Socio-economic status and health

Introduction : Neurolathyrism is an upper motor neuron disorder characterized by spastic paraparesis, which is caused by the prolonged over-consumption of grass pea. It is a devastating disease with great impacts on physical, social, mental, and economical health. Objective To determine the prevalence of neurolathyrism and its associated factors in grass pea cultivation areas of Dawunt wereda. Methods Community based cross-sectional study design was conducted from February 01-March 30, 2021 on 631 Households with a total of 3,350 individuals. Two-stage random sampling technique was used to select participants. Multilevel binary logistic regression was used to identify factors associated with neurolathyrism. Statistical significance was declared at p < 0.05; and AOR with 95% CI was used to interpret the results. Results The household and population level prevalence of neurolathyrism in Dawunt district were 9.2% (7.2-11.7%) and 2.4% (2.0-2.3.0%) respectively. Age (AOR = 7.4 (2.6-20.6)), male sex (AOR = 7.8 (3.9, 15.4)), and marital status (AOR = 4.0 (1.3-12.8)) were the individual level variables; family size (AOR = 12.6 (3.0-52.8)), annual grass pea production (AOR = 5.0 (2.3-11.0)), ever feeding only grass pea (AOR = 8.8(3.5-22.2)), ever feeding immature seeds of grass pea (AOR = 6.28 (2.80, 14.08)), high grass pea to other cereals mixing ratio (> 3:1) (AOR = 6.1 (1.1, 33.5)) were the household level variables found to have significant association with neurolathyrism. Conclusion The prevalence of neurolathyrism was found to be high. Ever feeding only grass pea, Grass pea to other cereals mixing ratio (using ratio of 1:1 or more), and Ever feeding immature grass pea seeds were the modifiable risk factors for neurolathyrism.

Introduction: Typhoid fever is a major public health problem in developing countries. Typhoid fever is transmitted by the feco-oral root through ingestion of contaminated food or water that contains Salmonella typhi. Poor knowledge and risk perception towards typhoid fever contributed to the prolonged transmission of diseases in the community. The aim of this study was to assess knowledge and risk perception towards typhoid fever among Gyadi-Gyadi communities in Kano, Nigeria. Methodology: A community based cross-sectional study was conducted in Gyadi-Gyadi from April, 2019 to May, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: Results: The result shows that 300 participants responded to the questionnaire. 165 respondents (55%) were male and the remaining 135 (45%) were female. Regarding sign and symptom most of 287 (95.7%) of the respondents have answered headache. Concerning risk perception, majority 160 (53.7%) agree that lack of hand washing practice contribute to typhoid fever infection Conclusion: The study revealed that the respondents have good knowledge towards typhoid fever. However, the risk perception status of the respondents towards typhoid fever is poor. Recommendation: Supportive supervision for health extension workers in order to strengthen effective health education to the community on the causes of the diseases and possible preventives measure.

Background: Worldwide, 663 million people do not have access to improved drinking water supplies and 2.5 billion people lack access to improved sanitation including one billion who practice open defecation. Eighty-eight percent (88%) of deaths from diarrheal diseases are attributable to unsafe water, inadequate sanitation, and insufficient hygiene practices. So this study is aimed at assessing water, sanitation and hygiene practice among rural communities of Gulu Kano, Nigeria. Methods: A community based cross-sectional study was conducted in Gulu from January, 2019 to February, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: The result shows that 300 participants responded to the questionnaire. The majority of respondents used unprotected spring 70 (23.3%) followed by protected hand dug well 65 (21.7%) for all domestic use. Most of the respondents 205 (68.3%) had covered their stored water and practiced pouring method to withdraw water from the stored container. Majority 204 (68%) of households had access to water within a time of 30 minutes or less. House hold water treatment was not common in the study area, only 25 (8.3%) households practiced. About one hundred and ninety-nine (66.3%) households had latrine facility, of which 208 (69.3%) was open Pit latrine without slab. Of those households having latrine only 111 (37%) households had hand washing facility. Conclusion: This study revealed that most of the respondents had poor water, sanitation and hygiene practice. Thus, it underscores that there should be great attention and further research and interventions are required to search for other sources of water and mobilize and educate the community towards protecting the water sources.

