scholarly journals Influenza Illness and Partial Vaccination in the First Two Years of Life

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 676
Author(s):  
Abram L. Wagner ◽  
Lionel Gresh ◽  
Nery Sanchez ◽  
Guillermina Kuan ◽  
John Kubale ◽  
...  
Keyword(s):  
Regression Models ◽  
Linear Models ◽  
Signs And Symptoms ◽  
Vaccination Schedule ◽  
Middle Income ◽  
Future Studies ◽  
Logistic Regression Models ◽  
Middle Income Countries ◽  
Duration Of Illness ◽  
Influenza Illness

More information about influenza in low- and middle-income countries could guide the establishment of pediatric influenza vaccine programs. This study (1) characterizes the burden of influenza in infants, and (2) compares signs and symptoms by prior influenza vaccination or influenza illness. Newborns from Managua, Nicaragua, were followed for two years. Data came from primary medical appointments, PCR testing, and parents’ daily symptom diaries. Logistic regression models estimated associations between preceding vaccination or illness and influenza incidence. Linear models compared duration of illness by prior vaccination or influenza illness. Among 833 infants, 31% had PCR-positive influenza, and 28% were vaccinated against influenza. Four (<0.5%) were fully vaccinated. Overall, influenza incidence was 21.0 (95% confidence interval (CI): 18.8, 23.2) per 100 person-years. Incidence was lower among those with prior influenza compared with those without preceding illness or vaccination (OR: 0.64, 95% CI: 0.44, 0.94). Partially vaccinated children had 1 day less fever than those without prior illness or vaccination (p = 0.049). A large proportion of children <2 years in Nicaragua contract influenza. Illness was attenuated for those partially vaccinated. Since few children were fully vaccinated, future studies will need to consider the effectiveness of a two-dose vaccination schedule.

scholarly journals Infant malnutrition in low- and middle-income countries: assessment and prevalence of small and nutritionally at-risk infants aged under 6 months in 54 Demographic & Health Survey datasets

2021 ◽  
Author(s):  
Marko Kerac ◽  
Philip Thomas James ◽  
Marie McGrath ◽  
Eilise Brennan ◽  
Charles Opondo ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Logistic Regression ◽  
Data Quality ◽  
Regression Models ◽  
Middle Income ◽  
Logistic Regression Models ◽  
Middle Income Countries ◽  
Low Weight ◽  
Weight For Age

Background There is increasing global focus on malnutrition in infants aged under 6 months (u6m) but evidence on how best to identify and manage at-risk individuals is sparse. Our objectives were to: explore data quality of commonly used anthropometric indicators; describe prevalence and disease burden of infant u6m malnutrition; compare wasting and underweight as measures of malnutrition by determining the strength and consistency of associations with biologically plausible risk factors. Methods We performed a cross-sectional secondary analysis of Demographic and Health Survey (DHS) datasets, focussing on infants u6m. We calculated underweight (low weight-for-age), wasting (low weight-for-length), stunting (low length-for-age), and concurrent wasting and stunting. We explored data quality by recording extreme (flagged, as per standard criteria) or missing values. We calculated the population-weighted prevalence of each type of malnutrition and extrapolated the burden to all low- and middle- income countries (LMICs). We explored associations between infant, maternal and household risk factors with underweight and wasting using logistic regression models. Results We analysed 54 DHS surveys. Data quality in terms of refusals and missingness was similar for both weight and length. There were more extreme (flagged) values for length-based measures (6.1% flagged for weight-for-length, 4.8% for length-for-age) than for weight-for-age (1.0% flagged). Overall, 20.1% of infants (95% CI: 19.5, 20.7) were underweight, 21.3% (95% CI: 20.7, 22.3) were wasted, 17.6% (95% CI: 17.0, 18.2) were stunted, and 2.0% (95% CI: 1.8, 2.2) were concurrently wasted and stunted. This corresponds to an estimated burden in LMICs of 23.8m underweight infants, 24.5m wasted infants, 21.5m stunted infants and 2.2m concurrently wasted and stunted. Logistic regression models showed that numerous risk factors were associated with wasting and underweight. Effect sizes of risk factors tended to be stronger and more consistently associated with underweight compared to wasting. Conclusion Malnutrition in infants u6m is a major problem in LMICs. This is true whether assessed by underweight, wasting or stunting. Our data build on other evidence suggesting that underweight may be a better anthropometric case definition than wasting: data quality is better when length is not involved; biologically plausible risk factors are better reflected by an infant being underweight. Future research, ideally from intervention trials, should further explore how best to identify malnourished (small and nutritionally at-risk) infants u6m. For now, treatment programmes should note that many factors might underlie problems in this age group: services should thus consider how to address maternal health and wider social circumstances as well as caring for infants themselves.

