The impact of an inadequate municipal water system on the residents of Chinhoyi town, Zimbabwe

OBJECTIVE: To assess the use and impact of the water reticulation system in Chinhoyi on its residents. DESIGN: Cross sectional and case series studies. SETTING: Chinhoyi town. SUBJECTS: 600 Chinhoyi residents. MAIN OUTCOME MEASURES: Practices and perceptions of Chinhoyi residents on the water system, and distribution of water-related diseases per area of residence. RESULTS: Out of 600 respondents, 565 (99.3%) had access to piped water and 558 (98.0%) to flush toilets. Breakdowns of water supply and functioning of toilet facility were reported by 308 (77.0%) and 110 (28.0%) respondents in the previous six months, respectively. Main complaints of Chinhoyi residents were about low water quality (36.2%), inadequate sewage system (31.3%) and environmental pollution (26.5%). Cases of water-related diseases were not associated with natural water bodies. CONCLUSIONS: Chinhoyi residents have good access to the municipal water and an adequate sanitation system. However, low quality of the water, frequent system breakdowns and the degradation and loss of amenity of the environment impair their quality of life.     

Risk awareness of HIV/AIDS among commercial farm workers in Zimbabwe

OBJECTIVE: To determine levels of perceived risk of HIV infection and the determinants of these perceptions among commercial farm workers. DESIGN: Cross sectional. SETTING: Commercial farms in Manicaland, Mashonaland Central, Mashonaland West and Mashonaland East provinces of Zimbabwe. SUBJECTS: 406 male and 411 female adults. MAIN OUTCOME MEASURES: Perceived risk of HIV infection. RESULTS: Out of 33 female respondents aged less than 20 years, 19 (57.6%) reported that they had no chance of acquiring the HIV infection. The majority (15) of these 19 teenagers indicated that they had no chance of being HIV infected because they had sex only with their spouses. Of the respondents aged 20 years or more, 235 (64.6%) males and 182 (55.3%) females reported that they had no chance of being HIV infected (OR = 1.47, 95% CI 1.07 to 2.02, p = 0.016). Most males (57.0%) and females (59.9%) of age 20 years or more said that they had no chance of being HIV infected because they had sex with only their spouses. Among the respondents of age 20 years or more who indicated they had a moderate to high chance of being infected or were already infected, 35 (33.3%) of the males reported that they had multiple partners and 41 (40.6%) of the females reported that their spouses had multiple partners. CONCLUSION: In general, despite high seroprevalence rates in Zimbabwe, many individuals do not perceive themselves at risk. Future health education intervention studies should seek to increase the general perception of low risk so that adequate precaution can be taken against being infected.     

Lung function status of some Nigerian men and women chronically exposed to fish drying using burning firewood

OBJECTIVE: To determine the lung function status of some Nigerian men and women chronically exposed to fish drying using burning firewood. DESIGN: Case control study. SETTING: Ibaka, Utaewa and Ikanga fishing settlements. SUBJECTS: 183 males and 192 females engaged in fishing, aged 20 to 45 years who have been exposed for a minimum of five years as cases. The control group comprised sex matched male (142) and female (152) Nigerians from the same area who were not exposed to any known air pollutant. MAIN OUTCOME MEASURES: Lung function indices: FVC, FEV1, FEV1% and PEFR. RESULTS: Lung function indices were significantly lower in men engaged in fishing than in their controls: FVC [mean (SD): 2.98 (0.20) vs 3.52 (0.29), p < 0.001]; FEV1 [2.08 (0.18) vs 2.82 (0.25), p < 0.001]; FEV1% [69.8 (3.1) vs 80.2 (6.7), p < 0.001]; and PEFR [335 (22) vs 592 (99), p < 0.001], respectively. Similarly, lung function indices were lower in females in the fishing industry than in their controls; FVC [2.42 (0.17) vs 3.02 (0.24), p < 0.001]; FEV1 [1.70 (0.19) vs 2.55 (0.21), p < 0.001]; FEV1% [72.9 (3.2) vs 84.4 (6.7), p < 0.001]; and PEFR [298 (22) vs 418 (34), p < 0.001]. All the lung function indices (except FEV1%) of the fishermen and women declined significantly (p < 0.001) with their duration of exposure. The results showed a predominantly mixed pattern (restrictive and obstructive) of respiratory defect. There were higher prevalences of respiratory and other symptoms among the cases than the controls. The respiratory symptoms included cough with sputum, chest pain, dyspnoea catarrh and sneezing and unproductive cough. Other symptoms were eye and skin irritation, internal heat and headache. CONCLUSIONS: Chronic exposure to fish drying using burning firewood can impair lung function and cause respiratory and other symptoms.     

Comparison of self-report and performance-based measures of everyday functioning in individuals with schizophrenia: implications for measure selection

Introduction. Both self-report and performance-based measures are often used in assessment of everyday functioning for individuals with schizophrenia. However, there is little evidence of overlap between them, and there are no established standards for which measures might be most appropriate. In order to better understand differences among these types of measures, we examined relationships between a self-report and two performance-based measures of everyday functioning. We also examined their patterns of interrelationships to neurocognition and psychiatric symptoms.

