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1.
Afr J Prim Health Care Fam Med ; 13(1): e1-e7, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34212744

RESUMO

BACKGROUND: Hypertension is a public health threat of global concern with increasing prevalence in many countries, including Nigeria. AIM: The aim of the study was to determine the prevalence and determinants of hypertension in a rural agrarian community in Edo North, Nigeria. SETTING: The study was carried out in Ayua, a community in Edo North, southern Nigeria. METHODS: This cross-sectional descriptive study involved the use of a structured interviewer-administered questionnaire to obtain relevant data. Body mass index (BMI), blood pressure and glucose were recorded. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. RESULTS: Two hundred and nineteen participants aged 15 years completed the study with a mean age of 54.03 ± 16.61 years and females comprising 159 (72.6%) of the total. The prevalence of hypertension was 27.9% (in 61 participants). Twenty-one (9.8%) respondents gave a family history of hypertension. The mean BMI amongst respondents was 27.10 ± 6.61 kg/m2. Obesity and pre-obesity were found in 58 (26.5%) and 71(32.4%) respondents, respectively. The determinants of hypertension were age and BMI. Compared with those who were less than 40 years old, those aged 40-65 years and 65 years had 1.9 and 4.2 times increased odds of developing hypertension, respectively. Similarly, compared with the non-obese, obese participants had 2.3 times increased odd of having hypertension. CONCLUSION: Hypertension was highly prevalent in this rural community. Health sensitisation and intervention programmes are recommended in rural communities for early detection and management of hypertension, especially amongst older and obese adults.


Assuntos
Hipertensão/epidemiologia , Obesidade/epidemiologia , Determinantes Sociais da Saúde , Adulto , Idoso , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Hipertensão/etnologia , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Obesidade/complicações , Obesidade/etnologia , Obesidade/psicologia , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
2.
Nutrients ; 13(6)2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34199924

RESUMO

The nutrition status of children is gaining more attention with a rapid nutrition transition. This study aimed to investigate trends and urban-rural differences in dietary energy and macronutrient composition among Chinese children. A total of 7565 participants aged 6 to 17 years were obtained from three rounds (1991, 2004 and 2015) of the Chinese Health and Nutrition Survey (CHNS). The individual diet was evaluated via three consecutive 24-hour dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs). From 1991 to 2015, there was a significant increase in children's fat intake, the proportion of energy intake from fat, and the proportion of children with more than 30% of energy from fat and less than 50% of energy from carbohydrates (p < 0.001). Compared with the DRI, the proportion with higher fat and lower carbohydrate intakes were, respectively, 64.7% and 46.8% in 2015. The urban-rural disparities in fat and carbohydrate intake gradually narrowed, while the gap in protein intake increased notably over time (p < 0.001). Chinese children experienced a rapid transformation to a low-carbohydrate and high-fat diet. Urban-rural disparities persistently existed; further nutritional interventions and education were of great significance, so as to ensure a more balanced diet for Chinese children.


Assuntos
Ingestão de Alimentos , Ingestão de Energia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Criança , China/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Inquéritos Nutricionais , Fatores Socioeconômicos
3.
Lancet ; 398(10294): 53-63, 2021 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-34217401

