D Robinson

Bio: D Robinson is an academic researcher. The author has an hindex of 1, co-authored 1 publications receiving 198 citations.

The prevalence of hypertension in seven populations of west African origin.

Abstract: OBJECTIVES: This study was undertaken to describe the distribution of blood pressures, hypertension prevalence, and associated risk factors among seven populations of West African origin. METHODS: The rates of hypertension in West Africa (Nigeria and Cameroon), the Caribbean (Jamaica, St. Lucia, Barbados), and the United States (metropolitan Chicago, Illinois) were compared on the basis of a highly standardized collaborative protocol. After researchers were given central training in survey methods, population-based samples of 800 to 2500 adults over the age of 25 were examined in seven sites, yielding a total sample of 10014. RESULTS: A consistent gradient of hypertension prevalence was observed, rising from 16% in West Africa to 26% in the Caribbean and 33% in the United States. Mean blood pressures were similar among persons aged 25 to 34, while the increase in hypertension prevalence with age was twice as steep in the United States as in Africa. Environmental factors, most notably obesity and the intak...

How Gender Roles Influence Sexual and Reproductive Health Among South African Adolescents

Abstract: Although the literature on Africa increasingly adopts a gendered approach to sexual and reproductive health issues, few studies have addressed adolescent pregnancy and parenthood in such a framework. This article examines links between gender ideology or gender roles and the social impact of adolescent childbearing in the lives of rural and urban adolescents in KwaZulu/Natal, South Africa. It employs a triangulated research methodology (focus-group discussions, narrative role playing and discussions, and questionnaires and in-depth interviews) to inform an analysis of adolescents' notions of male and female gender ideals. This analysis forms the basis for an exploration of the potential influence of adolescent childbearing on young peoples' lives and factors that shape their sexual and reproductive well-being. Results indicate that gender ideals are grounded in traits that reinforce poor sexual negotiation dynamics and behavioral double standards and that place adolescents at risk for early pregnancy and other sexual and reproductive health complications. Overall, adolescent parenthood is viewed negatively by participants of both sexes because it compromises personal, professional, and financial aspirations. Compared with its effect on boys, parenthood has a disproportionate (and highly negative) impact on girls that is directly linked to gender-based inequities. The article addresses the research and policy implications of these findings.

Determinants of vaccination coverage in rural Nigeria

Abstract: Childhood immunization is a cost effective public health strategy. Expanded Programme on Immunisation (EPI) services have been provided in a rural Nigerian community (Sabongidda-Ora, Edo State) at no cost to the community since 1998 through a privately financed vaccination project (private public partnership). The objective of this survey was to assess vaccination coverage and its determinants in this rural community in Nigeria A cross-sectional survey was conducted in September 2006, which included the use of interviewer-administered questionnaire to assess knowledge of mothers of children aged 12–23 months and vaccination coverage. Survey participants were selected following the World Health Organization's (WHO) immunization coverage cluster survey design. Vaccination coverage was assessed by vaccination card and maternal history. A child was said to be fully immunized if he or she had received all of the following vaccines: a dose of Bacille Calmette Guerin (BCG), three doses of oral polio (OPV), three doses of diphtheria, pertussis and tetanus (DPT), three doses of hepatitis B (HB) and one dose of measles by the time he or she was enrolled in the survey, i.e. between the ages of 12–23 months. Knowledge of the mothers was graded as satisfactory if mothers had at least a score of 3 out of a maximum of 5 points. Logistic regression was performed to identify determinants of full immunization status. Three hundred and thirty-nine mothers and 339 children (each mother had one eligible child) were included in the survey. Most of the mothers (99.1%) had very positive attitudes to immunization and > 55% were generally knowledgeable about symptoms of vaccine preventable diseases except for difficulty in breathing (as symptom of diphtheria). Two hundred and ninety-five mothers (87.0%) had a satisfactory level of knowledge. Vaccination coverage against all the seven childhood vaccine preventable diseases was 61.9% although it was significantly higher (p = 0.002) amongst those who had a vaccination card (131/188, 69.7%) than in those assessed by maternal history (79/151, 52.3%). Multiple logistic regression showed that mothers' knowledge of immunization (p = 0.006) and vaccination at a privately funded health facility (p < 0.001) were significantly correlated with the rate of full immunization. Eight years after initiation of this privately financed vaccination project (private-public partnership), vaccination coverage in this rural community is at a level that provides high protection (81%) against DPT/OPV. Completeness of vaccination was significantly correlated with knowledge of mothers on immunization and adequate attention should be given to this if high coverage levels are to be sustained.

A Not Quite as Quick but Much Cleaner Alternative to the Expanded Programme on Immunization (EPI) Cluster Survey Design

Abstract: Although the Expanded Program on Immunization (EPI) cluster survey methodology has been successfully used for assessing levels of immunization program coverage in developing country settings certain features of the methodology as it is usually carried out make it a less-than-optimal choice for large national surveys and/or surveys with multiple measurement objectives. What is needed is a middle ground between rigorous cluster sampling methods which are seen as unfeasible for routine use in many developing country settings and the EPI cluster survey approach. This article suggests some fairly straightforward modifications to the basic EPI cluster survey design that put it on a solid probability footing and render it easily adaptable to differing and/or multiple measurement objectives without incurring prohibitive costs or adding appreciably to the complexity of survey operations. The proposed modifications concern primarily the manner in which households are chosen at the second stage of sample selection. Because the modified sampling strategy maintains the scientific rigor of conventional cluster sampling methods while retaining many of the desirable features of the EPI survey methodology the methodology is likely to be a preferred middle ground survey design relevant for many applications particularly surveys designed to monitor multiple health indicators over time. The fieldwork burden in the modified design is only marginally higher than in EPI cluster surveys and considerably lower than in conventional cluster surveys. (authors)

Multiple parasite infections and their relationship to self-reported morbidity in a community of rural Cote d'Ivoire

Abstract: Background Concomitant parasitic infections are common in the developing world, yet most studies focus on a single parasite in a narrow age group. We investigated the extent of polyparasitism and parasite associations, and related these findings to self-reported morbidity. Methods Inhabitants of 75 randomly selected households from a single village in western Cote d’Ivoire provided multiple faecal specimens and a single finger prick blood sample. The Kato-Katz technique and a formol-ether concentration method were employed to screen faecal samples for Schistosoma mansoni, soil-transmitted helminths and intestinal protozoa. Giemsa-stained blood smears were analysed for malaria parasites. A questionnaire was administered for collection of demographic information and self-reported morbidity indicators. Results Complete parasitological data were obtained for 500/561 (89.1%) participants, similarly distributed among sex, with an age range from 5 days to 91 years. The prevalences of Plasmodium falciparum, hookworms, Entamoeba histolytica/E. dispar, and S. mansoni were 76.4%, 45.0%, 42.2%, and 39.8%, respectively. Threequarters of the population harboured three or more parasites concurrently. Multivariate analysis revealed significant associations between several pairs of parasites. Some parasitic infections and the total number of parasites were significantly associated with self-reported morbidity indicators. Conclusions Our data confirm that polyparasitism is very common in rural Cote d’Ivoire and that people have clear perceptions about the morbidity caused by some of these parasitic infections. Our findings can be used for the design and implementation of sound intervention strategies to mitigate morbidity and co-morbidity.