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1.
BMC Health Serv Res ; 22(1): 40, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34996445

RESUMO

BACKGROUND: Childhood vaccination is an important public health intervention but there is limited information on coverage, trends, and determinants of vaccination completion in Uganda at the regional level. We examined trends in regional vaccination coverage and established the determinants of vaccination completion among children aged 12-23 months in Uganda. METHODS: We analyzed data from the women's questionnaire for the 1995-2016 Uganda Demographic Health Survey (UDHS). Vaccine completion was defined as having received a dose of Bacillus-Calmette Guerin (BCG) vaccine; three doses of diphtheria, pertussis, and tetanus (DPT) vaccine; three doses of oral polio vaccine (OPV) (excluding OPV given at birth); and one dose of measles vaccine. We performed Chi-square tests to compare vaccination completion by socio-demographic factors stratified by 10 sub-regions: Eastern, East Central, Central 1, Central 2, Kampala, Karamoja, North, Western, West Nile, and Southwest. We performed logistic regression analysis for each of the regions to identify factors associated with vaccination completion at 5% level of statistical significance. RESULTS: Overall vaccination completion was 48.6% (95%CI, 47.2, 50.1) and ranged from 17.3% in Central 1 to 65.9% in Southwest. Vaccination completion rates declined significantly by 10.4% (95% confidence interval (CI), - 16.1, - 4.6) between 1995 and 2000, and increased significantly by 10.0% (95% CI, 4.6, 15.4) between 2000 and 2006, and by 5.4% (95% CI, 0.2, 10.6) between 2006 and 2011. Maternal education (secondary or higher level), receipt of tetanus toxoid (TT) during pregnancy, and possession of a child health card were associated with vaccination completion across all the sub-regions. Other factors like place of residence, religious affiliation, household wealth, maternal age, childbirth order, size of child at birth, and place of delivery were associated with vaccination completion but differed between the 10 sub-regions. CONCLUSION: Besides considerable regional variations, the vaccination completion rate among children aged 12-23 months in Uganda remains suboptimal despite the availability of vaccines. Maternal education, receipt of TT, and possession of a child health card are associated with a higher likelihood of vaccination completion among children aged 12-23 months in all the regions of Uganda. Interventions to improve the utilization of vaccination services in Uganda should consider these factors.


Assuntos
Vacina contra Sarampo , Vacinação , Criança , Demografia , Feminino , Inquéritos Epidemiológicos , Humanos , Programas de Imunização , Lactente , Recém-Nascido , Gravidez , Uganda
2.
Mymensingh Med J ; 31(1): 66-71, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34999682

RESUMO

Scrub typhus is one of the leading causes of undifferentiated treatable febrile illness in Asia pacific region. It is grossly under diagnosed in many tropical countries of South Asia including Bangladesh, due to wide range of non-specific clinical presentations, low index of suspicion among clinicians, limited awareness and lack of accurate diagnostic facilities. This cross sectional observational study was conducted at department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from March 2019 to February 2020 enrolling 113 diagnosed cases of scrub typhus by Immunochromatographic test (ICT) and / or Nested PCR to characterize the socio-demographic and clinico-epidemiological features of scrub typhus in Mymensingh area. Majority of the scrub typhus cases came from rural areas (63.83%) and there was a slight female predominance (52.21%). The young (32.74%) and the young-adult age group (28.31%) were mostly affected. Most of the scrub typhus cases were housewives (30.98%), followed by farmers (23.89%) and students (21.23%). All the enrolled cases presented with fever. Other findings were myalgia (76.10%), headache (56.63%), cough (30.97%), vomiting (12.38%) and Respiratory distress (9.73%). Typical eschar of scrub typhus was present only in 9(7.96%) cases and 4(3.53%) patients had rashes on their skin. Few cases (3.53%) had jaundice and 15.96% cases were anaemic. Oliguria (7.96%) and neck rigidity (1.76%) were also documented. Most of the Nested PCR positive scrub typhus cases were documented during late rainy season and beginning of winter months. Findings of the study may offer increased awareness about high burden of scrub typhus as well as heightened suspicion among clinicians for early diagnosis, timely treatment and prevention of complications.


