Volume 7, Number 39
15 October 2007

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FAMILY PLANNING RESEARCH

Oral contraceptives and the risk of death from breast cancer
(Abstract; subscription needed for full text; Global)
Obstetrics and Gynecology. 2007 Oct;110(4):793-800.
Wingo PA | Austin H | Marchbanks PA | Whiteman MK | Hsia J
The objective was to examine the relationship between the use of oral contraceptives and the risk of death from breast cancer. We used interview data from the Cancer and Steroid Hormone Study, linked to cancer registry data from the Surveillance, Epidemiology, and End Results Program, to examine the 15-year survival and prior use of oral contraceptives among 4,292 women aged 20 to 54 years when diagnosed with breast cancer from December 1, 1980, to December 31, 1982. Cox proportional hazard models were used to estimate the relative rate of death from breast cancer by oral contraceptive use. Duration of oral contraceptive use, time since first use, age at first use, and use of specific pill formulations were not associated with survival. For time since last use, the risk of death from breast cancer decreased significantly with increasing time since last use of oral contraceptives, but a consistent gradient effect was not observed. Adjusted hazard ratios ranged from 0.86 to 1.41 and were 1.00 or less for all recency categories except during 13 to 24 months before diagnosis; none was statistically significant. Women who were currently using oral contraceptives had an adjusted hazard ratio of 0.90 (0.68, 1.19). Overall, oral contraceptive use had neither a harmful nor a beneficial effect on breast cancer mortality. The differences between pill users and nonusers were slight, and the risk estimates were usually reduced with confidence limits that nearly always included 1.0.

Contraceptive injections by community health workers in Uganda: A nonrandomized community trial
(Research Article; Sub-Saharan Africa)
(You need Adobe Acrobat Reader to access this document)
Bulletin of the World Health Organization. 2007 Oct;85(10):733-820.
Stanback J | Mbonye AK | Bekiita M
The objective was to compare the safety and quality of contraceptive injections by community-based health workers with those of clinic-based nurses in a rural African setting. A nonrandomized community trial tested provision of injectable Depo Provera (DMPA) by community reproductive health workers and compared it with routine DPMA provision at health units in Nakasongola District, Uganda. The primary outcome measures were safety, acceptability and continuation rates. A total of 945 new DMPA users were recruited by community workers, clinic-based nurses and midwives. Researchers successfully followed 777 (82% follow-up): 449 community worker clients and 328 clinic-based clients. Ninety-five percent of community-worker clients were "satisfied" or "highly satisfied" with services, and 85% reported receiving information on side-effects. There were no serious injection site problems in either group. Similarly, there was no significant difference between continuation to second injection (88% among clients of community-based workers, 85% among clinic-going clients), nor were there significant differences in other measures of safety, acceptability and quality. Community-based distribution (CBD) of injectable contraceptives is now routine in some countries in Asia and Latin America, but is practically unknown in Africa, where arguably the need for this practice is greatest. This research reinforces experience from other regions suggesting that well-trained community health workers can safely provide contraceptive injections.

