BACKGROUND Introduction of pneumococcal conjugate vaccines (PCVs) of limited valency is justified in Africa by the high burden of pneumococcal disease. Long-term beneficial effects of PCVs may be countered by serotype replacement. We aimed to determine the impact of PCV-7 vaccination on pneumococcal carriage in rural Gambia. METHODS AND FINDINGS A cluster-randomized (by village) trial of the ...

The Health and Demographic Surveillance System (HDSS) in Niakhar, a rural area of Senegal, is located 135 km east of Dakar. The HDSS was established in 1962 by the Institut de Recherche pour le Développement (IRD) of Senegal to face the shortcomings of the civil registration system and provide demographic indicators. Some 65 villages in the Niakhar area were followed annually by the HDSS from 1...

Epidemiological surveys indicate that the prevalence of epilepsy is higher in developing countries than in industrialized countries. Except for neurocystocercosis due to Taenia solium, little is known about possible underlying causes. This article reports the relationship between epilepsy and onchocerciasis in an Onchocerca volvulus endemic area in West Uganda. Individuals complaining of seizur...

BACKGROUND There is a higher case-detection rate for leprosy among spatially proximate contacts such as household members and neighbors. Spatial information regarding the clustering of leprosy can be used to improve intervention strategies. Identifying high-risk areas within villages around known cases can be helpful in finding new cases. METHODS Using geographic information systems, we creat...

This study uses three rounds of panel data between October 1998 and November 1999 and covering 506 villages and 24,000 households in rural Mexico, to examine how the replacement of pre-existing subsidy programs by a conditional cash transfer program such as PROGRESA (the Health, Education and Nutrition Program) affects the consumption smoothing of households. The results obtained are consistent...

China accounts for a large number of suicides worldwide, and most occur in rural areas. Suicide research in China has primarily focused on individual-level risk factors, few have studied the influence of neighborhood contexts. This ecological study examines the association of suicide rates with social fragmentation and socioeconomic deprivation in Chinese rural villages. Data from the community...

Groundwater pollution from the petrochemical industry causes serious deterioration of soil and groundwater quality and impacts on human health worldwide. However, few studies have examined the effect of residential exposure to petrochemical chlorinated hydrocarbon-contaminated groundwater on renal function impairment in humans. We conducted an ecological study to investigate the two. A polyviny...

OBJECTIVES To evaluate the effects of a government insurance programme covering tertiary care for the poor in Karnataka, India--Vajpayee Arogyashree Scheme (VAS)--on treatment seeking and postoperative outcomes. DESIGN Geographic regression discontinuity. SETTING 572 villages in Karnataka, India. PARTICIPANTS 3478 households in 300 villages where VAS was implemented and 3486 households in...