Patterns of trematode infections of Opisthorchis viverrini (Opisthorchiidae) and Haplorchis taichui (Heterophyidae) in human populations from two villages in Savannakhet Province, Lao PDR.

The liver fluke, Opisthorchis viverrini, and the minute intestinal fluke, Haplorchis taichui, are prevalent in many Asian countries. This study analysed the patterns of infections of O. viverrini and H. taichui in Lahanam and Thakhamlien villages (Savannakhet Province, Lao PDR), in two cross-sectional investigations. Out of a total of 207 human participants, post-anthelmintic treatment positivity rates for expelled worms were 170 (82.1%) for H. taichui and 65 (31.4%) for O. viverrini. Both these species co-exist in the study villages. When each parasite was analysed separately, H. taichui infections reached a plateau among people aged >20 years. Opisthorchis viverrini infection rates were highest in the age group 21-30 years, with decreasing infection rates after the age of 30. Our findings indicated that fish-borne trematode infections were more prevalent among adults. Fish, common intermediate hosts, were acquired in the study area for analysis. The examination of 35 species of fish as intermediate hosts found O. viverrini metacercariae in only six species, and these were found mostly during the month of November. Many farmers who live on the rice fields obtain their food from their immediate environment, including these intermediate-host fish, potentially putting them at greater risk of O. viverrini infection. By contrast, H. taichui metacercariae were found in three species of fish obtained from the market, meaning that anyone could consume them and become infected. If people who work in rice fields limit the species of fish they consume, or avoid consuming raw fish during the month of November, they may reduce their risk of O. viverrini infection.

Short- and long-term impact of health education in improving water supply, sanitation and knowledge about intestinal helminths in rural Bangladesh.

OBJECTIVE: To investigate the long-term impact of health education in intestinal helminth infection control in rural Bangladesh. STUDY DESIGN: Longitudinal study to compare knowledge, awareness and practice for intestinal helminths between four communities: two receiving health education and two not receiving health education. METHODS: Parents of 1497 children aged between 2 and 8 years [781 (52.2%) received health education] were investigated by interview at baseline, endline (18 months) and follow-up (5 years). RESULTS: Health education had a significant effect on the installment of tubewells and latrines, but only had a temporary effect on health knowledge. CONCLUSION: This long-term follow-up study showed the lack of sustainability of knowledge and awareness in the long-term after health education interventions.

Sexual behavior and condom use in female students in Dar-es-Salaam, Tanzania: differences by steady and casual partners.

OBJECTIVE: In Tanzania female youth are increasingly becoming at greater risk of sexually transmitted HIV infection, whereby more than 80% cases occur through un-protected sex. The objective of this study was to examine related-factors which influence female students to have risky sexual contacts with casual partners including condom use and sex with sugar daddies. METHODS: A cross section study involving face-to-face interview was conducted regarding sexual behavior among 219 sexually-debuted female students aged between 18 and 24 years who were attending high schools and colleges in Dar-es-salaam, Tanzania. RESULTS: Eighty-three percent had at least one boyfriend in the past 12 months, 57% had engaged in sex with a "sugar daddy", and 24% had engaged in sex with a casual partner other than a sugar daddy. Sixty-nine percent had ever used a condom, and 66% had used a condom during their most recent sexual encounter. Thirty-two percent reported always using a condom during sex with their boyfriends, whereas only 2% always used a condom with a sugar daddy. Decision-making about condom use during sex with boyfriends was made by couples together (48%) or by the girls alone (34%), whereas the decision during sex with a sugar daddy was predominantly made by the male partner (79%). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 9.5 for frequencies, cross-tabulations and chi-squired test and statistical significance set at p<0.05. CONCLUSION: The study highlighted risk factors for female students towards HIV infection. Receiving money and/or presents were the major motivations for having sex irrelevant with types of sex partners. Although most female's students disagreed in principle to have sex in exchange for money or presents, sex with sugar daddies was common among female students and was a major risk factor for HIV infection. Based on the findings, recommendations for improvement in prevention programs among female youth within Tanzanian context are discussed.

