South Asian health issues

Reports, Surveys, Stats	Genetic issues
Heart disease	Cancer
Skin
Pregnancy, labour and delivery	Reproductive health and family planning
Emotional health	Diabetes
Nutrition	Bone disease
Miscellaneous	General health information

Disclaimer: This information is not intended, and should not be interpreted as, a substitute for advice and treatment from a medical practioner. The opinions are those of the web maintainers only, and do not represent Sawnet or the organizations for which they work.

Reports, Surveys, Statistics

• Health of South Asians in the US. A two-year evaluation and summary of existing knowledge about several key health indicators for South Asian Americans, from the South Asian Public Health Association. The full paper is available via their website.
• The trouble with thin. Eating disorders in the South Asian community, from masala.com
• A new website on health and law in India.
• Female Demographic Disadvantage in India 1981-1991: Sex Selective Abortion and Female Infanticide, in Development and Change, vol 30. no 3, July 1999. Special issue on Gendered poverty and well-being.
• Global Reproductive Health Forum provides access to original research on a wide variety of women's issues. See in particular the South Asia project.
• Green Monkeys, the Pakistan Public Health Forum.
• Women's Health in India, a report from the International Programs Center of the US Census Bureau.
• Delhi High Court affirms the right of patients to receive all medication, particularly morphine.
• The value of family planning in developing countries. Rand Corporation's Population Matters Project.
• Women's Voices, Women's Lives -- the Impact of Family Planning. Results of studies in 14 countries, including Bangladesh.
• The Demographic and Health Surveys has the National Family Health Survey of India 1992-1993 report online, with a special section on the status of women.
• Health needs of South Asian women in Northern California. A report from NAWHO.
• The Demographic and Health Surveys (DHS) program is one of the largest primary sources of information on health issues in Africa, Asia, Latin America and the Caribbean.
• Fact sheet on population, reproductive issues and health for Pakistan and Bangladesh are available at Demographic and Health Surveys
• Cancer rates (for different kinds of cancer) around the world. Interesting facts: stomach and gallbladder cancer are high in Japan and low in India. From National Cancer Institute, US.
• Women of the World -- India; an annotated description of reproductive health issues in India. Covers contraception, abortion, AIDS and more.
• A number of original articles on current concerns in reproductive health can be found on Suchana, a website of SNDT University in Mumbai, India.
• South Asian Women's Health Project

Genetic disorders in India. Abstract of a reference article.

Thalessemia is a blood disease which is one of the more common genetic problems in South Asia. It may confer resistance to malaria.

Consanguinity, the practice of marriage between cousins, uncles and nieces, and more distant relatives, is not uncommon in some communities in South Asia. Genetic defects are more common in children from such marriages than in the general population. Some relevant studies are listed below.

• A study of 400 children with genetic developmental problems in Pondicherry, India, indicated that consanguinity is correlated with a higher frequency of genetic heart disease, multiple malformations, neurological malformations, chromosomal disorders, genetic urinary disorders, and retardation. (Abstract and reference)
• A study of retinitis pigmentosa, a disease which causes an untreatable, slowly progressing degeneration of the eye, in 78 families in Madras, India, showed that a high proportion were in consanguinous marriages. (Abstract and reference)
• In 6 mohallas in Aligarh, India, 1721 children and infants were examined for heart disease, and the study showed a correlation between consanguineous marriages and congenital heart disease. (Abstract and reference)
• Birmingham, UK: A study of 4,934 children of different ethnic groups demonstrated a 3-fold increase of infant and childhood death in the offspring of consanguineous Pakistani parents.
• India: a study of 300 consecutive deliveries in a hospital indicated that consanguineous marriages significantly increased the rate of genetic problems. (Abstract and reference)
• Other related papers indicate that consanguineous marriages have been decreasing among the Kamma of Andhra Pradesh, but have not significantly changed in Karnataka.
• A study that shows that consangunity may be implicated in higher rates of congential cataract in the Indian population. (Abstract and reference)

