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المؤلفون: Hunduma Dinka, Tsegaye Chekol, Lemu Golassa, Gezahegn Solomon, Temesgen File
المصدر: Malaria Journal, Vol 20, Iss 1, Pp 1-10 (2021)
Malaria Journalمصطلحات موضوعية: Adult, Male, Adolescent, Msp-1, Plasmodium falciparum, Population, RC955-962, Infectious and parasitic diseases, RC109-216, P. falciparum, Loss of heterozygosity, Young Adult, Multiplicity of infection, Polymorphism (computer science), Arctic medicine. Tropical medicine, parasitic diseases, Prevalence, medicine, Humans, Malaria, Falciparum, Allele, Child, education, Alleles, Merozoite Surface Protein 1, Aged, Genetics, education.field_of_study, Genetic diversity, Polymorphism, Genetic, Genetic polymorphism, biology, Research, Infant, Middle Aged, medicine.disease, biology.organism_classification, Infectious Diseases, Child, Preschool, Female, Parasitology, Ethiopia, Nested polymerase chain reaction, Malaria
الوصف: Background One of the major challenges in developing an effective vaccine against asexual stages of Plasmodium falciparum is genetic polymorphism within parasite population. Understanding the genetic polymorphism like block 2 region of merozoite surface protein-1 (msp-1) gene of P. falciparum enlighten mechanisms underlining disease pathology, identification of the parasite clone profile from the isolates, transmission intensity and potential deficiencies of the ongoing malaria control and elimination efforts in the locality. Detailed understanding of local genetic polymorphism is an input to pave the way for better management, control and elimination of malaria. The aim of this study was to detect the most frequent allelic variant of the msp-1 gene of P. falciparum clinical isolates from selected health facilities in Adama town and its surroundings, Oromia, Ethiopia. Methods One hundred thirty-nine clinical isolates were successfully amplified for msp-1 gene using specific primers. Nested PCR amplification was conducted targeting K1, MAD20, and R033 alleles followed by gel electrophoresis for fragment analysis. Based on the detection of a PCR fragment, infections were classified as monoclonal or multiple infections. Results 19 different size polymorphism of msp-1 gene were identified in the study, with 67(48%) MAD20, 18 (13%) K-1 and 18 (13%) RO33 allelic family. Whereas, the multiple infections were 21(15%), 8 (5.8%), 4(2.9%), 3(2.2%) for MAD20 + K-1, MAD20 + RO33, K-1 + RO33, and MAD20 + K-1, RO33, respectively. The overall Multiplicity of infection (MOI) was 1.3 and the expected heterozygosity (He) was 0.39 indicating slightly low falciparum malaria transmission. Conclusion The status of msp-1 allele size polymorphism, MOI and He observed in the study revealed the presence of slightly low genetic diversity of P. falciparum clinical isolates. However, highly frequent MAD20 allelic variant was detected from clinical isolates in the study area. Moreover, the driving force that led to high predominance of MAD20 allelic variant revealed in such malaria declining region demands further research.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::506fe6814f5fec42bc3676367cd38428Test
https://doaj.org/article/accfed674df24c11a36676191a708527Test -
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المؤلفون: Angela A. Rivellese, Lutgarda Bozzetto, Brunella Capaldo, Luisa Palmisano, Giuseppe Della Pepa, Gabriele Riccardi, Maria Masulli, Roberta Lupoli, Nicola Tecce
المساهمون: Tecce, N., Masulli, M., Lupoli, R., Della Pepa, G., Bozzetto, L., Palmisano, L., Rivellese, A. A., Riccardi, G., Capaldo, B.
