Entomological indicators of Plasmodium species transmission in Goma Tsé-Tsé and Madibou districts, in the Republic of Congo.

BACKGROUND: Malaria remains a major public health problem in the Republic of Congo, with Plasmodium falciparum being the deadliest species of Plasmodium in humans. Vector transmission of malaria is poorly studied in the country and no previous report compared rural and urban data. This study aimed to determine the Anopheles fauna and the entomological indices of malaria transmission in the rural and urban areas in the south of Brazzaville, and beyond. METHODS: Indoor household mosquitoes capture using electric aspirator was performed in rural and urban areas during raining and dry seasons in 2021. The identification of Anopheles species was done using binocular magnifier and nested-PCR. TaqMan and nested-PCR were used to detect the Plasmodium species in the head/thorax and abdomens of Anopheles. Some entomological indices including the sporozoite infection rate, the entomological inoculation rate and the man biting rate were estimated. RESULTS: A total of 699 Anopheles mosquitoes were collected: Anopheles gambiae sensu lato (s.l.) (90.7%), Anopheles funestus s.l. (6.9%), and Anopheles moucheti (2.4%). Three species of An. gambiae s.l. were identified including Anopheles gambiae sensu stricto (78.9%), Anopheles coluzzii (15.4%) and Anopheles arabiensis (5.7%). The overall sporozoite infection rate was 22.3% with a predominance of Plasmodium falciparum, followed by Plasmodium malariae and Plasmodium ovale. Anopheles aggressiveness rate was higher in households from rural area (1.1 bites/night) compared to that from urban area (0.8 ib/p/n). The overall entomological inoculation rate was 0.13 ib/p/n. This index was 0.17 ib/p/n and 0.092 ib/p/n in rural and in urban area, respectively, and was similar during the dry (0.18 ib/p/n) and rainy (0.14 ib/p/n) seasons. CONCLUSION: These findings highlight that malaria transmission remains high in rural and urban area in the south of Republic of Congo despite the ongoing control efforts, thereby indicating the need for more robust interventions.

Challenges of Measuring Self-Reported Exposure to Occupational Biomechanical Risk Factors Amongst People with Low Literacy Engaged in Manual Labour: Findings from a Cross-Cultural Adaptation and Psychometric Investigation in an African Population with Chronic Low Back Pain.

PURPOSE: Occupational biomechanical factors are implicated in the aetiology and progression of low back pain (LBP). This study cross-culturally adapted and psychometrically investigated the Occupational Risk Factor Questionnaire (ORFQ) in a low literate Nigerian Igbo population with chronic LBP. METHODS: Forward and back translation of the original ORFQ by clinical and non-clinical translators was followed by an expert committee review. The adapted ORFQ was pre-tested amongst rural Nigerian adults with chronic LBP using cognitive think-aloud interviewing. Internal consistency (Cronbach's alpha) and test-retest reliability (unweighted and linear weighted k statistic for item-by-item agreement, and intra-class correlation coefficient-ICC) were investigated amongst 50 rural and urban Nigerian dwellers with chronic LBP. Spearman's correlation and regression analyses were conducted with the Igbo-ORFQ, and measures of disability [World Health Organisation Disability Assessment Schedule (WHODAS 2.0), Roland Morris Disability Questionnaire (RMDQ), Back performance scale (BPS)], pain intensity [Eleven-point box scale (BS-11)] and social support [Multidimensional Scale of Perceived Social Support (MSPSS)], to test construct validity with 200 rural Nigerian dwellers with chronic LBP. RESULTS: Cross-cultural adaptation highlighted difficulty conceptualising and concretising exposure to biomechanical risk factors. Item-by-item agreement, internal consistency (α = 0.84) and intraclass correlation coefficient (ICC = 0.83) were good. Some unexpected direction of associations between the biomechanical components of the Igbo-ORFQ, and disability, pain intensity, and social support prohibits establishment of construct validity. CONCLUSION: Prospective studies comparing the Igbo-ORFQ to other measures of exposure to occupational biomechanical risk factors are required to establish the construct validity of the Igbo-ORFQ.

