The burden and determinants of self-reported acute gastrointestinal illness in an Indigenous Batwa Pygmy population in southwestern Uganda

2014 ◽  
Vol 143 (11) ◽  
pp. 2287-2298 ◽  
Author(s):  
S. CLARK ◽  
L. BERRANG-FORD ◽  
S. LWASA ◽  
D. B. NAMANYA ◽  
V. L. EDGE ◽  
...  

SUMMARYAcute gastrointestinal illness (AGI) is an important public health priority worldwide. Few studies have captured the burden of AGI in developing countries, and even fewer have focused on Indigenous populations. This study aimed to estimate the incidence and determinants of AGI within a Batwa Pygmy Indigenous population in southwestern Uganda. A retrospective cross-sectional survey was conducted in January 2013 via a census of 10 Batwa communities (n= 583 participants). The AGI case definition included any self-reported symptoms of diarrhoea or vomiting in the past 2 weeks. The 14-day prevalence of AGI was 6·17% [95% confidence interval (CI) 4·2–8·1], corresponding to an annual incidence rate of 1·66 (95% CI 1·1–2·2) episodes of AGI per person-year. AGI prevalence was greatest in children aged <3 years (11·3%). A multivariable mixed-effects logistic regression model controlling for clustering at the community level indicated that exposure to goats [odds ratio (OR) 2·6, 95% CI 1·0–6·8], being a child aged <3 years (OR 4·8, 95% CI 1·2–18·9), and being a child, adolescent or senior Batwa in the higher median of wealth (OR 7·0, 95% CI 3·9–9·2) were significantly associated with having AGI. This research represents the first Indigenous community-census level study of AGI in Uganda, and highlights the substantial burden of AGI within this population.

2015 ◽  
Vol 143 (14) ◽  
pp. 3048-3063 ◽  
Author(s):  
S. L. HARPER ◽  
V. L. EDGE ◽  
J. FORD ◽  
M. K. THOMAS ◽  
D. L. PEARL ◽  
...  

SummaryFood- and waterborne disease is thought to be high in some Canadian Indigenous communities; however, the burden of acute gastrointestinal illness (AGI) is not well understood due to limited availability and quality of surveillance data. This study estimated the burden of community-level self-reported AGI in the Inuit communities of Rigolet, Nunatsiavut, and Iqaluit, Nunavut, Canada. Cross-sectional retrospective surveys captured information on AGI and potential environmental risk factors. Multivariable logistic regression models identified potential AGI risk factors. The annual incidence of AGI ranged from 2·9–3·9 cases/person per year in Rigolet and Iqaluit. In Rigolet, increased spending on obtaining country foods, a homeless person in the house, not visiting a cabin recently, exposure to puppies, and alternative sources of drinking water were associated with increased odds of AGI. In Iqaluit, eating country fish often, exposure to cats, employment status of the person responsible for food preparation, not washing the countertop with soap after preparing meat, a homeless person in the house, and overcrowding were associated with increased odds of AGI. The results highlight the need for systematic data collection to better understand and support previously anecdotal indications of high AGI incidence, as well as insights into unique AGI environmental risk factors in Indigenous populations.


2011 ◽  
Vol 140 (2) ◽  
pp. 290-298 ◽  
Author(s):  
L. MÜLLER ◽  
H. KORSGAARD ◽  
S. ETHELBERG

SUMMARYA cross-sectional telephone survey was conducted in Denmark throughout 2009 to determine the incidence of acute gastrointestinal illness (AGI). Using the Danish population register, a random population sample stratified by gender and age groups was selected and mobile or landline phone numbers found. Representative numbers of interviews were performed by gender, age group and month. A recently proposed international case definition of AGI, including cases with diarrhoea and/or vomiting in a 4-week recall period, was used. A total of 1853 individuals were included and 206 (11·1%) fulfilled the case definition; 78% reported diarrhoea. This corresponds to an overall standardized incidence rate of 1·4 (95% CI 1·2–1·6) episodes of AGI per person-year. The incidence rate was generally higher in the younger age groups; only being 2·3, 1·9 and 0·80 per person-year in the 0–9, 10–39 and ⩾40 years age groups, respectively. The incidence rate estimates were considerably higher when calculated from shorter recall periods.


