scholarly journals Trend and decomposition analysis of risk factors of childbirths with no one present in Nigeria, 1990–2018

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054328
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Segun Bello ◽  
Mobolaji M Salawu ◽  
Rotimi F Afolabi ◽  
Babatunde M Gbadebo ◽  
...  
Keyword(s):  
Maternal Education ◽  
Decomposition Analysis ◽  
Healthcare Utilisation ◽  
Educational Status ◽  
Secondary Outcome ◽  
Special Focus ◽  
Cross Sectional ◽  
Significance Level ◽  
Nationally Representative ◽  
Subnational Analysis

ObjectivesTo assess the trend and decompose the determinants of delivery with no one present (NOP) at birth with an in-depth subnational analysis in Nigeria.DesignCross-sectional.SettingNigeria, with five waves of nationally representative data in 1990, 2003, 2008, 2013 and 2018.ParticipantsWomen with at least one childbirth within 5 years preceding each wave of data collection.Primary and secondary outcome measuresThe outcome of interest is giving birth with NOP at delivery defined as childbirth assisted by no one. Data were analysed using Χ2 and multivariate decomposition analyses at a 5% significance level.ResultsThe prevalence of having NOP at delivery was 15% over the studied period, ranges from 27% in 1990 to 11% in 2018. Overall, the prevalence of having NOP at delivery reduced significantly by 35% and 61% within 2003–2018 and 1990–2018, respectively (p<0.001). We found wide variations in NOP across the states in Nigeria. The highest NOP practice was in Zamfara (44%), Kano (40%) and Katsina (35%); while the practice was 0.1% in Bayelsa, 0.8% in Enugu, 0.9% in Osun and 1.1% in Imo state. The decomposition analysis of the changes in having NOP at delivery showed that 85.4% and 14.6% were due to differences in women’s characteristics (endowment) and effects (coefficient), respectively. The most significant contributions to the changes were the decision-maker of healthcare utilisation (49%) and women educational status (24%). Only Gombe experienced a significant increase (p<0.05) in the level of having NOP between 2003 and 2018.ConclusionA long-term decreasing secular trend of NOP at delivery was found in Nigeria. NOP is more prevalent in the northern states than in the south. Achieving zero prevalence of NOP at delivery in Nigeria would require a special focus on healthcare utilisation, enhancing maternal education and healthcare utilisation decision-making power.

scholarly journals Factors affecting academic failure in medical students in Iran

2021 ◽  
Vol 10 (1) ◽  
pp. 14-14
Author(s):  
Zohreh Tajabadi ◽  
Matineh Sadat Miri ◽  
Soliman Ahmadi ◽  
Matineh Pourrahimi ◽  
Mojtaba Abdi ◽  
...  
Keyword(s):  
Student Satisfaction ◽  
Academic Failure ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Academic Probation ◽  
Affecting Factors ◽  
Cross Sectional ◽  
Significance Level ◽  
Factors Affecting ◽  
Significant Difference

Background: Students are considered part of the capital of each country. Several factors can affect their educational status and, as a result, contribute to their academic failure. The current study seeks to investigate the relationship between students’ academic failure and the affecting factors with the Iranian Educational Ranking of Universities. Methods: This is a descriptive cross-sectional study. The required sample size was calculated using Cochran’s formula. A researcher-made questionnaire with 5 parts was used to collect data. Kruskal Wallis and Spearman’s analysis of variance was used for analysis. The significance level was considered as 0.05. Results: A total of 1215 people participated; 13.7% of students had had an academic failure and 2.0% of them were on academic probation. There was a correlation between university RAD rank and academic failure (r = -0.098 and P = 0.0001) as well as student satisfaction (r = 0.264 – P = 0.0001). There was a significant difference between an academic drop and academic grade in three ranks of university (Pv= 0.0001), and, interestingly, having moved from Rank 1 to 3, having academic grade increases, and having academic failure decreases. Conclusion: According to the findings of this study, the higher ranked the college campus is on the RAD scale, the higher the academic failure rate. For annual assessment of universities, it is proposed that assessment of academic failure and grades be used as a benchmark.

scholarly journals Caesarean sections and the prevalence of preterm and early-term births in Brazil: secondary analyses of national birth registration

