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13 recordsLinked to original sources
PubMed1996

Falling diarrhoea mortality in Northeastern Brazil: did ORT play a role?

The impact of oral rehydration therapy (ORT) on the recent decline in diarrhoea mortality in the northeast of Brazil was studied. Proportionate infant mortality fell from 32% in 1980 to 17% in 1989 and infant deaths attributed to diarrhoea dropped from 41% to 25%, resulting in an overall reduction of 57%. Similar decreases were observed for children aged 1-4 years. Diarrhoea admissions also fell from 57% of infant hospitalizations in 1980 to 30% in 1990. None of the other major causes of death or admissions showed such decline. ORT was introduced in the early 1980s, being used in 35% of all episodes in 1991 and in 62% of those regarded as severe by the mother. Other changes included a worsening of socioeconomic conditions and increases in water supply, vaccine coverage, breastfeeding duration and nutritional status. A simulation model estimated that changes in factors other than ORT would lead to a 21% reduction in infant diarrhoea mortality, or about one-third of the actual decline. Finally, an ecological analysis showed that ORT use rates were inversely correlated to infant diarrhoea mortality (r=-0.61; p=0.04). Despite the shortcomings of the available data, these findings suggest an important impact of ORT on diarrhoea mortality.

Brazil↗
PubMed1999

Cancer mortality in Russia and Ukraine: validity, competing risks and cohort effects.

BACKGROUND: The dramatic increase in mortality in Russia and Ukraine in the late 1980s and 1990s has been due to increases in certain causes of death, particularly cardiovascular disease and accidents and violence. In contrast, there has been a slight fall in mortality from cancer. METHODS: This paper presents an analysis of trends and patterns in cancer mortality and examines four possible explanations for its recent fall: changes in data collection; cohort effects; competing mortality from other causes of death; and improvements in health care. RESULTS: All contribute to some extent to the observed changes, with each affecting predominantly different age groups. There is evidence of a significant underrecording of cancer deaths among the elderly especially in rural areas and of significant changes in coding practices in the early 1990s. Competing mortality from cardiovascular diseases and accidents can explain some reduction in male deaths from cancer in middle age. Birth cohort effects can explain some reduction among males after early middle age and among females at all ages. The impact of changes in health care are more difficult to identify with certainty but there is evidence of reduced deaths from childhood leukaemia. IMPLICATIONS: Recent changes in mortality in Russia are complex and their understanding will require a multidisciplinary approach embracing demography, epidemiology and health services research.

Adolescent↗
PubMed1994

[Latin America: demographic trends with emphasis on mortality].

"The paper presents the Latin American demographic situation and trends since 1950, with special emphasis on differential mortality across and within countries.... The large declines in mortality, specially those at young ages, are linked to changes in epidemiological profiles which imply a greater relative importance of non-transmissible diseases and a lesser role of infectious and parasitic diseases. Population ageing also contributes to these changes due to the increased fraction of adult and elderly population. In the majority of countries, excessive mortality due to avoidable causes is still present among the poor." (SUMMARY IN ENG)

Cause of Death↗
PubMedDate not supplied

Infant mortality decline in Germany, 1871-1925: the roles of changes in variables and changes in the structure of relations.

"This paper applies regression decomposition procedures to the infant mortality decline in Germany 1871-1925.... Data concern 59 administrative areas at seven times. In contrast to contemporary less developed countries, little of this historical infant mortality decline is explained either by changes in the relationships between infant mortality and the variables considered here or by exogenous factors. Rather, trends in variable values account for most of the decline. Smaller family size and more hygienic child care improved living conditions for infants, thereby increasing their survivorship." (SUMMARY IN FRE AND ITA)

Behavior↗
PubMed1994

Ovarian and endometrial cancers.

