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1.
Braz. j. biol ; 84: e246463, 2024. tab
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1355899

RESUMO

Abstract Quilombola communities are present in many Brazilian states living in precarious health conditions. This is due to geographic isolation, limitations to the access of the area in which they live in, and the lack of quality in the service when it is needed to be provided. Therefore, the aim of this study was to analyze the quality of life of women from a quilombola community in northeastern Brazil. It is an observational, cross-sectional and descriptive study. 160 adult women were first interviewed through a form to collect a profile and then it was applied the WHOQOL Quality of Life questionnaire - bref. It was observed that the women were on average 40.7 years old (±17.25), married, self-declared black, who did not finish elementary school, housewife, had no income, with their own masonry house, with up to 6 rooms, supplied by a box of community treated water. Quality of Life had median scores in the domains: physical (3.18), psychological (3.4), social relationships (3.45) and environment (2.59). With this research, it was possible to characterize the quilombola community of Santa Luzia do Norte-AL regarding the difficulties of access to health and income generation, issues that affect their health condition. The problems described in this study can contribute to health actions being planned and carried out in order to improve socioeconomic and health conditions in this community, considering the social, political and environmental context, valuing their traditional knowledge and practices.


Resumo As comunidades quilombolas, estão presentes em diversos estados brasileiros, vivendo em condições de saúde mais precárias. Isto ocorre por conta do isolamento geográfico, das limitações de acesso e da falta de qualidade no serviço quando este é prestado. Nesse sentido, o objetivo do estudo foi analisar a qualidade de vida de mulheres de uma comunidade quilombola do nordeste brasileiro. Estudo observacional, transversal e descritivo. Foram entrevistadas 160 mulheres adultas, através de um formulário para a coleta de perfil e do questionário de Qualidade de Vida WHOQOL - bref. Foi observado que as mulheres tinham em média 40,7 anos (±17,25), casadas, autodeclaradas negras, com fundamental incompleto, do lar, sem renda, com moradia de alvenaria, própria, com até 6 cômodos, abastecidas por caixa de água comunitária, tratada. A Qualidade de Vida, apresentou escores medianos nos domínios: físico (3,18), psicológico (3,4), relações sociais (3,45) e meio ambiente (2,59). Com a realização desta pesquisa foi possível caracterizar a comunidade quilombola de Santa Luzia do Norte-AL quanto as dificuldades de acesso a saúde e geração de renda, fatos que repercutem na sua condição de saúde. Os problemas descritos neste estudo podem contribuir para que ações de saúde sejam planejadas e efetivadas com o intuito de melhorar as condições socioeconômicas e de saúde nessa comunidade, considerando-se o contexto social, político e ambiental, valorizando seus saberes e práticas tradicionais.


Assuntos
Humanos , Feminino , Adulto , Qualidade de Vida , Brasil , Estudos Transversais , Inquéritos e Questionários
2.
Braz. j. biol ; 83: e248778, 2023. tab, graf
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1339371

RESUMO

Abstract This study aimed to analyze the socio-environmental characteristics, executive and nutritional functions in children aged 6 to 7 years, from public schools in Alagoas, Brazil. A quantitative, cross-sectional and descriptive study was performed involving 64 children of the mentioned age group, from public schools located in Alagoas: Maceió, on the coast; Major Isidoro, in the hinterland and Palmeira dos Índios, in the country. Such analyzes were made through the application of neuropsychological tests and anthropometric assessment with children and food and socio-environmental surveys with their parents. As for the type of housing, 100% were made of masonry, with a bathroom present in 98.4%. All children reported with the habit of bathing in the river / lagoon, presented some pathology. There was no significant difference between cities in terms of the sociodemographic characteristics evaluated, with the same result occurring with the factors associated with the occurrence of diseases in children. The subtests of WISC-IV, were below the average in all municipalities, and the TAC and SCC were classified within the average. However, even though the ranking were divided between below average and average, it is possible to identify from the subtests of WISC-IV, that the general IQ showed a cognitive level below the average. There was also no significant difference in the anthropometric assessment (weight, height, BMI and IMCI) between the evaluated students. The average weight was 23.3 kg to 25 kg, the height between 1.23 m to 1.24 m, the BMI between 16.4 to 17; the IMCI from 2.8 to 3.0. Children were classified within the average. Regarding micronutrients (Ca, Fe, K, Mg and Na, and vitamins A, C, D, B1, B9 and B12) and calories, there was also no significant difference between the cities evaluated. The same occurred with macronutrients (proteins, carbohydrates and lipids). This study showed that in general there was no difference between the students of the three municipalities. Probably, even though they are all public schools and from different cities, children have similar social conditions.


Resumo Este estudo teve como objetivo analisar as características socioambientais, funções executivas e nutricionais de crianças de 6 a 7 anos, de escolas públicas de Alagoas, Brasil. Foi realizado um estudo quantitativo, transversal e descritivo envolvendo 64 crianças, na referida faixa etária, de escolas públicas localizadas em Alagoas: Maceió, no litoral; Major Isidoro, no sertão e Palmeira dos Índios, no país. Tais análises foram feitas por meio da aplicação de testes neuropsicológicos e avaliação antropométrica com crianças e inquéritos alimentares e socioambientais com seus pais. Quanto ao tipo de habitação, 100% eram de alvenaria, com banheiro presente em 98,4%. Todas as crianças relataram o hábito de tomar banho no rio / lagoa, apresentavam alguma patologia. Não houve diferença significativa entre os municípios quanto às características sociodemográficas avaliadas, ocorrendo o mesmo resultado com os fatores associados à ocorrência de doenças em crianças. Os subtestes do WISC-IV, ficaram abaixo da média em todos os municípios, e o TAC e SCC foram classificados dentro da média. Porém, mesmo que a classificação tenha sido dividida entre abaixo da média e média, é possível identificar a partir dos subtestes do WISC-IV, que o QI geral apresentou um nível cognitivo abaixo da média. Também não houve diferença significativa na avaliação antropométrica (peso, altura, IMC e AIDPI) entre os alunos avaliados. O peso médio foi de 23,3 kg a 25 kg, a altura entre 1,23 ma 1,24 m, o IMC entre 16,4 a 17; A AIDPI de 2.8 a 3.0. As crianças foram classificadas dentro da média. Em relação aos micronutrientes (Ca, Fe, K, Mg e Na e vitaminas A, C, D, B1, B9 e B12) e calorias, também não houve diferença significativa entre os municípios avaliados. O mesmo ocorreu com os macronutrientes (proteínas, carboidratos e lipídios). Este estudo mostrou que de maneira geral não houve diferença entre os alunos dos três municípios. Provavelmente, mesmo sendo todas escolas públicas e de diferentes cidades, as crianças têm condições sociais semelhantes.


