Effect of Household Air Pollution on Blood Pressure – A Review.

High blood pressure (BP) remains a public health issue of concern in low- and middle-income countries (LMICs). Cooking with solid biomass fuel is common in LMICs, producing hazardous levels of household air pollution (HAP), and exposure to which results in significant morbidity and mortality. The primary victims are women, who are the immediate users. Therefore, a potential relationship between these factors would have massive public health reverberations. Our objective was thus to perform a literature review of the studies investigating the association between HAP and BP in women. We searched the PubMed, CORE, and Semantic Scholar databases from inception through March 2022 to identify reports investigating the relationship between BP and HAP from solid fuel use. The studies included in this report point to an increased risk of high BP from HAP generated as a consequence of using solid fuels for cooking. Conversely, few studies have reported a negative association between HAP and BP. Notably, this inconsistency and the limited evidence base necessitate confirmation of the association by more extensive and robust studies. Further, this report identifies a need to introduce and implement effective clean cooking solutions for public health benefits.

Medición de la situación de inseguridad alimentaria a nivel del hogar en los municipios de cobertura del Ejercicio Profesional Supervisado de la Escuela de Nutrición de la Universidad de San Carlos de Guatemala / Measurement of the situation of food insecurity at the household level in the municipalities covered by the Supervised professional Exercise of the School of Nutrition of the San Carlos of Guatemala

La inseguridad alimentaria (INSA) es la condición que resulta de un acceso incierto o nulo a alimentos nutricionalmente adecuados socialmente aceptables y/o insuficiente ingestión de alimentos. Las causas de la INSA son múltiples y difieren en cada país, entre ellas están inadecuado acceso, y disponibilidad a los alimentos nutricionalmente adecuados y a los capitales de desarrollo. Según los resultados de la Encuesta Nacional de Condiciones de Vida del 2014, la INSA afecta a más de la mitad de la población guatemalteca con repercusiones en su calidad de vida y desarrollo. El objetivo de la investigación fue determinar el nivel de INSA en hogares de los 29 municipios pertenecientes a 12 departamentos de cobertura del EPS de la Universidad de San Carlos de Guatemala. Se realizó un estudio de tipo cuantitativo, descriptivo, transversal, utilizando la metodología de recolección, validación y análisis de información establecida en el Manual de la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA). La muestra fue de 2,750 hogares, obtenida por medio de un muestreo probabilístico para poblaciones finitas. Los datos analizados fueron desagregados según sexo y edad de jefe de hogar, lugar de residencia, número de miembros en el hogar y presencia de menores de 18 años. La investigación mostró que, al momento de la entrevista, 2,035 (74%) [72.3, 75.7] hogares fueron clasificados en situación de INSA. Se presentó un mayor porcentaje de INSA en los hogares del área rural (85% [82.5, 87.4]) y en los hogares con niños menores de 18 años (80% [78.0, 81.5]). También se observó que, a mayor número de miembros del hogar, mayor porcentaje de INSA. Con los resultados obtenidos, se pretende motivar la implementación de estrategias que coadyuven a mejorar la situación de INSA en la población.

Food insecurity (FI) is the condition that results from uncertain or no access to socially acceptable, nutritionally adequate foods and/or insufficient food intake. The causes of FI are multiple and differ in each country, among them are inadequate access and availability to adequate nutritional foods and development capital. According to the results of the 2014 National Survey of Living Conditions, FI affects more than half of the Guatemalan population.The objective of the research was to determine the level of FI at household level of the 29 municipalities belonging to 12 departments covered by the Nutrition Supervised Professional Practice of the University of San Carlos of Guatemala, through a quantitative, descriptive, cross-sectional study, using the collection, validation and analysis of information established in the Manual of the Latin American and Caribbean Food Security Scale. The sample was 2,750 households, obtained by means of a probabilistic sampling for finite populations. The data analyzed were disaggregated according to the sex and age of the head of the household, place of residence, number of members in the household, and presence of children under 18 years of age. The investigation showed that, at the time of the interview, 2,035 (74%) [72.3, 75.7] households were classified as FI. There was a higher percentage of FI in households in rural areas (85% [82.5, 87.4]) and in households with children under 18 years of age (80% [78.0, 81.5]). It is intended that the results of this study contribute to motivate the implementation of strategies that help to improve the situation of FI in the evaluated population.

