RESUMO
Explanations for the association between teen-childbearing and subsequent mental morbidity vary considerably, from those based on neurological theories of development to those investigating underlying social and economic determinants. Based on longitudinal epidemiological and ethnographic sub-studies of the 1982 Pelotas birth cohort study, this paper explores the hypothesis that teen childbearing and subsequent mental morbidity have become associated through the interplay of culture, society, and biology in situations where teen pregnancy has become a stigmatised object of scientific and public health attention. Results show that the effect of teen childbearing on subsequent mental morbidity remained significant in the multivariate analysis. Ethnographic analysis, together with epidemiological effect modification analyses, suggest that this association is partially accounted for by the fact that it is more pronounced amongst a specific subgroup of women of low socio-economic status who, being more politicised about societal injustice, were also more critically engaged with - and thus troubled by - the inequitable institutionalisation of life-cycle transitions. With time, these women became highly critical of the institutionalised identification of early childbearing as a key violation of life-cycle norms and the differential class-based application of scientific knowledge on its causes and consequences. Public health campaigns should consider how the age-based institutionalisation of developmental norms has enabled the stigmatisation of those identified as transgressors.
Assuntos
Transtornos Mentais/epidemiologia , Mães/psicologia , Gravidez na Adolescência/psicologia , Estereotipagem , Adolescente , Brasil/epidemiologia , Criança , Estudos de Coortes , Feminino , Humanos , Idade Materna , Morbidade , Mães/estatística & dados numéricos , Gravidez , Estudos Prospectivos , Medição de Risco , Fatores Socioeconômicos , Adulto JovemAssuntos
Masculino , Feminino , Humanos , Recém-Nascido , Lactente , Criança , Diarreia , Doenças Respiratórias , Mortalidade Infantil , Saúde da Criança , Transtornos da Nutrição InfantilRESUMO
Acute respiratory infections are the leading cause of childhood death in developing countries. Current efforts at mortality control focus on case management and immunization, but other preventive strategies may have a broader and more sustainable effect. This review, commissioned by the World Health Organization, examines the relations between pneumonia and nutritional factors and estimates the potential effect of nutritional interventions. Low birth weight, malnutrition (as assessed through anthropometry), and lack of breast-feeding appear to be important risk factors for childhood pneumonia, and nutritional interventions may have a sizeable effect in reducing deaths from pneumonia. For all regions except Latin America, interventions to prevent malnutrition and low birth weight look more promising than does breast-feeding promotion. In Latin America, breast-feeding promotion would have an effect similar to that of improving birth weights, whereas interventions to prevent malnutrition are likely to have less of an effect. These findings emphasize the need for tailoring interventions to specific national and even local conditions.
Assuntos
Estado Nutricional , Pneumonia/prevenção & controle , Aleitamento Materno , Pré-Escolar , Ensaios Clínicos como Assunto , Países em Desenvolvimento , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Pneumonia/complicações , Desnutrição Proteico-Calórica/complicações , Fatores de RiscoRESUMO
OBJECTIVE: To evaluate the impact of large-dose vitamin A supplementation given to infants > 6 months old (200000 IU) and to preschool children aged 1-4 years (400000 IU) during a pneumonia episode, on their subsequent morbidity and severe morbidity. METHOD: In a randomized, double-blind, placebo controlled trial, the children were followed-up with 2-weekly visits at home for 16 weeks, with the first visit 2 weeks after treatment for pneumonia was initiated. The field workers asked about the presence of morbidity on the day of the visit and in the previous two weeks and about the occurrence and number of clinic attendances and hospital admissions since the last visit. They also measured the patients respiratory rate and temperature and assessed the children for the presence of cyanosis, chest indrawing and wheezing. RESULTS: Except for the prevalence of diet refusal which was higher in the vitamin A group, no differences between the study groups were observed, either in the prevalence of morbidity or in the incidence of clinic attendances and hospital admissions. CONCLUSION: No evidence was found for a beneficial effect of vitamin A given during acute pneumonia on the subsequent morbidity and severe morbidity of children in a population with marginal vitamin A deficiency.
