The determinants of infant and child morbidity in Lagos, Nigeria.

Analysis of the structure of real morbidity among children in Lagos, Nigeria, reveals that the leading diseases were of hygienic, nutritional and perinatal origin. These diseases were highly concentrated in infancy and early childhood; in the case of the former, the concentration was greater among boys than girls. During the 1970s, a decline is noticed in the frequency of infective and parasitic diseases particularly among male infants. Simultaneously, a slightly rising trend of diseases related to birth complications and perinatal nature afflicting predominantly early infancy occurred, off-setting, to some extent, the effect of the diminishing trend in infective diseases. The rising trend of perinatal diseases should be seen in conjunction with a likely increase in gravidity of women and the resultant increase of pregnancies and birth complications, which affected the health of the mother as well as that of the child. The findings seem to suggest that although both medical and non-medical factors contributed to the change in morbidity pattern in the decade 1968-1978, the role of factors of socio-economic nature was significant. The implication is that without socio-economic epidemiology, biomedical epidemiology could make a limited contribution to the reduction of morbidity.

Causes of death in Lagos: structure and change.

An analysis of the changing structure of causes of death in the city of Lagos between 1965 and 1975 was conducted. Registered deaths from the vital statistics system of the Lagos State Ministry of Health were employed. It was found that significant changes in causes of death among the population had occurred during the period. In the 1960s, diseases which killed children were more common than those which killed adults. The most significant feature of these fatal children diseases was the sharp contrast between the causes peculiar to neonates (perinatal) on the one hand and those common among post-neonates and pre-school-age children on the other. Commencing around 1970, however, children-related causes ameliorated considerably and the proportion of adults dying then became the higher. The most important cause of death during this period was accidents. The gap between male and female deaths from accidents is explained not only by different roles and behaviour of the sexes but also by men's obsession with high-risk vehicles. But this safety which women enjoyed was countered by increasing mortality from pregnancy complications, a phenomenon associated with higher gravidity in the 1970s.

Tessier type 3 oblique facial cleft with a contralateral complete cleft lip and palate.

Oblique facial clefts are extremely rare congenital deformities with a reported incidence of 0.24% of all facial clefts. This report presents a patient with a right-sided oblique cleft extending through the upper lip, the alar groove and the lower palpebra accompanied by a left-sided complete cleft lip and palate. Hypertylorism and bilateral microphthalmia as well as flexion wrist contractures were also present. Primary straight-line closure of the oblique cleft was undertaken followed by primary closure of the contralateral cleft lip. The treatment modality and 2 year follow-up results are presented.

Nuptiality patterns in an agrarian society.

Summary The paper deals with the non-European marital pattern and its determinants in an agrarian society before the onset of deliberate fertility decline. A wide range of patterns, from very early and almost universal to late marriage, existed among the populations of European Russia at the end of the nineteenth century. The analysis confirmed a close association, particularly between marital behaviour and socio-economic institutions. Scarcity of labour relative to land, the principle of landholding and land usage according to the amount of labour in the extensive type of family, and an equal-heir inheritance system were found to be conducive to early and common marriage. The spatial differentiation of marital patterns was found to be due to regional modifications in the above institutions, the degree of literacy, size of rural settlements, industrial and urban development, and the sex composition.

Polygyny and the rate of population growth.

Summary The roots, motives and feasibility of practising polygyny in societies with a balanced sex structure and the effect of polygyny on the rate of population growth are considered. High demand for labour combined with limited supply over the last several centuries, had been conducive to the evolution of a polygynous nuptiality pattern. The unprecedentedly high rates of population growth during the last several decades combined with progressive economic development have led to a change in the role of the labour factor and consequently diminished its impact upon polygyny. Polygyny is feasible because of a sex-age differential at first marriage, which enables younger cohorts of women to enter the marriage market, and thus results in a very early age at first marriage and universal incidence of marriage among women. A very young pattern of nuptiality inevitably evolves under polygyny, which tends to raise the rate of population growth. No significant variation in fertility between polygynous and monogamous women was found but substantial gaps in standards of living, child mortality, and educational attainment were noted for polygynous households. The findings imply that during the transition from polygyny to monogamy family size will tend to diminish, although initially fertility may not decline concurrently with changing socio-economic status. The most important effects on the rate of population growth thus result from the increase in age at first marriage and declining proportions of ever married women.

The role of nuptiality in the demographic transition. The case of Africa: a conceptual essay.

"The focus of analysis is on the direction of change and causes of shifts in age at first marriage among women in the demographic transition in Africa. The principal goal of the analysis is to assess and verify the paramount, determining role of nuptiality in affecting demographic transformation, especially in fertility. The findings confirm that in societies with early/universal marital patterns, initial demographic change is confined to nuptiality while fertility may be rising for decades. Two sets of causes of the shift to a later nuptiality pattern are examined. One refers to the role of nuptiality in premodern societies. The other considers: the built-in mechanism in the rate of population growth; diminishing frequency of polygyny; expansion in education; and increasing employment of women in non-traditional occupations." (SUMMARY IN ITA AND FRE)

Family limitation and fertility increase.

PIP: Researchers used data from a survey of women patients in the maternity ward during 1968-1969 and August 1978 of a hospital in Lagos, Nigeria and from the 1897 and 1926 censuses of 50 rural and urban populations in European russia to demonstrate that modernization factors that reduce mortality also increase fertility under early marital patterns. The researchers learned by examining the Nigerian data that, in a population that has recently experienced an improved standard of living just prior to the demographic transition, natural fertility rises. The pregnancy rate also increases which leads to a greater incidence of pregnancy complications. Hence more infants are born at a low birth weight and consequentially an increase in infant mortality. Yet not all populations witness this pattern. The most important find of the study was that the direction of change in fertility essentially hinges on the marital pattern current before the demographic transition begins. For example, in European Russia, 33% of the eastern provinces' rural population experienced a decline in marriages between 1897-1926 while marital fertility increased. Yet the opposite occurred among the rural marital fertility increased. Yet the opposite occurred among the rural population of the western provinces in the same period: both marital fertility and marriages fell, although the decline was stronger in fertility than in nuptiality. Presently the demographic transition theory excludes nuptiality as 1 of its consequential components. It also assumes interaction only between morality and fertility and that changes in fertility reflect changes in nuptiality. Yet evidence shows that if policy planners would include nuptiality into the theory, they could better predict the timing of sustained fertility decline. Hence population policy should be aimed at marital patterns, since affecting these more directly results in reduced fertility.^ieng

Electrophysiological investigation of the effects of ambroxol on the transepithelial Na+ ion transport pathway in airways.

Isolated tracheal wall was studied by the Ussing method during selective inhibition of single, electrogenic, transepithelial ion transport pathways with either amiloride (for Na+) or bumetanide (for Cl-). It was shown that ambroxol influences the Na+ transepithelial transport pathway which is partly responsible for the hyperpolarization after mechanical stimulation of the mucosal surface of tracheal wall. Ambroxol augments the Na+ current during the presence of bumetanide in the experimental system, but diminishes it during the washing of amiloride from the measuring chamber. These bidirectional effects of ambroxol provide indirect evidence that the drug is a partial agonist for the memberance receptors which form part of the intrawall control system responsible for integration of airwall function with the transepithelial ion transport.