RESUMO

BACKGROUND: In China, mean body-mass index (BMI) and obesity in adults have increased steadily since the early 1980s. However, to our knowledge, there has been no reliable assessment of recent trends, nationally, regionally, or in certain population subgroups. To address this evidence gap, we present detailed analyses of relevant data from six consecutive nationally representative health surveys done between 2004 and 2018. We aimed to examine the long-term and recent trends in mean BMI and prevalence of obesity among Chinese adults, with specific emphasis on changes before and after 2010 (when various national non-communicable disease prevention programmes were initiated), assess how these trends might vary by sex, age, urban-rural locality, and socioeconomic status, and estimate the number of people who were obese in 2018 compared with 2004. METHODS: We used data from the China Chronic Disease and Risk Factors Surveillance programme, which was established in 2004 with the aim to provide periodic nationwide data on the prevalence of major chronic diseases and the associated behavioural and metabolic risk factors in the general population. Between 2004 and 2018 six nationally representative surveys were done. 776 571 individuals were invited and 746 020 (96·1%) participated, including 33 051 in 2004, 51 050 in 2007, 98 174 in 2010, 189 115 in 2013, 189 754 in 2015, and 184 876 in 2018. After exclusions, 645 223 participants aged 18-69 years remained for the present analyses. The mean BMI and prevalence of obesity (BMI ≥30 kg/m2) were calculated and time trends compared by sex, age, urban-rural locality, geographical region, and socioeconomic status. FINDINGS: Standardised mean BMI levels rose from 22·7 kg/m2 (95% CI 22·5-22·9) in 2004 to 24·4 kg/m2 (24·3-24·6) in 2018 and obesity prevalence from 3·1% (2·5-3·7) to 8·1% (7·6-8·7). Between 2010 and 2018, mean BMI rose by 0·09 kg/m2 annually (0·06-0·11), which was half of that reported during 2004-10 (0·17 kg/m2, 95% CI 0·12-0·22). Similarly, the annual increase in obesity prevalence was somewhat smaller after 2010 than before 2010 (6·0% annual relative increase, 95% CI 4·4-7·6 vs 8·7% annual relative increase, 4·9-12·8; p=0·13). Since 2010, the rise in mean BMI and obesity prevalence has slowed down substantially in urban men and women, and moderately in rural men, but continued steadily in rural women. By 2018, mean BMI was higher in rural than urban women (24·3 kg/m2vs 23·9 kg/m2; p=0·0045), but remained lower in rural than urban men (24·5 kg/m2vs 25·1 kg/m2; p=0·0007). Across all six surveys, mean BMI was persistently lower in women with higher levels of education compared with women with lower levels of education, but the inverse was true among men. Overall, an estimated 85 million adults (95% CI 70 million-100 million; 48 million men [95% CI 39 million-57 million] and 37 million women [31 million-43 million]) aged 18-69 years in China were obese in 2018, which was three times as many as in 2004. INTERPRETATION: In China, the rise in mean BMI among the adult population appears to have slowed down over the past decade. However, we found divergent trends by sex, geographical area, and socioeconomic status, highlighting the need for a more targeted approach to prevent further increases in obesity in the Chinese general population. FUNDING: China National Key Research and Development Program, China National Key Project of Public Health Program, and Youth Scientific Research Foundation of the National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention.


Assuntos
Índice de Massa Corporal , Obesidade/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , China/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
4.
PLoS One ; 16(7): e0254430, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34280210

RESUMO

We have investigated the importance of the rate of vaccination to contain COVID-19 in urban areas. We used an extremely simple epidemiological model that is amenable to implementation in an Excel spreadsheet and includes the demographics of social distancing, efficacy of massive testing and quarantine, and coverage and rate of vaccination as the main parameters to model the progression of COVID-19 pandemics in densely populated urban areas. Our model predicts that effective containment of pandemic progression in densely populated cities would be more effectively achieved by vaccination campaigns that consider the fast distribution and application of vaccines (i.e., 50% coverage in 6 months) while social distancing measures are still in place. Our results suggest that the rate of vaccination is more important than the overall vaccination coverage for containing COVID-19. In addition, our modeling indicates that widespread testing and quarantining of infected subjects would greatly benefit the success of vaccination campaigns. We envision this simple model as a friendly, readily accessible, and cost-effective tool for assisting health officials and local governments in the rational design/planning of vaccination strategies.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Software , Vacinação/estatística & dados numéricos , COVID-19/epidemiologia , Humanos , Modelos Estatísticos , Quarentena/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Vacinação/métodos
5.
Nutrients ; 13(7)2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34206813

RESUMO

This study aimed to determine the relationships among hyperglycemia (HG), the presence of type 2 diabetes (T2D), and the outcomes of COVID-19. Demographic data, blood glucose levels (BG) measured on admission, and hospital outcomes of COVID-19 patients hospitalized at Boston University Medical Center from 1 March to 4 August 2020 were extracted from the hospital database. HG was defined as BG > 200 mg/dL. Patients with type 1 diabetes or BG < 70 mg/dL were excluded. A total of 458 patients with T2D and 976 patients without T2D were included in the study. The mean ± SD age was 56 ± 17 years and 642 (45%) were female. HG occurred in 193 (42%) and 42 (4%) of patients with and without T2D, respectively. Overall, the in-hospital mortality rate was 9%. Among patients without T2D, HG was statistically significantly associated with mortality, ICU admission, intubation, acute kidney injury, and severe sepsis/septic shock, after adjusting for potential confounders (p < 0.05). However, only ICU admission and acute kidney injury were associated with HG among patients with T2D (p < 0.05). Among the 235 patients with HG, the presence of T2D was associated with decreased odds of mortality, ICU admission, intubation, and severe sepsis/septic shock, after adjusting for potential confounders, including BG (p < 0.05). In conclusion, HG in the subset of patients without T2D could be a strong indicator of high inflammatory burden, leading to a higher risk of severe COVID-19.


