National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM): household survey component methods

ABSTRACT OBJECTIVE To describe methodological aspects of the household survey National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM) related to sampling design and implementation, the actual obtained sample, instruments and fieldwork. METHODS A cross-sectional, population-based study with probability sampling in three stages of the population living in households located in Brazilian urban areas. Fieldwork was carried out between September 2013 and February 2014. The data collection instrument included questions related to: information about households, residents and respondents; chronic diseases and medicines used; use of health services; acute diseases and events treated with drugs; use of contraceptives; use of pharmacy services; behaviors that may affect drug use; package inserts and packaging; lifestyle and health insurance. RESULTS In total, 41,433 interviews were carried out in 20,404 households and 576 urban clusters corresponding to 586 census tracts distributed in the five Brazilian regions, according to eight domains defined by age and gender. CONCLUSIONS The results of the survey may be used as a baseline for future studies aiming to assess the impact of government action on drug access and use. For local studies using a compatible method, PNAUM may serve as a reference point to evaluate variations in space and population. With a comprehensive evaluation of drug-related aspects, PNAUM is a major source of data for a variety of analyses to be carried out both at academic and government level.

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Socio-economic differences in the uptake of HIV testing and associated factors in South Africa

BMC Public Health ◽

10.1186/s12889-021-11583-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sean Jooste ◽

Musawenkosi Mabaso ◽

Myra Taylor ◽

Alicia North ◽

Yolande Shean ◽

...

Keyword(s):

South Africa ◽

Hiv Testing ◽

Urban Areas ◽

Associated Factors ◽

Economic Status ◽

Household Survey ◽

Population Based ◽

Low Ses ◽

Cross Sectional ◽

Testing Uptake

Abstract Background Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90–90-90 targets, which states that 90% of HIV positive individuals ought to know their HIV status. This study examined socio-economic status (SES) differences in HIV testing uptake and associated factors among youth and adults 15 years and older in South Africa. Methods This study used data from a national cross-sectional, population-based household survey conducted in 2017 using a multi-stage sampling design. A composite SES score was created using multiple correspondence analyses of household assets; households were classified into wealth quintiles and dichotomised into low SES/poorest (lowest 3 quintiles) and high SES/less-poor (highest 2 quintiles). Bivariate and multivariate logistic regression models were used to examine factors associated with the uptake of HIV testing in low and high SES households. Results HIV testing uptake was 73.8 and 76.7% among low and high SES households, respectively, both of which were below the first 90 targets. Among both low and high SES households, increased HIV testing uptake was significantly associated with females than males. The decreased likelihood was significantly associated with residing in rural formal areas than urban areas, those with no education or low levels of educational attainment and alcohol drinkers among low SES households. Whites and Indians/Asians had a decreased likelihood than Black Africans in high SES households. Conclusions HIV testing interventions should target males, residents in rural formal areas, those with no or low education and those that consume alcohol in low SES households, including Whites and Indians/Asians from high SES households in order to bridge socio-economic disparities in the uptake of HIV testing. This should entail expanding HIV testing beyond traditional centres for voluntary counselling and testing through outreach efforts, including mobile testing and home-based testing.

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Misuse of Tramadol in the United States: An Analysis of the National Survey of Drug Use and Health 2002-2017

Substance Abuse Research and Treatment ◽

10.1177/1178221820930006 ◽

2020 ◽

Vol 14 ◽

pp. 117822182093000

Author(s):

Scott A Reines ◽

Bonnie Goldmann ◽

Mark Harnett ◽

Lucy Lu

Keyword(s):

