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Background: Given the improvement in life expectancy of people living with HIV (PLWH) in sub-Saharan Africa, the risk of asymptomatic HIV-associated neurocognitive disorder (HAND) has increased. The study objectives were to investigate the prevalence of HAND and associated factors among treatment experienced adults in Ethiopia. Methods: A single-center observational cross-sectional study was conducted between December 2019 and June2020 to investigate HAND. International HIV dementia scale (IHDS) was used to screen for the disorder. Both descriptive and analytical statistics were used to analyze the data. Results: Total of 324 PLWH (63% females) who were on combination antiretroviral therapy for median of 144months (IQR: 108-168) were investigated. The mean age was 42.5 years (1SD=12.2). The prevalence of HAND was 75.3% and the difference was significantly more in those above 40 years of age (65.8% vs. 80.7%, p=0.003). Age is the only risk factor identified with multivariable logistic regression analysis. A linear decrement in the total score of cognitive performance was observed as the patient's age increase; age was responsible for 9.4% variation observed in IHDS score (r= -0.31, R2=0.094, p<0.0001). Although statistically not-significant, the trend for cardio-metabolic and behavioral risk factors (hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol and khat use) was higher in the group diagnosed with HAND. Conclusion: The occurrence of neurocognitive impairment was more pronounced in individuals aged 40 years and above who were HIV positive, compared to those below 40 years. Age was found to be an independent predictor of HAND. Cardiovascular and behavioral risk factors were observed more among patients with HAND compared to no-HAND
Subject(s)
Humans , Male , Female , Cognitive DysfunctionABSTRACT
Objective@#To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35-74 years.@*Methods@#Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey. Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China. A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes, with participants nested within districts/counties.@*Results@#A total of 69,332 participants aged 35-74 years, from 158 districts/counties were included in the analysis. Concentrations of selenium in soil varied greatly across the 158 districts/counties, with a median concentration of 0.219 mg/kg ( : 0.185-0.248). The results showed that both Quartile 1 (0.119-0.185 mg/kg) and Quartile 4 (0.249-0.344 mg/kg) groups were positively associated with diabetes compared to a soil selenium concentration of 0.186-0.219 mg/kg (Quartile 2), crude odds ratios ( s) (95% ) were 1.227 (1.003-1.502) and 1.280 (1.048-1.563). The values were 0.045 and 0.013, for Quartile 1 and Quartile 4 groups, respectively. After adjusting for all confounding factors of interest, the Quartile 1 group became non-significant, and the Quartile 4 group had an adjusted (95% ) of 1.203 (1.018-1.421) relative to the reference group (Quartile 2), the values was 0.030. No significant results were seen for the Quartile 3 group (0.220-0.248 mg/kg) compared to the reference group.@*Conclusion@#Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35-74 years.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , China , Epidemiology , Diabetes Mellitus , Epidemiology , Diet , Logistic Models , Odds Ratio , Risk Factors , Selenium , Metabolism , Soil , ChemistryABSTRACT
Introdução: As doenças crônicas não transmissíveis (DCNT) têm acarretado grande número de mortes prematuras, incapacidades e perda da qualidade de vida entre as mulheres, mesmo elas sendo as principais usuárias do sistema de saúde. Ao longo dos anos, os processos de urbanização e globalização contribuíram para o aumento dos fatores de risco comportamentais (FRC), elevando a prevalência das DCNT. Sabe-se que os FRC para DCNT afetam a saúde da mulher, inclusive a sua capacidade reprodutiva, ocasionando desfechos reprodutivos negativos. Objetivos: Estimar a prevalência e os fatores sociodemográficos e de acesso à ocorrência e coocorrência dos fatores de risco comportamentais para doenças crônicas não transmissíveis na população de mulheres em idade reprodutiva. Metodologia: Estudo transversal que utilizou dados das mulheres brasileiras em idade reprodutiva, que responderam à Pesquisa Nacional de Saúde (PNS), em 2013. Estimou-se a ocorrência e coocorrência dos seguintes FRC: consumo insuficiente