scholarly journals Differential Impact of Risk Factors on Stroke Occurrence Among Men Versus Women in West Africa

Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 820-827 ◽  
Author(s):  
Albert Akpalu ◽  
Mulugeta Gebregziabher ◽  
Bruce Ovbiagele ◽  
Fred Sarfo ◽  
Henry Iheonye ◽  
...  
Keyword(s):  
Risk Factors ◽  
West Africa ◽  
Salt Intake ◽  
Comprehensive Evaluation ◽  
Conditional Logistic Regression ◽  
Population Attributable Risk ◽  
Leafy Vegetables ◽  
Sub Saharan Africa ◽  
Odds Ratios ◽  
Modifiable Factors

Background and Purpose— The interplay between sex and the dominant risk factors for stroke occurrence in sub-Saharan Africa has not been clearly delineated. We compared the effect sizes of risk factors of stroke by sex among West Africans. Methods— SIREN study (Stroke Investigative Research and Educational Networks) is a case-control study conducted at 15 sites in Ghana and Nigeria. Cases were adults aged >18 years with computerized tomography/magnetic resonance imaging confirmed stroke, and controls were age- and sex-matched stroke-free adults. Comprehensive evaluation for vascular, lifestyle, and psychosocial factors was performed using validated tools. We used conditional logistic regression to estimate odds ratios and reported risk factor specific and composite population attributable risks with 95% CIs. Results— Of the 2118 stroke cases, 1193 (56.3%) were males. The mean±SD age of males was 58.1±13.2 versus 60.15±14.53 years among females. Shared modifiable risk factors for stroke with adjusted odds ratios (95% CI) among females versus males, respectively, were hypertension [29.95 (12.49–71.77) versus 16.1 0(9.19–28.19)], dyslipidemia [2.08 (1.42–3.06) versus 1.83 (1.29–2.59)], diabetes mellitus [3.18 (2.11–4.78) versus 2.19 (1.53–3.15)], stress [2.34 (1.48–3.67) versus 1.61 (1.07–2.43)], and low consumption of green leafy vegetables [2.92 (1.89–4.50) versus 2.00 (1.33–3.00)]. However, salt intake and income were significantly different between males and females. Six modifiable factors had a combined population attributable risk of 99.1% (98.3%–99.6%) among females with 9 factors accounting for 97.2% (94.9%–98.7%) among males. Hemorrhagic stroke was more common among males (36.0%) than among females (27.6%), but stroke was less severe among males than females. Conclusions— Overall, risk factors for stroke occurrence are commonly shared by both sexes in West Africa favoring concerted interventions for stroke prevention in the region.

scholarly journals Intraventricular haemorrhage in a Ugandan cohort of low birth weight neonates: the IVHU study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. MacLeod ◽  
J. N. Paulson ◽  
N. Okalany ◽  
F. Okello ◽  
L. Acom ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intraventricular Haemorrhage ◽  
Sub Saharan Africa ◽  
Cranial Ultrasound ◽  
High Grade ◽  
Odds Ratios ◽  
Antenatal Steroids ◽  
Eastern Uganda

