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1.
PLoS One ; 15(11): e0240526, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33141833

RESUMEN

In-person (face-to-face) data collection methods offer many advantages but can also be time-consuming and expensive, particularly in areas of difficult access. We take advantage of the increasing mobile phone penetration rate in rural areas to evaluate the feasibility of using cell phones to monitor the provision of key health and nutrition interventions linked to the first 1,000 days of life, a critical period of growth and development. We examine response rates to calendarized text messages (SMS) and phone calls sent to 1,542 households over a period of four months. These households have children under two years old and pregnant women and are located across randomly selected communities in Quiche, Guatemala. We find that the overall (valid) response rate to phone calls is over 5 times higher than to text messages (75.8% versus 14.4%). We also test whether simple SMS reminders improve the timely reception of health services but do not find any effects in this regard. Language, education, and age appear to be major barriers to respond to text messages as opposed to phone calls, and the rate of response is not correlated with a household's geographic location (accessibility). Moreover, response veracity is high, with an 84-91% match between household responses and administrative records. The costs per monitored intervention are around 1.12 US dollars using text messages and 85 cents making phone calls, with the costs per effective answer showing a starker contrast, at 7.76 and 1.12 US dollars, respectively. Our findings indicate that mobile phone calls can be an effective, low-cost tool to collect reliable information remotely and in real time. In the current context, where in-person contact with households is not possible due to the COVID-19 crisis, phone calls can be a valuable instrument for collecting information, monitoring development interventions, or implementing brief surveys.


Asunto(s)
Teléfono Celular/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Monitoreo Fisiológico/estadística & datos numéricos , Estado Nutricional/fisiología , Pandemias , Neumonía Viral/epidemiología , Población Rural/estadística & datos numéricos , Adulto , Teléfono Celular/economía , Preescolar , Femenino , Guatemala/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Monitoreo Fisiológico/economía , Embarazo , Sistemas Recordatorios/economía , Sistemas Recordatorios/estadística & datos numéricos , Encuestas y Cuestionarios , Telemedicina/economía , Telemedicina/estadística & datos numéricos , Envío de Mensajes de Texto/economía , Envío de Mensajes de Texto/estadística & datos numéricos
2.
MMWR Morb Mortal Wkly Rep ; 69(45): 1686-1690, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33180752

RESUMEN

Large indoor gatherings pose a high risk for transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), and have the potential to be super-spreading events (1,2). Such events are associated with explosive growth, followed by sustained transmission (3). During August 7-September 14, 2020, the Maine Center for Disease Control and Prevention (MeCDC) investigated a COVID-19 outbreak linked to a wedding reception attended by 55 persons in a rural Maine town. In addition to the community outbreak, secondary and tertiary transmission led to outbreaks at a long-term care facility 100 miles away and at a correctional facility approximately 200 miles away. Overall, 177 COVID-19 cases were epidemiologically linked to the event, including seven hospitalizations and seven deaths (four in hospitalized persons). Investigation revealed noncompliance with CDC's recommended mitigation measures. To reduce transmission, persons should avoid large gatherings, practice physical distancing, wear masks, stay home when ill, and self-quarantine after exposure to a person with confirmed SARS-CoV-2 infection. Persons can work with local health officials to increase COVID-19 awareness and determine the best policies for organizing social events to prevent outbreaks in their communities.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Neumonía Viral/epidemiología , Prisiones/estadística & datos numéricos , Instituciones Residenciales/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Anciano , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico , Trazado de Contacto , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Femenino , Humanos , Maine/epidemiología , Masculino , Matrimonio , Persona de Mediana Edad , Pandemias , Neumonía Viral/transmisión , Adulto Joven
3.
MMWR Morb Mortal Wkly Rep ; 69(45): 1671-1674, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33180753

