How well do antenatal clinic (ANC) attendees represent the general population? A comparison of HIV prevalence from ANC sentinel surveillance sites with a population-based survey of women aged 15-49 in Cambodia

BACKGROUND: The purpose of this study was to evaluate whether HIV-1 prevalence among antenatal clinic (ANC) attendees in Cambodia provided a reasonable estimate of HIV-1 prevalence among all women 15-49 years. METHODS Antenatal clinic attendees in five HIV sentinel surveillance sites (five provinces) were selected by consecutive sampling (n = 1695). The population survey of females by household was carried out in the same five areas. Household females aged 15-49 years were selected using a three-stage cluster sampling design (n = 3066). Serum-based HIV ELISA testing was done for both ANC attendees and household females. The HIV prevalence for ANC attendees and household females were compared by age group and urban versus rural location. RESULTS: The overall prevalence of HIV-1 infection among ANC attendees (1.62%, 95% CI : 1.26-1.98) was similar to the overall prevalence obtained from the general population of household females (1.24%, 95% CI : 0.92-1.55) in the same catchment areas in Cambodia. In the rural areas, the overall HIV prevalence among ANC attendees (2.18%, 95% CI : 1.59-2.77) was significantly higher than among the household females (0.86%, 95% CI : 0.49-1.23) after adjustment for age distribution and education level. In the 15-24 age group in rural areas, the HIV prevalence of ANC women was 2.71% (95% CI : 0.96-4.46) compared with 0.77% (95% CI : 0.02-1.53) in household females. CONCLUSIONS: Although ANC data can be used to estimate trends over time, it should be realized that ANC data may overestimate the actual prevalence in the younger age group in rural areas in Cambodia.     

Genital chlamydial infection among male attendees at a sexually transmitted disease clinic in urban Taiwan

OBJECTIVE: The aim of this study was to examine the epidemiology of genital Chlamydia trachomatis infection among male patients attending a sexually transmitted disease (STD) clinic in urban Taiwan. METHODS: From July 2003 to June 2004, all male attendees at an STD clinic were invited to participate in this study. Attendees provided a first-void urine sample for examination for C. trachomatis using polymerase chain reaction (PCR) assay. RESULTS: A total of 390 patients provided first-void urine specimens for testing for C. trachomatis. The overall prevalence of C. trachomatis was 17.7% (95% CI 16.3-19.1%). The age-specific prevalence was higher among patients aged under 20 years and lowest among those aged over 30 years. Approximately 40% of the infections were asymptomatic or subclinical. Younger age (aged 相似文献   

Seroprevalence and risk factors for hepatitis A among Montreal street youth

OBJECTIVE: To estimate the prevalence of hepatitis A virus (HAV) antibodies among Montreal street youth. METHOD: Anti-HAV antibody testing was performed on blood samples from a hepatitis B and C study conducted among street youth in 1995-96. RESULTS: Among the 427 youth aged 14 to 25 years, prevalence of HAV antibodies was 4.7% (95% confidence interval [CI]: 2.9%-7.2%). A multivariate logistic regression analysis showed that birth in a country with a high anti-HAV prevalence (Adjusted odds ratio [AOR]: 200.7; 95% CI: 38.1-1058.4), having had sexual partner(s) with history of unspecified hepatitis (AOR: 13.8; 95% CI: 4.2-45.2), and insertive anal penetration (AOR: 5.1; 95% CI: 1.6-16.7) were independently associated with infection. CONCLUSION: Based on the relatively low HAV prevalence, the high prevalence of risk factors for infection, and the substantial hepatitis B and C prevalence, vaccination against hepatitis A is now actively promoted among Montreal street youth.     

