Temporal trends in ambulatory antibiotic prescription rates in South Carolina: Impact of age, gender, and resident location

AbstractObjective:To examine the temporal trends in ambulatory antibiotic prescription fill rates and to determine the influences of age, gender, and location.Design:Population-based cohort study.Setting:Ambulatory setting in South Carolina.Patients:Patients ≤64 years of age from January 2012 to December 2017.Methods:Aggregated pharmacy claims data for oral antibiotic prescriptions were utilized to estimate community antibiotic prescription rates. Poisson regression or Student t tests were used to examine overall temporal trend in antibiotic prescription rates, seasonal variation, and the trends across age group, gender, and rural versus urban location.Results:Overall antibiotic prescription rates decrease from 1,127 to 897 per 1,000 person years (P < .001). The decrease was more noticeable in persons aged <18 years (26%) and 18–39 years (20%) than in those aged 40–64 years (5%; P < .001 for all). Prescription rates were higher among females than males in all age groups, although this finding was the most pronounced in group aged 18–39 years (1,232 vs 585 per 1,000 person years; P < .0001). Annualized antibiotic prescription rates were higher during the winter months (December–March) than the rest of the year (1,145 vs 885 per 1,000 person years; P < .0001), and rates were higher in rural areas than in urban areas (1,032 vs 941 per 1,000 person years; P < .0001).Conclusions:The decline in ambulatory antibiotic prescription rates is encouraging. Ongoing ambulatory antibiotic stewardship efforts across South Carolina should focus on older adults, rural areas, and during the winter season when antibiotic prescriptions peak.

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975. Clostridium difficile Infection and Antibiotic Prescription Rates in the Community: Explaining the Gender Gap

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy209.091 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S39-S39 ◽

Cited By ~ 1

Author(s):

Mariam Younas ◽

Julie Royer ◽

Hana Rac ◽

Julie Ann Justo ◽

P Brandon Bookstaver ◽

...

Keyword(s):

South Carolina ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Antibiotic Prescription ◽

Age Groups ◽

Incidence Rates ◽

Age Group ◽

Significant Difference ◽

Prescription Rates ◽

Carolina Population

Abstract Background Previous studies have reported higher incidence rates of community-associated Clostridium difficile infection (CA-CDI) in women than in men. This cross-sectional population-based study examines whether this difference in CA-CDI rates across genders is driven by or independent of antibiotic use. Methods Medicaid and State Employee Health Plan pharmacy claims for outpatient oral antibiotics and associated medical claims were utilized for estimation of community antibiotic prescription rates in South Carolina population 18 to 64 years of age from January 1, 2015 to December 31, 2015. CA-CDI cases were identified from National Healthcare Safety Network (NHSN) and South Carolina Infectious Disease and Outbreak Network (SCION) through complete enumeration of South Carolina population of the same age and study period as above. Incidence rates of CA-CDI were reported in both men and women 18–39 and 40–64 years of age before and after adjustments for antibiotic prescription rates in the same gender and age group. The 95% confidence intervals (CI) were calculated to examine statistical difference in incidence rates across genders within the same age group. Results During the calendar year 2015, a total of 1,564 CA-CDI cases were identified in South Carolina residents 18–64 years of age. The incidence rate of CA-CDI per 100,000 person-years was higher in women than in men in age groups 18–39 years (37.3 [95% CI: 32.8–41.8] vs. 21.0 [95% CI: 17.6–24.4]) and 40–64 years (86.4 [95% CI: 80.1–92.8] vs. 56.6 [95% CI: 51.2–61.9]. Similarly, antibiotic prescription rates per 100 person-years were higher in women than men in the 2 respective age groups (118.8 [95% CI: 118.3–119.3] vs. 54.3 [95% CI: 53.9–54.8] and 130.4 [95% CI: 129.8–130.9] vs. 83.8 [95% CI: 83.3–84.4]. After adjustments for antibiotic prescriptions, there was no significant difference in the incidence rates of CA-CDI per 100,000 prescriptions between women and men 18–39 years of age (31.4 [95% CI: 27.6–35.2] vs. 38.6 [95% CI: 32.4–44.8] and 40–64 years old (66.3 [95% CI 61.5–71.2] vs. 67.5 [95% CI: 61.1–73.8]). Conclusion Higher crude incidence rates of CA-CDI in women are likely due to higher outpatient antibiotic prescription rates in women when compared with men. Disclosures P. B. Bookstaver, CutisPharma: Scientific Advisor, <$1,000. Melinta Therapeutics: Speaker’s Bureau, <$1,000.

