scholarly journals Spatial Analysis of HIV Infection and Associated Risk Factors in Botswana

Author(s):  
Malebogo Solomon ◽  
Luis Furuya-Kanamori ◽  
Kinley Wangdi

Botswana has the third highest human immunodeficiency virus (HIV) prevalence globally, and the severity of the epidemic within the country varies considerably between the districts. This study aimed to identify clusters of HIV and associated factors among adults in Botswana. Data from the Botswana Acquired Immunodeficiency Syndrome (AIDS) Impact Survey IV (BIAS IV), a nationally representative household-based survey, were used for this study. Multivariable logistic regression and Kulldorf’s scan statistics were used to identify the risk factors and HIV clusters. Socio-demographic characteristics were compared within and outside the clusters. HIV prevalence among the study participants was 25.1% (95% CI 23.3–26.4). HIV infection was significantly higher among the female gender, those older than 24 years and those reporting the use of condoms, while tertiary education had a protective effect. Two significant HIV clusters were identified, one located between Selibe-Phikwe and Francistown and another in the Central Mahalapye district. Clusters had higher levels of unemployment, less people with tertiary education and more people residing in rural areas compared to regions outside the clusters. Our study identified high-risk populations and regions with a high burden of HIV infection in Botswana. This calls for focused innovative and cost-effective HIV interventions on these vulnerable populations and regions to curb the HIV epidemic in Botswana.

2017 ◽  
Vol 28 (11) ◽  
pp. 1082-1089 ◽  
Author(s):  
Mwumvaneza Mutagoma ◽  
Malamba S Samuel ◽  
Catherine Kayitesi ◽  
Antoine R Gasasira ◽  
Bassirou Chitou ◽  
...  

Human immunodeficiency virus (HIV) prevalence is often high among female sex workers (FSWs) in sub-Saharan Africa. Understanding the dynamics of HIV infection in this key population is critical to developing appropriate prevention strategies. We aimed to describe the prevalence and associated risk factors among a sample of FSWs in Rwanda from a survey conducted in 2010. A cross-sectional biological and behavioral survey was conducted among FSWs in Rwanda. Time–location sampling was used for participant recruitment from 4 to 18 February 2010. HIV testing was done using HIV rapid diagnostic tests (RDT) as per Rwandan national guidelines at the time of the survey. Elisa tests were simultaneously done on all samples tested HIV-positive on RDT. Proportions were used for sample description; multivariable logistic regression model was performed to analyze factors associated with HIV infection. Of 1338 women included in the study, 1112 consented to HIV testing, and the overall HIV prevalence was 51.0%. Sixty percent had been engaged in sex work for less than five years and 80% were street based. In multivariable logistic regression, HIV prevalence was higher in FSWs 25 years or older (adjusted odds ratio [aOR] = 1.83, 95% [confidence interval (CI): 1.42–2.37]), FSWs with consistent condom use in the last 30 days (aOR = 1.39, [95% CI: 1.05–1.82]), and FSWs experiencing at least one STI symptom in the last 12 months (aOR = 1.74 [95% CI: 1.34–2.26]). There was an inverse relationship between HIV prevalence and comprehensive HIV knowledge (aOR = 0.65, [95% CI: 0.48–0.88]). HIV prevalence was high among a sample of FSWs in Rwanda, and successful prevention strategies should focus on HIV education, treatment of sexually transmitted infections, and proper and consistent condom use using an outreach approach.


Author(s):  
Timotheus B. Darikwa ◽  
Samuel O. Manda

Background: Cardiovascular diseases (CVDs) are part of the leading causes of mortality and morbidity in developing countries, including South Africa, where they are a major public health issue. Understanding the joint spatial clustering of CVDs and associated risk factors to determine areas in need of enhanced integrated interventions would help develop targeted, cost-effective and productive mediations. We estimated joint spatial associations and clustering patterns of 2 CVDs (stroke and heart attack) and 3 risk factors (hypertension, high blood cholesterol (HBC) and smoking) among adults in South Africa. Methods: We used cross-sectional secondary adult (15–64-year olds) health data from the South African Demographic Health Survey 2016. Age and gender standardized disease incidence ratios were analyzed using joint spatial global and local bivariate Moran’s Index statistics. Results: We found significantly positive univariate spatial clustering for stroke (Moran; s Index = 0.128), smoking (0.606) hypertension (0.236) and high blood cholesterol (0.385). Smoking and high blood cholesterol (0.366), smoking and stroke (0.218) and stroke and high blood cholesterol (0.184) were the only bivariate outcomes with significant bivariate clustering. There was a joint stroke-smoking local “hot spots” cluster among four districts in the urban western part of the country (City of Cape Town; Cape Winelands; Overberg and Eden) and a joint “cold spots” cluster in the rural north-western part of the country. Similar joint “hot spots” clustering was found for stroke and high blood cholesterol, which also had “cold spots” cluster in the rural east-central part of the country. Smoking and high blood cholesterol had a “hot spots” cluster among five districts in the urban western part of the country (City of Cape Town; Cape Winelands; Overberg; Eden, and West Coast) and “cold spots” around the rural districts in east-southern parts of the country. Conclusions: Our study showed that districts tended to co-cluster based on the rates of CVDs and risk factors, where higher rates were found in urban places than in rural areas. These findings are suggestive of a more contagious and spatial diffusion process among interdependent districts in urban districts. Urbanization or rurality needs to be considered when intervention initiatives are implemented with more general approaches in rural areas. The finding of “hot spot” co-clusters in urban areas means that integrated intervention programmes aimed at reducing the risk of CVDs and associated risk factors would be cost-effective and more productive.


