scholarly journals Prevalence and correlates of alcohol use in a central Nepal district: secondary analysis of a population-based cross-sectional study

2018 ◽  
Vol 5 ◽  
Author(s):  
S. D. Rathod ◽  
N. P. Luitel ◽  
M. J. D. Jordans
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Help Seeking ◽  
Negative Binomial ◽  
Alcohol Use Disorders ◽  
Secondary Analysis ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Internalized Stigma ◽  
Cross Sectional

Background.As reported from studies conducted in Nepal, between 15% and 57% of adults had ever consumed alcohol and between 1.5% and 25% of adults have alcohol use disorders (AUD). Few studies in Nepal have identified the correlates of consumption or described the help-seeking patterns and stigma among those affected with AUD.Methods.Interviewers administered the Alcohol Use Disorders Identification Test (AUDIT) as part of population-based surveys of adults in Chitwan District between 2013 and 2017. We conducted a secondary analysis to identify sociodemographic and health-related correlates of recent alcohol consumption using the χ2 test, to identify correlates of total AUDIT scores among men who drink using negative binomial regression, and to describe the treatment-seeking and stigma beliefs of men with AUD.Results.Over half (53.7%, 95% CI 50.4–57.0) of men (n  =  1130) recently consumed alcohol, and there were associations between being a drinker with age, religion, caste, education, occupation and tobacco use. Nearly one in four (23.8%, 95% CI 20.2–27.8%) male drinkers screened positive for AUD, and AUDIT scores were associated with age, caste, marital status, occupation, tobacco use, depression, functional status and suicidal ideation. Few (13.3%, 95% CI 11.7–15.0) women (n  =  2352) recently consumed alcohol, and 5.3% (95% CI 3.0–9.1) of female drinkers screened positive for AUD. Among AUDIT-positive men, 38% spoke to another person about their problems and 80% had internalized stigma.Conclusions.This study revealed that nearly one in four men who drink likely have AUD. Higher AUDIT scores were associated with depression, suicidality, dysfunctionality and internalized stigma.

scholarly journals Modeling the trend of reported malaria cases in Kisumu county, Kenya

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 600
Author(s):  
Elsen Achieng ◽  
Vincent Otieno ◽  
Joseph Mung'atu
Keyword(s):  
Time Series ◽  
Regression Model ◽  
Negative Binomial ◽  
Scale Up ◽  
Secondary Analysis ◽  
Negative Binomial Regression ◽  
Categorical Variables ◽  
Negative Binomial Regression Model ◽  
Cross Sectional Survey ◽  
Cross Sectional

Background: Although there has been an extensive scale-up of malaria interventions in Kenya, malaria infections persist at unacceptably high levels in some of the regions. Even with renewed calls to eradicate the disease through increased international donor assistance and country-specific government involvement, malaria is still a cause of worry in endemic regions. The objective of this study was to determine the factors associated with the incidence of malaria in Kisumu County over time. Methods: The study conducted secondary analysis of data from a cross-sectional survey of routinely reported malaria cases. The population of interest were patients confirmed to have malaria by laboratory test. A sample size of 384 was randomly selected from all laboratory-confirmed malaria cases as reported by health facilities in Kisumu County from January 2014 to December 2017. The analysis involved descriptive, trend analysis and time series analysis (ARIMA). A negative binomial regression model was used to measure the effect of each of the selected predictor variables on incidence of malaria and the incidence rate ratio, was reported. Frequency distribution of each of the categorical variables was calculated. Results: The overall pattern of the reported malaria cases had seasonal variations for weekly cases. The best-fitting time series model developed for predicting the number of weekly reported cases of malaria was ARIMA (2, 0, 1). It was observed that the negative binomial was actually the best model to fit the incidences of malaria because the dispersion parameter given by Poisson regression model had been reduced from 70.292 to 1.103. Conclusion: There is a need to encourage health professionals to regularly review and report cases of malaria in their facilities. This is because reporting rates, completeness and the consistency of malaria reported cases remain extremely low.