Morbidity Pattern among the Farm House Residents in Vijayapur District, Karnataka � A Cross Sectional Study

Background : Agriculture Workers have a multitude of health problems, a fact which is often forgotten because of widespread misconception that occupational health is mainly concerned with industry and industrialized countries. The health problems of workers in agricultural field may be accidents (Snake and insect bites), toxic hazards (chemical exposure and insecticide poisoning), physical hazards (extreme conditions and solar radiation) and respiratory problems (farmer抯 lung and occupational asthma). Objectives : To study the morbidity pattern among the Farm house residents. Material and Methods : A cross sectional study was conducted among the farm house residents in rural areas of Vijayapura district. A Sample of 450 farm house residents were interviewed by pre-structured proferma containing information regarding Socio demographic profile, present and past six months morbidities. In each Taluka, the selection of households was done by considering villages as the Primary Sampling Unit (PSU). PSUs were selected with probability proportional to size sampling and 5 households in a selected PSU were selected by random sampling.All characteristics were summarized descriptively, Chi-square (?2) test was employed to determine the significance of differences between groups for categorical data. Results : The findings of the present study among Farm dwellers in the rural area of vijayapura district revealed that majority at the time of study were having Anaemia followed by Respiratory Infection and majority of Farm dwellers in past six months were having Dental carries as a morbidity followed by Respiratory infection. Conclusion : The present study concludes that overall majority of the Farm house residents presently suffering from Non-communicable Diseases (54%) followed by Communicable Diseases (46%).

Household Characteristics, Cost of Illness and Coping Mechanism of Families of Hospitalized Acute Encephalitis Syndrome Children: A Mix Method Study

Background: AES is responsible for causing high social and economic burden to the affected families. The study was conducted to know the household characteristics, cost of illness and coping strategy adopted by the family members of AES children admitted to a tertiary care facility in Assam, India. Methods: It was a sequential exploratory mixed method study, with a cross-sectional survey among AES chil-dren and their guardians, followed by In Depth interview. Results: Out of 51 cases 55% were male. The median age was 11 years. 53% of the families belonged to lower socioeconomic class. 96% of families reported to reside in rural areas. Commonly reported household assets were mobile phone 94%, bicycle 86%, television 31% and motorcycle 29%. Three major themes were emerged to contribute towards economic burden. The first major theme is “Direct cost” due to patient trans-portation cost (mean Rs 1161.00) and hospital costs: mostly due to medicinal cost (mean Rs1955.00), investi-gational cost (mean Rs 2920.00) and food cost (mean Rs 8375.00). The second theme “Indirect cost” is due to work days loss: 100% care providers had missed work days during hospital stay of their children and 84% had missed work days during post hospital care. The third theme is “Inherent cost spotted through coping mechanisms” which mostly 94% included borrowing money from the market and 31.4% selling household assets. Conclusion: Cost of illness is a huge burden to the AES afflicted families which demands reforms in health care financing and reimbursement in current context.

Transmisión domiciliaria de SARS-CoV-2: revisión sistemática y metaanálisis

Introducción: Las políticas de salud pública para la disminución de la incidencia, transmisión y mortalidad de la COVID-19 se enfocan en medidas extradomiciliarias y descuidan el contagio dentro del hogar. El objetivo fue estimar la tasa de ataque secundario domiciliario de SARS-CoV-2. Material y Métodos: Se realizó una revisión sistemática de estudios observacionales que evaluaron la transmisión domiciliaria de SARS-CoV-2 publicados entre diciembre de 2019 y el 1 setiembre de 2021 en las bases de datos Medline, Scopus, LILACS y Google Scholar. La definición de contacto domiciliario se refirió a toda persona que habitaba la misma vivienda que el paciente índice. El riesgo de sesgo fue evaluado con una versión modificada de la escala Newcastle-Ottawa. Se realizó un metaanálisis con un modelo de efectos aleatorios para calcular la tasa de ataque domiciliaria, subanálisis con variables sociodemográficas, epidemiológicas y comorbilidades, así como metaregresión. Resultados: De 4491 estudios encontrados, 44 fueron incluidos en el análisis. La tasa de ataque secundario domiciliario general fue de 27.7% (IC95%: 23% 32.7%). Además, fue mayor cuando el caso índice era sintomático (28.3%, IC95%: 8.1% 54.7%) o el contacto era adulto mayor (42.3%, IC95%: 32% 52.9%). Asimismo, la tasa fue mayor cuando los contactos domiciliarios presentaban diabetes mellitus (57.4%, IC95%: 45.2% 69.3%) e hipertensión arterial (51.1%, IC95%: 38% 64.1%). Conclusiones: La tasa de ataque secundario domiciliario de SARS-CoV-2 fue de 27.7%, siendo mayor al tener un caso índice adulto, contacto adulto mayor y contacto con diabetes mellitus o hipertensión arterial.