A comparative study of Cyclofem and depot medroxyprogesterone acetate (DMPA) effects on endometrial vasculature
(Abstract; subscription needed for full text; Global)
Journal of Family Planning and Reproductive Health Care. 2007 Oct;33(4):271-276.
Simbar M | Tehrani FR | Hashemi Z | Zham H | Fraser IS
The most common reason for discontinuation of long-acting progestogen-only contraceptives is irregular bleeding following local endometrial vascular changes. To reduce unpredictable bleeding episodes among depot medroxyprogesterone acetate (DMPA) users, the combined injectable contraceptive, Cyclofem, was offered as an alternative. However, there is a gap in our knowledge about the effects of Cyclofem on the endometrial vasculature and patterns of bleeding. This study aimed to compare the effects of Cyclofem and DMPA on endometrial vascular density, endometrial histology and pattern of bleeding. Sixty-eight healthy women with regular menstrual bleeding and seeking injectable long-acting contraceptives were recruited. Two endometrial samples (before and 3 to 6 months after initial exposure to DMPA or Cyclofem) were collected from each participant. The samples were stained using an immunohistochemical method and anti-CD34 to visualise the endometrial vasculature. Endometrial vascular density was assessed using standard techniques. Sixty-eight women were randomly assigned to Cyclofem (38 women) or DMPA (30 women). Endometrial vascular density was 149.3 plus or minus 6.7 (mean plus or minus SD)/mm2 before injection. This significantly decreased to 132.4 plus or minus 12.2 after DMPA use, and from 151.9 plus or minus 5.8 to 131.8 plus or minus 12.8 vessels/mm2 following Cyclofem use (paired t-test, p less than 0.05). However, there was no significant difference between endometrial vascular density during treatment with Cyclofem or DMPA. Total bleeding days in the first and second 3-month time intervals were 28 plus or minus 23 and 18 plus or minus 12 days in DMPA users and 22 plus or minus 14 and 16 plus or minus 9 days in Cyclofem users, respectively. Spotting was the most common type of bleeding experienced, and atrophic endometrium was the most common histological pattern observed in both groups. This study demonstrated that both Cyclofem and DMPA use are associated with decreased endometrial vascular density and atrophic endometrium, in addition to irregular bleeding, mainly spotting. There was no significant difference in bleeding patterns or endometrial findings observed for these two injectable contraceptives in Iranian women.

FAMILY PLANNING NEWS

China erases "coarse" family planning signs
(News Article; Asia)
11 Oct 2007
Reuters

UNFPA to promote family planning in Madagascar
(News Article; Sub-Saharan Africa)
9 Oct 2007
Xinhua News Agency

Uganda: Taking family planning to Acholi families
(Feature Article; Sub-Saharan Africa)
8 Oct 2007
Aber P | Akena C, The Monitor Publications

HIV/AIDS and STIs RESEARCH

Scaling-up co-trimoxazole prophylaxis in HIV-exposed and HIV-infected children in high HIV-prevalence countries
(Abstract; subscription needed for full text; Global | Sub-Saharan Africa)
Lancet Infectious Diseases. 2007 Oct;7(10):686-693.
Zachariah R | Harries AD | Luo C | Bachman G | Graham SM
Co-trimoxazole (trimethoprim-sulfamethoxazole) is a widely available antibiotic that substantially reduces HIV-related morbidity and mortality in both adults and children. Prophylaxis with co-trimoxazole is a recommended intervention of proven benefit that could serve not only as an initial step towards improving paediatric care in young children with limited access to antiretroviral treatment, but also as an important complement to antiretroviral therapy in resource-limited settings. Despite co-trimoxazole's known clinical benefits, the potential operational benefits, and favourable recommendations by WHO, UNAIDS, and UNICEF, its routine use in developing countries -- particularly sub-Saharan Africa -- has remained limited. Out of an estimated 4 million children in need of co-trimoxazole prophylaxis (HIV-exposed and HIV-infected), only 4% are currently receiving this intervention. We discuss some of the major barriers preventing the scale-up of co-trimoxazole prophylaxis for children in countries with a high prevalence of HIV and propose specific actions required to tackle these challenges.

How much should we expect? Family caregiving of AIDS patients in rural Uganda
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Transcultural Nursing. 2007 Oct;18(4):358-365.
Kipp W | Tindyebwa D | Karamagi E | Rubaale T
The aim of this study was to measure the burden of care for family caregivers of AIDS patients. A cross-sectional exploratory design was used to describe the care experiences of family caregivers of AIDS care recipients. A questionnaire was used to interview 120 family caregivers of AIDS patients from four rural areas in western Uganda. The questions asked were related to 12 domains of family caregiving. Care burden scores of caregivers were calculated. It was found that care burden scores were high in all domains except those regarding relationships within the families and substance abuse. Serious work overload and low health status were reported. The high burden of caregiving puts family caregivers at risk for decreased health status and increased social isolation and depression.

