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1.
Pan Afr Med J ; 33: 31, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31384346

RESUMO

Tuberculosis (TB) is endemic in the Central African Republic (CAR) with an incidence rate of 391 per 100,000 population in 2015. This study aims to analyze current epidemiological and clinical features of TB at the Hôpital de l'Amitié in the Central African Republic. We conducted an analytic retrospective study of patients hospitalized in the Department of Medicine at the Hôpital de l'Amitié from 15 April 2010 to 14 October 2011. Data were collected using a questionnaire and then analyzed with Epi info software 3.5.3. Chi-square test was used to compare proportions, using a threshold significance level of 5%. The study included 220 patients, of whom 128 were women (58.18%). The average age of patients was 35.69± 10.65 years. In 42.70% of cases, patients had no professional activity. Prevalence of tuberculosis in hospital was 10.99%. On average, 12 cases of TB were recorded each month. Most common clinical signs included: chronic cough (71.81%), fever (96.82%), alteration of the general state (91.36%) and pulmonary condensation syndrome (63.64%). The diseases most commonly associated with tuberculosis were HIV/AIDS (73.36%), malaria (48.63%) and anemia (31.81%). The mean time between symptom onset and diagnosis was 37.65 days. Mortality rate was 18.63%. TB/HIV co-infection and neuromeningeal TB were associated with a high mortality rate (p < 0.05). Tuberculosis is a common disease in Bangui and it is often associated with HIV infection. Prognosis is poor in the case of neuromeningeal involvement. Prevention and routine monitoring in HIV infected patients may contribute to reduce the extent and severity of TB.


Assuntos
Infecções por HIV/epidemiologia , Hospitalização , Tuberculose Meníngea/epidemiologia , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Anemia/epidemiologia , República Centro-Africana/epidemiologia , Coinfecção , Feminino , Humanos , Malária/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de Tempo , Tuberculose/diagnóstico , Tuberculose/mortalidade , Tuberculose Meníngea/mortalidade , Adulto Jovem
2.
Pan Afr Med J ; 33: 34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384349

RESUMO

Introduction: A cross-sectional study was conducted between the months of April to October 2015, to determine the effects of intestinal parasitic infections (IPIs) on nutritional status of school age children in Owerri and Orlu geographical zones, in Imo State, Nigeria. Methods: Faecal samples were examined using Kato Katz method and formol-ether concentration techniques, while blood samples were examined using cyamethahaemoglobin method. Anthropometric indices were used as indicators of nutritional status, children whose Height-for-Age, Weight-for-Age and Weight-for-Height were <-2 standard deviation (SD) were classified as stunted, wasted, and underweight respectively. Results: Total prevalence rate of 16.6% was recorded in the study areas with Ascaris lumbricoides (4.0%), Trichuris trichiura (0.6%), Hookworm (1.0%) Taenia sp (0.3%), Entaomeba histolytica (5.3%), Entamoeba coli (2.7%) and Giardia lambia (2.7) Majority (73.4%) of the children had light intensity. Anthropometric study results showed that 79(31.3%) of the children were malnourished. The prevalence of stunting, under-weight and wasting were higher in uninfected (86.1%, 90.0% and 10%) respectively than in infected children (13.9%, 10.0% and 0.0%) respectively, although not significant at p = 0.857, 0.587 and 0.368 respectively. Prevalence of anaemia was 17.4%, anaemia was insignificantly (p = 0.09) higher in infected (21.1%) than in uninfected (16.5%) children. Children that had co-infection recorded higher prevalence (2.2%) of severe anaemia. There was an association (p = 0.002) between anaemia and intensity of helminth infection. Malnutrition was insignificantly (p = 0.319) higher in children with heavy (100.0%) and moderate (75.0%) intensity of helminth infection than children that had light intensity (41.7%) of helminth infection. Conclusion: When compared with previous study, there were decline in the prevalence of intestinal parasitic infections and anaemia among school age children. Low intensity parasitemia with intestinal parasites had no significant effect on the malnutrition and haemoglobin profile of the children in the study areas. Therefore, improved sanitation and more deworming efforts should be intensified to ensure further decline in prevalence of intestinal parasitic infections.


Assuntos
Anemia/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Enteropatias Parasitárias/epidemiologia , Estado Nutricional , Adolescente , Anemia/parasitologia , Criança , Transtornos da Nutrição Infantil/parasitologia , Pré-Escolar , Estudos Transversais , Fezes/parasitologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/parasitologia , Humanos , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/parasitologia , Nigéria/epidemiologia , Prevalência , Magreza/epidemiologia , Magreza/parasitologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/parasitologia
3.
West Afr J Med ; 36(2): 133-137, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385599

