scholarly journals The burden of typhoid fever in Klang Valley, Malaysia, 2011–2015

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eida Nurhadzira Muhammad ◽  
Mohd Hatta Abdul Mutalip ◽  
Mohd Hazrin Hasim ◽  
Faizah Paiwai ◽  
Sayan Pan ◽  
...  

Abstract Background Typhoid fever causes global morbidity and mortality and is a significant health burden, particularly in low- and middle-income countries. The direct fecal-oral route is the main transmission mode, but indirect environmental transmission could occur, particularly in urban settings. This study aimed to investigate the burden and trend of typhoid fever, reporting the coverage system between government and private practice and pattern of multidrug-resistant (MDR) typhoid cases in the urban Klang Valley area from 2011 to 2015. Methods The data from a cross-sectional study retrieved from the e-Notifikasi System, a national reporting system for communicable diseases provided by the Disease Control Division, Ministry of Health Malaysia and secondary data of all the typhoid cases were obtained from the public and private hospitals and laboratories in Klang Valley. Descriptive analysis was performed to examine the sociodemographic characteristics, spatial mapping was conducted to examine trends, and the crude incidence rates of confirmed typhoid cases and percentage of reporting coverage were calculated. Significant differences between MDR and non-MDR Salmonella typhi were determined in the patient’s sociodemographic characteristics, which were analyzed using χ2 test. P values < 0.05 were considered statistically significant. Results In total, 507 typhoid fever cases were reported in Klang Valley; however, only 265 cases were confirmed by culture tests. The crude incidence rates of confirmed cases were between 0.5 to 0.7 but peaked at 1.42 per 100,000 population in 2015. Most typhoid fever cases were observed among men (55.6%), individuals aged 21 to 30 years (27.6%), Malaysians (86.3%) and individuals of Malay ethnicity (52.1%). The reporting coverage of confirmed cases was 78.9% and non-reporting coverage of unconfirmed typhoid cases was 79.5%. The predictive value positive (PVP) was 89.3, and 7.5% were detected as MDR Salmonella typhi. Statistical significance was found in gender, citizenship and ethnicity regarding MDR Salmonella typhi (p = 0.004, p = 0.008 and p = 0.034, respectively). Conclusions The local transmission of typhoid is still prevalent in the Klang Valley despite rapid urbanization and development in recent years. These findings are essential for policy makers to plan and implement focused and effective preventative activities to curb typhoid infection in urban areas.

2021 ◽  
Author(s):  
Elina Khatri ◽  
Rajesh Kumar Yadav ◽  
Sushila Baral ◽  
Sudha Poudel ◽  
Kedar Prasad Baral

Abstract Background Adolescence, being a crucial stage for experimentation and acceptance of new behavioral and lifestyle choices, is detrimental to their nutritional status. The nutritional status of adolescents being shaped by socio-cultural, environmental, and economic factors has also been impacted by their food habits and level of physical activity. The current nutritional shift and rapid urbanization had emerged overweight as an additional burden for consistently prevalent undernutrition issues. So, the study aimed to identify the prevalence of and risk factors for overweight among school adolescents. Methods A school-based cross-sectional analytical study was carried out among school adolescents in a Sub-metropolitan city of Nepal. A random sample of 279 adolescents from nine schools was included in the study. The anthropometric measurement of the height and the weight were measured as per the standard. The odds ratio with a 95% CI was calculated and a p-value of ≤ 0.05 was considered as cut off for statistical significance by fitting into the final multivariable logistic regression. Results The overall prevalence of overweight was obtained as 9.31% (95% CI: 6.40 − 13.3). The mean age of respondents was 15.5 years. The early aged adolescents were more overweight than compared to middle-aged adolescents (AOR: 0.27, CI: 0.028–2.67) and late adolescents (AOR: 0.66, CI: 0.068–6.44) respectively. Similarly, adolescents residing in rural areas had 0.35 (AOR = 0.33, CI: 0.030–3.71) odds of being overweight compared to their counterparts. Adolescents with sedentary behavior were 4 times (AOR = 3.51, CI: 0.79–15.54) more likely of being overweight than their counterparts. Conclusions Overweight among adolescents in urban areas has emerged as an alarming issue with the increasing burden. It is therefore pertinent to emphasize adolescents to improve healthy weight status.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Małgorzata Lesińska-Sawicka