RESUMEN

In the United States, outbreaks of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), were initially reported in densely populated urban areas (1); however, outbreaks have since been reported in rural communities (2,3). Rural residents might be at higher risk for severe COVID-19-associated illness because, on average, they are older, have higher prevalences of underlying medical conditions, and have more limited access to health care services.* In May, after a cluster of seven COVID-19 cases was identified in a rural Ohio Amish community, access to testing was increased. Among 30 additional residents tested by real-time reverse transcription-polymerase chain reaction (RT-PCR; TaqPath COVID-19 Combo Kit),† 23 (77%) received positive test results for SARS-CoV-2. Rapid and sustained transmission of SARS-CoV-2 was associated with multiple social gatherings. Informant interviews revealed that community members were concerned about having to follow critical mitigation strategies, including social distancing§ and mask wearing.¶ To help reduce the ongoing transmission risk in a community, state and county health department staff members and community leaders need to work together to develop, deliver, and promote culturally responsive health education messages to prevent SARS-CoV-2 transmission and ensure that access to testing services is timely and convenient. Understanding the dynamics of close-knit communities is crucial to reducing SARS-CoV-2 transmission.


Asunto(s)
Amish/psicología , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Neumonía Viral/epidemiología , Población Rural , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Amish/estadística & datos numéricos , Niño , Infecciones por Coronavirus/transmisión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ohio/epidemiología , Pandemias , Neumonía Viral/transmisión , Población Rural/estadística & datos numéricos , Conducta Social , Adulto Joven
4.
MMWR Morb Mortal Wkly Rep ; 69(44): 1617-1621, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33151923

RESUMEN

Stroke is the fifth leading cause of death in the United States (1). In 2017, on average, a stroke-related death occurred every 3 minutes and 35 seconds in the United States, and stroke is a leading cause of long-term disability (1). To prevent mortality or long-term disability, strokes require rapid recognition and early medical intervention (2,3). Common stroke signs and symptoms include sudden numbness or weakness of the face, arm, or leg, especially on one side; sudden confusion or trouble speaking; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance; and a sudden severe headache with no known cause. Recommended action at the first sign of a suspected stroke is to quickly request emergency services (i.e., calling 9-1-1) (2). Public education campaigns have emphasized recognizing stroke signs and symptoms and the importance of calling 9-1-1, and stroke knowledge increased 14.7 percentage points from 2009 to 2014 (4). However, disparities in stroke awareness have been reported (4,5). Knowledge of the five signs and symptoms of stroke and the immediate need to call emergency medical services (9-1-1), collectively referred to as "recommended stroke knowledge," was assessed among 26,076 adults aged ≥20 years as part of the 2017 National Health Interview Survey (NHIS). The prevalence of recommended stroke knowledge among U.S. adults was 67.5%. Stroke knowledge differed significantly by race and Hispanic origin (p<0.001). The prevalence of recommended stroke knowledge was highest among non-Hispanic White adults (71.3%), followed by non-Hispanic Black adults (64.0%) and Hispanic adults (57.8%). Stroke knowledge also differed significantly by sex, age, education, and urbanicity. After multivariable adjustment, these differences remained significant. Increasing awareness of the signs and symptoms of stroke continues to be a national priority. Estimates from this report can inform public health strategies for increasing awareness of stroke signs and symptoms.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Accidente Cerebrovascular/diagnóstico , Adulto , Anciano , Asesoramiento de Urgencias Médicas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados Unidos , Población Urbana/estadística & datos numéricos , Adulto Joven
5.
BMC Public Health ; 20(1): 1559, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33066763

RESUMEN

BACKGROUND: Undernutrition among under five children in India is a major public health problem. Despite India's growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas. Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India. METHODS: A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. RESULTS: The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37). Overall prevalence of stunting among children under five was 45.9%, wasting was 17.1 and 35.4% children were underweight. Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area. In the rural areas exclusive breast feeding (p < 0.001) and acute diarrhea (p = 0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p < 0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding (p < 0.05) was associated with wasting, sex of the child (p < 0.05) and type of family (p < 0.05) were associated with stunting,and low income of the family (p < 0.05) was associated with underweight. CONCLUSIONS: Factors like sex of the child, birth order,exclusive breast feeding,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community. TRIAL REGISTRATION: Trial registration number: CTRI/2017/12/010881 ; Registration date:14/12/2017. Retrospectively registered.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Áreas de Pobreza , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Preescolar , Estudios Transversales , Femenino , Humanos , India/epidemiología , Lactante , Masculino , Madres/estadística & datos numéricos , Prevalencia , Factores de Riesgo , Factores Socioeconómicos
6.
Rev Saude Publica ; 54: 90, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33027343