Assuntos
COVID-19/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Hospitalização/estatística & dados numéricos , Hiperglicemia/epidemiologia , Injúria Renal Aguda/epidemiologia , Adulto , Idoso , Glicemia , Boston/epidemiologia , COVID-19/mortalidade , Estudos de Coortes , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Intubação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2 , Sepse/epidemiologia , Índice de Gravidade de Doença , População Urbana/estatística & dados numéricos
6.
JAMA Netw Open ; 4(6): e2116425, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34170303

RESUMO

Importance: The COVID-19 pandemic has severely disrupted US educational institutions. Given potential adverse financial and psychosocial effects of campus closures, many institutions developed strategies to reopen campuses in the fall 2020 semester despite the ongoing threat of COVID-19. However, many institutions opted to have limited campus reopening to minimize potential risk of spread of SARS-CoV-2. Objective: To analyze how Boston University (BU) fully reopened its campus in the fall of 2020 and controlled COVID-19 transmission despite worsening transmission in Boston, Massachusetts. Design, Setting, and Participants: This multifaceted intervention case series was conducted at a large urban university campus in Boston, Massachusetts, during the fall 2020 semester. The BU response included a high-throughput SARS-CoV-2 polymerase chain reaction testing facility with capacity to deliver results in less than 24 hours; routine asymptomatic screening for COVID-19; daily health attestations; adherence monitoring and feedback; robust contact tracing, quarantine, and isolation in on-campus facilities; face mask use; enhanced hand hygiene; social distancing recommendations; dedensification of classrooms and public places; and enhancement of all building air systems. Data were analyzed from December 20, 2020, to January 31, 2021. Main Outcomes and Measures: SARS-CoV-2 diagnosis confirmed by reverse transcription-polymerase chain reaction of anterior nares specimens and sources of transmission, as determined through contact tracing. Results: Between August and December 2020, BU conducted more than 500 000 COVID-19 tests and identified 719 individuals with COVID-19, including 496 students (69.0%), 11 faculty (1.5%), and 212 staff (29.5%). Overall, 718 individuals, or 1.8% of the BU community, had test results positive for SARS-CoV-2. Of 837 close contacts traced, 86 individuals (10.3%) had test results positive for COVID-19. BU contact tracers identified a source of transmission for 370 individuals (51.5%), with 206 individuals (55.7%) identifying a non-BU source. Among 5 faculty and 84 staff with SARS-CoV-2 with a known source of infection, most reported a transmission source outside of BU (all 5 faculty members [100%] and 67 staff members [79.8%]). A BU source was identified by 108 of 183 undergraduate students with SARS-CoV-2 (59.0%) and 39 of 98 graduate students with SARS-CoV-2 (39.8%); notably, no transmission was traced to a classroom setting. Conclusions and Relevance: In this case series of COVID-19 transmission, BU used a coordinated strategy of testing, contact tracing, isolation, and quarantine, with robust management and oversight, to control COVID-19 transmission in an urban university setting.


Assuntos
COVID-19/prevenção & controle , Controle de Infecções/normas , Universidades/tendências , População Urbana/estatística & dados numéricos , Boston/epidemiologia , COVID-19/epidemiologia , COVID-19/transmissão , Busca de Comunicante/instrumentação , Busca de Comunicante/métodos , Higiene das Mãos/métodos , Humanos , Controle de Infecções/métodos , Controle de Infecções/estatística & dados numéricos , Quarentena/métodos , Universidades/organização & administração
7.
PLoS One ; 16(6): e0252373, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34106993

RESUMO

OBJECTIVE: To assess whether the basic reproduction number (R0) of COVID-19 is different across countries and what national-level demographic, social, and environmental factors other than interventions characterize initial vulnerability to the virus. METHODS: We fit logistic growth curves to reported daily case numbers, up to the first epidemic peak, for 58 countries for which 16 explanatory covariates are available. This fitting has been shown to robustly estimate R0 from the specified period. We then use a generalized additive model (GAM) to discern both linear and nonlinear effects, and include 5 random effect covariates to account for potential differences in testing and reporting that can bias the estimated R0. FINDINGS: We found that the mean R0 is 1.70 (S.D. 0.57), with a range between 1.10 (Ghana) and 3.52 (South Korea). We identified four factors-population between 20-34 years old (youth), population residing in urban agglomerates over 1 million (city), social media use to organize offline action (social media), and GINI income inequality-as having strong relationships with R0, across countries. An intermediate level of youth and GINI inequality are associated with high R0, (n-shape relationships), while high city population and high social media use are associated with high R0. Pollution, temperature, and humidity did not have strong relationships with R0 but were positive. CONCLUSION: Countries have different characteristics that predispose them to greater intrinsic vulnerability to COVID-19. Studies that aim to measure the effectiveness of interventions across locations should account for these baseline differences in social and demographic characteristics.


