Reduced cardiorespiratory fitness, low physical activity and an urban environment are independently associated with increased cardiovascular risk in children.

AIMS/HYPOTHESIS: To assist in the development of preventive strategies, we studied whether the neighbourhood environment or modifiable behavioural parameters, including cardiorespiratory fitness (CRF) and physical activity (PA), are independently associated with obesity and metabolic risk markers in children. METHODS: We carried out a cross-sectional analysis of 502 randomly selected first and fifth grade urban and rural Swiss schoolchildren with regard to CRF, PA and the neighbourhood (rural vs urban) environment. Outcome measures included BMI, sum of four skinfold thicknesses, homeostasis model assessment of insulin resistance (HOMA-IR) and a standardised clustered metabolic risk score. RESULTS: CRF and PA (especially total PA, but also the time spent engaged in light and in moderate and vigorous intensity PA) were inversely associated with measures of obesity, HOMA-IR and the metabolic risk score, independently of each other, and of sociodemographic and nutritional parameters, media use, sleep duration, BMI and the neighbourhood environment (all p < 0.05). Children living in a rural environment were more physically active and had higher CRF values and reduced HOMA-IR and metabolic risk scores compared with children living in an urban environment (all p < 0.05). These differences in cardiovascular risk factors persisted after adjustment for CRF, total PA and BMI. CONCLUSIONS/INTERPRETATION: Reduced CRF, low PA and an urban environment are independently associated with an increase in metabolic risk markers in children.

Low utilization of health care services following screening for hypertension in Dar es Salaam (Tanzania): a prospective population-based study.

BACKGROUND: Drug therapy in high-risk individuals has been advocated as an important strategy to reduce cardiovascular disease in low income countries. We determined, in a low-income urban population, the proportion of persons who utilized health services after having been diagnosed as hypertensive and advised to seek health care for further hypertension management. METHODS: A population-based survey of 9254 persons aged 25-64 years was conducted in Dar es Salaam. Among the 540 persons with high blood pressure (defined here as BP >or= 160/95 mmHg) at the initial contact, 253 (47%) had high BP on a 4th visit 45 days later. Among them, 208 were untreated and advised to attend health care in a health center of their choice for further management of their hypertension. One year later, 161 were seen again and asked about their use of health services during the interval. RESULTS: Among the 161 hypertensive persons advised to seek health care, 34% reported to have attended a formal health care provider during the 12-month interval (63% public facility; 30% private; 7% both). Antihypertensive treatment was taken by 34% at some point of time (suggesting poor uptake of health services) and 3% at the end of the 12-month follow-up (suggesting poor long-term compliance). Health services utilization tended to be associated with older age, previous history of high BP, being overweight and non-smoking, but not with education or wealth. Lack of symptoms and cost of treatment were the reasons reported most often for not attending health care. CONCLUSION: Low utilization of health services after hypertension screening suggests a small impact of a patient-centered screen-and-treat strategy in this low-income population. These findings emphasize the need to identify and address barriers to health care utilization for non-communicable diseases in this setting and, indirectly, the importance of public health measures for primary prevention of these diseases.

Effect of race, genetic population structure, and genetic models in two-locus association studies: clustering of functional renin-angiotensin system gene variants in hypertension association studies

Previous genetic association studies have overlooked the potential for biased results when analyzing different population structures in ethnically diverse populations. The purpose of the present study was to quantify this bias in two-locus association studies conducted on an admixtured urban population. We studied the genetic structure distribution of angiotensin-converting enzyme insertion/deletion (ACE I/D) and angiotensinogen methionine/threonine (M/T) polymorphisms in 382 subjects from three subgroups in a highly admixtured urban population. Group I included 150 white subjects; group II, 142 mulatto subjects, and group III, 90 black subjects. We conducted sample size simulation studies using these data in different genetic models of gene action and interaction and used genetic distance calculation algorithms to help determine the population structure for the studied loci. Our results showed a statistically different population structure distribution of both ACE I/D (P = 0.02, OR = 1.56, 95% CI = 1.05-2.33 for the D allele, white versus black subgroup) and angiotensinogen M/T polymorphism (P = 0.007, OR = 1.71, 95% CI = 1.14-2.58 for the T allele, white versus black subgroup). Different sample sizes are predicted to be determinant of the power to detect a given genotypic association with a particular phenotype when conducting two-locus association studies in admixtured populations. In addition, the postulated genetic model is also a major determinant of the power to detect any association in a given sample size. The present simulation study helped to demonstrate the complex interrelation among ethnicity, power of the association, and the postulated genetic model of action of a particular allele in the context of clustering studies. This information is essential for the correct planning and interpretation of future association studies conducted on this population.