Assuntos
Humanos , Criança , Ingestão de Energia , Função Executiva , Sódio , Brasil , Estudos Transversais
3.
Braz. j. biol ; 83: e249911, 2023. tab, graf
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1339366

RESUMO

Abstract Hematological and hematopoietic cells malignancies of the genes and hematopoietic cells are associated with the genetic mutation, often at the chromosomal level. The standard cytogenetic study is widely accepted as one of the main diagnostics and prognostic determinants in patients. Therefore, the current descriptive and cross-sectional study sought to determine the cytogenetic analysis of frequent hematological malignancies in Pakistan. A total of 202 peripheral bone marrow or blood samples from patients with benign and malignant hematological malignancy were taken using a conventional G-banding technique. Among enrolled patients, the mean age was 21.5 years ± 23.4, and gender-wise distribution showed a marked predominance of the male 147 (73%) population compared to the female 55 (27%). Patients in the age group (2-10 years) had the highest frequency, 48 (24%), of hematological neoplasms, followed by age (11-20 years) with 40 (20%). Normal karyotypes (46, XX/46, XY) was found in 51% (n=103) patients. Furthermore, the frequency of complex karyotype was 30 (15%), while normal was seen in 171 (85%) patients. Pre-B Acute Lymphoblastic Leukemia (Pre-B ALL) was the most prevalent malignancy of 66 (33%), followed by Chronic Myelogenous Leukemia (CML) of 41 (20%) and Acute Lymphocytic Leukemia of 29 (14%). Translocation was the most prevalent 50 (25%), followed by hypotriploidy 14 (7%) and monosomy 8 (4%) on chromosome aberration analysis. In addition, t(9:22) translocation was found to be 20 (10%) in CML, with the majority in the age group (31-40 years). This study recommends that karyotyping should be tested frequently in hematological conditions because it may provide insight into the relative chromosomal changes associated with particular malignancies.


Resumo As neoplasias hematológicas e de células hematopoiéticas dos genes e as células hematopoiéticas estão associadas à mutação genética, geralmente em nível cromossômico. O estudo citogenético padrão é amplamente aceito como um dos principais determinantes diagnósticos e prognósticos em pacientes. Portanto, o presente estudo descritivo e transversal buscou determinar a análise citogenética de neoplasias hematológicas frequentes no Paquistão. Um total de 202 amostras de medula óssea periférica ou sangue de pacientes com malignidade hematológica benigna e maligna foi coletado usando uma técnica convencional de banda G. Entre os pacientes inscritos, a média de idade foi de 21,5 anos ± 23,4, e a distribuição por gênero mostrou uma marcada predominância da população masculina de 147 (73%) em comparação com a feminina de 55 (27%). Pacientes na faixa etária (2-10 anos) tiveram a maior frequência, 48 (24%), de neoplasias hematológicas, seguida da idade (11-20 anos) com 40 (20%). Cariótipos normais (46, XX / 46, XY) foram encontrados em 51% (n = 103) dos pacientes. Além disso, a frequência de cariótipo complexo foi de 30 (15%), enquanto normal foi observada em 171 (85%) pacientes. Leucemia linfoblástica aguda pré-B (LLA Pré-B) foi a doença maligna mais prevalente de 66 (33%), seguida por leucemia mieloide crônica (LMC) de 41 (20%) e leucemia linfocítica aguda de 29 (14%). A translocação foi o 50 mais prevalente (25%), seguido por hipotriploidia 14 (7%) e monossomia 8 (4%) na análise de aberração cromossômica. Além disso, a translocação t (9:22) encontrada foi de 20 (10%) na LMC, com a maioria na faixa etária (31-40 anos). Este estudo recomenda que o cariótipo deve ser testado com frequência em condições hematológicas porque pode fornecer informações sobre as alterações cromossômicas relativas associadas a doenças malignas específicas.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Adulto Jovem , Aberrações Cromossômicas , Neoplasias Hematológicas/genética , Neoplasias Hematológicas/epidemiologia , Paquistão/epidemiologia , Estudos Transversais , Cariotipagem
4.
Braz. j. biol ; 83: e249209, 2023.
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1339360

RESUMO

Abstract Alo vera is a centenary remedy use for minor wounds and burns, but its mechanism of wound healing has not been know since. This article will evaluate and gather evidence of the effectiveness and safety of the use of aloe vera in the treatment of burns. A systematic review was carried out on the databases: MEDLINE, LILACS, DECS, SCIELO, in the last 7 years, with the descriptors: "Aloe", "Burns" and "treatment". 16 articles were found. After using the exclusion criteria; research in non-humans and literature review; 5 articles were selected. The article Teplick et al. (2018) performed an in vitro clinical experiment in A. Vera solution, and demonstrated that there was proliferation and cell migration of human skin fibroblasts and keratinocytes, in addition to being protective in the death of keratonocytes. That is, it accelerates the healing of wounds. Muangman et al. (2016), evaluated 50 patients with 20% of the total body surface area burned with second-degree burns, between 18-60 years old, with half of the group receiving gauze dressings with soft paraffin containing 0.5% chlorhexidine acetate and the other half receiving polyester dressings containing extracts of medicinal plants mainly Aloe Vera. It had positive results, a higher healing speed and shorter hospital stay compared to the control group. Hwang et al. (2015) investigated the antioxidant effects of different extracts from 2,4,6,8,12 months of Aloe Vera. And the 6-month concentrated extract of 0.25 mg / mL had a higher content of flavonoids (9.750 mg catechin equivalent / g extract) and polyphenols (23.375 mg gallic acid equivalent / g extract) and the greater ferric reducing antioxidant power (0.047 mM equivalent ferrous sulfate / mg extract), that is, greater potential for free radical scavenging and also a protective effect against oxidative stress induced by tert-butyl hydroperoxide (t-BHP), suggesting evidence of a bioactive potential of A. vera . However, in the article Kolacz et al. (2014) suggested as an alternative treatment the use of Aloe Vera dressing in combination with honey, lanolin, olive oil, wheat germ oil, marshmallow root, wormwood, comfrey root, white oak bark, lobelia inflata, glycerin vegetable oil, beeswax and myrrh, without obtaining significant and conclusive results that would allow the conventional treatment of burns to be subsidized. Finally, in the article by Zurita and Gallegos (2017), it carried out a descriptive cross-sectional study with 321 people, both sexes between 17-76 years of age, of an inductive nature, exploring the experience of this population and their behavioral attitudes regarding the treatment of dermatoses. Aloe vera had 13.8% cited by individuals in the treatment of acne and 33.6% in the treatment of burns. Even with evidence that suggests the efficacy in the treatment of burns with the use of Aloe Vera extract, further clinical trials with larger sample space on the use of Aloe vera dressings in medium burns are suggested for further conclusions.


