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1.
JAMA Netw Open ; 3(9): e2019686, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32876685

RESUMO

Importance: The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. Objective: To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. Design, Setting, and Participants: This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. Exposures: The COVID-19 pandemic and outcomes associated with the measures to mitigate it. Main Outcomes and Measures: Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20). Results: A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during-COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre-COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). Conclusions and Relevance: These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post-COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.


Assuntos
Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Renda/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Betacoronavirus , Depressão/psicologia , Escolaridade , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias , Questionário de Saúde do Paciente , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Estresse Psicológico/psicologia , Estados Unidos/epidemiologia , Adulto Jovem
2.
J Community Health ; 45(6): 1263-1269, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32894387

RESUMO

This study aimed to describe knowledge, attitudes, and practices (KAP) in controlling COVID-19 and some related factors among the Vietnamese population in 2020. A cross-sectional study was conducted involving 1999 participants aged 18-59 years old, through an online questionnaire. The results showed that 92.2% of the participants had a high knowledge level regarding COVID-19 prevention measures, 68.6% had a positive attitude toward COVID-19 prevention measures, and 75.8% practiced all six measures for preventing the spread of the virus. Age, sex, marital status, knowledge, and fear were significantly associated with the practices aimed at COVID-19 prevention. Married people and participants with high levels of knowledge were more likely to practice all preventive measures. In contrast, young people, men, and those who fear COVID-19 were less likely to practice all preventative measures. Good KAP among Vietnamese people could be an important factor in helping authorities gain initial success in containing the coronavirus and COVID-19. In addition to continuously raising and maintaining the community's awareness, attitude, and practices in disease prevention, the introduction and strict implementation of sanctions and regulations were also important in ensuring good practices were implemented and sustained over time. Groups with lower KAP levels should be provided with more information and support to promote appropriate disease prevention practices.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Betacoronavirus , Estudos Transversais , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Inquéritos e Questionários , Vietnã , Adulto Jovem
3.
PLoS One ; 15(9): e0238348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32936820

RESUMO

We examined family isolation, economic hardship, and long-distance migration as potential patterns of an extreme outcome of a lonely death: bodily remains that remain unclaimed and are left to the state. This paper combines a unique dataset-Los Angeles County's records of unclaimed deaths-with the Vital Statistics' Mortality data and the Annual Social and Economic Survey (ASEC) to examine 1) whose remains are more likely to become unclaimed after death and, 2) whether population-level differences and trends in family isolation, economic hardship, and long-distance migration explain the differences in the rates of unclaimed deaths. We employ multivariate Poisson models to estimate relative rates of unclaimed deaths by social and demographic characteristics. We find that increases in never married, divorced/separated, and living without family were positively associated with rates of unclaimed deaths. Unemployment among men and poverty among women was associated with higher unclaimed deaths. Long-distance migration was not associated with more unclaimed bodies.


Assuntos
Causas de Morte , Solidão/psicologia , Estado Civil/estatística & dados numéricos , Pobreza , Desemprego/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
PLoS One ; 15(9): e0238957, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915880

RESUMO

BACKGROUND: Anemia in women of reproductive age is a major public health challenge for low- and middle-income countries with a long-term negative impact on the health of women, their children, and the economic growth of the society. Even though the world health organization targeted a 50% global reduction of anemia among women of reproductive age by 2025, with the current trend it is unlikely to achieve this goal. OBJECTIVE: This study aimed to assess the prevalence and associated factors of anemia among women of reproductive age in eastern Africa. METHODS: A secondary data analysis, using demographic and health survey (DHS) data of 10 eastern African countries, was conducted. For our study, a total weighted sample of 101524 women of reproductive age was used. We employed a multilevel mixed-effects generalized linear model (using Poisson regression with robust error variance). Both unadjusted and adjusted prevalence ratios with their 95% confidence interval were reported. RESULTS: The prevalence of anemia in eastern Africa was 34.85 (95%CI: 34.56-35.14) ranging from 19.23% in Rwanda to 53.98% in Mozambique. In the multivariable multilevel analysis, being older age, having primary and above education, being from households with second to highest wealth quantiles, being currently working, not perceiving distance as a big problem, use of modern contraceptive methods, and rural residence was associated with a lower prevalence of anemia. While, being married and divorced/separated/widowed, women from female-headed households, women from households with unimproved toilet facility and unimproved water source, ever had of a terminated pregnancy, having high parity, and being from large household size was associated with a higher prevalence of anemia. CONCLUSION: The prevalence of anemia in eastern Africa was relatively high. Both individual level and community level factors were associated with the prevalence of anemia in women of reproductive age. Therefore, giving special attention to those women who are at a higher prevalence of anemia such as younger women, those who are from households with low socioeconomic status, unimproved toilet facility, and source of drinking water, as well as pregnant women could decrease anemia in women of reproductive age.