Introduction: Typhoid fever is a major public health problem in developing countries. Typhoid fever is transmitted by the feco-oral root through ingestion of contaminated food or water that contains Salmonella typhi. Poor knowledge and risk perception towards typhoid fever contributed to the prolonged transmission of diseases in the community. The aim of this study was to assess knowledge and risk perception towards typhoid fever among Gyadi-Gyadi communities in Kano, Nigeria. Methodology: A community based cross-sectional study was conducted in Gyadi-Gyadi from April, 2019 to May, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: Results: The result shows that 300 participants responded to the questionnaire. 165 respondents (55%) were male and the remaining 135 (45%) were female. Regarding sign and symptom most of 287 (95.7%) of the respondents have answered headache. Concerning risk perception, majority 160 (53.7%) agree that lack of hand washing practice contribute to typhoid fever infection Conclusion: The study revealed that the respondents have good knowledge towards typhoid fever. However, the risk perception status of the respondents towards typhoid fever is poor. Recommendation: Supportive supervision for health extension workers in order to strengthen effective health education to the community on the causes of the diseases and possible preventives measure.

Background: Worldwide, 663 million people do not have access to improved drinking water supplies and 2.5 billion people lack access to improved sanitation including one billion who practice open defecation. Eighty-eight percent (88%) of deaths from diarrheal diseases are attributable to unsafe water, inadequate sanitation, and insufficient hygiene practices. So this study is aimed at assessing water, sanitation and hygiene practice among rural communities of Gulu Kano, Nigeria. Methods: A community based cross-sectional study was conducted in Gulu from January, 2019 to February, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: The result shows that 300 participants responded to the questionnaire. The majority of respondents used unprotected spring 70 (23.3%) followed by protected hand dug well 65 (21.7%) for all domestic use. Most of the respondents 205 (68.3%) had covered their stored water and practiced pouring method to withdraw water from the stored container. Majority 204 (68%) of households had access to water within a time of 30 minutes or less. House hold water treatment was not common in the study area, only 25 (8.3%) households practiced. About one hundred and ninety-nine (66.3%) households had latrine facility, of which 208 (69.3%) was open Pit latrine without slab. Of those households having latrine only 111 (37%) households had hand washing facility. Conclusion: This study revealed that most of the respondents had poor water, sanitation and hygiene practice. Thus, it underscores that there should be great attention and further research and interventions are required to search for other sources of water and mobilize and educate the community towards protecting the water sources.

Background: Worldwide, 663 million people do not have access to improved drinking water supplies and 2.5 billion people lack access to improved sanitation including one billion who practice open defecation. Eighty-eight percent (88%) of deaths from diarrheal diseases are attributable to unsafe water, inadequate sanitation, and insufficient hygiene practices. So this study is aimed at assessing water, sanitation and hygiene practice among rural communities of Gulu Kano, Nigeria. Methods: A community based cross-sectional study was conducted in Gulu from January, 2019 to February, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: The result shows that 300 participants responded to the questionnaire. The majority of respondents used unprotected spring 70 (23.3%) followed by protected hand dug well 65 (21.7%) for all domestic use. Most of the respondents 205 (68.3%) had covered their stored water and practiced pouring method to withdraw water from the stored container. Majority 204 (68%) of households had access to water within a time of 30 minutes or less. House hold water treatment was not common in the study area, only 25 (8.3%) households practiced. About one hundred and ninety-nine (66.3%) households had latrine facility, of which 208 (69.3%) was open Pit latrine without slab. Of those households having latrine only 111 (37%) households had hand washing facility. Conclusion: This study revealed that most of the respondents had poor water, sanitation and hygiene practice. Thus, it underscores that there should be great attention and further research and interventions are required to search for other sources of water and mobilize and educate the community towards protecting the water sources.

Background: Worldwide, 663 million people do not have access to improved drinking water supplies and 2.5 billion people lack access to improved sanitation including one billion who practice open defecation. Eighty-eight percent (88%) of deaths from diarrheal diseases are attributable to unsafe water, inadequate sanitation, and insufficient hygiene practices. So this study is aimed at assessing water, sanitation and hygiene practice among rural communities of Gulu Kano, Nigeria. Methods: A community based cross-sectional study was conducted in Gulu from January, 2019 to February, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: The result shows that 300 participants responded to the questionnaire. The majority of respondents used unprotected spring 70 (23.3%) followed by protected hand dug well 65 (21.7%) for all domestic use. Most of the respondents 205 (68.3%) had covered their stored water and practiced pouring method to withdraw water from the stored container. Majority 204 (68%) of households had access to water within a time of 30 minutes or less. House hold water treatment was not common in the study area, only 25 (8.3%) households practiced. About one hundred and ninety-nine (66.3%) households had latrine facility, of which 208 (69.3%) was open Pit latrine without slab. Of those households having latrine only 111 (37%) households had hand washing facility. Conclusion: This study revealed that most of the respondents had poor water, sanitation and hygiene practice. Thus, it underscores that there should be great attention and further research and interventions are required to search for other sources of water and mobilize and educate the community towards protecting the water sources.

