Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.872
Filtrar
1.
Biomed Res Int ; 2022: 9170322, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35909485

RESUMO

Wasting among infants and young children in underdeveloped countries including Ethiopia is one of the most serious public health issues. Therefore, this study was designed to assess the magnitude of wasting and the variables that associate with it among infants and young children in the Kuyu district of Northern Oromia, Ethiopia. A community-based cross-sectional study of 612 infants and young children aged 6-23 months was conducted. To select eligible infants and young children from each family in the Kuyu district, a multilevel sampling approach was used. The amount and determinants related to wasting were investigated using the Statistical Package for Social Sciences (SPSS) version 20.0. In the study area, 14.1% of infants and young children were found to be wasting. Maternal educational status (AOR = 1.8, 95% CI; 1.01, 4.32), diarrhoea (AOR = 2.3, 95% CI; 1.98, 4.56), exclusive breastfeeding (AOR = 2.46, 95% CI, 1.4, 4.58), antenatal care visits (AOR = 2.21; 95% CI, 1.32, 3.48), and wealth index (AOR = 1.66, 95% CI; 1.07, 4.47) were significantly associated with wasting. According to the findings of this study, mother educational status, the occurrence of diarrhoea, exclusive breastfeeding, antenatal care visits, and wealth index have an impact on infants and young children's wasting. Therefore, to lower the burden of wasting among infants and young children in the study, community-based schooling and nutritional interventions are urgently needed.


Assuntos
Aleitamento Materno , Caquexia , Criança , Pré-Escolar , Estudos Transversais , Diarreia/epidemiologia , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Gravidez , Prevalência
2.
Front Public Health ; 10: 861629, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910920

RESUMO

Objective: Investigating the trends of child diarrhea-related mortality (DRM) is crucial to tracking and monitoring the progress of its prevention and control efforts worldwide. This study explores the spatial patterns of diarrhea-related mortality in children under five for monitoring and designing effective intervention programs. Methods: The data used in this study was obtained from the World Health Organization (WHO) public dataset that contained data from 195 countries from the year 2000 to 2017. This dataset contained 13,541,989 DRM cases. The worldwide spatial pattern of DRM was analyzed at the country level utilizing geographic information system (GIS) software. Moran's I, Getis-Ord Gi, Mean center, and Standard Deviational Ellipse (SDE) techniques were used to conduct the spatial analysis. Results: The spatial pattern of DRM was clustered all across the world during the study period from 2000 to 2017. The results revealed that Asian and African countries had the highest incidence of DRM worldwide. The findings from the spatial modeling also revealed that the focal point of death from diarrhea was mainly in Asian countries until 2010, and this focus shifted to Africa in 2011. Conclusion: DRM is common among children who live in Asia and Africa. These concentrations may also be due to differences in knowledge, attitude, and practices regarding diarrhea. Through GIS analysis, the study was able to map the distribution of DRM in temporal and spatial dimensions and identify the hotspots of DRM across the globe.


Assuntos
Diarreia , Sistemas de Informação Geográfica , Ásia , Criança , Diarreia/epidemiologia , Humanos , Incidência , Análise Espacial
3.
J Glob Health ; 12: 10011, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35916658

RESUMO

Background: Early and exclusive breastfeeding have been shown to protect young infants from all-cause and diarrhoea-related mortality. Ideally breastfeeding should be initiated within the first hour of birth. Despite efforts to increase rates of early and exclusive breastfeeding in low- and middle-income countries (LMICs), challenges with uptake remain. This analysis reviews trends in early and exclusive breastfeeding, and the impact of infant feeding interventions in reducing childhood diarrhoea. Methods: We conducted a detailed review of articles written in English between 1990 and 2020 on the impact and efficacy of breastfeeding and complementary feeding on diarrhoea in children aged 0-2 years in LMICs. Using data from 86 countries and all WHO global regions collected from the mid-1980s through 2018 obtained from publicly available Demographic Health Surveys, we assessed trends in five-year intervals of timing of breastfeeding initiation, exclusive breastfeeding, median and mean duration of exclusive breastfeeding, and complementary feeding. Results: The literature search identified ten articles that described variable rates of early initiation of breastfeeding from 20% in Pakistan to 76% in Egypt. An analysis of 288 DHS studies found that the proportion of women who reported initiating breastfeeding within an hour of birth increased from 32% in the early 1990s to 55% between 2016 and 2020. Exclusive breastfeeding increased from 20% in the late 1980s to 48% between 2016 and 2020 and the mean duration of exclusive breastfeeding of 2-to-4-month-old infants doubled. Early initiation of breastfeeding and exclusive breastfeeding was associated with reductions in diarrhoea prevalence in the South East Asian, Western Pacific, Eastern Mediterranean, and African regions. Eight studies evaluating the effectiveness of different maternal education interventions, health care worker training, and media campaigns demonstrated improvements in exclusive breastfeeding, and most resulted in reductions in the incidence or duration of diarrhoea. Conclusions: During the last two decades, early and exclusive breastfeeding have increased. Nevertheless, the uptake of this basic, low-cost intervention remains suboptimal across all global regions. Given the potential benefits the in reduction of diarrhoea and diarrhoea-associated mortality, interventions for improving the uptake of early and exclusive breastfeeding in different sociological contexts need to be designed, implemented, and evaluated.


