Hypertension, urbanization, social and spatial disparities: a cross-sectional population-based survey in a West African urban environment (Ouagadougou, Burkina Faso)

Data show that hypertension has become a public health problem in developing countries. Many studies have reported social disparities among the affected populations, but few of them pointed out spatial disparities within towns. We aimed to show that hypertension could be a good indicator of the medical change that occurs unequally in towns. A cross-sectional survey was done in April and October 2004 in Ouagadougou, Burkina Faso, among 2087 adults over 35 years old in different kinds of urban areas. Social and demographic data were collected and blood pressure was measured. Prevalence of hypertension was 40.2%. Age, body mass index, level of equipment, absence of community integration, absence of occupation, duration of residence over 20 years, protein-rich diet and absence of physical activity were identified as risk factors, but there were social and spatial disparities according to location of housing (parcelled-out or non-parcelled-out areas) and to integration within the town. The high rate of hypertension found in Ouagadougou and the heterogeneity of the risk within the population highlights that social and spatial risk factors have to be taken into account for the prevention of the non-transmissible diseases in countries in full process of urbanization and medical change.     

The incidence of type 1 diabetes among children in Finland--rural-urban difference

The aim of the study was to investigate the incidence of type 1 diabetes among children aged 14 years or under according to the level of urbanization of the place of residence of children at the time of diagnosis in Finland during 1987 to 1996. The analysis was carried out using a Bayesian approach and GIS. The incidence was the highest in the rural heartland areas while the increase in incidence was sharpest in urban areas. The level of urbanization seems to explain only a part of the spatial variation in the incidence in Finland. It is possible that some environmental risk factors for type 1 diabetes have been more prevalent in rural heartland areas than in the rest of the country. These factors might have increased in urban environments in Finland particularly during the first half of 1990s.     

广东省清远市快速城市化过程中蚊虫群落动态变化规律

目的 研究城市化过程中病媒蚊虫群落特征和演替动态变化,了解主要传播媒介蚊虫种群动态及与城市化的关系.方法 采用人诱法,连续4年在清远市调查蚊虫种群密度.结果 此次调查清远市蚊虫有致倦库蚊、骚扰阿蚊、白纹伊蚊、中华按蚊和三带喙库蚊5种;致倦库蚊为优势蚊种,占群落种群数量的92.27％;其次为骚扰按蚊,占3.98％;白纹伊蚊和三带喙库蚊数量较少,各占1.62％;中华按蚊仅占0.51％.在研究期间,比较2006年与2008、2009年数据,结果表明群落构成发生显著变化,其中致倦库蚊在种群中所占比例逐渐减少,白纹伊蚊所占比例逐渐增加,中华按蚊在种群中逐渐消失,三带喙库蚊在群落中数量波动较大.不同蚊种在夜间呈现不同活动节律,致倦库蚊和三带喙库蚊19:00-22:00其密度逐渐增加,高峰主要在21:00之后;白纹伊蚊在夜晚各个时间段都有活动,活动高峰主要在20:00之前;骚扰阿蚊呈现与白纹伊蚊相似的活动规律.结论 清远市在城市化过程中,登革热媒介白纹伊蚊逐渐增加,而流行性乙型脑炎(乙脑)媒介三带喙库蚊则在不同年份中波动较大;传疟媒介中华按蚊逐渐减少,甚至消失.因此在城市化过程中,需要加强登革热和乙脑媒介的监测和防控.     

Quantifying Urbanization as a Risk Factor for Noncommunicable Disease

The aim of this study was to investigate the poorly understood relationship between the process of urbanization and noncommunicable diseases (NCDs) in Sri Lanka using a multicomponent, quantitative measure of urbanicity. NCD prevalence data were taken from the Sri Lankan Diabetes and Cardiovascular Study, comprising a representative sample of people from seven of the nine provinces in Sri Lanka (n = 4,485/5,000; response rate = 89.7%). We constructed a measure of the urban environment for seven areas using a 7-item scale based on data from study clusters to develop an “urbanicity” scale. The items were population size, population density, and access to markets, transportation, communications/media, economic factors, environment/sanitation, health, education, and housing quality. Linear and logistic regression models were constructed to examine the relationship between urbanicity and chronic disease risk factors. Among men, urbanicity was positively associated with physical inactivity (odds ratio [OR] = 3.22; 2.27–4.57), high body mass index (OR = 2.45; 95% CI, 1.88–3.20) and diabetes mellitus (OR = 2.44; 95% CI, 1.66–3.57). Among women, too, urbanicity was positively associated with physical inactivity (OR = 2.29; 95% CI, 1.64–3.21), high body mass index (OR = 2.92; 95% CI, 2.41–3.55), and diabetes mellitus (OR = 2.10; 95% CI, 1.58 – 2.80). There is a clear relationship between urbanicity and common modifiable risk factors for chronic disease in a representative sample of Sri Lankan adults.     

