| 1. |
- Berhane, Yemane, et al.
(författare)
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Gender, literacy, and survival among Ethiopian adults, 1987 - 96.
- 2002
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Ingår i: Bulletin of the World Health Organization. - 0042-9686 .- 1564-0604. ; 80:9, s. 714-20
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Tidskriftsartikel (refereegranskat)abstract
- Special attention should be given to raising literacy levels among rural women with a view to improving their survival.
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| 2. |
- Byass, Peter, et al.
(författare)
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The role of demographic surveillance systems (DSS) in assessing the health of communities : an example from rural Ethiopia
- 2002
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Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 116:3, s. 145-150
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Tidskriftsartikel (refereegranskat)abstract
- Longitudinal demographic surveillance systems (DSSs) in selected populations can provide important information in situations where routine health information is incomplete or absent, particularly in developing countries. The Butajira Rural Health Project is one such example, initiated in rural Ethiopia in 1987. DSSs rely on regular community-based surveillance as a means of vital event registration, among a sufficient population base to draw meaningful conclusions about rates and trends in relatively rare events such as maternal death. Enquiries into specific health problems can also then use this framework to quantify particular issues or evaluate interventions. Demographic characteristics and trends for a rural Ethiopian population over a 10-y period are presented as an illustration of the DSS approach, based on 336 000 person-years observed. Overall life expectancy at birth was 50 y. Demographic parameters generally showed modest trends towards improvement over the 10-y period. The DSS approach is useful in characterising populations at the community level over a period of time, providing important information for health planning and intervention. Methodological issues underlying this approach need further exploration and development.
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| 3. |
- Hang, Hoang Minh, et al.
(författare)
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Community-based assessment of unintentional injuries: a pilot study in rural Vietnam
- 2003
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905 .- 1403-4956. ; 31:Supplement 62, s. 38-44
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Although unintentional injuries are recognised as a major public health problem globally, little is known about their patterns and rates at the community level in most low-income countries. Rapid social development, leading to increased traffic and industrialization, may be changing patterns of injury. Injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries in Vietnam, largely because they have not been effectively counted. This study took place in northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi, as a pilot project aiming to determine the community incidence of unintentional injury and to explore appropriate methods for community-based injury surveillance. METHODS: An initial study population of 23,807 was identified and asked about their experience of injury in the preceding three months. RESULTS: Overall 450 new injuries were detected over 5,952 person-years, a rate of 76 per 1,000 person-years. Males were injured at 1.6 times the rate of females, and home and road traffic accidents were most common. Most injuries occurred during unpaid household tasks. Cutting and crushing injuries occurred most frequently. Of 221 deaths from all causes in the FilaBavi population during 1999 among 43,444 person-years, 25 were attributed to unintentional injuries and two to suicide. Unintentional injury was the third leading cause of death in this community, with a case-fatality rate of 0.8%. DISCUSSION: The findings suggest that greater attention needs to be directed toward the prevention of injuries occurring in the home in rural Vietnam. On the basis of this pilot study, a one-year study using the same approach is under way to characterize the patterns of unintentional injury in more detail, including any seasonal variation.
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| 4. |
- Hang, Hoang Minh, 1959-
(författare)
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Epidemiology of unintentional injuries in rural Vietnam
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main objective of this epidemiological study was to assess the incidence of unintentional non-fatal injuries, together with their determinants and consequences, in a defined Vietnamese population, thus providing a basis for future prevention. A one-year follow-up survey involved four quarterly cross-sectional household injury interviews during 2000. This cohort study was based within a demographic surveillance site in Bavi district, northern Vietnam, which provides detailed, longitudinal information in a continuous and systematic way. Findings relate to three phases of the injury process: before, during and after injury. The study showed that unintentional non-fatal injuries were an important health problem in rural Vietnam. The high incidence rate of 89/1000 pyar reflected almost one tenth of the population being injured every year. Home injuries were found to be most common, often due to a lack of proper kitchens and dangerous surroundings in the home. Road traffic injuries were less common but tended to be more severe, with longer periods of disability and higher unit costs compared with other types of injury. The leading mechanisms of injury were impacts with other objects, falls, cuts and crushing. Males had higher injury incidence rates than females except among the elderly. Elderly females were often injured due to falls in the home. Being male or elderly were significant risk factors for injury. Poverty was a risk factor for injuries in general and specifically for home and work related injuries, but not for road traffic injuries. The middle income group was at higher risk of traffic injuries, possibly due to their greater mobility. Injuries not only affected people’s health, but were also a great financial burden. The cost of an injury, on average, corresponded to approximately 1.3 months of earned income, increasing to 7 months for a severe injury. Ninety percent of the economic burden of injury fell on households, only 8% on government and 2% on health insurance agencies. Self-treatment was the most common way of treating injuries (51.7%), even in some cases of severe injury. There was a low rate of use of public health services (23.2%) among injury patients, similar to private healthcare (22.4%). High cost, long distances, residence in mountains, being female and coming from ethnic minorities were barriers for seeking health services. People with health insurance sought care more, but the coverage of health insurance was very low. Some prevention strategies might include education and raising awareness about the possible dangers of injury and the importance of seeking appropriate care following injury. To avoid household hazards, several strategies could be used: better light in the evening, making gravel paths around the house, clearing moss to avoid slipping, wearing protective clothing when using electrical equipment and improving kitchens. Similarly, improving road surfaces, having separate paths for pedestrians and cyclists and better driver training could reduce road accidents. In Vietnam, and especially in a rural district without any injury register system, a community-based survey of unintentional injuries has been shown to be a feasible approach to injury assessment. It gave more complete results than could have been obtained from facility-based studies and led to the definition of possible prevention strategies.