Incidence and Transmission Dynamics of Bordetella pertussis Infection in Rural and Urban Communities, South Africa, 2016‒2018.

We conducted 3 prospective cohort studies (2016-2018), enrolling persons from 2 communities in South Africa. Nasopharyngeal swab specimens were collected twice a week from participants. Factors associated with Bordetella pertussis incidence, episode duration, and household transmission were determined by using Poisson regression, Weibull accelerated time-failure, and logistic regression hierarchical models, respectively. Among 1,684 participants, 118 episodes of infection were detected in 107 participants (incidence 0.21, 95% CI 0.17-0.25 infections/100 person-weeks). Children <5 years of age who had incomplete vaccination were more likely to have pertussis infection. Episode duration was longer for participants who had higher bacterial loads. Transmission was more likely to occur from male index case-patients and persons who had >7 days infection duration. In both communities, there was high incidence of B. pertussis infection and most cases were colonized.

Home health services for minorities in urban and rural areas with Alzheimer's and related dementia.

Timely access and continuum of care in older adults with Alzheimer's Disease and Related Dementia (ADRD) is critical. This is a retrospective study on Medicare fee-for-service beneficiaries with ADRD diagnosis discharged to home with home health care following an episode of acute hospitalization. Our sample included 262,525 patients. White patients in rural areas have significantly higher odds of delay (odds ratio [OR], 1.03; 95% CI, 1.01-1.06). Black patients in urban areas (OR, 1.15; 95% CI, 1.12-1.19) and Hispanic patients in urban areas also were more likely to have a delay (OR, 1.07; 95% CI, 1.03-1.11). Black and Hispanic patients residing in urban areas had a higher likelihood of delay in home healthcare initiation following hospitalization compared to Whites residing in urban areas.

Prevalence and risk factors of general and abdominal obesity and hypertension in rural and urban residents in Bangladesh: a cross-sectional study.

BACKGROUND: Obesity and hypertension are global health concerns. Both are linked with increased risks of all-cause and cardiovascular mortality. Several early studies reported the prevalence of obesity and hypertension in Bangladeshi adults, but the associated factors in this country population are not clear yet. We aimed to estimate the prevalence and related risk factors of general and abdominal obesity and hypertension in rural and urban adults in Bangladesh. METHODS: In this cross-sectional study, data (n = 1410) was collected on rural (n = 626) and urban (n = 784) adults from eight divisional regions of Bangladesh. Both anthropometric and socio-demographic measurements were recorded in a standardized questionnaire form. General and abdominal obesity were defined based on WHO proposed cut-off values and hypertension was defined by SBP ≥ 140 mmHg and/or, DBP ≥ 90 mmHg and/or, intake of anti-hypertensive drugs at the time of data collection. Multivariable logistic regression analyses were performed to assess the relationship of general and abdominal obesity and hypertension with various factors. RESULTS: The overall prevalence of general obesity, abdominal obesity and hypertension was 18.2, 41.9 and 30.9%, respectively. The women had a higher prevalence of general obesity (25.2%), abdominal obesity (56.1%) and hypertension (32.3%) compared to the men (12.2, 29.0, and 29.7%, respectively). The prevalence of both general and abdominal obesity was higher in urban participants (21.7 and 46.6%, respectively) than in the rural participants (13.8 and 35.1%, respectively), whereas, the rural participants had a higher prevalence of hypertension (35.1%) compared to the urban participants (27.5%). In geographical region comparison, the prevalence of general and abdominal obesity and hypertension were higher in participants enrolled from Dhaka (30.8%), Khulna (63.6%) and Mymensingh (43.5%) regions, respectively compared to other regions. In regression analysis, increased age, place of residence and less physical activity were positively associated with the increased risk of both types of obesity and hypertension. The analysis also showed a significant positive association between high BMI and an increased risk of hypertension. CONCLUSION: This study shows a high prevalence of obesity and hypertension in rural and urban adults. Increased age, inadequate physical activity and place of residence were significant determinants of general and abdominal obesity and hypertension. A comprehensive intervention program focusing on modifiable risk factors such as lifestyles and food habits is needed to increase awareness and prevent the burden of obesity and hypertension in the Bangladeshi population.