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An Epidemiological, Diagnostic and Therapeutic Study of Giardia lamblia in Anbar Province – Iraq

International Journal of Drug Delivery Technology ◽

10.25258/ijddt.9.1.7 ◽

2019 ◽

Vol 9 (01) ◽

pp. 39-45

Author(s):

Suad Shallal Shahatha

Keyword(s):

Teaching Hospital ◽

Rural Areas ◽

Giardia Lamblia ◽

Urban Areas ◽

Culture Media ◽

Age Groups ◽

Stool Samples ◽

Women And Children ◽

Teucrium Polium L ◽

Therapeutic Study

This study was carried out to investigate the epidemiology of Giardia lamblia parasites in patients who visited some of the hospitals in Anbar province, which included (Fallujah Teaching Hospital, Ramadi Teaching Hospital, Ramadi Teaching Hospital for Women and Children and Hit Hospital) during by examining 864 stool samples in a direct examination method, The results revealed the infection rate was 41.7 % and the percentage of infection among males 47.8% is higher than that of females 35.4% with significant differences (p≤0.05). The age groups (1-9) years recorded the highest rates 55.4% and the lowest rate 13.6% in the age group (40-49) years. The highest rate of infection was 62.5% during the month of June, while the month of October was the lowest rate 5% and significant differences. The incidence rate in rural areas was 50.6% higher than in the urban areas 32.5%. The study also included the effect of Teucrium polium L. on the parasite in the culture media HSP-1, the concentrations of 0.5-3 mg / mL significantly affected Giardia, it was noted whenever the greater the concentration, the greater the effect during different treatment periods (1-4) days, as the highest concentration 3 mg/ml killed all Giardia parasites on the fourth day of treatment.

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Trends in prevalence of gestational diabetes mellitus in Zhejiang Province, China, 2016–2018

Nutrition & Metabolism ◽

10.1186/s12986-020-00539-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Meng Wang ◽

Ru-Ying Hu ◽

Wei-Wei Gong ◽

Jin Pan ◽

Fang-Rong Fei ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Rural Areas ◽

Urban Areas ◽

Age Groups ◽

Zhejiang Province ◽

Advanced Age ◽

Female Population ◽

Annual Prevalence

Abstract Background Limited population-based studies have investigated the secular trend of prevalence of gestational diabetes mellitus (GDM) in mainland China. Therefore, this study aimed to estimate the prevalence of GDM and time trends in Chinese female population. Methods Based on Diabetes Surveillance System of Zhejiang Province, 97,063 diagnosed GDM cases aged 20–50 years were identified from January 1, 2016 to December 31, 2018. Annual prevalence, prevalence rate ratios (PRRs) and average annual percentage change with their 95% confidence intervals (CIs) were reported. Results The age-standardized overall prevalence of GDM was reported to be 7.30% (95% CI 7.27–7.33%); 9.13% (95% CI 9.07–9.19%) in urban areas and 6.24% (95% CI 6.21–6.27%) in rural areas. Compared with 20–24 years age group, women in advanced age groups (25–50 years) were at higher risk for GDM (PRRs ranged from 1.37 to 8.95 and the 95% CIs did not include the null). Compared with rural areas, the risk for GDM was higher in urban areas (PRR: 1.69, 95% CI 1.67–1.72). The standardized annual prevalence increased from 6.02% in 2016 to 7.94% in 2018, with an average annual increase of 5.48%, and grew more rapidly in rural than urban areas (11.28% vs. 0.00%). Conclusions This study suggested a significant increase in the prevalence of GDM among Chinese female population in Zhejiang province during 2016–2018, especially in women characterized by advanced age and rural areas.