Assuntos
Aleitamento Materno , Países em Desenvolvimento , Criança , Diarreia/epidemiologia , Diarreia/prevenção & controle , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Pobreza
4.
Pan Afr Med J ; 42: 12, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35812258

RESUMO

Introduction: even if there were different control and prevention strategies were implemented in worldwide in general and in Ethiopia in particular. Diarrheal disease was still one of the top ten leading causes of morbidity. Hence, this study aims to assess prevalence and associated factors of acute diarrhea among under five years' children in Simada District, Ethiopia, 2021. Methods: community based cross-sectional study design, simple and systematic random sampling technique was used to select 8 kebeles and 717 study unit respectively from August 1-15 /2021 in Simada District. Data were analyzed by Statistical Package for Social Science (SPSS), version 25. Binary logistic regression model was used to measure the association between dependent and independent variables. Bi-variables analysis at P < 0.05 was used to select independent variable to multi variable analysis. Results: two-week prevalence of acute diarrhea was 14.5% (CI: 12.3%-17.3%). Mothers/caregivers child whose latrine was not clean (AOR=11.48(5.64-23.35)). Mothers/caregivers who had not handwashing facility (AOR=7.07(3.84-13.03)), mothers/caregivers who did not practice handwashing at critical time (AOR=5.92(2.58-13.70), mothers/caregivers who store water at home by jerican (AOR=8.6 (1.51-48.84)), and mothers/caregivers child who start supplementary feeding before six months (AOR=6.49(2.01-20.96)) had significant association with acute diarrhea morbidity. Conclusion: two-week prevalence of acute diarrhea was low. Latrine cleanness, availability of handwashing facilities around latrine, handwashing practice at critical time for handwashing, knowledge on diarrhea transmission and prevention methods, storage of water by jerican and time of initiation of supplementary food had determinant factor of diarrheal disease's occurrence.


Assuntos
Diarreia , Água , Criança , Estudos Transversais , Diarreia/epidemiologia , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Prevalência
5.
Pan Afr Med J ; 42: 13, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35812262

RESUMO

Introduction: Salmonella and Shigella infections are waterborne associated infections globally known to cause serious illnesses in all age groups, but can be more devastating in children below five years. Antimicrobial resistance has been known to worsen the existing challenge in the management of Salmonella and Shigella infections. The aim is to isolate and identify Salmonella and Shigella among children less than five years with diarrhea and to determine resistance to commonly prescribed drugs at the Lodwar County and Referral Hospital in Northern Kenya. Methods: using a cross-sectional study design, a descriptive experimental study was conducted on 196 children with diarrhea using rectal swabs. A structured questionnaire was used to collect sociodemographic information. Samples were then received in the microbiology laboratory, and macroscopic and microscopic examinations were done before culture on specific selective media. Thereafter, biochemical confirmation of the growths done then confirmed results tabulated before analysis. Results: from the total samples collected (196) Shigella dysenteriae cases were 4 (5%), while Shigella Flexneri were 7 (9%), Shigella sonnei were 3 (4%), Shigella boydii were 4 (5%) and Salmonella typhimurium were 2 (2.4%). From these, about 70% of the isolated Salmonella and Shigella demonstrated high antibiotic resistance to Amoxilliclav and Ampicillin, both with high minimum inhibitory concentrations (MICs) values of about 8ug/ml. While over 80% drug susceptibility was noted in Amikacin (1ug/ml), Ciprofloxacin (2ug/ml), Ceftriaxone (4ug/ml) and Ceftazidime (4ug/ml). Conclusion: Salmonella and Shigella are among the common contributors of diarrhea among children less than five years. Drug resistance among the commonly used antibiotics is a serious indicator that possible misuse of antibiotics especially the beta lactam penicillin's.