Risk factors for preterm, low birth weight and small for gestational age birth in urban Aboriginal and Torres Strait Islander women in Townsville

OBJECTIVES: To assess the characteristics of Indigenous births and to examine the risk factors for preterm (<37 weeks), low birth weight (<2,500 g) and small for gestational age (SGA) births in a remote urban setting. DESIGN: Prospective cohort of singleton births to women attending Townsville Aboriginal and Islander Health Services (TAIHS) for shared antenatal care between 1 January 2000 and 31 December 2003. MAIN OUTCOME MEASURES: Demographic, obstetric, and antenatal care characteristics are described. Risk factors for preterm birth, low birth weight and SGA births are assessed. RESULTS: The mean age of the mothers was 25.0 years (95% CI 24.5-25.5), 15.8% reported hazardous or harmful alcohol use, 15.1% domestic violence, 30% had an inter-pregnancy interval of less than 12 months and 9.2% an unwanted pregnancy. The prevalence of infection was 50.2%. Predictors of preterm birth were a previous preterm birth, low body mass index (BMI) and inadequate antenatal care, with the subgroup at greatest risk of preterm birth being women with a previous preterm birth and infection in the current pregnancy. Predictors of a low birth weight birth were a previous stillbirth, low BMI and an interaction of urine infection and non-Townsville residence; predictors of an SGA birth were tobacco use, pregnancy-induced hypertension and interaction of urine infection and harmful alcohol use. CONCLUSION: The prevalence of demographic and clinical risk factors is high in this group of urban Indigenous women. Strategies addressing potentially modifiable risk factors should be an important focus of antenatal care delivery to Indigenous women and may represent an opportunity to improve perinatal outcome in Indigenous communities in Australia.     

Occurrence of Conotruncal Heart Birth Defects in Texas: A Comparison of Urban/Rural Classifications

Purpose: (1) Determine if there is an association between 3 conotruncal heart birth defects and urban/rural residence of mother. (2) Compare results using different methods of measuring urban/rural status. Methods: Data were taken from the Texas Birth Defects Registry, 1999-2003. Poisson regression was used to compare crude and adjusted birth prevalence. Findings: Based on residences of births in Texas, the values for urban influence code (UIC), rural urban continuum code (RUCC), and rural urban commuting area (RUCA) were highly correlated with each other and, less highly, to percentage of land in crops. For tetralogy of Fallot, the most rural category consistently showed the highest prevalence ratio for all measures. The adjusted prevalence ratio for highest percentage cropland was 1.73 [95% CI, 1.14-2.51] using natural breaks and 1.42 [95% CI, 1.07-1.86] using quartiles. The trend with cropland percentage was significant (P < .03), whether crude or adjusted. The crude trend was also significant using RUCC. Neither truncus arteriosus nor transposition of the great arteries exhibited consistent associations with urban or rural residence. Conclusions: The urban/rural measures were generally correlated with each other; as a broad measure, RUCA has advantages for many health studies. Tetralogy of Fallot was most prevalent in rural areas; that pattern was strongest using percentage of land in crops.     

A National Study of Obesity Prevalence and Trends by Type of Rural County

CONTEXT: Obesity is epidemic in the United States, but information on this trend by type of rural locale is limited. PURPOSE: To estimate the prevalence of and recent trends in obesity among US adults residing in rural locations. METHODS: Analysis of data from the Behavioral Risk Factor Surveillance System (BRFSS) for the years 1994-1996 (n = 342,055) and 2000-2001 (n = 385,384). The main outcome measure was obesity (body mass index [BMI] > or = 30), as determined by calculating BMI from respondents' self-reported height and weight. RESULTS: In 2000-2001, the prevalence of obesity was 23.0% (95% confidence interval [CI] 22.6%-23.4%) for rural adults and 20.5% (95% CI 20.2%-20.7%) for their urban counterparts, representing increases of 4.8% (95% CI 4.2%-5.3%) and 5.5% (95% CI 5.1%-5.9%), respectively, since 1994-1996. The highest obesity prevalence occurred in rural counties in Louisiana, Mississippi, and Texas; obesity prevalence increased for rural residents in all states but Florida over the study period. African Americans had the highest obesity prevalence of any group, up to 31.4% (95% CI 29.1%-33.6) in rural counties adjacent to urban counties. The largest difference in obesity prevalence between those with a college education compared with those without a high school diploma occurred in urban areas (18.4% [95% CI 17.9%-18.9%] vs 23.5% [95% CI 22.5%-24.5%], respectively); the smallest difference occurred in small, remote rural counties (20.3% [95% CI 18.7%-21.9%] versus 22.3% [95% CI 20.7%-24.0%], respectively). CONCLUSIONS: The prevalence of obesity is higher in rural counties than in urban counties; obesity affects some residents of rural counties disproportionately.     

