Volume 7, Number 8
12 March 2007

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FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Contraceptive discontinuation and failure and subsequent abortion in Romania: 1994–99
(Abstract; subscription needed for full text; Europe)
Studies in Family Planning. 2007 Mar;38(1):23–34.
Creanga AA | Acharya R | Ahmed S | Tsui AO
This study examines the levels and correlates of contraceptive failure and discontinuation in Romania, together with the consequences of contraceptive method failure in terms of induced abortion. Overall, 19 and 28 percent of women became pregnant within the first year of using any contraceptive method and of practicing withdrawal, respectively. About 57 and 59 percent of failures from use of all methods and from withdrawal ended in abortion.

Human papillomavirus vaccine update
(Abstract; subscription needed for full text; Global)
Current Infectious Disease Reports. 2007 Mar;9:151-158.
Ames A | Gravitt P
With the approval of Gardasil® and the pending approval of Cervarix®, two prophylactic human papillomavirus (HPV) vaccines will be available for clinical use. Randomized controlled trials have shown that both vaccines are safe and highly effective in preventing persistent infection and lesions caused by HPV 16 and 18, the types responsible for 70% of cervical cancers worldwide. The authors discuss the appropriate age of vaccination, vaccine acceptance, implementation strategies in low resource settings, and the future of screening.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

India: No coercive methods for family planning: PM
(News Article; Asia)
2007 Mar 8;8 Mar 2007
The Times of India
Prime Minister Manmohan Singh of India has made it clear that the Indian government would not use "coercive" methods for population stabilization and the problem would be addressed through education and empowerment of women. He said the government was stressing investment in education to ensure that children, particularly girls, are given quality education to enable them to "take charge of their own destiny."

HIV/AIDS RESEARCH

The link between HIV/AIDS and recent fertility patterns in Kenya
(Working Paper; Sub-Saharan Africa)
(You need Adobe Acrobat Reader to access this document)
2007 Feb;Measure Evaluation, 2007
Magadi M | Agwanda A, Carolina Population Center
HIV/AIDS may influence fertility through one or more behavioral and/or biological proximate fertility determinants. This study explores (i) the regional variations in the link between HIV/AIDS and fertility; (ii) possible mechanisms through which HIV/AIDS may influence fertility; and (iii) the effect of individual and contextual community-level HIV/AIDS factors on fertility. The study is based on secondary analysis of the 2003 Kenya DHS data.

Infectious disease morbidity among young HIV-1-exposed but uninfected infants in Latin American and Caribbean countries: The National Institute of Child Health and Human Development International Site Development Initiative Perinatal Study
(Abstract; subscription needed for full text; Central America and the Caribbean | South America)
Pediatrics. 2007 Mar;Online access Februrary 17, 2007. 19(3):E694-E704.
Mussi-Pinhata MM | Freimanis L | Yamamoto AY | Korelitz J | Pinto JA | Cruz ML | Losso MH | Read JS
The study's goal was to describe the frequency, characteristics, and correlates of infectious disease morbidity during the first 6 months of life among HIV-1-exposed but uninfected infants. Overall, the most common infections were skin or mucous membrane infections and respiratory tract infections. Overall, 17.5% of infants were hospitalized with an infection. Infants with lower respiratory tract infections were hospitalized frequently (40.7%). The occurrence of neonatal infection was associated with more-advanced maternal HIV-1 disease, tobacco use during pregnancy, infant anemia, and crowding.

Microbicide drug candidates to prevent HIV infection
(Abstract; subscription needed for full text; Global)
Lancet. 2007 Mar;Online access March 7, 2007. 369(9563):787-798.
Balzarini J | Van Damme L
More than 90% of HIV-infected people live in developing countries, most of whom do not have access to anti-retroviral treatments. The development of efficient, widely available, and low-cost microbicides (gels and creams that can be applied topically before sex) to prevent sexually transmitted HIV infections should be given high priority. This study reviews different categories of microbicide drugs and lead compounds, their mechanism of action, current status of development, and progress in phase III trials.