scholarly journals Domestic violence, mental health, and repeat self-harm in Sri Lanka

2021 ◽  
Author(s):  
Piumee Bandara ◽  
Andrew Page ◽  
Thilini Rajapakse ◽  
Duleeka Kniipe
Keyword(s):  
Domestic Violence ◽  
Sri Lanka ◽  
Regression Models ◽  
Psychiatric Morbidity ◽  
Middle Income ◽  
Logistic Regression Models ◽  
Clinical Assessments ◽  
Middle Income Countries ◽  
Self Harm ◽  
Age And Sex

Background: Evidence on the risk factors for repeat self-harm from low- and middle-income countries is scarce and requires urgent attention. Aims: We sought to examine psychosocial correlates of repeat self-harm in Kandy, Sri Lanka. Methods: Logistic regression models (adjusting for age and sex) were used to examine associations between study factors and repeat self-harm among adult patients (N=292) admitted for self-poisoning. Results: Depression (OR 2.8 95% CI 1.7-4.7), prior psychiatric diagnosis (OR 4.8 95% CI 2.2-10.2), past-year exposure to suicidal behaviour (OR 1.9 95% 1.1-3.3), physical/sexual abuse (OR 3.0 95% CI 1.3-6.9), and psychological abuse (OR 2.3 95% CI 1.3-4.2) were strongly associated with repeat self-harm. Conclusions: Identification and management of domestic violence and psychiatric morbidity should be part of routine clinical assessments of patients presenting with self-harm.

scholarly journals Awareness, Attitudes, and Practices Toward Meningococcal B Vaccine among Pediatricians in Italy

Medicina ◽  
2018 ◽  
Vol 54 (6) ◽  
pp. 100
Author(s):  
Pietro Ferrara ◽  
Lucia Stromillo ◽  
Luciana Albano
Keyword(s):  
Regression Models ◽  
Positive Attitude ◽  
Daily Practice ◽  
Cross Sectional Study ◽  
Vaccination Schedule ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Attitudes And Practices ◽  
4Cmenb Vaccine

Background and objectives: Vaccination against bacterial pathogens is decisive for preventing invasive meningococcal disease and pediatricians play a pivotal role in vaccination compliance and coverage. The aim of this study was to investigate awareness, attitude, and practices toward the vaccine against Meningococcal B serogroup (4CMenB) among a sample of Italian pediatricians. Materials and Methods: A cross-sectional study was carried out using an online questionnaire from March to May 2015. Three multivariate logistic regression models were built to identify factors associated with the outcomes of interest. Results: The data showed that 95.5% of the interviewees correctly responded about the availability of 4CMenB vaccine in Italy, while only 28.0% knew the vaccination schedule for children aged two years or under. This knowledge was significantly higher in younger pediatricians and in those who worked a higher number of hours per week. Pediatricians self-reported a positive attitude toward the utility and safety of 4CMenB vaccine. Those pediatricians with a strong positive attitude toward the utility of the vaccine, who knew the vaccination schedules for children of two years or under, and who declared a satisfactory or good knowledge about the vaccine were more likely to inform parents about its availability in Italy, recommend the vaccination, and verify patients’ vaccination status, in their daily practice. Conclusions: The study highlights factors that currently influence pediatricians’ practices regarding the 4CMenB vaccine. The results showed the possible actions recommended to improve physicians’ awareness and behaviors in order to improve the vaccination compliance and invasive meningococcal diseases prevention.

Acute Medical Ward for better care coordination of patients admitted with infection – evidence from a tertiary hospital in Singapore

2017 ◽  
Vol 16 (4) ◽  
pp. 170-176
Author(s):  
Tharmmambal Balakrishnan ◽  
◽  
Pek Siang Edmund Teo ◽  
Wan Tin Lim ◽  
Xiao Hui Xin ◽  
...  
Keyword(s):  
Regression Models ◽  
Linear Models ◽  
Tertiary Hospital ◽  
General Ward ◽  
Medical Ward ◽  
South East Asia ◽  
Multivariate Models ◽  
Readmission Rates ◽  
Logistic Regression Models ◽  
Acute Admissions