المصدر: Cardiovascular Diabetology, Vol 19, Iss 1, Pp 1-9 (2020)
Cardiovascular Diabetologyمصطلحات موضوعية: Adult, Male, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Endocrinology, Diabetes and Metabolism, Concordance, Population, Disease, ESC guideline, Risk Assessment, Young Adult, Internal medicine, Diabetes mellitus, medicine, Health Status Indicators, Humans, education, Angiology, Retrospective Studies, Original Investigation, Type 1 diabetes, education.field_of_study, business.industry, Middle Aged, medicine.disease, Prognosis, Cardiovascular risk, STENO Type 1 risk engine, Diabetes Mellitus, Type 1, Cardiovascular Diseases, Heart Disease Risk Factors, ESC guidelines, lcsh:RC666-701, Cohort, Female, Cardiology and Cardiovascular Medicine, business, Risk classification, Algorithms
الوصف: BackgroundPatients with type 1 diabetes (T1D) have higher mortality risk compared to the general population; this is largely due to increased rates of cardiovascular disease (CVD). As accurate CVD risk stratification is essential for an appropriate preventive strategy, we aimed to evaluate the concordance between 2019 European Society of Cardiology (ESC) CVD risk classification and the 10-year CVD risk prediction according to the Steno Type 1 Risk Engine (ST1RE) in adults with T1D.MethodsA cohort of 575 adults with T1D (272F/303M, mean age 36 ± 12 years) were studied. Patients were stratified in different CVD risk categories according to ESC criteria and the 10-year CVD risk prediction was estimated with ST1RE within each category.ResultsMen had higher BMI, WC, SBP than women, while no difference was found in HbA1c levels between genders. According to the ESC classification, 92.5% of patients aged 20 years) alone identified few patients (ConclusionsUsing ESC criteria, a large proportion (45%) of T1D patients without CVD are classified at very high CVD risk; however, among them, none of those
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f8048c5130d1ddf0a5cbb466f4a0b7c6Test
http://link.springer.com/article/10.1186/s12933-020-01137-xTest -
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المصدر: Orphanet Journal of Rare Diseases, Vol 16, Iss 1, Pp 1-5 (2021)
Orphanet Journal of Rare Diseasesمصطلحات موضوعية: Adult, Male, 0301 basic medicine, Pediatrics, medicine.medical_specialty, Neurofibromatosis 1, Neurofibromatoses, Lymphoma, Population, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Pharmacology (medical), Medical history, Lymphoproliferative diseases, Neurofibromatosis, education, Letter to the Editor, Genetics (clinical), education.field_of_study, Leukemia, business.industry, Incidence, Incidence (epidemiology), General Medicine, medicine.disease, 030104 developmental biology, Standardized mortality ratio, 030220 oncology & carcinogenesis, Female, France, business
الوصف: Neurofibromatosis 1 (NF1) is an inherited, autosomal-dominant, tumor predisposition syndrome with a birth incidence as high as 1:2000. A patient with NF1 is four to five times more likely to develop a malignancy as compared to the general population. The number of epidemiologic studies on lymphoproliferative malignancies in patients with NF1 is limited. The aim of this study was to determine the incidence rate of lymphoproliferative malignancies (lymphoma and leukemia) in NF1 patients followed in our referral center for neurofibromatoses. We used the Informatics for Integrated Biology and the Bedside (i2b2) platform to extract information from the hospital’s electronic health records. We performed a keyword search on clinical notes generated between Jan/01/2014 and May/11/2020 for patients aged 18 years or older. A total of 1507 patients with confirmed NF1 patients aged 18 years and above were identified (mean age 39.2 years; 57% women). The total number of person-years in follow-up was 57,736 (men, 24,327 years; women, 33,409 years). Mean length of follow-up was 38.3 years (median, 36 years). A total of 13 patients had a medical history of either lymphoma or leukemia, yielding an overall incidence rate of 22.5 per 100,000 (0.000225, 95% confidence interval (CI) 0.000223–0.000227). This incidence is similar to that of the general population in France (standardized incidence ratio 1.07, 95% CI 0.60–1.79). Four patients had a medical history leukemia and 9 patients had a medical history of lymphoma of which 7 had non-Hodgkin lymphoma, and 2 had Hodgkin lymphoma. Our results show that adults with NF1 do not have an increased tendency to develop lymphoproliferative malignancies, in contrast to the general increased risk of malignancy. While our results are consistent with the recent population-based study in Finland, they are in contrast with the larger population-based study in England whereby NF1 individuals were found to be 3 times more likely to develop both non-Hodgkin lymphoma and lymphocytic leukemia. Large-scale epidemiological studies based on nationwide data sets are thus needed to confirm our findings.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f6a7fedf62d3dce674a48ac2ace2c5b2Test
