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1.
Braz. j. oral sci ; 20: e219638, jan.-dez. 2021. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1254752

RESUMO

Diagnosis of oral and oropharyngeal cancer in advanced stages may be associated with social nature factors, access to health care, education, occupation, and behavioral/ cultural factors. Aim: To determine the factors related to high clinical-staging in patients diagnosed with squamous cell carcinoma in the oral and oropharyngeal region in a Cancer Center in Brazil between 2009 and 2015. Methods: It is an epidemiological, retrospective, and exploratory study. Patients diagnosed with squamous cell carcinoma had their medical records analyzed. The variables considered were sociodemographic, lifestyle, and disease characteristics. Descriptive and exploratory tests (Pearson's, chi-square test and, Student's t-test) were realized. Results: We analyzed 365 patient records, among which 289 (79.17%) were male, and 73 (20.0%) were female. Age ranged from 16 to 101 years, with a mean of 61.13. Regarding education, 157 (43.01%) studied < 8 years, 103 (28.21%) were illiterate and 102 (27.94%) studied > 8 years. 305 (83.56%) patients live in urban areas. There was an association between high clinical-staging and low educational level. For high clinical-staging, symptomatology, tobacco, and alcohol intake as well. Conclusion: Patients with low educational levels tend to report the disease later, and their diagnostics occurred in advanced stages. Thus, specific public health policies for this population, including access to dental care to recognize the clinical signs and early diagnosis, are necessary


Assuntos
Fatores Socioeconômicos , Neoplasias Bucais/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Registros Médicos
2.
BMJ Glob Health ; 6(9)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34518205

RESUMO

INTRODUCTION: We describe COVID-19 morbidity, mortality, case fatality and excess death in a country-wide study of municipalities in Hungary, exploring the association with socioeconomic status. METHODS: The spatial distribution of morbidity, mortality and case fatality was mapped using hierarchical Bayesian smoothed indirectly standardised ratios. Indirectly standardised ratios were used to evaluate the association between deprivation and the outcome measures. We looked separately at morbidity and mortality in the 10 districts with the highest and 10 districts with the lowest share of Roma population. RESULTS: Compared with the national average, the relative incidence of cases was 30%-36% lower in the most deprived quintile but the relative mortality and case fatality were 27%-32% higher. Expressed as incidence ratios relative to the national average, the most deprived municipalities had a relative incidence ratio of 0.64 (CI: 0.62 to 0.65) and 0.70 (CI: 0.69 to 0.72) for males and females, respectively. The corresponding figures for mortality were 1.32 (CI: 1.20 to 1.44) for males and 1.27 (CI: 1.16 to 1.39) for females and for case fatality 1.27 (CI: 1.16 to 1.39) and 1.32 (CI: 1.20 to 1.44) for males and females, respectively. The excess death rate (per 100 000) increased with deprivation levels (least deprived: 114.12 (CI: 108.60 to 119.84) and most deprived: 158.07 (CI: 149.30 to 167.23)). The 10 districts where Roma formed the greatest share of the population had an excess mortality rate 17.46% higher than the average for the most deprived quintile. CONCLUSIONS: Those living in more deprived municipalities had a lower risk of being identified as a confirmed COVID-19 case but had a higher risk of death. An inverse association between trends in morbidity and mortality by socioeconomic conditions should be a cause for concern and points to the need for responses, including those involving vaccination, to pay particular attention to inequalities and their causes.


Assuntos
COVID-19 , Teorema de Bayes , Feminino , Humanos , Hungria/epidemiologia , Masculino , Pandemias , Fatores de Risco , SARS-CoV-2 , Fatores Socioeconômicos
3.
Lima; OPS; 2021-09-17. (OPS/SAM/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-54854

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS en la subregión en el 2020, mediante la aplicación de la estrategia de cooperación subregional, la respuesta a las necesidades y prioridades subregionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Cobertura Universal de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Sistemas de Informação em Saúde , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração em Saúde Pública , Administração Financeira , América do Sul
4.
Tegucigalpa; OPS; 2021-09-16. (OPS/HND/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54846

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Cobertura Universal de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Sistemas de Informação em Saúde , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração Financeira , Administração em Saúde Pública , América Central , Honduras
5.
Asunción; OPS; 2021-09-14. (OPS/PRY/21-0003).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54834

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Cobertura Universal de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Sistemas de Informação em Saúde , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração Financeira , Administração em Saúde Pública , América do Sul , Paraguai
6.
Lima; OPS; 2021-09-09. (OPS/PER/21-0002).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54813