Sensory profile and acceptance of maize tortillas by rural and urban consumers in Mexico.

BACKGROUND: Maize tortillas are the staple food of Mexico and their consumption contributes to preserving the gastronomic patrimony and food security of the population. The aim of the present study was to generate a reference sensory profile for different types of tortillas and to evaluate the effect that these sensory characteristics have on consumer liking and how this influences their consumption preferences and purchase intent. Three types of maize tortillas were analyzed: traditional (T1), combined (T2) and industrialized (T3). The samples were characterized using the modified flash profile method. Sensory acceptability and preference tests were conducted on 240 urban and rural consumers. RESULTS: The judges characterized 19 attributes in the tortilla samples, eight of which were also identified by consumers. In the case of traditional tortillas, the matching attributes were maize flavor, color, thickness and moisture. Only rural consumers were able to perceive significant differences between the samples in terms of aroma and taste/flavor. The study has contributed to understanding the complex mechanisms of sensory acceptance through the use of tools that combine qualitative and quantitative data. CONCLUSION: Although 56% of rural and urban consumers prefer traditional tortillas for their sensory characteristics, purchase intent is also affected by socioeconomic, cultural and microbiological factors. © 2021 Society of Chemical Industry.

The Roles of Life Satisfaction and Community Recreational Facilities in the Relationship between Loneliness and Depression in Older Adults.

OBJECTIVES: This study examined the mediating effect of life satisfaction and the moderating effect of the availability of community recreational facilities (CRF) in the association between loneliness and depression in rural older adults and urban older adults, respectively. METHODS: Quantitative data collected from 7547 Chinese older adults were analyzed using the SPSS macro PROCESS to test a moderated mediation model with life satisfaction as the mediator and CRF availability and residency type (rural vs. urban) as moderators. RESULTS: Loneliness negatively predicted life satisfaction, life satisfaction negatively predicted depression, and loneliness positively predicted depression. The interaction of loneliness and CRF availability had a significant effect on depression for urban older adults but not for rural older adults. The direct impact of loneliness on depression differed significantly between rural and urban older adults. CONCLUSIONS: Life satisfaction mediated the association between loneliness and depression in both rural and urban older adults; CRF availability unexpectedly boosted the effect of loneliness on depression in urban older adults but not in rural older adults. Given the same level of loneliness, urban older adults were more likely to be depressed than rural older adults. CLINICAL IMPLICATIONS: Psychogeriatric practitioners may embed life satisfaction into intervention programs to minimize depression among older adults. Public administrators should examine the utilization of public facilities to avoid wasted resources and counterproductive effects on older adults. Lonely urban older adults deserve special attention.

Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents.

