Improvement In Socioeconomic Conditions Research Articles

Socioeconomic status, stature, and obesity in women: 20‐year trends in urban Colombia

Ongoing social and economic changes in developing countries are associated with increases in body size, and most notably increases in the prevalence of obesity. The social patterning of these changes in terms of socioeconomic status (SES) is not well documented. The aim of this study was to assess the changes in stature, body mass index (BMI) and fatness in adult women in urban Cali, Colombia between 1988-1989 and 2007-2008. We compared the results of anthropometric surveys completed in 1988-1989 and 2007-2008 of nonpregnant, nonlactating women, 18-44 years of age. Samples in both studies were stratified by SES. We calculated age-standardized prevalence rates to assess time trends in obesity. Body fatness was assessed by skinfold thicknesses. Stature increased in all SES groups and remained positively associated with SES. BMI increased only in the lower SES group, from 24.4 to 25.9 kg/m(2) and remained negatively associated with SES. The age-standardized prevalence of obesity increased from 7.9 to 17.0% in the lower SES group, but only from 4.5 to 8.2% in the middle SES group, and was unchanged in the upper SES group. Body fatness increased in all SES groups, but only in the upper body. The increased stature in all SES groups is indicative of general improvements in socioeconomic conditions. The increased prevalence of obesity in the lower SES groups is in keeping with the findings in other middle-income developing countries.

The effect of land use change and ecotourism on biodiversity: a case study of Manuel Antonio, Costa Rica, from 1985 to 2008

Development in biodiversity rich areas is of global concern. While development may lead to socioeconomic benefits, this often comes concomitant with biodiversity loss and deforestation. Biodiversity rich areas present the opportunity for both improvements in socioeconomic conditions and conservation; however numerous challenges exist. Costa Rica’s Manuel Antonio National Park presents an ideal case study to investigate the balance between alternative forms of development which have contrasting environmental impacts. The Manuel Antonio region is a highly dynamic landscape experiencing deforestation, from agriculture, cattle ranching and oil palm plantations; and also reforestation from abandonment of land holdings and nature oriented tourism. Landscape dynamics are closely intertwined with the livelihoods and perspectives on biodiversity conservation of local communities, determining ecological sustainability. We use an analysis combining multi-temporal remote sensing of land cover dynamics from 1985 to 2008 with questionnaire data from local families on their socioeconomic status, perspectives on conservation, and perceived changes in local wildlife populations. Our results show that, while regeneration occurred and forest fragmentation in the area decreased from 1985 to 2008, Manuel Antonio National Park is rapidly becoming isolated. Decreasing ecological connectivity is related to the rapid expansion of oil palm plantations adjacent to the park and throughout the lowland areas. Perceived decreases in wildlife abundance and compositional change are evident throughout the area, with local communities attributing this primarily to illegal hunting activities. Nature based tourism in the area presents an effective strategy for conservation, including reductions in hunting, through increased valuation of biodiversity and protected areas, and socioeconomic advantages. However, without urgent efforts to limit deforestation and preserve the remaining forested corridor connecting the park to core primary forest, the ability to maintain biodiversity in the park will be reduced.

Ancient‐to‐modern secular changes in Korean stature

Statural growth in human populations is a sensitive indicator of socio-economic well-being, and improvements in socio-economic status are reflected in secular increases in adult height. In the present study, we investigated the statures of historical Korean societies to show how stature changed over time. Applying Fujii's equation, derived from modern Japanese, to the measurement of femora removed from 15th- to 19th-century Joseon tombs, the average heights of Korean adults during the Joseon dynasty were estimated to be 161.1 ± 5.6 cm and 148.9 ± 4.6 cm for males and females, respectively. Plotting statures for successive historical societies against time revealed that Korean heights remained relatively unchanged through to the end of the 19th century, a pattern that differs from that seen in many Western countries in which stature transiently decreases after the Middle Ages. In contrast, a sharp increase in Korean stature was observed at the beginning of the 20th century, similar to trends seen in other nations (although exact timing varies in different countries). There were no accompanying changes of stature sexual dimorphism. The data reported in this study reflect the unique historical experience of Korea; the relative isolation of Joseon society, the late onset of modernization (at the end of the 19th century), and the later occurrence of industrialization (during the 1960s).