Abstract Introduction Cervical cancer and its etiopathogenesis, the age of women in whom it is diagnosed, average life expectancy, and prognosis are information widely covered in scientific reports. However, there is no coherent information regarding which regions—urban or rural—it may occur more often. This is important because the literature on the subject reports that people living in rural areas have a worse prognosis when it comes to detection, treatment, and life expectancy than city dwellers. Material and methods The subjects of the study were women and their knowledge about cervical cancer. The research was carried out using a survey directly distributed among respondents and via the Internet, portals, and discussion groups for women from Poland. Three hundred twenty-nine women took part in the study, including 164 from rural and 165 from urban areas. The collected data enabled the following: (1) an analysis of the studied groups, (2) assessment of the respondents’ knowledge about cervical cancer, and (3) comparison of women’s knowledge depending on where they live. Results The average assessment of all respondents’ knowledge was 3.59, with women living in rural areas scoring 3.18 and respondents from the city—4.01. Statistical significance (p < 0.001) between the level of knowledge and place of residence was determined. The results indicate that an increase in the level of education in the subjects significantly increases the chance of getting the correct answer. In the case of age analysis, the coefficients indicate a decrease in the chance of obtaining the correct answer in older subjects despite the fact that a statistically significant level was reached in individual questions. Conclusions Women living in rural areas have less knowledge of cervical cancer than female respondents from the city. There is a need for more awareness campaigns to provide comprehensive information about cervical cancer to women in rural areas. A holistic approach to the presented issue can solve existing difficulties and barriers to maintaining health regardless of the place of life and residence. Implication for cancer survivors They need intensive care for women’s groups most burdened with risk factors.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Laíla D. Andrade ◽  
Fernanda A. Oliveira ◽  
Victor D. Mariano ◽  
Monique C. A. Santos ◽  
Fernanda A. Pereira ◽  
...  

Background/Aims. Identify the degree of adherence to drug therapy in patients with inflammatory bowel diseases followed up at a referral center in Bahia-Brazil. Methods. Observational, analytical, and cross-sectional studies carried out from June/2017 to July/2018, with questionnaire application and medical record review at a referral center in inflammatory bowel diseases in Salvador, Bahia. The Morisky Green Levine Scale was applied to assess adherence. Mean, standard deviation, and frequency analyses were performed using the statistical package SPSS, and chi-square was used to evaluate the association between categorical variables and adherence degree to treatment. Significant associations were considered with p<0.05. Results. 302 patients with inflammatory bowel diseases were included. Nonadherence was highlighted in the sample. Most part of the study population was female, declared themselves to be mixed race, claimed to be from urban areas, and married. Nonadherence was more frequent than adherence in most sociodemographic variables of the present study. Nonadherence also stood out among the clinical variables, such as disease activity, drug side effect, and use of more than two additional medications. The association between all studied variables and adherence degree to treatment, considering the general sample, did not show statistical significance. When Crohn’s disease and ulcerative colitis patients were evaluated separately, a statistically significant association between nonadherence and female patients with ulcerative colitis was observed. Conclusions. The high frequency of nonadherence was observed in the studied sample. Female gender was associated to nonadherence in the subpopulation with ulcerative colitis.


2019 ◽  
Vol 22 (17) ◽  
pp. 3288-3297
Author(s):  
Anna Strid ◽  
Elinor Hallström ◽  
Therese Hjorth ◽  
Ingegerd Johansson ◽  
Bernt Lindahl ◽  
...  