Abstract Background Globally, 15 million neonates are born prematurely every year, over half in low income countries (LICs). Premature and low birth weight neonates have a higher risk of intraventricular haemorrhage (IVH). There are minimal data regarding IVH in sub-Saharan Africa. This study aimed to examine the incidence, severity and timing of and modifiable risk factors for IVH amongst low-birth-weight neonates in Uganda. Methods This is a prospective cohort study of neonates with birthweights of ≤2000 g admitted to a neonatal unit (NU) in a regional referral hospital in eastern Uganda. Maternal data were collected from interviews and medical records. Neonates had cranial ultrasound (cUS) scans on the day of recruitment and days 3, 7 and 28 after birth. Risk factors were tabulated and are presented alongside odds ratios (ORs) and adjusted odds ratios (aORs) for IVH incidence. Outcomes included incidence, timing and severity of IVH and 28-day survival. Results Overall, 120 neonates were recruited. IVH was reported in 34.2% of neonates; 19.2% had low grade (Papile grades 1–2) and 15% had high grade (Papile grades 3–4). Almost all IVH (90.2%) occurred by day 7, including 88.9% of high grade IVH. Of those with known outcomes, 70.4% (81/115) were alive on day 28 and survival was not associated with IVH. We found that vaginal delivery, gestational age (GA) < 32 weeks and resuscitation in the NU increased the odds of IVH. Of the 6 neonates who received 2 doses of antenatal steroids, none had IVH. Conclusion In this resource limited NU in eastern Uganda, more than a third of neonates born weighing ≤2000 g had an IVH and the majority of these occurred by day 7. We found that vaginal birth, earlier gestation and need for resuscitation after admission to the NU increased the risk of IVH. This study had a high rate of SGA neonates and the risk factors and relationship of these factors with IVH in this setting needs further investigation. The role of antenatal steroids in the prevention of IVH in LICs also needs urgent exploration.

scholarly journals An outbreak of haemorrhagic fever with renal syndrome linked with mountain recreational activities in Zagreb, Croatia, 2017

2018 ◽  
Vol 146 (10) ◽  
pp. 1236-1239
Author(s):  
Z. Lovrić ◽  
B. Kolarić ◽  
M. L. Kosanović Ličina ◽  
M. Tomljenović ◽  
O. Đaković Rode ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Conditional Logistic Regression ◽  
Hantavirus Infection ◽  
Haemorrhagic Fever ◽  
Recreational Activity ◽  
Odds Ratios ◽  
Recreational Activities

AbstractIn 2017 Zagreb faced the largest outbreak of haemorrhagic fever with renal syndrome (HFRS) to date. We investigated to describe the extent of the outbreak and identify risk factors for infection. We compared laboratory-confirmed cases of Hantavirus infection in Zagreb residents with the onset of illness after 1 January 2017, with individually matched controls from the same household or neighbourhood. We calculated adjusted matched odds ratios (amOR) using conditional logistic regression. During 2017, 104 cases were reported: 11–81 years old (median 37) and 71% (73) male. Compared with 104 controls, cases were more likely to report visiting Mount Medvednica (amOR 60, 95% CI 6–597), visiting a forest (amOR 46, 95% CI 4.7–450) and observing rodents (amOR 20, 95% CI 2.6–159). Seventy per cent of cases (73/104) had visited Mount Medvednica prior to infection. Among participants who had visited Mount Medvednica, cases were more likely to have drunk water from a spring (amOR 22, 95% CI 1.9–265), observed rodents (amOR 17, 95% CI 2–144), picked flowers (amOR 15, 95% CI 1.2–182) or cycled (amOR 14, 95% CI 1.6–135). Our study indicated that recreational activity around Mount Medvednica was associated with HFRS. We recommend enhanced surveillance of the recreational areas during an outbreak.

scholarly journals Edible Leafy Vegetables from West Africa (Guinea-Bissau): Consumption, Trade and Food Potential

Foods ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. 493 ◽  
Author(s):  
Luís Catarino ◽  
Maria M. Romeiras ◽  
Quintino Bancessi ◽  
Daniel Duarte ◽  
Diana Faria ◽  
...  
Keyword(s):  
Rural Communities ◽  
West Africa ◽  
Nutritional Composition ◽  
Leafy Vegetables ◽  
Sub Saharan Africa ◽  
Wild Plant ◽  
Adansonia Digitata ◽  
African Countries ◽  
Plant Resources ◽  
Guinea Bissau