Background: Public health policies for decreasing the incidence, transmission, and mortality of COVID-19 focus on extradomiciliary measures and neglect transmission within the home. We aimed to estimate the rate of secondary home attack of SARS-CoV-2. Material and Methods: We conducted a systematic review of observational studies that evaluated home transmission of SARS-CoV-2 published between December 2019 and September 1, 2021 in Medline, Scopus, LILACS, and Google Scholar databases. The definition of household contact referred to any person living in the same house as the index patient. The risk of bias was assessed with a modified version of the Newcastle-Ottawa tool. A meta-analysis was performed with a random-effects model to calculate the household attack rate, subanalysis with sociodemographic, epidemiological variables, and comorbidities, as well as meta-regression. Results: Of 4491 studies found, 44 were included in the analysis. The overall household secondary attack rate was 27.7% (95%CI: 23% 32.7%). Furthermore, it was higher when the index case was symptomatic (28.3%, 95%CI: 8.1% 54.7%) or the contact was an older adult (42.3%, 95%CI: 32% 52.9%). Likewise, the rate was higher when the household contacts had diabetes mellitus (57.4%, 95%CI: 45.2% 69.3%) and arterial hypertension (51.1%, 95%CI: 38% 64.1%). Conclusions: The SARS-CoV-2 household secondary attack rate was 27.7%, being higher when there was an adult index case, older adult contact and contact with diabetes mellitus or hypertension.

Clinical characteristics of family clustering pediatric and adult cases with severe acute respiratory syndrome coronavirus 2 Omicron variant infection / 中华传染病杂志

Objective:To investigate the clinical characteristics of family clustering pediatric and adult cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection in Shanghai City.Methods:A field investigation among the pediatric cases with Omicron variant infection and their household contacts from April 4 to April 30, 2022 in Children′s Hospital of Fudan University was conducted. The informations on case finding, clinical manifestations and SARS-CoV-2 vaccination status were collected. The epidemiological and clinical characteristics were compared between pediatric cases and adult cases. The independent sample t test or chi-square test was used for statistical analysis, and the relative risk ( RR) and 95% confidence interval (95% CI) were used to evaluate the protective effect of vaccination on the infection of Omicron variant. Results:There were 1 274 family members in 297 families including 370 children and 904 adults of whom 1 110(87.13%) were infected with Omicron variant, with 989(89.10%) symptomatic and 121(10.90%) asymptomatic. There were 355 children infected with Omicron variant, of whom 337(94.93%) were symptomatic, and the main manifestations were fever (96.74%(326/337)) and cough (40.36%(136/337)). Only one pediatric case with Rett syndrome developed critically severe pneumonia. A total of 194 pediatric cases had imaging examination, 64(32.99%) showed pulmonary inflammatory lesions. There were 755 adult cases infected with Omicron variant, of whom 652(86.26%) reported symptoms, and the main manifestations were fever (73.16%(477/652)) and cough (49.85%(325/652)). Among symptomatic cases, fever was more common in pediatric cases than in adult cases, while cough was more common in adult cases than in pediatric cases, and the differences were both statistically significant ( χ2=80.87 and 8.04, respectively, both P<0.01). The fever spike was higher in pediatric cases than in adult cases ((39.3±0.7) ℃ vs (38.6±0.6) ℃), and the difference was statistically significant ( t=9.85, P<0.001). The interval from the onset of symptoms to cycle threshold (Ct) value of the nucleic acid of Omicron variant≥35 was longer in pediatric cases than in adult cases ((13.0±3.1) d vs (10.9±3.6) d), and the difference had statistically significance ( t=2.97, P=0.004). Among 160 children aged 3 to 18 years, 54 (33.75%) received two-dose vaccination. Among the 904 adults, 388 (42.92%) received two-dose vaccination and 293 (32.41%) received a booster dose. In the adult cases, the risk of symptomatic infection was reduced by only 8% ( RR=0.92, 95% CI 0.86 to 0.98, P=0.014) following two-dose vaccination, and the risks of fever and cough following booster vaccination were reduced by 42%( RR=0.58, 95% CI 0.49 to 0.67, P=0.001) and 50% ( RR=0.50, 95% CI 0.34 to 0.78, P=0.001), respectively. Conclusions:Secondary attack rate and symptomatic rate of household infection are high in the context of the Omicron variant outbreak in Shanghai. Symptomatic infection is common in children and adults in household setting. Fever is the most common symptom and fever duration is short. Booster vaccination may provide certain protection against common symptoms caused by Omicron variant infection.

