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PubMed2006

Rapid Urban Malaria Appraisal (RUMA) IV: epidemiology of urban malaria in Cotonou (Benin).

BACKGROUND: An estimated 40 % of the population in Benin lives in urban areas. The purpose of the study was to estimate malaria endemicity and the fraction of malaria-attributable fevers in health facilities in Cotonou. METHODS: A health care system evaluation and a series of school parasitaemia surveys and health facility-based surveys were carried out during the dry season in of 2003, applying standard Rapid Urban Malaria Appraisal (RUMA) methodology. This study was part of a multi-site assessment supported by the Roll Back Malaria Partnership. RESULTS: The field work was carried out in February-March 2003. In 2002 and out of 289,342 consultations in the public health facilities of Cotonou there were 100,257 reported simple malaria cases (34.6%) and 12,195 complicated malaria cases (4.2%). In the school parasitaemia surveys, a malaria infection was found in 5.2 % of all samples. The prevalence rates of parasitaemia in the centre, intermediate and periphery zones were 2.6%, 9.0% and 2.5%, respectively. In the health facility surveys the malaria infection rates in presenting fever cases were 0% (under one year old), 6.8% (one to five years old), 0% (> five to 15 years old) and 0.9% (over 15 years old), while these rates in the control group were 1.4%, 2.8%, 1.3% and 2.0%. The malaria-attributable fractions among presenting fever cases were 0.04 in the one to five years old and zero in the three other age groups. Hence, malaria played only a small role in fever episodes at the end of the dry season. In total, 69.2% of patients used a mosquito net the night before the survey and 35.1% used an insecticide-treated net, which was shown to be protective for an infection (OR = 0.23, 95% CI 0.07-0.78). Travelling to a rural area (5.8% of all respondents) did not increase the infection risk. CONCLUSION: The homogenously low malaria prevalence might be associated with urban transformation and/or a high bednet usage. Over-diagnosis of malaria and over-treatment with antimalarials was found to be a serious problem.

Adolescent↗

PubMed1991

Environmental determinants of acute respiratory symptoms and diarrhoea in young coloured children living in urban and peri-urban areas of South Africa.

The impact of environmental risk factors associated with housing was examined in relation to diarrhoeal disease and acute respiratory symptoms in South African coloured children. A multistage cluster sample representative of all coloured people living in the major urban and peri-urban areas of South Africa was used for the study. Interviews were conducted with respondents from 1,227 households. Overall, 8.5% children under 5 years were reported to have had diarrhoea, while 29% had experienced coughing and breathing problems in a 2-week recall period. Individual risk factors identified using the odds ratios (ORs) for diarrhoea included not having an inside tap or a flush toilet in the homes (both yielded an OR of 3.3), not owning a refuse receptacle (OR = 2.5), not being connected to an electricity supply (OR = 2.5), low household income (OR = 1.8), more than 2 people per room (OR = 2.0) and less than Standard 5 maternal education (OR = 1.6). Absence of an inside toilet, not having a refuse receptacle and overcrowding all remained as independent risk factors after logistic regression analyses. Multiple logistic regression analyses revealed that not having a refuse receptacle and the absence of electricity for heating purposes were independently associated with respiratory symptoms. The overall preventive potentials for respiratory symptoms were significantly less than those for diarrhoea. Improving physical access to essential environmental health services in urban areas and improvements in the educational status of women are urgently needed if childhood infections are to be prevented.

Black or African American↗

PubMed1978

Health risks associated with animals in different types of urban areas: present status and new ecological conditions due to urbanization.

For different reasons urban areas are colonized by numerous animal groups. From the aspect of the incidence of zoonoses the following animal groups are primarily significant: 1) food-producing animals; 2) pets; 3) synanthropic mammals; 4) synanthropic birds; 5) synanthropic arthropods. Certain species live in central parts of urban areas which the A. attempts to classify, and particularly in suburban areas which serve for recreation of town inhabitants. From the aspect of the occurrence of different animal species the A. points out the significance of various parts of urban agglomerations.

Animal Population Groups↗

PubMed1998

[Factors aggravating bronchial asthma in urban children (II)--The involvement of atopy and serum fatty acids, and their interaction with urban living environment].