https://doaj.org/article/af92d7c4cd8842b0a1f8c5f2a9d90b0aTest -
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المؤلفون: François Hemery, Pierre Wolkenstein, Christina Bergqvist, Salah Ferkal
المصدر: Orphanet Journal of Rare Diseases, Vol 15, Iss 1, Pp 1-4 (2020)
Orphanet Journal of Rare Diseasesمصطلحات موضوعية: Adult, Male, Pediatrics, medicine.medical_specialty, congenital, hereditary, and neonatal diseases and abnormalities, Neurofibromatosis 1, Population, lcsh:Medicine, Multiple sclerosis, Epidemiology, Autoimmune disease, medicine, Humans, Pharmacology (medical), Genodermatosis, Neurofibromatosis, education, Letter to the Editor, Genetics (clinical), education.field_of_study, Neurofibromin 1, business.industry, Incidence (epidemiology), lcsh:R, General Medicine, Odds ratio, medicine.disease, Confidence interval, nervous system diseases, Chromosome 17 (human), Mutation, Female, France, business
الوصف: Neurofibromatosis 1 (NF1) is one of the most common autosomal dominant genetic disorders with a birth incidence as high as 1:2000. It is caused by mutations in the NF1 gene on chromosome 17 which encodes neurofibromin, a regulator of neuronal differentiation. While NF1 individuals are predisposed to develop benign and malignant nervous system tumors, various non-tumoral neurological conditions including multiple sclerosis (MS) have also been reported to occur more frequently in NF1. The number of epidemiologic studies on MS in NF1 individuals is very limited. The aim of this study was to determine the estimated population proportion of MS in NF1 patients followed in our Referral Centre for Neurofibromatosis using the Informatics for Integrated Biology and the Bedside (i2b2) platform to extract information from the hospital’s electronic health records. We found a total 1507 patients with confirmed NF1, aged 18 years (y) and above (mean age 39.2y, range 18-88y; 57% women). Five NF1 individuals were found to have MS, yielding an estimated population proportion of 3.3 per 1000 (0.0033, 95% Confidence Interval 0.0014–0.0077). The median age at diagnosis was 45 y (range 28–49 y). Three patients had relapsing-remitting MS and two patients had secondary progressive MS. Patients with NF1 were found to be twice more likely to develop MS than the general population in France (odds ratio 2.2), however this result was not statistically significant (95% Confidence Interval 0.91–5.29). Our results show that patients with NF1 might have a slight increased tendency to develop MS; however, due to the small sample size of our study, the results may not be sufficiently powered to detect this rare association. Large-scale epidemiological studies based on nationwide datasets are needed to confirm our findings. These findings further emphasize the need for a focused follow-up of patients with NF1, as early detection and management of MS can prevent further neurological disability.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4bf918dca1bf1cfa9dcebb62d7597094Test
http://link.springer.com/article/10.1186/s13023-020-01463-zTest -
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المؤلفون: Rizwan Shahid, Xiaoxiao Liu, Terrence McDonald, Deborah A. Marshall, Judy E. Seidel, Alka B Patel, Nigel Waters, Stefania Bertazzon
المصدر: BMC Public Health, Vol 20, Iss 1, Pp 1-16 (2020)
BMC Public Healthمصطلحات موضوعية: Adult, Male, Rural Population, medicine.medical_specialty, Urban Population, Population, Disparities, Comorbidity, Alberta, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Environmental health, Osteoarthritis, Prevalence, Medicine, Humans, Rural, 030212 general & internal medicine, education, Socioeconomic status, 030203 arthritis & rheumatology, education.field_of_study, Descriptive statistics, Geography, business.industry, Public health, lcsh:Public aspects of medicine, 1. No poverty, Public Health, Environmental and Occupational Health, Spatial analysis, lcsh:RA1-1270, Health Services, Middle Aged, medicine.disease, Health equity, 3. Good health, Hypertension, Female, Rural area, Biostatistics, business, Research Article
