Clinico demographic profile of newly diagnosed HIV sero positive patients attending an ART centre: a cross sectional study

Background: India faces a high burden of HIV. An understanding of the determinants of this disease is of vital importance in curtailing this epidemic. The objective was to study the clinico-demographic profile of the study subject.Methods: This is a cross sectional study done on 142 patients which includes all newly diagnosed (diagnosed on or after 1st January 2012), sero positive, adult patients, enrolled at ART centre, Nalgonda and started on treatment during the months of December 2012, January 2013, February 2013. A pre designed, pre tested questionnaire was used. Data regarding their demographic characteristics and various clinical aspects was obtained. Results: Out of a total of 142 study subjects, majority (78.88%) belonged to economically productive age group (16-45 years). Married individuals constituted a majority (79.57%). A majority of the subjects were skilled laborers, belonged to lower middle class of BG Prasad classification, hailed from rural areas and belonged to nuclear families. Very few had high educational attainment. A majority (95.78%) reported not using condoms during their last sexual act and 9.16% subjects reported being previously diagnosed with an STD. Most common presenting complaint was fever and most common opportunistic infections were candidiasis and tuberculosis. Majority were found to belong to stage 1 HIV. Participants were mostly underweight and had severe anaemia. Majority had CD4 count between 201- 350 cells/mm3. Conclusions: Interventions targeting improvement in socio economic status, education levels, nutritional status as well as awareness about condom use must be built into the national HIV programme.

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A Cross-sectional Study to Evaluate Causes of Maternal Mortality in Rural Areas of Punjab, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49569.15416 ◽

2021 ◽

Author(s):

Sarbhjit Kaur ◽

Navneet Kaur ◽

Manjit Kaur Mohi ◽

Manjeet Kaur ◽

Neeraj Singh ◽

...

Keyword(s):

Maternal Mortality ◽

Maternal Death ◽

Rural Areas ◽

Economic Status ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Maternal Deaths ◽

Common Cause ◽

Socio Economic Status

Introduction: Maternal mortality is an index of reproductive health of the society. In India illiteracy, late referrals, low socio-economic status of the community and direct causes are responsible for high incidence of maternal deaths which contributes to one-fifth of the global burden. Aim: To evaluate the causes of maternal death in rural areas of Punjab. Materials and Methods: The present retrospective cross-sectional study was conducted in 10 districts of Punjab, India chosen from five different zones i.e., east, west, north, south and central zone for a period of one year from 2016 to 2017. Information of all the deaths was taken from the civil surgeon office of the chosen district and then data of maternal deaths occurring within 42 days of delivery was collected by visiting patient’s residence and verbal autopsy was conducted. The data was collected and entered in predesigned proforma and percentages were calculated in Microsoft Excel version 2016. Results: A total of 67 maternal deaths were noted from above five zones, out of total rural population of 94,59,553. Maximum (n=51) maternal deaths were between age range of 20-30 years. Of these 67, majority 29 (43.28%) were illiterate, 66 (98.5%) women belonged to middle and low socio-economic status, 55 (82.1%) deaths occurred in the postnatal period, 33 (49.25%) occurred at more than 37 weeks period of gestation and 51 (76.12%) were due to direct causes. Out of 67 deaths, haemorrhage (n=29) was the most common cause. Anaemia contributed to 16.7% (11) as an indirect cause of maternal death. Conclusion: The maximum maternal deaths were contributed by illiterate women from middle and low socio-economic status. The most common cause was postpartum haemorrhage followed by pre-eclampsia/eclampsia.