scholarly journals General Healthcare Utilization and Out-of-Pocket Expenditures Associated with Depression in Adults: A Cross-Sectional Analysis in Nepal

2019 ◽  
Author(s):  
Selina Rajan ◽  
Sujit D Rathod ◽  
Nagendra P Luitel ◽  
Adrianna Murphy ◽  
Tessa Roberts ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Low Income ◽  
Negative Binomial ◽  
Mental Healthcare ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Universal Healthcare ◽  
Probable Depression

Abstract Background: Despite attempts to improve universal healthcare coverage (UHC) in low income countries like Nepal, most healthcare utilization is still financed by out-of-pocket (OOP) payments, with detrimental effects on the poorest and most in need. Evidence from high income countries shows that depression is associated with increased healthcare utilization, which may lead to increased OOP expenditures, placing greater stress on families. To inform policies for integrating mental healthcare into UHC in LMIC, we must understand general healthcare utilization and OOP expenditure patterns in people with depression. Aims: We examined associations between symptoms of depression and frequency and type of general healthcare utilization and OOP expenditure among adults in Chitwan District, Nepal. Methods: We analysed data from a population-based survey of 2040 adults in 2013, who completed the PHQ-9 screening tool for depression and answered questions about general healthcare utilization. We modelled associations between increasing PHQ-9 score and healthcare utilization frequency and OOP expenditure using negative binomial regression. We also compared sector-specific utilization of outpatient healthcare and their related costs among adults with and without probable depression, determined by a PHQ-9 score of 10 or more. Results: We classified 80 (3.6%) participants with probable depression, 70.9% of whom used some form of general healthcare in the past year compared to 43.9% of people without probable depression. Mean annual OOP healthcare expenditures were $118 USD in people with probable depression, compared to $110 USD in people without. With each unit increase in PHQ-9 score, there was a 14% increase in total healthcare visits (95% CI 7%-22%, p<0.0001) and $9 USD increase in OOP expenditures (95% CI $2-$17; p<0.0001). People with depression sought most general healthcare from pharmacists (30.1%) but reported the greatest expenditure on specialist doctors ($36 USD). Conclusions: In this population-based sample from Central Nepal, we identified dose-dependent increases in healthcare utilization and OOP expenditure with increasing PHQ-9 scores. Strengthening UHC to include early detection and treatment for people affected by depression as an integrated component of general healthcare should lead to a reduction in financial pressures on families, which is likely to reduce the incidence of depression in Nepal.

scholarly journals Healthcare Utilization and Out-of-Pocket Expenditures Associated with Depression in Adults: A Cross-Sectional Analysis in Nepal

2019 ◽  
Author(s):  
Selina Rajan ◽  
Sujit D Rathod ◽  
Nagendra P Luitel ◽  
Adrianna Murphy ◽  
Tessa Roberts ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Low Income ◽  
Negative Binomial ◽  
Mental Healthcare ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Universal Healthcare ◽  
Probable Depression