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021538 ◽  
Author(s):  
Fernando C Barros ◽  
Dacio de Lyra Rabello Neto ◽  
Jose Villar ◽  
Stephen H Kennedy ◽  
Mariangela F Silveira ◽  
...  
Keyword(s):  
Maternal Education ◽  
Age Distribution ◽  
National Database ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Early Term ◽  
Individual Level ◽  
Developmental Problems ◽  
Term Births ◽  
Years Of Schooling

ObjectivesTo investigate whether the high rates of caesarean sections (CSs) in Brazil have impacted on the prevalence of preterm and early-term births.DesignIndividual-level, cross-sectional analyses of a national database.SettingAll hospital births occurring in the country in 2015.Participants2 903 716 hospital-delivered singletons in 3157 municipalities, representing >96% of the country’s births.Primary and secondary outcome measuresCS rates and gestational age distribution (<37, 37–38, 39–41 and 42 or more weeks’ gestation). Outcomes were analysed according to maternal education, measured in years of schooling and municipal CS rates. Analyses were also adjusted for maternal age, marital status and parity.ResultsPrevalence of CS was 55.5%, preterm prevalence (<37 weeks’ gestation) was 10.1% and early-term births (37–38 weeks of gestation) represented 29.8% of all births, ranging from 24.9% among women with <4 years of schooling to 39.8% among those with >12 years of education. The adjusted prevalence ratios of preterm and early-term birth were, respectively, 1.215 (1.174–1.257) and 1.643 (1.616–1.671) higher in municipalities with≥80% CS compared with those <30%.ConclusionsBrazil faces three inter-related epidemics: a CS epidemic; an epidemic of early-term births, associated with the high CS rates; and an epidemic of preterm birth, also associated with CS but mostly linked to poverty-related risk factors. The high rates of preterm and early-term births produce an excess of newborns at higher risk of short-term morbidity and mortality, as well as long-term developmental problems. Compared with high-income countries, there is an annual excess of 354 000 preterm and early-term births in Brazil.

scholarly journals Use of complementary medicine products: a nationally representative cross-sectional survey of 2019 Australian adults

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e024198 ◽  
Author(s):  
Joanna E Harnett ◽  
Erica McIntyre ◽  
Amie Steel ◽  
Hope Foley ◽  
David Sibbritt ◽  
...  
Keyword(s):  
Complementary Medicine ◽  
Adult Population ◽  
Herbal Medicines ◽  
Pharmaceutical Products ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Product Use ◽  
Hospital Doctors ◽  
Nationally Representative

ObjectivesTo provide a contemporary description of complementary medicine (CM) product use in Australia.DesignCross-sectional survey.SettingOnline.ParticipantsA nationally representative sample (n=2019) of the Australian adult population.Primary and secondary outcome measuresPrimary outcomes measures included the use and type of CM products used, and source of recommendation. Secondary measures included disclosure of CM product use to health practitioners, concomitant use of pharmaceuticals and predictors of use.ResultsPrevalence of CM product use was 50.3%, with the most frequently used being vitamin and mineral supplements (VMSs; 47.8%) and homoeopathic medicines the least used (6.8%). A majority of respondents using CM products were also using pharmaceutical products, and small but significant associations were found between the use of CM products and pharmaceuticals (p<0.05). Small statistically significant associations were found between use of vitamin products and disclosure of use to general practitioners (GPs; Cramer’s V=0.13, p=0.004) and hospital doctors (Cramer’s V=0.11, p=0.04), and between use of herbal medicines and disclosure to both GPs (Cramer’s V=0.11, p=0.02) and hospital doctors (Cramer’s V=0.12, p=0.03). Women, those with higher education and those with no private health insurance were more likely to use CM products (p<0.05), while those without chronic conditions were less likely to use CM products (p<0.05) (χ2(29)=174.70, p<0.001).ConclusionsThe number of Australians using CM products has remained relatively stable and substantial for nearly two decades. The majority of CM use relates to VMSs. Given the number of Australians using both CM products and pharmaceutical medicines, it is important to evaluate the potential clinical implications of such practices to ensure safe, effective and coordinated health policy and patient care.

scholarly journals Frequency of television viewing and association with overweight and obesity among women of the reproductive age group in Myanmar: results from a nationwide cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024680 ◽  
Author(s):  
Rajat Das Gupta ◽  
Ibrahim Hossain Sajal ◽  
Mehedi Hasan ◽  
Ipsita Sutradhar ◽  
Mohammad Rifat Haider ◽  
...  
Keyword(s):  
Rural Women ◽  
Television Viewing ◽  
Wealth Index ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional

