Pre-adolescents with multiple health complaints redeem more prescriptions: A follow-up study in the Danish National Birth Cohort

Aims: This study aimed to examine the association between multiple health complaints (MHC) in pre-adolescence and prescription redemption in adolescence. Methods: This was a nationwide population-based study based on the Danish National Birth Cohort for an average of 6.9 years (2010–2018). A total of 96,382 children were invited at the age of 11. A modified version of the Health Behaviour in School Children Symptom Checklist was dichotomised into the World Health Organization’s definition of MHC (⩾2 complaints, each with a frequency of at least weekly, yes/no). The number of prescriptions was retrieved from Danish registries. Negative binomial regression estimated incidence rate ratios (IRRs) comparing children with MHC to children without. Prescription redemption was further stratified by psychiatric/somatic medication and into subtypes of prescriptions. Results: A total of 47,365 (49.1%) children participated ( Mage=11.2 years, 52% girls). MHC were reported by 10.3%. The unadjusted IRR (MHC vs. no MHC) of all types of redemptions was 1.57 (95% confidence interval (CI) 1.49–1.64). Results were robust to adjustment for socio-demographic variables and somatic/psychiatric morbidity at baseline (IRR=1.47; 95% CI 1.40–1.54). Associations were especially strong for psychiatric medication (adjusted IRR=3.88; 95% CI 3.43–4.40) and were modified by neither sex nor maternal education. Conclusions: MHC in pre-adolescents predict prescription redemption. This implies that changes in MHC might be indicative of changes in public health. This requires further study, as the cause of a change in reporting of symptoms might also cause a change in treatment response. The latter determines whether prescriptions are treating ill-being or needlessly medicalising subjective symptoms.

Download Full-text

Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends

10.21203/rs.2.15477/v2 ◽

2019 ◽

Author(s):

Toby Bonvoisin ◽

Leah Utyasheva ◽

Duleeka Knipe ◽

David Gunnell ◽

Michael Eddleston

Keyword(s):

Negative Binomial ◽

Public Health Problem ◽

State Level ◽

Negative Binomial Regression ◽

World Health ◽

State Governments ◽

Suicide Rates ◽

Level Data ◽

Agricultural Yield ◽

Health Organization

Abstract Background Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides (HHPs) from agricultural use has been successful in reducing suicides in several Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of HHPs and explore how they might relate to suicide rates across India.Methods Information on pesticide regulation was collated from agriculture departments of the central and state governments. National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate any effects on trends in suicide rates nationally and in Kerala.Results As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization criteria. Despite many HHPs still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio [RR] 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected pesticide suicide rate (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect. Agricultural outputs continued growing following the bans.Discussion Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of HHPs could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

Download Full-text

Determinants of Antenatal Care Visit Utilization of Child-Bearing Mothers in Kaffa, Sheka, and Bench Maji Zones of SNNPR, Southwestern Ethiopia

Health Services Research and Managerial Epidemiology ◽

10.1177/2333392819866620 ◽

2019 ◽

Vol 6 ◽

pp. 233339281986662 ◽

Cited By ~ 6

Author(s):

Abiyot Negash Terefe ◽

Assaye Belay Gelaw

Keyword(s):

Health Care ◽

Antenatal Care ◽

Rural Areas ◽

Goodness Of Fit ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Care Program ◽

Normal Pregnancy ◽

World Health ◽

Child Bearing

Background: Antenatal care (ANC) is a preventive obstetric health-care program aimed at optimizing maternal fetal outcome through regular monitoring of pregnancy. Even if World Health Organization recommends a minimum of 4 ANC visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it due to different reasons. The purpose of this article is to identify determinants significantly influencing the ANC visit utilization of child-bearing mothers in the Kaffa, Sheka, and Bench-Maji zones of Southern Nation Nationalities and Peoples Region, Ethiopia. Methods: A total of 1715 child-bearing mothers were selected. Several count models such as Poisson, negative binomial, zero-inflated Poisson, zero-inflated negative binomial, hurdle Poisson, and hurdle negative binomial regression models were fitted to select the model which best fits the data. The parameters were estimated by maximum likelihood. Measures of goodness of fit were based on the Rootogram. Results: The data were found zeros (8.1%); the variance (3.794), which is less than its mean (3.91). Hurdle Poisson regression model was found to be better fitted with the data given. Variables are selected by backward selection method, through the analysis, zones, residence, age at first pregnancy, source of information, knowledge during danger sin, willingness, time of visit, and satisfaction, which were major predictors of ANC service utilization. The estimated odds that the number of ANC visits those child-bearing mothers made (mothers who lived in urban) are 3.52 times more likely than mothers who lived in rural keeping others variables constant and the like. Conclusion: Based on our findings, a lot of effort needs to be made by health offices to create awareness, maternal health-care programs should be expanded and intensified in rural areas, improve women’s knowledge and awareness about the risk factor of late visit, the necessary investigations and follow-up throughout the antenatal period to promote regular attendance for ANC, and fulfill the client’s satisfaction.