Educational intervention for preventing bloodborne infection among medical students in China.

Although medical students are known to be at risk for bloodborne infections, there have been no systematic studies, effective intervention programmes, or guidelines for them in China. We developed prevention guidelines, implemented an intervention, and evaluated the effectiveness of knowledge among medical students. This study was designed as a cluster randomised controlled trial. All those who completed a consent form were randomly assigned either to an intervention or to a control group. The intervention group underwent an educational intervention programme consisting of a series of lectures and videos following a baseline survey. The control group completed the same intervention programme after the study was completed. A questionnaire of 25 items was sent to participants three months and nine months after the initial intervention programme. Outcomes measured before and after intervention included knowledge of transmission route, first-aid care, and post-exposure prophylaxis. Pearson's chi(2)-test was used, and the efficacy of students was analysed to control for bias. Intervention in the form of a one-time bloodborne pathogen educational prevention programme for Chinese medical students had little effect on knowledge.

Parasite egg contamination of vegetables from a suburban market in Hanoi, Vietnam.

Helminth egg contamination of vegetables purchased at suburban market in Hanoi, Vietnam was examined. A total of 317 vegetables were examined and 82 (26%) were revealed to be positive for parasite eggs. Of the 15 varieties, 13 were positive except for horseradish and cucumber. Contamination was highest in leafy vegetables (31%), followed by root vegetables (17%) and fruit vegetables (3%). Throughout the survey, five species of parasite eggs were found: Ascaris sp., Trichuris sp., Toxocara sp., Taenia sp. and Ascaridia galli. In the interview with the villagers, 121 (81%) of 149 adult villagers stated that they usually use not only animal feces but also human feces as a fertilizer. Throughout the survey, a total of 453 eggs were recovered. Number of eggs recovered from vegetables was higher in the dry season (355 eggs) than in the rainy season (98 eggs). The study revealed that vegetables purchased at a market in suburban Hanoi (Vietnam) were highly contaminated with parasite eggs excreted by humans and animals. Considering the eating habits of the Vietnamese and the 17% embryonation rate of detected parasites, vegetables seem to play an important role in soil-transmitted helminth infection in this country.

Suppressive effect of partially hydrolyzed guar gum on transitory diarrhea induced by ingestion of maltitol and lactitol in healthy humans.

OBJECTIVES: To estimate the suppressive effect of partially hydrolyzed guar gum (PHGG) on transitory diarrhea induced by ingestion of a sufficient amount of maltitol or lactitol in female subjects. DESIGN: The first, the minimal dose level of maltitol and lactitol that would induce transitory diarrhea was estimated separately for each subject. Individual subject was administered a dose that increased by 5 g stepwise from 10 to 45 g until diarrhea was experienced. Thereafter, the suppressive effect on diarrhea was observed after each subject ingested a mixture of 5 g of PHGG and the minimal dose level of maltitol or lactitol. SETTING: Laboratory of Public Health Nutrition, Department of Nutrition and Health Sciences, Siebold University of Nagasaki. SUBJECTS: Thirty-four normal female subjects (21.3+/-0.9 years; 49.5+/-5.3 kg). MAIN OUTCOME MEASUREMENT: Incidence of diarrhea caused by the ingestion of maltitol or lactitol and the ratio of suppression achieved by adding PHGG for diarrhea. RESULTS: The ingestion of amounts up to 45 g of maltitol, diarrhea caused in 29 of 34 subjects (85.3%), whereas the ingestion of lactitol caused diarrhea in 100%. The diarrhea owing to maltitol was improved in 10 of 28 subjects by the addition of 5 g of PHGG to minimal dose-induced diarrhea, and that owing to lactitol was in seven of 19 subjects. Adding 10 g of PHGG strongly suppressed the diarrhea caused by maltitol, and the cumulative ratio was 82.1% (23/28). CONCLUSION: The transitory diarrhea caused by the ingestion of maltitol or lactitol was clearly suppressed by the addition of PHGG. These results strongly suggest that diarrhea caused by the ingestion of a sufficient amount of non-digestible sugar substitute can be suppressed by the addition of dietary fiber.

