Promoting household food and nutrition security in Myanmar. (25/350)

Myanmar has a policy of promoting food and nutrition security and, at the national level, food production is more than that required to meet the country's needs. Nevertheless, food and nutrition surveillance has revealed that malnutrition still exists in the country, despite economic growth and national food self-sufficiency. The National Plan of Action for Food and Nutrition, formulated in 1994 and adopted in 1995, accorded priority to household food and nutrition security. Accordingly, in 1996, in partnership with the World Health Organization (WHO), the National Nutrition Centre embarked on a study of household food and nutrition security in Myanmar. A preliminary situation analysis revealed that transitional changes in the economic, demographic and social sectors have driven dramatic changes in people's lifestyles, behaviour and practices and that these changes affect food and nutrition security. The present paper explores household and intrahousehold determinants of nutrition problems in Myanmar.  (+info)

Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. (26/350)

This two-part article provides an overview of the global burden of atherothrombotic cardiovascular disease. Part I initially discusses the epidemiologic transition which has resulted in a decrease in deaths in childhood due to infections, with a concomitant increase in cardiovascular and other chronic diseases; and then provides estimates of the burden of cardiovascular (CV) diseases with specific focus on the developing countries. Next, we summarize key information on risk factors for cardiovascular disease (CVD) and indicate that their importance may have been underestimated. Then, we describe overarching factors influencing variations in CVD by ethnicity and region and the influence of urbanization. Part II of this article describes the burden of CV disease by specific region or ethnic group, the risk factors of importance, and possible strategies for prevention.  (+info)

Prevention of yellow fever in persons traveling to the tropics. (27/350)

Yellow fever (YF) is a potentially lethal mosquito-borne viral hemorrhagic fever endemic in Africa and South America. Nine million tourists annually arrive in countries where YF is endemic, and fatal cases of YF have occurred recently in travelers. In this article, we review the risk factors for YF during travel and the use of YF 17D vaccine to prevent the disease. Although the vaccine is highly effective and has a long history of safe use, the occurrence of rare, fatal adverse events has raised new concerns. These events should not deter travelers to areas where YF is endemic from being immunized, because the risk of YF infection and illness may be high in rural areas and cannot be easily defined by existing surveillance. To avoid unnecessary vaccination, physicians should vaccinate persons at risk on the basis of knowledge of the epidemiology of the disease, reports of epidemic activity, season, and the likelihood of exposure to vector mosquitoes.  (+info)

Determinants of STD epidemics: implications for phase appropriate intervention strategies. (28/350)

Determinants of evolving epidemics of sexually transmitted diseases (STD) are equally influenced by the evolution of the STD epidemics themselves and by the evolution of human societies. A temporal approach to STD transmission dynamics suggests the need to monitor infectivity, rate of exposure between infected and susceptible individuals, and duration of infectiousness in societies. Different indicators may be used to monitor rate of exposure in the general population and in core groups. In addition, underlying determinants of STD epidemics such as poverty, inequality, racial/ethnic discrimination, unemployment, sex ratio, volume of migration, and health care coverage and quality are important variables to monitor through a surveillance system focused on social context. Ongoing large scale societal changes including urbanisation, globalisation, increasing inequality, and increasing volume of migrant populations may affect the evolution of STD epidemics. Globalised STD epidemics could pose a major challenge to local public health systems.  (+info)

Sex in the city: sexual behaviour, societal change, and STDs in Saigon. (29/350)

HIV infection is increasing among sex workers and injection drug users in southern Vietnam. Vietnamese sex workers returning from Cambodia are an important factor. This phase I growth stage is being accelerated by widespread prostitution and escalating heroin use. Sexually transmitted disease (STD) rates are significant in sex workers but low in the general population. STD epidemics in developing countries may not follow the dynamic topology that is common in developed countries. Vietnam has the potential for significant HIV and STD epidemics but also the capacity to respond to these threats.  (+info)