Download Full-text

1960. Lost in Translation: Comparing Rates of Outpatient Antibiotic Use in Three Metrics

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.137 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S62-S63

Author(s):

Christopher Prestel ◽

Laura M King ◽

Monina Bartoces ◽

Melinda M Neuhauser ◽

Lauri Hicks ◽

...

Keyword(s):

Negative Binomial ◽

National Level ◽

Negative Binomial Regression ◽

Antibiotic Use ◽

World Health ◽

Oral Antibiotic ◽

Defined Daily Doses ◽

Days Of Therapy ◽

Health Organization ◽

Over Time

Abstract Background The Centers for Disease Control and Prevention (CDC) tracks US outpatient antibiotic use in prescriptions per 1000 persons (Rx/1000), while the World Health Organization uses defined daily doses per 1000 persons (DDD/1000), which are based on average adult dose, for global surveillance. A third metric, days of therapy (DOT)/1,000 persons, has not been previously evaluated at the national level. We aim to compare time trends in outpatient oral antibiotic use as Rx/1000, DDD/1000, and DOT/1,000 in the same data to inform ongoing CDC surveillance and facilitate international comparison. Methods We identified dispensed outpatient oral antibiotics using pharmacy claims in 2011–2016 IBM® MarketScan® Commercial Databases for individuals <65 years old. Using enrollment data, we calculated mean annual membership with drug coverage. Annual rates of outpatient oral antibiotic use were calculated for Rx/1000, DDD/1000, and DOT/1000 persons. Prescriptions written with a ratio of DDD to days supplied >10 were considered biologically implausible and excluded from DDD calculations. We examined trends for each metric from 2011 to 2016 using negative binomial regression. Results Annual numbers of outpatient oral antibiotic prescriptions ranged from 18.6 million to 30.0 million (mean 24.3 million). Overall, Rx/1000 decreased by 7% from 892 in 2011 to 829 in 2016 (Figure 1). From 2011 to 2016, DDD/1000 increased 2% from 23.8 to 24.2 while DOT/1000 decreased 9% from 25.4 to 23.1. Significant per-year decreases were found from 2011 to 2016 for Rx/1000 (−1.1%) and for DOT/1000 (−1.6%), while no significant per-year change was seen with DDD/1000 (table). DDD/1000 underestimate use in pediatrics under the age of 10 (Figure 2). Prolonged duration is seen in adolescents and reflected by DOT/1000. Conclusion Trends in DDD/1000 for population aged <65 years do not mirror trends in Rx/1000 and DOT/1000. These differences may reflect that Rx/1000 and DOT/1000 more accurately capture antibiotic prescriptions in children than DDD/1000. As DDD/1000 underestimate antibiotic use in children, DDD/1000 underestimates reduction in antibiotic use over time and may not accurately reflect changes in use over time. Disclosures All Authors: No reported Disclosures.

Download Full-text

Regulation of highly hazardous pesticides in India - implications for suicide prevention

10.21203/rs.2.15477/v1 ◽

2019 ◽

Author(s):

Toby Bonvoisin ◽

Leah Utyasheva ◽

Duleeka Knipe ◽

David Gunnell ◽

Michael Eddleston

Keyword(s):