BACKGROUND: Patient experience is a key measure widely used to evaluate quality of healthcare, yet there is little discussion about it in China using national survey data. This study aimed to explore rural and urban differences in patient experience in China. METHODS: Data regarding this study were drawn from Chinese General Social Survey (CGSS) 2015, with a sample size of 9604. Patient experience was measured by the evaluation on healthcare services. Coarsened exact matching (CEM) method was used to balance covariates between the rural and urban respondents. Three thousand three hundred seventy-two participants finally comprised the matched cohort, including 1592 rural residents and 1780 urban residents. Rural and urban differences in patient experience were tested by ordinary least-squares regression and ordered logistic regression. RESULTS: The mean (SD) score of patient experience for rural and urban residents was 72.35(17.32) and 69.45(17.00), respectively. Urban residents reported worse patient experience than rural counterparts (Crude analysis: Coef. = - 2.897, 95%CI: - 4.434, - 1.361; OR = 0.706, 95%CI: 0.595, 0.838; Multivariate analysis: Coef. = - 3.040, 95%CI: - 4.473, - 1.607; OR = 0.675, 95%CI: 0.569, 0.801). Older (Coef. = 2.029, 95%CI: 0.338, 3.719) and healthier (Coef. = 2.287, 95%CI: 0.729, 3.845; OR = 1.217, 95%CI: 1.008, 1.469) rural residents living in western area (Coef. = 2.098, 95%CI: 0.464, 3.732; OR = 1.276, 95%CI: 1.044, 1.560) with higher social status (Coef. = 1.158, 95%CI: 0.756, 1.561; OR = 1.145, 95%CI: 1.090, 1.204), evaluation on adequacy (Coef. = 7.018, 95%CI: 5.045, 8.992; OR = 2.163, 95%CI: 1.719, 2.721), distribution (Coef. = 4.464, 95%CI: 2.471, 6.456; OR = 1.658, 95%CI: 1.312, 2.096) and accessibility (Coef. = 2.995, 95%CI: 0.963, 5.026; OR = 1.525, 95%CI: 1.217, 1.911) of healthcare resources had better patient experience. In addition, urban peers with lower education (OR = 0.763, 95%CI: 0.625, 0.931) and higher family economic status (Coef. = 2.990, 95%CI: 0.959, 5.021; OR = 1.371, 95%CI: 1.090,1.723) reported better patient experience. CONCLUSIONS: Differences in patient experience for rural and urban residents were observed in this study. It is necessary to not only encourage residents to form a habit of seeking healthcare services in local primary healthcare institutions first and then go to large hospitals in urban areas when necessary, but also endeavor to reduce the disparity of healthcare resources between rural and urban areas by improving quality and capacity of rural healthcare institutions and primary healthcare system of China.

Trends in COVID-19 cases, deaths, and staffing shortages in US nursing homes by rural and urban status.

The purpose of the study was to examine trends in COVID-19 cases, related deaths, and staffing shortages in nursing homes (NH) by rural and urban status from May 2020 to Feb 2021. Generalized linear mixed models with state-fixed effects were used to estimate the interaction effect of study period and rural/urban status on having at least: one COVID-19 case, one related death, and/or at least one week of staffing shortage using the NH COVID-19 data spanning the 40-week period. The findings revealed shortages in staff, particularly direct care providers, were greatly accelerated in rural NHs as the pandemic wore on over time. Conversely, staffing shortages in urban NHs were relatively stable despite the fluctuating COVID-19 cases over the same time period. The findings highlight the need of identifying effective strategies that prevent rural NHs from encountering staffing deficits in response to long-lasting natural disasters such as the COVID-19 pandemic.

Extended gender inequality? Intergenerational coresidence and division of household labor.

This study investigates the effect of coresidence with the husband's or the wife's parents on division of household labor between the couple in China. We further examine how life course, education, hukou, and the gender composition of coresiding parents moderate the relationship between intergenerational coresidence and division of household labor. Previous research on housework division has looked at nuclear families. Little is known about the effect of intergenerational coresidence on housework division. Despite rapid modernization, intergenerational coresidence remains prevalent in China as families try to adapt to the changing social and economic conditions. While patrilocal coresidence dominates in both rural and urban China, matrilocal coresidence is increasingly common in urban China. Based on panel data from the 2010, 2014, 2016, and 2018 waves of the China Family Panel Studies, fixed effects models are used to account for both observed and unobserved individual-specific confounders. Both patrilocal and matrilocal coresidence seem to widen the within-couple gender gap in housework time among urban hukou holders. Among rural hukou holders, though patrilocal coresidence is associated with reduced housework time for the wife and the couple as a whole, neither patrilocal nor matrilocal coresidence significantly influences how much time the husband spent on housework. Coresidence with the husband's or the wife's parents may exacerbate gender inequality in housework division.

