Volume 7, Number 47
10 December 2007

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ADOLESCENT HEALTH NEWS

Rwanda: Antiretroviral treatment not enough for children with HIV
(News Article; Sub-Saharan Africa)
5 Dec 2007
All Africa

Teen birth rate rises for first time in 14 Years
(Press Release; North America)
5 Dec 2007
Centers for Disease Control

ADOLESCENT HEALTH RESEARCH

Reduction in human immunodeficiency virus risk among youth in developing countries
(Abstract; subscription needed for full text; Central America and the Caribbean)
Archives of Pediatrics and Adolescent Medicine. 2007 Dec;161(12):1130-1139.
Deveaux L | Stanton B | Lunn S | Cottrell L | Yu S
The objective was to address the 6-month efficacy of a human immunodeficiency virus (HIV) prevention intervention targeted to youth and delivered with and without a parental monitoring intervention in a developing country (the Bahamas). The design used was a randomized, controlled, 3-cell intervention trial with a 6-month postintervention follow-up. Elementary schools in the Bahamas were used for the setting of the study. The participants in the study were a total of 1282 Bahamian sixth-grade students (and 1175 parents) in 15 schools. Youth and parents were randomized at the level of the school to receive the following interventions: (1) Focus on Youth in the Caribbean (FOYC) plus Caribbean Informed Parents and Children Together (CImPACT), (2) FOYC plus an attention control for parents (Goal for It [GFI]), or (3) an attention control for the youth (Wonderous Wetlands [WW]) plus the GFI. The 10-session FOYC or WW curriculum was delivered as part of the elementary school curriculum. The GFI or CImPACT was delivered to parents in the evenings or on weekends. The main outcome measures were risk and protective knowledge, condom use skills, perceptions, interventions, and self-reported behaviors. Compared with the WW, the FOYC significantly increased knowledge, condom use skills, protective perceptions, and intentions to engage in safer behaviors. Among youth, no differences were found in knowledge or condom use skills based on parent intervention; among parents, those receiving the CImPACT demonstrated superior condom use skills after the intervention. Protective knowledge, skills, perceptions, and intentions of youth from 1 developing country can be significantly improved by youth intervention delivered through the schools. Longer follow-up is needed to determine if risk behaviors will be reduced and how long protective results will be sustained.

Influence of institutionalization on time to HIV disease progression in a cohort of Romanian children and teens
(Abstract; subscription needed for full text; Europe)
Pediatrics. 2007 Dec;120(6):e1476-e1480.
Ferris M | Burau K | Constantin AM | Mihale S | Murray N
The purpose of this work was to investigate the effect of institutionalization on death and CD4 decline in a cohort of 325 HIV-infected Romanian children. A retrospective database analysis was conducted. Data from a nearly 3-year period were examined with Kaplan-Meier survival analysis and Cox regression analysis models. Subjects all received primary and HIV specialty care and treatment at the Romanian American Children's Center in Constanta, Romania. Children in one group resided with their biological families and the other children resided in "family home"-style institutions. There was no difference between groups for death during the follow-up period, although there was a trend for survival advantage for children in institutional care. There was no statistically significant difference between the study groups in terms of CD4 decline, although there was a trend toward greater decline among children who resided with their biological families. Children with their biological families were more likely to experience disease progression through either death or CD4 decline than were children in institutions. The family home-style institution may prove to be a replicable model for the safe and appropriate care of HIV-infected orphaned and abandoned children and teens.

Adolescents: Is there an association between knowledge of oral contraceptives and profession of provider?
(Abstract; subscription needed for full text; Europe)
European Journal of Contraception and Reproductive Health Care. 2007 Dec;12(4):303-308.
Hansen T | Skjeldestad FE
Knowledge about oral contraceptives (OCs) was investigated among young users of OCs by profession of provider, namely, physician or public health nurse. A 44-item questionnaire designed to assess communication about contraception and knowledge of OCs was distributed to students in 11 of 13 high schools in Trondheim, Norway. Data from 688 OC users were eligible for analyses. Knowledge about OCs was measured by means of 15 questions, from which scores on three separate indices and a total index were determined. Separate indices included knowledge about physical changes during OC use (index I), knowledge about the pill's relative efficacy (index II) and knowledge about risks of cancer/thromboembolism (index III). Logistic regression analyses showed that high scores with regard to knowledge indices were predicted by sexual activity and communication about contraception with peers and/or parents. Profession of provider was not associated with high knowledge scores. Information given during brief and annual discussions with health professionals appears to have an insignificant impact as compared with information from other sources. Our results plead for an over-the-counter practice.

