scholarly journals Is being a 'left-behind' child associated with an increased risk of self-poisoning in adulthood? Findings from a case–control study in Sri Lanka

2021 ◽  
Vol 6 (3) ◽  
pp. e003734
Author(s):  
Duleeka Knipe ◽  
Paul Moran ◽  
Laura D Howe ◽  
Piumee Bandara ◽  
Kolitha Wickramage ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Case Control Study ◽  
Medical Toxicology ◽  
Case Control ◽  
Statistical Evidence ◽  
Adverse Outcomes ◽  
Left Behind ◽  
Increased Risk ◽  
The Impact ◽  
Control Study

PurposeThe long-term consequences of parental emigration on offspring self-harm risk is unknown.MethodsWe investigated the association between experiencing parental emigration in childhood with hospital presentations for self-poisoning in adulthood using a hospital case–control study. Cases were adult self-poisoning patients (≥18 year olds) admitted to the medical toxicology ward Teaching Hospital Peradeniya, Sri Lanka. Sex and age frequency matched controls were recruited from the outpatient department or nearby specialist clinics at the same hospital. Details of parental emigration were collected using a pre-piloted questionnaire. The relationship between parental emigration and self-poisoning in adulthood was estimated using logistic regression models.Results298 cases, and 500 hospital controls were interviewed for the study. We estimate that one in five adults experienced parental emmigration as children (95% CI 17% to 24%). We find limited evidence that children from households with emigrating parents were more likely to experience adverse childhood experiences than those with non-emigrating parents. We found no statistical evidence of an increased risk of self-poisoning in adulthood in individuals who experienced parental emigration (maternal or paternal) during childhood. There was no statistical evidence that the impact differed by the sex of the participant.ConclusionAdults who experienced parental emigration as children were no more likely to self-poison than adults with non-emigrating parents. Further research using longitudinal data are needed to understand whether any adverse outcomes observed in 'left-behind' children are a consequence of parental emigration or due to factors associated but predate the emigration. Prospective data are also important to investigate whether there are any lasting effects on children who experience parental emigration.

scholarly journals Environmental asbestos exposure and clustering of malignant mesothelioma in community: a spatial analysis in a population-based case–control study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
C. Airoldi ◽  
C. Magnani ◽  
F. Lazzarato ◽  
D. Mirabelli ◽  
S. Tunesi ◽  
...  
Keyword(s):  
Spatial Variation ◽  
Malignant Mesothelioma ◽  
Case Control Study ◽  
Disease Risk ◽  
Population Based ◽  
Case Control ◽  
Contour Plot ◽  
Increased Risk ◽  
The Impact ◽  
Control Study

Abstract Background Neighborhood exposure to asbestos increases the risk of developing malignant mesothelioma (MM) in residents who live near asbestos mines and asbestos product plants. The area of Casale Monferrato (Northwest Italy) was impacted by several sources of asbestos environmental pollution, due to the presence of the largest Italian asbestos cement (AC) plant. In the present study, we examined the spatial variation of MM risk in an area with high levels of asbestos pollution and secondly, and we explored the pattern of clustering. Methods A population-based case–control study conducted between 2001 and 2006 included 200 cases and 348 controls. Demographic and occupational data along with residential information were recorded. Bivariate Kernel density estimation was used to map spatial variation in disease risk while an adjusted logistic model was applied to estimate the impact of residential distance from the AC plant. Kulldorf test and Cuzick Edward test were then performed. Results One hundred ninety-six cases and 322 controls were included in the analyses. The contour plot of the cases to controls ratio showed a well-defined peak of MM incidence near the AC factory, and the risk decreased monotonically in all directions when large bandwidths were used. However, considering narrower smoothing parameters, several peaks of increased risk were reported. A constant trend of decreasing OR with increasing distance was observed, with estimates of 10.9 (95% CI 5.32–22.38) and 10.48 (95%CI 4.54–24.2) for 0–5 km and 5–10 km, respectively (reference > 15 km). Finally, a significant (p < 0.0001) excess of cases near the pollution source was identified and cases are spatially clustered relative to the controls until 13 nearest neighbors. Conclusions In this study, we found an increasing pattern of mesothelioma risk in the area around a big AC factory and we detected secondary clusters of cases due to local exposure points, possibly associated to the use of asbestos materials.