Abstract Background: Despite attempts to improve universal healthcare coverage (UHC) in low income countries like Nepal, most healthcare utilization is still financed by out-of-pocket (OOP) payments, with detrimental effects on the poorest and most in need. Evidence from high income countries shows that depression is associated with increased healthcare utilization, which may lead to increased OOP expenditures, placing greater stress on families. To inform policies for integrating mental healthcare into UHC in LMIC, we must understand healthcare utilization and OOP expenditure patterns in people with depression. Aims: We examined associations between symptoms of depression and frequency and type of healthcare utilization and OOP expenditure among adults in Chitwan District, Nepal. Methods: We analysed data from a population-based survey of 2040 adults in 2013, who completed the PHQ-9 screening tool for depression and answered questions about healthcare utilization. We modelled associations between increasing PHQ-9 score and healthcare utilization frequency and OOP expenditure using negative binomial regression. We also compared sector-specific utilization of outpatient healthcare and their related costs among adults with and without probable depression, determined by a PHQ-9 score of 10 or more. Results: We classified 80 (3.6%) participants with probable depression, 70.9% of whom used some form of healthcare in the past year compared to 43.9% of people without probable depression. Mean annual OOP healthcare expenditures were $118 USD in people with probable depression, compared to $110 USD in people without. With each unit increase in PHQ-9 score, there was a 14% increase in total healthcare visits (95% CI 7%-22%, p<0.0001) and $9 USD increase in OOP expenditures (95% CI $2-$17; p<0.0001). People with depression sought most healthcare from pharmacists (30.1%) but reported the greatest expenditure on specialist doctors ($36 USD). Conclusions: In this population-based sample from Central Nepal, we identified dose-dependent increases in healthcare utilization and OOP expenditure with increasing PHQ-9 scores. Strengthening UHC to include early detection and treatment for people affected by depression as an integrated component of healthcare should lead to a reduction in financial pressures on families, which is likely to reduce the incidence of depression in Nepal.

scholarly journals Contextual and individual determinants of tooth loss in adults: a population-based multilevel study

2020 ◽  
Author(s):  
Luana Leal Roberto ◽  
Marise Fagundes Silveira ◽  
Alfredo Mauricio Batista De Paula ◽  
Efigênia Ferreira Ferreira ◽  
Andréa Maria Eleutério De Barros Lima Martins ◽  
...  
Keyword(s):  
Oral Health ◽  
Tooth Loss ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Cross Sectional Study ◽  
Social Characteristics ◽  
Dental Services ◽  
Cross Sectional ◽  
Individual Level

Abstract Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. Methods: This was a multilevel cross-sectional study with data from 9,564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

scholarly journals Contextual and individual determinants of tooth loss in adults: a population-based multilevel study

2020 ◽  
Author(s):  
Luana Leal Roberto ◽  
Marise Fagundes Silveira ◽  
Alfredo Mauricio Batista De Paula ◽  
Efigênia Ferreira Ferreira ◽  
Andréa Maria Eleutério De Barros Lima Martins ◽  
...  
Keyword(s):  
Oral Health ◽  
Tooth Loss ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Cross Sectional Study ◽  
Social Characteristics ◽  
Dental Services ◽  
Cross Sectional ◽  
Individual Level

Abstract Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. Methods: This was a multilevel cross-sectional study with data from 9,564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

scholarly journals Assessment of alcohol use disorder and its associated factors among alcohol users of medical and surgical outpatients attending a specialized hospital in Gondar, Ethiopia: a cross-sectional study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Demeke Demilew ◽  
Berhanu Boru ◽  
Getachew Tesfaw ◽  
Habtamu Kerebih ◽  
Endalamaw Salelew
Keyword(s):  
Alcohol Use ◽  
Associated Factors ◽  
Alcohol Use Disorder ◽  
Alcohol Use Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
History Of ◽  
Male Sex

Abstract Background Alcohol use disorder increase the risk of physical harm, mental or social consequences for patients and others in the community. Studies on alcohol use disorder and associated factors among medical and surgical outpatients in Ethiopia are limited. Therefore, this study is meant to provide essential data on alcohol use disorder and associated factors among alcohol user medical and surgical outpatients to intervene in the future. Methods An institution-based cross-sectional study was conducted by using the systematic random sampling technique. Alcohol use disorders were assessed using the World Health Organization’s 10-item Alcohol Use Disorder Identification Test (AUDIT) questionnaire. Bivariate and multivariate logistic regression analyses were performed, a P-value less than 0.05 were considered statistically significant in the multivariate analysis and the strength of association was measured at a 95% confidence interval. Results The prevalence of alcohol use disorder was 34.5% with a 95% CI (29.20, 39.80) among study participants. In the multivariate logistic regression analysis, male sex (AOR = 3.33, 95%CI: 1.40, 7.93), history of mental illness (AOR = 2.68, 95%CI: 1.12, 6.38), drinking for relaxation (AOR = 1.88, 95%CI: 1.02, 3.48) and history of lifetime tobacco use (AOR = 5.64, 95%CI: 1.95, 16.29) were factors significantly associated with alcohol use disorder. Conclusion The prevalence of alcohol use disorders among medical and surgical outpatients was found to be high. Male sex, history of mental illness, alcohol use for relaxation and lifetime cigarette smoking need more attention during the assessment of patients in the medical and surgical outpatient departments.