Drug Use ◽

National Survey ◽

Household Survey ◽

The United States ◽

Population Based ◽

Cross Sectional ◽

Health Related ◽

Nationally Representative ◽

The U.S ◽

Intravenous Formulation

Objective: To analyze the rates of misuse - that is, use in any way not directed by a doctor - of products containing oral tramadol, a Schedule IV opioid, from the National Survey of Drug Use and Health (NSDUH), as compared to comparator Schedule II opioids (morphine, oxycodone, and hydrocodone) and alprazolam, a commonly prescribed Schedule IV controlled substance in the U.S. Methods: The NSDUH is a congressionally mandated household survey that collects information on tobacco, alcohol, and drug use, mental health and other health-related issues in the US. A cross-sectional surveillance study design was used to examine lifetime and past year misuse of oral tramadol and comparators of interest among NSHUH respondents aged 12 years or older. Based on when particular data were available, the past-year misuse analysis includes NSDUH data from 2015 to 2017, and the lifetime misuse analysis includes NSDUH data from 2002 to 2014. Results: In 2015 to 2017, past-year misuse of oral tramadol was approximately 4% of the total number of prescriptions, versus 7% to 8% for all of the comparators when adjusted for drug availability. In 2002 to 2014, lifetime misuse of oral tramadol remained at 1.5% or less over the 13-year period, and was lower than reported for hydrocodone (6%) and oxycodone (4%), respectively. Comparison of oral tramadol and alprazolam showed misuse of tramadol was also much lower than alprazolam. Too few reports of tramadol misuse by injection (n = 7) were reported, versus 570, 1096, and 32 reports of injection of morphine, oxycodone, and hydrocodone, respectively, during the 16-year analysis period to allow for any population-based estimation. Only morphine has an intravenous formulation available and tramadol was not available as an intravenous formulation in the U.S. during that time period. Conclusions: This analysis shows a low prevalence of oral tramadol misuse, relative to other commonly prescribed opioids, in a nationally representative sample of noninstitutionalized US residents. Estimates of reported oral tramadol misuse have remained relatively stable over time and are substantially lower than those reported for comparators when adjusted for prescription volume. Reports of oral tramadol misuse are also much less than alprazolam, another Schedule IV drug.

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Prevalence of double burden on malnutrition at household level in four Latin America countries

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042020000100003 ◽

2020 ◽

Vol 20 (1) ◽

pp. 27-35 ◽

Cited By ~ 1

Author(s):

Hanrieti Rotelli Temponi ◽

Gustavo Velasquez-Melendez

Keyword(s):

Short Stature ◽

National Survey ◽

Rural Areas ◽

Urban Areas ◽

Population Based ◽

Double Burden ◽

Cross Sectional ◽

Household Level ◽

Rural And Urban Areas ◽

Maternal Overweight

Abstract Objectives: to estimate the prevalence of maternal overweight and short stature in children at household level in Brazil, Bolivia, Colombia and Peru. Methods: a cross-sectional descriptive study. Population-based studies on children (0-5 years old) and women (15 to 49 years old) who participated in the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher(National Survey on Children and Women Demography and Health) in Brazil and the Encuesta Nacional de Demografía y Salud, (National Survey on Demography and Health), in Bolivia, Colombia and Peru. Variables of interest: overweight mother and child with short stature, a double burden when both outcomes are present. Global prevalence and stratification, according to rural and urban areas and 95% confidence intervals, were estimated. Results: the global sample consisted of 26,506 households. The prevalence of double burden was 9.3% in Bolivia (CI95%= 8.3-10.4), 6.7% in Peru (CI95%=5.9-7.5), Colombia (3.2%; CI95%=2.8-3.6) and Brazil (2.2%; CI95%=1.4-3.2). The highest prevalence were observed in the rural areas in Bolivia (13% vs 6.5%; p<0.001) and Peru (11.9% vs 4.1%; p<0.001). Conclusions: the highest prevalence were registered in Peru and Bolivia, and the lowest in Brazil and Colombia.

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National Survey on Access, Use and Promotion of Rational Use of Medicines: methods

Revista de Saúde Pública ◽

10.11606/s1518-8787.2017051007027 ◽

2017 ◽

Vol 51 (suppl.2) ◽

Cited By ~ 1

Author(s):

Juliana Álvares ◽

Maria Cecilia Goi Porto Alves ◽

Maria Mercedes Loureiro Escuder ◽

Alessandra Maciel Almeida ◽

Jans Bastos Izidoro ◽

...

