Technology and Inequity in Health： The Geographical Distribution of Glucometers for the Control of Diabetes

Technological innovation plays an important role in the dynamics of economic growth and in promoting the welfare of the general population. In support of this hypothesis, an empirical study was carried out to assess the spatial distribution of insulin and supplies （glucometers） for the control of diabetes in patients registered in the Public Healthcare System in Salvador, Bahia, from 1998 to 2012. In order to achieve this objective, we applied a combination of data collection strategies, including spatial analysis and discrete choice model estimation. The study proposed to answer the following question： What factors affect access to the supplies required to control diabetes in insulin-dependent patients？ To this end, we assessed the spatial distribution of diabetic patients in Salvador who had received glucometers. The hypothesis asserted that social, economic and geographical factors determine access to the supplies （glucometers） used to control diabetes. Exploratory Spatial Data Analysis （ESDA） was therefore performed using the Global Spatial Autocorrelation Index in order to analyze the spatial distribution of glucometers. We then performed econometric estimations and analyzed the results. The final results initially demonstrated that there were major inconsistencies in the distribution of glucometers; i.e. purely random factors largely determined the probability of obtaining this device. Individual characteristics were not decisive factors in the probability of obtaining a glucometer, which were insteadrelated to type of diabetes and recommended treatment.

Socio-environmental factors associated with small mammal assemblage and Leptospira prevalence in Suburban Areas of Terengganu,Malaysia

Objective:To examine the socio-environmental factors associated with the assemblage of small mammals and the prevalence of Leptospira pathogen in poor suburban communities of Terengganu,Malaysia.Methods:We trapped small mammals from 119 trapping points scattered around three suburban communities of Terengganu using sausage-baited live traps.On the average,we set up five traps for three nights at each sampling point during the trapping period.Kidneys of captured animals were harvested and processed for Leptospira investigation.Additionally,environmental survey was conducted at each trapping point to obtain information about possible variables supporting small mammal assemblage.We used a generalized linear model to evaluate the effect of different socio-environmental variables on small mammals’assemblage.Results:A total of 89 small mammals,specifically,Rattus norvegicus(n=39),Rattus rattus(n=27),Rattus exulans(n=10),Suncus murinus(n=11),and Tupaia glis(n=2)were captured from 1385 trap nights.Fourteen individuals(15.7%)of the captured animals tested positive for Leptospira bacteria using PCR detection.Results of our generalized linear model showed only residences bordering vacant lots as the variable positively associated with small mammal occurrence in the three study sites.Conclusions:Small mammal community,especially the often neglected species,could harbour and potentially contribute towards pathogenic Leptospira maintenance in the study sites.To adequately control small mammals’population and subsequent human zoonoses transmission,it is critical to advocate and promote appropriate infrastructure and suburban services,together with good hygiene practices that can reduce the animals’access to food and harborage.