RESUMO

BACKGROUND: Anaemia is a common disorder occurring in about 33% of the global population. It is an important cardiovascular risk factor and a key indicator of some chronic complications of Diabetes Mellitus (DM). This study aimed to determine the burden of anaemia and its correlation with some clinical and biochemical parameters among patients with DM attending a tertiary health facility in Zaria, Northwestern Nigeria. SUBJECTS, MATERIALS AND METHODS: This was a case-control study in which 168 participants were enrolled (84 DM patients, 84 controls). It was conducted in the Endocrinology and Metabolic clinics of Ahmadu Bello University Teaching Hospital, Zaria. Consenting DM patients were enrolled consecutively and subsequently, sex- and age-matched with non-diabetic controls. Data on age, gender and Haemoglobin (Hb) concentrations were collated for all study participants. Additional data on type of DM, duration of DM once diagnosis, treatment, type of treatment, history of hypertension, chronic kidney disease, peripheral neuropathy, and Fasting Blood Sugar (FBS) were collated for all cases. Data were collated and analyzed using SPSS version 21. Level of significance was set at <0.05. Ethical approval for the study was obtained from the Institutional Health Research Ethics Committee and informed consent was obtained from the all the participants. RESULTS: Females constituted 39/84(46.4%) of each arm of the study. The mean ± SD of age for both cases and controls was 53.7 ± 8.9 years. The mean ± SD duration of DM, treatment for DM and FBS were 8.4 ± 5.7 years, 5.0 ± 3.6 years and 6.1 ± 2.5mmol/L respectively. Cases had significantly lower Hb concentration compared to controls (12.1±2.2g/dl vs. 13.1 ± 1.4g/dl, t= -3.446, p = 0.001). Overall prevalence of anaemia among cases and controls was 36/84(42.9%) vs. 26/84(31.0%) Z = 1.6, p = 0.110. Among cases, haemoglobin concentration had very weak, inverse and non-statistically significant relationships with age, duration of DM diagnosis, duration of therapy and FBS levels. There was a significant relationship between anaemia on one hand and type of DM and treatment on the other. The odds of DM patients with history of CKD or uncontrolled FBS having anaemia were OR= 0.600 (95% CI 0.196, 1.836) and OR=1.755 (95% CI 0.737, 4.181) respectively. CONCLUSION: The burden of anaemia amongst patients with DM is high in Zaria, Northwestern Nigeria, and it is associated with poor glycaemic control. Hence, the need to include haematological assessment as part of routine care of patients with DM.


Assuntos
Anemia/epidemiologia , Glicemia/análise , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobina A Glicada/análise , Adulto , Idoso , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Doenças do Sistema Nervoso Periférico/epidemiologia , Prevalência , Insuficiência Renal Crônica/epidemiologia
4.
BMC Public Health ; 19(1): 735, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196013

RESUMO

BACKGROUND: Anemia is associated with impaired quality of life (QoL). We examined the relationship between anemia and QoL in the Korean population using the EuroQol five-dimensional (EQ-5D) questionnaire. METHODS: Data of 30,526 subjects were included from the Korean National Health and Nutrition Examination Survey (2008-2016). The QoL was assessed using three-levels of the EQ-5D questionnaire (G1, G2, and G3). Analysis of variance was used to compare the prevalence of anemia according to the three levels of health status in each of the five dimensions of EQ-5D. Multiple linear regression analysis was used to evaluate the association between hemoglobin level and QoL, and multivariable logistic regression analysis was used to evaluate the odds ratios (ORs) and 95% confidence intervals (CIs) for low levels of each of the five dimensions of EQ-5D. RESULTS: As the level of EQ-5D was worse (from G1 to G3), the prevalence of anemia increased (p for trend < 0.001). Hemoglobin level and EQ-5D showed positive association after adjusting for all covariates such as age, sex, smoking, alcohol drinking, exercise, education, income, marital status, urban living, diabetes mellitus, hypertension, hypercholesterolemia, chronic kidney disease, total calorie intake, and protein intake. Subjects with anemia had increased ORs for low levels (G2 + G3) of each dimension of EQ-5D compared to subjects without anemia. ORs and 95% CIs for mobility, self-care, and usual activities were 1.208(1.078, 1.353), 1.161(0.98, 1.376), and 1.331(1.173, 1.51), respectively, after adjusting for all covariates. Pain/discomfort and anxiety/depression were not associated with increased ORs for low levels of EQ-5D. CONCLUSIONS: In South Korea, low QoL was associated with anemia, particularly in the mobility, self-care, and usual activities dimensions of EQ-5D.


Assuntos
Anemia/epidemiologia , Qualidade de Vida , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , República da Coreia/epidemiologia , Inquéritos e Questionários
5.
BMC Public Health ; 19(1): 762, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200672