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Prioridades em Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Cobertura Universal de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Saúde Mental , Fatores Socioeconômicos , Administração em Saúde Pública , Sistemas de Informação em Saúde , América do Sul , Peru
7.
San Salvador; OPS; 2021-09-09. (OPS/SLV/21-0002).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54810

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Cobertura Universal de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração em Saúde Pública , Administração Financeira , Sistemas de Informação em Saúde , América Central , El Salvador
8.
Guatemala; OPS; 2021-09-09. (OPS/GTM/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54809

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Cobertura Universal de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração Financeira , Administração em Saúde Pública , Sistemas de Informação em Saúde , América Central , Guatemala
9.
Montevideo; OPS; 2021-09-02. (OPS/URI/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54792

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Sistemas Nacionais de Saúde , Política de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração em Saúde Pública , Administração Financeira , América do Sul , Uruguai
10.
Panamá; OPS; 2021-09-02. (OPS/PAN/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54791

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Sistemas Nacionais de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração Financeira , Administração em Saúde Pública , América Central , Panamá
11.
La Paz; OPS; 2021-09-02. (OPS/BOL/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54783

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração Financeira , Administração em Saúde Pública , América do Sul , Bolívia
12.
J Glob Health ; 11: 13002, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484709

RESUMO

Background: Early marriage and maternity prevalence rates among adolescent girls remain alarmingly high in West and Central Africa (WCA). This study aims to explore the associations between socio-economic factors and the prevalence of early marriage and maternity, thus contributing to the identification of girls at risk of early pregnancy or marriage. Methods: We pooled data from national representative surveys (1986 - 2017) for 23 countries in WCA to examine associations between wealth, educational attainment, religious affiliation, and place of residence with adolescent marriage and maternity. We decomposed the wealth and education gradients for individual countries, while controlling for common characteristics of the local environment via the use of primary sampling unit fixed-effects. The pooled sample provides information on 262 721 girls (age 15-19 years). Survey weights and population share weights were used in the estimations. Results: The prevalence of adolescent maternity and marriage exhibited a wealth and education gradient. Prevalence of marriage in the poorest wealth quintile was 41.1% (95% confidence interval (CI) = 38.8%-43.5%) and 10.5% (95% CI = 9.5%-11.6%) in the richest. For maternity it was 38.3% (95% CI = 36.4%-40.3%) in the poorest quintile and 12.7% (95% CI = 11.5%-13.9%) in the richest. Marriage/maternity is three/two times more likely to occur among girls with incomplete primary or no formal education than in those with at least primary. Maternity and marriage among adolescents exhibit a geographical pattern and differences between religious groups. Adolescent marriage prevalence was 34.4% (95% CI = 32.9%-35.8%) in rural areas compared to 13.3% (95% CI = 12.3%-14.2%) in urban areas. Adolescent maternity prevalence was 32.8% (95% CI = 31.7%-33.9%) in rural compared to 16.3% (95% CI = 15.3%-17.3%) in urban areas. Finally, the prevalence of adolescent marriage was substantially higher among Muslims compared to all other religious groups. Conclusions: Our results highlight the disparities in the prevalence of adolescent marriage and maternity and confirm the existence of wealth and education gradients. These findings can help to improve targeting of vulnerable adolescents and to identify areas for policy implementation.


Assuntos
Casamento , População Rural , Adolescente , Adulto , África Central , Escolaridade , Feminino , Humanos , Gravidez , Prevalência , Fatores Socioeconômicos , Adulto Jovem
13.
J Glob Health ; 11: 13003, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484710

