International journal of epidemiology
-
Health care in Zimbabwe is provided by both orthodox and traditional care providers. With formal medical services under economic strain it is important to understand the extent of consulting with traditional care providers and their effectiveness. ⋯ While members of the community appear to recognize physical problems and take them to medical care, traditional and orthodox medical consultations appear to be equally effective for non-specific pain or non-specific physical problems. The role of traditional medicine in relation to non-specific physical problems and psychological problems is one which deserves further examination from both clinical and administrative perspectives. Poverty appears to be associated with poorer outcomes; this is a potentially important issue in times of increasing economic hardship.
-
The Discontinuity Index (DI), which measures the percentage of infants who were exclusively breastfed (EBF) at the beginning of a given age interval and had abandoned this mode of feeding at its end, and the relative weight of this discontinuation, was introduced and employed in the National Survey on Breast Feeding and Infant Feeding Practices carried out in Cuba in 1990. The aim of this article is to illustrate, through a specific example, the quality of DI as a simple procedure for assessing breastfeeding trends. ⋯ Discontinuity indices are useful complements to prevalence rates in epidemiological studies of breastfeeding. The separate analysis of discontinuation in different periods can be highly useful when comparing trends and in the study of the impact of breastfeeding promotion programmes focused on different age intervals.
-
Several studies have reported differences in health care utilization by marital status, but usually only controlling for age and sex. Our study aimed at answering the questions: 1) To what extent are differences in health care utilization by marital status due to confounding by socio-demographic variables other than age and sex? and 2) To what extent are these differences due to differences in health status by marital status? ⋯ There are differences in health care utilization by marital status which are not due to confounding by other socio-demographic variables or differences in health status. Further investigation of these differences is necessary, and is likely to benefit from inclusion of socio-psychological variables. Living arrangements should also be included in these future analyses.
-
Vitamin A deficiency is a significant problem in many countries in the developing world. Reports have noted demographic and socioeconomic risk factors for vitamin A deficiency. 'Deficiency' has usually been defined by clinical signs and symptoms which represent only a small proportion of those children at increased risk for vitamin A preventable morbidity and mortality. ⋯ We found that owning land and that the highest and lowest categories of reported household income were associated with higher serum retinol levels. We also noted clustering of serum retinol levels by village and discovered that children from larger sibships and infants had significantly lower serum retinol levels. Vitamin A supplementation of lactating mothers, particularly of high parity, and/or their infants should be considered.
-
Comparative Study
Application of Markov process modelling to health status switching behaviour of infants.
This study is an attempt to apply Markov process modelling to health status switching behaviour of infants. The data for the study consist of monthly records of diagnosed illnesses for 1152 children, each observed from the month of first contact with Kasangati Health Centre, Kampala, Uganda, until age 18 months. ⋯ The study has shown that the transitions between Health and Illness for infants, from month to month, can be modelled by a Markov Chain for which the (single-step) transition probabilities are generally time-dependent or age-dependent. After the first few months of life the dependence on age may wear off, as in this study, leading to a time-homogeneous Markov Chain, which eventually attains a steady state distribution in about 12 months. Interpretations of the transition probabilities as measures of disease prevalence are discussed.