Assuntos
Anemia/epidemiologia , Adolescente , Adulto , África Oriental/epidemiologia , Fatores Etários , Água Potável , Feminino , Humanos , Modelos Lineares , Estado Civil , Casamento , Pessoa de Meia-Idade , Análise Multinível , Paridade , Gravidez , Prevalência , Fatores de Risco , Classe Social , Toaletes , Mulheres Trabalhadoras , Adulto Jovem
5.
S Afr Med J ; 110(7): 671-677, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32880346

RESUMO

BACKGROUND: Despite substantial progress in reducing pregnancy-related preventable morbidity and mortality, these remain unacceptably high in developing countries. In 2016, the World Health Organization (WHO) revised recommendations for antenatal care (ANC) from a 4-visit model to a minimum of 8 ANC contacts to reduce perinatal mortality further and improve women's experience of care. The guidelines also recommend that the first ANC visit (ANC-1) should occur during the first trimester. OBJECTIVES: To describe the uptake of routine ANC and its associated factors in South Africa (SA) prior to the 2016 WHO recommendations, when the country recommended 4 ANC visits, to bring to light potential challenges in achieving the current recommendations. METHODS: Secondary data analyses were performed from 3 facility-based, cross-sectional national surveys, conducted to measure 6-week mother-to-child transmission of HIV and coverage of related interventions in SA. These surveys recruited mother-infant pairs attending selected public primary healthcare facilities for their infants' 6-week immunisation in 2010, 2011 -2012 and 2012 -2013. Quantitative questionnaires were used to gather sociodemographic and antenatal-to-peripartum information from Road to Health cards and maternal recall. The inclusion criteria for this secondary assessment were at least 1 ANC visit, the primary outcome being uptake of ≥4 ANC visits. A multivariable logistic regression model was used to: (i) identify maternal factors associated with ANC visits; and (ii) establish whether receiving selected ANC activities was associated with frequency or timing of ANC-1. RESULTS: Of the 9 470, 9 646 and 8 763 women who attended at least 1 ANC visit, only 47.5% (95% confidence interval (CI) 45.4 -49.6), 55.6% (95% CI 53.2 -58.0) and 56.7% (95% CI 54.3 -59.1) adhered to ≥4 ANC visits, while 36.0% (95% CI 34.5 -37.5), 43.5% (95% CI 42.0 -45.1) and 50.8% (95% CI 49.3 -52.2) attended ANC-1 early (before 20 weeks' gestation) in 2010, 2011 -2012 and 2012 -2013, respectively. Multiparity and lower socioeconomic status were significantly associated with non-adherence to the 4-visit ANC recommendation, while a later survey year, higher education, being married, >19 years old, HIV-positive, planned pregnancy and knowing how HIV is transmitted vertically were strongly related to ≥4 ANC visits. The number of women who received selected ANC activities increased significantly with survey year and ≥4 ANC visits, but was not associated with timing of ANC-1. CONCLUSIONS: Despite increases in the uptake of ≥4 ANC visits and early ANC-1 rates between 2010 and 2013, these practices remain suboptimal. Adhering to ≥4 ANC visits improved coverage of selected ANC activities, implying that strengthening efforts to increase the uptake of ANC from at least 4 to 8, could improve overall outcomes.


Assuntos
Infecções por HIV/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Fatores Etários , Estudos Transversais , Escolaridade , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Estado Civil , Paridade , Cooperação do Paciente , Gravidez , Classe Social , África do Sul/epidemiologia
6.
BMC Public Health ; 20(1): 1228, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787807

RESUMO

BACKGROUND: Vasectomy is one of the highly effective and non-reversible types of long-term family planning methods for men. Ethiopia has a limited number of studies on the use of vasectomy, and they are focused on men rather than married men. The current study was aimed to identify the intention to use vasectomy as a method of contraception among married men in the study setting. METHODS: A community-based cross-sectional study was conducted from February 1 - April 30, 2018. A sample of 422 married men was recruited using a systematic random sampling method. We conducted face to face interviews with a structured questionnaire (i.e. closed-ended questions). Data were entered into Epi data version 3.1 and SPSS version 23 used for data analysis. The statistical association between the outcome variable (Intention to use vasectomy) and the explanatory variables were first tested with binary logistic regression. Multivariable logistic regression was used to control for confounding effect of each predictor. RESULTS: The study findings showed that the intention to use vasectomy as a method of family planning was reported as high (24%). About 34.8% of the respondents had good knowledge and nearly a quarter (23.2%) of them had a positive attitude toward the acceptance of vasectomy use. In multivariate analysis, age range between 30 and 39 years [AOR = 2.4, 95% CI = (1.16-4.82)], having good knowledge about vasectomy use [AOR = 6.22, 95% CI = (3.17-12.21)], and having a positive attitude toward vasectomy use [AOR = 7.81, 95% CI = (4.25-14.38)] were factors significantly associated to use vasectomy as compared to their counterparts. CONCLUSION: The level of acceptance of vasectomy (24%) was high compared to the level of its use in developing countries (i.e. if acceptability translates to use). The study revealed that age, good knowledge, and a positive attitude towards the use of vasectomy were important predictors of the intention to accept vasectomy. To further promote the use of vasectomy effective communication strategies in family planning programs are needed.


