Nasopharyngeal carcinoma is a disease with a remarkable racial and geographical distribution. In most parts of the world it is a rare condition and in only a handful of places does this low risk profile alter. These include the Southern Chinese, Eskimos and other Arctic natives, inhabitants of South-East Asia and also the populations of North Africa and Kuwait.
AIDS continues to pose a grave global problem because it is spreading in the general population by increasing heterosexual transmission and vertical transmission from seropositive mothers to fetuses. A minor rate of transmission has been observed from blood transfusion and blood products. On October 31, 1990 WHO data indicated that a total of 298,914 AIDS cases had been reported. In Africa there were 75,642 cases: 15,569 were in Uganda, 11,732 in Zaire, 9139 in Kenya, 7160 in Malawi, 3647 in the Ivory Coast, 3494 in Zambia, and 3134 in Zimbabwe, with the rest averaging less than 4% of the total African caseload. There were 180,663 cases in the Americas: 149,498 in the US, 11,070 in Brazil, 4941 in Mexico, 4427 in Canada, 2456 in Haiti, 1368 in the Dominican Republic, 870 in Venezuela, 743 in Honduras, 710 in Argentina, 648 in Trinidad an Tobago, 643 in Colombia, 507 in the Bahamas, and 203 in Panama, the rest being less than 200. Asia had only 790 cases: 290 in Japan, 116 in Israel, 48 in India, 45 in Thailand, 37 each in Turkey and the Philippines, 31 in Lebanon, and 27 in Hong Kong. Europe had 39,526 cases: 9718 in France and 6701 in Italy as of June 30, 1990, however, by December 31, 1990 there were 8227 cases reported of whom 4074 had died. There were 6210 in Spain, 5266 in the German Federal Republic, 3798 in England, 1462 in Switzerland, 1443 in the Netherlands, 999 in Romania, 764 in Belgium, 663 in Denmark, 481 in Portugal, 450 in Austria, 443 in Sweden, and 347 in Greece. Little attention has paid to notification in eastern Europe: 40 cases in the USSR, 43 in Poland, 23 in Czechoslovakia, 22 in the German Democratic Republic, 42 in Hungary which is contrasted to 999 cases in Romania. Oceania had 2293 cases: 2040 in Australia, 207 in New Zealand, 16 in French Polynesia, 14 in New Caledonia, 13 in New Guinea, 2 in Tonga, 1 in Fiji, and 1 in the Federated States of Micronesia.
If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in countries where people are heavily affected by the epidemic. Fortunately, investments in programs that prevent infection and provide treatment for employees who have HIV/AIDS are profitable for many businesses--that is, they lead to savings that outweigh the programs' costs. Due to the long latency period between HIV infection and the onset of AIDS symptoms, a company is not likely to see any of the costs of HIV/AIDS until five to ten years after an employee is infected. But executives can calculate the present value of epidemic-related costs by using the discount rate to weigh each cost according to its expected timing. That allows companies to think about expenses on HIV/AIDS prevention and treatment programs as investments rather than merely as costs. The authors found that the annual cost of AIDS to six corporations in South Africa and Botswana ranged from 0.4% to 5.9% of the wage bill. All six companies would have earned positive returns on their investments if they had provided employees with free treatment for HIV/AIDS in the form of highly active antiretroviral therapy (HAART), according to the mathematical model the authors used. The annual reduction in the AIDS "tax" would have been as much as 40.4%. The authors' conclusion? Fighting AIDS not only helps those infected; it also makes good business sense.
Over the past few decades, obesity has reached epidemic proportions, and is a major contributor to the global burden of chronic diseases and disability. There is little evidence on obesity related co-morbidities in BRICS countries. The first objective is to examine the factors associated with overweight and obesity in four of the five BRICS countries (China, India, Russia and South Africa). The second is to examine the linkage of obesity with selected morbidities.
We used data from the Study on Global Ageing and Adult Health (SAGE) survey conducted by the World Health Organization (WHO) in China, India, Russia and South Africa during 2007-10. The morbidities included in the analysis are Hypertension, Diabetes, Angina, Stroke, Arthritis and Depression.
The prevalence of obesity was highest in South Africa (35%) followed by Russia (22%), China (5%) and India (3%). The prevalence of obesity was significantly higher in females as compared to males in all the countries. While the wealth quintile was associated with overweight in India and China, engaging in work requiring physical activity was associated with obesity in China and South Africa. Overweight/obesity was positively associated with Hypertension and Diabetes in all the four countries. Obesity was also positively associated with Arthritis and Angina in China, Russia and South Africa. In comparison, overweight/obesity was not associated with Stroke and Depression in any of the four countries.