[Prevalence of age-related macular degeneration of retina among rural and urban population of the western region of Azerbaijan]. / Rasprostranennost' vozrastnoi makulyarnoi degeneratsii setchatki sredi sel'skogo i gorodskogo naseleniya Zapadnogo regiona Azerbaidzhana.

PURPOSE: To compare the prevalence rates of age-related macular degeneration (AMD) of retina among the rural and urban populations. MATERIAL AND METHODS: The study was conducted at the National Centre of Ophthalmology named after the Academician Zarifa Aliyeva, which in 2016 provided specialized ophthalmic care to the population of the western region of the Azerbaijan Republic - the Ganja-Gazakh economic region. Three types of settlements were determined among administrative units of the region: big city; small towns; rural settlements within the administrative regions. All patients were examined by specialists of the mobile ophthalmologic team using complex diagnostic methods. RESULTS: According to patient data, the prevalence rate of AMD among people aged 60 years and older was not high and varied within the interval of 0.2‰ in the Gadabay district to 1.0‰ in the Goranboy district with statistically significant inter-regional differences. General prevalence rate changed within the interval of 1.0‰ in the Gadabay district to 3.1‰ in the Goranboy district, also with statistically significant inter-regional differences. Comparison of the prevalence rate of this pathology among the population of a big city, small towns and rural settlements aged 40-49 years confirms the validity of the null hypothesis. According to our survey, gender differences in the prevalence rates of AMD among the population were not statistically significant (p>0.05). CONCLUSION: Comparative assessment of the prevalence rates of age-related macular degeneration of retina among rural and urban populations confirms its high risk in rural settlements. According to patient statistics, the prevalence rate of AMD in the available data is many times lower than its actual prevalence (≥60‰). Significant increase in AMD risk is observed in individuals aged 50 years and older in rural settlements, and 60 years and older in cities.

Quality of life and its predictors among aging people in urban and rural Nepal.

PURPOSE: We studied the quality of life (QoL) of the elderly in Nepal and their special needs. Nepal is a low- and middle-income country where the elderly population is growing significantly. METHODS: A random selection of informants from the Kavre district was carried out in this cross-sectional, population-based, door-to-door survey. The district has a mixture of urban and rural communities. In Nepal, families generally take care of their elderly. Hardly any placement is made in institutions. A validated Nepali version of World Health Organization Quality of Life 8-question scale (WHOQoL-8) estimated QoL among the elderly (≥ 60 years; N = 439). Other variables of interest were socio-demographics, substance use, physical and psychological health, and family support. Depression was measured by Geriatric Depression Scale short form [GDS-15]. Due to a high illiteracy rate, a structured and culturally adapted questionnaire was presented in an interview format. The relationships between the variables and QoL were analyzed using independent sample t tests, linear regression and Pearson's correlations. RESULTS: The mean QoL score was 25.7 (± 4.2); 49.2% rated their QoL as good. Positive predictors of QoL were: urban residence (p = 0.03); employment (p = 0.02); absence of chronic physical health problems (p = 0.02); absence of depression (p < 0.001); adequate time given by family (p = 0.001), and reports of non-abusive family relationships (p < 0.001). A negative correlation was found between geriatric depression and the QoL score (r = - 0.697; p < 0.001). CONCLUSION: QoL of the elderly in Nepal may potentially improve by care directed towards their physical and psychological health, by strengthening family relations, and by financial independence.

Application of satisfaction index of basic medical insurance for rural and urban residents to pupils' familial decision making in Kunming and Changsha City. / åŸŽä¹¡å± æ°‘åŸºæœ¬åŒ»ç–—ä¿é™©æ»¡æ„åº¦æŒ‡æ•°æ¨¡åž‹åœ¨æ˜†æ˜Žå¸‚å’Œé•¿æ²™å¸‚å°å­¦ç”Ÿå®¶åº­å†³ç­–è€ ä¸­çš„åº”ç”¨.