Cardiac involvement in diphtheria: Study from a tertiary referral infectious disease hospital

Background: Diphtheria is still a fatal disease even in the era of universal immunization. Diphtheria myocarditis, one of the serious complications of respiratory diphtheria may cause death if not recognized and treated properly. Aims and Objectives: To determine the outcomes of cardiac involvement in respiratory diphtheria. Materials and Methods: One hundred (n = 100) patients with respiratory tract diphtheria were evaluated in respect to cardiac involvement. All patients were closely monitored for a minimum period of 4-6 weeks from the onset of respiratory symptoms. Continuous ECG monitoring including blood biochemistry (SGOT, CPK-MB, and Troponin-T) were done in each case. Results : The most common symptoms were throat pain seen in 94 cases, palpitation in 56 cases, bull neck in 40 cases, shortness of breath in 12 cases, fever in 9 cases, and nasal regurgitation in 8 cases. Most common complication observed was myocarditis seen in 70 patients and majority of patients (60) were asymptomatic. The ECG changes were T wave inversion in 54 patients, inappropriate sinus tachycardia in 38 patients, ST segment depression in precordial leads in 8 patients, Mobitz type II block in 6 patients, Mobitz type I block in 4 patients, RBBB in 4 patients, multiple atrial ectopics in 4 patients, and sinus bradycardia in 2 patients. A total number of five patients died. Conclusions: Myocarditis was commonest and serious complication of respiratory diphtheria. Increase in vaccination coverage and improvement of socioeconomic status are all effective preventive measures to reduce the incidence of diphtheria.

Arrow injuries in North Eastern Nigeria

Background : Arrow injuries are common presentation at the Federal Medical Centre (FMC), Nguru, North East Nigeria. The injuries are mostly unreported and there is neither a policy nor an action plan to curb their incidence Aim : To establish an accurate data base for this clinical entity in this part of Nigeria and suggest ways to curb it. Methods: A prospective study of all patients presenting with arrow shot injuries at FMC, Nguru, from January 2007 to June 2009. The age, gender, tribe, occupation, motive of assault, perpetrator information, part of body injured, treatment given and outcome were collected in a proforma. The data was analyzed using Microsoft Excel. Results : All 57 patients seen were males. Their ages ranged from 13 to 60 years, with the mean age of 32.9±12.2years. The peak age incidence was 21-30years, accounting for 21cases (36.8%). Fighting between herdsmen and farmers over grazing land was the most common cause of arrow shot injuries, accounting for 25 cases (43.9%), followed by armed banditry with 17 cases (29.8%). Fighting over women was the cause in 10 cases (17.5%). Most of the patients had high Revised Trauma Score. Resuscitative and surgical procedures carried out resulted in recovery of 55 patients. Two patients with the highest number of arrow shots (11 and 4 each) and low Revised Trauma Score of 2 and 4 respectively, died pre-operatively. Conclusion : The rate of arrow shot assault injuries in the North East of Nigeria remains high with its attendant morbidity and mortality. It stems mainly from interpersonal conflicts between herdsmen and farmers over grazing land. Mapping out of grazing lands away from farm lands, enlightenment campaigns, improvement of socio-economic conditions as well as enforced legislative control on the use of bow and arrow will go a long way to reduce the incidence of arrow shot injuries in the region.