Author(s):  
Yoshito Nishimura ◽  
Tomoko Miyoshi ◽  
Hideharu Hagiya ◽  
Yoshinori Kosaki ◽  
Fumio Otsuka

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
Rie Suzuki ◽  
Jennifer Blackwood ◽  
Shailee Shah ◽  
Sabah Ganai ◽  
Kimberly Warden

Abstract The built environment is commonly cited as a facilitator to local walking. Although health promotion programs targeting physical activity are available, few studies have investigated the associations of the perceived neighborhoods with the incidence of falls in the minority communities. Hence, the purpose of this preliminary study was to understand whether the perceived built environment influenced the fall experiences in older adults living in the underserved community. The preliminary cross-sectional survey was conducted at the regional health clinic in Flint, MI. Descriptive statistics and analysis of variance (ANOVA) were performed using SAS v8.4. The eligibility criteria included over 65 years old and Flint residents. Of 132 participants, the mean age was 69.75 (SD=5.00). The majority were female (68%), African Americans (80%), single, divorced or widowed (80%), and &gt; GED (84%). The ANOVAs supported that “had fallen in the past year” was associated with “stores are within easy walking distance,” “easy to walk to a transit stop” and “there is a dirt strip that separates the streets from the sidewalks.” The fall experience was more likely to associate with the sedentary lifestyle and the comorbidities such as diabetes, fatigues, muscle spasms, and chronic pain. To summarize, the built environment increased the incidence of falls in the past year. Those who had fallen had poor health conditions. Further studies are needed for older adults to engage in physical activity. It is essential to develop the age-friendly support systems and accommodations to local walking in this community.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Tidenek Mulugeta Tujo ◽  
Tadesse Gudeta Gurmu

Background. The increased morbidity and mortality rates in children under five in developing countries are mostly attributed to poor availability and failure of prescribing lifesaving medicines. This study was aimed at evaluating the availability and utilization of the WHO-recommended priority lifesaving medicines for children under five in public health facilities. Method. A cross-sectional survey complemented with a qualitative method was conducted in 14 health centers and four hospitals in the Jimma Zone, Ethiopia. In the facilities, we assessed the availability within the last half year and on the day of the visit. Utilization of the medicines was assessed through a review of patient records of the last one year. Twelve in-depth interviews were carried out to collect the qualitative data, and the analysis was executed using thematic analysis. Results. For treatment of pneumonia, amoxicillin dispersible tablets and gentamycin injection were available in 94.4% of the facilities. For treatment of malaria, artemether/lumefantrine was available in 61.1% of the facilities. For pain management, paracetamol tablets were available in 94.4% of the facilities. AZT+3TC+NEV for HIV/AIDS management was available in all facilities. At least one essential medicine was out of stock in the past six months with the average duration of 33.6 days in health centers and 28.25 days in hospitals. Oral rehydration salt and zinc (84.7%) and AZT+3TC+NEV (100%) had better utilization. However, for almost all cases, other nonpriority medicines were highly prescribed. Lack of administrative commitment, supply of near expiry products, complexity of diseases, and lack of customized child formulations were among the challenges of availability and utilization of those medicines. Conclusions. The overall availability of lifesaving medicines on the day of the visit was fairly good but with poor utilization in almost all facilities. Some products were not available for considerable length of time in the past six months.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039792
Author(s):  
Anna Gottschlich ◽  
Sophia Mus ◽  
Jose Carlos Monzon ◽  
James F Thrasher ◽  
Joaquin Barnoya

ObjectivesHeated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.Design, setting and participantsA cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.Primary and secondary outcome measuresThe primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.ResultsOf all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).ConclusionsAmong this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).