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How left behind are rural parents of migrant children? Evidence from Thailand

Ageing and Society ◽

10.1017/s0144686x09990699 ◽

2010 ◽

Vol 30 (5) ◽

pp. 811-841 ◽

Cited By ~ 39

Author(s):

JOHN KNODEL ◽

JIRAPORN KESPICHAYAWATTANA ◽

CHANPEN SAENGTIENCHAI ◽

SUVINEE WIWATWANICH

Keyword(s):

Adult Children ◽

Rural Areas ◽

Living Arrangements ◽

Urban Areas ◽

Extended Family ◽

Age Groups ◽

Social Contact ◽

Migrant Children ◽

Older Parents ◽

Economic Changes

ABSTRACTThe consequences of adult children's migration from rural areas for older parents who remain behind are keenly debated. While the mass media and international advocacy organisations favour an ‘alarmist’ view of desertion, the academic literature makes more sanguine assessments using the ‘household strategy’ and ‘modified extended family’ perspectives. We examine the relationship between the migration of adult children and various dimensions of older parents' wellbeing in Thailand using evidence from a survey that focused on the issues. The results provide little support for the alarmist view, but instead suggest that parents and adult children adapt to the social and economic changes associated with development in ways not necessarily detrimental to intergenerational relations. The migration of children, especially to urban areas, often benefits parents' material support while the recent spread of cell phones has radically increased their ability to maintain social contact. Nevertheless, changing living arrangements through increased migration and the smaller family sizes of the youngest age groups of older people pose serious challenges for aspects of filial support, especially at advanced ages when chronic illness and frailty require long-term personal care. Dealing with this emerging situation in a context of social, economic and technological change is among the most critical issues facing those concerned with the implications of rapid population ageing in Thailand and elsewhere.

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Diversity, status and habitat usage of avifauna at sadar upazila, magura, Bangladesh

Bangladesh Journal of Zoology ◽

10.3329/bjz.v48i2.52434 ◽

2021 ◽

Vol 48 (2) ◽

pp. 441-456

Author(s):

Ashikur Rahman Shome ◽

Md Mahabub Alam ◽

Md Fazle Rabbe ◽

Mohammad Mijanur Rahman ◽

Mohammad Firoj Jaman

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Winter Season ◽

Bird Species ◽

Diversity Indices ◽

Habitat Diversity ◽

Seasonal Abundance ◽

Line Transect ◽

Common Myna ◽

Rural And Urban

A study on diversity, status, and habitat preference of avifauna was conducted from November 2017 to October 2018 in Magura Sadar upazila, Magura. Data was collected through direct field observations using line-transect method. Field surveys were made for three days per month in both rural and urban sites. A total of 140 species of birds belonged to 18 orders and 48 families were reported. Among the total species, 55% (77 species) were non-passerines and 45% (63 species) passerines with the highest individuals were counted under order Passeriformes. Resident bird species were dominant (106 species, 75.71%) over migratory (34 species, 24.28%) species. Species richness was the highest in the rural areas (124 species, 88.57%) and occurrence was the highest in winter season (97 species, 69.29%). The maximum species were recorded from trees (87 species, 62.14%) as preferred habitat. In this study, in total 4,060 individuals of birds were counted and among them, 51.55% (n=2093) were observed in the rural areas and 48.45% (n=1967) were in the urban areas. The highest number of birds was found in December (10.34%, n=432) and seasonal abundance was the highest in winter (40.15%, n=1630). Abundance was the highest for Common Myna (5.76%, n=234) among all recorded species. Diversity indices showed that the bird species were the most diverse in the rural areas in the winter season and in July. Habitat diversity indices were the highest for trees and birds used different types of habitats at different times for roosting, breeding and feeding. Regarding the observation status, 29.28% species was very common, 4.28% common, 31.42% fairly common, and 35% were few. This baseline data indicate that this study site is significant from the ecological and conservation point of views. Therefore, further research is necessary to understand how this avian diversity is maintained in this ecological setting. Bangladesh J. Zool. 48(2): 441-456, 2020

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Is global dimming and brightening in Japan limited to urban areas?

10.5194/acp-2016-559 ◽

2016 ◽

Author(s):

Katsumasa Tanaka ◽

Atsumu Ohmura ◽

Doris Folini ◽

Martin Wild ◽

Nozomu Ohkawara

Keyword(s):