Assuntos
Suplementos Nutricionais , Pneumonia/tratamento farmacológico , Vitamina A/uso terapêutico , Brasil , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Lactente , Masculino , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the impact on clinical recovery and severity of the addition of large doses of vitamin A to the standard treatment for childhood pneumonia. DESIGN: A randomised, double blind, placebo controlled trial. SETTING: Study children were recruited at a public hospital in Recife, north east Brazil, an area of marginal vitamin A deficiency. SUBJECTS: 472 children aged 6 to 59 months with clinical diagnosis of pneumonia. INTERVENTIONS: 200,000 IU (infants) or 400,000 IU (1-4 year olds) of vitamin A in oil or similar capsules of placebo divided into two daily oral doses, in addition to the standard treatment. MAIN OUTCOME MEASURES: Duration of the episode and incidence of adverse outcomes. RESULTS: The groups were similar with respect to overall duration of pneumonia and incidence of adverse outcomes. Children who received vitamin A, however, were less likely to have fever by day 3 (P = 0.008) and were 29% less likely to fail to respond to the first line antibiotic (P = 0.054). CONCLUSION: There was little evidence for an effect of vitamin A treatment on the immediate outcome of the pneumonia episode.
Assuntos
Pneumonia/tratamento farmacológico , Vitamina A/uso terapêutico , Pré-Escolar , Método Duplo-Cego , Feminino , Febre/etiologia , Hospitalização , Humanos , Lactente , Masculino , Pneumonia/complicações , Falha de Tratamento , Vitamina A/efeitos adversosRESUMO
The early identification of children at high risk of dehydration as a consequence of diarrhoea would be of great value for health care workers in developing countries. By comparing children aged less than two years with diarrhoea and moderate to severe dehydration with matched controls who had uncomplicated diarrhoea, a number of prognostic factors were assessed. Low body weight, regardless of age, was strongly associated with the risk of dehydration; using 7.0 kg as a cut-off, it had a sensitivity of 75% and a specificity of 68%. Low body weight was superior to more complex anthropometric indices, including weight for age, weight for length or length for age, and also to early signs and symptoms during the episode. By reflecting the effects of both young age and those of malnutrition, low body weight may prove to be a simple indicator for predicting dehydration among children with diarrhoea presenting at a health service.
Assuntos
Desidratação/diagnóstico , Diarreia/epidemiologia , Peso Corporal , Estudos de Casos e Controles , Desidratação/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Distúrbios Nutricionais/diagnóstico , Fatores de RiscoRESUMO
Reported are the results of a case-control study carried out between July 1989 and June 1990 in Fortaleza city, Ceará State, Brazil, to determine the factors that place young children living in urban slum conditions at increased risk of contracting pneumonia. Cases were 650 under-2-year-olds with a radiological diagnosis of pneumonia who were recruited at the main paediatric hospital in the city over a full calendar year. Age-matched controls were recruited from the neighbourhood where the cases lived. Cases and controls were compared with respect to a variety of sociodemographic, environmental, reproductive, nutritional, and morbidity factors, and a risk factor questionnaire was administered to the mother of each child or to the child's normal guardian. Cases and controls were also weighed and measured. Malnutrition was the most important risk factor for childhood pneumonia in the study population, with weight-for-age, height-for-age, and weight-for-height also being important risk factors. In view of the high prevalence of stunting in the study population, there is an urgent need to reduce the level of malnutrition as a priority. Attendance at a day care centre was also associated with a high odds ratio. In view of the growing numbers of children attending day care centres in both developing and developed countries, it is essential that ways be identified to improve the design and management of such centres in order to minimize the risk of pneumonia. Increased risks of childhood pneumonia were also associated with low birth weight, non-breast-feeding, crowding, high parity, and incomplete vaccination status, but not with socioeconomic status or environmental variables. Finally, children who had suffered from previous episodes of wheezing or been hospitalized for pneumonia had a greater than threefold increased risk of contracting the disease.