Impact of Early Factor VIII Exposure, Prophylaxis and Prenatal/Perinatal Events on Inhibitor Risk in Children with Hemophilia A: A Case-Control Study.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 37-37 ◽  
Author(s):  
Elena Santagostino ◽  
Angiola Rocino ◽  
Maria E. Mancuso ◽  
Maria G. Mazzucconi ◽  
Giacomo Mancuso ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Case Control Study ◽  
Hemophilia A ◽  
Univariate Analysis ◽  
Case Control ◽  
Inhibitor Development ◽  
Intron 22 Inversion ◽  
Increased Risk ◽  
The Impact ◽  
Control Study

Abstract In a multicenter case-control study we investigated the impact of prenatal/perinatal events and early FVIII exposure on the inhibitor risk in hemophiliacs. Patients: 102 children (age:13–196 months) with hemophilia A (FVIII≤2%) exclusively treated with recombinant FVIII and evaluated for inhibitors every 3 months were included. Forty-seven patients who developed inhibitors at the median age of 26 months (4–80) after a median of 16 exposure days (ED, 5–150), 37 high-responders (6–500 BU/mL) and 10 low-responders (<5 BU/mL), were compared with 55 children who did not develop inhibitors after at least 20 ED (5<50, 4<100, 10<200 and 36>200 ED). Results: by univariate analysis, family history of inhibitors, intron 22 inversion and prophylaxis started after the first 20 ED were significantly associated with an increased risk of inhibitor development (OR 9.5, 95%CI 1.1–79.9; OR 2.7, 95%CI 1.1–6.6; OR 3.7, 95%CI 1.1–12.1, respectively). No statistically significant differences were found for variables such as villocentesis/amniocentesis, premature/caesarian birth, breast-feeding, surgery, central venous devices and FVIII infusions associated with infections/vaccinations. By multivariate analysis, the inhibitor risk was 2.8-folds (95%CI 1.1–7.3) in children with intron 22 inversion and 4.5-folds (95%CI 1.1–17.5) in patients who started prophylaxis after the first 20 ED. By univariate and multivariate analysis, there was not a linear trend in the inhibitor development according to the age at first FVIII exposure (≤6, 7–12, 13–18, 19–24, >24 months). Conclusions: this study showed that starting prophylaxis within the first 20 ED had a favourable impact on the inhibitor risk independently from the age at first FVIII exposure.

scholarly journals Genitourinary Procedures as Risk Factors for Prosthetic Hip or Knee Infection: A Hospital-Based Prospective Case-Control Study

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Arjun Gupta ◽  
Douglas R. Osmon ◽  
Arlen D. Hanssen ◽  
Deborah J. Lightner ◽  
Walter R. Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Prophylaxis ◽  
Case Control Study ◽  
Joint Infection ◽  
Case Control ◽  
Total Hip ◽  
Control Subjects ◽  
Increased Risk ◽  
The Impact ◽  
Control Study

Abstract Background.  The purpose of this study was to determine the risk of prosthetic joint infection (PJI) as a complication of routine genitourinary (GU) procedures in patients with total hip arthroplasty (THA) or total knee arthroplasty (TKA) and to study the impact of antibiotic prophylaxis administered prior to these procedures. Methods.  We conducted a prospective, single-center, case-control study between December 1, 2001 and May 31, 2006. Case patients were hospitalized with total hip or knee PJI. Control subjects underwent a THA or TKA and were hospitalized during the same period on the same orthopedic floor without a PJI. Data regarding demographic features and potential risk factors were collected. The outcome measure was the odds ratio (OR) of PJI after GU procedures performed within 2 years of admission. Results.  A total of 339 case patients and 339 control subjects were enrolled in the study. Of these, 52 cases (15%) and 55 controls (16%) had undergone a GU procedure in the preceding 2 years. There was no increased risk of PJI for patients undergoing a GU procedure with or without antibiotic prophylaxis (adjusted OR [aOR] = 1.0, 95% confidence interval [CI] = 0.2–4.5, P = .95 and aOR = 1.0, 95% CI = 0.6–1.7, P = .99, respectively). Results were similar in a subset of patients with a joint age less than 6 months, less than 1 year, or greater than 1 year. Conclusions.  Genitourinary procedures were not risk factors for subsequent PJI. The use of antibiotic prophylaxis before GU procedures did not decrease the risk of subsequent PJI in our study.