Solar Radiation ◽

Rural Areas ◽

Urban Areas ◽

Large Scale ◽

Temporal Trends ◽

Surface Radiation ◽

Surface Solar Radiation ◽

Decadal Time Scale ◽

Global Dimming ◽

Urban And Rural Areas

Abstract. Observations worldwide indicate secular trends of all-sky surface solar radiation on decadal time scale, termed global dimming and brightening. Accordingly, the observed surface radiation in Japan generally shows a strong decline till the end of the 1980s and then a recovery toward around 2000. Because a substantial number of measurement stations are located within or proximate to populated areas, one may speculate that the observed trends are strongly influenced by local air pollution and are thus not of large-scale significance. This hypothesis poses a serious question as to what regional extent the global dimming and brightening are significant: Are the global dimming and brightening truly global phenomena, or regional or even only local? Our study focused on 14 meteorological observatories that measured all-sky surface solar radiation, zenith transmittance, and maximum transmittance. On the basis of municipality population time series, historical land use maps, recent satellite images, and actual site visits, we concluded that eight stations had been significantly influenced by urbanization, with the remaining six stations being left pristine. Between the urban and rural areas, no marked differences were identified in the temporal trends of the aforementioned meteorological parameters. Our finding suggests that global dimming and brightening in Japan occurred on a large scale, independently of urbanization.

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Examining the Dietary Diversity of Children in Niger

Nutrients ◽

10.3390/nu13092961 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2961

Author(s):

Nafissatou Cisse Egbuonye ◽

Ariun Ishdorj ◽

E.L.J. McKyer ◽

Rahma Mkuu

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Dietary Diversity ◽

Descriptive Analysis ◽

Age Groups ◽

Wealth Index ◽

Cross Sectional Study ◽

Health Concern ◽

Cross Sectional ◽

Child Factors

Malnutrition is a major public health concern in Niger. The stunting rate in children in Niger is over 50%, one of the highest in the world. The purpose of this cross-sectional study was to examine children’s dietary diversity (CDD) and the maternal factors that impact CDD. A total of 1265 mother–child pairs were analyzed. Descriptive analysis was conducted to present maternal and child characteristics. To compare the mean scores of CDD in relation to the region, an independent sample t-test was conducted. A one-way ANOVA test was conducted to evaluate the CDD score by different age groups. A linear regression model was estimated to identify household, maternal and child factors that affect the CDD score. Our results indicate that most of the participants of our survey resided in rural areas and the majority (80.7%) of the mothers had no education. Factors such as region, children’s age, woman’s empowerment, vitamin A intake and wealth index were significant predictors of CDD (p < 0.05). The children residing in rural areas were more likely to have lower CDD scores (p < 0.05) than the children in urban areas, therefore becoming more susceptible to malnutrition.

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Pathogenicity and non-opportunistic character of Blastocystis spp.: a hospital-based survey in Central Cameroon

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10122 ◽

2018 ◽

Vol 12 (05) ◽

pp. 373-379 ◽

Cited By ~ 3

Author(s):

Stéphanie Jupsa-Mbiandou ◽

Samuel Fosso ◽

Edimo Billé ◽

Tito T Mélachio-Tanekou ◽

Gideon Ajeagah-Aghaindum ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Age Groups ◽

Clinical Signs ◽

Hiv Positive ◽

Cross Sectional ◽

Significant Difference ◽

Blastocystis Spp ◽

Stool Samples ◽

Hiv Negative

Introduction: Blastocystis spp. is a protist found in humans. Although usually the most frequent protozoa found in stool samples of both symptomatic and healthy subjects, its pathogenic or rather opportunistic role is yet to be clearly elucidated. To attempt to fill this gap, a cross-sectional study was conducted to compare the frequency of Blastocystis spp. in HIV positive (HIV+) versus HIV negative (HIV-) individuals in four health facilities of the Center Region of Cameroon. Methodology: Stool samples were collected from 283 HIV positive and 245 HIV negative subjects and analyzed using direct diagnostic tests. Results: A total of 46 (8.7%) individuals were found infected with Blastocystis spp., including 6.7% HIV positive and 11.0% HIV negative. This species was more frequent in urban and semi-urban areas than in rural areas, but evenly distributed among genders and age groups as well as among all sectors of activity. The prevalence of Blastocystis spp. (11.3%) was higher in HIV+ patients with a CD4 count ≥ 500 cells / mm3, but no significant difference was found among HIV clinical stages. Likewise prevalence, the mean number of cysts per gram of stool was similar between HIV positive and HIV negative individuals. People infected with Blastocystis spp. showed diverse clinical signs, but only flatulence was significantly more prevalent. The frequencies of these clinical signs were not related to HIV status. Conclusion: No clear relationship links the infection with Blastocystis spp. to HIV, although its presence was associated with digestive disorder, suggesting that this parasite might not be opportunist.

