scholarly journals Variation in Prescription Opioid Dispensing across Neighborhoods of Diverse Socioeconomic Disadvantages in Victoria, Australia

2018 ◽  
Vol 11 (4) ◽  
pp. 116 ◽  
Author(s):  
M Islam ◽  
Dennis Wollersheim

The study examined the relationship between dispensing patterns of prescription opioids, neighborhood-disadvantage-index, and standardized doses dispensed. Three-year’s dispensing data drawn from 80 local government areas (LGAs) within Victoria, Australia’s second most populous state, was analyzed. Quantities dispensed in defined daily dose (DDD)/1000-people/day were computed for LGAs of low, moderate, high, and very high socio-economic disadvantage. LGAs with various levels of dispensing, and neighborhood disadvantage were identified and mapped. A multivariable regression model examined the effect of neighborhood level disadvantage and identified other factors that are associated with standardized doses dispensed. More women were dispensed opioids than men. Dispensing increased with increasing age. Most of the LGAs with relatively high dispensing were socioeconomically disadvantaged and located outside the major cities. Dispensing gradually increased from low disadvantage to very high disadvantage areas. Dispensing of standardized doses were consistently higher in rural areas than in urban areas. Neighborhood level disadvantage, age, sex, and urbanization were significant factors in the standardized doses dispensed. As inappropriate dispensing of opioids is a major public health problem, research should facilitate understanding of utilization in small areas to enable tailored public health programs. Nationwide and consistent introduction of real-time prescription drug-monitoring programs, and structural interventions to reduce the fundamental causes of socioeconomic disadvantage and isolation are recommended.

2013 ◽  
Vol 110 (S3) ◽  
pp. S36-S44 ◽  
Author(s):  
Nipa Rojroongwasinkul ◽  
Kallaya Kijboonchoo ◽  
Wanphen Wimonpeerapattana ◽  
Sasiumphai Purttiponthanee ◽  
Uruwan Yamborisut ◽  
...  

In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5–12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0–5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0–12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off < 0·7 μmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off < 1·05 μmol/l) was more prevalent (29·4–31·7 %) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6 % among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.


2000 ◽  
Vol 6 (5-6) ◽  
pp. 1017-1025
Author(s):  
F. El Sahn ◽  
S. Sallam ◽  
A. Mandif ◽  
O. Galal

We aimed to estimate the nationwide prevalence of anaemia among adolescents in Egypt and to study possible risk factors. A cross-sectional approach was used. Blood samples were collected from 1980 adolescents for haemoglobin estimation. The overall prevalence of anaemia was 46.6%, most of which was mild or moderate, with severe cases in less than 1.0% of the sample. Gender difference was almost nonexistent. A significant inverse relationship was observed between the level of anaemia and age [especially among boys], socioeconomic level and educational level. Anaemia was more prevalent in rural areas and in Upper [southern] Egypt. Anaemia is a major public health problem among Egyptian adolescents and wide-scale public health education is warranted.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rukundo Benedict ◽  
Wenjuan Wang ◽  
Lindsay Mallick