Resumo Alo vera é um remédio centenário usado para pequenas feridas e queimaduras, mas seu mecanismo de cicatrização de feridas não foi conhecido desde então. Este artigo avaliará e reunirá evidências da eficácia e segurança do uso de aloe vera no tratamento de queimaduras. Realizada revisão Sistemática nas bases de dados: MEDLINE, LILACS, DECS, SCIELO, nos últimos 7 anos, com os descritores: "Aloe", "Burns" and "treatment". Foram encontrados 16 trabalhos. Após utilizarmos os critérios de exclusão; pesquisa em nao humanos e revisão da literatura ; foram selecionados 5 artigos. O artigo Teplick et al. (2018) realizou um experimento clinico in vitro em solução de A. Vera, e demonstrou que houve proliferação e migração celular de fibroblastos e queratinócitos de pele humana, além de ser protetor na morte de queratonócitos. Ou seja, acelera a cicatrização das feridas. Já Muangman et al. (2016), avaliou 50 pacientes com 20% do total da área superficial corporal queimada com queimaduras de segundo grau, entre 18-60 anos, tendo metade do grupo como controle recebendo curativos de gaze com parafina mole contendo 0,5% acetado de clorexidina e a outra metade recebendo curativos com poliéster contendo extratos de plantas medicinais principalmente Aloe Vera. Teve resultados positivos, uma maior velocidade de cicatrização e menor tempo de internação comparado ao grupo controle. Já Hwang et al. (2015) investigou os efeitos antioxidante de diferentes extratos de 2,4,6,8,12 meses da Aloe Vera. E o extrato com 6 meses concentrado de 0,25 mg/mL teve maior teor de flavanóides (9,750 mg equivalente catequina / g extrato) e polifenóis (23,375 mg equivalente ácido gálico / g extrato) e o maior poder antioxidante redutor férrico (0,047 mM de sulfato ferroso equivalente / extrato mg), ou seja, maior potencial de eliminação de radicais livres e também efeito proteror contra o estresse oxidativo induzido por hidroperóxido de terc-butila (t-BHP), sugerindo indícios de um potencial bioativo da A. vera. Porém, no artigo Kolacz et al. (2014) sugeriu como tratamento alternativo o uso do curativo com Aloe Vera em conjunto de mel, lanolina, azeite de oliva, óleo de gérmen de trigo, raiz de marshmallow, absinto, raiz de confrei, casca de carvalho branco, lobelia inflata, glicerina vegetal, cera de abelha e mirra, não obtendo resultados significativos e conclusivos que permitam subsidiar o tratamento convencional das queimaduras. Por fim, no artigo de Zurita and Gallegos (2017), realizou um estudo descritivo transversal com 321 pessoas, ambos os sexos entre 17-76 anos, de natureza indutiva, explorando a vivência dessa população e suas atitudes comportamentais quanto ao tratamento de dermatoses. Aloe vera teve 13,8% citada pelos indivíduos no tratamento de acne e 33,6% no tratamento de queimaduras. Mesmo tendo evidências que sugerem a eficácia no tratamento de queimaduras com o uso do extrato da Aloe Vera, sugere-se mais ensaios clínicos com espaço amostral maior sobre o uso de curativos de Aloe vera em médio queimados para maiores conclusões.


Assuntos
Humanos , Plantas Medicinais , Queimaduras/tratamento farmacológico , Aloe , Cicatrização , Extratos Vegetais/uso terapêutico , Extratos Vegetais/farmacologia , Estudos Transversais
5.
Braz. j. biol ; 83: e246514, 2023. tab, graf
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1285640

RESUMO

Abstract The poultry sector in Pakistan is contributing mainly in bridging gap between demand and supply for protein. Mycoplasma gallisepticum is an emerging bacterium causing serious problems in poultry industry of Pakistan. A cross-sectional study was conducted to evaluate the M. gallisepticum load in poultry populated regions of Pakistan. Total 600 serum and 600 swab samples were collected, 200 from each broiler, layers and breeders poultry in Rawalpindi and Abbottabad districts. Serum samples were analyzed through ELISA for seroprevalence. Swabs were cultured on Frey's medium followed by PCR and partial mgc2 gene sequencing. Results of seroprevalence of M. gallisepticum showed that layers (75%, n=150) are more positive as compared to breeders (70%, n=140) and broilers (50%, n=100). Typical colonies of the M. gallisepticum were observed in breeder (26.5%), followed by layer (21%) and broilers (9%). A total of 37.1% (n=42) samples were identified positive through PCR out of total 113 cultured based positive samples. A total of six M. gallisepticum isolates of current study showed 98-99 percent similarity with previously reported isolates on the basis of mgc2 gene partial sequencing. The M. gallisepticum was found highly prevalent in different poultry breads. Results of this study would add into basic data and provide a direction for livestock sector to strengthen a control strategy for mycoplasmosis in poultry farms.