scholarly journals Childhood adversity and deliberate self-poisoning in Sri Lanka: a protocol for a hospital-based case–control study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027766 ◽  
Author(s):  
Duleeka W Knipe ◽  
Piumee Bandara ◽  
Lalith Senarathna ◽  
Judi Kidger ◽  
José López-López ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Suicidal Behaviour ◽  
Case Control Study ◽  
Childhood Adversity ◽  
Case Control ◽  
Ethical Review ◽  
Low Middle Income Countries ◽  
Increased Risk ◽  
Modifiable Factors ◽  
Control Study

IntroductionChildhood adversity (CA) has been suggested as a key risk factor for suicidal behaviour, but evidence from low/middle-income countries is lacking. In Sri Lanka, CA, in the form of child maltreatment or as a consequence of maternal separation, has been highlighted in primarily qualitative or case series work, as a potentially important determinant of suicidal behaviour. To date, there have been no quantitative studies to investigate CA as a key exposure associated with suicidal behaviour in Sri Lanka. The aim of the research is to understand the association between CA and suicidal behaviour in Sri Lanka and to identify potentially modifiable factors to reduce any observed increased risk of suicidal behaviour associated with CA.Methods and analysisThis is a hospital-based case–control study. Cases (n=200) will be drawn from individuals admitted to the medical toxicology ward of the Teaching Hospital Peradeniya, Sri Lanka, for medical management of intentional self-poisoning. Sex and age frequency-matched controls (n=200) will be recruited from either patients or accompanying visitors presenting at the outpatient department and clinic of the same hospital for conditions unrelated to the outcome of interest. Conditional logistic regression will be used to investigate the association between CA and deliberate self-poisoning and whether the association is altered by other key factors including socioeconomic status, psychiatric morbidity, current experiences of domestic violence and social support.Ethics and disseminationEthics approval has been obtained from the Ethical Review Committee of the Faculty of Medicine, University of Peradeniya, Sri Lanka. Researchers have been trained in administering the questionnaire and a participant safety and distress protocol has been designed to guide researchers in ensuring participant safety and how to deal with a distressed participant. Results will be disseminated in local policy fora and peer-reviewed articles, local media, and national and international conferences.

scholarly journals Predictors of Fetal Macrosomia Among Women Delivering at a Tertiary Hospital in Tanzania: A Case Control Study

2021 ◽  
Author(s):  
Emmanuel Imani Ngadaya ◽  
Maria Angelica Rweyemamu ◽  
Proffesor Ipyana Hudson Mwampagatwa ◽  
Athanase Gervase Lilungulu
Keyword(s):  
Diabetes Mellitus ◽  
Case Control Study ◽  
Case Control ◽  
Adverse Outcomes ◽  
Referral Hospital ◽  
Fetal Macrosomia ◽  
Regional Referral Hospital ◽  
Gestation Age ◽  
Increased Risk ◽  
Control Study

Abstract Purpose: The study aimed at assessing predictors of fetal macrosomia at Iringa Regional Referral hospital in Tanzania. It is currently challenging to predict fetal macrosomia before delivery which possess women to an increasing risk of sustaining adverse maternal or fetal outcomes. Methods: A case-control study design in which cases were women who delivered babies weighing ≥ 4000g while controls were those who delivered babies weighing 2500g to 3500g. Purposive sampling technique was employed to recruit both controls and cases. A total of 216 participants were included. This was an unmatched case control study. SPSS version 25 software program was used for data entry and analysis. Chi-squared test, P-value, unadjusted and adjusted logistic regression were used to determine statistical significant. Results: Predictors of fetal macrosomia at Iringa Regional Referral hospital were advanced gestation age (AOR=8.10, 95% CI 3.66-17.91, p=<0.0001) and diabetes mellitus during pregnancy (AOR =14.94, 95% CI 1.60 -39.91, p= 0.0178).Conclusion: Women with advanced gestation age and diabetes mellitus during pregnancy are at an increased risk of delivering a macrosomic baby. Assessing predictors of fetal macrosomia will enable early prediction and intervention of women with fetal macrosomia hence preventing further maternal and fetal adverse outcomes.

