scholarly journals Spatial Modelling for Cholera Incidence Rates in Morogoro Municipality, Tanzania

2021 ◽  
Vol 47 (3) ◽  
pp. 1266-1281
Author(s):  
Caroline Ngereza ◽  
Rosalia S. Katapa ◽  
Ali R. Mniachi
Keyword(s):  
Risk Factors ◽  
Poisson Model ◽  
Spatial Modelling ◽  
Incidence Rates ◽  
Significant Positive Association ◽  
Spatial Lag ◽  
Community Factors ◽  
Factors Associated ◽  
Community Risk ◽  
Market Density

Spatial modelling was conducted to examine community factors associated with cholera incidence rates in Morogoro Municipality. The study employed both secondary (cholera cases) and primary (geographic coordinates of community risk factors) data. Spatial lag model was applied in examining association between the variables. All wards of Morogoro Municipality were considered in the study to capture their variations because cholera cases have a tendency to be clustered. Results indicated that market density, distance to the market and distance to the dumpster are significant factors associated with cholera incidence rates in the wards (p < 0.05). Geographically weighted Poisson model was used to show the variations of those factors between the wards in Municipality. A statistically significant positive association of cholera incidence rates; and market density was only found in Mazimbu ward (p < 0.05) and distance from the community to the dumpster was found in Kihonda, Kingolwira, Bigwa, Kichangani, Kilakala and Boma wards (p < 0.001) and some wards at the centre of the municipality which are Mji Mkuu and Kingo (p < 0.05). A statistically significant negative association of cholera incidence rates and distance from the centre of the community to the market was found in Kihonda, Kingolwira and Kichangani (p < 0.001) and Bigwa wards (p < 0.05). Therefore, measures taken to control and prevent cholera disease should base on the variations of the risk factors found in the Municipal wards. Keywords:    Cholera incidence rate; Spatial lag regression model; Community risk factor; Geographically weighted Poisson model

scholarly journals Enhanced infection control interventions reduced catheter-related bloodstream infections in the neonatal department of Hung Vuong Hospital, Vietnam, 2011–2012: a pre- and post-intervention study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Hang Thi Phan ◽  
Thuan Huu Vo ◽  
Hang Thi Thuy Tran ◽  
Hanh Thi Ngoc Huynh ◽  
Hong Thi Thu Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intervention Study ◽  
Bloodstream Infections ◽  
Incidence Rates ◽  
Intervention Period ◽  
Intravenous Catheter ◽  
Aseptic Technique ◽  
Post Intervention ◽  
Post Intervention Period ◽  
Factors Associated

Abstract Background Catheter-related bloodstream infections (CR-BSI) cause high neonatal mortality and are related to inadequate aseptic technique during the care and maintenance of a catheter. The incidence of CR-BSI among neonates in Hung Vuong Hospital was higher than that of other neonatal care centres in Vietnam. Methods An 18-month pre- and post-intervention study was conducted over three 6-month periods to evaluate the effectiveness of the intervention for CR-BSI and to identify risk factors associated with CR-BSI. During the intervention period, we trained all nurses in the Department of Neonatology on BSI preventive practices, provided auditing and feedback about aseptic technique during catheter care and maintenance, and reorganised preparation of total parenteral nutrition. All neonates with intravenous catheter insertion ≥48 h in the pre- and post-intervention period were enrolled. A standardised questionnaire was used to collect data. Blood samples were collected for cultures. We used Poisson regression to calculate rate ratio (RR) and 95% confidence interval (CI) for CR-BSI incidence rates and logistic regression to identify risk factors associated with CR-BSI. Results Of 2225 neonates enrolled, 1027 were enrolled in the pre-intervention period, of which 53 CR-BSI cases occurred in 8399 catheter-days, and 1198 were enrolled in the post-intervention period, of which 32 CR-BSI cases occurred in 8324 catheter-days. Incidence rates of CR-BSI significantly decreased after the intervention (RR = 0.61, 95% CI 0.39–0.94). Days of hospitalisation, episodes of non-catheter–related hospital-acquired infections, and the proportion of deaths significantly decreased after the intervention (p < 0.01). The CR-BSI was associated with days of intravenous catheter (odds ratio [OR] = 1.05, 95% CI 1.03–1.08), use of endotracheal intubation (OR = 2.27, 95% CI 1.27–4.06), and intravenous injection (OR = 8.50, 95% CI 1.14–63.4). Conclusions The interventions significantly decreased the incidence rate of CR-BSI. Regular refresher training and auditing and feedback about aseptic technique during care and maintenance of catheters are critical to reducing CR-BSI.

scholarly journals Living on the Edge of the Community: Factors Associated with Discontinuation of Community Living Among People with Cognitive Impairment