Keyword(s):

National Survey ◽

Secondary Data ◽

Access To Medicines ◽

National Sample ◽

Pharmaceutical Services ◽

Cross Sectional ◽

Rational Use ◽

Rational Use Of Medicines ◽

Telephone Interviews ◽

Unified Health System

The Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services) aimed to characterize the organization of pharmaceutical services in the Primary Health Care of the Brazilian Unified Health System (SUS). PNAUM – Services is a cross-sectional and evaluative study, with planned sample of 600 cities, held between 2014 and 2015, composed of a remote phase, with telephone interviews with health managers. Of these 600 cities, 300 were selected for a survey on health services. We selected the 27 capitals, the 0.5% largest cities of each region, and the remaining cities were drawn. The estimate of the representative national sample size considered three levels: cities, medicine dispensing services, and patients. The interviews were carried out with a structured questionnaire specific for: municipal secretaries of health, professionals responsible for pharmaceutical services in the city, professionals responsible for the dispensing of medicines, physicians, and patients. The secondary data were obtained in official databases, in the latest update date. PNAUM – Services was the first nationwide research aimed at the assessment and acquisition of national and regional indicators on access to medicines, as well as use and rational use, from the perspective of various social subjects

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Maternal depression and loss of children under the one-child family planning policy in China: a cross-sectional study of 300 000 women

BMJ Open ◽

10.1136/bmjopen-2020-048554 ◽

2021 ◽

Vol 11 (7) ◽

pp. e048554

Author(s):

Hanyu Wang ◽

Eric Frasco ◽

Jie Shang ◽

Minne Chen ◽

Tong Xin ◽

...

Keyword(s):

Family Planning ◽

Maternal Depression ◽

Urban Areas ◽

The Elderly ◽

Population Based ◽

Cross Sectional Study ◽

Only Child ◽

Cross Sectional ◽

Live Births ◽

Child Group

ObjectivesThis study aims to explore the association between maternal depression and the loss of the only child under the family-planning (FP) policy.DesignCross-sectional data from a Chinese population-based study were analysed.SettingPopulation from 10 (5 rural and 5 urban) areas in China.ParticipantsAround 300 000 females were included in the study. The FP group was defined as women with one or two live births. Those with no surviving child were classified into the loss-of-only-child group. The non-FP group included women who had more than two live births. Logistic regression was used to assess the relationship between major depressive disorder (MDD) and family types, after stratification and adjustment.OutcomeMDD was assessed using the Composite International Diagnostic Inventory.ResultsThe odds of MDD are 1.42 times higher in the FP group in general (OR=1.42, 95% CI: 1.28 to 1.57), as opposed to the non-FP group. In particular, the odds of MDD are 1.36 times greater in the non-loss-of-only-child group (OR=1.36, 95% CI: 1.21 to 1.51) and 2.80 (OR=2.80, 95% CI: 0.88 to 8.94) times greater in the loss-of-only-child group, compared with the non-FP group. The associations between FP groups and MDD appeared to be stronger in the elderly population, in those who were married, less educated and those with a higher household income. The association was found progressively stronger in those who lost their only child.ConclusionsPeople in the FP group, especially those who lost their only child, are more susceptible to MDD than their counterparts in the non-FP group. Mental health programmes should give special care to those who lost their only child and take existing social policies and norms, such as FP policies, into consideration.

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Characteristics of those most vulnerable to employment changes during the COVID-19 pandemic: a nationally representative cross-sectional study in Wales

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-216030 ◽

2021 ◽

pp. jech-2020-216030

Author(s):

Benjamin J Gray ◽

Richard G Kyle ◽

Jiao Song ◽

Alisha R Davies

Keyword(s):

Multinomial Logistic Regression ◽

Household Survey ◽

Well Being ◽

Employment Outcomes ◽

Cross Sectional Study ◽

Public Health Response ◽

Cross Sectional ◽

Exact Test ◽

Nationally Representative ◽

The Impact

BackgroundThe public health response to the SARS-CoV-2 (COVID-19) pandemic has had a detrimental impact on employment and there are concerns the impact may be greatest among the most vulnerable. We examined the characteristics of those who experienced changes in employment status during the early months of the pandemic.MethodsData were collected from a cross-sectional, nationally representative household survey of the working age population (18–64 years) in Wales in May/June 2020 (n=1379). We looked at changes in employment and being placed on furlough since February 2020 across demographics, contract type, job skill level, health status and household factors. χ2 or Fisher’s exact test and multinomial logistic regression models examined associations between demographics, subgroups and employment outcomes.ResultsOf our respondents, 91.0% remained in the same job in May/June 2020 as they were in February 2020, 5.7% were now in a new job and 3.3% experienced unemployment. In addition, 24% of our respondents reported being placed on furlough. Non-permanent contract types, individuals who reported low mental well-being and household financial difficulties were all significant factors in experiencing unemployment. Being placed on ‘furlough’ was more likely in younger (18–29 years) and older (60–64 years) workers, those in lower skilled jobs and from households with less financial security.ConclusionA number of vulnerable population groups were observed to experience detrimental employment outcomes during the initial stage of the COVID-19 pandemic. Targeted support is needed to mitigate against both the direct impacts on employment, and indirect impacts on financial insecurity and health.