Resumo O setor avícola do Paquistão está contribuindo principalmente para preencher a lacuna entre a demanda e a oferta de proteína. Mycoplasma gallisepticum é uma bactéria emergente que causa sérios problemas na indústria avícola do Paquistão. Um estudo transversal foi conduzido para avaliar a carga de M. gallisepticum em regiões de avicultura do Paquistão. Um total de 600 amostras de soro e 600 amostras de esfregaço foi coletado, 200 de cada frango de corte, poedeiras e aves reprodutoras nos distritos de Rawalpindi e Abbottabad. Amostras de soro foram analisadas por ELISA para soroprevalência. As zaragatoas foram cultivadas em meio Frey, seguido de PCR e sequenciação parcial do gene mgc2. Os resultados da soroprevalência de M. gallisepticum mostraram que as poedeiras (75%, n = 150) são mais positivas em comparação com matrizes (70%, n = 140) e frangos de corte (50%, n = 100). Colônias típicas de M. gallisepticum foram observadas em reprodutoras (26,5%), seguidas de poedeiras (21%) e frangos de corte (9%). Um total de 37,1% (n = 42) das amostras foi identificado como positivas por PCR de um total de 113 amostras positivas baseadas em cultura. Um total de seis isolados de M. gallisepticum do estudo atual mostrou 98-99% de similaridade com isolados relatados anteriormente com base no sequenciamento parcial do gene mgc2. O M. gallisepticum foi encontrado com alta prevalência em diferentes pães de aves. Os resultados deste estudo acrescentariam dados básicos e forneceriam orientação para o setor pecuário fortalecer uma estratégia de controle da micoplasmose em granjas avícolas.


Assuntos
Animais , Doenças das Aves Domésticas/epidemiologia , Mycoplasma gallisepticum/genética , Paquistão/epidemiologia , Aves Domésticas , Estudos Soroepidemiológicos , Galinhas , Estudos Transversais
6.
Horm Metab Res ; 54(2): 67-75, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35130567

RESUMO

Resistance to thyroid hormone syndrome (RTHS) is defined as increased thyroxine and triiodothyronine associated with normal or increased thyrotropin. This is usually due to a pathogenic variant of the gene coding for thyroid hormone receptor B (THRB). THRB is a rare genetic disorder characterized by an altered response of target tissue to the thyroid hormone action. Retrospective cross-sectional observational study with diagnosis of RTHS evaluated in secondary and tertiary hospitals for 6 years, from 2014 to 2020, in order to describe variables including age, sex, anthropometric data, clinical and biochemical characteristics of patients, who were divided according to age, in a pediatric group from 0 to 14 years (index cases), and an adult group composed of adult relatives of index cases. A molecular analysis of the THRB gene was performed. The total retrospective cohort included 7 pediatric patients and 15 adults. We found 22 cases with a clear male predominance (14/22). Mean age is 24.8 years old (22 days-70 years). Patients were referred because of symptoms 18.2% (4/22), analysis results 22.7% (5/22), or familial study 59.1% (13/22). About 31.8% (7/22) cases show goiter, 31.8% (7/22) sympathetic symptoms and 13.6% (3/22) abnormalities in behavior. In most cases, 77.3%, (17/22) show familial background of thyroid abnormalities. It is important to remark that 18.2% (4/22) relatives received previous incorrect treatments such as thyroidectomy, because of wrong diagnosis. In conclusion, a better understanding of RTHS, its prompt molecular diagnosis and genetic counseling, could avoid unnecessary tests and inappropriate treatments.


Assuntos
Síndrome da Resistência aos Hormônios Tireóideos , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Recém-Nascido , Masculino , Mutação , Estudos Retrospectivos , Receptores beta dos Hormônios Tireóideos/genética , Síndrome da Resistência aos Hormônios Tireóideos/diagnóstico , Síndrome da Resistência aos Hormônios Tireóideos/genética , Tireotropina , Tiroxina , Tri-Iodotironina , Adulto Jovem
7.
Horm Metab Res ; 54(2): 104-112, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35130571

RESUMO

Some studies have suggested that diabetes may be a risk factor for osteoarthritis. However, whether prediabetes is also associated with osteoarthritis has not been comprehensively examined. We performed a meta-analysis to evaluate the relationship between prediabetes and osteoarthritis. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intra-study heterogeneity was selected to pool the results. Ten datasets from six observational studies were included, which involved 41 226 general adults and 10 785 (26.2%) of them were prediabetic. Pooled results showed that prediabetes was not independently associated with osteoarthritis [risk ratio (RR): 1.07, 95% confidence interval (CI): 1.00 to 1.14, p=0.06, I2=0%]. Sensitivity limited to studies with adjustment of age and body mass index showed consistent result (RR: 1.06, 95% CI: 0.99 to 1.14, p=0.09, I2=0%). Results of subgroup analyses showed that prediabetes was not associated with osteoarthritis in cross-sectional or cohort studies, in studies including Asian or non-Asian population, or in studies with different quality scores (p for subgroup difference>0.10). Besides, prediabetes was not associated with osteoarthritis in men or in women, in studies with prediabetes defined as impaired fasting glucose, impaired glucose tolerance, or HbA1c (approximately 39-46 mmol/mol). Moreover, prediabetes was not associated with overall osteoarthritis, and knee or hip osteoarthritis. Current evidence does not support that prediabetes is independently associated with osteoarthritis in adult population.


Assuntos
Intolerância à Glucose , Osteoartrite , Estado Pré-Diabético , Adulto , Glicemia/metabolismo , Estudos Transversais , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Estudos Observacionais como Assunto , Osteoartrite/complicações , Osteoartrite/epidemiologia , Estado Pré-Diabético/complicações , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/metabolismo , Fatores de Risco
8.
AIDS Care ; 34(3): 301-309, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33615903