Assuntos
Pneumonia/etiologia , Adulto , Antropometria , Brasil/epidemiologia , Aleitamento Materno , Estudos de Casos e Controles , Creches , Comorbidade , Aglomeração , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Pneumonia/epidemiologia , Áreas de Pobreza , Fatores de Risco , Estudos de Amostragem , Fatores Socioeconômicos , VacinaçãoRESUMO
In Pelotas, Brazil, 400 newborns from low income families were followed-up until 26 wk of life to study the relationship between their feeding patterns and growth as modified by access to water and by diarrhea. Effects of access to water were the strongest among non-breastfed infants. In houses without indoor water taps, the weight gain of non-breastfed infants during the first 3 mo was approximately half that of partially or predominantly breastfed infants (P < 0.001). In houses with indoor water taps, non-breastfed infants' growth was similar to or exceeded that of predominantly breastfed infants from 2 mo. Predominantly breastfed infants' growth was similar in houses with and without water taps. Breastfed infants had less weight loss per day of diarrhea than non-breastfed infants during the first 4 mo and less diarrhea through 6 mo of life, particularly in houses without taps, in which diarrhea was most prevalent. The existence of a "weanling's dilemma" was approached by comparing the duration of the detrimental effects of not breastfeeding (i.e., 0-3 mo in this study) with the age at which breast milk alone becomes less than optimal for growth (i.e., at 5 mo). Because these two points did not coincide, we conclude that there is no "weaning's dilemma" in this population.
Assuntos
Aleitamento Materno , Ingestão de Líquidos , Desmame , Brasil , Diarreia Infantil/fisiopatologia , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Necessidades Nutricionais , Abastecimento de Água , Aumento de PesoRESUMO
OBJECTIVE: To investigate risk factors for pneumonia for infants < 2 years of age. DESIGN: Hospital-based, case-control study with neighborhood control subjects. SETTING: Urban area in southern Brazil. SUBJECTS: Five hundred ten infants with radiologically confirmed pneumonia who were admitted to a pediatric hospital. One age-matched neighborhood control subject was selected for each case. RESULTS: Multiple conditional regression modeling was used to control for confounding, taking into account the hierarchical relationships between risk factors. The incidence of radiologically confirmed pneumonia was associated with low paternal education, the number of persons in the household, young maternal age, attendance at day-care centers, low birth weight and weight-for-age, lack of breast-feeding and of non-milk supplements, and a history of previous pneumonia or wheezing. Day-care center attendance showed the highest risk, with an adjusted odds ratio of 11.75. CONCLUSIONS: In addition to continued efforts toward appropriate case management, actions directed against the above risk factors may help prevent the major cause of deaths of children younger than 5 years.