Characteristics and Differences of Household Fine Particulate Matter Pollution Caused by Fuel Burning in Urban and Rural Areas in China / 中国医学科学院学报

Objective To explore the overall level,distribution characteristics,and differences in household fine particulate matter (PM2.5) pollution caused by fuel burning in urban and rural areas in China. Methods The relevant articles published from 1991 to 2021 were retrieved and included in this study.The data including the average concentration of household PM2.5 and urban and rural areas were extracted,and the stoves and fuel types were reclassified.The average concentration of PM2.5 in different areas was calculated and analyzed by nonparametric test. Results The average household PM2.5 concentration in China was (178.81±249.91) μg/m3.The mean household PM2.5 concentration was higher in rural areas than in urban areas[(206.08±279.40) μg/m3 vs. (110.63±131.16) μg/m3;Z=-5.45,P<0.001] and higher in northern areas than in southern areas[(224.27±301.66) μg/m3 vs.(130.11±140.61) μg/m3;Z=-2.38,P=0.017].The north-south difference in household PM2.5 concentration was more significant in rural areas than in urban areas[(324.19±367.94) μg/m3 vs.(141.20±151.05) μg/m3,χ2=-5.06,P<0.001].The PM2.5 pollution level showed differences between urban and rural households using different fuel types (χ2=92.85,P<0.001),stove types (χ2=74.42,P<0.001),and whether they were heating (Z=-4.43,P<0.001).Specifically,rural households mainly used solid fuels (manure,charcoal,coal) and traditional or improved stoves,while urban households mainly used clean fuels (gas) and clean stoves.The PM2.5 concentrations in heated households were higher than those in non-heated households in both rural and urban areas (Z=-4.43,P<0.001). Conclusions The household PM2.5 pollution caused by fuel combustion in China remains a high level.The PM2.5 concentration shows a significant difference between urban and rural households,and the PM2.5 pollution is more serious in rural households.The difference in the household PM2.5 concentration between urban and rural areas is more significant in northern China.PM2.5 pollution in the households using solid fuel,traditional stoves,and heating is serious,and thus targeted measures should be taken to control PM2.5 pollution in these households.

Unpaid domestic work: persistence of gender-based labor division and mental disorders / Trabalho doméstico não remunerado: persistência da divisão sexual e transtornos mentais

ABSTRACT OBJECTIVE Evaluating characteristics of unpaid domestic work and its association with mental disorders, exploring gender differences. METHODS We analyzed cross-sectional data from the second wave of an urban population cohort (n = 2,841) aged 15 and older from a medium-sized city in Bahia (BA). The representative population sample was randomly selected in subsequent multiple steps. We interviewed the survey participants at their homes. This study analyzed sociodemographic, occupational, unpaid domestic work and mental illness data, stratified by sex (gender). We investigated the association between the work-family-personal time conflict, the effort-reward imbalance in domestic and family work and the occurrence of common mental disorders, such as generalized anxiety disorder and depression. We estimated prevalence, prevalence ratios and their respective 95% confidence intervals. RESULTS Among the participants, the unpaid domestic activities were performed by 71.3% of men and 95.2% of women, who were responsible for the investigated activities, except for minor repairs. The percentages of paid work were higher among men (68.1% versus 47.2% among women). The distribution of stressors and conflict experiences showed an inverse situation between genders: men depicted the highest high percentage of low work-family-personal time conflict (39.0%), while among women, the highest percentage was of high conflict (40.0%); 45.8% of the men reported low effort-reward imbalance in domestic and family work, while only 28.8% of women reported low imbalance. The investigated mental disorders were more prevalent among women, who showed a significant association between work-family-personal time conflict and common mental disorders, as well as depression; among men, conflict was positively associated with common mental disorders. The effort-reward imbalance, in turn, was strongly related to CMD (Common Mental Disorders), generalized anxiety disorder and depression among women. Amid men, this discrepancy was only associated to depression. CONCLUSIONS Domestic work persists as a mostly feminine assigned activity. The stressful situations of unpaid domestic work and the work-family-personal time conflict were more strongly associated with adverse effects on the female mental health.