Assuntos
Tifo por Ácaros , Bangladesh/epidemiologia , Estudos Transversais , Demografia , Feminino , Humanos , Índia , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/epidemiologia , Centros de Atenção Terciária
3.
J Environ Manage ; 304: 114280, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-35021588

RESUMO

Previous studies on the supply and demand of ecosystem services (ES) mainly focused on inter-annual changes, and no studies have explored the impact of demographic change on the ES supply and demand on fine-grained time scales. Thus, taking Shenzhen as an example, the status of ES supply and demand, as well as diurnal population changes and their impacts on cultural services were analyzed at different time periods using mobile phone signaling data, ecological supply-demand ratio (ESDR), Geo-Informatic Tupu, InVEST model and buffer zone. The results showed that the population declines successively on workdays, weekends and holidays, and that the daytime population is greater than the nighttime. Water yield services can basically meet the demand in terms of quantity and spatial distribution, however, carbon sequestration and cultural services showed the opposite results. The main type of ESDR changes in cultural services are the mutual conversion of deficit and balance, and these are concentrated in areas with high forest coverage and small populations, but frequent population changes. In addition, when the fixed population is too large, the use of time-varying population data will conceal the impact of demographic changes on ES supply and demand, and other data are needed for auxiliary analysis. Overall, this study provides a new research perspective for the ES supply and demand and can provide a theoretical basis for refined sustainable urban management.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Sequestro de Carbono , China , Demografia
4.
N C Med J ; 83(1): 17-21, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34980647

RESUMO

Gale-force demographic disruptors such as unequal population growth can potentially prevent our state from achieving the exemplary goals and targeted outcomes set forth in Healthy North Carolina 2030 These forces also present opportunities if carefuly addressed. Policy prescriptions and strategic investments required to ensure success are outlined here, following an overview of demographic drivers that create public health vulnerabilities.


Assuntos
Equidade em Saúde , Vento , Demografia , Humanos , North Carolina , Saúde Pública
5.
Acta Neurol Taiwan ; 31(1): 15-23, 2022 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-34988950

RESUMO

OBJECTIVE: Neurofibromatosis is one of the most common dominantly inherited genetic disorders. This study aimed to study the demographic and clinical profile of neurofibromatosis patients. METHODS: This study is cross-sectional conducted in 2020 on the population of patients with neurofibromatosis. Patients who are members of the Neurofibromatosis Association answered the online demographic and clinical information questionnaire. RESULTS: 446 patients with neurofibromatosis participated in this study with a mean age of 33.39 plus or minus 12.87 years. 297 patients (66.6%) were women and 378 (84.8%) patients had type 1 neurofibromatosis. The disease visibility was reported to be moderate in 254 patients (54.9%) and the severity of the disease was mild in 238 (53.4%) patients. The type of neurofibromatosis was not significantly related to gender, age groups, parental education, and ethnicity. The relationship between severity and age (p is equal to less than 0.001) and gender (p is equal to 0.042) was significant and the relationship between visibility and age (p is equal to less than 0.001) was significant but despite the fact that the disease was more visible in men than women, it was not significantly related to gender. CONCLUSIONS: The study results showed that the most common complication in the study population was Cafe au lait spot. In addition, visibility and severity of the disease were mild and moderate, respectively. Keyword: Neurofibromatosis, Demographic information, Clinical Information.


Assuntos
Neurofibromatose 1 , Doenças Raras , Adulto , Manchas Café com Leite , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Neurofibromatose 1/epidemiologia
6.
Res Aging ; 44(1): 22-33, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33472553

RESUMO

Touch is an important element of human social interaction linked to various dimensions of well-being, but we know little of how it is distributed among older adults. This study considers whether greeting/affectionate touch is a function of characteristics such as race, gender, and socioeconomic status. Data come from Wave 1 (2005-2006) of the NSHAP study from the United States. Results reveal that women experienced more frequent touch relative to men, net of several features of the interpersonal environment. Mediation analyses revealed that gender differences in associations with touch were partially explained by women's greater participation in formal and informal social activity. No patterns were detected related to race, education, or wealth. This study situates greeting/affectionate touch as a form of corporeal non-verbal interaction that offers a unique lens into patterns of social connection. We close by considering what this form of interaction means in the wake of the COVID-19 pandemic.


