Cemil Özcan

Retinol and α-tocopherol concentrations in breast milk of Turkish lactating mothers under different socio-economic status

Retinol and α-tocopherol levels in breast milk of Turkish mothers under different socio-economic status were investigated. Mature milk samples were collected from 92 lactating mothers living in İzmir and in Manisa, cities of Turkey, who were at 60–90 days of the lactating period. Socio-economic, anthropometric, and dietary data were collected by means of a questionnaire. The body mass index was used to determine the nutritional status. The retinol and α-tocopherol contents of breast milk were determined by high-performance liquid chromatography; the concentration of α-tocopherol was 9.84 µg/ml whereas retinol levels were 81.5 µg/100 ml. The questionnaire survey was used to determine the level of these vitamins in the daily ration of the women. No significant differences were found in terms of milk retinol and α-tocopherol levels for the variables income, educational level and mothers’ body mass index.

Fertility preferences, contraceptive behaviors and unmet needs: a gap between urban and suburban parts of a city

Objectives To explore the differences in unwanted fertility in different parts of a city. Methods Data were obtained from the 1999 Manisa Demographic and Health Survey (MDHS) in Turkey. We collected information from a representative sample of 1728 ever-married women aged 15–49 years on fertility, fertility preferences, unmet need for family planning, contraceptive discontinuation, and abortion. Data were analyzed using SPSS 10.0 for Windows®. Results Of the persons studied, 1238 (71.6%) were living in urban settlements and 490 (28.4%) in suburban (gecekondu) settlements. The total fertility rate is higher among gecekondu women (2.42) than among urban women (2.14) although gecekondu women have a lower wanted fertility rate (1.54) than urban women (1.77). Married women in the urban area were currently using a contraceptive method more frequently (75.6%) than those living in the gecekondu area (61.7%) (OR 2.5; 95% CI 1.9–3.2; p < 0.001). The unmet need percentage in gecekondu women (17.7%) is higher than in urban women (8.3%; p < 0.001). The induced abortion rate is higher in urban women (14.8 per 1000 pregnancies) than in gecekondu women (7.1 per 1000 pregnancies; OR 2.1; 95% CI 1.4–3.1; p < 0.001). Conclusions There are inequalities in the achievement of fertility preferences and in accessibility to family planning services between urban and suburban parts of the city.

The frequency of wheezing phenotypes and risk factors for persistence in aegean region of Turkey

The aim of the study was to determine the prevalence of wheezing and evaluate the risk factors for its persistence in children. Survey data was collected on 725 children aged 17 years or below. The mean age was 8.94 ± 5.16 years; 22.1% of them were reported to have had a wheezing episode at any point in their lives. A wheezing episode was reported in 18.1% of children 3 years of age or younger and persisted in 51% of these subjects; 69.6% of ever wheezers had late onset wheezing. Persistence was significantly common in males. Perinatal disease, lack of breast feeding, and low income were significant risk factors for persistence. In summary, breast feeding, perinatal disease, and income status may be significant risk factors influencing wheezing peristence and consequent asthma.

Contrasting children and women’s health and the determinants of health in a small-sized city

Contrasts that exist in urban infrastructure and accessibility of public health and social services between suburban and urban districts of mega-cities have been well defined. There has been less research in small-sized cities (population under 500,000). This cross-sectional study was done on 1,728 ever-married reproductive-aged women living in Manisa, Turkey, in the year 2000. The probability proportion to size cluster sampling approach was used in the sample selection. Data were collected for women and 7,016 inhabitants of the interviewed households. The data were collected from the women by face to face interviews. Suburban areas (illegally occupied public land called “Gecekondu” dwellings) in Manisa differ from other urban regions (legal settlements of the city) on socioeconomic factors including household occupancy, adult literacy, social class, rates of religious marriages, unemployment, health insurance coverage, migration, cultural segregation, and social status of women. Some traditional practices were also highly prevalent in gecekondu families, where poverty is more common. Although gross fertility rate (GFR), total fertility rate (TFR), and percent decrease of the TFR were higher for gecekondu women than urban women, total wanted fertility rate (TWFR) was lower. In urban neighborhoods, prevalence of contraceptive use was higher, and the infant and child mortality rates were lower; however, when rates were adjusted for mother’s age, education and number of births, the differences turned out to be nonsignificant. Women living in urban areas receive better antenatal care, child immunization services, and professional health delivery assistance and services in a health facility; these services are very scarce in gecekondu districts. Health status of gecekondu populations can be improved by social and economic support and by making health services more available and accessible, especially maternity and child health services.