ABSTRACT
Reduction of the under-5 mortality rate is a target of the Sustainable Development Goals. Therefore, this study aimed to estimate under-5 child mortality rates in 52 low-migration countries using population data. The study utilized population data from the US Census Bureau from 1990 to 2015. The method involved first estimating mortality rates for countries with negligible net migration and then applying these rates to countries with matching mortality profiles, where it is reasonable to assume that migration is negligible for children under the age of 5 years. The highest child mortality was concentrated in the African region, followed by Asia and the Western region. However, steady progress in child mortality trends was concentrated in low-income countries. This simple method demonstrated that child mortality has significantly improved in high-income countries, followed by middle- and low-income countries. To reduce the under-5 mortality rates even further in these 52 countries, there is a need to accelerate equitable plans and policies related to child health to promote children's longevity and survival.
ABSTRACT
OBJECTIVES@#Stillbirth is a common adverse pregnancy outcome that represents a distressing and traumatic event for women and their partners. The aim of this study was to identify factors associated with stillbirth in ever-pregnant women in Nepal.@*METHODS@#This study utilized the individual women's dataset from the Nepal Demographic and Health Survey, conducted in 2016. The dependent variable of interest was whether women had at least 1 stillbirth during their lifetime. The associations between independent variables and the dependent variable of the study were analyzed using a multiple logistic regression model.@*RESULTS@#Among 8918 ever-pregnant women aged 15-49 years, 488 had experienced at least 1 stillbirth during their lifetime, representing 5.5% of the total. After adjusting each factor for the confounding effects of other factors, maternal age, maternal education, place of residence, and sub-region remained significantly associated with having experienced stillbirth.@*CONCLUSIONS@#Stillbirth continues to be a major problem among women, especially those with higher maternal age, those who are illiterate, and residents of certain geographical regions. To minimize stillbirth in Nepal, plans and policies should be focused on women with low education levels and residents of rural areas, especially in the western mountain and far-western hill regions.
ABSTRACT
OBJECTIVES: Stillbirth is a common adverse pregnancy outcome that represents a distressing and traumatic event for women and their partners. The aim of this study was to identify factors associated with stillbirth in ever-pregnant women in Nepal. METHODS: This study utilized the individual women's dataset from the Nepal Demographic and Health Survey, conducted in 2016. The dependent variable of interest was whether women had at least 1 stillbirth during their lifetime. The associations between independent variables and the dependent variable of the study were analyzed using a multiple logistic regression model. RESULTS: Among 8918 ever-pregnant women aged 15-49 years, 488 had experienced at least 1 stillbirth during their lifetime, representing 5.5% of the total. After adjusting each factor for the confounding effects of other factors, maternal age, maternal education, place of residence, and sub-region remained significantly associated with having experienced stillbirth. CONCLUSIONS: Stillbirth continues to be a major problem among women, especially those with higher maternal age, those who are illiterate, and residents of certain geographical regions. To minimize stillbirth in Nepal, plans and policies should be focused on women with low education levels and residents of rural areas, especially in the western mountain and far-western hill regions.
Subject(s)
Female , Humans , Pregnancy , Dataset , Education , Health Surveys , Logistic Models , Maternal Age , Nepal , Pregnancy Outcome , Pregnant Women , StillbirthABSTRACT
@#Introduction: Malnutrition is one of the leading causes of childhood death. In the southern provinces of Thailand that are encountering a civil conflict, the extent of malnutrition among young children has not been adequately reported. Methods: A cross-sectional study was undertaken to assess the nutritional status of children aged 2-5 years enrolled in early childhood development centres (ECDC) in Pattani Province. A total of 112 ECDCs were randomly selected and 871 children who met the inclusion criteria were recruited. Anthropometric measurements were taken and nutritional status determined according to World Health Organization (2006) growth standards. Statistical analyses of nutritional indicators, namely wasting, stunting, underweight and Composite Index of Anthropometric Failure (CIAF) across sociodemographic variables were carried out. Binary logistic regression models, based on the different nutritional indicators, were used to determine the relationships between undernutrition status and associated factors. Results: Prevalence of wasting (7.7%), stunting (19.6%) and underweight (16.8%) were determined. Based on CIAF, 27.4% of the children were undernourished. Logistic regression odds showed that prevalence of all forms of undernutrition was statistically independent of sex and place of residence. Religion was associated with all four indicators of undernutrition. Stunting was associated with child’s age and religion, while underweight and CIAF were associated with the child’s age, religion and mother’s occupation. Conclusion: Prevalence of undernutrition was estimated to be high in comparison with the national average figure. The study findings highlighted the need for more effective nutrition promotion activities to alleviate undernutrition problems among young children in Pattani Province.