RESUMEN

OBJECTIVE: To analyze factors associated with diarrheal disease in the rural Caribbean region of Colombia. METHOD: A cross-sectional study conducted in the rural area of the Cesar Department, Colombia, between November 2017 and June 2018. Self-reported cases of diarrheal disease were surveyed, and water samples from 42 households were collected and analyzed. Descriptive statistics were employed in the analysis of socioeconomic status, environmental and sanitary conditions, and we evaluated their association with the diarrheal disease using the Poisson regression models. Each model was adjusted with variables suggested by specific directed acyclic graphs. RESULTS: Poor water supply conditions, hygiene and basic sanitation were reported in the study area. All water samples were classified either as high risk for health problems or unfit for human consumption. The diarrheal disease had a prevalence of 7.5% across all ages and of 23.5% in children under five years old. The variables rainy season (PR = 0.24; 95%CI 0.07-0.85), children under five years old (PR = 4.05; 95%CI 1.70-9.68), water from deep wells (PR = 16.90; 95%CI 2.45-116.67), water from artificial ponds (PR = 11.47; 95%CI 1.27-103.29), toilets availability (PRA = 0.23; 95%CI 0.06-0.96), and swine presence (PR = 0.20; 95%CI 0.05-0.74) were significantly associated with the occurrence of diarrheal disease. CONCLUSION: Water supply, hygiene and basic sanitation conditions have been associated with the diarrheal disease, affecting almost a quarter of the population under five years old. There is an urge for the design of effective policies that improve environmental and sanitation conditions in rural areas.


Asunto(s)
Diarrea/epidemiología , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Colombia/epidemiología , Estudios Transversales , Encuestas Epidemiológicas , Humanos , Lactante , Persona de Mediana Edad , Factores de Riesgo , Adulto Joven
8.
PLoS One ; 15(10): e0240785, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33057375

RESUMEN

Masks are an effective tool in combatting the spread of COVID-19, but some people still resist wearing them and mask-wearing behavior has not been experimentally studied in the United States. To understand the demographics of mask wearers and resistors, and the impact of mandates on mask-wearing behavior, we observed shoppers (n = 9935) entering retail stores during periods of June, July, and August 2020. Approximately 41% of the June sample wore a mask. At that time, the odds of an individual wearing a mask increased significantly with age and was also 1.5x greater for females than males. Additionally, the odds of observing a mask on an urban or suburban shopper were ~4x that for rural areas. Mask mandates enacted in late July and August increased mask-wearing compliance to over 90% in all groups, but a small percentage of resistors remained. Thus, gender, age, and location factor into whether shoppers in the United States wear a mask or face covering voluntarily. Additionally, mask mandates are necessary to increase mask wearing among the public to a level required to mitigate the spread of COVID-19.


Asunto(s)
Utilización de Equipos y Suministros/estadística & datos numéricos , Máscaras/estadística & datos numéricos , Equipo de Protección Personal/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Población Rural/estadística & datos numéricos , Factores Sexuales , Población Urbana/estadística & datos numéricos , Wisconsin
9.
PLoS One ; 15(10): e0241330, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33112922