Coordination and consolidation of care provided in acute care hospitals need reconfiguration and reorganization to meet the demand of large number of acute admissions. We report on the effectiveness of an Acute Medical Ward AMW (AMW) receiving cases that were suspected to have infection related diagnosis on admission by Emergency Department (ED), addressing this in a large tertiary hospital in South East Asia. Mean Length of Stay (LOS) was compared using Gamma Generalized Linear Models with Log-link while odds of readmissions and mortality were compared using logistic regression models. The LOS (mean: 5.8 days, SD: 9.1 days) of all patients admitted to AMW was similar to discharge diagnosis-matched general ward (GW) patients admitted before AMW implementation, readmission rates were lower (15-day: 5.3%, 30-day: 8.1%). Bivariate and multivariate models revealed that mean LOS after AMW implementation was not significantly different from before AMW implementation (Ratio: 0.99, p=0.473). Our AMW had reduced readmission rates for patients with infection but has not made an overall impact on the LOS and readmission rates for the epartment as a whole.

Abstract 24: Sex Differences in Outcomes After Out-of-Hospital Cardiac Arrest Patients: Insights From the Resuscitation Outcomes Consortium Continuous Chest Compression Trial

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Purav Mody ◽  
Ambarish Pandey ◽  
Rohan Khera ◽  
Colby Ayers ◽  
Mark Link ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Chest Compression ◽  
Regression Models ◽  
Neurological Function ◽  
Future Studies ◽  
Logistic Regression Models ◽  
Shockable Rhythm ◽  
Bystander Cpr ◽  
Sex Disparities ◽  
Hospital Cardiac Arrest

Background: Previous studies examining sex-based differences among out-of-hospital cardiac arrest (OHCA) patients have been conflicting. Methods: Patients with OHCA enrolled in the Continuous Chest Compression trial between 2011 and 2016 were included in the present analysis. Hierarchical multivariable logistic regression models were constructed to evaluate the association between sex and sustained ROSC i.e. ROSC on ER arrival, discharge survival and survival with favorable neurological function after adjustment for age, witnessed status, presenting rhythm, public location, bystander CPR, resuscitation duration, and EMS response time. Results: Among 22,540 OHCA patients, 8,099 (35.9%) were women. Women were older (median 71 vs. 67 years), received less bystander CPR (45% vs. 47%), and had a lower proportion of cardiac arrests that were witnessed (39% vs. 45%) or had an initial shockable rhythm (15% vs. 28%, p<= 0.001 for all). There was no difference in sustained ROSC rates (24.7% vs. 24.8%, p=0.7) but discharge survival (6.5% vs. 10.3%, p<0.001) and survival with favorable neurological function (4.9 vs. 8.6%, p<0.001) were significantly lower in women (vs. men). In adjusted analysis, women (vs. men) had significantly higher likelihood of sustained ROSC ( Table ) but no difference in likelihood of discharge survival and survival with favorable neurological function. In the adjusted landmark analysis beginning after achieving ROSC, women had significantly lower likelihood of discharge survival and survival with favorable neurological function ( Table ) . Conclusions: Among resuscitated OHCA patients, women have a higher likelihood of achieving sustained ROSC despite a higher burden of poor prognostic factors. However, after successful ROSC, the likelihood of discharge survival is significantly lower in women (vs. men). Future studies are needed to understand how care provided post-ROSC may modify the sex-disparities in discharge survival outcomes.

scholarly journals In-hospital mortality among incident hemodialysis older patients in Peru

2019 ◽  
Vol 12 (2) ◽  
pp. 142-147
Author(s):  
Percy Herrera-Añazco ◽  
Pedro J Ortiz ◽  
Jesus E Peinado ◽  
Tania Tello ◽  
Fabiola Valero ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Older Patients ◽  
Linear Models ◽  
Venous Catheter ◽  
Ageing Population ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Understanding the pattern of mortality linked to end stage renal disease (ESRD) is important given the increasing ageing population in low- and middle-income countries. Methods We analyzed older patients with ESRD with incident hemodialysis, from January 2012 to August 2017 in one large general hospital in Peru. Individual and health system-related variables were analyzed using Generalized Linear Models (GLM) to estimate their association with in-hospital all-cause mortality. Relative risk (RR) with their 95% confidence intervals (95% CI) were calculated. Results We evaluated 312 patients; mean age 69 years, 93.6% started hemodialysis with a transient central venous catheter, 1.7% had previous hemodialysis indication and 24.7% died during hospital stay. The mean length of stay was 16.1 days (SD 13.5). In the adjusted multivariate models, we found higher in-hospital mortality among those with encephalopathy (aRR 1.85, 95% CI 1.21-2.82 vs. without encephalopathy) and a lower in-hospital mortality among those with eGFR ≤7 mL/min (aRR 0.45, 95% CI 0.31-0.67 vs. eGFR&gt;7 mL/min). Conclusions There is a high in-hospital mortality among older hemodialysis patients in Peru. The presence of uremic encephalopathy was associated with higher mortality and a lower estimated glomerular filtration rate with lower mortality.