Background: The year 2022 started with protests against COVID-19 restrictions throughout North America. These events manifest the fact that some segments of the population are not compliant with the preventive measures of COVID-19, and the reasons of the disobedience against public health regulation remain unclear. The current paper examined the joint effect of financial and health status on people’s likelihood of pursuing active coping efforts (i.e., following preventive measures) and giving up coping with the COVID-19 pandemic. Method: We conducted a large-scale survey study in China (N = 3834) in May 2020. Results: Our results showed that people with low financial status were less likely to manifest active coping behavior and more likely to give up coping with the pandemic. People’s self-confidence in coping with the pandemic mediated this effect. We showed that one’s health status could interact with their financial status in a way that healthy people with low financial status w...

Background: The year 2022 started with protests against COVID-19 restrictions throughout North America. These events manifest the fact that some segments of the population are not compliant with the preventive measures of COVID-19, and the reasons of the disobedience against public health regulation remain unclear. The current paper examined the joint effect of financial and health status on people's likelihood of pursuing active coping efforts (i.e., following preventive measures) and giving up coping with the COVID-19 pandemic. Method: We conducted a large-scale survey study in China (N = 3834) in May 2020. Results: Our results showed that people with low financial status were less likely to manifest active coping behavior and more likely to give up coping with the pandemic. People's self-confidence in coping with the pandemic mediated this effect. We showed that one's health status could interact with their financial status in a way that healthy people with low financial status would have less confidence in their coping abilities and thus become less likely to pursue active coping efforts and more likely to give up coping with the pandemic. Conclusions: Our results call for policymakers to find more effective solutions for noncompliant groups so that they can abide by the general guidelines in the COVID-19 context and other social crises that may emerge in the future. We suggest that governments should concentrate their support efforts on healthy populations of low financial segments to prevent COVID-19 and other infectious diseases in the future from spreading further.

Background: Worldwide, 663 million people do not have access to improved drinking water supplies and 2.5 billion people lack access to improved sanitation including one billion who practice open defecation. Eighty-eight percent (88%) of deaths from diarrheal diseases are attributable to unsafe water, inadequate sanitation, and insufficient hygiene practices. So this study is aimed at assessing water, sanitation and hygiene practice among rural communities of Gulu Kano, Nigeria. Methods: A community based cross-sectional study was conducted in Gulu from January, 2019 to February, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: The result shows that 300 participants responded to the questionnaire. The majority of respondents used unprotected spring 70 (23.3%) followed by protected hand dug well 65 (21.7%) for all domestic use. Most of the respondents 205 (68.3%) had covered their stored water and practiced pouring method to withdraw water from the stored container. Majority 204 (68%) of households had access to water within a time of 30 minutes or less. House hold water treatment was not common in the study area, only 25 (8.3%) households practiced. About one hundred and ninety-nine (66.3%) households had latrine facility, of which 208 (69.3%) was open Pit latrine without slab. Of those households having latrine only 111 (37%) households had hand washing facility. Conclusion: This study revealed that most of the respondents had poor water, sanitation and hygiene practice. Thus, it underscores that there should be great attention and further research and interventions are required to search for other sources of water and mobilize and educate the community towards protecting the water sources.

The study examined the influence of primary Health Care delivery services on the health status of rural dwellers in Abia State Nigeria. A sample size of 120 respondents selected via multi-stage random sampling technique was used. in selecting .Primary data generated using structured questionnaire and Focus Group Discussion were analyzed using descriptive statistics such as frequency counts, percentages, means, pooled means, and KAP analysis respectively. Result showed a mean age of 25 years, 58.3% were male, and 75% were married. About 61.0% had secondary education, 58.3% were farmers/traders, and earned mean monthly income of N48, 250.00 and had a mean household size of 4 persons respectively. Majority (50.0%) owed water system toilets, and 58.3% sourced their drinking water from boreholes, 75.0% fed 32 meals/day and 83.3% were not registered with NHIS. Result further showed high (X = 3.03) level of awareness on seven out of eight PHC delivery service packages in the study area. Th...