Assuntos
COVID-19 , Tato , Idoso , Demografia , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2 , Estados Unidos
7.
Sci Total Environ ; 806(Pt 2): 150564, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34582859

RESUMO

Prescribed fire is an increasingly important tool in restoring ecological conditions and reducing uncontrolled wildfire. Prescribed burn techniques could reduce public health impacts associated with wildfire smoke exposure. However, there have been few assessments of the health impacts of prescribed burning, and potential vulnerabilities among populations exposed to smoke from prescribed fires. Our study area focused on counties in and near U.S. National Forests - a set of lands distributed across the U.S. In county-level analyses, we compared the sociodemographic and health characteristics of areas that were exposed with those that were not exposed to prescribe burns during the years 2010-2019 on a national level and within three regions. In addition, using spatial error regression models, we looked for associations between prescribed fire exposure and health behaviors and outcomes while controlling for spatial autocorrelation. On a national level, we found disproportionate prescribed fire exposure in rural counties with higher percentage mobile home and vacant housing units, and higher percentage African-American and white populations. Regionally, we found evidence of disproportionate exposure to prescribed burns among counties with lower percentage white population, higher percentage Hispanic population and mobile homes in the southern region, and to high poverty counties with high vacancy in the western region. These findings could indicate that vulnerable populations face potential health risks from prescribed burning smoke exposure, but also that they are not missing out on the benefits of prescribed burning, which could involve considerably lower smoke exposure compared to uncontrolled wildfire. In addition, in regression analyses, we found no evidence of disproportionate health burden in exposed compared to unexposed counties. Awareness of these patterns could influence both large-scale or institutional polices about prescribed burning practice, and could be used to build decision-making factors into modeling tools and smoke management plans, as well as community-engagement around wildfire risk reduction.


Assuntos
Queimaduras , Incêndios , Demografia , Florestas , Humanos , Fumaça
8.
Inquiry ; 58: 469580211062426, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34913376

RESUMO

Population aging is an economic and social challenge in most countries in the world as it generates higher dependency rates and increased demand for long-term care. Undertaking the care of older dependent adults can result in new opportunities for job creation. There is limited knowledge of the impact of dependent care and long-term care on employment. We examined this impact through a systematic review. Countries with conditional cash benefits show job creation, and countries with unconditional economic benefits reveal the development of a grey care market with high participation of migrant labor. Migrant employment in developed countries affects the development of the labor market in the countries of origin. The employment created to care for dependent persons is generally precarious. In conclusion, global aging will increase long-term care worker demand, but the variations in policies can determine what kind of employment is created.


Assuntos
Mão de Obra em Saúde , Assistência de Longa Duração , Adulto , Envelhecimento , Demografia , Emprego , Humanos , Dinâmica Populacional
10.
Ann Glob Health ; 87(1): 114, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34900614

