scholarly journals Asthma in South African adolescents: a time trend and risk factor analysis over two decades

2020 ◽  
pp. 00576-2020
Author(s):  
C.B. Baard ◽  
Z. Franckling-Smith ◽  
J. Munro ◽  
L. Workman ◽  
H.J. Zar

BackgroundSouth Africa has undergone major economic and health system changes impacting the epidemiology of childhood asthma. This study aimed to investigate prevalence time-trends of asthma in South African adolescents over 2 decades and to identify associated risk-factors.MethodsA cross-sectional survey was conducted in 2017, in a randomised sample of 13–14 year-old Cape Town adolescents, using the standardised Global Asthma Network written, video, and environmental questionnaires. Using time-trend analysis, the prevalence and severity of asthma were compared with data from the 2002 ISAAC phase III study. Environmental and social risk-factors were analysed.Results3979 adolescents were included. Prevalence of lifetime and current asthma were 34.5% and 21.3%, respectively, on the self-report written questionnaire, similar to 2002 results. The prevalence of severe asthma in the last 12 months increased, measured by wheeze limiting speech (7.8% to 11.8%), ≥4 attacks of wheezing (5.0% to 5.8%) or ≥1 night·week−1 waking from wheezing (5.0% to 6.9%). The video questionnaire revealed increases in lifetime (16.9% to 22.5%), current (11.2% to 18.7%), or severe asthma (12.1% to 14.8%). Multivariate analysis showed associations between current asthma and smoking, female sex, pet exposure or higher socioeconomic status. Severe asthma was associated with smoking, pet exposure, outdoor pollution exposure or informal housing. 33% of those with severe or current asthma had been diagnosed.ConclusionThe prevalence of asthma is high, with increasing rates of severe asthma in adolescents. Underdiagnosis is a major concern and reduction in exposure to environmental factors, particularly smoking, and improved socioeconomic development are needed.

BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen19X101643 ◽  
Author(s):  
Nat MJ Wright ◽  
Philippa Hearty ◽  
Victoria Allgar

BackgroundThe size and mean age of the prison population has increased rapidly in recent years. Prisoners are a vulnerable group who, compared with the general population, experience poorer health outcomes. However, there is a dearth of research quantifying the prevalence of non-communicable diseases (NCDs) among prisoner populations.AimTo explore both the prevalence of NCDs and their risk factors.Design & settingA cross-sectional survey was undertaken that was compared with clinical records in two male prisons in the north of England.MethodSelf-report surveys were completed by 199 prisoners to assess sociodemographic characteristics, general health, NCD prevalence, and risk factor prevalence. Data were checked against that retrieved from prison clinical records.ResultsIt was found that 46% reported at least one NCD and 26% reported at least one physical health NCD. The most common self-reported NCD was 'anxiety and depression' (34%), followed by 'respiratory disease' (17%), and 'hypertension' (10%). Having a physical health NCD was independently associated with increasing age or drug dependence.The level of agreement between clinical records and self-report ranged from 'fair' for alcohol dependence (kappa 0.38; P<0.001) to 'very good' for diabetes (kappa 0.86; P<0.001).ConclusionCompared with mainstream populations and despite high prevalence of risk factors for NCDs physical illness NCDs, with the exception of respiratory disease, are less common. However, poor mental health is more common. These differences are possibly owing to the younger average age of prison populations, since prevalence of risk factors was reported as high.Secondary data analysis of clinical records is a more methodologically robust way of monitoring trends in prisoner population disease prevalence.


2021 ◽  
Author(s):  
Eleanor Blakey ◽  
Lucy Reeve ◽  
Neville Q Verlander ◽  
David Edwards Edwards ◽  
David Wyllie ◽  
...  

Objectives To define risk factors for SARS-CoV-2 infection in University of Cambridge students during a period of increased incidence in October and November 2020. Study design Survey Methods Routine public health surveillance identified a marked increase in the numbers of University of Cambridge students with respiratory illness and SARS-CoV-2 positivity in the 10 days after a national lockdown was announced in the UK on 5 November 2020. Cases were identified both through symptom-triggered testing and a universal asymptomatic testing program. An online questionnaire was sent to all University of Cambridge students on 25 November to investigate risk factors for testing positive in the period after 30 October 2020. This asked about symptoms, SARS-CoV-2 test results, in-person teaching settings, other aspects of University life, and attendance at social events in the period just prior to lockdown, from 30th October and 4th November 2020. Univariate and multivariable analyses were undertaken evaluating potential risk factors for SARS-CoV-2 positivity. Results Among 3,980 students responding to the questionnaire, 99 (2.5%) reported testing SARS-CoV-2 positive in the period studied; 28 (28%) were asymptomatic. We found strong independent associations with SARS-CoV-2 positivity were attendance at two social settings in the City of Cambridge (adjusted odds ratio favouring disease 13.0 (95% CI 6.2,26.9) and 14.2 (95% CI 2.9,70)), with weaker evidence of association with three further social settings. By contrast, we did not observe strong independent associations between disease risk and type of accommodation or attendance at, or participation in, a range of activities associated with the University curriculum. Conclusions Attendance at social settings can facilitate widespread SARS-CoV-2 transmission in University students. Constraint of transmission in higher education settings needs to emphasise risks outside University premises, as well as a COVID-safe environment within University premises.