OBJECTIVES: To verify the applicability and extensibility of the satisfaction index of basic medical insurance for rural and urban residents, and to explore the mechanism responsible for the satisfaction index in Kunming and Changsha City, and provide references for effective management and policy making. METHODS: A stratified cluster sampling method was conducted. A total of 560 familial decision makers were randomly selected in 24 classes of 14 schools of Kunming and Changsha City. Model reliability was tested by SPSS18.0. In addition, Smart PLS 3.0 was applied to conduct model validity test, calculate the satisfaction index, and to compare the model path coefficients of Kunming and Changsha by multi-group analysis. RESULTS: In the application of the satisfaction index of basic medical insurance for rural and urban residents in Kunming, Cronbach's α of the model was 0.93, split-half reliability coefficient was 0.90, and the latent variable composite reliability coefficient values were more than 0.86; the latent variable average variance extraction (AVE) values were greater than 0.66, and the square root of the AVE of each latent variable (all greater than 0.66) was larger than the correlation coefficient with other latent variables. The factor loading values were greater than 0.70, with statistical significance. The basic health insurance satisfaction index of Kunming and Changsha was 60.40 and 52.05, respectively. The difference between the path coefficient of Kunming and Changsha was not statistically significant except the path from public satisfaction to public loyalty. Perceived value had the largest direct and total effect on public satisfaction latent variable in Kunming City. While the perceived value had the largest direct effect on public satisfaction, and the perceived quality had the largest total effect on public satisfaction in Changsha City. CONCLUSIONS: The satisfaction index model reflects the satisfaction of pupils' basic medical insurance for urban and rural residents, and it also shows good reliability and validity in Changsha and Kunming. What's more the model can be extended to the national level to evaluate the satisfaction of basic medical insurance for urban and rural residents for primary school students. The basic health insurance satisfaction index of familial decision makers in Kunming is higher than that of Changsha. There are differences between Kunming and Changsha in the influential mechanism of the satisfaction index of for Chinese pupils with basic medical insurance for rural and urban residents, and the measures taken by the government and relevant departments to improve the satisfaction of basic medical insurance should be based on local conditions.

The Pennsylvania Longitudinal Study of Parents and Children (PALSPAC) Twin Registry.

The Pennsylvania Longitudinal Study of Parents and Children Twin Registry was developed to capture a representative sample of multiple births and their parents in the state of Pennsylvania. The registry has two main efforts. The first began in 2012 through recruitment of adolescents in Pennsylvania schools. The second effort began in January 2019 in partnership with the Pennsylvania Department of Health to capture the birth cohort of twins born from 2007 to 2017. Study recruitment, sample demographics, focus and measures are provided, as well as future directions.

Understanding Geographic and Neighborhood Variations in Overdose Death Rates.

The current opioid epidemic continues to challenge us in new and potentially troubling ways. For example, research today finds more overdose deaths occurring in rural, rather than urban, geographic areas. Yet, studies have often ignored heterogeneities within these spaces and the neighborhood variations therein. Using geodemographic classification, we investigate neighborhood differences in overdose death rates by geographical areas to further understand where and among what groups the problem might be most concentrated. For deaths between 2013 and 2016, we find significant variation in rates among neighborhoods, defined by their socio-economic and demographic characteristics. For example, overdose death rates vary up to 13-fold among neighborhoods within geographic areas. Our results overall show that while the rural or urban classification of a geographic area is important in understanding the current overdose problem, a more segmented analysis by neighborhood's socio-economic and demographic makeup is also necessary.

Exposures to the tobacco retail environment among adolescent boys in urban and rural environments.