Prevalence of metabolic syndrome and its association with educational inequalities among Brazilian adults: a population-based study

The present study estimated the prevalence of metabolic syndrome (MS) according to the criteria established by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) and analyzed the contribution of social factors in an adult urban population in the Southeastern region of Brazil. The sample plan was based on multistage probability sampling according to family head income and educational level. A random sample of 1116 subjects aged 30 to 79 years was studied. Participants answered a questionnaire about socio-demographic variables and medical history. Fasting capillary glucose (FCG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides were determined and all non-diabetic subjects were submitted to the 75-g oral glucose tolerance test. Body mass index (BMI, kg/m²), waist circumference and blood pressure (BP) were determined. Age- and gender-adjusted prevalence of MS was 35.9 and 43.2% according to NCEP-ATPIII and IDF criteria, respectively. Substantial agreement was found between NCEP-ATPIII and IDF definitions. Low HDL-C levels and high BP were the most prevalent MS components according to NCEP-ATPIII criteria (76.3 and 59.2%, respectively). Considering the diagnostic criteria adopted, 13.5% of the subjects had diabetes and 9.7% had FCG ≥100 mg/dL. MS prevalence was significantly associated with age, skin color, BMI, and educational level. This cross-sectional population-based study in the Southeastern region of Brazil indicates that MS is highly prevalent and associated with an important social indicator, i.e., educational level. This result suggests that in developing countries health policy planning to reduce the risk of MS, in particular, should consider improvement in education.

Hypertension artérielle dans la population adulte du Burkina Faso : prévalence, détection, traitement et contrôle

