scholarly journals Variation in Anopheles distribution and predictors of malaria infection risk across regions of Madagascar

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nicholas J. Arisco ◽  
Benjamin L. Rice ◽  
Luciano M. Tantely ◽  
Romain Girod ◽  
Gauthier N. Emile ◽  
...  

Abstract Background Deforestation and land use change is widespread in Madagascar, altering local ecosystems and creating opportunities for disease vectors, such as the Anopheles mosquito, to proliferate and more easily reach vulnerable, rural populations. Knowledge of risk factors associated with malaria infections is growing globally, but these associations remain understudied across Madagascar’s diverse ecosystems experiencing rapid environmental change. This study aims to uncover socioeconomic, demographic, and ecological risk factors for malaria infection across regions through analysis of a large, cross-sectional dataset. Methods The objectives were to assess (1) the ecological correlates of malaria vector breeding through larval surveys, and (2) the socioeconomic, demographic, and ecological risk factors for malaria infection in four ecologically distinct regions of rural Madagascar. Risk factors were determined using multilevel models for the four regions included in the study. Results The presence of aquatic agriculture (both within and surrounding communities) is the strongest predictive factor of habitats containing Anopheles larvae across all regions. Ecological and socioeconomic risk factors for malaria infection vary dramatically across study regions and range in their complexity. Conclusions Risk factors for malaria transmission differ dramatically across regions of Madagascar. These results may help stratifying current malaria control efforts in Madagascar beyond the scope of existing interventions.

2020 ◽  
Author(s):  
Nicholas Arisco ◽  
Benjamin L Rice ◽  
Luciano M Tantely ◽  
Romain Girod ◽  
Gauthier N Emile ◽  
...  

Abstract Background Deforestation and land use change is widespread in Madagascar, altering local ecosystems and creating opportunities for disease vectors, such as the Anopheles mosquito, to proliferate and more easily reach vulnerable, rural populations. Knowledge of risk factors associated with malaria infections is growing globally, but these associations remain understudied across Madagascar’s diverse ecosystems experiencing rapid environmental change. This study aims to uncover socioeconomic, demographic, and ecological risk factors for malaria infection across regions through analysis of a large, cross-sectional dataset.Methods The objectives were to assess(1) the ecological correlates of malaria vector breeding through larval surveys, and (2) the socioeconomic, demographic, and ecological risk factors for malaria infection in four ecologically distinct regions of rural Madagascar. Risk factors were determined using multilevel models for the four regions included in the study.Results The presence of aquatic agriculture (both within and surrounding communities) is the strongest predictive factor of habitats containing Anopheles larvae across all regions. Ecological and socioeconomic risk factors for malaria infection vary dramatically across study regions and range in their complexity.Conclusions Risk factors for malaria transmission differ dramatically across regions of Madagascar. These results may help stratifying current malaria control efforts in Madagascar beyond the scope of existing interventions.


2020 ◽  
Author(s):  
Nicholas Arisco ◽  
Benjamin L Rice ◽  
Luciano M Tantely ◽  
Romain Girod ◽  
Gauthier N Emile ◽  
...  

Abstract BackgroundDeforestation and land use change is widespread in Madagascar, altering local ecosystems and creating opportunities for disease vectors, such as the Anopheles mosquito, to proliferate and more easily reach vulnerable, rural populations. Knowledge of risk factors associated with malaria infections is growing globally, but these associations remain understudied across Madagascar’s diverse ecosystems experiencing rapid environmental change. This study aims to uncover socioeconomic, demographic, and ecological risk factors for malaria infection across regions through analysis of a large, cross-sectional dataset.MethodsHere, we assess (1) the ecological correlates of malaria vector breeding through larval surveys, and (2) the socioeconomic, demographic, and ecological risk factors for malaria infection in four ecologically distinct regions of rural Madagascar. We determine risk factors using multilevel models for the four regions included in the study.ResultsThe presence of aquatic agriculture (both within and surrounding communities) is the strongest predictive factor of habitats containing Anopheles larvae across all regions. We determine that ecological and socioeconomic risk factors for malaria infection vary dramatically across study regions and range in their complexity.ConclusionsRisk factors for malaria transmission differ dramatically across regions of Madagascar. These results may help stratifying current malaria control efforts in Madagascar beyond the scope of existing interventions.