FAMILY PLANNING NEWS

Sierra Leone supports family planning
(News Article; Sub-Saharan Africa)
6 Dec 2007
Sesay BB, AfricaNews

Philippines: Natural family planning as "gesture of peace"
(News Article; Asia)
7 Dec 2007
Manaytay AM, MindaNews

China: Healthcare services to improve
(News Article; Asia)
7 Dec 2007
china.org.cn

FAMILY PLANNING RESEARCH

Secrecy, disclosure and accidental discovery: Perspectives of diaphragm users in Mombasa, Kenya
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Culture, Health and Sexuality. 2008 Jan;10(1):13-28.
Okal J | Stadler J | Ombidi W | Jao I | Luchters S | Temmerman M | Chersich MF
The diaphragm is receiving renewed attention as a promising female-controlled method of preventing HIV and other sexually-transmitted infections. It is anticipated that female-controlled technologies will reduce women's biological susceptibility and assist in counteracting their sociocultural vulnerability to HIV. Understanding the subjective experiences of diaphragm users in different settings has the potential to inform the development and promotion of such methods. This paper explores the perspectives of female sex workers and women attending sexual and reproductive health services in Mombasa, Kenya. Data are reported from focus group discussions and in-depth interviews with women and men, following a prospective study investigating diaphragm continuation rates over six months. Discussions highlighted covert use of the diaphragm, during sex work or with casual partners, and coital independence as favourable attributes. These features were especially pronounced compared with male condoms. Few difficulties with diaphragm use were reported, although its insertion and removal occasionally presented problems. Many women-especially those in long term partnerships-wished to disclose its use but found the disclosure process highly problematic. Accidental discovery often resulted in partner conflict. Although future uptake of the diaphragm may be high in this setting, its use may be limited to certain types of relationships and relationship context.

Hormonal implants: new, improved, and potentially popular
(Fact Sheet; Global)
[New York, New York], Engender Health, ACQUIRE Project, 2007. [2] p.
Jacobstein R | Pile JM
Related Report: Implants: The Next Generation
(You need Adobe Acrobat Reader to access this document)
Hormonal implants are a highly effective, very safe, convenient and simple form of contraception that is provided easily in an outpatient setting. Implants are small, thin, flexible rods or capsules made of soft plastic that are placed beneath the skin of a client's upper arm. A trained provider performs a minor surgical procedure under local anesthesia to insert or remove the rods. Two new implants, Jadelle (a two-rod system effective for five years) and Implanon (a one-rod system effective for three years), are even easier to insert and remove than the previously available implant, Norplant (a six-capsule system effective for seven years). Hormonal implants are an excellent contraceptive option for women at all phases of their reproductive lives-those who want to delay, space, or limit births. Though implants are the most costly contraceptive method, their availability in programs reduces demand on health services because they are more effective and their continuation rates are higher than short-acting methods, such as pills and injectables.

Contraception for women taking antiretroviral medications (ARVs): An update
(Fact Sheet; Global)
Baltimore, MD, INFO Project, Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, 2007.
Richey C | Shelton J
Women with HIV/AIDS, including those who are taking ARVs, can start and use almost all family planning methods safely and effectively. Women on ARVs need access to contraception for compelling reasons. Preventing unintended pregnancy in women with HIV can prevent mother-to-child transmission of HIV. It will also reduce the number of abortions and the number of children orphaned by AIDS. To successfully reach ARV recipients, contraceptive services need to be integrated with HIV care from the start. Reaching potential ARV recipients in resource-poor settings may require using a variety of service delivery "entry points," such as maternal-child health services or family planning services. Such entry points might either provide ARVs directly or refer clients to other sites. Offering multiple services at one location is more likely to attract larger numbers of potential ARV clients, help overcome stigma, and support treatment adherence and follow-up.

