Prevalence and Severity of Adolescent Asthma in Yazd, Iran: Based on the 2020 Global Asthma Network (GAN) Survey

Asthma, as the most common chronic disease in children, encompasses substantial health and socioeconomic burden worldwide. This study aimed to evaluate the prevalence, severity, and management of asthma in adolescents aged 13-14 years. This cross-sectional study, which was part of the Global Asthma Network (GAN) 2020 survey, was conducted in early 2020 in Yazd, Iran. A total of 48 schools in Yazd city were selected by cluster sampling. In this study, 5141 students, including 3069 (59.7%) females and 2072 (40.3%) males participated. Prevalence of ever and current wheezing was 19% and 9% respectively. The former was significantly higher in males than females (p<0.001). About 2% of the participants, which was 22.1% of students with current wheezing, had severe asthma. The prevalence of severe asthma was significantly higher in males (p=0.026). Our results showed that 4.8% of students had confirmed asthma by a doctor, significantly predominant in males (p<0.001). The prevalence of using inhaled medicines in the past 12 months was 3.8%, which was significantly higher in males than females (p<0.001). The prevalence of using short-acting β-agonists (SABA) and long-acting β-agonists (LABA) was 2.3% and 1.4% among the students, respectively, with a male predominance (p=0.019). About 1.2% and 0.8% of participants were using inhaled corticosteroids (ICS) and the combination of ICS and LABA, respectively, which was significantly higher in male participants (p<0.001). According to our findings and in comparison to the previous ISAAC study in Yazd, the prevalence of severe asthma has decreased which indicates better management of asthma during the past two decades.

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Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000400003 ◽

2013 ◽

Vol 39 (4) ◽

pp. 409-417 ◽

Cited By ~ 13

Author(s):

Charleston Ribeiro Pinto ◽

Natalie Rios Almeida ◽

Thamy Santana Marques ◽

Laira Lorena Lima Yamamura ◽

Lindemberg Assuncao Costa ◽

...

Keyword(s):

Adverse Effects ◽

Severe Asthma ◽

Inhaled Corticosteroids ◽

Oral Candidiasis ◽

Control Program ◽

Cross Sectional Study ◽

Cross Sectional ◽

Convenience Sample ◽

Throat Clearing ◽

Asthma Patients

OBJECTIVE: To describe and characterize local adverse effects (in the oral cavity, pharynx, and larynx) associated with the use of inhaled corticosteroids (ICSs) in patients with moderate or severe asthma. METHODS: This was a cross-sectional study involving a convenience sample of 200 asthma patients followed in the Department of Pharmaceutical Care of the Bahia State Asthma and Allergic Rhinitis Control Program Referral Center, located in the city of Salvador, Brazil. The patients were ≥ 18 years of age and had been using ICSs regularly for at least 6 months. Local adverse effects (irritation, pain, dry throat, throat clearing, hoarseness, reduced vocal intensity, loss of voice, sensation of thirst, cough during ICS use, altered sense of taste, and presence of oral candidiasis) were assessed using a 30-day recall questionnaire. RESULTS: Of the 200 patients studied, 159 (79.5%) were women. The mean age was 50.7 ± 14.4 years. In this sample, 55 patients (27.5%) were using high doses of ICS, with a median treatment duration of 38 months. Regarding the symptoms, 163 patients (81.5%) reported at least one adverse effect, and 131 (65.5%) had a daily perception of at least one symptom. Vocal and pharyngeal symptoms were identified in 57 (28.5%) and 154 (77.0%) of the patients, respectively. The most commonly reported adverse effects were dry throat, throat clearing, sensation of thirst, and hoarseness. CONCLUSIONS: Self-reported adverse effects related to ICS use were common among the asthma patients evaluated here.