Association of increased platelet-associated immunoglobulins with thrombocytopenia and the severity of disease in secondary dengue virus infections.

Severe thrombocytopenia and increased vascular permeability are two major characteristics of dengue haemorrhagic fever (DHF). To develop a better understanding of the roles of platelet-associated IgG (PAIgG) and IgM (PAIgM) in inducing thrombocytopenia and its severity of disease in patients with secondary dengue virus infection, the relationship between the PAIgG or PAIgM levels and disease severity as well as thrombocytopenia was examined in 78 patients with acute phase secondary infection in a prospective hospital-based study. The decrease in platelet count during the acute phase recovered significantly during the convalescent phase. In contrast, the increased levels of PAIgG or PAIgM that occurred during the acute phase of these patients decreased significantly during the convalescent phase. An inverse correlation between platelet count and PAIgG or PAIgM levels was found in these patients. Anti-dengue virus IgG and IgM activity was found in platelet eluates from 10 patients in an acute phase of secondary infection. Increased levels of PAIgG or PAIgM were significantly higher in DHF than those in dengue fever (DF). An increased level of PAIgM was associated independently with the development of DHF, representing a possible predictor of DHF with a high specificity. Our present data suggest that platelet-associated immunoglobulins involving antidengue virus activity play a pivotal role in the induction of thrombocytopenia and the severity of the disease in secondary dengue virus infections.

Chart analysis of body composition change among pre- and postadolescent Japanese subjects assessed by underwater weighing method.

OBJECTIVE: To examine the effect of age on the relationship between fat-free mass (FFM) and fat mass (FM), and fat-free mass index (FFMI) and fat mass index (FMI) by applying body composition chart analysis on pre- and postadolescent Japanese subjects. SUBJECTS AND METHOD: A sample of 516 children (244 boys and 272 girls) ranging in age from 11 to 17 y and 840 adults (288 male and 552 female subjects) ranging in age from 18 to 59 y were studied to determine a body composition by an underwater weighing method. FMI and FM were put on an x- and y-axis in body composition chart 1, and FFMI (FFM/ height(2)) and FMI (FM/height(2)) were taken on an x- and y-axis in body composition chart 2. RESULTS: In body composition chart 1, the plots for male subjects stayed flat from 11 to 14 y and after that a steady growth of FFM concurring with the FM growth was observed. During the adult stage, steady increments of FM and gradual decreases of FFM were observed. In body composition chart 2, steady increases of FFMI and gradual decreases of FMI were indicated in the male preadolescent period. In the adult stage, FFMI decreased year by year, although the FMI continued to increase. In female subjects, a conspicuous increase of FMI was observed throughout all periods of the present subjects. After middle age, the decline of FFMI was characteristically demonstrated in the chart. CONCLUSION: The relationships between FFM and FM are characteristically delineated on the body composition charts demonstrating clear gender differences. The change of body mass index was not reflecting the change of adiposity level in male subjects, although it was occurring along with the changes of the adiposity level in female subjects.

Age-related pattern of body density and body composition of Japanese men and women 18-59 years of age.

