The incidence, aetiology, and adverse clinical consequences of less severe diarrhoeal episodes among infants and children residing in low-income and middle-income countries: a 12-month case-control study as a follow-on to the Global Enteric Multicenter Study (GEMS)

Abstract Background Suicide is an important contributor to the burden of mental health disorders, but community-based suicide data are scarce in many low- and middle-income countries (LMIC) including Kenya. Available data on suicide underestimates the true burden due to underreporting related to stigma and legal restrictions, and under-representation of those not utilizing health facilities. Methods We estimated the cumulative incidence of suicide via verbal autopsies from the Health and Demographic Surveillance System (HDSS) in Kisumu County, Kenya. We then used content analysis of open history forms among deaths coded as accidents to identify those who likely died by suicide but were not coded as suicide deaths. We finally conducted a case-control study of suicides (both verbal autopsy confirmed and likely suicides) compared to accident-caused deaths to assess factors associated with suicide in this HDSS. Results A total of 33 out of 4306 verbal autopsies confirmed suicide as the cause of death. Content analysis of a further 228 deaths originally attributed to accidents identified 39 additional likely suicides. The best estimate of suicide-specific mortality rate was 14.7 per 100,000 population per year (credibility window = 11.3 – 18.0). The most common reported method of death was self-poisoning (54%). From the case-control study interpersonal difficulties and stressful life events were associated with increased odds of suicide in both confirmed suicides and confirmed combined with suspected suicides. Other pertinent factors such as age and being male differed depending upon which outcome was used. Conclusion Suicide is common in this area, and interventions are needed to address drivers. The twofold increase in the suicide-specific mortality rate following incorporation of misattributed suicide deaths exemplify underreporting and misclassification of suicide cases at community level. Further, verbal autopsies may underreport suicide specifically among older and female populations.

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Exposure to landscape fire smoke reduced birthweight in low- and middle-income countries: findings from a siblings-matched case-control study

eLife ◽

10.7554/elife.69298 ◽

2021 ◽

Vol 10 ◽

Author(s):

Jiajianghui Li ◽

Tianjia Guan ◽

Qian Guo ◽

Guannan Geng ◽

Huiyu Wang ◽

...

Keyword(s):

Low Birthweight ◽

Case Control Study ◽

Case Control ◽

Middle Income ◽

Middle Income Countries ◽

Gestational Exposure ◽

Fire Smoke ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

Landscape fire smoke (LFS) has been associated with reduced birthweight, but evidence from low- and middle-income countries (LMICs) is rare. Here, we present a sibling-matched case-control study of 227,948 newborns to identify an association between fire-sourced fine particulate matter (PM2.5) and birthweight in 54 LMICs from 2000 to 2014. We selected mothers from the geocoded Demographic and Health Survey with at least two children and valid birthweight records. Newborns affiliated with the same mother were defined as a family group. Gestational exposure to LFS was assessed in each newborn using the concentration of fire-sourced PM2.5. We determined the associations of the within-group variations in LFS exposure with birthweight differences between matched siblings using a fixed-effects regression model. Additionally, we analyzed the binary outcomes of low birthweight (LBW) or very low birthweight (VLBW). According to fully adjusted models, a 1 µg/m3 increase in the concentration of fire-sourced PM2.5 was significantly associated with a 2.17 g (95% confidence interval [CI]: 0.56-3.77) reduction in birthweight, a 2.80% (95% CI: 0.97-4.66) increase in LBW risk, and an 11.68% (95% CI: 3.59-20.40) increase in VLBW risk. Our findings indicate that gestational exposure to LFS harms fetal health.

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1503. Risk Factors for Contracting Infection with SARS-CoV-2: a Prospective Case-control Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1684 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S754-S754

Author(s):

Saeed Shoar ◽

Siamak Khavandi ◽

Elsa Tabibzadeh ◽

Aydin Vaez ◽

Ali Khabbazi Oskouei ◽

...

Keyword(s):

