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At least 991 records · Page 55Linked to original sources
PubMed1997

Effect of zinc supplementation on cell-mediated immunity and lymphocyte subsets in preschool children.

OBJECTIVE: In a zinc supplementation trial (with a significant impact on diarrheal morbidity), to evaluate effect of zinc supplementation on cellular immune status before and after 120 days of supplementation. DESIGN: A double blind, randomized controlled trial with immune assessment at baseline and after 120 days on supplement. SETTING: Community based study in an urban slum population. SUBJECTS: Randomly selected children (zinc 38, control 48), had a Multitest CMI skin test at both times. In 66 children (zinc 22, control 34), proportions of CD3, CD4, CD8, CD16, CD20 cells and the CD/CD8 ratio were also estimated using a whole blood lysis method and flowcytometry. INTERVENTION: Zinc gluconate to provide elemental zinc 10 mg daily and 20 mg during diarrhea. MAIN OUTCOME RESULTS: Regarding CMI, the percentage of anergic or hypoergic children (using induration score) decreased from 67% to 47% in the zinc group, while in the control group it remained unchanged (73% vs 71%) (p = 0.05). The percentage of children deteriorating between first and second tests was significantly lower in the zinc group (13% vs 33%, p = 0.03). Regarding lymphocyte subsets, the zinc group had a significantly higher rise in the geometric means of CD3 (25%, p = 0.02), CD4 (64% p = 0.001), and CD4/CD8 ratio (73% p = 0.004) with no difference in CD8 and CD20. The rise in CD4 was significantly higher in the zinc as compared to the control group; the ratio of geometric means was 1.45 (95% CI, 1.03-2.01). CONCLUSION: Zinc supplementation improves cellular immune status, which may have been one of the mechanisms for observed impact of zinc supplementation on diarrheal morbidity.

Child, Preschool↗
PubMed1998

Review of carcinoma cervix cases--epidemiological considerations.

One thousand six hundred ninety-four (1694) cases of carcinoma cervix have been reviewed out of a total of 11919 malignancies, over a period of 4 years (1992-1995), in the department of radiotherapy, Safdarjung Hospital, New Delhi. The epidemiological features studied showed that there was a gradual decline in the total number of cases, age at presentation and parity. There has been a definite increase in the proportion of adenocarcinoma cases. Adenocarcinoma of cervix showed statistically significant preponderance in comparatively younger age group viz, 40-60 years (p < 0.005); 76% of overall cases were illiterate; 77% of cases belonged to rural/urban slum settings compared to 23% which were purely urban in origin. About 65% cases had haemoglobin levels below 10 g/dl at the time of presentation.

Adenocarcinoma↗
PubMed1998

A randomised controlled trial of regular surveillance in Thai elderly using a simple questionnaire administered by non-professional personnel.

To test the benefits of regular surveillance of the elderly at home using a simple-questionnaire, 142 randomly selected subjects aged 70 years or over and living in a slum area of Bangkok were recruited and were designated as cases (n = 70) and controls (n = 72). At the beginning of the study period all subjects were visited and their characteristics, including morbidity data, activities of daily living (Barthle ADL Index, Chula ADL Index) and number of falls during the last three months, were collected. Over three years the cases were visited every three months, in their own home, by non-professional personnel. They and/or their care-givers were interviewed using a short questionnaire designed for the home visiting programme. The elderly who had problems according to the criteria were visited and assessed by nurses and/or a geriatrician. Appropriate management was provided to these elderly. After three years, all subjects were visited and outcome data were collected. Rates of service use among the cases were higher than among the controls but there was not a statistically significant difference. The rate of declining in Chula ADL Index score of the cases was significantly less than that of the controls. (p < 0.05) There was no statistically significant difference between other main outcomes of the case and control groups. However, regular home visiting of old people at home by non-professional personnel using a simple questionnaire is a practical way for community care of the elderly population living in poor areas.

Activities of Daily Living↗
PubMed1997

Contamination of soil with parasite eggs and oocysts in southern Thailand.

Soil contamination with parasite eggs and oocysts was surveyed in southern Thailand in December 1994 and September 1995. The survey areas were Hat Kai Tao Village in Phatthalung Province and a slum area in a city of Songkhla Province. We used a modification of the centrifugal floatation technique with sucrose solution (specific gravity, 1.200) to recover helminth eggs and protozoa oocysts. Overall, 10 genera and 11 species of parasite eggs and oocysts were recovered. They included eight species of nematoda eggs, one species of cestoda eggs, and two species of protozoan oocysts. The definitive hosts of these parasites are dogs, cats, sheep, lizards, humans, etc. The contamination rates in two areas at different occasions varied from 55% to 72% with an average of 64%. Contamination rates of Hat Kai Tao Village in beginning and end of the rainy seasons were 72%, and 55%, respectively. Although the contamination rate in the end of rainy season was higher than that in beginning of the rainy season, the difference was not statistically significant (p > 0.05). Of the 11 parasites recovered, six were infective to humans, of which, Trichuris trichura, Ascaris lumbricoides, and Toxocara species were predominant. The mean numbers of these eggs recovered in each test were more than 10. Therefore, the contamination was estimated to be more than an egg per gram of soil sample based on the recovery efficiency (40%) of this test. These results suggested that the soil in some parts of southern Thailand may be heavily contaminated by both animal and human feces.

