bluuebunny/crossref_metadata_2025 huggingface dataset:
1395Estimates of people infected with soil-transmitted-helminthiasis and drug requirements for preventive chemotherapy in Ogun, Nigeria
Authors: Mogaji Hammed , Olatunji Johnson , Adigun Abass , Ekpo Uwem
Published: September 2021

Background

Soil transmitted helminthiasis (STH) are among the most common human infections worldwide with over 1 billion people affected. This study produced predictive risk maps of STH and estimated the number of people infected, and the amount of drug required for preventive chemotherapy in Ogun state, Nigeria.

Methods

Georeferenced STH infection data obtained from community cross-sectional survey, at 33 locations between July 2016-November 2018, together with remotely sensed environmental and socio-economic data were analyzed using Bayesian geostatistical models.

Result

An overall prevalence of 17.2% (95 % CI: 14.9, 19.5) was recorded for STH infection. Ascaris lumbricoides infections was the most predominant, 13.6% (95% CI: 11.5, 15.7), while Hookworm and Trichuris trichiura had 4.6 % (95% CI: 3.3, 5.9) and 1.7% (95 % CI: 0.9, 2.4), respectively. The predictive maps reveal a spatial pattern of high risk in the central, western and on the border connecting Republic of Benin. The model identified soil pH, soil moisture and elevation as important predictors of the STH infection. Approximately 1.1 million persons (preschoolers, school-aged children (SAC) and adults) are infected and requires 7.8 million doses. Also, 375,374 SAC were estimated to be infected, requiring 2.7 million doses for annual PC.

Conclusion

Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, by identifying priority areas for delivery of interventions in Ogun State, Nigeria.
1136Leveraging on waste management for supplemental vaccinations to incinerate wastes from routine immunization in nigeria
Authors: Momoh Jenny
Published: September 2021

Background

Nigeria, in 2019, implemented an Integrated Measles and Meningitis A vaccination campaign (IVC) majorly in the northern part of the country including the Federal Capital Territory (FCT), Abuja. The campaign was necessary to interrupt the transmission of these diseases in unimmunized under-fives. FCT aligned with this novel approach to reach its target population of 692697 children aged 9-59 months and 651951 children aged 1-5 years with the Measles and Men A vaccines respectively. Given the integration, FCT was going to generate twice the volume of wastes compared to previous stand-alone campaigns. This paper aims to document the best practices FCT used to incinerate the large volume of sharp wastes generated during the IVC as well as outstanding wastes generated during routine immunization (RI) services.

Methods

A waste management working group was inaugurated at the state level to coordinate all waste management activities in FCT. They developed a waste management plan outlining the expected amount of wastes to be generated, cost implications, mapping of incineration sites and modalities of evacuation and incineration.

Result

A total of 20000 safety boxes generated from the integrated Measles and Men A vaccination campaign (17645) and RI (2355) were incinerated.

Conclusion

FCT has incinerated all sharps generated during the 2019 integrated Measles and Men A vaccination campaign as well as outstanding routine immunization wastes.

Key message

Coordinated waste management activities are required to continuously manage RI wastes.
1431Dietary patterns and diet quality of Portuguese children and adolescents: the UPPER project
Authors: Moraes Milena , Oliveira Bruno , Afonso Cláudia , Santos Cristina , Torres Duarte , Lopes Carla , Miranda Renata , Rauber Fernanda , Antoniazzi Luiza , Levy Renata , Rodrigues Sara
Published: September 2021

Background

Based on a classification that considers the nature, extent and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with diet quality.

Methods

Sample from the 2015-2016 National Food, Nutrition and Physical Activity Survey (n = 1153;3-17y). Dietary intake from 2 non-consecutive 24h-recalls. Foods classified by NOVA system into 42 subgroups from 4 groups: unprocessed/minimally processed (G1), processed culinary ingredients (G2), processed (G3) and ultra-processed (UPF) (G4). Percentage of grams related to total daily grams consumed were considered to identify DPs by latent class analysis. Adjusted linear regressions were performed to test association with nutritional indicators.

Results

Subjects followed 3 DPs: “Unhealthy” (51%), “Traditional” (36%), and “Dairy” (13%). Consumption in NOVA groups/subgroups differentiated them: “Unhealthy”, high in G4 and low in G1; “Traditional”, high in G1, G2 and G3, but also some subgroups from G4; and “Dairy”, high in milk, yogurt and milk-based beverages from G1 or G4 and low in most G3 subgroups. Energy from UPF represented 39% in “Unhealthy” and 34-35% in “Traditional” and “Dairy”. Compared to “Traditional” DP, “Unhealthy” was higher in free sugars, and lower in fibre, vitamin A, vitamin C, folates, sodium, potassium, magnesium, and iron. “Dairy” had lower total energy, energy density, fats and sodium, and higher carbohydrates, potassium, calcium, phosphorus and magnesium.

Conclusions

“Unhealthy” had the worst nutrient profile, although all DPs presented significant consumption of UPF. This should be considered in food-based interventions and school-feeding policies.

Key messages

Half of Portuguese <18 years presented an “Unhealthy” DP.
352Postpartum diet quality: A cross-sectional analysis from the Australian longitudinal study on women’s health
Authors: Martin Julie , Joham Anju , Mishra Gita , Hodge Allison , Moran Lisa , Harrison Cheryce
Published: September 2021

Background

Reproductive-aged women are at high risk of developing obesity, and diet quality is a potential modifiable risk factor. There is limited research exploring postpartum diet quality.

