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Objective: To assess whether HIV surveillance data from pregnant women attending antenatal care (ANC) clinics in Zimbabwe represent infection levels in the general population. Methods: HIV prevalence estimates from ANC surveillance sites in 2006 were compared with estimates from the corresponding Zimbabwe Demographic and Health Survey 2005-06 (ZDHS) clusters using geographic information systems. Results: The ANC HIV prevalence estimate (17.9%, 95% CI 17.0%-18.8%) was similar to the ZDHS estimates for all men and women aged 15-49 years (18.1%, 16.9%-18.8%), for pregnant women (17.5%, 13.9%-21.9%), and for ANC attendees living within 30 km of ANC surveillance sites (19.9%, 17.1%-22.8%). However, the ANC surveillance estimate (17.9%) was lower than the ZDHS estimates for all women (21.1%, 19.7%-22.6%) and for women living within 30 km catchment areas of ANC surveillance sites (20.9%, 19.4%-22.3%). HIV prevalence in ANC sites classified as urban and rural was significantly lower than in sites classified as "other". Conclusions: Periodic population surveys can be used to validate ANC surveillance estimates. In Zimbabwe, ANC surveillance provides reliable estimates of HIV prevalence among men and women aged 15-49 years in the general population. Three classifications of ANC sites (rural/urban/other) should be used when generating national HIV estimates. [ABSTRACT FROM AUTHOR]

Using the 2005-2006 Zimbabwe Demographic and Health Survey, we investigated the prevalence of HIV testing uptake within a sample of women (6839) and men (5315), and identified the independent effects of AIDS stigma on testing uptake, with particular emphasis on three pathways to testing: voluntary testing, testing when offered, and testing when required. The prevalence of self-reported HIV testing was higher among women (31%) than men (22%). For women, the main pathway to testing uptake was to accept testing when it is offered (46%), whereas for men it was voluntary testing (53%). In the logistic regression models, we found that social rejection stigma was inversely associated with uptake across all pathways of testing for women, but not men. As regards observed enacted stigma, respondents who both knew someone with HIV and had observed discrimination against someone with HIV were more likely to test for HIV through all pathways, while those who knew someone with HIV but had not observed stigma were more likely to test voluntarily. Individual characteristics important to the adoption of testing included high educational attainment, religion, exposure to mass media, and ever use of condoms; while being never married and self-perceived risk were barriers to testing. Programmatic strategies aimed at increasing HIV testing uptake should consider reducing stigma toward people living with HIV/AIDS and also addressing the role of agency and structure in individual's decision to be tested for HIV. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between household use of biomass fuels for cooking and birth weight.Methods: Analysis is based on 3559 childbirths in the 5 years preceding the 1999 Zimbabwe Demographic and Health Survey. Birth weights, recorded by trained professionals at local health clinics, were derived from health cards at home or from mother''s recall. Multiple regression method was used to estimate the effect of household use of biomass cooking fuels (wood, dung, or straw) on birth weight, after controlling for child''s sex and birth order, mother''s education and nutritional status, pregnancy care, household living standard, and other potentially confounding factors.Results: Babies born to mothers cooking with wood, dung, or straw were 175 g lighter (95% CI,-300,-50), on average, compared with babies born to mothers using LPG, natural gas, or electricity. The difference was 120 g (95% CI,-301, 61) for children whose birth weights were taken from health cards, and 183 g (95% CI,-376, 10) for children whose birth weights were reported by mothers.Conclusions: Household use of high pollution cooking fuels may cause reduced birth weight. The relationship needs to be further investigated using more direct measures of smoke exposure and birth weight and accounting for environmental tobacco smoke. [Copyright &y& Elsevier]

Background: Iron deficiency in pregnant women has been shown to reduce the oxygen supply to the fetus, cause intrauterine growth retardation, and increase the risk of premature delivery and reduced birthweight. Yet the effects of iron supplementation programs on pregnancy outcomes are not well documented for developing countries., Objective: To examine the relation between iron supplementation of mothers during pregnancy and children's birthweight using data from a national population-based survey in Zimbabwe., Methods: The analysis uses information on 3559 births during the five years preceding the 1999 Zimbabwe Demographic and Health Survey. The effect of iron supplementation during pregnancy on birthweight was estimated by multiple regression, controlling for potential confounding effects of prenatal care, child's sex and birth order, mother's education and nutritional status (measured by body-mass index), household living standard, smoke exposure, and other variables., Results: Babies born to mothers who received iron supplementation during pregnancy were 103 g heavier (95% confidence interval, 42-164; p = .001), on average, than babies born to mothers who did not receive iron supplementation during pregnancy. The difference was 64 g (95% confidence interval, 2-125; p = .043) for children whose birthweights were taken from health cards and 163 g (95% confidence interval, 44-281; p = .008) for children whose birthweights were reported by their mothers., Conclusions: Iron supplementation during pregnancy is associated with significantly higher birthweight, independent of other pregnancy care factors, mother's nutritional status, smoke exposure, and a number of demographic and socioeconomic factors. Prenatal iron supplementation programs can improve pregnancy outcomes and promote child survival in developing countries.

Background: Reliance on biomass for cooking and heating exposes many women and young children in developing countries to high levels of air pollution indoors. This study investigated the association between household use of biomass fuels for cooking and acute respiratory infections (ARI) in preschool age children (<5 years) in Zimbabwe., Methods: Analysis is based on 3559 children age 0-59 months included in the 1999 Zimbabwe Demographic and Health Survey (ZDHS). Children who suffered from cough accompanied by short, rapid breathing during the 2 weeks preceding the survey were defined as having suffered from ARI. Logistic regression was used to estimate the odds of suffering from ARI among children from households using biomass fuels (wood, dung, or straw) relative to children from households using cleaner fuels (liquid petroleum gas [LPG]/natural gas, or electricity), after controlling for potentially confounding factors., Results: About two-thirds (66%) of children lived in households using biomass fuels and 16% suffered from ARI during the 2 weeks preceding the survey interview. After adjusting for child's age, sex, birth order, nutritional status, mother's age at childbirth, education, religion, household living standard, and region of residence, children in households using wood, dung, or straw for cooking were more than twice as likely to have suffered from ARI as children from households using LPG/natural gas or electricity (OR = 2.20; 95% CI: 1.16, 4.19)., Conclusions: Household use of high pollution biomass fuels is associated with ARI in children in Zimbabwe. The relationship needs to be further investigated using more direct measures of smoke exposure and clinical measures of ARI.