, within a shorter observation period, must remain undetected-that is, could be disguised by population migrations.

Adolescent↗
PubMed1993

[Geographic inequalities in mortality in Cameroon].

Because of the geographic diversity of Cameroon, the analysis of spatial inequalities of mortality is a challenging research topic. This is true for mortality and morbidity as well as for the distribution of underlying factors. Among these are the geographic (or ecological) factors. The example of the distribution of infant mortality is given here. It seems difficult to isolate geographical and socioeconomic factors which are intertwined. Anyway, taking into account the spatial variation of mortality can be a fundamental element in the implementation of health policy.

Cameroon↗
PubMed1998

Urbanization and childhood leukaemia in Taiwan.

BACKGROUND: In the 1980s socioeconomic development was dramatically rapid in the urbanized municipalities of Taiwan due to a prospering economy. This study addressed the question: Could differences in the incidence of childhood leukaemia (age <15) be demonstrated between urban and rural communities in Taiwan between 1981 and 1990? METHODS: The log-linear regression model was used to assess the effects of age, level of urbanization, and calendar year on the variation of childhood leukaemia incidence rates between 1981 and 1990. RESULTS: Between 1981 and 1990, the overall incidence rate of childhood leukaemia increased by 20% (rate ratio (RR) = 1.2, 95% CI: 1.0-1.5). As compared to rural areas, metropolitan regions showed a significantly higher incidence rate during the study period (RR = 1.3, 95% CI: 1.1-1.6). This urban-rural difference was particularly notable among children <5 years old (RR = 1.5, 95% CI: 1.2-1.9). Dose-response analysis further indicated that risk of childhood leukaemia was monotonically associated with levels of urbanization. The significant gradient in the risk of childhood leukaemia with urbanization was contributed solely by children in the 0-4 years age group. CONCLUSIONS: We noticed a relationship between urbanization and risk of leukaemia in children. Because of a dramatic influx of people into metropolitan areas during the 1980s, our findings may have provided support for the putative association between 'population mixing' or 'population density' and risk of childhood leukaemia. Whether such association can be attributable to virus infection or other aetiologically related leukemogens warrants further investigations.

Adolescent↗