824. Analysis of Comorbidities and Use of Co-medications in 28,089 HIV-positive Patients: A Nationwide Cohort Study From 2009 to 2019 in Japan

Abstract Background Comorbidities are associated with a high burden of disease in human immunodeficiency virus (HIV)- positive patients. The objective was to investigate the prevalence of chronic comorbidities and the use of co-medications in HIV-positive patients in Japan. Methods This longitudinal cohort study retrospectively analyzed clinical information from HIV-positive patients using antiretroviral therapy (ART) between April 2009 and April 2019. Demographic characteristics, numbers and types of chronic comorbidities and numbers and types of co-medications, were described by age groups. This is the first report to analyze comorbidities and the polypharmacy of all patients in the cross-sectional National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), which contains data on the largest number of HIV-positive patients in Japan, available to date. Results Overall, 28,089 HIV-positive patients (male 91·9%) who used ART were identified. About 40% of 28,089 patients had at least one chronic comorbidity. The number of acquired immunodeficiency syndrome (AIDS)-defining cancers and non-AIDS-defining cancers in this Japanese cohort was 2,432 (8·7%) and 2,485 (8·8%), respectively. The incidence of AIDS-defining cancers was 6·4% for non-Hodgkin lymphoma and 2·5% for Kaposi’s sarcoma, with bronchus or lung cancer being the most common of the non-AIDS-defining cancers. Syphilis was the most common infection (47·2%). The cumulative burden of vascular disease and AIDS-free cancer increased with age. The most common therapeutic categories of co-medications were systemic antibacterials (42%) and antacids, antiflatulents and antiulcerants (38·8%). Most of the patients used at least one co-medication (71·4%), and the numbers of co-medications used were greater in the older age groups. Conclusion The burden of chronic comorbidities and co-medication were found to be greater in older than younger patients, among 28,089 HIV-positive patients in a nationwide study in Japan. This finding suggests the need to identify elderly persons living with HIV and to appropriately manage their HIV and comorbidities. Disclosures All Authors: No reported disclosures

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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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Estimating the burden of pediatric HIV in an ‘A’ category district in India: an epidemiological study

BMC Pediatrics ◽

10.1186/s12887-021-02836-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anju Sinha ◽

Reynold Washington ◽

Rajeev Sethumadhavan ◽

Rajaram Subramanian Potty ◽

Shajy Isac ◽

...

Keyword(s):

Disease Burden ◽

Control Program ◽

Hiv Prevalence ◽

Pediatric Hiv ◽

Hiv Positive ◽

People Living With Hiv ◽

Cross Sectional ◽

Longitudinal Methods ◽

Persons Living With Hiv ◽

Living With Hiv

Abstract Background India lacks epidemiological information on the disease burden of pediatric HIV. The National AIDS Control Program (NACP) estimates the numbers of HIV-positive children as a proportion of adult persons living with HIV. A third of HIV-positive children die before their first birthday and a half before they reach their second birthday. The early detection of HIV is crucial for the prevention of morbidities, growth delays, and death among HIV-positive children. Methods The study aimed to estimate the disease burden of pediatric HIV among children in ‘A’ category district of a high HIV prevalence state. An ‘A’ category district is defined by the presence of > 1% HIV prevalence among the general population, as estimated by HIV Sentinel Surveillance. The study used an innovative three-pronged strategy combining cross-sectional and longitudinal methods. The overall burden of pediatric HIV was calculated as a product of cases detected multiplied by a net inflation factor, for each of three strategies. Results The existing pool of HIV infection in the district is estimated to be 3266 (95% CI: 2621–4197) HIV positive children < 15 years of age, in a mid-year (2013) projected child population of about 1.4 million, thus giving an HIV prevalence of 0.23% (CI: 0.19–0.30) among children (0–14 years of age). The proportion of children among all people living with HIV in the district works out to 10.4% (CI: 8.6–13.5%). Conclusions The study estimate of 0.23% HIV prevalence among children (0–14 years of age) is higher than the NACP estimates (0.02) and is 2.5 higher than the Karnataka state estimate (0.09)22. Similarly, the proportion of children among all persons living with HIV in Belgaum district is 10.4% in this study, as against 6.54% for India. The study methodology is replicable for other settings and other diseases.

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Female Genital Mutilation/Cutting in the Swiss HIV Cohort Study: A Cross-Sectional Study

10.21203/rs.3.rs-1065495/v1 ◽

2021 ◽

Author(s):

Fabio Mauri ◽

Sara Cottler-Casanova ◽

Matthias Cavassini ◽

Marcel Stoeckle ◽

Gilles Wandeler ◽

...

