Cross-sectional study of prevalence and risk factors, and a cost-effectiveness evaluation of screening and preventive treatment strategies for latent tuberculosis among migrants in Singapore

ObjectivesWHO recommends that low burden countries consider systematic screening and treatment of latent tuberculosis infection (LTBI) in migrants from high incidence countries. We aimed to determine LTBI prevalence and risk factors and evaluate cost-effectiveness of screening and treating LTBI in migrants to Singapore from a government payer perspective.DesignCross-sectional study and cost-effectiveness analysis.SettingMigrants in Singapore.Participants3618 migrants who were between 20 and 50 years old, have not worked in Singapore previously and stayed in Singapore for less than a year were recruited.Primary and secondary outcome measuresCosts, quality-adjusted life-years (QALYs), threshold length of stay, incremental cost-effectiveness ratios (ICERs), cost per active TB case averted.ResultsOf 3584 migrants surveyed, 20.4% had positive interferon-gamma release assay (IGRA) results, with the highest positivity in Filipinos (33.2%). Higher LTBI prevalence was significantly associated with age, marital status and past TB exposure. The cost-effectiveness model projected an ICER of S$57 116 per QALY and S$12 422 per active TB case averted for screening and treating LTBI with 3 months once weekly isoniazid and rifapentine combination regimen treatment compared with no screening over a 50-year time horizon. ICER was most sensitive to the cohort’s length of stay in Singapore, yearly disease progression rates from LTBI to active TB, followed by the cost of IGRA testing.ConclusionsFor LTBI screening and treatment of migrants to be cost-effective, migrants from high burden countries would have to stay in Singapore for ~50 years. Risk-stratified approaches based on projected length of stay and country of origin and/or age group can be considered.

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Prevalence of latent tuberculosis infection and feasibility of TB preventive therapy among Thai prisoners: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-021-11271-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sivaporn Gatechompol ◽

Weerakit Harnpariphan ◽

Ruamthip Supanan ◽

Gompol Suwanpimolkul ◽

Jiratchaya Sophonphan ◽

...

Keyword(s):

Latent Tuberculosis ◽

Cross Sectional Study ◽

Preventive Therapy ◽

Sectional Study ◽

Cross Sectional ◽

Ltbi Prevalence ◽

History Of ◽

Chest X Ray ◽

Latent Tb ◽

Latent Tb Infection

Abstract Background Prisons are considered as major reservoirs for tuberculosis. Preventive therapy for latent TB infection (LTBI) is an adjunctive strategy to control TB. However, LTBI data in Thai prisoners is limited. This study assessed the prevalence of LTBI and feasibility of isoniazid preventive therapy (IPT). Methods A cross-sectional study was conducted among prisoners in Klong Prem Central Prison, Bangkok. Participants were screened for active TB by questionnaire and chest X-ray. LTBI was evaluated by Tuberculin skin test (TST) and QuantiFERON-TB Gold Plus (QFTP) among subgroup. Participants with positive TST or QFTP were considered to have LTBI. Participants with LTBI were offered IPT. Results From August 2018–November 2019, 1002 participants were analyzed. All participants were male with a median age of 38 (IQR 32–50) years. LTBI identified by either TST/QFTP was present in 466 (46.5%) participants. TST was positive in 359 (36%) participants. In the subgroup of 294 participants who had both TST and QFTP results, 181/294 (61.6%) tested positive by QFTP. Agreement between TST and QFTP was 55.1% (Kappa = 0.17). The risk factors associated with LTBI were previous incarceration (aOR 1.53, 95%CI, 1.16–2.01, p = 0.002), history of prior active TB (aOR 3.02, 95%CI, 1.74–5.24, p < 0.001) and duration of incarceration ≥10 years (aOR 1.86, 95%CI, 1.24–2.79, p = 0.003). Majority of LTBI participants (82%) agreed to take IPT. Three hundred and 56 (93%) participants completed treatment whereas 27 (7%) participants discontinued IPT due to the side effects of INH. Conclusion This is the first study to evaluate the prevalence of LTBI and feasibility of IPT among Thai prisoners. LTBI prevalence in male prisoners in Thailand is high. LTBI screening and treatment should be implemented together with other preventive components.