RESUMEN

OBJECTIVES: According to current reporting, the number of active coronavirus disease 2019 (COVID-19) infections is not evenly distributed, both spatially and temporally. Reported COVID-19 infections may not have properly conveyed the full extent of attention to the pandemic. Furthermore, infection metrics are unlikely to illustrate the full scope of negative consequences of the pandemic and its associated risk to communities. METHODS: In an effort to better understand the impacts of COVID-19, we concurrently assessed the geospatial and longitudinal distributions of Twitter messages about COVID-19 which were posted between March 3rd and April 13th and compared these results with the number of confirmed cases reported for sub-national levels of the United States. Geospatial hot spot analysis was also conducted to detect geographic areas that might be at elevated risk of spread based on both volume of tweets and number of reported cases. RESULTS: Statistically significant aberrations of high numbers of tweets were detected in approximately one-third of US states, most of which had relatively high proportions of rural inhabitants. Geospatial trends toward becoming hotspots for tweets related to COVID-19 were observed for specific rural states in the United States. DISCUSSION: Population-adjusted results indicate that rural areas in the U.S. may not have engaged with the COVID-19 topic until later stages of an outbreak. Future studies should explore how this dynamic can inform future outbreak communication and health promotion.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Geografía Médica , Pandemias , Neumonía Viral , Medios de Comunicación Sociales , Actitud Frente a la Salud , Participación de la Comunidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Estudios Prospectivos , Salud Pública , Población Rural/estadística & datos numéricos , Medios de Comunicación Sociales/estadística & datos numéricos , Factores de Tiempo , Estados Unidos/epidemiología , Población Urbana/estadística & datos numéricos
10.
Indian J Ophthalmol ; 68(11): 2396-2398, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33120626

RESUMEN

Purpose: With the outbreak of coronavirus disease 2019 (COVID-19), India went for lockdown-I on March 23, 2020. In this article, we report on the demographic profile and ocular disorders from our 20 rural eye centres during lockdown-I and its comparison with the pre-lockdown period. Methods: A retrospective analysis was conducted for all patients who visited or had teleconsultations at the 20 rural centres in our network between March 23 and April 19, 2020. Demographic and clinical details were collected from electronic medical records (EMR). Subspecialty was decided based on the diagnosis. Patients who needed advanced care were referred to the higher tertiary centres. We report the profile of patients seen and managed at the rural centres and the reasons for referrals. We also compare the data with the pre-lockdown period. Results: During the lockdown-I period, a total of 263 patients were treated including 48 teleconsultations (18.25%). The mean age was 48.16 years (SD: 19.53 years). There were 118 females (44.87%). As compared to pre-lockdown, during the lockdown, the patient visits were highest in the cornea and anterior segment specialty with 114 patients (43.35%), including conjunctivitis (n = 25; 22.32%). Of the 263 patients, 24 patients (9.12%) were referred to tertiary centres. This includes 6/27 (22.22%) patients of microbial keratitis. As compared to this, during pre-lockdown, 28,545 patients were seen. The mean age was 49.03 years (SD: 19.24 years). There were 14,927 (52.29%) females. The referral was 1525 (5.34%), including 34/249 (13.65%) of those with keratitis. Conclusion: Lockdown-I had significantly impacted patient care in rural areas. As compared to the pre-lockdown period, during the lockdown, there was an issue with access to services by females. Despite a higher number of specialty patients (including emergencies) visiting during the lockdown, 91% of the patients who visited rural centres could be managed locally, avoiding long-distance travel.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Oftalmopatías/epidemiología , Neumonía Viral/epidemiología , Cuarentena/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Centros de Atención Terciaria/estadística & datos numéricos , Adulto , Anciano , Estudios Transversales , Prestación de Atención de Salud/estadística & datos numéricos , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(9): 1522-1526, 2020 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-33076611