The aggravation of bronchial asthma in today's urban child population was studied by an epidemiological study in order to elucidate the involvement of food habits as well as individual factors such as age, sex, and history of atopic dermatitis, and the interaction with urban living environments. The asthma group consisted of 202 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 81 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The individual factors and the urban living environments (atmospheric environment, housing style) were surveyed by questionnaire. Also, the mite (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) specific immunoglobulin E (Dp-IgE, Df-IgE) and the composition of serum fatty acid were examined as objective indicators for atopy and dietary habits, respectively. In this study, bronchial asthma was classified into two types: atopic/non-atopic, according to whether Dp-IgE was present/absent (positive/negative). Thus, for the risk factors given above, their involvement in each type of asthma was examined. As atopy is an important factor of child asthma, the relative risk (odds ratio) of Dp-IgE increase (atopy) was also examined by logistic regression analysis in each of the asthma and non-asthma groups. The results are as follows: 1. As age increased, the risk of atopy increased but the risk of asthma decreased. 2. The risk of asthma increased as Dp-IgE rather than Df-IgE increased. 3. For the composition of serum fatty acid, the lower quartile ranking (LQR) group for a saturated fatty acid, stearic acid, and the upper quartile ranking (UQR) group for a mono-unsaturated fatty acid, oleic acid, had a higher risk of nonatopic asthma. 4. The LQR group for omega 6-poly-unsaturated fatty acid such as linoleic acid, had a lower risk of atopy. 5. The UQR group for a omega 3-poly-unsaturated fatty acid, eicosapentaenoic acid, had a higher risk of nonatopic asthma. The UQR of eicosapentaenoic acid and living environments within 25 m from a major road or housing of reinforced concrete structure showed involvement in synergistic increase in the risk of non-atopic asthma.

Asthma↗

PubMedDate not supplied

Urbanization and counter-urbanization in Italy.

Counter-urbanization in Italy is examined, using data from 1958-1964, 1968-1974, and 1974-1980 from a recent study by the Association of Italian Geographers. "The paper, divided into four parts, deals consecutively with an examination of the new patterns of dispersed demographic growth; a review of the factors involved in this phenomenon; a discussion of the principal spatial models which describe counter-urbanization; and finally an assessment of the more general significance--social and political--of the process."

Demography↗

PubMed2005

Mapping hazard from urban non-point pollution: a screening model to support sustainable urban drainage planning.

Non-point sources of pollution are difficult to identify and control, and are one of the main reasons that urban rivers fail to reach the water quality objectives set for them. Whilst sustainable drainage systems (SuDS) are available to help combat this diffuse pollution, they are mostly installed in areas of new urban development. However, SuDS must also be installed in existing built areas if diffuse loadings are to be reduced. Advice on where best to locate SuDS within existing built areas is limited, hence a semi-distributed stochastic GIS-model was developed to map small-area basin-wide loadings of 18 key stormwater pollutants. Load maps are combined with information on surface water quality objectives to permit mapping of diffuse pollution hazard to beneficial uses of receiving waters. The model thus aids SuDS planning and strategic management of urban diffuse pollution. The identification of diffuse emission 'hot spots' within a water quality objectives framework is consistent with the 'combined' (risk assessment) approach to pollution control advocated by the EU Water Framework Directive.

Cities↗

PubMed2004

The dynamics of social-ecological systems in urban landscapes: Stockholm and the National Urban Park, Sweden.

This study addresses social-ecological dynamics in the greater metropolitan area of Stockholm County, Sweden, with special focus on the National Urban Park (NUP). It is part of the Millennium Ecosystem Assessment (MA) and has the following specific objectives: (1) to provide scientific information on biodiversity patterns, ecosystem dynamics, and ecosystem services generated; (2) to map interplay between actors and institutions involved in management of ecosystem services; and (3) to identify strategies for strengthening social-ecological resilience. The green areas in Stockholm County deliver numerous ecosystem services, for example, air filtration, regulation of microclimate, noise reduction, surface water drainage, recreational and cultural values, nutrient retention, and pollination and seed dispersal. Recreation is among the most important services and NUP, for example, has more than 15 million visitors per year. More than 65 organizations representing 175,000 members are involved in management of ecosystem services. However, because of population increase and urban growth during the last three decades, the region displays a quite dramatic loss of green areas and biodiversity. An important future focus is how management may reduce increasing isolation of urban green areas and enhance connectivity. Comanagement should be considered where locally managed green space may function as buffer zones and for management of weak links that connect larger green areas; for example, there are three such areas around NUP identified. Preliminary results indicate that areas of informal management represent centers on which to base adaptive comanagement, with the potential to strengthen biodiversity management and resilience in the landscape.