Contexte : L’hypertension artérielle (HTA) est reconnue comme un important facteur de risque des maladies cardiovasculaires et de la mortalité prématurée. Les données montrent qu’un adulte sur 4 dans le monde souffrait d’hypertension en 2000 et ce chiffre serait en augmentation. Dans les pays africains, les estimations prévoient une progression plus rapide de la prévalence de l’HTA engendrant ainsi un problème additionnel à gérer pour le système de santé qui est toujours aux prises avec les maladies transmissibles. Les progrès économiques et l’urbanisation semblent entraîner des modifications des habitudes de vie dans ces pays qui seraient associés à une émergence des maladies non transmissibles, dont l’HTA. Le Burkina Faso, pays de l’Afrique de l’Ouest classé comme un pays à faibles revenus, aurait amorcé sa transition épidémiologique et il importe de faire un état sur les maladies non transmissibles en émergence. Afin de contribuer à la connaissance des aspects épidémiologiques de l’HTA au Burkina Faso, trois objectifs spécifiques ont été retenus pour la présente recherche : 1) Estimer la prévalence de l’HTA et identifier les facteurs associés dans la population rurale et la population semi-urbaine du Système de Surveillance démographique et de Santé de Kaya (Kaya HDSS) ; 2) Déterminer la différence de prévalence de l’HTA entre la zone lotie et la zone non lotie de la ville de Ouagadougou et identifier les facteurs associés ; 3) Déterminer la détection, le traitement, le contrôle de l’HTA et estimer la fréquentation des centres de santé par les personnes hypertendues nouvellement dépistées dans la population adulte du Centre Nord du Burkina Faso. Méthodologie : Le cadre de notre recherche est le Burkina Faso. Deux sites ont fait l’objet de nos investigations. Kaya HDSS, situé dans la région du Centre Nord du Burkina Faso a servi de site pour les enquêtes ayant permis l’atteinte du premier et du troisième objectif général. Une étude transversale a été menée en fin 2012 sur un échantillon aléatoire de 1645 adultes résidents du site. Un entretien suivi de mesures anthropométriques et de la pression artérielle (PA) ont été réalisés au domicile des participants. Toutes les personnes qui avaient une PA élevée (PA systolique ≥ 140 mm Hg et/ou PA diastolique ≥ 90 mm Hg) et qui n’avaient pas été diagnostiquées auparavant ont été référées à une formation sanitaire. Un second entretien a été réalisé avec ces personnes environ un mois après. Pour le second objectif général, c’est le système de surveillance démographique et de santé de Ouagadougou (Ouaga HDSS) qui a été retenu comme site. Ouaga HDSS couvre 5 quartiers de la zone nord de Ouagadougou. Une étude transversale a été réalisée en 2010 sur un échantillon aléatoire représentatif de la population adulte résidante du site (N = 2041). Des entretiens suivis de mesures anthropométriques et de la PA ont été réalisés durant l’enquête. Résultats : Notre premier article examine la prévalence de l’HTA et les facteurs associés en milieu rural et en milieu semi-urbain. Au total 1481 participants ont été dépistés et la prévalence totale pondérée était de 9,4 % (95 % IC : 7,3 % - 11,4 %) avec une grande différence entre le milieu semi-urbain et le milieu rural : un adulte sur 10 était hypertendu en milieu semi-urbain contre un adulte sur 20 en milieu rural. L’analyse multivariée nous a permis d’identifier l’âge avancé, le milieu semi-urbain et l’histoire familiale de l’HTA comme des facteurs de risque. Dans le deuxième article, nous avons déterminé la différence entre la zone lotie et la zone non lotie du milieu urbain en ce qui concerne l’HTA. Sur 2 041 adultes enquêtés, la prévalence totale est estimée à 18,6 % (95 % IC : 16,9 % - 20,3 %). Après ajustement avec l’âge, il n’y avait pas de différence de prévalence entre la zone lotie et la zone non lotie de la ville de Ouagadougou. Dans ce milieu urbain, l’obésité et l’inactivité physique sont confirmées comme des facteurs à risque. En plus des personnes âgées qui constituent un groupe à risque, les migrants venant du milieu rural et les veuves ont été identifiés comme des personnes à risque. Notre troisième article examine la détection, le traitement, le contrôle de l’HTA ainsi que la fréquentation des structures de santé par les personnes nouvellement dépistées hypertendues dans le milieu non urbain. Sur les 1481 participants à l’étude, 41 % n’avaient jamais mesuré leur PA. Sur les 123 participants (9,4 %) dépistés comme hypertendus, 26,8 % avaient déjà bénéficié d’un diagnostic et 75,8 % de ces derniers étaient sous traitement anti hypertensif. Parmi les participants sous traitement, 60 % (15 sur 25) avaient leur PA sous contrôle. Le suivi de 2 mois a permis de retrouver 72 des 90 personnes nouvellement dépistées. Seulement 50 % ont été en consultation et parmi ces derniers 76 % (28 personnes sur les 37) ont reçu une confirmation de leur hypertension. Conclusion : Notre recherche montre l’évolution de l’HTA en fonction du niveau d’urbanisation de la population. Même si les maladies infectieuses restent la priorité du système de santé, la lutte contre l’HTA doit s’inscrire dans un cadre général de lutte contre les maladies cardiovasculaires. Cette lutte doit être amorcée maintenant avant que des proportions inquiétantes ne soient atteintes. Des actions de prévention telles que la promotion de saines habitudes de vie, le dépistage de masse et un renforcement des capacités du système de soins sont à mettre en œuvre.