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Prevalence, patterns and socio-demographic correlates of tobacco use in Davangere taluka, Karnataka: a community-based, cross-sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204950 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4799

Author(s):

Basanagouda K. Patil ◽

Vijay S. Patil ◽

A. Nagrajachari ◽

D. Kiran ◽

Sunita B. Patil

Keyword(s):

Tobacco Use ◽

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Cross Sectional Study ◽

Family Type ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Demographic Correlates

Background: Tobacco use is the single, largest preventable cause of death and disability worldwide. Area-specific community-based epidemiological studies on tobacco use are required to quantify the problem, identify the determinants and their distribution. The objectives were to find out the prevalence, patterns and socio-demographic correlates of tobacco use in Davangere taluka, Karnataka, India.Methods: This was a community-based, cross-sectional study of 2008 subjects (>10 years of age) in urban and rural areas of Davangere taluka, Karnataka. Interviews were conducted by using a structured, pre-tested questionnaire by house-house visits. Results are presented using percentages, chi-square test, odds ratio and multiple logistic regression analysis.Results: The prevalence of tobacco use was 30.7%. Among urban males it was 39.5%, rural males 39.6%, rural females 26% and urban females 18.5%. Tobacco use was significantly associated with sex, locality, religion, caste, marital status, family type, occupation, and tobacco use in family or friends. There was direct relationship of tobacco use with age and inverse relationship with education and socio-economic status. Mixed tobacco use was higher in rural areas compared to urban areas. About 73.9% of 10-29 years persons had started before the age of 18 years. Among older participants there was higher frequency of consumption and duration of use.Conclusions: Tobacco use is common and it is influenced by various local socio-demographic factors. Addressing these factors and providing tobacco cessation services should be included as key strategies in tobacco control.

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Cervical cancer awareness and its prevention among rural women of Kancheepuram district of Tamil Nadu, India, A Cross-Sectional Study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3926 ◽

2020 ◽

Vol 11 (4) ◽

pp. 7398-7404

Author(s):

Thahirabanuibrahim I ◽

Muthunarayanan Logaraj

Keyword(s):

Cervical Cancer ◽

Rural Women ◽

Rural Areas ◽

Tamil Nadu ◽

Economic Status ◽

Behavioural Change ◽

Cross Sectional Study ◽

Sectional Study ◽

Cancer Awareness ◽

Cross Sectional

Cervical cancer is the second most common cancer among Indian women; around 20% of cervical cancer cases all over the world are from India. Even though amelioration in the health care system had progressed compared to earlier days, the mortality due to cervical cancer in developing countries like India. The study focuses on the awareness, prevention and screening of cervical cancer in rural women of Kancheepuram district. The cross-sectional study with 416 women using multistage sampling method was conducted, the tool was Cervical cancer awareness measure toolkit version 2.1 with altered changes in the socio-demographic section with B. G Prasad scale for socio-economic status was included accordingly to the rural area. The awareness about the term cervical cancer was 43.2% (180/416). Still, the awareness about the term human papillomavirus (HPV) was only 7.1%(32/416), of the 416 women who participated in the study only 15.5% of women were screened for cervical cancer at least once in their lifetime, Less than 50% of the women participants were aware of cervical cancer, hence planned health education with behavioural change program is needed for promoting the knowledge and screening of cervical cancer in rural areas of Kancheepuram district.

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Prevalence of hypertension and selected factors associated to hypertension in a rural area of South Karnataka: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20193125 ◽

2019 ◽

Vol 6 (8) ◽

pp. 3186

Author(s):

Dharaneesh Prasad S. ◽

Rajeev K. H.

Keyword(s):