RESUMO

Background and aims: Childhood acute malnutrition, in the form of wasting defined by a severe weight loss as a result of acute food shortage and/or illness. It is a critical public health problem that needs urgent attention in developing countries, like Ethiopia. Despite its variation between localities, the risk factors and its geospatial variation were not addressed enough across the various corner of the country. Therefore, the current study was undertaken to assess spatial variation and factors associated with acute malnutrition among under-five children in Ethiopia. Methods: A total weighted sample of 4 955 under-five children were included from the 2019 Demographic and Health Survey. Getis-Ord spatial statistical tool used to identify the hot and cold spot areas of severe and acute malnutrition. A multilevel multivariable logistic regression model using was used to examine predictors of acute malnutrition. In the multivariable multilevel analysis, Adjusted Odds Ratio with 95% CI was used to declare significant determinants of acute malnutrition among children. Result: Among 4 955 under-five children, 7% of them were wasted and 1% of them were severely wasted in Ethiopia during the 2019 national demographic survey. The distribution was followed some spatial geo-locations where most parts of Somali were severely affected (RR = 1.46, P37 value <0.001), and the distribution affected few areas of Afar, Gambella, and Benishangul Gumz regions. Factors that significantly associated with childhood wasting were: gender(male)1.9 (1.3-2.7), age (above 36 months) 0.5 (0.2-0.9), wealth index(richest) 0.5 (0.2-0.8), and water source (unimproved source) 1.5 (1.0-2.3). Conclusions: Our finding implies, the distribution of childhood wasting was not random. Regions like Afar, Somali, and pocket areas in Gambella and SNNP should be considered as priority areas nutritional interventions for reducing acute malnutrition. The established socio-demographic and economic characteristics can be also used to develop strategies.


Assuntos
Desnutrição , Criança , Pré-Escolar , Demografia , Etiópia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Análise Espacial
11.
PLoS One ; 16(12): e0260812, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34914747

RESUMO

Understanding the points in a species breeding cycle when they are most vulnerable to environmental fluctuations is key to understanding interannual demography and guiding effective conservation and management. Seabirds represent one of the most threatened groups of birds in the world, and climate change and severe weather is a prominent and increasing threat to this group. We used a multi-state capture-recapture model to examine how the demographic rates of a long-lived trans-oceanic migrant seabird, the Manx shearwater Puffinus puffinus, are influenced by environmental conditions experienced at different stages of the annual breeding cycle and whether these relationships vary with an individual's breeding state in the previous year (i.e., successful breeder, failed breeder and non-breeder). Our results imply that populations of Manx shearwaters are comprised of individuals with different demographic profiles, whereby more successful reproduction is associated with higher rates of survival and breeding propensity. However, we found that all birds experienced the same negative relationship between rates of survival and wind force during the breeding season, indicating a cost of reproduction (or central place constraint for non-breeders) during years with severe weather conditions. We also found that environmental effects differentially influence the breeding propensity of individuals in different breeding states. This suggests individual spatio-temporal variation in habitat use during the annual cycle, such that climate change could alter the frequency that individuals with different demographic profiles breed thereby driving a complex and less predictable population response. More broadly, our study highlights the importance of considering individual-level factors when examining population demography and predicting how species may respond to climate change.


Assuntos
Migração Animal/fisiologia , Cruzamento , Mudança Climática , Demografia/estatística & dados numéricos , Ecossistema , Reprodução , Estações do Ano , Animais , Aves , Oceanos e Mares
12.
An. Fac. Cienc. Méd. (Asunción) ; 54(3): 119-128, Dec. 2021.
Artigo em Espanhol | LILACS | ID: biblio-1352967

RESUMO

Introducción: La sarcoidosis es una enfermedad inflamatoria, granulomatosa de etiología desconocida. Puede afectar cualquier órgano siendo la afectación pulmonar la más frecuente. La piel se compromete en aproximadamente 30% de los casos, pudiendo ser inicial o único. La sarcoidosis es muy rara en el Paraguay. Objetivos: Realizar una revisión de los casos de sarcoidosis observados en el Servicio de Dermatología del Hospital Nacional en el periodo 2010-2020; determinando sus características demográficas, clínicas, laboratoriales y evolutivas. Materiales y métodos: Estudio retrospectivo, descriptivo y observacional. Resultados: Se diagnosticaron 5 casos, todas mujeres de raza blanca, con edades que oscilaban de 41 a 63 años. Las formas clínicas fueron papulosa en 3 casos, en placa 1 y mixta 1. Las lesiones cutáneas eran asintomáticas y estaban ubicadas preferentemente en rostro (4 casos). El compromiso sistémico se objetivó en las primeras consultas en 2 casos (pulmonar, ocular y ganglionar en 1 y del aparato lagrimal en otro). En todos los casos el diagnóstico se fundamentó en la correlación clínico-histológica, con el hallazgo de los granulomas sarcoides. Todos recibieron clobetasol tópico, 3 pacientes ciclos de prednisona y 2 hidroxicloroquina. La evolución fue favorable en 3 casos y 2 no volvieron a sus controles. Conclusión: La sarcoidosis con manifestaciones cutáneas es rara en nuestro Servicio, pero representa un desafío diagnóstico, que debe ser oportuno para diferenciarla de otras patologías más prevalentes en nuestro medio