RESUMEN

Objective: To explore the current status of HBV infection before pregnancy among rural childbearing age people in Yunnan province, find out the population at high risk and areas with high incidence and provide evidence for promoting pre-pregnancy aristogenesis and medical interventions for prevention of HBV infection. Methods: The subjects in the study were rural childbearing age people aged 18-49 who received the national free pre pregnancy eugenic health examination in Yunnan province during 2013-2017. Descriptive analysis was conducted for HBsAg positive rate and its difference among various characteristics. The SPSS 22.0 software was used for statistical analysis. Results: A total of 2 180 841 rural childbearing age people were surveyed, the HBsAg positive rate before pregnancy was 3.13%(68 314/2 180 841) in Yunnan. And the HBsAg positive rate was 3.56% (37 694/1 057 376) in men, higher than that in women (2.73%, 30 620/1 123 465). The HBsAg positive rate was highest in age group 41-49 years (3.77%, 3 126/82 931). The HBsAg positive rate was higher in minority ethnic group (3.77%, 27 974/742 518) than in Han ethnicity group (2.81%, 40 024/1 425 870). Moreover, the highest HBsAg positive rate of was 8.20%(851/10 378) in Yao ethnic group. The people with education level of primary education had the highest HBsAg positive rate (3.97%, 17 294/435 219). The HBsAg positive rate was highest in Xishuangbanna Dai autonomous prefecture (6.65%, 3 875/58 232) in Yunnan. Moreover, the HBsAg positive population in severe poor area (3.32%, 19 755/595 665) was higher than those in less poor area (3.17%, 29 750/939 101) or normal areas (2.91%, 18 809/646 075). There was significant difference in HBsAg positive rate among populations in different age groups, ethnic groups, education level groups, areas and economic level groups (P<0.001). Conclusions: The HBsAg positive rate in rural childbearing age people in Yunnan was related to multi factors, including sex, age, ethnic group, education level, area and economic development level. The HBsAg positive rate was higher in men, older age and lower education level, minority ethnic group (especially in Yao ethnic group), from Xishuangbanna prefecture and the poor living conditions in childbearing age population.


Asunto(s)
Antígenos de Superficie de la Hepatitis B , Tamizaje Masivo , Población Rural , Adolescente , Adulto , China , Grupos Étnicos/estadística & datos numéricos , Femenino , Antígenos de Superficie de la Hepatitis B/análisis , Humanos , Masculino , Tamizaje Masivo/estadística & datos numéricos , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Adulto Joven
12.
BMC Public Health ; 20(1): 1442, 2020 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-32967642

RESUMEN

BACKGROUND: There has been an increase in older rural-to-urban migrant workers (aged 50 and above) in mainland China, little known about their depressive symptoms. The aim of this study was to identify depressive symptoms among older rural-to-urban migrant workers, as well as explored the factors leading to differences in depressive symptoms between older rural-to-urban migrant workers and their rural counterparts (older rural dwellers) and urban counterparts (older urban residents) in mainland China. The results provided a comprehensive understanding of the depressive symptoms of older rural-to-urban migrant workers, and had great significance for improving the depressive symptoms for this vulnerable group. METHODS: Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015, and coarsened exact matching (CEM) method was employed to control confounding factors. This study employed a Chinese version 10-item short form of the Center for Epidemiologic Studies-Depression Scale (CES-D 10) to measure depressive symptoms, and used the Social-Ecological Model as a framework to explore influential factors related to depressive symptoms. Specifically, the approach of Fairlie's decomposition was used to parse out differences into observed and unobserved components. RESULTS: After matching, our findings indicated that the prevalence of depressive symptoms in older rural-to-urban migrant workers was lower than older rural dwellers; and the prevalence of depressive symptoms in older rural-to-urban migrant workers was higher than older urban residents. Fairlie's decomposition analysis indicated that type of in-house shower, sleeping time at night and ill in the last month were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older rural dwellers; self-reported health and sleeping time at night were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older urban residents. CONCLUSIONS: Differences in depressive symptoms between older rural-to-urban migrant workers and their rural and urban counterparts did exist. Our findings contributed to a more reliable understanding in depressive symptoms among older rural-to-urban migrant workers. Our findings would be of referential significance for improving older rural-to-urban migrant workers' depressive symptoms.