Assuntos
Pneumonia/epidemiologia , Doença Aguda , Brasil/epidemiologia , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/epidemiologia , Características da Família , Feminino , Humanos , Incidência , Lactente , Masculino , Análise Multivariada , Razão de Chances , Pneumonia/diagnóstico por imagem , Radiografia , Fatores de Risco , Fatores Socioeconômicos , Saúde da População Urbana/estatística & dados numéricosRESUMO
A cohort of 5914 liveborns (99% of the city births) was followed up to the age of 4 years in Pelotas, southern Brazil. Besides the perinatal evaluation, the cohort children were examined again at mean ages of 11, 23, and 47 months. During each visit the children were weighed and measured and information on morbidity was collected. Also, multiple sources of information were used for monitoring mortality throughout the study. Of the babies with known gestational age, 9.0% were classified as intrauterine growth-retarded and 6.3% as preterm. Excluding those of unknown gestational age, 62% of low birth weight babies were intrauterine growth-retarded and 36% were preterm. Intrauterine growth retardation was statistically associated with maternal height, prepregnancy weight, birth interval, and smoking, whereas preterm births were associated with maternal prepregnancy weight and maternal age. Preterm babies had a perinatal mortality rate 13 times higher than that of babies of appropriate birth weight and gestational age and 2 times higher than that of intrauterine growth-retarded babies. Infant mortality rates presented a similar pattern, with the differentials being more pronounced during the neonatal than in the postneonatal period. In the first 2 years of life intrauterine growth-retarded children were at almost twice the risk of being hospitalized for diarrhea compared with appropriate birth weight, term children, while preterm children experienced only a slightly greater risk. For pneumonia, however, both groups of children were hospitalized significantly more than appropriate birth weight, term children. In terms of growth, despite their earlier disadvantage, preterm children gradually caught up with their appropriate birth weight, term counterparts.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Retardo do Crescimento Fetal/etiologia , Recém-Nascido Prematuro , Peso ao Nascer , Estatura , Peso Corporal , Brasil/epidemiologia , Pré-Escolar , Estudos de Coortes , Diarreia/epidemiologia , Morte Fetal/epidemiologia , Seguimentos , Idade Gestacional , Crescimento , Humanos , Renda , Lactente , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido , Estudos Longitudinais , Idade Materna , Pneumonia/epidemiologia , Fatores de Risco , Fumar/efeitos adversosRESUMO
Early identification of children at high risk of diarrhoea-associated dehydration would be of great value to health care workers in developing countries. To identify prognostic factors for life-threatening dehydration, we carried out a case-control study among under-2-year-olds in Porto Alegre, Brazil. Cases were 192 children admitted to hospital with moderate or severe dehydration, while controls were children matched to controls by neighbourhood and age, who experienced nondehydrating diarrhoea in the week preceding the interview. The following variables were significantly associated with an increased risk of dehydration, after adjustment for age and other confounding variables: absence of the father from the home; low paternal education level; young age; maternal age 25-29 years or less than 20 years; mother of mixed race; high birth order; short birth interval; low birth weight; stunting, underweight and wasting; lack of breast-feeding; presence of other under-5-year-olds in the home; families with 4-5 members; lack of antenatal care; less than three doses of diphtheria-pertussis-tetanus or poliomyelitis vaccine; previous admission to hospital; use of medicines during the fortnight prior to the episode; and living in an unclean home. The associations were particularly strong (P less than 0.001) for the child's age, birth weight and other anthropometric indicators, birth interval, and feeding mode. In terms of their sensitivity and specificity, however, these prognostic factors were not as effective as early signs and symptoms for predicting the outcome of the episode.
PIP: During the primary diarrhea season (December 1987-April 1988) in metropolitan Porto Alegre in southern Brazil, researchers compared 192 children aged less than 2 years who were admitted to a hospital with moderate or severe dehydration with 192 neighborhood- and age-matched controls who had a diarrhea episode without dehydration during the seven days before the interview. They aimed to identify factors predicting life-threatening dehydration. When the researchers controlled for age and other confounding variables, the following factors were significantly related to an increased risk of dehydration: no father in the household, low paternal education level, young age, maternal age 25-29 years or less than 20 years, mixed race mother, high birth order, short birth interval, low birth weight, stunting, underweight and wasting, non-breast milk, children aged less than 5 in the household, family size of 4-5, no prenatal care, less than three doses of diphtheria-pertussis-tetanus or poliomyelitis vaccine, previous admission to a hospital, use of medicines during the two weeks before the diarrhea episode, and living in an unsanitary household. The strongest factors associated with an increased risk of dehydration (p 0.001) included young age, low birth weight and malnutrition, short birth interval, and non-breast milk. These factors were not as effective at predicting an increased risk of dehydration as early signs and symptoms. Specifically, their sensitivities were lower than those of early signs and symptoms. Notwithstanding, these findings support current efforts towards promotion of breast feeding, prevention and treatment of malnutrition, and birth spacing since they contribute to the prevention of diarrhea-related dehydration.