Keyword(s):

Cohort Study ◽

Female Genital Mutilation ◽

Cross Sectional Study ◽

Hiv Positive ◽

Cross Sectional ◽

Female Population ◽

Genital Mutilation ◽

Previous Discussion ◽

Health Complications ◽

Female Genital

Abstract BackgroundFemale genital mutilation or cutting (FGM/C) is the practice of partial or total removal or injury of the external female genitalia for non-medical reasons. It has been documented in at least 30 countries and, as a result of migration, in high-income countries too. FGM/C causes various negative health complications, and may increase the risk of acquiring human immunodeficiency virus (HIV).Our study aims to generate descriptive statistics about FGM/C among HIV positive migrant women included in the Swiss HIV cohort study (SHCS).MethodsThe Swiss HIV Cohort study (www.SHCS.ch) is a national, prospective cohort study with ongoing community and hospital enrolment of HIV-positive individuals in Switzerland. Two questions on history of FGM/C and previous discussion about it with a healthcare professional were administered by treating infectious disease specialists during the 6-monthly routine visits occurring between June and December 2019. We included all women aged above 18 years, born in one of the 30 countries where FGM/C is prevalent, in care for an HIV-infection and recorded in the Swiss HIV Cohort Study.ResultsOur findings show that FMG/C is common (21%) in the SHCS female population originating from Africa. Such data may be largely underestimated given the 33.6% of non-respondents. The vast majority (70%) of the women reporting to have been cut had never discussed FGM/C with a health professional before the study.Conclusions FMG/C is common in the SHCS female population originating from Africa, but often overlooked by health professionals working with this population. FGM/C screening, diagnosis, care and prevention could be improved significantly through training and information.Trial registration: Not Applicable

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HOSPITAL ADMISSIONS FOR STROKE IN THE BRAZILIAN NATIONAL HEALTH SYSTEM: EPIDEMIOLOGICAL FINDINGS FROM 2019-2020

10.14293/s2199-1006.1.sor-.ppoguxa.v1 ◽

2021 ◽

Author(s):

Mariana Guelli ◽

Tulio Loyola Correa

Keyword(s):

Health System ◽

National Health ◽

Skin Color ◽

Hospital Admissions ◽

Age Groups ◽

National Health System ◽

National Database ◽

Cross Sectional ◽

Unified Health System ◽

Time Period

Background and Aims Stroke is one of the leading causes of death and disability in adults, accounting for a high number of hospitalizations worldwide.This study aims to evaluate the epidemiology of hospitalizations for stroke in Brazil during 2019 and 2020. Methods Cross-sectional, descriptive and retrospective study, which evaluated the epidemiology of hospital admissions for stroke in the Brazilian National Health System in the years 2019 and 2020.Hospital admissions were evaluated by sex, race and age group using the national database (DATASUS – Department of Informatics of the Unified Health System). The official classification of race/skin color in Brazil is composed of five categories: White, Brown [Pardo], Black,Yellow and Indigenous. Results During this time period, there was a total of 316,859 hospitalizations for stroke in the Brazilian National Health System, with 163,120 (51.5%) hospital admissions in 2019 and 153,739 (48.5%) in 2020. Also, 166,178 (52.4%) patients were male and 150,681 (47.6%) were female. Regarding race (n=250,446); 106,998 (42.7%) patients considered themselves white, 116,601 (46.6%) brown, 17,085 (6.8%) black and 9,762 (3.9%) others. Regarding age groups; 64,939 (20.5%) were >80 years old, 163,114 (51.5%) were 60-79, 74,605 (23.5%) were 40-59 and 14,201 (4.5%) were <40. Conclusions The majority of patients hospitalized for stroke were 60-79 years old and white or brown. The similar number of hospital admissions in 2019 and 2020 may suggest that hospitalizations for stroke were not significantly impacted by hospital’s oversaturation by the COVID-19 pandemic.

