Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Slums”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources
PubMed2002

Effect of zinc supplementation between 1 and 6 mo of life on growth and morbidity of Bangladeshi infants in urban slums.

BACKGROUND: Evidence for an effect of zinc supplementation on growth and morbidity in very young infants in developing countries is scarce and inconsistent. OBJECTIVE: We assessed the effect of zinc supplementation on growth and morbidity in poor Bangladeshi infants aged 4-24 wk. DESIGN: Infants from Dhaka slums were enrolled at 4 wk of age and randomly assigned to receive 5 mg elemental Zn/d (n = 152) or placebo (n = 149) until 24 wk of age. They were followed weekly for information on compliance and morbidity; anthropometric measurements were performed monthly. Serum zinc was assessed at baseline and at 24 wk of age. RESULTS: At 24 wk of age, serum zinc concentrations were higher in the zinc than in the placebo group (13.3 +/- 3.8 and 10.7 +/- 2.9 micro mol/L, respectively; P < 0.001). Significantly greater weight gains were observed in the zinc than in the placebo group for 43 infants who were zinc deficient (< 9.18 micro mol/L) at baseline (3.15 +/- 0.77 and 2.66 +/- 0.80 kg, respectively; P < 0.04). In the other infants, no significant differences were observed in mean weight and length gains during the study period. Zinc-deficient infants showed a reduced risk of incidence of acute lower respiratory infection after zinc supplementation (relative risk: 0.30; 95% CI: 0.10, 0.92); among the non-zinc-deficient infants there were no significant differences between treatment groups. CONCLUSIONS: Zinc-deficient Bangladeshi infants showed improvements in growth rate and a reduced incidence of acute lower respiratory infection after zinc supplementation. In infants with serum zinc concentrations > 9.18 micro mol/L, supplementation improved only biochemical zinc status.

Acute Disease↗
PubMed2004

Birth weight predicts response to vaccination in adults born in an urban slum in Lahore, Pakistan.

BACKGROUND: Substantial evidence exists linking small size at birth to later-life susceptibility to chronic disease. Evidence is also emerging that some components of immune function may be programmed in early life. However, this evidence is limited and requires confirmation. OBJECTIVE: We investigated the association between size at birth and response to vaccination in a cohort of 257 adults (mean age: 29.4 y; 146 men) born in an urban slum in Lahore, Pakistan, during 1964-1978. DESIGN: A single dose of Vi polysaccharide vaccine for Salmonella typhi and 2 doses of rabies vaccine were given to each subject. Antibody titers were measured in prevaccination serum samples (Vi) and in postvaccination samples (Vi and rabies). RESULTS: The mean birth weight of the subjects was 3.24 kg; 14% of the subjects had low birth weights (<2.5 kg). Vaccine responses were not consistently associated with contemporary variables (month of study, sex, current age, or indicators of wealth). Response to typhoid vaccination was positively related to birth weight (anti-Vi immunoglobulin G: r = 0.138, P = 0.031; anti-Vi immunoglobulin M: r = 0.197, P = 0.034). Response to the rabies vaccine was not significantly associated with birth weight. CONCLUSIONS: These findings add to a growing body of evidence suggesting that components of the immune system may be permanently programmed by events in early life. The contrasting effects on typhoid and rabies responses suggest that antibody generation to polysaccharide antigens, which have greater B cell involvement, is compromised by fetal growth retardation.

Adult↗
PubMed2006

Breastfeeding beliefs and practices among migrant mothers in slums of Diyarbakir, Turkey, 2001.