Wild Edible Plants are common in the diet of rural communities of sub-Saharan Africa. In Guinea-Bissau, West Africa, wild plant resources are widely used in human diet, but very few studies have addressed them. The aim of this study is to reveal: (1) the wild and semi-cultivated leafy vegetables consumed in Guinea-Bissau; and (2) the nutritional composition of those plants traded at the largest country market in Bissau. Our results revealed that 24 native or naturalized species with edible leaves are currently consumed by Guinea-Bissau population. Five of them were found at the market: dried leaves of Adansonia digitata, Bombax costatum and Sesamum radiatum, and fresh leaves and shoots of Amaranthus hybridus and Hibiscus sabdariffa. The analysis of the nutritional properties revealed that leaves contain a significant amount of protein (10.1–21.0 g/100 g, dry basis), high values of macronutrients and micronutrients, as well as of phenolic compounds (13.1–40.3 mg GAE/g) and a considerable antioxidant capacity (DPPH 111.5–681.9 mg Eq Trolox). Although price and availability vary among the leafy vegetables analyzed, these traditional foods appear to be a good dietary component that can contribute to food security in Guinea-Bissau and in other West African countries, as these species are widely distributed in this region.

scholarly journals A case-control study of risk factors for death from 2009 pandemic influenza A(H1N1): is American Indian racial status an independent risk factor?

2015 ◽  
Vol 144 (2) ◽  
pp. 315-324 ◽  
Author(s):  
T. W. HENNESSY ◽  
D. BRUDEN ◽  
L. CASTRODALE ◽  
K. KOMATSU ◽  
L. M. ERHART ◽  
...  
Keyword(s):  
Risk Factors ◽  
American Indian ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Conditional Logistic Regression ◽  
Healthcare Access ◽  
Case Control ◽  
Medical Attention ◽  
Modifiable Factors ◽  
Influenza A H1n1

SUMMARYHistorically, American Indian/Alaska Native (AI/AN) populations have suffered excess morbidity and mortality from influenza. We investigated the risk factors for death from 2009 pandemic influenza A(H1N1) in persons residing in five states with substantial AI/AN populations. We conducted a case-control investigation using pandemic influenza fatalities from 2009 in Alaska, Arizona, New Mexico, Oklahoma and Wyoming. Controls were outpatients with influenza. We reviewed medical records and interviewed case proxies and controls. We used multiple imputation to predict missing data and multivariable conditional logistic regression to determine risk factors. We included 145 fatal cases and 236 controls; 22% of cases were AI/AN. Risk factors (P < 0·05) included: older age [adjusted matched odds ratio (mOR) 3·2, for >45 years vs. <18 years], pre-existing medical conditions (mOR 7·1), smoking (mOR 3·0), delayed receipt of antivirals (mOR 6·5), and barriers to healthcare access (mOR 5·3). AI/AN race was not significantly associated with death. The increased influenza mortality in AI/AN individuals was due to factors other than racial status. Prevention of influenza deaths should focus on modifiable factors (smoking, early antiviral use, access to care) and identifying high-risk persons for immunization and prompt medical attention.

scholarly journals Intraventricular haemorrhage in a Ugandan cohort of low birth weight neonates: The IVHU study

2020 ◽  
Author(s):  
Rachael MacLeod ◽  
Joseph N Paulson ◽  
Noella Okalany ◽  
Francis Okello ◽  
Linda Acom ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Intraventricular Haemorrhage ◽  
Sub Saharan Africa ◽  
High Grade ◽  
Odds Ratios ◽  
Antenatal Steroids ◽  
Eastern Uganda

