Papers by Peter K Streatfield
Carolina Digital Repository (University of North Carolina at Chapel Hill), 2012
Groundwater is routinely analyzed for fecal indicators but direct comparisons of fecal indicators... more Groundwater is routinely analyzed for fecal indicators but direct comparisons of fecal indicators to the presence of bacterial and viral pathogens are rare. This study was conducted in rural Bangladesh where the human population density is high, sanitation is poor, and groundwater pumped from shallow tubewells is often contaminated with fecal bacteria. Five indicator microorganisms (E. coli, total coliform, F+RNA coliphage, Bacteroides and human-associated Bacteroides) and various environmental parameters were compared to the direct detection of waterborne pathogens by quantitative PCR in groundwater pumped from 50 tubewells. Rotavirus was detected in groundwater filtrate from the largest proportion of tubewells (40%), followed by Shigella (10%), Vibrio (10%), and pathogenic E. coli (8%). Spearman rank correlations and sensitivity-specificity calculations indicate that some, but not all, combinations of indicators and environmental parameters can predict the presence of pathogens. Culture-dependent fecal indicator bacteria measured on a single date did not predict total bacterial pathogens, but annually averaged monthly measurements of culturable E. coli did improve prediction for total bacterial
Health Policy and Planning, 1999
The paper reviews the achievements in tetanus immunization coverage and child immunization in Ban... more The paper reviews the achievements in tetanus immunization coverage and child immunization in Bangladesh. It uses data from the 1993-94 Bangladesh Demographic and Health Survey to identify and examine the programmatic and non-programmatic factors that influence the coverage of tetanus (TT) immunization during pregnancy, and full immunization among children 12-23 months old in rural Bangladesh. The purpose of this analysis is to identify the areas that need further programme attention. The logistic regression results show that the coverage of TT immunization was significantly associated with proximity to outreach clinics and the presence of a health worker in the community. Home visits by health/family planning fieldworkers and the proximity to outreach clinics had larger influences on TT coverage of poorer households compared to those better-off. The effect of distance to static clinics varied by regions. Among children, full immunization coverage (coverage of all of BCG, DPT1, DPT2, DPT3, Polio1 Polio2, Polio3) was significantly associated with distance to outreach clinics, the greater the distance to the clinics, the less the likelihood of immunization.
Feeding, home-remedy practices, and consultation with health care providers during childhood illness in rural Bangladesh
PubMed, Jun 1, 1995
The nature of feeding, home-remedy practices, and consultation with health care providers during ... more The nature of feeding, home-remedy practices, and consultation with health care providers during illnesses of children in Matlab, a rural subdistrict of Bangladesh, were studied. Data were collected between October 1986 and February 1987 from mothers of children aged 3-36 months. About half of the mothers initiated home-remedies for treating their children. The treatment included: pouring water on the head, feeding juice of herbs, using sanctified water and ORT. The type of treatment was dependent on the nature of illness. The use-rate of ORT was low. Breastfeeding was discontinued for 16% of the episodes; the reduction was the highest for fever with cough, followed by fever and diarrhoea. A reduction in intake of other foods was observed for 39% of the episodes with a total discontinuation for 10%. The reduction was the highest for dysentery, followed by diarrhoea, and fever with or without cough. Total withdrawal of foods other than breastmilk was the highest for diarrhoea. Contact with at least one health care provider of any type by the fifteenth day of illness was made for 41% of the episodes. The contact rate was significantly greater for children living in the health intervention area; for boys, for infants, for richer households, and for severe cases. A higher contact rate in cases of diarrhoeal illness was observed for children of illiterate mothers than that of literate ones.
Journal of Biosocial Science, Oct 1, 1992
In a prospective study in Matlab, a rural area in Bangladesh, the relationship between a variety ... more In a prospective study in Matlab, a rural area in Bangladesh, the relationship between a variety of covariates and childhood mortality was examined. Economic status of household, education of mother, sex of the children, health intervention programmes, age of mother, and live birth order of the children were identified as having a statistically significant impact on child survival when the effect of age was controlled. The effects of sex of the children, health programmes, age of mother, and birth order were found to be dependent on the age of the children, but the effect of mother's education was dependent on sex of the children.