Agricultural practices and horizontal nutrient balances in urban gardens and the alternative use of urban agricultural land in Khartoum, Sudan

The surge in the urban population evident in most developing countries is a worldwide phenomenon, and often the result of drought, conflicts, poverty and the lack of education opportunities. In parallel with the growth of the cities is the growing need for food which leads to the burgeoning expansion of urban and peri-urban agriculture (UPA). In this context, urban agriculture (UA) contributes significantly to supplying local markets with both vegetable and animal produce. As an income generating activity, UA also contributes to the livelihoods of poor urban dwellers. In order to evaluate the nutrient status of urban soils in relation to garden management, this study assessed nutrient fluxes (inputs and outputs) in gardens on urban Gerif soils on the banks of the River Nile in Khartoum, the capital city of Sudan. To achieve this objective, a preliminary baseline survey was carried out to describe the structure of the existing garden systems. In cooperation with the author of another PhD thesis (Ms. Ishtiag Abdalla), alternative uses of cow dung in brick making kilns in urban Khartoum were assessed; and the socio-economic criteria of the brick kiln owners or agents, economical and plant nutritional value of animal dung and the gaseous emission related to brick making activities were assessed. A total of 40 household heads were interviewed using a semi-structured questionnaire to collect information on demographic, socio-economic and migratory characteristics of the household members, the gardening systems used and the problems encountered in urban gardening. Based on the results of this survey, gardens were divided into three groups: mixed vegetable-fodder gardens, mixed vegetable-subsistence livestock gardens and pure vegetable gardens. The results revealed that UA is the exclusive domain of men, 80% of them non-native to Khartoum. The harvested produce in all gardens was market oriented and represented the main source of income for 83% of the gardeners. Fast growing leafy vegetables such as Jew’s mallow (Corchorous olitorius L.), purslane (Portulaca oleracea L.) and rocket (Eruca sativa Mill.) were the dominant cultivated species. Most of the gardens (95%) were continuously cultivated throughout the year without any fallow period, unless they were flooded. Gardeners were not generally aware of the importance of crop diversity, which may help them overcome the strongly fluctuating market prices for their produce and thereby strengthen the contributions of UA to the overall productivity of the city. To measure nutrient fluxes, four gardens were selected and their nutrients inputs and outputs flows were monitored. In each garden, all plots were monitored for quantification of nutrient inputs and outputs. To determine soil chemical fertility parameters in each of the studied gardens, soil samples were taken from three selected plots at the beginning of the study in October 2007 (gardens L1, L2 and H1) and in April 2008 (garden H2) and at the end of the study period in March 2010. Additional soil sampling occurred in May 2009 to assess changes in the soil nutrient status after the River Nile flood of 2008 had receded. Samples of rain and irrigation water (river and well-water) were analyzed for nitrogen (N), phosphorus (P), potassium (K) and carbon (C) content to determine their nutrient inputs. Catchment traps were installed to quantify the sediment yield from the River Nile flood. To quantify the nutrient inputs of sediments, samples were analyzed for N, P, K and organic carbon (Corg) content, cation exchange capacity (CEC) and the particle size distribution. The total nutrient inputs were calculated by multiplying the sediment nutrient content by total sediment deposits on individual gardens. Nutrient output in the form of harvested yield was quantified at harvest of each crop. Plant samples from each field were dried, and analyzed for their N, P, K and Corg content. Cumulative leaching losses of mineral N and P were estimated in a single plot in garden L1 from December 1st 2008 to July 1st 2009 using 12 ion exchange resins cartridges. Nutrients