BACKGROUND: A qualitative investigation and a population survey were conducted to explore the breastfeeding beliefs and practices of mothers who were forced to migrate from their original villages and were currently living in the slums of Diyarbakir in Turkey. METHODS: Qualitative data collection on breastfeeding beliefs was conducted using in-depth interviews. In-depth interviews were tape-recorded. Quantitative data on breastfeeding practices were collected using a structured questionnaire. RESULTS: Mothers generally have a positive attitude towards breastfeeding, but colostrum is usually perceived negatively. No woman was found to feed her infant exclusively by breastfeeding. Only 9.9% of mothers initiated breastfeeding within the first hour of birth. Forty per cent of mothers started solid foods before 4 months. Mother's education appeared as a significant factor influencing the introduction of colostrum to the newborn. Mothers with lower education generally believed that the colostrum should not be fed to the infant and that a pregnant woman's milk is unhealthy for the baby. There was also a belief that 'working under the sun' decreased the quality of milk of a mother. CONCLUSION: Cultural beliefs have a significant influence on breastfeeding practices. Some of these practices are potentially harmful to newborns. Health education programmes should address these beliefs and practices in culture sensitive ways.

Adult↗
PubMed1990

Malnutrition is associated with increased diarrhoea incidence and duration among children in an urban Brazilian slum.

This study was undertaken to further define the relationship between malnutrition and subsequent diarrhoeal illness among children. A cohort of 61 children under five years of age was followed for two years in an urban Brazilian slum. Nutritional status was determined at two-month intervals and was used to predict the subsequent occurrence of diarrhoea. A significant, graded association between worsened nutritional status, as measured by length- or weight-for-age, and diarrhoea incidence was found. This relationship was present for both two-month and one-year periods following nutritional assessment. The average duration of diarrhoea was also significantly longer during the two-month periods which were preceded by the worst nutritional status. Overall, the most malnourished children had nearly twice the total number of days of diarrhoea that better nourished children had. These results provide additional evidence that a significant association between malnutrition and both increased diarrhoea incidence and duration exists.

Age Factors↗
PubMed1998

Cause-specific mortality in under fives in the urban slums of Lucknow, north India.

We recorded the causes of death in the preceding 3 years in a slum population of 24,196 children less than 5 years of age in Lucknow, North India. Of 1469 deaths recorded, 298 were stillbirths. For each death, a 'verbal autopsy' was conducted by interviewing the parents to ascertain the cause of death. 71.8 per cent of deaths were at home; 94.5 per cent of hospital deaths had no death certificate. Excluding stillbirths, 69.9 per cent of deaths were in the first year of life. Leading causes of death in the neonatal period were prematurity (38.5 per cent) and tetanus (36.4 per cent). Beyond the neonatal period, the leading causes of death were pneumonia (23.4 per cent), diarrhoeal disease (20.9 per cent), and malnutrition and/or anaemia (11.4 per cent). The existent mortality-recording system was under-reporting at least one third of the deaths. We conclude that stillbirths and neonatal mortality can be reduced by improved antenatal and natal care. In the postnatal period, since most of the mortality is due either to infective diseases or malnutrition, interventions to improve the nutritional status of preschool children can reduce this.

Age Distribution↗
PubMed1999

Helminthic infection and anthropometric indicators in children from a tropical slum: Ascaris reinfection after anthelmintic treatment.

We evaluated helminthic infection and anthropometric indicators of nutritional status in a group of school-age children from a slum area of Caracas, Venezuela. The proportions of children at or below the 10th percentiles for height/age and weight/age were significantly higher in those presenting helminthiasis than in those uninfected. Although this could partially reflect a codependence of both helminthic infection and undernutrition or poverty, when the children were administered regular anthelmintic treatment for a year their anthropometric values improved significantly. When they were re-evaluated 8 months after the end of anthelmintic administration, the degree of reinfection by the most common helminth, Ascaris lumbricoides, was significantly higher in the growth-retarded children. These results confirm the relationship between helminthic infection and decreased growth rates in underprivileged populations, and indicate that children at nutritional risk are more susceptible to such infections, even after a prolonged parasite-free period.

Anthelmintics↗
PubMed1991

Potential role of adherence traits of Escherichia coli in persistent diarrhea in an urban Brazilian slum.