City Planning↗

PubMed2003

The Chennai Urban Rural Epidemiology Study (CURES)--study design and methodology (urban component) (CURES-I).

The report of World Health Organization (WHO) shows that India tops the world with the largest number of diabetic subjects. This increase is attributed to the rapid epidemiological transition accompanied by urbanization, which is occurring in India. There is very little data regarding the influence of affluence on the prevalence of diabetes and its complications particularly retinopathy in the Indian population. Furthermore, there are very few studies comparing the urban/rural prevalence of diabetes and its complications. The Chennai Urban Rural Epidemiology Study (CURES) is designed to answer the above questions. CURES is initially planned as a cross-sectional study to evolve later into a longitudinal study. Subjects for the urban component of the CURES have been recruited from within the corporation limits of Chennai City. Chennai (formerly Madras), the largest city in Southern India and the fourth largest in India has been divided into 10 zones and 155 wards. 46 wards were selected by a systematic random sampling method to represent the whole of Chennai. Twenty thousand and one individuals were recruited for the study, this number being derived based on a sample size calculation. The study has three phases. Phase one is a door to door survey which includes a questionnaire, anthropometric, fasting capillary blood glucose and blood pressure measurements. Phase two focussed on the prevalence of diabetic complications particularly retinopathy using standardized techniques like retinal photography etc. Diabetic subjects identified in phase one and age and sex matched non-diabetic subjects will participate in these studies. Phase three will include more detailed studies like clinical, biochemical and vascular studies on a sub-sample of the study subjects selected on a stratified basis from phase one. CURES is perhaps one of the largest systematic population based studies to be done in India in the field of diabetes and its complications like retinopathy, nephropathy and neuropathy.

Adult↗

PubMed1991

The determinants of migrating with a pre-arranged job and of the initial duration of urban unemployment: an analysis based on Indian data on rural-to-urban migrants.

"Based on survey data on 1,400 rural migrants in Delhi, this paper examines within a multivariate context the determinants of migrating with a pre-arranged job and of the initial duration of urban unemployment. The results show that the probability of moving with a pre-arranged job increases with education and with age, and is higher for those who seek non-manual jobs. For migrants who arrive in the city without a pre-arranged job, unemployment duration depends on marital status, premigration information on urban employment opportunities, and on the reliance on contacts for job search."

Age Factors↗

PubMed2005

Primary care, social inequalities and all-cause, heart disease and cancer mortality in US counties: a comparison between urban and non-urban areas.

OBJECTIVE: The objective of this study was to test whether the association between primary care and income inequality on all-cause, heart disease and cancer mortality at county level differs in urban (Metropolitan Statistical Area-MSA) compared with non-urban (non-MSA) areas. STUDY DESIGN: The study consisted of a cross-sectional analysis of county-level data stratified by MSA and non-MSA areas in 1990. Dependent variables included age and sex-standardized (per 100,000) all-cause, heart disease and cancer mortality. Independent variables included primary care resources, income inequality, education levels, unemployment, racial/ethnic composition and income levels. METHODS: One-way analysis of variance and multivariate ordinary least squares regression were employed for each health outcome. RESULTS: Among non-MSA counties, those in the highest income inequality category experienced 11% higher all-cause mortality, 9% higher heart disease mortality, and 9% higher cancer mortality than counties in the lowest income inequality quartile, while controlling for other health determinants. Non-MSA counties with higher primary care experienced 2% lower all-cause mortality, 4% lower heart disease mortality, and 3% lower cancer mortality than non-MSA counties with lower primary care. MSA counties with median levels of income inequality experienced approximately 6% higher all-cause mortality, 7% higher heart disease mortality, and 7% higher cancer mortality than counties in the lowest income inequality quartile. MSA counties with low primary care (less than 75th percentile) had significantly lower levels of all-cause, heart disease and cancer mortality than those counties with high primary care. CONCLUSIONS: In non-MSA counties, increasing primary physician supply could be one way to address the health needs of rural populations. In MSA counties, the association between primary care and health outcomes appears to be more complex and is likely to require intervention that focuses on multiple fronts.

Analysis of Variance↗

PubMed2003

Fine urban and precursor emissions control for diesel urban transit buses.