Age-related patterns of body size and composition were studied in a cross-sectional sample of Japanese adults 18-59 years of age. Height, weight, the body mass index (BMI), body density (BD), percentage body fat (%Fat), fat mass (FM), fat-free mass (FFM), and the sum of seven skinfold thicknesses (SF) of 288 men and 552 women were considered. Body density was measured by underwater weighing densitometry. Mean values of height, weight, BMI, BD, %Fat, FM, FFM, and SF of males were 169.0 cm, 65.3 kg, 22.8 kg/m(2), 1.0600 g/ml, 17.0%, 11.4 kg, 53.9 kg, and 95.0 mm, respectively, while corresponding values for females were 157.4 cm, 52.9 kg, 21.4 kg/m(2), 1.0420 g/ml, 24.4%, 13.1 kg, 39.7 kg, and 128.2 mm, respectively. Height, BD, and FFM correlated negatively with age in both sexes, while weight, BMI, %Fat, FM, and SF correlated positively with age. The highest BD and the lowest %Fat were observed in males ages 20 to <25 years (G20) and in females 25 to <30 years (G25). The lowest BD and highest %Fat were observed in G50 in both sexes. Correlations among parameters of body size and composition were stable with age in each sex. Height correlated negatively with BMI and %Fat in females, but not in males. In males, FM started to increase between G20 and G25 and continued to increase until G50, while SF and BMI remained stable during this period. In females, FM accumulation started around 30 years of age and continued until G50 and was accompanied by increases in SF and BMI.

Age-related pattern of body density and body composition in Japanese males and females, 11 and 18 years of age.

The age-related pattern of body density and body composition in Japanese males (n = 266) and females (n = 318), 11.00 to 18.99 years of age was studied. Body density (BD) as well as height, body weight, and seven skinfold thicknesses were measured. Percentage fat (%Fat) was calculated using the age- and sex-specific equation of Lohman. Fat mass (FM), fat-free mass (FFM), and the body mass index (BMI) were calculated. The trend for BD in males was lowest at 11 years (1.0530 g/ml) and increased to 1.0695 g/ml at 14 years, and then decreased slightly at 15 to 17 years. In female, BD decreased from 1.0530 g/ml at 13 years to 1.0424 g/ml at 17 years. Mean %Fat was highest in males at 11 years (15.8%), and lowest at 14 years (10.1%). The highest mean %Fat in females occurred at 16 years (22.8%), and the lowest at age 11 years (15.2%). Overall, only 6.8% of males and 3.1% of females were classified as obese. Between 11 and 18 years, FFM of males differed by 20.7 kg or 67.9%, whereas females showed a difference of only 10.8 kg or 34.7%. Consequently, age effects explained approximately 60% of the male variance of FFM but only 26% in females. Body density of each sex and age group in this study did not differ significantly from previous Japanese studies, and the pooled BD data for 1,457 Japanese including the present study are reported as a reference.

[Validity of various indices of obesity calculated from height and weight data for adult males use of the underwater-weighing method as a reference].

PURPOSE: We evaluated associations between excess body fat (%Fat) and various indices of obesity calculated from height and weight data. METHODS: In 147 adult males, %Fat was measured by the underwater-weighing method, and obesity indices were generated by the following 5 approaches: the Broca-Katsura (Katsura method), the Kato-Wataya (Kato method), Japan Society for the Study of Obesity (BMI method; based on the body weight at which the BMI is 22), and the Meiji Life Insurance Co. methods, and the Tables and Figures for Assessment of Obesity and Leanness published by the Ministry of Health and Welfare (MHW method). RESULTS: %Fat was 20% or more (obese) in 67 males (45.6%), 15-20% in 39 (26.5%), 10-15% in 35 (23.8%), and less than 10% in 6 (4.1%). The correlation coefficients between the obesity indices and %Fat were 0.612 for the Katsura method, 0.590 for the Kato-method, 0.611 for the BMI method, 0.612 for the Meiji Life Insurance Co. method, and 0.550 for the MHW method, being significant in each case (P < 0.01). When the cut-off point was set as 110% for each obesity index, sensitivity was highest with the Kato-method (82.1%), and specificity was highest with the Meiji Life Insurance Co. method (93.8%). With the MHW method, the receiver operating characteristic (ROC) curve was slightly farther from the point of sensitivity of 100% and 1-specificity of 0% than the others. CONCLUSION: Excess fat accumulation can not be accurately assessed by obesity indices calculated from body height and weight data. Validity was similar among obesity indices examined.

