Affordable, Social, and Substandard Housing and Mortality: The EPIPorto Cohort Study, 1999–2019

2020 ◽  
Vol 110 (7) ◽  
pp. 1060-1067
Author(s):  
Ana Isabel Ribeiro ◽  
Henrique Barros

Objectives. To examine the association between residence in different housing typologies and all-cause and cause-specific mortality, and to compare with the 25 × 25 risk factors defined by the World Health Organization. Methods. We used data from EPIPorto cohort (Porto, Portugal; n = 2485). We georeferenced and matched participants to a housing type—conventional, affordable, social, or substandard housing (locally called ilhas). We used Poisson regression models to estimate mortality rates and associations. Results. Age- and sex-adjusted mortality rates (per 100 000 person-years) were 713 (95% confidence interval [CI] = 584, 863) for individuals residing in conventional housing, and 1019 (95% CI = 637, 1551), 1200 (95% CI = 916, 1551), and 1239 (95% CI = 839, 1772) for individuals residing in affordable housing, social housing, and ilhas, respectively. After further adjustment, the associations between mortality and residence in social housing (rate ratio [RR] = 1.59; 95% CI = 1.22, 2.06) and in ilhas (RR = 1.64; 95% CI = 1.12, 2.33) remained. The association between disadvantaged housing and mortality was stronger than that observed for well-established risk factors such as hypertension, sedentariness, heavy drinking, manual occupation, or obesity. Conclusions. Disadvantaged housing is a major risk factor for mortality that should be accounted for by health policies and surveillance systems.

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S51-S52
Author(s):  
Kajal Mehta ◽  
Nikitha Thrikutam ◽  
Kiran K Nakarmi ◽  
Paa Ekow Hoyte-Williams ◽  
Michael Peck ◽  
...  

Abstract Introduction Cooking- and cookstove-related burns (CSBs) comprise a large proportion of burn injuries globally. A cookstove is any apparatus that provides heat and is used for cooking (e.g., three-stone fire, traditional or improved cookstove). There are limited data on patterns of cooking behaviors and CSBs to inform prevention initiatives and advocacy. We aimed to describe the epidemiology, risk factors and outcomes of cooking-related burns and CSBs, specifically. Methods Patients with cooking and non-cooking related burns from 2018 to 2020 were identified in the World Health Organization (WHO) Global Burn Registry (GBR). Patient demographics, cooking arrangement, injury characteristics [mechanism, total body surface area (TBSA), revised Baux score] and outcomes were described. Differences in proportions and medians were compared. Bivariate regression was performed to identify risk factors associated with occurrence of CSB. Results GBR contained data of 6,965 burn-injured patients from 17 countries; 88% were from middle-income countries. One quarter of burn injuries (1,723 burns) were cooking-related. More than half of cooking-related burns (55%) occurred in females. Median age for cooking-related burns was 11 years (IQR 2–35). Of cooking-related burns, 22% were cookstove-related burns (CSBs; 311 burns). The most common mechanism in CSB was flame (87%), whereas the most common mechanism in other cooking burns was scald (62%). Patients with CSBs were more often female (65% vs 53%; p< 0.001) and much older than patients with other cooking burns (32 years, IQR 22–47 vs 5 years, IQR 2–30). CSBs were significantly larger in TBSA size (30%, IQR 15–45% vs 15%, IQR 10–25%; p< 0.001), had higher revised Baux scores (70, IQR 46–95 vs 28, IQR 10–25; p< 0.001) and more often resulted in death (41 vs 11%; p< 0.001) than other cooking burns (Table1). Patients with CSBs were more likely to be burned by fires (OR 4.74; 95% CI 2.99–7.54) and explosions (OR 2.91, 95% CI 2.03–4.18) than other cooking injuries. Kerosene had the highest odds of CSB than all other cooking fuels (OR 2.37, 95% CI 1.52–3.69). Conclusions Cooking-related burns are common and have different epidemiology than CSBs, specifically (e.g., more often female, older, larger burn size, higher mortality). CSBs were more likely caused by structural factors (e.g., explosion, fire) than behavioral factors (e.g., accidental movements) when compared to other cooking burns.


2021 ◽  
pp. 1-14
Author(s):  
Md Mokbul Hossain ◽  
Fahmida Akter ◽  
Abu Abdullah Mohammad Hanif ◽  
Md Showkat Ali Khan ◽  
Abu Ahmed Shamim ◽  
...  

Abstract The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.


2021 ◽  
Vol 42 (2) ◽  
pp. 394-402
Author(s):  
O.B. Aribodor ◽  
C.E. Okaka ◽  
S.O. Sam-Wobo ◽  
B.C. Okpala ◽  
D.N. Aribodor ◽  
...  