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Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-043814 ◽

2021 ◽

Vol 11 (3) ◽

pp. e043814

Author(s):

Mesfin Tadese ◽

Andargachew Kassa ◽

Abebaw Abeje Muluneh ◽

Girma Altaye

Keyword(s):

Risk Factors ◽

Academic Performance ◽

University Students ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Grade Point ◽

Significant Difference ◽

Associated Risk Factors

ObjectivesThe study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.Design and methodInstitution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.Setting and participantsEthiopia (2019: n=647 female university students).OutcomesThe primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.ResultsThe prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).ConclusionsDysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

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Isolation measures and protection awareness are significant for latent tuberculosis infection: a cross-sectional study based on T-SPOT.TB among health care workers in China

Epidemiology and Infection ◽

10.1017/s0950268818002777 ◽

2019 ◽

Vol 147 ◽

Author(s):

Yunfeng Deng ◽

Yun Liu ◽

Yan Li ◽

Hui Jing ◽

Yan Wang ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Health Care Workers ◽

Healthcare Service ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Care Workers

AbstractThis study aimed to reveal the associated risk factors for latent tuberculosis infection (LTBI) detected by T-SPOT.TB assay among health care workers (HCWs) at different working locations or job categories in China. This cross-sectional study included 934 HCWs who underwent the T-SPOT.TB assay. Demographic and social characteristics of the participants, including age, sex, job categories, department/ward and duration of healthcare service, were recorded. Among 934 HCWs, 267 (28.5867%) were diagnosed as having LTBI with positive T-SPOT.TB assay. HCWs working in inpatient tuberculosis (TB) (odds ratio (OR) 2.917; 95% confidence interval (CI) 1.852–4.596; P < 0.001) and respiratory wards (OR 1.840; 95% CI 1.124–3.011; P = 0.015), and with longer duration of healthcare service (OR 1.048; 95% CI 1.016–1.080; P = 0.003) were risk factors for positive T-SPOT.TB result. Furthermore, longer working duration increased the positive rate of T-SPOT.TB results for physicians and nurses, and physicians had higher risks than nurses for the same working duration. Inpatient TB and respiratory wards were high-risk working locations for HCWs with LTBI, and longer duration of healthcare service also increased the risk of LTBI among HCWs. A complete strategy for TB infection control and protection awareness among HCWs should be enhanced.

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Prevalence of pressure ulcers in hospitalised patients: a cross-sectional study

Journal of Wound Care ◽

10.12968/jowc.2020.29.sup3.s20 ◽

2020 ◽

Vol 29 (Sup3) ◽

pp. S20-S28

Author(s):

Stella Olivo ◽

Cristina Canova ◽

Angela Peghetti ◽

Maurilio Rossi ◽

Renzo Zanotti

Keyword(s):

Risk Factors ◽

Length Of Stay ◽

Pressure Ulcer ◽

Pressure Ulcers ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Hospitalised Patients ◽

Number Of Patients ◽

Present On Admission

Objective: The main aim of this study was to estimate the prevalence of pressure ulcers (PU) and related risk factors of PU development in hospitalised patients in Italy. Furthermore, the study investigated the association between risk factors for PU present on admission and the development during hospitalisation (hospital-acquired pressure ulcer, HAPU). Methods: A cross-sectional study, using two separate designs at two separate timepoints: 2010 and 2015. The methodology used to measure PU prevalence was that recommended by the European Pressure Ulcer Advisory Panel (EPUAP). Results: The total sample was 7681 hospitalised patients (3011 patients in 2010, 4670 in 2015). Prevalence of PU in hospital was 19.5% in 2010 and 17% in 2015. The number of patients with PU present on admission were 9.60% in 2010 and 9.42% in 2015. Patients with HAPU were 5.08% in 2010 and 5.87% in 2015. Older age and comorbidities, and a total Braden score of ≤16 were positively associated with PU present on admission and HAPU in hospitals (p<0.05). A longer length of stay appeared to correlate positively with a better clinical outcome for PU if there were already present on admission. Heterogeneous results emerged for length of stay of >30 days and being admitted to intensive care unit (ICU). Conclusion: Our results are comparable with other European and Italian studies. Most of the risk factors associated with PU development have been confirmed. However, further studies are needed to examine the effects of context on PU present on arrival and HAPU, especially regarding hospital length of stay.