Trends of HIV-1 and HIV-2 prevalence among pregnant women in Guinea-Bissau, West Africa: Possible effect of the civil war 1998 -- 1999
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Sexually Transmitted Infections. 2007 Oct;83(6):463-467.
Mansson F | Alves A | da Silva ZJ | Dias F | Andersson S
Sentinel surveys in Bissau, the capital of Guinea-Bissau, have shown low prevalence of HIV-1 but high HIV-2 prevalence before 1998. Guinea-Bissau experienced a civil war in 1998-1999. To examine specifically the trends of HIV prevalence from antenatal surveys in Bissau, Guinea-Bissau in 1987-2004, and whether the civil war in 1998-1999 could have an effect on HIV prevalence levels after the conflict. Since 1987, anonymous HIV testing in delivering women has been performed at the maternity clinic, Simao Mendes National Hospital, Bissau, as part of the national sentinel surveillance programme. Consecutive sampling was performed for approximately 3 months between September and December each year. Serological analyses were performed at the National Public Health Laboratory in Guinea-Bissau. A total of 20 422 women were tested for HIV between 1987 and 2004. The total HIV-1 prevalence increased from 0.0% in 1987 to 4.8% in 2004 and the total HIV-2 prevalence decreased from 8.3% in 1987 to 2.5% in 2004. The HIV-1 prevalence increased from 2.5% in 1997 to 5.2% in 1999, but stabilized in subsequent years. There was a significant increase in HIV-1 prevalence in the years 1987-2004 and a significant decline in HIV-2 prevalence over the same period. The civil war in 1998-1999 may have sparked HIV-1 transmission, as HIV-1 prevalence more than doubled between 1997 and 1999, but there is no evidence of a long-term effect on the trends of HIV-1 or HIV-2 prevalence.

Validity of coital diaries in a feasibility study for the Microbicides Development Programme trial among women at high risk of HIV/AIDS in Mwanza, Tanzania
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Sexually Transmitted Infections. 2007 Oct;83(6):490-497.
Allen CF | Lees SS | Desmond NA | Der G | Chiduo B
The objectives were to compare coital diaries and face-to-face interviews (FFIs) in measuring sexual behaviour among women at high risk of HIV. To assess the effect of differing levels of support from researchers on reporting in coital diaries and FFIs. Three groups of 50 women were randomly selected from a cohort of food and recreational facility workers participating in a microbicide trial feasibility study and received differing levels of researcher support. Minimum support involved delivering and collecting coital diaries weekly; medium support included a weekly FFI and discussion of concerns; intensive support also included an unscheduled mid-week visit when diaries were checked and concerns addressed. All respondents participated in an exit FFI, including questions on sexual behaviour over the four-week study period and study acceptability. Sexual behaviours were generally reported more frequently in coital diaries than weekly or exit interviews. Vaginal and anal sex, male and female condom use, vaginal cleaning and lubrication, sex during menstruation and sex with irregular and regular partners were reported more frequently in coital diaries than exit interviews. In coital diaries, level of support was associated with reporting of vaginal sex and cleaning. In exit interviews, support level was associated with reporting of vaginal sex, vaginal cleaning and sex with regular, irregular and commercial partners. Women with minimum support reported least satisfaction with the research process. Women with intensive support were most likely to report that they informed someone about their study participation and that they completed diaries daily. Compared with FFIs, coital diaries resulted in higher reporting of socially stigmatised activities, and sexual behaviour reporting varied less by level of support.

HIV/AIDS and STIs NEWS

Uganda: Government opens Africa's first Aids drugs factory
(News Article; Sub-Saharan Africa)
9 Oct 2007
Catholic Information Service for Africa (Nairobi)

Ghana: HIV/Aids is still scary in Brong Ahafo
(News Article; Sub-Saharan Africa)
8 Oct 2007
Boateng M, Ghanaian Chronicle (Accra)

Botswana: Country doing well in universal access
(News Article; Sub-Saharan Africa)
9 Oct 2007
Mokwathi N, The Voice (Francistown)

Liberia: Aids stigmatization also kills, says health minister
(News Article; Sub-Saharan Africa)
9 Oct 2007
Sworh BB, The NEWS (Monrovia)