Particulate emission from diesel engines is one of the most important pollutants in urban areas. As a result, particulate emission control from urban bus diesel engines using particle filter technology is being evaluated at several locations in the US. A project entitled "Clean Diesel Air Quality Demonstration Program" has been initiated by the New York City Metropolitan Transit Authority (MTA) under the supervision of New York State Department of Environmental Conservation and with active participation from Johnson Matthey, Corning, Equilon, Environment Canada and RAD Energy. Under this program, several MTA transit buses with DDC Series 50 engines were equipped with Continuously Regenerating Technology (CRTTM) particulate filter systems and have been operated with ultra low sulfur diesel (<30 ppm S) in transit service in Manhattan since February 2000. These buses were evaluated over a 9-month period for durability and maintainability of the particulate filter. In addition, an extensive emissions testing program was carried out using transient cycles on a chassis dynamometer to evaluate the emissions reductions obtained with the particle filter. In this paper, the emissions testing data from the Clean Diesel Air Quality Demonstration Program are discussed in detail.

Filtration↗

PubMed1999

Bancroftian filariasis on Pemba Island, Zanzibar, Tanzania: an update on the status in urban and semi-urban communities.

Cross-sectional clinical, parasitological and entomological surveys for bancroftian filariasis were conducted in Konde, Chake Chake and Kengeja, three urban and semiurban communities on Pemba Island, and the results were compared with similar surveys done 15 years earlier. The overall prevalences of clinical manifestations among males aged 15 years or more (n = 614) was remarkably similar to those recorded 15 years earlier: elephantiasis 1.4% in 1975 and 1.1% in 1990; hydrocele, 22.4% and 21.8%, respectively. However, when the communities were compared individually, there was a reduction in the hydrocele prevalence in Konde from 22.4% to 11.5% and an increase in Kengeja from 27.0% to 35.5%. The overall microfilarial prevalence found during night blood surveys of all individuals aged 1 year or more (n = 2687) was 9.7%, compared to 14.2% recorded in 1975. The reduction was most pronounced in Konde. Of 1052 female mosquitoes caught with CDC light traps, 95% were Culex quinquefasciatus and 5% Anopheles gambiae s.l. Infective larvae of Wuchereria bancrofti were found only in the former. The filariasis situation in urban and semiurban communities on Pemba Island appears not to have changed considerably over the last 15 years.

Adolescent↗

PubMed1996

Urban to urban migration: Soviet patterns and post-Soviet implications.

"In spite of extensive literature on migration in the Soviet Union, we know little about household-level decisions. This study specifies and estimates those variables important to understanding the migration decision. Using data from the Soviet Interview Project (SIP), we examine the forces influencing the decision to migrate or not to migrate, and in addition, for those who did migrate, the forces influencing the locational choices made. The results indicate that, while some of the traditional factors influencing migration are important, others are not, suggesting that in the post-Soviet era, differentiating the persistence of Soviet-type forces from emerging market-type forces will be important for an understanding of urban to urban migration."

Behavior↗

PubMed2004

Prevention with HIV-seropositive men who have sex with men: lessons from the Seropositive Urban Men's Study (SUMS) and the Seropositive Urban Men's Intervention Trial (SUMIT).

SUMMARY: Men who have sex with men (MSM) are disproportionately affected by HIV, and HIV-seropositive (HIV-positive) MSM are an especially important group for prevention efforts. This article describes findings from the Seropositive Urban Men's Study (SUMS, N = 456) and the Seropositive Urban Men's Intervention Trial (SUMIT, N = 1168). These studies were conducted from 1996 to 2002 with racially diverse samples from New York and San Francisco. Patterns of sexual behavior often reflected an understanding of the relative risks of specific sexual practices and were generally consistent with harm reduction strategies to reduce the risk of HIV transmission to uninfected partners. Some men, however, continued to engage in behaviors that placed themselves and their partners at risk for exposure to HIV and other sexually transmitted infections. Correlates of unprotected sex included self-efficacy, personal responsibility, substance use, mental health, and contextual influences. Disclosure of HIV status was a difficult issue for many HIV-positive MSM. Most participants had disclosed to their main partner, but they disclosed to less than half of their non-main partners before first sex. The interest of HIV-positive MSM in prevention efforts, the design of the SUMIT intervention trial, and implications for future research and programmatic efforts are discussed.

HIV Infections↗

PubMed2001

Urban history, urban health.

Over the course of the 20th century, the United States became an urban nation: 80% of Americans now live in metropolitan areas. Supplying basic sanitary services-drinking water, sewers, and garbage removal-to these cities is a gargantuan task, yet most people have little understanding of urban infrastructure systems and their enormous regional ecologic impacts. Municipalization of sanitary services, especially since 1880, distanced people from their wastes and gave city dwellers a simplistic experience of one-way material flow through cities, without knowledge of the environmental costs. Most sanitary infrastructures were built primarily for durability and lack the elasticity to meet changing needs. The challenge now is to adapt sanitary systems for flexibility and simultaneously move from unchecked material consumption toward resource-based thinking.

