scholarly journals Prevalence and socioeconomic determinants of development delay among children in Ceará, Brazil: a population-based study

2019 ◽  
Author(s):  
Luciano L. Correia ◽  
Hermano A. L. Rocha ◽  
Christopher R. Sudfeld ◽  
Sabrina G. M. O. Rocha ◽  
Álvaro J. M. Leite ◽  
...  

ABSTRACTObjectiveTo assess the prevalence of child development delay and to identify socioeconomic determinants.Study DesignWe conducted a population-based cross-sectional study of children 2 to 72 months of age residing in the state of Ceará, Brazil. In total, 3200 households were randomly selected for participation in the study and had child development assessed with the Ages and Stages Questionnaire (ASQ) version 3. Development delay was defined as a score less than −2 standard deviations below the median of the Brazilian ASQ standard. We present population-level prevalence of delay in five development domains and assess socioeconomic determinants.ResultsA total of 3566 children completed the ASQ development assessment of which 9.2% (95% CI: 8.1-10.5) had at least one domain with development delay. The prevalence of delay increased with age in all domains and males were at higher risk for communication, gross motor and personal-social development delays as compared to females (p-values <0.05). We found robust associations of indicators of socioeconomic status with risk of development delay; increasing monthly income and higher social class were associated with reduced risk of delay across all domains (p-values <0.05). In addition, children in poor households that participated in conditional cash transfer (CCT) programs appeared to have reduced risk of delay as compared to children from households that were eligible, but did not participate, in CCT programs.ConclusionsThere is a relatively high population-level prevalence of development delay in at least one domain among children 0-6 years of age in Ceará, Brazil. Integrated child development, social support, and poverty reduction interventions may reduce the population-level prevalence of development delay in Ceará and similar settings.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-215
Author(s):  
Rahul Sharma ◽  
Anil Lalwani ◽  
Justin Golub

Abstract The progression and asymmetry of age-related hearing loss has not been well characterized in those 80 years of age and older because public datasets mask upper extremes of age to protect anonymity. We aimed to model the progression and asymmetry of hearing loss in the older old using a representative, national database. This was a cross-sectional, multicentered US epidemiologic analysis using the National Health and Nutrition Examination Study (NHANES) 2005-2006, 2009-2010, and 2011-2012 cycles. Subjects included non-institutionalized, civilian adults 80 years and older (n=621). Federal security clearance was granted to access publicly-restricted age data. Outcome measures included pure-tone average air conduction thresholds and the 4-frequency pure tone average (PTA). 621 subjects were 80 years old or older (mean=84.2 years, range=80-104 years), representing 10,600,197 Americans. Hearing loss exhibited constant acceleration across the adult lifespan at a rate of 0.0052 dB/year2 (95% CI = 0.0049, 0.0055). Compounded over a lifetime, the velocity of hearing loss would increase five-fold, from 0.2 dB loss/year at age 20 to 1 dB loss/year at age 100. This model predicted mean PTA within 2 dB of accuracy for most ages between 20 and 100 years. There was no change in the asymmetry of hearing loss with increasing age over 80 years (linear regression coefficient of asymmetry over age=0.07 (95% CI=-0.01, 0.24). In conclusion, hearing loss steadily and predictably accelerates across the adult lifespan to at least age 100, becoming near-universal. These population-level statistics will guide treatment and policy recommendations for hearing health in the older old.


2018 ◽  
Vol 14 (4) ◽  
pp. 552-557
Author(s):  
V. S. Kaveshnikov ◽  
V. N. Serebryakova ◽  
I. A. Trubacheva ◽  
S. A. Shalnova

Material and methods. In the cross-sectional population-based study of general unorganized population of Tomsk aged 25-64 years ultrasound screening examination of the carotid arteries was done for detection of atherosclerotic plaques (plaque). As potential plaque determinants the following factors were studied: age, gender, smoking, low and high density lipoproteins (LDL-C and HDL-C), triglycerides, arterial hypertension, body mass index (BMI), low educational status (LES), high-sensitive C-reactive protein, glucose, diabetes mellitus, antihypertensive and hypolipidemic therapy. Study of relationships was carried out with logistic regression analysis. The error probability of less than 5% was considered statistically significant.Results. In the crude analysis most of the determinants under study showed statistically significant relationship with plaque presence. After adjustment for age and sex, LDL-C, smoking and LES were associated with CAS prevalence. In multivariable regression analysis 9 risk factors appeared to be independently associated with plaque presence, wherein age, male sex, LDL-C, BMI and HDL-C were the most significant. In the participants of 50 years and older the smoking effect was the next in significance after LDL-C.Conclusion. The results obtained focus attention on the comparative value of the major atherogenic risk factors and suggest that currently effective and timely control of LDL-C is of primary importance for prevention of carotid atherosclerosis in the general working-age population. As well the findings of the study evidence that at the population level smoking is still one of the leading atherogenic risk factors.