Abstract Background Globally, 15 million neonates are born prematurely every year, over half in low income countries (LICs). Premature and low birth weight neonates have a higher risk of intraventricular haemorrhage (IVH). There are minimal data regarding IVH in sub-Saharan Africa. This study aimed to examine the incidence, severity and timing of and modifiable risk factors for IVH amongst low-birth-weight neonates in Uganda.Methods This is a prospective cohort study of neonates with birthweights of ≤2000g admitted to a neonatal unit (NNU) in a regional referral hospital in eastern Uganda. Maternal data were collected from interviews and medical records. Neonates had cranial ultrasound (cUS) scans on the day of recruitment and days 3, 7 and 28 after birth. Risk factors were tabulated and are presented alongside odds ratios (ORs) and adjusted odds ratios (aORs) for IVH incidence. Outcomes included incidence, timing and severity of IVH and 28-day survival. Results Overall, 120 neonates were recruited. IVH was reported in 34.2% of neonates; 19.2% had low grade (Papile grades 1-2) and 15% had high grade (Papile grades 3-4). Almost all IVH (90.2%) occurred by day 7, including 88.9% of high grade IVH. Of those with known outcomes, 70.4% (81/115) were alive on day 28 and survival was not associated with IVH. We found that vaginal delivery, gestational age (GA) <32 weeks, resuscitation in the NNU and being small for gestational age (SGA, <10th centile) increased the odds of IVH. Of the 6 neonates who received 2 doses of antenatal steroids, none had IVH. Conclusion In this resource limited NNU in eastern Uganda, more than a third of neonates born weighing ≤2000g had an IVH and the majority of these occurred by day 7. We found that vaginal birth, earlier gestation, being SGA and need for resuscitation after admission to the NNU increased the risk of IVH. This study had a high rate of SGA neonates and the risk factors and relationship of these factors with IVH in this setting needs further investigation. The role of antenatal steroids in the prevention of IVH in LICs also needs urgent exploration.

Abstract WP233: Unraveling the Profile and Risk Factors of Post-Stroke Cognitive Impairment Among West African Stroke Survivors: Data From the SIREN Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Rufus Akinyemi ◽  
Bruce Ovbiagele ◽  
Onoja Akpa ◽  
Fred Sarfo ◽  
Joshua Akinyemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Conditional Logistic Regression ◽  
Leafy Vegetables ◽  
Stroke Severity ◽  
Stroke Survivors ◽  
Community Screening ◽  
Post Stroke ◽  
Green Leafy Vegetables ◽  
Education Network

Background: There is paucity of data on the epidemiology of post-stroke cognitive impairment among African stroke survivors. The aim of this study is to report the profile and risk factors of post- stroke cognitive impairment among stroke survivors participating in the Stroke Investigative Research and Education Network (SIREN) Study. Methods: 1566 were evaluated with the Montreal Cognitive Assessment (MoCA) tool, the Community Screening Instrument for Dementia (CSID) and the Stick Design Test three months after the index stroke. Domain scores were derived for executive function, language memory and visuo-constructive/visuospatial domains. Cut off scores were derived from normative cognitive data obtained from comparable healthy stroke-free control subjects. We used conditional logistic regression to estimate odds ratios (OR) with 95% CIs. Results: Of 1566 stroke survivors [mean age 57.7 (13.4) years] who were assessed 3 months after stroke, 37% were impaired in global cognition and 18-43% were impaired in different domains of cognition (executive, memory, language and visuo-constructive). Stroke severity measured by modified NIHSS score had a strong significant negative association with cognitive function in all domains OR 1.96(1.32-2.91). Older age 1.04 (1.02-2.05), male gender 0.69 (0.50 -0.96), low intake of green leafy vegetables 2.83 (2.03 -3.95) and cardiac disease 1.86 (1.31 -2.75) were associated with poorer cognitive performance in different cognitive domains. Conclusion: The frequency of post-stroke cognitive impairment was high among African stroke survivors three months after the ictus. Diet low in green leafy vegetables is a potentially modifiable risk factor for post-stroke cognitive impairment among West Africans.

Risk Factors for Adverse Drug Events: A 10-Year Analysis

2005 ◽  
Vol 39 (7-8) ◽  
pp. 1161-1168 ◽  
Author(s):  
R Scott Evans ◽  
James F Lloyd ◽  
Gregory J Stoddard ◽  
Jonathan R Nebeker ◽  
Matthew H Samore
Keyword(s):  
Risk Factors ◽  
Creatinine Clearance ◽  
Drug Administration ◽  
Adverse Drug Events ◽  
Conditional Logistic Regression ◽  
Patient Characteristics ◽  
Patient Specific ◽  
Administration Route ◽  
Odds Ratios ◽  
Tertiary Teaching