Assuntos
Número Básico de Reprodução/estatística & dados numéricos , COVID-19/epidemiologia , Renda/estatística & dados numéricos , Mídias Sociais/estatística & dados numéricos , Fatores Etários , COVID-19/economia , COVID-19/transmissão , COVID-19/virologia , Bases de Dados Factuais , Saúde Global , Humanos , Modelos Estatísticos , Pandemias , SARS-CoV-2/isolamento & purificação , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
8.
Nutrients ; 13(6)2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34072813

RESUMO

Anemia is a worldwide concern. This cross-sectional population-based study examined the prevalence of iron-deficiency anemia (IDA) among residents of São Paulo (n = 898; 12-93 years), considering sociodemographic factors, dietary iron inadequacy, and food contributors to iron intake. Blood cell count and iron biomarkers were quantified. Dietary iron intake was measured using two 24-h dietary recalls. Iron intake inadequacy was estimated using a probabilistic approach. The prevalence of anemia was 6.7%, depleted iron stores 5.1%, and IDA 1.1%. Women of all age groups, older adults, and those who were underweight or obese had the highest prevalence of anemia, and female adolescents had the highest prevalence of depleted iron stores. Female adolescents and adults were more vulnerable to depleted iron stores. Male adults and older adults had a considerable prevalence of iron overload. Except for female adolescents and adults, all groups had mild probabilities of inadequate iron intake. The main food iron contributor was wheat flour. Hemoglobin concentrations were directly associated with being an adult, having a higher income, and inversely associated with being female. Serum ferritin concentrations were directly associated with age and inversely correlated with female sex. Residents of São Paulo had a low prevalence of anemia, iron deficiency, and IDA, and sociodemographic factors interfered with these parameters.


Assuntos
Anemia Ferropriva/epidemiologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Criança , Estudos Transversais , Dieta/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Adulto Jovem
9.
PLoS One ; 16(6): e0253466, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34138950

RESUMO

OBJECTIVE: Reports of disparities in COVID-19 mortality rates are emerging in the public health literature as the pandemic continues to unfold. Alcohol misuse varies across the US and is related to poorer health and comorbidities that likely affect the severity of COVID-19 infection. High levels of pre-pandemic alcohol misuse in some counties may have set the stage for worse COVID-19 outcomes. Furthermore, this relationship may depend on how rural a county is, as access to healthcare in rural communities has lagged behind more urban areas. The objective of this study was to test for associations between county-level COVID-19 mortality, pre-pandemic county-level excessive drinking, and county rurality. METHOD: We used national COVID-19 data from the New York Times to calculate county-level case fatality rates (n = 3,039 counties and county equivalents; October 1 -December 31, 2020) and other external county-level data sources for indicators of rurality and health. We used beta regression to model case fatality rates, adjusted for several county-level population characteristics. We included a multilevel component to our model and defined state as a random intercept. Our focal predictor was a single variable representing nine possible combinations of low/mid/high alcohol misuse and low/mid/high rurality. RESULTS: The median county-level COVID-19 case fatality rate was 1.57%. Compared to counties with low alcohol misuse and low rurality (referent), counties with high levels of alcohol and mid (ß = -0.17, p = 0.008) or high levels of rurality (ß = -0.24, p<0.001) demonstrated significantly lower case fatality rates. CONCLUSIONS: Our findings highlight the intersecting roles of county-level alcohol consumption, rurality, and COVID-19 mortality.


Assuntos
Alcoolismo/epidemiologia , COVID-19/epidemiologia , População Rural/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , População Urbana/estatística & dados numéricos , Alcoolismo/fisiopatologia , COVID-19/mortalidade , COVID-19/virologia , Comorbidade , Geografia , Disparidades nos Níveis de Saúde , Humanos , Modelos Teóricos , Análise Multivariada , Pandemias/prevenção & controle , Fatores de Risco , SARS-CoV-2/fisiologia , Índice de Gravidade de Doença , Fatores Socioeconômicos , Taxa de Sobrevida , Estados Unidos/epidemiologia
10.
JMIR Public Health Surveill ; 7(7): e29865, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34174781