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Socioeconomic Factors Associated with Suicide in Elderly Populations in British Columbia: An 11-Year Review

The Canadian Journal of Psychiatry ◽

10.1177/070674379804300808 ◽

1998 ◽

Vol 43 (8) ◽

pp. 829-836 ◽

Cited By ~ 18

Author(s):

M Oluwafemi Agbayewa ◽

Stephen A Marion ◽

Sandi Wiggins

Keyword(s):

British Columbia ◽

Labour Force ◽

Age Groups ◽

The Elderly ◽

Elderly Persons ◽

Elderly Male ◽

Cross Sectional ◽

Suicide Rates ◽

Male Suicide ◽

And Migration

Objective: The effects of socioeconomic factors on suicide rates in the general population are widely documented. Few of these reports have specifically studied the effects of socioeconomic variables on suicide rates in the elderly population. Elderly persons have the highest suicide rates of any age-group. This group is different from the rest of the population insofar as suicide is concerned. For example, since most elderly persons are no longer in the labour force, it would be expected that they would be affected differently by economic factors such as unemployment. We report the findings of an ecological study of old-age suicide in British Columbia over an 11-year period. Methods: We obtained information on all suicide counts (International Classification of Diseases [ICD-9] codes E590–959) recorded in the 21 health units of British Columbia over the 11-year period from October 1, 1981, to September 30, 1991, from the Division of Vital Statistics of the Province of British Columbia and Statistics Canada. Social, economic, and demographic information for the health units was obtained from census data and included the number of persons per household, proportion of the population that lived in 1-person households, immigration and migration rates for each region, proportion of the population with less than grade 9 education, proportion with less than grade 12 certification, marital status rates, unemployment rates by gender, average household income, average census family income, and labour-force participation rate by gender. We calculated overall and gender-specific suicide rates for elderly persons (65 years and older) and younger populations. Using Poisson regression analyses, we determined the cross-sectional and longitudinal relative risks associated with the socioeconomic variables for the units, and we also examined trends in suicide rates. Results: There were 4630 suicides in the 11-year period. The mean suicide rate (per 100 000 population) for those over age 9 years was 18.6 (between health unit SD 5.2, 95% confidence interval [CI] = 17.0–20.2). The elderly have a higher suicide rate in every region. The male suicide rates (mean = 26.9, SD 6.4, 95% CI = 24.0–30.0) are higher than female rates (mean = 7.5, SD 1.7, 95% CI = 6.8–8.3) in every region. The factors influencing suicides were different for elderly males and elderly females. In all analyses, suicide rates in elderly females remained essentially stable across age-groups and units and over the years. Elderly male suicide rates varied across units and age-groups and over the years. Conclusions: Suicide rates are highest in males over age 74 years. There are regional differences in elderly suicide rates and the factors that influence them. Longitudinal and cross-sectional risk factors differ, and there are gender differences in the risk factors. For both elderly males and females, suicide rates appear to be influenced by social factors in the population as a whole, not just in the elderly population. Male and female employment patterns are associated with elderly male suicide rates, even though the latter are not in the labour force. For suicide in elderly women the important factors are population education, income, and migration levels.

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Age, period and cohort effects on body weight and body mass index in adults: The Doetinchem Cohort Study

Public Health Nutrition ◽

10.1017/s1368980008003091 ◽

2009 ◽

Vol 12 (6) ◽

pp. 862-870 ◽

Cited By ~ 52

Author(s):

Astrid CJ Nooyens ◽

Tommy LS Visscher ◽

WM Monique Verschuren ◽

A Jantine Schuit ◽

Hendriek C Boshuizen ◽

...

Keyword(s):

Body Weight ◽

Cohort Study ◽

Longitudinal Data ◽

Adult Population ◽

Age Groups ◽

Cohort Effects ◽

Cross Sectional ◽

Educational Levels ◽

General Adult Population

AbstractObjectiveTo study the development of body weight with ageing, in a general adult population, taking into account possible period and cohort effects.DesignA prospective cohort study with 11 years of follow-up. At baseline and after 6 and 11 years, body weight and height were measured.SettingThe Doetinchem Cohort Study, consisting of inhabitants of Doetinchem, a town in a rural area of The Netherlands.SubjectsIn total, 4070 healthy men and women aged 20–59 years at baseline.ResultsIncrease in BMI with ageing was less profound based on cross-sectional data than based on longitudinal data. More recent-born cohorts had a higher BMI at a given age than cohorts who were born earlier. Increase in mean BMI with ageing was observed in all age groups and was similar for groups with a different educational level. Highest increase in BMI over 11 years was observed in the youngest group, aged 20–29 years at baseline (2·2 [95 % CL 2·0, 2·3] kg/m2), and lowest increase in the oldest group, aged 50–59 years at baseline (1·1 [1·0, 1·3] kg/m2).ConclusionsFindings of the present study using longitudinal data suggest that increase in BMI with ageing is underestimated in all age groups by studying cross-sectional data only. Further, weight gain is present in all educational levels and does not stop at middle age.