BACKGROUND Many adverse drug events (ADEs) are the result of known pharmacologic properties, and some result from medication errors. However, some are the result of patient-specific risk factors. OBJECTIVE To identify inpatient risk factors for ADEs. METHODS Conditional logistic regression was used to analyze all pharmacist-verified ADEs by therapeutic class of drugs and severity during a 10-year study period. All inpatients ≥18 years of age from a 520-bed tertiary teaching hospital were included. Each case patient was matched with up to 16 control patients. Odds ratios for patient factors associated with ADEs were calculated from different therapeutic classes of drugs. RESULTS Odds ratios for numerous risk factors were identified for 4376 ADEs and were found to vary depending on therapeutic classification. The risk factors for the different classifications were grouped by (1) patient characteristics—female (OR 1.5–1.7), age (0.7–0.9), weight (1.2–1.4), creatinine clearance (0.8–4.7), and number of comorbidities (1.1–12.6); (2) drug administration—dosage (1.2–3.7), administration route (1.4–149.9), and number of concomitant drugs (1.2–2.4); and (3) patient type—service (1.2–4.9), nursing division (1.5–3.8), and diagnosis-related group (1.5–5.7). CONCLUSIONS Some risk factors are consistent for all ADEs and across multiple therapeutic classes of drugs, while others are class specific. High-risk agents should be closely monitored based on patient characteristics (gender, age, weight, creatinine clearance, number of comorbidities) and drug administration (dosage, administration route, number of concomitant drugs).

scholarly journals Intraventricular haemorrhage in a Ugandan cohort of low birth weight neonates: The IVHU study.

2020 ◽  
Author(s):  
Rachael MacLeod ◽  
Joseph N Paulson ◽  
Noella Okalany ◽  
Francis Okello ◽  
Linda Acom ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Intraventricular Haemorrhage ◽  
Sub Saharan Africa ◽  
High Grade ◽  
Odds Ratios ◽  
Antenatal Steroids ◽  
Eastern Uganda

Abstract Background Globally, 15 million neonates are born prematurely every year, over half in low income countries (LICs). Premature and low birth weight neonates have a higher risk of intraventricular haemorrhage (IVH). There are minimal data regarding IVH in sub-Saharan Africa. This study aimed to examine the incidence, severity and timing of and modifiable risk factors for IVH amongst low-birth-weight neonates in Uganda.Methods This is a prospective cohort study of neonates with birthweights of ≤2000g admitted to a neonatal unit (NNU) in a regional referral hospital in eastern Uganda. Maternal data were collected from interviews and medical records. Neonates had cranial ultrasound (cUS) scans on the day of recruitment and days 3, 7 and 28 after birth. Risk factors were tabulated and are presented alongside odds ratios (ORs) and adjusted odds ratios (aORs) for IVH incidence. Outcomes included incidence, timing and severity of IVH and 28-day survival. Results Overall, 120 neonates were recruited. IVH was reported in 34.2% of neonates; 19.2% had low grade (Papile grades 1-2) and 15% had high grade (Papile grades 3-4). Almost all IVH (90.2%) occurred by day 7, including 88.9% of high grade IVH. Of those with known outcomes, 70.4% (81/115) were alive on day 28 and survival was not associated with IVH. We found that vaginal delivery, gestational age (GA) <32 weeks, resuscitation in the NNU and being small for gestational age (SGA, <10th centile) increased the odds of IVH. Of the 6 neonates who received 2 doses of antenatal steroids, none had IVH. Conclusion In this resource limited NNU in eastern Uganda, more than a third of neonates born weighing ≤2000g had an IVH and the majority of these occurred by day 7. We found that vaginal birth, earlier gestation, being SGA and need for resuscitation after admission to the NNU increased the risk of IVH. This study had a high rate of SGA neonates and the risk factors and relationship of these factors with IVH in this setting needs further investigation. The role of antenatal steroids in the prevention of IVH in LICs also needs urgent exploration.

scholarly journals Intraventricular haemorrhage in a Ugandan cohort of low birth weight neonates: The IVHU study.

