Social inequality, urban growth and leprosy in Manaus: a spatial approach.

OBJECTIVE: To analyze the epidemiology of leprosy according to spatial distribution and living conditions of the population. METHODS: Ecological study based on the spatial distribution of leprosy in the municipality of Manaus, Northern Brazil, from 1998 to 2004. The 4,104 cases identified in the Sistema de Informações de Agravos de Notificação (Sinan -National Notification System) were georeferenced according to the addresses in the 1,536 urban census tracts through four different sources: postal service (73.7% of addresses found), Property Registration Program (7.3%), Family Health Program (2.1%), and Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics) data sheet (1.5%). Calculation of detection coefficient was performed based on the 2001 population. Local empirical Bayesian method was used for the spatial distribution analysis, in order to estimate leprosy risk, making rate variation shorter when they were calculated for small areas. Logistic regression was employed to analyze the association between geographical distribution and risk factors. The incidence of cases in children under 15 (severity indicator) and Social Need Index built from variables of the 2000 census were adopted as explicative variables. RESULTS: The mean coefficient of detection was hyperendemic in 34.0% of the census tracts, and very high in 26.7%. Odds ratio was obtained for explicative variables and proved to be significant. Low-income and incidence in children under 15 were combined to identify priority areas for intervention. CONCLUSIONS: Spatial analysis of leprosy showed that the distribution of the disease is heterogeneous and is more strongly present in regions inhabited by more vulnerable groups.

Dynamics and diversity of non-Saccharomyces yeasts during the early stages in winemaking.

This detailed study observed the yeasts present in the ecological niche of "wine must". The dynamics and identity of non-Saccharomyces yeasts during the cold maceration and alcoholic fermentation of grape must were investigated under real production conditions in the Bordeaux region. Furthermore, we studied the impact of two oenological parameters on the development and diversity of non-Saccharomyces yeasts during cold maceration: temperature management and the timing of dried yeast addition. The non-Saccharomyces community underwent constant changes throughout cold maceration and alcoholic fermentation. The highly diverse non-Saccharomyces microflora was present at 10(4)-10(5) CFU/mL during cold maceration. The population increased to a maximum of 10(6)-10(7) CFU/mL at the beginning of alcoholic fermentation, then declined again at the end. The population at this point, evaluated at around 10(3)-10(4) CFU/mL, was shown to be dependent on the timing of yeast inoculation. The choice of temperature was the key factor for controlling the total yeast population growth, as well as the species present at the end of cold maceration. Hanseniaspora uvarum was a major species present in 2005 and 2006, while Candida zemplinina was very abundant in 2006. A total of 19 species were isolated.

USAID in Nepal.

PIP: The USAID's mission in Nepal is to assist development until the people can sustain their own needs: although the US contributes only 5% of donor aid, USAID coordinates donor efforts. The mission's theme is to emphasize agricultural productivity, conserve natural resources, promote the private sector and expand access to health, education and family planning. Nepal, a mountainous country between India and Tibet, has 16 million people growing at 2.5% annually, and a life expectancy of only 51 years. Only 20% of the land is arable, the Kathmandu valley and the Terai strip bordering India. Some of the objectives include getting new seed varieties into cultivation, using manure and compost, and building access roads into the rural areas. Rice and wheat yields have tripled in the '80s relative to the yields achieved in 1970. Other ongoing projects include reforestation, irrigation and watershed management. Integrated health and family planning clinics have been established so that more than 50% of the population is no more than a half day's walk from a health post. The Nepal Fertility Study of 1976 found that only 2.3% of married women were using modern contraceptives. Now the Contraceptive Retail Sales Private Company Ltd., a social marketing company started with USAID help, reports that the contraceptive use rate is now 15%. Some of the other health targets are control of malaria, smallpox, tuberculosis, leprosy, acute respiratory infections, and malnutrition. A related goal is raising the literacy rate for women from the current 12% level. General education goals are primary education teacher training and adult literacy. A few descriptive details about living on the Nepal mission are appended.^ieng

Togo.

PIP: This compendium on Togo contains a summary of current and projected demographic indicators, of government population policies and attitudes, and of the current status of the country's population data collecting system. The information is further summarized in a 1-page fact sheet. In 1981 the total population was 2.7 million. In 1980-85, the annual population growth rate was 2.9%, and the annual natural increase rate was 2.9%, life expectancy at birth was 48.7 years, the infant mortality rate was 113, and the crude birth rate was 45.4. Per capita income was US$406 in 1979, and in 1981, 67% of the labor force was engaged in agriculture. Currently the government has no policies in regard to population growth and is satisfied with the current fertility level. Earlier the government's position was pronatalist; but, in 1976, the government approved the establishment of the Togolese Family Welfare Association (ATBEF), an affiliate of the International Planned Parenthood Federation. In addition, the government is promoting the integration of family planning services in the nation's primary health program. The government is concerned with the problem of teenage pregnancy. Abortion, except to save the life of the mother, is illegal, and there are no legal provisions concerning sterilization. In recent years, the government adopted several measures aimed at improving the status of women. These measures included the passage of a new family code. The major concerns of the government are to improve the health status of the population and to promote rural and regional development. The primary health care program was expanded in 1977, and the country has a fairly successful immunization program. It also operates a leprosy control program and is improving the country's water supply. Currently the level of international migration, both emigration and immigration, is low, and the government has no migration policy. Togo has a low urban rate (17.4%), and between 1970-80, the rate of annual urban growth rate was 5.3%. The government is concerned about the high rate of growth in Lome, the capital city. Togo conducts a census every 10 years, and the last one was conducted in 1981. Birth and death registration is incomplete. There is no institutionalized mechanism for promoting the integration of population and development planning.^ieng

The malaria burden and population growth in the Solomon Islands.

This paper outlines the result of the control of infectious diseases, and more especially malaria, on the growth of populations in the Solomon Islands since 1931, the year of the first census, to 1976, the year in which the fourth census revealed, that a population explosion had occurred, and was occurring unabated.

PIP: The result of the control of infectious diseases, and particularly malaria, on the growth of populations in the Solomon Islands over the 1931-1976 period is outlined. The 1976 4th census revealed that a population explosion had occurred and was occurring unabated. The greatest population increase was during the 1970-1976 period, when the population rose from 160,998 to 196,708, representing an annual rate of growth of 3.4% per annum. The primary reason for this dramatic population increase is the control of infectious diseases, and to the control of malaria in particular. The control of malaria was most marked since total coverage with insecticide spraying was achieved in early 1972, following the initiation of the Malaria Eradication Program. Along with the attacks on the endemic diseases, there has been a progressive improvement in the coverage and care provided by the basic Health Services. The assessment of a Malaria Eradication Program is carried out by the determination of the Annual Parasite Incidence or API which must be based on full surveillance activities, and the Annual Blood Examination Rate.