were extracted and analyzed for nitrate (NO3--N), ammonium (NH4+-N) and phosphate PO4-3-P. Changes in soil nutrient balance were assessed as inputs minus outputs. The results showed that across gardens, soil N and P concentrations increased from 2007 to 2009, while particle size distribution remained unchanged. Sediment loads and their respective contents of N, P and Corg decreased significantly (P < 0.05) from the gardens of the downstream lowlands (L1 and L2) to the gardens of the upstream highlands (H1 and H2). No significant difference was found in K deposits. None of the gardens received organic fertilizers and the only mineral fertilizer applied was urea (46-0-0). This equaled 29, 30, 54, and 67% of total N inputs to gardens L1, L2, H1, and H2, respectively. Sediment deposits of the River Nile floods contributed on average 67, 94, 6 and 42% to the total N, P, K and C inputs in lowland gardens and 33, 86, 4 and 37% of total N, P, K and C inputs in highland gardens. Irrigation water and rainfall contributed substantially to K inputs representing 96, 92, 94 and 96% of total K influxes in garden L1, L2, H1 and H2, respectively. Following the same order, total annual DM yields in the gardens were 26, 18, 16 and 1.8 t ha-1. Annual leaching losses were estimated to be 0.02 kg NH4+-N ha-1 (SE = 0.004), 0.03 kg NO3--N ha-1 (SE = 0.002) and 0.005 kg PO4-3-P ha-1 (SE = 0.0007). Differences between nutrient inputs and outputs indicated negative nutrient balances for P and K and positive balances of N and C for all gardens. The negative balances in P and K call for adoptions of new agricultural techniques such as regular manure additions or mulching which may enhance the soil organic matter status. A quantification of fluxes not measured in our study such as N2-fixation, dry deposition and gaseous emissions of C and N would be necessary to comprehensively assess the sustainability of these intensive gardening systems. The second part of the survey dealt with the brick making kilns. A total of 50 brick kiln owners/or agents were interviewed from July to August 2009, using a semi-structured questionnaire. The data collected included general information such as age, family size, education, land ownership, number of kilns managed and/or owned, number of months that kilns were in operation, quantity of inputs (cow dung and fuel wood) used, prices of inputs and products across the production season. Information related to the share value of the land on which the kilns were built and annual income for urban farmers and annual returns from dung for the animal raisers was also collected. Using descriptive statistics, budget calculation and Gini coefficient, the results indicated that renting the land to brick making kilns yields a 5-fold higher return than the rent for agriculture. Gini coefficient showed that the kiln owners had a more equal income distribution compared to farmers. To estimate emission of greenhouse gases (GHGs) and losses of N, P, K, Corg and DM from cow dung when used in brick making, samples of cow dung (loose and compacted) were collected from different kilns and analyzed for their N, P, K and Corg content. The procedure modified by the Intergovernmental Panel on Climate Change (IPCC, 1994) was used to estimate the gaseous emissions of cow dung and fuel wood. The amount of deforested wood was estimated according to the default values for wood density given by Dixon et al. (1991) and the expansion ratio for branches and small trees given by Brown et al. (1989). The data showed the monetary value of added N and P from cow dung was lower than for mineral fertilizers. Annual consumption of compacted dung (381 t DM) as biomass fuel by far exceeded the consumption of fuel wood (36 t DM). Gaseous emissions from cow dung and fuel wood were dominated by CO2, CO and CH4. Considering that Gerif land in urban Khartoum supports a multifunctional land use system, efficient use of natural resources (forest, dung, land and water) will enhance the sustainability of the UA and brick making activities. Adoption of new kilns with higher energy efficiency will reduce the amount of biomass fuels (cow dung and wood) used the amount of GHGs emitted and the threat to the few remaining forests.