RESUMO

BACKGROUND: Although anemia is one of the leading causes of the global burden of disease, information about its prevalence in Russia is mostly missing. We therefore assessed its prevalence and associated factors in a Russian population. METHODS: The population-based Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age:59.0 ± 10.7 years;range:40-94 years) who underwent a standardized interview and detailed general examination. The definition of anemia was based on the hemoglobin concentration (definition #1:hemoglobin concentration < 140 g/L in men,< 130 g/L in women; definition #2:hemoglobin concentration < 130 g/L in men,< 120 g/L in women [World Health Organization definition]). RESULTS: Higher hemoglobin concentration (mean:142.6 ± 14.8 g/L; range:80-171 g/L) was associated (multivariable analysis) with male gender (P < 0.001; standardized regression coefficient beta:-0.20), higher waist-hip circumference ratio (P < 0.001;beta:0.05), higher prevalence of car ownership (P < 0.001;beta:0.05), higher blood concentrations of bilirubin (P < 0.001;beta:0.05) and triglycerides (P < 0.001;beta:0.06), lower erythrocyte sedimentation rate (P < 0.001;beta:-0.32), and shorter blood clotting time (P < 0.001;beta:-0.39). Using definition #1 and #2, anemia was detected in 1385 individuals (23.6%;95% confidence interval CI)CI:22.5,24.7) and in 453 individuals (7.7%;95%CI:7.0,8.4), respectively. Prevalence of moderate anemia (hemoglobin concenttration:110 g/L-80 g/L), detected in 165 individuals (2.8%;95%CI:2.4,3.2), increased with younger age (P = 0.008;odds ratio (OR):0.98;95%CI:0.96,0.99), female gender (P < 0.001;OR:2.52;95%CI:1.47,4.33), higher erythrocyte sedimentation rate (P < 0.001;OR:1.08;95%CI:1.06,1.09), longer blood clotting time (P < 0.001;OR:8.56;95%CI:5.68,12.9), and marginally significantly, with a lower waist-hip circumference ratio (P = 0.058;OR:0.13;95%CI:0.02,1.07). In women, it was significantly (P < 0.001) higher before menopause (8.8%;95%CI:6.4,11.1) than after menopause (3.5%;95%CI:2.8,4.3). CONCLUSIONS: In this Russian population as compared to populations from countries with a similar socio-demographic index, anemia prevalence was relatively low. As in other populations, higher anemia prevalence was strongly and inversely associated with menopause, and to a minor degree, with lower waist-hip circumference ratio and lower socio-economic background.


Assuntos
Anemia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Federação Russa/epidemiologia
6.
BMC Infect Dis ; 19(1): 483, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146689

RESUMO

BACKGROUND: Previous studies reported contradicting findings about the association between intestinal parasitosis and maternal anemia. In this study we aimed to determine the prevalence of intestinal parasitic infection and its association with anemia among pregnant women in Wondo Genet district, Southern Ethiopia. METHODS: This facility-based cross-sectional study was conducted in June and July 2018. Pregnant women (n = 352) were randomly drawn from five health centers using antenatal care follow-up lists. Trained data collectors administered the questionnaire. Capillary blood was collected and analyzed for hemoglobin using the HemoCue method. Stool sample was collected following standard procedure and analyzed for the presence and types of intestinal parasites using direct microscopy with Formalin-ether concentration technique. Association between intestinal parasitosis and anemia was measured using multivariable binary logistic regression analysis. The outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI). RESULTS: The overall prevalence of intestinal parasitic infection was 38.7% (95% CI: 33.6-43.8%). One-tenth (9.7%) of the pregnant women were infected with polyparasites. Ascaris lumbricoides was the predominant infection encountered in 24.9% of the women. The other infections identified were: hookworms (11.2%), Giardia lamblia (5.4%), Entamoeba histolytica (3.4%), Trichuris trichiura (2.9%) and Schistosoma mansoni (2.3%). The mean (± standard deviation) hemoglobin concentration was 12.3 (±1.9) g/dl and 31.5% (95% CI: 26.6-36.4%) women were anemic (hemoglobin < 11 g/dl). The prevalence of anemia among women infected with intestinal parasite (55.6%) was substantially higher than the prevalence in their counterparts (16.4%) (p <  0.001). In a multivariable model adjusted for multiple potential confounders including socio-economic status indicators, the odds of anemia were six times increased (AOR = 6.14, 95% CI: 2.04-18.45) among those affected by at least one intestinal parasite. CONCLUSION: Strengthening the existing water, sanitation and hygiene programs and routine deworming of pregnant mothers may help to reduce the burden of both intestinal parasitic infection and anemia in pregnant women.


Assuntos
Anemia/epidemiologia , Enteropatias Parasitárias/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/epidemiologia , Adolescente , Adulto , Anemia/complicações , Anemia/parasitologia , Animais , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Higiene , Enteropatias Parasitárias/complicações , Masculino , Gravidez , Complicações Hematológicas na Gravidez/parasitologia , Prevalência , Saneamento , Classe Social , Adulto Jovem
7.
Pan Afr Med J ; 32: 111, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223401

RESUMO

Introduction: Anaemia and malnutrition are common health problems in developing countries with children being the most vulnerable. They have negative impacts on human performance, growth and development, in children, both as cause and consequences of disease. Although annual mass deworming and nutrition supplement strategies have been implemented in the Tiko Health District (THD), no study has been carried out to determine the prevalence of anaemia and malnutrition. The aim of this study was therefore designed to determine the prevalence of anaemia and malnutrition among primary school children aged 5-15 years in the Tiko Health District. Methods: A cross-sectional study was carried out in 10 randomly selected schools in the THD and a total of 400 school children were enrolled in the study. Body weight and height were measured using an electronic weighing scale and stadiometer respectively. Anthropometric indices: Height-for-Age Z scores (HAZ), Weight-for-Age Z scores (WAZ) and Body Mass Index-for-Age Z scores (BMIAZ) were analyzed and compared with WHO Growth Reference Standards using WHO Anthroplus software. Hemoglobin levels were determined using Urit-12 Haemoglobinometer and anaemia defined as Hemoglobin (Hb) < 11g/dl. Data analysis was done using the SPSS software. Results: The overall prevalence of malnutrition was 9.25%, prevalence of stunting 7.5% with 0.8% being severely stunted. The prevalence of wasting was 1% and underweight 0.7%. The overall prevalence of anaemia was 5%. Parents occupation and the absence of toilet were statistically associated with anaemia (P = 0.04 and P = 0.003). Age, floor type, absence of toilet and BMI were significantly associated with malnutrition (P = 0.00, P = 0.01, P = 0.02 and P = 0.003). Conclusion: This study revealed a low prevalence of malnutrition and anaemia which could be attributed to the deworming and nutrition supplement strategies which have been implemented.