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Prevalence and incidence of enuresis before puberty

Urologia Journal ◽

10.1177/039156039606300101 ◽

1996 ◽

Vol 63 (1) ◽

pp. 9-15

Author(s):

C Trombetta ◽

G. Savoca ◽

S. Siracusano ◽

E. Belgrano

Keyword(s):

Primary School ◽

Urban Area ◽

Rural Areas ◽

Nursery School ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Cross Sectional ◽

Male Predominance ◽

Incidence Data

— A mixed study of prevalence and incidence of enuresis carried out at schools in the province of Sassari was planned over a 2-year period. 734 children aged between 3 and 11 years from 3 schools representative of the urban, suburban and rural areas of Sassari, were selected by “cluster” sampling. In this first stage of the project a study of prevalence on children aged 3, 6 and 9 years was carried out. The second stage encompassed a 2-year longitudinal study on those selected in the first stage and provided incidence data pertinent to children aged 4, 7 and 10 years. At the end of the second year of follow-up incidence data relative to children aged 5, 8 and 11 years will be available. Information about children's families and possible urologic disease was collected by means of a questionnaire. Urologic examination then followed. Cross sectional study. In the 73 children aged 3 years, who attended nursery schools, 7 cases of enuresis (9.6%) were ascertained. In the 306 6-year-old children of the first year of primary school, 22 cases of enuresis (7.2%) were observed. In the 355 9-year-old students of the fourth year of primary school, 10 cases (2.8%) were reported. Focusing on the geographical origin of the students, we observed 11 cases of enuresis (5.2%) in cluster I (suburban quarter), 11 cases (6.3%) in cluster II (urban area), and 17 cases (4.9%) in cluster III (rural area). Follow-up. No case of enuresis was observed among the nursery school children (aged 4 years); 2 new cases (0.7%) were ascertained in the 7-year-old group. In the group of children aged 10, only 1 new case (0.57%) was encountered. Taking into account the results of every single cluster, we observed 2 new cases (0.99%) in cluster I, one (0.61%) new case in cluster II and no cases in cluster III. Prevalence of enuresis reached 5.3% in the whole sample, showed a progressive decrease from the younger to the older age group (9.6% in 3-year-olds; 7.2% in 6-year-olds and 2.8% in 9-year-olds), with a clear though not significant male predominance. When data were analysed according to geographical “clusters” a higher prevalence of enuresis was observed among subjects living in the urban area (cluster II). Our results did not differ significantly from those collected by other Authors in similar surveys (Bloom 1993).

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Suicidal Ideation Among Medical Students in Dammam, Saudi Arabia

Crisis ◽

10.1027/0227-5910/a000720 ◽

2020 ◽

pp. 1-6

Author(s):

Mohammed Madadin ◽

Ritesh G. Menezes ◽

Maha A. Alassaf ◽

Abdulaziz M. Almulhim ◽

Mahdi S. Abumadini ◽

...

Keyword(s):

Saudi Arabia ◽

Medical Students ◽

Suicidal Ideation ◽

General Health Questionnaire ◽

Cross Sectional Study ◽

Eastern Province ◽

Cross Sectional ◽

The Past ◽

Depression Subscale ◽

History Of

Abstract. Background: Medical students are at high risk of suicidal ideation. Aim: We aimed to obtain information on suicidal ideation among medical students in Dammam located in the Eastern Province of Saudi Arabia. Method: This cross-sectional study was conducted at the College of Medicine affiliated with Imam Abdulrahman Bin Faisal University in the Eastern Province of Saudi Arabia. Suicidal ideation in the past 12 months was assessed based on responses to four questions in the depression subscale of the General Health Questionnaire 28 (GHQ-28). In addition, data were collected to examine the association of suicidal ideation with various factors. Results: We found that 1 in 3 medical students in the study had suicidal ideation in the past 12 months, while around 40% had lifetime suicidal ideation. Suicidal ideation was associated with feelings of parental neglect, history of physical abuse, and dissatisfaction with academic performance. Limitations: The cross-sectional nature of this study limits its ability to determine causality regarding suicidal ideation. Conclusion: These rates are considerably high when compared with rates from studies in other countries around the world. This study provides a reference in the field of suicidology for this region of Saudi Arabia.