Assuntos
Intenção , Estado Civil/estatística & dados numéricos , Vasectomia/psicologia , Adulto , Estudos Transversais , Etiópia , Serviços de Planejamento Familiar/métodos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos e Questionários
7.
PLoS One ; 15(8): e0235830, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745083

RESUMO

BACKGROUND: Premarital HIV testing is the key entry point in prevention, care, treatment, and support services, in which people learn their HIV status and its implications to make informed decisions about their health. This study was, therefore, conducted to identify factors associated with premarital HIV testing among married women in Ethiopia. METHODS: A cross-sectional study design was used, and secondary data analysis was done using 2016 Ethiopian demographic health survey (EDHS). Two-stage stratified cluster sampling technique was used. The data were analyzed by using SPSS version 20. Frequencies and weighted percentage of the variables, and second-order Rao-Scott statistic were computed. Multivariate logistic regression analysis was performed to control confounders and to identify predictors of premarital HIV testing. Adjusted odds ratio with 95% confidence interval was considered to declare statistically significant associations. RESULT: The total sample comprised 9602 married women. In this study, the odds of premarital HIV testing were associated with being urban residents (AOR: 1.81; 95% CI: 2.74-5.20), attended primary education (AOR:1.54; 95%:1.27-1.87), secondary education (AOR:2.34; 95% CI:1.70-3.23), higher education (AOR:2.92; 95% CI:1.90-4.50), access to media (AOR: 1.44; 95% CI:1.20-1.76), being rich (AOR: 1.52; 95%CI:1.12-2.07), andrichest (AOR: 1.67;95%CI:1.15-2.44), known the place of HIV testing (AOR: 4.95; 95% CI:3.44-7.11), discriminatory attitude to PLHIV (AOR: 1.47; 95%CI:1.23-1.76), being khat chewer(AOR: 1.60;95%CI:1.11-2.31), and alcohol drinker (AOR: 1.55; 95% CI:1.27-1.90). CONCLUSION: It is possible to conclude that being urban resident, attending education (primary, secondary, higher), media access, improved wealth index, knowing the places for HIV testing, chewing khat, drinking alcohol, and having discriminatory attitude towards PLHIV were positively associated with premarital HIV testing. The Ethiopian government needs to step up efforts to expand education for all Women. Advancing access to HIV testing for rural women may also increase premarital HIV testing services uptake. Further qualitative researches need to be done to assess the relationship between discriminatory attitude towards PLHIV and premarital HIV testing.


Assuntos
Infecções por HIV/diagnóstico , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Estado Civil , Casamento , Programas de Rastreamento , Pessoa de Meia-Idade , Adulto Jovem
8.
PLoS One ; 15(8): e0236869, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745127

RESUMO

Many factors influence the incidence of type 2 diabetes mellitus (T2DM). Here, we investigated the associations between socio-demographic characteristics and familial history with the 5-year incidence of T2DM in a family-based study conducted in Brazil. T2DM was defined as baseline fasting blood glucose ≥ 126 mg/dL or the use of any hypoglycaemic drug. We excluded individuals with T2DM at baseline or if they did not attend two examination cycles. After exclusions, we evaluated a sample of 1,125 participants, part of the Baependi Heart Study (BHS). Mixed-effects logistic regression models were used to assess T2DM incident given different characteristics. At the 5-year follow-up, the incidence of T2DM was 6.7% (7.2% men and 6.3% women). After adjusting for age, sex, and education status, the model that combined marital and occupation status, skin color, and familial history of T2DM provided the best prediction for T2DM incidence. Only marital status was independently associated with T2DM incidence. Individuals that remained married, despite having significantly increased their weight, were significantly less likely to develop diabetes than their divorced counterparts.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Estado Civil , Adulto , Glicemia/análise , Brasil , Grupos de Populações Continentais , Diabetes Mellitus Tipo 2/diagnóstico , Educação , Feminino , Humanos , Hipertensão , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade , Fatores de Risco , População Rural
9.
PLoS One ; 15(8): e0237349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776957

RESUMO

BACKGROUND: Dimensions of social location such as socioeconomic position or sex/gender are often associated with low response rates in epidemiological studies. We applied an intersectionality-informed approach to analyze non-response among population strata defined by combinations of multiple dimensions of social location and subjective health in a health survey in Germany. METHODS: We used data from the cross-sectional sample of the German Health Interview and Examination Survey for Adults (DEGS1) conducted between 2008 and 2011. Information about non-responders was available from a mailed non-responder questionnaire. Intersectional strata were constructed by combining all categories of age, sex/gender, marital status, and level of education in scenario 1. Subjective health was additionally used to construct intersectional strata in scenario 2. We applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to calculate measures of discriminatory accuracy, proportions of non-responders among intersectional strata, as well as stratum-specific total interaction effects (intersectional effects). Markov chain Monte Carlo methods were used to estimate multilevel logistic regression models. RESULTS: Data was available for 6,534 individuals of whom 36% were non-responders. In scenario 2, we found weak discriminatory accuracy (variance partition coefficient = 3.6%) of intersectional strata, while predicted proportions of non-response ranged from 20.6% (95% credible interval (CI) 17.0%-24.9%) to 57.5% (95% CI 48.8%-66.5%) among intersectional strata. No evidence for intersectional effects was found. These results did not differ substantially between scenarios 1 and 2. CONCLUSIONS: MAIHDA revealed that proportions of non-response varied widely between intersectional strata. However, poor discriminatory accuracy of intersectional strata and no evidence for intersectional effects indicate that there is no justification to exclusively target specific intersectional strata in order to increase response, but that a combination of targeted and population-based measures might be appropriate to achieve more equal representation.


