Is the positive association between middle-income and rich household wealth and adult sub-Saharan African women’s overweight status modified by the level of education attainment? A cross-sectional study of 22 countries

ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.

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The Relationships Between Serum DHEA-S and AMH Levels in Infertile Women: A Retrospective Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm10061211 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1211

Author(s):

Li-Te Lin ◽

Kuan-Hao Tsui

Keyword(s):

Generalized Linear Models ◽

Large Scale ◽

Linear Models ◽

Positive Association ◽

Cross Sectional Study ◽

Dehydroepiandrosterone Sulphate ◽

Sectional Study ◽

Cross Sectional ◽

Infertile Women ◽

The Relationship

The relationship between serum dehydroepiandrosterone sulphate (DHEA-S) and anti-Mullerian hormone (AMH) levels has not been fully established. Therefore, we performed a large-scale cross-sectional study to investigate the association between serum DHEA-S and AMH levels. The study included a total of 2155 infertile women aged 20 to 46 years who were divided into four quartile groups (Q1 to Q4) based on serum DHEA-S levels. We found that there was a weak positive association between serum DHEA-S and AMH levels in infertile women (r = 0.190, p < 0.001). After adjusting for potential confounders, serum DHEA-S levels positively correlated with serum AMH levels in infertile women (β = 0.103, p < 0.001). Infertile women in the highest DHEA-S quartile category (Q4) showed significantly higher serum AMH levels (p < 0.001) compared with women in the lowest DHEA-S quartile category (Q1). The serum AMH levels significantly increased across increasing DHEA-S quartile categories in infertile women (p = 0.014) using generalized linear models after adjustment for potential confounders. Our data show that serum DHEA-S levels are positively associated with serum AMH levels.

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Removable denture is a risk indicator for peri-implantitis and facilitates expansion of specific periodontopathogens: a cross-sectional study

BMC Oral Health ◽

10.1186/s12903-021-01529-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jasmin Grischke ◽

Szymon P. Szafrański ◽

Uthayakumar Muthukumarasamy ◽

Susanne Haeussler ◽

Meike Stiesch

Keyword(s):

Bacterial Species ◽

Positive Association ◽

Cross Sectional Study ◽

Risk Indicators ◽

Risk Indicator ◽

Sectional Study ◽

Significant Positive Association ◽

Cross Sectional ◽

Linear Discriminant ◽

Removable Denture

Abstract Background The prevalence of peri-implantitis ranges between 7 and 38.4% depending on risk indicators such as smoking, diabetes mellitus, lack of periodontal maintenance program, and history or presence of periodontitis. Currently, the possible effect of the type of superstructure on peri-implant health is unclear. This cross-sectional study aims to investigate the influence of the superstructure on the prevalence of peri-implant mucositis, peri-implantitis and peri-implant dysbiosis. Methods During a 32-month recruitment period dental implants were assessed to diagnose healthy peri-implant tissues, mucositis or peri-implantitis. The study included 1097 implants in 196 patients. Out of all peri-implantitis cases 20 randomly chosen submucosal biofilms from implants with fixed denture (FD) originating from 13 patients and 11 biofilms from implants with removable dentures (RD) originating from 3 patients were studied for microbiome analysis. Composition of transcriptionally active biofilms was revealed by RNAseq. Metatranscriptomic profiles were created for thirty-one peri-implant biofilms suffering from peri-implantitis and microbiome changes associated with superstructure types were identified. Results 16.41% of the implants were diagnosed with peri-implantitis, 25.00% of implants with RD and 12.68% of implants with FD, respectively. Multivariate analysis showed a significant positive association on patient (p = < 0.001) and implant level (p = 0.03) between the prevalence of peri-implantitis and RD. Eight bacterial species were associated either with FD or RD by linear discriminant analysis effect size method. However, significant intergroup confounders (e.g. smoking) were present. Conclusions Within the limitations of the present work, RDs appear to be a risk indicator for peri-implantitis and seem to facilitate expansion of specific periodontopathogens. Potential ecological and pathological consequences of shift in microbiome from RDs towards higher activity of Fusobacterium nucleatum subspecies animalis and Prevotella intermedia require further investigation.

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Prenatal greenspace exposure and cord blood cortisol levels: A cross-sectional study in a middle-income country

Environment International ◽

10.1016/j.envint.2020.106047 ◽

2020 ◽

Vol 144 ◽

pp. 106047

Author(s):

Lilian Marie Boll ◽

Ramezanali Khamirchi ◽

Lucia Alonso ◽

Elisa Llurba ◽

Óscar J Pozo ◽

...

Keyword(s):

Cord Blood ◽

Cross Sectional Study ◽

Middle Income Country ◽

Income Country ◽

Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

Cortisol Levels

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Understanding neighbourhood retail food environmental mechanisms influencing BMI in the Caribbean: a multilevel analysis from the Jamaica Health and Lifestyle Survey: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-033839 ◽

2020 ◽

Vol 10 (8) ◽

pp. e033839

Author(s):

Colette Andrea Cunningham-Myrie ◽

Novie O Younger ◽

Katherine P Theall ◽

Lisa-Gaye Greene ◽

Parris Lyew-Ayee ◽

...

Keyword(s):

Social Class ◽

Fast Food ◽

Intraclass Correlation ◽

Buffer Zone ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

Retail Food

ObjectiveTo derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity.DesignCross-sectional study.SettingData from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts.ParticipantsA subsample of 2529 participants aged 18–74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded.Primary outcome measureMean BMI, calculated as weight divided by height squared (kg/m2).ResultsThere was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10−3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity.ConclusionsHigher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations.

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Prevalence and correlates of adherence to movement guidelines among urban and rural children in Mozambique: a cross-sectional study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-019-0861-y ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 6

Author(s):

Taru Manyanga ◽

Joel D. Barnes ◽

Jean-Philippe Chaput ◽

Peter T. Katzmarzyk ◽

Antonio Prista ◽

...

Keyword(s):

Physical Activity ◽

Sleep Duration ◽

Screen Time ◽

Cross Sectional Study ◽

Rural Children ◽

Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries

Abstract Background Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. Methods This is cross-sectional study of 9–11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. Results More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16–0.87), school location (OR: 0.21; CI: 0.09–0.52), and outdoor time (OR: 0.67; CI: 0.53–0.85) were significant correlates of meeting all three 24-h movement guidelines. Conclusions Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.

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