Assuntos
Anemia/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Transtornos do Crescimento/epidemiologia , Magreza/epidemiologia , Adolescente , Antropometria , Estatura/fisiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Camarões/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Instituições Acadêmicas
8.
Aust N Z J Public Health ; 43(4): 319-327, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31180619

RESUMO

OBJECTIVE: Early childhood anaemia affects health and neurodevelopment. This study describes anaemia among Aboriginal and Torres Strait Islander children of Far North Queensland. METHODS: This retrospective cohort study used health information for children born between 2006 and 2010 and their mothers. We describe the incidence of early childhood anaemia and compare characteristics of children and mothers where the child had anaemia with characteristics of children and mothers where the child did not have anaemia using bivariate and multivariable analysis, by complete case (CC) and with multiple imputed (MI) data. RESULTS: Among these (n=708) Aboriginal and Torres Strait Islander children of Far North Queensland, 61.3% (95%CI 57.7%, 64.9%) became anaemic between the ages of six and 23 months. Multivariable analysis showed a lower incidence of anaemia among girls (CC/MI p<0.001) and among children of Torres Strait Islander mothers or both Aboriginal and Torres Strait Islander mothers (CC/MI p<0.001) compared to children of Aboriginal mothers. A higher incidence of anaemia was seen among children of mothers with parity three or more (CC/MI p<0.001); children born by caesarean section (CC/MI p<0.001); and children with rapid early growth (CC/MI p<0.001). CONCLUSION: Early childhood anaemia is common among Aboriginal and Torres Strait Islander children of Far North Queensland. Poor nutrition, particularly iron deficiency, and frequent infections are likely causes. Implications for public health: Prevention of early childhood anaemia in 'Close the Gap' initiatives would benefit the Aboriginal and Torres Strait Islander children of Far North Queensland - and elsewhere in northern Australia.


Assuntos
Anemia/epidemiologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Anemia/diagnóstico , Feminino , Humanos , Incidência , Lactente , Masculino , Gravidez , Queensland/epidemiologia , Estudos Retrospectivos
9.
Medicine (Baltimore) ; 98(18): e15513, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045842

RESUMO

INTRODUCTION: Over the last few decades, the concepts of minimally invasive surgery and enhanced recovery after surgery (ERAS) protocols have been introduced into the field of total joint arthroplasty (TJA), and tranexamic acid (TXA) has been widely used in TJA. Modern-day surgical techniques and perioperative care pathways of TJA have experienced unexpected improvements. Recently, the necessity of the practice of ordering routine postoperative laboratory tests for patients undergoing primary TJA has been challenged, especially in the context of implementation of ERAS protocols in TJA. These studies have consistently suggested that routine postoperative laboratory tests are not necessary in modern-day primary, unilateral total hip arthroplasty (THA) or total knee arthroplasty (TKA), and laboratory tests after surgery should only be obtained for patients with risk factors. However, it remains unclear whether routine postoperative laboratory tests after THA and TKA remains justified in the Chinese patient population. Therefore, we developed this study to address this issue. METHODS AND ANALYSIS: This retrospective cohort study will include adult patients who underwent primary unilateral THA or TKA and received multimodal perioperative care pathways according to ERAS protocols. The following patient data will be collected from the electronic medical record system: patients' demographics, preoperative and postoperative laboratory values, operation time, intraoperative blood loss, TXA use, tourniquet use, postoperative length of stay, and any medical intervention directly related to abnormal laboratory values. The main study outcomes are the incidence of acute anemia requiring transfusion and incidence of hypoalbuminemia requiring albumin supplementation. The secondary outcomes are the rates of acute kidney injury, incidence of abnormal serum sodium level, incidence of abnormal serum potassium level, and incidence of abnormal serum calcium level. These clinical data will be analyzed to determine the incidence of abnormal postoperative laboratory values following primary unilateral THA and TKA; to clarify the frequency of any medical intervention directly related to abnormal postoperative laboratory values; and to identify risk factors that predispose patients to have abnormal postoperative laboratory results. STUDY REGISTRATION: Chinese Clinical Trial Registry (http://www.chictr.org.cn): ChiCTR1900020690.


Assuntos
Artroplastia de Quadril/reabilitação , Artroplastia do Joelho/reabilitação , Técnicas de Laboratório Clínico/normas , Cuidados Pós-Operatórios/normas , Complicações Pós-Operatórias/diagnóstico , Adulto , Anemia/diagnóstico , Anemia/epidemiologia , Anemia/etiologia , Antifibrinolíticos/uso terapêutico , Artroplastia de Quadril/estatística & dados numéricos , Artroplastia do Joelho/estatística & dados numéricos , Técnicas de Laboratório Clínico/métodos , Protocolos Clínicos/normas , Feminino , Humanos , Hipoalbuminemia/diagnóstico , Hipoalbuminemia/epidemiologia , Hipoalbuminemia/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Projetos de Pesquisa , Estudos Retrospectivos , Fatores de Risco , Ácido Tranexâmico/uso terapêutico
10.
BMC Public Health ; 19(1): 456, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035969