Crisis ◽  
2019 ◽  
Vol 40 (2) ◽  
pp. 134-140 ◽  
Author(s):  
Christopher R. DeCou ◽  
Stephanie P. Kaplan ◽  
Julie Spencer ◽  
Shannon M. Lynch

Abstract. Background and Aim: This study evaluated trauma-related shame as a mediator of the association between sexual assault severity and perceived burdensomeness and thwarted belongingness. Method: A total of 164 female undergraduates who reported attempted or completed sexual assault completed self-report measures of sexual assault, trauma-related shame, perceived burdensomeness, and thwarted belongingness. Results: Using path analysis, trauma-related shame mediated the association between sexual assault severity and perceived burdensomeness, and between sexual assault severity and thwarted belongingness. Limitations: The findings of this study are limited by the retrospective, self-report, and cross-sectional nature of these data, and do not allow for causal inference. Conclusion: Trauma-related shame warrants additional investigation as a mechanism that explains the association between sexual assault and psychosocial risk factors for suicidal ideation and behavior.


2019 ◽  
Vol 15 (1) ◽  
pp. 10-16
Author(s):  
Shreyan Kar ◽  
Tushar Kanti Das ◽  
Prasanta Kumar Mohapatra ◽  
Brajaballav Kar ◽  
Anupama Senapati ◽  
...  

Background: While it is apparent that old age is associated with multiple health concerns, the extent of its multiplicity and burden is often not clear. It was intended to find out self-reported health concerns for one month and cardiovascular risk factors in middle and older adults. Methods: In the cross-sectional survey, attendees of a Healthy Ageing Conference were approached with a semi-structured questionnaire about their health concerns and cardiovascular risks. Risk of a cardiovascular event in 10 years based on QRISK3 was calculated. Results: A considerable proportion of older adults had a range of physical symptoms, depressive mood state and memory problems. Mean number of health problems reported were 4.8±3.3 (male 4.4±3.1 and female 5.0±4.3). Cardiovascular risk was high, mean QRISK3 score for males were 22.2% (±14.4), and for females 10.3% (±6.6) (p<0.05). On average, the heart age was increased by 7.9±6.2 years (8.6±6.6 years for males and 5.0±3.3 for females). The relative risk of participants was 2.1 for males and 1.5 for females for heart attack or stroke within the ten years, compared to healthy persons. The symptoms and risk factors were elicited easily, and the process probably facilitated improving the awareness about the health concerns holistically. The survey also identified issues related to the engagement of older adults in the existing health care systems. Conclusions: The results suggested that questionnaire-based health screening in a community can identify a range of health concerns and identify multi-morbidity in general and cardiovascular risks in particular. This process may help to focus on the appropriate public health awareness and intervention programmes required in the community.


2001 ◽  
Vol 15 (6) ◽  
pp. 414-421 ◽  
Author(s):  
Pebbles Fagan ◽  
Marla Eisenberg ◽  
Anne M. Stoddard ◽  
Lindsay Frazier ◽  
Glorian Sorensen

Purpose. To examine the relationships between worksite interpersonal influences and smoking and quitting behavior among adolescent workers. Design. The cross-sectional survey assessed factors influencing tobacco use behavior. Setting. During the fall of 1998, data were collected from 10 grocery stores in Massachusetts that were owned and managed by the same company. Subjects. Eligible participants included 474 working adolescents ages 15 to 18. Eighty-three percent of workers (n = 379) completed the survey. Measures. The self-report questionnaire assessed social influences, social norms, social support, friendship networks, stage of smoking and quitting behavior, employment patterns, and demographic factors. Results. Thirty-five percent of respondents were never smokers, 21% experimental, 5% occasional, 18% regular, and 23% former smokers. Using analysis of variance (ANOVA), results indicate that regular smokers were 30% more likely than experimental or occasional smokers to report coworker encouragement to quit (p = .0002). Compared with regular smokers, never smokers were 15% more likely to report greater nonacceptability of smoking (p = .01). χ2 tests of association revealed no differences in friendship networks by stage of smoking. Conclusions. These data provide evidence for the need to further explore social factors inside and outside the work environment that influence smoking and quitting behavior among working teens. Interpretations of the data are limited because of cross-sectional and self-report data collection methods used in one segment of the retail sector.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041609
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Farag Shuweihdi ◽  
Mitch Waterman ◽  
Allan House