Perceived risk of HIV infection among deported male injection drug users in Tijuana,Mexico

Deported injection drug users (IDUs) in Mexico may be vulnerable to HIV infection following expulsion from the USA. We examined factors associated with HIV risk perception among a sample of deportees in Tijuana. From January to April 2010, 313 male IDUs who reported ever being deported from the USA completed a questionnaire. Overall, 35% (N = 110) of deportees perceived HIV risk. In multivariate logistic regression analyses, factors independently associated with HIV risk perception included ever having a steady female partner in Tijuana post-deportation (adjusted odds ratio [AOR]: 2.26; 95% confidence interval [CI]: 1.01–5.07) and years spent in a US prison (AOR: 1.29 per year; 95% CI: 1.13–1.48). Conversely, years of drug injection use (AOR: 0.95 per year; 95% CI: 0.91–0.99), ever witnessing family members use drugs prior to first migration trip (AOR: 0.24; 95% CI: 0.09–0.65), years of residence in the USA (AOR: 0.91 per year; 95% CI: 0.84–0.98) and being a Tijuana native (AOR: 0.40; 95% CI: 0.16–0.99) were negatively associated with HIV risk perception. US–Mexico border cities that receive deported migrants should target HIV prevention interventions to specific subgroups, including drug-using male deportees. Interventions should consider migrant's time in the USA, the role of their social networks, and reducing missed opportunities for HIV testing/education.     

Risk factors for malaria in pregnancy in an urban and peri-urban population in western Kenya

To assess risk factors for malaria in pregnancy in Kisumu, western Kenya, we studied healthy women with an uncomplicated pregnancy of > or = 32 weeks attending the antenatal clinic in the Provincial Hospital. Between June 1996 and March 1999, malaria and human immunodeficiency virus (HIV) infection were examined in 5093 pregnant women: 20.1% of the women were parasitaemic and 24.9% were HIV-seropositive. 2502 women delivered in the hospital and a smear was obtained: the prevalence of placental malaria, maternal peripheral parasitaemia, and HIV infection was respectively 19.0%, 15.2% and 24.5%. HIV infection (risk ratio [RR] 1.58, 95% confidence interval [95% CI] 1.32-1.89), young age (< 21 years: RR 1.51, 95% CI 1.19-1.91), being a primigravidae (RR 1.41, 95% CI 1.05-1.88), a peri-urban residence (RR 1.50, 95% CI 1.21-1.88), and Luo ethnicity (RR 1.74, 95% CI 1.35-2.24) were risk factors for malaria at delivery. Use of sulfadoxine-pyrimethamine (SP), reported by 2.1% of the women, was a protective factor (RR 0.44, 95% CI 0.18-1.06). Results were similar in the third trimester. In this urban/peri-urban setting, preventing HIV infection, delaying the first pregnancy until after adolescence, and applying an effective antimalarial strategy such as intermittent therapy with SP will reduce the prevalence of malaria in pregnancy.     