The Dar Es Salaam Urban Health Project, Tanzania: a multi-dimensional evaluation. (30/350)

BACKGROUND: In the 1990s, as a response to rapid urbanization, there were a number of large, urban health initiatives in sub-Saharan Africa. Most tended to be comprehensive as opposed to selective in scope: they aimed at strengthening the health system as a whole, and placed emphasis on delivering improved services at the primary level, with increased community participation. A multi-dimensional approach is required to assess the achievements of such initiatives. METHODS: In 2000 an external evaluation of the Swiss-funded Dar es Salaam Urban Health Project, Tanzania, used 50 key informant interviews, 90 health facility exit interviews, 90 community resident interviews and document analysis to assess achievements over a 10 year period. The study considered achievements in terms of capacity building, improving quality of care, community involvement, inter-sectoral action and sustainability. RESULTS: Although the project achieved improvements in capacity building and in structural and technical quality of care, there were difficulties in generating inter-sectoral action and the concept of participation was limited. However, city-level 'ownership' of the activities was high, and, with the advent of sector-wide allocation of funds (SWAPs) in the health sector in Tanzania, the prospects for sustainability of the achievements made in the project appear to be good. CONCLUSION: Both the multi-dimensional method of the evaluation and the findings can inform future urban health initiatives in sub-Saharan Africa and in other resource-constrained environments. The decentralization that occurred in Dar es Salaam and the general approach of the project provided a platform to test out various elements that are common to health sector reform across developing countries.  (+info)

Urbanization, urbanicity, and health. (31/350)

A majority of the world's population will live in urban areas by 2007. The most rapidly urbanizing cities are in less-wealthy nations, and the pace of growth varies among regions. There are few data linking features of cities to the health of populations. We suggest a framework to guide inquiry into features of the urban environment that affect health and well-being. We consider two key dimensions: urbanization and urbanicity. Urbanization refers to change in size, density, and heterogeneity of cities. Urbanicity refers to the impact of living in urban areas at a given time. A review of the published literature suggests that most of the important factors that affect health can be considered within three broad themes: the social environment, the physical environment, and access to health and social services. The development of urban health as a discipline will need to draw on the strengths of diverse academic areas of study (e.g., ecology, epidemiology, sociology). Cross-national research may provide insights about the key features of cities and how urbanization influences population health.  (+info)

Prolactin, testosterone and cortisol as possible markers of changes in cardiovascular function associated with urbanization. (32/350)

People living in large informal settlements in South Africa showed a significant increase in cardio/cerebrovascular disease. This study was undertaken to compare the cardiovascular and endocrine parameters of urbanized and rural black female and males. The hormone levels such as prolactin, cortisol and testosterone may also change with urbanization and could make a contribution to the high rate of hypertension. For this study, 1202 black subjects were selected from 37 randomly selected rural and urbanized settlements. Resting blood pressure was recorded with a Finapres apparatus. Cardiac output, stroke volume, heart rate, total peripheral vascular resistance and compliance had been obtained with the Fast Modelflow software program. An acute laboratory stressor (hand dynamometer exercise) was applied to challenge the cardiovascular system and the measurements were repeated. Blood sampling was done and hormone levels were determined by biochemical analyses. For females, significant lower levels of cortisol were found in the urban strata in comparison with the rural strata. The testosterone levels were significantly lower and the prolactin levels significantly higher for females in the informal settlements compared with the rural strata. It is noticeable that most cardiovascular parameters showed the highest changes with the application of the stressor in the informal settlement strata and the lowest in people living on farms for both male and female. The prolactin levels in males are significantly higher in the informal settlement stratum. Subjects living in informal settlements showed a noticeable endocrine pattern of ongoing stress that can be associated with changes in the cardiovascular parameters with urbanization. This can partly explain the reported high rate of cardio/cerbrovascular disease in black South Africans living in informal settlements.  (+info)