Author(s):  
Madhumita Mukherjee ◽  
Rashmi Singh ◽  
Amrita Mukherjee ◽  
Madhulekha Bhattacharya

Background: India’s Janany Surakhsha Yojana (JSY) is the largest conditional cash transfer (CCT) program in the world in terms of the number of beneficiaries - covering about 9·5 million (36%) of 26 million women giving birth in India. Eleven States/UTs including Bihar, are still below the National estimate for institutional delivery of 78.9% (NFHS 4). In this study we attempted to find out the status of institutional and home deliveries in district Arwal of Bihar and reasons why in spite of cash incentives a proportion of mothers are opting for home delivery.Methods: A cross sectional descriptive design was used to interview 407 women, who had given birth to a child in previous one year. Focuss group discussions was held with community and health staff to corroborate the interview data.Results: Fifty nine percent of mothers were found to have preferred home delivery over institutional one. Reasons which came to light were home deliveries are cheaper (24.1%), unawareness about JSY (22%), unavailability of transport to reach hospital (22%) and better care being taken at home delivery (20.1%) variables. Older age, having a BPL card, and literacy of husband were found as favoring institutional delivery whereas dissatisfaction during a previous abortion or a livebirth in hospital were both associated with non-use.Conclusions: Better client awareness, strengthening of public health infrastructure, availability of skilled birth attendants at health subcentres (HSCs) and emergency transport in time can reduce number of home deliveries and lead to success of JBSY programme and subsequent reduction in maternal morbidity and mortality.


2020 ◽  
Author(s):  
Cheryl Case Johnson ◽  
Melissa Neuman ◽  
Peter MacPherson ◽  
Augustine Choko ◽  
Caitlin Quinn ◽  
...  

Abstract Background Many southern African countries are nearing the global goal to diagnose 90% of people with HIV by 2020. In 2016, 84% and 86% of people with HIV knew their status in Malawi and Zimbabwe respectively. Despite this progress, gaps remain, particularly among men (≥25 years). We investigated awareness, use and willingness to HIV self-test (HIVST) prior to large scale implementation and explored sociodemographic associations. Methods We pooled responses from two of the first cross-sectional Demographic Health Surveys to include HIVST questions: Malawi and Zimbabwe in 2015-16. Sociodemographic factors and sexual risk behaviours associated with previously testing for HIV, and awareness, past use and future willingness to self-test were investigated using univariable and multivariable logistic regression, adjusting for the sample design and limiting analysis to participants with completed questionnaire and a valid HIV result. Analysis of willingness to self-test was restricted to Zimbabwean men, as Malawians and women were not asked this question. Results Of 31 385 individuals, the proportion never-tested was higher for men (31.2%) than women (16.5%), p<0.001. For men, having ever tested increased with age. Past use and awareness of HIVST was very low, 1.2% and 12.6% respectively. Awareness was lower among women than men (9.1% vs 15.3%, adjusted odds ratio (aOR)=1.55; 95% confidence interval [CI]: 1.37-1.75), and at younger ages, and lower education and literacy levels. Willingness to self-test among Zimbabwean men was high (84.5%), with having previously tested for HIV, high sexual risk, and being ≥25 years associated with greater willingness. Wealthier men had greater awareness of HIVST than poorer men (p<0.001). Men at higher HIV-related sexual risk, compared to men at lower HIV-related sexual risk, had the greatest willingness to self-test (aOR=3.74; 95%CI: 1.39-10.03, p<0.009).Conclusions In 2015-16 many Malawian and Zimbabwean men had never tested for HIV. Despite low awareness and minimal HIVST experience at that time, willingness to self-test was high among Zimbabwean men, especially in older men with moderate to high HIV-related sexual risk. These data provide a valuable baseline against which to investigate population-level uptake of HIVST as programmes scale-up. Programmes introducing, or planning to introduce HIVST, should consider including questions in population-based surveys.


BJPsych Open ◽  
2018 ◽  
Vol 4 (4) ◽  
pp. 256-261 ◽  
Author(s):  
Lauren Hirsch ◽  
Scott B. Patten ◽  
Lauren Bresee ◽  
Nathalie Jette ◽  
Tamara Pringsheim

BackgroundUse of second-generation antipsychotics (SGA) has increased in recent years; however, their use and effect on metabolic outcomes has been poorly characterised in population-level studies.AimsThis study aimed to determine the associations between SGA use and metabolic indicators in a general population.MethodWe used data from the Canadian Health Measures Survey, a cross-sectional survey of Canadian households. Participants were Canadians aged 3–79 years, living in one of the ten provinces. Several metabolic indicators were examined, including weight, body mass index, waist circumference, hypertension, diabetes and two definitions of metabolic syndrome.ResultsThe proportion of Canadians taking an SGA tripled over the study period. SGA use was significantly associated with hypertension (odds ratio 1.94, 95% CI 1.07–3.55) and abdominal obesity in adults, as defined by the National Cholesterol Education Program–Adult Treatment Panel III (odds ratio 2.62, 95% CI 1.45–4.71).ConclusionsEvidence of metabolic dysfunction with SGAs is seen in the Canadian population, along with a rapid increase in prevalence of use since 2007.Declaration of interestNone.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246321
Author(s):  
Dorie E. Apollonio ◽  
Lauren M. Dutra ◽  
Stanton A. Glantz