We examined stools from 40 children with persistent diarrhea (duration, 14 days or more), from 50 children with acute diarrhea and from 38 control children to determine infectious etiologies for persistent diarrhea in Goncalves Dias, an urban favela (slum) in Fortaleza, Ceara, Brazil. Children with persistent diarrhea and children with acute diarrhea had similar rates of isolation of routine viral, bacterial and parasitic enteric pathogens. Routine pathogens were identified in at least 20% of cultures done more than 14 days into the diarrheal illness. We examined Escherichia coli isolated from these stools for adherence potential. Enteroaggregative E. coli were isolated significantly more often from children with persistent diarrhea than from control children or children with acute diarrhea (P less than 0.05). E. coli with hemagglutination patterns suggestive of adherence pili were also isolated more often from children with persistent diarrhea than from children with acute diarrhea (38% vs. 18%; P less than 0.05). Enterotoxigenic E. coli were isolated in combination with rotavirus more often from children with persistent diarrhea than from children with acute diarrhea. E. coli which were hydrophobic or exhibited hemagglutination were also seen more often in association with Giardia in children with persistent diarrhea. These findings suggest that the etiology of persistent diarrhea in children is complex and that the aggregative E. coli are associated with prolonged diarrheal illness. Although routine diarrheal pathogens may be present for more than 14 days, combinations of pathogens, including E. coli with adherence potential, may also contribute to prolonged diarrheal disease.

Animals↗
PubMed1993

Ascaris reinfection of slum children: relation with the IgE response.

Total and Ascaris-specific serum IgE levels were measured in a group of 98 Ascaris-infected children from a slum area of Caracas, Venezuela, in whom the infections were eliminated by regular treatment for 22 months with the anthelmint Oxantel/Pyrantel ('Quantrel'). The children were re-evaluated at the end of the treatment programme, and then 8 months later, at which time reinfection was assessed. Total IgE levels at the beginning of the study were significantly higher in the children who became reinfected after treatment, compared with those who did not. The anthelmint treatment caused a significant decrease in the total IgE levels in most of the children, and after a period of 8 months without treatment these continued to decrease in the non-reinfected group, but increased again in the reinfected children. The reverse pattern was found for Ascaris-specific IgE antibody levels, and in fact an inverse correlation was found between total and anti-Ascaris IgE levels. Striking associations were found between reinfection and high pretreatment values of total IgE, but low levels of specific IgE antibody. These data support the concept that specific IgE antibody may participate in the protection against helminthic infection, and suggest that the polyclonal stimulation of IgE synthesis caused by these parasites may reduce the effectiveness of such responses. The results also indicate that different individuals have varying propensities to respond polyclonally to the helminths, and this influences their resistance to infection.

Animals↗
PubMed1993

Modulation of the allergic reactivity of slum children by helminthic infection.

Infection by helminthic parasites can cause the polyclonal stimulation of IgE synthesis, possibly via an enhanced production of interleukin-4 (IL-4), and this has been suggested to influence the allergic reactivity of tropical populations where these parasites are endemic. We evaluated a group of urban slum children in Caracas, Venezuela, with a high prevalence of helminthic infection (70.8%), to establish the relationship between the elevated IgE levels (3696 IU/ml) induced by these parasites and various aspects of the allergic response. Although the absolute levels of IL-4 detected in the sera of these children were low (0.65 +/- 0.20 ng/ml), a strong positive correlation (r = 0.78) was found between these and serum IgE. The cutaneous immediate hypersensitivity reactivity to extracts of common environmental allergens was relatively low (17.5% to house dust), although that to Ascaris extract was moderately high (49.4%). Significant inverse correlations were found between total IgE levels and the different skin test reaction diameters, including Ascaris. The positivity of Prausnitz-Kustner passive transfer tests was low in this group (34%), with a strong inverse correlation (r = -0.75) being found between this and total IgE levels. Significant inverse correlations were also found between total IgE levels and specific IgE antibody to environmental allergens, and to Ascaris antigen. We suggest that the polyclonal production of IgE stimulated by helminthic infection can suppress the allergic response to environmental and parasite allergens via both mast cell saturation and inhibition of specific IgE production.

Allergens↗
PubMed1996

Community-based investigation of an outbreak of acute viral conjunctivitis in urban slums.

