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Socio-economic inequalities as a predictor of health in South Africa--the Yenza cross-sectional study.

OBJECTIVES: To describe the demographic, environmental and health characteristics of the rural Eastern Cape and to explore demographic and environmental predictors of health. DESIGN: Cross-sectional study. SETTING: Engcobo and Umtata in the Eastern Cape, South Africa. SUBJECTS: 12,049 people from 4608 households. OUTCOME MEASURES: (i) Children: immunisation history and being breastfed; (ii) women aged 15-45 years: use of contraception; (iii) women aged 20-25 years: total numbers of dead children; and (iv) all adults: smoking status, body mass index and blood pressure. RESULTS: 2741 houses (59.5%) were structurally adequate, 1795 (39.0%) had access to clean water, and 1174 (25.6%) had access to gas or electric energy. Of children up to 5 years of age 1436 (44.2%) were fully immunised and 2472 (76.1%) were breastfed in their first year of life. Among women aged 15-45 years, 903 (37.8%) used contraceptives, and among women aged 20-25 years, 56 (11.8%) had lost at least 1 child. Self-report of chronic illness and disability was low. Current smokers include 264 men (12.7%) and 325 women (6.0%), and 315 men (15.2%) and 1439 women (26.7%) had a body mass index > 30. Adequate housing (odds ratio (OR) 1.31, 95% confidence interval (CI): 1.12-1.53) and access to refuse disposal (OR 1.65, 95% CI: 1.36-2.00) were predictive of complete immunisation in children. Children living in houses with access to clean water (OR 0.8, 95% CI: 0.64-0.99) and a fitted toilet (OR 0.56, 95% CI: 0.38-0.83) were less likely to be breastfed in the first year of their life. Women aged 15-45 years were likely to use contraception if they were well educated (OR 2.75, 95% CI: 1.76-4.28) and lived in houses with access to refuse disposal (OR 1.46, 95% CI: 1.20-1.78). Better education was associated with a reduced likelihood of loss of a child (OR 0.11, 95% CI: 0.02-0.51) and being a smoker (OR 0.52, 95% CI: 0.38-0.73). Obesity was associated with being female (OR 1.88, 95% CI: 1.62-2.18) and living in a house with electricity (OR 1.46, 95% CI: 1.26-1.68). High blood pressure was associated with living in a house with electricity (OR 1.36, 95% CI: 1.10-1.70) and with monthly household income exceeding R2 000 (OR 1.38, 95% CI: 1.07-1.78). CONCLUSIONS: High socio-economic deprivation in the Eastern Cape is associated with health status comparable to that of poorer regions in sub-Saharan Africa. The educational level of the population, access to electricity, clean water and refuse disposal facilities are important predictors of child, maternal and adult health.

Adolescent↗

Hyperendemicity of diarrhea in a valley area, Asir Region, southwestern Saudi Arabia.

A random sample of 781 subjects living around a valley in Shebaa area, southwestern Saudi Arabia, and 1284 subjects from the rest of Shebaa, along with a sample of 1095 from a nearby urban community in Abha city have been studied following a notification of a suggestive increase of diarrhea in the valley. This was to determine whether the prevalence of diarrhea was high in the valley and to formulate hypotheses about possible implicated factors. The family head was interviewed about episodes of diarrhea among family members during the 2-week period preceding the interview, about source of drinking water, and about some demographic variables. Observations were made and data were collected on presence and frequency of flies in the house, methods of excreta and refuse disposal, valley and wells water, and the nearby agricultural farms. The 2-week diarrhea episode rate per subject was significantly (p<0.0001) highest in the valley (0.20), was 0.09 in the rest of Shebaa, and was lowest in the urban community area. (0.05). The rate decreased by age (p<0.001) and increased by frequency of flies in the house (p<0.0001), particularly in the valley. Drinking only from the desalinated water was associated with diarrhea episode rate of 0.12 as compared to 0.05 for drinking only from bottled water or from any other combination of sources (p<0.01). The valley and wells water was grossly polluted and was regularly used for irrigating and washing fresh fruits and vegetables from nearby farms. Hypotheses for the factors possibly contributing to this hyperendemicity of diarrhea in the valley include inadequate excreta and refuse disposal, contamination of the valley and wells water, contamination of the desalinated water during transportation or storage and abundance of flies.