Heart disease

• South Asian Heart: Preventing Heart Disease - from the heart to the edge of the diaspora. By VS Rambihar. Vashna Publications, Toronto, 1996 & 2002.
• Risk factors for heart disease. South Asians settled abroad and those in urban India are at increased risk for ischemic heart disease. Risk factors include smoking, abdominal obesity, high blood pressure. Vegetarianism reduces the risk. Another study found that higher ghee consumption was associated with higher coronary artery disease even in groups with otherwise low fat intake. (Abstracts and references)
• Higher rates of Coronary Heart Disease. Canadians of South Asian origin had the highest rates of death from cardiac disease but the lowest rates of death from cancer in this study of the Canadian mortality database conducted over several years. (Abstract and reference)
  Similar results based on mortality records in Britain. (Abstract and reference)
  This study concludes that hypertension and diabetes are two to three fold higher among South Asians than in whites in Britain. (Abstract and reference)
  A recent article about a study that suggests that a genetic abnormality in triglyceride regulation may be the culprit in the high rate of corornary heart disease among South Asians. India West, 26 Nov 99. reference.
• Diabetes and heart disease. Ethnic differences in mortality due to heart disease were found to be increased in patients with diabetes in this British study. (Abstract and reference)
  Insulin resistance, stress, socioeconomic deprivation are postulated to be the reasons for the higher rates of heart disease in South Asians. (Abstract and reference)
• Lifestyle reasons? This study suggests that dietary differences may play a role in the higher incidence of coronary disease in South Asians living in the UK - plasma vitamin C levels in South Asians were found to be lower on average. (Abstract and reference)
  This study suggests that control of obesity and increased physical exercise offers the best preventive measure against heart disease among South Asians. (A bit strange, since the obesity seemed correlated with insulin resistance). (Abstract and reference)
• Service related problems. This survey found that Hindus and Sikhs living in London were likelier to seek medical assistance for anginal symptoms, but still experienced delays in care, suggesting service-related problems. (Abstract and reference)
• Differences among South Asians. Bangladeshis had higher insulin concentrations, smoking rates, triglycerides, and incidence of diabetes, but lower blood pressure and cholestrol levels in this British study. (Abstract and reference)
  This study finds differences between Bangladeshis, Indians, and Pakistanis living in Britain, in terms of risk factors for heart disease. (Abstract and reference)

Skin

Brown Skin and Sunscreen. Do brown-skinned people need sunscreen, and if so, what SPF? A summary of the available data.

Pregnancy, Labour, and Delivery

Many 'standard' measurements of fetal size and pregnancy development are based on studies of Caucasian children in the US or Europe. Similar studies on Indian women are producing the unsurprising result that the 'standards' are somewhat different for different populations.
Scientific reports about pregnancy-related medical problems, nutrition, and traditional practices related to pregnancy, labour and delivery are also in this section.

• Growth pattern of the Indian fetus. A 1995 study from CMC, Vellore, India, which found that the pattern of growth of Indian fetuses is different from that of British fetuses, as measured by ultrasound. Since the standards in the West are based on Caucasian kids, Indian women in the west could end up having unnecessary tests or treatment if their ob/gyn doctors are not aware of these differences. This study also found that the average length of the pregnancy was shorter for Indian babies. The slowing of fetal growth after 28 weeks along with the shorter pregnancy resulted in smaller Indian babies. (Abstract and reference)
• Fetal size and growth in Bangladeshi pregnancies. . A smallscale study of 20 women which found that Bangladeshi fetuses, although smaller than Caucasian fetuses, grow at a similar rate during the third trimester. (as opposed to the previous study of 120 Indian pregnancies). (Abstract and reference)
• Food cravings. are common during pregnancy. This study in Sri Lanka followed the dietary cravings of 473 pregnant women. Among other conclusions, they found that food cravings were significantly higher among women who had love marriages than arranged marriages, and in those who believed in "devil dancing and gods". :-) (Abstract and reference)
• Ghee on the umbilical cord is commonly applied several times each day for the first few days of a baby's life in the North West Frontier Province of Pakistan. However, it significantly increases the risk of the baby getting tetanus. (Abstract and reference)
• Comparison of ovulatory activity among well-nourished and undernourished women. Better-nourished mothers still resume ovulation at around the same time as poorly-nourished mothers.
• Gestational diabetes. This study in Melbourne found that the incidence of gestational diabetes was significantly higher (15%) among women born in the Indian subcontinent as compared with women from Northern Europe or the Americas. (Abstract and reference)
  Similar results were found in this study in London. (Abstract and reference)
  This US study also finds that immigrant women born in South Asia have a higher risk of gestational diabetes. (Abstract and reference)
  The prevalence of gestational diabetes in this study in this South Indian study was found to be only 0.56%, in contrast with the studies of immigrant women. (Abstract and reference)
  This Karachi study found that prevalence of gestational diabetes was similar in Pakistan to that in Western countries, but complication rates were higher, possibly due to poorer glycemic control. (Abstract and reference)
  Some personal experiences of sawnet members with gestational diabetes have been compiled.
• Congenital rubella. The incidence of congenital rubella was found to be 2.3 times higher in Asian than non-Asian births in England and Wales. (Abstract and reference)
  
