scholarly journals Prevalence and correlates of comprehensive HIV/AIDS knowledge among adolescent girls and young women aged 15–24 years in Malawi: evidence from the 2015–16 Malawi demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chrispin Mandiwa ◽  
Bernadetta Namondwe ◽  
Mtondera Munthali

Abstract Background HIV epidemic remains a major public health issue in Malawi especially among adolescent girls and young women (AGYW). Comprehensive HIV/AIDS knowledge (defined as correct knowledge of two major ways of preventing the sexual transmission of HIV and rejection of three misconceptions about HIV) is a key component of preventing new HIV infections among AGYW. Therefore, the aim of this study was to identify the correlates of comprehensive HIV/AIDS knowledge among AGYW in Malawi. Methods The study was based on cross-sectional data from the 2015–2016 Malawi Demographic and Health Survey. It involved 10,422 AGYW aged 15–24 years. The outcome variable was comprehensive HIV/AIDS knowledge. Data were analysed using descriptive statistics, bivariate and multivariable logistic regression model. All the analyses were performed using complex sample analysis procedure of the Statistical Package for Social Sciences to account for complex survey design. Results Approximately 42.2% of the study participants had comprehensive HIV/AIDS knowledge. Around 28% of the participants did not know that using condoms consistently can reduce the risk of HIV and 25% of the participants believed that mosquitoes could transmit HIV. Multivariable logistic regression model demonstrated that having higher education (AOR = 2.97, 95% CI: 2.35–3.75), belonging to richest households (AOR = 1.24, 95% CI: 1.05–1.45), being from central region (AOR = 1.65, 95% CI:1.43–1.89), southern region (AOR = 1.65, 95% CI: 1.43–1.90),listening to radio at least once a week (AOR = 1.27, 95% CI: 1.15–1.40) and ever tested for HIV (AOR = 1.88, 95% CI: 1.68–2.09) were significantly correlated with comprehensive HIV/AIDS knowledge. Conclusions The findings indicate that comprehensive HIV/AIDS knowledge among AGYW in Malawi is low. Various social-demographic characteristics were significantly correlated with comprehensive HIV/AIDS knowledge in this study. These findings suggest that public health programmes designed to improve comprehensive HIV/AIDS knowledge in Malawi should focus on uneducated young women, those residing in northern region and from poor households. There is also a need to target AGYW who have never tested for HIV with voluntary counselling and testing services. This measure might both improve their comprehensive HIV/AIDS knowledge and awareness of their health status.

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256598
Author(s):  
Samuel Dessu ◽  
Tadesse Tsehay ◽  
Tadele Girum ◽  
Abebe Timerga ◽  
Mamo Solomon ◽  
...  

Introduction Internationally, countries have reacted to the COVID-19 outbreak by introducing key public health non-pharmaceutical interventions to protect vulnerable population groups. In response to COVID-19, the Government of Ethiopia has been taking a series of policy actions beyond public health initiatives alone. Therefore, this study was aimed to assess the applicability of basic preventive measures of the pandemic COVID-19 and associated factors among the residents of Guraghe Zone from 18th to 29th September, 2020. Methods Community based cross sectional study was conducted at Guraghe Zone from 18th to 29th September, 2020. Systematic random sampling method was applied among the predetermined 634 samples. Variables which had p-value less than 0.25 in bivariate analysis were considered as candidate for multivariable logistic regression model. P-value <0.05 was used as a cutoff point to determine statistical significance in multiple logistic regressions for the final model. Result In this study, 17.7% (95% CI: 14.7, 20.5) of the respondents apply the basic preventive measures towards the prevention of the pandemic COVID-19. In addition, being rural resident (AOR: 4.78,; 95%CI: 2.50, 8.90), being studied grade 1–8 (AOR: 3.70; 95%CI: 1.70, 7.90), being a farmer (AOR: 4.10; 95%CI: 1.25, 13.35), currently not married (AOR: 2.20, 95%CI: 1.24, 4.06), having family size 1-3(AOR: 6.50; 95%CI: 3.21, 3.35), have no diagnosed medical illness (AOR: 6.40; 95%CI: 3.85, 10.83) and having poor knowledge (AOR: 3.50; 95%CI: 1.60, 7.40) were factors which are statistically significant in multivariable logistic regression model. Conclusion Despite the application of preventive measures and vaccine delivery, the applicability of the pandemic COVID-19 preventive measures was too low, which indicate that the Zone is at risk for the infection. Rural residents, those who have lower educational level, farmers, non-marrieds, those who have lower family size, those who have diagnosed medical illnesses and those who have poor knowledge were prone to the infection with the pandemic COVID-19 due to the lower practice of applying the basic preventive measures. In addition, awareness creation should be in practice at all levels of the community especially lower educational classes and rural residents.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S448-S448
Author(s):  
Alison L Blackman ◽  
Sabeen Ali ◽  
Xin Gao ◽  
Rosina Mesumbe ◽  
Carly Cheng ◽  
...  