Assuntos
Disenteria Bacilar , Shigella , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Estudos Transversais , Diarreia/epidemiologia , Diarreia/etiologia , Farmacorresistência Bacteriana , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Fezes/microbiologia , Humanos , Quênia/epidemiologia , Testes de Sensibilidade Microbiana , Prevalência , Salmonella
6.
Bull World Health Organ ; 100(7): 422-435, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35813509

RESUMO

Objective: To compare coverage of key child health policy indicators across provinces and to explore their association with under-five mortality and level of conflict in the Democratic Republic of the Congo. Methods: We made a secondary analysis of nationally representative data from 1380 health facilities and 20 792 households in 2017-2018. We analysed provincial-level data on coverage of 23 different indicators for improving common causes of childhood mortality, combined into mean scores for: newborn health, pneumonia, diarrhoea, malaria and safe environment. Using negative binomial regression we compared the scores with provincial-level under-five mortality. With binary logistic regression at the individual level we compared indicators (outcome) with living in a conflict-affected province (exposure). Findings: All grouped coverage scores demonstrated large ranges across the 26 provinces: newborn health: 20% to 61%; pneumonia: 26% to 86%; diarrhoea: 25% to 63%; malaria: 22% to 53%; and safe environment: 4% to 53%. The diarrhoea score demonstrated the strongest association with under-five mortality (adjusted coefficient: -0.026; 95% confidence interval: -0.045 to -0.007). Conflict-affected provinces had both the highest as well as the lowest mortality rates and indicator coverages. The odds of coverage were higher in conflict-affected provinces for 13 out of 23 indicators, whereas in provinces unaffected by conflict only one indicator had higher odds of coverage. Conclusion: Conflict alone is a poor predictor for child health. Ensuring that children in unaffected provinces are not neglected while addressing the needs of the most vulnerable in conflict settings is important. Prevent, protect and treat strategies for diarrhoeal disease could help improve equity in child survival.


Assuntos
Características da Família , Malária , Criança , República Democrática do Congo/epidemiologia , Diarreia/epidemiologia , Humanos , Recém-Nascido , Inquéritos e Questionários
7.
Biomed Res Int ; 2022: 4053085, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35898685

RESUMO

Objective: To assess the pooled prevalence of mothers' or caregivers' healthcare-seeking behavior for childhood diarrhea, fever, and respiratory tract infections and associated factors in Ethiopia. Study Design. Systematic review and meta-analysis. Methods: Literature searches were conducted through databases (Google Scholar, PubMed, CINHAL, ScienceDirect, HINARI, and gray literatures) from September 1 to 30, 2021, using key terms in accordance with the PRISMA guidelines. The characteristics of the original articles were described using text and tables. Heterogeneity among the reported prevalence of studies was checked by using a heterogeneity χ 2 test and I2 test. Publication bias was examined by performing Egger's correlation and Begg's regression intercept tests at a 5% significant level. A random-effect model was employed to estimate the pooled prevalence of the outcome variable and its determinants in Ethiopia. Results: Of the total identified studies, 25 studies were included in the review, with a total of 29,993 study participants. The overall pooled prevalence of mothers' or caregivers' health-seeking behavior for childhood diarrhea, fever, and respiratory tract infections was 60.33% (95% CI: 50.14-70.52). The significant factors were residence (AOR = 3.06, 95% CI: 1.11-8.39), wealth index (AOR = 2.18, 95% CI: 1.92-2.48), perceived severity of illness (AOR = 2.7, 95% CI: 1.12-6.51), and knowledge of the illness (AOR = 1.95, 95% CI: 1.37-2.75). Conclusion: This review suggests that the overall pooled prevalence of mothers' or caregivers' HSB for childhood diarrhea, fever, and respiratory tract infections was 60.33%. Residence, wealth index, perceived severity of illness, and knowledge of the illness by mothers were the significant factors. Therefore, providing interventions by considering the above factors will improve the overall seeking behavior.


Assuntos
Mães , Infecções Respiratórias , Cuidadores , Criança , Estudos Transversais , Diarreia/epidemiologia , Etiópia/epidemiologia , Feminino , Febre/epidemiologia , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Prevalência , Infecções Respiratórias/epidemiologia
8.
Breast J ; 2022: 7146172, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35833190