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Temporal Processing Abilities across Different Age Groups

Journal of the American Academy of Audiology ◽

10.3766/jaaa.22.1.2 ◽

2011 ◽

Vol 22 (01) ◽

pp. 005-012 ◽

Cited By ~ 28

Author(s):

Ajith Kumar U ◽

A.V. Sangamanatha

Keyword(s):

Temporal Processing ◽

Age Groups ◽

Duration Discrimination ◽

Elderly Persons ◽

Research Subjects ◽

Cross Sectional ◽

Age Related ◽

Fourth Decade ◽

Processing Abilities ◽

Effects Of Aging

Background: Psychophysical evidence indicates age-related decline over a broad range of auditory abilities. Thus, age-related deterioration in temporal processing abilities also may be expected. At issue is whether the various dimensions of temporal processing decline at the same or at different rates across age. Purpose: To determine whether various temporal processes decline with aging and whether some are more resistant to the effects of aging than others. Study Sample: A total of 176 subjects in the age range from 20 to 85 yr participated in this research. Subjects were divided into six cross-sectional age groups. There were 30 subjects per age decade up to 70 yr and 26 subjects in the age group >70 yr. Data Collection and Analysis: Temporal processing was evaluated using gap detection, duration discrimination, modulation detection, and duration pattern. Results: Individuals in the 20–30 and 30–40 yr groups performed significantly better in all the psychoacoustic measures in comparison to other age groups. Deterioration in temporal processing began after the fourth decade of life. Deterioration accelerated after 70 yr of age. Conclusions: There is a systematic, age-related decline in temporal processing starting from the fourth decade of life. The deficits in temporal processing observed in the present study may be related in part to the difficulties that elderly persons encounter in noisy listening situations.

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Correlates of fasting blood glucose among children living with hiv in a Nigerian tertiary hospital: a cross-sectional study

BMC Pediatrics ◽

10.1186/s12887-020-02335-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ijeoma Onyinye Ohuche ◽

Ugo Nnenna Chikani ◽

Elizabeth Eberechi Oyenusi ◽

Justus Uchenna Onu ◽

Abiola Oduwole

Keyword(s):

Blood Glucose ◽

Fasting Blood Glucose ◽

Clinical Information ◽

Clinical History ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Cumulative Exposure ◽

Hiv Positive ◽

Cross Sectional ◽

Duration Of Illness

Abstract Background There is growing concern as regards the emergence of metabolic disorders among children living with the Human Immunodeficiency Virus (HIV) worldwide. However, there is paucity of data on the correlates of metabolic indices among HIV-positive children in Africa. Methods This study examined 84 HIV-positive children on HAART recruited from the paediatric infectious diseases clinic of the University of Nigeria Teaching Hospital for blood glucose levels using finger-prick testing with an Accu-check glucose meter and test strips. Clinical information was obtained via clinical history and medical records. Data was analyzed to examine the relationship between FBG and the classes of HAART, duration of illness and treatment using analysis of variance (ANOVA). Results FBG was significantly associated with the classes of HAART (x2=12.4, p = 0.017). In addition, there was a significant association between FBG and duration of illness [F(2, 81) = 6.0; P = 0.004], as well as FBG and duration on HAART [F(2, 81) = 7.9; P = 0.001]. However, duration on HAART and type of HAART were the significant predictors of FBG in this study accounting for 10.5% and 4.1% of the variance, respectively. Conclusions There is a greater risk of dysglycemia in paediatric patients with a longer cumulative exposure to HAART. Routine blood glucose checks among children on HAART, especially those who have received HAART for a longer duration of time may therefore be useful in their management.

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Bullying in the Australian medical workforce: cross-sectional data from an Australian e-Cohort study

Australian Health Review ◽

10.1071/ah11048 ◽

2012 ◽

Vol 36 (2) ◽

pp. 197 ◽

Cited By ~ 42

Author(s):

Deborah A. Askew ◽

Philip J. Schluter ◽

Marie-Louise Dick ◽

Patricia M. Régo ◽

Catherine Turner ◽

...