Asunto(s)
Depresión/epidemiología , Disparidades en el Estado de Salud , Población Rural/estadística & datos numéricos , Migrantes/psicología , Población Urbana/estadística & datos numéricos , Anciano , China/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Migrantes/estadística & datos numéricos
13.
Environ Health Prev Med ; 25(1): 51, 2020 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-32912134

RESUMEN

BACKGROUND: China has the largest elderly population in the world; little attention has been paid to the mental health of elderly in areas of extreme poverty. This is the first study to investigate the mental health of the rural elderly in poverty state counties in Chongqing and was part of the Chongqing 2018 health literacy promotion project. METHODS: In 2019, a cross-sectional study was conducted to investigate the mental health status of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of 1400 elderly aged ≥ 65 years were interviewed, where mental health status was measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic regression was performed to evaluate the influencing factors related to mental health of the elderly in these areas. RESULTS: The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and the mental health status of the elderly in the northeastern wing of Chongqing was better than the one in the southeastern wing of Chongqing. A worse self-rated health was the risk factor for mental health both in the northeastern and southeastern wings of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12-1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR (95% CI) = 1.33 (1.13-1.56), P = 0.001) was a risk factors in the southeastern wing. CONCLUSIONS: The results showed that mental health of the elderly in poverty state counties was poor, especially in the southeastern wing of Chongqing. Particular attention needs to be paid to the males who were less educated, older, and single; female with lower annual per capital income; and especially the elderly with poor self-rated health.


Asunto(s)
Salud Mental/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Anciano , Anciano de 80 o más Años , China , Estudios Transversales , Femenino , Política de Salud , Humanos , Modelos Logísticos , Masculino , Análisis Multivariante
15.
J Rural Health ; 36(4): 602-608, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32894612

RESUMEN

PURPOSE: This study compared the average daily increase in COVID-19 mortality rates by county racial/ethnic composition (percent non-Hispanic Black and percent Hispanic) among US rural counties. METHODS: COVID-19 daily death counts for 1,976 US nonmetropolitan counties for the period March 2-July 26, 2020, were extracted from USAFacts and merged with county-level American Community Survey and Area Health Resource File data. Covariates included county percent poverty, age composition, adjacency to a metropolitan county, health care supply, and state fixed effects. Mixed-effects negative binomial regression with random intercepts to account for repeated observations within counties were used to predict differences in the average daily increase in the COVID-19 mortality rate across quartiles of percent Black and percent Hispanic. FINDINGS: Since early March, the average daily increase in the COVID-19 mortality rate has been significantly higher in rural counties with the highest percent Black and percent Hispanic populations. Compared to counties in the bottom quartile, counties in the top quartile of percent Black have an average daily increase that is 70% higher (IRR = 1.70, CI: 1.48-1.95, P < .001), and counties in the top quartile of percent Hispanic have an average daily increase that is 50% higher (IRR = 1.50, CI: 1.33-1.69, P < .001), net of covariates. CONCLUSION: COVID-19 mortality risk is not distributed equally across the rural United States, and the COVID-19 race penalty is not restricted to cities. Among rural counties, the average daily increase in COVID-19 mortality rates has been significantly higher in counties with the largest shares of Black and Hispanic residents.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Betacoronavirus , Infecciones por Coronavirus/mortalidad , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Neumonía Viral/mortalidad , Infecciones por Coronavirus/terapia , Femenino , Disparidades en el Estado de Salud , Humanos , Pandemias , Neumonía Viral/terapia , Pobreza/estadística & datos numéricos , Factores de Riesgo , Población Rural/estadística & datos numéricos , Estados Unidos
16.
Ann Agric Environ Med ; 27(3): 448-455, 2020 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-32955229

