1312Population-attributable fraction estimates for factors of different types of anaemia among women: multilevel multinomial analysis

Abstract Background Anaemia is one indicator of poor health in women and responsible for substantial mortality. Assessing the relative impact of predictors for anaemia among women could help to prioritize targeted preventions strategies. This study aimed to quantify the attributable burden of modifiable factors for different severity levels of anaemia among Ethiopian women. Methods Adjusted odds ratio and exposure prevalence for selected factors were used to calculate population attributable fractions using the 2016 Ethiopian Demographic and Health Surveys data. Adjusted odds ratios (AOR) with 95% confidence intervals (CIs) were computed using multilevel multinomial regression models. Results In Ethiopia, an estimated 14.6% (95% confidence interval, CI: 3.4, 24.5) of mild anaemia was attributable to no formal education, 11.2% (95%CI: 1.2, 19.9) to high gravidity (≥ 4) and 5.2% (95%CI: 0, 10.7) to currently breastfeeding. Similarly, proportion of moderate-severe anaemia attributable to rural residence was 38.1% (95%CI: 15.9, 54.8), poorest wealth quantile was 12.6% (95%CI: 2.9, 24.6), previous five years birth was 10.5% (95%CI: 2.9, 18.2), and unimproved latrine was 17% (95% CI: 0, 32.5). Conclusions The result suggests that low education, low wealth status, high parity, rural residency, pregnancy and breastfeeding contribute substantially to the occurrence of anaemia among women. Key messages Mild anaemia could be reduced by setting intervention strategies targeting women with low education, multigravida women, and breastfeeding women, while preventing moderate-to-severe anaemia may require increasing income, and improving living environments like hygienic latrines.

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Population attributable fraction estimates for factors associated with different types of anaemia among women in Ethiopia: multilevel multinomial analysis

Public Health Nutrition ◽

10.1017/s1368980020003109 ◽

2020 ◽

pp. 1-11

Author(s):

Kelemu Tilahun Kibret ◽

Catherine Chojenta ◽

Ellie D’Arcy ◽

Deborah Loxton

Keyword(s):

Breast Feeding ◽

Formal Education ◽

Population Attributable Fraction ◽

Severe Anaemia ◽

Attributable Fraction ◽

Reproductive Age ◽

Multinomial Regression ◽

Wealth Status ◽

Low Education ◽

Mild Anaemia

Abstract Objective: This study aimed to identify factors for different levels of anaemia among Ethiopian women and to estimate the population attributable fraction (PAF). Design: This study was a detailed analysis of data of the 2016 Ethiopian Demographic and Health Survey data. Adjusted OR (AOR) with 95 % CI was computed using multilevel multinomial regression models, and the PAF were estimated using these AOR. Setting: This study was conducted in Ethiopia. Participants: Women of reproductive age. Results: The PAF showed that the proportion of mild anaemia cases attributable to having no formal education was 14·6 % (95 % CI 3·4, 24·5), high gravidity (≥4) was 11·2 % (95 % CI 1·2, 19·9) and currently breast-feeding was 5·2 % (95 % CI 0·0, 10·7). Similarly, the proportion of moderate–severe anaemia cases attributable to being in a rural residence was 38·1 % (95 % CI 15·9, 54·8); poorest wealth quantile, 12·6 % (95 % CI 2·9, 24·6); giving birth in the last 5 years, 10·5 % (95 % CI 2·9, 18·2) and unimproved latrine facilities, 17 % (95 % CI 0, 32·5). Conclusions: The PAF suggest that rural residency, low education, low wealth status, high parity, pregnancy and breast-feeding contribute substantially to the occurrence of anaemia among women in Ethiopia. Mild anaemia could be reduced by setting intervention strategies targeting women with low education, multigravida women and breast-feeding women, while preventing moderate–severe anaemia may require increasing income and improving living environments through the accessibility of hygienic latrines.

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Stillbirth maternity care measurement and associated factors in population-based surveys: EN-INDEPTH study

Population Health Metrics ◽

10.1186/s12963-020-00240-1 ◽

2021 ◽

Vol 19 (S1) ◽

Author(s):

Lydia Di Stefano ◽

◽

Matteo Bottecchia ◽

Judith Yargawa ◽

Joseph Akuze ◽

...