Changes in prescription contraceptive use, 1995 -- 2002: The effect of insurance status
(Abstract; subscription needed for full text; North America)
Obstetrics and Gynecology. 2007 Dec;110(6):1371-1378.
Culwell KR | Feinglass J
The objective was to examine changes in prescription contraception use between 1995 and 2002 by insurance status among women at risk for unintended pregnancy. Data from the National Survey of Family Growth, including 4,767 women at risk of unintended pregnancy in 1995 and 3,569 in 2002, were used to evaluate changes in primary contraception methods by health insurance status and year of survey. Logistic regression models tested differences in the likelihood of prescription contraceptive use among privately insured, publicly insured, and uninsured women in each year, after controlling for age, race and ethnicity, education, income, employment, marital status, number of children, religion, and self reported overall health. Overall prescription contraceptive use increased between 1995 and 2002 by 3% (48.9% to 51.9%, P = .049). Nonuse of contraception also increased (11.6% to 16.1%, P less than .001). The change in the likelihood of prescription contraceptive use was greatest and only significant among privately insured women (+5.5%, P = .002). In multiple regression analysis, women in 1995 were 10% less likely to report use of prescription contraceptives compared with women in 2002 (relative risk 0.90, 95% confidence interval 0.82-0.98), and uninsured women were more than 20% less likely to report prescription contraceptive use compared with privately insured women (relative risk 0.78, 95% confidence interval 0.67-0.90). Prescription contraceptive use increased most significantly among privately insured women between 1995 and 2002, potentially reflecting state mandates enacted during that period requiring contraceptive coverage by private insurers. It is important for clinicians to understand these differences and address issues of insurance coverage with patients when discussing contraceptive options.

Advance provision of emergency contraception for pregnancy prevention: A meta-analysis
(Abstract; subscription needed for full text; Global)
Obstetrics and Gynecology. 2007 Dec;110(6):1379-1388.
Polis CB | Schaffer K | Blanchard K | Glasier A | Harper CC | Grimes DA
Advance provision of emergency contraception can circumvent some obstacles to timely use. We performed a meta-analysis to summarize randomized controlled trials evaluating advance provision of emergency contraception to explore effects on pregnancy rates, sexually transmitted infections, and sexual and contraceptive behaviors. In August 2006, we searched CENTRAL, EMBASE, POPLINE, MEDLINE, a specialized emergency contraception article database, and contacted experts to identify published or unpublished trials. We included randomized controlled trials comparing advance provision to standard access, defined as any of the following: counseling (with or without information about emergency contraception) or provision of emergency contraception on request at a clinic or pharmacy. Two reviewers independently assessed study quality. We performed a meta-analysis using Review Manager software. Eight randomized controlled trials met inclusion criteria, representing 6,389 patients in the United States, China, and India. Advance provision did not decrease pregnancy rates, despite increased use (single use, odds ratio [OR] 2.52, 95% confidence interval [CI] 1.72-3.70; multiple use: OR 4.13, 95% CI 1.77-9.63) and faster use (weighted mean difference -14.6 hours, 95% CI -16.77 to -12.4 hours). Advance provision did not increase rates of sexually transmitted infections (OR 0.99, 95% CI 0.73-1.34), unprotected intercourse, or changes in contraceptive methods. Women who received emergency contraception in advance were as likely to use condoms as other women. Advance provision of emergency contraception did not reduce pregnancy rates and did not negatively affect sexual and reproductive health behaviors and outcomes compared with conventional provision.

GENDER and HEALTH NEWS

South Africa: Men standing up against gender-based violence
(News Article; Sub-Saharan Africa)
28 Nov 2007
Khumalo G, BuaNews (Tshwane)

Liberia: New study spotlights sexual violence
(News Article; Sub-Saharan Africa)
5 Dec 2007
Shriner C, All Africa

GENDER and HEALTH RESEARCH

Palestinian women's pregnancy intentions: Analysis and critique of the Demographic and Health Survey 2004
(Abstract; subscription needed for full text; Middle East)
Health Policy. 2008 Jan;85(1):83-93.
Giacaman R | Abu-Rmeileh NM | Mataria A | Wick L
The Palestinian DHS2004 reports on pregnancy intentions and their determinants are analyzed for the first time. Through this analysis, the survey instrument limitations are also highlighted. Data on 15-49 years old ever married, non-pregnant women reporting on their last pregnancy were selected from a nationally representative cross sectional survey dataset. Older women were more likely not to desire the pregnancy at all, and younger women more likely to have desired to wait; with higher reports of not desiring the pregnancy at all or desiring to wait among those with a higher number of children; with higher reports of not desiring the pregnancy at all, or desiring to wait, among women who reported ever using family planning methods. Women who experienced prenatal and postnatal complications reported higher levels of having desired to wait or not having wanted the pregnancy at all, calling for the inclusion of process measures in pregnancy intention studies. While some of our findings are comparable to those cited in the international literature, the analysis was limited to the type of questions asked in the Palestinian DHS survey. There is a need to further develop the survey instrument in order to address women's needs from a public health policy perspective. We call for the inclusion of additional social measures to identify some of the contextual factors that influence pregnancy intentions.