ABSTRACT
<p><b>OBJECTIVE</b>To understand the perception for the use of cataract surgical services in a population of acceptors and non-acceptors of cataract surgery in urban Beijing.</p><p><b>METHODS</b>From a community-based screening program a total of 158 patients with presenting visual acuity of less than 6/18 on either eye due to age-related cataract were informed about the possibility of surgical treatment. These patients were interviewed and re-examined 36 to 46 months after initial screening. The main reasons for not accepting surgery were obtained using a questionnaire. Vision function and vision-related quality of life scores were assessed in those who received and did not receive surgery.</p><p><b>RESULTS</b>At the follow-up examination 116 of the 158 patients were available and 36 (31.0%) had undergone cataract surgery. Cases who chose surgery had higher education level than those who did not seek surgery (OR=2.64, 95% CI: 1.08-6.63, P=0.02). There were no significant differences in vision function (P=0.11) or quality of life scores (P=0.16) between the surgery group and the non-surgery group. Main reasons for not having surgery included no perceived need (50.0%), feeling of being "too old" (19.2%), and worry about the quality of surgery (9.6%). Cost was cited by 1 (1.9%) subject as the main reason for not seeking surgery.</p><p><b>CONCLUSIONS</b>The data suggest that in China's capital urban center for patients with moderate visual impairment there is a relative low acceptance rate of cataract surgery, mainly due to people's perception of marginal benefits of surgery. Cost is not a determining factor as barrier to undergo surgery and patients with poorer education are less likely to undertake surgery.</p>
Subject(s)
Aged , Animals , Female , Humans , Male , Aging , Pathology , Cataract , Cataract Extraction , China , Follow-Up Studies , Urban Population , Vision DisordersABSTRACT
<p><b>OBJECTIVE</b>To identify the possible association between C(-106)T polymorphism of the aldose reductase (ALR) gene and diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>From November 2009 to September 2010, patients with T2DM were recruited and assigned to DR group or diabetic without retinopathy (DWR) group according to the duration of diabetes and the grading of 7-field fundus color photographs of both eyes. Genotypes of the C(-106)T polymorphism (rs759853) in ALR gene were analyzed using the MassARRAY genotyping system and an association study was performed.</p><p><b>RESULTS</b>A total of 268 T2DM patients (129 in the DR group and 139 in the DWR group) were included in this study. No statistically significant differences were observed between the 2 groups in the age of diabetes onset (P=0.10) and gender (P=0.78). The success rate of genotyping for the study subjects was 99.6% (267/268), with one case of failure in the DR group. The frequencies of the T allele in the C(-106)T polymorphism were 16.0% (41/256) in the DR group and 19.4% (54/278) in the DWR group (P=0.36). There was no significant difference in the C(-106)T genotypes between the 2 groups (P=0.40). Compared with the wild-type genotype, odds ratio (OR) for the risk of DR was 0.7 (95% CI, 0.38-1.3) for the heterozygous CT genotype and 0.76 (95% CI, 0.18-3.25) for the homozygous TT genotype. The risk of DR was positively associated with microalbuminuria (OR=4.61; 95% CI, 2.34-9.05) and insulin therapy (OR=3.43; 95% CI, 1.94-6.09).</p><p><b>CONCLUSIONS</b>Microalbuminuria and insulin therapy are associated with the risk of DR in Chinese patients with T2DM. C(-106)T polymorphism of the ALR gene may not be significantly associated with DR in Chinese patients with T2DM.</p>