RESUMO

BACKGROUND: COVID-19 has disrupted lives and livelihoods and caused widespread panic worldwide. Emerging reports suggest that people living in rural areas in some countries are more susceptible to COVID-19. However, there is a lack of quantitative evidence that can shed light on whether residents of rural areas are more concerned about COVID-19 than residents of urban areas. OBJECTIVE: This infodemiology study investigated attitudes toward COVID-19 in different Japanese prefectures by aggregating and analyzing Yahoo! JAPAN search queries. METHODS: We measured COVID-19 concerns in each Japanese prefecture by aggregating search counts of COVID-19-related queries of Yahoo! JAPAN users and data related to COVID-19 cases. We then defined two indices-the localized concern index (LCI) and localized concern index by patient percentage (LCIPP)-to quantitatively represent the degree of concern. To investigate the impact of emergency declarations on people's concerns, we divided our study period into three phases according to the timing of the state of emergency in Japan: before, during, and after. In addition, we evaluated the relationship between the LCI and LCIPP in different prefectures by correlating them with prefecture-level indicators of urbanization. RESULTS: Our results demonstrated that the concerns about COVID-19 in the prefectures changed in accordance with the declaration of the state of emergency. The correlation analyses also indicated that the differentiated types of public concern measured by the LCI and LCIPP reflect the prefectures' level of urbanization to a certain extent (ie, the LCI appears to be more suitable for quantifying COVID-19 concern in urban areas, while the LCIPP seems to be more appropriate for rural areas). CONCLUSIONS: We quantitatively defined Japanese Yahoo users' concerns about COVID-19 by using the search counts of COVID-19-related search queries. Our results also showed that the LCI and LCIPP have external validity.


Assuntos
Ansiedade/epidemiologia , Atitude Frente a Saúde , COVID-19/psicologia , Internet/estatística & dados numéricos , Ferramenta de Busca/estatística & dados numéricos , Adulto , Idoso , COVID-19/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos
11.
Ann Agric Environ Med ; 28(2): 243-249, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34184505

RESUMO

OBJECTIVE: The aim of the study was to explore the influence of exudative age-related macular degeneration on the quality of life of patients from urban and rural areas. MATERIAL AND METHODS: The retrospective study included 144 Polish Caucasians with exudative age-related macular degeneration, treated with anti-VEGF, recruited from Department of Medical Retina in Lublinbetween March and June 2017. Clinical assessment included age, gender, visual acuity, complete ophthalmic examination, fundus fluorescein angiography and optical coherence tomography, medical history and the NEI VFQ-25 questionnaire. RESULTS: The mean age of the study group was 76.73±12.3 years, average time of AMD was 4.24±4.1 years. 21.5% of patients reported comorbidities such as hypertension, cardiovascular disease, diabetes mellitus. 99 (68.75%) lived in a city, while 45(31.25%) in a village. There was a tendency of females to complain more than males about moderate and severe discomfort and pain (p = 0.09). Most of the patients did not drive a car before the onset of the disease (female vs.male: 81% vs 62.9%; p = 0.01). 62.8% males and 25.8% females gave up driving (p = 0.003), whereas significantly more males gave up driving' and 25% of villagers gave up driving (p = 0.07). The parameter because of the eyesight - female vs. male: 50% vs. 20.8%; p = 0.03. There was a tendency of village respondents to complain more often about extreme difficulty in reading newspapers, street signs or the names of stores than (p = 0.08). 44.2% city residents. Rural patients felt to achieve much less because of their eyesight, which was not observed in patients from the city (p = 0.06). CONCLUSIONS: The place of residence and gender influenced perception of the disease in exudative form of age-related macular degeneration.


Assuntos
Degeneração Macular/psicologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Degeneração Macular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Acuidade Visual
12.
Pan Afr Med J ; 38: 249, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104297

RESUMO

Introduction: blood donation (BD) is affected by several factors, among which people's knowledge and attitude are the key determinants. However, the level of knowledge and attitude towards BD in Ethiopia is not yet well studied. Therefore, this study aimed to assess the level and factors associated with knowledge and attitude towards blood donation among health science college students in Southwest Ethiopia. Methods: a cross-sectional study was conducted among 394 health science students from June 1st to 15th 2019. The data were collected using a structured self-administered questionnaire. The data were entered using EPI-data version 4.2.0.0 and analyzed using SPSS version 20. The correlation analysis was done to determine the association between the knowledge sum score and the attitude sum score. A binary logistic regression analysis was done to determine the association between the dependent and independent variables. Results: the proportions of good knowledge and positive attitude towards BD were 69.3%, 95% CI (64.8%-73.4%) and 58.1%, 95% CI (52.3%-63.0%) respectively. The study also found that age ≥23 years (adjusted odds ratio (AOR)=1.67, 95% CI (1.04-2.67)), having a father with primary and secondary school and above (AOR=2.24, 95% CI (1.20-4.17) and AOR=2.26, 95% CI (1.26-4.06) respectively) and ever donated blood (AOR=3.64, 95%CI (2.26-5.85)) were factors associated with good knowledge of blood donation. Being a rural resident (AOR=1.59, 95% CI (1.01-2.40)) and graduating class student (AOR=0.56, 95% CI (0.34-0.96)) were factors associated with a positive attitude towards blood donation. The knowledge-related questions´ sum score value was positively correlated with the attitude-related questions' sum score value (r=0.30, P<0.001). Conclusion: the knowledge and attitude towards BD among the study population are a substantial deficiency. Therefore, more effort is needed to increase the level of knowledge and attitude towards BD by inculcating short training courses for these groups of population in the existing curriculum.