2020 ◽  
Author(s):  
Rachael MacLeod ◽  
Joseph N Paulson ◽  
Noella Okalany ◽  
Francis Okello ◽  
Linda Acom ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intraventricular Haemorrhage ◽  
Sub Saharan Africa ◽  
Cranial Ultrasound ◽  
High Grade ◽  
Odds Ratios ◽  
Antenatal Steroids ◽  
Eastern Uganda

Abstract BackgroundGlobally, 15 million neonates are born prematurely every year, over half in low income countries (LICs). Premature and low birth weight neonates have a higher risk of intraventricular haemorrhage (IVH). There are minimal data regarding IVH in sub-Saharan Africa. This study aimed to examine the incidence, severity and timing of and modifiable risk factors for IVH amongst low-birth-weight neonates in Uganda.MethodsThis is a prospective cohort study of neonates with birthweights of ≤2000g admitted to a neonatal unit (NU) in a regional referral hospital in eastern Uganda. Maternal data were collected from interviews and medical records. Neonates had cranial ultrasound (cUS) scans on the day of recruitment and days 3, 7 and 28 after birth. Risk factors were tabulated and are presented alongside odds ratios (ORs) and adjusted odds ratios (aORs) for IVH incidence. Outcomes included incidence, timing and severity of IVH and 28-day survival. ResultsOverall, 120 neonates were recruited. IVH was reported in 34.2% of neonates; 19.2% had low grade (Papile grades 1-2) and 15% had high grade (Papile grades 3-4). Almost all IVH (90.2%) occurred by day 7, including 88.9% of high grade IVH. Of those with known outcomes, 70.4% (81/115) were alive on day 28 and survival was not associated with IVH. We found that vaginal delivery, gestational age (GA) <32 weeks and resuscitation in the NU increased the odds of IVH. Of the 6 neonates who received 2 doses of antenatal steroids, none had IVH. ConclusionIn this resource limited NU in eastern Uganda, more than a third of neonates born weighing ≤2000g had an IVH and the majority of these occurred by day 7. We found that vaginal birth, earlier gestation and need for resuscitation after admission to the NU increased the risk of IVH. This study had a high rate of SGA neonates and the risk factors and relationship of these factors with IVH in this setting needs further investigation. The role of antenatal steroids in the prevention of IVH in LICs also needs urgent exploration.

Risk factors for pneumonic and ulceroglandular tularaemia in Finland: a population-based case-control study

2013 ◽  
Vol 142 (10) ◽  
pp. 2207-2216 ◽  
Author(s):  
H. ROSSOW ◽  
J. OLLGREN ◽  
P. KLEMETS ◽  
I. PIETARINEN ◽  
J. SAIKKU ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Population Attributable Risk ◽  
Population Based ◽  
Case Control ◽  
Type B ◽  
Conditional Logistic Regression Model ◽  
Control Subjects ◽  
Control Study

SUMMARYFew population-based data are available on factors associated with pneumonic and ulceroglandular type B tularaemia. We conducted a case-control study during a large epidemic in 2000. Laboratory-confirmed case patients were identified through active surveillance and matched control subjects (age, sex, residency) from the national population information system. Data were collected using a self-administered questionnaire. A conditional logistic regression model addressing missing data with Bayesian full-likelihood modelling included 227 case patients and 415 control subjects; reported mosquito bites [adjusted odds ratio (aOR) 9·2, 95% confidence interval (CI) 4·4–22, population-attributable risk (PAR) 82%] and farming activities (aOR 4·3, 95% CI 2·5–7·2, PAR 32%) were independently associated with ulceroglandular tularaemia, whereas exposure to hay dust (aOR 6·6, 95% CI 1·9–25·4, PAR 48%) was associated with pneumonic tularaemia. Although the bulk of tularaemia type B disease burden is attributable to mosquito bites, risk factors for ulceroglandular and pneumonic forms of tularaemia are different, enabling targeting of prevention efforts accordingly.

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