Introduction: Sarcoidosis is an inflammatory, granulomatous disease of unknown etiology. It can affect any organ, lung involvement being the most frequent. The skin is compromised in approximately 30% of the cases, and can be initial or unique. Sarcoidosis is very rare in Paraguay. Objectives: To carry out a review of the sarcoidosis cases observed in the Dermatology Service of the National Hospital in the period 2010-2020; determining their demographic, clinical, laboratory and evolutionary characteristics. Materials and methods: Retrospective, descriptive and observational study. Results: 5 cases were diagnosed; all white women; with ages ranging from 41 to 63 years. The clinical forms were papular in 3 cases, in plate 1 and mixed 1. The skin lesions were asymptomatic and were preferably located on the face (4 cases). Systemic involvement was observed in the first consultations in 2 cases (pulmonary, ocular and lymph node in 1 and the lacrimal apparatus in another). In all cases the diagnosis was based on the clinical-histological correlation, with the finding of sarcoid granulomas. All received topical clobetasol, 3 patients received prednisone cycles and 2 hydroxychloroquine. The evolution was favorable in 3 cases and 2 did not return to their controls. Conclusion: Sarcoidosis with skin manifestations is rare in our Service, but it represents a diagnostic challenge that must be timely to differentiate it from other more prevalent pathologies in our setting


Assuntos
Sarcoidose , Patologia , Pele , Demografia , Doença , Dermatologia , Diagnóstico , Laboratórios
13.
PLoS One ; 16(12): e0262032, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34972156

RESUMO

Diseases from food of animal origin are common health problems in Ethiopia. A cross-sectional study was carried out to estimate health and economic burden, and to identify demographic factors associated with community awareness of foodborne zoonotic diseases in Amhara region, Ethiopia. Data was collected from 435 households in three towns: Gondar, Lalibela and Debark. A retrospective data was also collected from health records in each town. The health burden due to zoonotic diseases was estimated at 0.2, 0.1 and 1.3 DALYs per household per year and at 73.2, 146.6 and 1,689.5 DALYs out of 100,000 populations per year in Gondar, Lalibela and Debark, respectively. The overall health burden due to foodborne zoonotic diseases (aggregated over the 435 households in the three towns) was estimated to be 89.9 DALYs per 100,000 populations per year. The economic impact of foodborne zoonotic diseases in the three towns of Amhara regional state was 278.98 Ethiopian Birr (ETB) (1ETB = 0.025 US Dollar) per household per year and 121,355.68 ETB per year. Costs of preventive measures followed by costs of patients' time made the highest contribution while costs of diagnosis made the lowest contribution to the total economic burden of foodborne zoonotic diseases. From a total of 435 respondents, 305 (70.1%) had known the presence of zoonotic diseases. Level of education, number of families in the house and income were highly associated with awareness of zoonosis. Although majority of respondents had known zoonotic diseases exists (70.1%) and disease can be acquired from animal source food (63.2%), the health and economic burden associated to foodborne zoonotic diseases are still high. Therefore, changing mindset and practical training aiming in controlling foodborne zoonotic diseases may be suggested to the community in the health improvement extension service.