Assuntos
Doadores de Sangue/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , População Rural/estatística & dados numéricos , Inquéritos e Questionários , Universidades , População Urbana/estatística & dados numéricos , Adulto Jovem
14.
MMWR Morb Mortal Wkly Rep ; 70(22): 818-824, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34081685

RESUMO

Disparities in vaccination coverage by social vulnerability, defined as social and structural factors associated with adverse health outcomes, were noted during the first 2.5 months of the U.S. COVID-19 vaccination campaign, which began during mid-December 2020 (1). As vaccine eligibility and availability continue to expand, assuring equitable coverage for disproportionately affected communities remains a priority. CDC examined COVID-19 vaccine administration and 2018 CDC social vulnerability index (SVI) data to ascertain whether inequities in COVID-19 vaccination coverage with respect to county-level SVI have persisted, overall and by urbanicity. Vaccination coverage was defined as the number of persons aged ≥18 years (adults) who had received ≥1 dose of any Food and Drug Administration (FDA)-authorized COVID-19 vaccine divided by the total adult population in a specified SVI category.† SVI was examined overall and by its four themes (socioeconomic status, household composition and disability, racial/ethnic minority status and language, and housing type and transportation). Counties were categorized into SVI quartiles, in which quartile 1 (Q1) represented the lowest level of vulnerability and quartile 4 (Q4), the highest. Trends in vaccination coverage were assessed by SVI quartile and urbanicity, which was categorized as large central metropolitan, large fringe metropolitan (areas surrounding large cities, e.g., suburban), medium and small metropolitan, and nonmetropolitan counties.§ During December 14, 2020-May 1, 2021, disparities in vaccination coverage by SVI increased, especially in large fringe metropolitan (e.g., suburban) and nonmetropolitan counties. By May 1, 2021, vaccination coverage was lower among adults living in counties with the highest overall SVI; differences were most pronounced in large fringe metropolitan (Q4 coverage = 45.0% versus Q1 coverage = 61.7%) and nonmetropolitan (Q4 = 40.6% versus Q1 = 52.9%) counties. Vaccination coverage disparities were largest for two SVI themes: socioeconomic status (Q4 = 44.3% versus Q1 = 61.0%) and household composition and disability (Q4 = 42.0% versus Q1 = 60.1%). Outreach efforts, including expanding public health messaging tailored to local populations and increasing vaccination access, could help increase vaccination coverage in high-SVI counties.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Disparidades em Assistência à Saúde/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Cidades/epidemiologia , Humanos , Fatores Socioeconômicos , Estados Unidos/epidemiologia
15.
Health Secur ; 19(S1): S27-S33, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33956531

RESUMO

More than a century of research has shown that sociodemographic conditions affect infectious disease transmission. In the late spring and early summer of 2020, reports of the effects of sociodemographic variables on the spread of COVID-19 were used in the media with minimal scientific proof attached. With new cases of COVID-19 surging in the United States at that time, it became essential to better understand how the spread of COVID-19 was varying across all segments of the population. We used hierarchical exponential growth curve modeling techniques to examine whether community socioeconomic characteristics uniquely influence the incidence of reported COVID-19 cases in the urban built environment. We show that as of July 19, 2020, confirmed coronavirus infections in New York City and surrounding areas-one of the early epicenters of the COVID-19 pandemic in the United States-were concentrated along demographic and socioeconomic lines. Furthermore, our data provides evidence that after the onset of the pandemic, timely enactment of physical distancing measures such as school closures was essential to limiting the extent of the coronavirus spread in the population. We conclude that in a pandemic, public health authorities must impose physical distancing measures early on as well as consider community-level factors that associate with a greater risk of viral transmission.


