Introduction and Purpose Overweight and obesity have recently emerged as major problems of malnutrition among children in developing countries. However, risk factors for childhood obesity in Asian countries remain largely unknown. Identification of target populations for its prevention and intervention is urgently needed. This survey was conducted to assess the prevalence of overweight and obesity and identify possible risk factors among kindergarten children in Ho Chi Minh City, Vietnam. Methods In this cross-sectional study conducted in March, 2005, 780 children in their third and fourth years in kindergarten and their mothers were randomly selected from eight local kindergartens. Height and weight of mother-child pairs were measured, and an interview was conducted by trained staff using a questionnaire in Vietnamese. Overweight/obesity was defined as a weight-for-height > 2 SD above the National Center for Health Statistics median reference value. Risk factors for overweight/obesity were analyzed using logistic regression. Results There were 741 respondents (377 boys and 364 girls); the response rate was 95.0%. Average age of children was 61.8 ± 6.8 months; the average age of mothers was 35.0 ± 5.2 years. The average height and weight were 110 ± 5.7cm and 21.2 ± 4.0kg respectively. Of the 741 children, 27.8% were identified as being overweight/obesity. Four possible variables selected were: 1) child's sex, 2) mother's awareness of her child's current body type, 3) mother's expectation for her child's body type in the future, 4) mother's awareness of her own current body type . Conclusion Our findings point to the importance of addressing appropriate body images in the management of children's nutritional health. Providing sufficient amounts of information on appropriate body type in addition to feeding practice to mothers should be a priority at the Ho Chi Minh City Nutrition Center to prevent child overweight and obesity.
Introduction Tuberculosis is a major health problem in Lusaka, Zambia, where 16% of the people of productive age was infected with HIV. DOTS coverage is 100% with 81% case detection and 73% cure rate. Following the spread of HIV infection, the number of tuberculosis patients has been increasing. Within this context, the HIV/AIDS and TB Control Project established a model external quality assessment (EQA) system for AFB microscopy service at peripheral laboratories. This study aims to show importance of EQA in quality NTP laboratory system. Methods All 22 diagnostic centers in Lusaka during the period from July 2003 to September 2005 were evaluated following internationally recognized guidelines. Sample slides were taken randomly from among slides read at peripheral diagnostic centers and were blindly rechecked by controllers at the quality assurance (QA) center. Quality of smear preparation was also assessed. Results and Discussions Between 2003 and 2005, major reading errors (discrepancy: two reading scales and over) found by controllers decreased from 5% of sample slides to 0.7%, and minor errors (one scale discrepancy) from 3.4% to 0.3%. The number of diagnostic centers without any errors was only 3 at the beginning of study and this number increased to 17 at the end. Quality of smear preparation such as thickness, size and evenness also improved based on international standards. These results highlighted the effectiveness of the quality assurance system (blinded rechecking of sample slides and effective feedback with frequent visits to peripheral diagnostic centers) in terms of maintaining the proficiency of AFB microscopy service. EQA system should be expanded in the areas where both HIV and TB prevalence is high. The effective implementation of EQA service in the NTP is the essential factor for the success of DOTS strategy and may contribute ultimately to prevent new tuberculosis infection among persons, including HIV-infected.
Introduction As for the available healthcare services, there is a big gap not only between developed and developing countries but also those are not equally available even in a single country. In order to cope with geographical gaps of healthcare services in the Republic of Yemen, the improvement of accessibility to healthcare services is placed as priority of the 5-year plan of health development. However, analysis of health information in developing countries may not be easy because of the weak health statistics mechanism. The data from national TB control program may be considered as a possible way to analyze the geographical gaps and improve the tuberculosis case finding in developing countries. Methods The case detection rate of new smear positive tuberculosis patients in districts was calculated by using data from the latest population census in the Republic of Yemen. The calculated case detection rate was statistically analyzed with the factors such as availability of microscopy centre, population and the distance from provincial capital. Results The case detection rate of new smear positive tuberculosis patient is significantly different in the districts that have microscopy centre or more than 42,322 populations. The availability of the microscopy centre may be considered as the significant factor for achieving better case finding of new smear positive tuberculosis patients in the districts. Population of the districts where new smear positive tuberculosis patients found has been calculated as 74.1% of the total population. This calculation almost matches the target of the population that may be covered by the public health services according to the 5-year health development plan of the Ministry of Public Health. Conclusions The statistically analyzed data may provide a possible way to improve the national TB control program.