Keyword(s):

Maternity Care ◽

Population Level ◽

Evidence Base ◽

Population Based ◽

Reproductive Age ◽

Demographic And Health Surveys ◽

Household Surveys ◽

Wealth Status ◽

Increased Risk ◽

Modifiable Factors

Abstract Background Household surveys remain important sources of maternal and child health data, but until now, standard surveys such as Demographic and Health Surveys (DHS) have not collected information on maternity care for women who have experienced a stillbirth. Thus, nationally representative data are lacking to inform programmes to address the millions of stillbirths which occur annually. Methods The EN-INDEPTH population-based survey of women of reproductive age was undertaken in five Health and Demographic Surveillance System sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda (2017–2018). All women answered a full birth history with additional questions on pregnancy losses (FBH+) or full pregnancy history (FPH). A sub-sample, including all women reporting a recent stillbirth or neonatal death, was asked additional maternity care questions. These were evaluated using descriptive measures. Associations between stillbirth and maternal socio-demographic characteristics, babies’ characteristics and maternity care use were assessed using a weighted logistic regression model for women in the FBH+ group. Results A total of 15,591 women reporting a birth since 1 January 2012 answered maternity care questions. Completeness was very high (> 99%), with similar proportions of responses for both live and stillbirths. Amongst the 14,991 births in the FBH+ group, poorer wealth status, higher parity, large perceived baby size-at-birth, preterm or post-term birth, birth in a government hospital compared to other locations and vaginal birth were associated with increased risk of stillbirth after adjusting for potential confounding factors. Regarding association with reported postnatal care, women with a stillbirth were more likely to report hospital stays of > 1 day. However, women with a stillbirth were less likely to report having received a postnatal check compared to those with a live birth. Conclusions Women who had experienced stillbirth were able to respond to questions about pregnancy and birth, and we found no reason to omit questions to these women in household surveys. Our analysis identified several potentially modifiable factors associated with stillbirth, adding to the evidence-base for policy and action in low- and middle-income contexts. Including these questions in DHS-8 would lead to increased availability of population-level data to inform action to end preventable stillbirths.

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The Importance of Engaging in Physical Activity in Older Adulthood for Transitions Between Cognitive Status Categories and Death: A Coordinated Analysis of 14 Longitudinal Studies

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa268 ◽

2020 ◽

Author(s):

Tomiko Yoneda ◽

Nathan A Lewis ◽

Jamie E Knight ◽

Jonathan Rush ◽

Rebecca Vendittelli ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Impairment ◽

Longitudinal Studies ◽

Sex Education ◽

Cognitive Status ◽

Extensive Literature ◽

Multinomial Regression ◽

Older Adulthood ◽

Modifiable Factors ◽

The Impact

Abstract Background Given increasing incidence of cognitive impairment and dementia, further understanding of modifiable factors contributing to increased healthspan is crucial. Extensive literature provides evidence that physical activity (PA) delays the onset of cognitive impairment; however, it is unclear whether engaging in PA in older adulthood is sufficient to influence progression through cognitive status categories. Method Applying a coordinated analysis approach, this project independently analyzed 14 longitudinal studies (NTotal = 52 039; mean baseline age across studies = 69.9–81.73) from North America and Europe using multistate survival models to estimate the impact of engaging in PA on cognitive status transitions (nonimpaired, mildly impaired, severely impaired) and death. Multinomial regression models were fit to estimate life expectancy (LE) based on American PA recommendations. Meta-analyses provided the pooled effect sizes for the role of PA on each transition and estimated LEs. Results Controlling for baseline age, sex, education, and chronic conditions, analyses revealed that more PA is significantly associated with decreased risk of transitioning from nonimpaired to mildly impaired cognitive functioning and death, as well as substantially longer LE. Results also provided evidence for a protective effect of PA after onset of cognitive impairment (eg, decreased risk of transitioning from mild-to-severe cognitive impairment; increased likelihood of transitioning backward from severe-to-mild cognitive impairment), though between-study heterogeneity suggests a less robust association. Conclusions These results yield evidence for the importance of engaging in PA in older adulthood for cognitive health, and a rationale for motivating older adults to engage consistently in PA.