Assuntos
COVID-19/epidemiologia , Características de Residência/estatística & dados numéricos , População Urbana/estatística & dados numéricos , COVID-19/diagnóstico , Estudos Transversais , Humanos , Incidência , Cidade de Nova Iorque/epidemiologia , Saúde Pública , Fatores de Risco , Fatores Socioeconômicos , Análise Espacial
16.
J Sch Health ; 91(7): 535-540, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33954993

RESUMO

BACKGROUND: Adjustments in teaching resources and school meal programs are urgently needed during the COVID-19 pandemic. This study examined teaching resources that would have been helpful when schools closed, and how school meal programs should be changed in the 2020-2021 school year. METHODS: In October 2020, a 27-item, cross-sectional, online survey was administered to 99 teachers and staff members in an urban, Midwestern school district. Data were analyzed using frequencies and proportions, and open-ended responses were analyzed using content analysis. RESULTS: Online teaching was difficult for teachers and students, and training for online teaching, improved Internet access, and more time for grading or office hours would have been helpful when schools closed. Meal programs were offered by 86% of schools after closing, and many participants supported continuing meal programs for 2020-2021. Resources needed to continue meal programs included funding for meal reimbursement, transportation to the meal sites, and more staff. Suggested changes to meal programs included offering more variety or more food, and solving transportation issues. CONCLUSION: Addressing these concerns can improve school and community health. Findings will inform efforts to enhance online teaching and improve and continue school meal programs as the world continues to be affected by COVID-19.


Assuntos
COVID-19/epidemiologia , Serviços de Alimentação/organização & administração , Serviços de Saúde Escolar/organização & administração , População Urbana/estatística & dados numéricos , Estudos Transversais , Promoção da Saúde/organização & administração , Humanos , Política Nutricional , Estudantes/estatística & dados numéricos
17.
Health Secur ; 19(S1): S34-S40, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33944605

RESUMO

In the context of the COVID-19 pandemic, reassessing intensive care unit (ICU) use by population should be a priority for hospitals planning for critical care resource allocation. In our study, we reviewed the impact of COVID-19 on a community hospital serving an urban region, comparing the sociodemographic distribution of ICU admissions before and during the pandemic. We executed a time-sensitive analysis to see if COVID-19 ICU admissions reflect the regional sociodemographic populations and ICU admission trends before the pandemic. Sociodemographic variables included sex, race, ethnicity, and age of adult patients (ages 18 years and older) admitted to the hospital's medical and cardiac ICUs, which were converted to COVID-19 ICUs. The time period selected was 18 months, which was then dichotomized into pre-COVID-19 admissions (December 1, 2018 to March 13, 2020) and COVID-19 ICU admissions (March 14 to May 31, 2020). Variables were compared using Fisher's exact tests and Wilcoxon tests when appropriate. During the 18-month period, 1,861 patients were admitted to the aforementioned ICUs. The mean age of the patients was 62.75 (SD 15.57), with the majority of these patients being male (52.23%), White (64.43%), and non-Hispanic/Latinx (95.75%). Differences were found in racial and ethnic distribution comparing pre-COVID-19 admissions to COVID-19 admissions. Compared with pre-COVID-19 ICU admissions, we found an increase in African American versus White admissions (P = .01) and an increase in Hispanic/Latinx versus non-Hispanic/Latinx admissions (P < .01), during the COVID-19 pandemic. During the first 3 months of admissions to COVID-19 ICUs, the number of admissions among Hispanic/Latinx and African American patients increased while the number of admissions among non-Hispanic/Latinx and White patient decreased, compared with the pre-COVID-19 period. These findings support development of strategies to enhance allocation of resources to bolster novel, equitable strategies to mitigate the incidence of COVID-19 in urban populations.


Assuntos
COVID-19/epidemiologia , Cuidados Críticos/tendências , Grupos Étnicos/estatística & dados numéricos , Unidades de Terapia Intensiva/tendências , Admissão do Paciente/tendências , População Urbana/estatística & dados numéricos , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso de 80 Anos ou mais , COVID-19/terapia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença
18.
MMWR Morb Mortal Wkly Rep ; 70(20): 759-764, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34014911

RESUMO

Approximately 60 million persons in the United States live in rural counties, representing almost one fifth (19.3%) of the population.* In September 2020, COVID-19 incidence (cases per 100,000 population) in rural counties surpassed that in urban counties (1). Rural communities often have a higher proportion of residents who lack health insurance, live with comorbidities or disabilities, are aged ≥65 years, and have limited access to health care facilities with intensive care capabilities, which places these residents at increased risk for COVID-19-associated morbidity and mortality (2,3). To better understand COVID-19 vaccination disparities across the urban-rural continuum, CDC analyzed county-level vaccine administration data among adults aged ≥18 years who received their first dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine, or a single dose of the Janssen COVID-19 vaccine (Johnson & Johnson) during December 14, 2020-April 10, 2021 in 50 U.S. jurisdictions (49 states and the District of Columbia [DC]). Adult COVID-19 vaccination coverage was lower in rural counties (38.9%) than in urban counties (45.7%) overall and among adults aged 18-64 years (29.1% rural, 37.7% urban), those aged ≥65 years (67.6% rural, 76.1% urban), women (41.7% rural, 48.4% urban), and men (35.3% rural, 41.9% urban). Vaccination coverage varied among jurisdictions: 36 jurisdictions had higher coverage in urban counties, five had higher coverage in rural counties, and five had similar coverage (i.e., within 1%) in urban and rural counties; in four jurisdictions with no rural counties, the urban-rural comparison could not be assessed. A larger proportion of persons in the most rural counties (14.6%) traveled for vaccination to nonadjacent counties (i.e., farther from their county of residence) compared with persons in the most urban counties (10.3%). As availability of COVID-19 vaccines expands, public health practitioners should continue collaborating with health care providers, pharmacies, employers, faith leaders, and other community partners to identify and address barriers to COVID-19 vaccination in rural areas (2).


