Epidemiology of childhood tuberculosis and factors associated with unsuccessful treatment outcomes in Tigray, Ethiopia: a ten-year retrospective cross sectional study.

BACKGROUND: Childhood TB is an indicator of a recent transmission of the disease in a community and it is estimated to constitute 15-20% of all TB cases in many of developing countries. However, only few studies which dominated by industrial countries were engaged to assess the situation. Therefore, this study was aimed to see epidemiology of childhood TB and factors associated with poor treatment outcome in developing country. METHOD: Using retrospective cross-sectional study design; Socio-demographic and clinical data of children aged less than 15 years old, treated for all forms of TB in the past 10 years (2007-2016) was collected from randomly selected eight public hospitals of Tigray. Then, Univariate logistic regression and adjusted multivariate logistic regressions was done to identify variables which had association with unsuccessful treatment outcomes at P-value less than 0.05. RESULT: In the past 10 years, a total of 13,345 Tuberculosis cases were observed. Of these, 1086 (8.1%) cases were children aged less than 15 years old. Sixty seven (6.2%) cases were smear positive. Among those that tested for HIV, 69 (8.3%) cases were TB/HIV co-infected. Of those with treatment outcome record 746 (88.7%) were successfully treated. Factors like being female (AOR, 1.79; 95% CI, 1.07-3.00), Age 0-5 years (AOR, 3.35; 95% CI, 2.11-5.33), Unknown HIV status (AOR, 2.44; 95% CI, 1.51-3.95) and pulmonary positive case (AOR, 2.56; 95% CI, 1.13-5.77), were more likely to have unsuccessful treatment outcome than their counterparts. CONCLUSION: In Tigray 8.1% all TB cases were children age less than 15 years old. Childhood TB treatment outcome varied with sex, age and HIV status.

Gender differences in geriatric depressive symptoms in urban China: the role of ADL and sensory and communication abilities.

Objectives: ADL and Sensory and Communication Abilities are important indicators of the quality of life of the elderly which are significant determinants of health, particularly in developing countries. The present cross-sectional study investigated effect of ADL and Sensory and Communication Abilities on depressive symptoms, as well as the the role of gender in these effects. Design: This is a cross-sectional study. Setting: A nationally representative cross-sectional survey among the Chinese population aged 60 years and over. Participants: A total of 163296 females and 148724 males aged 65 and over in 2019 in urban China. Outcome measures: Prevalence, risk factors and gender differences in geriatric depressive symptoms among urban elderly. Results: Approximately 95.69% of the participants had depressive symptoms according to the CESD-10, with no statistically significant gender difference of 52.15% in females and 47.85% in males. Logistic regression findings suggest that geriatric depressive symptoms are significantly associated with the lack of eldercare (OR=2.427, female; OR=1.426, male), living alone(OR= 1.430, female; OR= 1.179, male), ADL dysfunction (OR=1.528, female; OR=1.246, male), and impaired sensory and communication ability (OR=1.338, female; OR=1.185, male) among both female and male participants. Remarkably, geriatric depressive symptoms are only significantly associated with age (≥75, OR = 1.327), marital status (unmarried, OR=1.598), the number of children (no children, OR=2.271), and the living arrangement (living alone, OR= 1.430) among female participants. Conclusion: Significant gender differences in these associations were found for living alone, ADL dysfunction and impaired sensory and communication ability. Moreover, the study emphasized that the gender difference exists in terms of geriatric depression in urban China. Females are more likely to experience depressive than males with the same circumstances.

Gender Differences in Geriatric Depressive Symptoms in Rural China: The Role of Physical Housing Environments and Living Arrangements.

Physical housing environment and living arrangements are significant determinants of health, particularly in developing countries, although results are mixed. We conducted this study to examine the gender differences in geriatric depressive symptoms in rural China, and further explored the influence of housing environments and living arrangements on depressive symptoms. The data used for this study were from the third wave of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) survey in 2015; a total of 2056 females and 2529 males were included in this study. According to the analysis findings, 46.15% of the respondents had depressive symptoms based on the CES-D, with a statistically significant gender difference of 54.32% in females and 39.50% in males. Logistic Regression findings identified that with regard to the items of physical housing environments, toilets without seats (OR = 1.349) and the unavailability of bathing facilities (OR = 1.469) were statistically associated with depressive symptoms among male participants, whereas for female participants the use of polluting fuels (OR = 1.248) and living arrangements (i.e., living with children, OR = 1.430) was statistically associated with depressive symptoms. Statistically significant gender differences were found for having shower or bath facilities and our findings underscored that physical housing environments and living arrangements were associated with depressive symptoms for both genders. Moreover, the study revealed that a slight gender difference exists in terms of geriatric depression in rural China. Females are more likely to become depressed than their male counterparts with the same characteristics.