Author(s):  
Brett Snider ◽  
Edward McBean

Over the last two decades, a variety of reports have suggested that watermains in Canada are deteriorating, and break rates are increasing. However, these reports are often limited as the years of break records being utilized are brief; this paper revisits those assessments using over forty-five years of break records and shows that three of the five utilities investigated are experiencing significant decreases in break rates over the past 10 years while the two other utilities are maintaining consistent break rates. These results indicate that these utilities are effectively managing their watermain infrastructure, and suggest watermain infrastructure throughout Canada may be performing better than suggested by cross-sectional survey results. Analyses indicate that on average, 22% of the watermains analysed have exceeded the 0.125 brk/km/yr break rate threshold and may be considered for pipe replacement / rehabilitation. In particular 50% of cast iron pipes installed post-WWII have exceeded a break rate threshold of 0.125 brks/km/yr, suggesting large pipe replacement/rehabilitation of this pipe cohort is required.


Author(s):  
Jiayao Xu ◽  
Xiaomin Wang ◽  
Kai Sing Sun ◽  
Leesa Lin ◽  
Xudong Zhou

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.


Sexual Health ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 139 ◽  
Author(s):  
Wendy Heywood ◽  
Anthony Lyons ◽  
Bianca Fileborn ◽  
Victor Minichiello ◽  
Catherine Barrett ◽  
...  

Background: Rates of sexually transmissible infections (STIs) are increasing among older adults in many countries. Little is known about the testing and treatment histories of these populations. Correlates of testing in the past 5 years among older adults who may be at risk of a STI were examined. Methods: A cross-sectional survey of 2137 Australians aged 60+ years that involved questions on STIs and STI testing was conducted in 2015. To help inform potential education campaigns, analyses focused on those who may have been at risk of a STI (n = 805, 38%). Results: Less than one in three reported a STI test in the past 5 years (n = 241, 30%) while 6% (n = 51) reported a STI diagnosis. Those diagnosed typically received treatment from a family doctor or general practitioner. Among men, lower testing rates were associated with older age, identifying as heterosexual, lower educational attainment, not using online dating and reporting one partner in the past 5 years. For women, lower rates of testing were found among those who did not use a condom at their most recent sexual encounter and those with one partner in the past 5 years. Conclusions: STI testing rates were low. This study indicates that consideration should be given to the way targeted education campaigns are formulated, such as emphasising the importance of STI testing to older people who are at risk, as well as encouraging healthcare professionals to discuss sexual health with their older patients.


2017 ◽  
Vol 32 (5) ◽  
pp. 1228-1233 ◽  
Author(s):  
Olivier Drouin ◽  
Robert C. McMillen ◽  
Jonathan D. Klein ◽  
Jonathan P. Winickoff

Purpose: To report on adults’ recall of discussion by physicians and dentists about e-cigarettes. Design: A nationally representative cross-sectional survey (Internet and random digit dialing) in the United States. Participants: Adults who ever used e-cigarettes. Measures: Participant-reported discussion about the potential benefits and harms of e-cigarettes with their doctor, dentist, or child’s doctor in the past 12 months. Analysis: Fisher exact test for the analysis between benefits and harms for each type of provider and for rates of advice between provider types. Results: Among the 3030 adults who completed the survey, 523 (17.2%) had ever used e-cigarettes. Of those who had seen their doctor, dentist, or child’s doctor in the last year, 7.3%, 1.7%, and 10.1%, respectively, reported discussing potential harms of e-cigarettes. Conversely, 5.8%, 1.7%, and 9.3% of patients who had seen their doctor, dentist, or child’s doctor in the last year reported that the clinician discussed the potential benefits of e-cigarettes. Each clinician type was as likely to discuss harms as benefits. Rates of advice were similar between doctors and child’s doctors but lower for dentists. Rates were comparable when the analysis was limited to current e-cigarette users, participants with children, or those who reported using both e-cigarettes and combusted tobacco. Conclusions: Few physicians and dentists discuss either the harms or benefits of e-cigarettes with their patients. These data suggest an opportunity to educate, train, and provide resources for physicians and dentists about e-cigarettes and their use.


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