RESUMO

HIV pre-exposure prophylaxis (PrEP) is not yet included in India's national AIDS program, with demonstration projects for MSM in planning stages. In order to support PrEP roll-out for MSM, we assessed: (1) associations between guideline-informed PrEP eligibility, HIV risk perception, and perceived PrEP benefits and costs, with willingness to use PrEP (WTUP); and (2) correlates of non-WTUP among PrEP-eligible MSM. Data were collected from MSM (n = 197) sampled from cruising sites in Mumbai and Chennai. More than half (58.4%) reported inconsistent condom use with male partners, 88.3% >1 male partner, and 48.6% engaging in sex work (all past month). Overall, 76.6% reported they would "definitely use" PrEP. Among 92.9% deemed PrEP-eligible, 79.2% reported WTUP. In adjusted analyses, PrEP eligibility (aOR = 5.31, 95% CI 1.11, 25.45), medium (aOR = 2.41, 95% CI 1.03, 5.63) or high (aOR = 13.08, 95% CI 1.29, 132.27) perceived HIV risk, and greater perceived benefits (aOR = 1.13, 95% CI 1.03, 1.24) were associated with higher odds of WTUP. Among PrEP-eligible MSM, non-WTUP was associated with low HIV risk perception and lower perceived benefits. Facilitating accurate risk assessment and promoting awareness of PrEP benefits and eligibility criteria may increase PrEP uptake among MSM in India.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Estudos Transversais , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Índia , Masculino , Percepção
9.
Health Qual Life Outcomes ; 20(1): 71, 2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35488344

RESUMO

BACKGROUND: It is estimated that, worldwide, 9% of deaths occur as a result of insufficient physical activity (PA) practice. Practicing PA can prevent and/or reduce the deleterious effects of different types of diseases and can improve general health aspects related to health-related quality of life (HRQoL). PURPOSE: To analyze the relationship of different PA domains with different HRQoL domains over a two-year period. METHODS: This is an observational study with a two-year longitudinal design. The sample, composed of adults, was selected from a randomization of the streets of the different regions (north, south, east, west and center) covering individuals from all areas of the city. To assess the practice of PA, the Baecke questionnaire was used. The instrument Medical Outcomes Study SF-36-Item Short Form Health Survey was used to assess the HRQoL domains. Linear regression models were used to analyzed the association of different PA domains with changes in HRQoL. Multivariate statistical models were adjusted for gender, age, socioeconomic status, marital status, the respective PA score at baseline, smoking, body mass index, and morbidity. RESULTS: 331 adults were evaluated. There was a decrease in the practice of PA in the occupational domain and an increase in the leisure/locomotion domain. Regarding HRQoL, there was an increase in the scores of body pain and mental health, and a decrease in scores of general health, vitality, social aspects and emotional aspects. The PA practice in the occupational domain was inversely related to functional capacity (ß = - 7.2 [CI 95% - 13.0; - 1.4]). The practice of PA through sports in leisure time was positively associated with vitality (ß = 5.5 [CI 95% 0.2; 10.7]) and mental health (ß = 15.2 [CI 95% 6.8; 23.7]). PA practice during leisure and locomotion was inversely associated with functional capacity (ß = - 5.68 [CI 95% - 10.7; - 0.6]) and positively associated with vitality ß = 4.8 [CI 95% 0.8; 8.7]) and mental health (ß = 8.4 [CI 95% 2.0; 14.9]). The total PA practice was inversely associated with functional capacity (ß = - 3.8 [CI 95% - 6.5; - 1.2]) and positively associated with pain in the body (ß = 4.9 [CI 95% 0.3; 9.4]), vitality (ß = 2.9 [CI 95% 0.7; 5.0]) and mental health (ß = 5.7 [CI 95% 2.2; 9.2]). CONCLUSIONS: It is suggested that practicing PA continuously within a period of two years can positively affect some physical aspects and some mental aspects related to HRQoL, but not all of them. A strategy for public policy actions is to explore these variables by domain and thus detect the real needs and improvements that can be made for the population.


Assuntos
Nível de Saúde , Qualidade de Vida , Adulto , Estudos Transversais , Exercício Físico/psicologia , Humanos , Dor , Qualidade de Vida/psicologia
11.
BMC Infect Dis ; 22(1): 510, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641908

RESUMO

BACKGROUND: Hepatitis C virus self-testing (HCVST) is an additional approach that may expand access to HCV testing. We conducted a mixed-methods cross-sectional observational study to assess the usability and acceptability of HCVST among people who inject drugs (PWID), men who have sex with men (MSM) and transgender (TG) people in Tbilisi, Georgia. METHODS: The study was conducted from December 2019 to June 2020 among PWID at one harm reduction site and among MSM/TG at one community-based organization. We used a convergent parallel mixed-methods design. Usability was assessed by observing errors made and difficulties faced by participants. Acceptability was assessed using an interviewer-administered semi-structured questionnaire. A subset of participants participated in cognitive and in-depth interviews. RESULTS: A total of 90 PWID, 84 MSM and 6 TG were observed performing HCVST. PWID were older (median age 35 vs 24) and had a lower level of education compared to MSM/TG (27% vs 59%). The proportion of participants who completed all steps successfully without assistance was 60% among PWID and 80% among MSM/TG. The most common error was in sample collection and this was observed more often among PWID than MSM/TG (21% vs 6%; p = 0.002). More PWID requested assistance during HCVST compared to MSM/TG (22% vs 8%; p = 0.011). Acceptability was high in both groups (98% vs 96%; p = 0.407). Inter-reader agreement was 97% among PWID and 99% among MSM/TG. Qualitative data from cognitive (n = 20) and in-depth interviews (n = 20) was consistent with the quantitative data confirming a high usability and acceptability. CONCLUSIONS: HCVST was highly acceptable among key populations in Georgia of relatively high educational level, and most participants performed HCVST correctly. A significant difference in usability was observed among PWID compared to MSM/TG, indicating that PWID may benefit from improved messaging and education as well as options to receive direct assistance when self-testing for HCV.