Carolina Digital Repository (University of North Carolina at Chapel Hill), 2011
The health risks of As exposure due to the installation of millions of shallow tubewells in the B... more The health risks of As exposure due to the installation of millions of shallow tubewells in the Bengal Basin are known, but fecal contamination of shallow aquifers has not systematically been examined. This could be a source of concern in densely populated areas with poor sanitation because the hydraulic travel time from surface water bodies to shallow wells that are low in As was previously shown to be considerably shorter than for shallow wells that are high in As. In this study, 125 tubewells 6-36 m deep were sampled in duplicate for 18 months to quantify the presence of the fecal indicator Escherichia coli. On any given month, E. coli was detected at levels exceeding 1 most probable number per 100 mL in 19-64% of all shallow tubewells, with a higher proportion typically following periods of heavy rainfall. The frequency of E. coli detection averaged over a year was found to increase with population surrounding a well and decrease with the As content of a well, most likely because of downward transport of E. coli associated with local recharge. The health implications of higher fecal contamination of shallow tubewells, to which millions of households in Bangladesh have switched in order to reduce their exposure to As, need to be evaluated.
gSCIENCE ORIGINAL R ESEARCH Adult Cardiopulmonary Mortality and Indoor Air Pollution A 10-Year Retrospective Cohort Study in a Low-Income Rural Setting
Could the authors please clarify what specific STDs they are targeting? On page 3, the authors ta... more Could the authors please clarify what specific STDs they are targeting? On page 3, the authors talk about PN for HIV, but the rest of the paper appears to be devoted to non-HIV STDs. On page 5, it says the search was limited to syphilis, Chlamydia and gonorrhea and then on page 6 they say it was limited to curable bacterial STDs. PN for syphilis and HIV are likely to have different impact and cost effectiveness strategies than for PN for Chlamydia and gonorrhea and may need to be considered separately.
Perilaku fertilitas penduduk pedesaan dalam menuju norma keluarga kecil :: Suatu studi kasus di Kalurahan Margodadi Kecamatan Seyegan Kabupaten Sleman
Hubungan partisipasi angkatan kerja wanita dengan pendidikan dan fertilitas di Indonesia :: Suatu analisis data sensus tahun 1971 dan 1980
Barriers to Effective Emergency Obstetric Care in Bangladesh: Insights from Verbal Autopsy Data
Verbal autopsies represent an increasingly deployed approach for ascertaining causes of maternal ... more Verbal autopsies represent an increasingly deployed approach for ascertaining causes of maternal death in developing countries. To date, they have been less utilized for understanding the familial and health service factors that contribute to such deaths. Using data from a nationally representative survey of women in Bangladesh (2001), this paper examines 186 case narratives. Among 186 maternal deaths, the most prominent causes of death were hemorrhage (n=54), and eclampsia (n=42), accounting for more than one-half of all the maternal deaths. The data reveal the importance of delays in obtaining treatment, as well as the serious constraints of access, quality, and costs of maternal health care. These issues likely influence many Bangladeshi couples' maternal health care decisions. The paper also illustrates the largely untapped potential of the verbal autopsy approach for elucidating the specific factors, which must be addressed, to reduce maternal mortality levels in low resour...
Feeding, home-remedy practices, and consultation with health care providers during childhood illness in rural Bangladesh
Journal of diarrhoeal diseases research, 1995
The nature of feeding, home-remedy practices, and consultation with health care providers during ... more The nature of feeding, home-remedy practices, and consultation with health care providers during illnesses of children in Matlab, a rural subdistrict of Bangladesh, were studied. Data were collected between October 1986 and February 1987 from mothers of children aged 3-36 months. About half of the mothers initiated home-remedies for treating their children. The treatment included: pouring water on the head, feeding juice of herbs, using sanctified water and ORT. The type of treatment was dependent on the nature of illness. The use-rate of ORT was low. Breastfeeding was discontinued for 16% of the episodes; the reduction was the highest for fever with cough, followed by fever and diarrhoea. A reduction in intake of other foods was observed for 39% of the episodes with a total discontinuation for 10%. The reduction was the highest for dysentery, followed by diarrhoea, and fever with or without cough. Total withdrawal of foods other than breastmilk was the highest for diarrhoea. Contac...
Global Heart, 2012
Indoor air pollution (IAP) due to solid fuel use is a major risk factor of respiratory and cardio... more Indoor air pollution (IAP) due to solid fuel use is a major risk factor of respiratory and cardiovascular mortality and morbidity. Rural Matlab in Bangladesh has been partly supplied with natural gas since the early 1990s, which offered a natural experiment to investigate the long-term impact of IAP on cardiopulmonary mortality.