BACKGROUND: The tobacco industry spends billions on retail marketing and such marketing is associated with tobacco use. Previous research has not examined actual and potential exposures that adolescents have on a daily basis. OBJECTIVE: The objective of this study was to determine whether both self-reported and geographically estimated tobacco retailer exposures differ by participant or neighborhood characteristics among urban and rural adolescents. METHODS: The data for this study were part of a cohort study of 1220 adolescent males residing in urban and rural (Appalachian) regions in Ohio. The baseline survey asked participants how often they visited stores that typically sell tobacco in the past week (self-reported exposures). The number of tobacco retailers between home and school was determined using ArcGIS software (potential exposures). Adjusted regression models were fit to determine the characteristics that were associated with self-reported or potential exposures to retailers. RESULTS: Adolescents who were non-Hispanic black or other racial/ethnic minority, had used tobacco in the past, and lived in rural areas had higher self-reported exposures. Urban adolescents, non-Hispanic black or other racial/ethnic minority, and those living in neighborhoods with a higher percentage of poverty had more potential exposures to tobacco retailers in their path between home and school. CONCLUSIONS: Rural adolescents had more self-reported marketing exposures than urban adolescents. However, urban adolescents had more potential tobacco exposures between home and school. Thus, point of sale marketing limitations might be a more effective policy intervention in rural areas whereas limits on tobacco retailers might be more effective for urban areas.

Self-Medication Phenomenon; A Population Based Study from Lahore.

OBJECTIVE: To study the reasons of self-medication in rural and urban population.. METHODS: The cross-sectional descriptive study was conducted in Lahore, Pakistan, from March to August 2017, and comprised inhabitants of rural and urban areas of the city regardless of gender and aged 18-50 years. The subjects were enrolled using non probability convenience sampling technique. Data was collected using a semi-structured questionnaire, which was validated through content validity index. Data was analysed using SPSS 21. RESULTS: Of the 786 participants, 551(70%) were from the urban areas and 235(30%) were from the rural areas. The mean age of the sample was 30.54±8.50. Overall, 746(95%) were taking medicines without a prescription. Among them, 528(96%) were urban and 218(93%) were rural inhabitants (p<0.07). Besides, 352(47.2%) were males and 394(52.8%) were females (p>0.05). The most frequent reason cited for self-medication was quick relief by 478(64.1%) subjects. CONCLUSIONS: Self-medication prevalence was very high in both urban and rural populations.

Comparison of the prevalence of body mass disorders in 7-year-old children living in rural and urban areas of Lower Silesia in Poland

Background: Body height and weight are somatic qualities largely determined by genetic factors. These qualities are also modified by the factors of external environment which have a higher impact on body mass rather than height. Objective: The aim of the research was to identify the prevalence of disorders related to body mass / height ratio in children residing in areas of diverse population numbers. A reconnaissance of cross-environmental diversification of the BMI value was also conducted. Material and Methods: The sample consisted of 593 healthy children (314 boys; 279 girls) aged 7 from large city (Wroclaw), small city (Polkowice) and rural environment (villages in the Lower Silesia) in Poland. Body height and weight were measured using standard procedures and body mass index (BMI) was calculated. Children's BMI categories were defined using IOTF cutoff points. Statistical analysis was carried out using ANOVA. Differences were considered significant at p < 0.05. Results: The data analysis showed a general lack of significant cross-environmental and cross-gender differences in mean values of BMI among the studies girls and boys. Prevalence of children with abnormal body mass residing in areas of diverse degree of urbanisation varies from 20% to 28%. Prevalence of underweight in 7-year-old children is intensified particularly in urban environment where it occurs in a degree comparable to overweight (9.4% vs 10.7%). Conclusions: The observed not significant differences in BMI means in the 7-year-old children, indicate the disappearing of disproportions in basic somatic parameters between children from environments of different urbanisation degree. Underweight is found in 6%-12% children, which is particularly intensified in urban environment where it occurs with prevalence comparable to the phenomenon of overweight. This suggests the need to introduce intervention measures aimed at increasing the consciousness of parents in terms of effects of malnutrition in the contexts of health risks for a developing child.