scholarly journals Associations of Plasma 3-Methylhistidine with Frailty Status in French Cohorts of the FRAILOMIC Initiative

2019 ◽  
Vol 8 (7) ◽  
pp. 1010 ◽  
Author(s):  
Bastian Kochlik ◽  
Wolfgang Stuetz ◽  
Karine Pérès ◽  
Catherine Féart ◽  
Jesper Tegner ◽  
...  
Keyword(s):  
Regression Models ◽  
Linear Models ◽  
Estimated Glomerular Filtration Rate ◽  
Community Dwelling ◽  
Functional Tests ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Frailty Status ◽  
Imaging Parameters ◽  
Frailty Criteria

Frailty and sarcopenia are characterized by a loss of muscle mass and functionality and are diagnosed mainly by functional tests and imaging parameters. However, more muscle specific biomarkers are needed to improve frailty diagnosis. Plasma 3-methylhistidine (3-MH), as well as the 3-MH-to-creatinine (3-MH/Crea) and 3-MH-to-estimated glomerular filtration rate (3-MH/eGFR) ratios might support the diagnosis of frailty. Therefore, we investigated the cross-sectional associations between plasma 3-MH, 3-MH/Crea and 3-MH/eGFR with the frailty status of community-dwelling individuals (>65 years). 360 participants from two French cohorts of the FRAILOMIC initiative were classified into robust, pre-frail and frail according to Fried’s frailty criteria. General linear models as well as bivariate and multiple linear and logistic regression models, which were adjusted for several confounders, were applied to determine associations between biomarkers and frailty status. The present study consisted of 37.8% robust, 43.1% pre-frail and 19.2% frail participants. Frail participants had significantly higher plasma 3-MH, 3-MH/Crea and 3-MH/eGFR ratios than robust individuals, and these biomarkers were positively associated with frailty status. Additionally, the likelihood to be frail was significantly higher for every increase in 3-MH (1.31-fold) and 3-MH/GFR (1.35-fold) quintile after adjusting for confounders. We conclude that 3-MH, 3-MH/Crea and 3-MH/eGFR in plasma might be potential biomarkers to identify frail individuals or those at higher risk to be frail, and we assume that there might be biomarker thresholds to identify these individuals. However, further, especially longitudinal studies are needed.

Mental Health Indicators of Suicide in Cambodian Women

2018 ◽  
Vol 30 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Stephanie E. Armes ◽  
Charity M. Somo ◽  
Sareth Khann ◽  
Desiree M. Seponski ◽  
Cindy J. Lahar ◽  
...  
Keyword(s):  
Health Indicators ◽  
Middle Income ◽  
Logistic Regression Models ◽  
Young Females ◽  
Middle Income Countries ◽  
Suicide Intervention ◽  
Lack Of Information ◽  
Nationally Representative ◽  
Health Need ◽  
Critical Public Health

Global suicide rates are steadily increasing, and suicide completions in Asia outnumber those in Western countries. Young females are especially at risk, with higher rates of completion and lack of suicide support because of familial and cultural stigma and constraints. Lack of infrastructure to systematically record suicide deaths and attempts makes studying suicide in low- and middle-income countries challenging. Given the critical public health need for suicide intervention and prevention, research on suicide is crucial. The present study adds to the lack of information regarding suicide in Cambodia by exploring reports of attempted suicide by women from a nationally representative sample of Cambodian women (N = 1813). In a series of logistic regression models, findings indicate that a culturally salient measure of Cambodian syndromes, symptoms of depression, and posttraumatic stress disorder contributed to increased odds of attempting to commit suicide. Implications for policymakers and interventionists within Cambodia and Asian contexts are discussed.