Intimate partner violence: prevalence and perceptions of married men in Ibadan, Nigeria

In sub-Saharan Africa rates of intimate partner violence (IPV) are high. Thus, identifying reasons for abuse is crucial in ensuring women's health. Hence, mens perception of IPV was assessed, and prevalence of abuse determined. Survey of 820 married men from six urban communities in Ibadan was done using interviewer administered questionnaire. Four focus group discussions were conducted. Lifetime prevalence of perpetration of physical abuse was 25.1%, while psychological violence was 44.4%. Two hundred and forty (29.3%) had ever perpetrated sexual violence and 23.2% economic violence. At least one of these forms of violence had been perpetrated by 44.1% of the respondents. "Being rude" (66.4%) and "insufficient care of the children" (54.3%) were common justifications for IPV. Motive of the abuse were "to make partner responsible" (60.3%) and "to obtain respect" (59.9%). Predictors of perpetrating violence were being in polygamous unions (OR 1.83, 95% CI: 1.11-3.03), consuming alcohol (AOR 1.67; 95% CI: 1.10-2.53), and being Moslem (AOR = 1.87, 95% CI: 1.21-2.910). Men with inadequate knowledge and negative attitudes had greater likelihood of perpetrating IPV (AOR = 2.11, 95% CI: 1.37-3.26 and AOR = 2.09, 95% CI: 1.33-3.27). IPV was also associated with young age. Premarital counseling on how to resolve conflict without resulting to violence and early education of boys on violence to women is recommended.     

Intimate Partner Violence in Southwestern Nigeria: Are There Rural-Urban Differences?

The researchers in this study assessed the prevalence of different types and experience of intimate partner violence among 600 women aged 15 to 49 years in selected rural and urban communities in southwestern Nigeria between October and December, 2007. Lifetime prevalence of intimate partner violence was 64% in the rural and 70% in the urban areas. Controlling behavior was the most frequently reported type of intimate partner violence experienced by both groups of women, and sexual violence was reported least. More urban women reported sexual violence and controlling behaviors than rural women (16.4% versus 11.6% and 57.7% versus 42.0%, respectively). More rural women had experienced physical violence (28% versus 14%). More urban women experienced controlling behaviors, while more rural women experienced physical violence. In both locations, history of partners' involvement in physical fights was significantly associated with reporting sexual violence (rural: odds ratio [OR] = 3.9; 95% confidence interval [CI] 1.2–12.3; urban: OR = 8.4; 95% CI 1.4–51.8). History of alcohol consumption by partners was significantly associated with reporting physical violence (rural: OR = 2.3; 95% CI 1.2–4.4; urban: OR = 3.2; 95% CI 1.4–7.2). However, among rural respondents, younger partners were more likely to perpetuate controlling behavior (OR = 5.1; 95% CI 1.7–15.6) and being in a relationship for ≥10 years was related to psychological and physical violence. Among urban respondents, history of partners' involvement in physical fights was associated with controlling behavior (OR = 8.2; 95% CI 1.1–65.4) and physical violence (OR = 4.5; 95% CI 1.2–17.3). These results suggest that intimate partner violence is a frequent experience in women in both communities, although the types of intimate partner violence experienced differed, and multidisciplinary strategies are required to reduce intimate partner violence.     

Perinatal mortality in northern rural Tanzania

The study was conducted to investigate the association between perinatal mortalityand factors relating to nutrition and infections in a rural population in northern Tanzania. A cohort of 3,618 women attending antenatal clinics was registered with background information and the results of antenatal examinations, and followed up after delivery. Stillbirths and neonatal deaths were identified and traced for an interview with the closest relatives. No information on outcome of pregnancy was obtained for seven women, and incomplete information was obtained for 99. The perinatal mortality rate was 27/1,000 births [95% confidence interval (CI) 22/1,000-33/1,000]; 44% were early neonatal deaths; and 56% were stillborn. There was an increased risk of perinatal death among babies with low birth-weight [for babies weighing 2,000-2,499 g, adjusted odds ratio (AOR) 5.8, 95% CI 2.1-15.8, babies below 2,000 g AOR 45.7; 95% CI 18.3-114.1], babies of women with a small arm circumference (below 23 cm, AOR 5.3, 95% CI 1.3-22.2), babies of women with positive VDRL serology (AOR 5.1, 95% CI 1.0-25.7), babies of mothers who had previously lost a baby (AOR 1.9, 95% CI 1.1-3.2), and among babies of nulliparous women (AOR 1.7; 95% CI 1.0-3.0). Infections and nutritional deficiencies should be addressed at antenatal clinics.     