Violence and desire in Beijing: A young Chinese woman's strategies of resistance in father-daughter incest and dating relationships
(Abstract; subscription needed for full text; Asia)
Violence Against Women. 2007 December;13(12):1319-1338.
Wang X | Sik Ying Ho P
In Mainland China, there is a lack of public awareness of and systematic research on dating violence and incest. This article fills a gap in the research in this area by examining a woman's lived experience of father–daughter incest and dating violence. The article adopts the standpoint of third-wave feminists and highlights women's agency and resistance to abuse. Meng Xi, the subject of the case study in this article, is regarded as a "survivor" rather than a "victim," and her various strategies of resistance—in particular, how she talks about her body and linghun (intelligence soul), and uses the two as sites of resistance—are examined. The article sheds light on the desire and sexuality of women in contemporary China, and especially the struggle between spiritual and material pursuits.

Determinants of sexual activity and its relation to cervical cancer risk among South African women
(Abstract; subscription needed for full text; Sub-Saharan Africa)
BMC Public Health. 2007 Nov 27;7:341.
Cooper D | Hoffman M | Carrara H | Rosenberg L | Kelly J
Invasive cervical cancer is the commonest cause of cancer morbidity and mortality in South African women. This study provides information on adult women's sexual activity and cervical cancer risk in South Africa. The data were derived from a case-control study of hormonal contraceptives and cervical cancer risk. Information on age of sexual debut and number of lifetime sexual partners was collected from 524 incident cases and 1541 hospital controls. Prevalence ratios and adjusted prevalence ratios were utilised to estimate risk in exposures considered common. Crude and adjusted relative risks were estimated where the outcome was uncommon, using multiple logistic regression analysis. The median age of sexual debut and number of sexual partners was 17 years and 2 respectively. Early sexual debut was associated with lower education, increased number of life time partners and alcohol use. Having a greater number of sexual partners was associated with younger sexual debut, being black, single, higher educational levels and alcohol use. The adjusted odds ratio for sexual debut less than 16 years and greater than or equal to 4 life-time sexual partners and cervical cancer risk were 1.6 (95% CI 1.2 - 2.2) and 1.7 (95% CI 1.2 - 2.2), respectively. Lower socio-economic status, alcohol intake, and being single or black, appear to be determinants of increased sexual activity in South African women. Education had an ambiguous effect. As expected, cervical cancer risk is associated with increased sexual activity. Initiatives to encourage later commencement of sex, and limiting the number of sexual partners would have a favourable impact on risk of cancer of the cervix and other sexually transmitted infections.

HIV/AIDS and STIs NEWS

South Africa: Family doctors urged on HIV tests
(News Article; Sub-Saharan Africa)
7 Dec 2007
BBC News

China: Jackie Chan joins media campaign to raise AIDS awareness
(News Article; Asia)
6 Dec 2007
International Herald Tribune

United Kingdom: Ranbaxy gets nod to make, market ARV drug Coviro for children with HIV in India
(News Article; Europe)
6 Dec 2007
Thomson Financial

Canada: Three amigos, one deadly virus
(News Article; North America)
1 Dec 2007;
Butler D, Ottawacitizen.com

HIV/AIDS and STIs RESEARCH

Does the delivery of integrated family planning and HIV/AIDS services influence community-based workers? Client loads in Ethiopia?
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Health Policy and Planning. 2007 Nov;22(6):404-414.
Creanga AA | Bradley HM | Kidanu A | Melkamu Y | Tsui AO
Community-based reproductive health agents (CBRHAs) can increase community knowledge of and offer immediate access to reproductive health services, including HIV/AIDS. Due to growing interest in integration of family planning and HIV services in Ethiopia, it is important to examine whether CBRHAs are efficiently offering both service types. The present analysis uses survey data collected from Ethiopian CBRHAs and examines associations between agents' demographic, personality and work-related characteristics and their capacity to provide integrated services and have high client volumes. Multivariate probit and bivariate probit regression models are fitted for the two outcomes of interest. Nearly half of CBRHAs in our sample offer integrated services, but this is not jointly associated with increased productivity. Personality traits and work experience are more strongly associated with agents' capacity to provide integrated services than demographic characteristics, while agents' gender and work-related characteristics are significantly associated with increased likelihood of serving more clients.