Angola: Over 60 new HIV cases diagnosed in Viana District
(News Article; Sub-Saharan Africa)
8 Oct 2007
Angola Press Agency (Luanda)

Kenya: HIV mothers 'need focused healthcare post-birth'
(News Article; Sub-Saharan Africa)
3 Oct 2007
Ogodo O, SciDev.Net (London)

Uganda: Carelessness causing spread of HIV/Aids
(News Article; Sub-Saharan Africa)
11 Oct 2007
Apunyo H, The Monitor (Kampala)

Botswana: Junior school starts HIV/Aids project
(News Article; Sub-Saharan Africa)
10 Oct 2007
Maganu P, Mmegi/The Reporter (Gaborone)

MATERNAL AND CHILD HEALTH RESEARCH

Risk factors for syphilis infection among pregnant women: Results of a case-control study in Shenzhen, China
(Abstract; subscription needed for full text; Asia)
Sexually Transmitted Infections. 2007 Oct;83(6):476-480.
Zhou H | Chen XS | Hong FC | Pan P | Yang F
China has been experiencing a rapidly growing syphilis epidemic since the early 1990s, with the reported incidence of congenital syphilis increasing from 0.01 cases per 100 000 live births in 1991 to 19.7 cases per 100 000 live births in 2005. Detailed studies of risk factors for syphilis in pregnant women are needed to inform new preventive interventions. The objective was to investigate factors associated with recent syphilis infection among pregnant women and recommend strategies for improved preventive interventions in the community. A case-control study was conducted among women attending antenatal clinics in Shenzhen City, South China. Cases were antenatal clinic women testing positive for early syphilis, based on laboratory results, with those testing negative being controls. All participants completed the same anonymous questionnaire covering demographics, lifestyle, sexual behaviour, and sexual partnerships. 129 cases and 345 controls were recruited. Syphilis was significantly associated with unmarried status, less education, multiple sex partners, travel of sex partner in the past 12 months, a history of induced abortion, and previous sexually transmitted infections. Overall, there were no differences between syphilis-positive and negative women in household registration status (hukou), living district and duration in Shenzhen, monthly income, and age at first sex. Many demographic and behavioural risk factors are associated with syphilis among pregnant women. In the government congenital syphilis control programme, comprehensive preventive interventions should be provided in all clinical settings in addition to the current procedures for syphilis screening among antenatal women.

Strengthening public health priority-setting through research on fistula, maternal health, and health inequities
(Abstract; subscription needed for full text; Sub-Saharan Africa)
International Journal of Gynecology and Obstetrics. 2007 Nov;99 Suppl 1:S16-S20.
Bangser M
Related Abstract; subscription needed for full text: Obstetric fistula: Ending the silence, easing the suffering
Findings from 4 studies conducted by the Women's Dignity Project and partners on the subjects of obstetric fistula, maternal mortality and morbidity, and health inequities are presented. The studies include qualitative and quantitative research, a survey, and an analysis of secondary data that examine women's experiences of fistula; constraints in service delivery for fistula treatment; factors shaping women's access to delivery care and constraints health workers face in providing care; and health inequities. Findings from the studies are being used to improve fistula prevention and management, strengthen access to and provision of quality maternity care, and redress the health inequities that so adversely affect the poor. The studies provide policy makers, program managers, and service providers with evidence and the impetus to re-equilibrate policies, financial and human resources, and services in the interest of those in greatest need: women living in poverty.

'The bigger the better' -- mothers' social networks and child nutrition in Andhra Pradesh
(Abstract; subscription needed for full text; Asia)
Public Health Nutrition. 2007 Nov;10(11):1274-1282.
Moestue H | Huttly S | Sarella L | Galab S
It is hypothesised that mothers' social networks can positively affect child nutrition through the sharing of health knowledge and other resources. The present study describes the composition of mothers' networks, examines their association with child nutrition, and assesses whether health knowledge is shared within networks. Cross-sectional data for mothers of young children from Andhra Pradesh (south India) were combined with existing data from the Young Lives study, in which the mothers were participating (n = 282). The composition of social networks varied between urban and rural areas, with urban networks being larger, more female, more literate and with a greater proportion of members living outside the household and being non-family. There was a positive association between child's height-for-age Z-score and mother's network size and network literacy rate. The association with network literacy was stronger among the poorest households. Women commonly reported seeking or receiving health advice from network members. Big and literate social networks are associated with better child nutrition, especially among the poor. The dissemination of health knowledge between network members is a plausible way in which social networks benefit child nutrition in India. Further research into the underlying mechanisms is necessary to inform the development of interventions that channel health information through word of mouth to the most excluded and vulnerable families.