2020 ◽  
Author(s):  
Chiaki Ura ◽  
Tsuyoshi Okamura ◽  
Mika Sugiyama ◽  
Fumiko Miyamae ◽  
Mari Yamashita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Multiple Logistic Regression Analysis ◽  
Epidemiological Survey ◽  
Community Living ◽  
Baseline Survey ◽  
Community Factors ◽  
Factors Associated ◽  
Rights Protection ◽  
Term Insurance

Abstract BackgroundThe experiences of people with cognitive impairment in the real world have not been fully explored because of methodological difficulties. This study re-accessed people with cognitive impairment identified in a previous epidemiological survey to explore their current situation and the risk factors associated with all-cause discontinuation of community living.MethodsIn 2016, a three-step survey was conducted of 7,614 older residents. In the last step of the survey, a research team visited the homes of 198 participants with a Mini-Mental State Examination score <24. In 2019, we re-accessed these people. We ran a community space in the study area for 3 years to build partnerships with community residents and community workers, and were able to re-access the participants using multiple methods.ResultsWe found that 126 (63.6%) participants had continued living in the same community, but 58 (29.3%) had discontinued community living. Of these, 18 (9.1%) had died, 18 (9.1%) were institutionalized, 9 (4.5%) were hospitalized, and 13 (6.6%) had moved out of the community. A multiple logistic regression analysis identified the following risk factors associated with discontinuation of community living: being certified under long-term insurance, needing housing support, and needing rights protection.ConclusionsThree years after the baseline survey, 29.3% people with cognitive impairment had discontinued community living. Despite having dementia or living alone, older people could continue to live in the community if their needs for housing support and rights protection were met. Both social interventions and medical interventions are important to build age-friendly communities.Trial registrationUMIN, UMIN000038189,　Registered 3 October 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043521

Symptomatic Venous Thromboembolism After Achilles Tendon Rupture: A Nationwide Danish Cohort Study of 28,546 Patients With Achilles Tendon Rupture

2019 ◽  
Vol 47 (13) ◽  
pp. 3229-3237 ◽  
Author(s):  
Melissa Hornbæk Pedersen ◽  
Liv Riisager Wahlsten ◽  
Henrik Grønborg ◽  
Gunnar Hilmar Gislason ◽  
Michael Mørk Petersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Nonoperative Treatment ◽  
Incidence Rates ◽  
Factors Associated ◽  
Increased Risk ◽  
Male Sex

Background: Venous thromboembolism (VTE) is a well-known complication of Achilles tendon rupture (ATR) and carries a high risk of morbidity and mortality. Although routine thromboprophylaxis for patients with ATR is not recommended, sparse knowledge is available regarding risk factors associated with VTE in patients with ATR. Purpose: To use Danish nationwide registers to identify incidence rates for symptomatic VTE and risk factors associated with increased risk of developing VTE in patients with ATR. Study Design: Cohort study; Level of evidence, 3. Methods: By crosslinking nationwide registers, we identified all patients with diagnosed ATR in Denmark from 1997 to 2015. We stratified patients into 4 groups by age and treatment modality (ie, operative vs nonoperative treatment). The main outcome was VTE within 180 days. We calculated crude incidence rates and considered age, sex, year, comorbidities, and medications as risk factors for VTE in Poisson regression models. Results: We identified 28,546 patients with ATR, of whom 389 (1.36%) were hospitalized with VTE during the follow-up period: 278 due to deep vein thromboses and 138 due to pulmonary embolism. Incidence rates were highest during the first month and ranged from 4.6 to 14.6 events per 100 person-years. VTEs were most frequent among nonoperatively treated patients aged ≥50 years. In Poisson regression analyses, having had VTE beforehand was associated with an increased risk of VTE, as was male sex in the nonoperative treatment group aged ≥50 years; among women <50 years of age, hormonal contraceptives led to a 4- to 6-fold higher risk of VTE compared with patients in the same group without the equivalent risk factor. Conclusion: In this nationwide cohort of patients with ATR, 1.36% developed symptomatic VTE during follow-up. Hormonal contraception, previous VTE, older age group, and male sex increased the risk of VTE. Taken together, the results of the present study suggest that focus on risk stratification and initiatives to prevent VTE might be warranted. A randomized controlled trial could answer this question.

scholarly journals Factors Associated with SARS-CoV-2 Infection in Resident Physicians and Fellows in New York City During the First COVID-19 Wave

2021 ◽  
Author(s):  
Kate R Pawloski ◽  
Betty Kolod ◽  
Rabeea F Khan ◽  
Vishal Midya ◽  
Tania Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Mixed Effect ◽  
Community Factors ◽  
Factors Associated ◽  
Resident Physicians

Risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well-defined in resident physicians and fellows (trainees). We aimed to identify sociodemographic, occupational and community factors associated with SARS-CoV-2 infection among trainees during the first wave of the coronavirus disease 2019 (COVID-19) pandemic in New York City (NYC). In this retrospective cohort study, we administered an electronic survey between June 26 and August 31, 2020 to trainees at the Mount Sinai Health System in NYC to assess risk factors for SARS-CoV-2 infection between February 1 and June 30, 2020. We used Bayesian generalized linear mixed effect regression and structural equation models to examine associations. SAR-CoV-2 infection was determined by self-reported IgG antibody and reverse transcriptase-polymerase chain reaction results and confirmed with laboratory results. Among 2354 trainees invited to participate, 328 (14%) completed the survey and reported test results. The cumulative incidence of SARS-CoV-2 infection was 20.1%. Assignment to medical-surgical units (odds ratio [OR], 2.51; 95% CI, 1.18-5.34), and training in emergency medicine, critical care and anesthesiology (OR, 2.93; 95% CI, 1.24-6.92) were independently associated with infection. Deployment to care for unfamiliar patient populations was protective against infection (OR, 0.16; 95% CI, 0.03-0.73). Community factors were not significantly associated with infection after adjustment for occupational factors. Our findings may inform tailored infection prevention strategies for trainees responding to the COVID-19 pandemic.

scholarly journals Are maternal and community risk factors associated with the presence of asthma among children placed in foster care?

2013 ◽  
Vol 35 (1) ◽  
pp. 128-132 ◽  
Author(s):  
Jessica Hellyer ◽  
Edward F. Garrido ◽  
Christie L.M. Petrenko ◽  
Heather N. Taussig
Keyword(s):  
Risk Factors ◽  
Foster Care ◽  
Factors Associated ◽  
Community Risk ◽  
Community Risk Factors

scholarly journals Metabolic Syndrome in Arab Adults with Low Bone Mineral Density

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1405 ◽  
Author(s):  
Kaiser Wani ◽  
Sobhy M. Yakout ◽  
Mohammed Ghouse Ahmed Ansari ◽  
Shaun Sabico ◽  
Syed Danish Hussain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Metabolic Syndrome ◽  
Bone Loss ◽  
Central Obesity ◽  
Positive Association ◽  
Mineral Density ◽  
Significant Positive Association ◽  
Factors Associated ◽  
T Score

There are discrepancies in the reports on the association of metabolic syndrome (MetS) and its components with bone mineral density (BMD) and hence more population-based studies on this subject are needed. In this context, this observational study was aimed to investigate the association between T-scores of BMD at lumbar L1–L4 and full MetS and its individual components. A total of 1587 participants (84.7% females), >35 years and with risk factors associated with bone loss were recruited from February 2013 to August 2016. BMD was done at L1–L4 using dual-energy X-ray absorptiometry (DXA). T-Scores were calculated. Fasting blood samples and anthropometrics were done at recruitment. Fasting lipid profile and glucose were measured. Screening for full MetS and its components was done according to the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. Logistic regression analysis revealed that the odds of having full MetS increased significantly from the lowest T-score tertile to the highest one in both sexes (OR, odd ratio (95% CI, confidence interval) of tertile 2 and 3 at 1.49 (0.8 to 2.8) and 2.46 (1.3 to 4.7), p = 0.02 in males and 1.35 (1.0 to 1.7) and 1.45 (1.1 to1.9), p < 0.01 in females). The odds remained significant even after adjustments with age, body mass index (BMI), and other risk factors associated with bone loss. Among the components of MetS, only central obesity showed a significant positive association with T-score. The study suggests a significant positive association of T-score (spine) with full MetS irrespective of sex, and among the components of MetS this positive association was seen specifically with central obesity.

scholarly journals Incidence and Risk Factors of Immediate Hypersensitivity Reactions and Immunisation Stress-related Responses with COVID-19 mRNA Vaccine

2022 ◽  
Author(s):  
Kazuo Imai ◽  
Fumika Tanaka ◽  
Shuichi Kawano ◽  
Kotoba Esaki ◽  
Junko Arakawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vasovagal Syncope ◽  
Conditional Logistic Regression ◽  
Incidence Rates ◽  
Thyroid Diseases ◽  
Mass Vaccination ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Factors Associated ◽  
History Of