RESUMEN

INTRODUCTION: Cerebrovascular diseases in Poland constitute a bigger threat to life in men than in women, especially after the age of 60. Death rates indicate higher stroke over-mortality in the rural population rather than the urban. At the same time, stroke is the main cause of long-term disability, since half of the patients are unable to independently perform daily activities, which makes them dependent on other people. MATERIAL AND METHODS: The study was conducted in the Independent Public Healthcare Institution in Krasnik, eastern Poland. It covered the medical records of 1,500 patients, 780 women (52%) and 720 men (48%), aged 20-100, diagnosed with cerebral infarction. The patients were hospitalised between 2011-2016 in the Neurology Ward with a Stroke Unit, the Internal Medicine Ward, and the Anaesthetics and Intensive Care Ward. RESULTS: The stroke patients hospitalised in the Independent Public Healthcare Institution in Krasnik were residents of urban communes (59.1% of subjects) and rural communes (40.9%). The most often diagnosed type of stroke was due to embolism of the cerebral arteries (I63.4) in women (63.48%). In men, the most most often diagnosed type was cerebral infarction due to thrombosis of the cerebral arteries (I63.3; 51.33%). Stroke in 36.15% of the female subjects resulted in death. In male subjects, death occurred in 26.11% of the cases. CONCLUSIONS: Women aged around 78-years-old were the most likely to suffer a stroke. In men, it occurred eight years earlier. Despite residents of urban areas being hospitalised due to stroke more often, deaths caused by this disease were recorded the most frequently among rural residents. It can be concluded that primary stroke prevention is the only effective measure for reducing morbidity and premature mortality in the population.


Asunto(s)
Población Rural/estadística & datos numéricos , Accidente Cerebrovascular/epidemiología , Población Urbana/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Prevalencia , Accidente Cerebrovascular/clasificación , Accidente Cerebrovascular/etiología , Adulto Joven
17.
Ann Agric Environ Med ; 27(3): 469-475, 2020 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-32955231

RESUMEN

INTRODUCTION: Currently, malignancies are the most severe medical problems worldwide. Numerous, already known risk factors in carcinogenesis could be potentially avoided. Some cancer risk factors have been recognized and have become the targets of primary prophylaxis. OBJECTIVE: The aim of the study was to ascertain the state of knowledge about risk factors, primary prevention and early detection of malignancies of gastrointestinal tract (GIT) in the urban and rural population of the Lublin province in Eastern Poland. MATERIAL AND METHODS: The study was cross-sectional. The originally designed questionnaire was applied to the group of 1,352 patients, representatives of both the rural and urban environments of the Lublin province during random appointments with their general practitioner (GP). RESULTS: The study showed low awareness of the issues connected with GIT malignancies within the studied group. The problem was particulary apparent in the rural population. CONCLUSIONS: In order to raise general awareness of cancer, different means should be applied in urban and rural populations. GPs and the media were found to have the leading rols in the promotion of primary prevention.


Asunto(s)
Detección Precoz del Cáncer/estadística & datos numéricos , Neoplasias Gastrointestinales/psicología , Conocimientos, Actitudes y Práctica en Salud , Prevención Primaria/estadística & datos numéricos , Neoplasias Gastrointestinales/diagnóstico , Neoplasias Gastrointestinales/prevención & control , Polonia , Factores de Riesgo , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos
18.
J Environ Public Health ; 2020: 2123652, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879630

RESUMEN

Background: Open defecation was largely a rural phenomenon most widely attributed to poor latrine ownership at community level. We aimed at examining latrine ownership and its determinants in rural villages of the Tigray region, Northern Ethiopia. Methods: Community-based cross-sectional study was conducted from June to July 2018. A total of 756 randomly selected households were involved in the study. The multistage cluster sampling technique was used to select study households. Data were checked, coded, and entered into Epi-Info version 7. Besides, it was exported to SPSS version 20 for data analysis. Multivariable logistic regression analysis was involved to estimate the net effect size of factors associated with latrine ownership. Results: The proportion of households owning latrine was 35.7%. The majority (84.4%) of constructed latrines were utilized by household families. Households advocated latrine IEC by Health Extension Workers (HEWs) (AOR = 1.902, 95% CI: 1.269-2.852), living in their private house (AOR = 3.13, 95% CI: 1.528-6.401), and the occupation status of government employees (AOR = 3.54, 95% CI: 0.586-21.397) are more likely to lead to the construction of latrines. The availability of latrine made on slab floor (AOR = 1.790, 95% CI: 0.297-3.102), having a latrine constructed inside the household compound (AOR = 4.463, 95% CI: 1.021-19.516), and delivery of latrine IEC by Women Development Armies (WDAs) (AOR = 2.425, 95% CI: 0.728-8.083) may lead to better latrine utilization at the household level. Conclusion: Households owning latrine at the community level were low. The desired level of latrine ownership will be realized if all sanitation and hygiene components are kept on eye side by side in line with identified predictor factors.