ObjectivesThis study aimed to discern the association between the frequency of television viewing and overweight and obesity among reproductive age women of Myanmar.DesignThis was a cross-sectional study.SettingThis study used Myanmar Demographic and Health Survey (2015–2016) data.ParticipantsTotal of 12 021 women both aged 15–49 years and also not pregnant or did not deliver a child within the 2 months prior to the survey were included.Primary and secondary outcome measuresThe primary outcome was overweight (23.0 kg/m2to <27.5 kg/m2) and obesity (≥27.5 kg/m2), which was measured using the Asian body mass index cut-off. Ordered logistic regression analysis was conducted to find the association between the explanatory and outcome variables. The potential confounders controlled in the multivariable analyses were age, place of residence, region of residence, highest educational status, current employment status, wealth index, parity and number of household members.ResultsThe prevalence of overweight was 26.5% and obesity was 12.2% among the study participants. The odds of being overweight and obese were 20% higher (adjusted OR (AOR) 1.16, 95% CI 1.02 to 1.32; p=0.023) among those who watched television at least once a week compared with those who did not watch television at all. Rural women who watched television at least once a week were 1.2 times more likely to be obese (AOR 1.16, 95% CI 1.01 to 1.34; p=0.040) compared with those who did not watch television at all.ConclusionsFrequent television watching was associated with obesity among rural women of reproductive age in Myanmar.

scholarly journals Efficacy of deep learning methods for predicting under-five mortality in 34 low-income and middle-income countries

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034524
Author(s):  
Adeyinka Emmanuel Adegbosin ◽  
Bela Stantic ◽  
Jing Sun
Keyword(s):  
Neural Network ◽  
Deep Learning ◽  
Low Income ◽  
Maternal Education ◽  
Household Wealth ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Middle Income ◽  
Under Five ◽  
Middle Income Countries

ObjectivesTo explore the efficacy of machine learning (ML) techniques in predicting under-five mortality (U5M) in low-income and middle-income countries (LMICs) and to identify significant predictors of U5M.DesignThis is a cross-sectional, proof-of-concept study.Settings and participantsWe analysed data from the Demographic and Health Survey. The data were drawn from 34 LMICs, comprising a total of n=1 520 018 children drawn from 956 995 unique households.Primary and secondary outcome measuresThe primary outcome measure was U5M; secondary outcome was comparing the efficacy of deep learning algorithms: deep neural network (DNN); convolution neural network (CNN); hybrid CNN-DNN with logistic regression (LR) for the prediction of child’s survival.ResultsWe found that duration of breast feeding, number of antenatal visits, household wealth index, postnatal care and the level of maternal education are some of the most important predictors of U5M. We found that deep learning techniques are superior to LR for the classification of child survival: LR sensitivity=0.47, specificity=0.53; DNN sensitivity=0.69, specificity=0.83; CNN sensitivity=0.68, specificity=0.83; CNN-DNN sensitivity=0.71, specificity=0.83.ConclusionOur findings provide an understanding of determinants of U5M in LMICs. It also demonstrates that deep learning models are more efficacious than traditional analytical approach.

scholarly journals Pathways and associated costs of care in patients with confirmed and presumptive tuberculosis in Tanzania: A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025079 ◽  
Author(s):  
Grace Mhalu ◽  
Jerry Hella ◽  
Francis Mhimbira ◽  
Khadija Said ◽  
Thomas Mosabi ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Indirect Costs ◽  
Healthcare Utilisation ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Costs Of Care ◽  
Poverty Status

ObjectiveTo assess pathways and associated costs of seeking care from the onset of symptoms to diagnosis in patients with confirmed and presumptive tuberculosis (TB).DesignCross-sectional study.SettingDistrict hospital in Dar es Salaam, Tanzania.ParticipantsBacteriologically confirmed TB and presumptive TB patients.Primary and secondary outcome measuresWe calculated distance in metres and visualised pathways to healthcare up to five visits for the current episode of sickness. Costs were described by medians and IQRs, with comparisons by gender and poverty status.ResultsOf 100 confirmed and 100 presumptive TB patients, 44% of confirmed patients sought care first at pharmacies after the onset of symptoms, and 42% of presumptive patients did so at hospitals. The median visits made by confirmed patients was 2 (range 1–5) and 2 (range 1–3) by presumptive patients. Patients spent a median of 31% of their monthly household income on health expenditures for all visits. The median total direct costs were higher in confirmed compared with presumptive patients (USD 27.4 [IQR 18.7–48.4] vs USD 19.8 [IQR 13.8–34.0], p=0.02), as were the indirect costs (USD 66.9 [IQR 35.5–150.0] vs USD 46.8 [IQR 20.1–115.3], p<0.001). The indirect costs were higher in men compared with women (USD 64.6 [IQR 31.8–159.1] vs USD 55.6 [IQR 25.1–141.1], p<0.001). The median total distance from patients’ household to healthcare facilities for patients with confirmed and presumptive TB was 2338 m (IQR 1373–4122) and 2009 m (IQR 986–2976) respectively.ConclusionsPatients with confirmed TB have complex pathways and higher costs of care compared with patients with presumptive TB, but the costs of the latter are also substantial. Improving access to healthcare and ensuring integration of different healthcare providers including private, public health practitioners and patients themselves could help in reducing the complex pathways during healthcare seeking and optimal healthcare utilisation.