Methods

Using data from the Australian Longitudinal Study on women’s Health of women, who reported having previously given birth, we investigated the association between time since childbirth and diet quality, and differences in energy, macronutrients, micronutrient intake, and diet quality assessed by the dietary guideline index (DGI) in women stratified by time from last childbirth, early (≤6 months; n = 558) and late (7–12 months; n = 547), and others (>12 months post childbirth; n = 3434).

Results

From this cohort, 4539 participants completed a food frequency questionnaire and were included in this analysis. Overall, diet quality was higher in early and late postpartum women (mean DGI score 89.8±10.5 and 90.0±10.2, respectively) compared to others (>12 months post childbirth), (85.2±11.7; p < 0.001). Factors positively associated with diet quality included higher education, physical activity, health provider support, and vitamin and/or mineral supplement use. Conversely, increasing time from childbirth (>12 months), smoking compared with non-smoking and medium income level compared with no income was negatively associated with diet quality.

Conclusions

A lower diet quality in women >12 months post childbirth may be reflective of increased pressures, balancing childrearing and return to work responsibilities. This highlights the need to support women beyond the postpartum period to improve modifiable factors associated with weight gain, including diet quality, to optimize health and reduce chronic disease risk.

Key messages

Diet quality; nutrition; obesity; prevention; postpartum; reproductive; women
832Detecting spatial clusters of human salmonellosis in Victoria
Authors: Morgan Hannah , Cutcher Zoe , Firestone Simon , Stevenson Mark , Stylianopoulos Anastasia , Arnold Anna-Lena , Pfeiffer Caitlin
Published: September 2021

Focus of Presentation

‘Cluster Tracker’ is an automated tool for spatial cluster detection of notifiable disease data collected by the Department of Health (DH), Victoria. The tool combines R statistical software and a SaTScan cluster detection algorithm (prospective space-time permutation scan statistic) to detect notifiable disease case clusters in Victoria and is presently implemented for salmonellosis (categorised by type and/or MLVA). The objective of the tool is to conduct an initial screening of case data to improve the prioritisation of salmonellosis cases for epidemiological investigation.

Findings

The Cluster Tracker tool parameters have been validated using historical data from 2017-2018, comparing DH outbreak and cluster investigations identified by usual surveillance activities with clusters detected by the Cluster Tracker tool. Parameter selection considered cluster detection agreement and disagreement, disease-specific epidemiological characteristics, and operational requirements. The Cluster Tracker tool was able to provide closely-aligned agreement with existing DH outbreak and cluster investigations using the validated parameters.

Implications

This automated spatial cluster detection tool complements existing desktop surveillance of salmonellosis notifications to enhance public health decision making, and serves as an example of how spatial methods can improve real-time surveillance.

Key messages

Advanced spatial statistical tools have a role alongside traditional methods to make better use of limited epidemiological capacity and improve the timeliness and prioritisation of surveillance activities for notifiable diseases.
1470Relationship between dietary fibre to carbohydrate ratio and mortality risk in the NHANES
Authors: Morimoto Nobuhisa , Urayama Kevin , Tanaka Akira , Ai Masumi
Published: September 2021

Background

The evidence is inconsistent regarding associations between relative proportions of macronutrient intake and disease risk, potentially due to limitation in accounting for differential effects of simple sugars and dietary fibre, typically grouped as “carbohydrates.”

Methods

We performed an analysis comprising subjects enrolled in the National Health and Nutrition Examination Survey between 1999 and 2004 to examine the association between the ratio of dietary fibre to carbohydrate intake (FC-R) measure and mortality risk. Subjects were followed through 2011. We categorized subjects based on tertile cutpoints of FC-R, and compared their nutrient intake. We performed Cox proportional hazards regression to estimate hazard ratios (HR) with 95% confidence intervals (95% CI), adjusting for demographic, health history, and lifestyle and dietary factors.

Results

Among the 6,761 participants (48% males; mean age 57.0 years), 1339 deaths were observed during follow-up. The high FC-R group had the lowest caloric and carbohydrate intake, but the highest protein intake. Increasing values of FC-R was significantly associated with reduced mortality risk (HR 0.95, 95% CI 0.93, 0.97), while percent calories from carbohydrate showed no association. Compared to the low FC-R group, higher FC-R groups showed a trend towards a reduction in mortality risk after adjusting for potential confounders (high group: HR 0.66, 95% CI 0.57, 0.78).

Conclusions

Our findings support the protective effect of fibre in reducing mortality risk. Mechanisms of the association between FC-R and mortality warrant further investigation.

Key messages

Individuals with higher FC-R diets had lower mortality risk in a large population study.
1344Interbirth interval and maternal anaemia in 21 sub-Saharan African countries: a multinational cross-sectional study
Authors: Mruts Kalayu Brhane , Tessema Gizachew Assefa , Gebremedhin Amanuel Tesfay , Scott Jane , Pereira Gavin
Published: September 2021

Background

Anaemia is a global public health problem, which disproportionately affects women in sub-Saharan Africa (SSA). The causes of anaemia are multifactorial, and a short interbirth interval has been identified as a potentially modifiable risk factor. However, the current evidence for the association between interbirth interval and maternal anaemia remains inconclusive. Hence, this study aimed at examining the association between the interbirth interval and maternal anaemia in SSA.