Adherence to antiretroviral therapy in HIV-infected patients in Sousse, Tunisia

Adherence to antiretroviral therapy (ART) is a powerful predictor of survival for individuals living with human immunodeficiency virus (HIV). The purpose of this cross-sectional study conducted in December 2007 was to assess ART adherence and identify its determinants in HIV-infected patients in Sousse, Tunisia. Adherence was evaluated in a structured interview, during which questions were asked about the number of pills taken, treatment schedule, and any food restrictions within the previous 4 days. Determinants of adherence included patient characteristics, type of ART, and interpersonal relationships and were assessed from the medical records and questionnaire responses. Adherence was assessed in 30 of the 34 patients receiving ART at the time of the study. Twenty-two patients (73%) complied with all daily treatment recommendations and were considered adherent. Multivariate analysis showed that the main barriers to adherence were related to storage of the medication and doubts about its efficacy. Improvement of socioeconomic conditions and better psychosocial support are needed to optimize ART adherence by HIV-infected patients in Tunisia.

Age of menarche among basic level school girls in Medina, Accra.

The current study was designed to determine the age at which menarche occurs among school girls in Madina, Accra. A survey was conducted among 529 girls selected using multi-stage sampling from basic schools in Madina, Accra. Respondents completed a questionnaire that recorded age-at-first menstruation by recall, household characteristics, and anthropometry. Mean age at menarche was 12.74 +/- 1.15 years; probit analysis yielded a median age of 12.09 years. Menarcheal age was significantly correlated with current age (r = 0.48; p < 0.01). Most girls (90%) had first menstruation before age 13. Their mothers' mean age at menarche was 13.6 +/- 1.08 years. In a multivariate linear regression model, household wealth (p < 0.01) and body mass index (p < 0.01) were the main modifiable independent predictors of age at onset of menarche. School girls in Madina attained menarche earlier than previously estimated. Our study suggests an influence of household level improvement in socio-economic status on menarcheal age.

A study of psychosocial problems in families with HIV-infected children in coastal Karnataka

Individuals infected with HIV and AIDS and their families have to cope with a multitude of stressors. These chronic and stigmatized conditions can affect the overall functioning and lifestyle of affected children and their families. The aim of this study was to assess the impact of a child’s illness on psychosocial issues for parents or caregivers and the problems they face. The descriptive study was carried out at Kasturba Medical College Hospital, Mangalore, India. In total, 27 parents or relatives of HIV-positive children were interviewed after obtaining consent. The male/female ratio of affected children was 0.9:1 and the majority of the children were >5 years of age. Ten children were looked after by both parents, 13 by one parent and four by relatives. The majority of the families had a per capita income of <Rs500 per month and a low education level. Of the three children who knew about their illness, two showed behavioral changes. HIV status was known in school for 12 of the 20 school-going children, and discrimination was observed in one case. Family members were supportive in 65% of cases and opposition and fear were the reactions in 30%. Healthcare providers were unsupportive in two cases. Monthly medical expenditure varied from Rs250 to Rs1500. Fifteen children were on antiretroviral therapy largely funded by voluntary organizations. Ninety two percent of the caregivers were aware of the modes of transmission, 85% of the preventive measures and 70% of the complications of HIV/AIDS. In conclusion, in spite of all the efforts raise awareness of HIV, social discrimination and stigmatization persist. General improvements in socioeconomic status and levels of knowledge and well-organized health programs will go a long way in the battle against HIV/AIDS.

Seroprevalence of Hepatitis A and Associated Socioeconomic Factors in Young Healthy Korean Adults

An epidemiologic shift of hepatitis A virus (HAV) seroprevalence is expected due to an improvement in socioeconomic status in young adults in Korea. We investigated the age-specific seroprevalence and socioeconomic factors associated with HAV seropositivity in young, healthy Korean adults. Between March 2009 and February 2010, a total of 5,051 persons from 20 to 49 years of age presenting for a health check-up were included and responded to a questionaire. The seroprevalence of HAV was investigated by measuring immunoglobulin G (IgG) anti-HAV. A total of 984 pairs of cases and age- and sex-matched controls were analyzed for associated socioeconomic factors. The prevalence of seropositive HAV was 6.2% in the 20 to 29 age range, 33.1% in the 30 to 39 range and 82.4% in the 40 to 49 range (p<0.001). There were no significant differences in any group according to gender. A multivariate analysis for paired cases indicated that HAV seropositivity was significantly higher in the low monthly income (below five million won, approximately 4,300 dollars) group and the Helicobacter pylori (H. pylori)-positive group (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.27-2.14; p<0.001; OR, 1.45; 95% CI, 1.19-1.76; p<0.001, respectively). HAV seropositivity in young adults presenting for a health checkup appears to be decreasing, and the prevalence was significantly higher in the low monthly income group and the H. pylori-positive group.