Nine hundred and sixteen people from 143 randomly selected households were included in this community-based investigation of an outbreak of acute viral conjunctivitis in urban slum communities of Delhi in 1994. During the 2-weeks recall period, 456 (49.8%) had conjunctivitis and 229 (25%) were symptomatic at the time of this investigation. Overall, females had a higher attack rate than males (P < 0.05). The attack rate increased with age (P < 0.001). A total of 61.6% of the conjunctival swabs were antigen positive as evidenced by indirect immunofluorescence assay. Viruses could be isolated from 30.3% of the samples processed. Out of these, 70% were identified as Coxsackie A 24 and 30% as EV 70.

Acute Disease↗
PubMed2005

Determinants of health care seeking for childhood illnesses in Nairobi slums.

The practice of appropriate health seeking has a great potential to reduce the occurrence of severe and life-threatening child illnesses. We assessed the influence of socio-demographic, economic and disease-related factors in health care seeking for child illnesses among slum dwellers of Nairobi, Kenya. A survey round of the Nairobi Urban Demographic Surveillance System (NUDSS) generated information on 2-week child morbidity, illness symptoms, perceived illness severity and use of modern health services. During this round of data collection, interviewers visited a total of 15,174 households, where 3015 children younger than 5 years lived. Of the 999 (33.1%) children who were reported to have been sick, medical care of some sort was sought for 604 (60.5%). Lack of finances (49.6%) and a perception that the illness was not serious (28.1%) were the main reasons given for failure to seek health care outside the home. Health care seeking was most common for sick children in the youngest age group (0-11 months). Caretakers sought medical care more frequently for diarrhoea symptoms than for coughing and even more so when the diarrhoea was associated with fever. Perception of illness severity was strongly associated with health care seeking. Household income was significantly associated with health care seeking up to certain threshold levels, above which its effects stabilized. Improving caretaker skills to recognize danger signs in child illnesses may enhance health-seeking behaviour. Integrated Management of Child Illnesses (IMCI) programmes must be accessible free of charge to the urban poor in order to increase health care seeking and bring about improvements in child survival.

Age Factors↗
PubMed2004

Cutaneous larva migrans (creeping eruption) in an urban slum in Brazil.

BACKGROUND: Cutaneous larva migrans (CLM) is caused by the penetration of larvae of animal hookworms into the skin. Knowledge about this ectoparasitosis is mainly based on the examination of travelers or other expatriates. Population-based studies in an endemic area have never been performed. METHODS: A representative population sample of an urban slum in a Brazilian city was examined for the presence of CLM and asked about symptoms associated with the ectoparasitosis. RESULTS: In total, 3.1% (95% confidence interval, 2.2-4.3%) of the 1185 inhabitants examined presented CLM. Forty-three per cent had more than one larval track (range, 1-17). The prevalence rate in males was 4.2% vs. 2.3% in females. CLM occurred at similar prevalence rates in all age groups. All patients complained of moderate or severe itching. In three cases (8.1%), superinfection was present. Most lesions were located on the trunk, legs, and arms. Not a single lesion was located on the feet. CONCLUSIONS: This population-based study showed that CLM is endemic in this deprived community. The number of lesions and their topographic localization are in contrast with those obtained in previous reports based on the examination of individuals or groups affected in small outbreaks. We conclude that the clinico-epidemiologic pattern of CLM in a deprived community is different from that observed in travelers.

Adolescent↗
PubMed2002

Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum.