Opportunities and constraints of peri-urban buffalo and dairy cattle systems in Faisalabad, Punjab, Pakistan

In the big cities of Pakistan, peri-urban dairy production plays an important role for household income generation and the supply of milk and meat to the urban population. On the other hand, milk production in general, and peri-urban dairy production in particular, faces numerous problems that have been well known for decades. Peri-urban dairy producers have been especially neglected by politicians as well as non-government-organizations (NGOs). Against this background, a study in Pakistan’s third largest city, Faisalabad (Punjab Province), was carried out with the aims of gathering basic information, determining major constraints and identifying options for improvements of the peri-urban milk production systems. For data collection, 145 peri-urban households (HH) engaged in dairy production were interviewed face to face using a structured and pretested questionnaire with an interpreter. For analyses, HH were classified into three wealth groups according to their own perception. Thus, 38 HH were poor, 95 HH well off and 12 HH rich (26.2%, 65.5% and 8.3%, respectively). The richer the respondents perceived their HH, the more frequently they were actually in possession of high value HH assets like phones, bank accounts, motorbikes, tractors and cars. Although there was no difference between the wealth groups with respect to the number of HH members (about 10, range: 1 to 23), the educational level of the HH heads differed significantly: on average, heads of poor HH had followed education for 3 years, compared to 6 years for well off HH and 8 years for rich HH. About 40% of the poor and well off HH also had off-farm incomes, while the percentage was much higher - two thirds (67%) - for the rich HH. The majority of the HH were landless (62%); the rest (55 HH) possessed agricultural land from 0.1 to 10.1 ha (average 2.8 ha), where they were growing green fodder: maize, sorghum and pearl millet in summer; berseem, sugar cane and wheat were grown in winter. Dairy animals accounted for about 60% of the herds; the number of dairy animals per HH ranged from 2 to 50 buffaloes (Nili-Ravi breed) and from 0 to 20 cows (mostly crossbred, also Sahiwal). About 37% (n=54) of the HH did not keep cattle. About three quarters of the dairy animals were lactating. The majority of the people taking care of the animals were family workers; 17.3% were hired labourers (exclusively male), employed by 11 rich and 32 well off HH; none of the poor HH employed workers, but the percentages were 33.7% for the well off and 91.7% for the rich HH. The total number of workers increased significantly with increasing wealth (poor: 2.0; well off:2.5; rich: 3.4). Overall, 69 female labourers were recorded, making up 16.8% of employed workers and one fourth of the HH’s own labourers. Apparently, their only duty was to clean the animals´ living areas; only one of them was also watering and showering the animals. Poor HH relied more on female workers than the other two groups: 27.1% of the workers of poor HH were women, but only 14.8% and 6.8% of the labour force of well off and rich HH were female. Two thirds (70%) of the HH sold milk to dhodis (middlemen) and one third (35%) to neighbours; three HH (2%) did doorstep delivery and one HH (1%) had its own shop. The 91 HH keeping both species usually sold mixed milk (97%). Clients for mixed and pure buffalo milk were dhodis (78%, respectively 59%) and neighbours (28%, respectively 47%). The highest milk prices per liter (Pakistani Rupees, 100 PKR @ 0.8 Euro) were paid by alternative clients (44 PKR; 4 HH), followed by neighbours (40 PKR, 50 HH); dhodis paid lower prices (36 PKR, 99 HH). Prices for pure buffalo and mixed milk did not differ significantly. However, HH obtaining the maximum price from the respective clients for the respective type of milk got between 20% (mixed milk, alternative clients) and 68% (mixed milk, dhodi) more than HH fetching the minimum price. Some HH (19%) reported 7% higher prices for the current summer than the preceding winter. Amount of milk sold and distance from the HH to the city center did not influence milk prices. Respondents usually named problems that directly affected their income and that were directly and constantly visible to them, such as high costs, little space and fodder shortages. Other constraints that are only influencing their income indirectly, e.g. the relatively low genetic potential of their animals due to neglected breeding as well as the short- and long-term health problems correlated with imbalanced feeding and insufficient health care, were rarely named. The same accounts for problems accompanying improper dung management (storage, disposal, burning instead of recycling) for the environment and human health. Most of the named problems are linked to each other and should be addressed within the context of the entire system. Therefore, further research should focus on systematic investigations and improvement options, taking a holistic and interdisciplinary approach instead of only working in single fields. Concerted efforts of dairy farmers, researchers, NGOs and political decision makers are necessary to create an economic, ecological and social framework that allows dairy production to serve the entire society. For this, different improvement options should be tested in terms of their impact on environment and income of the farmers, as well as feasibility and sustainability in the peri-urban zones of Faisalabad.

Symptoms of Temporomandibular Disorders in the Population: An Epidemiological Study

Aims: To estimate the prevalence of symptoms of temporomandibular disorders (TMD) as a function of age and gender, in a representative urban sample from the Brazilian population. Methods: A total of 1,230 inhabitants (51.5% women) aged 15 to 65 years were interviewed by a validated phone survey. Sample size had been previously calculated. TMD symptoms were assessed through five questions, as recommended by the American Academy of Orofacial Pain, in an attempt to identify possible TMD. Data were derived by age and gender. Prevalence of each TMD symptom, and of combination of symptoms, was calculated. Results: At least one TMD symptom was reported by 39.2% of the individuals. Pain related to TMD was noted by 25.6% of the population. Temporomandibular joint (TMJ) sound was the most common symptom of TMD, followed by TMJ pain and masticatory muscle pain. All symptoms were more prevalent in women than in men. With men used as the reference, a relative risk (RR) of at least one TMD symptom in women was 1.31 (95% confidence interval [CI] = 1.14 to 1.52). When at least two symptoms were present, the RR was 1.93 (95% CI = 1.49 to 2.51). For three or more TMD symptoms, the RR was 2.49 (95% CI = 1.67 to 3.71). Women were also more likely than men to have TMD pain (RR = 1.78; 9% CI = 1.45 to 2.18). Conclusion: Individual symptoms, as well as a combination of TMD symptoms, are prevalent in the Brazilian urban population and are more frequent in women than in men. Additional studies should focus on risk factors for and relevance of TMD for the sufferers. J OROFAC PAIN 2010;24:270-278