Abstract Objectives Maternal anemia is a major public health problem in many low and middle income countries. In Malawi, consumption of iron folic acid supplements (IFA) has remained low and unchanged since 2004, even with the support of national policy and programs. To understand program implementation challenges, our study examined the relationship between the IFA-related health service environment (HSE) during antenatal care (ANC) and women's adherence to IFA supplementation guidelines. Methods Data from the 2015–16 Malawi Demographic and Health Survey (DHS) and the 2013–14 Malawi Service Provision Assessment (SPA), both of which collect GPS data of clusters or health facilities, were used. Each DHS cluster was linked to SPA facilities within a specified buffer distance (5 km for urban and 10 km for rural) using GPS data. IFA-related HSE was defined as availability of IFA, observed prescription of IFA, and observed counseling on IFA in health facilities within the buffer. The HSE variables were aggregated to the cluster-level and classified as low, medium, or high. Multilevel logistic regressions, stratified by urban and rural locale, were used to model associations between consumption of IFA and HSE variables controlling for individual-level factors. Results In Malawi 44% of women in urban and 32% in rural areas reported IFA consumption for at least 90 days during their most recent pregnancy. IFA supplements were available in the majority of health facilities (94%) providing ANC. Among clients, 85% received IFA or were given a prescription, 59% were counseled on how to use IFA, and 3% were counseled on side effects. In rural areas, regression models showed that high levels of IFA availability in facilities (OR = 2.07; 95% CI: 1.13–3.80) and IFA counseling (OR = 1.42; 95% CI: 1.12–1.78) were associated with IFA consumption. No associations with any HSE variables were observed in urban areas. Conclusions Despite widespread availability and prescription of IFA supplements from health facilities, receipt of counseling was low, particularly for side effects. Findings in rural areas reinforce the importance of health system strengthening to ensure IFA availability and counseling to support IFA consumption during pregnancy. Further research is warranted to investigate factors that affect IFA consumption in urban areas. Funding Sources United States Agency for International Development (USAID) through the DHS Program (7200AA18C00083).


2013 ◽  
Vol 110 (S3) ◽  
pp. S11-S20 ◽  
Author(s):  
Sandjaja Sandjaja ◽  
Basuki Budiman ◽  
Heryudarini Harahap ◽  
Fitrah Ernawati ◽  
Moesijanti Soekatri ◽  
...  

Indonesia is currently facing the double burden of malnutrition. While undernutrition is still a major public health problem, the prevalence of overnutrition is increasing. The objective of the South East Asian Nutrition Survey (SEANUTS) was to provide up-to-date data on nutritional status, food consumption and biochemical parameters related to nutrition for children aged 0·5–12 years. The SEANUTS study in Indonesia was conducted in a nationwide representative sample of 7·211 children using multistage cluster sampling based on probability proportional to size, stratified for geographical location, in forty-eight out of 440 districts/cities. The results show that the growth (weight for age, height for age, weight for height and BMI for age) of Indonesian pre-school- and school-aged children is below the WHO standards. The older the children, the more the deviation from the WHO standard curves. Underweight was more prevalent in rural areas (28·9 v. 19·2 %) and overweight/obesity was observed to be more widespread in urban areas (5·6 v. 3·2 %). The prevalence varied with age groups and sexes. The overall prevalence of stunting was 25·2 and 39·2 % in urban and rural areas, respectively. The prevalence of anaemia was nearly 55 % in children aged 0·5–1·9 years and ranged from 10·6 to 15·5 % in children aged 2–12 years. Fe deficiency was observed in 4·1–8·8 % of the children. The percentage of children with dietary intakes of energy, protein, and vitamins A and C below the Indonesian RDA was high and differed across urban and rural areas and age groups.


Anemia ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Gerardo Alvarez-Uria ◽  
Praveen K. Naik ◽  
Manoranjan Midde ◽  
Pradeep S. Yalla ◽  
Raghavakalyan Pakam

Anaemia is a major public health problem in India. Although nearly three quarters of the Indian population live in rural areas, the epidemiology of anaemia in rural settings is not well known. We performed a retrospective observational study using routine clinical data from patients attending the out-patient clinics of a rural hospital in India from June 2011 to August 2014. The study included 73,795 determinations of haemoglobin. 49.5% of patients were female. The median haemoglobin concentration was 11.3 g/dL (interquartile range (IQR), 9.8–12.4) in females and 12.5 g/dL (IQR, 10.6–14.2) in males. Anaemia was present in the majority of children <10 years, women after puberty, and older adults. Children <5 years had the highest prevalence of anaemia, especially children aged 1-2 years. The high proportion of microcytic anaemia and the fact that gender differences were only seen after the menarche period in women suggest that iron deficiency was the main cause of anaemia. However, the prevalence of normocytic anaemia increased with age. The results of this study can be used by public health programmes to design target interventions aimed at reducing the huge burden of anaemia in India. Further studies are needed to clarify the aetiology of anaemia among older adults.