Assuntos
Aleitamento Materno , Desidratação/diagnóstico , Diarreia Infantil/complicações , Estado Nutricional , Antropometria , Brasil , Estudos de Casos e Controles , Fatores de Confusão Epidemiológicos , Desidratação/etiologia , Características da Família , Humanos , Lactente , Recém-Nascido , Prognóstico , Fatores de Risco , Fatores SocioeconômicosRESUMO
Early detection of children who are likely to develop life-threatening dehydration as a consequence of diarrhoea would be of great value for health care workers in developing countries. We carried out a case-control study to compare the symptoms and signs observed on the first day of diarrhoea in two groups of 192 children aged under two years, in the Brazilian city of Porto Alegre. The cases were children admitted to a hospital with moderate or severe dehydration, and controls were children from the same neighbourhoods as the cases, who had diarrhoea which did not lead to hospital admission. The sensitivity and specificity of different clinical indicators were calculated. Alterations in thirst (82%), followed by six or more stools (71%), fever (60%), vomiting (58%) and loss of appetite (57%) had the highest sensitivities, whereas the specificities were largest for blood in the stools (97%), fever (78%) and vomiting (78%). Assuming that dehydration occurs in 5% of all episodes of diarrhoea, the use of fever as a screening criterion, or the use of vomiting, would select 24% of all children with diarrhoea, and capture about 60% of all episodes of dehydration. The combination of fever or vomiting would increase the proportion selected to 36%, and capture 75% of episodes of dehydration.
Assuntos
Desidratação/diagnóstico , Diarreia/complicações , Brasil/epidemiologia , Estudos de Casos e Controles , Desidratação/etiologia , Desidratação/mortalidade , Febre/complicações , Hospitalização , Humanos , Lactente , Fatores de Risco , Estações do Ano , Sensibilidade e Especificidade , Vômito/complicaçõesRESUMO
The synergism between nutrition status and hospital admissions due to diarrhea and pneumonia was studied in a population-based birth cohort of greater than 5000 children in southern Brazil. Children were identified soon after birth in 1982, and data on nutrition status (weight and length) and hospital admissions were collected in 1984 and in 1986. Diarrhea admissions were stronger predictors of malnutrition than were pneumonia admissions, but malnutrition was a more important risk factor for pneumonia than for diarrhea. All associations were stronger in the first 2 y of life, although the early effect of severe diarrhea and pneumonia on nutrition status could still be detected in the fourth year of life.
Assuntos
Diarreia/complicações , Crescimento/fisiologia , Distúrbios Nutricionais/complicações , Estado Nutricional , Pneumonia/complicações , Peso ao Nascer , Estatura , Peso Corporal , Brasil , Pré-Escolar , Estudos de Coortes , Diarreia Infantil/complicações , Seguimentos , Humanos , Lactente , Estudos Longitudinais , Fatores de Risco , Fatores Socioeconômicos , População UrbanaRESUMO
A study of breast-feeding practices over the first 6 months of life among a cohort of urban poor infants in southern Brazil indicated that the median duration of breast-feeding was 18 weeks, and at 6 months 41% of the infants were still being breast-fed. The duration of breast-feeding was significantly associated with the following: the infant's sex, mother's colour, type of first feed, timing of the first breast-feed, breast-feeding regimen and frequency of breast-feeding at 1 month, and the use of hormonal contraceptives by the mother. The following were significant risk factors for early termination of breast-feeding: the infant's sex, type of first feed, use of supplementary feeds, frequency of breast-feeding, feeding regimen, weight-for-age, and weight-for-age after controlling for birth weight. Dissatisfaction with their infant's growth rate was the most frequent reason given by mothers for supplementing the diets of infants who were exclusively breast-fed in the first 3 months of life. Also, the mothers' perception that their milk output was inadequate was the most frequent reason expressed for stopping breast-feeding in the first 4 months. The roles of health services and family support in providing favourable conditions for increasing the duration of breast-feeding in the study population are discussed, as well as the possibility of bias being introduced into studies of the relationship between infant feeding and growth by the effect of the infant's rate of growth on the mother's decision to continue breast-feeding.