Negative Binomial ◽

Public Health Problem ◽

State Level ◽

Negative Binomial Regression ◽

World Health ◽

State Governments ◽

Suicide Rates ◽

Level Data ◽

Agricultural Yield ◽

Health Organization

Abstract Background: Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides from agricultural use has been successful in reducing total suicide numbers in several South Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of highly hazardous pesticides and relate them to suicide rates across India. Methods: Information on pesticide regulation was collated from agriculture departments of central and state governments. National and state-level data on suicides for 1995 until 2015 was obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate the possible effects of pesticide bans on trends in suicide rates. Results: As of August 2019, 314 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization toxicity criteria. Despite many highly hazardous pesticides still being available, a number of bans have been implemented during the period studied. In our quantitative analyses we focussed on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. Time series analysis demonstrated statistical evidence of lower than expected rates of pesticide suicides and total suicides nationally after the 2011 endosulfan ban. In Kerala, there was a lower than expected rate of pesticide suicides but no change to the already decreasing trend in total suicides after both the 2005 ban of endosulfan and the 2011 ban of 14 pesticides. Discussion: Highly hazardous pesticides continue to be used in India, and pesticide suicide remains a serious public health problem. However, some bans of pesticides do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of highly hazardous pesticides could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

Download Full-text

Changes in potential cancer indicator reporting in primary-care during the COVID-19 pandemic

10.21203/rs.3.rs-123337/v1 ◽

2020 ◽

Author(s):

Lauren J Scott ◽

Mairead Murphy ◽

Sarah Price ◽

Rhys Lewis ◽

Rachel Denholm ◽

...

Keyword(s):

Primary Care ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Patient Characteristics ◽

World Health Organisation ◽

World Health ◽

Face To Face ◽

Rate Ratios ◽

Potential Cancer ◽

Remote Consultations

Abstract Background In March 2020, the World Health Organisation declared COVID-19 a pandemic.Aim To investigate how the pandemic affected presentation to primary-care with features potentially indicating cancer, and explore how reporting differed by patient characteristics and in face-to-face vs. remote consultations.Design and setting Retrospective cohort study in 21 practices in South-West England.Methods Potential cancer indicators were identified using pre-defined code lists for symptoms, signs, test results and diagnoses. Negative binomial regression models compared reporting of potential cancer indicators in April-July 2020 to April-July 2019. Incidence rate ratios (IRRs), 95% confidence intervals (CIs) and p-values are reported.Results During April-July 2019 and 2020, respectively, 152,447/344,184 (44%) and 123,775/350,966 (35%) patients consulted, with 44,662/344,184 (13%) and 29,150/350,966 (8%) reporting a potential cancer indicator (IRR=0.65, 95%CI 0.62-0.68, p<0.001). Reduced indicator reporting was stable across ethnicity, deprivation and shielding status, was greater in children (0-4 years IRR=0.50, 95%CI 0.46-0.55, p<0.001; 5-17 years IRR=0.45, 95%CI 0.41-0.49, p<0.001) and males (IRR=0.61, 95%CI 0.58-0.64), and less marked in patients with mental health conditions (IRR=0.75, 95%CI 0.72-0.79, p<0.001). Indicator reporting dropped for GP face-to-face consultations (IRR=0.88, 95%CI 0.80-0.97, p=0.011) and increased for remote consultations (IRR=1.22, 95%CI 1.11-1.34, p<0.001), but despite this, remained lower in remote consulting than face-to-face in April-July 2020.Conclusion Patient consulting in general, and for potential cancer indicators specifically, reduced during the first-wave of the COVID-19 pandemic. Remote consulting may be part of the reason for the reduction in reporting of potential cancer indicators, along with the reduced spreading of viral (non-cancer) infections.

Download Full-text

Trend Analysis of Tuberculosis Cases and the Effect of HIV Cases on Tuberculosis Cases in Some West African Countries Using Panel Poisson and Negative Binomial Regression Models

10.20944/preprints201910.0362.v1 ◽

2019 ◽

Author(s):

Monday Osagie Adenomon ◽

Gbenga Solomom Akinyemi

Keyword(s):

West Africa ◽

Regression Model ◽

Regression Models ◽

Negative Binomial ◽

Negative Binomial Regression ◽

West African ◽

World Health ◽

Negative Binomial Regression Model ◽

African Countries ◽

Binomial Regression

Tuberculosis cause of death worldwide and the leading cause from a single infectious agent, ranking above Human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). The aim of this study is to ascertain the trend of tuberculosis prevalence and the effect of HIV prevalence onl Tuberculosis case in some West African countries from 2000 to 2016 using count panel data regression models. The data used annual HIV and Tuberculosis cases spanning from 2000 to 2016 extracted from online publication of World health Organization (WHO). Panel Poisson regression model and Negative binomial regression model for fixed and random effects were used to analyzed the count data, the result revealed a positive trend in TB cases while increased in HIV cases leads to increase in TB cases in West African countries. Among the competing models used in this study, Panel Negative Binomial Regression Model with fixed effect emerged the best model with log likelihood value of -1336.554. This study recommended that Government and NGOs need more strategies to fight against HIV menace in West Africa as this will in turn reduced TB cases in West Africa.