RESUMO

Background: Randomized studies of neoadjuvant (NA) trastuzumab and pertuzumab combined with chemotherapy for HER2-positive breast cancers (BC) have reported pathological complete response (pCR) rates of 39 to 61%. This study aimed to determine the real-world efficacy and toxicity of NA trastuzumab and pertuzumab combined with chemotherapy in a UK tertiary referral cancer centre. Methods: HER2-positive early BC patients given neoadjuvant chemotherapy with trastuzumab and pertuzumab between October 2016 and February 2018 at our tertiary referral cancer centre were identified via pharmacy records. Clinico-pathological information, treatment regimens, treatment-emergent toxicities, operative details, and pathological responses and outcomes were recorded. Results: 78 female patients were identified; 2 had bilateral diseases and 48 of 78 (62%) were node positive at presentation. 55 of 80 (71%) tumours were ER-positive. PCR occurred in 37 of 78 (46.3%; 95% CI: 35.3-57.2%) patients. 14 of 23 (60.8%) patients with ER-negative tumours achieved pCR; 23 of 55 (41.8%) were ER-positive and 6 of 19 (31.6%) were ER-positive and PgR-positive. No cardiac toxicity was documented. Diarrhoea occurred in 53 of 72 (74%) patients. Grade 3-4 toxicity occurred in ≥2% patients. These were diarrhoea, fatigue, and infection. The Median follow up period was 45.2 months (95% CI 43.8-46.3) with 71 of 78 (91.0%) remaining disease-free and 72 of 78 (92.3%) alive. Estimated OS at 2 years 86% (95% CI: 75-99%). Conclusion: This data confirms the efficacy of neoadjuvant chemotherapy combined with dual HER2 directed therapy. While no cardiac toxicity was observed, diarrhoea occurred frequently. The low pCR rate observed in ER and PgR-positive BCs warrants further investigation and consideration of strategies to increase the pCR rate.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias da Mama , Terapia Neoadjuvante , Anticorpos Monoclonais Humanizados/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/toxicidade , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Diarreia/induzido quimicamente , Diarreia/epidemiologia , Feminino , Humanos , Terapia Neoadjuvante/efeitos adversos , Trastuzumab/uso terapêutico , Resultado do Tratamento
10.
BMC Pediatr ; 22(1): 394, 2022 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799163

RESUMO

BACKGROUND: Despite global interventions to prevent and control diarrhea, it still remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. In Uganda, diarrhea is amongst the five leading causes of under-five mortality, contributing to more than 140,000 deaths every year and this accounts for 7.1% of all under-five mortalities in Uganda. Efforts to prevent and lower diarrheal diseases need to be informed by data on determinants of diarrhea. The study assessed factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso District, Uganda. METHODS: The study employed a cross-sectional study design covering 384 randomly selected households having children < 5 years old in the study area using quantitative research methods. Data was collected using close-ended questionnaires and diarrhea disease history was captured for the last month before the survey. Bivariate and multivariate logistic regression analyses were used to identify the risk factors associated with childhood diarrhea considering a 95% confidence level. RESULTS: The prevalence of Diarrhea disease in children among the selected slum settlements in Entebbe municipality was found to be at 62.4%. Access to water from a protected water source (deep well and borehole), presence of a vent in toilets, age, and child birth weight were found to be significantly associated with diarrheal diseases among children below five years in the selected slum settlements in Entebbe municipality. CONCLUSION: The prevalence of childhood diarrhea among children < 5 years of age in selected slums of Entebbe municipality was found high. Use of water from a protected source, presence of a vent in toilets, age, child birth and weight were identified as predictors of diarrhea occurrence. These findings imply that community health education is urgently needed for fighting childhood diarrhea in the study area to eliminate the predisposing factors to diarrhea.


Assuntos
Diarreia , Áreas de Pobreza , Pré-Escolar , Estudos Transversais , Diarreia/epidemiologia , Diarreia/etiologia , Humanos , Lactente , Prevalência , Uganda/epidemiologia , Água
11.
Arch Razi Inst ; 77(1): 73-79, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35891729

RESUMO

Amebiasis and giardiasis are major health problems caused by Entamoeba histolytica and Giardia Lamblia which are the two most common intestinal protozoan parasites with worldwide distribution, especially in developing countries. Both protozoa are spread by the fecal-oral route; that is to say, by eating or drinking contaminated food or water. The present study aimed to assess the prevalence of E. histolytica and G.lamblia in children with clinical signs of diarrhea referring to Ibn Al-Atheer Hospital in Mosul, Iraq, from January 2019 to December 2020. A total of 2,296 samples were examined by the direct swab of stool method. The patients were within the age range of less than 1 year and above 12 years. The results demonstrated that in 2019 and 2020, the prevalence rates of E. histolytica infections were (152, 13.2%) and (181, 15.7%); moreover, the prevalence rates of G.lamblia were obtained at (10, 0.86%) and (12, 1.04%) (P<0.01). The prevalence of intestinal parasite infections was significantly associated with age and gender, and the prevalence of both E. histolytica and G.lamblia infections were higher in males. Furthermore, the highest and lowest prevalence rates of E. histolytica and G.lamblia infections were reported in the age groups of under 1 year and above 12 years (P<0.05). The high prevalence of protozoan infection in the age group of under 1 year can be attributed to their lack of developed immunity system and resistance. Due to disease transmission, the enhancement of health conditions is of utmost importance in controlling the prevalence of intestinal protozoan parasites.