الوصف: Background Knowledge of geospatial pattern in comorbidities prevalence is critical to an understanding of the local health needs among people with osteoarthritis (OA). It provides valuable information for targeting optimal OA treatment and management at the local level. However, there is, at present, limited evidence about the geospatial pattern of comorbidity prevalence in Alberta, Canada. Methods Five administrative health datasets were linked to identify OA cases and comorbidities using validated case definitions. We explored the geospatial pattern in comorbidity prevalence at two standard geographic areas levels defined by the Alberta Health Services: descriptive analysis at rural-urban continuum level; spatial analysis (global Moran’s I, hot spot analysis, cluster and outlier analysis) at the local geographic area (LGA) level. We compared area-level indicators in comorbidities hotspots to those in the rest of Alberta (non-hotspots). Results Among 359,638 OA cases in 2013, approximately 60% of people resided in Metro and Urban areas, compared to 2% in Rural Remote areas. All comorbidity groups exhibited statistically significant spatial autocorrelation (hypertension: Moran’s I index 0.24, z score 4.61). Comorbidity hotspots, except depression, were located primarily in Rural and Rural Remote areas. Depression was more prevalent in Metro (Edmonton-Abbottsfield: 194 cases per 1000 population, 95%CI 192–195) and Urban LGAs (Lethbridge-North: 169, 95%CI 168–171) compared to Rural areas (Fox Creek: 65, 95%CI 63–68). Comorbidities hotspots included a higher percentage of First Nations or Inuit people. People with OA living in hotspots had lower socioeconomic status and less access to care compared to non-hotspots. Conclusions The findings highlight notable rural-urban disparities in comorbidities prevalence among people with OA in Alberta, Canada. Our study provides valuable evidence for policy and decision makers to design programs that ensure patients with OA receive optimal health management tailored to their local needs and a reduction in current OA health disparities.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::878d394d7cbbd4e757aad42453968fc5Test
http://link.springer.com/article/10.1186/s12889-020-09599-0Test -
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المؤلفون: David D. Nassoro, Godlove Fred Mbwanji, Nyanda E. Ntinginya, Habakkuk Mwakyula Issakwisa, Gloria Reginald Mbwile, Anthony A. Nsojo
المصدر: BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-6 (2020)
BMC Infectious Diseasesمصطلحات موضوعية: Male, 0301 basic medicine, viruses, Prevalence, Herpesvirus 1, Human, Antibodies, Viral, medicine.disease_cause, Tanzania, Cohort Studies, 0302 clinical medicine, Risk Factors, Seroepidemiologic Studies, Medicine, 030212 general & internal medicine, education.field_of_study, biology, Incidence, Incidence (epidemiology), Middle Aged, HSV-1, Infectious Diseases, symbols, Population study, Female, Human Immunodeficiency Virus, Research Article, Adult, Adolescent, Sexual Behavior, 030106 microbiology, Population, Sexually Transmitted Diseases, lcsh:Infectious and parasitic diseases, Young Adult, 03 medical and health sciences, symbols.namesake, Humans, Seroprevalence, lcsh:RC109-216, Poisson regression, education, Mwakyula, AIDS-Related Opportunistic Infections, business.industry, Herpes Simplex, biology.organism_classification, Cross-Sectional Studies, Herpes simplex virus, HIV-1, business, Demography
الوصف: Background Despite the significant decline in the prevalence of HIV in Tanzania, the prevalence rates in Mbeya, Iringa, and Njombe regions are higher than the national average and have remained stable for years. The current stable HIV prevalence may be driven by factors such as a high incidence of sexually transmitted infections (STIs) and high-risk behaviours. In sub-Saharan Africa, it has previously been observed that up to 50% of HIV cases were attributed to herpes simplex type 2 (HSV-2) among low-risk populations. Because the proportion of sexually transmitted HSV-1 is rising, it is essential to study the interaction between HSV-1 and HIV infections. Methods We conducted a study in Mbeya region using the archived blood sera of participants from the recently completed EU-funded EMINI project. A specially designed questionnaire was used to obtain the social and demographic characteristics of the study participants in the database. We tested archived participants’ sera for herpes simplex virus type 1 using Virotech HSV-1 (gG1) IgG ELISA (Enzygnost, Behring, Germany). Univariate and multivariate Poisson regression models were used to identify factors associated with HSV-1. Results A total of 640 adults were randomly recruited after stratification by HIV status (318 were HIV positive), age, and sex. The overall seroprevalence of HSV-1 in the study population was 92.1%. The extrapolated seroprevalence estimate of herpes simplex virus type 1 in the general population was 95.0% (96.0% in males versus 94.0% in females). Males and females were equally affected by HSV-1. HSV-1 was less prevalent in HIV-positive individuals than in HIV-negative individuals. Conclusion People living with HIV were less likely to be HSV-1 seropositive. Further prospective studies are necessary to conclude a causal association.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::da5b9bcd10966ac1c7757ab4d9999f17Test