To explore the possibility for a statistically appropriate value of mid-upper arm circumference (MUAC) to identify the state of severe undernutrition, based on very low BMI, among adult Indian slum dwellers. Cross-sectional study on adults. Height and MUAC were recorded and BMI was computed. Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI&lt;18·5 kg/m2 and normal as BMI≥18·5 kg/m2. Besides calculating mean, sd and 25th, 50th and 75th percentile values, multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI. Receiver-operating characteristic curve analysis was performed to determine the best MUAC cut-off to identify CED status. The χ 2 test was used to assess significance of the difference in CED prevalence across MUAC categories. An urban slum in Midnapore town, West Bengal State, India. Male (n 467) and female (n 488) Indian slum dwellers. MUAC of 22·7 and 21·9 cm, respectively, in males a...

Objective: Data on the relationship between obesity, or high body mass index (BMI), and morbidity in adult individuals are frequently reported, but little is known about the relationship between morbidity and low BMI especially in developing countries. The present study was therefore an attempt to evaluate the relationship between BMI and morbidity in adult individuals. Design: The analyses were derived from the data based on self-reported morbidity and anthropometric measurements taken on adult males. The results were presented according to age and income groups for individuals of reporting and non-reporting illness. Subjects: The total sample size was 575 adult males (18-59 y) of the War Khasi population. Setting: Rural area of the state of Meghalaya in Northeast India. Results: The prevalence of chronic energy deficiency (CED) was found to be 35%, although the mean BMI (20.06 AE 2.65 kg=m 2) in individuals of non-reporting illness was higher than in those reported for many populations of Northeast India. The relationship between BMI and reported illness was not significant, although the morbidity curve tended to be U-shaped, and the prevalence of reported illness (32%) was highest in the individuals with BMI below 17.0 kg=m 2. Moreover, the suggested cutoff 18.5 of BMI for screening the prevalence of CED did not correspond with the rise in morbidity, but both BMI and morbidity were significantly associated with age and income of the household. Conclusion: In view of the present analysis and other related literature, BMI is likely to be a better indicator of standards of living than a predictor of illness as the latter may also predispose individuals to the former. Thus, morbidity and low BMI may be considered parts of ill health, which are influenced by a number of biological and environmental factors especially age, economic conditions, undernutrition, safe water sanitation, community pathogens, prevention and control measures of locally endemic diseases and infections.

SummaryA cross-sectional study of 212 adult (&gt;18 years) male slum dwellers (mean age=34·6±14·4 years) of Midnapore town, West Bengal, India, was undertaken to study the inter-relationships of chronic energy deficiency (CED), monthly family income (MFI), self-reported morbidity and hospitalization due to severe illness. The mean height, weight and body mass index (BMI) of the subjects were 160·0 cm, 50·8 kg and 19·9 kg/m2, respectively. The overall frequencies of CED (BMI&lt;18·5 kg/m2), morbidity and hospitalization were 38·2%, 34·4% and 13·7%, respectively. Based on the WHO classification, the prevalence of CED among this population was high (20–39%), indicating a serious situation. Overall, MFI was significantly (p&lt;0·01) positively correlated with BMI (r=0·21). Linear regression analyses showed that MFI had a significant impact (t=3·08; p&lt;0·002) on BMI. Overall, MFI explained 3·9% variation in BMI. Subjects belonging to the lowest family income group (FIG I) had the lowes...

Various intervention programmes targeted at different preventable childhood infections that can lead to child mortality have been implemented in Nigeria. While these global initiatives and programmes may have contributed to decline in childhood mortality rates over the years, the rate is still high in Nigeria. The causes of death are specific to different age categories; child mortality (ages 12 to 59 months) has been linked in several studies in Nigeria to household environment and maternal characteristics, among others. However, there is a dearth of information on the interaction effect of maternal education and household characteristics on child mortality in Nigeria. The key question is does maternal education affect the handling of household environment and related practices to the extent of being a significant predictor of child mortality? This paper therefore examined the interaction of maternal education and household environment on child mortality in Nigeria. Using Mosley an...