RESUMO

Background: Adequate antenatal care (ANC) utilization is recognized as one of the important drivers of safe childbirth and positive birth outcomes. The usage of ANC services fluctuates with various personal, socio-economic, and cultural characteristics and in resource-poor settings, adolescent mothers are at a particularly high risk of insufficient ANC utilization. Objectives: This paper investigates whether the usage of ANC services and institutional delivery as well as newborn birth weight differ systematically between adolescent and adult mothers in West and Central Africa. Moreover, we explore to what extent differences in birth weight are explained by ANC usage, adolescence, and select socio-economic characteristics of the mother. Methods: We pooled cross-sectional data from all Demographic and Health Surveys (DHS) and Multi Indicator Cluster Surveys (MICS) conducted in countries in West and Central Africa region between 1986 and 2017 to estimate measures of ANC usage and qualified delivery assistance (along with a combined measure of "adequate maternal healthcare" aggregating these two factors) and newborn birth weight by maternal age group. We estimated various regression models to analyze a) the association between adolescence and adequate prenatal and maternal health care controlling for select socio-economic maternal characteristics as well as the local environment and b) between adolescence, adequate maternal health care, and newborn birth weight outcomes, also controlling for maternal characteristics and the local environment. All regressions were linear probability models for binary outcomes and simple linear models for continuous outcomes. Results: Adequate maternal health care provision was lowest among adolescent mothers: 23.0% among adolescents vs an average of 29.2% across all other age groups. Moreover, we found maternal education and wealth to be positively and significantly associated with receiving adequate maternal health care. Adolescent mothers had the highest risk of low infantile birth weight with 14.5% (95% confidence interval (CI) = 13.6%-15.5%), which is roughly 1.5-2 times higher than in older mothers. We found that adolescence is still strongly associated with low birth weight even when adequate maternal health care and various socio-economic factors as well as the local environment are controlled for. Conclusions: Our findings suggest that ANC supply in resource-poor settings should be particularly tailored to adolescent mothers' needs and that further research is necessary to explore what individual maternal characteristics beyond socio-economic and physical (eg, BMI) factors drive the prevalence of low birth weight. Moreover, the currently used measures of maternal care quality are heavily dependent on pure quantitative measures (number of ANC visits). New indicators incorporating measures of factual quality and scope ought to be developed and incorporated into large routine household surveys such as DHS and MICS.


Assuntos
Serviços de Saúde Materna , Cuidado Pré-Natal , Adolescente , Adulto , Idoso , Peso ao Nascer , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Saúde Materna , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Fatores Socioeconômicos
14.
J Glob Health ; 11: 13004, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484711

RESUMO

Objective: Early marriage and childbearing have substantial detrimental effects on both, the affected girls and women at the micro level, as well as entire economies on the macro level. West and Central African countries have some of the highest prevalence rates of early marriage and maternity worldwide. This work attempts to quantify the long-term economic, societal, and fertility effects of marriage and pregnancy in early and late adolescence in West and Central Africa. Methods: We used pooled cross-sectional data collected between 1986 and 2017 in 21 West and Central African countries within the DHS and MICS programs to estimate the associations of marriage and maternity during early (10-14) and late (15-19) adolescence retrospectively on wealth accumulation, educational attainment, as well as the woman's lifetime fertility. Results: Descriptively, women who married or gave birth as young or very young adolescents are overrepresented among the poorest and least educated quintiles of the adult population and underrepresented among the richest and most educated. These gradients were confirmed within a regression analysis which additionally controlled for current age of the woman and PSU fixed effects. Marrying in early/late adolescence was associated with a 12%/6% higher likelihood of being in the poorest wealth quintile in later life and 29%/20% increased likelihood of not completing primary education, as compared to women who married as adults. Maternity in early/late adolescence was associated with a 7%/4% higher likelihood of belonging to the poorest quintile and 17%/10% higher likelihood of being uneducated. Moreover, women who married/gave birth during early or late adolescence, on average, have 2.2/2.3 or 1.4/1.5 more children than those who have married/become mothers as adults. Conclusions: Our findings suggest that the dire consequences of early marriage and maternity hit youngest girls the hardest - both immediately and long-term. Hence, it is not only worthwhile to prevent adolescent marriage and pregnancy in general, but also specifically target very young girls below age 15 to attempt to at least delay such far-reaching demographic life events.


Assuntos
Fertilidade , Casamento , Adolescente , Adulto , África Central , Fatores Etários , Criança , Estudos Transversais , Escolaridade , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Fatores Socioeconômicos
15.
J Glob Health ; 11: 13007, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484714

RESUMO

Background: Adolescence is a formative period when an individual acquires physical, cognitive, emotional, and social resources that are the foundation for later life, health, and well-being [1]. However, in West and Central African region, this trajectory is curtailed by early childbearing associated with an increased risk of undernutrition and anemia. Evidence on socio-economic determinants of anemia and undernutrition in adolescent mothers is limited. This paper aims to shed some light on this issue and, more specifically, assess the socio-economic determinants of anemia among childbearing adolescents in the region. Methods: For this observational study, we pooled data from all Demographic and Health Surveys (DHS) conducted in countries in West and Central Africa region between 1986 and 2017. Outcomes were undernutrition and anemia in adolescent mothers. Predictors were education, wealth, place of residence (rural/urban), and religion. Descriptive statistics were calculated using survey weights for individual surveys and in the pooled sample each country was additionally weighted with its population share. We estimated multiple regression models with and without primary sampling unit fixed effects for both outcomes. All regressions were linear probability models. Results: Having no formal education was the strongest predictor for both anemia and undernutrition. Belonging to the richest asset quintile was also associated with lower anemia and undernutrition prevalence in some specifications. While urban location of the mother was positively associated with anemia, there was no association with undernutrition. Conclusions: Overall, having any formal education emerged as a sole strong predictor of reduced adolescent maternal undernutrition and anemia. Promotion of female education can potentially serve as a high-impact intervention to improve adolescent girls' health in the region. However, we cannot make conclusions about its causal impact based on this study alone.