Blood Pressure ◽

Health Problem ◽

Rural Areas ◽

Public Health Problem ◽

Cross Sectional Study ◽

Health Care Facilities ◽

Major Public Health Problem ◽

Newly Diagnosed ◽

Sectional Study ◽

Cross Sectional

Background: Hypertension is one of the major risk factors for CVDs and its complications which account for 9.4 million deaths worldwide every year. Hypertension itself responsible for about 45% and 51% deaths due to heart disease and stroke respectively. It is a major public health problem in India both in urban and rural areas and is increasing at an alarming rate in rural population now days. Because of lack of access to health care facilities at rural areas, the early screening and treatment of hypertension is not done regularly, so we conducted this study. The objective of the study was to determine the prevalence and associated factors of hypertension in a rural community of South Karnataka.Methods: A community based cross sectional study was conducted at rural field practice area of a private medical college in Bengaluru. Sample size was 380 and convenient sampling method used. Data was collected by visiting homes and blood pressure measured with mercury sphygmomanometer. Descriptive statistics were used to analyse the data.Results: Among 380 participants, 58.4% and 41.6% were males and females respectively. The overall prevalence of hypertension among them was 22.6%, newly diagnosed cases were 7.1% and the proportion of hypertension was more among the age group of 50-59 years (40.7%).Conclusions: Our study shows that hypertension has creeped into the rural areas also and creating a huge health problem for the community. Newly diagnosed cases are also high which shows that most of the people are not aware of their blood pressure and importance of regular monitoring of blood pressure. Since screening helps in early detection, so strengthening of health facilities and creation of awareness at rural levels will reduce the morbidity and mortality due to hypertension and its complications.

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Characteristics of Confidence and Preparedness in Paramedics in Metropolitan, Regional, and Rural Australia to Manage Mental-Health-Related Presentations: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041882 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1882

Author(s):

Kate Emond ◽

Melanie Bish ◽

Michael Savic ◽

Dan I. Lubman ◽

Terence McCann ◽

...

Keyword(s):

Mental Health ◽

Rural Areas ◽

Cross Sectional Study ◽

Categorical Variables ◽

Considerable Proportion ◽

Sectional Study ◽

Cross Sectional ◽

Health Related ◽

Manage Mental ◽

Manage Mental Health

Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.

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Factors Influencing HIV Drug Resistance among Pregnant Women in Luanda, Angola: Findings from a Cross-Sectional Study

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010029 ◽

2021 ◽

Vol 6 (1) ◽

pp. 29

Author(s):

Cruz S. Sebastião ◽

Joana Morais ◽

Miguel Brito

Keyword(s):

Drug Resistance ◽

Pregnant Women ◽

Rural Areas ◽

Cross Sectional Study ◽

Drug Resistant ◽

Sectional Study ◽

Cross Sectional ◽

Hiv Drug Resistance ◽

Hiv 1 ◽

High Educational

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.

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Self-Rated Health and Subjective Economic Status in Life Satisfaction among Older Chinese Immigrants: A Cross-Sectional Study

Healthcare ◽

10.3390/healthcare9030342 ◽

2021 ◽

Vol 9 (3) ◽

pp. 342

Author(s):

Bum Jung Kim ◽

Lin Chen ◽

Ling Xu ◽

Yura Lee

Keyword(s):

Life Satisfaction ◽

Economic Status ◽

Chinese Immigrants ◽

The United States ◽

Ordinary Least Squares ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Self Rated Health ◽

Older Chinese

This study examines the influence of self-rated health and subjective economic status on the life satisfaction of older Chinese immigrants in the United States. Data were obtained from a cross-sectional survey of 205 older Chinese immigrants aged 66 to 90 years living in Los Angeles and Honolulu. Ordinary Least Squares (OLS) regression analysis was employed to explore the independent effects of self-rated health and subjective economic status. The results demonstrated that self-rated health and subjective economic status were positively associated with life satisfaction. This cross-sectional study provides empirical evidence that self-rated health and subjective economic status are directly associated with subjective life satisfaction among older Chinese immigrants.