scholarly journals Factors associated with low birth weight in Afghanistan: a cross-sectional analysis of the demographic and health survey 2015

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025715 ◽  
Author(s):  
Rajat Das Gupta ◽  
Krystal Swasey ◽  
Vanessa Burrowes ◽  
Mohammad Rashidul Hashan ◽  
Gulam Muhammed Al Kibria
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Health Survey ◽  
Urban Areas ◽  
Maternal Education ◽  
Multivariable Analysis ◽  
Demographic And Health Survey ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Factors Associated

ObjectivesThis study aimed to investigate the factors associated with low birth weight (LBW) in Afghanistan.DesignCross-sectional study.SettingThis study used data collected from the Afghanistan Demographic and Health Survey 2015.ParticipantsFacility-based data from 2773 weighted live-born children enrolled by a two-stage sampling strategy were included in our analysis.Primary and secondary outcome measuresThe primary outcome was LBW, defined as birth weight <2.5kg.ResultsOut of 2773 newborns, 15.5% (n=431) had LBW. Most of these newborns were females (58.3%, n=251), had a mother with no formal schooling (70.5%, n=304), lived in urban areas (63.4%, n=274) or lived in the Central region of Afghanistan (59.7%, n=257). In multivariable analysis, residence in Central (adjusted OR (AOR): 3.4; 95% CI 1.7 to 6.7), Central Western (AOR: 3.0; 95% CI 1.5 to 5.8) and Southern Western (AOR: 4.0; 95% CI 1.7 to 9.1) regions had positive association with LBW. On the other hand, male children (AOR: 0.5; 95% CI 0.4 to 0.8), newborns with primary maternal education (AOR: 0.5; 95% CI 0.3 to 0.8), birth interval ≥48 months (AOR: 0.4; 95% CI 0.1 to 0.8), belonging to the richest wealth quintile (AOR: 0.2; 95% CI 0.1 to 0.6) and rural residence (AOR: 0.3; 95% CI 0.2 to 0.6) had decreased odds of LBW.ConclusionsMultiple factors had association with LBW in Afghanistan. Maternal, Neonatal and Child Health programmes should focus on enhancing maternal education and promoting birth spacing to prevent LBW. To reduce the overall burden of LBW, women of the poorest wealth quintiles, and residents of Central, Central Western and South Western regions should also be prioritised. Further exploration is needed to understand why urban areas are associated with higher likelihood of LBW. In addition, research using nationally representative samples are required.

scholarly journals Prevalence and associated factors of self-reported ischaemic heart disease and/or stroke: a cross-sectional nationally representative community-based study of adults in Malawi in 2017

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048167
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Logistic Regression ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Associated Factors ◽  
Disease Risk ◽  
Communicable Disease ◽  
Adult Population ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Nationally Representative