ObjectivesTo identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana.DesignA cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data.SettingThree contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks).ParticipantsA regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13–21 years.Outcome measuresParticipants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities.ResultsThe lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56).ConclusionsSelf-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beibei Feng ◽  
Kedi Chen ◽  
Xiaoxia Zhu ◽  
Wing-Yuk Ip ◽  
Lars L. Andersen ◽  
...  

Abstract Background Carpal tunnel syndrome (CTS) is a common cause of pain, numbness and tingling in the wrist and hand region and is associated with repetitive wrist and hand use in office workers. However, scarce knowledge exists about the epidemiology of clinically confirmed CTS among Chinese office workers. This study aimed to investigate the prevalence of wrist/hand symptoms and CTS in office workers in China and to identify associated risk factors. Methods A cross-sectional survey was carried out in a metropolitan city in China involving 969 respondents (aged 17–49 years) from 30 workplaces. A questionnaire was distributed to each participant to collect their demographic, work-related physical and psychosocial factors, and wrist and hand symptoms. The wrist and hand pain/numbness symptoms were marked on a body chart and the nature and intensity of symptoms, nocturnal symptoms, as well as aggravating activities were also recorded. Clinically confirmed CTS cases were screened based on the history, Phalen’s test, Tinel Sign and skin sensation testing among symptomatic respondents. Logistic regression was employed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for the occurrence of self-reported wrist and hand symptoms and clinically confirmed CTS. Results The clinically confirmed CTS prevalence was 9.6%. The prevalence of wrist and hand symptoms were 22 and 15%, respectively. Frequently working in pain was associated with higher odds of CTS. Multivariate modelling adjusted for age and gender showed that prolonged computer use time and working without breaks were associated with presence of wrist/hand symptoms (adjusted ORs: 1.11 (95% CI 1.02–1.22) and 1.88 (95% CI 1.12–3.14)). Educational level was inversely associated with CTS and smoking was associated with wrist/hand complaints (adjusted OR: 2.20 (95% CI 1.19–4.07)). Conclusions The prevalence of work-related clinically confirmed CTS symptoms among young office workers in China is high. Frequently working in pain is closely associated with clinically confirmed CTS. Intense computer use and no breaks at work are associated with wrist and hand symptoms.


2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin

Summary COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rui Huang ◽  
Jian-Gao Fan ◽  
Jun-Ping Shi ◽  
Yi-Min Mao ◽  
Bing-Yuan Wang ◽  
...  

Abstract Background Health Related Quality of Life (HRQL) is a multi-dimensional construct that can comprehensively evaluate the patient’s health status, including physical, emotional, mental and social well-being. In this study, we aimed to evaluate the impact of non-alcoholic fatty liver disease (NAFLD) on HRQL in a Chinese population. Methods In this national multicenter cross-sectional survey, patients with NAFLD were enrolled. Chronic Liver Disease Questionnaire (CLDQ)-NAFLD was used to qualify HRQL. Univariate and multivariate analysis were used to identify independent risk factors of HRQL. Results A total of 5181 patients with NAFLD from 90 centers were enrolled in this study (mean age, 43.8 ± 13.3 years; male, 65.8%). The overall CLDQ score was 5.66 ± 0.89. Multivariate logistic regression analysis showed that body mass index (BMI: HR, 1.642; 95% CI, 1.330–2.026), alanine transaminase (ALT: HR, 1.006; 95% CI, 1.001–1.011), triglyceride (HR, 1.184; 95% CI, 1.074–1.305), disease severity (HR, 3.203; 95% CI, 1.418–7.232) and cardiovascular disease (HR, 4.305; 95% CI, 2.074–8.939) were independent risk factors for overall CLDQ score. In the logistic analyses of individual domain, BMI and triglyceride were independent risk factors of all domains. ALT, disease severity, diabetes, depression and cardiovascular disease were influencing factors for the CLDQ score of several domains. Conclusions This national multicenter cross-sectional survey in China indicated that the HRQL in patients with NAFLD was impaired. HRQL was found to be significantly associated with sociodemographic and clinical factors. Attention should be paid to the optimally managing care of patients with NAFLD to improve their HRQL.


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