Assuntos
Entamoeba histolytica , Giardia lamblia , Enteropatias Parasitárias , Criança , Pré-Escolar , Diarreia/epidemiologia , Diarreia/parasitologia , Feminino , Hospitais , Humanos , Lactente , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/epidemiologia , Iraque/epidemiologia , Masculino , Prevalência
12.
J Glob Health ; 12: 11007, 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35871400

RESUMO

Background: Although studies have provided the estimates of floods-diarrhoea associations, little is known about the lag effect, effect modification, and attributable risk. Based on Sichuan, China, an uneven socio-economic development province with plateau, basin, and mountain terrains spanning different climatic zones, we aimed to systematically examine the impacts of floods on diarrheal morbidity. Methods: We retrieved information on daily diarrheal cases, floods, meteorological variables, and annual socio-economic characteristics for 21 cities in Sichuan from January 1, 2017 to December 31, 2019. We fitted time-series Poisson models to estimate the city-specific floods-diarrhoea relation over the lags of 0-14 days, and then pooled them using meta-analysis for cumulative and lag effects. We further employed meta-regression to explore potential effect modifiers and identify effect modification. We calculated the attributable diarrheal cases and fraction of attributable morbidity within the framework of the distributed lag model. Results: Floods had a significant cumulative association with diarrhoea at the provincial level, but varied by regions and cities. The effects of the floods appeared on the second day after the floods and lasted for 5 days. Floods-diarrhoea relations were modified by three effect modifiers, with stronger flood effects on diarrhoea found in areas with higher air pressure, lower diurnal temperature range, or warmer temperature. Floods were responsible for advancing a fraction of diarrhoea, corresponding to 0.25% within the study period and 0.48% within the flood season. Conclusions: The impacts imposed by floods were mainly distributed within the first week. The floods-diarrhoea relations varied by geographic and climatic conditions. The diarrheal burden attributable to floods is currently low in Sichuan, but this figure could increase with the exposure more intensive and the effect modifiers more detrimental in the future. Our findings are expected to provide evidence for the formulation of temporal- and spatial-specific strategies to reduce potential risks of flood-related diarrhoea.


Assuntos
Diarreia , Inundações , China/epidemiologia , Cidades , Diarreia/epidemiologia , Humanos , Morbidade
13.
BMC Pediatr ; 22(1): 445, 2022 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-35879700

RESUMO

BACKGROUND: Child health, especially childhood mortality, is one of the critical indicators of human development. No child mortality is desirable, but it is still high in Bangladesh. We aimed to assess the effect of the child's desired status on childhood morbidity and mortality in Bangladesh. METHODS: We used the data from the nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2017-18 and restricted the analyses to children born in the past five years preceding the survey. We estimated the undesired status (excess in boy, girl, both, and parity) by subtracting an ideal number of children from the total live birth. We measured childhood mortality (perinatal, early neonatal, neonatal, post-neonatal, infant, child, and under-five mortality), morbidity (fever, diarrhea, cough, and acute respiratory infectious-ARI), nutritional problems (stunting, wasting, underweight, and low birth weight), and treatments (postnatal care, treatment for fever, diarrhea/cough, and vitamin A supplementation). Finally, we utilized the chi-square test and multilevel mixed-effects logistic regression analyses. RESULTS: The prevalence of undesired children was 19.2%, 21.5%, 3.7%, and 25.4% for boys, girls, both boys and girls, and parity, respectively. Age, education, residence, division, and wealth index were significantly associated with undesired children. The prevalence of under-five mortality was 3.3% among desired children, almost double (5.4%) among undesired children. The likelihood of under-five mortality was [adjusted odds ratio (aOR): 2.05, p ≤ 0.001] higher among undesired children. Despite lower under-five mortality among higher socioeconomic status, the relative contribution of undesired children to under-fiver mortality was substantial. The undesired girl children were associated with an increased likelihood of moderately wasting (aOR: 1.28, p = 0.072), severely underweight (aOR: 1.41, p = 0.066), and low birth weight (aOR: 1.50, p ≤ 0.05). Moreover, the undesired children were 19% (p ≤ 0.05) more likely to be infected with fever. The undesired children had lower treatment for diarrhea and fever/cough and were less likely to get vitamin A supplementation (aOR: 0.71, p ≤ 0.001). CONCLUSIONS: The share of childhood morbidity, mortality, and malnutrition were higher among undesired children. Every child should be wanted, and no unwanted pregnancies are desirable; thereby, the government should reemphasize the proper use of family planning methods to reduce child mortality and malnutrition.