RESUMO OBJETIVO Avaliar características do trabalho doméstico não remunerado e sua associação com transtornos mentais, explorando diferenciais de gênero. MÉTODOS Neste estudo foram analisados dados transversais da segunda onda de uma coorte da população urbana (n = 2.841) com idade a partir dos 15 anos de uma cidade de médio porte da Bahia (BA). A amostra representativa da população foi aleatoriamente selecionada em etapas múltiplas subsequentes. As entrevistas foram realizadas nos domicílios dos participantes do levantamento. O estudo analisou dados sociodemográficos, ocupacionais, do trabalho doméstico não remunerado e adoecimento mental, estratificadas por sexo. Investigou-se associação entre o conflito trabalho-família-tempo para si, o desequilíbrio esforço-recompensa no trabalho doméstico e familiar e a ocorrência de transtornos mentais comuns, de transtorno de ansiedade generalizada e de depressão. Foram estimadas prevalências, razões de prevalência e respectivos intervalos de confiança de 95%. RESULTADOS Entre os participantes, verificou-se que as atividades domésticas não remuneradas eram realizadas por 71,3% dos homens e 95,2% das mulheres, que se mostraram as principais responsáveis pelas atividades de trabalho investigadas, exceto pequenos consertos. A inserção em trabalho remunerado foi maior entre os homens (68,1% contra 47,2% entre as mulheres). A distribuição dos estressores e experiência de conflitos evidenciou situação inversa entre homens e mulheres: o maior percentual entre os homens foi de baixo conflito trabalho-família-tempo para si (39,0%), já entre as mulheres, maior percentual foi de alto conflito (40,0%); entre os homens, 45,8% referiram baixo desequilíbrio esforço-recompensa no trabalho doméstico e familiar, enquanto apenas 28,8% das mulheres relataram baixo desequilíbrio. Os transtornos mentais investigados foram mais prevalentes entre as mulheres, que apresentaram significativa associação entre o conflito trabalho-família-tempo pessoal e os transtornos mentais comuns e a depressão; entre os homens o alto conflito foi associado aos transtornos mentais comuns. Já o desequilíbrio esforço-recompensa se mostrou fortemente relacionado aos TMC, ao transtorno de ansiedade generalizada e à depressão entre as mulheres. Entre os homens, esse desequilíbrio relacionou-se apenas à depressão. CONCLUSÕES O trabalho doméstico persiste como atribuição majoritariamente feminina. As situações estressoras do trabalho doméstico não remunerado e o conflito trabalho-família-tempo para si associaram-se mais fortemente aos efeitos adversos na saúde mental das mulheres.

Nutritional indicators of food and nutrition security of families: 2008/2009 Household Budget Survey / Indicadores nutricionais da segurança alimentar e nutricional de famílias: Pesquisa de Orçamentos Familiares 2008/2009

ABSTRACT Objective To evaluate the food and nutrition insecurity of Brazilian families, according to indicators of food consumption and nutritional status, by location and situation of the households investigated using the 2008/2009 Household Budget Survey. Methods Inadequate consumption of macronutrients and nutritional dystrophies (underweight, short stature or overweight) in at least one family member were used as indicators, according to location and geographical situation of households. The prevalence of food and nutritional insecurity and their confidence intervals were calculated. Results Food consumption was assessed in a total of 13,569 households; a total of 67.55%, 43.96% and 6.85% revealed inadequacy for lipids, carbohydrates and proteins, respectively. Among the 53,640 households assessed by nutritional status, 15.10%, 35.15% and 45.50% had, at least one resident with low weight, short stature or overweight respectively. The Northeastern Region showed statistically higher prevalence than other Brazilian macro-regions for inadequate lipids (24.88%) and carbohydrates (15.32%), as well as for the presence of underweight (6.15%), overweight (14.77%) and short stature (15.17%), in at least one of the residents of the household. Conclusion Assessing the nutritional aspect of food insecurity allows for a better understanding of the dimensions of this situation by considering the effects of access and availability of food, as well as biological use and stability, based on indicators of inadequate food consumption and the presence of nutritional dystrophy. The results found in this study enhance the need to include nutritional indicators in the assessment of food security.