Differences between preschoolers with asthma and allergies in urban and rural environments.

OBJECTIVE: Previous studies have provided conflicting results about how living in a rural or urban environment influences schoolchildren with asthma and allergic diseases in different ways. The aim of the present study was to evaluate if recurrent wheezing preschoolers from rural or urban areas differ in asthma, allergic diseases, and atopy. METHODS: A cross-sectional-study in Rafaela, Argentina, on 143 preschoolers with recurrent wheezing from rural and urban settings was performed (2010-2012). Diagnosis of asthma (by positive asthma predictive index [API]), allergic diseases (rhinitis, dermatitis), and atopy (by skin prick test [SPT], peripheral blood eosinophils, and serum total IgE) were assessed. RESULTS: Preschoolers from rural settings had significantly higher prevalence of vaginal delivery, longer breastfeeding, earlier onset of wheezing, more parental smoking, siblings, shared a bedroom, and more exposure to chemicals used in plant fumigation or farm animals, and unpasteurized milk consumption, in comparison to preschoolers living in urban setting. In contrast, preschoolers from urban areas had significantly higher prevalence of parental history of allergy, positive skin prick test, and positive API. After multivariate analysis adjusting for covariates, maternal smoking [odds ratio (OR) = 3.44] and positive SPT (OR = 5.57) significantly increase the risk of asthma diagnosis (positive API); in contrast, living in rural setting (OR = 0.04), and having more siblings (OR = 0.51) decrease their risk. CONCLUSIONS: Recurrent wheezing preschoolers from rural areas had a significant inverse odds of being diagnosed with asthma (type-2 inflammation) when compared to those from urban areas. Exposure to farm animals and consumption of unpasteurized milk might have a role.

Analysis of low birth weight and its co-variants in Bangladesh based on a sub-sample from nationally representative survey.

BACKGROUND: Low birth weight (LBW) remains a leading global cause of childhood morbidity and mortality. This study leverages a large national survey to determine current prevalence and socioeconomic, demographic and heath related factors associated with LBW in Bangladesh. METHODS: Data from the Multiple Indicator Cluster Survey (MICS) 2012-13 of Bangladesh were analyzed. A total of 2319 women for whom contemporaneous birth weight data was available and who had a live birth in the two years preceding the survey were sampled for this study. However, this analysis only was able to take advantage of 29% of the total sample with 71% missing birth weight for newborns. The indicator, LBW (< 2500 g) of infants, was examined as the outcome variable in association with different socioeconomic, demographic and health-related covariates. Mixed-effects logistic regression was performed to identify possible factors related to LBW. RESULTS: In the selected sub-sample, about 20% of infants were born with LBW, with lowest rates observed in Rajshahi (11%) and highest rates in Rangpur (28%). Education of mothers (adjusted odds ratio [AOR] 0.52, 95% confidence interval [CI] 0.39-0.68 for secondary or higher educated mother) and poor antenatal care (ANC) (AOR 1.40, 95% CI 1.04-1.90) were associated with LBW after adjusting for mother's age, parity and cluster effects. Mothers from wealthier families were less likely to give birth to an LBW infant. Further indicators that wealth continues to play a role in LBW were that place of delivery, ANC and delivery assistance by quality health workers were significantly associated with LBW. However there has been a notable fall in LBW prevalence in Bangladesh since the last comparable survey (prevalence 36%), and an evidence of possible elimination of rural/urban disparities. CONCLUSIONS: Low birth weight remains associated with key indicators not just of maternal poverty (notably adequate maternal education) but also markers of structural poverty in health care (notably quality ANC). Results based on this sub-sample indicate LBW is still a public health concern in Bangladesh and an integrated effort from all stakeholders should be continued and interventions based on the study findings should be devised to further reduce the risk of LBW.