Langerin is a natural barrier to HIV-1 transmission by Langerhans cells
(Letter to the Editor; Global)
Nature Medicine. 2007 Mar;Online access March 7, 2007.
de Witte L | Nabatov A | Pion M | Fluitsma D | de Jong MAWP | de Gruijl T
Related News Article: Scientists discover 'natural barrier' to HIV
Researchers have discovered that cells in the mucosal lining of human genitalia produce a protein that "eats up" invading HIV, possibly keeping the spread of the AIDS more contained than it might otherwise be. Even more important, enhancing the activity of this protein, called Langerin, could be a potent new way to curtail the transmission of the virus that causes AIDS. Langerin is produced by Langerhans cells, which form a web-like network in skin and mucosa. This network is one of the first structures HIV confronts as it attempts to infect its host.

HIV/AIDS NEWS

South Africa: Women's rights groups push for more AIDS funding
(News Article; Sub-Saharan Africa)
8 Mar 2007
Integrated Regional Information Networks
Related Report: Show Us the Money: Is Violence Against Women on the HIV/AIDS Donor Agenda
(You need Adobe Acrobat Reader to access this document)
On International Women's Day, March 8, local and international women's and human rights groups urged donors to devote more funding to HIV/AIDS programs aimed at reducing women's vulnerability to infection. At the same time a new report cited the sexual violence and coercion women experience at the hands of their male partners as a leading factor in the increasing "feminization" of the AIDS pandemic. The report is entitled, "Show Us the Money: Is Violence Against Women on the HIV/AIDS Donor Agenda." [Report is large file: 81 pages; 2.61 MB]

Making policies for AIDS in the workplace, commonplace
(News Article; Sub-Saharan Africa)
5 Mar 2007
Mulama J, Inter Press Service News Agency
With AIDS cutting a swathe through Africa's workforce, there is an urgent need for employers to set up policies that support HIV-positive staff and ensure they are not victims of stigma. Resources can be saved with HIV/AIDS workplace policies in place. Data shows that when workers infected with HIV/AIDS are taken care of, they need less time off of work for sick leave.

India: AIDS awareness event attracts thousands, promotes HIV prevention
(News Article; Asia)
Mar 2007
Family Health International
In the largest such event in India, an estimated 15,000 sex workers attended a ceremony in Mumbai honoring their commitment to HIV prevention. The event featured Indian movie stars, singers, former "Indian Idol" winners and U.S. actor Richard Gere. Gere, who presented awards to sex workers, led the audience in a chant of "No condom, no sex. No condom, no sex." The ceremony sought to strengthen community activities, reinforcing with sex workers the importance of safer sex practices and to acknowledge the contribution of program participants.

Botswana: Ministry to roll out ARVs to 128 clinics
(News Article; Sub-Saharan Africa)
8 Mar 2007
Botswana Press Agency
Botswana's Ministry of Health intends to roll out anti-retroviral drugs to 128 clinics by the end of National Development Plan 9 (which ends in 2009). Currently 33 clinics and 32 hospitals are providing ARVs to 79,490 patients on treatment countrywide. The ministry is in the process of strengthening its drug regulation and quality assurance systems to ensure that drugs in the local market are safe, effective and high quality.

Helping DRC to drive down HIV and sexual violence
(News Article; Sub-Saharan Africa)
6 Mar 2007
United Kingdom Department for International Development (DFID)
Like many countries in Africa, HIV is a major problem in the Democratic Republic of Congo. Accurate statistics are hard to come by, but HIV-prevalence rates are believed to be between 1.7 and 7.6% depending on the region, and may be as high as 20% among women who have suffered sexual violence in areas of armed conflict. The DRC is also at a turning point in its development. Following the first democratic elections in 40 years, the country is beginning a process of national reconstruction in which controlling the spread of HIV is considered a priority.

MATERNAL AND CHILD HEALTH RESEARCH

Use of antiretroviral therapy in pregnant HIV-infected women and the risk of premature delivery: A meta-analysis
(Abstract; subscription needed for full text; Global)
AIDS. 2007 Mar 12;21(5):607-615.
Kourtis AP | Schmid CH | Jamieson DJ | Lau J
The authors conducted a meta-analysis on studies that reported premature delivery for HIV-infected women treated with antiretroviral therapy (ART) during pregnancy. ART during pregnancy did not increase the risk of premature delivery overall. Evidence indicates that antiretroviral therapy during pregnancy is not associated with an overall increased risk of premature delivery. The use of combination regimens before or early in pregnancy may slightly increase the risk of prematurity.

Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age
(Abstract; subscription needed for full text; North America)
Human Reproduction. 2007 Feb;
Luke B | Brown MB
Related News Article: Older moms more likely to have C-sections
This study evaluated the risks of pregnancy complications and adverse outcomes with increasing maternal age using national vital statistics from the U.S. The risks for most outcomes paralleled increasing maternal age including prolonged and dysfunctional labour, excessive labour bleeding, breech and malpresentation and primary Caesarean delivery. Increasing maternal age is associated with significantly elevated risks for pregnancy complications and adverse outcomes, which vary by parity.

Reducing infant mortality in Chile: Success in two phases
(Abstract; subscription needed for full text; South America)
Health Affairs. 2007 Mar;26(2):458-465.
Jiménez J | Romero MI
Chile has reduced infant mortality (IM) to rates of around 25 per 1,000 live births. There are two clear phases of declining IM: one largely influenced by poverty reduction, primary health care, and environmental and demographic factors; and a second one more sensitive to focused health care interventions. In 2000 Chile reached 8.9 infant deaths per 1,000 using interventions that represent an increase in the provision of services related to perinatal risks, acute respiratory diseases, congenital heart conditions, and certain vaccine-preventable infections.

MATERNAL AND CHILD HEALTH NEWS

Nigeria: Women to shun child-bearing if...
(News Article; Sub-Saharan Africa)
6 Mar 2007
Icheku T, Daily Sun
Mrs. Ejiro Otive-Igbuzor, a reproductive rights activist in Nigeria, argues that all women in Nigeria "should embargo child-bearing till the issue of women dying during childbearing is tackled head-on." She argues that the government should provide its citizens with free medical services for antenatal care and delivery, and that women should refuse to become pregnant if the government doesn't take action. She believes that maternal mortality is a governance issue, not just as a health issue, and if it were treated as such, it would get more attention.

Yemen has highest maternal mortality rate in the Arab world
(News Article; Middle East)
8 Mar 2007
BBS News
According to Yemen Ministry of Health estimates, eight women die in childbirth every day and 366 women die for every 100,000 live births. Yemen's Supreme Council for Motherhood and Childhood (SCMC) has proposed to raise the legal age of marriage to 18, as early marriage has been identified by Yemeni specialists and officials as a significant factor in Yemen's high rates of maternal mortality.

MEN'S HEALTH RESEARCH

Fate of bone marrow stem cells transplanted into the testis: Potential implication for men with testicular failure
(News Article; Global)
American Journal of Pathology. 2007 Mar;170:899-908.
Lue Y | Erkkila K | Liu P | Ma K | Wang C | Hikim A | Swerdloff R
Related News Article: Treating male infertility with stem cells
The study examined the usefulness of bone marrow stem cells for treating male infertility. Researchers injected bone marrow cells from adult green fluorescent protein transgenic mice into the seminiferous tubules and the testicular interstitium of busulfan-treated wild-type or c-kit mutant mice. They survived 10-12 weeks after transplantation. This clinically relevant finding raises the possibility for treatment of male infertility and testosterone deficiency through the therapeutic use of stem cells.

Pelvic lymph node dissection for penile carcinoma: Extent of inguinal lymph node involvement as an indicator for pelvic lymph node involvement and survival
(Abstract; subscription needed for full text; Europe)
The Journal of Urology. 2007 Mar;177(3):947-952.
Lonta A | Kroona B | Galleeb M | Tinteeren H | Moonend L | Horenblasa S
This study identified pathological parameters of inguinal lymph node for the prediction of pelvic lymph node involvement and survival among 308 patients with penile carcinoma. Tumor grade of the involved nodes and the number of involved nodes were independent prognostic factors for pelvic lymph node involvement. Patients with only 1 or 2 involved nodes without extracapsular growth and no poorly differentiated tumor within these nodes have a good prognosis with a 5-year survival rate of approximately 90%.