Asunto(s)
Propiedad/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Cuartos de Baño/estadística & datos numéricos , Adulto , Anciano , Estudios Transversales , Empleo , Etiopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Adulto Joven
19.
BMC Public Health ; 20(1): 1468, 2020 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-32993550

RESUMEN

BACKGROUND: In Ethiopia, malaria is one of the public health problems, and it is still among the ten top leading causes of morbidity and mortality among under-five children. However, the studies conducted in the country have been inconclusive and inconsistent. Thus, this study aimed to assess factors associated with malaria among under-five children in Ethiopia. METHODS: We retrieved secondary data from the malaria indicator survey data collected from September 30 to December 10, 2015, in Ethiopia. A total of 8301 under-five-year-old children who had microscopy test results were included in the study. Bayesian multilevel logistic regression models were fitted and Markov chain Monte Carlo simulation was used to estimate the model parameters using Gibbs sampling. Adjusted Odd Ratio with 95% credible interval in the multivariable model was used to select variables that have a significant association with malaria. RESULTS: In this study, sleeping under the insecticide-treated bed nets during bed time (ITN) [AOR 0.58,95% CI, 0.31-0.97)], having 2 and more ITN for the household [AOR 0.43, (95% CI, 0.17-0.88)], have radio [AOR 0.41, (95% CI, 0.19-0.78)], have television [AOR 0.19, (95% CI, 0.01-0.89)] and altitude [AOR 0.05, (95% CI, 0.01-0.13)] were the predictors of malaria among under-five children. CONCLUSIONS: The study revealed that sleeping under ITN, having two and more ITN for the household, altitude, availability of radio, and television were the predictors of malaria among under-five children in Ethiopia. Thus, the government should strengthen the availability and utilization of ITN to halt under-five mortality due to malaria.


Asunto(s)
Salud del Niño/estadística & datos numéricos , Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Malaria/prevención & control , Población Rural/estadística & datos numéricos , Teorema de Bayes , Niño , Preescolar , Etiopía , Composición Familiar , Femenino , Humanos , Lactante , Modelos Logísticos , Masculino , Análisis Multinivel , Estadísticas no Paramétricas , Encuestas y Cuestionarios
20.
BMC Public Health ; 20(1): 1472, 2020 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-32993592

RESUMEN

BACKGROUND: Urban-rural disparity in mortality at older ages is well documented in China. However, surprisingly few studies have systemically investigated factors that contribute to such disparity. This study examined the extent to which individual-level socioeconomic conditions, family/social support, health behaviors, and baseline health status contributed to the urban-rural difference in mortality among older adults in China. METHODS: This research used the five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, a nationally representative sample of older adults aged 65 years or older in China (n = 28,235). A series of hazard regression models by gender and age group examined the association between urban-rural residence and mortality and how this association was modified by a wide range of individual-level factors. RESULTS: Older adults in urban areas had 11% (relative hazard ratio (HR) = 0.89, p < 0.01) lower risks of mortality than their rural counterparts when only demographic factors were taken into account. Further adjustments for family/social support, health behaviors, and health-related factors individually or jointly had a limited influence on the mortality differential between urban and rural older adults (HRs = 0.89-0.92, p < 0.05 to p < 0.01). However, we found no urban-rural difference in mortality (HR = 0.97, p > 0.10) after adjusting for individual socioeconomic factors. Similar results were found in women and men, and among the young-old and the oldest-old populations. CONCLUSIONS: The urban-rural disparity in mortality among older adults in China was largely attributable to differences in individual socioeconomic resources (i.e., education, income, and access to healthcare) regardless of gender and age group.


Asunto(s)
Conductas Relacionadas con la Salud , Estado de Salud , Renta/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , China/epidemiología , Femenino , Humanos , Longevidad , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Riesgo , Percepción Social , Apoyo Social , Factores Socioeconómicos , Adulto Joven
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