scholarly journals Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

2015 ◽  
Vol 19 (7) ◽  
pp. 1260-1269 ◽  
Author(s):  
Anahit Demirchyan ◽  
Varduhi Petrosyan ◽  
Viktoria Sargsyan ◽  
Kim Hekimian
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Regression Models ◽  
Severe Anaemia ◽  
Linear Regression Models ◽  
Middle Income ◽  
Middle Income Countries ◽  
Daily Diet ◽  
Younger Age ◽  
Low Middle Income Countries

AbstractObjectiveDespite the trend of increasing prevalence of childhood anaemia in Armenia, no studies exploring its risk factors have been conducted in the country. The present study aimed to investigate the prevalence and determinants of childhood anaemia in rural Armenia.DesignBlood Hb level was measured among a representative sample of children using the HemoCue Hb201+ analyser. The revealed cases with anaemia were compared with randomly selected non-anaemic controls. Mothers of cases and controls were interviewed. Logistic and linear regression models were fitted to identify the risk factors of anaemia and low Hb level, respectively.SettingTalin communities, Aragatsotn Province, Armenia.SubjectsChildren under 5 years of age in Talin region.ResultsOf the 729 studied children, 32·4 % were anaemic with 14·7 % having moderate/severe anaemia. Infants were the most affected group with 51·1 % being anaemic before 6 months and 67·9 % at 6–12 months of age. Fitted regression models identified the following predictors of anaemia: younger age, male gender, shorter birth length, anaemia during pregnancy, lower meal frequency per day, lack of meat in the diet, using dung cakes for heating and living in a community that received an incomplete set of nutrition interventions.ConclusionsThe study identified several modifiable risk factors that could be targeted to reduce childhood anaemia in rural Armenia and, possibly, in rural areas in other low-/middle-income countries. The suggested interventions include prevention and treatment of anaemia during pregnancy, provision of adequate complementary feeding to children with inclusion of meat in their daily diet and reduction of their exposure to biomass fuel smoke.

scholarly journals Is multimorbidity associated with risk of elder abuse? Findings from the AHSETS study

2021 ◽  
Author(s):  
Jaya Singh Kshatri ◽  
Trilochan Bhoi ◽  
Shakti Ranjan Barik ◽  
Subrata Kumar Palo ◽  
Sanghamitra Pati
Keyword(s):  
Older Adults ◽  
Elder Abuse ◽  
Functional Dependence ◽  
Economic Status ◽  
Middle Income ◽  
Logistic Regression Models ◽  
Mediating Role ◽  
Middle Income Countries ◽  
Katz Index ◽  
Care Models

Abstract Introduction: Commensurate with demographic and lifestyle transition, increasing magnitude of multimorbidity is common among older adults in low- and middle-income countries (LMIC). At the same time the rising prevalence of elder abuse is concurrently observed in these populations. However, little is known about the elder abuse in the context of multimorbidity with no reports on their interplay from LMIC settings. This study examined the association of multimorbidity with the risk of elder abuse and its correlates in a rural elderly population of Odisha, India. Methods: The data was collected as a part of our ASHETS study encompassing 725 older adults residing in rural Odisha, India. Multimorbidity was assessed by previously validated MAQ PC tool. Hwalek-Sengstock elder abuse screening test (HS-EAST) was used to assess the risk of elder abuse. Care dependence was measured by Katz index questionnaire. We performed ordinal logistic regression models to identify the correlates of elder abuse. Results: Around 48.8% (95% CI:45.13-52.53%) older adults had multimorbidity while 33.8% (95% CI:30.35-37.35%) had some form of care dependence. Out of 725, 56.6% (CI 52.85 – 60.19%) were found to be at low-risk elder abuse and 15.9% (CI 13.27 – 18.72%) being at high-risk . The risk of elder abuse was significantly associated with multimorbidity (AOR=1.88; 95%CI: 1.54-2.21), economic dependence (AOR=1.62; 95%CI: 1.25-1.99) and functional dependence (AOR=1.86; 95%CI: 1.42-2.29). Staying alone (AOR= 1.75; 95%CI: 1.13-2.38) and lower socio-economic status (AOR=2.96; 95%CI: 2.09-3.84) were two other significant correlates. Conclusions: Older adults with multimorbidity are at 1.88 times higher risk of elder abuse compared to their non-multimorbid counterparts. Both economic and functional dependence are associated with an increase in elder abuse. This suggests the mediating role of care dependence in the pathway to elder abuse in multimorbidity. Future geriatric multimorbidity assessment studies should consider screening for care dependence as well as elder abuse while designing integrated care models.

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