Assuntos
Doenças Transmitidas por Alimentos/fisiopatologia , Zoonoses/fisiopatologia , Adolescente , Adulto , Idoso , Animais , Criança , Efeitos Psicossociais da Doença , Estudos Transversais , Demografia , Diarreia/epidemiologia , Diarreia/fisiopatologia , Anos de Vida Ajustados pela Incapacidade , Etiópia/epidemiologia , Características da Família , Comportamento Alimentar , Feminino , Estresse Financeiro , Alimentos , Doenças Transmitidas por Alimentos/economia , Doenças Transmitidas por Alimentos/prevenção & controle , Custos de Cuidados de Saúde , Humanos , Expectativa de Vida , Masculino , Carne , Pessoa de Meia-Idade , Modelos Econômicos , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem , Zoonoses/economia , Zoonoses/prevenção & controle
14.
CMAJ ; 193(49): E1868-E1877, 2021 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-34903591

RESUMO

BACKGROUND: The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity. METHODS: Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence. RESULTS: Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63-6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03-1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12-1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13-1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30-0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39-0.98). INTERPRETATION: Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.


Assuntos
COVID-19/epidemiologia , Doenças Profissionais/epidemiologia , SARS-CoV-2 , COVID-19/sangue , COVID-19/etiologia , Estudos Transversais , Demografia , Pessoal de Saúde , Hospitais , Humanos , Incidência , Doenças Profissionais/sangue , Doenças Profissionais/etiologia , Pandemias , Quebeque/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Inquéritos e Questionários
15.
BMC Pregnancy Childbirth ; 21(1): 822, 2021 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-34903198

RESUMO

BACKGROUND: Anaemia and related complications during pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA). Women's decision-making power has significantly been linked with maternal health service utilization but there is inadequate evidence about adherence to iron supplementation. This study therefore assessed the association between household decision-making power and iron supplementation adherence among pregnant married women in 25 sub-Saharan African countries. METHODS: We used data from the Demographic and Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010 and 2019. Women's decision-making power was measured by three parameters; own health care, making large household purchases and visits to her family or relatives. The association between women's decision-making power and iron supplementation adherence was assessed using logistic regressions, adjusting for confounders. The results were presented as adjusted odds ratio (AOR) with 95% confidence intervals (CIs). RESULTS: Approximately 65.4% of pregnant married women had made decisions either alone or with husband in all three decisions making parameters (i.e., own health care, making large household purchases, visits to her family or relatives). The rate of adherence to iron medication during pregnancy was 51.7% (95% CI; 48.5-54.9%). Adherence to iron supplementation was found to be higher among pregnant married women who had decision-making power (AOR = 1.46, 95% CI; 1.16-1.83), secondary education (AOR = 1.45, 95% CI; 1.05-2.00) and antenatal care visit (AOR = 2.77, 95% CI; 2.19-3.51). Wealth quintiles and religion were significantly associated with adherence to iron supplementation. CONCLUSIONS: Adherence to iron supplementation is high among pregnant women in SSA. Decision making power, educational status and antenatal care visit were found to be significantly associated with adherence to these supplements. These findings highlight that there is a need to design interventions that enhance women's decision-making capacities, and empowering them through education to improve the coverage of antenatal iron supplementation.


Assuntos
Tomada de Decisões , Suplementos Nutricionais , Ferro na Dieta/administração & dosagem , Adesão à Medicação/estatística & dados numéricos , Gestantes , Adolescente , Adulto , África ao Sul do Saara/epidemiologia , Demografia , Características da Família/etnologia , Feminino , Humanos , Estado Civil , Pessoa de Meia-Idade , Gravidez , Fatores Socioeconômicos , Adulto Jovem
16.
BMC Pregnancy Childbirth ; 21(1): 834, 2021 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-34906105

RESUMO

BACKGROUND: Despite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. METHODS: Demographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval. RESULTS: Approximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years. CONCLUSION: Early age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Idade Materna , Parto , Gravidez na Adolescência/etnologia , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , África ao Sul do Saara , Demografia , Utilização de Instalações e Serviços/estatística & dados numéricos , Feminino , Humanos , Gravidez , Adulto Jovem
17.
Medicina (Kaunas) ; 57(12)2021 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-34946326