ObjectiveThis study aimed to assess the prevalence and associated factors of self-reported ischaemic heart disease (IHD) and/or stroke among adults in Malawi.DesignPopulation-based cross-sectional study.SettingNationally representative sample of general adult population in Malawi.ParticipantsThe sample included 4187 persons aged 18–69 years (32 years of median age) that participated in the ‘2017 Malawi STEPwise Approach to Non-Communicable Disease Risk-Factor Surveillance survey.’Primary and secondary outcome measuresSelf-reported history of IHD and/or stroke, along with biological, behavioural, psychosocial stress and sociodemographic covariates. Multivariable logistic regression calculated OR with 95% CI for IHD and/or stroke.ResultsThe prevalence of IHD and/or stroke was 6.5%, 4.4% among men and 8.4% among women. In adjusted logistic regression analysis, older age (50–69 years) (adjusted OR (AOR) 3.49, 95% CI 1.75 to 6.94), female sex (AOR 2.09, 95% CI 1.45 to 3.01), Chewa speaking (AOR 4.62, 95% CI 1.32 to 16.22), English speaking (AOR 5.63, 95% CI 1.43 to 22.19), suicidal ideation, plan and/or attempt (AOR 1.87, 95% CI 1.11 to 3.13) and sedentary behaviour (AOR 2.00, 95% CI 1.12 to 3.59) were associated with IHD and/or stroke. In addition, in unadjusted analysis, non-paid or unemployed, urban residence, overweight, obesity and having hypertension were associated with IHD and/or stroke.ConclusionsAlmost 1 in 10 women and 1 in 20 men aged 18–69 years had IHD and/or stroke in Malawi. Several risk and protective factors were found that can be targeted in population health interventions.

scholarly journals Trends in the Prevalence of Overweight and Obesity and Associated Socioeconomic and Household Environmental Factors among Women in Nepal: Findings from the Nepal Demographic and Health Surveys

Obesities ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 113-135
Author(s):  
Kritika Rana ◽  
Puspa Ghimire ◽  
Romila Chimoriya ◽  
Ritesh Chimoriya
Keyword(s):  
Environmental Factors ◽  
Health Surveys ◽  
Wealth Index ◽  
Educational Status ◽  
Overweight And Obesity ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Toilet Facility ◽  
Nationally Representative

This study aimed to examine the trends in the prevalence of overweight and obesity and to determine the associated socioeconomic and household environmental factors among women in Nepal. Using nationally representative data from the 1996, 2001, 2006, 2011, and 2016 cross-sectional Nepal Demographic and Health Surveys (NDHSs) (n = 33,507), the prevalence of overweight–obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) among women aged 15–49 years were examined. From the latest NDHS 2016, non-pregnant women with recorded anthropometric measurements (n = 6165) were included in the final analyses. Multivariate logistic regression models were used to determine the socioeconomic and household environmental factors associated with BMI ≥ 25 and BMI ≥ 30. Between 1996 and 2016, the prevalence of overweight–obesity increased from 1.8% to 19.7%, while the prevalence of obesity increased from 0.2% to 4.1%. Age, marital status, wealth index, province of residence, type of cooking fuel, and household possessions—refrigerator and bicycle were significantly associated with having overweight–obesity and obesity. Similarly, educational status, religion, type of toilet facility, and household possessions—television and mobile phone were significantly associated with having overweight–obesity. Given the alarming increase in the prevalence of overweight and obesity among Nepalese women, there is an urgent need for interventions addressing these critical socioeconomic and household environmental factors.

scholarly journals Family functioning and dental trauma, malocclusion and anthropometry in adolescents

2021 ◽  
Vol 20 ◽  
pp. e211883
Author(s):  
Adelaine Maria de Sousa ◽  
Thais Carine Lisboa Silva ◽  
Bruna de Carvalho Vaigel ◽  
Roberto Carlos Mourão Pinho ◽  
Renata Cimões
Keyword(s):  
Multivariate Analysis ◽  
Public Schools ◽  
Family Cohesion ◽  
Maternal Education ◽  
Multinomial Logistic Regression ◽  
Dental Trauma ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Significance Level

Aim: The aim of the study was to investigate perceived family cohesion and adaptability and its association with trauma, malocclusion and anthropometry in school adolescents. Methods: Cross-sectional study with a representative sample of 921 adolescents from 13 to 19 years old of both sexes, enrolled in state public schools of a northeastern Brazilian municipality. A questionnaire with sociodemographic questions, the FACES III scale was applied and a clinical oral examination (dental trauma and malocclusion) and anthropometric (BMI by age) were performed. For statistical analysis, was evaluated by the Chi-square test. The variables that presented significance in the bivariate analysis of up to 25% were taken to the multivariate analysis (multinomial logistic regression), variables that presented significance in bivariate analysis of up to 25% were taken to multivariate analysis and all conclusions were drawn considering the significance level of 5%. Results: As a result, it was identified that displaced families were associated with low maternal education, agglutinated families associated with the absence of caries. Rigid families were associated with marked overjet and caries. The prevalence of dental trauma (37.5%) was considered high. Conclusion: It was concluded that family cohesion and adaptability were associated with oral health and socioeconomic factors.

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