RESUMO Objetivo Avaliar a insegurança alimentar e nutricional de famílias brasileiras segundo indicadores de consumo alimentar e estado nutricional, por localização e situação dos domicílios investigados pela Pesquisa de Orçamento Familiar 2008/2009. Métodos Foram utilizados, como indicadores de insegurança alimentar e nutricional, o consumo inadequado de macronutrientes e distrofias nutricionais (baixo peso, baixa estatura ou excesso de peso) em pelo menos um membro da família, conforme localização e situação geográfica dos domicílios. Calculou-se a prevalência de insegurança alimentar e nutricional e seus intervalos de confiança. Resultados Foram avaliados 13.569 domicílios pelo consumo alimentar, sendo que 67,55%, 43,96% e 6,85% apresentaram inadequação para lipídios, carboidratos e proteínas, respectivamente. Entre os 53.640 domicílios avaliados pelo estado nutricional, 15,10%, 35,15% e 45,50% apresentam, respectivamente, pelo menos um morador com baixo peso, baixa estatura ou excesso de peso. O Nordeste apresentou prevalências estatisticamente maiores do que as demais macrorregiões para as inadequações de lipídios (24,88%) e de carboidratos (15,32%), bem como para presença de baixo peso (6,15%), excesso de peso (14,77%) e baixa estatura (15,17%), em pelo menos um dos moradores do domicílio. Conclusão Avaliar a vertente nutricional da insegurança alimentar permite maior compreensão das dimensões dessa situação por considerar os reflexos do acesso e disponibilidade de alimentos, bem como a utilização biológica e estabilidade, a partir dos indicadores de consumo alimentar inadequado e presença de distrofia nutricional. Os resultados encontrados reforçam a necessidade de incluir indicadores nutricionais na avaliação da segurança alimentar.

Aquisição de alimentos em domicílios brasileiros com e sem crianças / Food pourchase in brazilian households with and without child

-A construção dos hábitos alimentares infantis pode ser influenciada pela disponibilidade dos alimentos presentes nos domicílios. Não se sabe o quanto os pais modificam seu padrão de compra de alimentos para mais saudáveis quando há crianças em casa. Esta informação é importante para avaliar a percepção dos pais sobre a influência do ambiente domiciliar na formação de hábitos alimentares saudáveis em seus filhos. A renda familiar é uma variável que pode ter efeito na modificação dos hábitos alimentares dos pais, uma vez que reflete os recursos financeiros disponíveis para compra de alimentos. Investigar a aquisição de alimentos no Brasil em dois períodos com dez anos de diferença possibilita avaliar o efeito macroeconômico do engajamento dos pais na alimentação de seus filhos, uma vez que o país experimentou momentos econômicos distintos na última década. A fim de comparar a aquisição de alimentos saudáveis e não saudáveis em domicílios com e sem crianças no Brasil este estudo utilizou os dados da Pesquisa de Orçamentos Familiares (POF) conduzidos pelo IBGE, no Brasil, em seus inquéritos de 2008-2009 e 2017-2018. Os domicílios foram classificados em: i) presença ou não de crianças de um a cinco anos de idade e ii) maiores de cinco anos até dez anos de idade. Foram considerados todos os domicílios que compunham as amostras: 55.970 (POF 2007-2008) e 69.660 (POF 2017-2018), sem distinção por macrorregião ou zona urbana e rural, assim representando todo o território brasileiro. Os grupos de alimentos utilizados foram constituídos a partir das adaptações de agregados estipulados pela POF nas duas edições do inquérito. Foram estimadas as médias per capita em quilogramas da aquisição (Kg) de frutas, vegetais, refrigerantes e biscoitos num período de 7 dias consecutivos (uma semana). As diferenças das médias per capita da aquisição (Kg) dos alimentos entre domicílios com e sem criança foram estimadas por modelos de regressão de duas partes, combinando um modelo de regressão logística e um modelo linear generalizado de distribuição gama para valores positivos de aquisição, em função da distribuição assimétrica e inflada de zeros para compra de alguns itens alimentares. As análises foram estratificadas por quartos de renda domiciliar per capita, com ajustes pelo sexo e idade do morador de referência do domicílio, número de bebês, adolescentes, adultos e idosos vivendo no domicílio, e gasto mensal com alimentação. A comparação entre as médias de aquisição de alimentos entre os domicílios com e sem crianças foi dada pela intersecção dos intervalos de confiança de 95% e levou-se em consideração o peso amostral e o desenho complexo das POF. A média de aquisição de frutas em 2008-2009 foi maior nos domicílios com crianças das duas faixas etárias nos domicílios mais pobres. Em 2017-2018, a média de aquisição de frutas foi maior entre os domicílios com crianças de cinco a dez anos de idade pertencentes aos estratos socioeconômicos mais ricos. A compra de vegetais diferiu para menos em domicílios com crianças de 5-10 anos nos dois períodos. Houve uma maior média de aquisição per capita de biscoitos nos domicílios com crianças de todas as classes de rendimentos, em ambos os períodos avaliados.