RESUMO

Background and Objectives: The COVID-19 pandemic has negatively impacted the health care system. Front-line health care workers (HCWs) are at a higher risk of mental health adverse outcomes. The aim of this study was to evaluate the frequency of the symptoms of depression and anxiety and associated demographic and occupational factors among front-line HCWs in Latvia. Materials and Methods: A cross-sectional quantitative study was performed in a population of HCWs during the first wave of the COVID-19 pandemic in Latvia. The participants were interviewed between 28 April 2020 and 2 June 2020. Answers from 864 HCWs were obtained. The participants reported their demographics, work-related information, contacts with COVID-19-positive patients and completed two standardised questionnaires that assessed the symptoms of anxiety (GAD-7) and depression (PHQ-9). The gathered data were analysed by a chi-squared test and binary logistic regression. The data analysis was performed using SPSS v25. Results: A total of 209 (24.8%) participants had depression symptoms and 145 (17.2%) had anxiety symptoms. Health care workers older than 50 had a lower risk of both depression (OR 0.422 (95% CI, 0.262-0.680)) and anxiety (OR 0.468 (95% CI, 0.270-0.813)). General practitioners had more frequent symptoms of depression and anxiety than participants who worked at hospitals (32.8% (n = 63) versus 19.4% (n = 73) and 27.1% (n = 52) versus 10.3% (n = 39), respectively (p = 0.037; p < 0.000)). Working more than 48 h during the week was associated with a higher risk of depression (OR 2.222 (95% CI, 1.315-3.753)) and anxiety (OR 2.416 (95% CI, 1.272-4.586)). Conclusions: The vulnerability of the health care system before the COVID-19 pandemic led to significant mental health adverse outcomes of HCWs during the COVID-19 pandemic in Latvia. A further cohort study is needed to evaluate the dynamics of mental health and other predisposing factors of HCWs.


Assuntos
COVID-19 , Ansiedade/epidemiologia , Estudos Transversais , Demografia , Depressão/epidemiologia , Pessoal de Saúde , Humanos , Letônia/epidemiologia , Saúde Mental , Pandemias , SARS-CoV-2
18.
BMC Pregnancy Childbirth ; 21(1): 841, 2021 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-34937554

RESUMO

BACKGROUND: Papua New Guinea (PNG) recorded 22 neonatal deaths out of every 1,000 livebirths in 2019. Some of these deaths are related to complications that arise shortly after childbirth; hence, postnatal care (PNC) utilisation could serve as a surviving strategy for neonates as recommended by the World Health Organisation. National level study on determinants of PNC uptake in PNG is limited. Utilising the Bronfenbrenner's Ecological Model of Human Development, the study aimed at assessing determinants of PNC utilisation for babies by their mothers aged 15-49 in PNG. METHODS: The study used data from the women's file of the 2016-18 PNG Demographic and Health Survey (2016-18 PNGDHS) and a sample of 4,908 women aged 15-49 who had complete information on the variables of interest to the study. Nineteen (19) explanatory variables were selected for the study whereas PNC for babies within first two months after being discharged after birth was the main outcome variable. At 95% confidence interval (95% CI), six multilevel logistic models were built. The Akaike Information Criterion (AIC) was used to assess models' fit. All analyses were carried out using STATA version 14.0. RESULTS: Generally, 31% of the women utilised PNC for their babies. Women with primary education [aOR = 1.42, CI = 1.13-1.78], those belonging to the middle wealth quintile [aOR = 1.42, CI = 1.08-1.87], working class [aOR = 1.28, CI = 1.10-1.49], women who had the four or more ANC visits [aOR = 1.23, CI = 1.05-1.43], those with twins [aOR = 1.83, CI = 1.01-3.29], women who belonged to community of medium literate class [aOR = 1.75, CI = 1.34-2.27] and those of moderate socioeconomic status [aOR = 1.60, CI = 1.16-2.21] had higher odds of seeking PNC for their babies. The odds to seek PNC services for babies reduced among the cohabiting women [aOR = 0.79, CI = 0.64-0.96], those at parity four or more [aOR = 0.77, CI = 0.63-0.93], women who gave birth to small babies [aOR = 0.80, CI = 0.67-0.98] and residents in the Highlands region [aOR = 0.47, CI = 0.36-0.62]. CONCLUSIONS: Maternal education, wealth quintile, occupation, partner's education, ANC visits, marital status, parity, child size at birth, twin status, community literacy and socioeconomic status as well as region of residence were associated with PNC uptake for babies in PNG. Variation in PNC uptake for babies existed from one community/cluster to the other. There is the need to strengthen public health education to increase awareness about the benefits of seeking PNC services for babies among women in PNG. Such programs should consider maternal and community/cluster characteristics in their design.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pós-Natal , Fatores Socioeconômicos , Adolescente , Adulto , Estudos Transversais , Demografia , Utilização de Instalações e Serviços/estatística & dados numéricos , Feminino , Humanos , Lactente , Pessoa de Meia-Idade , Análise Multinível , Papua Nova Guiné , Adulto Jovem
19.
J Prev Med Hyg ; 62(3): E709-E717, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34909499