Assuntos
Inquéritos Epidemiológicos/estatística & dados numéricos , Recusa de Participação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Escolaridade , Feminino , Alemanha , Nível de Saúde , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Análise Multinível , Fatores Sexuais , Adulto Jovem
10.
PLoS One ; 15(8): e0237333, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776993

RESUMO

Hypertension is the leading risk factor for mortality and it is also one of the major risk factors for other non-communicable diseases (NCDs). The objective of the study was to assess the prevalence of hypertension and its associated factors among adults residing in Arba Minch health and demographic surveillance site (HDSS), Southern Ethiopia. A community-based cross-sectional survey was conducted in 2017 on the estimated sample size of 3,368 adults at Arba Minch Health and Demographic Surveillance site (HDSS). Data were collected using the WHO STEPS survey tools. Bivariate analysis was done to detect candidate variables at P-value less than 0.25 and entered into the final model to identify the independent predictors of hypertension. The prevalence of hypertension was 18.92% (95% CI: 17.63-20.28). The magnitude increase among respondents in the older age group [AOR 1.39 (95%CI: 1.05-1.84), 1.68 (95% CI: 1.26-2.23) and 2.67 (95%CI: 2.01-3.56) for age group 35-44, 45-54 and 55-64, respectively, compared to 25-34 years old group] and those with the higher wealth index [AOR 1.86 (95%CI: 1.33-2.59), 2.68 (95% CI: 1.91-3.75) and 2.97 (95%CI: 2.08-4.25) for 3rd quantile, 4th quantile and 5th quantile, respectively, compared to 1st quantile]. The odds of hypertension reduce among married participants (AOR 0.66, 95%CI: 0.51-0.85). Respondents with overweight (AOR 1.44, 95%CI: 1.02-2.02), khat chewing (AOR3.31, 95%CI: 1.94-5.64), low fruit and/or vegetable consumption (AOR 1.27, 95%CI: 1.05-1.53) and those who do not use coffee and tea (AOR 1.52, 95%CI: 1.03-2.24) had significantly higher likelihood of hypertension. Nearly one out of five participants have hypertension in this population. As hypertension is one of the silent killers, it is advisable to develop a system for enabling early detection and monitoring in the older age groups and overweight individuals.


Assuntos
Comportamento Alimentar , Hipertensão/epidemiologia , Sobrepeso/epidemiologia , Adulto , Fatores Etários , Catha/efeitos adversos , Café , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Hipertensão/prevenção & controle , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Fatores de Risco , Chá , Verduras
11.
J Affect Disord ; 277: 75-84, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32799107

RESUMO

BACKGROUND: Mental health of the population during COVID-19 quarantine could be at risk. Previous studies in short quarantines, found mood-related and anxiety symptomatology. Here we aimed to characterize the subtypes of psychological distress associated with quarantine, assess its prevalence, explore risk/protective factors, and possible mechanisms. METHODS: Online cross-sectional data (n = 4408) was collected during the Argentine quarantine, between 1st-17th April 2020 along a small replication study (n = 644). Psychological distress clusters were determined using latent profile analysis on a wide-range of symptoms using the complete Brief-Symptom Inventory-53. Multinomial and Elastic-net regression were performed to identify risk/protective factors among trait-measures (Personality and Resilience) and state-measures (COVID-19 related fear and coping-skills). RESULTS: Three latent-classes defined by symptom severity level were identified. The majority of individuals were classified in the mild (40.9%) and severe classes (41.0%). Participants reported elevated symptoms of Phobic-Anxiety (41.3%), Anxiety (31.8%), Depression (27.5%), General-Distress (27.1%), Obsession-Compulsion (25.1%) and Hostility (13.7%). Logistic-regressions analyses mainly revealed that women, young individuals, having a previous psychiatric diagnosis or trauma, having high levels of trait-neuroticism and COVID-related fear, were those at greater risk of psychological distress. In contrast, adults, being married, exercising, having upper-class income, having high levels of trait-resilience and coping-skills, were the most protected. Mediation analysis, showed that state-measures mediated the association between trait-measures and class-membership. CONCLUSIONS: Quarantine was associated intense psychological distress. Attention should be given to COVID-19-related fear and coping-skills as they act as potential mediators in emotional suffering during quarantine.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Angústia Psicológica , Quarentena/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Betacoronavirus , Infecções por Coronavirus , Estudos Transversais , Exercício Físico/psicologia , Medo/psicologia , Feminino , Humanos , Renda , Análise de Classes Latentes , Masculino , Estado Civil , Transtornos Mentais/psicologia , Saúde Mental , Pessoa de Meia-Idade , Neuroticismo , Pandemias , Personalidade , Pneumonia Viral , Fatores de Proteção , Trauma Psicológico/psicologia , Resiliência Psicológica , Fatores de Risco , Estresse Psicológico/psicologia , Adulto Jovem
12.
PLoS One ; 15(8): e0236352, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760153