MATERNAL AND CHILD HEALTH NEWS

Rwanda: Prenatal mortality can now be prevented
(News Article; Sub-Saharan Africa)
12 Oct 2007
Mutesi F, New Times

In U.S. poll, most fail a quiz on global causes of child deaths
(News Article; Global)
11 Oct 2007
Dugger CW, The New York Times

GENDER and HEALTH RESEARCH

Randomized controlled evaluation of a theory-based postpartum sexual health education programme
(Abstract; subscription needed for full text; Asia)
Journal of Advanced Nursing. 2007 Nov;60(4):389-401.
Lee JT | Yen HW
This paper reports on a study to examine the effects of a theory-based interactive postpartum sexual health education programme on postpartum women's sexual health knowledge, attitudes towards sexual health, contraceptive self-efficacy and sexual self-efficacy. Childbearing can challenge marital satisfaction and the sexual life of women, making the childbearing years a vulnerable stage in the sexual life of a woman. Although sexual education used to be a routine aspect of local postpartum teaching, this teaching was inadequate to satisfy women's informational needs related to sexual health. For this two-group, randomized controlled trial, 166 participants were recruited at a medical centre in northern Taiwan. The experimental group (n = 84) received the intervention. The control group (n = 82) received routine postpartum teaching. Participants in the experimental group were separated according to their learning preparedness, as determined by the transtheoretical model. Their level of preparedness was then matched to different sexual health education strategies used in the intervention. Data were collected in 2003 at baseline and at 3 days and 8 weeks following the intervention. Descriptive and repeated-measures ANOVA were used to analyse data. Sexual health knowledge, attitudes and sexual self-efficacy were significantly greater for women in the experimental group at 3 days and 8 weeks after the intervention programme than for those in the control group. However, contraceptive self-efficacy was not significantly different in the two groups. The longer-term effectiveness of our theory-based interactive postpartum sexual health education programme will be enhanced by matching teaching strategies to participants' stage of learning preparedness.

Domestic violence politics in post-Soviet states
(Abstract; subscription needed for full text; Europe)
Social Politics: International Studies in Gender, State and Society. 2007 Fall;14(3):380-405.
Johnson JE
This article, drawing upon three approaches from comparative political science, compares domestic violence politics in Russia with Ukraine, Moldova, and Armenia. It suggests that foreign assistance, not without unintended consequences, holds the best promise for initiating reform. It also shows that there is nothing particular about Russian culture that limits reform, especially, as activists can manipulate gender neo-traditionalism. Finally, the study suggests that institutionalized political channels for considering women's issues can facilitate feminist policy-making when pushed by an autonomous women's movement. In conclusion, the article suggests that studying gender politics in non-Western contexts requires integrating comparative with international theories.