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SAT0078 SAFETY OF LOW DOSE METHOTREXATE (MTX) IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2968 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 974.2-974

Author(s):

A. Gunay ◽

A. Davidson ◽

I. Colmegna ◽

D. Lacaille ◽

H. Loewen ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Adverse Events ◽

Low Dose ◽

Opportunistic Infections ◽

Case Reports ◽

Cross Sectional Study ◽

Study Quality ◽

Sectional Study ◽

Cross Sectional ◽

Immunodeficiency Virus

Background:Increased awareness of the efficacy of MTX in rheumatic disease is leading to more MTX use in patients from HIV endemic areas. While HIV related immunosuppression may contribute to improvement of some rheumatic diseases, immune reconstitution from highly active antiretroviral therapy (HAART) may lead to exacerbation or presentation of autoimmune disorders for which MTX therapy may be warranted. Most management guidelines for rheumatic disease do not address MTX use in the context of HIV.Objectives:To systematically review the published literature on the safety of using MTX ≤30 mg per week in HIV.Methods:We searched CINAHL, Embase, Global, MEDLINE and World of Science databases (Jan 1990 to May 2018) for terms including ‘methotrexate’ and ‘human immunodeficiency virus’. We also searched citations from review articles. Titles, abstracts or full manuscripts were screened independently by 2 reviewers to identify studies reporting HIV in patients taking MTX. Study quality was assessed using the McGill Mixed Methods Appraisal Tool (MMAT). Data was extracted on MTX and HIV adverse events (MTX toxicity, HIV viral load, CD4 count). Descriptive summaries are presented for studies providing outcomes in patients taking MTX ≤30 mg per week.Results:After removing duplicates and studies not meeting criteria or not providing sufficient information, 42 of the 2714 identified reports were included (1 clinical trial, 2 cohort, 1 cross-sectional study, 38 case reports/case series). Most reports (81%) originated from USA or Europe. Study quality was generally good with most studies fulfilling 50-100% of MMAT criteria. The randomized controlled trial (USA) assessing MTX on atherosclerotic disease in HIV showed that adverse events were more common in MTX versus placebo (12.8% vs 5.6%, p non-inferiority <0.05) and included infection, transient CD4 and CD8 drop, pulmonary toxicity, and death (1 attributed to MTX/HIV, 1 unrelated). One cohort study (South Africa) reported 43 RA patients on MTX who acquired HIV. In this cohort, RA generally improved despite only 5 individuals continuing MTX. No data on MTX adverse event rates was reported. One cohort study (USA) reported 13 HIV patients with myositis. One received MTX (with other immunosuppression) without MTX adverse effects but died due to AIDS. A cross-sectional study (France) of 43 HIV pts with autoimmune disease reported one patient on MTX (and other immunosuppression) developed an adverse event (cytopenia) compared to 5/33 patients not on MTX (cytopenia). The 38 case reports/series described 54 individuals with HIV receiving MTX. Of these studies, 27 (describing 42 subjects) reported on MTX adverse events and 35 (describing 46 subjects) reported on HIV adverse events. MTX adverse events developed in 29 subjects (hematologic 13, renal/hepatic 1, opportunistic infections 10, other events 2). HIV adverse events were noted in 23 subjects (Kaposi’s sarcoma 4, CD4 decrease 16, HIV viral titer increase 4). Five deaths were reported (2 infection, 1 infection and wasting, 2 HIV related deaths). Most subjects also received corticosteroids or other immunosuppressants including biologics.Conclusion:There remains limited data on the safety of low dose MTX in HIV. Surveillance for HIV is warranted for individuals on MTX who are at risk for acquiring HIV. Caution and careful monitoring for MTX toxicity, opportunistic infections and HIV state is suggested if MTX is used in the setting of HIV particularly if combined with other immunosuppression.References:[1] Clin Infectious Disease 2019:68[2] J Rheumatology 2014:41[3] Arthritis and Rheumatism 2003:49[4] Medicine 2017:96Acknowledgments :Funding from International League Against RheumatismMcGill University Global Health Scholar AwardsDisclosure of Interests:Alize Gunay: None declared, Anna Davidson: None declared, Ines Colmegna: None declared, Diane Lacaille: None declared, Hal Loewen: None declared, Michele Meltzer: None declared, Yewondwossen Mengistu: None declared, Rosie Scuccimarri: None declared, Zenebe Yirsaw: None declared, Sasha Bernatsky: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada

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