Blood pressure and BMI in adolescents in Aracaju, Brazil.

OBJECTIVE: To assess the prevalence of high blood pressure (BP) and the association of overweight and obesity with high BP among adolescents in Aracaju, Brazil. DESIGN: Cross-sectional study. The main outcome measure was the proportion of adolescents with high BP (sex-, age- and height-specific ≥ 95th percentile). The main predictor variables were overweight and obesity defined according to the criteria of the International Obesity Task Force. Other covariates included age, socio-economic status and leisure-time physical activity. SETTING: Aracaju, Brazil, capital city of Sergipe State, north-eastern Brazil. SUBJECTS: A random sample of 1002 adolescents (442 boys and 560 girls) aged 12-17 years selected from twenty public schools and ten private schools were studied. RESULTS: The prevalence of high BP was 16.9 % (95 % CI 13.1, 21.7) in boys and 12.9 % (95 % CI 9.0, 18.0) in girls. After adjusting for age, socio-economic status and leisure-time physical activity in both boys and girls, overweight (prevalence ratio (PR) = 1.93, 95 % CI 1.08, 3.48; PR = 4.34, 95 % CI 2.58, 7.30, respectively) and obesity (PR = 4.87, 95 % CI 2.35, 10.11; PR = 5.18, 95 % CI 2.67, 10.06, respectively) were found to be associated with high BP. CONCLUSIONS: These findings indicate a high prevalence of high BP in both boys and girls in Aracaju, Brazil. Overweight and obesity were strongly associated with high BP. These findings underscore the urgent need for public health measures to prevent increasing high BP in adolescents in Brazil. Targeting intervention in adolescence may be a critical method for preventing high BP in later life.

Etiology and incidence of chronic ulcers in Blantyre, Malawi.

BACKGROUND: Little information is available on the incidence and etiology of chronic ulcers in the tropics. Therefore, the incidence and etiology of chronic skin ulcers were assessed in out-patients at the Department of Dermatology and in in-patients at the Departments of Dermatology, Surgery, Medicine, and Pediatrics, Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. METHOD: In a 10-week study period, 44 patients (31 males, 70%) with chronic skin ulcers were diagnosed from 6292 patients seen by the departments involved. RESULTS: The mean age of patients with ulcers was 38 years (range, 9 months to 82 years). The most frequent cause of ulcers was bacterial infection (n=22), followed by malignancy (n=11) and trauma (n=7). CONCLUSION: In contrast with developed countries, venous and diabetic ulcers were uncommon. In addition to bacterial infections, a surprisingly large number of malignancies were found in this study. We speculate that human immunodeficiency virus (HIV) infection, which is seen with a high prevalence at QECH, is a contributing factor. Because of the large number of malignancies, we recommend early histopathologic investigation of chronic ulcers in this part of Africa.

Sexuality and contraception among never married high school students in Butajira, Ethiopia.

Cross-sectional survey using a self-administered anonymous questionnaire was conducted to assess knowledge, attitude and practice of contraception and sexuality. The questionnaire was filled out in April 2000 by 752 high school students in Butajira, Ethiopia. The mean age of the subjects was 17.1 years. One hundred thirteen never married students (17.5%) claimed to have experienced intercourse; 22.0% of boys and 8.8% of girls. Sexual abstinence was not dictated by perception of risk. About 78% of boys and 91% of the females did not use modern contraceptives at their last sexual intercourse. Nine female students claimed to have been pregnant: two had delivered and seven had induced abortion. The most important reasons for non-use of contraception were lack of adequate knowledge, partner refusal, perception of diminished pleasure and embarrassment to buy. Seventy-one percent of the respondents knew at least one contraceptive method. Over half of the students had no source of information on sexuality and for 25.9% school was the main source of information. The attitude to sexuality was conservative, but liberal to introduction of sex-education at secondary schools. Higher percentage of boys admitted that they had exaggerated their response on sexual matters; girls admitted under-reporting. It is recommended that sex and family life education be discussed openly in schools and included in curricula.