Healthcare and support needs of women with suspected breast cancer
(Abstract; subscription needed for full text; Global)
Journal of Advanced Nursing. 2007 Nov;60(3):289-298.
Liao MN | Chen MF | Chen SC | Chen PL
This paper is a report of a study to investigate changes in the healthcare and support needs during the diagnostic period, and factors that affect these needs in women with suspected breast cancer. Although the needs of women with breast cancer are well recognized, few studies have examined the needs of women with suspected breast cancer during the diagnostic period. This longitudinal study used an investigator-developed, self-administered questionnaire to collect data from 127 women in Taiwan on three occasions: notification of need for breast biopsy, before biopsy and after diagnosis. The data were collected from November 2004 to April 2005. Participants had high need levels before and after diagnosis, with their top needs in the domains of healthcare services for diagnosis, follow-up and consultation, and information about the disease. They needed disease- and treatment-related information more than emotional support. Need levels were higher (P less than 0.01) before diagnosis than after, highest before biopsy, and lowest after diagnosis. Furthermore, needs were higher (P less than 0.01) before than after diagnosis for diagnostic services, disease information, and involvement of family and friends. Higher needs were found in married women with more education and no history of benign tumours. Need level did not differ statistically significantly by age, religious status, degree of social support, family history and breast symptoms. Need levels of women with suspected breast cancer vary during the diagnostic period, are highest before breast biopsy, and related to personal characteristics and cultural context. Therefore, during this period, nursing staff should provide patients and families with culturally sensitive, individualized, supportive care.

Preventing violence against women: Time to uphold an important aspect of the reproductive health needs of women in Nigeria
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Family Planning and Reproductive Health Care. 2007 Oct;33(4):235-236.
Ibekwe PC
Violence against women (VAW) is one area of reproductive health that has not been given due consideration in Nigeria despite the fact that Nigeria is a signatory to many international conventions on eliminating violence against women and promoting human rights. VAW is increasingly being recognised as a serious public health issue, resulting in significant physical, psychological and social impairment. The World Health Organization, nongovernmental organisations and other agencies have recognised this and called on countries to take appropriate measures to prevent violence against women. The 1994 International Conference on Population and Development Programme of Action is very specific about sexual violence when it states: "Countries should take full measures to eliminate all forms of exploitation, abuse, harassment and violence against women, adolescents and children". Also, one of the key issues addressed at the Fourth World Conference on Women in Beijing in 1995 was the elimination of violence against women. Several years after these conferences and conventions, which Nigeria ratified, violence against women still affects the lives of millions of women worldwide and cuts across ethnic, cultural and religious barriers, impinging on the rights of women to participate fully in society. In Nigeria, there is gross under-reporting of VAW but available data indicate that 24-79% of women have experienced physical assault by an intimate partner. Unfortunately, this is tolerated as a cultural norm and accepted more or less as part of the rules guiding intimate relationships, as entrenched in parts of the penal code operating in some states in Nigeria.

GENDER and HEALTH NEWS

Africa: Activists work to curb violence against women in region
(News Article; Sub-Saharan Africa)
9 Oct 2007
Kimani M, New Times

Development-India: Lack of water, lack of education
(News Article; Asia)
8 Oct 2007
Seneviratne K, Inter Press Service (IPS) News Agency

Angola: Bie - 487 cases of gender violence recorded in nine months
(News Article; Sub-Saharan Africa)
10 Oct 2007
Kuito, Angola Press Agency (Luanda)

Women make a living on the street
(Feature Article; Sub-Saharan Africa)
8 Oct 2007
Fotiadis A, Public Agenda (Accra)

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

The Chilean infant mortality decline: Improvement for whom? Socioeconomic and geographic inequalities in infant mortality, 1990 -- 2005
(Research Article; South America)
(You need Adobe Acrobat Reader to access this document)
Bulletin of the World Health Organization. 2007 Oct;85(10):798-804.
Hertel-Fernandez AW | Giusti AE | Sotelo JM
The objective was to measure socioeconomic inequalities and differential risk in infant mortality on national and regional levels in Chile from 1990 to 2005, and propose new policy targets. The study analysed Chilean vital events registries from 1990 to 2005 for infant mortality by maternal education, head of household occupational status, cause, age and location of death. Annual infant mortality rates and relative risk were calculated by maternal education and head of household occupational status for each cause and age of death. Socioeconomic inequalities were then mapped to 29 regional health services. Reductions in the national infant mortality rate were driven by reductions among highly educated mothers, while recent stagnation in the national rate is caused by high levels of infant mortality among uneducated mothers. These vulnerable households are particularly prone to infant mortality risk due to infectious disease and trauma. We also identify clustering of high socioeconomic inequalities in infant mortality throughout the poorer north, indigenous south and densely populated metropolitan centre of Santiago. Finally, we report large inequities in vital statistics coverage, with infant deaths among vulnerable households much more likely to be inadequately defined than in the remaining population. These results indicate that the socioeconomically disadvantaged in Chile are at a significantly higher risk for infant mortality by infectious diseases and trauma during the first month of life. Efforts to reduce national infant mortality in Chile and other countries must involve policies that target child survival for at-risk populations for specific diseases, ages and locations.