The association of higher depressive symptoms and sexual dysfunction in male haemodialysis patients
(Abstract; subscription needed for full text; Asia)
Nephrology Dialysis Transplantation. 2007 Mar;Online access November 22, 2006. 22(3):857-861.
Peng YS | Chiang CK | Hung KY | Chiang SS | Lu CS | Yang CS | et al
A multicenter cross-sectional study of 411 male hemodialysis patients was conducted to define the determinants of sexual dysfunction. Subjects with sexual dysfunction had significantly lower quality of life scores. The presence of depressive symptoms, highly prevalent in haemodialysis patients, is an independent factor of sexual dysfunction in male haemodialysis patients. In a comprehensive approach to the management of sexual dysfunction, a thorough evaluation of psychological depression must be included.

MEN'S HEALTH NEWS

HIV study raises caution about circumcision
(News Article; Sub-Saharan Africa)
7 Mar 2007
Brown D, Washington Post
Related Abstract; subscription needed for full text: Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial
Men with HIV who get circumcised hoping they will be less likely to transmit the AIDS virus may have a greater than normal risk of infecting their partners if they resume sexual activity too soon after the operation. This is drawn from preliminary analysis of a study in Uganda that was presented this week. The study also suggests that public health campaigns promoting circumcision must also include messages, directed principally at women, warning of the extreme hazard of intercourse with HIV-positive men who have just had the procedure.

Kill the sperm, spare the irritation
(News Article; Asia)
5 Mar 2007
New Scientist
Related Abstract; subscription needed for full text: Novel disulphide esters of carbothioic acid as potent, non-detergent spermicides with low toxicity to Lactobacillus and HeLa cells in vitro
Two new molecules kill sperm 25 times more effectively than the most commonly used spermicide, without irritating vaginal cells. A team at the Central Drug Research Institute in Lucknow, India has created two molecules that specifically target sperm by binding to molecules on the sperm membranes which trigger programmed cell death. The spermicides killed 100% of the sperm at just 4% of the concentration needed to get the same results with Nonoxynol-9. The molecules were also non-toxic to cultures of human cervical cells and bacteria found in the vagina.

POPULATION RESEARCH

The distribution of consecutive closed birth intervals in females in Uttar Pradesh
(Abstract; subscription needed for full text; Asia)
Journal of Biosocial Science . 2007 Mar;39(2):189-199.
Yadava RC | Sharma SS
Most studies of closed birth intervals are regarding their variation at specific orders among females. This paper attempts to study the nature of the distributions of consecutive closed birth intervals. Data from the Uttar Pradesh National Family Health Survey 1998-99 (NFHS-2) were analysed. It was found that, under certain assumptions, the postpartum amenorrhoea period and menstruating interval are negatively associated, indicating that socio-cultural factors are affecting the menstruating interval.

Foreign policy matters: a normative view of the G8 and population health
(Research Article; Global)
Bulletin of the World Health Organization. 2007 Mar;85(3):161-244.
Labonte R | Schrecker T
The G8 countries occupy a dominant position in the international economic and political order. Given what is known about influences on the social determinants of health in an interconnected world, the G8 are a logical starting point for any enquiry into the relations between foreign policy and health. Arguments for adopting an explicitly normative, equity-oriented perspective on the performance of G8 policy in areas related to population health are presented.

POPULATION NEWS

Life expectancy rising in Cyprus but birth rate dropping
(News Article; Middle East)
6 Mar 2007
The Financial Mirror
Life expectancy in Cyprus is on the rise for both men and women, but the island is facing the problem of low birth rates. Statistical data recently released show that in Cyprus the life expectancy of women in 2005 was 81.7 years, and for men the life expectancy was 77 years. Eurostat figures indicate that the fertility rate in Cyprus was 1.34 children per women, with the average in the European Union being 1.51 children.

Philippines: 1.9% population growth rate eyed by 2010
(News Article; Asia)
5 Mar 2007
The Asian Journal
The Philippine government is targeting a 1.9% annual population growth rate by 2010. The 2000 census showed the Philippine population growth rate was 2.36%. To accomplish the 1.9% growth rate target, the government has been conducting multi-pronged activities such as capacity training in natural family planning methods, while local governments will provide other means of contraception to manage the population growth. Programs for sex workers and reproductive health education for adolescents will also be addressed.