Assuntos
Vacinas contra COVID-19/administração & dosagem , Disparidades em Assistência à Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
19.
J Environ Public Health ; 2021: 2917874, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33986811

RESUMO

Background: Reproductive health is a universal concern but it has special importance for women particularly during the reproductive year. Although policy actions and strategic efforts made reproductive health service uptake of youths in Ethiopia, still its utilization remains low. Adolescence is not quite capable of understanding complex concepts. This makes them vulnerable to sexual exploitation and high-risk sexual behaviors and reproductive health problems. Objective: The aim of this study was to assess the utilization of reproductive health services and associated factors among adolescents in Woldia town secondary schools, Amhara, Ethiopia, 2019. Methods: An institutional-based descriptive cross-sectional study was conducted on 420 secondary school students in Woldia Town from January to June 2019. A self-administered, structured questionnaire was used to collect the data. The samples were distributed proportionally, and participants in each school were selected by the systematic sampling technique. Bivariable and multivariable logistic regression was carried out to assess the association between dependent and independent variables. Result: Out of 420 students participated in this study, 270 (64.3%) of the respondents utilize reproductive health service. Residence (AOR = 4.40, 95%CI (1.23, 9.362)), educational status of the partner (AOR = 2.66, 95%CI (2.35, 5.24)), presence of RHS facility in school (AOR = 2.53, 95%CI (1.57, 4.06)), and good knowledge level on reproductive health services (AOR = 1.77, 95%CI (1.14, 2.75)) were significantly associated with reproductive health service utilization. Conclusion: and Recommendations. Knowledge of respondents on reproductive health utilization in the study area was found to be low. Students who were from rural families have low utilization of reproductive health services. This low service utilization in these students might be disposed to different reproductive health risks such as sexually transmitted infections, HIV/AIDS, and unwanted pregnancy, which in turn can increase the school dropout rate and have an impact on an individual's future life. However, students who have good knowledge and were encouraged by their friends have good reproductive health service utilization. Therefore, it needs a great effort and attention of all concerned bodies including parents, school staff, and health professionals to improve service utilization in schools.


Assuntos
Utilização de Instalações e Serviços/estatística & dados numéricos , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Etiópia , Feminino , Humanos , População Rural/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
20.
Pan Afr Med J ; 38: 234, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34046139

RESUMO

Introduction: adherence to preventive measures to curb the spread of COVID-19 depends on the people´s knowledge, attitudes and practices (KAP) towards COVID-19. Living in rural areas may be associated with poor KAP towards COVID-19. This study compares the KAP regarding COVID-19 of people living in rural and urban areas in Cameroon. Methods: this was a comparative cross-sectional study, using data obtained through an online survey of 1,345 Cameroonians amongst which were 828 urban and 517 rural dwellers. The survey questionnaire consisted of; demographic characteristics, 10 questions on Knowledge, 4 on attitudes and 3 on practices. Data was analyzed using SPSS version 25. Results: overall, about two-thirds of participants had correct knowledge of COVID-19. The mean knowledge score for urban dwellers was about twice that of rural dwellers (15.77 ± 5.25 vs 8.86 ± 7.24 respectively, p < 0.001). Furthermore, when compared to people who live in urban areas, rural inhabitants are less optimistic about COVID-19 pandemic in Cameroon (OR = 3.43, P<0.001), less likely to accept a trial vaccine for COVID-19 (OR = 1.14, P<0.05), less likely to avoid going to crowded places (OR = 7.42, P<0.01), less likely to wear face mask outdoor (OR = 11.84, P<0,001), and less likely to practice hand hygiene (OR = 1.13, P<0.05). Conclusion: our findings suggest a big gap in COVID-19 related knowledge, attitudes, and practices between rural and urban inhabitants in Cameroon. This highlights the need for increase sensitization of Cameroonians, especially rural dwellers on COVID-19 related knowledge, attitudes and appropriate practices.


Assuntos
COVID-19/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Camarões , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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