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In: International Population Conference / Congres International de la Population, Montreal 1993, 24 August - 1st September. Volume 1, [compiled by] International Union for the Scientific Study of Population [IUSSP]. Liege, Belgium, IUSSP, 1993. 593-603.Using data collected in cooperation with the World Fertility Surveys (WFS) and the Demographic and Health Surveys (DHS) the aim was to determine the levels, age patterns, and trends of sterility in benin, Burundi, Cameroon, Ghana, Ivory Coast, Kenya, Lesotho, Liberia, Mali, Mauritania, Nigeria, Senegal, Sudan, Togo, and Uganda. In sub-Saharan Africa, 10 countries completed a WFS survey from 1977 to 1982. From 1986 to 1991 a DHS survey was carried out in 13 countries. In Sudan, Lesotho and Mauritania only ever married women were eligible for interview. All women (generally age 15-49) were eligible in the rest of the sub-Saharan countries. The selected samples included women who had been sexually active at least 5 years. Subsequently the levels and range patterns of sterility were estimated for each country and by produce within each country. The inhibiting effect of sterility on fertility was also assessed. Age-specific rates of sterility were estimated by the subsequently infertile estimator. At age 34, the proportions sterile reached .41 in Cameroon, .11 in Burundi, and intermediate levels in the rest of the countries. Burundi had the lowest prevalence of sterility at all ages, Cameroon had the highest up to about age 42, and at older ages Sudan and Lesotho ranked highest. In general, sterility rose moderately up to age 35 and then more rapidly after age 40. Sterility was particularly prevalent along major rivers, lakes, and coastal areas. Sterility was relatively high around Lake Victoria as well as in the Coast region of Kenya in 1977-78. Primary sterility was less than 3% in Burundi, Ghana, Kenya, Togo, and in Ondo state, Nigeria; 3-5% in Lesotho, Liberia, Mali, and Nigeria (1990), Senegal, Sudan (1989-90) and Uganda; and 5% or more in Cameroon, Nigeria (1981-82), and Sudan (1978-79). Differential disease patterns caused the most variation in age-specific rates of sterility. Under the hypothesis of Burundi levels of age specific sterility and unchanged fertility, and African woman in the age range from 20 to 44 would have an additional .5 to 2 children.
Intercom. 1980 Jan; 8(1):14.Guyana, a former British colony of about 830,000 population, in the 1970 Census had a composition of 52% East Indian, 31% African, and the balance Amerindian, Portuguese, Chinese, and mixed descent. The crude birth rate is believed to have peaked in 1957-59 at 44.5/1000; by 1978 the birth rate had dropped to about 28.3/1000. The World Fertility Survey of 1975 found that a total fertility rate of 7.1 children/woman in 1961 dropped to 4.4 in 1974. The largest decline in childbearing was in the over 30 age group and the under 20's. Knowledge of contraceptive methods is high; over 95% of a sample of ever-married women had heard of some method. Contraceptive usage is not as high as knowledge; of women exposed and with a partner, 38% said they were contracepting. The pill (11%) and female sterilization (10%) were the 2 most popular effective methods. Usage was lowest among women in common law marriages and visiting unions. Guyanese women overall preferred 4.6 children. Women age 20 thought 3.4 ideal; those over 40 reported 5.8 children as their choice. African women, who marry later than Indian women, preferred more children, 4.8, compared to 4.6 for Indian women. Rural women wanted 4.9 children while urban women wanted 4.3. The crude birth and death rates combine to give a rate of natural increase of 2.1% per year.
In: Diczfalusy, E. and Borel, U., eds. Control of human fertility. Proceedings of the Fifteenth Nobel Symposium, Sodergarn, Lidingo, Sweden, May 27-29, 1970. New York, Wiley, 1971. 39-51.A drug delivery system providing for a controlled release of progestogen and affecting ovulation and steroidogenesis minimally would deal effectively with some of the problems associated with contraception. 2 systems being developed which fit these criteria are the primary topics of discourse in this article. In 1 system an implant consists of a polymer membrane of polydimethylsiloxane (PDS) and contains the progestogen in crystalline form. Major problems with the PDS implants include a lack of intraindividual constance of release and interindividual variation in the slope of the decay in release. In the second system the implant consists of a lipid-steroid membrane containing a steroid. In this implant the concentration of the steroid in the membrane and the nature of the lipid phase may be important in determining the pattern of release. In vivo metabolic studies with lipid-steroid pellets are limited, but the patterns of output may be similar to those seen with PDS implants. Because of rate problems, a shorter regime slow-release implant seems more feasible than a longer lasting system. Surgical difficulties associated with the implantation and removal of the PDS implant make the choice of a lipid-steroid micropellet preparation more feasible for a short-term regimen. The discussion, following the main body of the article, focuses primarily on problems associated with implants.