Global Health Action, 2014
Public Health Nutrition, 2009
ObjectiveTo investigate the associations and relative impact of illness, socio-economic and socia... more ObjectiveTo investigate the associations and relative impact of illness, socio-economic and social indicators for nutritional status among elderly persons in rural Bangladesh.DesignA multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant.SettingMatlab, Bangladesh.SubjectsA total of 625 randomly selected individuals (≥60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women.ResultsTwenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensor...
Mothers' Education and Survival of Female Children in a Rural Area of Bangladesh
Population Studies, 1991
... Mother's education was measured by years of secular schooling and was grouped into three... more ... Mother's education was measured by years of secular schooling and was grouped into three categories: 0 (no ... 13 Cholera Research Laboratory, Demographic Surveillance System - Matlab, vol. ... processes: two models from Bangladesh: the Matlab project and the Companiganj ...
Population and Development Review, 1986
In the late 1970s a number of reports indicated that the Indonesian Family Planning Program had c... more In the late 1970s a number of reports indicated that the Indonesian Family Planning Program had contributed to a rapid and substantial fertility decline in Bali. The high fertility setting in Bali into which the program was introduced around 1970, did not appear to be conducive to a small family norm and thus to such a fertility decline. Socially, Bali was still effectively traditional; economically, there had been little development in the areas usually considered, in demographic transition theory, prerequisite for fertility decline. This thesis describes a village study undertaken to examine the questions of the apparent changes in fertility, and the apparent dramatic rise in family planning use; and if such changes were verified, to attempt to elucidate the underlying reasons. The study is based primarily on a survey of 1,088 ever-married women aged 15 to 54 years in three villages in the traditional regency of Klungkung, Bali. The findings are that fertility in these villages had indeed fallen dramatically, from a total fertility rate of 6.5 in the late 1960s to 3.5 in the late 1970s. During this period family planning prevalence had increased from less than 5 percent to around 50 percent of eligible couples. The analysis indicates that almost all the fertility decline was the result of program family planning use. The virtual absence of differentials in both fertility and family planning use led to a conclusion emphasizing the critical importance of Balinese cultural factors in the rapidity of the uptake of family iv planning, and the subsequent change in fertility behaviour. While credit is given to the family planning program for efficient implementation, the conclusion is that the Balinese communities readily accepted the concept of family planning and fertility limitation as a potentially fruitful approach to alleviate the current problems of limited resources, particularly land, and to achieve the aspirations stemming from the modernizing changes of recent years.
Journal of Biosocial Science, 1992
SummaryIn a prospective study in Matlab, a rural area in Bangladesh, the relationship between a v... more SummaryIn a prospective study in Matlab, a rural area in Bangladesh, the relationship between a variety of covariates and childhood mortality was examined. Economic status of household, education of mother, sex of the children, health intervention programmes, age of mother, and live birth order of the children were identified as having a statistically significant impact on child survival when the effect of age was controlled. The effects of sex of the children, health programmes, age of mother, and birth order were found to be dependent on the age of the children, but the effect of mother's education was dependent on sex of the children.
International Journal of Epidemiology, 2009
Background Studies in urban cities have consistently shown evidence of increased mortality in ass... more Background Studies in urban cities have consistently shown evidence of increased mortality in association with hot and cold weather. However, few studies have examined temperature-mortality relationship in the rural areas of developing countries. In this study we therefore aimed to characterize the daily temperature-mortality relationships in rural Bangladesh. Methods A generalized linear Poisson regression model was used to regress a time-series of daily mortality for all-cause and selected causes against temperature, controlling for seasonal and interannual variations, day of week and public holidays. A total of 13 270 all-cause deaths excluding external causes for residents under demographic surveillance in Matlab, Bangladesh were available between January 1994 and December 2002. Results There was a marked increase in all-cause deaths and deaths due to cardiovascular, respiratory and perinatal causes at low temperatures over a lag of 0-13 days. Every 18C decrease in mean temperature was associated with a 3.2% (95% CI 0.9-5.5) increase in all-cause mortality. However, there was no clear heat effect on all-cause mortality for any of the lags examined. Conclusions This study found that daily mortality increased with low temperatures in the preceding weeks, while there was no association found between high temperatures and daily mortality in rural Bangladesh. Preventive measures during low temperatures should be considered especially for young infants.
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Papers by Peter K Streatfield