Abstract Background The use of intraoperative topical vancomycin (VAN) is a strategy aimed to prevent surgical site infections (SSI). Although there is evidence to support its efficacy in SSI prevention following orthopedic spine surgeries, data describing its safety, specifically acute kidney injury (AKI) risk, is limited. The purpose of this study was to determine the AKI incidence associated with intraoperative topical VAN. Methods This is a retrospective cohort study reviewing patient encounters where intraoperative topical VAN was administered from February 2018 to July 2018. All adult patients ( ≥18 years) that received topical VAN in the form of powder, beads, rods, paste, cement spacers, or unspecified topical routes were included. Patient encounters were excluded for AKI or renal replacement therapy (RRT) at baseline, ≤ 2 serum creatinine values drawn after surgery, and/or if irrigation was the only topical formulation given. The primary outcome was the percentage of patients who developed AKI after intraoperative topical VAN administration. AKI was defined as an increase in serum creatinine (SCr) ≥50% from baseline, an increase in SCr >0.5 from baseline, or0 if RRT was initiated after topical VAN was given. Secondary outcomes included analysis of AKI risk factors and SSI incidence. AKI risk factors were analyzed using a multivariable logistic regression model. Results A total of 589 patient encounters met study criteria. VAN powder was the most common formulation (40.9%), followed by unspecified topical routes (30.7%) and beads (9.9%%). Nonspinal orthopedic surgeries were the most common procedure performed 46.7%. The incidence of AKI was 8.7%. In a multivariable logistic regression model, AKI was associated with concomitant systemic VAN (OR 3.39, [3.39–6.22]) and total topical VAN dose. Each doubling of the topical dose was associated with increased odds of developing AKI (OR = 1.42, [1.08–1.86]). The incidence of SSI was 5.3%. Conclusion AKI rates associated with intraoperative topical VAN are comparable to that of systemic VAN. Total topical vancomycin dose and concomitant systemic VAN was associated with an increased AKI risk. Additional analysis is warranted to compare these patients to a similar population that did not receive topical VAN. Disclosures All authors: No reported disclosures.


Author(s):  
Takashi Kunihara ◽  
Claudia Vukic ◽  
Fumihiro Sata ◽  
Hans-Jaochim Schäfers

Abstract Background Surgical thoracoabdominal aortic aneurysm (TAAA) repair remains challenging. Apart from mortality, spinal cord injury (SCI) is a dreaded complication. We analyzed our experience to identify predictors for SCI in a nonhigh-volume institution. Patients and Methods All patients who underwent TAAA repair between February 1996 and November 2016 (n = 182) were enrolled. Most were male (n = 121; 66.4%), median age was 68 years (range: 21–84). Elective operations were performed in 153 instances (84.1%). Our approach to minimize SCI includes distal aortic perfusion, mild hypothermia, identification of the Adamkiewicz artery, and sequential aortic clamping. Cerebrospinal fluid drainage was introduced in 2001 and liberal use of selective visceral perfusion in 2006. Results Early mortality was 12.1%; it was 8.5% after elective procedures. Reduced left ventricular function, nonelective setting, older age, and longer bypass time were identified as independent predictors for mortality in multivariable logistic regression model. Permanent SCI was observed in nine patients (4.9%), of whom seven (3.8%) developed paraplegia. In a multivariable logistic regression model for paraplegia, peripheral arterial disease (PAD), Crawford type II repair, smaller body surface area, and era before 2001 were identified as independent predictors, whereas only PAD was significant for SCI. The incidence of paraplegia was 13.8% in extensive repair out of the first 91 cases, whereas it was improved up to 2.7% thereafter. Conclusion Using an integrated approach, acceptable outcome of TAAA repair can be achieved, even in a nonhigh-volume center. PAD and extensive involvement of the aorta are strong independent predictors for spinal cord deficit after TAAA repair.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 572-572
Author(s):  
Nour Abuhadra ◽  
Kenneth R. Hess ◽  
Jennifer Keating Litton ◽  
Gaiane M Rauch ◽  
Alastair Mark Thompson ◽  
...  