Assuntos
Desnutrição , Magreza , Bangladesh/epidemiologia , Tosse , Estudos Transversais , Diarreia/epidemiologia , Feminino , Nível de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Desnutrição/epidemiologia , Gravidez , Prevalência , Fatores Socioeconômicos , Magreza/epidemiologia , Vitamina A
14.
Am J Trop Med Hyg ; 106(6): 1791-1799, 2022 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-35895429

RESUMO

Malaria incidence has declined in southern Zambia over recent decades, leading to efforts to achieve and sustain malaria elimination. Understanding the remaining disease burden is key to providing optimal health care. A longitudinal study conducted in a rural area of Choma District, Southern Province, Zambia, assessed the prevalence of and factors associated with symptoms of non-malarial illnesses and treatment-seeking behavior. We analyzed data collected monthly between October 2018 through September 2020 from 1,174 individuals from 189 households. No incident malaria cases were detected by rapid diagnostic tests among febrile participants. Mixed-effects logistic regression identified factors associated with cough, fever, diarrhea, and treatment-seeking. Incidence rates of cough (192 of 1,000 person-months), fever (87 of 1,000 person-months), and fever with cough (37 of 1,000 person-months) were highest among adults older than 65 years. Diarrhea incidence (37 of 1,000 person-months) was highest among children younger than 5 years. For every additional symptomatic household member, one's odds of experiencing symptoms increased: cough by 47% (95% CI, 40-55), fever by 31% (95% CI, 23-40), diarrhea by 31% (95% CI, 17-46), and fever with cough by 112% (95% CI, 90-137), consistent with household clustering of illnesses. However, between 35% and 75% of participants did not seek treatment for their symptoms. Treatment-seeking was most common for children 5 to 9 years old experiencing diarrhea (adjusted odds ratio, 3.61; 95% CI, 1.42-9.18). As malaria prevalence reduces, respiratory and diarrheal infections persist, particularly among young children but, notably, also among adults older than 65 years. Increasing awareness of the disease burden and treatment-seeking behavior are important for guiding resource re-allocation as malaria prevalence declines in this region.


Assuntos
Tosse , Malária , Adulto , Criança , Pré-Escolar , Tosse/epidemiologia , Diarreia/epidemiologia , Febre/epidemiologia , Humanos , Estudos Longitudinais , Malária/epidemiologia , Malária/terapia , Zâmbia/epidemiologia
15.
BMC Geriatr ; 22(1): 562, 2022 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-35794520

RESUMO

BACKGROUND: Antibiotic-associated diarrhea (AAD) is diarrhea associated with consuming antibiotics that cannot be explained by other causes. AAD prolongs admission time and increases mortality and financial costs. Elderly individuals are more prone to receive antibiotic treatment and develop AAD. The finding that living probiotic microorganisms decrease AAD incidence in adults (<65 years) has been clarified. However, it is controversial among elderly individuals. METHODS: We aimed to explore whether probiotics could prevent AAD in elderly individuals. We searched three electronic databases (PubMed, EMBASE, and The Cochrane Library), and two reviewers independently screened and assessed the studies. RevMan5.4 software was used to perform a meta-analysis according to the PRISMA guidelines. RESULTS: Eight RCTs of 4691 participants were included. We excluded two large studies because probiotics were used 48 hours after the first dose of antibiotics, and there was no effect. Subgroup analysis of 6 RCTs showed that probiotics given within two days of antibiotic treatment produced a lower AAD prevalence rate in elderly individuals. CONCLUSION: We recommend that elderly individuals could be routinely distributed probiotics to prevent AAD development when receiving antibiotic treatment. TRIAL REGISTRATION: The review was not registered.