Download Full-text

Forecasting COVID-19 Pandemic and Capital Market Efficiency in Africa

Journal of Quantitative Methods ◽

10.29145/2021/jqm/050106 ◽

2021 ◽

Vol 5 (1) ◽

pp. 136-153

Author(s):

Kolawole Lookman Subair ◽

Ibrahim Ayoade Adekunle

Keyword(s):

Capital Market ◽

Poisson Regression ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Jel Classification ◽

World Health ◽

Policy Document ◽

Market Capitalization ◽

Development Indicators ◽

Percentage Decrease

Despite a large and growing list of studies on COVID-19 across space and time and on heterogeneous social, environmental and welfare issues, the empirical relations on the consequences of COVID-19 pandemic and Africa’s market capitalization objectives remain dimly discerned. Even more worrisome is Africa, where the condition for growth and development has not been adequately fulfilled. This structural ambiguity calls for a policy document that is evidence-based to reach conclusions to aid the containment, risk analysis, structures and features of the deadly and fast-spreading disease. This study employed negative binomial and the Poisson regression to establish the contemporaneous influence of COVID-19 pandemic on market capitalization capabilities in Africa. Health data from various reports of the World Health Organization (WHO) is regressed on the all-share index from World Development Indicators (WDI) to establish a clear line of thought. It is found that the growth of confirmed cases and attributable deaths are inversely related to the growth in market capitalization in Africa. The findings from this study show that Africa market capitalization is inversely related to total growth in the number of confirmed cases of COVID-19 and attributable COVID-19 deaths. This leads to the assertion that Africa’s capital market is fast nosediving in the time of COVID-19 due to global uncertainties caused by the pandemic. With no known cure or vaccine procedure discovered yet, the global uncertainty around the novel coronavirus disease will lead to approximately 0.56 percentage decrease in market capitalization in Africa. To this end, emphases must be laid on identifying and including non-traditional sources of financing strictly tied to projects that could encourage institutional investors. It is therefore equally imperative for Africa to form a formidable and integrated capital market among themselves. Keywords: market capitalization; COVID-19 pandemic, negative binomial Regression, poisson, Regression, Africa JEL Classification: C10, C31, G15, I12

Download Full-text

Analyzing Overdispersed Antenatal Care Count Data in Bangladesh: Mixed Poisson Regression with Individual-Level Random Effects

Austrian Journal of Statistics ◽

10.17713/ajs.v50i4.1163 ◽

2021 ◽

Vol 50 (4) ◽

pp. 78-90

Author(s):

Zakir Hossain ◽

Maria

Keyword(s):

Antenatal Care ◽

Random Effects ◽

Count Data ◽

Poisson Regression ◽

Negative Binomial ◽

Wealth Index ◽

Negative Binomial Regression ◽

Information Criterion ◽

World Health ◽

Individual Level

Poisson regression (PR) is commonly used as the base model for analyzing count data with the restrictive equidispersion property. However, overdispersed nature of count data is very common in health sciences. In such cases, PR produces misleading inferences and hence give incorrect interpretations of the results. Mixed Poisson regression with individual--level random effects (MPR_ILRE) is a further improvement for analyzing such data. We compare MPR_ILRE with PR, quasi-Poisson regression (Q_PR) and negative binomial regression (NBR) for modelling overdispersed antenatal care (ANC) count data extracted from the latest Bangladesh Demographic and Health Survey (BDHS) 2014. MPR_ILRE is found to be the best choice because of its minimum Akaike information criterion (AIC) value and the overdispersion exists in data has also been modelled very well. Study findings reveal that on average, women attended less than three ANC visits and only 6.5\% women received the World Health Organization (WHO) recommended eight or more ANC visits for the safe pregnancy and child birth. Administrative division, place of residence, birth order, exposure of media, education, wealth index and body mass index (BMI) have significant impact on adequate ANC attendance of women to reducing pregnancy complications, maternal and child deaths in Bangladesh.