Introduction Women in northeast Asian countries follow special practices during prenatal and postnatal periods. The traditional ‘Yu fai’ custom in Thailand includes a food taboo known as kalum. This paper intends to describe the unknown details of parturient women's traditional taboos in northeast Thailand. Methods Ethnographic semistructured interviews in the Thai language were conducted in February 2006 with 10 women in northeast Thailand who had babies ranging in age from newborn to 6 years. Results The purpose of Yu fai is to enable a mother who has recently undergone parturition to recover her pregestation physical and mental conditions following childbirth. Some new mothers will complain of bad health if they fail to apply Yu fai. Certain food taboos and recommendations are part of the Yu fai practice, and each has a specific context based on traditional beliefs. Conclusions The three objectives of Yu fai are identified as follows: to recover the mother's body to its usual pregestation condition; to enable sufficient breast milk or the capability for future pregnancies; to endure a long and healthy life. Applying Yu fai will influence a mother's lifetime health conditions after childbirth. Each of the prohibited or recommended food items is the result of specific contexts based on traditional beliefs. However, Yu fai is now changing, along with urbanization and improved communications, even in the rural areas of northeast Thailand.
Objectives The Constitution of Pakistan offer guarantees regarding women s rights, but unfortunately some laws and also customs violate the above commitments seriously affecting the health of women and even endangering their lives. The purpose of the study is to describe various aspects of women s health in Pakistan vis- -vis human rights. Methods Review of available literature was undertaken. The scientific electronic database (such as PubMed, Science-Direct & Pakistani database) was searched for women health issues in Pakistan, covering a period from 1980s to present. Published government reports have also been included as sources of information for this paper. Results In Asia, Pakistan s, maternal mortality ratio is among the highest; more than half of the women are anemic. Access to health services is deprived whether be it economic, geographical or social. Majority of women are illiterate. Pakistan is among the countries with low gender indices and where female life span is less then men, and men outnumber women. Government spending on health and particularly women health is low compared to other countries. Conclusion Women s disproportionate poverty, low social status, gender imbalances, and inadequate maternal services at the community level play a significant role in contributing to maternal deaths. In view of the fact that given accessible, quality health services, many maternal deaths can be avoided, demonstrates maternal mortality is clearly an issue of human rights. There is a strong need that health sector spending is increased, role of women health care providers in rural areas be expanded (such as LHW) and involvement of private and NGO sector to fill gaps in service delivery, be ensured. In order to meet the targets of MDGs, the gender dimensions of demographic and social change need to be stressed further in all policies and development plans, which may result in narrowing of gender disparities and improving women lives.
Introduction In this review, we present: (1) trends of environmental lead exposure of global dimension including Japan, (2) environmental lead exposure issue in the field of international health, (3) effects of environmental lead exposure in mothers and children, (4) introduction of our research in Kunming, China, and (5) further consideration. Lead poisoning is one of the oldest diseases to humankind because human has been used lead for long time to fabricate various products. Industrial uses of lead have decreased sharply in many industrially developed nations including Japan in the past several decades. However, environmental lead exposure still remains an important problem because of rapid industrialization in less developed nations and the persistence of lead in the environment. Since elevated blood lead levels of immigrating children and people who are exposed to lead from imported consumer products have been reported, health-care providers should be aware of the information for appropriate follow-up care. In addition, lead is a well-known human reproductive toxin, and moreover, several studies have demonstrated that lead can be mobilized from the maternal skeleton during pregnancy and lactation. It is very important to prevent lead exposure for not only mothers and children but also women in pre-pregnancy period. Health burden of environmental lead exposure are only a part of issues of environmental lead pollution. To solve this problem, health-care providers should state expert opinion and collaborate with other field of specialists.
This study aimed to analyze roles and status of Iraqi female medical doctors in the society and their homes, their career consciousness, influence of conflicts upon health services in Iraq. As Iraq is an Islamic society in conflicts, this study further aimed to provide a basis to consider the feasibility and problems to train them in neighboring countries, as well as possibilities of future training courses. We conducted face-to-face interviews to 16 Iraqi female medical doctors who participated in a four-week-training course in Egypt under the trilateral medical technical cooperation project. We could not carry out our survey in Iraq because of security concerns. Most of the interviewed Iraqi female medical doctors were engaged in obstetrics and gynecology or pediatrics, and they usually examined female patients. These female medical doctors were highly motivated and rarely felt the gender discrimination in their work sites. They tended to choose husbands who would not hinder their professional career. They were also keen to participate in training courses outside Iraq, if the duration of the courses were within a few months. Their family agreed to send wives or daughters abroad alone for the training. Quality of the training was the most important for those doctors. Therefore, the religion or the distance from Iraq to the training places did not matter much. They expected that training courses of the hospital management systems and nurses'awareness raising should be taken place in future. Female health professionals are preferable to provide female patients with health services in Islamic societies. Although, women and children are especially vulnerable in times of conflicts, the current security situation in Iraq prevents them from receiving direct support. Therefore, this study suggests that inviting female medical doctors to abroad for medical training should be a worthwhile alternative to improve the health status of women and children in Iraq.