OBJECTIVES: To evaluate the effect of daily zinc supplementation in children on the incidence of acute lower respiratory tract infections and pneumonia. DESIGN: Double masked, randomised placebo controlled trial. SETTING: A slum community in New Delhi, India. PARTICIPANTS: 2482 children aged 6 to 30 months. INTERVENTIONS: Daily elemental zinc, 10 mg to infants and 20 mg to older children or placebo for four months. Both groups received single massive dose of vitamin A (100 000 IU for infants and 200 000 IU for older children) at enrollment. MAIN OUTCOME MEASURES: All households were visited weekly. Any children with cough and lower chest indrawing or respiratory rate 5 breaths per minute less than the World Health Organization criteria for fast breathing were brought to study physicians. RESULTS: At four months the mean plasma zinc concentration was higher in the zinc group (19.8 (SD 10.1) v 9.3 (2.1) micromol/l, P<0.001). The proportion of children who had acute lower respiratory tract infection during follow up was no different in the two groups (absolute risk reduction -0.2%, 95% confidence interval -3.9% to 3.6%). Zinc supplementation resulted in a lower incidence of pneumonia than placebo (absolute risk reduction 2.5%, 95% confidence interval 0.4% to 4.6%). After correction for multiple episodes in the same child by generalised estimating equations analysis the odds ratio was 0.74, 95% confidence interval 0.56 to 0.99. CONCLUSIONS: Zinc supplementation substantially reduced the incidence of pneumonia in children who had received vitamin A.

Acute Disease↗
PubMed2006

Prevalence of anaemia among adolescent girls in the urban slums of Vellore, south India.

A community-based, cross-sectional study was conducted to determine the prevalence of anaemia among unmarried, adolescent south Indian girls in an urban slum setting. A total of 100 apparently healthy girls between the ages of 11 and 18 years were recruited. Their socioeconomic, dietary and anthropometric information was collected, and blood haemoglobin (Hb) was estimated. The prevalence of anaemia (Hb < 12 g%) was 29%. Most had mild anaemia; severe anaemia was not seen. Two-thirds of those with anaemia had low serum ferritin (<12 microg/L). Significant associations were observed between anaemia and low socioeconomic status, religion and reporting infrequent/non-consumption of meat (heme iron). Only meat consumption was related to haemoglobin by multiple regression analysis. Anaemia is a common problem among adolescent girls in this setting, though severe anaemia is rare. There is a need to improve their haemoglobin status through dietary modification along with preventive supplementation and nutrition education.

Adolescent↗
PubMed2003

Sexually transmitted infections prevalence rates in slum communities of Dhaka, Bangladesh.

The study objective was to estimate the prevalence of selected sexually transmitted infections (STIs) and associated factors among Dhaka slum dwellers. Blood and urine specimens were collected from 1534 men and women. Participants in this cross-sectional study responded to a questionnaire, providing socioeconomic data, symptomatology and treatment-seeking behaviour. Specimens were tested for syphilis, hepatitis B (HBsAg), Neisseria gonorrhoeae, Chlamydia trachomatis, and HIV. Serologic evidence of syphilis infection was found in 6.0% of respondents, HBsAg in 3.8%. Prevalence rates of gonorrhoea and chlamydia were 1.7% and <1%, respectively. No HIV infections were found. Men were more than twice as likely as women to be infected with syphilis or HBsAg carriers. Behaviours facilitating STI transmission were common among men. Syphilis infection is prevalent enough to warrant the initiation of screening programmes in this population. The prevalence rate of hepatitis B carriage suggests that this population would benefit from universal vaccination against hepatitis B.

Adolescent↗
PubMed1998

Indoor air quality and acute lower respiratory infection in Indian urban slums.

The present prospective study was conducted at two urban slums of Delhi, Kusumpur Pahari and Kathputly Colony, in the peak winter season from November 1994 through February 1995. We studied 642 infants to determine the incidence of acute lower respiratory infection (ALRI) and its relationship to indoor air pollution due to fuel used for cooking (wood or kerosene). In Kusumpur Pahari, there were 317 children (142 wood and 175 kerosene), including 64 controls and 78 cases of ALRI in the wood fuel group and 81 controls and 94 ALRI cases in the kerosene group (p > 0.05). Out of 316 children in Kathputly Colony (174 wood and 142 kerosene), there were 33 and 45 ALRI cases in the wood and kerosene groups, respectively (p < 0.05). Controls were children without ALRI and were used as controls in different groups. The demographic data and risk factors, namely, nutritional and immunization status, were comparable in ALRI cases and controls in both study areas. Pneumonia was the most common ailment in all the groups. Bronchiolitis was reported in 22.5% of the wood group and 27.1% of the kerosene group in Kathputly Colony versus 13.7% in the wood group and 12.1% in the kerosene group in Kusumpur Colony. Only one case of croup was reported from Kusumpur Pahari among wood users. The duration of illness was longer in the Kusumpur Pahari due to poor compliance, feeding, and child rearing habits. In conclusion, a higher incidence of ALRI was reported in kerosene users in Kathputly Colony, a high pollution area; however, the reasons for the differences observed need further elucidation.