Download Full-text

The impact of surveillance and other factors on detection of emergent and circulating vaccine derived polioviruses

Gates Open Research ◽

10.12688/gatesopenres.13272.1 ◽

2021 ◽

Vol 5 ◽

pp. 94

Author(s):

Megan Auzenbergs ◽

Holly Fountain ◽

Grace Macklin ◽

Hil Lyons ◽

Kathleen M O'Reilly

Keyword(s):

Negative Binomial ◽

Oral Polio Vaccine ◽

Negative Binomial Regression ◽

Polio Eradication ◽

Outbreak Detection ◽

World Health ◽

Negative Binomial Regression Model ◽

Uncertainty Interval ◽

Health Organization ◽

The Impact

Background: Circulating vaccine derived poliovirus (cVDPV) outbreaks remain a threat to polio eradication. To reduce cases of polio from cVDPV of serotype 2, the serotype 2 component of the vaccine has been removed from the global vaccine supply, but outbreaks of cVDPV2 have continued. The objective of this work is to understand the factors associated with later detection in order to improve detection of these unwanted events. Methods: The number of nucleotide differences between each cVDPV outbreak and the oral polio vaccine (OPV) strain was used to approximate the time from emergence to detection. Only independent emergences were included in the analysis. Variables such as serotype, surveillance quality, and World Health Organization (WHO) region were tested in a negative binomial regression model to ascertain whether these variables were associated with higher nucleotide differences upon detection. Results: In total, 74 outbreaks were analysed from 24 countries between 2004 and 2019. For serotype 1 (n=10), the median time from seeding until outbreak detection was 284 (95% uncertainty interval (UI) 284-2008) days, for serotype 2 (n=59), 276 (95% UI 172-765) days, and for serotype 3 (n=5), 472 (95% UI 392-603) days. Significant improvement in the time to detection was found with increasing surveillance of non-polio acute flaccid paralysis (AFP) and adequate stool collection. Conclusions: cVDPVs remain a risk globally; all WHO regions have reported at least one VDPV outbreak since the first outbreak in 2001. Maintaining surveillance for poliomyelitis after local elimination is essential to quickly respond to both emergence of VDPVs and potential importations. Considerable variation in the time between emergence and detection of VDPVs were apparent, and other than surveillance quality and inclusion of environmental surveillance, the reasons for this remain unclear.

Download Full-text

Study of sociodemographic profile of juvenile boys admitted in an observation home

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170117 ◽

2017 ◽

Vol 4 (1) ◽

pp. 230 ◽

Cited By ~ 2

Author(s):

Nitin D. Bhoge ◽

Smita N. Panse ◽

Alka V. Pawar ◽

Girish T. Raparti ◽

Sunita J. Ramanand ◽

...

Keyword(s):

Parental Education ◽

Maternal Education ◽

Psychiatric Morbidity ◽

Dropout Rate ◽

World Health ◽

World Health Report ◽

Age Group ◽

Health Report ◽

Sociodemographic Profile ◽

Conflict Of Law

Background: World Health Report estimated that 20% of children and adolescent suffer from a disabling mental illness worldwide. Incidences of vagrancy, delinquency and crime have been growing among steadily increasing juvenile population in the last few years. Various studies have revealed the presence of difficult family environment, lower socio-economic status, and low parental education associated with the psychiatric morbidity in children. Given the growth of juvenile delinquent population, epidemiologic data of this high risk group is becoming increasingly important. Therefore this study was undertaken to study the sociodemographic profile of male juvenile admitted in an observation home.Methods: This cross sectional study was conducted in an Observation Home for Boys. The study sample consists of 50 boys aged between 6-16 years. Out of 50, 20 juveniles under conflict of law and 30 under care and protection were included.Results: All the juveniles in this study were belonging to the lower socioeconomic status. Delinquency was significantly more common in older age group (12-16 years) than younger age group (6-11 years). The maternal education and school dropout rate had significant correlation with delinquency in our study, found to be more common in juveniles under conflict of law than those under care and protection.Conclusions: Establishment of multidisciplinary mental health services at each juvenile center of India, for complete rehabilitation of the juveniles admitted there, under social justice system is immediately required.

Download Full-text