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Non-compliance to Mass Drug Administration Associated with the Low Perception of the Community Members About their Susceptibility to Lymphatic Filariasis in Ankobra, Ghana

Infectious Disorders - Drug Targets ◽

10.2174/1871526519666190206210808 ◽

2020 ◽

Vol 20 (2) ◽

pp. 167-174

Author(s):

Ilo Dicko ◽

Yaya Ibrahim Coulibaly ◽

Modibo Sangaré ◽

Bismark Sarfo ◽

Priscillia Awo Nortey

Keyword(s):

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Health Workers ◽

Compliance Rate ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Cross Sectional ◽

Improve Compliance ◽

Degree Of Association

Background: Lymphatic filariasis (LF) is a parasitic disease that has been targeted for elimination through the Mass Drug Administration (MDA.) Although the MDA started in the Ankobra community in Ghana in 2000, LF prevalence as reported in 2014 was relatively high (4.5%). Non-compliance to the MDA has been associated with the persistent LF prevalence in endemic regions. Objective: This study determined the factors associated with the non-compliance to the MDA among patients living in the Ankobra community, Ghana. Methods: A cross-sectional study using a one-stage cluster sampling method was used to collect data between June and July, 2017 in Ankobra. Questionnaires were used to collect data from health workers, the MDA drug distributors and study participants in Ankobra. Data analysis was performed using STATA 14. Logistic regression was used to measure the degree of association between the dependent (non-compliance) and independent variables. Non-compliance rate was defined as the percentage of individuals who self-reported that they did not actually swallow the drugs provided during the MDA. Results: The MDA coverage and non-compliance rates were 73.5% (147/200) and 33.33% (49/147) respectively. The main reason for non-compliance was fear of drug adverse events (75.51%, 37/49). Thought of “not being susceptible to LF” was significantly associated with the non-compliance (aOR= 2.83, [CI= 1.15, 6.98]). Conclusion: Health education about the susceptibility of residents getting LF disease in endemic community must be intensified to improve compliance to MDA medication ingestion and thus meet the Global Elimination of Lymphatic Filariasis by 2020.

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The usefulness of competitive PCR: airway gene expression of IL-5, IL-4, IL-4δ2, IL-2, and IFNγ in asthma

Thorax ◽

10.1136/thx.56.7.541 ◽

2001 ◽

Vol 56 (7) ◽

pp. 541-548

Author(s):

E M Glare ◽

M Divjak ◽

M J Bailey ◽

E H Walters

Keyword(s):

Gene Expression ◽

Inhaled Corticosteroids ◽

In Situ Hybridisation ◽

Housekeeping Gene ◽

Cross Sectional Study ◽

Mrna Levels ◽

Competitive Pcr ◽

Cross Sectional ◽

Steroid Use ◽

Biopsy Specimens

BACKGROUNDAsthma has been described as an eosinophilic bronchitis driven by interleukin(IL)-4 and IL-5. The quantification of cytokine mRNA levels in airway samples has been confounded by housekeeping gene expression which differs between and within asthmatics and controls.METHODSThe usefulness of competitive reverse transcriptase-polymerase chain reaction (RT-PCR) that is independent of housekeeping gene expression for quantitating the mRNA for interferon (IFN)γ, IL-2, IL-5, IL-4 and its receptor antagonist encoding splicing variant IL-4δ2 was determined in a cross sectional study of 45 normal control subjects and 111 with asthma.RESULTSAtopic controls and atopic asthmatic subjects expressed more IL-5 than non-atopic controls (p<0.02) in bronchoalveolar lavage (BAL) cells, but not in biopsy specimens. IL-5 mRNA expression in BAL cells from asthmatic subjects using inhaled corticosteroids (ICS) was significantly lower than those not receiving ICS (p=0.04). IL-2 mRNA levels differed with steroid use in biopsy specimens but not in BAL cells. IFNγ, IL-4, and IL-4δ2 mRNA levels did not differ between any groups and were not affected by steroid use. IL-4 and IL-4δ2 mRNA levels were positively correlated (p<0.0001), suggesting coordinated transcription.CONCLUSIONSWhile the signal differentiation of competitive PCR in asthma may rival that of in situ hybridisation and immunohistochemistry, the method is expensive and wasteful of material.