Author(s):  
Hillary K. Wakhungu ◽  
Gertrude M. Were ◽  
Charlotte A. Serrem ◽  
Caroline J. Kibosia

Dental caries is a major public health problem associated with diet and nutrition affecting 60-90% of children globally with the burden in both industrialized and less industrialized countries undergoing nutrition transition. The aim of this study was to assess the relation between the dietary intake and nutritional status on dental caries prevalence of 5-year-old school children in urban and rural areas of Uasin-Gishu County.  In this study, 382 five year old children and their parents/caregivers were sampled from urban and rural schools in Uasin-Gishu County to participate in the study. Dental caries status was assessed based on the criteria proposed by WHO for oral health surveys. Structured questionnaires was used to gather information on demographic and socio-economic status. A quantitative food frequency questionnaire was used to collect data on dietary intake. Dietary intake data was analyzed using ENA for SMART computer programmes and the rest of the data was analyzed using the Statistical Package for Social Sciences (SPSS) Version 21 (2007). The prevalence of dental caries stood at 39.3% with a mean dft of 1.55 and 60.7% being dental caries free. Children met their nutrient requirements for protein, vitamin C, calcium, and phosphorus, but did not meet the requirements for energy, folate, vitamin A, and iron. Many children from urban than rural areas consumed sweets/candies at 33.5% and 15.3% respectively.  Children from urban areas (288) had the highest mean dft of 1.83±1.37 while those from rural areas (154) had a mean dft score of 1.16±1.13. This was significantly different (p<0.05). Overweight was higher in the urban population compared to the rural population at 13.64% and 8.96% respectively. The prevalence of underweight was higher in rural areas at 10.7%, stunting at 14.6% and wasting at 6.8%. There is inadequate intake of Energy, Vitamin A and Iron in the diet consumed by the 5-year-old which might be contributing to dental caries prevalence both in the urban and rural areas of Uasin – Gishu County, Kenya. Children should be fed on nutrient rich foods and cariogenic foods should be consumed occasionally.


Author(s):  
Gautam B. Sawase ◽  
Sunayana G. Kumthekar ◽  
Shweta N. Salphale ◽  
Mohan K. Doibale

Background: Hypertension is the commonest cardiovascular disorder, posting a major public health problem of the world and especially to population in socio-economic and epidemiological transition. Around 7.5 million deaths or 12.8% of the total of all annual deaths worldwide occur due to high blood pressure. It is predicted to be increased to 1.56 billion adults with hypertension in 2025. In India there is 24-30% of prevalence of hypertension in urban areas and 12-14% in rural areas. The objectives of the study were to find out the prevalence of hypertension in study population of 18 years and above and to study some socio-demographic factors affecting hypertension.Methods: A community based cross sectional study was carried out in urban slum area, under urban field practice area of a Govt. Medical College & hospital. Sample size of 360 participants of age more than 18 yrs residing in study area taken. Data collected by using systematic random sampling by house to house visit. A semi-structured & pretested questionnaire used to interview the patients after obtaining their consent. The data was analyzed using SPSS version 23. Appropriate statistical tests were applied.Results: The overall prevalence of hypertension was 30.5%. Out of 360 subjects, 47 (13%) found elevated hypertensive. Out of 110 hypertensive population nearly 53 (48%) were in older age group, nearly 60 (55%) were illiterate and 53 (48%) were unskilled workers out of 110 was found statistically significant (p<0.05).Conclusions: Prevalence of hypertension found to be 30.5%. Some socio-demographic factors like age, sex, education, occupation were statistically significant (p<0.05).