http://link.springer.com/article/10.1186/s12879-020-05301-2Test -
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المصدر: BMC Public Health, Vol 20, Iss 1, Pp 1-9 (2020)
BMC Public Health
BMC public healthمصطلحات موضوعية: Male, Health Knowledge, Attitudes, Practice, Psychological intervention, Disease, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Epidemiology, Uganda, 030212 general & internal medicine, 2. Zero hunger, education.field_of_study, lcsh:Public aspects of medicine, 1. No poverty, Middle Aged, 3. Good health, Cardiovascular Diseases, Hypertension, symbols, Educational Status, Female, medicine.symptom, Diet, Healthy, Research Article, Adult, medicine.medical_specialty, Population, Physical activity and sub-Saharan Africa, Asymptomatic, 03 medical and health sciences, symbols.namesake, Environmental health, medicine, Humans, Poisson regression, Healthy Lifestyle, education, Exercise, Aged, business.industry, Public health, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Diet, Cross-Sectional Studies, Socioeconomic Factors, Human medicine, Biostatistics, business, Healthy lifestyles, Cell Phone
الوصف: Background With the growing epidemic of Cardiovascular Disease (CVD) in sub-Saharan Africa, behavioural change interventions are critical in supporting populations to achieve better cardiovascular health. Population knowledge regarding CVD is an important first step for any such interventions. This study examined CVD prevention knowledge and associated factors among adults in Mukono and Buikwe districts in Uganda. Methods The study was cross-sectional in design conducted among adults aged 25 to 70 years as part of the baseline assessment by the Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa (SPICES) – project. Data were collected using pretested semi-structured questionnaires, and respondents categorized as knowledgeable if they scored at least five out of six in the knowledge questions. Data were exported into STATA version 15.0 statistical software for analysis conducted using mixed-effects Poisson regression with fixed and random effects and robust standard errors. Results Among the 4372 study respondents, only 776 (17.7%) were knowledgeable on CVD prevention. Most respondents were knowledgeable about foods high in calories 2981 (68.2%), 2892 (66.1%) low fruit and vegetable intake and high salt consumption 2752 (62.9%) as CVD risk factors. However, majority 3325 (76.1%) thought the recommended weekly moderate physical activity was 30 min and half 2262 (51.7%) disagreed or did not know that it was possible to have hypertension without any symptoms. Factors associated with high CVD knowledge were: post-primary education [APR = 1.55 (95% CI: 1.18–2.02), p = 0.002], formal employment [APR = 1.69 (95% CI: 1.40–2.06), p p = 0.004]. Other factors were: household ownership of a mobile phone [APR = 1.35 (95% CI: 1.07–1.70), p = 0.012] and ever receiving advice on healthy lifestyles [APR = 1.38 (95% CI: 1.15–1.67), p = 0.001]. Conclusions This study found very low CVD knowledge with major gaps around recommended physical activity duration, diet and whether hypertension is asymptomatic. Observed knowledge gaps should inform suitable interventions and strategies to equip and empower communities with sufficient information for CVD prevention. Trial registration ISRCTN Registry ISRCTN15848572, January 2019, retrospectively registered.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e44debd369e57eac0e4cccdcff61fb63Test
http://link.springer.com/article/10.1186/s12889-020-09264-6Test -
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المؤلفون: Joseph Ouma, Caroline Jeffery, Jim Todd, Rhoda K. Wanyenze, Jonathan Levin, Joseph J. Valadez
المصدر: BMC Public Health, Vol 20, Iss 1, Pp 1-14 (2020)
BMC Public Healthمصطلحات موضوعية: Male, Databases, Factual, wc_503, HIV Infections, Population survey, 0302 clinical medicine, Surveys and Questionnaires, Prevalence, Mass Screening, Uganda, 030212 general & internal medicine, media_common, wa_105, education.field_of_study, Data Collection, lcsh:Public aspects of medicine, 1. No poverty, Hybrid Prevalence Estimate, wa_100, 3. Good health, Female, Research Article, wc_503_4, Adult, media_common.quotation_subject, wc_503_6, 030231 tropical medicine, Population, wa_395, Combining, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Bias, Environmental health, medicine, Humans, Serologic Tests, education, Selection Bias, Selection bias, Estimation, Data collection, business.industry, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, Confidence interval, Health Information System, Standard error, Logistic Models, Sample size determination, District Health Information System, Health Facilities, business