Screening Mammography Utilization in Tennessee Women: The Association With Residence

ABSTRACT:  Context: Approximately 70% of US women over age 40 report mammography screening within 2 years. However, rates are likely to vary by age, income, educational level, and residence. Purpose: To describe the prevalence of screening mammography and associated factors in women living in rural and urban areas of Tennessee. Methods: Using pooled data from the Tennessee Behavioral Risk Factor Surveillance System (BRFSS; 2001 and 2003), utilization of screening mammography within a 2-year period was examined for a sample of 1,922 women, 40 years and older. Demographic, behavior, and health-related variables were used to examine associations with utilization. Findings: The prevalence of screening mammography utilization (71.3% 95% CI 67.4-75.2) in women living in rural areas of Tennessee was significantly lower than utilization among women living in urban areas (78.3% 95% CI 75.9-80.7). Higher utilization was associated with having attained at least a high school education, having health insurance, identifying a personal health care provider, being a nonsmoker, recent use of alcohol, having had a recent clinical breast exam or Papanicolau (Pap) test done, and meeting the Healthy People 2010 (HP 2010) recommendation for physical activity. After controlling for all other factors, rural residence was not associated with utilization. For rural women, identifying a personal health care provider was significantly associated with increased likelihood of utilization. Conclusions: Lower income and lower education, each associated with lower screening utilization, were more common in rural Tennessee women. The significance of a personal health care provider for utilization in rural women is meaningful for service providers.     

HIV-1 and HIV-2 prevalence and associated risk factors among postnatal women in Harare, Zimbabwe

Studies of antenatal women form the predominant source of data on HIV-1 prevalence in Africa. Identifying factors associated with prevalent HIV is important in targeting diagnostic services and care. Between November 1997 and January 2000, 14,110 postnatal women from Harare, Zimbabwe were tested by ELISAs reactive to both HIV-1 and HIV-2; a subset of positive samples was confirmed with assays specific for HIV-1 and HIV-2. Baseline characteristics were elicited and modelled to identify risk factors for prevalent HIV infection. HIV-1 and HIV-2 prevalences were 32.0% (95% CI 31.2-32.8) and 1.3% (95% CI 1.1-1.5), respectively; 4% of HIV-1-positive and 99% of HIV-2-positive women were co-infected. HIV-1 prevalence increased from 0% among 14-year-olds to >45% among women aged 29-31 years, then fell to <20% among those aged>40 years. In multivariate analyses, prevalence increased with parity, was lower in married women than in single women, divorcees and widows, and higher in women with the lowest incomes and those professing no religion. Adjusted HIV-1 prevalence increased during 1998 and decreased during 1999. Age modified the effects of parity, home ownership and parental education. Among older women, prevalence was greater for women who were not homeowners. Among younger women, prevalence increased with parity and low parental education. None of these factors distinguished women co-infected with HIV-2 from those infected with HIV-1 alone. Prevalent HIV-1 infection is associated with financial insecurity and weak psychosocial support. The ZVITAMBO study apparently spanned the peak of the HIV-1 epidemic among reproductive women in Harare.     

Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh

BACKGROUND: Although undernutrition and communicable diseases dominate the current disease burden in resource-poor countries, the prevalence of diet related chronic diseases is increasing. This paper explores current trends of under- and overweight in Bangladeshi women. METHOD: Nationally representative data on reproductive age women from rural Bangladesh (n = 242,433) and selected urban poor areas (n = 39,749) collected by the Nutritional Surveillance Project during 2000-2004 were analyzed. RESULTS: While the prevalence of chronic energy deficiency [CED, body mass index (BMI) < 18.5 kg/m(2)] continues to be major nutritional problem among Bangladeshi women (38.8% rural, 29.7% urban poor; P < 0.001), between 2000-2004, 9.1% of urban poor and 4.1% of rural women were overweight (BMI > or = 25 kg/m(2), P < 0.001). In addition, 9.8% of urban poor and 5.5% of rural women were found to be 'at risk of overweight' (BMI 23.0-<25 kg/m(2)). From 2000 to 2004, prevalence of CED decreased (urban poor: 33.8-29.3%; rural: 42.6-36.6%), while prevalence of overweight increased (urban poor: 6.8-9.1%; rural: 2.8-5.5%). The risk of being overweight was higher among women who were older and of higher socioeconomic status. Rural women with at least 14 years of education had a 8.1-fold increased risk of being overweight compared with non-educated women [95% confidence intervals (CI): 6.6-8.7]. Women living in houses of at least 1000 sq ft (93 m(2)) were 3.7 times more likely to be overweight compared with women living in <250 sq ft (23 m(2)) houses (95% CI: 3.2-4.3). CONCLUSION: The recent increase in overweight prevalence among both urban poor and rural women, along with high prevalence of CED, indicates the emergence of a double burden of malnutrition in Bangladesh.     

Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey

Objective : Mistimed, unexpected or unwanted pregnancies occur in Australia, despite widespread contraception use. The objective was to estimate prevalence and ascertain modifiable social factors for prevention of unintended pregnancy. Methods : National population‐based survey of women and men aged 18–51 years recruited from a random sample of electors on the Australian Electoral Roll in 2013. Data were weighted to reduce non‐response bias. Factors associated with unintended pregnancy were identified in multivariable analyses. Results : Data from 2,235 completed questionnaires were analysed (Women: 69%; Men: 31%). Of those ever pregnant or partner in pregnancy (59%), 40% had experienced an unintended pregnancy. Adjusting for other risks, ever having experienced sexual coercion (AOR, 95%CI=Women 1.948; 1.458–2.601; Men 1.657, 1.014–2.708); socioeconomic disadvantage (AOR, 95%CI=Women 1.808, 1.373, 2.381; Men 1.360, 1.004–1.841), living in a rural area (AOR, 95%CI=Women 1.403, 1.056–1.864; Men 1.583, 1.161–2.159), and for men being born overseas (AOR, 95%CI 1.989, 1.317–3.002) were significantly associated with unintended pregnancy. Conclusions : Experiences of sexual coercion, social disadvantage, rural residence and overseas birth are independently associated with unintended pregnancy in Australia. Implications : Public health policy and health service initiatives should prioritise prevention of sexual coercion, reduction of social inequality and reduction of geographic inequality for those in rural areas.     

Factors associated with complete immunization coverage in children aged 12¿23 months in Ambo Woreda, Central Ethiopia

ABSTRACT: BACKGROUND: Vaccination is a proven tool in preventing and eradicating communicable diseases, but a considerable proportion of childhood morbidity and mortality in Ethiopia is due to vaccine preventable diseases. Immunization coverage in many parts of the country remains low despite the efforts to improve the services. In 2005, only 20% of the children were fully vaccinated and about 1 million children were unvaccinated in 2007. The objective of this study was to assess complete immunization coverage and its associated factors among children aged 12-23 months in Ambo woreda. METHODS: A cross-sectional community-based study was conducted in 8 rural and 2 urban kebeles during January- February, 2011. A modified WHO EPI cluster sampling method was used for sample selection. Data on 536 children aged 12-23 months from 536 representative households were collected using trained nurses. The data collectors assessed the vaccination status of the children based on vaccination cards or mother's verbal reports using a pre-tested structured questionnaire through house-to-house visits. Bivariate and multivariate logistic regression analyses were used to assess factors associated with immunization coverage. RESULTS: About 96% of the mothers heard about vaccination and vaccine preventable diseases and 79.5% knew the benefit of immunization. About 36% of children aged 12-23 months were fully vaccinated by card plus recall, but only 27.7% were fully vaccinated by card alone and 23.7% children were unvaccinated. Using multivariate logistic regression models, factors significantly associated with complete immunization were antenatal care follow-up (adjusted odds ratio(AOR=2.4, 95% CI: 1.2- 4.9), being born in the health facility (AOR=2.1, 95% CI: 1.3-3.4), mothers' knowledge about the age at which vaccination begins (AOR= 2.9, 95% CI: 1.9-4.6) and knowledge about the age at which vaccination completes (AOR=4.3, 95% CI: 2.3-8), whereas area of residence and mother's socio-demographic characteristics were not significantly associated with full immunization among children. CONCLUSION: Complete immunization coverage among children aged 12-23 months remains low. Maternal health care utilization and knowledge of mothers about the age at which child begins and finishes vaccination are the main factors associated with complete immunization coverage. It is necessary that, local interventions should be strengthened to raising awareness of the community on the importance of immunization, antenatal care and institutional delivery.     