Assuntos
Infecções por HIV , Hepatite C , Minorias Sexuais e de Gênero , Abuso de Substâncias por Via Intravenosa , Adulto , Estudos Transversais , República da Geórgia/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Hepacivirus , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Hepatite C/psicologia , Homossexualidade Masculina , Humanos , Masculino , Autoteste , Abuso de Substâncias por Via Intravenosa/psicologia
12.
BMC Public Health ; 22(1): 1080, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641915

RESUMO

BACKGROUND: Stigma and discrimination have fueled the transmission of the disease and dramatically increased its negative public health impact. Even though the disease has extremely ravaged human life, stigma, and discrimination attached to it are not well addressed in Ethiopia at the country level. The reduction of stigma and discrimination in a population are important indicators of the success of programs that target HIV prevention and control. This study aimed to assess the level of HIV-related stigma and its determinants among sexually active Ethiopians. METHODS: A public domain data were obtained from 2016 Ethiopian Demographic and Health Survey in which two-stage cross-sectional stratified cluster sampling was applied. A total of 28,371 sexually active Ethiopians were interviewed from both rural and urban parts of Ethiopia. Descriptive Statistics and multilevel ordinal logistic regression (proportional odds model) were used to summarize data and to investigate correlates of HIV-related stigma. RESULTS: Only 5.1% (95% CI: 4.5%, 5.8%) of sexually active Ethiopians did not have a stigmatizing attitude, whereas, 59.2% (95% CI: 57.3%, 61.1%) and 35.65% (95% CI: 33.5%, 37.9%) of them had a moderate and high level of stigma respectively. Regression results show that residence (AOR = 1.82, 95% CI:1.46, 2.27), education (AOR = 0.65,95% CI: 0.50,0.84), owning mobile (AOR = 0.63,95% CI:0.55,0.72), HIV-testing (AOR = 0.77, 95% CI:0.70,0.84), age (AOR = 0.81, 95% CI: 0.73, 0.91), religion (AOR = 1.53,95% CI:1.33,1.76), and marital status (AOR = 1.38, 95% CI:1.19, 1.61) were significantly associated with HIV-related stigma (p < 0.0001). CONCLUSION: Regardless of all efforts put in a place to prevent and control HIV, a significant proportion of sexually active Ethiopians have stigmatizing attitudes. Residence, educational level, owning mobile, HIV test uptake, age, religion, and marital status were determinants of HIV-related stigma. Expanding mobile coverage, promoting HIV counseling and tests, promoting HIV education, and working with religious leaders, among other strategies could be used to minimize the stigma attached to the disease to best prevent and control it.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/epidemiologia , Estudos Transversais , Demografia , Etiópia/epidemiologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Humanos
13.
BMC Infect Dis ; 22(1): 507, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641926

RESUMO

BACKGROUND: This study aimed to identify differences and similarities among adolescents and parents in various psychosocial factors influencing meningococcal ACWY (MenACWY) vaccination acceptance. Besides, the impact of the Covid-19 pandemic was assessed as well as resulting organizational adjustments. METHODS: We conducted a cross-sectional survey among adolescents that attended the appointment for the MenACWY vaccination in South Limburg between May and June 2020, and their parents. Independent t-tests and χ2 test were performed to explore differences in psychosocial and organisational factors between adolescents and parents. RESULTS: In total, 592 adolescents (20%) and 1197 parents (38%) filled out the questionnaire. Adolescents scored lower on anticipated negative affect towards MenACWY vaccination refusal [t (985.688) = - 9.32; ρ < 0.001], moral norm towards MenACWY vaccination acceptance [t (942.079) = - 10.38; ρ < 0.001] and knowledge about the MenACWY vaccination and meningococcal disease [t (1059.710) = - 11.24; ρ < 0.001]. Both adolescents and parents reported a social norm favouring accepting childhood vaccinations, but adolescent scored higher [t (1122.846) = 23.10; ρ < 0.001]. The Covid-19 pandemic did barely influence the decision to accept the MenACWY vaccination. Only 6% of the participants indicated that Covid-19 influenced their decision. In addition, the individual vaccination appointment was rated very positive. Most adolescents (71.5%) and parents (80.6%) prefer future vaccinations to be offered individually rather than having mass vaccinations sessions. CONCLUSIONS: This study provides an indication of which psychosocial and organisational factors should be addressed in future MenACWY vaccination campaigns. Individual vaccination appointments for adolescents should be considered, taking the costs and logistical barriers into account.


Assuntos
COVID-19 , Neisseria meningitidis , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Humanos , Vacinas Meningocócicas , Pandemias , Pais , Vacinação , Vacinas Conjugadas
14.
BMC Health Serv Res ; 22(1): 720, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641927

RESUMO

BACKGROUND: Internet-based Cognitive Behaviour Therapy (iCBT) for depression have been implemented in routine care across Europe in varying ways, at various scales and with varying success. This study aimed to advance our understanding of organisational implementation climate from the perspectives of implementers and mental health service deliverers. METHODS: Qualitative and quantitative methods were combined to study the concept of organisational implementation climate in mental health care settings. Based on concept mapping, a qualitative workshop with implementers was used to conceptualise organisational implementation climate for optimizing iCBT use in routine practice. Service deliverers involved in the provision of iCBT were invited to participate in an explorative cross-sectional survey assessing levels of satisfaction and usability of iCBT, and organisational implementation climate in implementing iCBT. The two methods were applied independently to study viewpoints of implementers as well as service deliverers. Corresponding to the explorative nature of the study, inductive reasoning was applied to identify patterns and develop a reasonable explanation of the observations made. Correlative associations between satisfaction, usability and implementation climate were explored. RESULTS: Sixteen implementers representing fourteen service delivery organisations across Europe participated in the workshop. The top-three characteristics of a supportive organisational implementation climate included: (1) clear roles and skills of implementers, (2) feasible implementation targets, and (3) a dedicated implementation team. The top-three tools for creating a supportive implementation climate included: (1) feedback on job performance, (2) progress monitoring in achieving implementation targets, and (3) guidelines for assessing the impact of iCBT. The survey (n=111) indicated that service providers generally regarded their organisational implementation climate as supportive in implementing iCBT services. Organisational implementation climate was weakly associated with perceived usability and moderately with satisfaction with iCBT services. CONCLUSIONS: Organisational implementation climate is a relevant factor to implementers and service deliverers in implementing iCBT in routine care. It is not only an inherent characteristic of the context in which implementation takes place, it can also be shaped to improve implementation of iCBT services. Future research should further theorise organisational implementation climate and empirically validate the measurement instruments such as used in this study.