Animals↗
PubMed1998

Effectiveness and cost analysis of community-based rehabilitation service in Bangkok.

This paper aimed to clarify the effectiveness and the cost of the community-based rehabilitation service in Klong Toey slum after a three year study period. One hundred and seventy eight patients used community-based rehabilitation during the three year period. One hundred and fifty-seven patients (86.5%) reported that their problems/conditions were cured or improved. Only nine patients (5.1%) reported that they stopped using community-based rehabilitation because their problems/conditions did not improve. A statistically significant improvement in pain level and walking velocity assessment, in 105 and 78 patients respectively, was demonstrated. Total cost and cost per patient-day of the community-based rehabilitation were Bt 559,920 and Bt 111.1 respectively. Cost per-patient-day of this community-based rehabilitation service was compared with an estimated cost per patient-day of using rehabilitation services at Chulalongkorn University Hospital and was found to be cheaper. This study supported the role of community-based rehabilitation in Thailand. The need for a health service study in rural areas was also noted.

Cost-Benefit Analysis↗
PubMedDate not supplied

An introspective qualitative report on dietary patterns and elevated levels of dental decay in a deprived urban population in northern Mexico.

Disorganized urbanization in Latin America has led to masses of impoverished people to become squatters in the larger urban areas. Using a community development network in the outskirts of Tijuana, in Northern Mexico, this investigation assessed the dental health situation, aiming to establish the underlying behavioral causes of poor oral health in these slums. Using quantitative and qualitative tools, fifty-six mothers (mean age 30.1 +/- 7.2) with their accompanying children (n = 56; mean age 6.1 +/- 3.3; 46.4 percent female) were interviewed and examined. Dental health was poor and characterized by vast unmet treatment needs in adults and children. 22.2 percent of children under three years of age suffered from Early Childhood Caries, strongly linked to inappropriate patterns of bottle use. Dietary patterns for the overall child population included many cariogenic snacks and beverages. A straightforward model to explain behavioral structures incorporates these findings against the background of living in a highly-deprived environment, whereby the allure of more affordable gratifications for self and family is often translated in the form of tokens such as junk food.

Adult↗
PubMed1998

Water management practices in rural and urban homes: a case study from Bangladesh on ingestion of polluted water.

Although Bangladesh has achieved remarkable success in extending the availability of hand pumped and piped water, unsafe water is still ingested. This brief study attempted to assess water management practices in rural and urban homes in Bangladesh so as to establish the routes by which unsafe water is ingested, to examine methods of collection and storage, and determine why unsafe water sources are used when unsafe supplies are available. Forty-eight rural and forty-five urban slum households were studied. Observations, interviews and water quality investigations were conducted. The results show that the respondents were aware that hand pump/tap water is safe and took care to use these safe sources for drinking purposes. However, they continued to use surface water for non-drinking activities such as bathing, washing and rinsing their mouths. Reasons were given that it was a traditional practice to bathe in surface water and was more enjoyable. One of the reasons given for not using hand pumped water to wash clothing and food was that such groundwater caused staining. Bacteriological results from such ingested water showed the quality, especially in rural areas, to be poor. Results also showed the internal surfaces of the base of storage containers to be heavily contaminated with bacteria. This showed that water that was safe when it was first drawn would became contaminated during storage. This study had a limited scope; much further research is needed to find what determines and how water becomes contaminated in containers. These factors include how to reduce contamination of water, in particular the relationship between growth of bacteria in stored water and the material from which the container is made and how to improve the overall quality of water. On the management side, studies could be conducted as to how to improve people's understanding of the use of water for domestic purposes and its safe management.

Adult↗
PubMed1998

Subclinical vitamin A deficiency in undersix children in Nagpur, India.

The present cross sectional study was carried out to estimate prevalence of subclinical vitamin A deficiency among undersix children by using conjunctival impression cytology in urban slums of Nagpur city in central India. The study population included 308 non-xerophthalmic undersix children selected randomly. Conjunctival impression cytology was performed by standard procedure. Out of 308 children 110 (35.7%) had subclinical vitamin A deficiency. Increasing prevalence of subclinical vitamin A deficiency was non-significantly associated with advancing age. Higher prevalence of subclinical vitamin A deficiency was observed in severely malnourished children. The prevalence of subclinical vitamin A deficiency observed in this study (35.7%) is much more than the criteria laid down by WHO, which warrants community wide intervention. This problem assumes more significance because they are apparently healthy and if timely vitamin A supplementation is not given, any intercurrent infection is likely to worsen the vitamin A status and result in known consequences of xerophthalmia.

