Obesity in a rural and an urban Palestinian West Bank population

OBJECTIVE: To compare the prevalence of obesity, household food consumption patterns, physical activity patterns and smoking between a rural and an urban community in the Palestinian West Bank and to describe the associations of the latter factors with body mass index (BMI). DESIGN: A population-based cross-sectional survey in a rural and an urban Palestinian West Bank community. SUBJECTS: A total of 549 women and 387 men aged 30-65 y, excluding pregnant women. MEASUREMENTS: Obesity was defined as BMI >/=30 kg/m(2). RESULTS: The prevalence of obesity was 36.8 and 18.1% in rural women and men, respectively, compared with 49.1 and 30.6% in urban women and men, respectively. The mean difference (s.e) in BMI levels was 1.6 (0.52) kg/m(2) between urban and rural women and 0.9 (0.46) kg/m(2) in men. At the household level, the mean energy consumption from 25 selected food items was 13.8 MJ (3310 kcal)/consumption unit/day in the rural community compared to 14.5 MJ (3474 kcal)/consumption unit/day in the urban community (P=0.021). BMI was positively associated with age in both men and women and with urban residence in women. BMI was negatively associated with smoking and physical activity in men and with educational level in women. CONCLUSION: BMI was associated with urban residence in women after adjusting for age, smoking, education, physical activity and nutrition-related variables, suggesting that the differences in the conventional determinants of obesity could not fully explain the difference in the prevalence of obesity between the two communities. Among men, the measured determinants explained the rural-urban differences in BMI.     

Risky drinking and alcohol use patterns in a national sample of women of childbearing age

AIMS: We examined risky drinking and alcohol use patterns associated with prenatal effects of alcohol exposure in women of childbearing age, using various definitions of low-risk drinking. DESIGN: Computer-assisted telephone interview (CATI) methodology was used to gather information in a cross-sectional survey on alcohol use and problems, pregnancy and likelihood of future pregnancy. SETTING: Participants were respondents in the 2000 National Alcohol Survey (NAS, N10, response rate 58%) which includes men and women from all 50 states of the United States and the District of Columbia. PARTICIPANTS: A total of 1504 women aged 18-39 years were included; 72 were pregnant, 511 were currently not pregnant but reported being likely to be pregnant in the next 5 years, and 921 women were neither pregnant nor likely to be in the next 5 years. MEASUREMENTS: Various alcohol use patterns in the past 12 months including average volume, amount per session, drinking with food and time spent drinking were assessed. FINDINGS: Seven per cent of childbearing age women exceeded guidelines used to classify women as risky drinkers in the past month. Thirty per cent were classified as risky drinkers when these guidelines were extended to past-year drinking. Examination of specific alcohol use patterns revealed that while under 10% of risky drinkers reported past-month heavy episodic drinking, 30% or more reported heavy episodic drinking and exceeding daily limits for alcohol consumption in the past year. CONCLUSIONS: Public health professionals should note that past-year drinking in a significant proportion of women of childbearing age exceeds guidelines for alcohol use. When targeting such prevention efforts, they should thus include assessment of past-year alcohol use patterns.     

Rubella antibody among Thai women of childbearing age.

Result of rubella haemagglutination inhibition antibody test on 300 Thai women of childbearing age in upper socioeconomic group showed that 25% were susceptible to rubella. The high frequency of susceptibility in this group of women would be of considerable public health problem, should rubella become epidemic again. The introduction of immunization against rubella in this group of women was also discussed.     

HIV-1 seroprevalence among childbearing women in northern Thailand: monitoring a rapidly evolving epidemic

OBJECTIVES: To describe trends in prevalence of HIV-1 infection among women giving birth at Chiang Rai Hospital (CRH) and to assess risk factors associated with HIV infection in this population. DESIGN: Analysis of hospital registry data for all deliveries at CRH from 1990 to mid-1997. METHODS: From 1990 to mid-1997, women giving birth at CRH were tested for HIV-1 infection using enzyme immunoassay (EIA); positive sera were confirmed using a different manufacturer's EIA. Demographic and clinical data were abstracted from delivery-ward log books. RESULTS: Data from 40723 deliveries indicated that overall HIV-1 seroprevalence increased sharply, from 1.3% in 1990 to a peak of 6.4% in 1994, and then declined to 4.6% in the first 6 months of 1997. Prevalence was highest, at 7.0%, among young (age < or = 24 years) primigravidas, compared with 2.4% among older (age > or = 25 years) multigravidas. When we controlled for age, prevalence declined 40% from 1994 to 1997 among young primigravidas (95% confidence interval for percentage reduction, 16-57). Amongst older multigravid women, prevalence was consistently lower but increased steadily from 2.7% in 1994 to 3.4% in 1997. CONCLUSIONS: A rapid rise in HIV prevalence in childbearing women was followed by a sharp decline among young primigravidas. In each year, the prevalence was highest among young primigravidas. They may be the best subgroup of pregnant women for monitoring HIV epidemic trends, but they also represent a challenging prevention priority that will require its own targeted interventions.     

