Is the wealth index a proxy for consumption expenditure? A systematic review.

BACKGROUND: Many epidemiological studies require a measure of socioeconomic position. The monetary measure preferred by economists is consumption expenditure; the wealth index has been proposed as a reliable, simple alternative to expenditure and is extensively used. METHODS: A systematic review was conducted of the agreement between wealth indices and consumption expenditure, summarising the agreement and exploring factors affecting agreement. RESULTS: Seventeen studies using 36 datasets met the inclusion criteria. Of these, 22 demonstrated weak agreement, 10 moderate agreement, and four strong agreement. There was some evidence that agreement is higher: in middle-income settings; in urban areas; for wealth indices with a greater number of indicators; and for wealth indices including a wider range of indicators. CONCLUSIONS: The wealth index is mostly a poor proxy for consumption expenditure.

Risk factors for injuries in young children in four developing countries: the Young Lives Study.

OBJECTIVE: To assess the occurrence of child injury in four developing country settings and to explore potential risk factors for injury. METHODS: Injury occurrence was studied in cohorts of 2000 children of age 6-17 months at enrolment, in each of Ethiopia, Peru, Vietnam and India (Andhra Pradesh). Generalized estimating equation models were used to explore potential risk factors for child injury. RESULTS: Occurrence of child injury was high in all countries. Caregiver depression emerged as a consistent risk factor for all types of injury measured (burns, serious falls, broken bones and near-fatal injury) across all countries. Other risk factors also showed consistent associations, including long-term child health problems, region of residence and the regular care of the child by a non-household member. CONCLUSIONS: This report provides further evidence of the importance of childhood injury in developing countries and emphasizes the importance of including infants in injury research and prevention strategies. It provides strong evidence of an association between caregiver mental health and child injury risk and contributes to the limited knowledge base on risk factors for child injury in developing countries.

Determinants of mental and motor development at 12 months in a low income population: a cohort study in northeast Brazil.

AIM: To identify biological and environmental factors associated with poorer mental and motor development at age 12 mo in urban communities in northeast Brazil. METHODS: A cohort of 245 infants born during January August 1998 in six hospitals in the interior of Pernambuco was followed twice weekly from birth until 12 mo of age. Socio-economic, demographic and environmental data were collected, together with daily information on morbidity and feeding patterns. Gestational age, birth anthropometry and nutritional status at 12 mo were measured. Multiple linear regression analysis was used to identify variables that had independent effects on mental and motor development assessed at 12 mo of age with the Bayley Scales of Infant Development. RESULTS: Environmental factors explained about 21% and 19% of the variance in mental and motor development, respectively. Of these, the most important were poverty-related. Significant biological factors associated with mental development were birthweight and infant sex. For motor development, the biological factors were weight-for-age and haemoglobin concentration. Biological factors explained only 6% and 5% of the variance in mental and motor development, respectively. CONCLUSION: Of the variables examined, environmental factors had a greater detrimental effect on child development than biological factors in this population. Interventions that enhance social capital and alleviate poverty are advocated.

Effectiveness of BCG vaccination against tuberulous meningitis: A case-control study in Sao Paulo, Brazil

A case-control study was carried out in the Metropolitan Region of Sào Paulo, Brazil, to determine the protection against tuberculous meningitis conferred by BCG vaccination to children aged less than 5 years. The BCG vaccination coverage in the study area was about 88 per cent. A total of 72 tuberculous meningitis patients were studied as well as 505 neighbourhood and 81 hospital controls. Analysis of the data using a conditional logistic regression for matched case-control studies indicated that the efficacy of BCG was similar for both groups of controls, that for neighbourhood controls (84.5 per cent) being slightly greater than that for hospital controls (80.2 per cent). No sifnificant interactions were found between vaccination status and sex, age, or socioeconomic status(AU)

Water supply, sanitation and hygiene education: report of a health impact study in Mirzapur, Bangladesh

The UNDP-World Bank Water and Sanitation Program was organized as a joint endeavor of the United Nations Development Programme and the World Bank and has been one of the primary players in worldwide efforts to meet the challenge of providing basic water supply and sanitation services to those most in need in the developing world. Partners in this venture are the developing countries themselves and the multilateral and bilateral agencies that fund the Program's activities. Tle UNDP-World Bank Water and Sanitation Program produces its own publications and also releases vicrks under the auspices of the World Bank. The Program's publications are divided into two series, a Water and Sanitation Program Report series and a Water and Sanitation Discussion Paper series. The Program Report series presents formal discussions of the Program's operations and research activities as well as examinations of relevant projects and trends within the water and sanitation sector. Program Reports are subject to rigorous external review by independent authorities from appropriate fields. The Discussion Paper series is a less formal means of communicating timely and topical observations, findings, and opinions concerning Program activities and sector issues

Infant feeding and risk of severe diarrhoea in Basrah city, Iraq: a case-control study

A case-control study of the relationship between feeding mode and risk of hospitalized diarrhoea in infants (aged 2-11 months) in Basrah city was conducted between September 1983 and May 1984. A total of 597 cases were recruited from among infants admitted with diarrhoea to the major paediatric hospital in the city, while 723 controls were recruited from among healthy infants attending any of the seven maternal and child health clinics in Basrah. A variety of potentially confounding variables were controlled in the analysis. For infants aged 2-5 months, breast-feeding alone or breast-feeding plus food were the least risky feeding modes. Bottle-feeding was dangerous and bottle-feeding alone was associated with a risk of 55 among infants aged 2-3 months, and 37 among infants aged 4-5 months, relative to exclusive breast-feeding. For other infants (6-11 months), the risks of hospitalized diarrhoea were not significantly different among different partial breast-feeding modes, but non-breastfeeding was dangerous, especially exclusive bottle-feeding. Food intake was associated with a reduced risk of severe diarrhoea among bottle-fed infants but not with an increased risk among breast-fed infants. Among bottle-fed infants, no association was found between risk of severe diarrhoea and method of bottle-cleaning. Previous breast-feeding conferred no current protection(AU)