Birth rate in Russia to grow 26% by late 2009
(News Article; Asia)
6 Mar 2007
Russian News and Information Agency
Russia's health ministry predicts that the birth rate in Russia is set to increase by 26% by the end of 2009 as a result of measures taken to resolve the demographic problem. A set of measures was introduced in Russia early in 2006 to alleviate the problem, including maternity hospital funding and capital payouts ($9,500) for the birth of two or more children. Russia is faced with an acute demographic problem, and the government is implementing a number of programs designed to increase the birth rate and attract more migrants as solutions.

WOMEN'S HEALTH RESEARCH

Cervical cancer: A qualitative study on subjectivity, family, gender and health services
(Research Article; Central America and the Caribbean)
Reproductive Health. 2007 Mar;Online access Mar 9, 2007. 4(2)
Pelcastre Villafuerte B | Tirado Gomez L | Mohar Betancourt A | Lopez Cervantes M
This qualitative study analyzed the role of different social and cultural factors in the timely detection of cervical cancer based on individual interviews with women diagnosed with cervical cancer, their female friends, relatives, and husbands. The results showed that denial and fear are two important components that regulate the behavior of women and their partners. Women with a small support network may have limited opportunities for taking action in favor of their own health and well-being.

Intimate partner violence among Afghan women living in refugee camps in Pakistan
(Abstract; subscription needed for full text; Asia)
Social Science and Medicine. 2007 Apr;Online access March 9, 2007. 64(7):1536-1547.
Hyder AA | Noor Z | Tsui E
This paper explores events and factors that lead to conflict in the home in Afghan refugee settings and the current status of the health sector's ability to respond to evidence of conflict. It analyzes women's explanations of how various marriage traditions may be linked to conflict in the home and how different family members may be related to conflict. It also provides information to frame the issues of family violence in refugee populations for intervention designers and those who work to craft a health sector response.

WOMEN'S HEALTH NEWS

Brazil: Lula tells Brazil to respect women
(News Article; South America)
7 Mar 2007
Reuters
Brazil has been applauded by global health organizations for slowing overall AIDS infection rates by giving away free condoms, though studies show men sometimes ask women not to use condoms and women are more likely to be infected with HIV by men than vice versa. President Luiz Inacio Lula da Silva said Brazilians must show women more respect by using condoms during sex. Lula's words marked the start of a new Health Ministry program to lower AIDS infection rates among women, up 44 percent from 1995 to 2005.

Cameroon: Plight of female HIV carriers x-rayed
(News Article; Sub-Saharan Africa)
6 Mar 2007
Yufeh B, Cameroon Tribune
As a prelude to the celebration of International Women's Day in Cameroon on March 8, 2007, the Coordination Committee for the Organization of the Fight against HIV/AIDS in the Center Province (COLSCE) organized a roundtable discussion to examine problems faced by women infected with HIV. Amidst these problems are the HIV communication messages pasted along the streets (such as "HIV kills" or "Cameroon needs HIV free men and women") as well as stigma from society toward women who do not breastfeed their children.

South Africa: MRC's HIV project empowered eastern Cape women
(News Article; Sub-Saharan Africa)
6 Mar 2007
Dlamini N, BuaNews
Related Abstract: RCT evaluation of the South African adaptation of Stepping Stones: Methods and methodological dilemmas
An HIV prevention program undertaken by the Medical Research Council (MRC) was found to have empowered women in the Eastern Cape by encouraging dialogue on sex and health issues. Participants, particularly women, found that after they participated in the MRC's educational program, they felt more empowered to discuss and negotiate issues such as condom use with their partners.

Hormone 'could treat infertility'
(News Article; Global)
6 Mar 2007
BBC News
A team at London's Hammersmith Hospital has shown that shots of the hormone kisspeptin stimulate the release of the hormones that control periods. Kisspeptin has already been identified as the genetic switch that turns on puberty. Humans who lack the hormone remain sexually immature. Kisspeptin increased luteinising hormone concentrations at all stages of the menstrual cycle, but the effect was greatest in the pre-ovulation phase.

World fails to treat rape as crime - UN agencies
(News Article; Global)
7 Mar 2007
Nichols M, Reuters
The U.N. Development Fund for Women (UNIFEM) and the U.N. Children's Fund (UNICEF) said that while 104 out of 192 countries in the world had made rape a crime, these laws were poorly enforced. The Security Council called for an end to impunity for gender-based violence during armed conflict and the inclusion of sexual and other violent acts against women and girls in genocide, crimes against humanity and war crimes prosecutions.