الوصف: Background National or regional population-based HIV prevalence surveys have small sample sizes at district or sub-district levels; this leads to wide confidence intervals when estimating HIV prevalence at district level for programme monitoring and decision making. Health facility programme data, collected during service delivery is widely available, but since people self-select for HIV testing, HIV prevalence estimates based on it, is subject to selection bias. We present a statistical annealing technique, Hybrid Prevalence Estimation (HPE), that combines a small population-based survey sample with a facility-based sample to generate district level HIV prevalence estimates with associated confidence intervals. Methods We apply the HPE methodology to combine the 2011 Uganda AIDS indicator survey with the 2011 health facility HIV testing data to obtain HIV prevalence estimates for districts in Uganda. Multilevel logistic regression was used to obtain the propensity of testing for HIV in a health facility, and the propensity to test was used to combine the population survey and health facility HIV testing data to obtain the HPEs. We assessed comparability of the HPEs and survey-based estimates using Bland Altman analysis. Results The estimates ranged from 0.012 to 0.178 and had narrower confidence intervals compared to survey-based estimates. The average difference between HPEs and population survey estimates was 0.00 (95% CI: − 0.04, 0.04). The HPE standard errors were 28.9% (95% CI: 23.4–34.4) reduced, compared to survey-based standard errors. Overall reduction in HPE standard errors compared survey-based standard errors ranged from 5.4 to 95%. Conclusions Facility data can be combined with population survey data to obtain more accurate HIV prevalence estimates for geographical areas with small population survey sample sizes. We recommend use of the methodology by district level managers to obtain more accurate HIV prevalence estimates to guide decision making without incurring additional data collection costs.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f78cc5946d98385b2d919896c023751aTest
http://link.springer.com/article/10.1186/s12889-020-8436-zTest -
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المؤلفون: Patrick M. Wilson, Jennifer L. St. Sauver, Cynthia M. Boyd, Lila J. Finney Rutten, Chun Fan, Walter A. Rocca, Alanna M. Chamberlain, Debra J. Jacobson
المصدر: BMC Public Health, Vol 20, Iss 1, Pp 1-10 (2020)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Minnesota, Population, 030204 cardiovascular system & hematology, Logistic regression, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rochester Epidemiology Project, Residence Characteristics, Risk Factors, Poverty Areas, Epidemiology, Prevalence, medicine, Humans, 030212 general & internal medicine, 10. No inequality, education, Socioeconomic status, Aged, Aged, 80 and over, education.field_of_study, Geocoding, business.industry, Public health, lcsh:Public aspects of medicine, 1. No poverty, Public Health, Environmental and Occupational Health, Multimorbidity, lcsh:RA1-1270, Health Status Disparities, Odds ratio, Middle Aged, Area deprivation index, US Census, Chronic Disease, Female, Biostatistics, business, Demography
الوصف: Background Persons with low socioeconomic status may be disproportionately at risk for multimorbidity. Methods Adults aged ≥20 years on 4/1/2015 from 7 counties in Minnesota were identified using the Rochester Epidemiology Project (population-based sample). A composite measure of neighborhood socioeconomic disadvantage, the area deprivation index (ADI), was estimated at the census block group level (n = 251). The prevalence of 21 chronic conditions was obtained to calculate the proportion of persons with multimorbidity (≥2 chronic conditions) and severe multimorbidity (≥5 chronic conditions). Hierarchical logistic regression was used to estimate the association of ADI with multimorbidity and severe multimorbidity using odds ratios (OR). Results Among 198,941 persons (46.7% male, 30.6% aged ≥60 years), the age- and sex-standardized (to the United States 2010 census) median prevalence (Q1, Q3) was 23.4% (21.3%, 25.9%) for multimorbidity and 4.8% (4.0%, 5.7%) for severe multimorbidity. Compared with persons in the lowest quintile of ADI, persons in the highest quintile had a 50% increased risk of multimorbidity (OR 1.50, 95% CI 1.39–1.62) and a 67% increased risk of severe multimorbidity (OR 1.67, 95% CI 1.51–1.86) after adjusting for age, sex, race, and