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House construction, triatomine distribution, and household distribution of seroreactivity to Trypanosoma cruzi in a rural community in northeast Brazil.

Household distribution of seroreactivity to Trypanosoma cruzi in inhabitants was analyzed in relation to house construction and the distribution of Panstrongylus megistus, the principal domestic vector of Chagas' disease in a rural area in northeast Brazil. No children residing in mud-brick houses were seroreactive to T. cruzi. The highest rates of seroreactivity occurred in residents of unplastered mud-stick houses, and were twice as high as those found in persons living in mud-brick houses or plastered mud-stick houses. Two-thirds of seroreactive children in this area resided in unplastered mud-stick houses. Over 90% of the P. megistus infestations were found in mud-stick houses. Mud-brick houses had the lowest infestation rates of P. megistus and the lowest household rates of seroreactivity to T. cruzi.

Adult↗

Analysis of the household distribution of trachoma in a Gambian village using a Monte Carlo simulation procedure.

Studies on the household distribution of trachoma have reached conflicting conclusions. This paper describes a cross-sectional survey of endemic trachoma in a Gambian village. Cases of active trachoma were mapped, and the compound and household distribution of the disease analysed by a Monte Carlo simulation procedure which takes into account differences in the size and age distribution within individual households. Significant clustering of active trachoma cases both by village compound (p less than 0.0001) and bedroom (less than 0.05) were detected supporting the concept that intra-familial transmission of trachoma is important. There was no evidence of spatial clustering of rooms with higher than expected prevalence of trachoma. Clustering of disease in space or time provides important evidence of infectious aetiology and route of transmission. The methods discussed here are generally applicable in the study of other infectious diseases.

Adolescent↗

The epidemiology and household distribution of seroreactivity to Trypanosoma cruzi in a rural community in northeast Brazil.

The prevalence rates and household distribution of seroreactivity to Trypanosoma cruzi by complement fixation (CF) and indirect immunofluorescent antibody methods were determined in a population of 1,087 persons living in a rural area endemic for Chagas' disease in northeast Brazil. There was a gradual rise in the rate of seropositivity to 60% by age 20. Between ages 20 and 55 the prevalence rate remained at about 60%, but declined thereafter. The decline in the older age groups was not accompanied by a fall in geometric mean titer, suggesting that the decline might better be explained by an increased mortality among those seropositive than by a decrease in CF reactivity associated with age. There was variation in the rates of seropositivity in children among the geographic subunits, but the rates among adults were fairly uniform. Household clustering of seropositivity was demonstrated when both household size and age distribution were taken into account. The presence of a seropositive child less than 5 years of age was a good indicator of a household with a high rate of seropositivity; screening for young seropositive children might be a useful tool to locate high risk households. Seropositive children in households where the mother was seropositive but the father seronegative were significantly younger than seropositive children in households where the father was seropositive but the mother seronegative even though the age distribution and the overall rate of seropositivity in both groups of children were similar; thus, conversion to seropositivity earlier in life in children of seropositive mothers may not be due solely to increased exposure, but may indicate that the immunologic response in such children differed from that of children from seronegative mothers.

Adolescent↗

Household distribution of contraceptives in rural Egypt.

Oral contraceptives were offered to all married, fecund women 15-44 years of age living in 38 Egyptian villages with a population of 200,000. Before the household distribution, contraceptive prevalence was 19.1 percent. Nine months after the distribution, the contraceptive prevalence increased to 27.7 percent, a relative increase of 45 percent. Based on this study, a modified delivery system is currently being tested on a governoratewide basis. The modified system will include a wider range of fertility regulation methods and will also have health and community development components.

Adolescent↗

Seasonal variations, and the intra-household distribution of food in a Bangladeshi village.

Individual food intakes and body weights were measured in 53 rural Bangladeshi households at four seasons. Energy and protein intakes (kcal/kg/d) showed significant seasonal differences for adults and young children (1-4 yr). Energy intakes of women and children were expressed as a proportion of the male household heads', to give an indicator of food allocation. Women's and older children's proportional energy intakes remained constant through the year, and in line with expected values. Young children's proportional intakes were low, girls' being lower than boys'. The only seasonal variation was an increase in young girls' proportional energy intake when household food supplies were lowest. It is concluded that women's proportional intakes are not depressed when family food intake decreases. There is evidence that young girls receive particularly low intakes.