YOUTH HEALTH RESEARCH

Size of newborn and caesarean section deliveries among teenagers in Sub-Saharan Africa: Evidence from DHS
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Biosocial Science. 2007 Mar;Online access March 7, 2007. 39(2):175-187.
Magadi M | Agwanda A | Obare F | Taffa N
This paper uses DHS data from 20 countries in sub-Saharan Africa, collected in the late 1990s and early 2000s, to examine perceived size of newborn and Caesarean section deliveries among teenagers in the region. An examination of the country-level variations shows significant differences in perceived size of newborn and Caesarean section deliveries between countries. However, the observed pattern by maternal age does not vary significantly between countries, suggesting that these patterns are generalizable for the region.

Determinants of adolescent pregnancy in an urban area in Turkey: A population-based case-control study
(Abstract; subscription needed for full text; Europe)
Journal of Biosocial Science. 2007 Mar;Online access March 7, 2007. 39(2):301-311.
Gokce B | Ozsahin A | Zencir M
This population-based case-control study determined the degree to which socioeconomic status is a risk factor for first birth at age 19 or younger in married women in an urban area of Turkey. The study group comprised all married and pregnant women aged 15-19 attending primary care centers. Married women between 20 and 29 years of age, experiencing their first pregnancy, were determined as the control group. Adolescent pregnancy was more frequent in women from families with a low socioeconomic status.

Age at first sex and HIV infection in rural Zimbabwe
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Studies in Family Planning. 2007 Mar;Online access 9 Mar 2007. 38(1):1-10.
Hallett TB | Lewis JC | Lopman BA | Nyamukapa CA | Mushati P | Wambe M | Garnett GP | Gregson S
In this study, cross-sectional behavioral data linked to HIV-status from 4,138 men and 4,948 women interviewed in rural Zimbabwe were analyzed to investigate the distribution and consequences of early first sex. The study found that age at first sex has declined among males over the past 30 years but increased recently among females. Early sexual debut before marriage precedes a lifetime of greater sexual activity, but with more consistent condom use. Women who have sex earlier than others are more likely to be infected with HIV.

"But there are no snakes in the wood:" Risk mapping as an outcome measure in evaluating complex interventions
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Sexually Transmitted Infections. 2007 Mar;Online access March 7, 2007.
Power R | Cowan F | Langhaugh L
Through a participatory workshop with adolescent boys and girls in rural Zimbabwe, researchers developed an innovative "risk map research workshop" to be conducted throughout study sites. Six "risk areas" emerged from the data: bush/rural terrain, commercial centers, home, school environs, religious and spiritual venues, and roadside. Risks and the consequences included: STIs (including HIV), violence, sexual abuse, expulsion from school, and illegal abortion. Risk maps provide unique data that can be used to examine subtle changes that occur as a result of social behavioral interventions aimed at addressing reproductive health.

YOUTH HEALTH NEWS

Malaysia: Sex education for children
(News Article; Asia)
5 Mar 2007
Daily Express News
A Malaysian health official has said that children should be exposed to sex education as early as 12 or 13 years old. Health officials also argue that parents, and especially single mothers, should equip themselves with the knowledge and skills to discuss sex with their children effectively.

Brazil's president says sex education helps combat teenage pregnancy, AIDS
(News Article; South America)
7 Mar 2007
Associated Press
Brazilian President Luiz Inacio Lula da Silva said that sex education is the best way to combat AIDS and teenage pregnancy, taking a swipe at the church in this predominantly Catholic country. Silva said that 30% of Brazilian girls aged 15 to 17 leave school due to pregnancy and argued that sex education could help solve the problem.

South Africa: Teenage pregnancy figures cause alarm
(News Article; Sub-Saharan Africa)
6 Mar 2007
Integrated Regional Information Networks
Alarming figures released by a South African provincial education department indicate that adolescent pregnancies have doubled in the past year, despite a decade of spending on sex education and AIDS awareness. The number of pregnant schoolgirls jumped from 1,169 in 2005 to 2,336 in 2006 in Gauteng, the country's economic heartland and most populous province, according to statistics released in the provincial parliament.

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Volume 7, Number 812 March 2007