The study examined the influence of primary Health Care delivery services on the health status of rural dwellers in Abia State Nigeria. A sample size of 120 respondents selected via multi-stage random sampling technique was used. in selecting .Primary data generated using structured questionnaire and Focus Group Discussion were analyzed using descriptive statistics such as frequency counts, percentages, means, pooled means, and KAP analysis respectively. Result showed a mean age of 25 years, 58.3% were male, and 75% were married. About 61.0% had secondary education, 58.3% were farmers/traders, and earned mean monthly income of N48, 250.00 and had a mean household size of 4 persons respectively. Majority (50.0%) owed water system toilets, and 58.3% sourced their drinking water from boreholes, 75.0% fed 32 meals/day and 83.3% were not registered with NHIS. Result further showed high (X = 3.03) level of awareness on seven out of eight PHC delivery service packages in the study area. Th...

Autores: Patricia Hernández Medina, Juan Francisco Mejía Zubillaga

Español

Se pretende determinar el impacto del nivel socioeconómico sobre la morbilidad en diabetes e hipertensión en Venezuela, a partir de los datos obtenidos de la Encuesta Nacional de Condiciones de Vida (ENCOVI), estudio desarrollado por la Universidad Católica Andrés Bello, la Universidad Central de Venezuela y la Universidad Simón Bolívar en el año 2015. Empleando un modelo probit para la morbilidad, en ambas enfermedades, se obtuvo una relación positiva y significativa para el nivel educativo y el estatus laboral: elevar el nivel educativo reduce en promedio un 4,69 % la probabilidad de enfermar, mientras que la mejora en el estatus laboral lo hace en 5,81 %. Para el caso del nivel de ingreso, funciona como un modo de umbral, un aumento del ingreso solo reporta beneficios, en términos de salud, para los individuos de menores ingresos.

Palabras clave: Morbilidad, hipertensión, diabetes, salud y nivel socioeconómico.

English

This article aims to determine the impact of the individual’s socio-economic level on morbidity in diabetes and hypertension in Venezuela, using data from the national survey of living conditions (ENCOVI), a study carried out by three Venezuelan universities: Universidad Católica Andrés Bello, Universidad Central de Venezuela and Universidad Simón Bolívar in the year 2015. We use a probit model to test our hypthesis. We found that the relationship between the educational level reduces the probability of reporting morbidity in any of the two diseases by 4.96% on average, while an improvement in the employment status reduces the probability of being sick by 5.81% on average. The relationship between the income level an morbidity works as a threshold model; an increase in income only reported benefits, in terms of health, for the individuals of the lower end of the income distribution.

Keywords: Morbidity, hypertension, diabetes, health and economic status.

Background: Despite policies and programmes designed to ensure safe motherhood, maternal morbidity and mortality rates have remained high in Nigeria. Household environment has been identified as crucial in maternal health; yet, little has been done to identify the environmental conditions that predispose women to morbidity and mortality in predominantly rural Northern Cross River State. This study investigated the role of household decisionmaking, domestic violence, access to and utilisation of maternal health facilities and socio-cultural practices that influence maternal health status. Methods: A sample of 823 respondents was drawn and used for the study. The study involved both qualitative and quantitative approaches. Twenty each of Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) were conducted among women of different ages, traditional birth attendants and elders were key informants. Results: Household environment is significantly related to maternal health (χ 2 =15.8; P<0.05). The likelihood of better maternal health was significantly higher among households that used flush toilet than pit/latrine (OR=3.2; P<0.05), pipe-borne water than stream water (OR=5.0 P<0.05), 1 2 electricity/gas for cooking than firewood (OR=8.9, P<0.05). Toilet facilities, water sources and cooking environment were poor among many women thereby exposing them to various infections. Socioeconomic status of women played a significant role in maternal health (χ 2 =13.8; P<0.05). Ever married women had better health status than those that were single (χ 2 =10.0; P<0.05); women who had their first babies earlier than 20 years of age had poorer health status compared to those who had them later (χ 2 =14.9; P<0.05). However, maternal educational qualification showed no significant relationship with maternal health. Household sanitation and hygiene behaviour were significantly related to maternal health status (χ 2 =10.5; P<0.05; χ 2 =16.5; P<0.05). Conclusion: Maternal health is the result of cumulative effects of household environment, cultural practices, attitudes and behaviours. Improving the household environment and behaviour could improve maternal health. This could be achieved through improvement of health services and information in the rural communities.