PIP: A study of breastfeeding practices over the 1st 6 months of life among a cohort of urban poor infants in southern Brazil indicated that the median duration of breastfeeding was 18 weeks, and at 6 months, 41% of the infants were still being breastfed. The duration of breastfeeding was significantly associated with the following: infant's sex, mother's color, type of 1st feed, timing of the 1st breastfeed, breastfeeding regimen and frequency of breastfeeding at 1 month, and the use of hormonal contraceptives by the mother. The significant risk factors for early termination of breastfeeding were: infant's sex, type of 1st feed, use of supplementary feeds, frequency of breastfeeding, feeding regimen, weight-for-age, and weight-for age after controlling for birthweight. Dissatisfaction with infant growth rate was the most frequent reason given for mothers for supplementing the diets of those infants who were exclusively breastfed for the 1st 3 months of life. Also, them other's perception that their milk output was inadequate was the most frequent reason expressed for the cessation of breastfeeding in the 1st 4 months. The roles of health services and family support in providing favorable conditions for increasing the duration of breastfeeding in the study population are discussed, as well as the possibility of bias being introduced into studies of the relationship between infant feeding and growth by the effect of the infant's rate of growth on the mother;s decision to breastfeed. (author's)
Assuntos
Aleitamento Materno , Mães/psicologia , Adulto , Brasil , Feminino , Humanos , Lactente , Masculino , Áreas de Pobreza , População UrbanaRESUMO
In a prospective survey of 1342 Trinidadian men aged 35 to 69 years at recruitment, age-adjusted mean blood pressures were highest in those of African descent, intermediate in Indians and mean of Mixed origin, and lowest in Europeans. Age-adjusted fasting blood glucose concentrations were highest in Indians and lowest in men of European descent. Relative risks of all-cause, cardiovascular and cerebrovascular mortality increased progressively with increasing systolic pressure, whereas for fasting blood glucose concentration the associations were U-shaped. No ethnic differences were apparent in relative risks. For systolic pressure, mortality from all-causes and cardiovascular diseases respectively were about two and three times higher at 180 mmHg or more than at pressures below 130 mmHg. For blood glucose, all-cause and cardiovascular mortality were about four times higher at fasting concentrations greater than 7.7 mmol/l than in the lowest risk group (4.2-4.6 mmol/l). All-cause population attributable mortality rates for systolic pressures of 130 mmHg or more were 1.3 to 2.8 times higher in Indian men than in other groups. For blood glucose in excess of 4.6 mmol/l, population attributable mortality was between 2.9 and 6.9 times higher in Indians than in other groups. The findings emphasized the high mortality in men of Indian descent, partly due to an apparent underlying predisposition to cardiovascular disease, and partly to their high prevalence of diabetes mellitus.
Assuntos
Glicemia/análise , Pressão Sanguínea , Doenças Cardiovasculares/mortalidade , Transtornos Cerebrovasculares/mortalidade , Grupos Raciais , Adulto , Idoso , População Negra , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/fisiopatologia , Causas de Morte , Transtornos Cerebrovasculares/etnologia , Transtornos Cerebrovasculares/fisiopatologia , Humanos , Índia/etnologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Trinidad e Tobago , População BrancaRESUMO
In a prospective survey of 1342 Trinidadian men aged 35 to 69 years at recruitment, aged-adjusted mean blood pressures were highest in those of African descent, intermediate in Indians and men of Mixed origin, and lowest in Europeans. Age-adjusted fasting blood glucose concentrations were highest in Indians and lowest in men of European descent. Relative risks all-cause cardiovascular and cerebrovascular mortality increased progressively with increasing systolic pressure, whereas for fasting blood glucose concentration the association were U-shaped. No ethnic difference were about two and three times higher at 180 mmHg or more than at pressures below 130 mmhg. For blood glucose, all cause and cardiovascular mortality were about four times higher at fasting concentrations.7.7 mmol/i than in the lowest risk group (4.2-4.6 mmol.l). All cause population attributable mortality rates for systolic pressures of 130 mmhg or more were 1.3 to 2.8 times higher in Indian men than in other groups. For blood glucose in excess of 4.6 mmol/l, population attributable mortality was between 2.9 and 6.9 times higher in Indians than in other groups. The findings emphasized the high mortality in men of Indian descent, partly due to an apparent underlying predisposition to cardiovascular disease, and partly to their high prevalence of diabetes mellitus. (AU)