The construction of children's eating habits can be influenced by the availability of food at the home. It's not known how much parents change their pattern of food purchase when there are children at household. That information is important in order to assess parents' perception of the home environment influence in the construction of healthy eating habits at their children. It's possible that family income have an effect on parents' eating habits, once reflects the financial resources available to food purchase. Investigating the food purchase in Brazil in two periods with ten years of diference leads to assess the macroeconomic effect of parental engagement in children's eating habits, since the country has experienced different moments in the last decade. In order to compare the food disponibility in households with and without children, this study utilized data from the Household Budget Surveys (POF) conducted by the Brazilian Institute of Geography and Statistics (IBGE), in Brazil, surveys 2008-2009 and 2017- 2018. The households were categorized into: i) presence or not of children aged between one and five years old and ii) children aged five and ten years old. The sample considered was 55,970 (POF 2007-2008) and 69,660 (POF 2017-2018). The food groups used were constituted from the recommendations of aggregates previously stipulated by the POF in the two editions of the survey. The means per capita were calculated in kilograms of purchase (Kg) of fruits, vegetables, soft drinks and cookies, over a period of 7 consecutive days (one week). Diferences in of food means per capita purchase (Kg) between households with and without children were estimated by using two-part regression models, that combines a logistic regression model and a generalized linear model with gamma distribution for positive values ​​of purchase, in function of the asymmetric and zero-inflated distribution for purchase of some food items. The analyzes were stratified by income quartiles per capita. With adjustments for sex and age of the household's main resident, number of babies, adolescents, adults and elderlys living in the household, and monthly expenditure on food purchase. The comparison between the means of food purchase between households with and without children was given by the intersection of the 95% confidence intervals, considering the weight sample. The means per capita purchase (Kg) of fruit in 2008-2009 was higher in households with children of both age groups in the poorest households. In 2017-2018, the average purchase of fruit was higher among households with children between five and ten years of age belonging to the elevates socioeconomic stratas. The purchase of vegetables were less in households with children aged 5-10 years in both periods. There was a higher purchase of cookies in households with children of all income classes, in both periods.

Tuberculosis preventive treatment in children and adolescents: an observational study of secondary data

Abstract Objective To analyze the effectiveness, safety, outcomes, and associated factors of tuberculosis preventive treatment (TPT) in children and adolescents in Paraná, southern Brazil. Method This was an observational cohort study with a retrospective collection of secondary data from the TPT information systems of the state of Paraná from 2009 to 2016, and tuberculosis in Brazil from 2009 to 2018. Results In total, 1,397 people were included. In 95.4% of the individuals, the indication for TPT was a history of patient-index contact with pulmonary tuberculosis. Isoniazid was used in 99.9% of the cases with TPT, and 87.7% completed the treatment. The TPT protection was 98.7%. Among the 18 people who had TB, 14 (77.8%) became ill after the second year of treatment, and four (22.2%) in the first two years (p < 0.001). Adverse events were reported in 3.3% of cases, most of them were gastrointestinal and medication was discontinued in only 2 (0.1%) patients. No risk factors associated with the illness were observed. Conclusions The authors observed a low rate of illness in pragmatics routine conditions in TPT for children and adolescents, especially within the first two years after the end of treatment, with good tolerability and a good percentage of adherence to the treatment. TPT should be encouraged to achieve the goals of the End TB Strategy of the World Health Organization as an essential strategy to reduce the incidence rate of the disease, but studies with new schemes must continue to be carried out in real-life scenarios.

Perception and willingness to the uptake of COVID-19 vaccine among household-heads in a rural community of South-Western Nigeria

Background:The COVID-19 pandemic and its vaccine have been met with varying perceptions that may have both negative and positive effects on the willingness to uptake the COVID-19 vaccine. The study is set to determine the perception and willingness of the household heads to the uptake of COVID-19 vaccine in a rural community in Southwestern, Nigeria.Materials and Methods:A cross-sectional study was carried out among 409 household heads selected through a multistage sampling technique. The instrument of data collection was a semi-structured interviewer-administered questionnaireusing the Health Belief model constructs. Data were analyzed with IBM SPSS version 21.0 and Pearson's Chi-square test was used to determine the association between perception and willingness to uptake vaccine. P<0.05 was taken as significant at 95% confidence interval.Results:The majority of the unvaccinated respondents in the study were not willing to take the COVID-19 vaccine (60.1%). There was a poor perception of the susceptibility/severity of unvaccinated respondents to COVID-19 infection and a poor perception of the benefit/barrier to the uptake of the COVID-19vaccine. Perception of susceptibility and severity of COVID-19 infection were statistically related to the willingness to uptake the COVID-19vaccine.Conclusion:There should be an increase in awareness campaigns to change the perception of people positively to COVID-19 infection and uptake of the COVID-19vaccine.