• Nutritional issues. This study demonstrates that vegetarians give birth to infants with less DHA in their plasma and cord artery phospholipids but this did not appear to be independently related to the outcome of pregnancy. (Abstract and reference)
  Educational level but not income was found to have an impact on how closely the daily nutrient intake of pregnant women from farming and non-farming families in Haryana matched recommeded quantities. (Abstract and reference)
  This study at CMC Vellore found that maternal zinc levels were not associated with intrauterine growth retardation in South Indian women, in contrast with earlier studies. (Abstract and reference)
• Maternal mortality rates in South Asia. Maternity mortality rates are at least an order of magnitude higher in South Asia than in western countries. In North America, it is estimated to 11 deaths per 100,000 live births, but in South Asia, the estimates vary from about 100 to 600. One study found that signifcant risk factors were severe anemia, presence of hemorrhage or toxemia as a complicating factor, short birth intervals, and age of mother outside the 20-35 range. A number of articles assessing the problem and risk factors can be found at theSuchana website
• Service-related problems. A British study found that midwives commonly use stereotypes of women in order to help them provide care, particularly in situations where they could not get to know the individual woman. The stereotype of women of Asian descent contained four main themes: communication problems; failure to comply with care and service abuse; making a fuss about nothing; a lack of normal maternal instinct !!??!! (Abstract and reference)
• Pregnancy and malaria. This Jabalpur study seems to indicate that pregnant women are particularly susceptible to malaria. (Abstract and reference)
• Miscarriage. This study concludes that low socioeconomic status, chronic undernutrition and illiteracy in rural India are associated with high pregnancy wastage (Abstract and reference)
  In contrast, this study concludes that various nutrient deficiencies have no correlation with the occurrence of miscarriage. (Abstract and reference)
• Episiotomy. The rates of episiotomy in women from the Indian sub-continent and Orient were very high compared with those for white women in this British study; the reasons need to be studied. (Abstract and reference)
• Pregnancy and night blindness. Nepalese women believed that night blindness is a transient condition associated with pregnancy, and thought it to be second in severity only to vaginal bleeding. (Abstract and reference)
• Birthweight. Factors influencing birthweight were gestation at birth, sex of infant, birth order and maternal height. The authors argue that these should be taken into account when calculating birthweight centiles. (Abstract and reference)
• This British study found that babies born to second generation Asian women were heavier (mean birthweight 3196g) than those born to first generation women (mean birthweight 2946g). (Abstract and reference)
• Maternal blood lead levels. The results of this Lucknow study indicate that maternal blood lead levels were higher in those who experienced abnormal deliveries and in those who ate nonvegetarian diets or drank groundwater compared with the respective control groups (Abstract and reference)
• What is a full-term baby? There may be reason to believe that African and Indian fetuses matuee a week earlier (on average) that Caucasian babies, says a prominent French obstetrician. Read the article.

Family planning and reproductive health

• Social Aspects of Family Planning. This paper looks at the family structure and its effects on demographic characterisitcs like low mortality and fertility rates in Sri Lanka. (Abstract and reference)
  This paper explores the relationship between central Kerala Nayar social constructions of fertility and gender, and the Nayar institution of matrilineality (Abstract and reference)
  Married non-professional women experience significant difficulties in using family planning services largely due to communication problems with health professionals and their low levels of personal autonomy. Most Asian women in this study showed a strong preference for a female GP and a non-Asian GP for sexual health and contraceptive services. (Abstract and reference)
  This report presents an analysis of 1981 Indian census data that documents low natural fertility in Ladakh. Sterility from STDs, high rates of fetal loss, and nutritional contraints on ovarian hormone status are considered as possible contributing factors. (Abstract and reference)
• Attitudes to sex. This study of undergraduate medical students in Delhi was carried out to examine the attitudes, knowledge, and behavior of these students concerning sex. A large percentage had satisfactory knowledge about sex, contraception, and STD's, but very few felt comfortable discussing sex with parents, teachers, or people of the other sex. About 12 % had had sexual intercourse, and almost all viewed homosexuality as being normal. (Abstract and reference)
  