Evaluation of a 25-year-program for the control of schistosomiasis mansoni in an endemic area in Brazil.

BackgroundVarious studies showed that chemotherapy can control schistosomiasis morbidity, but association of measures (water supply, sewage disposal and increase of socioeconomic conditions) is necessary for transmission control.Methodology/Principal FindingsA survey dealing with socioeconomic conditions, snail survey, contact with natural waters, and clinical and stool examinations was undertaken at an endemic area in the State of Minas Gerais, Brazil. The methodology used was the same for both evaluations (1981 and 2005). Four hundred and seventy-five out of 1,474 individuals studied in 1981 could be contacted. From these, 358 were submitted to stool examination, and 231 of them were clinically examined. Patients eliminating S. mansoni eggs in their stools were treated. The results showed that the prevalence rate in Comercinho, a municipality of the State of Minas Gerais, Brazil, was substantially reduced to 70.4% and 1.7% in 1981 and 2005, respectively, as well as the frequency of the hepatosplenic form (7% to 1.3%) after five treatments effectuated between 1981 and 1992. No other new case of this form was detected from 1981 onwards. Another important aspect to be considered was the improvement of people's living standard that occurred in the region after more than two decades' efforts (better housing, professional skill and adequate basic sanitation).Conclusion/SignificanceThe control of morbidity and very significant decrease of schistosomiasis transmission in an area until then considered as hyperendemic was possible by means of association of successive specific treatments of the local population, together with the construction of privies, water supply in the houses and improvement of socioeconomic conditions.

Learning lessons from the 2009 pandemic: putting infections in their proper place

Learning lessons from the 2009 pandemic: putting infections in their proper place

Household Location and Race: A Twenty-Year Retrospective

In a paper published in the Review of Economics and Statistics some 20 years ago (Gabriel and Rosenthal [1989]), we sought to assess the disparate residential location choices of black and white households in the Washington, D.C. metropolitan area. The paper showed that simulated closure of large socio-economic gaps between blacks and whites did little to diminish prevailing high levels of residential segregation or otherwise enhance moves by black households to areas of educational, employment, and housing opportunity. In the wake of intervening decades and related urban development, the current paper applies data from 2000 to assess anew racial variations in residential location choice. Results of the multinomial logit analysis indicate persistent, large racial differentials in residential location choice. While black location choice in 2000 was relatively more dispersed than in 1980, it remained remarkably concentrated in DC and Prince Georges County. As in our prior analysis, results showed that large simulated gains in black economic and educational status had little effect on prevailing racial segregation. These findings underscore the persistent, limited access of black households to schooling, employment, and housing opportunities available outside traditional areas of settlement. In marked contrast, the locational choices of Latino and immigrant households bore greater similarity to those of whites and were more sensitive to improvements in socio-economic status.

Intense cold and mortality in Castile-La Mancha (Spain): study of mortality trigger thresholds from 1975 to 2003

Studies on temperature-mortality time trends especially address heat, so that any contribution on the subject of cold is necessarily of interest. This study describes the modification of the lagged effects of cold on mortality in Castile-La Mancha from 1975 to 2003, with the novelty of also approaching this aspect in terms of mortality trigger thresholds. Cross-correlation functions (CCFs) were thus established with 15 lags, after application of ARIMA models to the mortality data and minimum daily temperatures (from November to March), and the results for the periods 1975-1984, 1985-1994 and 1995-2003 were then compared. In addition, daily mortality residuals for the periods 1975-1989 and 1990-2003 were related to minimum temperatures grouped in 2°C intervals, with a cold threshold temperature being obtained in cases where such residuals increased significantly (p < 0.05) with respect to the mean for the study period. A cold-related mortality trigger threshold of -3°C was obtained for Ciudad Real for the period 1990-2003. The significant number of lags (p < 0.05) in the CCFs declined every 10 years in Toledo (5-2-0), Cuenca (4-2-0), Albacete (4-3-0) and Ciudad Real (3-2-1). This meant that, while the trend in cold-related mortality trigger thresholds in the region could not be ascertained, it was possible to establish a reduction in the lagged effects of cold on mortality, attributable to the improvement in socio-economic conditions over the study period. Evidence was shown of the effects of cold on mortality, a finding that renders the adoption of preventive measures advisable in any case where intense cold is forecast.