ethnicity. Associations were stronger after further adjustment for individual level of education; persons in the highest quintile had a 78% increased risk of multimorbidity (OR 1.78, 95% CI 1.62–1.96) and a 92% increased risk of severe multimorbidity (OR 1.92, 95% CI 1.72–2.13). There was evidence of interactions between ADI and age, between ADI and sex, and between ADI and education. After age 70 years, no difference in the risk of multimorbidity was observed across quintiles of ADI. The pattern of increasing multimorbidity with increasing ADI was more pronounced in women. Finally, there was less variability across quintiles of ADI for the most highly educated group. Conclusions Higher ADI was associated with increased risk of multimorbidity, and the associations were strengthened after adjustment for individual level of education, suggesting that neighborhood context plays a role in health above and beyond individual measures of socioeconomic status. Furthermore, associations were more pronounced in younger persons and women, highlighting the importance of interventions to prevent chronic conditions in younger women, in particular.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0b1e90ed2306acbd3625c0887ef1b50bTest
https://doaj.org/article/306e3e28a50943c1b09cd8b6eeddf694Test -
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المؤلفون: Lynn Atuyambe, Harriet Babikako, Doris Kwesiga, Swaibu Zziwa, Olive Kobusingye, Rebecca Nuwematsiko, Frederick Oporia, Jacob A. Bentley, Nino Paichadze, Abdulgafoor M. Bachani
المصدر: BMC Public Health, Vol 19, Iss 1, Pp 1-11 (2019)
BMC Public Healthمصطلحات موضوعية: Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Adolescent, Cross-sectional study, medicine.medical_treatment, Population, People with physical disability, Poison control, Suicide prevention, Rehabilitation Centers, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Quality of life (healthcare), medicine, Prevalence, Humans, Disabled Persons, Uganda, 10. No inequality, education, Child, Socioeconomic status, education.field_of_study, Rehabilitation, business.industry, 4. Education, Public health, lcsh:Public aspects of medicine, 1. No poverty, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Patient Acceptance of Health Care, Cross-Sectional Studies, Socioeconomic Factors, Family medicine, Child, Preschool, Female, Rehabilitation services and Kawempe division, 0305 other medical science, business, 030217 neurology & neurosurgery, Research Article
الوصف: BackgroundWorldwide, fifteen percent (15%) of the world’s population or one (1) billion people live with some form of disability. In Uganda, 12.4% of the Uganda’s population lives with some form of disability and Kawempe division accounts for (22.6%) of all persons with disabilities living in Kampala district. Rehabilitation services are provided within Kawempe division at Mulago hospital physiotherapy department and Katalemwa rehabilitation center in Kampala district, Uganda at a free and a subsidized cost to help to improve the function, independence, and quality of life of persons with physical disabilities. However, many people with physical disabilities do not utilize the services and the reasons are not clear.MethodsThe study design was a descriptive cross-sectional study employing quantitative methods of data collection. A total of 318 participants were included in the study. Simple random sampling was used to select the study participants. Ethical issues were maintained at all levels during data collection and dissemination of results.ResultsThe study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Kampala, Uganda. Factors that were significantly associated with utilization of rehabilitation services among people with physical disabilities at multivariable logistic regression analysis included; age (AOR: 0.30; 95% CI: 0.12–0.74), socioeconomic status (AOR: 2.13; 95% CI: 1.03–4.41), education level (AOR: 4.3; 95% CI: 1.34–13.91) and awareness of the participants about the rehabilitation services (AOR: 5.1; 95% CI: 2.74–9.54) atpvalue ≤0.05.ConclusionThe study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Uganda. Factors that were significantly associated with utilization of rehabilitation services included; age, socioeconomic status, education level and awareness of the participants about the services. Therefore, the government and other relevant stake holders should increase sensitization and awareness of rehabilitation services, their benefits and facilities providing such services to people with physical disabilities, healthcare professionals and the general public.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cd36a2956d38c2825e2f83b151d01607Test
https://doaj.org/article/3ffa023f898444fdafdb31e520f736bfTest