2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.


2021 ◽  
Vol 5 (01) ◽  
pp. 26-35
Author(s):  
Dhiren Subba Limbu ◽  
Samana Shrestha ◽  
Kamana Bantawa ◽  
Ramesh Majhi ◽  
Milan Kharel

 Intestinal parasitic infections have been a major public health burden of developing countries, especially in children. Higher prevalence has been reported among school children, mostly in rural areas of Nepal where water, toilets, hygiene, and sanitation facilities are insufficient. This cross-sectional study was carried out from April to September 2019 to determine the prevalence of intestinal parasitic infections among school-going children1-5 years of Dharan, Nepal, and to assess the associated risk factors. Stool samples were collected in a clean, dry, screw-capped, and wide-mouthed plastic container, kept in an icebox, and transported to the laboratory. Data relating to different risk factors were collected from the parents of 116 participants using a structured questionnaire. The parasites were identified by using the direct wet mount method and formal-ether concentration method. Pearson’s chi-square test was carried out to establish associations between dependent and independent variables using SPSS version 20, and the test considered a greater than < 0.05% as statistically significant with a 95% confidence level. Out of the 116 stool samples, 9 (7.75%) tested positive for the parasitic infections in which 5 (55.5%) were protozoa and 4 (44.45%) were helminths. The prevalent parasites, were Entamoeba histolytica (23%), Hyamenolepis nana (22%), Giardia lamblia (11%), Hookworm (11%), Entamoeba coli (11%), Ascaris lumbricoides (11%), and Intestinal parasitic infections had a significant association with drinking water, bowel syndrome, bathing habit, toilet facility, and washing hands after toilets (p<0.05). Lack of toilets, poor hygiene, and unsafe drinking water were the main risk factors. Improved hygienic practices, safe drinking water, and the use of latrines could lower the rate of parasitic infections.


2021 ◽  
Vol 6 (12) ◽  
pp. e006838
Author(s):  
Mohammad Anwar Hossain ◽  
K M Amran Hossain ◽  
Karen Saunders ◽  
Zakir Uddin ◽  
Lori Maria Walton ◽  
...  

BackgroundThe objective of this study was to identify the prevalence of long COVID symptoms in a large cohort of people living with and affected by long COVID and identify any potential associated risk factors.MethodsA prospective survey was undertaken of an inception cohort of confirmed people living with and affected by long COVID (aged 18–87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented were contacted by face-to-face interview, and were interviewed regarding long COVID, and restriction of activities of daily living using post COVID-19 functional status scale. Cardiorespiratory parameters measured at rest (heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation levels, maximal oxygen consumption, inspiratory and expiratory lung volume) were also measured.ResultsAmong 2198 participants, the prevalence of long COVID symptoms at 12 weeks was 16.1%. Overall, eight long COVID symptoms were identified and in descending order of prominence are: fatigue, pain, dyspnoea, cough, anosmia, appetite loss, headache and chest pain. People living with and affected by long COVID experienced between 1 and 8 long COVID symptoms with an overall duration period of 21.8±5.2 weeks. Structural equation modelling predicted the length of long COVID to be related to younger age, female gender, rural residence, prior functional limitation and smoking.ConclusionIn this cohort, at 31 weeks post diagnosis, the prevalence of long COVID symptoms was 16.1%. The risk factors identified for presence and longer length of long COVID symptoms warrant further research and consideration to support public health initiatives.


2020 ◽  
Author(s):  
Fabrice Carrat ◽  
Mathilde Touvier ◽  
Gianluca Severi ◽  
Laurence Meyer ◽  
Florence Jusot ◽  
...  