Assuntos
Diarreia , Probióticos , Idoso , Antibacterianos/efeitos adversos , Diarreia/induzido quimicamente , Diarreia/epidemiologia , Diarreia/prevenção & controle , Humanos , Probióticos/uso terapêutico , Software
17.
Front Cell Infect Microbiol ; 12: 901324, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35873159

RESUMO

Escherichia coli (E. coli) pathotypes are the most common cause of diarrhea, especially in developing countries. Environmental Enteric Dysfunction (EED) is presumed to be the result of infection with one or more pathotypes and can affect intestinal health and childhood growth. We sought to investigate the association of E. coli pathotypes infection with biomarkers of EED and nutritional status among slum-dwelling malnourished children in Bangladesh. This study comprised a total of 1050 stunted and at risk of stunting children. TaqMan Array Card assays were used to determine the presence of E. coli pathotypes in feces. Prevalence of infection with EAEC was highest (68.8%) in this cohort of children, followed by EPEC (55.9%), ETEC (44%), Shigella/EIEC (19.4%) and STEC (3.2%). The levels of myeloperoxidase and calprotectin were significantly higher in EAEC (P=0.02 and P=0.04), EPEC (P=0.02 and P=0.03) and Shigella/EIEC (P=0.05 and P=0.02) positive participants while, only calprotectin was significantly higher in ETEC (P=0.01) positive participants. Reg1B was significantly higher in participants with EAEC (P=0.004) while, neopterin levels were significantly lower in ETEC (P=0.003) and Shigella/EIEC (P=0.003) positive cases. A significant positive relationship was observed between EAEC and fecal levels of Reg1B (ß = 0.28; 95% CI = 0.12, 0.43; p-value<0.001). Besides, ETEC was found to be positively and significantly associated with the levels of calprotectin (ß = 0.14; 95 percent CI = 0.01, 0.26; p-value=0.037) and negatively with neopterin (ß = -0.16; 95% CI = -0.30, -0.02; p-value=0.021). On the other hand, infection with EPEC was found to be negatively associated with length-for-age (ß = -0.12; 95% CI = -0.22, -0.03; p-value=0.011) and weight-for-age (ß = -0.11; 95% CI = -0.22, -0.01; p-value=0.037). The study findings suggest that infection with certain E. coli pathotypes (EAEC and ETEC) influences gut health and EPEC is associated with linear growth and underweight in Bangladeshi children.


Assuntos
Infecções por Escherichia coli , Enteropatias , Bangladesh/epidemiologia , Biomarcadores , Criança , Diarreia/epidemiologia , Escherichia coli/genética , Infecções por Escherichia coli/epidemiologia , Fezes , Humanos , Complexo Antígeno L1 Leucocitário , Neopterina , Estado Nutricional
18.
Front Immunol ; 13: 908753, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35874746

RESUMO

Huanjiang mini-pig is an indigenous pig breed in China; however, the optimal dietary crude protein (CP) levels for this pig breed during different growth stages has not been standardized yet. This study investigated the effects of different CP levels on diarrhea incidence, immunity, and intestinal barrier function in pigs. A total of 360 Huanjiang mini-pigs were assigned to three independent trials and fed the following CP diets: 5-10 kg stage, 14, 16, 18, 20, and 22%; 10-20 kg stage, 12, 14, 16, 18, and 20% and 20-30 kg stage, 10, 12, 14, 16, and 18%. In the 5-10 kg stage, the 22%; diet increased the plasma IL-1ß, IL-6, IL-8, and TNF-α concentrations compared to the 14-20% diets and decreased IL-10 and TGF-ß; however, these results were fluctuated in the later stages, including the decrease of IL-1ß and IL-8 in the 20% group, TNF-α in the 18-20% groups, and the increase of IFN-γ in the 20% group at the 10-20 kg stage and the decrease of TNF-α in the 16% group at the 20-30 kg stage. The 20% diet increased the jejunal and ileal IL-10 concentration compared to the 14% diet at the 5-10 kg stage, as well as in the 16% diet compared to the 12% diet at the 10-20 kg stage. In addition, ileal IL-10 concentration was increased in the 16% diet compared to the 10, 12, and 18% diets at the 20-30 kg stage. Furthermore, the 18% diet at the 5-10 kg stage and the 16% diet at the 10-20 kg stage decreased jejunal IL-6 expression, whereas the 20% diet increased the TNF-α and IFN-γ at the 5-10 kg stage. The 20% diet increased the Claudin, Occludin, ZO-1, ZO-2, Mucin-1, and Mucin-20 expressions at the 5-10 kg stage, as well as TLR-2, TLR-4, and NF-κB in the 22 and 20% diets at the 5-10 and 10-20 kg stages, respectively. Collectively, these findings suggest optimal dietary CP levels of 16, 14, and 12% for Huanjiang mini-pigs during the 5-10, 10-20, and 20-30 kg growth stages, respectively; and provide the guiding significance of dietary CP levels for Huanjiang mini-pigs during different growth stages.