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Knowledge and perceptions of cardiopulmonary resuscitation amongst New Zealand podiatrists: a web-based survey

Journal of Foot and Ankle Research ◽

10.1186/s13047-021-00481-9 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Angela Brenton-Rule ◽

Daniel Harvey ◽

Kevin Moran ◽

Daniel O’Brien ◽

Jonathon Webber

Keyword(s):

New Zealand ◽

Cardiopulmonary Resuscitation ◽

Life Support ◽

Survival Rates ◽

Sudden Cardiac Arrest ◽

Cross Sectional Study ◽

Trial Registration ◽

Cross Sectional ◽

Web Based ◽

The Past

Abstract Background Podiatrists in New Zealand have a duty of care to assist patients in an emergency, and current cardiopulmonary resuscitation (CPR) certification is a requirement for registration. However, it is unknown how competent and confident podiatrists are in administering CPR and how they would respond in an emergency. Having a health professional who has a competent knowledge of CPR and skills in basic life support, can improve survival rates from sudden cardiac arrest. Therefore, the aim of this study was to survey New Zealand podiatrists to determine their CPR knowledge and qualifications; beliefs about the application of CPR; and perceptions of their competency in CPR. Methods This cross-sectional study used a web-based survey. Participants were New Zealand registered podiatrists with a current annual practising certificate. The 31-item survey included questions to elicit demographic information, CPR practice and attitudes, and CPR knowledge. Responses were collected between March and August 2020. Results 171 podiatrists responded to the survey. 16 % of the podiatrists (n = 28) had performed CPR in an emergency, with a 50 % success rate. Participants were predominantly female (n = 127, 74 %) and working in private practice (n = 140,82 %). Nearly half of respondents were younger than 40 years (n = 75,44 %) and had less than 10 years of clinical experience (n = 73, 43 %). Nearly all (n = 169,97 %) participants had received formal CPR training in the past two years, with 60 % (n = 105) receiving training in the past 12 months. Most respondents (n = 167,98 %) self-estimated their CPR ability as being effective, very effective, or extremely effective. Participants’ knowledge of CPR was variable, with the percentage of correct answers for CPR protocol statements ranging between 20 and 90 %. Conclusions This study provides the first insight into New Zealand podiatrists’ CPR knowledge and perceptions. Podiatrists were found to have high levels of CPR confidence but demonstrated gaps in CPR knowledge. Currently, New Zealand registered podiatrists require biennial CPR re-certification. However, resuscitation authorities in New Zealand and overseas recommend an annual update of CPR skills. Based on this study’s findings, and in line with Australia and the United Kingdom, the authors recommend a change from biennial to annual CPR re-certification for podiatrists in New Zealand. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001144909).

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Multimorbidity patterns in old adults and their associated multi-layered factors: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-021-02292-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiao Lu ◽

Yuan Wang ◽

Lihong Hou ◽

Zhenxing Zuo ◽

Na Zhang ◽

...

Keyword(s):