Urinary schistosomiasis is considered a major public health parasitic disease in African communities. Prior to this study, Nsugbe community was not considered endemic for the disease and as such was not involved in Praziquantel-Preventive Chemotherapy (PC). Longitudinal study of 281 consented pupils aged 5-16 years was carried out with aim of determining the status of urinary schistosomiasis. Urinalysis laboratory test strip, urine filtration technique and syndromic diagnosis were used for the confirmation of the presence of haematuria in urine samples, identification of Schistosoma haematobium ova and the confirmation of female genital schistosomiasis (FGS), respectively. Risk factors for urinary schistosomiasis infection were determined using pre-tested structured questionnaire. Data were analyzed using Minitab 17 software and intensity of infection categorized following World Health Organization (WHO) recommendations. Of the 281 pupils, 117 (42%) were males and 164 (58%) were females with mean age of 9 years. At baseline, an overall prevalence of 0.4% (1/281) which was of light intensity was established. At follow-up, an overall prevalence of 2.1% (6/281) which was of both light (16.7%) and heavy infection (83.3%) was established. The result of the clinical examination showed eggs of S. haematobium in and around the vaginal area indicating FGS of a female pupil aged 12 years. This was treated. Identified risk factors for S. haematobium infection in the community include water-contact activities, ignorance, source of water supply among others. The study revealed the need for an all inclusive mass administration of Praziquantel-PC in the study community for effective control and possible elimination.


2016 ◽  
Vol 9 (6) ◽  
pp. 22 ◽  
Author(s):  
Abdullah M. Al-Shahrani ◽  
Mohammed A. Al-Saleem ◽  
Mohamed O’haj ◽  
Faleh Th. Mohammed ◽  
Mutasim E. Ibrahim

OBJECTIVES: To determine the prevalence and associated risk factors of diabetes mellitus (DM) among the adult population in Bisha province, Saudi Arabia.METHODS: A cross sectional study was conducted during December, 2015 using the World Health Organization STEPS wise approach for data collection. Blood glucose level and anthropometric measurements of blood pressure, height, weight, and waist circumference were performed per standard methods.  Logistic regression analysis was used to assess the prevalence and risk of diabetes.RESULTS: Of 542 adult individuals included in the study, 13.3% (72) had diabetes, of which 8.1% were previously diagnosed and 5.2% represented new cases. The proportions of DM were 14.7% for men and 10.8% for women. Diabetes was significantly higher among married compared to unmarried individuals (19.3% vs 5.5 %; p<0.001) and among individuals aged ≥40 years old compared to those <40 years (31.3% vs 9.3%; p<0.001). The risk of diabetes was significantly increased with older age (Odds Ratio=4.470; 95% CI 2.264-7.614), married individuals (OR=4.097; 95% CI 2.188-7.672), weight/obesity (OR=2.827; 95% CI 1.567-5.072), hypertension (OR=4.383; 95% CI 2.085-9.214) and having a job (OR=2.327; 95% CI 1.347-4.02). The independent risk factors predicted diabetes were hypertension (Adjusted OR=2.897; 95% CI 1.269-66.13) and job patterns (Adjusted OR=2.793; 95% CI 1.064-7.329).CONCLUSION: Different risk factors alarming diabetes among adult population in Bisha province were detected.  Strategies aimed to improving a healthy lifestyle are necessary to reduce the burden of the disease. 


Molecules ◽  
2021 ◽  
Vol 26 (18) ◽  
pp. 5543
Author(s):  
Michael Piameu ◽  
Philippe Nwane ◽  
Wilson Toussile ◽  
Konstantinos Mavridis ◽  
Nadja Christina Wipf ◽  
...  

Previous studies have indicated widespread insecticide resistance in malaria vector populations from Cameroon. However, the intensity of this resistance and underlying mechanisms are poorly known. Therefore, we conducted three cross-sectional resistance surveys between April 2018 and October 2019, using the revised World Health Organization protocol, which includes resistance incidences and intensity assessments. Field-collected Anopheles gambiae s.l. populations from Nkolondom, Nkolbisson and Ekié vegetable farms in the city of Yaoundé were tested with deltamethrin, permethrin, alpha-cypermethrin and etofenprox, using 1× insecticide diagnostic concentrations for resistance incidence, then 5× and 10× concentrations for resistance intensity. Subsamples were analyzed for species identification and the detection of resistance-associated molecular markers using TaqMan® qPCR assays. In Nkolbisson, both An. coluzzii (96%) and An. gambiae s.s. (4%) were found together, whereas only An. gambiae s.s. was present in Nkolondom, and only An. coluzzii was present in Ekié. All three populations were resistant to the four insecticides (<75% mortality rates―MR1×), with intensity generally fluctuating over the time between mod-erate (<98%―MR5×; ≥98%―MR10×) and high (76–97%―MR10×). The kdr L995F, L995S, and N1570Y, and the Ace-1 G280S-resistant alleles were found in An. gambiae from Nkolondom, at 73%, 1%, 16% and 13% frequencies, respectively, whereas only the kdr L995F was found in An. gambiae s.s. from Nkolbisson at a 50% frequency. In An. coluzzii from Nkolbisson and Ekié, we detected only the kdr L995F allele at 65% and 60% frequencies, respectively. Furthermore, expression levels of Cyp6m2, Cyp9k1, and Gste2 metabolic genes were highly upregulated (over fivefold) in Nkolondom and Nkolbisson. Pyrethroid and etofenprox-based vector control interventions may be jeopardized in the prospected areas, due to high resistance intensity, with multiple mechanisms in An. gambiae s.s. and An. coluzzii.