Abstract Background Our main objectives were to estimate the incidence of illnesses presumably caused by SARS-CoV-2 infection during the lockdown period and to identify the associated risk factors.Methods Participants from 3 adult cohorts in the general population in France were invited to participate in a survey on COVID-19. The main outcome was possible COVID-19, defined as a sudden onset of cough, fever, dyspnea, ageusia and/or anosmia, that lasted more than 3 days and occurred during the 17 days before the survey. We used delayed-entry Cox models to identify associated factors.Results Between April 2, 2020 and May 12, 2020, 279,478 participants were invited, 116,903 validated the questionnaire and 106,848 were included in the analysis. Three thousand thirty-five cases of possible COVID-19 were reported during 62,099 person-months of follow-up. The cumulative incidences of possible COVID-19 were 6.2% (95% Confidence Interval (95%CI): 5.7%; 6.6%) on day 15 and 8.8% (95%CI 8.3%; 9.2%) on day 45 of lockdown. The risk of possible COVID-19 was lower in older age groups and higher in French regions with a high prevalence of SARS-CoV-2 infection, in participants living in cities >100,000 inhabitants (vs rural areas), when at least one child or adolescent was living in the same household, in overweight or obese people, and in people with chronic respiratory diseases, anxiety or depression or chronic diseases other than diabetes, cancer, hypertension or cardiovascular diseases. Conclusion The incidence of possible COVID-19 in the general population remained high during the first two weeks of lockdown, and decreased significantly thereafter. Modifiable and non-modifiable risk factors were identified.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Abid Ali ◽  
Talha Omer ◽  
Asad Ullah ◽  
Abdul Haleem ◽  
Maryam Naseem ◽  
...  

Toxoplasma infection is one of the most common human parasitic diseases. During 2018-2020, in the rural areas of three districts of Pakistan, we surveyed a total of 451 animals, belonging to different asymptomatic ruminant species, to determine the prevalence of Toxoplasma gondii antibodies. We used ELISA assay as well as recorded some associated risk factors contributing to its transmission. IgM antibodies were detected in 17% and IgG in 13.4% of ruminant samples with the highest percentage, 10% for IgM and 8.6% for IgG in sheep. A strong significant association was found between antibodies and different species (IgM, χ 2 = 29 .280, P = .000 , and IgG, χ 2 = 22.580 , P = .000 ), respectively. Infection with T. gondii seems mainly associated with different geographic features and the presence of cats in the environment, low hygiene water systems and livestock that are mostly dependent on outdoor drinking and grazing. There was no significant association between IgM and age grouping ( χ 2 = 6.660 , P = 0.840 nor for IgG ( χ 2 = 8.136 , P = 0.43 ). The results of this study may be considered the starting point to promote the awareness about parasitic infections in ruminants in Pakistan in order to prevent this infection from further spreading.


2019 ◽  
Vol 16 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Prajjwal Pyakurel ◽  
Deepak Kumar Yadav ◽  
Jeevan Thapa ◽  
Nishant Thakur ◽  
Pramita Sharma ◽  
...  

Background: Hypertension is one of the major risk factors for the rising burden of cardiovascular diseases (CVDs) in developing region. It has also been recognized as one of the major public health problems in the developing countries since the early seventies and the rate is increasing not only in urban areas but in rural areas with low socio-economic condition.  Methods: A cross sectional study was conducted in Jogidaha Village Development Comittee(VDC) and Triyuga Municipality of Udaypur district of South-Eastern Nepal. A total of 430 participants of age 18-59 years were selected. Semi-structured questionnaire (WHO NCD STEPS instrument) was used to collect information on demographic variables and associated risk factors with use of show cards. Clinical and anthropometric measurement were done. Primary outcome was prevalence of hypertension. Bivariate and multivariate analysis were performed to show strength of association among various risk factors with hypertension.  Results: The prevalence of hypertension was found to be 25.1%. Prevalence of overweight and obesity was found to be 49.8%. Hypertension was significantly associated with age (AOR=1.09, CI=1.05-1.10) and gender (male >female; AOR= 2.12,CI =1.22-3.68). Similarly, increased waist-hip ratio(7.12; CI 2.87-17.67),alcohol consumption(OR=2.82,CI=1.77-4.52), and use of tobacco products (OR =1.8,CI=1.02-3.20) showed significant association with hypertension. Conclusion: There is high prevalence of hypertension in rural districts of South-Eastern Nepal. A community-based preventive approach with early detection and treatment and life-style modification is needed to reduce the burden of disease and make sustainable changes. 


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