Assuntos
Terapia Cognitivo-Comportamental , Serviços de Saúde Mental , Terapia Cognitivo-Comportamental/métodos , Estudos Transversais , Depressão/terapia , Humanos , Internet
15.
BMC Prim Care ; 23(1): 135, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641930

RESUMO

BACKGROUND: Social distancing and lockdowns were implemented during the first period of the COVID-19 pandemic. Primary care physicians needed to adapt quickly to deliver remote care/telemedicine. METHODS: A cross-sectional, 47-item online Google Survey was distributed through the Israel Association of Family Physicians (IAFP) mailing list between March 31-May 5, 2020. The questionnaire included demographics, physician characteristics, and information on usage and perceived telemedicine quality. Sampling weights by sex and age groups were applied. RESULTS: One hundred fifty-nine primary care physicians (10.6% of registered IAFP members; 63.5% women; mean age 53.4 ± 10.4 years and median professional experience 21.3 years) replied to the survey. The majority (59.7%) of the participants performed a mixture of in-person along with phone counseling. About 40% had no former telemedicine experience. The majority indicated that telephone and video formats were inferior to in-person consultation (68%, 57.1% online and phone, respectively). The overall counseling quality grade (on a 1-10 scale,)median (IQR)) was 6.2 (3) for telephone and 7(2) for video. While 66.9% reported experiencing no challenges, 10% had technical problems, 10% interpersonal problems, 5.6% scheduling difficulties, and 7.5% other difficulties. Majority of 56.6% physicians indicated they prescribed more antibiotics,16.4% sent more blood tests, 24.5% referred more to experts, and 49.7% referred more to imaging in comparison to usual counseling. Higher phone quality score was significantly associated with physicians who indicated not prescribing more antibiotics during the pandemic (OR = 0.30, 95%CI 0.134-0.688, p = 0.004). Higher online quality score was associated with physicians who indicated not sending more blood tests during the pandemic (OR = 0.06 95%CI 0.008-0.378, P = 0.003). CONCLUSIONS: Our findings suggest telehealth holds considerable promise for counseling in the primary care setting. However, interpersonal challenges raised by physicians should be understood in-depth to develop tailored training and further examine it in randomized trials while integrating patient-reported outcomes. Finally, further research on utility, cost, and cost-efficiency during remote counseling with follow-ups, medical prescribing, and additional referrals is needed.


Assuntos
COVID-19 , Pandemias , Adulto , Antibacterianos , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Médicos de Família , Atenção Primária à Saúde
16.
BMC Health Serv Res ; 22(1): 724, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641931

RESUMO

BACKGROUND: Physicians commonly suffer from workplace aggression and its negative consequences. Previous studies have shown that stressors such as job demands increase the risk of inappropriate treatment at workplace. Poorly functioning, and constantly changing information systems form a major work stressor for physicians. The current study examined the association between physicians' stress attributed to information systems (SAIS) and their experiences of workplace aggression. Workplace aggression covered physical and non-physical aggression, perpetrated by coworkers, patients, patient's relatives, or supervisors. METHODS: A cross-sectional survey study was conducted. The participants included 2786 physicians (67.4% women) who were sampled randomly from the registry of Finnish Medical Association, which covers almost all of the Finnish physician population. First, bivariate associations were studied among participant characteristics, SAIS and workplace aggression. Logistic regression analysis was then used to further determine how SAIS was associated with the likelihood of experiencing different types of aggression. RESULTS: Higher levels of SAIS were associated with higher likelihood of aggression with regard to all types of aggression, except non-physical aggression perpetrated by patients or relatives. The demographic factors (work-sector, gender, age) did not have a noticeable influence on the association between SAIS and aggression. CONCLUSIONS: The present results build on previous evidence on the prevalence of SAIS and its negative effects on healthcare workers. Since SAIS may increase the risk of experiencing aggression, it is possible that SAIS also endangers the wellbeing of physicians and thereby the quality of patient care. Resourcing time and training during introduction of a new IS could alleviate time pressure and thus stress attributed to managing new information systems. The role of organizational climate and general workload in arousing SAIS and aggression should be examined in future studies.


Assuntos
Médicos , Local de Trabalho , Agressão , Estudos Transversais , Feminino , Finlândia/epidemiologia , Humanos , Sistemas de Informação , Masculino
17.
BMC Public Health ; 22(1): 1077, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641948

RESUMO

BACKGROUND: Governments have attempted to combat the COVID-19 pandemic by issuing guidelines for disease prevention behavior (e.g., wearing masks, social distancing, etc.) and by enforcing these guidelines. However, while some citizens have complied with these guidelines, others have ignored them or have even participated in large-scale protests. This research aims both to understand the causes of such variation in citizens' adherence to government guidelines on disease prevention behavior and to extend the scientific literature on disease prevention to account for the collective resilience of a society to diseases. Thus, this research draws on the health belief model and collective resilience theory to develop hypotheses about the determinants of a citizen's disease prevention behavior. These hypotheses deal with how citizens' vulnerability, attitudes toward disease prevention, and social orientation are associated with COVID-19 prevention behaviors. METHODS: From March 24 to April 4, 2020, a cross-sectional online survey was conducted in Bolivia. It included questions on demographic characteristics, chronic health problems, emotional burden, attitudes towards preventive behaviors, trust in public institutions, and culture. Among 5265 participants who clicked on the survey, 1857 at least partially filled it out. After removing data with missing responses to any variable, the final sample consists of 1231 respondents. The collected data were analyzed using hierarchical linear modeling. RESULTS: Regarding a citizen's vulnerability, chronic health problems have a U-shaped association with disease prevention behavior. Moreover, age, female gender, and worries have positive associations with disease prevention behavior, whereas depression showed a negative association. Regarding attitudes toward disease prevention, trust in public institutions, and attitudes toward social distancing, a government-imposed lockdown and the enforcement of this lockdown showed positive associations with disease prevention behavior. Regarding social orientation, individualism and collectivism both have positive relationships with disease prevention behavior. CONCLUSIONS: In the COVID-19 pandemic, a citizen's low vulnerability, weak social orientation, and beliefs about low benefits of disease prevention behavior are associated with poor compliance with guidelines on disease prevention behavior. More research on these associations would help generalize these findings to other populations and other public health crises.