Global child health: Burden of disease, achievements, and future challenges
(Abstract; subscription needed for full text; Global)
Current Problems in Pediatric and Adolescent Health Care. 2007 Oct;37(9):338-362.
Rosenberg M
Children in developing countries are disproportionately affected by the worlds' diseases. Ninety percent of children under 5 years old live in the developing world. Over 10 million children under 5 die each year, most from preventable or treatable causes, and 90% of these deaths occur in only 42 of the world's countries. While progress in reducing mortality has been made over the last several decades, an enormous discrepancy persists between mortality in industrialized and in developing countries.

Demographic change and immigration in age-structured epidemic models
(Abstract; subscription needed for full text; Global)
Mathematical Population Studies. 2007 Jul;14(3):169-191.
Iannelli M | Manfredi P
Immigration might be a remedy against the stress that low fertility causes to demographic and welfare systems. Sustained immigration, however, can alter both the demographic and epidemiological profiles of the receiving population. An age-structured SIR (susceptible-infective-recovered) model with realistic immigration under conditions of below replacement fertility is studied. Equilibria and threshold phenomena are characterized. The immigration profile and the epidemiological features of immigrants affect the reproduction number and the force of infection in the receiving population. Finally, an illustration is given, showing the potential effects of immigration for rubella control in Italy, by considering how the age profile of immigration influences the reproduction number of the disease.

POPULATION/FERTILITY/DEMOGRAPHY NEWS

More Indians want small family
(News Article; Asia)
12 Oct 2007
The Times of India

Angola: Community police answers population worries
(News Article; Sub-Saharan Africa)
10 Oct 2007
Angola Press Agency

Uganda: When lifestyle ruins men's fertility
(News Article; Sub-Saharan Africa)
8 Oct 2007
Serunjogi T, New Vision

Russia reports highest birth rate over past 15 years
(News Article; Asia)
8 Oct 2007
ITAR TASS News Agency

ADOLESCENT HEALTH RESEARCH

De-standardization of family-life trajectories of young adults: A cross-national comparison using sequence analysis
(Abstract; subscription needed for full text; Global)
European Journal of Population. 2007 Oct;23(3-4):225-250.
Elzinga CH | Liefbroer AC
We introduce a number of new methods based on sequence analysis to test hypotheses on the de-standardization of family-life trajectories in early adulthood, using Fertility and Family Survey data on 19 countries. Across cohorts, family-life trajectories of young adults have not become more turbulent. However, in most countries family-life trajectories of young adults have become less similar to one another and the variation in the types of family-trajectories has increased. Contrary to expectations, no clear differences in de-standardization were observed between countries characterized by a social-democratic welfare-state regime and countries characterized by either liberal or conservative welfare-state regimes.