• Contraceptive methods. A study by the Indian Council of Medical Research (ICMR) looks at ex-Norplant users and their conception rates and miscarriage rates after discontinuing Norplant use. They find that those who discontinued Norplant because of bleeding irregularities has significantly lower rates of conception than those who discontinued it for the purpose of planning pregnancy. (Abstract and reference)
  This ICMR study looks at irregular bleeding patterns caused by use of several contraceptive methods including Norplant, the IUD and injectable contraceptive. All three produced irregular bleeding patterns in the majority of users, with Norplant creating such disturbances in 80% of users in the first year. (Ed note: the results of this study are very interesting and difficult to summarize; please read abstract.) (Abstract and reference)
  Quinacrine is a new, controversial chemical sterilization system..Indian activists demand that the government stop import and distribution of this drug.

• Gynecological problems. Bleeding cervices were found to be associated with the herpes virus and baterial vaginosis. The mean delay of seeking medical treatment was 7-13 months! (Abstract and reference)
  This article presents an analysis of self-reported gynecological problems among a sample of recent mothers in Karnataka. The factors increasing likelihood of problems were found to be problems during the last delivery, delivery at public hospital, using non-reversible contraceptive methods. (Abstract and reference)
  A number of articles reporting a high rate of sexually transmitted diseases in India can be found at the Suchana website.
• Infertility. The following studies look at Indian women with polycystic ovary syndrome. (Abstract and reference) (Abstract and reference)
  This study concludes that the prevalence of polycystic ovaries in Indian subcontinent Asian women is very high and studies the clinical associations. (Abstract and reference)
  Under the same IVF protocol Asian women's response to controlled ovarian stimulation and IVF outcome are comparable to their white Caucasian peers, as found in a study conducted at Birmingham Women's Hospital. (Abstract and reference)
  This study differs in finding differences between Indian and white women. (Abstract and reference)
  A very high percentage of infertile women in a Bombay study were found to have tuberculosis as the cause of tubal blockage. (Abstract and reference)
• Menopause. A study of middle-aged women in a fishing village on the southwest coast of India found that the women experience none of the physiological symptoms of menopause commonly reported, nor to they experience a midlife crisis. Furthermore, they continue to identify themselves as well established fish sellers. (Abstract and reference)

Cancer

• Ethnic differences in cancer rates. Rates of death from cancer are lower in South Asian Canadians as compared to those of Chinese or European origin, as found in this study based on the Canadian Mortality database. (Abstract and reference)
  Similar results from a study of mortality records in Britain. Breast cancer mortality was lowest in people born in the Indian subcontinent. Lung cancer mortality among Bangladeshi men was significantly higher than Indians and Pakistanis. (Abstract and reference)
  Using data from death certificates, risks of cancer mortality for immigrants from the Indian subcontinent in England and Wales were compared with those of native residents. Oral, pharyngeal and liver cancers occurred at higher rates among the South Asian immigrants, while colon, rectal, and ovarian cancer occurred at lower rates. (Abstract and reference)
  Cancer incidence in Asian immigrants to Australia was studied; interestingly, the rates of most types of cancer, while lower than in native born Australians, were closer to this group than to rates in the countries of birth. (Abstract and reference)
• Tobacco chewing. Pan chewing is thought to be linked to the high rates of oral cancer in South Asia. 92% of first generation Bangladeshi immigrant women said they chewed pan in this study conducted in inner city Leeds and Bradford. (Abstract and reference)
  A similar study found similar but slightly lower rates in London. (Abstract and reference)
• Cervical cancer. Indian women had the highest rate of cervical cancer in this study done in Singapore, higher than in Chinese and Malay women. (Abstract and reference)
  Cervical cancer is the leading cancer for Indian women, and early age of marriage (sexual activity? childbearing?) may be a factor. (Abstract and reference)
  Mortality from cervical cancer was significantly related to how early the disease was diagnosed, in this Bangalore study. (Abstract and reference)
• Digestive tract cancers. Digestive tract cancers have a lower incidence in India than in the so-called developed countries. An interesting observation is that the incidence is higher among urban Indians than in rural Indians, and similarly among those who migrated as compared to those who stayed behind in India. (Abstract and reference)
  Gall bladder cancer seems to have a much higher incidence in Uttar Pradesh, Bihar, Orissa, West Bengal and Assam than in Southern states. The cancer is twice more common in women and is the leading cancer among digestive cancers in women in the northern Indian cities of Delhi and Bhopal. Immigrants from the northern states to Western countries also have a high incidence. (Abstract and reference)
• Breast cancer. A sample of South Asian immigrant women in Toronto was found to have minimal knowledge of breast cancer and did not engage in breast cancer detection practices. (Abstract and reference)
  Parsi women have a fourfold higher rate of breast cancer than the general population in Bombay. Possible contributing factors are studied. (Abstract and reference)
• Thyroid cancer. In an international ranking, the incidence of thyroid cancer in both men and women was found to be lowest in Bombay. A descriptive epidemiology is presented. (Abstract and reference)