Incidence of venous thromboembolic disease in nonpregnant women of childbearing age.

Data from 12 Cincinnati hospitals were examined to determine the incidence of venous thromboembolic disease in nonpregnant women of reproductive age. The incidence of superficial and deep vein thromboembolic disease in women age 15 to 44 was 1.09 cases per 1,000 women per year; for women age 20 to 44 the incidence was 1.3 cases for 1,000 women per year. These figures include idiopathic and non-idiopathic cases and thus are representative of the general population of nonpregnant women of reproductive age. The incidence of pulmonary embolism was approximately 1 case per 5,000 women age 20 to 44. There were two deaths from pulmonary embolism, giving a mortality rate of 11.3 deaths per million women age 15 to 44.     

Tetanus immunization status among women of childbearing age in Turkey

In order to assess the effect of the neonatal tetanus elimination program in Turkey, tetanus antibody prevalence among women of childbearing age from three selected provinces was evaluated in relation to vaccination doses of the single-type tetanus vaccine. A combined method of in-house enzyme-linked immunosorbent assay and particle agglutination test was used to determine tetanus antibody titers. Among 205 women aged 20-39 years, the tetanus antibody level was higher in women with 1-3 children than those without children. The geometric mean of the log antibody titer was increased proportionally with a slope of 0.405 +/- 0.174 per dose between 0 and 3 doses (P > 0.05). However, the proportion of 20-39-year-old women with the protective antibody in the provinces ranged from 54.8 to 86.6%. Diyarbakir had the lowest immunity with a larger number of children in the household, and a lower educational level. The results of our serological study demonstrated that the neonatal tetanus elimination program in Turkey is effectively promoting immunity against tetanus in pregnant women. However, the study also revealed that the tetanus immunity among women of childbearing age was still insufficient. Intensive implementation of the supplemental immunization activities and encouraging vaccinations through neonatal care services will improve the situation.     

Lead in breastmilk samples from women living in the West Bank: a cross-sectional study

Background

Breastmilk is the recommended form of enteral nutrition for all infants. Infants nourishing on breastmilk contaminated with lead are at high risk of exposure to this neurotoxic heavy metal. The aim of this study was to screen lead concentrations in samples of breastmilk obtained from women living in three main regions of the West Bank and to investigate the sociodemographic characteristics associated with high lead concentrations.

Changes in the distribution of rubella antibodies in women of childbearing age during the first eight years of a rubella vaccination programme

During eight years of rubella vaccination in the Leeds region 149,711 serum samples from women of childbearing age were tested for rubella haemagglutination inhibiting antibodies. In 1971-2 11·3 per cent of these women were sero-negative, and a further 5·9 per cent had low antibody titres of 1:8 or 1:16. By 1978 7·7 per cent were sero-negative and 4·2 per cent had low antibody titres. In the 15–19-year age group the decrease in seronegative patients was greater, and fell from 14·3 per cent to 4·8 per cent. Rubella was serologically confirmed in 135 women at various stages of pregnancy. These pregnancies resulted in 66 terminations, eight spontaneous abortions, and 61 live births; a clinical diagnosis of congenital rubella was made in only one child. These results indicate only moderate success in the vaccination programme during the first eight years, and further efforts are necessary to increase the immune status of the childbearing population.     

育龄期慢性乙型肝炎女性患者的抗病毒治疗

本文介绍了近年来育龄期慢性乙型肝炎女性患者抗病毒治疗的一些研究结果,分析了育龄期女性干扰素的应用、核苷(酸)类药物在妊娠患者中应用的临床依据以及核苷(酸)类药物在阻断乙型肝炎病毒母婴传播中的意义及母乳喂养问题,指出对于育龄期未怀孕患者来说首选干扰素治疗,同时对于妊娠的患者来说,选择相对安全的核苷(酸)类药物抗病毒治疗可...     

Screening women of childbearing age for human immunodeficiency virus. A cost-benefit analysis.

In light of the increasing problem of perinatal human immunodeficiency virus (HIV) transmission, the issue of screening women for HIV is receiving considerable attention. We analyzed the costs and benefits of screening women of childbearing age for HIV. The analysis was based on a dynamic model of the HIV epidemic that incorporated disease transmission and progression, behavioral changes, and effects of screening and counseling. We found that the primary benefit of screening programs targeted to women of childbearing age lies not in the prevention of HIV infection in their newborns but in the prevention of infection in their adult contacts. Because of this benefit, screening medium- and high-risk women is likely to be cost-beneficial over a wide range of assumptions about program cost and behavioral changes in response to screening.     