RESUMO

BACKGROUND: Slums are home to nearly one billion people in the world and are expanding at an exponential rate. Devarjeevanahalli is a large notified slum in Bangalore, South India which is characterised by poverty, overcrowding, hazardous living environment and social complexities. The poor living conditions not only affect the health of the people living there but also poses distinctive challenges to conducting health surveys. The purpose of this paper is to report the findings of a household survey that was done to study the health condition of people living in a slum. METHODS: A community-based cross-sectional survey was designed to determine the prevalence of health conditions using a mobile screening toolkit-THULSI (Toolkit for Healthy Urban Life in Slums Initiative). Devarjeevanahalli slum was chosen purposively as it is fairly representative of any slum in a big city in India. Sample size was calculated as 1100 households and demographic parameters at the household level and parameters related to priority health conditions (hypertension, diabetes mellitus, anaemia and malnutrition) at the individual level were studied. Six zones within the slum were purposively selected and all the contiguous households were selected. The last of the six zones was partially surveyed as the desired sample size was achieved. RESULTS: A total of 1186 households were surveyed and 3693 people were screened. More than three fourth (70.4%) of the population were below poverty line. Only one third had a regular job and the average daily income was 5.3$ and 2.6$ in men and women respectively. The prevalence of hypertension (35.5%), diabetes (16.6%) and anaemia (70.9%) was high in the screened slum population. Most of the people (56.5% of hypertensives and 34.4% diabetics) were screened for the first time. Almost half of the children under the age of five years were stunted. CONCLUSIONS: Poor income security and huge burden of health issues were reported among adults and children in the household health screening in a large notified slum in South India. Most people were unaware of their disease condition prior to the screening. Relatively simple technological solutions enabled the local health team to screen the slum population despite many challenges.


Assuntos
Programas de Rastreamento/métodos , Aplicativos Móveis , Áreas de Pobreza , Saúde da População Urbana/estatística & dados numéricos , Adolescente , Adulto , Anemia/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Prioridades em Saúde , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Índia/epidemiologia , Lactente , Masculino , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Prevalência , Características de Residência , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Adulto Jovem
11.
Malar J ; 18(1): 173, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31096985

RESUMO

BACKGROUND: In Latin America, where Plasmodium vivax malaria is more prevalent, it is known that this species plays an important role in the sustainability of transmission, and can have an impact on morbidity in terms of anaemia, nutritional status, and cognitive development in children. METHODS: The present study aimed to assess the impact of malaria infection on cognition of children in a peri-urban community in the Brazilian Amazon with moderate endemicity by applying Home Inventory and WPPSI-IV. A non-concurrent cohort study was designed and the cognitive, haematological, and nutritional profiles of the children were assessed. Children with documented malaria history were identified from official reported data. RESULTS: A total of 219 children aged between 2 and 7 years were enrolled. Although 205 (95%) children had normal birth weight, 177 (81%) were malnourished, and 35 (16%) had anaemia. Among the 100 (46%) children who experienced at least one episode of malaria, 89 (89%) children demonstrated low level of cognitive development. The findings showed that Plasmodium vivax malaria was an independent risk factor for low cognitive development. CONCLUSIONS: In addition to the known economic impact of malaria in the Amazon region, the study highlights the deleterious effects P. vivax malaria has on the socio-cultural development of the population.


Assuntos
Cognição , Malária Vivax/complicações , Malária Vivax/epidemiologia , Anemia/complicações , Anemia/epidemiologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Desnutrição/complicações , Desnutrição/epidemiologia , Morbidade , Plasmodium vivax/isolamento & purificação , Prevalência , Fatores de Risco , Inquéritos e Questionários , População Urbana
12.
Pan Afr Med J ; 32(Suppl 1): 6, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30984327

RESUMO

Introduction: human cytomegalovirus (CMV) has remained a cause of morbidity and mortality in pregnancy and immunocompromised patients. CMV is transmissible through blood transfusion. We conducted a descriptive, cross-sectional study to assess blood donor safety and to determine the prevalence and associated factors for CMV infection among blood donors in Minna, Nigeria. Methods: all consenting blood donors were screened for CMV antibodies (IgM and IgG) using ELISA kit and haematological indices using a haematological analyzer. We administered structured questionnaires to obtain socio-demographic and socio-economic data. Data were subjected to univariate, bivariate and multivariate statistical analyses using Epi Info version 3.5.4. Significant associations were presumed if p < 0.05. Results: a total of 345 participantswere recruited, the majority were males 336 (97.4%). Monthly earnings of majority of the blood donors, 136 (40.6%) ranged from ₦18,000 to ₦35,000. The prevalence of CMV infection was 96.2%. The prevalence of anti-CMV IgG antibodies was 96.2% and that of IgM was 2.6%. Most of the study participants, 274 (79.4%) were family replacement donors. The majority of the blood donors 195 (56.5%) were anaemic (PCV < 36, Hb < 12g/dl). Those with positive CMV were more likely to be of high-income level (OR = 0.32, P = 0.04). Conclusion: the seroprevalence of CMV was high with a significant proportion of donors capable of transmitting CMV infection to blood recipients. The majority of the blood donors were anaemic. High income level is associated with CMV infection. Quality of screening for anemia be improved.


Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue/estatística & dados numéricos , Segurança do Sangue , Infecções por Citomegalovirus/epidemiologia , Adulto , Anemia/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Renda/estatística & dados numéricos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Estudos Soroepidemiológicos , Inquéritos e Questionários , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-31010238

RESUMO

In this study, we assessed the hemoglobin levels and anemia status of Chinese children and adolescents from the Chinese National Nutrition and Health Survey (CNNHS) in 2010⁻2012 and analyzed the factors associated with anemia. The hemoglobin concentration and prevalence of anemia for children and adolescents aged 6⁻17 years from both CNNHS 2010⁻2012 and CNNHS 2002 were analyzed. Multi-variable logistic regression analysis was used to assess the factors associated with anemia. The mean hemoglobin concentration increased among Chinese children and adolescents, from 135.2 ± 13.9g/L in CNNHS 2002 to 141.2 ± 15.8 g/L in CNNHS 2010⁻2012, with the prevalence of anemia decreasing from 12.6% to 6.6% (p<0.0001). Anemia was specifically related to girls (p < 0.0001);children aged 6⁻8 years (p = 0.0175), 12⁻14 years (p = 0.0007), and 15⁻17 years (p < 0.0001);ordinary rural areas (p = 0.0009) and poor rural areas (p < 0.0001);spring (p < 0.0001), autumn (p < 0.0001), and winter (p < 0.0001);underweight individuals (p < 0.0001); and an annual average income per capita of less than 20,000 RMB (p < 0.0001).The prevalence of anemia in Chinese children and adolescents has improved significantly in comparison to 10 years prior; however, it remains a public health problem in this population. Further research is required to understand the determinants of iron status, which could then lead to strategies to alleviate iron deficiency for Chinese children and adolescents, especially for girls, those living in rural areas, underweight individuals, and those with a low family income.


Assuntos
Anemia/epidemiologia , Hemoglobinas/metabolismo , Adolescente , Anemia/sangue , Grupo com Ancestrais do Continente Asiático , Criança , China/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Renda , Ferro , Masculino , Inquéritos Nutricionais , Estado Nutricional , Pobreza , Prevalência
14.
Artigo em Inglês | MEDLINE | ID: mdl-30974871

RESUMO

Anemia is a public health issue for developing countries, especially for women of childbearing age. The aim of this study was to assess the anemia status and analyze the risk factors for anemia in Chinese childbearing women aged 18-49 years. Hemoglobin concentration was measured by the HiCN method in the Fifth Chinese National Nutrition and Health Survey (CNNHS) in 2010-2012. Age, region type, ethnicity, bodyweight, height, education, season and smoke habit were recorded in unified questionnaires. Latitude was divided by China's Qinling Mountains and Huaihe River. Childbearing women (28,289) from the CNNHS 2010-2012 were included in this study. The median hemoglobin concentration was 136.2(126.6-145.0) g/L, and it was significantly higher than in CNNHS 2002 (132.5 (122.3-141.6) g/L). The prevalence of anemia was 15.0%, and it was significantly lower than 10 years ago. The logistic regression analysis showed anemia in Chinese childbearing women was specifically related to 30-39 age group (P = 0.004), in spring (P < 0.0001) or in winter (P = 0.006), small and medium-sized cities (P = 0.044) and middle school education level (P = 0.027). The results showed that anemia status among childbearing women was greatly improved over 10 years since 2002, but it was still more severe than the rest of the populations. The nutrition propaganda and education is recommended for childbearing women to help them to improve the nutritional status on their own.


Assuntos
Anemia/epidemiologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , China/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estado Nutricional , Prevalência , Fatores de Risco , Adulto Jovem
15.
J Stroke Cerebrovasc Dis ; 28(7): 2026-2030, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31005562

RESUMO

BACKGROUND: Acute ischemic stroke patients are a group at high risk for pressure sores. It is important to identify risk factors for pressure sores in acute ischemic stroke patients in order to facilitate early adoption of appropriate preventive and treatment measures. METHODS: Data were derived from the China National Stroke Registry. Acute ischemic stroke patients aged >18 years who presented at the hospital within 14 days after the onset of symptoms were eligible for this study. Comprehensive baseline data were collected. The definition of pressure sores was based on assessment at discharge of whether the patient had pressure sores at any time during hospitalization. RESULTS: 12,415 patients with a mean age of 67 years and a mean length of hospitalization of 14 days were included in the study. Among these patients, 97 (0.8%) had pressure sores during hospitalization. In the multivariate analysis of risk factors for pressure sores, age (each increment of 5 years), being unmarried, NIHSS at admission (each increment of 3 points), mRS at admission (3-5 points), diabetes mellitus, hemoglobin at admission (each incremental reduction of 10 units), and history of peripheral vascular disease all were significantly correlated with the occurrence of pressure sores among acute ischemic stroke patients during hospitalization. CONCLUSIONS: Old age, severe neurological disability, being unmarried, low hemoglobin, and history of diabetes mellitus and peripheral vascular disease were risk factors for pressure sores in acute ischemic stroke patients.