Obesity was statistically associated with Hypertension, Angina, Diabetes and Arthritis in China, Russia and South Africa. In India, obesity was associated only with Hypertension and Diabetes.
There is little published data on the potential health benefits of active travel in low and middle-income countries. This is despite increasing levels of adiposity being linked to increases in physical inactivity and non-communicable diseases. This study will examine: (1) socio-demographic correlates of using active travel (walking or cycling for transport) among older adults in six populous middle-income countries (2) whether use of active travel is associated with adiposity, systolic blood pressure and self-reported diabetes in these countries.
Data are from the WHO Study on Global Ageing and Adult Health (SAGE) of China, India, Mexico, Ghana, Russia and South Africa with a total sample size of 40,477. Correlates of active travel (=150 min/week) were examined using logistic regression. Logistic and linear regression analyses were used to examine health related outcomes according to three groups of active travel use per week.
46.4% of the sample undertook =150 min of active travel per week (range South Africa: 21.9% Ghana: 57.8%). In pooled analyses those in wealthier households were less likely to meet this level of active travel (Adjusted Risk Ratio (ARR) 0.77, 95% Confidence Intervals 0.67; 0.88 wealthiest fifth vs. poorest). Older people and women were also less likely to use active travel for =150 min per week (ARR 0.71, 0.62; 0.80 those aged 70+ years vs. 18-29 years old, ARR 0.82, 0.74; 0.91 women vs. men). In pooled fully adjusted analyses, high use of active travel was associated with lower risk of overweight (ARR 0.71, 0.59; 0.86), high waist-to-hip ratio (ARR 0.71, 0.61; 0.84) and lower BMI (-0.54 kg/m(2), -0.98;- 0.11). Moderate (31-209 min/week) and high use (=210 min/week) of active travel was associated with lower waist circumference (-1.52 cm (-2.40; -0.65) and -2.16 cm (3.07; -1.26)), and lower systolic blood pressure (-1.63 mm/Hg (-3.19; -0.06) and -2.33 mm/Hg (-3.98; -0.69)).
In middle-income countries use of active travel for =150 min per week is more common in lower socio-economic groups and appears to confer similar health benefits to those identified in high-income settings. Efforts to increase active travel levels should be integral to strategies to maintain healthy weight and reduce disease burden in these settings.
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Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--are currently undergoing a deep epidemiological transition that is mainly driven by rapid economic growth and technological change. The changes being observed in the distribution of the burden of diseases and injuries--such as recent increases in the incidence of road traffic injuries--are matters of concern. BRICS may need stronger institutional capacity to address such changes in a timely way. In this paper, we present data on road traffic injuries in BRICS and illustrate the enormous challenge that these countries currently face in reducing the incidence of such injuries. There is an urgent need to improve road safety indicators in every country constituting BRICS. It is imperative for BRICS to invest in system-wide road safety interventions and reduce the mortality and morbidity from road traffic injuries.
Sixty-three Turkish children with Burkitt's lymphoma (BL) diagnosed over a 10-year period in a single institution were retrospectively analyzed. Burkitt's lymphoma included 41.7% of non-Hodgkin's lymphomas and 17.2% of all childhood malignant solid tumors diagnosed in our department in this duration. The patients studied with BL were aged between 3 and 14 years (mean 5.9 years), with a male of female ratio of 2:1. While the age distribution in our patients was similar to that in African BL (endemic), the predominance of abdominal involvement and the frequency of bone marrow infiltration and pleural effusion were reminiscent of American BL (sporadic). The incidence of jaw involvement (15.9%) in our group was higher than in American BL, however, and was not a high as in African BL. Most of the patients were of a lower socioeconomic status. Significant growth retardation was found in the children with BL compared with 40 age-matched children without malignancy, nor chronic or endocrinologic disorders, who were of a similar socioeconomic status. A serological study for Epstein-Barr virus (EBV) was performed in 18 children, and the IgG-type antibody to the viral capsid antigen of EBV was found to be positive in all of them. As a result, BL seems to include a considerable proportion of all childhood malignant solid tumors in Turkey. The epidemiological and clinical presentation and course indicate that BL appears in Turkish children in a form that is between the African and American types of the disease. Further molecular and chromosomal studies in Turkish children with BL are needed.