Sexual behaviors and their correlates among young people in Mauritius: A cross-sectional study
(Research Article; Sub-Saharan Africa)
BMC International Health and Human Rights. 2007 Oct 5;7(1):8.
Nishimura YH | Ono-Kihara M | Mohith J | NgManSun R | Homma T
Little is known about the HIV/AIDS epidemic in the Indian Ocean region, including Mauritius. National records suggest a prevalence of HIV in Mauritius of less than 1% in the general population, which is one of the lowest prevalence rates in southern Africa. However, HIV-positive cases have been increasing recently in Mauritius. We conducted a cross-sectional survey in January 2003 to assess the prevalence of HIV-related sexual behaviors and their correlates among young people aged 15-24 years in Mauritius. We identified 1200 participants using two-stage cluster sampling. Demographic, social, sexual, and knowledge of HIV/AIDS data were obtained in face-to-face interviews using a structured questionnaire administered by trained interviewers. The prevalence of sexual behaviors was described in relation to gender, and the correlates of ever having had sex and nonuse of condom at last sex were analyzed using logistic regression. In the target population, 30.9% of males and 9.7% of females reported a history of sexual intercourse. Of the currently sexually active participants, 50.6% of men and 71.2% of women did not use condoms at their last sexual encounter. Logistic regression revealed that work experience and marijuana use were significantly associated with men's sexual experience, whereas being out of school and drinking experience were significantly associated with women's sexual experience. For both men and women, being Christian and visiting nightclubs were associated with having ever had sexual intercourse (P less than 0.05). In addition, not using a condom at the first sexual encounter and lack of exposure to a nongovernmental organization (NGO) dealing with HIV/AIDS were associated with the nonuse of condoms at the last sexual encounter (P less than 0.05). Young people in Mauritius are at risk of a future HIV epidemic because behaviors predisposing to HIV infection are prevalent among sexually experienced youth. A focused prevention program targeting young people should be reinforced as part of the National AIDS Control Program, taking into account the predictors of sexual behaviors identified here.

Perceptions and practice with regard to reproductive health among out-of-school adolescents
(Research Article; Asia)
Indian Journal of Community Medicine. 2007 Apr-Jun;32(2):141-143.
Kushwah SS | Mittal A
In India, there are approximately 200 million adolescents (NFHS II: 1998-99). Adolescents constitute 22.8% of the population in India as of March 1, 2000. Madhya Pradesh is a poor state, and a large proportion of adolescents do not even complete their primary education. This illiteracy and lack of proper reproductive education may result in problems like increasing population and higher burden of sexually transmitted diseases. Recognizing the potential for young, a reproductive health program for out-of-school adolescents has been started by the Government of Madhya Pradesh, Ministry of Health and Family Welfare with financial and technical support from Integrated Population Development Project (IPDP) funded by United Nations Population Fund (UNFPA). This program involves out-of-school adolescents of five districts of Madhya Pradesh, namely, Rewa, Satna, Sidhi, Panna, and Chhatarpur. The present study has been carried out with the following objectives in mind: to assess the knowledge gained by adolescents who have been trained in the ARH area; to assess the attitude of adolescents toward reproductive and sexual health; and to assess the behavior of the adolescents.

ADOLESCENT HEALTH NEWS

Uganda: '43 percent of Manafwa girls pregnant before 16'
(News Article; Sub-Saharan Africa)
11 Oct 2007
Mafabi D, The Monitor (Kampala)

Uganda: Child prostitution on the rise, says Kinobe
(News Article; Sub-Saharan Africa)
9 Oct 2007
Nafula J, The Monitor (Kampala)

South Africa: 'Innocent' bunking can lead to sex, drugs and crime
(News Article; Sub-Saharan Africa)
7 Oct 2007
Naidoo T, The Time (Johannesburg)

New campaign targets teens, promotes responsible sex
(News Article; Asia)
7 Oct 2007
Nie HY, Channel NewsAsia

Philippines: Saving the youth from risks
(News Article; Asia)
6 Oct 2007
Rodriguez MC, Inquirer (Mindanao)

SPECIAL REPORTS/PROFILES/RESOURCES

NGO In A Box –Open Source Tools Designed with the NGO in Mind
(Tool; Global)
22 Nov 2006
Tactical Tech
The Open Publishing Edition of NGO-in-a-box is one of many Open Source products developed with NGOs in mind. Open Source and Open Content publishing methods offer a low-cost way for NGOs to use information and communication technology (ICT) in their work. Open Publishing Edition of NGO-in-a-box is a toolkit of Free and Open Source software, tutorials and guides for producing, publishing and distributing content. The Edition, produced by Tactical Tech in collaboration with iCommons, is aimed at small to medium sized non-profits, independent media organizations, free culture creators and grassroots journalists with a particular emphasis on those in developing and transition countries.

The contents of the toolkit were selected by an editorial team made up of leading international practitioners working in publishing, free culture, technology for social justice and the development and deployment of free and open source software.

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Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 7, Number 3915 October 2007