Assuntos
Humanos , Masculino , Transtornos Cerebrovasculares/mortalidade , Trinidad e Tobago/epidemiologia , Doenças Cardiovasculares/mortalidade , Região do Caribe , Países em DesenvolvimentoRESUMO
The presence of antibody to human T-cell leukaemia virus (HLTV-I) has been assessed in 2,143 men and women who represent 83% of all adults aged 35 to 69 years resident in a defined urban community in Trinidad. Individuals of African descent had a higher sero-positivity rate (7.0%) than those originating from India (1.4%), Europe (0%) or of mixed descent (2.7%). Women were infected more frequently than men, and the prevalence of infection increased with age in both sexes. Sero-positivity rates were significantly increased in adults who lived in housing of poor quality (p less than 0.001) or close to water courses (p less than 0.025). These data and others raise the possibility that one route of HLTV-I transmission may be via insect vectors under particular domestic circumstances.
Assuntos
Infecções por Deltaretrovirus/epidemiologia , Habitação , Adulto , Fatores Etários , Idoso , Anticorpos Antivirais/análise , Anticorpos Antideltaretrovirus , Infecções por Deltaretrovirus/etnologia , Infecções por Deltaretrovirus/transmissão , Feminino , Humanos , Insetos Vetores , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Trinidad e TobagoRESUMO
A prospective survey has been undertaken of a total community of 1343 men and 1149 women, aged 35-69 years at recruitment, living in Port-of-Spain, Trinidad. By comparison with adults of African descent, age-adjusted relative risks of death from all causes and from cardiovascular diseases were significantly increased in those of Indian origin (1.5 and 2.6, respectively) and reduced in those of mixed descent (0.5 and 0.3, respectively). Adults of European descent had an all-cause and cardiovascular mortality relative risk of 0.8 and 2.1, respectively. These ethnic differences in risk were not explained by systolic blood pressure, fasting blood glucose concentration, serum high-density lipoprotein or low-density lipoprotein concentration, or smoking habits. Differences in risk of cardiovascular death between Indian and European men seemed to be accounted for by the high prevalence of diabetes in Indians (19%) but other ethnic contrasts in mortality were unrelated to diabetes mellitus.
Assuntos
Doenças Cardiovasculares/mortalidade , Adulto , África/etnologia , Idoso , Pressão Sanguínea , Serviços de Saúde Comunitária , Diabetes Mellitus Tipo 2/complicações , Europa (Continente)/etnologia , Feminino , Teste de Tolerância a Glucose , Humanos , Índia/etnologia , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Risco , Fumar , Trinidad e TobagoRESUMO
A prospective survey has been undertaken of a total community of 1343 men and 1149 women, aged 35-69 years at recruitment, living in Port-of-Spain, Trinidad. By comparison with adults of African descent, age-adjusted relative risks of death, from all causes and from cardiovascular diseases were significantly increased in those of Indian origin (1.5 and 2.6, respectively) and reduced in those of mixed descent (0.5 and 0.3, respectively). Adults of European descent had an all-cause and cardiovascular mortality relative risk of 0.8 and 2.1, respectively. These ethnic differences in risk were not explained by systolic blood pressure, fasting blood glucose concentration, serum high-density lipoprotein or low-density lipoprotein concentration, or smoking habits. Differences in risk of cardiovascular death between Indian and European men seemed to be accounted for by the high prevalence of diabetes in Indians (19 percent) but other ethnic contrasts in mortality were unrelated to diabetes mellitus (AU)