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Awareness of risk factors and warning symptoms and attitude towards gastric cancer screening among the general public in China: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029638 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029638 ◽

Cited By ~ 3

Author(s):

Qi Liu ◽

Xi Zeng ◽

Wen Wang ◽

Ruo-lin Huang ◽

Yan-jin Huang ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Cancer Screening ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Knowledge Level ◽

Cancer Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Gastric Cancer Screening

ObjectivesThis study aimed to assess the knowledge of risk factors and warning symptoms and attitude towards gastric cancer screening among the general population in China.SettingHunan province, ChinaParticipantsIndividuals aged older than 18 years were recruited using a cluster sampling method.DesignA cross-sectional study, and a pretested structured questionnaire was used to assess participants’ awareness of gastric cancer.Primary and secondary outcome measuresKnowledge level of risk factors and warning symptoms of gastric cancer, gastric cancer screening attitude, sociodemographic factors associated with gastric cancer knowledge and screening behaviour.ResultsThis study comprised 1200 participants with a mean age of 40.31 (SD 16.73) years, of whom 622 (51.8%) were women. The mean score for gastric cancer knowledge was 8.85/22 (SD 6.48). There were 47.0% of the participants who had a low knowledge level about the risk factors and warning symptoms of gastric cancer. In total, 83.8% believed screening is helpful for early detection of gastric cancer, and 15.2% had undergone gastric cancer screening. The most common reason for not undergoing screening was having ‘no symptoms’ (63.0%), followed by ‘fear of undergoing gastroscopy’ (38.1%). Independent factors related to lower knowledge levels included male sex, living in rural areas, lower educational level, working as a farmer and without a family history of gastric cancer (p<0.05). Factors independently associated with screening behaviour included white-collar employment, higher income and having upper gastrointestinal tract diseases (p<0.05).ConclusionsIn China, people have poor knowledge about risk factors and warning symptoms of gastric cancer, but a majority have a positive attitude towards the benefits of gastric cancer screening. Being asymptomatic and having a fear of gastroscopy were the main self-reported reasons for not undergoing screening. These results highlight the urgent need for educational campaigns to improve gastric cancer awareness.

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Association between the Use of Alternative Medicine and Adherence to Treatment in Patients with Type 2 Diabetes

Journal of Family Medicine ◽

10.26420/jfammed.2021.1247 ◽

2021 ◽

Vol 8 (3) ◽

Author(s):

Perez-Sosa Abigail M ◽

Keyword(s):

Risk Factors ◽

Alternative Medicine ◽

Medical Treatment ◽

Cross Sectional Study ◽

Sectional Study ◽

Adherence To Treatment ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

The Cost

Background: Diabetes mellitus 2 (T2D) is the leading cause of morbidity and mortality in northern Mexico. Various treatments are used to control the disease; however, the cost of these and the difficulty of dietary management have as a consequence that the patient abandons them and looks for cheaper and easier-to-use alternatives. Aim: The purpose of this study is to determine the relationship between the use of alternative medicine and adherence to medical treatment in patients with T2D. Design and Setting: Analytic cross-sectional study. Methods: An analytical cross-sectional study was designed between March and July 2019 including 464 patients with T2D from the family medicine unit #48 Ciudad Juarez, Mexico. We used the Morisky-Green scale for adherence to treatment and the use of Alternative Medicine (CAM) was evaluated with a holistic complementary and alternative medicine questionnaire. The Chi-Square test was used for comparison of proportions and risk factors were calculated using odds ratio with 95% confidence intervals. Results: 53% of patients use CAM; biological therapy (herbs and supplements) is the most frequent (94%). The association between CAM use and adherence to medical treatment was 2.1 (95% CI 1.4-3.1, p= 0.001). The risk factors for the use of CAM were female sex, basic level education, uncontrolled disease and a time of evolution greater than 10 years. Conclusion: CAM users are 2.1 times more at risk of having a regular or bad adherence to medical treatment.

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Cognitive impairment in a primary healthcare population: a cross-sectional study on the island of Crete, Greece

BMJ Open ◽

10.1136/bmjopen-2019-035551 ◽

2020 ◽

Vol 10 (9) ◽

pp. e035551

Author(s):

Antonios Konstantinos Bertsias ◽

Ioanna Tsiligianni ◽

Sophia Papadakis ◽

Ioannis Zaganas ◽

George Duijker ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Primary Healthcare ◽

Urban Areas ◽

Cross Sectional Study ◽

Cognitive Status ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Sleep Complaints