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Maternal Correlates of Poliomyelitis Vaccination Uptake: Evidence from Afghanistan, Pakistan, and Nigeria

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0327 ◽

2021 ◽

Author(s):

Muhammad Muzammil ◽

Sameen Zafar ◽

Shazia Aziz ◽

Muhammad Usman Bhutta ◽

Rafi Amir-Ud-Din

Keyword(s):

Multinomial Logistic Regression ◽

Viral Disease ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Wealth Status ◽

Vaccination Uptake ◽

Agriculture Sector ◽

Polio Vaccination ◽

Working Status ◽

The Impact

Poliomyelitis (polio) is a communicable viral disease that mainly affects under-5 children. This study focuses on the impact of women’s empowerment and women’s working status on the uptake of polio vaccination of children in polio-endemic countries, including Pakistan and Afghanistan, and Nigeria, the latter of which has recently been declared polio-free. The polio vaccination status can be divided into no vaccination (NV), incomplete vaccination (IV), and complete vaccination. We used data from the most recent Demographic and Health Surveys (DHS) rounds for this manuscript. Multinomial logistic regression-based estimates suggest that mothers’ working status, empowerment, age, education, father’s education, and household wealth status reduce the risk of NV and IV in the polio-endemic countries (Afghanistan and Pakistan) and Nigeria. In addition, the mothers’ working status, empowerment, age, education, and father’s education increase the child’s healthcare information that helps complete polio vaccination of the child. On the other hand, the children whose mothers work in the agriculture sector or are engaged in a blue-collar job are more likely to remain unvaccinated than women in white-collar jobs. Similarly, mothers engaged in government jobs are more likely to get their children fully vaccinated than unemployed mothers. Thus, as a child’s polio vaccination is strongly dependent on a mother’s working status and empowerment, the focus of public policy on empowering women and promoting their labor force participation may increase polio vaccination uptake, besides adopting other measures to increase immunization.

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The role of education in mini-mental state examination: a study in Northeast Brazil

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2004000200003 ◽

2004 ◽

Vol 62 (2a) ◽

pp. 206-211 ◽

Cited By ~ 25

Author(s):

Paulo Roberto de Brito-Marques ◽

José Eulálio Cabral-Filho

Keyword(s):

Mental State ◽

Formal Education ◽

Mini Mental State Examination ◽

False Negative ◽

Low Education ◽

Main Effects ◽

State Examination ◽

Better Than ◽

Total Test

BACKGROUND: There is evidence that schooling can influence performance in cognitive assessement tests. In developing countries, formal education is limited for most people. The use of tests such as Mini-Mental State Examination (MMSE), could have an adverse effect on the evaluation of illiterate and low education individuals. OBJECTIVE: To propose a new version of MMSE as a screening test to assess Illiterate and low education people. METHOD: A study was carried out enrolling 232 individuals, aged 60 or more of low and middle socio-economic classes. Three groups were studied: Illiterate;1-4 schooling years; 5-8 schooling years. The new version (MMSEmo) consisted of modifications in copy and calculation items of the adapted MMSE (MMSEad) to Portuguese language. The maximum possible score was the same in the two versions: total, 30; copy, 1 and calculation, 5. RESULTS: In the total test score ANOVA detected main effects for education and test, as well as an interaction between these factors: higher schooling individuals performed better than lower schooling ones in both test versions; scores in MMSE-mo were higher than in MMSE-ad in every schooling group. CONCLUSION: Higher schooling levels improve the perfomance in both test versions, the copy and calculation items contributing to this improvement. This might depend on cultural factors. The use of MMSE-mo in illiterate and low school individuals could prevent false positive and false negative cognitive evaluations.

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Evaluation of anaemia

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174581 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4481 ◽

Cited By ~ 1

Author(s):

Suchita V. Ingale ◽

Milind P. Ullewar ◽

Vikas C. Ingale ◽

Jayshree J. Upadhye

Keyword(s):