Methods

We conducted a multinational cross-sectional study of interbirth interval (time between two singleton live births) and maternal anaemia for 21 SSA countries using the most recent nationally representative Demographic and Health Surveys, 2010-2017. Modified Poisson regression models were used to estimate the relative risk (RR) and 95% confidence intervals (CIs) after adjusting for confounding variables.

Results

There were 81,693 women included in the study (89.2% nonpregnant, 10.8% pregnant and 32.2% postpartum). Overall, 36.9% of women had anaemia (36.0% of non-pregnant, 44.3% pregnant, and 38.7% of postpartum women). Compared to a 24-35 months interbirth interval, maternal anaemia was not associated with short (<24 months) interbirth intervals (aRR 1.01, 95% CI; 0. 98, 1.04) or long (≥60 months) interbirth interval (aRR 1.00, 95% CI 0.96, 1. 04).

Conclusions

Our finding revealed insufficient evidence that both short and long birth intervals were associated with the risk of maternal anaemia in SSA.

Key messages

It is unlikely that the high prevalence of maternal anaemia in SSA can be reduced by avoiding short nor long interbirth intervals.
1293Identifying Shared Symptoms and Comorbidities to Inform Risk Reduction Strategies Across Prevalent Neurological disorders
Authors: Nag Nupur , Lin Xin , Jelinek George , Neate Sandra , Levin Michele
Published: September 2021

Background

The global burden of neurological disorders continues to grow. Many have a long disease course and symptoms that can impact daily living and reduce quality of life. Common symptoms are reported across neurological disorders, however, have not been assessed in detail. Assessment of shared symptoms and conditions across neurological disorders may provide insight into similar risk reduction and disease management opportunities.

Methods

Data from an Australian cohort (n = 192,091) were analysed. Log-binomial regression assessed shared symptoms and comorbidities in ten pre-defined categories across people with Alzheimer’s disease (AD), stroke, motor neuron disease (MND), multiple sclerosis (MS), or Parkinson’s disease (PD). Then, to identify sub-categories of symptoms and conditions that were driving the shared associations across disorders.

Results

Positive associations shared across neurological disorders were observed for cancers, digestive system, mental health, kidney and urinary, lung and breathing, and other conditions, categories. Bladder and urinary problems, incontinence, fatigue, muscle weakness, depression, and sleep apnoea, were associated with at least 3 of 5 neurological disorders.

Conclusions

Six overarching symptoms and condition categories were shared across neurological disorders. Bladder and urinary problems, incontinence, fatigue, muscle weakness, depression, and sleep apnoea were associated across most neurological disorders.

Key messages

Shared symptoms and conditions were identified across five neurological disorders. These findings may inform risk prevention and disease management strategies with broad applicability.
683Data envelopment analysis for predicting pre-diabetes for primary disease prevention
Authors: Nakamura Sho , Narimatsu Hiroto
Published: September 2021

Background

Identifying a population at risk of risks is imperative for primary disease prevention and allows the promotion of health maintenance in a healthy population. Previous studies on hypertension and dyslipidemia using data envelopment analysis (DEA) showed that populations at risk of risks could be identified using this method. In this study, we extended DEA to include pre-diabetes.

Methods

A retrospective cohort study was conducted using specific health check-up data from 2008 to 2013. DEA efficiency scores were calculated for healthy subjects with baseline glycated hemoglobin (HbA1c) <5.7%. Odds ratios (ORs) for pre-diabetes onset within 3 years were analyzed.

Results

Among 1,501 subjects, with 373 cases of disease onset (24.9%), the OR for the incidence of pre-diabetes (on the basis of a 0.1-point increase in the efficiency score) was 0.77 (90% confidence interval [CI] 0.68–0.86, p < 0.0002). After adjusting for age and sex, the OR was 0.66 (90% CI 0.58–0.75, p < 0.0001). Furthermore, for the subgroup with no conventional diabetes risk factors, the adjusted OR was 0.50 (90% CI 0.38–0.67, p = 0.0001).

Conclusions

We showed that the DEA efficiency score can help identify a pre-diabetes population at risk of risks. Further studies to validate these findings would be worthwhile for optimizing primary preventative measures.

Key messages

DEA was assessed for its ability to evaluate the risk of pre-diabetes. Results showed that an efficiency score could predict pre-diabetes onset and demonstrated the feasibility of applying this analysis in primary preventive healthcare.
1486Preference for person-centered care model, perceptions of family physicians and patients of East Mediterranean Region
Authors: Nanji Kashmira , Qidwai Waris , Khoja Tawfik A M , Rawaf Salman
Published: September 2021

Background

Person-centered care is one of the vital components of a health care system and signifies the concept of health promotion and disease prevention. This study aimed to identify the perceptions of patients and physicians regarding person-centered care in the Eastern Mediterranean Region (EMR).

Methods

A cross-sectional study was conducted in six countries of EMR during June 2019 to August 2019. In first phase, 190 family physicians (FPs) practicing for atleast six months were recruited. In the next phase, the recruited FPs then approached their patients aged more than 18 years. Multinomial regression analysis was conducted using SPSS version 20.

