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Biomedical subjects

H Pickering

Publications and source records attributed to H Pickering.

29 records · Page 2Linked to original sources
PubMed1993

The effects of post-test counselling on condom use among prostitutes in The Gambia.

OBJECTIVES: To determine the effect of counselling on condom use by prostitutes. DESIGN: Cohort study. SETTING: Field-based study in The Gambia. PARTICIPANTS: Thirty-one (12 HIV-positive and 19 HIV-negative) prostitutes. INTERVENTIONS: Post-test HIV counselling. MAIN OUTCOME MEASURES: Levels of condom use. RESULTS: Overall, counselling had no effect on condom use. CONCLUSIONS: Scarce resources should be directed towards providing condoms in bars rather than counselling.

Cohort Studies↗
PubMed1993

Determinants of condom use in 24,000 prostitute/client contacts in The Gambia.

OBJECTIVE: To determine the factors that influence condom use among prostitutes and their clients in The Gambia. DESIGN: A cohort of 181 prostitutes working in seven bars and several rural markets in The Gambia were monitored daily for 14 months. A sample of 747 clients of these prostitutes was also questioned. MAIN OUTCOME MEASURE: Proportion of sexual contacts for which a condom was used. RESULTS: Data on 24,181 sexual contacts reported by the prostitutes indicated condom use varied according to type of partner (from 84% with clients to only 4% with regular partners). Condom use with clients varied according to location (from 91% in high-class bars to 59% in rural markets), decreased from 91% with the first client of the evening to 37% with the tenth client, and from 75% with clients paying higher charges (> D19) to 52% with those paying lower charges (< D20). Condom use was not related to the socio-demographic characteristics of the prostitutes. Clients reported lower condom use than prostitutes. Clients aged 20-24 years were least likely to use condoms, while white collar workers, traders, and those paying higher charges, were more likely to use condoms. CONCLUSIONS: The level of condom use in this cohort of prostitutes was high but not consistent. Condom use was determined more by the type of establishment and the characteristics of clients, than by any fixed tendency among the prostitutes. Thus, education campaigns should be directed as much to clients as to prostitutes. In The Gambia, 'lower-class' bars and those in rural areas where prostitutes work should be a priority target.

Adolescent↗
PubMed1992

Prostitutes and their clients: a Gambian survey.

The social backgrounds and working behaviour of 248 prostitutes in urban and rural areas of The Gambia were investigated. Prostitutes were found to be highly mobile, moving frequently between a number of working locations in The Gambia and neighbouring Senegal, from which most of them originated. The educational level of prostitutes and the standard of living of their natal families were above average. Prostitutes worked on average four days a week and had between two and three clients a night. Condoms were used in up to 80% of contacts. 795 clients of prostitutes were interviewed and found to be on average of low educational and occupational status. Half were non-Gambian and most were currently travelling or living away from home.

Abortion, Therapeutic↗
PubMed1992

Measurement of child mortality in association with a multipurpose birth certificate programme in the Southern Highlands Province of Papua New Guinea.

A simple and inexpensive method for monitoring child mortality in association with birth registration was introduced into the Southern Highlands of Papua New Guinea. Eight thousand two hundred and one newborn infants were registered in 1988, approximately 77% of all children born in that year. The risk of death by age 2 was determined from reports given by the mother on the present status of a previously born child at the time of a recent delivery or during clinic registration of the current birth. This was 91 per 1000 for the province and corresponds to a risk of death by age 1 of 77/1000 by extrapolation using standard lifetables. This method was validated by comparison with a continuing demographic surveillance system covering 30,000 people in the western part of the province. The new birth certificate has been an incentive to increase supervised delivery rates and to generate a register that can be used to increase vaccination coverage.

Birth Certificates↗
PubMed1989

Knowledge of AIDS, use of condoms and results of counselling subjects with asymptomatic HIV2 infection in The Gambia.

A questionnaire administered to subjects seen during a serological survey in The Gambia revealed that knowledge of AIDS and HIV infection was limited. Males, those with a secondary education and people who lived in urban areas had a better understanding but only 17% of women seen in rural areas had any knowledge of the condition. Only 8% of the subjects seen had used condoms in the preceding 12 months; during this time half of them had done so on less than five occasions. Subjects with a secondary education were more likely to have used condoms. A counsellor met 31 asymptomatic seropositive subjects identified during this survey on two occasions. In the majority, the information given caused anxiety rather than modification of behaviour and, at the time of the second interview, only one subject had discussed the situation with the partner and begun using condoms. Some of the cultural factors which may affect the outcome of counselling in an African society are discussed in the light of these findings.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Continuous monitoring of child mortality from clinic records.