Low Income ◽

Case Control Study ◽

Population Level ◽

Population Based ◽

Case Control ◽

Healthy Controls ◽

Middle Income ◽

Low Income Country ◽

Control Study ◽

Prospective Case Control Study

Abstract Background As the COVID-19 pandemic has exhausted the healthcare system and economic infrastructures, controlling measures are directed toward population-based strategies including individual’s hygiene and safe socializing. We conducted this study to identify individual’s factors at the population level which are associated with the risk of infection with SARS-CoV-2 in a middle-to-low income country. Methods A prospective case-control study was conducted to compare the demographics, socioeconomics, and individual’s behavior between patients with COVID-19 and randomly selected healthy controls from the same population referring to a general hospital in northwest Iran. Results Data of 250 patients with a positive RT-PCR test for COVID-19 was compared with 250 healthy controls between March 1st and May 15th (Table1). Higher education, better socioeconomic status, having access to the internet or following relevant news, having an obsession for cleanliness especially regular hands washing with alcohol-based disinfectants, wearing masks in public especially those with an N-95 filter, complying with stay-home orders, and receiving the flu shot over the past season were protective against contracting COVID-19. On the contrary, cigarette smoking or opium consumption, a history of recent travel, having an individual with infection with SARS-CoV-2 within the household, and recent hospitalization were associated with COVID-19. Table1. Comparison of individual’s factors between COVID-19 positive and negative patients Conclusion Individuals’ characteristics at a family or public level can guide healthcare authorities and lawmakers in their ongoing endeavors toward controlling the COVID-19 pandemics, especially in low-to-middle income regions. Disclosures All Authors: No reported disclosures

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Risk factors for suicidal tendency in people with epilepsy in China: a case–control study

Scientific Reports ◽

10.1038/s41598-021-81870-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mintao Lin ◽

Jiani Chen ◽

Sisi Li ◽

Yingjie Qin ◽

Xuruan Wang ◽

...

Keyword(s):

Risk Factors ◽

Low Income ◽

Case Control Study ◽

Univariate Analysis ◽

Case Control ◽

Conditional Inference ◽

Suicidal Tendency ◽

Patients With Epilepsy ◽

Nested Case Control ◽

Control Study

AbstractPeople with epilepsy (PWE) have an increased suicide prevalence. This study aimed to identify the risk factors for suicidal tendency among PWE in West China. A nested case–control study was designed in a cohort of patients with epilepsy (n = 2087). In total, 28 variates were calculated. In the univariate analysis, unemployment, low income, seizure frequency, seizure-free time, infectious or structural etiology, levetiracetam or phenobarbital use, anxiety, depression, and stigma were associated with suicidal tendency. A multivariate analysis indicated that unemployment (odds ratio [OR] 5.74, 95% confidence interval [CI] 2.13–15.48), levetiracetam use (OR 2.80, 95%CI 1.11–7.05), depression (C-NDDI-E score ≥ 13; OR 3.21, 95%CI 1.26–8.21), and stigma (SSCI score ≥ 16; OR 6.67, 95%CI 1.80–24.69) were independently associated with suicidal tendency. Conditional inference tree analysis indicated that SSCI and C-NDDI-E scores could effectively identify patients with suicidal tendency. Thus, this study suggests that unemployment, levetiracetam use, depression, and stigma are independent risk factors for suicidal tendency in PWE in China.

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754 Social Determinants Associated with Paediatric Burn Injury: A Population Based, Case-control Study

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.335 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S210-S211

Author(s):

Adam A Padalko ◽

Justin Gawaziuk ◽

Sarvesh Logsetty

Keyword(s):

Social Determinants ◽

Low Income ◽

Case Control Study ◽

Burn Injury ◽

Case Control ◽

Teen Mother ◽

Income Household ◽

Increased Risk ◽

Income Assistance ◽

Control Study

Abstract Introduction Children are disproportionately represented as victims of burn injury compared to adults. Life-long sequelae post-burn manifest as increased rates of mental and physical illness, substance abuse, and suicide. Social determinants of health (SDoH) influence risk of injury, however the extent and influence of SDoH on burn injury is less clear. To determine which social determinants influence burn injury in children, a retrospective case-control study was conducted. Methods Children (< 17 years of age) admitted to a regional burn centre between January 1 1999 and March 30 2017 were matched based on age, sex and geographic location 1:5 with an uninjured cohort. Population level administrative data describing the SDoH, at the regional administrative multifaceted data repository were compared between the cohorts. Thirteen SDoH were chosen based on a systematic review conducted by the research team. Results No significant differences existed in descriptive statistics between the burn and control cohorts. Mean age at burn injury = 5.46 (± 5.23), average TBSA (%) = 10.5 (± 13.4). The most common mechanism of burn injury was scald (42.03%) Upon multivariable logistic regression, children: from a low-income household (O.R. 1.97 (1.46, 2.65)); in foster care (O.R. 1.57 (1.11, 2.21)); from a family that received income assistance (O.R. 1.71 (1.33, 2.19)); or born to a teen mother (O.R. 1.43 (1.13, 1.81)) were associated with an increased risk of burn injury. Conclusions This study identified SDoH associated with an increased risk of burn injury. This case-control study supports the finding that children from a low-income household, children in care, from a family that received income assistance, and children born to a teen mother are at an elevated risk of burn injury. Applicability of Research to Practice Identifying children at increased potential risk provides an opportunity to prevent burn injuries, bypassing the associated long-term physical disfigurement, life-long mental health consequences and mortality. This study also has merit in maximizing the efficiency of a burn prevention budget through targeted burn safety and risk reduction programs.