2020 ◽  
Author(s):  
Pintu Paul

Abstract Background Globally, diarrhoea is a second leading cause of deaths among under-five children and is a major public health problem. Despite several health care initiatives, a large proportion of under-five children are still experienced diarrhoeal diseases causes high mortality in India. This study aims to examine the socio-demographic and environmental factors of diarrhoea among children under-five in India.Methods A cross-sectional study was designed using the recent round of the National Family Health Survey (NFHS), conducted in 2015-16. A total of living children below 5 years of age were utilized for the analysis of this study. Bi-variate and multivariate logistic regression were carried out to investigate the factors of childhood diarrhoea.Results In India, about 9% under-five children experience diarrhoeal disease in the past 2 weeks. Children from rural areas (AOR: 1.05; 95% CI: 1.01, 1.09), Scheduled Tribe (AOR: 0.83; 95% CI: 0.79, 0.89) and others caste (AOR: 0.92; 95% CI: 0.88, 0.97), Muslim (AOR: 1.18; 95% CI: 1.13, 1.24), and from central (AOR: 1.61; 95% CI: 1.52, 1.70) and west region (AOR: 1.08; 95% CI: 1.01, 1.15) were significantly associated with higher likelihood of diarrhoea in past 2 weeks. Furthermore, this study also revealed that child’s stool disposal (AOR: 1.06; 95% CI: 0.98, 1.09), floor materials (AOR: 1.08; 95% CI: 1.03, 1.12) and roof materials (AOR: 1.08; 95% CI: 1.04, 1.13) of the household were found to be significant factors of childhood diarrhoea occurrence.Conclusions Diarrhoeal disease remains a serious public health problem in India. The findings of this study suggest strengthening of existing health care programs. Policy intervention should also address socio-economic vulnerabilities of mothers and children to combat the incidence of diarrhoea. In addition, provisioning of sanitation and housing facilities may help positively to control diarrhoeal disease that could eventually reduce the incidence of child mortality.


Author(s):  
Shreyans D. Singhvi ◽  
Preksha T. Singh ◽  
Gautam Bhandari

Background: Children are the future of our country and hence their mental and physical wellbeing should be our upmost priority. Undernutrition is a major public health problem in our country and is one of the most common reasons for morbidity and mortality in children under 5yrs of age. The first few years of life are particularly important because vital development occurs in all domains. Therefore, this study has aimed to study the Intelligence Quotient (IQ) of the children of the age group 3-5 in urban and rural areas and study the factors associated with it.Methods: A cross section study of the children group of population was performed. Two sections of the children group were taken for the study- children population residing in an urban area and children population residing in a rural community of Rajasthan, India. The data was compiled and analyzed using appropriate statistical methods.Results: In our study, we have found that The following chosen demographic factors were found associated with children Intelligence quotient (IQ) - nutritional status, socioeconomic status, and age, while gender was not found to be associated with IQ.Conclusions: As, cognitive development is fairly important to children and their future, it should be paid more acknowledgment, as well as early preventive methods of it’s associated factors. 


Author(s):  
Vijaykumar P. Mane ◽  
Yuvaraj Banot Yenkanaik ◽  
Smita M. Nimbannavar ◽  
Anilkumar L. ◽  
Sharankumar Holyachi ◽  
...  

Background: Iodine deficiency disorders are recognized as major public health problem in India and the simplest, most effective and inexpensive preventive method is the consumption of Iodized salt. The objective of this study is to estimate the prevalence of goitre among children aged 6 to 12 years in rural areas of Koppal district, to determine various factors associated with goiter among children, to estimate the level of urinary iodine excretion among urine samples collected from children and to estimate the level of iodine content among salt samples collected in the study setting.Methods: A cross sectional study was conducted for a duration of 6 months from June 2018 to November 2018 in rural areas of Koppal district among 3047 school children aged 6 to 12 years selected by cluster sampling technique. Goiter was detected and graded using standard techniques and the collected salt and urine samples were sent to MRHRU, Sirwar, Raichur for analysis. Data was collected using pretested and semistructured questionnaire and was analyzed using WHO Epi info software version 3.5.4.Results: The prevalence of goitre among school children in Koppal district was 442 (14.5%) and it was found to be significantly associated with age and source of drinking water. Majority i.e., 65.96% of urine samples had iodine content less than 100 µg/l and majority i.e., 79.15% of salt samples had iodine content less than 15 PPM.Conclusions: Goiter is mild public health problem in Koppal district with majority of urine samples excreting iodine below optimum levels and majority of salt samples being inadequately iodized.


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