Diabetes

(Note: Gestational diabetes is discussed in the pregnancy section.)
• Ethnic differences in prevalence rates. Microalbuminuria was found to ahve higher prevalence in Soith Asians with diabetes than Europeans. (Abstract and reference)
  Another study based in London also found that ethnic minorities of both sexes had raised (2-3 times) prevalence rates of hypertension and diabetes compared to white people. (Abstract and reference)
  Ethnic differences in mortality rates due to cardiovascular disease were found to be greater in people with diabetes. (Abstract and reference)
  Diabetes was three times as common in Bangladeshis than Europeans in this London study. (Abstract and reference)
• Insulin resistance and central obesity. A population survey in London seems to confirm the existence of an insulin resistance phenomenon among South Asians. They also find that mean waist-to-hip ratios were higher in the South Asian group than in the European group, and in each group was correlated with glucose intolerance, insulin, etc. (Abstract and reference) Abdominal fat distribution among non-diabetic South Indians was found to be similar to values in white populations. (Abstract and reference)

Nutritional issues

• Energy costs of standard activities among Indian adults. Could be interesting if you are doing a detailed analysis for weight gain/loss.
• Vitamin C differences. Dietary differences in Vitamin C appear to exist between different ethnic groups living in England; in particular plasma Vitamin C levels were highest in whites and lowest in South Asians living in the same London neighborhood, possibly accounting for the higher risk of South Asians living abroad for coronary heart disease. (Abstract and reference)
• Gender differences in cereal intake. Male-female differences in cereal intake may be higher in peak season than in lean season. (Abstract and reference)
• How pervasive are sex differentials in childhood nutritional levels in south Asia? This report examines preliminary field data and existing literature to conclude that there are no significant differences in the amount of food given to girls and boys in the household. (Abstract and reference)
  A study in Nepal, India and the Phillipines which indicated that the poor nutritional status of girls becomes serious during adolescence. (Abstract and reference)
• Iron deficiency anaemia. This study suggests that attitudes to menstruation and menstrual blood may help to account for the relatively high levels of iron deficiency anaemia found in women of South Asian descent living in Britain. (Abstract and reference)
  The prevalence of anemia is high in adolescent girls in India, with over 70% anemic. This study from Vadodara found that supplementation with iron and folic acid seems to enhance growth in adolescent girls. (Abstract and reference)
  The aim of this study was to investigate the importance of nutritional deficiencies and infections in the development of anaemia in pregnant Nepali women in Kathmandu. The authors conclude that prevention and treatment of infections should, together with dietary advice, be emphasized more strongly in the antenatal care. (Abstract and reference)
• Basal metabolism. Indians have been reported to have a lower basal metabolic rate than Westerners; however this difference may disappear when adjusted for fat-free mass, suggesting the use of fat-free mass for prediction of BMR and hence energy requirements. (Abstract and reference)
• Eating disorders. Asian women seem to be referred for eating disorders at one-fourth the rate of white women in this study from Leicestershire; this could be because of lower prevalence. (Abstract and reference)
  Relatively little difference in eating attitudes and problems was found according to ethnicity, although self-induced vomiting for weight control was more common among Caucasian women. (Abstract and reference)
• Vegetarianism and effects on dental health. A Saudi Arabian study of Indians finds that vegetarians have different teeth than non-vegetarians, but does not say if either kind is problematic :-) (Abstract and reference)
• Zinc. Zinc deficiency can cause severe growth retardation in children; however routing zinc supplementaion is not called for, and indeed may cause harm. There may be differences between breastfed and exclusively bottlefed babies. (Abstract and reference)