RESUMO

INTRODUCTION: Despite the desire of adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) to use contraceptives, the majority of them have challenges with access to contraceptive services. This is more evident in high fertility countries in SSA. The purpose of this study was to examine the predictors of unmet need for contraception among AGYW in selected high fertility countries in SSA. MATERIALS AND METHODS: Data from current Demographic and Health Surveys (DHS) carried out between 2010 and 2018 in 10 countries in SSA were analysed. A sample size of 24,898 AGYW who were either married or cohabiting was used. Unmet need for contraception was the outcome variable in this study. The explanatory variables were age, marital status, occupation, educational level, frequency of reading newspaper/magazine, frequency of listening to radio, frequency of watching television and parity (individual level variables) and wealth quintile, sex of household head, place of residence and decision-maker in healthcare (household/community level variables). Descriptive and multilevel logistic regression analyses were carried out. The results of the multilevel logistic regression analyses were reported using adjusted odds ratios at 95% confidence interval. RESULTS: The prevalence of unmet need for contraception in all the countries considered in this study was 24.9%, with Angola, recording the highest prevalence of 42.6% while Niger had the lowest prevalence of 17.8%. In terms of the individual level predictors, the likelihood of unmet need for contraception was low among AGYW aged 20-24 [aOR = 0.82; 95% CI = 0.76-0.88], those with primary [aOR = 1.22; 95% CI = 1.13-1.31] and secondary/higher levels of formal education [aOR = 1.18; 95% CI = 1.08-1.28, p < 0.001], cohabiting AGYW [aOR = 1.52; 95% CI = 1.42-1.63] and AGYW with three or more births [aOR = 3.41; 95% CI = 3.02-3.85]. At the household/community level, the odds of unmet need for contraception was highest among poorer AGYW [aOR = 1.36; 95% CI = 1.21-1.53], AGYW in female-headed households [aOR = 1.22; 95% CI = 1.13-1.33], urban AGYW [aOR = 1.21; 95% CI = 1.11-1.32] and AGYW who took healthcare decisions alone [aOR = 1.10; 95% CI = 1.01-1.21]. CONCLUSION: This study has identified disparities in unmet need for contraception among AGYW in high fertility countries in SSA, with AGYW in Angola having the highest prevalence. Both individual and household/community level factors predicted unmet need for contraception among AGYW in this study. However, based on the ICC values, household/community level factors prevailed the individual level factors. Enhancing access to contraception among poorer AGYW, those in female-headed households, those in urban areas and those who take healthcare decisions alone by both governmental and non-governmental organisations in high fertility countries is recommended.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Anticoncepcionais/provisão & distribução , Dispositivos Anticoncepcionais/provisão & distribução , Serviços de Planejamento Familiar/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Adolescente , África ao Sul do Saara , Feminino , Inquéritos Epidemiológicos , Humanos , Estado Civil/estatística & dados numéricos , Análise Multinível/métodos , Fatores Socioeconômicos , Adulto Jovem
13.
Am J Trop Med Hyg ; 103(3): 1050-1056, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32618243

RESUMO

Identifying predictors of loss to follow-up (LTFU; treatment lapse ≥ 2 months) among people with tuberculosis (TB) may assist programmatic efforts in controlling the spread of TB. Newly diagnosed smear-positive TB patients were enrolled in the Regional Prospective Observational Research for TB study in Puducherry and Tamil Nadu, India. Treatment records were used to identify LTFU of those who were enrolled from May 2014 through December 2017. This nested case-control study evaluated male TB patients. Predictors were assessed using multivariable logistic regression. Of 425 men with TB, 82 (19%) were LTFU. In the adjusted analyses of males, divorced/separated marital status (adjusted odds ratio [aOR] 3.80; 95% CI: 1.39-10.38) and at-risk alcohol use (aOR 1.92; 95% CI: 1.12-3.27) were significant predictors for increased risk of LTFU, and diabetes was a significant predictor for decreased risk of LTFU (aOR 0.52; 95% CI: 0.29-0.92). Of 53 men with recorded date of last treatment visit, 23 (43%) and 43 (81%) had LTFU within the first 2 and first 4 months of treatment, respectively. Addressing at-risk alcohol use and providing more intensive follow-up could lead to improved treatment completion.