Results

Of a total of 300 patients, 25% were aged 40 years or above and the majority 56% were females. Among physicians, 62.8% were between 25 to 35 years and 88% had a postgraduate training in Family Medicine. Thirty six percent of patients and 62.6% of physicians, preferred a person-centered care model of care. Among physicians, field of specialization (ORadj= 0.7; 95% C.I: 0.3-0.9) and regularity in continuing medical education sessions (ORadj= 0.3; 95% C.I: 0.1-0.5) while, among patients, educational status was significantly associated with preference for person-centered care model.

Conclusions

The transition towards person centered care model has already started and most care providers endorse it. However, there is a need to apply this approach consistently, keeping the cultural aspects in mind.

Key messages

There is a need for intensive research on the development of integrated primary care models to improve access to person-centered care.
237Spatial distribution and correlates of HIV prevalence in South Africa
Authors: Ncayiyana Jabulani , Bell Griffin , Solomon Ari , Emch Micheal
Published: September 2021

Background

South Africa has a high HIV prevalence and generalized HIV epidemic. It is now well established that the HIV epidemic and its drivers are highly heterogeneous, even in generalized HIV epidemic settings.

Methods

This study uses data from South African HIV/AIDS, Behavioural Risks, Sero-status, and Mass Media Impact (SABSSM), 2005, 2008 and 2012 surveys. To identify spatial clusters, we used the spatial scan statistic method in SaTScan, assuming discrete Poisson distributions. Poisson regression models were used to explore the municipality-level correlates of HIV prevalence and a logistic regression model was used to determine individual-level correlates of HIV infection.

Results

Between 2005 and 2012, There was significant geographical variation in estimated HIV prevalence (range = <1.0%–27.5%). Eight, five and six significant overlapping high-risk spatial clusters of high HIV prevalence were detected in 2005, 2008 and 2012, respectively. HIV prevalence is clustered in the central and north-eastern regions of South Africa. Living in municipalities with high percentage of black South Africans, higher poverty index, higher population aged 25-49, and higher early sexual debut were associated with HIV prevalence, while living in municipalities with higher percentage male circumcision and a high percentage married were associated with low risk of HIV. Logistic regression revealed race, sex and mobility as correlates of HIV infection.

Conclusions

HIV prevalence is highly spatially heterogenous and affected by various municipal-level factors.

Key messages

Identification of the spatial clusters of HIV prevalence and contextual factors should inform targeted interventions that are necessary to bringing HIV infections under control.
89Factors associated with pneumococcal nasopharyngeal carriage: a systematic review
Authors: Neal Eleanor , Chan Jocelyn , Russell Fiona M. , Nguyen Cattram. D
Published: September 2021

Background

Pneumococcal disease is a major contributor to global childhood morbidity and mortality. Pneumococcal carriage is a prerequisite for pneumococcal disease. Identifying factors associated with pneumococcal carriage can aid public health intervention programs. It is unknown if risk factors for pneumococcal carriage differ between low, middle, and high-income countries. We present preliminary findings of our systematic review of factors associated with pneumococcal carriage in community settings, in all ages.

Methods

A systematic search for pneumococcal nasopharyngeal carriage studies, published in English before July 2019. Two researchers independently reviewed studies that described factors associated with pneumococcal nasopharyngeal carriage. Study quality was assessed using the NIH Study Quality Assessment Tools. Results are presented as narrative summaries due to heterogeneity amongst factor definitions.

Results

Preliminary results are shown. Sixty-seven studies were included. 49% were conducted in high-income countries. Pneumococcal prevalence ranged from 0.3%-97%, 2.6%-89.6%, 14%-73%, 1.6%-82.4% in low-, lower-middle, upper-middle, and high-income classifications. Age, respiratory tract infection symptoms, living with young children, poverty, exposure to smoke, and season were positively associated with pneumococcal carriage in all income classifications.

Conclusions

Pneumococcal carriage prevalence was highest in low-income classifications. Pneumococcal carriage is associated with similar factors across income classifications. Differences in prevalence of risk factors associated with pneumococcal carriage by income classification may contribute to differences in carriage prevalence by income classifications.

Key messages

Pneumococcal carriage is considered a prerequisite for pneumococcal disease. Pneumococcal carriage prevalence is highest in low-income countries, however preliminary results suggest risk factors for carriage may be similar across income classifications.
90Factors associated with pneumococcal carriage in children and adults in Fiji, using four cross-sectional surveys
Authors: Neal Eleanor , Nguyen Cattram , Ratu Felista Tupou , Dunne Eileen , Kama Mike , Ortika Belinda , Boelsen Laura , Kado Joseph , Tikoduadua Lisi , Devi Rachel , Tuivaga Evelyn , Reyburn Rita , Catherine Satzke A. , Rafai Eric , Kim Mulholland E. , Russell Fiona
Published: September 2021

Background

Pneumococcal disease is preceded by carriage of pneumococci. We describe factors associated with pneumococcal nasopharyngeal carriage in Fiji, using data from annual (2012-2015) cross-sectional surveys, pre- and post-introduction of ten-valent pneumococcal conjugate vaccine (PCV10).

Methods

Infants (5-8 weeks), toddlers (12-23 months), children (2-6 years), and their caregivers participated. Pneumococci were detected using lytA qPCR, with molecular serotyping by microarray. We used logistic regression to determine predictors of carriage and density.