Adolescent↗

The effect of household distribution on transmission and control of highly infectious diseases.

Two epidemic threshold parameters are derived for the spread of a highly infectious disease in a community of households, where a household is any group whose members have frequent contacts with each other. It is assumed that the infection of any member of a household results in the infection of all susceptible members of that household. The threshold parameters have simple expressions in terms of the mean household size and the mean and variance of the number of susceptibles per household. They provide a basic reproduction number R0 for the spread of infection from individual to individual and a basic reproduction number RH0 for the spread of infection from household to household. The threshold parameters are used to derive the levels of immunity required for the prevention of major epidemics in the community. They are also used to evaluate various vaccination strategies having the same vaccination coverage. For a community with households of equal size, it is found that random vaccination of individuals is better than immunizing all members of a corresponding fraction of households. In contrast, when households have varying sizes, immunizing all members of large households can be better than a corresponding vaccination coverage of randomly selected individuals. It is illustrated that these threshold parameters can also be used for a community of households with schools or day care centers. In particular, the effectiveness of immunizing all members of a school is quantified.

Child↗

The household distribution of trachoma in a Tanzanian village: an application of GIS to the study of trachoma.

The distribution of active trachoma in Kahe Mpya, Tanzania, an endemic village of approximately 1000 people, was mapped spatially and analysed for associated risk factors and evidence of clustering. An association between distance to water source and active disease was demonstrated, although this was reduced after accounting for the lack of independence between cases in the same household. Significant clustering of active trachoma within households was demonstrated, adding support to the hypothesized importance of intra-familial transmission. The spatial distribution of trachoma was analysed using the spatial scan statistic, and evidence of clustering of active trachoma cases detected. Understanding the distribution of the disease has implications for understanding the dynamics of transmission and therefore appropriate control activities. The demonstrated spatial clustering suggests inter-familial as well as intra-familial transmission of infection may be common in this setting. The association between active trachoma and geographical information system (GIS) measured distance to water may be relevant for planning control measures.

Adolescent↗

Household distribution of house dust mite in central Taiwan.

House dust mite (HDM) is a common inhalant allergen which can precipitate atopic disease episodes including asthma and allergic rhinitis. However, the relationship between HDM and asthma in subtropical regions of Asia, which may be affected by differences in climate and environmental variables, has not been widely studied. To assess this relation in the subtropical region of central Taiwan, we collected HDM samples from the houses of eight asthmatic patients as well as four normal subjects over a 1-year period. HDMs were collected by vacuum from the following four areas: living room floor, sofa, the top surface of child's mattress and bedroom floor. The mite concentrations, site distribution, seasonal variation, individual species and correlation with asthmatic attacks were studied. The HDM concentration had a seasonal variation, with the highest concentrations noted from July to November with gradually decrease from December to June. Among the four areas of collection, the highest concentration of mites was found on the child's mattress (p < 0.05). Dermatophagoides pteronyssinus was the dominant species (77%) and Dermatophagoides farinae was the second (13%). Our data showed that: 1. The highest concentrations of HDM occurred during the period from July to November. 2. The child's mattress was the household region with the highest percentage of HDM and thus should be considered of great concern as a likely source of the exacerbation of asthma. 3. D. pteronyssinus was the dominant species.

Animals↗

[Nutritional assessment of recipes distributed to households].

This study examines the nutritional standards of recipes in six pamphlets distributed to all households in Denmark. The publications all purport to contain recipes for a healthy diet. The nutritional values given in the publications are compared to calculated values and found to be almost identical. The fat content of most of the recipes is too high: recipes in the first three pamphlets had a median fat energy content of 50%. The later publications are better: 40% in two pamphlet and 33% in the last pamphlet. It is likely that the high fat content of the household distributed pamphlets contributes to the continued high fat content in the Danish diet. We suggest that the fat energy percent should be less than 30 in half the recipes and be only 30-35 on average. The energy content should not be greater than 2.5-3.5 MJ per portion. Nutritional value estimates and the nutrition information should be standardized so as to make them more accessible for the consumer who wishes to make healthy diet choices, and more instructive generally concerning general principles of an appetizing and healthy diet.