Assuntos
Perda de Seguimento , Mycobacterium tuberculosis/patogenicidade , Tuberculose Pulmonar/microbiologia , Adulto , Consumo de Bebidas Alcoólicas/fisiopatologia , Antituberculosos/uso terapêutico , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Índia , Modelos Logísticos , Masculino , Estado Civil , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Fatores de Risco , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/patologia
14.
PLoS One ; 15(7): e0235211, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645010

RESUMO

BACKGROUND: The current international physical activity guidelines for health recommend children to engage in at least 60 minutes of moderate-to-vigorous physical activity (MVPA) daily. Yet, accurate prevalence estimates of physical activity levels of children are unavailable in many African countries due to the dearth of accelerometer-measured physical activity data. The aim of this study was to describe the prevalence and examine the socio-demographic correlates of accelerometer-measured physical activity among school-going children in Kampala city, Uganda. METHODS: A cross-sectional study design was used to recruit a sample of 10-12 years old school-going children (n = 256) from 7 primary schools (3 public schools and 4 private schools) in Kampala city, Uganda. Sedentary time, light-intensity physical activity (LPA), moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA) were measured by accelerometers (ActiGraph GT3X+ [Pensacola, Florida, USA]) over a seven-day period. Socio-demographic factors were assessed by a parent/guardian questionnaire. Weight status was generated from objectively measured height and weight and computed as body mass index (BMI). Multi-level logistic regressions identified socio-demographic factors that were associated with meeting physical activity guidelines. RESULTS: Children's sedentary time was 9.8±2.1 hours/day and MVPA was 56±25.7 minutes/day. Only 36.3% of the children (38.9% boys, 34.3% girls) met the physical activity guidelines. Boys, thin/normal weight and public school children had significantly higher mean daily MVPA levels. Socio-demographic factors associated with odds of meeting physical activity guidelines were younger age (OR = 0.68; 95% CI = 0.55-0.84), thin/normal weight status (OR = 4.08; 95% CI = 1.42-11.76), and socioeconomic status (SES) indicators such as lower maternal level of education (OR = 2.43; 95% CI = 1.84-3.21) and no family car (OR = 0.31; 95% CI = 0.17-0.55). CONCLUSION: Children spent a substantial amount of time sedentary and in LPA and less time in MVPA. Few children met the physical activity guidelines. Lower weight status, lower maternal education level and no family car were associated with meeting physical activity guidelines. Effective interventions and policies to increase physical activity among school-going children in Kampala, are urgently needed.


Assuntos
Acelerometria/estatística & dados numéricos , Exercício Físico , Instituições Acadêmicas/estatística & dados numéricos , Comportamento Sedentário , Fatores Socioeconômicos , Adulto , Idoso , Índice de Massa Corporal , Peso Corporal , Criança , Cidades/estatística & dados numéricos , Estudos Transversais , Feminino , Guias como Assunto , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Instituições Acadêmicas/normas , Fatores de Tempo , Uganda , Adulto Jovem
15.
Orv Hetil ; 161(28): 1175-1180, 2020 07.
Artigo em Húngaro | MEDLINE | ID: mdl-32609625

RESUMO

INTRODUCTION: Due to sedentary lifestyle, not only the risk of many chronic diseases and multimorbidity increase, but older people also lose their functional independency earlier. The first step to design effective interventions aiming to decrease sedentary lifestyle is to explore the factors associated with sedentary lifestyle. AIM: Our aims were to describe the type and duration of sitting activities and to examine the factors associated with sedentary lifestyle, namely 1) sociodemographic factors (i.e., age, gender, education level, marital status); 2) medical factors (chronic diseases, use of walking aids); 3) lifestyle factors (i.e., duration of institutionalization, smoking status) among older people living in nursing homes providing long-term care. METHOD: Data collected with questionnaire from 248 participants were analysed using logistic regression. RESULTS: There were 159 participants (64.1%) in total who were characterized by sedentary lifestyle. In our sample, the sedentary lifestyle was associated with the smoking status, the number of age-related chronic diseases, the duration of institutionalization, and the use of walking aids. CONCLUSION: The older people who have more chronic diseases, who are smokers and were institutionalized earlier are more likely to be characterised by sedentary lifestyle. Therefore, decision-making graduate health-care professionals should preferably focus their efforts on these older people in order to change the sedentary lifestyle by providing information about risk of this lifestyle, and offering programs relevant to older people's interests and functional status. Orv Hetil. 2020; 161(26): 1175-1180.


Assuntos
Doença Crônica/epidemiologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Comportamento Sedentário , Caminhada , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Hungria/epidemiologia , Estilo de Vida , Masculino , Estado Civil , Fumar , Classe Social , Inquéritos e Questionários
16.
Medicine (Baltimore) ; 99(29): e21338, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702931

RESUMO

Anophthalmic patients not only cause obvious functional deficits and facial deformities, but lead to poor psychological outcomes, although prosthesis wearing can offer improvements in psychological well-being to some extent. The study aimed to comprehensively evaluate the psychological symptoms and analyze related factors in anophthalmic patients wearing ocular prosthesis.Total of 150 anophthalmic patients and 120 control subjects were included in this cross-sectional study. Baseline characteristics survey and the symptom checklist-90 scale were completed by all participants to assess the psychological symptoms and analyze their related factors by multivariate analysis.The anophthalmic patients exhibited the increased levels of somatization, depression, anxiety, and hostility compared with control subjects. The most prominent symptom was hostility with the median score of 1.20. Female patients presented with higher somatization, depression, anxiety, and hostility. Marital status single was positively associated with depression, anxiety, and hostility symptoms. Lower education and cause of enucleation were related to higher levels of hostility.Anophthalmic patients wearing ocular prosthesis presented with more prominent hostility and somatization besides its higher depression and anxiety symptoms. The findings suggest that for female single anophthalmic patients with low education, especially caused by trauma, timely psychological assessment and intervention should be provided to avoid undesirable consequences.