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Prevalence of nocturia among community-dwelling adults: a population-based study in Malaysia

BMC Urology ◽

10.1186/s12894-021-00860-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hui-Yin Yow ◽

John Jeh Lung Tiong ◽

Chun-Wai Mai ◽

Esther van der Werf ◽

Zulkifli Md Zainuddin ◽

...

Keyword(s):

Medical Condition ◽

Population Based ◽

Community Dwelling ◽

Medical Attention ◽

Night Time ◽

Cross Sectional ◽

Population Based Study ◽

Waking Up ◽

The Impact

Abstract Background Nocturia is widely prevalent condition with detrimental effects on quality of life and general health. In Malaysia, there is a lack of up-to-date prevalence study on nocturia. This study aimed to investigate the prevalence of nocturia and awareness pertaining to nocturia among Malaysian adults. Methods A cross-sectional population-based study was conducted among Malaysian adults aged ≥ 18 years old. The data was collected by mixed mode self-administered questionnaire from May 2019 to September 2019. Nocturia was defined as one or more voids at night. Results There were a total of 4616 respondents with 74.5% of response rate. The overall prevalence of nocturia among Malaysian adults was found to be 57.3%. In multivariate analysis, respondents aged 31–40 (1.91 [1.52–2.40]) or > 60 years old (2.03 [1.48–2.71]), and those who presented with hypertension (2.84 [2.28–3.53]), diabetes mellitus (1.78 [1.42–2.25]), renal disease (3.58 [1.93–6.63]) or overactive bladder (1.61 [1.10–2.35]) were associated with higher prevalence of nocturia. A significantly lower disease prevalence (p < 0.05) was noted among those aged 41–50 (0.73 [0.59–0.91]), male (0.78 [0.69–0.88]) and Chinese (0.47 [0.30–0.74]) or Indian (0.34 [0.21–0.54]) ethnicities. A total of 37.3% of respondents with nocturia reported that they faced sleeping difficulty about half the time or more after waking up in the middle of night. Those who had ≥ 2 voids per night experienced significantly higher mean bother score than those who had 1 void per night (p < 0.001). Approximately half (56.7%) of all respondents were not aware that night time urination is a medical condition. Only 25.2% of respondents with nocturia had sought medical attention for their nocturia. Conclusions The prevalence of nocturia among Malaysian adults is high and strongly influenced by age, sex, race and comorbidities. However, the general awareness pertaining to nocturia being a health issue remains low among Malaysians. The findings also highlighted the impact of nocturia on sleep and the need for nocturia education to better address this disease.

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“We Make Our Community”: Youth Forging Environmental Identities in Urban Landscapes

Sustainability ◽

10.3390/su13147736 ◽

2021 ◽

Vol 13 (14) ◽

pp. 7736

Author(s):

Erin Gallay ◽

Alisa Pykett ◽

Constance Flanagan

Keyword(s):

High School Students ◽

Urban Areas ◽

Local Environment ◽

Natural World ◽

Urban Landscapes ◽

Youth Of Color ◽

School Students ◽

Environmental Leadership ◽

And Gender ◽

The Impact

Insofar as race, class, and gender have profound effects on people’s environmental experiences, and consequently their activism, the environmental field needs more work on the environmental experiences and insights of groups whose voices have been missing, including youth of color who live in urban areas in the U.S. In this paper, we focus on African American and Latinx students engaged in environmental projects in their urban communities and the impact of such projects on promoting pro-environmental leadership, agency, and behavior. We draw from written reflections and focus group interviews of several hundred 4th–12th graders (majority middle- and high-school students) who participated in place-based civic science projects. Thematic analyses of student responses found that students engaged in work on local environmental issues cultivated an appreciation for the natural world and an understanding of human-nature interdependence and the ties between the local environment and their communities’ health. Through taking action with others in their communities, students viewed themselves as contributors to their communities and started to form environmental identities in ways that are not traditionally measured. Findings point to the need for forms of environmental education that are contextually grounded and centered on environmental justice in urban areas.

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