de frutas, verduras e legumes (FLV), inatividade física, consumo de álcool e tabagismo. Em seguida, estimou-se prevalências e razões de prevalência da ocorrência e coocorrência dos FRC, de acordo com as características sociodemográficas (faixa etária, escolaridade, região, zona de moradia, cor da pele/raça, estado civil) e de acesso, utilizando a combinação das variáveis plano de saúde e Papanicolau. Estimou-se também a prevalência da autoavaliação de saúde de acordo com FRC. Foram calculados os intervalos de 95% de confiança das estimativas. Utilizou-se Regressão de Poisson para estimar a razão de prevalência. Considerou-se o desenho amostral complexo do inquérito para obter estimativas populacionais. Resultados: Dentre as mulheres estudadas, mais de 70% apresentaram consulta recente no serviço de saúde. Entretanto, 89% das mulheres apresentaram consumo insuficiente de FLV; 79,9% eram inativas; 18,8% consumiam álcool; 9,7% eram tabagistas, 10% ex-tabagistas e mais da metade das mulheres apresentavam acúmulo de dois ou mais fatores de risco (65,3%). Mulheres com maior escolaridade, residentes na região Sul, que viviam na zona urbana, bem como com consulta recente no serviço privado apresentaram maior prevalência de consumo de álcool (p<0,05). Mulheres na faixa etária de 40-49 anos, com menor escolaridade e com consulta recente no serviço público apresentaram maior prevalência de inatividade física (p<0,05). Para o tabaco houve menor prevalência entre ambos os grupos de acordo com o acesso (p<0,05). Mesmo na presença de FRC, as mulheres autoavaliaram sua saúde majoritariamente como positiva. Conclusões: A maioria das mulheres brasileiras em idade reprodutiva tem acesso a uma consulta de saúde da mulher, contudo foi identificada alta ocorrência e coocorrência de FRC. Também foi identificada alta ocorrência e coocorrência de acordo com as características sociodemográficas, principalmente nas mulheres mais velhas e com baixa escolaridade. Sabe-se que esses FRC podem interferir na saúde pré-concepcional das mulheres que desejam ou não engravidar, reforçando a necessidade de ações de promoção da saúde que devem ser incorporadas às rotinas de assistência à mulher.(AU)
Introduction: Chronic noncommunicable diseases (NCDs) have led to a high number of premature deaths, disabilities and loss of quality of life among women, even though they are the main users of the health system. Over the years, urbanization and globalization processes have contributed to the increase of behavioral risk factors (BRF), raising the prevalence of NCDs. We known that BRFs for NCDs affect women's health, including their reproductive capacity, leading to negative reproductive outcomes. Objectives: To estimate the prevalence and associated factors (sociodemographic and access) to the occurrence and co-occurrence of behavioral risk factors for chronic non-communicable diseases in the reproductive age women population. Methodology: Cross-sectional study using data from Brazilian women of reproductive age who responded to the National Health Survey (PNS), in 2013. We estimated the ocurrence and co-occurrence of the following BRFs: insufficient consumption of fruits and vegetables (FLV), physical inactivity, alcohol consumption and smoking. Next, we estimated prevalence and prevalence ratios of BRF occurrence and co-occurrence according to socio-demographic characteristics (age range, schooling, region, dwelling area, skin color / race, marital status) and access using the combination of health plan and pap smear variables. It was also estimated the prevalence of health self-assessment according to the BRF. The 95% confidence intervals of the estimates were also calculated. Poisson regression was used to estimate the prevalence ratios. We considered the complex sample design of the survey to obtain population estimates. Results: Among the women studied, more than 70% had a recent consultation in the health service. However, 89% of the women had insufficient FLV consumption; 79.9% were inactive; 18.8% consumed alcohol; 9.7% were smokers and 10%, former smokers. More than half of the women had an accumulation of two or more risk factors (65.3%). Women with higher levels of schooling, living in the South, who lived in the urban area, as well as with a recent consultation in the private service, showed a higher prevalence of alcohol consumption (p <0.05). Women in the age group 40-49, with lower schooling and with a recent public service consultation had a higher