Agent-based model to rural-urban migration analysis

In this paper, we analyze the rural-urban migration phenomenon as it is usually observed in economies which are in the early stages of industrialization. The analysis is conducted by means of a statistical mechanics approach which builds a computational agent-based model. Agents are placed on a lattice and the connections among them are described via an Ising-like model. Simulations on this computational model show some emergent properties that are common in developing economies, such as a transitional dynamics characterized by continuous growth of urban population, followed by the equalization of expected wages between rural and urban sectors (Harris-Todaro equilibrium condition), urban concentration and increasing of per capita income. (c) 2005 Elsevier B.V. All rights reserved.

Urban and suburban malaria in Rondônia (Brazilian Western Amazon) II. Perennial transmissions with high anopheline densities are associated with human environmental changes

Longitudinal entomological surveys were performed in Vila Candelária and adjacent rural locality of Bate Estaca concomitantly with a clinical epidemiologic malaria survey. Vila Candelária is a riverside periurban neighborhood of Porto Velho, capital of the state of Rondônia in the Brazilian Amazon. High anopheline densities were found accompanying the peak of rainfall, as reported in rural areas of the region. Moreover, several minor peaks of anophelines were recorded between the end of the dry season and the beginning of the next rainy season. These secondary peaks were related to permanent anopheline breeding sites resulting from human activities. Malaria transmission is, therefore, observed all over the year. In Vila Candelária, the risk of malaria infection both indoors and outdoors was calculated as being 2 and 10/infecting bites per year per inhabitant respectively. Urban malaria in riverside areas was associated with two factors: (1) high prevalence of asymptomatic carriers in a stable human population and (2) high anopheline densities related to human environmental changes. This association is probably found in other Amazonian urban and suburban communities. The implementation of control measures should include environmental sanitation and better characterization of the role of asymptomatic carriers in malaria transmission.

Cytogenetic and random amplified polymorphic DNA analysis of Leptodactylus species from rural and urban environments (Anura, Amphibia)

Cytogenetic and random amplified polymorphic DNA analyses carried out in the species Leptodactylus podicipinus, L. ocellatus, L. labyrinthicus, and L. fuscus from rural and urban habitats of the northwest region of São Paulo State, Brazil, showed that the karyotypes (2n = 22), constitutive heterochromatin distribution and nucleolus organizer region (NOR) location did not differ between the populations from the two environments. The in situ hybridization with an rDNA probe confirmed the location of the NORs on chromosome 8 revealing an in tandem duplication of that region in one of the chromosomes of L. fuscus. DAPI showed that part of the C-band-positive heterochromatin is rich in AT, including that in the proximity the NORs in L. podicipinus and L. ocellatus. The molecular analyses showed that the two populations (urban and rural) of L. podicipinus and L. fuscus are similar from a genetic point of view. The urban and rural populations of species L. ocellatus and L. labyrinthicus showed differences in genetic structures, probably due to urbanization which interferes with the dispersion of those frogs. The marked differences observed between the two populations of L. ocellatus can be representing the cryptic condition of the species. Unweighted pair-group method of analysis and genetic distance analysis detected the genetic proximity between L. ocellatus and L. fuscus. The results indicate that there was no reduction in the genetic diversity in the populations from the urban environment; however, the survival of these frogs would not be guaranteed in the case of an increase in human impact especially for populations of L. labyrinthicus and L. ocellatus. ©FUNPEC-RP.

