scholarly journals 1091Evaluation of symptom screening methods for tuberculosis: secondary analysis of Mongolian nationwide tuberculosis prevalence survey

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yasunori Ichimura ◽  
Bayasgalan Purev ◽  
Tsolmon Boldoo ◽  
Naranzul Dambaa ◽  
Tugsdelger Sovd

Abstract Background Symptom screening for tuberculosis (TB) is a key component for identifying TB suspects and TB cases, particularly in resource-limited countries. This study aimed to evaluate the effectiveness of symptom screening using TB-related symptoms including the standard symptom screening criterion of chronic cough: cough for two weeks or more, to identify TB cases in the general population. Methods This study is a secondary analysis of the nationwide population-based, cross-sectional survey for TB prevalence in Mongolia in 2014-2015. Each TB-related symptom was compared between bacteriologically confirmed TB cases and bacteriologically negative participants. Results Of the 50,309 adults who received symptom screening, 248 were diagnosed as bacteriologically confirmed TB cases. The sensitivity and specificity of standard symptom screening of cough for two weeks or more were 20.6% and 95.3%, respectively. The higher sensitivity and lower specificity were reported in chronic sputum: sputum for two weeks or more (22.2% and 93.6%, respectively), in prolonged fever: fever for four days or more (21.4% and 95.0%, respectively), in weight loss (36.3% and 89.3%, respectively), in combination with standard symptom screening. TB cases had more chronic cough (OR 2.78, 95% CI: 1.83-4.22), chronic sputum (OR 1.67, 95% CI: 1.06-2.65), prolonged fever (OR 3.46, 95% CI: 1.90-6.28) and “weight loss” (OR 3.73, 95% CI: 2.77-5.02). Conclusions The addition of TB-related symptoms, namely, chronic sputum, fever and weight loss to the standard symptom screening criterion, may facilitate the detection of more TB cases efficiently. Key messages The utility of TB-related symptom screening may improve detection of TB cases.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Bin Jiang ◽  
Hongmei Liu ◽  
Dongling Sun ◽  
Haixin Sun ◽  
Xiaojuan Ru ◽  
...  

Abstract Background and purpose Epidemiological data on primary brain tumours (PBTs) are lacking due to the difficulty in case ascertainment among the population. Thus, we aimed to estimate mortality due to PBTs in China nationwide and the detection rate in people with suspected symptoms. Methods A multistage, complex sampling survey regarding mortality due to PBTs in Chinese individuals was carried out by reviewing all causes of death within a year. The detection rates in people with suspected symptoms were estimated based on PBT symptom screening and neurologist reviews and compared between groups by logistic regression analysis. Results Weighted mortality due to PBT was 1.6 (0.8–3.3) per 100,000 population in Chinese individuals, 1.8 (0.7–4.6) per 100,000 population in men, and 1.5 (0.5–4.5) per 100,000 population in women. Among 14,990 people with suspected symptoms, the PBT detection rate was 306.9 (95% CI 224.7–409.3) per 100,000 population in the total population, 233.0 (95% CI 135.7–373.1) per 100,000 population in men, and 376.9 (95% CI 252.4–546.3) per 100,000 population in women. People with an unsteady gait (OR 2.46; 95% CI 1.09–5.51; P=0.029), visual anomalies (3.84; 1.88–7.85; P<0.001), and headache (2.06; 1.10–3.86; P=0.023) were more likely to have a brain tumour than those without corresponding symptoms, while people with dizziness/vertigo were less likely to have a brain tumour than those without corresponding symptoms (0.45; 0.23–0.87; P=0.017). Conclusions Mortality due to PBT in China was low, with a nationwide estimate of 21,215 (10,427–43,165) deaths attributable to PBTs annually. However, the detection rate of PBTs can be greatly improved based on symptom screening in the population.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047757
Author(s):  
Heba AlSawahli ◽  
Caleb D Mpyet ◽  
Gamal Ezzelarab ◽  
Ibrahim Hassanin ◽  
Mohammad Shalaby ◽  
...  

ObjectivesTo determine the prevalence of diabetes mellitus (DM), prevalence of diabetic retinopathy (DR) and sight-threatening conditions among persons with DM aged 50 years and older in Sohag governorate in Upper Egypt.DesignPopulation-based, cross-sectional survey using the standardised Rapid Assessment of Avoidable Blindness with the addition of the Diabetic Retinopathy module methodology.SettingsSohag governorate in Egypt where 68 clusters were selected using probability proportional to population size. Households were selected using the compact segment technique.Participants4078 people aged 50 years and older in 68 clusters were enrolled, of which 4033 participants had their random blood sugar checked and 843 examined for features of DR.Primary and secondary outcomesThe prevalence of DM and DR; secondary outcome was the coverage with diabetic eye care.ResultsThe prevalence of DM was 20.9% (95% CI 19.3% to 22.5%). The prevalence in females (23.8%; 95% CI 21.4% to 26.3%) was significantly higher than in males (18.9%; 95% CI 17.1% to 20.7%) (p=0.0001). Only 38.8% of persons diagnosed with diabetes had good control of DM. The prevalence of DR in the sample was 17.9% (95% CI 14.7% to 21.1%). The prevalence in females was higher (18.9%; 95% CI 14.0% to 23.8%) than in males (17.1%; 95% CI 13.0% to 21.2%). Up to 85.3% of study participants have never had eye examination. Sight-threatening DR (R4 and/or M2) was detected in 5.2% (95% CI 3.4% to 7.0%) with only 2.3% having had laser treatment.ConclusionThe prevalence of uncontrolled DM in Sohag governorate in Egypt is higher than the national prevalence. There is a high prevalence of sight-threatening retinopathy and/or maculopathy with few people having access to diabetic eye care. A public health approach is needed for health promotion, early detection and management of DR.