2020 ◽  
Author(s):  
Nicholas Arisco ◽  
Benjamin L Rice ◽  
Luciano M Tantely ◽  
Romain Girod ◽  
Gauthier N Emile ◽  
...  

Abstract Background: Deforestation and land use change is widespread in Madagascar, altering local ecosystems and creating opportunities for disease vectors, such as the Anopheles mosquito, to proliferate and more easily reach vulnerable, rural populations. Knowledge of risk factors associated with malaria infections is growing globally, but these associations remain understudied across Madagascar’s diverse ecosystems experiencing rapid ecological change. This study aims to uncover socioeconomic, demographic, and ecological risk factors for malaria infection across regions through analysis of a large, cross-sectional dataset.Methods: Here, we assess (1) the ecological correlates of malaria vector breeding through larval surveys, and (2) the socioeconomic, demographic, and ecological risk factors for malaria infection in four ecological regions of rural Madagascar. We determine risk factors using multilevel models for each unique ecological region of included in the study.Results: We find that regardless of the region, the presence of forms of aquatic agriculture around a community are predictive of the presence of malaria vectors. We determine that ecological and socioeconomic risk factors for malaria infection vary dramatically across study regions and range in their complexity.Conclusions: Risk factors for malaria transmission differ dramatically across regions of Madagascar. These results may help stratifying current malaria control efforts in Madagascar beyond the scope of existing interventions.


2020 ◽  
Author(s):  
Oluwaseun Awosolu ◽  
Zary Shariman Yahaya ◽  
Farah Haziqah Meor Termizi ◽  
Iyabo Adepeju Simon-Oke ◽  
Comfort Fakunle

Abstract Background Malaria is a serious global public health challenge which causes great morbidity and mortality worldwide particularly in sub-Saharan Africa. This study was designed to determine the prevalence, parasite density and risk factors associated with malaria infection transmission among residents of two urban communities of Ibadan, southwestern Nigeria. Methods A cross-sectional hospital-based study was carried out on 300 participants. Blood samples were obtained. Thick and thin blood films were prepared and viewed using the standard parasitological technique of microscopy. Moreover, data on sociodemographic and environmental variables were obtained using standard questionnaire. Results Of the 300 participants examined, a total of 165 (55.0%) were found positive for Plasmodium falciparum with a mean (S.D) parasite density of 1814.70 (1829.117) parasite/µL of blood. The prevalence and parasite density of malaria infection was statistically significant (P < 0.05) in relation to age group. Obviously, malaria infection decreases as age increasing with ≤ 5 years having the highest prevalence and mean parasite density. Similarly, in relation to gender, males significantly (P < 0.05) had higher prevalence (60.2%) and mean (S.D) parasite density of malaria infection [2157.73 (1659.570) parasite/µL of blood] compared to females. Additionally, those without formal education had the highest prevalence (73.0%) and mean (S.D) parasite density of infection [2626.96 (2442.195) parasite/µL of blood]. The binary logistic regression analysis showed that age group 6–10 (COR 0.066, 95% CI: 0.007–0.635), presence of streams (COR 0.225, 95% CI: 0.103–0.492), distance from streams within ≤ 1 Km (COR 0.283, 95% CI: 0.122–0.654) and travel to rural area (COR 4.689, 95% CI: 2.430–9.049) were the major risk factors. Conclusions Malaria infection is apparently endemic in the study area and greatly influenced by rural-urban movement. Multifaceted and integrated control strategy should be adopted. Health education on mosquito prevention and use of chemoprophylaxis before and during travel to rural areas are important.