Death before dying: Understanding AIDS stigma in the South African Lowveld
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Southern African Studies. 2007 Dec;33(4):845-860.
Niehaus I
This article explores some of the social and cultural factors that have undermined effective treatment and care for persons living with AIDS in South Africa. Drawing on ethnographic fieldwork conducted in Bushbuckridge, I observe that AIDS stigma has been both pervasive and intense. However, contrary to conventional wisdom, I argue that the association of AIDS with sexual promiscuity has not been the major source of its stigma. Instead, I suggest that denial, silence, fear and fatalism have stemmed from the construction of persons living with AIDS as being 'dead before dying', and from their symbolic location in the anomalous domain betwixt-and-between life and death. This article also challenges the notion that older cultural practices in the folk domain impede an effective biomedical response to AIDS. I see the construction of persons with AIDS as 'dead before dying' as an outcome of the manner in which biomedical discourses have articulated with religious and popular ones. In this process the notion that AIDS is a fatal terminal illness carries as much symbolic weight as the popular association of persons suffering from AIDS with lepers and zombies.

HIV prevalence and incidence in rural Tanzania: Results from 10 years of follow-up in an open-cohort study
(Abstract; subscription needed for full text; Sub-Saharan Africa)
JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2007 Dec;46(5):616-623.
Wambura M | Urassa M | Isingo R | Ndege M | Marston M
Tanzanian antenatal clinic surveillance data suggest stabilizing HIV levels. Data from an open cohort in northern Tanzania provide robust estimates of prevalence and incidence. Between 1994 and 2004, 19 rounds of household-based demographic surveillance and 4 rounds of individually linked HIV serologic surveys were conducted. Longitudinal knowledge of individuals' testing histories is used to allow for effects of selective participation on prevalence estimates; multiple imputation procedures allow for interval censoring effects on incidence. A total of 16,820 adults donated blood for HIV testing in at least 1 of 4 serologic surveys. HIV prevalence increased steadily from 6.0% in 1994/1995 to 8.3% in 2000/2001, leveling out thereafter. HIV incidence increased sharply from 0.8% in 1994 to 1997 to 1.2% per thousand in 1997 to 2000, remaining high (1.1%) in 2000 to 2003. In roadside areas, incidence fell in the last interval, especially among women, but in remote rural areas, incidence rose slightly. HIV spread is continuing in rural areas, suggesting a need for more intensive HIV prevention efforts and antiretroviral interventions. The leveling off in prevalence is attributable to a combination of high mortality among HIV-infected persons and a slight decrease in incidence in roadside villages.

Risk factors for herpes simplex virus type 2 and HIV among women at high risk in northwestern Tanzania: Preparing for an HSV-2 intervention trial
(Abstract; subscription needed for full text; Sub-Saharan Africa)
JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2007 Dec;46(5):631-642.
Watson-Jones D | Weiss HA | Rusizoka M | Baisley K | Mugeye K
The objectives were to determine prevalence of and risk factors for herpes simplex virus type 2 (HSV-2) and HIV among women being screened for a randomized, controlled trial of HSV suppressive therapy in northwestern Tanzania. Two thousand seven hundred nineteen female facility workers aged 16 to 35 were interviewed and underwent serological testing for HIV and HSV-2. Factors associated with HSV-2 and HIV in women aged 16 to 24 were examined using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). HSV-2 seroprevalence was 80%, and HIV seroprevalence was 30%. Among women aged 16 to 24, both infections were significantly and independently associated with older age, being a bar worker, working at a truck stop, and having more lifetime sexual partners. HSV-2 infection was also associated with lower socioeconomic status, increased alcohol intake, younger age at first sex, inconsistent condom use, and vaginal douching. There was a strong association between the 2 infections after adjustment for other factors (OR = 4.22, 95% CI: 2.6 to 6.9). Female facility workers in northwestern Tanzania are vulnerable to HSV-2 and HIV infections. Programs designed to increase safer sexual behavior and reduce alcohol use could be effective in reducing HSV-2 incidence and, in turn, HIV infection. This is a suitable population for an HSV suppressive therapy trial.

