4. Child Sex Ratio Imbalance, Fertility Behaviour and Development in India: Recent Evidence from Haryana and Punjab

In Haryana and Punjab, the last census shows a sharp increase in the masculinity of the juvenile population, with the child sex ratio level exceeding 120 males for 100 females in 2001. Despite their impressive economic achievement, Haryana and Punjab seem to revert back to some ancient forms of female discrimination, which is, in some way, paradoxical. The tradition of female infanticide, which has virtually disappeared, is being progressively replaced by female foeticide, indicating a trend towards transfer of gender discrimination from the post-to the prenatal stage. In specific areas of the two states, this type of sex selective discrimination is leading to child sex ratios as high as 133 boys for 100 girls.This paradoxical increase in gender bias, in a context of overall improvement of the standard of living, can be explained by the desire among couples to limit their family size, in an environment of continued son preference. Technical progress also plays a role, giving couples an easy way to structure and shape their families in terms of intended size and sex. Economic development may also increase the cost of the girl child, because of the expected amount of dowry.Le dernier recensement indien a montré, pour l’Haryana et le Punjab, un accroissement rapide du rapport de masculinité chez les enfants, celui-ci dépassant 120 garçons pour 100 filles en 2001. En dépit de progrès économiques importants, l’Haryana et le Punjab semblent renouer avec des pratiques anciennes de discrimination des filles, ce qui paraît paradoxal. La tradition de l’infanticide des filles, qui a presque entièrement disparu dans ces états, est remplacée par un fœticide féminin, indiquant un transfert des discriminations de la phase post-natale vers la phase prénatale. Dans certaines régions de ces deux états, cette pratique a pour conséquence une forte élévation du rapport de masculinité juvénile, aujourd’hui de 133 garçons pour 100 filles.Cette accentuation du déséquilibre des sexes alors que le niveau de vie global s’améliore s’explique par un désir des couples de limiter leur descendance dans un contexte de forte préférence pour les fils. Les progrès technologiques jouent également un rôle, en ce sens qu’ils donnent aux couples un moyen facile de choisir la composition de leur descendance. Par ailleurs, le développement économique s’accompagne d’une augmentation rapide du montant de la dot, ce qui accroît le coût d’une fille

Etiological role of hepatitis E virus in sporadic fulminant hepatitis

Non-A, non-B hepatitis viruses have been implicated as the etiological agent(s) in up to 60% of patients with fulminant hepatitis. These agents are reported to induce a higher mortality than other causes of fulminant hepatitis. Hepatitis E virus (HEV) and hepatitis C virus (HCV) at present constitute the major identifiable non-A, non-B hepatitis agents. Of these, HEV has been established as the sole cause of epidemic hepatitis in Afro-Asian countries, and fulminant hepatitis has been recorded during such epidemics. However, in sporadic cases, the etiological role of HEV in fulminant hepatitis has remained uncertain. The role of HCV in acute liver disease and fulminant hepatitis remains unclear. The present study was undertaken to investigate the association of HEV and HCV in patients with fulminant hepatitis by direct detection of the viral genome using reverse transcription-polymerase chain reaction (RT-PCR). Serum samples from 50 sero-logically identified non-A, non-B fulminant hepatitis cases negative for cryptic hepatitis B virus (HBV) infection examined via PCR were tested for HEV and HCV RNA using RT-PCR. For HEV primers from the nonstructural region (ORF-1) were used, and for HCV primers from the highly conserved 5' untranslated regions were used. The products were analysed using agarose gel electrophoresis and confirmed by hybridisation with radiolabelled internal oligonucleotide probes. HEV was detected in 31 (62%) of the 50 fulminant non-A, non-B hepatitis cases. In 18 (36%) cases, HCV RNA was detected. In 11 (22%) of the HCV cases, the HEV genome was also amplified. In 20 (40%) cases, HEV was detected alone. Twelve (24%) patients were negative for all viral hepatitis markers. This study establishes HEV as one of the major agents associated with sporadic fulminant hepatitis in a geographical region where epidemics of hepatitis caused by HEV are frequent