RESUMO

Aims: Genoa is a city hit by a strong economic, demographic and social involution. The changes in the demographic and socio-economic (SE) situation were analysed and the capacity of two Socio-Economic and Health Deprivation Indices (SEHDI) in describing the evolutions of the recent period were verified. Material and methods: The data about the evolution of demographic and SE situation in Genoa came from publications of Statistics Offices of Genoa Municipality and Liguria Region and from published analyses of Bank of Italy. The two SEHDIs, referring to 2001 and 2011 population, were computed at census tract level by linear regression, factor and clusters analyses and had been already validated and published. Results: Wide transformations in aging and population composition by age groups and gender occurred in Genoa between 1951 and 2016. Internal (from other Italian regions) and external (from other countries) migrations concurred to change the profile of Genoese population. These changes followed the industrial history of city and its deindustrialization occurred since 2001. A progressive SE involution, worsened by the Italian and international crises, carried out the recent impoverishment of the city. Between 2001 and 2011 the population at medium-high deprivation increased and the SEHDIs 2001 and 2011 contributed to describe the population distribution by deprivation groups, either geographically, and by groups of citizenships (Italians and Foreigners). The first identified in 2001 some aspects of a well-off society regarding education, labour market and characteristics of the family and housing structure. The second depicted in 2011 an impoverished society in aging, lack of family support and of property of the main house, diminishing of educational level. Discussion: Genoa city demonstrated an its own specific decline. Starting from the deindustrialization, a worsening of welfare, independently from the national and international economic troubles, was evident. The aging and the changed equilibria among age groups testified the growing difficulties of society in keeping up with the deep social and economic changes. The results demonstrated that specific deprivation indices aid to better define the populations under analysis, because they identify the subpopulations that could have the maximum benefit from investments of resources targeted to the correction of inequalities.


Assuntos
Recessão Econômica , Envelhecimento , Demografia , Humanos , Classe Social , Fatores Socioeconômicos
20.
Artigo em Inglês | MEDLINE | ID: mdl-34948863

RESUMO

Although the United States Safe Drinking Water Act (SDWA) theoretically ensures drinking water quality, recent studies have questioned the reliability and equity associated with community water system (CWS) service. This study aimed to identify SDWA violation differences (i.e., monitoring and reporting (MR) and health-based (HB)) between Virginia CWSs given associated service demographics, rurality, and system characteristics. A novel geospatial methodology delineated CWS service areas at the zip code scale to connect 2000 US Census demographics with 2006-2016 SDWA violations, with significant associations determined via negative binomial regression. The proportion of Black Americans within a service area was positively associated with the likelihood of HB violations. This effort supports the need for further investigation of racial and socioeconomic disparities in access to safe drinking water within the United States in particular and offers a geospatial strategy to explore demographics in other settings where data on infrastructure extents are limited. Further interdisciplinary efforts at multiple scales are necessary to identify the entwined causes for differential risks in adverse drinking water quality exposures and would be substantially strengthened by the mapping of official CWS service boundaries.


Assuntos
Água Potável , Demografia , Humanos , Reprodutibilidade dos Testes , Estados Unidos , Virginia , Qualidade da Água
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