Red Blood Cells ◽

Blood Cells ◽

Complete Blood Count ◽

Severe Anaemia ◽

Peripheral Smear ◽

Pathology Laboratory ◽

Mild Anemia ◽

Normocytic Normochromic Anaemia ◽

Moderate Anemia ◽

Mild Anaemia

Background: Often, the first test used to diagnose anemia is a complete blood count (CBC). It determines the number, size, volume, and hemoglobin content of red blood cells. Peripheral smear is done for typing of anaemia. Such evaluation is necessary for proper treatment.Methods: A retrospective study was done in 300 anaemic patients at Shakuntala pathology laboratory, Nagpur. Patients were randomly selected including males and females. CBC and peripheral smear were analyzed.Results: Out of total 300 patients evaluated, the prevalence of anaemia was quite significant in females 225 (75%) than males 75 (25%). 66 females (22%) had mild anemia while 129 females (43%) had moderate anemia and 30 females (10%) had severe anaemia 36 males (12%) had mild anaemia, 30 males (10%) had moderate anaemia while 9 males (3%) had severe anaemia. In morphology of red blood cells, normocytic normochromic anaemia was seen in 132 (44%) females and in 45 (15%) of males. Microcytic hypochromic anaemia was seen in 90 (30%) females and 27 (9%) males. Macrocytic anaemia was seen in 3 (1%) females and 3 (1%) males.Conclusions: Prevalence of anaemia is quite high in females than males. Also, the severity of anaemia is more in females than males. So, heath programmes should be directed more towards females since adolescent age.

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Severity of anaemia and association with all-cause mortality in patients with medically managed left-sided endocarditis

Heart ◽

10.1136/heartjnl-2021-319637 ◽

2021 ◽

pp. heartjnl-2021-319637

Author(s):

Mia Marie Pries-Heje ◽

Rasmus Bo Hasselbalch ◽

Christoffer Wiingaard ◽

Emil Loldrup Fosbøl ◽

Andreas Birkedal Glenthøj ◽

...

Keyword(s):

Antibiotic Treatment ◽

Mortality Rates ◽

Severe Anaemia ◽

Valve Surgery ◽

Oral Antibiotic ◽

Intravenous Antibiotic ◽

All Cause Mortality ◽

Mild Anaemia ◽

Multivariable Adjustment

ObjectiveTo assess the prevalence and severity of anaemia in patients with left-sided infective endocarditis (IE) and association with mortality.MethodsIn the Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis trial, 400 patients with IE were randomised to conventional or partial oral antibiotic treatment after stabilisation of infection, showing non-inferiority. Haemoglobin (Hgb) levels were measured at randomisation. Primary outcomes were all-cause mortality after 6 months and 3 years. Patients who underwent valve surgery were excluded due to competing reasons for anaemia.ResultsOut of 400 patients with IE, 248 (mean age 70.6 years (SD 11.1), 62 women (25.0%)) were medically managed; 37 (14.9%) patients had no anaemia, 139 (56.1%) had mild anaemia (Hgb <8.1 mmol/L in men and Hgb <7.5 mmol/L in women and Hgb ≥6.2 mmol/L) and 72 (29.0%) had moderate to severe anaemia (Hgb <6.2 mmol/L). Mortality rates in patients with no anaemia, mild anaemia and moderate to severe anaemia were 2.7%, 3.6% and 15.3% at 6-month follow-up and 13.5%, 20.1% and 34.7% at 3-year follow-up, respectively. Moderate to severe anaemia was associated with higher mortality after 6 months (HR 4.81, 95% CI 1.78 to 13.0, p=0.002) and after 3 years (HR 2.14, 95% CI 1.27 to 3.60, p=0.004) and remained significant after multivariable adjustment.ConclusionModerate to severe anaemia was present in 29% of patients with medically treated IE after stabilisation of infection and was independently associated with higher mortality within the following 3 years. Further investigations are warranted to determine whether intensified treatment of anaemia in patients with IE might improve outcome.

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Trends and predictors of early initiation, exclusive, and continued breastfeeding in Bangladesh (2004-2018): a multilevel analysis of Demographic and Health Survey data

British Journal Of Nutrition ◽

10.1017/s0007114521004761 ◽

2021 ◽

pp. 1-29

Author(s):

Md. Sabbir Ahmed ◽

Kyly C Whitfield ◽

Fakir Md Yunus

Keyword(s):

