scholarly journals Inequities in childhood anaemia at provincial borders in Mozambique: cross-sectional study results from multilevel Bayesian analysis of 2018 National Malaria Indicator Survey

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051395
Author(s):  
Nazeem Muhajarine ◽  
Daniel A Adeyinka ◽  
Mbate Matandalasse ◽  
Sergio Chicumbe

ObjectivesThis study aims to identify the child-level, maternal-level, household-level and community-level determinants of anaemia among children aged 6–59 months, and determine the inequities of anaemia prevalence across communities in Mozambique.DesignCross-sectional study.SettingMozambique.ParticipantsThis study used data of a weighted population of 3946 children, 6–59 months, delivered by women between 15 and 49 years of age, from the 2018 Mozambique Malaria Indicator Survey.Primary outcome measureChild’s anaemic status, measured as altitude-adjusted haemoglobin concentration (in g/L); the severity of anaemia was categorised based on predefined threshold values. Multilevel Bayesian linear regressions identified key determinants of childhood anaemia. Based on data availability and policy implications, spatial analysis was used to determine geographical variation of anaemia at the community level and areas with higher risks.ResultsThe mean prevalence of childhood anaemia was 77.7% (SD: 5.5%). Provincially, Cabo Delgado province (86.2%) had the highest prevalence, Maputo province (70.2%) the lowest. Children with excess risk were mostly found in communities that had proximity to provincial borders: Niassa-Cabo Delgado-Nampula triprovincial border, Gaza-Inhambane border, Zambezia-Nampula border and provinces of Manica and Inhambane. Children with anaemia tended to be younger, males and at risk of having malaria because they were not sleeping under mosquito nets. In addition, children from poor families relative to children from wealthier households and those living in female-headed households were prone to anaemia.ConclusionFindings from this study provide evidence that spatial inequities in childhood anaemia exist in Mozambique, mostly concentrated in the communities living close to the provincial borders. Anaemia among children could be effectively reduced through malaria prevention, for example, bed netting. Interventions are needed that generate income for households, increase community support for households headed by women, improve malaria control, build capacity of healthcare workers to manage severely anaemic children and health education for mothers.

2021 ◽  
Author(s):  
Nazeem Muhajarine ◽  
Daniel Adedayo Adeyinka ◽  
Mbate Matandalasse ◽  
Sergio Chicumbe

Childhood anaemia is a common public health problem worldwide. The geographical patterns and underlying factors of childhood anaemia have been understudied in Mozambique. The objectives of this study were to identify the child, maternal, household, and community level determinants of anaemia among children aged 6-59 months, and the contribution of these factors to the variation in childhood anaemia at the community level in Mozambique. This is a cross sectional study that utilized data of a weighted population of 4,141 children aged 6-59 months delivered by women between 15-49 years of age, from the 2018 Mozambique Malaria Indicator Survey. Multilevel Bayesian linear regressions identified key determinants of childhood anaemia. Spatial analysis was used to determine geographic variation of anaemia at the community level and areas with higher risks. The overall national prevalence of childhood anaemia was 78-80.3%. There was provincial variation with Cabo Delgado province (86.2%) having highest prevalence, and Maputo province (70.2%) the lowest. Children with excess risk were mostly found in communities that had proximity to provincial borders: Niassa-Cabo Delgado-Nampula tri-provincial border, Gaza-Inhambane border, Zambezia-Nampula border, and provinces of Manica and Inhambane. Children with anaemia tended to be younger, males, and at risk of having malaria because they were not sleeping under mosquito nets. In addition, children from poor families and those living in female-headed households were prone to anaemia. This study provides evidence that anaemia among children aged 6-59 months is a severe public health threat across the provinces in Mozambique. It also identifies inequity in childhood anaemia, worse among communities living close to the provincial borders. We recommend interventions that would generate income for households, increase community support for households headed by women, improve malaria control, build capacity of healthcare workers to manage severely anaemic children and health education for mothers. More importantly, there is need to foster collaborations between communities, districts and provinces to strengthen maternal and child health programmes for the severely affected areas.


2012 ◽  
pp. 83-87
Author(s):  
Thi Minh Xuan Doan ◽  
Xuan Chuong Tran

Children with mental retardation have low intelligence, slow thinking, low learning ability in comparison with the same age children. Objectives: 1. To determine the prevalence of children with mental retardation in Hue City. 2. To study some characteristics of children with mental retardation. Materials and methodes: All children with mental retardation in Hue city. Cross sectional study. Results: The prevalence of children with mental retardation (CMR) among children under 15 yrs is 0.23%, among disable children 38.16%. The highest prevalences ware in Phu Binh, Xuan Phu quarters (0.79 and 0.66%), lowest in Thuan Loc, Thuan Thanh quarters (0.03 and 0.06%). Children over 5 yrs old were 75.95%. Most of children have slow development in movement and daily activities. More than 78% have late walking, 84% have late speaking. Conclusions: The prevalence of children with mental retardation among children under 15 yrs is 0.23%, among disable children 38.16%. Most of children have slow development in movement and daily activities.