Conservation of Natural Resources↗

PubMed1999

[Latent factors aggravating airway allergic symptom in urban population: the involvement of urban living environments].

The involvement of urban living environments in IgE-increase (atopy) and ECP-increase (enhanced eosinophil activity), the inter-relationship of IgE-increase and ECP-increase, and their involvement in developing airway allergic symptoms were studied on a population of adult nonsmoking women, in order to elucidate the latent factors aggravating airway allergic symptoms in an urban population. In our earlier study on child asthma in 1994, we examined the relationship between living environments and mite proliferation in asthma and non-asthma groups and the involvement of mite proliferation in developing atopy in the non-asthma group. The asthma group consisted of 190 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 78 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The adult woman group consisted of 423 non-smoking women who had been diagnosed as having no allergic disease by the medical examination done at Yao City, Osaka, each March from 1995 to 1997. Individual living environments such as housing and heating styles were surveyed by questionnaire. Also, the amount of mite allergen (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) in room and bedding dust (only in the case of children) and the concentration of continine in urine were examined as objective indicators for the load of environmental allergen and the indoor air pollution by tobacco smoke, respectively. Atopy was diagnosed according to whether Dp-specific immunoglobulin E (Dp-IgE) was present/absent (positive/negative), and ECP-increase was defined as serum ECP concentration over 10 ng/ml. The results were as follows: 1. An environment of higher humidity (dampness) causing a room to become moldy appeared to enhance mite proliferation, while heating only with an electric heater or kotatsu appeared to suppress it. 2. Living environments were involved in the development of atopy in children and adult women through the effects on mite proliferation. In the case of children, heating with oil or gas heater appeared to have a positive effect while reinforced concrete housing a negative effect, probably by effects on the immune system. However, in the case of adult women, such modification was not observed. 3. Passive smoking in adult women was related to ECP-increase. 4. IgE-increase and ECP-increase appeared to be involved in each other. 5. Among airway allergic symptoms such as cough, sputum and wheeze, atopy was involved in wheeze, and ECP-increase in cough.

Adult↗

PubMedDate not supplied

Prevalence and intensity of the schistosomiasis situation along the Zimbabwean urban and peri-urban shoreline of lake Kariba.

OBJECTIVE: To determine the prevalence and intensity of schistosomiasis in urban and peri-urban Kariba. DESIGN: A cross sectional schistosomiasis survey involving screening people for infection and searching for intermediate host snails. SETTING: Lake Kariba Research Station, Zimbabwe. SUBJECTS: One thousand and seventy three people living in four residential areas of Kariba were screened for both Schistosoma haematobium and Schistosoma mansoni. Seventeen water contact sites along the shoreline close to the residential areas were surveyed for snails. MAIN OUTCOME MEASURES: Prevalence and intensity of both S. haematobium and S. mansoni and abundance of intermediate host snails at potential transmission sites. RESULTS: The prevalence of S. haematobium and S. mansoni were 7.2% and 2.1% respectively. More males (8.4%) were infected with S. haematobium than females (5.7%). There was no difference in prevalence of S. mansoni between males (2.2%) and females (2.0%). Most infections of S. haematobium were in the age group of 15 to 19 years while the age distribution pattern for S. mansoni was patchy. Most of the infections detected were light i.e. one to 100 eggs per gram of faeces or less than 50 eggs per 10 ml of urine. Few intermediate host snails for schistosomiais were collected and none of them were infected with human schistosomes. CONCLUSION: Prevalence and intensity of schistosomiasis were low and therefore, the disease was not considered to be a major public health problem.

Animals↗

PubMed1997

Ozone measurements in the urban and extra-urban areas of Pisa during the summer of 1995.

During the Summer of 1995, atmospheric ozone concentrations were measured in five areas with different geographical and environmental characteristics. The five areas included: 1. Pisan coastline. 2. An urban area with a high volume of traffic. 3. A rural area away from emission sources. 4. Monte Serra (Alt. 900 m). 5. The monitoring station within a small urban park. The aim of this study was to identify relationships between ozone concentrations and the different geophysical factors related to the designated areas, such as traffic volume, height above sea level, and the meteorological aspects of the Pisan coastline.

Air Pollutants↗