Role of socioeconomic status and housing conditions in geriatric depression in rural China: a cross-sectional study.

OBJECTIVES: The primary aim of this study was to describe the socioeconomic status (SES), housing conditions and depression of the elderly in rural China, as well as to examine the associations between depression and SES and housing conditions using the China Health and Retirement Longitudinal Study (CHARLS). DESIGN: This is a cross-sectional study. SETTING: A nationally representative sample of elderly in rural China. PARTICIPANTS: A total of 4585 elderly adults in 2015 in rural China. OUTCOME MEASURES: Prevalence and risk factors of depression among rural elderly. RESULTS: Among the participants in this study, approximately 46.15% (2116/4585) reported depressive symptoms (10-item Center for Epidemiologic Studies Depression Scale [CESD-10] score >10) in rural China. The results revealed significant associations between higher scores on CESD-10 (indicating more symptoms of depression) and lowest personal annual income (OR=1.63, 95% CI 1.290 to 2.060), polluting cooking fuel (OR=1.16, 95% CI 1.018 to 1.321), toilet without seat (OR=1.273, 95% CI 1.056 to 1.535), as well as having no bath facility (OR=1.172, 95% CI 1.025 to 1.341) after adjustment for confounders. CONCLUSION: Elderly in rural China experienced severe depressive symptoms. Lowest personal annual income, polluting cooking fuel, toilet without seat and having no bath facility were significantly associated with more depressive symptoms. Caution needs to be taken in generalising the findings of this study to the rest of the population in China since its highly selected sample.

Tuberculosis treatment outcome: The case of women in Ethiopia and China, ten-years retrospective cohort study.

BACKGROUND: Every year tuberculosis kills above half million women all over the world. Nonetheless, the factor affecting TB treatment outcome of women was less frequently studied and compared among countries. Hence, this study was aimed to measure and compare outcome of treatment and the death size of these two countries. METHOD: Socio demographic and clinical data of women treated for all form of tuberculosis in the past ten years 2007-2016 were collected from total of eight hospitals and six treatment centers of Tigray and Zigong respectively. Then, we measured the magnitude of TB, level of treatment success and identify factors associated with the unsuccessful TB outcome. RESULT: In the past ten years, a total of 5603(41.5%) and 4527 (24.5%) tuberculosis cases were observed in Tigray and Zigong respectively. Of those with treatment outcome record a total of 2602(92%) in Tigray and 3916(96.7%) in Zigong were successfully treated. Total of 170 (6%) cases in Tigray and 36(0.8%) cases in Zigong were dead. In Tigray, retreatment cases (aOR, 0.29; 95% CI: 0.16-0.53) and MDR-TB cases (aOR, 0.31; 95% CI: 0.003, 0.27) were less likely to show treatment success. However,, HIV co-infected TB cases (aOR, 3.58; 95% CI: 2.47, 5.18) were more likely to show treatment success compared with unknown HIV status. In Zigong, women with MDR TB (aOR, 0.90; 95%CI: 0.24, 0.34) were less likely to show treatment success and women in the age category of 15-49 (aOR, 1.55; 95% CI: 1.08, 2.206) were more likely to show treatment success. CONCLUSION: Big number of tuberculosis cases and death were observed in Tigray comparing with Zigong. Hence, a relevant measure should be considered to improve treatment outcome of women in Tigray regional state.

Comparison of validation and application on various cardiovascular disease mortality risk prediction models in Chinese rural population.

This research aims to assess application of different cardiovascular disease (CVD) mortality risk prediction models in Chinese rural population. Data was collected from a 6-year follow-up survey in rural area of Henan Province, China. 10338 participants aged 40 to 65 years were included. Baseline study was conducted between 2007 and 2008, and followed up from 2013 to 2014. Seven models: general Framingham risk score (general-FRS), simplified-FRS, Systematic Coronary Risk Evaluation for high (SCORE-high), SCORE-low, Chinese ischemic CVD (CN-ICVD), Pooled Cohort Risk Equation for white (PCE-white) and for African-American (PCE-AA) were assessed and recalibrated. The model performance was evaluated by C-statistics and modified Nam-D'Agostino test. 168 CVD deaths occurred during follow-up. All seven models showed moderate C-statics ranging from 0.727 to 0.744. Following recalibration, general-FRS, simplified-FRS, CN-ICVD, PCE-white and PCE-AA had improved C-statistics of 0.776, 0.795, 0.793, 0.779, and 0.776 for men and 0.756, 0.753, 0.755, 0.758 and 0.760 for women, respectively. Calibrations χ2 of general-FRS, simplified-FRS, SCORE-high, CN-ICVD and PCE-AA model for men, and general-FRS, CN-ICVD and PCE-white model for women were statistically acceptable, indicating these models predicts CVD mortality risk more accurately than others and could be recommended in Chinese rural population.