Methods. Participants were 71 outpatients with schizophrenia spectrum disorder. Measures of everyday functioning (Independent Living Skill Survey-Self Report (ILSS-SR); University of California San Diego Performance-based Skills Assessment; and Medication Management Ability Assessment), cognition and psychiatric symptoms were administered. Correlation analyses were conducted to examine the relationships among the functioning measures, and their relationships to cognition and symptoms. Regression analyses further examined the unique contributions of neurocognitive and symptom variables to functional measures.

Results. Consistent with the literature, the two performance-based measures were related to each other, but not to the self-report measure. Whereas the performance-based measures were related to neurocognition but not to the psychiatric symptoms, the opposite pattern was observed for the self-report measure.

Conclusions. The pattern of interrelationships among these self-report and performance-based measures suggests that they tap different aspects of everyday functioning. This has important implications for measure selection, particularly for evaluating intervention outcomes. When targeting symptoms, a self-report measure like the ILSS-SR may be more appropriate, whereas a performance-based measure may be more sensitive to functional changes subsequent to treatments targeting cognition.     

Correlates of current cigarette smoking among in-school adolescents in the Kurdistan region of Iraq

Background  

Many adult cigarette smokers initiated the habit as adolescents. Adolescent tobacco use may be a marker of other unhealthy behaviours. There are limited data on the prevalence and correlates of cigarette smoking among in-school adolescents in Iraq. We aimed to estimate the prevalence of, and assess the socio-demographic correlates of current cigarette smoking among in-school adolescents in Kurdistan region of Iraq.     

Associations between sexual behaviour change in young people and decline in HIV prevalence in Zambia

Background  

Evidence suggests that HIV prevalence amongst young Zambians has declined recently, especially in higher-education groups. We studied trends in key sexual behaviour indicators among 15–24 year-olds from 1995 to 2003, including the associations between sexual behaviour change and education.     

Minimum incidence of congenital talipes equino-varus (CTEV) and post treatment evaluation of residual deformities in a population in Zimbabwe

OBJECTIVE: To determine the minimum incidence (MI) of congenital talipes equino-varus (CTEV) in children; evaluate the association between CTEV and other congenital anomalies, and to assess the presence of residual deformities after conservative management at the physiotherapy department of Harare Central Hospital (HCH), Zimbabwe. DESIGN: A three year retrospective study. SETTING: Physiotherapy Department, HCH, Harare, Zimbabwe. SUBJECTS: Eighty-two children with CTEV who were assessed and treated at HCH Physiotherapy Department from January 1994 to December 1996. MAIN OUTCOME MEASURE: MI of club foot and degree of correction of the club foot after conservative management of the deformity by the physiotherapist. RESULTS: An MI rate of about 0.9 per 1000 was found over a three year period. It was also found that 30.5% of these children had other associated congenital abnormalities. There was no significant association between gender and severity of deformity (P = 0.326). A significant association between the severity of CTEV and the presence of other associated congenital deformities was found (P = 0.013). 91% of the feet were found to have a satisfactory result of treatment using the Wynne Davis scoring system (WDSS). 52% of the patients with residual deformity after discharge from physiotherapy presented with limitation in ankle and sub-talar movements. This study also indicated that children with grade 2 type of deformities were more likely to have other congenital abnormalities than those with grades 1 or 3. CONCLUSION: The MI of CTEV in the studied population was found to be lower than other countries. The WDSS indicated that a great majority of the feet examined scored above average score.     

Comparison of wheelchair accessibility of public buildings pre and post the International Year of Disabled Persons (IYDP) in Harare, Zimbabwe: a case study

OBJECTIVE: To compare the accessibility to wheelchair users of public buildings built pre and post the International Year of the Disabled Persons (1981) in Harare central business district in Zimbabwe. DESIGN: A case study. SETTING: Harare central business district. SUBJECTS: 20 public buildings with at least two floors open to all users in the central business district of Harare, Zimbabwe. MAIN OUTCOME MEASURES: Wheelchair accessibility of public buildings. RESULTS: There were no significant differences in the median percentage compliance of parking areas (p = 0.546), ramps (p = 0.155) and toilets (p = 0.648) between the buildings built before the International Year of the Disabled Persons (IYDP) and those built after the IYDP. The overall median compliance of parking areas, ramps and toilets was 14% (Q1 = 14, Q3 = 21), 54% (Q1 = 43, Q3 = 62) and 45% (Q1 = 31.5, Q3 = 70), respectively. However, there was some evidence (p = 0.067) to suggest that compliance of entrances was better IYDP [median = 100% (Q1 = 90, Q3 = 100)] than pre IYDP [median = 80% (Q1 = 70, Q3 = 100)]. Meanwhile there was a significant difference in the median percentage compliance of elevators (p = 0.014) between pre[median = 90% (Q1 = 80, Q3 = 90)] and post [median = 100% (Q1 = 100, Q3 = 100)] IYDP. CONCLUSION: Overall compliance was poor. It is recommended that people with disabilities and the experts in the area of physical ability management be consulted and involved in the design and construction of these buildings.