AbstractObjective:The objective of this study was to examine climate impact from diet across background and sociodemographic characteristics in a population-based cohort in northern Sweden.Design:A cross-sectional study within the Västerbotten Intervention Programme. Dietary data from a 64-item food frequency questionnaire collected during 1996–2016 were used. Energy-adjusted greenhouse gas emissions (GHGE) for all participants, expressed as kg carbon dioxide equivalents/day and 4184 kJ (1000 kcal), were estimated using data from life cycle analyses. Differences in background and sociodemographic characteristics were examined between participants with low and high GHGE from diet, respectively. The variables evaluated were age, BMI, physical activity, marital status, level of education, smoking, and residence.Setting:Västerbotten county in northern Sweden.Participants:In total, 46 893 women and 45 766 men aged 29–65 years.Results:Differences in GHGE from diet were found across the majority of examined variables. The strongest associations were found between GHGE from diet and age, BMI, education, and residence (all P < 0·001), with the highest GHGE from diet found among women and men who were younger, had a higher BMI, higher educational level, and lived in urban areas.Conclusions:This study is one of the first to examine climate impact from diet across background and sociodemographic characteristics. The results show that climate impact from diet is associated with age, BMI, residence and educational level amongst men and women in Västerbotten, Sweden. These results define potential target populations where public health interventions addressing a move towards more climate-friendly food choices and reduced climate impact from diet could be most effective.


Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Sharon B. Weissman ◽  
Hana R. Winders ◽  
Sangita Dash ◽  
...  

Abstract In this cross-sectional population-based study, women had significantly higher crude incidence rates of both community-associated Clostridioides difficile infection (CA-CDI) and ambulatory antibiotic prescriptions compared to men in South Carolina in 2015. After adjustments for antibiotic prescription rates, there was no difference in the incidence rates of CA-CDI between the genders.


2007 ◽  
Vol 35 (1) ◽  
pp. 39-47 ◽  
Author(s):  
Olli P. Nummela ◽  
Tommi T. Sulander ◽  
Heikki S. Heinonen ◽  
Antti K. Uutela

Aims: This paper examines associations between self-rated health, three indicators of SES (self-reported education, disposable household income, adequacy of income) and three types of communities (urban, densely or sparsely populated rural areas) among ageing men and women in the Province of Päijät-Häme, Southern Finland. There is a lack of knowledge regarding the magnitude of community type when examining the relation between subjective health and SES. Methods: Cross-sectional questionnaire data gathered in the spring of 2002 for a prospective follow-up of community interventions were used. These data, together with a number of clinical and laboratory measurements, yielded the baseline for a 10-year community intervention study. A representative stratified (age, gender, area) sample of men and women living in the province and belonging to the birth cohorts 1926—1930, 1936—1940, and 1946—1950 was obtained from the National Population Registry. The target sample was 4,272, with 2,815 persons responding (66% response rate). Results: Positive associations between indicators of SES and self-rated health were observed in all three community types. After adjusting for other factors, adequacy of income showed the strongest (positive) association with self-rated health in urban areas in all age groups. A similar pattern of associations, with varying statistical significance, though, was found in the two rural areas. Conclusions: This study supports the view that while actual income is positively correlated to health, adequacy of income is an even stronger predictor of it. Thus, there was a significant link between better financial standing and good health among ageing people, especially in urban areas.


2021 ◽  
Vol 5 (2) ◽  
pp. 118-124
Author(s):  
Justin Marson ◽  
Graham Litchman ◽  
Darrell Rigel