Results

There were 8,109 participants. Pneumococcal carriage was associated with: years post-PCV10 introduction (global P<0.001), iTaukei ethnicity (aOR 2.74 [95% CI 2.17-3.45] P<0.001); young age (global P<0.001); urban residence (aOR 1.45 [95% CI 1.30-2.57] P<0.001); living with >2 children <5 years (aOR 1.42 [95% CI 1.27-1.59] P<0.001); poverty (aOR 1.44 [95% CI 1.28-1.62] P<0.001); and upper respiratory tract infection (URTI) symptoms (aOR 1.77 [95% CI 1.57-2.01] P<0.001). Factors associated with PCV10 and non-PCV10 carriage were similar to those associated with overall carriage. Additionally, PCV10 carriage was associated with PCV10 vaccination (0.58 [95% CI 0.41-0.82] P=0.002) and cigarette smoke exposure (aOR 1.21 [95% CI 1.02-1.43] P=0.031. Non-PCV10 carriage was not associated with years post-PCV10 introduction.

Conclusions

Introduction of PCV10 reduced the odds of overall and PCV10 pneumococcal carriage in Fiji. ITaukei ethnicity was positively associated with carriage after adjustment for PCV10.

Key messages

PCV10 introduction was associated with reduced odds of overall and PCV10 pneumococcal carriage in Fiji. Despite high and similar PCV10 coverage rates, iTaukei ethnicity is positively associated with pneumococcal carriage, compared with Fijian of Indian Descent populations.
1193Developing a Multifactorial Prognostic Index in Relapsing Onset Multiple Sclerosis and Clinically Isolated Syndrome
Authors: Ngwa Valery Fuh
Published: September 2021

Background

Disease course in multiple sclerosis (MS) is characterised by relapses and worsening of disability. This study aims to create, from available clinical, genetic, and environmental factors; a multifactorial prognostic index (MPI) to predict disease course in MS.

Methods

We analysed prospectively assessed MS cases (N = 253) with 2858 repeated measurements over 10-years. Of the 253 cases, N = 219 were diagnosed as relapsing-onset, while N = 34 remained as clinically isolated syndrome by the 10th-year review. Cox regression models with Least Absolute Shrinkage and Selection Operator were used to select potential genetic, clinical, and environmental factors that are predictive of relapses and/or worsening of disability. Multivariate Cox regression models with leave-one-out cross-validation were used to construct a MPI, from which robust dynamic predictions were obtained by landmarking. The predictive performance at diagnosis was evaluated using the Kullback-Leibler and Brier prediction error curves.

Results

The MPI predicted a quadratic time-dynamic disease course in terms of relapses (HR = 2.16, CI: 1.74-2.68; C-index=0.85) and worsening of disability (HR = 2.74, CI: 2.00-3.76; C-index=0.76). The Kullback-Leibler and Brier dynamic prediction error curves showed reasonable performance for both short- (≤5-years from diagnosis) and long-term (>5-years from diagnosis) prognostications, respectively.

Conclusions

The MPI provided reliable information that is relevant for long-term prognostication and may be used as a selection criterion or risk stratification tool for clinical trials.

Key messages

Using relevant clinical, environmental, and genotype data, we have created a MPI for people living with MS and clinically isolated syndrome.
505Maternal autoimmune disease and increased attention deficit/hyperactivity disorder among offspring: A cohort study and meta-analysis
Authors: Nielsen Timothy , Nassar Natasha , Shand Antonia , Dale Russell , Lain Samantha
Published: September 2021

Background

Maternal autoimmune disease (AD) has been associated with increased neurodevelopmental disorders in the offspring, but few studies have assessed Attention Deficit/Hyperactivity Disorder (ADHD).

Methods

Population-based record linkage study of 831,718 singleton term births in New South Wales, Australia, 2000-2010. Any maternal AD and specific autoimmune conditions were identified from hospital admission data, and ADHD in children was ascertained from stimulant prescription data (up to 2014). The association between maternal AD and ADHD was examined using Cox regression analysis after propensity score matching (1:4) to control for maternal confounders. A systematic review and meta-analyses were conducted, and pooled hazard ratios (HR) were calculated using random-effects meta-analysis with inverse variance weights.

Results

Of 831,718 births, 12,767 (1.5%) women had AD. In a propensity score-matched cohort (n = 63,050) maternal AD was associated with ADHD in offspring: “any AD” (HR 1.30, 95%CI 1.15-1.46), type-1 diabetes (T1D) (HR 2.23, 95%CI 1.66-3.00), psoriasis (HR 1.66, 95%CI 1.02-2.70) and rheumatic fever/carditis (HR 1.75, 95%CI 1.06-2.89). Five studies including ours were identified and included in the meta-analysis. Any AD (2 studies: HR 1.20, 95%CI 1.03-1.38), T1D (4 studies: HR 1.53, 95%CI 1.27-1.85), hyperthyroidism (3 studies: HR 1.15, 95%CI 1.06-1.26), and psoriasis (2 studies: HR 1.31, 95%CI 1.10-1.56) were associated with ADHD.

Conclusions

Maternal ADs were associated with increased ADHD among offspring, suggesting shared underlying genetic vulnerability or a role for maternal immune activation in fetal neurodevelopment. Future studies are required to understand causal mechanisms and identify interventions.