OBJECTIVES: To calculate and present the caries prevalence for some countries/states among 12-year-olds, expressed as Significant Caries Index (SiC Index) and to analyse the relationship between the mean DMFT and the SiC Index for these countries. SiC Index is the mean DMFT of the one-third of a population with the highest caries values. METHODS: An Excel(R) application for calculating SiC was developed (http://www.whocollab.od.mah.se/expl/siccalculation.xls) and indices were calculated from the data collected for 14 countries and one state from the Country/Area Profile Programme (http://www.whocollab.od.mah.se/index.html). To investigate the provinces of a country that had already reached the proposed SiC Index goal of 3 DMFT among the 12-year-olds, data for 17 counties and a city from Sweden were collected and the respective mean DMFT and SiC Indices calculated. RESULTS: The mean DMFT varied from 1.0 to 8.5 and the SiC Index varied from 2.8 to 13.7 in the national data. Jamaica, Senegal and Sweden were the only three countries that showed SiC Indices that were less than 3 DMFT. The mean DMFT varied from 0.5 to 1.4 and the SiC Index varied from 1.4 to 3.6 in the Swedish county/city data examined. A strong linear relationship between the mean DMFT and the SiC Index was found for the populations presented in this study. CONCLUSION: The SiC Index is an indicator that reflects the situation among the most caries-exposed individuals and could be included in future population-based oral health surveys together with the mean DMFT.
BACKGROUND. Asthma mortality among young people varies widely between different countries. Geographical differences in asthma prevalence are also believed to exist, but evidence is sparse owing to the lack of multicentre surveys using common protocols. A survey was conducted of 12-year-old children living in defined areas of New Zealand, Wales, South Africa and Sweden, in order to see whether asthma prevalence and mortality rates in children show parallel differences. METHODS. Questionnaires enquiring about a history of asthma and respiratory symptoms were issued to the parent. The children performed a simple exercise challenge test. RESULTS. Information was obtained for 4353 children. A history of asthma at any time was reported for 16.8% of children in New Zealand, 12.0% in Wales, 11.5% in South Africa and 4.0% of Sweden, and a similar pattern was shown by several other indices of asthma (various relevant symptoms, inhaler use, response to exercise challenge, and asthma mortality at ages 5-19 years). In Sweden wheezing was negatively associated with pet ownership; elsewhere there was a positive (though non-significant) association. Cat ownership was highest in New Zealand and lowest in Sweden. CONCLUSIONS. The prevalence of asthma in children shows geographical variation which is parallel to that of asthma mortality, being high in New Zealand and low in Sweden. Differential exposure to animal allergens is a possible factor in this variation.
Data on the association between chronic conditions or the number of chronic conditions and sleep problems in low- or middle-income countries is scarce, and global comparisons of these associations with high-income countries have not been conducted.
Data on 42116 individuals 50 years and older from nationally-representative samples of the Collaborative Research on Ageing in Europe (Finland, Poland, Spain) and the World Health Organization's Study on Global Ageing and Adult Health (China, Ghana, India, Mexico, Russia, South Africa) conducted between 2011-2012 and 2007-2010 respectively were analyzed.
The association between nine chronic conditions (angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, obesity, and stroke) and self-reported severe/extreme sleep problems in the past 30 days was estimated by logistic regression with multiple variables. The age-adjusted prevalence of sleep problems ranged from 2.8% (China) to 17.0% (Poland). After adjustment for confounders, angina (OR 1.75-2.78), arthritis (OR 1.39-2.46), and depression (OR 1.75-5.12) were significantly associated with sleep problems in the majority or all of the countries. Sleep problems were also significantly associated with: asthma in Finland, Spain, and India; chronic lung disease in Poland, Spain, Ghana, and South Africa; diabetes in India; and stroke in China, Ghana, and India. A linear dose-dependent relationship between the number of chronic conditions and sleep problems was observed in all countries. Compared to no chronic conditions, the OR (95%CI) for 1,2,3, and = 4 chronic conditions was 1.41 (1.09-1.82), 2.55 (1.99-3.27), 3.22 (2.52-4.11), and 7.62 (5.88-9.87) respectively in the overall sample.
Identifying co-existing sleep problems among patients with chronic conditions and treating them simultaneously may lead to better treatment outcome. Clinicians should be aware of the high risk for sleep problems among patients with multimorbidity. Future studies are needed to elucidate the best treatment options for comorbid sleep problems especially in developing country settings.
Cites: J Clin Sleep Med. 2007 Aug 15;3(5):489-9417803012