ObjectivesCognitive impairment is known to have a significant impact on the quality of life of individuals and their caregivers, yet it is often underdiagnosed. The objective of this study is to assess the extent of cognitive impairment among elders visiting primary healthcare (PHC) practice settings, to explore associated risk factors and discuss current care challenges for PHC providers.DesignA cross-sectional study was conducted between March 2013 and May 2014.SettingFourteen PHC units located in rural and urban areas of the Heraklion district in Crete, Greece.ParticipantsConsecutive visitors aged at least 60 years attending selected PHC practices.Primary and secondary outcome measuresThe Mini-Mental State Examination (MMSE) was used to indicate cognitive status. Associations of low MMSE scores (≤23/24, adjusted for education level) with 12 socio-demographic factors, comorbidities and lifestyle factors were assessed.ResultsA total of 3140 PHC patients met inclusion criteria (43.2% male; mean age 73.7±7.8 years). The average MMSE score was 26.0±3.8; 26.7±3.5 in male and 25.4±3.9 in female participants (p<0.0001). Low MMSE scores were detected in 20.2% of participants; 25.9% for females vs 12.8% for males; p<0.0001. Female gender (adjusted OR (AOR)=2.72; 95% CI 2.31 to 3.47), age (AOR=1.11; 95% CI 1.10 to 1.13), having received only primary or no formal education (AOR=2.87; 95% CI 2.26 to 3.65), alcohol intake (AOR=1.19; 95% CI 1.03 to 1.37), reporting one or more sleep complaints (AOR 1.63; 95% CI 1.14 to 2.32), dyslipidaemia (AOR=0.80; 95% CI 0.65 to 0.98) and history of depression (AOR=1.90; 95% CI 1.43 to 2.52) were associated with low MMSE scores.ConclusionsThis study identified a relatively high prevalence of low MMSE scores among persons attending PHC practices in a southern European community setting and associations with several known risk factors.

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Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-031281 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031281 ◽

Cited By ~ 5

Author(s):

Manel Mata-Cases ◽

Josep Franch-Nadal ◽

Jordi Real ◽

Marta Cedenilla ◽

Didac Mauricio

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Primary Care ◽

Chronic Conditions ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.

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Toxoplasma gondii infection in pregnant women: a cross-sectional study in Matehuala City, Mexico

BMJ Open ◽

10.1136/bmjopen-2019-033995 ◽

2020 ◽

Vol 10 (8) ◽

pp. e033995

Author(s):

Ada-Agustina Sandoval-Carrillo ◽

Angel Antonio Vértiz-Hernández ◽

Jose-Manuel Salas-Pacheco ◽

Olga Edith González-Lugo ◽

Elizabeth-Irasema Antuna-Salcido ◽

...

Keyword(s):

Risk Factors ◽

Toxoplasma Gondii ◽

Pregnant Women ◽

Protective Factor ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Infection Age ◽

Igm Antibodies

ObjectivesThis study aimed to determine the seroprevalence of Toxoplasma gondii (T. gondii) infection in pregnant women in Matehuala City, Mexico; and the associated risk factors.DesignA cross-sectional study.SettingMatehuala City, Mexico.Participants311 pregnant women.Primary and secondary outcome measuresSera of women were analysed for anti-T. gondii IgG and IgM antibodies by commercially available immunoassays. Bivariate and multivariate analyses were used to assess the association between T. gondii seroprevalence and the characteristics of the pregnant women.ResultsThirteen (4.2%) of the 311 pregnant women studied were positive for anti-T. gondii IgG antibodies. No anti-T. gondii IgM antibodies were found in anti-T. gondii IgG seropositive women. No association between seropositivity and history of blood transfusion, transplantation, caesarean sections, deliveries, miscarriages or number of pregnancies was found. Logistic regression analysis of sociodemographic, behavioural and housing variables showed that availability of potable water at street represented a risk factor for T. gondii infection (age-adjusted OR=2.18; 95% CI: 1.05 to 4.53; p=0.03), whereas being born in Mexico was a protective factor for infection (age-adjusted OR=0.01; 95% CI: 0.001 to 0.35; p=0.008).ConclusionsIn this first study on the seroepidemiology of T. gondii infection in pregnant women in Matehuala, we conclude that the seroprevalence of T. gondii infection is low and similar to those reported in pregnant women in other Mexican cities. However, the seroprevalence found is lower than those reported in pregnant women in other countries in the Americas and Europe. Two risk factors associated with T. gondii infection were identified. Results of the present study may help for the optimal planning of preventive measures against toxoplasmosis in pregnant women.

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