Latent Class ◽

Metabolic Diseases ◽

Ecological Model ◽

Explanatory Power ◽

Cross Sectional Study ◽

Shanxi Province ◽

Cluster Sampling ◽

Cross Sectional ◽

Old Patients ◽

Old Adults

Abstract Background Influenced by various factors such as socio-demographic characteristics, behavioral lifestyles and socio-cultural environment, the multimorbidity patterns in old adults remain complex. This study aims to identify their characteristics and associated multi-layered factors based on health ecological model. Methods In 2019, we surveyed a total of 7480 participants aged 60+ by using a multi-stage random cluster sampling method in Shanxi province, China. Latent class analysis was used to discriminate the multimorbidity patterns in old adults, and hierarchical regression was performed to determine the multi-layered factors associated with their various multimorbidity patterns. Results The prevalence of multimorbidity was 34.70% among the old patients with chronic disease. Over half (60.59%) of the patients with multimorbidity had two co-existing chronic diseases. “Degenerative/digestive diseases”, “metabolic diseases” and “cardiovascular diseases” were three specific multimorbidity patterns. Behavioral lifestyles-layered factors had the most explanatory power for the three patterns, whose proportions of explanatory power were 54.00, 43.90 and 48.15% individually. But the contributions of other multi-layered factors were different in different patterns; balanced diet, medication adherence, the size of family and friendship network, and different types of basic medical insurance might have the opposite effect on the three multimorbidity patterns (p < 0.05). Conclusions In management of old patients with multimorbidity, we should prioritize both the “lifestyle change”-centered systematic management strategy and group-customized intervention programs.

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Higher Omega-3 Index Is Associated with Better Asthma Control and Lower Medication Dose: A Cross-Sectional Study

Nutrients ◽

10.3390/nu12010074 ◽

2019 ◽

Vol 12 (1) ◽

pp. 74 ◽

Cited By ~ 2

Author(s):

Isobel Stoodley ◽

Manohar Garg ◽

Hayley Scott ◽

Lesley Macdonald-Wicks ◽

Bronwyn Berthon ◽

...

Keyword(s):

Fatty Acids ◽

Asthma Control ◽

Inhaled Corticosteroids ◽

Asthma Management ◽

Airway Disease ◽

Cross Sectional Study ◽

Erythrocyte Membranes ◽

Omega 3 ◽

Asthma Control Questionnaire ◽

Cross Sectional

Asthma is a chronic inflammatory airway disease, associated with systemic inflammation. Omega-3 polyunsaturated fatty acids (n-3 PUFA) have established anti-inflammatory effects, thus having potential as an adjunct therapy in asthma. This study aimed to compare erythrocyte n-3 PUFA in adults with (n = 255) and without (n = 137) asthma and determine the relationship between erythrocyte n-3 PUFA and clinical asthma outcomes. Subjects had blood collected, lung function measured and Juniper Asthma Control Questionnaire (ACQ) score calculated. Fatty acids were measured in erythrocyte membranes by gas chromatography, and the omega-3 index (O3I) was calculated (% eicosapentaenoic acid + % docosahexaenoic acid). O3I was similar in subjects with and without asthma (p = 0.089). A higher O3I was observed in subjects with controlled or partially controlled asthma (ACQ < 1.5) compared to subjects with uncontrolled asthma (ACQ ≥ 1.5) (6.0% (5.4–7.2) versus 5.6% (4.6–6.4) p = 0.033). Subjects with a high O3I (≥8%) had a lower maintenance dose of inhaled corticosteroids (ICS) compared to those with a low O3I (<8%) (1000 μg (400–1000) versus 1000 μg (500–2000) p = 0.019). This study demonstrates that a higher O3I is associated with better asthma control and with lower ICS dose, suggesting that a higher erythrocyte n-3 PUFA level may have a role in asthma management.

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Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study

International Journal of STD & AIDS ◽

10.1177/09564624211015028 ◽

2021 ◽

pp. 095646242110150

Author(s):

Doreen Nabukalu ◽

Matthew Ponticiello ◽

Thomas Bennett ◽

Sunday Clark ◽

Rachel King ◽

...