The use of disease modifying antirheumatic drugs in women with rheumatoid arthritis of childbearing age: a survey of practice patterns and pregnancy outcomes

OBJECTIVE: To describe the practices of rheumatologists when prescribing the disease modifying antirheumatic drugs (DMARD) methotrexate (MTX), leflunomide (LF), etanercept (ET), and infliximab (IN) to women of childbearing age with rheumatoid arthritis (RA) and the pregnancy outcomes of patients who become pregnant while taking these medications. METHODS: A questionnaire was mailed to 600 members of the American College of Rheumatology inquiring about their perception of fetal risk, their recommendations regarding the use of birth control in women of childbearing age taking DMARD, and the pregnancy outcomes of women with DMARD exposure. RESULTS: One hundred seventy-five rheumatologists (29%) returned completed surveys. Respondents were more likely to agree that pregnancy is contraindicated in women taking MTX (95%) or LF (92.7%) than for women taking ET (38.6%) or IN (46.5%). Accordingly, most required birth control for women taking MTX (95.7%) and LF (97.3%), and fewer for women taking ET (75.4%) or IN (73.4%). A total of 65 pregnancies exposed to these DMARD were reported (MTX 38, LF 10, ET 14, IN 2, MTX and ET 1). Only 3 congenital malformations, all in the MTX group, were reported among the 52 pregnancies with known outcomes. CONCLUSION: Rheumatologists agree that there is a risk of teratogenicity with MTX and LF and usually require the use of reliable methods of birth control in women taking these medications. There is no consensus about ET and IN; however, physicians still tend to discuss reliable birth control methods with their female patients. We have confirmed there is a risk of congenital malformations with in utero exposure to MTX. No malformations were reported in infants exposed to LF, ET, or IN, but the number of reported pregnancy outcomes was small.     

High seroprevalence of antibodies to varicella zoster virus in adult women in a tropical climate

OBJECTIVES: To determine whether the seroprevalence of antibodies to varicella zoster virus (VZV) in adults is similar to that reported in tropical populations elsewhere. METHODS: We measured the seroprevalence of VZV IgG antibodies, using an enzyme immunoassay (EIA) in women attending an antenatal clinic in an urban centre in tropical Australia. RESULTS: The overall seroprevalence of VZV antibodies in 298 women was 92% (95% CI 88-95), with no difference between women who spent their childhoods in the tropics and colleagues. None of the overseas-born women was seronegative. CONCLUSION: The seroprevalence of VZV antibodies in this tropical population in Australia is as high as that reported from temperate regions, suggesting that social and cultural factors and population mobility are more important determinants of age distribution of VZV immunity than tropical climate.     

Tetanus antitoxin titers in women of childbearing age from nine diverse populations

The proportion of women with tetanus antitoxin titers adequate to provide protection for themselves and for their newborn infants varied from 96% in New Haven, Connecticut to 19% in Santiago, Chile. Women of childbearing age in five of the nine areas (S?o Paulo, Recife, and P?rto Alegre, Brazil; Ecuador; and Gazankulu, South Africa) had an average of 40% immunity to tetanus and did not differ significantly from one another. By comparison with Chile, where vaccination during pregnancy is not current policy, we estimate that 21%-34% of the women in these five areas had received toxoid recently. In general about half the women with inadequate titer had undetectable levels of antibody and may require more than one dose of vaccine to attain immunity.     

育龄女性社区获得性生殖道支原体感染及耐药分析

目的 了解本地区育龄女性社区获得性生殖道支原体感染及耐药情况,为临床诊治提供依据。方法 2016年11月至2017年10月,采集门诊育龄女性患者生殖道分泌物标本共2 836份进行支原体培养、鉴定及药敏操作。育龄女性按每10岁年龄段进行分组并计算分析结果。结果 育龄女性社区获得性生殖道支原体感染以Uu单纯感染为主(430/574,74.9%),其次为Mh单纯感染(83/574,14.5%),同时感染Uu+Mh(61/574,10.6%),不同年龄段以25~34岁为感染检出的数量最多。单纯Uu感染时仅对氟喹诺酮类药物的耐药率大于10%,其余抗生素耐药率较低(<10%);单纯Mh感染时,仅对氟喹诺酮类药物的耐药率大于50%;混合感染Uu+Mh时耐药性明显高于单纯感染。结论 育龄女性社区获得性生殖道支原体感染以25~34岁居多,Uu感染为主,其次为Mh感染,除氟喹诺酮类药物外,其余抗生素均较为敏感。     

Dietary habits,energy drink consumption,obesity, and physical activity in marginalised Palestinian schools in the West Bank: a cross-sectional study

Background

Socioeconomic factors have been found to be related to adolescents' dietary habits, physical activity, and body mass index (BMI). 50 schools in the West Bank that face socioeconomic and political challenges in terms of infrastructure, academic achievement, dropout rate, limited access, geography, and economic status were labelled as marginalised by the AMIDEAST School Support Program (SPP). This study aimed to describe and assess factors relating to dietary habits, energy drink consumption, BMI index, and physical activity in Palestinian adolescents attending marginalised schools.