Key messages

Maternal ADs are associated with increased ADHD among offspring.
83Replacing sedentary time with moderate-to-vigorous physical activity is associated with decreased serum SPARC in men
Authors: Nishida Yuichiro , Hara Megumi , Higaki Yasuki , Taguchi Naoto , Nakamura Kazuyo , Nanri Hinako , Imaizumi Takeshi , Sakamoto Tatsuhiko , Shimanoe Chisato , Horita Mikako , Shinchi Koichi , Tanaka Keitaro
Published: September 2021

Background

Secreted protein acidic and rich in cysteine (SPARC) may play a role in the prevention of colon cancer through exercise, while SPARC is considered as a promoter of insulin resistance. The purpose of the present study was to clarify the effects of replacing sedentary time with either light-intensity PA (LPA) or moderate- to vigorous-intensity PA (MVPA) on serum SPARC in a general population.

Methods

The study subjects were 4000 men and 6040 women (40 to 69 years) who participated in baseline surveys of a population-based cohort study. Sedentary time, LPA, and MVPA were objectively measured by an accelerometer. The serum SPARC concentration was measured by an enzyme-linked immunosorbent assay. Using an isotemporal substitution model, cross-sectional associations of replacing sedentary time with either LPA or MVPA on serum SPARC levels were analyzed according to sex. Adjustment was made for potential confounding factors.

Results

In men, replacing 60 min of sedentary time with 60 min of MVPA was associated with 23 ng/mL (confidence interval -43, -2) lower serum SPARC levels even after adjusting for confounders, including the BMI (P = 0.028), while no such association was observed for LPA. Furthermore, no such significant replacement effects were observed in women.

Conclusions

The current study showed that replacing sedentary time with MVPA results in reduced serum SPARC concentrations in men.

Key messages

Effect of habitual PA to decrease circulating SPARC is PA intensity-specific.
597Factors associated with malaria among febrile patients aged from five years in Ngoma district-Rwanda, 2019
Authors: Niyoyita Jean Claude
Published: September 2021

Background

Malaria is a public health problem mostly in African region. More malaria studies have been investigated for under five children while little information is known for persons aged five and above. We assessed the prevalence and factors associated with malaria among febrile patients aged from five years in Ngoma district.

Method

Cross-sectional study was conducted from November to December, 2018. Systematic sampling method was used for participant’s selection. Data collection questionnaires were completed after informed or assent forms were signed by the participants. Thick blood smears were collected and tested for malaria parasites by laboratory personnel. Data entry was done through Microsoft Excel while STATA Version 13.0 was used for analysis. Bivariate and multivariate logistic regression was computed to determine the association between dependent and independent variables at 95%CI, p < 0.05.

Results

Overall, 420 febrile patients aged from five years were recruited and 257(61.2%) were confirmed malaria positive. Malaria microscopic positive results were significantly associated with being Male (aOR=1.57,95%CI:1.01-2.46) and living in Mutenderi Sector (aOR=7, 95%CI:1.2-40.92) compared to living elsewhere in Ngoma district. However in reference to 5-14 years age group, being in the age group of 15-24 years (aOR= 0.34, 95%CI:0.12-0.94) and ≥35 years (aOR=0.29, 95%CI:0.11-0.79) were more likely protected from the infection.

Conclusion

Malaria parasitaemia was found high in febrile patients aged five and above in the study area thus its prevention and control measures should be taken into consideration in this aged group as well. Moreover, particular attention is needed to male, Mutenderi residents and those in the 5-14 age group as they are more likely to get the malaria infection.

Key messages

Malaria, aged from five ,febrile patients
1502The elderly in Cameroon: between daily misery and hope
Authors: Nkwescheu Armand Seraphin , ZOA Alain Thierry OVONO , Tanue Elvis Asangbeng , Kobela Marie , Biyaga Paul Theodore Tjek , Bachire Hassan Ben , Emah Irene CharlotteYakana Ndjouma , Ngalame Alphonse
Published: September 2021

Background

The world population is growing older. The WHO has declared the ongoing decade (2020- 2030) as one of healthy ageing. Cameroon counts about 25 million people, among whom 3.5% are aged 60 years and above (elderly). However, the increasing number of aged population faces many difficulties that undermine their health and wellbeing. The survey aimed at exploring the baseline situation of the older people in Cameroon by giving a voice to the elderly, their care-givers and stakeholders.

Methods

We conducted in December 2019, a mixed method study on the care to the older people in Cameroon. Focus group discussions among the elderly within 5 regions; coupled with in-depth interviews of key informants among stakeholders.

Results

It emerges that the elderly Cameroonian, whether in rural or urban areas, lives in conditions close to poverty, but continues despite many odds to hope for a better tomorrow in terms of care. Respondents highlighted a need for financial autonomy among many other needs. Their caregivers report lack of means of action singled out for a better implementation of the care strategies. Efforts are currently being done by the authorities, partners to development and civil society to curtail the challenges.

Conclusions

The elderly in Cameroon are not yet at the centre of public health policies. Nevertheless more should be implemented as older people are unsatisfied with their present living conditions.

Key messages

The elderly have numerous unmet health, financial and social needs with those residing in rural communities posing with even higher demands.
1146Assessing the uncertainty around age-mixing patterns in HIV transmission inferred from phylogenetic trees
Authors: Nyasulu Peter
Published: September 2021

Introduction

Understand age-mixing patterns in HIV transmission is a key to design and implement HIV prevention interventions. As such, the use of phylogenetic tree seems promising since this approach is based on data from a transmission network.