[Prevalence of disabilities of the upper and lower extremities among community-dwelling middle-aged and elderly women].

OBJECTIVE: In order to obtain baseline data for designing programs aimed at promoting physical function among elderly people in Japan, we determined the prevalence of disabilities affecting upper and lower extremities and their impact on function in community-dwelling middle-aged and elderly Japanese women. METHODS: Subjects were 580 women aged 40 years and over, living in Oshima town, Nagasaki, Japan. Information on disabilities affecting all four extremities was collected by questionnaire. Subjects were asked about the extent of disability in each extremity (no disability, some, moderate, cannot or very difficult to use extremity) and the reason for the disability. The functional level was defined using a disability score, calculated by summing the disabilities for upper or lower extremities (no disability, 0; some, 1; moderate, 2; cannot or very difficult to use, 3). Women who scored 0 were classified as 'good', women who scored 1-2 'fair', and who scored 3-6 as 'poor'. RESULTS: Prevalence of disability affecting the upper extremities increased significantly with age (11.9% with some or greater, and 4.3% with moderate or worse). Disabilities of the lower extremities also increased significantly with age (27.2% with some or greater, and 12.9% with moderate or worse), affecting a larger proportion of individuals. With regard to the upper extremities, the women classified a 'fair' and 'poor' increased significantly with age (9.5% with 'fair', and 2.4% with 'poor'), and function decreased (p = 0.003). The same was the case for the lower extremities (19.0% with 'fair', and 8.3% with 'poor') (P < 0.001). The most frequently cited cause of disability was arthritis, both in the upper (20%) and lower (40%) extremities, followed by stroke (10%), fracture (10%) and trauma not associated with fracture (10%). CONCLUSIONS: In middle aged and elderly women, disabilities of the upper and lower extremities become more prevalent and are associated with further functional impairment with aging. Such disabilities are more common in the lower extremities, and arthritis seems to be the most frequent cause.

Stiffness index of the calcaneus measured by quantitative ultrasound and menopause among Japanese women: The Hizen-Oshima Study.

Quantitative ultrasound (QUS) is a recently developed technique for evaluating fracture risk that can assess both bone mass and architecture. Although numerous studies have shown that menopause is associated with accelerated loss of bone mineral density, there are only a few studies on the association of QUS parameter (stiffness index) with menopausal status, especially among Japanese population. We examined age-specific changes in stiffness index, and relation with age, body mass index (BMI) and menopausal status among 506 community-dwelling Japanese women aged 40-89 years. Mean age at menopause (standard deviation) among 459 women with natural menopause was 49.4 (4.0) years. Stiffness index significantly decreased with increasing age. Stiffness index among 80-89 years age group was 40% lower, compared with that of 40-49 years age group. The greatest decline among adjacent ten-year age groups in stiffness index (15%) was found between 40-49 and 50-59 years of age. Multiple regression analysis showed that menopause related with decreased stiffness index, independent of age and BMI. Our findings indicate that menopause influences loss of bone mass and induces deterioration of bone trabecular microstructure.

[Validity of various obesity indices calculated from height and weight in adult females using the underwater-weighing method as a reference].