A simple method is described for estimating childhood mortality when mothers are seen at or soon after a birth. The main bias in the method arises from omission of reports from mothers not contacted in the immediate postnatal period. Recent work indicates that the key question on the survival of the preceding born child might be usefully included in household surveys. A comparison between data from Tari, Papua New Guinea on childhood mortality collected as part of a regular community surveillance scheme and the results from asking the supplementary question in clinics indicates that the simpler preceding birth technique appears to give good results quickly and cheaply.

Actuarial Analysis↗
PubMed1987

Alternative measures of diarrhoeal morbidity and their association with social and environmental factors in urban children in The Gambia.

Diarrhoeal morbidity was studied during a 15-week period of the rainy season in 244 children aged 6 to 35 months in an urban Gambian community. The average prevalence of diarrhoea was 12.0% and the mean number of episodes per child varied between 2.4 and 2.9 depending on the definition of an episode. The number of chronic episodes lasting 14 d or more was tripled when 7 rather than one diarrhoea-free days were required to define a new episode. Neither prevalence nor the number of episodes varied significantly with age or sex. There was little association between the social and environmental characteristics of the children and diarrhoeal morbidity. The implications of using differing measures of diarrhoeal morbidity are discussed.

Child, Preschool↗
PubMed1986

Social and environmental factors associated with the risk of child mortality in a peri-urban community in The Gambia.

A group of 479 children born in a peri-urban West African community during a two-year period was studied in an attempt to identify social and environmental factors associated with the risk of dying in early childhood. Comparison of the characteristics of the 17 children that had died with those of the 462 survivors suggested an increased risk among the children of self-employed women, and among children living in compounds in which animals were kept. Of 500 mothers who were studied (including some whose children were born elsewhere), 145 had experienced at least one child death. When these 145 women were compared with the remaining 355, several factors related to living conditions, maternal education and health knowledge were found to be associated with the risk of child mortality.

Adult↗
PubMed1985

Social and environmental factors associated with diarrhoea and growth in young children: child health in urban Africa.

This study investigates the relationship between social and environmental variables and diarrhoea and growth in children aged between 6 and 36 months in an urban area of The Gambia, West Africa. The social and environmental conditions of 493 children were observed and recorded over a period of 12 months. Two hundred and seventy-seven children were under weekly diarrhoea surveillance for a 15 week period during the wet season and 322 children had anthropometric measurements taken in May and September. Computer analysis was used to determine association between single and multiple environmental and social factors and diarrhoea prevalence and growth. The results of the diarrhoea surveillance showed that there was considerable variation between individual children. Thirty children had no diarrhoea during the period of surveillance and 30 had diarrhoea for over 24% of the time, with 2 children having diarrhoea for more than 50 days out of a total of 105. None of the social and environmental variables recorded showed a significant relationship with diarrhoea prevalence. The anthropometric measurements showed that at the end of the wet season, in September, 23% of children in this age group were less than 90% of the National Centre for Health Statistics standards of height for age and several of the variables recorded showed a statistically significant association with this measurement.

Child, Preschool↗
PubMedDate not supplied

Crossing the public-private sector divide with reproductive health in Cambodia: out-patient services in a local NGO and the national MCH clinic.

Set within the context of recent literature on the private-public divide in the health sector of developing countries generally and Asia specifically, this study considers the major government and the major indigenous non-government clinics offering out-patient reproductive health services in Phnom Penh, Cambodia. Reproductive health is of critical importance in Cambodia, which has one of the highest levels of unmet need for family planning in the developing world and suffers from what is arguably the most severe STD and HIV/AIDS problem in Asia. The study is unusual in that it examines and compares aspects of service delivery and pricing along with the socio-economic profile and health-seeking behaviour of clients self-selecting services in the two settings. The socio-economic status of clients was much higher than the norm in Cambodia but did not differ significantly between the two clinics. A few service indicators suggested that the quality of care was better in the NGO clinic. Underlying variables--such as the broader mandate of the public sector institution and the significant discrepancy between public and private sector salaries--offer an obvious explanation for these differences. The Ministry of Health in Cambodia has been developing policies related to the NGO sector, which has expanded rapidly in Cambodia during the 1990s, and it is struggling to increase staff remuneration within the public sector.

Adult↗