Cigarette smoking patterns vary within the population, with some individuals remaining never smokers, some remaining occasional users, and others progressing to daily use or quitting. There is little research on how population-level tobacco control policy interventions affect individuals within different smoking trajectories. We identified associations between tobacco control policy interventions and changes across different smoking trajectories among adolescents and young adults. Using 15 annual waves of data drawn from the National Longitudinal Survey of Youth 1997 (NLSY97), we applied a group-based trajectory model to identify associations between days smoked per month, comprehensive smoke-free laws, cigarette tax rates, and known socio-demographic risk factors for membership in different smoking trajectories. Comprehensive smoke-free laws were associated with reduced risk of initiation and reductions in days smoked per month for all trajectories other than occasional users. Higher tax rates were associated with reduced risk of initiation and days smoked for all trajectories other than established users. Overall, population-based tobacco control policies, particularly comprehensive smoke-free laws, were associated with reduced smoking. Tobacco taxes primarily reduced risk of initiation and use among never smokers, experimenters, and quitters, consistent with previous research suggesting that tobacco manufacturers lower prices after tax increases to reduce the cost of continued smoking for established users. These results provide support for expanding smoke-free laws and establishing a minimum tobacco floor price, which could improve public health by reducing the risk of initiation as well as use among occasional and established smokers.


2020 ◽  
Vol 36 (12) ◽  
Author(s):  
Débora Letícia Frizzi Silva ◽  
Doroteia Aparecida Höfelmann ◽  
Cesar Augusto Taconeli ◽  
Regina Maria Ferreira Lang ◽  
Camila Dallazen ◽  
...  

Abstract: Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children’s hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals’ data were collected using a structured questionnaire, and secondary and ecological data of children’s municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.


2018 ◽  
Vol 5 (7) ◽  
pp. 2620
Author(s):  
Manjunath Krishna ◽  
Anu M. Oommen ◽  
Jackwin Sam Paul G. ◽  
Vinod J. Abraham ◽  
Kuryan George

Background: Population based estimates from India on the prevalence of Peripheral Artery Disease (PAD) are scarce. This study aimed to assess the population-based prevalence of PAD in rural and urban Vellore, Tamil Nadu, South India.Methods: A cross sectional survey was conducted using the WHO STEPS methodology and the WHO/Rose questionnaire for intermittent claudication for identifying symptomatic PAD among adults aged 30-64 years. The study was done in nine villages of one rural block and in 48 urban wards of Vellore, between 2011-12. Risk factors for PAD such as sociodemographic factors, tobacco use, anthropometry, known medical conditions, Fasting Plasma Glucose and lipid profile were also assessed and association with PAD estimated using odds ratios, chi-square tests and logistic regression.Results: Among 5429 adults aged 30-64 years, the prevalence of PAD (intermittent claudication) was 4.9/1000 (95% Confidence Interval CI: 3.0/1000 - 6.8/1000). The prevalence in urban Vellore was higher than in the rural area (6.9/1000 vs. 3.8/1000).  After adjusting for sociodemographic factors and other confounding factors, current tobacco use was found to be significantly associated with the presence of PAD (adjusted Odds Ratio: 2.89, 95% CI: 1.10-7.54).Conclusions: This study provides estimates of the burden of PAD in rural and urban adults in Vellore, Tamil Nadu. The trend of this condition needs to be monitored in various locations to assess the public health significance and the need for population level measures for diagnosis, treatment and screening. Education regarding harmful effects of tobacco use should also involve education regarding risk of PAD.


2019 ◽  
Author(s):  
Sarah Cuschieri ◽  
Julian Mamo

Abstract Background Depression is an ever more common chronic non communicable disease and its control constitutes a growing public health concern given its links with a number of co-morbidities, including diabetes mellitus. The study aimed to estimate the prevalence of depression at a population level across groups of different glycaemic status, whilst establishing its socioeconomic phenotypic characteristics.Methods A nationally representative cross-sectional study was conducted in Malta between 2014 and 2016. Participants were categorized into different sub-populations according to their glycaemic status. Depression prevalence rates and socio-economic characteristics for each sub-population were established. Multiple regression analysis was performed to identify links with depression.Results Depression was prevalent in 17.15% (CI 95%: 16.01 – 18.36) with a female predominance. The normoglycaemic sub-population had the highest depression rates. However, persons with known diabetes had a higher probability of having a history of depression (OR:2.36 CI 95%:1.12 – 4.96), as well as with being of the female gender, having lower educational status, having a history of smoking tobacco and having established cardiovascular disease.Conclusions Depression was highly prevalent among the normoglycaemic population especially as age progress. Physicians in primary care should implement a depression screening tool as part of their routine health check-ups, with special attention to those with cardiovascular co-morbidities and any signs of psycho-socio-economic burden.


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