Comparative geographic concentrations of 4 sexually transmitted infections

OBJECTIVES: We measured and compared the concentration of primary and secondary syphilis, gonorrhea, chlamydial infection, and genital herpes in a large county with urban, suburban, and rural settings. METHODS: We geocoded sexually transmitted infections reported to King County, Washington health department in 2000-2001 to census tract of residence. We used a model-based approach to measure concentration with Lorenz curves and Gini coefficients. RESULTS: Syphilis exhibited the highest level of concentration (estimated Gini coefficient = 0.68, 95% confidence interval [CI] = 0.64, 0.78), followed by gonorrhea (estimated Gini coefficient=0.57; 95% CI=0.54, 0.60), chlamydial infection (estimated Gini coefficient = 0.45; 95% CI = 0.40, 0.43), and herpes (estimated Gini coefficient=0.26; 95% CI=0.22, 0.29). CONCLUSIONS: Geographically targeted interventions may be most appropriate for syphilis and gonorrhea. For less-concentrated infections, control strategies must reach a wider portion of the population.     

中国内地居民2000-2009年被动吸烟率Meta分析

目的 运用Meta分析综合评价中国内地居民2000-2009年被动吸烟率,并分析其在性别、城/乡及不同经济发展水平地区、场所等因素间的差别.方法 检索万方数据库、维普信息资源系统、中国期刊全文数据库、中国生物医学文献数据库及PubMed数据库,收集所有关于居民吸烟的调查研究,再从中筛选出有关被动吸烟的研究报告.各资料间进行异质性检验,以确定采用固定模型或随机模型进行合并分析,采用秩相关检验法进行发表偏倚的评估.结果 共入选相关文献19篇,累计不吸烟人数为195 349人,被动吸烟人数为70 781人,总被动吸烟率为47.04%(95%CI:38.88%～55.27%).将被动吸烟率按照性别、城/乡、研究年份、研究地区和被动吸烟场所进行分层分析,男、女性被动吸烟率分别为44.80%(95%CI:34.07%～55.79%)和49.09%(95%C:39.62%～58.59%),P＜0.05;城市、农村地区合并的被动吸烟率分别为46.10%(95%CI:28.88%～63.82%)和47.55%(95%CI:17.85%～78.25%),P＜0.05;研究年份在2000-2004年被动吸烟率合并为47.59%(95%CI:38.31%～56.95%),2005-2009年为46.90%(95%CI:33.19%～60.87%),P＜0.05;东、西部地区居民被动吸烟率分别为41.38%(28.88%～54.47%)和74.38%(95%CI:59.08%～87.10%),P＜0.05;家庭、工作场所、公共场所被动吸烟率分别为73.03%(95%CI: 60.41%～84.00%)、14.72%(95%CI:8.83%～21.82%)和25.90%(95%CI:5.65%～54.24%),P＜0.05.结论 合并的被动吸烟率女性高于男性,农村地区高于城市,研究年份为2005-2009年的被动吸烟率低于2000-2004年,西部地区居民被动吸烟率高于东部地区,家庭内被动吸烟率高于工作场所和公共场所.