Translating evidence into policy for cardiovascular disease control in India.

Cardiovascular diseases (CVD) are leading causes of premature mortality in India. Evidence from developed countries shows that mortality from these can be substantially prevented using population-wide and individual-based strategies. Policy initiatives for control of CVD in India have been suggested but evidence of efficacy has emerged only recently. These initiatives can have immediate impact in reducing morbidity and mortality. Of the prevention strategies, primordial involve improvement in socioeconomic status and literacy, adequate healthcare financing and public health insurance, effective national CVD control programme, smoking control policies, legislative control of saturated fats, trans fats, salt and alcohol, and development of facilities for increasing physical activity through better urban planning and school-based and worksite interventions. Primary prevention entails change in medical educational curriculum and improved healthcare delivery for control of CVD risk factors-smoking, hypertension, dyslipidemia and diabetes. Secondary prevention involves creation of facilities and human resources for optimum acute CVD care and secondary prevention. There is need to integrate various policy makers, develop effective policies and modify healthcare systems for effective delivery of CVD preventive care.

The challenges of girl-child education and alternative jobs in Nigeria

Real life experiences indicate that the current Global Economic Crisis (GEC) have worsened the state of Nigerian-girl-child. This study examines the effects of GEC on the education of girl-child and engagement in alternative jobs. Data were obtained from 1200 female children between 6–14 years selected on purposive random sampling-technique engaged in hawking from three States in Nigeria. About 20 selected parents went through sessions of in-depth interview. They responded to a semi-structured questionnaire. Findings show that 45 percent recently dropped out of school and engaged hawking to enhance self and family economy, make an average of USD1 gains daily. They hawk in crowded markets, hotels and busy road junctions. There are reported cases of child-sexual abuse for fee. Four percent in paid housework were impregnated resulting in clandestine abortion. An improvement in socio-economic conditions of parents and social protection policy for girl-child are recommended.

Prevalência de rotavírus em crianças atendidas na rede pública de saúde do estado de Pernambuco

Rotaviruses are considered important etiological agents of acute gastroenteritis and a common cause of the hospitalization of children aged zero to four years-old. In Brazil, the incidence of rotavirus gastroenteritis in children is 12 to 42% and the distribution of infection is related to seasonality, which apparently occurs in different periods and intensity according to each region. The study investigated group A rotavirus in fecal samples of suspected children attended by the public health system of the State of Pernambuco. Diagnosis was achieved by ELISA and the Latex agglutination test. Of the 171 samples studied, 33 (19.3%) presented positivity for Rotavirus A. Among positive samples, 72.7% belonged to male patients and 27.3% to female. Among the positive casuistic, 15.2% were vaccinated. When comparing the results obtained for the ELISA and Latex agglutination tests, 100% agreement between positivity by Latex agglutination and ELISA was verified. The high incidence of this infection reinforces the need to monitor this virus and define health policies concerning its diagnosis, prophylaxis, improvement in socioeconomic conditions and the refinement of the vaccine.

Cancrum oris in an adult with human immunodeficiency virus infection: case report

New cases of cancrum oris in adults are rare and there are no previous reports in the literature from Kenya. Since noma is related to factors associated with poverty and immunosuppression, reducing the incidence of noma can be achieved with improvement in socio-economic status of communities and prevention of HIV infection. An unusual case of a human immunodeficiency virus (HIV) infected a 49 year old female with a full thickness cheek defect following a recent cancrum oris infection is reported. The disfiguring defect was successfully reconstructed using a two staged delto-pectoral flap with a satisfactory aesthetic and functional outcome.