Trends in the incidence and mortality of endometrial and ovarian cancer are described for England and Wales from 1950 to 1991 and for other selected countries from 1955 to 1985. The mortality from endometrial cancer has been falling in England and Wales since 1950 in all age groups. This has not been reflected by a decline in incidence. Most of the other countries show a similar decline in mortality in all ages but stable incidence rates. Mortality from ovarian cancer has been declining in women aged under 55 in England and Wales since the early 1970s but has been rising in women over 55. The international pattern is varied, but several countries show a decline in mortality in younger women that began in the early 1970s. The incidence in younger women has not fallen to the same degree. It is difficult to explain the trends in endometrial cancer mortality in terms of the known risk factors for the disease. The trends in ovarian cancer mortality are consistent with an effect of the combined oral contraceptive pill.

Adult↗
PubMedDate not supplied

Why did maternal mortality decline in Matlab?

In 1991, an article on the Maternity Care Program in Matlab, Bangladesh, reported a substantial decline in direct obstetric deaths in the intervention area, but not in the control area. The decline was attributed primarily to the posting of midwives at the village level. In this article, data are presented from the same period and area on a variety of intermediate events. They indicate that the decline in deaths was probably due to the combined efforts of community midwives and the physicians at the Matlab maternity clinic. Their ability to refer patients to higher levels of care was important. The data further indicate that the decline in deaths depended upon the functioning of the government hospital in Chandpur, where cesarean sections and blood transfusions were available. Midwives might also have made a special contribution by providing early termination of pregnancy, which is legal in Bangladesh.

Abortion, Induced↗
PubMedDate not supplied

Women's status and infant mortality in rural Colombia.

This paper investigates the effects of maternal demographic characteristics and social and economic statuses on infant mortality in rural Colombia. Demographic characteristics include the age of the mother, parity and length of preceding interbirth interval, and sex of infant. Measures of women's status at the time of birth include education, wage labor and occupation, economic stratum, place of residence, and whether the mother is living with a husband. The life history data for the study (involving 4,928 births) were collected in 1986 from a representative sample of two cohorts of women resident in rural central Colombia. Overall differentials in infant mortality by measures of women's status are small and are in good part associated with the differing reproductive behaviors of the women and variations in breastfeeding practices. The sharp declines in infant mortality recorded in rural Colombia in recent years appear less related to improved status of women than to reductions in fertility that enhance infant survivorship and to public health interventions shared by all segments of the population.

Adult↗
PubMedDate not supplied

Development policy and the African demographic transition: issues and questions.

"This paper gives an overview of the recent demographic history of countries in sub-Saharan Africa, especially the start of a fertility decline. After discussing the evidence for a decline, and the nature of changes in fertility behaviour, the paper moves on to look at possible causes, in relation to development policy. Mortality, cultural structure, the status of women, education and economic crisis are all considered as candidates. The conclusion is reached that available evidence raises as many questions about the causes of fertility decline as it resolves, particularly in our understanding of the process of change. Finally, the potential consequences of falls in fertility and population growth slowdown in sub-Saharan Africa are considered."

Africa↗
PubMedDate not supplied

Prospects and programs for fertility reduction, 1990-2015.

What is the likelihood that each of the 37 developing countries with populations of 15 million or more in 1990 will reach replacement fertility by the year 2015? These countries have a combined population of 3.9 billion, 91 percent of the population of all developing countries. For this article, a composite index was used as the basis for predicting future levels of total fertility. The index was constructed from socioeconomic variables (life expectancy at birth, infant mortality rates, percent adult literacy, ratio of children enrolled in primary or secondary school, percent of the labor force in nonagricultural occupations, gross national product per capita, and percent of the population living in urban areas), total fertility rates for the years 1985-90, total fertility rate decline from 1960-65 to 1985-90, family planning program effort scores in 1989, and the level of contraceptive prevalence in 1990. Eight countries are classified as certain to reach replacement fertility by 2015, and an additional thirteen probably will also. Five countries are classified as possibly reaching replacement fertility, and eleven as unlikely to do so.

Birth Rate↗