Assuntos
Ração Animal , Interleucina-10 , Ração Animal/análise , Animais , Diarreia/epidemiologia , Proteínas na Dieta/metabolismo , Suplementos Nutricionais , Incidência , Interleucina-6 , Interleucina-8 , Suínos , Porco Miniatura/metabolismo , Fator de Necrose Tumoral alfa
19.
J Environ Public Health ; 2022: 4671719, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35874895

RESUMO

Background: Cholera is a major public health problem in Ethiopia. This study aimed to generate evidence to better understand the epidemiology of cholera as well as chronicle the city administration's emergency management efforts during the Addis Ababa cholera outbreak in 2016. Method: A descriptive analysis was performed using the cholera outbreak data collected from June 8 to October 31, 2016. A case was defined as a patient aged 5 years or older who develops acute watery diarrhea with or without vomiting. Administrative and laboratory finding reports were also used, as well as documented situational updates. Result: A total of 8,083 cases (AR of 0.24 percent) with 15 deaths (CFR of 0.18 percent) were reported. Males in unskilled manual occupations and housewives accounted for 2,198 (27.2%) and 1,195 (14.8%), respectively, of the total. A total of 6,908 cases (85.46 percent) sought medical attention within two days of the onset of the condition. The presence of the Kolfie river as well as the relatively confined living conditions of the residents aided in the emergence and rapid spread of the disease. The increased in-and-out movement of people, combined with the city administration's deficient development infrastructure of water, hygiene, and sanitation, contributes to higher morbidity and a longer duration of the outbreak. Multiple command posts established in various locations as well as a lack of collaboration among relevant stakeholders resulted in inefficient information and resource management. Furthermore, there is a lack of risk factor surveillance for the early detection of cholera-causing agents. Conclusion and Recommendations. This outbreak caused significant morbidity and mortality. Prioritizing early risk detection, implementing preventive measures, and developing positive working relationships with relevant parties are all critical. A well-established community-based surveillance system and incident management system (IMS) will be required for future emergency management. It is recommended that the city administration make critical adjustments to its developmental infrastructures related to water, sanitation, and hygiene and implement risk factor surveillance from sewerage lines for the early detection of agents that cause cholera.


Assuntos
Cólera , Cólera/epidemiologia , Diarreia/epidemiologia , Diarreia/etiologia , Surtos de Doenças , Etiópia/epidemiologia , Humanos , Masculino , Saneamento , Água
20.
PLoS One ; 17(7): e0271685, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35862358

RESUMO

INTRODUCTION: Globally, childhood mortality is an important public health concern. In Ghana, both diarrhoea and acute respiratory infections (ARIs) are among the top five causes of morbidity and mortality among children under five years old (CU5). Yet, there is a paucity of studies on the comorbidity of diarrhoea and ARIs in CU5 in Ghana. AIM: This study sought to examine factors associated with comorbidity of diarrhoea and ARIs among CU5 in Ghana. METHODS: The Ghana Demographic and Health Survey (GDHS) 2014 was used for this study. A total of 932 CU5 who had at least one morbidity were included in the study. Binary logistic regression was used to predict the factors associated with comorbidity among CU5. RESULTS: The prevalence of comorbidity of diarrhoea and ARI among CU5 was 11%. Factors including unimproved source of water, unimproved main floor material, age of child, and initiation of breastmilk were significantly associated with comorbidity of diarrhea and ARI. Improved source of water (AOR = 0.42; 95% CI = 0.22-0.78; p = 0.01) reduces the likelihood of having comorbidity than unimproved source of water. Children aged 36-47 months were less likely (AOR = 0.36; 95% CI = 0.14-0.93; p = 0.04) to have comorbidity than those aged 48-59 months. Also, improved floor materials (AOR = 0.45; 95% CI = 0.22-0.95; p = 0.03) reduces the likelihood of having comorbidity than unimproved floor materials. Children breastfed within the first day of birth were more likely (AOR = 1.66; 95% CI = 1.01-0.2.72; p = 0.04) to have comorbidity than those breastfed immediately after birth. CONCLUSION: Policymakers and health practitioners should consider risk factors such as age of child, initiation of breastfeeding, unimproved floor material, and unimproved water supply in the design of interventions to reduce morbidity and mortality associated with comorbidity of diarrhoea and ARI among CU5.


Assuntos
Diarreia , Infecções Respiratórias , Criança , Pré-Escolar , Comorbidade , Diarreia/epidemiologia , Feminino , Gana/epidemiologia , Humanos , Lactente , Prevalência , Infecções Respiratórias/epidemiologia , Fatores de Risco , Água
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...