Objective: Data on the relationship between obesity, or high body mass index (BMI), and morbidity in adult individuals are frequently reported, but little is known about the relationship between morbidity and low BMI especially in developing countries. The present study was therefore an attempt to evaluate the relationship between BMI and morbidity in adult individuals. Design: The analyses were derived from the data based on self-reported morbidity and anthropometric measurements taken on adult males. The results were presented according to age and income groups for individuals of reporting and non-reporting illness. Subjects: The total sample size was 575 adult males (18-59 y) of the War Khasi population. Setting: Rural area of the state of Meghalaya in Northeast India. Results: The prevalence of chronic energy deficiency (CED) was found to be 35%, although the mean BMI (20.06 AE 2.65 kg=m 2) in individuals of non-reporting illness was higher than in those reported for many populations of Northeast India. The relationship between BMI and reported illness was not significant, although the morbidity curve tended to be U-shaped, and the prevalence of reported illness (32%) was highest in the individuals with BMI below 17.0 kg=m 2. Moreover, the suggested cutoff 18.5 of BMI for screening the prevalence of CED did not correspond with the rise in morbidity, but both BMI and morbidity were significantly associated with age and income of the household. Conclusion: In view of the present analysis and other related literature, BMI is likely to be a better indicator of standards of living than a predictor of illness as the latter may also predispose individuals to the former. Thus, morbidity and low BMI may be considered parts of ill health, which are influenced by a number of biological and environmental factors especially age, economic conditions, undernutrition, safe water sanitation, community pathogens, prevention and control measures of locally endemic diseases and infections.

An anthropometric cross-sectional study of urban Bengalee Muslim boys (n=350) aged 11-17 years of North Dum Dum, West Bengal, was undertaken to study their health and nutritional status. The subjects were classified into seven age groups: 11-11.9 (n = 48), 12-12.9 (n = 53), 13-13.9 (n = 45), 14-14.9 (n = 49), 15-15.9 (n = 51), 16-16.9 (n = 58), 17-17.9 (n = 46). Physical status (estimated by height and weight) was compared with national standard (ICMR, 1989). Nutritional status (undernutrition) was determined following (WHO, 1995) the age and sex specific BMI cutoffs (less than fifth percentile values) based on the National Health and Nutrition Examination Survey (NHANES I). Analyses of the results demonstrated that Bengalee Muslim boys were slightly taller than the national standard at each age and heavier at late adolescence. The overall rate of undernutrition was 53.14%. The rates of undernutrition varied between 41.67% among 11 year olds to 65.31% at age 14 years. There was a gradual increasing trend of undernutrition from 11 to 14 years. Thereafter, there was a slight declining trend in the rates of undernutrition at ages 15 (58.82%), 16 (53.45%) and 17 (52.17%) years. In general, this study provided facts that the urban adolescent Muslims boys had alarming rates of undernutrition. These rates of undernutrition were, in general, agree with the earlier Indian studies but higher than those found among adolescents in several developing countries.

Background: Uganda Christian University's Department of Public Health with Buvuma District local government, the local communities and the local Anglican Church of Uganda conducted a study to assess the household health and socioeconomic status of communities on Buvuma's main island. Methods: The Study design was cross-sectional and descriptive. The sample was 212 households and data were collected using Pretested Questionnaires, Focus Group Discussions, and Key Informants Interviews. Results: Most respondents (59.9%) were female, aged 18-59 years (89.9%) with primary education (48.1%). About 21% of respondents had no formal education. Housing was mainly (73.1%) one or two roomed with earthen floors in 84.4%.; the lake was a source of water in 41% of households and water was used untreated in 36.8% of households; latrine coverage was 62.7%. Wood (70.5%) and charcoal (29.5%) were the energy sources for cooking and solar energy was used for lighting in 54.3% of the households. Malaria was the commonest cause of morbidity; 100% of households had nets, but 32.1% did not use them. 92% of mothers received antenatal care but 88.2% delivered in health facilities. Income was mostly from subsistence farming (74%) with per capita income of 20,000 to 50,000 Uganda shillings for 45% households. Most income (54%) was spent on children's education. About 50.9% of respondents did not own land but 89.6% had a garden to grow food. Conclusion: Overall, the study community, in a hard to reach island district, had poorer health and socioeconomic indicators than the Country.