2021 ◽  
Author(s):  
Sara Gianella ◽  
Rowan Saloner ◽  
Genevieve Curtin ◽  
Susan J. Little ◽  
Anne Heaton ◽  
...  

AbstractThis observational cross-sectional study of 152 people with HIV (PWH) examined the effects of age and estimated duration of HIV infection (EDI) on depressive and anxiety symptoms. All participants were cisgender men and completed the Profile of Moods State (POMS), a self-report inventory of current (i.e., past week) mood states. Overall, study results confirmed higher levels of anxiety and depression in PWH compared to individuals without HIV. Age group (< 50 or ≥ 50 years) moderated the effect of EDI (< 3 or ≥ 3 years) on mood disturbance. Specifically, younger PWH with early diagnosed infection exhibited the highest levels of depression and anxiety, whereas depression and anxiety were attenuated in older PWH with early infection such that their POMS scores did not significantly differ from the HIV-negative and chronically HIV-infected groups. Despite the small sample size and other important limitations in our study design, our preliminary findings confirm previous observations that older people may have some adaptive ability to better handle the acute psychological stressors associated with recent HIV infection.


Author(s):  
D. Devi ◽  
V. Monica ◽  
Ravi Santhosh ◽  
Vijaya Raghavan ◽  
P. Poornachandrika

Background: The COVID-19 pandemic is a global health threat and is by far the largest outbreak of atypical pneumonia, since the SARS outbreak in 2003. A range of psychiatric morbidities such as persistent depression, anxiety, panic attacks, delirium and suicidality were observed in the post infectious state across the world. Hence, the aim of the study was to understand the psychological status of the patients affected by COVID during their post-COVID follow-up period and to examine the socio-demographic and clinical factors associated with high psychological morbidity. Materials and Methods: A cross sectional study conducted in the post-COVID follow up clinic, at a tertiary care hospital between the months of August - November 2020, using a semi structured proforma and rating scales such as Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) for depression, anxiety and insomnia, respectively. Results: The study results indicate that the prevalence of depression and anxiety among post-COVID-19 patients was 21.9% and 11.9%, respectively. Insomnia was observed among 21.7%Among various sociodemographic and clinical variables examined, it was observed that female gender, patients with ongoing stressors and patients with post-COVID-19 persistent physical symptoms were found to be associated with greater depression and anxiety among the study population. Conclusions: Persistent physical symptoms and ongoing life stressors are found to be associated with depression and anxiety among post-COVID-19 patients. Hence, periodic screening for individuals with persisting physical symptoms and care for the vulnerable population such as those with ongoing stressors will provide a significant advantage in the follow up of the mental health of the patients affected with COVID-19.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027752
Author(s):  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Mariko Kobayashi ◽  
...  

ObjectivesWeight gain after 20 years of age is associated with chronic kidney disease (CKD). However, the impact of weight gain on CKD might differ by current obesity status. We investigated the association of the combination of weight gain after 20 years of age and current obesity with CKD among adults in Japan.DesignA cross-sectional study.Setting and participantsWe analysed data from 94 822 adults aged 40–64 years who had an annual health check-up in Japan from April 2013 to March 2014.Primary outcome measureCKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2and/or proteinuria.ResultsBoth weight gain ≥10 kg after 20 years of age plus obesity (OR 2.21, 95% CI 2.07 to 2.36) and weight gain of ≥10 kg plus non-obesity (OR 1.31, 95% CI 1.21 to 1.42) significantly increased the OR for CKD when compared with weight gain <10 kg plus non-obesity in men. In women, weight gain ≥10 kg plus obesity (OR 2.04, 95% CI 1.84 to 2.25) and weight gain ≥10 kg plus non-obesity (OR 1.53, 95% CI 1.36 to 1.72) significantly increased the OR for CKD compared with weight gain <10 kg plus non-obesity. These results persisted even after adjustment for age, lifestyle factors, hypertension, dyslipidaemia and diabetes.ConclusionsWeight gain ≥10 kg after 20 years of age was significantly associated with CKD in both obese and non-obese subjects. Moreover, the influence of weight gain ≥10 kg plus obesity on CKD was greater than that of weight gain ≥10 kg plus non-obesity on CKD. The present study results suggest that it is important to consider weight gain after maturity in both obese and non-obese subjects to prevent CKD among Japanese middle-aged adults.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036519 ◽  
Author(s):  
Mussie Alemayehu ◽  
Araya Abrha Medhanyie ◽  
Elizabeth Reed ◽  
Afework Mulugeta