Assuntos
Isquemia Encefálica/epidemiologia , Hospitalização , Pacientes Internados , Lesão por Pressão/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Fatores Etários , Idoso , Anemia/sangue , Anemia/epidemiologia , Biomarcadores/sangue , Isquemia Encefálica/diagnóstico , China/epidemiologia , Comorbidade , Diabetes Mellitus/epidemiologia , Avaliação da Deficiência , Feminino , Hemoglobinas/análise , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/epidemiologia , Lesão por Pressão/diagnóstico , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Pessoa Solteira , Acidente Vascular Cerebral/diagnóstico , Fatores de Tempo
16.
Clin Lab ; 65(4)2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30969067

RESUMO

BACKGROUND: Anemia, particularly pregnancy related iron deficiency anemia, increases the risk of maternal morbidity and mortality and the effects are more devastating in less developed and developing continents where pregnant women have low socioeconomic status. Thus, this study aimed to assess the prevalence and associated factors of anemia and iron deficiency anemia among pregnant women. METHODS: This institution based, cross-sectional study was conducted from January 1 to April 30, 2015 on a total of 217 pregnant women attending at University of Gondar Hospital, Northwest Ethiopia. A structured, pretested questionnaire was used to obtain sociodemographic information, nutritional factors, obstetrics and gynecological factors, and clinical condition. About 3 mL blood sample was collected for hemoglobin and serum ferritin deter-mination. Hgb concentrations and other RBC parameters were analyzed using a Cell Dyne 1800 hematology analyzer. Serum ferritin was measured by an automated Elecsys 1,020 using commercial kits. The data was entered to Epi info version 3.5.3 software and analyzed using SPSS 20. Frequency, proportion, and summery statistics was used to describe the study population in relation to study variables. Bi-variable and multi-variable statistical analysis was used. P-value < 0.05 was considered as statically significant. RESULTS: Out of 217 women enrolled in the study, 28 (12.9%) were found to be anemic with 75% mild, 21.4% moderate and 3.6% severe type of anemia. Anemia was more prevalent in the first (21%) and third (17.9%) trimesters. The overall prevalence of iron deficiency anemia was 3.2% (7/217) while from anemic pregnant women one fourth (25%) of them developed iron deficiency anemia. CONCLUSIONS: The overall prevalence of anemia was low and it was considered a mild public health problem. In this study, there were no statistically associated risk factors for anemia. Based on this finding, iron supplementation should be encouraged as a prophylactic measure.


Assuntos
Anemia Ferropriva/epidemiologia , Anemia/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Cuidado Pré-Natal/organização & administração , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Ferritinas/sangue , Hemoglobinas/análise , Humanos , Análise Multivariada , Pobreza , Gravidez , Prevalência , Controle de Qualidade , Risco , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
17.
BMC Res Notes ; 12(1): 202, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30940190

RESUMO

OBJECTIVE: To assess the clinical presentation and hematological profile among young (≤ 55 years) and old (> 55 years) chronic lymphocytic leukemia patients in Sudan. RESULT: In the present cross-sectional descriptive study, out of 110 cases studied, among them 31 (28.2%) were young (≤ 55 years) patients with mean age 48 years, and 79 (71.8%) were elder patients (> 55 years) with mean age 66 years, the overall mean age was 62.97 ± 12.06 with range (22-85 years), and 79 (71.8%) were males and 31 (28.2%) were females (M:F = 2.6:1) (P = 0.000). (7.3%) were asymptomatic, 61 (55.5%) presented with nonspecific complains. Generalized lymphadenopathy was seen in 52 (47.27%) with elder predominance (P = 0.03). Splenomegaly, hepatomegaly, thrombocytopenia and anemia were seen in 54 (49.1%), 14 (12.7%), 43 (39.1%) and 38 (34.5%) of patients respectively with male predominance. 54 (49.1%) and 42 (38.18%) of patients presented at Rai high risk and Binet C stages respectively with nearly same age and sex distribution. CLL in Sudan is a disease of elders, same as seen in literature, with high male to female ratio. In general hematological parameters means were noted to be distributed equally according to age and sex groups. Majority of patients were presented with nonspecific symptoms and nearly half of patients presented at late stages as reported in most developing countries.


Assuntos
Anemia , Hepatomegalia , Leucemia Linfocítica Crônica de Células B , Linfadenopatia , Esplenomegalia , Trombocitopenia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anemia/sangue , Anemia/epidemiologia , Anemia/etiologia , Feminino , Hepatomegalia/sangue , Hepatomegalia/epidemiologia , Hepatomegalia/etiologia , Humanos , Leucemia Linfocítica Crônica de Células B/sangue , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/epidemiologia , Linfadenopatia/sangue , Linfadenopatia/epidemiologia , Linfadenopatia/etiologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Esplenomegalia/sangue , Esplenomegalia/epidemiologia , Esplenomegalia/etiologia , Sudão/epidemiologia , Trombocitopenia/sangue , Trombocitopenia/epidemiologia , Trombocitopenia/etiologia , Adulto Jovem
18.
BMC Res Notes ; 12(1): 127, 2019 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-30867036

RESUMO

OBJECTIVES: Our study aimed to assess local data for compliance with IFA supplementation and prevalence of anaemia among the pregnant mothers visiting government health facilities of eastern Nepal. RESULTS: In our study samples, IFA compliance rate was 58% during pregnancy and 42% were anaemic. Anemia was 24 times more likely to occur in IFA noncompliant women during pregnancy than their counterparts (aOR = 24.2, 95% CI 10.1-58.3), and anemia was three times less likely to be found in those taking foods rich in heme-iron than their counterparts (aOR = 3.3, 95% CI 1.4-8.1).