prevalence of physical inactivity (p <0.05). For tobacco, there was lower prevalence between both groups according to access (p <0.05). Even in the presence of BRF, women self-rated their health as positive. Conclusions: Most Brazilian women of reproductive age had access to a women's health consultation, however, a high occurrence and co-occurrence of BRF has been identified. High occurrence and second co-occurrence were also identified according to sociodemographic characteristics, especially in older women with low schooling. It is known that these BRFs may interfere with the preconceptional health of women who wish to become pregnant or not, reinforcing the need for health promotion interventions that should be incorporated into women's health care routines.(AU)
Subject(s)
Humans , Female , Adult , Chronic Disease/epidemiology , Risk Factors , Women's Health , Socioeconomic Factors , Tobacco Use Disorder , Exercise , Eating , Academic DissertationABSTRACT
OBJECTIVE: This study describes exposure labor among Brazilian 9th grade students from public and private schools and investigates socio-demographic characteristics, behaviors, violent situations and psychosocial factors associated with labor among adolescents. METHODS: The present study included 108,984 students from the National Adolescent School-based Health Survey carried out in 2012. Variables were grouped into sociodemographic characteristics, behavioral factors, violent situations and psychosocial aspects. Associations between labor and several health risk variables were identified by multiple logistic regression analysis, after adjustment for sex and age. RESULTS: Approximately 13% of the students reported having a job: 17.4% of them were male. The chance of working was lower between females and individuals whose fathers' have incomplete superior education. Students who worked had greater chances to smoke (OR = 2.26; 95%CI 2.04 - 2.51), drink alcohol, use illicit drugs (OR = 2.63; 95%CI 2.29 - 3.02), drive motorized vehicles (OR = 2.15; 95%CI 2.03 2.27), have sexual intercourse (OR = 2.10; 95%CI 1.99 - 2.24), suffer physical violence (OR = 1.57; 95%CI 1.46 1.68), engage in fights (OR = 1.65; 95%CI 1.55 - 1.76), feel lonely (OR = 1.26; 95%CI 1.17 - 1.36) and report sleeping problems (OR = 1.46; 95%CI 1.34 - 1.60). They also have lower chances of having close friends (OR = 0.78; 95%CI 0.68 - 0.90). CONCLUSION: The prevalence of labor among students is high. Socioeconomical disadvantages increase the chances of early working. Early working is also associated to health damaging behavior, violent situations, sleeping problems, and social isolation. Adolescents who study and work experiment expositions that may affect distinct health dimensions and perpetuate disadvantages over lifetime. .
OBJETIVOS: Descrever a prevalência de trabalho em estudantes da 9ª série do ensino fundamental de escolas públicas e privadas brasileiras e investigar as características sociodemográficas, comportamentos relacionados à saúde, situações de violência e aspectos psicossociais associados ao trabalho. MÉTODOS: Foram utilizados dados da PeNSE 2012 e investigadas associações independentes entre características sociodemográficas e trabalho e a associação entre trabalho e fatores comportamentais e de proteção à saúde, situações de violência e aspectos psicossociais, ajustadas por sexo e faixa etária. Utilizou-se regressão logística binária para obter o Odds Ratio e seu intervalo de confiança de 95%. RESULTADOS: Foram incluídos 108.984 estudantes. Deste total, 13,1% trabalhavam: 17,4% eram meninos e 22,1% tinham 16 anos ou mais. A chance de trabalhar foi menor entre as meninas e entre aqueles com escolaridade paterna com nível universitário incompleto, e maior entre alunos das escolas públicas. Após ajuste por sexo e idade, os alunos que trabalhavam tiveram maior chance de tabagismo (OR = 2,26; IC95% 2,04 - 2,51), consumo de álcool, drogas ilícitas (OR = 2,63; IC95% 2,29 - 3,02), direção de veículo motorizado (OR = 2,15; IC95% 2,03 - 2,27), relação sexual (OR = 2,10; IC95% 1,99 - 2,24), sofrer agressão física (OR = 1,57; IC95% 1,46 - 1,68), envolvimento em briga (OR = 1,65; IC95% 1,55 - 1,76), sofrer ferimentos, sentir-se só e dificuldade em dormir, além de menor chance de ter amigos próximos (OR = 0,78; IC95% 0,68 - 0,90). CONCLUSÃO: A prevalência de trabalho é elevada. Desvantagens socioeconômicas aumentam a chance de trabalho precoce. Este também está associado a comportamentos ...