Age Distribution↗

Influence of distance on the motivation and frequency of household recycling.

People choose to participate in recycling for a variety of reasons. This study analyzes the relationship between the frequency of selective separation and general refuse disposal, and the influence on the recycling habit of the walking distance to drop off the materials. The methodology employed was one of personal interviews in the street, the study population being a region in the north of Spain (Principality of Asturias). More than one thousand people participated in this survey carried out in 2002. Five hypotheses related to three variables (the frequency for depositing recycling materials and general refuse, the distance to recycling and general bins, and the recycling habit) were tested using different statistical tests. Results show that the people who frequently go to the bins to dispose of general refuse are more likely to recycle some product at home, and in most cases, as the distance to the recycling bins decreases, the number of fractions that citizens separate and collect at home increases. Most of the results obtained have been compared with other previous in literature.

Conservation of Natural Resources↗

[Hygienic problems of sanitation procedures in civil aviation].

Hygiene problems that arise in connection to sanitation procedures in civil aviation are described; the relevant international regulation and recommendation are explained. The particular problems that arise in connection to prophylaxis to infections, food hygiene, sanitation, refuse disposal and the maintenance lavoratory facilities are emphasized. Relevant rules and recommendations are quoted.

Aviation↗

Occupational factors and pancreatic cancer.

The relation between occupational factors and pancreatic cancer has been studied by two different approaches: a population based case-control study with two series of controls and a retrospective cohort study based on register data. With both approaches, some support was found for an association with occupational exposure to petroleum products. Associations were also indicated with exposure to paint thinner (case-control study) and work in painting and in paint and varnish factories (cohort study), for exposure to detergents, floor cleaning agents, or polish (case-control study) and with floor polishing or window cleaning (cohort study), and for exposure to refuse (case-control study) and work in refuse disposal plants (cohort study).

Adult↗

Assessment of nutritional status using anthropometric methods on 1-4 year old children in an urban ghetto in Lagos, Nigeria.

This study assessed the nutritional status using anthropometry of 1-4 year old children in an urban slum in the Mushin Local Government Area of Lagos State, with a view to determining the impact of urbanization on child health. A total of 365 children were enrolled using multistage random sampling techniques. Anthropometric measurements used were weight and height. Height-for-age, weight-for-height, and weight-for-age Z-scores below -2.00 SD of the reference NCHS standard were used to define stunting, wasting and underweight, respectively. The study revealed a prevalence of underweight of 39.2%, stunting of 34.5% and wasting of 21.9%. The mean of weight-for-age, height-for-age, weight-for-height and mid-upper-arm-circumference were less than the mean of the NCHS reference population. This difference might be due to the socio economic backgrounds of the two populations. Using the modified Wellcome Classification of malnutrition, 37.8% of the children were malnourished. Most subjects came from homes with inadequate water supply and poor refuse disposal methods.

Anthropometry↗

Analytical determination of the microbial utilization and transformation of humic acids extracted from municipal refuse.

Humic substances are usually the refractory part of natural organic matter, and in a landfill they can retain inorganic and organic micropollutants. This study has investigated analytically whether humic acids (HA) extracted by use of alkali from either fresh municipal refuse or from refuse disposed of in a landfill for up to 12 months can resist microbial degradation under aerobic conditions. When added as a supplementary nutrient source, up to 63.6% of HA was utilized and this percentage was enhanced to a mean value of 88.5% when different HA preparations were used as the sole source of carbon. In cultures of a soil microbial community containing the same preparations as sole sources of nitrogen, HA was usually completely utilized. The remaining HA re-isolated from some microbial cultures were highly depleted in carbon and, simultaneously, the nitrogen content was enhanced. The FTIR spectra were indicative of strong participation of aliphatic structural units in the refuse-related HA preparations. Because of the microbial activity, different carbonaceous substances were primarily removed from the HA structure, and an increase in nitrogenous molecular groups became apparent. The structural transformations brought about by soil microorganisms "in vitro" corresponded to those occurring naturally in HA obtained from refuse aged for 12 months in a landfill.

Bacteria↗