572 Background: Increased TIL in TNBC is associated with higher rates of pCR. High TIL is also associated with improved disease free survival and overall survival. The aim of this study is to identify data cut-points of pre-treatment low, moderate and high TIL count based on pCR and to identify clinical and pathological predictors of pCR in patients with moderate TIL. Methods: We evaluated the relationship between pCR and TIL in 180 patients with stage I-III TNBC enrolled in the ARTEMIS trial (NCT02276443). Recursive portioning was used to identify cut-points. Clinical and pathological variables such as age at diagnosis, stage, race, histology as well as Ki-67, vimentin, and androgen receptor (AR) by immunohistochemistry, were evaluated in pts with moderate TIL. A multivariable logistic regression model identified variables independently, significantly associated with pCR. Results: Four TIL groups were identified with pCR rates of 23%, 31%, 48% and 78% respectively (p < 0.0001) (Table A). In the two combined moderate TIL groups, 90 (97%) pts were evaluable for the multivariate model. Stage I-II disease, high Ki-67 and low AR were associated with increased probability of pCR (Table B). The multivariable logistic regression model area under the ROC curve was 0.78 (95% CI=0.68-0.88; p<0.0001). A model of computed risk score [ Stage I-II (score 2)+Ki-67≥ 50% (score 1)+AR<10% (score 1)] predicted a probability of 67% for pCR when all three variables were favorable (Table). Conclusions: Four TIL groups were identified. In pts with moderate TIL levels, early stage disease, high Ki-67 and low AR were associated with increased probability of pCR with neoadjuvant therapy. [Table: see text]


2017 ◽  
Vol 29 (9) ◽  
pp. 1535-1541 ◽  
Author(s):  
Shih-Wei Lai ◽  
Cheng-Li Lin ◽  
Kuan-Fu Liao

ABSTRACTBackground:The purpose of this paper was to examine whether glaucoma could be a non-memory manifestation of Alzheimer's disease in older people.Methods:We conducted a population-based, retrospective, case-control study to analyze the database of the Taiwan National Health Insurance Program. There were 1,351 subjects ≥65 years old with newly diagnosed Alzheimer's disease as the cases, and 5,329 subjects without any type of dementias as the controls during 2000–2011. The odds ratio (OR) and 95% confidence interval (CI) for the risk of Alzheimer's disease associated with glaucoma was estimated by the multivariable unconditional logistic regression model.Results:After controlling for confounders, the multivariable logistic regression model demonstrated that the adjusted OR of Alzheimer's disease was 1.50 in subjects with glaucoma (95% CI 1.19, 1.89), compared to subjects without glaucoma.Conclusions:Older people with glaucoma are associated with 1.5-fold increased odds of Alzheimer's disease in Taiwan. Glaucoma may be a non-memory manifestation of Alzheimer's disease in older people. Further research is needed to confirm this issue.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261772
Author(s):  
Mor Amital ◽  
Niv Ben-Shabat ◽  
Howard Amital ◽  
Dan Buskila ◽  
Arnon D. Cohen ◽  
...  

Objective To identify predicators of patients with fibromyalgia (FM) that are associated with a severe COVID-19 disease course. Methods We utilized the data base of the Clalit Health Services (CHS); the largest public organization in Israel, and extracted data concerning patients with FM. We matched two subjects without FM to each subject with FM by sex and age and geographic location. Baseline characteristics were evaluated by t-test for continuous variables and chi-square for categorical variables. Predictors of COVID-19 associated hospitalization were identified using univariable logistic regression model, significant variables were selected and analyzed by a multivariable logistic regression model. Results The initial cohort comprised 18,598 patients with FM and 36,985 matched controls. The mean age was 57.5± 14.5(SD), with a female dominance of 91%. Out of this cohort we extracted the study population, which included all patients contracted with COVID-19, and consisted of 571 patients with FM and 1008 controls. By multivariable analysis, the following variables were found to predict COVID-19 associated hospitalization in patients with FM: older age (OR, 1.25; CI, 1.13–1.39; p<0.001), male sex (OR, 2.63; CI, 1.18–5.88; p<0.05) and hypertension (OR, 1.75; CI, 1.04–2.95; p<0.05). Conclusion The current population-based study revealed that FM per se was not directly associated with COVID-19 hospitalization or related mortality. Yet classical risk factors endangering the general population were also relevant among patients with FM.