Subject(s)
Adolescent , Child , Female , Humans , Male , Child Health , Employment/statistics & numerical data , Brazil , Health Surveys , Risk Factors , Risk-Taking , Schools , Socioeconomic Factors , Surveys and Questionnaires , Violence/statistics & numerical dataABSTRACT
Objetivos: Determinar los factores de riesgo conductuales que se relacionan con bacteriuria asintomática en gestantes. Diseño: Estudio caso control incidente. Institución: Hospital Daniel Alcides Carrión, Callao, Perú. Participantes: Gestantes. Intervenciones: Entre julio 2010 y junio del 2011 se realizó un estudio de gestantes con urocultivo positivo y sin síntomas de infección urinaria (casos) y gestantes con urocultivo negativo y sin síntomas de infección urinaria (controles). Se utilizó el chi cuadrado y una regresión logística bivariada para ver la asociación y finalmente una regresión logística multivariada con edad, procedencia, grado de instrucción, estado civil, ocupación, paridad y uso de sonda vesical. Principales medidas de resultados: Factores de riesgo conductuales de bacteriuria asintomática. Resultados: Se observó asociación entre los siguientes: a) reprimir la micción y la bacteriuria asintomática, con ORcrudo 3,694 (IC 95%: 2,556 a 5,356); al ajustar el odds ratio (OR) por probables variables confusoras, la asociación se mantuvo, OR: 3,4766 (3,057 a 7,421); b) entre relación sexual diaria y bacteriuria asintomática, con ORcrudo 1,883 (1,260 a 2,842); al ajustar por las mismas variables el ORajustado 1,729 (1,118 a 2,675), se mantuvo de manera significativa. No se encontró asociación entre bacteriuria asintomática e higiene menor de seis veces por semana. Conclusiones: La frecuencia de bacteriuria asintomática fue tres veces mayor en gestantes que retuvieron la orina, y las gestantes que tenían relaciones sexuales diarias tuvieron 70% mayor posibilidad de hacer bacteriuria asintomática. Es recomendable considerar estos resultados en la consejería de la gestante.
Objectives: To determine behavioral risk factors related to asymptomatic bacteriuria in pregnant women. Design: Case control study. Setting: Daniel Alcides Carrion National Hospital, Callao, Peru. Participants: Pregnant women. Interventions: From July 2010 through June 2011 pregnant women with positive urine cultures and without urinary tract infection (cases) and asymptomatic pregnant women with negative urine culture (controls) were studied. Chi square and bivaried logistic regression were used for association and multivaried logistic regression with age, origin, education level, marital status, occupation, parity and use of bladder catheter. Main outcome measures: Behavioral risk factors for asymptomatic bacteriuria. Results: Association was found between: a) restraining voiding and asymptomatic bacteriuria, ORcrude 3.694 (95% CI: 2.556- 5.356); association remained when adjusting odds ratio (OR) for probable confounding variables, OR: 3.4766 (3.057- 7.421); b) daily coitus and asymptomatic bacteriuria, ORcrude 1.883 (1.260-2.842); adjusted ORadjusted 1.729 (1.118-2.675) maintained significantly. No association between asymptomatic bacteriuria and hygiene less than six weeks per week was found. Conclusions: Frequency of asymptomatic bacteriuria was three times higher in pregnant women that retained from voiding, and pregnant women who had coitus daily had 70% more possibility of presenting asymptomatic bacteriuria. It is advisable to consider these findings in counseling pregnant women.
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OBJECTIVE: Stroke is a major cause of mortality throughout the world and several studies have reported survival experience following stroke in different populations. This study estimates the prevalence of behavioral risk factor after stroke and explores lifestyle changes. METHOD: The subjects were 529 patients, who were admitted at the Kyung Hee Medical Center from January 2000 to February 2001. Data collection was done through chart reviews, telephone interviews, and mail. Main measures included smoking status, alcohol use, and obesity. Chisquare test and multiple logistic regression were used to determine sociodemographic differences in these measures. RESULTS: At 1 year after stroke, 11.2% of patients still smoked, 31.4% of patients were obese, and 13% drank excessively. Younger patients and patients with high blood pressure were more likely to smoke. Younger patients were more likely to drink excessively. Women, patients with diabetes, and those living in the metropolitan areas were more likely to be obese. CONCLUSION: Different behavioral risk factors were associated with specific sociodemographic groups within the stroke population. After stroke, high-risk groups should continue to be targeted to prevent stroke recurrence.