MATERNAL AND CHILD HEALTH NEWS

Nigeria: Maternal health - Saraki Bags award
(News Article; Sub-Saharan Africa)
5 Dec 2007
This Day (Lagos)

South Africa: Better drugs to prevent mother-to-child HIV
(News Article; Sub-Saharan Africa)
30 Nov 2007
UN Integrated Regional Information Networks

Burkina Faso: Too many women dying in childbirth
(News Article; Sub-Saharan Africa)
30 Nov 2007
UN Integrated Regional Information Networks

MATERNAL AND CHILD HEALTH RESEARCH

Journey to the motherland: Assessing capacity for the prevention of HIV mother-to-child transmission in South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Home Health Care Management and Practice. 2007 Dec;20(1):50-57.
Rose MA | Schaal MG | Doherty A
Strategies to prevent mother-to-child transmission of HIV have successfully affected pediatric HIV infections in many developed countries, but not as dramatically in developing countries. This article presents the findings and perspectives of a team of public health nurses who visited and assessed capacity of selected antenatal clinics across South Africa to successfully implement and evaluate HIV prevention of maternal-to-child transmission programs conducted for a private nongovernmental organization. Through development and implementation of a needs-assessment tool, the clinics were systematically assessed by observation and interviews. Consistently, three additional areas of concern, other than HIV, were reported by the people interviewed. These concerns were hunger, poverty, and the need for home-based care.

Maternal disease stage and child undernutrition in relation to mortality among children born to HIV-infected women in Tanzania
(Abstract; subscription needed for full text; Sub-Saharan Africa)
JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2007 Dec;46(5):599-606.
Chatterjee A | Bosch RJ | Hunter DJ | Fataki MR | Msamanga GI
The objective was to examine whether maternal HIV disease stage during pregnancy and child malnutrition are associated with child mortality. The design used was a prospective cohort study in Tanzania. Indicators of disease stage were assessed for 939 HIV-infected women during pregnancy and at delivery, and children's anthropometric status was obtained at scheduled monthly clinic visits after delivery. Children were followed up for survival status until 24 months after birth. Advanced maternal HIV disease during pregnancy (CD4 count less than 350 vs. greater than of equal to 350 cells/mm3) was associated with increased risk of child mortality through 24 months of age (hazard ratio [HR] = 1.74, 95% confidence interval [CI]: 1.32 to 2.30). CD4 count less than 350 cells/ mm3 was also associated with an increased risk of death among children who remained HIV-negative during follow-up (HR = 2.00, 95% CI: 1.36 to 2.94). Low maternal hemoglobin concentration and child undernutrition were related to an increased risk of mortality in this cohort of children. Low maternal CD4 cell count during pregnancy is related to increased risk of mortality in children born to HIV-infected women. Care and treatment for HIV disease, including highly active antiretroviral therapy to pregnant women, could improve child survival. Prevention and treatment of undernutrition in children remain critical interventions in settings with high HIV prevalence.