Proyecciones de población = Population projections

El Observatorio Demográfico 2013 contiene indicadores seleccionados de la revisión de 2013 de las estimaciones y proyecciones de la población analizada. Las cifras contenidas en esta publicación constituyen una revisión de las presentadas en el Observatorio 2012. En esta oportunidad, se actualizaron las estimaciones y proyecciones de la población urbana y rural desde 1950 hasta 2050, extendiéndose el período de estimación y de proyección. La metodología utilizada es la habitual, pero en esta oportunidad se ajustaron las tendencias observadas para lograr una proyección de más largo plazo en los países que no cuentan con censos de la década de 2010. En las próximas ediciones se irán incorporando las nuevas estimaciones y proyecciones de población en que se consideren los censos más recientes y otras fuentes a medida que estén disponibles. Como es habitual, se incluye un capítulo en el que se analizan las tendencias demográficas. En esta oportunidad, se examinan el crecimiento y la perspectiva de la población urbana en la región. En las notas técnicas de este Observatorio se enumeran las fuentes de datos consideradas para cada país. Cabe señalar que la información correspondiente a las estimaciones y proyecciones de la población nacional, urbana, rural y económicamente activa está disponible en formato de hojas de cálculo en el sitio web del CELADE-División de Población de la CEPAL (http://www.eclac.org/celade/).

Thioredoxin interacting protein genetic variation is associated with diabetes and hypertension in the Brazilian general population

Objective: To investigate the relationship between TXNIP polymorphisms, diabetes and hypertension phenotypes in the Brazilian general population. Methods: Five hundred seventy-six individuals randomly selected from the general urban population according to the MONICA-WHO project guidelines were phenotyped for cardiovascular risk factors. A second, independent, sample composed of 487 family-trios from a different site was also selected. Nine TXNIP polymorphisms were studied. The potential association between TXNIP variability and glucose-phenotypes in children was also explored. TXNIP expression was quantified by real-time PCR in 53 samples from human smooth muscle cells primary culture. Results: TXNIP rs7211 and rs7212 polymorphisms were significantly associated with glucose and blood pressure related phenotypes. In multivariate logistic regression models the studied markers remained associated with diabetes even after adjustment for covariates. TXNIP rs7211 T/rs7212 G haplotype (present in approximately 17% of individuals) was significantly associated to diabetes in both samples. In children, the TXNIP rs7211 T/rs7212 G haplotype was associated with fasting insulin concentrations. Finally, cells harboring TXNIP rs7212 G allele presented higher TXNIP expression levels compared with carriers of TXNIP rs7212 CC genotype (p = 0.02). Conclusion: Carriers of TXNIP genetic variants presented higher TXNIP expression, early signs of glucose homeostasis derangement and increased susceptibility to chronic metabolic conditions such as diabetes and hypertension. Our data suggest that genetic variation in the TXNIP gene may act as a "common ground" modulator of both traits: diabetes and hypertension. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

BDKRB2+9/-9 Polymorphism Is Associated with Higher Risk for Diabetes Mellitus in the Brazilian General Population

Some mechanisms have been proposed to explain the role of bradykinin on glucose homeostasis and some studies reported that the BDKRB2 +9/-9 polymorphism was associated to the transcriptional activity of the receptor. In this scenario, the main aim of this study was to evaluate the association of the BDKRB2 +9/-9 polymorphism with diabetes mellitus risk in the Brazilian general population. This study included 1,032 subjects of the general urban population. Anthropometrical, blood pressure, biochemical, and genotype analyses for the BDKRB2 +9/-9 bp insertion/deletion polymorphism were performed. Individuals carrying +9/+9 or +9/-9 genotypes had higher glucose values (84.5 mg/dL versus 80.6 mg/dL, resp.) and higher frequency of diabetes mellitus (7.6% versus 3.6%, resp.) compared to individuals carrying -9/-9, adjusting for age and gender. In addition, higher diabetes mellitus risk was associated to presence of the +9/+9 or +9/-9 genotypes (OR = 1.91; 95% CI = 1.09-4.19; P = 0.03). Our data suggest that the BDKRB2 +9/-9 polymorphism may act as a genetic modulator of glucose homeostasis. It was previously associated to insulin sensitivity, glucose uptake, and insulin secretion, and, in this study, data suggest that the polymorphism may increase susceptibility to chronic metabolic conditions such as diabetes in the Brazilian population.