An anthropometric cross-sectional study of urban Bengalee Muslim boys (n=350) aged 11-17 years of North Dum Dum, West Bengal, was undertaken to study their health and nutritional status. The subjects were classified into seven age groups: 11-11.9 (n = 48), 12-12.9 (n = 53), 13-13.9 (n = 45), 14-14.9 (n = 49), 15-15.9 (n = 51), 16-16.9 (n = 58), 17-17.9 (n = 46). Physical status (estimated by height and weight) was compared with national standard (ICMR, 1989). Nutritional status (undernutrition) was determined following (WHO, 1995) the age and sex specific BMI cutoffs (less than fifth percentile values) based on the National Health and Nutrition Examination Survey (NHANES I). Analyses of the results demonstrated that Bengalee Muslim boys were slightly taller than the national standard at each age and heavier at late adolescence. The overall rate of undernutrition was 53.14%. The rates of undernutrition varied between 41.67% among 11 year olds to 65.31% at age 14 years. There was a gradual increasing trend of undernutrition from 11 to 14 years. Thereafter, there was a slight declining trend in the rates of undernutrition at ages 15 (58.82%), 16 (53.45%) and 17 (52.17%) years. In general, this study provided facts that the urban adolescent Muslims boys had alarming rates of undernutrition. These rates of undernutrition were, in general, agree with the earlier Indian studies but higher than those found among adolescents in several developing countries.

The study examined the influence of primary Health Care delivery services on the health status of rural dwellers in Abia State Nigeria. A sample size of 120 respondents selected via multi-stage random sampling technique was used. in selecting .Primary data generated using structured questionnaire and Focus Group Discussion were analyzed using descriptive statistics such as frequency counts, percentages, means, pooled means, and KAP analysis respectively. Result showed a mean age of 25 years, 58.3% were male, and 75% were married. About 61.0% had secondary education, 58.3% were farmers/traders, and earned mean monthly income of N48, 250.00 and had a mean household size of 4 persons respectively. Majority (50.0%) owed water system toilets, and 58.3% sourced their drinking water from boreholes, 75.0% fed 3 2 meals/day and 83.3% were not registered with NHIS. Result further showed high (X = 3.03) level of awareness on seven out of eight PHC delivery service packages in the study area. There was also high level of utilization on immunization (X= 3.00) and moderate level of utilization on treatment for malaria, prevention/ treatment of communicable diseases, family planning/ HIV and AIDS, maternal / child health care, public health education and environmental health education respectively. The KAP analysis showed the Knowledge, Attitude, and Practice Levels of the respondents towards these PHC activities and interventions influenced their health status positively in the study area.

A cross-sectional study of 469 adult (418 years) Bengalee male slum dwellers of Dum Dum, Kolkata, India, was undertaken to study the relationships of family income and house type with body mass index (BMI) and chronic energy deficiency. The overall frequency of chronic energy deficiency was 32.0%. Based on the World Health Organization classification, the prevalence of chronic energy deficiency among this population was high and thus the situation is serious. Overall, monthly family income was significantly positively correlated with BMI. Significant differences in mean weight, BMI and monthly family income, were observed between the two house type groups. All values were found to be significantly higher in the brick household group who also earned a comparatively higher income as evident from the mean monthly family income values. The prevalence of chronic energy deficiency was also found to be significantly higher in the bamboo-fenced household group. Subjects belonging to the lowest family income group had the lowest mean BMI and the highest rate of chronic energy deficiency while those in the highest family income group had the largest mean BMI and lowest rate of chronic energy deficiency. There was a significant family income group difference in mean BMI. There existed significant differences in chronic energy deficiency rates in family income group categories. Linear regression analyses showed that monthly family ARTICLE IN PRESS www.elsevier.de/jchb 0018-442X/$ -see front matter income and house type had a significant impact on BMI. Subsequent multiple regression analyses revealed that both monthly family income and house type had a significant impact on BMI, even after controlling for each other.