Methods

Through a simulation study, we used transmission clusters computed from phylogenetic trees to investigate age-mixing patterns. From transmission clusters, we estimated a transmission network using pairings. We inferred measurements, which depict age-mixing patterns in transmission i.e. ‘proportions of men/women of a certain age-group paired with women/men of another age-group’, and mean, median, and standard deviation of average age difference between women/men with their respective pairs. We investigated the uncertainty around these measurements as a function of sampling coverage in different sequence missingness scenarios.

Results

According to the simulation set-up of age mixing in partnership, there are relationships, which are less likely and others highly likely. Explicitly, partnerships between younger men (<25 years) and older women (25 to 50 years) are less likely to happen in the sexual network, whereas partnership between younger women (<25 years) and older men (25 to 50 years) are more likely to happen as are age group relationship having intermediate magnitude in partnership.

Conclusion

Transmission clusters allow us to strive with more improved information regarding cross-generation transmission. It enables us to understand the importance of age mixing beyond describing the mean age difference, and that one needs to consider the variation of age differences between pairs of individuals as well as among the partners of a given individual.
426Awareness and Response to Intimate Partner Violence in WLWHA and HIV negative women in Umuahia
Authors: Odini Franklin , Emma-Ukaegbu Uloaku , Nwamoh Uche
Published: September 2021

Background

Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. IPV is the commonest form of violence against women and one of the most pervasive human rights abuses against women. The UN reported that 1 in 3 women had experienced physical/sexual violence at some point in their lives and 2 in 3 victims of intimate partner homicide are women.

This study is aimed at determining the level of awareness and responses to abuse by WLWHA and HIV negative women in Umuahia, Nigeria.

Methods

A comparative cross-sectional study involving 200 WLWHA and 200 HIV negative women in Umuahia using systematic random sampling method. An interviewer-administered questionnaire was deployed for data collection. Data analysis was done using IBM SPSS.

Results

The age range of WLWHA respondents was 23-70 years while that of HIV negative women was 18-70 years. Awareness on IPV was higher amongst HIV negative women (77%) compared to WLWHA respondents (52.5%). Among those who suffered any form of IPV, majority of the WLWHA (46.1%) and HIV negative women (58.9%) did nothing while the least common response was separating permanently (3.5% as against 6.8%).

Conclusion

The awareness and response to IPV especially amongst WLWHA is sub-optimal. Mass awareness campaigns amongst all women are advocated for to help combat this problem.

Keywords

Intimate Partner Violence, Awareness, Response.
430Predictors of Intimate Partner Violence amongst WLWHA and HIV negative women in Umuahia
Authors: Odini Franklin , Emma-Ukaegbu Uloaku , Nwamoh Uche
Published: September 2021

Background

Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. IPV is the commonest form of violence against women and one of the most pervasive human rights abuses against women. The UN reported that 1 in 3 women had experienced physical/sexual violence at some point in their lives and 2 in 3 victims of intimate partner homicide are women.

This study is aimed at determining the predictors of IPV amongst WLWHA and HIV negative women in Umuahia, Nigeria.

Methods

A comparative cross-sectional study involving 200 WLWHA and 200 HIV negative women in Umuahia using systematic random sampling method. An interviewer-administered questionnaire was deployed for data collection. Data analysis was done using IBM SPSS.

Results

Predictors of IPV amongst WLWHA included partner involvement in concurrent relationship and having childhood exposure to domestic violence while those amongst HIV negative women included coerced first sex, woman earning more than her partner, partner frequent use of alcohol and partner use of either or both cigarette and marijuana.

Conclusion

Predictors of IPV differed amongst both groups of women. Primary prevention interventions aimed at prevention and reduction should be instituted especially amongst WLWHA. Health care settings should be equipped to ensure a comprehensive response whenever IPV is detected.

Keywords

Intimate Partner Violence, Predictors, WLWHA.
33Visual acuity and knowledge of road safety measures among commercial motorcyclist in Nigeria’s metropolitan city
Authors: Ogunkeyede Omoseye , Osungabade Kayode , Ogunkeyede Ayodele
Published: September 2021

Background

Motorcycle crash is the second most common cause of road traffic injuries in Nigeria. The study aimed to assess the prevalence of visual disorder and the knowledge of road safety measures of commercial motorcyclist.

Methods

A cross-sectional study was carried out among motorcyclists in all five motorcycle parks in Ibadan. A total of 439 motorcyclists were interviewed through a simple random sampling technique. An interviewer-administered questionnaire was used for data collection.

Results

Age of the respondents was 34.4±7.8 years. Majority were males and 15.2% (n = 67) had tertiary education. Half of respondents 228 (51.9) had good knowledge of road safety measures. Only 26 (5.9%) had ever had their vision screened before. Majority of respondents 380 (86.6%) had good right vision (visual acuity ≥6/9). Respondent with tertiary education were significantly more likely to have good knowledge of road safety measures (p = <0.001). Respondent who had ever been involved in road crash were significantly more likely to have poor vision (p = 0.028). Motorcyclists who had complete training on motorcycle riding were three times more likely to have good knowledge of safety measures (OR = 2.8; 95% CI = 1.6-5.0).

Conclusions

Commercial motorcyclist’s good vision, education and training contributed to good knowledge of road safety measures. There is therefore the need to encourage proper medical examination before issuance of driver’s license, conduct training and create stringent laws to guide road safety.