Background: COVID-19 materially delayed patient visits and potential skin cancer biopsies/diagnoses among US dermatology practices. However, given a likely heterogenous impact across the US, this study sought to determine COVID-19’s effect on urban versus rural dermatology practices. Methods: Data were analyzed from the first 1000 responses to 3 pre-validated surveys of 9891 practicing US dermatologists comparing outpatient volumes and scheduling issues for the week of February 17th to the week of March 16th (Survey 1), April 13th (Survey 2) and May 18th, 2020 (Survey 3). First 3 US zip-code digits were compared to US Census Bureau data to determine “Urban/Rural” status. Representativeness with AAD membership was confirmed. Statistical significance was calculated using chi-square with Marascuilo procedure and two-tailed independent t-test/ANOVA with post-hoc Tukey-Kramer testing. Results: In April 2020 urban practices reported more closed practices (21.4% vs 5.8%, p<0.0001) and predicted significantly larger patient volume decreases (-45.2%  vs -31.4%, p<0.0001) and practice closures (11.9% vs. 2.5% p<0.0001) in the following 2 weeks. In May 2020, urban areas saw significantly fewer patients/week (90.9 vs 142.4 p<0.0001), larger decrease in patient volume relative to May 2019 (-49.4% vs -35.1%, p<0.0001), and conducted more telemedicine visits (27.0% vs 15.1%, p<0.0001). Significantly more rural practices reported already being at baseline volume (Mean Difference 6.2%, 95% CI 2.7%-9.8%) while urban practices predicted return to baseline volume by August (5.7, 95% CI 2.1%-9.3%) or were unsure (5.6, 95% CI 1.6%-9.7%). Conclusion: The initial COVID-19 pandemic differentially affected urban dermatology practices. The effects of the pandemic were mitigated in part by increased use telemedicine. Future studies may further elucidate COVID-19’s effect on clinical practice and highlight areas for improvement in practice logistics and patient care.


Author(s):  
Kefas Hellamada Kwala ◽  
Aminu Innocent Asika

Typhoid fever is one of the major and common health problem worldwide. Typhoid fever caused by Salmonella typhi may be a cause of significant morbidity and mortality in both the mother and fetus in developing countries, where sanitation facilities, personal and food hygiene are inadequate. Thus, the present research was a cross-sectional study of Salmonella infection among pregnant women in Specialist Hospital Yola, Nigeria. The objectives of this study is to determine the prevalence of typhoid infection among pregnant women in Adamawa state in relation to age, educational level, occupation and location, explore factors associated with the infection and to provide information on its prevention and control strategies. Serological analyses (Widal test) and bacteriological analyses (stool culture) were carried out and compared among 313 participants. The results obtained showed that 209 (66.77%) of the participants were seropositive for typhoid fever, whereas 188 (60.06%) were positive based on bacteriological technique. Participants between age groups; 26-35 years old had the highest prevalence of 64.10%.There was no statistically significant difference (P>0.05) between the prevalence of typhoid fever among the various age groups of the pregnant women examined. In relation to Educational level, participants with Non-formal education had the highest prevalence of typhoid infection 75.00%. There was no statistically significant difference (P>0.05) between the prevalence of typhoid fever based on the educational level of the pregnant women examined.  Based on occupation of the participants, women who were involved in farming recorded the highest prevalence rate of 88.37%.There was statistically significant difference (P< 0.05) between the prevalence of typhoid fever and the occupation of the pregnant women examined. With respect to the location of the participants, subjects belonging to Semi-urban areas recorded the highest prevalence of 80.98%. There was statistically significant difference (P< 0.05) between the prevalence of typhoid fever and the location of the pregnant women examined. Pregnancy state makes the women more vulnerable to typhoid fever by affecting the physiology of pivotal organs, as such causing complications in pregnant women therefore early and prompt diagnosis of the infection is essential.


2018 ◽  
Vol 8 (01) ◽  
pp. 734-743
Author(s):  
Ny. Marhani

The success of epidemiological survey of Salmonella is associated with procedures adopted to differentiate the genotypes of Salmonella typhi. The research aimed identification of Salmonella typhi from the blood culture of typhoid fever suspect.The research was conducted in the Microbiology Laboratory, Faculty of Medicine, Hasanuddin University. Samples were taken from Public health centers (PHC) in Malili. This was an analytic quantitative research with the cross sectional approach. Samples were collected from the blood of the patients with suspected positive typhoid fever suspects. The samples were cultured to obtain S.typhi isolates finally the data were analysed.The research result indicates that in the culture examination, the isolation result of the Salmonella typhi from the blood samples of 98 patients, its obtained 20 (20.4%) positive typhoid fever samples. This show that successfull identification of Salmonella typhi still lower. This is depend of several factor such as using antibiotic before take of blood, limited used of isolation media, total of less bacteria in blood, less volume of blood and time to take of blood not exactly.Keywords : Salmonella typhi,isolation, typhoid fever


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