Assuntos
Anemia , Desnutrição , Adolescente , África Central , Anemia/epidemiologia , Escolaridade , Feminino , Humanos , Desnutrição/epidemiologia , Mães , Prevalência , Fatores Socioeconômicos
16.
J Glob Health ; 11: 13009, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484716

RESUMO

Background: While the prevalence of childhood diseases and related mortality have been decreasing over the past decades, progress has been unequally distributed. The poorest households often carry the highest disease burden. As morbidity and mortality also decline most slowly among children of the poorest households, socioeconomic status may become a more relevant risk factor for childhood diseases. Methods: We analysed the association between socioeconomic status and highly prevalent childhood diseases, specifically diarrhoea, acute respiratory infections (ARI), and malaria, and how this association changed over time. For this observational study, we used repeated cross-sectional data, namely all available Demographic and Health Surveys as well as Multi-Indicator Cluster Surveys from Western and Central Africa between 1995 and 2017. We estimated the predicted prevalence of each disease for the entire region in three time periods. We repeated the analysis separately for each country to highlight heterogeneity between countries. Results: A notable wealth gradient can be seen in the prevalence rates of diarrhoea, ARI, and malaria in Western and Central Africa. Children in the poorest quartile have a much higher morbidity than children in the richest quartile and have experienced a considerably slower decline in prevalence rates. In the period 2010-2017, predicted prevalence of diarrhoea was 17.5% for children in the poorest quartile and 12.5% for children in the richest quartile. Similarly, the predicted prevalence was 11.1% and 8.6% for ARI, and 54.1% and 24.4% for malaria in endemic countries. The pattern does not differ between boys and girls. While exact prevalence rates vary between countries, only few countries have seen a decline in the wealth gradient for childhood diseases. Conclusions: The increasing wealth gradient in health raises concerns of increasing inequality that goes beyond wealth. It suggests a need to further improve targeting of health programmes. Moreover, these programmes should be adapted to address the interlinked challenges which burden the poorest households.


Assuntos
Malária , Infecções Respiratórias , África Central , Criança , Estudos Transversais , Diarreia/epidemiologia , Feminino , Humanos , Lactente , Malária/epidemiologia , Masculino , Prevalência , Infecções Respiratórias/epidemiologia , Fatores Socioeconômicos
17.
East Mediterr Health J ; 27(8): 772-781, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34486713

RESUMO

Background: The health and social care needs of people aged ≥ 80 years are a neglected topic. Aims: To determine the prevalence of unmet health and social care needs and associated factors in community-dwelling individuals aged ≥ 80 years in Izmir District of Balçova, Turkey. Methods: There were 1075 participants aged ≥ 80 years. The dependent variables were unmet health and social care needs. Independent variables were sociodemographic, socioeconomic and lifestyle characteristics. The data were collected in face-to-face interviews conducted at the homes and analysed by multiple logistic regression model. Ethical approval was obtained from the Non-Invasive Research Ethics Board of Dokuz Eylul University Medical Faculty (2017/26-24). Results: The mean age was 84.1 (3.7) years and 61.0% were female. Healthcare needs were expressed by 88.2% of the participants and 78.9% claimed that they had social care needs. Prevalence of unmet health and social care needs was 32.5% and 46.6%, respectively. Approximately 90.0% of their needs were covered by families. Perceived low-income status was a risk factor for unmet healthcare needs, and lack of social support was a risk factor for unmet social care needs. Additionally, not receiving formal education was a protective factor in unmet social care needs. Conclusion: Public health policy should be developed to enable better access to care, especially for the oldest people, considering that nearly one third of the participants in this study had unmet healthcare needs and almost half had unmet social care needs.


Assuntos
Acesso aos Serviços de Saúde , Apoio Social , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Fatores Socioeconômicos , Turquia/epidemiologia
18.
PLoS One ; 16(9): e0256085, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469440

RESUMO

Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these issues by describing racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational standing, defined as the proportion of workers within each occupation with at least some college education. This measure serves as a proxy for whether workplaces and workers employ COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational standing and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational standing shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower standing occupations overall and in lower standing occupations associated with high risk, and thus may be less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low standing occupations and for the development of programs outside the workplace.