We evaluated association between excess percent body fat (%Fat) and various obesity indices calculated from height and weight in 322 adult females. %Fat was measured by the underwater-weighing method, and obesity indices were based on the following 5 methods; Broca-Katsura method (Katsura method), Kato-Wataya method (Kato method), Japan Society for the Study of Obesity method (BMI method; based on the body weight at which BMI is 22), Meiji Life Insurance Co. method, and Table and Figure for the Assessment of Obesity and Leanness by the Ministry of Health and Welfare (MHW method). %Fat was 30% or more (obese) in 73 females (22.7%), 25-30% in 97 (30.1%), 20-25% in 88 (27.3%), and less than 20% in 64 (19.9%). The correlation coefficient between the obesity indices and %Fat were 0.71 for the Katsura method, 0.70 for the Kato-method, 0.72 for the BMI method, 0.70 for the Meiji Life Insurance Co. Method, and 0.63 for the MHW method, being significant for all methods (P < 0.01). When the cut-off point was set as 110% for each obesity index, sensitivity was the highest for the Katsura method (67.1%), and specificity was the highest for the Meiji Life Insurance Co. method (95.2%). Receiver operating characteristic (ROC) curves were similar in figure for the Katsura method, Kato-method, BMI method, and Meiji Life Insurance Co. method. For the MHW method, however, the curve was slightly farther from the point of sensitivity of 100% and 1-specificity of 0% than the others. Excess fat accumulation could not be accurately assessed by the obesity indices calculated from body height and weight. Validity was similar among the obesity indices except for the MHW method.

Calcaneus bone mineral density is lower among men and women with lower physical performance.

Fracture risk is influenced by both bone strength and by falls. Measures of physical function and performance are predictors of falls. However, the interrelationships among bone mineral density (BMD), regular physical activity, and measures of physical performance are not well known. We studied 447 community-dwelling Japanese people aged 40 years and over (96 men and 351 women) to examine the association of calcaneus BMD with measures of physical performance (grip strength, walking speed, chair stand, and functional reach) and regular physical activity. Calcaneus BMD decreased with age by approximately 25% in men and 42% in women. Measures of physical performance decreased with age by approximately 30% in both genders, however, performance on the chair stand test declined by approximately 60%. There were only minimal differences in performance measures and calcaneus BMD between people with and those without regular physical activity in both genders, and most differences were not significant. However, there were significant BMD increases of 3-6% per standard deviation (SD) increase in all performance measures for women and a 7% increase in BMD per SD increase in grip strength for men, after adjusting for age. These associations remained after additional adjustment for body mass index and regular physical activity. These findings suggest that bone density and physical function decline markedly in both men and women with age, and that low BMD and poor function tend to occur together, which would increase fracture risk more than either risk factor alone.

Knowledge and attitudes toward AIDS among female college students in Nagasaki, Japan.

This study assesses knowledge and attitudes concerning HIV infection and individuals with AIDS among 383 female students attending colleges in Nagasaki, Japan. A structured questionnaire containing questions concerning knowledge about AIDS, sources of information, beliefs and attitudes toward people with HIV/AIDS was administered during sessions set up for that purpose. The mean age of participants was 18.8 +/- 0.8 years (+/- SD). The main source of information for AIDS awareness as reported by the students was the mass media. Good knowledge about AIDS was positively associated with ease of acceptance of living in the same house with a person diagnosed with AIDS [odds ratio (OR): 1.90; 95% confidence interval (CI): 1.07-3.38]. However, residing at home (OR: 0.64; 95% CI: 0.42-0.98) and involvement in nurse education programmes (OR: 0.59; 95% CI: 0.37-0.95) showed a negative association. Students demonstrated a high level of knowledge concerning AIDS and HIV, but had considerable misconceptions and prejudices about people having HIV/AIDS. Our results suggest that a more appropriate education programme in colleges in Japan may be necessary to reduce the discrepancy between general knowledge and desirable attitude regarding HIV/AIDS.

Demographic and reproductive factors for high seroprevalence of Chlamydia trachomatis among pregnant women in Japan.

In order to elucidate demographic and reproductive factors associated with Chlamydia trachomatis seropositivity, serological screening and questionnaire survey were conducted on pregnant women in Nagasaki Prefecture, Japan. Serum samples were taken from 1718 pregnant women between September and December, 1996, at the cooperative obstetric hospitals and clinics, and tested for the presence of antibodies to C. trachomatis using the enzyme immunoassay. A questionnaire was administered on a sub-sample (n -409), among whom 85 (20.8%) were seropositive. A multiple logistic analysis revealed that four characteristics showed a significant association with the seropositivity: (i) experience of premarital pregnancy, (ii) non use of condoms, (iii) short duration of education, and (iv) more frequent induced abortion. The unsafe sexual behavior of young people lacking proper knowledge of how to prevent STD is the most important intervention target for control of the C. trachomatis epidemic in Japan.