ObjectiveThe study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia.DesignA community-based cross-sectional study was conducted in September 2018. Data were analysed using R software. To determine the fixed effect of individual-level and community-level factors of FP use, a two-level mixed-effects logistic regression was used. The result was described using the Adjusted OR (AOR), and the variance partition coefficient.Setting and participantsAfar, Ethiopia (2018; n=891) married women of reproductive age (15–49) years.Primary outcome measuresFP use or non-use.ResultsThe current use of FP was 18.7% (16.31%–21.43%). Women who need to walk 1 hour and more to the nearest health facility (AOR 0.14, 95% CI 0.05 to 0.3), have ANC visit of 4 and above (AOR 6.02, 95% CI 1.74 to 20.8), had their last birth at a health facility (AOR 2.71 95% CI 1.27 to 5.81), have five and more children (AOR 4.71, 95% CI 1.86 to 11.9), have high knowledge on FP (AOR 2.74, 95% CI 1.11 to 6.74) and had high intentions to use FP (AOR 10.3, 95% CI 3.85 to 27.6) were more likely to report FP use. The magnitude of the effect of for FP use was smaller than that of 9 of the 13 individual factors. Apart from this 19.4% of the total variance in the odds of using FP attributed to between community difference (intraclass correlation coefficient=0.194). Regarding the community-level characteristics, clusters of having higher electronic media possession (AOR 2.84, 95% CI 1.2 to 6.72) and higher women decision making on FP (AOR 8.35, 95% CI 2.7 to 27.1) were significantly associated with increased FP use compared with clusters with lower reports of these aspects.ConclusionFP use among the pastoralist community is influenced by both individual cluster/community-level characteristics or factors. Even though the effect of clustering in FP use was large in comparison with the unexplained between-cluster variation, it was lower than the individual-level factors.Trail registrtion numberNCT03450564


Author(s):  
Priya Arora ◽  
Manisha Arora ◽  
Vishal Sharma ◽  
Atul Kotwal

Background: Dengue, an arboviral disease transmitted by Aedes egypti mosquito, has become an important public health problem, with almost half the population of the world being at risk. Community awareness and involvement for vector control is an important aspect of disease prevention and control. The aims and objective was to assess awareness and preventive practices used for dengue and related water storage behaviour in an urban area of Delhi. Methods: Observational, descriptive, cross sectional study. Results: Awareness about dengue fever and its mode of spread is quite high but the participants are not aware about the practices that are putting their surroundings at risk of vector breeding; especially when it comes to water storage behaviour. Conclusions: Behaviour change at individual and community level is essential for vector and hence dengue control, adoption of proper preventive practices and water storage behaviour needs to be emphasized at the community level. 


2021 ◽  
Vol 15 (5) ◽  
pp. 1399-1402
Author(s):  
H. J. Mahmood ◽  
R. H. Ibrahim ◽  
M. F. Abdulghani ◽  
Z. F. Al-Zaidy

Background and aim: The Objectives of the present study to determine the VV among people with different background occupations in the City of Mosul, Iraq. Materials and method: A cross-sectional study was performed at Mosul Teaching Hospital between November 2019 and February 2020. Two hundred people who were physically examined represented different jobs in Iraqi society (Nurses, address, Policemen, and teachers). A physical examination was conducted of all participants who agreed to engage in this study. Results: The overall prevalence rate of VV among different occupational backgrounds in the City of Mosul is 19.5%. The study found that the percentage of men (50.5%) and women (49.5%). Most of the patient was beyond to age group (41-45) years and the mean age of the participants was (39.1+3.1). According to the BMI, the results indicated that most subjects belong to a class<30 (77%). Conclusions: The nurses will seek to prevent excessive extended occupational standing and using sitting or walking when appropriate. As a result, an improvement in clinical practice may reduce the incidence of vascular disease. Keywords: Varicose, Veins, Occupational


Medwave ◽  
2020 ◽  
Vol 20 (10) ◽  
pp. e8064-e8064
Author(s):  
Jairo Rojano Rada ◽  
Paulette Terán Pereira ◽  
Liliana López Grassa

Introduction Psoriasis is a chronic disease that affects the skin. One hundred twenty-five million people around the world suffer from this condition. In specific groups of patients, the joints may also be involved. To control and follow-up patients with psoriasis, psoriasis area severity and dermatological quality of life measurements were established. Both parameters are necessary for the initiation of biological therapy, as specified in the psoriasis management guide (2015) of the national committee of rheumatological, immunological, and bone metabolism diseases of the Venezuelan Institute of Social Security. Objective To characterize the clinical and epidemiological variables and the prescription of biological therapy in patients with psoriasis who access the high-cost dispensing program of the Venezuelan Institute Social Security (IVSS) pharmacy. Methods This is a descriptive, cross-sectional study. Results A total of 374 patient records were assessed. The male gender was more frequent, with 56.1% (p <0.001), mostly from Caracas city. In comparing age groups with sex, a difference among these was observed (p <0.05). 57.5% previously used methotrexate, 6.68% biological, 3.2% topical steroids, and 31% did not report which type of previous therapy they had received. Amongst the clinical presentations, 70% corresponded to plaque psoriasis. 79% of the patients presented moderate activity according to the Psoriasis Area and Severity Index (PASI): Eleven percent were assessed with the Dermatology Life Quality Index (DLQI); 39% of them reported an extremely important effect. The anergic range of the Mantoux test represented 70.9% of the cases, and 0.3% took the booster evaluation. Chest X-ray was reported normal in 95% of the cases. The most demanded biological medicine was etanercept, in 52% of the cases. Conclusions Male gender and its association with psoriasis was an important finding. The need to improve the administrative components in completing the medication request formats and strengthen clinical measurements and good medical practice was also found.


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