Abstract：

Objective To analyze the prevalence of passive smoking among inland residents in China from 2000 to 2009 and to analyze the differences between sex, urban/rural geographic distribution, different levels of economic development etc.. Methods Electronic search strategy was carried out, using WanFang database, China Journal Full-text database, VIP database, CBM and PubMed database to collect data on smoking, and passive smoking status, among residents in China.Fixed effects model or random effects model was employed according to statistical tests for homogeneity. Publication bias was assessed by rank correlation test. All statistical analysis was conducted with R 2.8.0. Results Nineteen studies were selected with a total of 195 349 non-smokers and 70 781 passive smokers involved. The overall prevalence of passive smoking was 47.04%(95%CI: 38.88%-55.27%). The prevalence of passive smoking was stratified by factors as sex, urban/rural, year and areas of the study, and areas where passive smoking was studied. The pooled prevalence rates of passive smoking were as follows: 44.80% (95%CI: 34.07%-55.79%) and 49.09%(95%CI:39.62%-58.59%) ,P＜0.05 for male and female;46.10%(95%CI:28.88%-63.82%),47.55%(95% CI: 17.85%-78.25% ), P＜0.05 for urban and rural, respectively. The pooled prevalence rates of passive smoking were 47.59% (95% CI: 38.31%-56.95% ) in the study year of 2000-2004 and 46.90% (95%CI: 33.19%-60.87% ) in 2005-2009 (P＜0.05). The pooled prevalence rates of passive smoking for eastern and western areas were 41.38%(28.88%-54.47%) and 74.38%(95%CI: 59.08% -87.10% ) (P＜0.05), and 73.03% (95%CI: 60.41% - 84.00% ), 14.72% (95%CI: 8.83%-21.82% )and 25.90% (95% CI: 5.65% - 54.24% ) for family, workplace and public place, respectively (P＜0.05). Conclusion The pooled prevalence of passive smoking was higher in females than males, in rural than in urban and in the western area than in the eastern areas. The prevalence of passive smoking in the study year of 2005-2009 was lower than of 2000-2004. The pooled passive smoking rate in the family was higher than in the workplace or in public.     

Prevalence and Risk Factors of Undernutrition among Children Less than 2 Years in Urban Slums of Pune,Maharashtra, India

ABSTRACT

Undernutrition and its risk factors among children aged 0-23 months in urban slums of Pune was studied. Maternal and child characteristics, household food security and anthropometric measurements of 400 children were recorded. Results identified prevalence of stunting to be 34%, wasting 15.3% and underweight 21.8%. Odds of stunting was higher among children 7 to 12 months of age (AOR=7.064, 95% CI: 1.908-26.150). Odds of wasting was higher among children 7 to 12 months (AOR=3.144, 95% CI: 1.631-6.060), age < 6 months (AOR=2.546, 95% CI: 1.259-5.149) and not feeding colostrum (AOR=2.806, 95% CI=1.059 -7.478). Birth weight < 2500gm increased the risk of all three manifests of undernutrition. Children who were not immunised or received partial immunization had 1.5 times greater risk of being underweight (AOR=1.933, 95% CI: 1.118-3.342). Age specific interventions to address specific risk factors is a priority to address this public health issue.     

Decrease in the prevalence of environmental tobacco smoke exposure in the home during the 1990s in families with children

OBJECTIVES: This study explored correlates with and changes in the prevalence of environmental tobacco smoke (ETS) exposure of children in the home. METHODS: We used multiple logistic regression to explore ETS exposures as reported in the 1992 and 2000 National Health Interview Survey. RESULTS: ETS exposure in homes with children declined from 35.6% to 25.1% (P <.001) between 1992 and 2000, whereas smoking prevalence declined 26.5% to 23.3%. Home ETS exposures were more prevalent among non-Hispanic Whites than among African Americans (adjusted odds ratio [AOR] = 0.702; 95% confidence interval [CI] = 0.614, 0.802), Asian Americans (AOR = 0.534; 95% CI = 0.378, 0.754), and Hispanics (AOR = 0.388; 95% CI = 0.294, 0.389). Exposures declined across all groups, with greater gains in higher education and income groups. CONCLUSIONS: Home ETS exposure declined sharply between 1992 and 2000, more than would be predicted by the decline in adult smoking prevalence.