Assuntos
COVID-19/epidemiologia , Grupos de Populações Continentais , Exposição Ocupacional/efeitos adversos , Ocupações , SARS-CoV-2 , Adulto , Grupos Étnicos , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Local de Trabalho
19.
Ann Med ; 53(1): 1419-1428, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34482788

RESUMO

INTRODUCTION: Previous studies suggested that almost one-third of U.S. adults did not plan to get a COVID-19 vaccine once it is available to them. The purpose of this study was to examine changes in vaccine intentions and attitudes by sociodemographic characteristics and geographic areas, factors associated with vaccination intent, and reasons for non-vaccination among a nationally representative sample of U.S. adults. METHODS: Data from six waves of the Household Pulse Survey (6 January - 29 March 2021) were analyzed. Differences between January and March were assessed using t-tests. Factors associated with vaccination intent were examined in multivariable logistic regression models. RESULTS: From early January to late March, vaccination receipt of ≥1 dose of the COVID-19 vaccine or intention to definitely get vaccinated increased from 54.7 to 72.3%; however, disparities in vaccination intent continued to exist by age group, race/ethnic groups, and socioeconomic characteristics. Vaccine receipt and the intent were the lowest for region 4 (southeastern U.S.) throughout this period. Adults who had a previous COVID-19 diagnosis or were unsure if they have had COVID-19 were less likely to intend to get vaccinated [prevalence ratio = 0.92 (95%CI: 0.90-0.93) and 0.80 (95%CI: 0.74-0.85), respectively]. The belief that a vaccine is not needed increased by more than five percentage points from early January to late March. CONCLUSION: Intent to definitely get a COVID-19 vaccine increased by almost 18 percentage points from early January to late March; however, younger adults, adults who are non-Hispanic Black or other races, adults of lower socioeconomic status, and adults living in the southeastern U.S. region (Region 4) continue to have higher coverage gaps and levels of vaccine hesitancy. Emphasizing the importance of vaccination among all populations, and removing barriers to vaccines, may lead to a reduction of COVID-19 incidence and bring an end to the pandemic.KEY MESSAGESReceipt of ≥1 dose of the COVID-19 vaccine and intent to probably or definitely get vaccinated increased from early January to late March; however, disparities in vaccine intent continued to exist by age group, race/ethnic groups, and socioeconomic characteristics.Vaccine receipt and the intent were the lowest for region 4 (southeastern U.S.) compared to other regions during this period.Adults who had a previous COVID-19 diagnosis or were unsure if they have had COVID-19 were less likely to intend to get vaccinated; overall, the belief that a vaccine is not needed to be increased by more than 5% points from early January to late March.[Formula: see text].


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Cobertura Vacinal/tendências , Vacinação/psicologia , Adulto , Idoso , COVID-19/epidemiologia , Feminino , Geografia , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Intenção , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologia
20.
West Afr J Med ; 38(8): 800-806, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34505500

RESUMO

BACKGROUND: In Nigeria, many men and women from different socioeconomic classes, commonly incur expenses in the pursuit of lighter skin. This recurrent expenditure and the associated costs of the alternative foregone as well as added costs associated with management of the adverse effects have the capacity to negatively impact on the finances of individuals and households who engage in skin lightening practices. OBJECTIVES: This study aimed to identify the sociodemographic characteristics of respondents in Benin City, Nigeria, determine the prevalence of the skin lightening practices among these respondents and explore the financial implications of these practices. METHODS: A cross-sectional community-based survey using pretested structured questionnaires was conducted on 454 men and women aged 18-70 years selected via multistage sampling in Oredo local government area of Benin city, Edo state, Nigeria. RESULTS: There were 207 males and 247 females included in the survey. Of these 55.3 % were currently using skin lightening products. The average monthly expenditure on cosmetics was significantly higher for users of skin lightening agents (Mean = N==2,183.13, SD = 2,822.91) compared to respondents who did not use skin lightening agents (Mean = =N=1,292.91, SD =1,379.43) (p < 0.001). Cost was the least common factor (2.5%) observed to influence respondents' purchase of skin lightening agents while recommendations from friends and family (59.2%) was the most common factor observed to influence their purchase. Majority of respondents engaged in this practice (77.5%) had seen a doctor or health worker for treatment of a skin problem that occurred during the use of skin lightening agents. CONCLUSION: Engaging in skin lightening practices was done by more than half of the respondents regardless of the cost of the agents and socioeconomic class, with the average monthly expenditure on cosmetics being significantly higher for users of skin lightening agents. This has the potential to negatively impact on the socioeconomic status of the individuals, households and the Nigerian economy over time.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários
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