Survey Data ◽

Early Initiation ◽

Demographic And Health Surveys ◽

Child Feeding ◽

Logistic Regression Models ◽

Young Child Feeding ◽

Region Division ◽

Infant And Young Child ◽

Rural Residency ◽

Health And Development

Abstract The early initiation of breastfeeding (EIBF) within one hour of birth, exclusive breastfeeding (EBF) to 6 months, and continued breastfeeding (CBF) to 2 years are key infant and young child feeding guidelines promoted globally for optimal child health and development. Using publicly available national survey data from the five most recent, consecutive Bangladesh Demographic and Health Surveys (2004, 2007, 2011, 2014, 2017-18), we assessed the trends in these key breastfeeding indicators. Multiple multilevel logistic regression models were built to assess sociodemographic predictors of breastfeeding using the latest 2017-18 dataset. Both EIBF and EBF have increased significantly between 2004 and 2017-18, from 26% to 60% and 36% to 68%, respectively and CBF decreased from 94% to 85%. Caesarean section delivery conferred lower EIBF practice (OR= 0.34, 95% CI: 0.27 to 0.42) compared to vaginal delivery. Women who were currently working had 32% lower odds of EBF (OR= 0.68, 95% CI: 0.48 to 0.95). Compared to delivery at home, women who delivered in a health facility had 81% higher odds of EBF (OR= 1.81, 95% CI: 1.25 to 2.34). Larger family size (≥5) also predicted EBF (OR= 1.70, 95% CI: 1.21 to 2.40). Rural residency was associated with 2.39 (95% CI 1.32 to 4.31) times of higher odds of CBF. Administrative region (division) was also predictive of the various breastfeeding indicators. Although Bangladesh currently exceeds the 2019 global prevalence rates for these three breastfeeding indicators, efforts should be made to continue improving EIBF and EBF, and to prevent future decreases in CBF.

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Prevalence of Anaemia among Rural Women Population of Paschim Medinipur, West Bengal, India

Nepal Journal of Medical Sciences ◽

10.3126/njms.v2i1.7644 ◽

2013 ◽

Vol 2 (1) ◽

pp. 9-12

Author(s):

S Maiti ◽

KM Ali ◽

A Ghosh ◽

D Ghosh ◽

S Paul

Keyword(s):

Rural Women ◽

West Bengal ◽

Standard Procedure ◽

Haemoglobin Concentration ◽

World Health Organisation ◽

Severe Anaemia ◽

World Health ◽

Adult Women ◽

The World ◽

Mild Anaemia

Background: Anaemia is a common health problem among women throughout the world and vast majority of this burden occurs in developing countries. In the present study, an attempt has been made to gauge the prevalence of anaemia among adult women residing in five rural blocks of Paschim Medinipur, West Bengal, India. Therefore, associations between haemoglobin concentration and anthropometric data were evaluated. Methods: The study was confined to the non-pregnant women of age group of 21-50 years. A total of 368 women were participated in the present study. The estimation of anaemia was undertaken using the standard procedure and anthropometric measurements were collected. Anaemia was classified as per the World Health Organisation (WHO) grading criteria. Results: The overall prevalence of anaemia among women was 70.1%. The majority 205 (55.7%) demonstrated moderate anaemia while mild anaemia was recorded in 53 (14.4%) and none of the subject had severe anaemia. Lower body mass index was associated with higher prevalence of anaemia. Conclusion: This study revealed that anaemia is present at considerable levels among adult women in our study area which provide intensive approaches are required to combat the anaemia in this population. Nepal Journal of Medical Sciences | Volume 02 | Number 01 | Jan-Jun 2013 | Page 9-12 DOI: http://dx.doi.org/10.3126/njms.v2i1.7644

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The Development of Non-Formal Technological and Vocational Education in Village Communities

Innovation of Vocational Technology Education ◽

10.17509/invotec.v12i1.4503 ◽

2016 ◽

Vol 12 (1) ◽

Author(s):

Lilis Widaningsih ◽

Ade Gafar Abdullah

Keyword(s):

Human Resources ◽

Vocational Education ◽

Formal Education ◽

Practical Knowledge ◽

Learning Needs ◽

Life Long Learning ◽

Low Education ◽

Technological And Vocational Education ◽

Village Communities

This article presents a preliminary study which was done through a literature review of various scientific references on the development of human resources through non-formal technological and vocational education. Current issues and problems in developing countries are related to the low quality of human resources in villages due to the low education and skills (technological and vocational skills). The development of non-formal technological and vocational education for village communities becomes an alternative solution, particularly when formal education does not provide solutions. With the concept of life-long learning, non-formal technological and vocational education is based on practical knowledge and skills. Non-formal education allows a learning model which addresses individuals’ learning needs. Thus, it becomes one of solutions to overcome unemployment.

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