A cross-sectional study of 212 adult (>18 years) male slum dwellers (mean age=34·6 14·4 years) of Midnapore town, West Bengal, India, was undertaken to study the inter-relationships of chronic energy deficiency (CED), monthly family income (MFI), self-reported morbidity and hospitalization due to severe illness. The mean height, weight and body mass index (BMI) of the subjects were 160·0 cm, 50·8 kg and 19·9 kg/m 2 , respectively. The overall frequencies of CED (BMI<18·5 kg/m 2 ), morbidity and hospitalization were 38·2%, 34·4% and 13·7%, respectively. Based on the WHO classification, the prevalence of CED among this population was high (20-39%), indicating a serious situation. Overall, MFI was significantly (p<0·01) positively correlated with BMI (r=0·21). Linear regression analyses showed that MFI had a significant impact (t=3·08; p<0·002) on BMI. Overall, MFI explained 3·9% variation in BMI. Subjects belonging to the lowest family income group (FIG I) had the lowest mean BMI (19·1 kg/m 2 ) and the highest rate of CED (46·3%) and morbidity (36·6%). Those in the highest family income group (FIG III) had the largest mean BMI (20·8 kg/m 2 ) and lowest rate of CED (30·2%) and morbidity (30·2%). The highest rate (18·9%) of hospitalization was found in this group. There were significant family income group differences in mean BMI . The frequency of morbidity (24·6%) and hospitalization (11·9%) was lowest among normal BMI individuals. Morbidity was significantly higher ( 2 =11·92, p=0·0026) among CED (48·2%) subjects compared with normal BMI individuals (OR=2·85; CI=1·49-5·46). Similarly, compared with normal BMI subjects, morbidity was higher (38·5%; OR=1·92; 95% CI=0·50-7·18) among overweight subjects. Hospitalization was more common among CED subjects (16·1%; OR=1·42; CI=0·58-3·45) compared with normal BMI subjects. Similarly, the frequency of hospitalization was more among overweight individuals (15·4%; OR=1·35; 95% CI=0·0-7·59). In conclusion, this study

This cross-sectional study explored the relationships between income levels and food intake patterns among slum dwellers in Kolkata, India. A total of 284 male subjects of Bengalee ethnicity participated in the study. The mean (SD) age, monthly family income and monthly per capita income of the subjects were 40.8 years (14.2), Indian Rupees (Rs.) 3259 (1574) and Rs. 700 (416) respectively. Potatoes, fresh vegetables, sweets and eggs were among the most frequently consumed food items on a daily basis. Butter, soft drinks, milk and ghee were least frequently consumed. The frequency of consumption of snacks, sweets and fruits showed strong significant correlations (p < 0.001). Principal component analysis of the frequency of consumption of different foods showed five components that explained a cumulative variance of 56%. Eigen values of components one to five were: 1.49 for fruit, sweets and snacks; 1.36 for fish and soft drinks; 1.16 for ghee and butter; 0.65 for fresh vegetables; and 1.02 for milk. Individually, these components explained 14, 12, 11, 10 and 9% of the variations respectively. Regression analyses showed monthly per capita income to be significantly associated with frequency of consumption of soft drinks (F = 6.79, p < 0.001) and fish (F = 7.90, p< 0.005). Age showed a significantly positive association with butter consumption (F = 9.41, p<0.002), and was negatively associated with intake of soft drinks and fried snacks (F = 10.10, p< 0.002). Using regression equations to predict the impact of increased income on consumption patterns, it was found that a 10% increase in income is associated with 1% increase in consumption of fish, which carries traditional prestige. A similar increase in income would also lead to 10% increase in consumption of soft drinks that has connotations of brand associated prestige.

A cross-sectional study of 191 adult (>18 years) Bengalee male slum dwellers of Kolkata, India, was undertaken to study the relationships of family income with body mass index (BMI) and chronic energy deficiency (CED). Results revealed that the mean height, weight, and BMI of the subjects were 162.2 cm, 54.0 kg, and 20.5 kg/m2, respectively. The overall frequency of CED (BMI < 18.5 kg/m2) was 33.5%. Based on the World Health Organization classification, the prevalence of CED among this population was high (20–39%) and thus the situation is serious. Overall, monthly family income (MFI) was significantly positively correlated (r = 0.18, p < 0.05) with BMI. Linear regression analyses showed that MFI had significant impact (p < 0.05) on BMI. The percent variation in BMI explained by MFI was 2.6%. Subjects belonging to the lowest family income group (FIG) had the lowest mean BMI (19.5 kg/m2) and the highest rate of CED (46.6%) while those in the highest FIG had the largest mean BMI (21.4 kg/m2) and lowest rate of CED (23.1%). There was a significant FIG difference (F = 2.965, p < 0.05) in mean BMI. Moreover, there existed FIG differences (χ 2 = 7.54, p < 0.06) in CED rates. In conclusion, this study provided strong evidence that FIG was significantly associated with BMI and the presence of CED. The rate of CED was high, indicating a serious situation. These findings may have severe public health implications. It is recommended that immediate nutritional intervention programs be initiated among this population along with serious efforts to increase their family income.