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Using RFLP-PCR Technique in Determining Genotypes of Giardia lamblia from Diarrhea Cases in Children in AL-Diwaniyah City, Iraq

International Journal of Medical Parasitology and Epidemiology Sciences ◽

10.34172/ijmpes.2020.10 ◽

2020 ◽

Vol 1 (2) ◽

pp. 29-34

Author(s):

Hadi M. Hamza AL-Mayali ◽

Lubna Abdul-Kadir AL-Ibrahim

Keyword(s):

Rural Areas ◽

Giardia Lamblia ◽

Urban Areas ◽

Age Groups ◽

Intestinal Protozoa ◽

Gender And Age ◽

Dehydrogenase Gene ◽

Urban And Rural Areas ◽

Child Hospital ◽

Genotype A

Introduction: Giardia lamblia is one of the most prevalent intestinal protozoa in the world, which affect children in both undeveloped and developing countries. This study aimed to determine genotypes of the Giardia lamblia using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP)-PCR techniques. Additionally, the relationship between genotype patterns and their geographical distribution, gender, and age was investigated. Methods: The current study included 926 samples of faeces of children suffering from diarrhoea, who visits the internal clinics at Teaching Hospital, and Child Hospital in AL- Diwaniyah City from November 2012 - Jun 2013. For age groups of 1-12 years exclusively. The samples were examined using a direct mount wet smear, The positive samples were preserved without adding preservatives at a temperature of -20°C until the DNA extraction for G. lamblia genotyping by using PCR and RFLP-PCR technique. Results: Giardia lamblia was detected in 2.15% (20/926) of samples from diarrhea cases in children by amplification of glutamate dehydrogenase gene (gdh) using two specific primers GDHiR and GDHiF. It was revealed that 7 samples belonged to genotype A (35%) and 13 samples belonged to genotype B (65%). All genotype A samples belonged to subgenotype AII (100%), while genotype B samples belonged to subgenotypes BIII (53.61 %) and BIV (47.38 %). Genotype A was detected in children of 1-6 years of age while B genotype was detected in all age groups. Both of the genotypes have been detected in both genders (male and female) and genotype B was found in both urban and rural areas; however, its prevalence was higher in rural areas than in urban areas (100% and 30%, respectively). Conclusion: There are two genotypes of Giardia lamblia, genotype A and genotype B, each of which has secondary genetic patterns which include AII, BIII, and BIV.

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Urban-Rural Differences in Nutritional Status and Dietary Intakes of School-Aged Children in Cambodia

Nutrients ◽

10.3390/nu11010014 ◽

2018 ◽

Vol 11 (1) ◽

pp. 14 ◽

Cited By ~ 5

Author(s):

Yoko Horiuchi ◽

Kaoru Kusama ◽

Sar Kanha ◽

Nobuo Yoshiike ◽

Keyword(s):

Nutritional Status ◽

Rural Areas ◽

Urban Areas ◽

Age Groups ◽

Overweight And Obesity ◽

Dietary Intakes ◽

Nutrition Survey ◽

Rural And Urban Areas ◽

School Aged Children ◽

Urban Rural

: This study aimed to describe the nutritional status and dietary patterns of Cambodian school-aged children compared with those in the South East Asian Nutrition Survey (SEANUTS; Indonesia, Malaysia, Thailand, and Vietnam in 2011) and to clarify the urban-rural differences using data from a nationally representative sample. The survey was conducted in 2014/2015 with a sample of 2020 children aged 6–17 years from 136 randomly selected schools. Standardized anthropometric measurements and a 1-day dietary survey by 24-hour recall method were conducted. Extended analyses in the present study revealed that the difference between rural and urban areas was similar to that of the SEANUTS; the overall prevalence of stunting remained high (33.2%). Stunting was more prevalent in children living in rural areas than in those in urban areas (total: 36.4% vs 20.4%). In contrast, the overall prevalence of overweight and obesity was not as high (3.1%), but was higher among urban children in all age groups compared with those living in rural areas (total: 6.4% vs 2.3%). Overall, the dietary intake of children did not meet the local recommended dietary allowances, which was similar to the results of the SEANUTS and differed across urban and rural areas.

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