Emotional health

• National Association for the Mentall Ill in India contains a lot of information related to mental health. They also have lists of hospitals and discussions of traditional healing practices.
• Antidepressants. GPs appear to prescibe antidepressants in lower doses and for shorter courses for South Asian patients. It is possible that this means that successful drug treatment is less likely for depressed South Asian patients than for white patients.(Warning: the sample doesn't look too big.) (Abstract and reference)
• Ethnic differences in depression symptoms. Sex and ethnic differences are found in self-reported strength of depression symptoms in this study of university students in Toronto. (Abstract and reference)
• Mental disorders. This study from a general practice in West London examines the previous belief that women of Indian origin have a lower rate of recognized common mental disorders, while at the same time having a higher rate of seeking assistance. (Abstract and reference) Another paper tries to explain the fact that British South Asians suffer an excess of psychological distress on measures of self-assessed distress, but not on a clinically validated measure (the GHQ). It suggests that the GHQ is less sensitive to certain stressful situations which might be more likely experienced by immigrants and limited English speakers. (Abstract and reference)
• Suicide. Using mortality data from England and Wales, the investigators find that suicide ratios were significantly low for Bangladeshi, Pakistani, and Sri Lankan men, but elevated for young Indian men. Ratios were significantly high for Indian women, and all women from the subcontinent seem to have an elevated risk of suicide at 15-34 years. 20% of Asian female suicides are by burning (deserves more study, anyone?). ( Abstract and reference)
  Another study based on an online search found similar results about immigrants from the subcontinent. In particular, young women immigrants have higher rates of suicide than their male counterparts (this is contrast with the general population in the US at least). Family conflict appears to be a precipitating factor in many suicides. (Abstract and reference)
  Suicide trends are examined in this report of suicide mortality from 1955-1989 for 57 countries, which found that the highest suicide rate for women was in Sri Lanka. (Abstract and reference)
• Depression. High levels of anxiety and depression were reported in rural Punjab, especially among women. (Abstract and reference)

Bone disease

• Bone density Contrary to previous belief, an Australian study finds no correlation between bone mineral density and ethnicity. (Abstract and reference)
  A London study argues for taking skeletal size into consideration while comparing bone mineral density, saying some of the previously observed differences disappear when this is taken into account. (Abstract and reference)
  A study from New Zealand finds similar results (differences between Indian, Chinese and European women are almost completely eliminated when size is taken into account). (Abstract and reference)
• Osteoperosis An Indian study finds that Indians seem to suffer hip fractures at a relatively early age than their western counterparts, also Indian males might be at higher risk than women for hip fractures. A nutritional hypothesis is postulated. (Abstract and reference)

Miscellaneous

• Cataract surgery. A Nepalese study finds that in a sample population, the majority of whom are either blind or are experiencing severe vision loss, the utilisation of cataract surgery is below 60%, even when patients are offered free surgery and trnasport. The reasons cited by the non-acceptors were economic and logistical constraints, followed by fear of surgery and lack of time. (Abstract and reference)
• Leg ulceration. Far fewer South Asians proportionally to their population were found to sought treatment for leg ulceration in west London. It is not clear if this is because of low prevalence or unmet need in the community. (Abstract and reference)
• Alcohol consumption and related problems. Average alcohol consumption amoing South Asians living in Britain is supposedly lower than for the native British population; however, alcohol-related problems seem to have a higher prevalence among South Asians than for the general population. Alcohol-related psychiatric admission rates for South Asians have risen since 1971, and appear to be especially high in Sikh men. (Abstract and reference)
• Tuberculosis. South Asian immigrants to Britain have a significantly higher incidence of tuberculosis than white people, and Hindus seem to be at a much higher risks than Muslims, a fact that the authors wonder if it might be related to a vegetarian diet. (Abstract and reference)
• Asthma. A study of schoolchildren in Delhi found that the prevalence of current asthma among them was 11.9%. Significant risk factors for its development are male sex, a positive family history of atopic disorders, and the presence of smokers in the family. (Abstract and reference)
• HIV/HPV infection in Pakistan. HIV prevalence is low in Pakistan, but a high percentage of reported cases in Sindh appear to Pakistani workers deported from the Gulf states. (Abstract and reference)
  Household members of people with hepatitis C are at increased risk of HCV infection. The prevalence and routes of transmission of HCV to household members in Hafizabad, Pakistan were investigated. The greatest risk for HCV infection to household members of infected people appears to be injections given by health-care workers rather than household contact with infected persons. (Abstract and reference)

General Health Information