scholarly journals A Cross-Sectional Comparison of Drinking Patterns, Alcohol Use and Related Medical Morbidities in a Secondary Versus Tertiary Setting

2015 ◽  
Vol 11 (2) ◽  
pp. 152-157
Author(s):  
A Risal ◽  
H Tharoor
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Tertiary Care ◽  
Alcohol Use Disorders ◽  
Care Utilization ◽  
Drinking Patterns ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Patterns Of Drinking ◽  
Level Hospital

Background Alcohol Dependence exists in different spectrums at different settings and associated with various medical morbidities, disability and health care utilization costs. Objectives To study the drinking patterns, alcohol use disorders and alcohol related medical morbidities in patients diagnosed with Alcohol Dependence Syndrome (ADS) and attending out / in-patient psychiatry services at secondary and tertiary care centre. Methods A cross-sectional comparative study was done among the patients diagnosed with ADS attending psychiatry services at District hospital, Udupi and Kasturba Hospital, Manipal. Serial sampling was done. Patients having any other psychiatric illnesses were excluded. The two groups were compared in relation to socio-demographic variables, drinking related variables, patterns of drinking and alcohol related medical morbidities identified. Results Significant differences in some socio-demographic parameters among the patients from the two different treatment centers were found with secondary level hospital (N=50) having more illiterate, laborers and below the poverty line population in comparison to the tertiary level hospital (N=75). Maximum frequency of gastro-intestinal morbidities was seen in both the hospital population, irrespective of the patterns of drinking. Conclusion Alcohol use disorders and alcohol related medical morbidities show some variations in their presentations in the different treatment centers. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12492 Kathmandu University Medical Journal Vol.11(2) 2013: 152-157

scholarly journals A Comparison of Disability Weights for Alcohol Use Disorders

2020 ◽  
Author(s):  
Jiraluck Nontarak ◽  
Sawitri Assanangkornchai ◽  
Sarah Callinan
Keyword(s):  
Alcohol Use ◽  
Family Income ◽  
Alcohol Use Disorders ◽  
Disability Weight ◽  
Control Group ◽  
Health States ◽  
Cross Sectional ◽  
Face To Face ◽  
Valuation Methods ◽  
Disability Weights

Objective: This study aims to determine and compare the disability weights of alcohol use disorders (AUD) based on responses from AUD patients and a non-patient population using three valuation methods. Material and Methods: Cross-sectional data were collected from three hospitals in southern Thailand. Two groups of participants were recruited: 150 patients diagnosed with AUD and a control group containing 150 persons without AUD. Both groups were asked to rate the AUD health states using a visual analogue scale (VAS), and again using either the European Quality of Life-5 Dimension (EQ-5D) instrument or the time trade-off (TTO) technique. Data were collected via face-to-face interviews. Results: The mean disability weights, based on the VAS, TTO and EQ-5D valuation methods obtained from AUD patients were: 0.485, 0.405, and 0.311, respectively, while those obtained from the control group were: 0.541, 0.330, and 0.237, respectively. Disability weights had a positive correlation with AUD severity levels. Employment status and family income were significantly associated with VAS disability weight among the control group. Conclusion: The use of three different instruments to calculate disability weights for people with AUD is feasible in Thailand. The disability weights differ depending on the valuation methods used and respondent groups.

Sign in / Sign up

Export Citation Format

Share Document