2021 ◽  
Vol 9 (40) ◽  
pp. 37-46
Author(s):  
Medha Ghose ◽  
Maehali Patel

On March 11, 2020, the World Health Organization (WHO) released a statement characterizing COVID-19 as a pandemic that has, as of October 2020, caused almost 36 million confirmed global cases and over 1 million deaths. One of the long-term complications suggested by researchers is fibrosis. It has been hypothesized that the combination of ongoing pulmonary injury caused by COVID-19 and the inability to promptly repair damage results in interstitial matrix widening and eventual compression and destruction of alveoli and capillaries. Here we focus on pathogenesis, risk factors, different infectious causes of fibrosis along with COVID-19, and potential treatment options that might reduce its effects. Key words: COVID-19, pulmonary fibrosis, mechanism, treatment


2020 ◽  
Vol 44 ◽  
Author(s):  
Jason A Roberts ◽  
Linda K Hobday ◽  
Aishah Ibrahim ◽  
Bruce R Thorley

Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2017, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.33 non-polio AFP cases per 100,000 children, meeting the WHO performance criterion for a sensitive surveillance system. Three non-polio enteroviruses, coxsackievirus B1, echovirus 11 and enterovirus A71, were identified from clinical specimens collected from AFP cases. Australia established enterovirus and environmental surveillance systems to complement the clinical system focussed on children and an ambiguous vaccine-derived poliovirus type 2 was isolated from sewage in Melbourne. In 2017, 22 cases of wild polio were reported with three countries remaining endemic: Afghanistan, Nigeria and Pakistan.


Author(s):  
Judith Ju Ming Wong ◽  
Qalab Abbas ◽  
Soo Lin Chuah ◽  
Ririe Fachrina Malisie ◽  
Kah Min Pon ◽  
...  

There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.


Author(s):  
Shaun Purkiss ◽  
Tessa Keegel ◽  
Hassan Vally ◽  
Dennis Wollersheim

BackgroundQuantifying the mortality risk for people with diabetes is challenging because of associated comorbidities. The recording of cause specific mortality from accompanying cardiovascular disease in death certificate notifications has been considered to underestimate the overall mortality risk in persons with diabetes. Main AimDevelop a technique to quantify mortality risk from pharmaceutical administrative data and apply it to persons diagnosed with diabetes, and associated cardiovascular disease and dyslipidaemia before death. MethodsPersons with diabetes, cardiovascular disease and dyslipidaemia were identified in a publicly available Australian Pharmaceutical data set using World Health Organization anatomic therapeutic codes assigned to medications received. Diabetes associated multi-morbidity cohorts were constructed and a proxy mortality (PM) event determined from medication and service discontinuation. Estimates of mortality rates were calculated from 2004 for 10 years and compared persons with diabetes alone and associated cardiovascular disease and dyslipidemia. ResultsThis study identified 346,201 individuals within the 2004 calendar year as having received treatments for diabetes (n=51,422), dyslipidaemia (n=169,323) and cardiovascular disease including hypertension (n=280,105). Follow up was 3.3 x 106 person-years. Overall crude PM was 26.1 per 1000 person-years. PM rates were highest in persons with cardiovascular disease and diabetes in combination (47.5 per 100 person years). Statin treatments significantly improved the mortality rates in all persons with diabetes and cardiovascular disease alone and in combination over age groups >44 years (p<.001). Age specific diabetes PM rates using pharmaceutical data correlated well with Australian data from the National Diabetes Service Scheme (r=0.82) ConclusionProxy mortality events calculated from medication discontinuation in persons with chronic conditions can provide an alternative method to estimate disease mortality rates. The technique also allows the assessment of mortality risk in persons with chronic disease multi-morbidity.


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