Assuntos
COVID-19 , Bolívia/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Modelo de Crenças de Saúde , Humanos , Pandemias/prevenção & controle
18.
BMC Public Health ; 22(1): 1076, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641963

RESUMO

BACKGROUND: This study aimed to investigate the association between dietary fiber intake and long-term cardiovascular disease (CVD) risk based on the National Health and Nutrition Examination Survey (NHANES) database. METHODS: A total of 14,947 participants aged 20-79 from the NHANES database were included in this study between 2009 and 2018. The atherosclerotic cardiovascular disease (ASCVD) score was utilized to predict the 10-year risk of CVD in individuals (low, borderline, intermediate, and high risk). Weighted univariate and multinomial multivariate logistic regression analyses were used to analyze the association between dietary fiber intake and long-term CVD risk. RESULTS: Higher dietary fiber density may be associated with a reduced ASCVD risk in participants with intermediate risk [odds ratio (OR) = 0.76; 95% confidence interval (CI), 0.61-0.94] and high risk (OR = 0.60; 95%CI, 0.45-0.81) compared with those in the group with low risk. Higher total dietary fiber intake may also reduce ASCVD risk in participants with high risk (OR = 0.84; 95%CI, 0.75-0.95). Subgroup analyses showed that higher dietary fiber density may be related to reduced ASCVD risk in intermediate-risk participants aged 20-39 (OR = 0.62; 95%CI, 0.43-0.89) and 40-59 (OR = 0.67; 95%CI, 0.49-0.94). In high-risk participants, higher dietary fiber density may reduce ASCVD risk in 20-39-year-old (OR = 0.38; 95%CI, 0.19-0.77), 40-59-year-old (OR = 0.37; 95%CI, 0.20-0.70), male (OR = 0.47; 95%CI, 0.23-0.97) and female (OR = 0.57; 95%CI, 0.38-0.86) participants. CONCLUSION: Higher dietary fiber density and total dietary fiber intake were associated with a lower long-term CVD risk, especially in the 20-39 and 40-59 age groups, where the reduction was most significant.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Adulto , Aterosclerose/epidemiologia , Aterosclerose/prevenção & controle , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Fibras na Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores de Risco , Adulto Jovem
19.
BMC Public Health ; 22(1): 1072, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641969

RESUMO

BACKGROUND: Food security, malnutrition, and poverty are some of the challenges that most of the sub-Saharan African countries have been historically facing. With the coming of Covid-19 pandemic, the sustainability of the Village Savings and Loans Association which are formed to counter fight these challenges is questioned. AIM: This study aimed to assess factors associated with the Sustainability of VSLAs amidst Covid-19 and its impacts on households' income levels. METHODS: An online cross-sectional design was conducted from November to January 2021, targeting VSLAs members in Mzuzu. A snowball and respondent-driven sampling technique were used to recruit the needful participants using a referral approach. IBM SPSS version 23 was used to perform descriptive statistics, Chi-Square, and binary logistic regression with unstandardized Beta (ß), Odds Ratios (OR), and 95% Confidence Interval (CI) being taken into account with P-value set at 0.1, 0.05 and 0.01 significance levels. RESULTS: Our study finds that household income declined by 54% for those earnings belonged to ˂ MK5,000, as compared to 38% and 15% for medium (MK5,000 ≥ MK10,000) and higher (> MK10,000) income bands respectively. Our study shows that gender (ß = 0.437, p = 0.094), age-group (ß = 1.317, p = 0.000), education (ß = 2.181, p = 0.047), share contributions (ß = 1.035, p = 0.008), meetings (ß = 0.572, p = 0.021), occupation (ß = -0.453, p = 0.106), and frequency of meeting (ß = -0.507, p = 0.049) were positively and negatively statistically significant predictors. CONCLUSION: According to the findings of this study, households with lower income earners, which is one of the indicators of poverty, are more affected by the pandemic than their counterparts. We urge that the Malawi governments should maintain and, if they haven't already, implement programs that support low-income households, such as transfer payments, which have been shown to uplift people out of income poverty in many developing countries.


Assuntos
COVID-19 , COVID-19/epidemiologia , Estudos Transversais , Humanos , Renda , Malaui/epidemiologia , Pandemias
20.
BMC Public Health ; 22(1): 1075, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641975

RESUMO

BACKGROUND: Despite recent progress in rural economic development and food production, the prevalence of household food insecurity (FI) and use of unimproved toilet facilities are widespread in Bangladesh. Evidence regarding the consequencs of household FI and poor sanitation on child morbidity is scarce. This study aimed to understand the association of FI and unimproved toilet facility with morbidity status of under-5 children in Bangladesh. METHODS: We used data from a cross-sectional survey that was conducted as part of an evaluation of the Maternal, Infant and Young Child Nutrition (MIYCN) Program in 9 districts of Bangladesh. The study population included children aged 6-59 months and their caregivers, identified using a two-stage cluster-sampling procedure. Child morbidity status was the outcome variable, and household FI status and type of toilet used were considered the main exposure variables in this study. We performed logistic regression, calculated adjusted odds ratios (AOR) to assess the association of child morbidity with household FI and unimproved toilet facility after adjusting for potential confounders. RESULTS: A total of 1,728 households were eligible for this analysis. About 23% of the households were food-insecure, and a large number of households had improved toilet facilities (93.4%). In the multivariable logistic regression model, we found that children in food-insecure households with unimproved toilet facility had 5.88 (AOR: 5.88; 95% CI 2.52, 13.70) times more chance, of being morbid compared to the children of food-secure households with improved toilet facility. A similar association of FI and toilet facilities with each of the morbidity components was observed, including diarrhea (AOR:3.6; 95% CI 1.79, 7.89), fever (AOR:3.47; 95% CI 1.72, 6.99), difficult or fast breathing with cough (AOR:3.88; 95% CI 1.99, 7.59), and difficult or fast breathing with blocked or running nose (AOR:1.29; 95% CI 0.56, 2.95). CONCLUSIONS: Our study shows that household FI and unimproved toilet facility jointly have more deteriorative effects on child morbidity than either of these conditions alone. Therefore, it is recommended to consider these two critical factors while designing a public health intervention for reducing morbidity among under-five children.


Assuntos
Mães , Toaletes , Bangladesh/epidemiologia , Criança , Estudos Transversais , Feminino , Insegurança Alimentar , Humanos , Lactente , Prevalência
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