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| 5. |
- Hang, Minh Hang, et al.
(författare)
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Incidence and seasonal variation of injury in rural Vietnam : a community-based survey
- 2004
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Ingår i: Safety Science. - : Elsevier BV. - 0925-7535 .- 1879-1042. ; 42:8, s. 691-701
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Tidskriftsartikel (refereegranskat)abstract
- Study objective: To describe seasonal effects on injury incidence at the community level and to assess the relative merits of cross-sectional or longitudinal surveillance for injuries in such a setting. Population and methods: This study took place in Bavi district, northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi. All non-fatal unintentional injuries which occurred in a sample of 24,776 people living in 5801 households were recorded during 2000. Four interview surveys per household were conducted continuously during 2000, each covering a 3-month period of recall. Injury morbidity data were analysed according to gender, age and circumstances of injury. Statistical analyses were based on monthly, quarterly and annual incidence rates with 95% confidence intervals. Significant differences between incidence rates were noted where the 95% confidence interval of the rate ratio excluded unity. Results: There were 1917 persons who experienced a total of 2079 new non-fatal injuries during the period of observation, corresponding to an incidence of 89/1000 person-years. Seasonal variations were found in all types of injury. Overall, the highest incidence rates were observed in July and April, while the lowest monthly rates were found in May and November. Peaks were observed in February and April for traffic injuries, June for work-related injuries, July, August and October for home injuries. A significantly higher incidence rate was found in the third quarter survey (103/1000 person-years, p<0.05). Conclusion: There can be interesting and significant seasonal variations in injury incidence within a community such as seen here in rural Vietnam and these variations have important implications for the design and planning of injury surveillance activities. Seasonal effects may cause invalid assessments of an injury problem if only cross-sectional household surveys are used, demonstrating the need for longitudinal approaches to injury incidence surveillance.
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| 6. |
- Huong, Dao Lan, et al.
(författare)
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Applying verbal autopsy to determine cause of death in rural Vietnam
- 2003
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 31:Suppl. 62, s. 19-25
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Verbal autopsy (VA) is an attractive method for ascertaining causes of death in settings where the proportion of people who die under medical care is low. VA has been widely used to determine causes of childhood and maternal deaths, but has had limited use in assessing causes in adults and across all age groups. The objective was to test the feasibility of using VA to determine causes of death for all ages in Bavi District, Vietnam, in 1999, leading to an initial analysis of the mortality pattern in this area. Methods: Trained lay field workers interviewed a close caretaker of the deceased using a combination closed/open-ended questionnaire. Results: A total of 189 deaths were studied. Diagnoses were made by two physicians separately, with good agreement (k~0.84) and then combined to reach one single underlying cause of death for each case. The leading causes of death were cardiovascular and infectious diseases (accounting for 20.6% and 17.9% of the total respectively). Drowning was very prevalent in children under 15 (seven out of nine cases of drowning were in this age group). Discussion: One month seemed an acceptable minimum recall period to ensure mourning procedures were over. A combination VA questionnaire was an appropriate instrument provided it was supported by adequate training of interviewers. Two physicians were appropriate for making the diagnoses but predefined diagnostic methods for common causes should be developed to ensure more replicable results and comparisons, as well as to observe trends of mortality over time. The causes of death in this study area reflect a typical pattern for developing countries that are in epidemiological transition. No maternal deaths and a low infant mortality rate may be the result of improvements in maternal and child health in this study area. Using the VA gave more precise causes of death than those reported at death registration. Although the validity of the VA method used has not been fully assessed, it appeared to be an appropriate method for ascertaining causes of death in the study area. Key words: cause of death, community data, field survey, mortality, verbal autopsy, Vietnam.
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