Assuntos
Anemia/prevenção & controle , Dieta/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Ácido Fólico/administração & dosagem , Hospitais Públicos/estatística & dados numéricos , Ferro/administração & dosagem , Adesão à Medicação/estatística & dados numéricos , Complicações Hematológicas na Gravidez/prevenção & controle , Oligoelementos/administração & dosagem , Complexo Vitamínico B/administração & dosagem , Adolescente , Adulto , Anemia/epidemiologia , Estudos Transversais , Feminino , Humanos , Nepal/epidemiologia , Gravidez , Complicações Hematológicas na Gravidez/epidemiologia , Adulto Jovem
19.
Orthopedics ; 42(2): 103-109, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30889256

RESUMO

Current antifibrinolytics have decreased perioperative blood loss; however, some patients still require transfusions postoperatively. The authors sought to determine the risk factors associated with postoperative transfusions and to establish a "cutoff" preoperative hemoglobin threshold value specific to total knee arthroplasty (TKA) that would identify patients who would benefit from blood conservation programs. The institutional database was queried for primary TKA patients. Preoperative patient demographics and hemoglobin values were determined in addition to intraoperative and postoperative variables, including transfusion rate. Patients were stratified by whether they received a transfusion perioperatively, and risk factors were identified through univariable and multivariable analysis. Optimal cutoff values for hemoglobin were identified by concurrently maximizing the sensitivity and specificity for predicting the risk of a postoperative transfusion event. Men and women were analyzed independently. A total of 532 primary TKAs were included for analysis, and 33 patients (6.2%) required a transfusion. Advanced age (P=.019), low pre-operative hemoglobin value (P<.001), and failure to receive tranexamic acid (P<.001) were associated with increased risk of postoperative transfusion. A preoperative hemoglobin value of 12.5 g/dL was identified as the optimal cutoff for predicting postoperative transfusion requirements across all patients, with a sensitivity of 84.8% and a specificity of 76.4%. Preoperative anemia remains predictive of transfusion following TKA despite current antifibrinolytics. Patients with a preoperative hemoglobin value of less than 12.5 g/dL who are not receiving intravenous tranexamic acid are particularly at risk and should be considered for blood conservation programs. [Orthopedics. 2019; 42(2):103-109.].


Assuntos
Antifibrinolíticos/uso terapêutico , Artroplastia do Joelho , Transfusão de Sangue/estatística & dados numéricos , Hemoglobinas/análise , Ácido Tranexâmico/uso terapêutico , Fatores Etários , Idoso , Anemia/epidemiologia , Feminino , Humanos , Masculino , Cuidados Pós-Operatórios , Período Pré-Operatório , Estudos Retrospectivos
20.
Lancet ; 393(10176): 1101-1118, 2019 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-30876706

RESUMO

BACKGROUND: Rapid demographic, epidemiological, and nutritional transitons have brought a pressing need to track progress in adolescent health. Here, we present country-level estimates of 12 headline indicators from the Lancet Commission on adolescent health and wellbeing, from 1990 to 2016. METHODS: Indicators included those of health outcomes (disability-adjusted life-years [DALYs] due to communicable, maternal, and nutritional diseases; injuries; and non-communicable diseases); health risks (tobacco smoking, binge drinking, overweight, and anaemia); and social determinants of health (adolescent fertility; completion of secondary education; not in education, employment, or training [NEET]; child marriage; and demand for contraception satisfied with modern methods). We drew data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016, International Labour Organisation, household surveys, and the Barro-Lee education dataset. FINDINGS: From 1990 to 2016, remarkable shifts in adolescent health occurred. A decrease in disease burden in many countries has been offset by population growth in countries with the poorest adolescent health profiles. Compared with 1990, an additional 250 million adolescents were living in multi-burden countries in 2016, where they face a heavy and complex burden of disease. The rapidity of nutritional transition is evident from the 324·1 million (18%) of 1·8 billion adolescents globally who were overweight or obese in 2016, an increase of 176·9 million compared with 1990, and the 430·7 million (24%) who had anaemia in 2016, an increase of 74·2 million compared with 1990. Child marriage remains common, with an estimated 66 million women aged 20-24 years married before age 18 years. Although gender-parity in secondary school completion exists globally, prevalence of NEET remains high for young women in multi-burden countries, suggesting few opportunities to enter the workforce in these settings. INTERPRETATION: Although disease burden has fallen in many settings, demographic shifts have heightened global inequalities. Global disease burden has changed little since 1990 and the prevalence of many adolescent health risks have increased. Health, education, and legal systems have not kept pace with shifting adolescent needs and demographic changes. Gender inequity remains a powerful driver of poor adolescent health in many countries. FUNDING: Australian National Health and Medical Research Council, and the Bill & Melinda Gates Foundation.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Anemia/epidemiologia , Doenças Transmissíveis/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Doenças não Transmissíveis/epidemiologia , Obesidade/epidemiologia , Adolescente , Saúde do Adolescente/tendências , Austrália/epidemiologia , Criança , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Crescimento Demográfico , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Recursos Humanos/tendências , Adulto Jovem
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