Diagnosis of hepatitis C virus-associated chronic liver disease in India: comparison of HCV antibody assay with a polymerase chain reaction for the 5' noncoding region

The relative value of an anti-hepatitis C virus (HCV) serological assay and reverse transcriptase-nested polymerase chain reaction assays (RT-PCR) were investigated for the constant 5' putative noncoding region of HCV for the diagnosis of HCV-associated chronic liver diseases in India. One hundred fifteen patients with biopsy proven chronic active hepatitis and 140 cases of cirrhosis of the liver were investigated for anti HCV antibody using a second generation commercial enzyme-linked immunosorbent assay (ELISA). A proportion of these patients: 42 with chronic hepatitis and 27 with cirrhosis of the liver were analysed further for HCV RNA in the serum using RT-nested PCR assay. Thirty-three (12.9%) of the 255 patients were positive for anti-HCV antibody and 23 of 69 (33.3%) patients were positive for HCV RNA in serum. Fifteen of the 33 (45.5%) anti-HCV positive patients had HCV RNA in the serum. Eight of 36 (22.2%) HCV seronegative patients tested were found with HCV RNA. This indicates that the diagnosis of HCV infection is not possible if it is based solely on the available serodiagnostic tests. Inclusion of both assays improved the diagnostic efficiency, 18.8% (13/69) were negative for all virological markers associated with HBV and HCV infection. Since a majority of the chronic liver disease patients (143/255 [56%]) were seronegative for either HBV or HCV infection, it is significant that HCV RNA was detected in 38% (8/21) of a randomly selected group from these patients. The antibody assay and PCR were compared using interclass correlation (kappa statistics). Both these tests were found to be independent of each other. Considering the wide strain variation throughout the world, it is suggested that the current commercial anti-HCV testing is inadequate for the diagnosis of all HCV infections in all geographical regions

Gender discriminations among young children in Asia

Subsequent to the demographic transition, Asian countries have been experiencing deep-rooted changes in family structures. In this context, the question of gender relations within the family, and more generally within society, is crucial, in view of the increase in discriminatory practices toward women, beginning at foetal conception and continuing through all stages of life. Asia is the “black continent” for women. Estimates place the deficit in the number of women in the world at between 60 and 100 million, the vast majority of which is found on this continent. This book focuses on the intensity of female discrimination, from a demographic perspective, in the earliest stages of life, and more specifically around birth, in China, India, Pakistan, the Republic of Korea and Taiwan. These societies share cultural characteristics that are not favourable to women: patriarchal systems, patrilineal families, socialization processes encouraging the submission of wives to their husband's family, etc. In these societies, a son is needed to perpetuate the family line and ensure social and biological reproduction of the family. These are among the reasons why they share a strong son preference, which is in some cases accentuated by economic constraints. A son is generally the only person to support his parents in old age, and as a rule help with work in the fields. Moreover, girls and women still occupy a marginal position in society, whereas a male heir offers countless advantages.La transition démographique suscite, en Asie, de profondes transformations dans les structures familiales. Dans ce contexte, la question des rapports sociaux des sexes au sein de la famille, et plus généralement au sein de la société, est cruciale, dans la mesure où elle entraîne l’augmentation des discriminations à l’égard des femmes dès la conception et à tous les âges de la vie. L’Asie est le “continent noir” pour les femmes. Ce livre traite, par une approche démographique, des discriminations des femmes aux jeunes âges de la vie, et en particulier autour de la naissance, en Chine, en Inde, au Pakistan, en République de Corée et à Taiwan. Ces sociétés d’Asie partagent des caractéristiques culturelles qui ne sont pas favorables aux femmes ; un fils est désiré pour perpétuer la lignée et assurer la reproduction biologique et sociale de la famille. Des contraintes économiques peuvent aussi expliquer la préférence pour les garçons