2019 ◽  
Vol 15 ◽  
Author(s):  
Bekalu Getachew Gebreegziabher ◽  
Tesema Etefa Birhanu ◽  
Diriba Dereje Olana ◽  
Behailu Terefe Tesfaye

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.


2021 ◽  
Vol 10 (12) ◽  
pp. 2740
Author(s):  
Efrat L. Amitay ◽  
Tobias Niedermaier ◽  
Anton Gies ◽  
Michael Hoffmeister ◽  
Hermann Brenner

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
A. Olalekan Uthman ◽  
Latifat Ibisomi

AbstractSeveral studies have documented the burden and risk factors associated with diarrhoea in low and middle-income countries (LMIC). To the best of our knowledge, the contextual and compositional factors associated with diarrhoea across LMIC were poorly operationalized, explored and understood in these studies. We investigated multilevel risk factors associated with diarrhoea among under-five children in LMIC. We analysed diarrhoea-related information of 796,150 under-five children (Level 1) nested within 63,378 neighbourhoods (Level 2) from 57 LMIC (Level 3) using the latest data from cross-sectional and nationally representative Demographic Health Survey conducted between 2010 and 2018. We used multivariable hierarchical Bayesian logistic regression models for data analysis. The overall prevalence of diarrhoea was 14.4% (95% confidence interval 14.2–14.7) ranging from 3.8% in Armenia to 31.4% in Yemen. The odds of diarrhoea was highest among male children, infants, having small birth weights, households in poorer wealth quintiles, children whose mothers had only primary education, and children who had no access to media. Children from neighbourhoods with high illiteracy [adjusted odds ratio (aOR) = 1.07, 95% credible interval (CrI) 1.04–1.10] rates were more likely to have diarrhoea. At the country-level, the odds of diarrhoea nearly doubled (aOR = 1.88, 95% CrI 1.23–2.83) and tripled (aOR = 2.66, 95% CrI 1.65–3.89) among children from countries with middle and lowest human development index respectively. Diarrhoea remains a major health challenge among under-five children in most LMIC. We identified diverse individual-level, community-level and national-level factors associated with the development of diarrhoea among under-five children in these countries and disentangled the associated contextual risk factors from the compositional risk factors. Our findings underscore the need to revitalize existing policies on child and maternal health and implement interventions to prevent diarrhoea at the individual-, community- and societal-levels. The current study showed how the drive to the attainment of SDGs 1, 2, 4, 6 and 10 will enhance the attainment of SDG 3.


Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kai Saito ◽  
Hitoshi Sugawara ◽  
Tamami Watanabe ◽  
Akira Ishii ◽  
Takahiko Fukuchi

AbstractRisk factors associated with 72-h mortality in patients with extremely high serum aspartate aminotransferase levels (AST; ≥ 3000 U/L) are unknown. This single-centre, retrospective, case-controlled, cross-sectional study obtained data from medical records of adult patients treated at Saitama Medical Center, Japan, from 2005 to 2019. We conducted a multivariate logistic after adjusting for age, sex, height, weight, body mass index, Brinkman Index, vital signs, biochemical values, updated Charlson Comorbidity Index (CCI) score, CCI components, and underlying causes. A logistic regression model with selected validity risks and higher C-statistic for predicting 72-h mortality was established. During the 15-year period, 428 patients (133 non-survivors and 295 survivors [cases and controls by survival < 72 and ≥ 72 h, respectively]) with AST levels ≥ 3000 U/L were identified. The 72-h mortality rate was 133/428 (31.1%). The model used for predicting 72-h mortality through the assessment of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus levels had a C-statistic value of 0.852 (sensitivity and specificity, 76.6%). The main independent risk factors associated with 72-h mortality among patients with AST levels ≥ 3000 U/L included higher serum values of alkaline phosphatase, creatine kinase, serum sodium, potassium, and phosphorus.


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