2020 ◽  
Vol 35 ◽  
pp. 101086
Author(s):  
Amal Akour ◽  
Violet Kasabri ◽  
Nailya Bulatova ◽  
Suha Al Muhaissen ◽  
Ruba Al Tarawneh ◽  
...  

Author(s):  
Siobhan M. Hartigan ◽  
Kemberlee Bonnet ◽  
Leah Chisholm ◽  
Casey Kowalik ◽  
Roger R. Dmochowski ◽  
...  

There are a variety of factors and influences, both internal and external, that may impact an individual’s public toileting experience and may ultimately have repercussions for bladder health. This study sought to identify predominant constructs underlying a women’s attitude towards using restrooms at work, at school, and in public in order to develop a conceptual model incorporating these themes. We performed a secondary analysis of a cross-sectional, survey-based study that included open-ended questions about limitations to restroom use using a mixed-methods approach. Qualitative data coding and analysis was performed on 12,583 quotes and, using an iterative inductive-deductive approach, was used to construct the conceptual framework. Our conceptual framework reveals a complicated interplay of personal contexts, situational influences, and behavioral strategies used by women to manage their bladder and bowel habits away from home. These findings can inform future research and public policy related to bladder health awareness related to toilet access in the workplace and in public.


2020 ◽  
Vol 26 (5) ◽  
pp. 417
Author(s):  
Brett Vaughan ◽  
Michael Fleischmann ◽  
Kylie Fitzgerald ◽  
Sandra Grace ◽  
Paul Orrock ◽  
...  

The study aimed to compare the characteristics of Australian osteopaths who definitely agree that prescribing scheduled medicines is part of their future scope of practice with those who do not. A secondary analysis of a cross-sectional survey of osteopaths from an Australian practice-based research network was undertaken. Demographic, practice and treatment characteristics were identified using inferential statistics and backward linear regression modelling. Over one-quarter (n=257, 25.9%) of the total participants (n=992) indicated that they ‘definitely’ agree that osteopaths should seek prescription rights. Adjusted odds ratios (OR) suggested these osteopaths were more likely to engage in medication discussions with patients (OR 1.88), frequently manage migraines (OR 1.68) and seek increased practice rights for referrals to medical specialists (OR 2.61) and diagnostic imaging (OR 2.79). Prescribing as part of the future scope of practice for Australian osteopaths is associated with patient management (medication discussions) and practice characteristics (increased referral rights for specialists and diagnostic imaging) that warrant additional investigation. Understanding of the practice, clinical and patient management characteristics of Australian osteopaths who see prescribing as part of the future scope of practice informs the case for regulatory and health policy changes for prescribing scheduled medicines.


2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Martha Ali Abdulai ◽  
Frank Baiden ◽  
Samuel Afari-Asiedu ◽  
Lawrence Gyabaa-Febir ◽  
Kwame Kesse Adjei ◽  
...  

Sexually transmitted infection (STI) affects the reproductive health of both men and women worldwide. Condoms are important part of the available preventive strategies for STI control. The lack of proper risk-perception continues to impede women’s ability to negotiate condom use with their partners. This paper is the outcome of secondary analysis of data collected in a cross-sectional survey that explored the perception of risk of STI and its influence on condom use among 504 pregnant women attending antenatal clinic at two health facilities in the Kintampo North Municipality. Consecutively, three Focus Group Discussions were conducted among 22 pregnant women which was analyzed using thematic analysis technique. Multivariate logistic regression analysis was used to identify possible predictors of condom use and risk of STI. Respondents mean age was 26.0±5.9 years. 47% of respondents self-identified themselves as high risk for contracting STI, 50% of whom were married. High risk status (OR = 2.1, 95% CI: 1.1–4.4), ability to ask for condoms during sex (OR = 0.3, 95% CI: 0.1–0.73), and partner’s approval of condom use (OR = 0.2, 95% CI: 0.01–0.05) were independent predictors of condom use. Condom use (OR 2.9 (1.5–5.7); p=0.001) and marital status (engaged, OR 2.6 (1.5–4.5); p=0.001) were independent predictors of risk of STI. Women who self-identified themselves as high risk for STI successfully negotiated condom use with their partners. This is however influenced by partner’s approval and ability to convince partner to use condoms. Self-assessment of STI risk by women and the cooperation of male partners remain critical.


2021 ◽  
Vol 25 (1) ◽  
pp. 16-22
Author(s):  
Z. Akhter ◽  
S. Razzaq ◽  
U. Rabbani ◽  
M. Irfan ◽  
P. Burney ◽  
...  

OBJECTIVE: To determine prevalence of and risk factors for respiratory symptoms in an adult urban Pakistani population.METHODS: We conducted a multi-stage, community-based, cross-sectional survey from May 2014 to August 2015, comprising 1629 adults from 75 random clusters in Karachi using questionnaire-based interviews.RESULTS: Around 60% of participants were females and 43% belonged to the >37 years age group. At least one respiratory symptom was reported by 37.5% of participants. Breathlessness was the most common symptom (25.2%, 95%CI 23.1–27.3), followed by acute wheeze (10.1%, 95%CI 8.7–11.7). Multivariable models revealed that males and those aged >37 years were more likely to report acute and chronic phlegm and bronchitis, and breathlessness. Participants with a higher level of education were less likely to report acute and chronic cough. Participants with >5 years pack-years of smoking were more likely to report acute and chronic cough and breathlessness. Other risk factors included passive smoking, regular use of air conditioning and mosquito coils, wet spots and mould in the house, and exposure to dusty jobs.CONCLUSION: We found breathlessness to be the most prevalent respiratory symptom and identified various risk factors for respiratory symptoms.


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