2018 ◽  
Vol 87 (5) ◽  
pp. 255-262 ◽  
Author(s):  
A. Dufourni ◽  
A. Decloedt ◽  
L. Lefère ◽  
D. De Clercq ◽  
P. Deprez ◽  
...  

While mature coastal bermudagrass hay is strongly associated with ileal impaction in the Southeastern United States, stabling on flax bedding has anecdotally been associated with this condition in Europe. The aim of this retrospective study was to investigate the association between ileal impaction and the use of flax shives compared to straw as bedding in horses with colic. Medical records of 2336 referral cases evaluated for abdominal pain between January 2008 and May 2017 at the Department of Large Animal Internal Medicine, Ghent University were reviewed. Diagnosis, date of admission, age, breed, gender, body weight and stable bedding were recorded. Conditional logistic regression analysis was used to assess the association between ileal impaction and each individual variable. Odds ratios (OR) and 95% confidence intervals (CI) were determined. Predictors with a value of P < 0.2 were included in a multivariable Cox regression model and Wald’s test was used to assess parameter estimate significance. Further, the association between survival to discharge and type of bedding or type of treatment (medical versus surgical) was analyzed for horses with ileal impactions. The proportion of colic cases stabled on flax bedding at home was 11.3%. The overall prevalence of ileal impaction was 4.2%. In the flax group, the prevalence of ileal impaction was 9.4% as opposed to 3.6% within the straw group. The OR of 2.8 (95% CI 1.7-4.7; P < 0.001) in the multivariable logistic regression model indicated that horses stabled on flax shives were approximately three times more likely to have ileal impactions than horses stabled on straw. There was no significant association found between ileal impaction and the period of admission, age, gender or body weight in a multivariable logistic regression model. The odds for having ileal impaction is approximately six times (OR 6.3; 95% CI 2.4-16.4; P < 0.001) higher in draft horses than in warmbloods in the multivariable logistic regression model. No significant association was found between survival to discharge and type of bedding or treatment. These results suggest that horses with colic that were housed on flax bedding are more likely to present ileal impactions than horses housed on straw.


2020 ◽  
Author(s):  
Razieh Ahmadi ◽  
Milad Shafii ◽  
Hosein Ameri ◽  
Roohollah Askari ◽  
Hossein Fallahzadeh

Objective: Methods: The data was collected through face-to-face interview during a single visit. The World Health Survey (WHS) questionnaire was completed by 400 households. The relationships between CHE and variables were examined by the Fisher exact tests, and the impacts of variables on CHE were assessed by logistic regression model. Methods: The data was collected through face-to-face interview during a single visit. The World Health Survey (WHS) questionnaire was completed by 400 households. The relationships between CHE and variables were examined by the Fisher exact tests, and the impacts of variables on CHE were assessed by logistic regression model. Results: The exposure of the households to CHE increased from 8.2% in 2011 to 14.25% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that in 2011(4.3% vs. 7.5%). The economic status, dental services and inpatients services were the key factor determining CHE. The most important determinant affecting the exposure to CHE was dental service utilization in 2011(92.64) and 2020(122.68). Conclusion: The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatients services, as well as the presence of member ≥65 years and economic status were the key determining factors for CHE. The services need to be more widely covered by the basic health insurance and households having members ≥65 years and the poor households should be exempted from paying some of the healthcare expenditures for improving financial protection against CHE.


Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 30-31
Author(s):  
Alba Cabirta ◽  
Macarena Izuzquiza ◽  
Isabel Ruiz-Camps ◽  
David Valcarcel ◽  
Eva Catala ◽  
...  

INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic raises many questions about the management of patients with significant comorbidities. Hematologic patients are usually fragile due to an important immunosuppression, so the impact of coronavirus disease (COVID-19) is yet to be determined. MATERIALS AND METHODS: We conducted a single-center retrospective observational study of patients with hematologic malignancies diagnosed with SARS-CoV-2 at Vall d´Hebron University Hospital (HUVH) between March 1st and May 31st 2020 to analyze their clinical characteristics and evolution. Patient's demographic data, underlying pathology, signs and symptoms of COVID-19, treatment received and clinical course were collected. A statistical analysis was performed to identify the possible variables associated with COVID-19 mortality. For this purpose, we used univariate and multivariable logistic regression models. RESULTS: We identified 70 patients with PCR confirmed SARS-CoV-2 infection and hematologic malignancy. The median age was 75 years (range 22-91), and 44% were female. The majority (74%) had evidence of active malignancy and 53% were receiving active therapy. Lymphoid pathology (73%) predominated over myeloid. The median number of previous lines of treatment was 0 (range 0-6), 23% had received at least 2 lines, whereas 10% underwent hematopoietic stem cell transplantation (HSCT) (5 patients allo-HSCT, 2 auto-HSCT). Half of the patients had more than one pre-existing comorbidity (17% obstructive pulmonary disease). At diagnosis the most common symptoms were fever (76%), cough (60%) and dyspnea (31%). We observed that 58% of patients presented a chest X-ray compatible with COVID-19. Regarding laboratory parameters, stood out lymphopenia (65% of patients presented &lt;1200 lymphocytes/mm3) and elevation of inflammation parameters, such as D-dimer (median 365 ng/mL, range 50-5860), ferritin (median 1063 ng/mL, range 73-14191), IL-6 (median 59,6 pg/mL, range 3-4079) and PCR (median 11,2 mg/dL, range 0,3-79,9). Empirical therapy for COVID-19 included antibiotics (78%), anti-virals (50%, 3% remdesivir), and hydroxychloroquine (88%). Only 24% received tocilizumab, 50% heparin (33% prophylactic dose), 12% G-CSF, 9% norepinephrine, 4% corticosteroids and 1% ß-IFN. Most of patients (73%) required oxygen therapy: 36% high-flow, 29% low flow and 8% endotracheal intubation. There were 6 patients who did not receive any treatment. COVID-19 was acquired via nosocomial infection in 23% of patients, 91% of them requiring hospitalization, 14% in the Intensive Care Unit (ICU). The median days of hospitalization since diagnosis was 17 (range 3-55). The case fatality rate (CFR) from COVID-19 was higher in hematologic patients than the one observed in non-hematologic patients at the HUVH (figure 1), being of 41% at 11 days from diagnosis. CFR was higher in patients older than 75 years old (61%), while the mortality among patients receiving active therapy was 42%. The main cause of death was acute respiratory failure (93%). In the univariate logistic regression model, age &gt;75 years (OR 1.07; p=0.008), active malignancy (OR 5; p=0,02), &gt;1 comorbidity (OR 5.3; p=0,049) and high levels of IL-6 (OR 8.2; p= 0.005) were statistically significant. In the multivariable logistic regression model, age ≥75 years (OR 4.4; p=0.01) and IL-6 levels at baseline &gt; 59.6 pg/mL (OR 7.2; p=0.01) were associated with a higher mortality (table 1). The presence of an active malignancy was not a significant variable in the multivariable logistic regression model. CONCLUSIONS: Patients with hematologic malignancies and COVID-19 presented similar symptoms, signs and radiological characteristics to those described in the general population at diagnosis. In our cohort, advanced age and high IL-6 values were associated with higher mortality. Furthermore, it was observed that active hematologic disease is a factor of poor prognosis of COVID-19. Disclosures Salamero: Daichii Sankyo:Honoraria;Celgene:Consultancy, Honoraria;Novartis:Consultancy, Honoraria;Jazz Pharmaceuticals:Consultancy, Honoraria;Pfizer:Consultancy.Abrisqueta:Janssen:Consultancy, Honoraria, Speakers Bureau;AbbVie:Consultancy, Honoraria, Speakers Bureau;Roche:Consultancy, Honoraria, Speakers Bureau;Celgene:Consultancy, Honoraria.Bosch:Hoffmann-La Roche:Research Funding.


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