Background: With the implementation of mass vaccination campaigns against COVID 19, the safety of vaccine needs to be evaluated. Objective: We aimed to assess the incidence and risk factors for immediate hypersensitivity reactions (IHSR) and immunisation stress related responses (ISRR) with the Moderna COVID 19 vaccine. Methods: This nested case control study included recipients who received the Moderna vaccine at a mass vaccination centre, Japan. Recipients with IHSR and ISRR were designated as cases 1 and 2, respectively. Controls 1 and 2 were selected from recipients without IHSR or ISRR and matched (1:4) with cases 1 and cases 2, respectively. Conditional logistic regression analysis was used to identify risk factors associated with IHSR and ISRR. Results: Of the 614,151 vaccine recipients who received 1,201,688 vaccine doses, 306 recipients (cases 1) and 2,478 recipients (cases 2) showed 318 events of IHSR and 2,558 events of ISRR, respectively. The incidence rates per million doses were estimated as IHSR: 266 cases, ISRR: 2,129 cases, anaphylaxis: 2 cases, and vasovagal syncope: 72 cases. Risk factors associated with IHSR included female, asthma, atopic dermatitis, thyroid diseases, and history of allergy; for ISRR, they were younger age, female, asthma, thyroid diseases, mental disorders, and a history of allergy and vasovagal reflex. Conclusion: In the mass vaccination settings, the Moderna vaccine can be used safely owing to the low incidence rates of IHSR and anaphylaxis. However, providers should beware of the occurrence of ISRR. Risk factor identification may contribute to the stratification of high risk recipients for IHSR and ISRR.

scholarly journals Spatial analysis and mapping of child malnutrition in Burkina Faso

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Chuang
Keyword(s):  
Regression Analysis ◽  
Burkina Faso ◽  
Spatial Regression ◽  
Sub Saharan Africa ◽  
Child Malnutrition ◽  
Spatial Lag ◽  
Community Factors ◽  
Factors Associated ◽  
Geographical Variations ◽  
Spatial Regression Analysis

Abstract Background Approximately 45% of all child deaths are associated with malnutrition in sub-Saharan Africa. However, information on the geographical variations of child malnutrition in Burkina Faso is limited. This study examined the geographical distribution and the community characteristics associated with child malnutrition in Burkina Faso using spatial regression analysis. Methods Data from the 2011 Burkina Faso Demographic Health Survey were analyzed. A representative sample of 572 communities and 6,120 children under age of five were in the survey. A general Kriging interpolation method was used to generate spatial malnutrition patterns. The Local Indicator of Spatial Autocorrelation was used to identify particular communities clustering with high and low child malnutrition scores. In the spatial regression analysis, we used a two-step procedure combining generalized estimating equation models (GEE) and spatial lag modeling techniques. Results The average rates of stunting and wasting were 32.48%, and 15.05%, respectively. Stunting hotspots were observed to be in the eastern and northeastern part of Burkina Faso (i.e. Oudolan, Séno), while high rates of wasting were observed in the central-north part. The results of the spatial regression analysis revealed lower stunting rates in communities with a higher percentage of households with improved sanitation. Communities with higher rates of professionally assisted births were associated with low wasting rates while communities with higher rates of households with low wealth index reported higher rates of wasting. Spatial lag models appeared to estimate the relationship between community-level risk factors and stunting and wasting more accurately than the ordinary least squares models. Conclusions This study revealed significant geographical patterns and community factors associated with childhood malnutrition. These factors should be considered for future programs aiming at reducing child malnutrition in Burkina Faso. Key messages The study identifies spatial trends and contextual factors associated with child malnutrition in Burkina Faso. Public health programs should focus on the regions identified as hot spots of child malnutrition in Burkina Faso.

scholarly journals A Retrospective Study of Macropod Progressive Periodontal Disease (“Lumpy Jaw”) in Captive Macropods across Australia and Europe: Using Data from the Past to Inform Future Macropod Management

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 1954
Author(s):  
Jessica Rendle ◽  
Bethany Jackson ◽  
Stephen Vander Hoorn ◽  
Lian Yeap ◽  
Kristin Warren ◽  
...  
Keyword(s):  
Risk Factors ◽  
Periodontal Disease ◽  
Health Management ◽  
Disease Risk ◽  
Positive Impact ◽  
Management Strategies ◽  
Epidemiological Data ◽  
Incidence Rates ◽  
High Morbidity ◽  
Factors Associated

Macropod Progressive Periodontal Disease (MPPD) is a well-recognised disease that causes high morbidity and mortality in captive macropods worldwide. Epidemiological data on MMPD are limited, although multiple risk factors associated with a captive environment appear to contribute to the development of clinical disease. The identification of risk factors associated with MPPD would assist with the development of preventive management strategies, potentially reducing mortality. Veterinary and husbandry records from eight institutions across Australia and Europe were analysed in a retrospective cohort study (1995 to 2016), examining risk factors for the development of MPPD. A review of records for 2759 macropods found incidence rates (IR) and risk of infection differed between geographic regions and individual institutions. The risk of developing MPPD increased with age, particularly for macropods >10 years (Australia Incidence Rate Ratio (IRR) 7.63, p < 0.001; Europe IRR 7.38, p < 0.001). Prognosis was typically poor, with 62.5% mortality reported for Australian and European regions combined. Practical recommendations to reduce disease risk have been developed, which will assist zoos in providing optimal long-term health management for captive macropods and, subsequently, have a positive impact on both the welfare and conservation of macropods housed in zoos globally.

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