Gender and risk of depression in Saudi Arabia, a systematic review and meta-analysis.

Depression is one of the leading causes of mortality and morbidity worldwide. In the year 2000 depression accounted for 4.4% of the global disability adjusted life years (DALYs). The Kingdom of Saudi Arabia (KSA) has a population of 28 million people and is one of the countries experiencing demographic transition in its population structure. Improvements in socioeconomic status have been shown to be associated with increased chronic diseases including chronic mental diseases like depression, but still there is no comprehensive review summarizing the various reports currently existing in the literature. Although individual studies within Saudi Arabia have reported prevalence rates and risks, the quality of such studies need to be subjected to rigorous assessment and their findings pooled to give combined weighted evidence that will provide basis for targeted intervention. Pooled risks have the advantage of adjusting inherent variations within sampled populations and therefore providing more reliable estimates even though there are concerns about possible magnification of smaller individual risks.

Regionale Unterschiede der Lebenserwartung in Deutschland auf Ebene der Kreise und kreisfreien Städte und deren möglichen Determinanten

The aim of this study is to show health differences at a county level in Germany and to identify possible reasons for these differences. The study calculates life expectancy as being representative for the health status. The analytical part of the study uses a wide database with socioeconomic, environmental, educational and health-care data. In a first step, the set of variables is reduced by a factor analysis and three factors are generated (socioeconomic conditions, environment, health-care). Secondly, a cluster analysis is used to show the regional distribution of the gained factors and thirdly a regression analysis is used to show the influence of the three factors on life expectancy. The results of the regression analysis show that socioeconomic conditions have the greatest influence on health status. Because of this, preventive health-care measures should integrate an improvement of socioeconomic conditions.

An epidemiologic study of carcinoma gall bladder.

e14677 Background: Most gall bladder cancer (GBC) patients present in advanced/unresectable stage with poor response to therapy. Prevention or early detection is the best way to prevent death which requires identification of susceptible sub-group. Keeping this in mind this study was done to study the association between selected demographic, lifestyle and dietary factors and GBC. Methods: A hospital based case-control study was done in All India Institute of Medical Sciences, New Delhi, India. Cases were defined as newly registered primary GBC patients. Controls were defined as healthy relatives of patients other than GBC. Data were collected from February 2008 to October 2009 using a semi-structured interview schedule from both cases and controls. Food frequency questionnaire was used for dietary variables. Analysis was done using SPSS version 15 and Epi-Info version 6. For categorical variables chi-square test and chi square for trend were used. For continuous variables t-test was done. P value < 0.05 was considered as significant. Factors found significant in bi-variate analysis were entered in a multivariate logistics regression analysis. Results: A total of 122 cases and 122 controls were included in the study. There was no significant difference in age (p = 0.06) and gender (p = 0.66) between cases and controls. In bivariate analysis factors found significantly associated with GBC were illiteracy (odds ratio [OR]: 8.00, 95% confidence interval [CI] :3.47- 18.62; p 0.000), lower socioeconomic status (OR 2.45: 95% CI 2.45-9.10, p - 0.000), parity > 3 (OR 9.06, CI 4.10-20.35, p - 0.000), age at first pregnancy <20 yrs (OR 2.034, 95% CI 1.27-3.36, p - 0.018), non-liquefied petroleum gas (LPG) cooking fuel (OR 4.17, 95% CI 1.88-9.40, p - 0.000). Higher vitamin C intake had protective effect (OR 0.33, 95% CI 0.15-0.76, p - 0.004). In multivariate analysis education, intake of vitamin C, parity and type of fuel used were significant factors. Conclusions: The risk factors for carcinoma gallbladder that have been identified in the present study delineate a high-risk population group that can be targeted for preventive measures including improvement in socioeconomic status, education and life style and dietary intervention. No significant financial relationships to disclose.