Keyword(s):

Rural Communities ◽

Hiv Testing ◽

Cross Sectional Study ◽

Traditional Healers ◽

Sectional Study ◽

Cross Sectional ◽

The Past ◽

Male Clients ◽

Hiv Test ◽

Testing Uptake

Uptake of HIV testing is suboptimal in Uganda, particularly in rural communities. Reaching UNAIDS 95-95-95 goals requires strategies to increase HIV testing among hard-to-reach populations. This cross-sectional study sought to characterize engagement with HIV testing among traditional healers and their clients in rural Uganda. We enrolled 175 traditional healers and 392 adult clients of healers in Mbarara District. The primary outcome for this study was having received an HIV test in the prior 12 months. Most clients ( n = 236, 65.9%) had received an HIV test within 12 months, compared to less than half of healers ( n = 75, 46.3%) who had not. In multivariate regression models, male clients of healers were half as likely to have tested in the past year, compared with female (adjusted odds ratios (AORs) = 0.43, 95% CI = 0.26–0.70). Increasing age negatively predicted testing within the past year (AOR = 0.95, 95% CI = 0.93–0.97) for clients. Among healers, more sexual partners predicted knowing ones serostatus (AOR = 1.6, 95% CI 1.03–2.48). Healers (AOR = 1.16, 95% CI 1.07–1.26) and clients (AOR = 1.28, 95% CI 1.13–1.34 for clients) with greater numbers of lifetime HIV tests were more likely to have tested in the past year. Traditional healers and their clients lag behind UNAIDS benchmarks and would benefit from programs to increase HIV testing uptake.

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Use of electronic cigarettes and secondhand exposure to their aerosols are associated with asthma symptoms among adolescents: a cross-sectional study

Respiratory Research ◽

10.1186/s12931-020-01569-9 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Abdullah Alnajem ◽

Abdullah Redha ◽

Dalal Alroumi ◽

Ahmed Alshammasi ◽

Mohamad Ali ◽

...

Keyword(s):

Cigarette Smoking ◽

Cross Sectional Study ◽

Cigarette Use ◽

Sectional Study ◽

Uncontrolled Asthma ◽

Cross Sectional ◽

Current Asthma ◽

The Past ◽

Asthma Symptoms ◽

History Of

Abstract Background Globally, a surge in electronic cigarette (e-cigarette) use has been observed in recent years, with youth being the most susceptible group. Given their recent emergence, studies assessing the health consequences of using e-cigarettes and exposure to their secondhand aerosols (SHA) are limited. Hence, this study sought to assess associations between e-cigarette use and household exposure to SHA from e-cigarettes with asthma symptoms among adolescents. Methods A school-based cross-sectional study was conducted by enrolling high school students (n = 1565; aged 16–19 years) in Kuwait. Participants self-completed a questionnaire on tobacco products use (e-cigarettes and cigarettes) and asthma symptoms. Current e-cigarette use and cigarette smoking were defined as any use in the past 30 days. Household exposure to SHA from e-cigarettes in the past 7 days was reported as none (0 days), infrequent (1–2 days), and frequent (≥ 3 days). Asthma symptoms included current (past 12 months) wheeze, current asthma (history of clinical diagnosis and current wheeze and/or medication use), and current symptoms of uncontrolled asthma (≥ 4 attacks of wheeze, ≥ 1 night per week sleep disturbance from wheeze, and/or wheeze affecting speech). Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. Results Among the analytical study sample (n = 1345), current e-cigarette use and cigarette smoking was reported by 369 (27.4%) and 358 (26.6%) participants, respectively. Compared to never e-cigarette users and never cigarette smokers, current e-cigarette users with no history of cigarette smoking had increased prevalence of current wheeze (aPR = 1.54, 95% CI 1.01–2.45) and current asthma (aPR = 1.85, 95% CI 1.03–3.41). Moreover, the frequency of exposure to household SHA from e-cigarettes was associated with asthma symptoms. For example, compared to those with no exposure to household SHA, frequent exposure to household SHA was associated with current wheeze (aPR = 1.30, 95% CI 1.04–1.59), current asthma (aPR = 1.56, 95% CI 1.13–2.16), and current uncontrolled asthma symptoms (aPR = 1.88, 95% CI 1.35–2.62). Conclusions E-cigarette use and their household SHA exposure were independently associated with asthma symptoms among adolescents. Hence, such observations indicate that e-cigarette use and passive exposure to their aerosols negatively impact respiratory health among adolescents.

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