scholarly journals Serious adverse events and the risk of stroke in patients with rheumatoid arthritis: results from the German RABBIT cohort

2017 ◽  
Vol 76 (9) ◽  
pp. 1583-1590 ◽  
Author(s):  
Y Meissner ◽  
A Richter ◽  
B Manger ◽  
HP Tony ◽  
E Wilden ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Adverse Events ◽  
Case Control Study ◽  
Case Control ◽  
Serious Adverse Events ◽  
Increased Risk ◽  
Serious Infections ◽  
The Impact ◽  
Control Study

ObjectiveIn the general population, the incidence of stroke is increased following other serious events and hospitalisation. We investigated the impact of serious adverse events on the risk of stroke in patients with rheumatoid arthritis (RA), taking risk factors and treatment into account.MethodsUsing data of the German biologics register RABBIT (Rheumatoid Arthritis: Observation of Biologic Therapy) with 12354 patients with RA, incidence rates (IRs) and risk factors for stroke were investigated using multi-state and Cox proportional hazard models. In addition, in a nested case–control study, all patients with stroke were matched 1:2 to patients with identical baseline risk profile and analysed using a shared frailty model.ResultsDuring follow-up, 166 strokes were reported. The overall IR was 3.2/1000 patient-years (PY) (95% CI 2.7 to 3.7). It was higher after a serious adverse event (IR: 9.0 (7.3 to 11.0)), particularly within 30 days after the event (IR: 94.9 (72.6 to 121.9)). The adjusted Cox model showed increased risks of age per 5 years (HR: 1.4 (1.3 to 1.5)), hyperlipoproteinaemia (HR: 1.6 (1.0 to 2.5)) and smoking (HR: 1.9 (1.3 to 2.6)). The risk decreased with better physical function (HR: 0.9 (0.8 to 0.96)). In the case–control study, 163 patients were matched to 326 controls. Major risk factors for stroke were untreated cardiovascular disease (HR: 3.3 (1.5 to 7.2)) and serious infections (HR:4.4 (1.6 to 12.5)) or other serious adverse events (HR: 2.6 (1.4 to 4.8)).ConclusionsIncident adverse events, in particular serious infections, and insufficient treatment of cardiovascular diseases are independent drivers of the risk of stroke. Physicians should be aware that patients who experience a serious event are at increased risk of subsequent stroke.

scholarly journals Predictors of Fetal Macrosomia Among Women Delivering at a Tertiary Hospital in Tanzania: A Case Control Study

2021 ◽  
Author(s):  
Emmanuel Imani Ngadaya ◽  
Maria Angelica Rweyemamu ◽  
Proffesor Ipyana Hudson Mwampagatwa ◽  
Athanase Gervase Lilungulu
Keyword(s):  
Diabetes Mellitus ◽  
Case Control Study ◽  
Case Control ◽  
Adverse Outcomes ◽  
Referral Hospital ◽  
Fetal Macrosomia ◽  
Regional Referral Hospital ◽  
Gestation Age ◽  
Increased Risk ◽  
Control Study

Abstract Purpose: The study aimed at assessing predictors of fetal macrosomia at Iringa Regional Referral hospital in Tanzania. It is currently challenging to predict fetal macrosomia before delivery which possess women to an increasing risk of sustaining adverse maternal or fetal outcomes. Methods: A case-control study design in which cases were women who delivered babies weighing ≥ 4000g while controls were those who delivered babies weighing 2500g to 3500g. Purposive sampling technique was employed to recruit both controls and cases. A total of 216 participants were included. This was an unmatched case control study. SPSS version 25 software program was used for data entry and analysis. Chi-squared test, P-value, unadjusted and adjusted logistic regression were used to determine statistical significant. Results: Predictors of fetal macrosomia at Iringa Regional Referral hospital were advanced gestation age (AOR=8.10, 95% CI 3.66-17.91, p=<0.0001) and diabetes mellitus during pregnancy (AOR =14.94, 95% CI 1.60 -39.91, p= 0.0178).Conclusion: Women with advanced gestation age and diabetes mellitus during pregnancy are at an increased risk of delivering a macrosomic baby. Assessing predictors of fetal macrosomia will enable early prediction and intervention of women with fetal macrosomia hence preventing further maternal and fetal adverse outcomes.

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