Cooking↗

Distributions of households by size: differences and trends.

"This article deals with the distributions of households by size, that is, by number of persons, as they are observed in international comparisons, and for fewer countries, over time." The contribution of differentials in household size to inequality in income distribution among persons and households is discussed. Data are for both developed and developing countries.

Demography↗

Postcensal estimates of household income distributions.

This article develops and evaluates a method for deriving postcensal estimates of household income distributions for counties. A modified lognormal probability curve is used as a model of income distribution. The function is closely related to the classical lognormal model, but it contains a nonlinear component in its derivation. Simulated postcensal estimates of household income distributions are compared with 1980 census data for the counties in California. The results indicate that the modified lognormal curve approximates observed income distributions well and produces reliable postcensal estimates for areas with a wide variety of median income levels and numbers of households.

Family↗

[Household food distribution behavior in periurban communities of Guatemala: lessons for food distribution programs].

Do mothers of undernourished children recognize their offspring's needs? How do they feed these target children compared to other households members when food supplements are available? Which cultural principles of intra-household food distribution are associated with feeding behavior? How do household members perceive and use food supplements that are donated for undernourished target children? Answers were sought in a dietary-ethnographic study of 45 households receiving supplements for a low-weight child between one and five years, of age in two periurban low-income communities of the City of Guatemala. The central hypothesis was that we would find four cultural principles of food distribution: contributions, need, equity, and demand. The dietary survey combined direct measure and recall techniques and was done twice for all 230 individuals conforming these households. Ethnographic interviews were carried out with mothers of all target children. T-tests determined the relation between food distribution behavior and cultural rules. Findings revealed that the cultural principles of contributions, needs, and demand are present, but instead of the equity principle, we found one of equality. In the great majority of the feeding events observed, the child's mother prepares and distributes the food. The target child does not receive preferential treatment in the intra-household distribution of food supplements and other foodstuffs. Donated milk is destined principally for the children in the household; all other supplements are distributed among all members. Adult males are favored in the distribution of kcal at regular mealtimes. Children are favored in the distribution of kcal when total daily consumption is calculated. There are significant associations between the expressions of the cultural principle favoring equal distribution and that of contribution which favors adult men, and actual food distribution behavior. These principles seem to operate at formal meal events only. It was found that feeding behavior between meals (snacks, nibbling, etc.) is not subject to these salient principles and tends to compensate those household members who are not given preferential treatment in food distribution at formal mealtimes.

Adolescent↗

The Euiryong experiment: a Korean innovation in household contraceptive distribution.

Although contraceptive practice has increased substantially in Korea as a result of a strong national family planning program, surveys indicate the existence of an additional unmet demand. A number of obstacles tend to limit availability of family planning services and supplies. The effects of total availability are being tested in a three-year experiment in household contraceptive distribution, for which an exploratory study was carried out in 1975 in Euiryong gun. Three distribution systems were tried in three areas of Euiryong, each enlisting local women to canvass and distribute pills and condoms (and refer those desiring IUDs or sterilization to physician). Results of the preliminary test showed that household distribution was culturally acceptable and administratively feasible and that it did increase contraceptive use. Cost-effectiveness was considered to be within the range of the national program. The most successful of the three distribution systems is being applied in the main study, begun late in 1976 in Cheju province.

Contraception Behavior↗

Cultural issues in maternal and child health and nutrition.

Social science research on cultural issues in maternal and child health has stressed some aspects and neglected others. From the perspective of both policy applications and theory development, new research efforts could profitably be directed to the following areas: cultural adjustments to changed energy and nutrient requirements in pregnancy and lactation; maternal illness; the mother/infant dyadic interaction; emic views of growth and development; determinants of infant and young child feeding; management of childhood illnesses; popular medicine and childhood illnesses; intra-household food distribution; household composition and maternal and child health; and macrolevel/microlevel linkages and health.

Child Nutritional Physiological Phenomena↗