Acute Disease↗
PubMedDate not supplied

A comparison of pregnancy and child health outcomes between teenage and adult mothers in the slums of Nairobi, Kenya.

The study assessed and compared pregnancy and child health outcomes of teenage (aged less than 20 years) and adult (20-34 years of age) mothers. A total of 226 teenage and 205 adult mothers met the study criteria out of the 3,256 women in the reproductive age group (15-49 years) and 318 adolescent girls (12-14 years of age) covered by the Nairobi Cross-sectional Slums Survey (NCSS). The main comparison involved socio-demographic variables, events during pregnancy, obstetric outcome, child morbidity and mortality and care provided during an illness episode. Results showed that a significantly higher percentage of teenage mothers and their partners had lower educational achievement compared with adult mothers and their partners. They were more likely to be economically disadvantaged than the adult mothers. Teenage mothers and their parents were also less likely to have ever been married. The two groups of mothers were comparable in terms of the rate and timing of antenatal care visits, place of delivery, rate of operative deliveries, reported size of the baby at birth, child vaccination status and reported morbidity and health care practice during an illness episode. The index child was alive during the survey period for 89.4% of the teenage and 96.6% of the adult mothers (OR = 3.36; 95% CI = 1.34, 8.79; P = 0.004). Child survival rates in the two groups of mothers were found to be quite similar after controlled analysis for the influence of socio-economic factors. The study concluded that bad obstetric outcomes were not associated with maternal age. Although teenage and adult mothers were not significantly different on child health practices, children born to the former group died most frequently probably due to their poor socioeconomic achievements.

Adolescent↗
PubMed2001

Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums.

OBJECTIVES: To describe breastfeeding practices and investigate the influence of exclusive breastfeeding in early infancy on the risk of infant deaths, especially those attributable to respiratory infections (ARI) and diarrhea. METHODS: A prospective observational study was conducted on a birth cohort of 1677 infants who were born in slum areas of Dhaka in Bangladesh and followed from birth to 12 months of age. After enrollment at birth, the infants were visited 5 more times by 12 months of age. Verbal autopsy, based on a structured questionnaire, was used to assign a cause to the 180 reported deaths. Proportional hazards regression models were used to estimate the effect of breastfeeding practices, introduced as a time-varying variable, after accounting for other variables, including birth weight. Overall neonatal, postneonatal and infant mortality, and mortality attributable to ARI and diarrhea were measured. RESULTS: The proportion of infants who were breastfed exclusively was only 6% at enrollment, increasing to 53% at 1 month and then gradually declining to 5% at 6 months of age. Predominant breastfeeding declined from 66% at enrollment to 4% at 12 months of age. Very few infants were not breastfed, whereas the proportion of partially breastfed infants increased with age. Breastfeeding practices did not differ between low and normal birth weight infants at any age. The overall infant mortality rate was 114 deaths per 1000 live births. Compared with exclusive breastfeeding in the first few months of life, partial or no breastfeeding was associated with a 2.23-fold higher risk of infant deaths resulting from all causes and 2.40- and 3.94-fold higher risk of deaths attributable to ARI and diarrhea, respectively. CONCLUSION: The important role of appropriate breastfeeding practices in the survival of infants is clear from this analysis. The reduction of ARI deaths underscores the broad-based beneficial effect of exclusive breastfeeding in prevention of infectious diseases beyond its role in reducing exposure to contaminated food, which may have contributed to the strong protection against diarrhea deaths.

Bangladesh↗