Intra-urban Differentials in the Utilization of Reproductive Healthcare in India, 1992–2006

This paper examines trends in three reproductive healthcare indicators— namely, antenatal care, medical assistance at delivery, and contraceptive use among the urban poor and non-poor in India using data from the National Family Health Surveys, 1992–1993 and 2005–2006. The urban poor and non-poor are derived from composite wealth indices based on a set of economic proxies. Results indicate that the estimates of poor and non-poor are reliable. During the last 14 years, the service coverage in all three indicators has increased in the country, among both the urban poor and non-poor. However, the utilization of reproductive health services is concentrated among the urban non-poor cutting across the states, with the exception of Kerala. While the non-poor/poor gap in antenatal care and medical assistance at delivery remained large over the years, the gap in contraceptive use has narrowed down cutting across states. After adjusting for other confounders, household poverty was found to be a significant barrier in the utilization of reproductive healthcare services across the states. It has been observed that the utilization of reproductive healthcare services followed a continuum of rural total, urban poor, and urban non-poor.     

Epidemiological aspects of cutaneous leishmaniasis in the Iguazú falls area of Argentina

Over the last three decades the incidence of American cutaneous leishmaniasis (ACL) has increased sharply in Argentina and throughout the world. In the Iguazú Falls area, on the border between Brazil and Paraguay, the incidence of human ACL has risen since 2004. Most of the 36 cases of human ACL reported until 2005 have involved males over 15 years old (75%) infected during deforestation to establish individual farms. Captures carried out in primary forest, periurban areas, and deforested land sites yielded 18,438 sand flies belonging to 13 species; the most prevalent species were Lutzomyia (Nyssomyia) whitmani (87.4%) and Lutzomyia (Mygonemyia.) migonei (7.6%). Cluster analysis was used to group traps according to species and abundance of sand flies. The group of traps located in recently deforested places, in pig and chicken dwellings of houses where ACL cases had been reported in the past, and at one house with an active ACL case, had the highest abundance of Lu. whitmani and Lu. whitmani + Lu. migonei as well as the highest ratio of Lu. whitmani/Lu. migonei. Leishmania sp. infections, both in Lu. whitmani, in Lu. quinquefer, and in smears from human cases were detected by DNA kinetoplast amplification using a generic PCR protocol. The risk of ACL outbreak in the Iguazú Falls area is still associated with economic and leisure activities in primary-secondary forest, including deforestation, rural settlements, fishing, hunting, and ecotourism. In addition, the risk of periurban transmission seems likely, and this is discussed within the framework of surveillance and prevention strategies.     

Residence in urban and rural areas over the life course and depression among Ghanaian and South African older adults

This study assessed associations between depression and urban/rural residence from a life-course perspective within African settings. Data on Ghanaian and South African adults aged 50 years and older were taken from wave 1 of the World Health Organization Study on Global Ageing and Adult Health (SAGE). Neither urbanicity of childhood nor adulthood residence was associated with later-life depression in either country. Significant differences were also not observed for residence changes over the life course, but there were trends in the data suggestive of higher depression prevalence in Ghanaian recent rural-urban migrants and lower prevalence among South African recent urban-rural migrants.     

Association between blood cadmium and vitamin D levels in the Yangtze Plain of China in the context of rapid urbanization

BackgroundChina has experienced rapid urbanization in the past 30 years. We aimed to report blood cadmium level (BCL) in the rapidly urbanized Yangtze Plain of China, and explore the association between BCL and 25-hydroxyvitamin D (25(OH)D).MethodsOur data source was the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) cross-sectional study (ChiCTR-ECS-14005052, www.chictr.org). We enrolled 3234 subjects from 12 villages in the Yangtze Plain. BCLs were measured by atomic absorption spectrometry. 25(OH)D was measured with a chemiluminescence assay.ResultsA total of 2560 (79.2%) subjects were diagnosed with vitamin D deficiency. The median (interquartile range) BCL was 1.80 μg/L (0.60–3.42) for men and 1.40 μg/L (0.52–3.10) for women. In women, mean 25(OH)D concentrations were inversely associated with BCL (0.401, 95% confidence interval: –0.697 to –0.105 nmol/L lower with each doubling of the BCL) after adjustment for age, educational status, current smoking, body mass index, diabetes, and season. However, there was no significant difference in 25(OH)D across the BCL tertiles for men.ConclusionsBCL in Chinese residents in the Yangtze Plain were much higher than that in developed countries. An inverse association between BCL and 25(OH)D was found in general Chinese women after multivariable adjustment. Future prospective cohort and animal studies are warranted to resolve the direction and temporality of these relationships, and to elucidate the exact mechanisms involved.