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Pregnancy and fertility-related adverse outcomes associated with Chlamydia trachomatis infection: a global systematic review and meta-analysis

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-053999 ◽

2019 ◽

Vol 96 (5) ◽

pp. 322-329 ◽

Cited By ~ 4

Author(s):

Weiming Tang ◽

Jessica Mao ◽

Katherine T Li ◽

Jennifer S Walker ◽

Roger Chou ◽

...

Keyword(s):

Cohort Studies ◽

Risk Ratio ◽

Low Income ◽

Case Control ◽

High Income ◽

Adverse Outcomes ◽

Chlamydia Infection ◽

Case Control Studies ◽

Middle Income ◽

Middle Income Countries

BackgroundGenital chlamydia infection in women is often asymptomatic, but may result in adverse outcomes before and during pregnancy. The purpose of this study was to examine the strength of the relationships between chlamydia infection and different reproductive health outcomes and to assess the certainty of the evidence.MethodsThis review was registered and followed the Cochrane guidelines. We searched three databases to quantitatively examine adverse outcomes associated with chlamydia infection. We included pregnancy and fertility-related outcomes. We performed meta-analyses on different study designs for various adverse outcomes using unadjusted and adjusted analyses.ResultsWe identified 4730 unique citations and included 107 studies reporting 12 pregnancy and fertility-related outcomes. Sixty-eight studies were conducted in high-income countries, 37 studies were conducted in low-income or middle-income countries, and 2 studies were conducted in both high-income and low-income countries. Chlamydia infection was positively associated with almost all of the 12 included pregnancy and fertility-related adverse outcomes in unadjusted analyses, including stillbirth (OR=5.05, 95% CI 2.95 to 8.65 for case–control studies and risk ratio=1.28, 95% CI 1.09 to 1.51 for cohort studies) and spontaneous abortion (OR=1.30, 95% CI 1.14 to 1.49 for case–control studies and risk ratio=1.47, 95% CI 1.16 to 1.85 for cohort studies). However, there were biases in the design and conduct of individual studies, affecting the certainty of the overall body of evidence. The risk of adverse outcomes associated with chlamydia is higher in low-income and middle-income countries compared with high-income countries.ConclusionChlamydia is associated with an increased risk of several pregnancy and fertility-related adverse outcomes in unadjusted analyses, especially in low-income and middle-income countries. Further research on how to prevent the sequelae of chlamydia in pregnant women is needed.Trial registration numberCRD42017056818.

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Clinical consequences of primary CMV infection after renal transplantation: a case–control study

Transplant International ◽

10.1111/tri.13667 ◽

2020 ◽

Vol 33 (9) ◽

pp. 1116-1127

Author(s):

Ramandeep Singh ◽

Hessel Peters‐Sengers ◽

Ester B.M. Remmerswaal ◽

Unsal Yapici ◽

Karlijn A. M .I. Pant ◽

...

Keyword(s):

Renal Transplantation ◽

Case Control Study ◽

Case Control ◽

Cmv Infection ◽

Clinical Consequences ◽

Control Study

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Social Determinants Associated with Pediatric Burn Injury: A Population-Based, Case–Control Study

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa045 ◽

2020 ◽

Vol 41 (4) ◽

pp. 743-750

Author(s):

Adam Padalko ◽

Justin Gawaziuk ◽

Dan Chateau ◽

Jitender Sareen ◽

Sarvesh Logsetty

Keyword(s):

Social Determinants ◽

Low Income ◽

Case Control Study ◽

Burn Injury ◽

Population Based ◽

Case Control ◽

Teen Mother ◽

Increased Risk ◽

Income Assistance ◽

Control Study

Abstract Social determinants of health (SDoH) influence risk of injury. We conducted a population-based, case–control study to identify which social determinants influence burn injury in children. Children (≤16 years of age) admitted to a Canadian regional burn center between January 1, 1999 and March 30, 2017 were matched based on age, sex, and geographic location 1:5 with an uninjured control cohort from the general population. Population-level administrative data describing the SDoH at the Manitoba Center for Health Policy (MCHP) were compared between the cohorts. Specific SDoH were chosen based on a published systematic review conducted by the research team. In the final multivariable model, children from a low-income household odds ratio (OR) (95% confidence interval) 1.97 (1.46, 2.65), in care 1.57 (1.11, 2.21), from a family that received income assistance 1.71 (1.33, 2.19) and born to a teen mother 1.43 (1.13, 1.81) were significantly associated with an increased risk of pediatric burn injury. This study identified SDoH that are associated with an increased risk of burn injury. This case–control study supports the finding that children from a low-income household, children in care, from a family that received income assistance, and children born to a teen mother are at an elevated risk of burn injury. Identifying children at increased potential risk allows targeting of burn risk reduction and home safety programs.

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