Keyword(s):

Mental Health ◽

Job Satisfaction ◽

Cohort Study ◽

Patient Care ◽

Workplace Bullying ◽

Age Groups ◽

Direct Patient Care ◽

Medical Workforce ◽

Job Stressors ◽

Cross Sectional

Objective. This study aimed to describe the prevalence of perceived workplace bullying in the Australian medical workforce, and investigate the relationship between workplace bullying and job satisfaction, health status, and current and planned medical workforce participation. Methods. An electronic cross-sectional survey of doctors currently in the paid workforce, conducted between April 2008 and October 2009, was nested within a longitudinal cohort study investigating factors affecting the recruitment and retention of the Australian medical workforce. To address the specific aims of this study, a subset of questions in the survey investigated the prevalence of self-reported bullying; physical and mental health; workforce participation patterns; job satisfaction; and job stressors. Results. Seven hundred and forty-seven participants responded to the bullying question and were included in this analysis. Twenty-five percent of participants reported being bullied in the last 12 months. There were no differences in the reported rates of bullying across age groups, sex and country of medical qualification. Bullied doctors were least satisfied with their jobs (P < 0.001), had taken more sick leave in the last 12 months (P < 0.001), and were more likely to be planning to decrease the number of hours worked in medicine in the next 12 months (P = 0.01) or ceasing direct patient care in the next 5 years (independent of their age or the number of hours currently worked in patient care) (P = 0.006). Conclusions. Our findings suggest that Australian doctors, independent of age or sex, have experienced workplace bullying, and although no conclusions can be made about causal pathways, there were strong associations between this exposure and poorer health and wellbeing, and on remaining in the medical workforce. What is known about the topic? Bullying and harassment have a significant impact on mental health, job satisfaction, and intention to leave the workforce. Workplace bullying in healthcare organisations affects the individuals involved, the organisations and the patients. The prevalence of workplace bullying throughout the medical workforce in Australia or elsewhere has not been investigated, with previous studies focussing on subsets of doctors, particularly junior doctors. What does this paper add? This paper found that 25% of doctors participating in this study reported experiencing persistent behaviours in the last 12 months that had undermined their professional confidence or self-esteem. There were no differences in the prevalence of bullying observed between sexes, age groups, country of medical qualifications, or employment sector. Victims of bullying had poorer mental health, had taken more sick leave in the last 12 months, were less satisfied with their current jobs and with being doctors, were more affected by job stressors and were more likely to be considering ceasing direct patient care than non-bullied doctors. What are the implications for practitioners? Practitioners need to be alert for potential bullying and harassment within healthcare organisations and be prepared to act decisively to minimise its impact on staff health, satisfaction and retention, and patient quality of care.

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Trend Analysis of Cutaneous Leishmaniasis Incidence in Izeh County During 2014-2019

Disease and Diagnosis ◽

10.34172/ddj.2021.19 ◽

2021 ◽

Vol 10 (3) ◽

pp. 99-103

Author(s):

Marziyeh Ahmadi Mirqhaed ◽

Maryam Dastoorpoor ◽

Abdolamir Behbahani

Keyword(s):

Cutaneous Leishmaniasis ◽

Health Centre ◽

Age Groups ◽

Clinical Information ◽

Cross Sectional ◽

Infected People ◽

Khuzestan Province ◽

Significant Difference ◽

Control And Prevention ◽

Epidemiological Characteristics

Background: A cutaneous form of leishmaniasis (cutaneous leishmaniasis, CL) is becoming increasingly common, and this study was conducted to investigate the epidemiological features of CL in the county of Izeh in Khuzestan province. Materials and Methods: This retrospective cross-sectional research was performed during 2014- 2019. Basic demographic and clinical information was gathered from patients with CL referring to Izeh health centre and then processed using SPSS software, version 25.0. Results: Overall, data related to 131 patients were recorded from 2014 to 2019. The incidence of CL showed a decrease from 16.207 to 5.028 per 100000 individuals in Izeh. Based on the analysis of CL incidence in Izeh county, a statistically significant difference was observed through the mentioned six-year study (P<0.05). Male patients with a frequency rate of 65.6% demonstrated a statistically significant association in the CL and the type of gender compared to 34.4% of females (P<0.05). The age group of 20-29 years old (32.1%) had a higher frequency of CL in the age groups. Finally, there was a statistically considerable discrepancy in the frequencies of infected people with CL related to age groups (P<0.05). Conclusion: Based on the findings and other epidemiological characteristics, Izeh does not seem to be an endemic focus of CL. Nonetheless, it is a concerning situation, and proper preparation is strongly advised for disease control and prevention.

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