Daily response of blood pressure to day-to-day variation of urinary sodium to potassium ratio.

The relationship between blood pressure and urinary sodium-to-potassium (Na/K) ratio was assessed in eight healthy men, none of whom used antihypertensive medications. Blood pressure and urinary sodium and potassium concentrations were measured for 11 to 33 days without any dietary restriction. For two of the eight subjects, the urinary Na/K ratio significantly correlated with systolic blood pressure (r=0.70 and 0.45, respectively), and in one of the two subjects, the urinary ratio also positively correlated with diastolic blood pressure (r=0.72). In the others, no relationship between the ratio and blood pressure was observed (r=-0.24 to 0.26). The results indicate that, in some individuals, the daily variation of urinary Na/K ratio is closely correlated with day-to-day changes in blood pressure level, and suggest that the urinary Na/K ratio is useful in the management of the daily sodium and potassium intake balance of hypertensive patients who need to restrict salt intake.

Knowledge, risk perception of AIDS and reported sexual behaviour among students in secondary schools and colleges in Tanzania.

A questionnaire survey was carried out among 1041 students in secondary schools and colleges in Dar-es-Salaam, Tanzania to evaluate the relationship between HIV-risky sexual behaviour and anti-condom bias, as well as with AIDS-related information, knowledge, perceptions and attitudes. Self-reportedly, 54% of students (75% of the boys and 40% of the girls) were sexually active, 39% had a regular sexual partner and 13% had multiple partners in the previous year. The condom use rate was higher than previous reports. However, 30% of sexually active respondents did not always use condoms (Risk-1 behaviour) and 35% of those with multiple partners in the previous year did not always use condoms (Risk-2 behaviour). Multiple logistic regression analyses indicated that 'sex partner hates condom' had association with both Risk-1 behaviour (OR 2.47; 95% CI 1.58-3.85) and Risk-2 behaviour (OR 2.47; 95% CI 1.10-5.48). 'Use of condom prevents HIV infection' also had association with both Risk-1 behaviour (OR 2.09; 95% CI 1.19-3.67) and Risk-2 behaviour (OR 3.73; 95% CI 1.28-11.03). Students engaging in risky behaviour were aware of the risk, even though they failed to change their behaviour. Reasons for the AIDS epidemic among Tanzanian students and the importance of more effective AIDS education are also discussed.

PIP: Tanzania has reported to the World Health Organization (WHO) the largest number of AIDS cases of any country in Africa. As of the end of November 1996, 82,174 AIDS cases had been officially reported to WHO, although the Tanzanian Ministry of Health estimated that about 400,000 people in Tanzania had AIDS at the end of 1995. 419 male and 622 female students aged 16-24 years in secondary schools and colleges in Dar-es-Salaam, Tanzania, answered questionnaires during March-April 1996 in a study conducted to evaluate the relationship between HIV risky sexual behavior and anti-condom attitudes, as well as with AIDS-related information, knowledge, perceptions, and attitudes. Self-reportedly, 75% of the boys and 40% of the girls were sexually active, 54% of the sample overall. 39% had a regular sex partner and 13% had multiple partners in the previous year. 30% of the sexually active respondents and 35% of those with multiple sex partners did not always use condoms when having sex. Multiple regression analysis found that the belief that a sex partner hates condoms was positively associated with inconsistent condom use. Belief in the use of a condom to prevent HIV infection was also associated with inconsistent use. While these students were aware of their risk in having unprotected sexual intercourse, they failed to adopt risk reduction behavior.