Assuntos
Anoftalmia/psicologia , Olho Artificial/psicologia , Adulto , Anoftalmia/complicações , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos de Casos e Controles , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Fatores de Risco , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/etiologia , Inquéritos e Questionários , Adulto Jovem
17.
PLoS One ; 15(7): e0235917, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645088

RESUMO

There is a dearth of information on induced abortion in Ghana, possibly owing to the sensitive nature of the subject. In this study, we examine the effect of socioeconomic and contextual factors on induced abortion in Ghana. This study draws on data from the 2017 Ghana Maternal Health Survey. The study used a Bayesian multilevel logistic regression analysis to estimate both individual- and contextual-level factors affecting induced abortion levels in Ghana. The results show a total induced abortion prevalence of 19.6% coupled with considerable district-level disparities. Induced abortion is significantly associated with socioeconomic factors such as educational attainment, wealth status, and marital status at the individual-level. The risk of induced abortion is considerably higher among the educated, wealthy, and cohabiting women. The current age of women, age at first sex, religious affiliation, parity, and type of residence are the demographic factors having an association with induced abortion levels. At the contextual-level, district health insurance coverage and poverty rate have a significant association with induced abortion. Induced abortion appears to be prevalent in Ghana and is underpinned by both individual-level socioeconomic and aggregate-level factors. Addressing induced abortion levels in Ghana may require policies that take a multilevel approach by focusing on the socioeconomic status of women and district-level contextual factors.


Assuntos
Aborto Induzido/estatística & dados numéricos , Fatores Socioeconômicos , Adolescente , Adulto , Teorema de Bayes , Escolaridade , Feminino , Gana/epidemiologia , Inquéritos Epidemiológicos , Humanos , Cobertura do Seguro , Modelos Logísticos , Estado Civil , Pessoa de Meia-Idade , Paridade , Pobreza , Gravidez , Prevalência , Adulto Jovem
18.
PLoS One ; 15(7): e0234415, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673322

RESUMO

BACKGROUND: Discrimination is associated with depressive symptoms and other negative health effects, but little is known about the mental health risks of workplace gender discrimination. We aimed to investigate the association of workplace gender discrimination and depressive symptoms among employed women in South Korea. METHODS: The 6th wave (2016) survey datasets of the Korean Longitudinal Survey of Women and Family (KLoWF) were analyzed for 2,339 respondents who are identified as wage workers. Depressive symptoms were evaluated by the short-form (10-item) Center for Epidemiological Studies-Depression scale. Association of workplace gender discrimination and depressive symptoms was assessed using multivariate logistic regression, adjusted for potential confounding variables including age, income satisfaction, education level, marital status, and currently diagnosed disease. We then measured the age effect using age stratification multivariate logistic regression model. RESULTS: Women who experienced gender discrimination at workplace had higher odds of depressive symptoms regardless of the type of the discrimination including hiring, promotion, work assignments, paid wages, and firing. These associations were consistent in younger women below 40 years of age in regard to hiring, promotion, paid wages and firing, whereas inconsistent among older women above 40 years of age. LIMITATIONS: We did not investigate the effect of workplace gender discrimination on depressive symptoms in a longitudinal manner. CONCLUSIONS: Workplace gender discrimination was found to be significantly associated with depressive symptoms after adjustment for socio-demographic factors. Further, women under 40 years of age were especially vulnerable to workplace gender discrimination.


Assuntos
Bullying/psicologia , Depressão/psicologia , Sexismo/psicologia , Adulto , Estudos Transversais , Depressão/etiologia , Emprego , Feminino , Humanos , Modelos Logísticos , Estado Civil , Pessoa de Meia-Idade , Razão de Chances , Satisfação Pessoal , República da Coreia , Salários e Benefícios , Sexismo/ética , Inquéritos e Questionários , Local de Trabalho/psicologia
19.
Epidemiol Psychiatr Sci ; 29: e141, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32665045