Key messages

Commercial motorcyclists, knowledge, Road safety measure, Visual acuity
365Disease burden of mumps in Japan: descriptive epidemiology based on the health insurance reimbursement database
Authors: Ohfuji Satoko , Takagi Akira , Nakano Takashi , Kumihashi Hideaki , Kano Munehide , Tanaka Toshihiro
Published: September 2021

Background

In Japan, mumps vaccination coverage is low, since it is a voluntary vaccination. In this situation, the number of mumps cases as reported by pediatric sentinel hospitals suggests the occurrence of periodical mumps outbreaks.

Methods

To examine the annual incidences of mumps and mumps-related complications, we analyzed data from the health insurance reimbursement database for subscribers aged 0-64 years between 2005 and 2017. Cases with mumps and mumps-related complications including meningitis, orchitis, deafness, were extracted according to ICD-10 codes entered into the disease section for health insurance reimbursement.

Results

During the 13 year period, 68,307 of 5,209,660 subjects were reimbursed for mumps, with an incidence of 325 per 100,000 person-years (95% confidence interval (CI): 323-328). Among the 68,307 mumps cases, 787 were reimbursed for mumps-related complications, with an incidence of 11.5 per 1,000 mumps cases (95% CI: 10.7-12.4). Incidence of mumps-related complications (per 1,000 mumps cases) was highest for orchitis (6.6), followed by meningitis (5.8), deafness (1.3), pancreatitis (0.5), and encephalitis (0.3). Mumps incidence was highest among children aged 0-5 years, while incidence of mumps-related complications was highest among adults aged 26-35 years.

Conclusions

In Japan, the disease burden of mumps remains high among adults, as well as children.

Key messages

To reduce the disease burden of mumps among all ages in Japan, immunization in childhood is required. A national immunization program for children would result in high vaccination coverage and lower disease burden.
344Impact of a disease surveillance training program on knowledge of health workers in South-western Nigeria
Authors: Oladoyin Victoria , Osifo Joy , Temitayo-Oboh Abiola , Fatiregun Ayoola , Isere Elvis
Published: September 2021

Background

Poor knowledge of frontline health workers on integrated disease surveillance and response (IDSR) is a cause of poor surveillance reporting performance in Nigeria. To improve the knowledge of frontline health workers, they are trained annually, together with the surveillance focal persons, on IDSR. This study determined the immediate impact of one of such trainings on IDSR knowledge of the trainees.

Methods

A quasi experimental study, involving a pre- and post-test questionnaire survey, was conducted among 205 surveillance training participants in Ondo State, Nigeria. Data was analysed using descriptive and inferential statistics at 5% statistical level of significance.

Results

Mean age was 39.4 ± 9.1 years, 77.6% were females and 51.7% were clinicians. Although most (89.3%) were aware of IDSR, only 48.3 % and 43.9% had been involved in IDSR implementation and training respectively. Overall, the mean pre-test IDSR knowledge score was 12.43. This increased significantly to 18.63 in the post-test (p < 0.001). Sex (p = 0.003) and previous involvement in IDSR implementation (p = 0.043) were associated with improved knowledge score. Females were significantly more likely to have an improved knowledge score [β = 1.876 (CI: 0.305-3.447)].

Conclusions

IDSR trainings has the capacity to improve surveillance knowledge in the short-term with a possible resultant improvement in disease prevention and control in the long-term.

Key messages

Training on IDSR should be conducted regularly for all health care workers and special attention should be given to male health workers.
228Relationship of pesticide exposure with kidney function in NHANES: lessons from low level chronic exposure
Authors: Osborne Nicholas , Reid Simon , Karatela Shamshad , Assefa Yibeltal , Wan En-Tzu Grace
Published: September 2021

Background

Exposure to pesticides has been linked to many health outcomes. More recently, chronic kidney disease not related to diabetes or hypertension (CKDu) has been postulated to be related to rural occupational exposures in agricultural workers in several Low to Middle Income Country (LMIC) regions such as Mesoamerica and the Subcontinent. Our study wished to examine the relationship between pesticide exposure and kidney function.

Methods

We used the resources of pooled population from NHANES 2001-2004, 2007-2010 (n = 29,053). We examined pesticide exposure (logged, continuous) with kidney function as measured by glomerular filtration rate (derived from urinary creatinine) with and without presence of hypertension and diabetes. Logistic regression was adjusted for a range of cofactors such as age, sex, SES, tobacco, and heavy metals. Cadmium was used as a positive control.

Results

Pesticides 2,4-D, chlorpyrifos, malathion and 3-phenoxybenzoic acid (the major metabolite of deltamethrin) were associated with the increasing risk of kidney dysfunction (not with hypertension or diabetes) after adjusting for a range of known risk factors (OR 1.80 (1.47-2.21); 2.16 (1.57-2.98); 1.20 (0.94-1.54) and 1.40 (1.19-1.64), respectively). Cd was not associated with kidney dysfunction (OR 0.99 (0.81-1.21)), or acephate (OR 0.43 (0.13-1.48)).

Conclusions

Chronic or acute pesticide exposure may increase the risk of kidney dysfunction, which is not related to hypertension or diabetes in particular. It may have a different pathological pathway from heavy metal exposures and CKD. This has repercussions for interventions in LMIC agricultural practices.

Key messages

Pesticides are associated with kidney dysfunction not related to hypertension and diabetes.