Prevalence of anemia and deficiency of iron, folic acid, and zinc in children under 2 years of age and beneficiaries of the Mexican Social Security Institute
(Abstract; subscription needed for full text; North America)
BMC Public Health. 2007 Nov 30;7:345.
Duque X | Flores S | Flores-Huerta S | Mendez-Ramirez I | Munoz S
In Mexico, as in other developing countries, micronutrient deficiencies are common in infants between 6 and 24 months of age and are an important public health problem. The objective of this study was to determine the prevalence of anemia and of iron, folic acid, and zinc deficiencies in Mexican children under 2 years of age who use the health care services provided by the Mexican Institute for Social Security (IMSS). A nationwide survey was conducted with a representative sample of children younger than 2 years of age, beneficiaries, and users of health care services provided by IMSS through its regular regimen (located in urban populations) and its Oportunidades program (services offered in rural areas). A subsample of 4,955 clinically healthy children was studied to determine their micronutrient status. A venous blood sample was drawn to determine hemoglobin, serum ferritin, percent of transferrin saturation, zinc, and folic acid. Descriptive statistics include point estimates and 95% confidence intervals for the sample and projections for the larger population from which the sample was drawn. Twenty percent of children younger than 2 years of age had anemia, and 27.8% (rural) to 32.6% (urban) had iron deficiency; more than 50% of anemia was not associated with low ferritin concentrations. Iron stores were more depleted as age increased. Low serum zinc and folic acid deficiencies were 28% and 10%, respectively, in the urban areas, and 13% and 8%, respectively, in rural areas. The prevalence of simultaneous iron and zinc deficiencies was 9.2% and 2.7% in urban and rural areas. Children with anemia have higher percentages of folic acid deficiency than children with normal iron status. Iron and zinc deficiencies constitute the principal micronutrient deficiencies in Mexican children younger than 2 years old who use the health care services provided by IMSS. Anemia not associated with low ferritin values was more prevalent than iron-deficiency anemia. The presence of micronutrient deficiencies at this early age calls for effective preventive public nutrition programs to address them.

POPULATION/FERTILITY/DEMOGRAPHY NEWS

China population to reach 1.5 billion by 2033
(News Article; Asia)
4 Dec 2007
Reuters

Sindh population growing fast
(News Article; Asia)
4 Dec 2007
Daily Times

Beijing population exceeds 17.4 million
(News Article; Asia)
4 Dec 2007
Xi Y, Xinhua General News Service

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

Ecology of increasing diseases: Population growth and environmental degradation
(Abstract; subscription needed for full text; Global)
Human Ecology. 2007 Dec;35(6):653-668.
Pimentel D | Cooperstein S | Randell H | Filiberto D | Sorrentino S
The World Health Organization (WHO) and other organizations report that the prevalence of human diseases during the past decade is rapidly increasing. Population growth and the pollution of water, air, and soil are contributing to the increasing number of human diseases worldwide. Currently an estimated 40% of world deaths are due to environmental degradation. The ecology of increasing diseases has complex factors of environmental degradation, population growth, and the current malnutrition of about 3.7 billion people in the world.

The implications of long term community involvement for the production and circulation of population knowledge
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Demographic Research. 2007 Nov 27;17(13):369-388.
Madhavan S | Collinson M | Townsend NW | Kahn K | Tollman SM
Demographic surveillance systems (DSS) depend on community acceptance and involvement to produce high quality longitudinal data. Ensuring community support also exposes power relations usually concealed in the research process. We discuss the Agincourt Health and Demographic Surveillance System in South Africa to argue that: 1) long-term presence and community involvement contribute to high response rates and data quality, 2) to maintain community support the project must demonstrate its usefulness, 3) reporting to community members provides valuable checks on the local relevance and comprehension of questions, and 4) community opinion can modify both wording and content of research questions.

Generations and Gender Survey (GGS): Towards a better understanding of relationships and processes in the life course
(Abstract; subscription needed for full text; Global)
Demographic Research. 2007 Nov 30;17(14):389-440.
Vikat A | Speder Z | Beets G | Billari FC | Buhler C
The Generations and Gender Survey (GGS) is one of the two pillars of the Generations and Gender Programme designed to improve understanding of demographic and social development and of the factors that influence these developments. This article describes how the theoretical perspectives applied in the survey, the survey design and the questionnaire are related to this objective. The key features of the survey include panel design, multidisciplinarity, comparability, context-sensitivity, inter-generational and gender relationships. The survey applies the life course approach, focussing on the processes of childbearing, partnership dynamics, home leaving, and retiring. The selection of topics for data collection mainly follows the criterion of theoretically grounded relevance to explaining one or more of the mentioned processes. A large portion of the survey deals with economic aspects of life, such as economic activity, income, and economic well-being; a comparably large section is devoted to values and attitudes. Other domains covered by the survey include gender relationships, household composition and housing, residential mobility, social networks and private transfers, education, health, and public transfers. The third chapter of the article describes the motivations for their inclusion. The GGS questionnaire is designed for a face-to-face interview. It includes the core that each participating country needs to implement in full, and four optional submodules on nationality and ethnicity, on previous partners, on intentions of breaking up, and on housing, respectively. The participating countries are encouraged to include also the optional sub-modules to facilitate comparative research on these topics.

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Volume 7, Number 4710 December 2007