RESUMO

AIMS: Mental health problems in early adulthood may disrupt partner relationship formation and quality. This prospective study used four waves of Australian data to investigate the effects of depression and anxiety in early adulthood on the quality of future partner (i.e. marriage or cohabiting) relationships. METHODS: A representative community sample of Australian adults aged 20-24 years was assessed in 1999, 2003, 2007 and 2011. Analyses were restricted to those who at baseline had never entered a marriage or cohabiting relationship with no children (n = 1592). Associations were examined between baseline depression and anxiety levels (using the Goldberg Depression and Anxiety scales) and (a) future relationship status and (b) the quality of marriage or cohabiting relationships recorded at follow-up (up to 12 years later) (partner social support and conflict scales). RESULTS: Depression in early adulthood was associated with never entering a partner relationship over the study period. For those who did enter a relationship, both depression and anxiety were significantly associated with subsequently lower relationship support and higher conflict. Supplementary analyses restricting the analyses to the first relationship entered at follow-up, and considering comorbid anxiety and depression, strongly supported these findings. CONCLUSIONS: Depression and anxiety in early adulthood is associated with poorer partner relationship quality in the future. This study adds to evidence showing that mental health problems have substantial personal and inter-personal costs. The findings support the need to invest in prevention and early intervention.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Relações Interpessoais , Estado Civil , Casamento/estatística & dados numéricos , Ansiedade/psicologia , Austrália/epidemiologia , Depressão/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Casamento/psicologia , Estudos Prospectivos , Qualidade de Vida , Apoio Social , Fatores Socioeconômicos , Adulto Jovem
20.
JAMA Netw Open ; 3(6): e203833, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32530470

RESUMO

Importance: Sexual relationships are important for well-being and health. Recent trends in sexual activity among US adults are unknown. Objectives: To examine trends in reported frequency of sexual activity and number of sexual partners by sex and age and the association between measures of sexual activity and sociodemographic variables. Design, Setting, and Participants: In this survey study, repeat, cross-sectional analyses of participants aged 18 to 44 years from 10 rounds of the General Social Survey (2000-2018), a US nationally representative survey, were performed for men and women separately. Main Outcomes and Measures: Sexual frequency in the past year (sexual inactivity, once or twice per year, 1-3 times per month, or weekly or more) and number of sexual partners in the past year (0, 1, 2, or ≥3 partners). The association between measures of sexual activity and sociodemographic variables were assessed using logistic regression. Results: The study population included 4291 men and 5213 women in the analysis of sexual frequency and 4372 men and 5377 women in the analysis of number of sexual partners (mean [SD] age, 31.4 [7.6] years; survey response rate, 59.5%-71.4%). Between 2000-2002 and 2016-2018, the proportion of 18- to 24-year-old individuals who reported having had no sexual activity in the past year increased among men (18.9% vs 30.9%; age-adjusted odds ratio [aOR] for trend across survey periods, 1.20; 95% CI, 1.04-1.39) but not among women (15.1% vs 19.1%; aOR for trend, 1.03; 95% CI, 0.89-1.18). Smaller absolute increases in sexual inactivity were observed among those aged 25 to 34 years for both men (7.0% vs 14.1%; aOR for trend, 1.23; 95% CI, 1.07-1.42) and women (7.0% vs 12.6%; aOR for trend, 1.17; 95% CI, 1.01-1.35) but not among those aged 35 to 44 years. The increase in sexual inactivity coincided with decreases in the proportion reporting weekly or more sexual frequency (men aged 18-24 years: 51.8% vs. 37.4%; aOR for trend, 0.88 [95% CI, 0.79-0.99]; men aged 25-34 years: 65.3% vs 50.3%; aOR for trend, 0.87 [95% CI, 0.81-0.94]; women aged 25-34 years: 66.4% vs. 54.2%; aOR for trend, 0.90 [95% CI, 0.84-0.96]) or 1 sexual partner (men aged 18-24 years: 44.2% vs. 30.0%; aOR for trend, 0.88 [95% CI, 0.80-0.98]; women aged 25-34 years: 79.6% vs 72.7%; aOR for trend, 0.91 [95% CI, 0.84-0.99]) and occurred mainly among unmarried men (unmarried men aged 18-44 years: 16.2% vs 24.4%; aOR for trend, 1.14 [95% CI, 1.04-1.25]). Among married men and women, weekly or more sexual frequency decreased (men: 71.1 % vs 57.7%; aOR for trend, 0.86 [95% CI, 0.79-0.93]; women: 69.1% vs 60.9%; aOR for trend, 0.92 [95% CI, 0.86-0.99]). Men with lower income (aOR for men with an annual income of ≥$50 000 vs $0-$9999, 0.37 [95% CI, 0.15-0.90]) and with part-time (aOR vs full-time employment, 2.08; 95% CI, 1.48-2.93) and no employment (aOR vs full-time employment, 2.08; 95% CI, 1.48-2.93) were more likely to be sexually inactive, as were men (aOR vs full-time employment, 2.94; 95% CI, 2.06-4.21) and women (aOR vs full-time employment, 2.37; 95% CI, 1.68-3.35) who were students. Conclusions and Relevance: This survey study found that from 2000 to 2018, sexual inactivity increased among US men such that approximately 1 in 3 men aged 18 to 24 years reported no sexual activity in the past year. Sexual inactivity also increased among men and women aged 25 to 34 years. These findings may have implications for public health.


Assuntos
Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Emprego , Humanos , Renda , Estado Civil , Fatores Sexuais , Sexualidade , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
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