Age Distribution↗
PubMed1993

Use of pacifiers and breastfeeding duration.

Pacifiers are widely used in many developing countries. Although their use is not recommended for breastfeeding infants, there have been no published reports on the association between pacifier use and risk of early weaning. In a study of 354 infants in Brazil, mothers were asked about pacifier use at age 1 month, duration of breastfeeding, and introduction of other foods. Among 249 children still breastfed at 1 month, the risk that a child would be weaned at any age between 1 and 24 months was higher in pacifier users than in non-users (hazard ratio 3.0, 95% CI 2.0-4.6). The association remained even after adjustment for the child's age, sex, birthweight, socioeconomic status, and age at introduction of bottle-feeding.

Breast Feeding↗
PubMed1998

The prevalence and demographic characteristics of consanguineous marriages in Pakistan.

Consanguineous marriages are strongly preferred in much of West and South Asia. This paper examines the prevalence and sociodemographic correlates of consanguineous unions in Pakistan using local and national data. Information from 1011 ever-married women living in four multi-ethnic and multi-lingual squatter settlements of Karachi, the main commercial centre of the country, are compared with data from the national 1990/91 Pakistan Demographic and Health Survey (PDHS), based on information provided by 6611 women. Both sets of results indicate that approximately 60% of marriages were consanguineous, over 80% of which were between first cousins. The mean coefficients of inbreeding (F) in the present generation were 0.0316 and 0.0331 for the Karachi and PDHS data respectively. In both surveys the prevalence of consanguineous unions appeared to be unchanged over the past three to four decades. Consanguineous unions were more common among women who were illiterate or had only primary level education, were first or second generation migrants from rural areas of Pakistan or, in the PDHS, lived in rural areas, and whose parents were also consanguineously married.

Adolescent↗
PubMed1994

A fractal model of HIV transmission on complex socio-geographic networks. Part 2: spread from a ghettoized 'core group' into a 'general population'.

"Study of the initial stages of HIV transmission along a 'sociogeographic network'--a large, complex, spatially focused social network with possibly fractal geometry--is extended to include interaction between a low-dimensional ghettoized 'core group' within which the disease spreads very rapidly and a higher dimensional, more loosely structured 'general population' in which spread is relatively slow. A mathematical modeling exercise suggests that contextually modulated interaction between them can be highly nonlinear and may greatly increase the initial rate of disease transmission within the general population. This work contributes to a growing body of literature which suggests that programs to control HIV infection within the majority heterosexual population of the United States will fail spectacularly without particular focus on the coupled physical and social stabilization and rehabilitation of the urban ghettoes of marginalized populations which are the present, and rapidly expanding, disease epicenters. Evidence suggests their continued disintegration can both increase disease rates within the epicenters and increase the coupling between core groups and general populations by creating large numbers of spatially or economically displaced refugees."

Americas↗
PubMed1990

Adolescents, sex and injecting drug use: risks for HIV infection.

In this paper we present data on the HIV-related risks for adolescents growing up in an area where injecting drug use is prevalent and HIV infection has been identified among local injecting drug users. We report on young peoples' knowledge, attitudes and perceptions of drug use and injectors; HIV and AIDS; sex, safer sex and condom use. These adolescents had an extensive and practically oriented knowledge of illicit drugs and drug injectors. The majority of adolescents contacted had an unsophisticated but approximate understanding of HIV transmission dynamics and how to guard against infection. Our data suggest that many adolescents find issues relating to sex awkward, embarrassing and difficult subjects for discussion. In a final section we consider some of the policy implications of our work focussing in particular on the prevention of injecting, the promotion of condom use, and the necessity of avoiding a focus upon risk groups.

Adolescent↗
PubMed1992

Prevalence of childhood disability in a southern Indian city: independent effect of small differences in social status.

A random sample of mothers living in two neighbourhoods of a southern Indian city were interviewed in order to determine the prevalence of serious disability in children 2-9 years old. These areas were selected because residents constitute either the lowest class or the next higher socioeconomic class (next-to-lowest class), with monthly incomes of US$ 10-15 and 32-42 respectively. A previously validated screening instrument was used with documented sensitivity of 100% and specificity of 95% when applied under similar conditions. Disability was found to be more common among children of the lowest class families (17.2%) when compared with the next-to-lowest class families (8.4%); with an odds ratio (OR) of 2.36 (95% confidence interval (CI): 1.08-3.64). Specific types of disability were examined and found to be consistently more prevalent in the lowest class. These results suggest that comparatively small differences in social status can be associated with important differences in health status.

Child↗