Implementation of points-based household registration policy for voluntary blood donors in Nanjing / 中国输血杂志

【Objective】 To analyze the implementation effect of points-based household registration policy for blood donors in Nanjing, so as to provide reference for other provinces and cities to develop incentive policies for blood donation. 【Methods】 The basic demographic profile, registration situation and deferral reasons of blood donors who applied for points-based household registration from 2017 to 2021 were analyzed by Excel. 【Results】 1) A total of 388 blood donors applied for points-based household registration for blood donation from 2017 to 2021, accounting for 0.042% of the total blood donors in Nanjing (388/923 160), and 357 applications were approved, accounting for 0.039% (357/923 160). 2) The proportion of male applicants was higher than that of female applicants (55.15% vs 44.85%). Applicants aged 26~35 accounted for the largest, followed by applicants aged 36~45, and applicants aged 18~25 accounted for the least. The proportion of applicants in Jiangsu province(23.27%) was higher than that of applicants from other provinces. The top three occupations were employees, workers and jobless. In terms of education level, applicants with junior high school education or below accounted for the largest, followed by high school and secondary school (35.05% vs 29.38% vs 23.20%). The proportion of first-time blood donors was the highest (33.24%). Among the repeated blood donors, blood donors who donated blood 2~3 times were with the highest share (23.93%). Nineteen donors(4.90%) got more than 100 points. 3) A total of 31 blood donors were deferred from 2017 to 2021, accounting for 7.90% of the total applicants. Among them, 23 applicants donated in other cities than Nanjing, 5 applicants failed to provide valid blood donation certificates, and 3 applicants submitted irrelevant material. 【Conclusion】 The implementation of points-based household registration policy for voluntary blood donors in Nanjing helped blood donors who could not reach other points due to low education level and income to become registered permanent residence in Nanjing

Household symptomatic contact screening of sputum smear positive tuberculosis patients at the DOTS clinic of SGT hospital, Gurugram

Background: Contact screening was conducted under ICMR (REFERENCE ID: 2019-07811) programme in villages near SGT hospital, Gurugram. Objective: To evaluate risk factors, extent of spread of tuberculosis among household contacts of tuberculosis cases and to create awareness. Methods and Material: Address of TB cases were taken from RNTCP register at DOTS clinic, SGT medical college. Then all household contacts of positive cases were screened, counselled and advised to approach ASHA Workers if such symptoms appear. Data was analysed using appropriate statistical methods. Results:21 Index cases along with 94 household contacts were screened. 61.90% families still use chullahs for cooking. 76.1% families have overcrowding. 3) 61.90% families had inadequate ventilation 4) 19.05%families were aware about the spread of this disease. 5)Only 23.80% families practised adequate sanitation methods and precautions6) 42.8% Index cases had a history of smoking. 7) 44.4% 4 continue to smoke with infection. The association of adequate sanitation with presence of awareness was found to be statistically significant. (p-value<0.05). Other factors were not significantly associated with level of awareness regarding prevention of tuberculosis spread among study participants. Conclusions: Contact screening is an effective tool and it gives the real-time picture of TB in India.

Modelación espacial bayesiana de la estructura de los hogares y la fecundidad en municipios de México

El trabajo busca modelar el efecto de diferentes patrones de composición de hogares sobre los niveles observados de fecundidad en los municipios de México al año 2020, se trata de una investigación de tipo cuantitativo de cohorte transversal basada en la aplicación de métodos bayesianos espaciales. La hipótesis sostiene que la presencia de un mayor porcentaje de hogares familiares debería impactar en mayores tasas de fecundidad municipales. La metodología comprende la implementación de dos modelos gaussianos latentes. Un modelo nulo busca determinar si los patrones observados de fecundidad se asocian a algún mecanismo sociodemográfico o, al contrario, surgieron aleatoriamente, y otro modelo con covariables, cuyo objetivo es replicar el comportamiento de la fecundidad evaluando las consecuencias de la proporción de hogares nucleares, ampliados y compuestos presentes en los municipios. Los resultados obtenidos a partir de la estimación del modelo nulo confirmaron la existencia de una relación directa entre el aumento del índice de hogares nucleares y ampliados y el de la fecundidad municipal. Sin embargo, se puede concluir que el nivel alcanzado de fecundidad de reemplazo es producto de marcadas diferencias entre municipios, originadas por la presencia de una tipología heterogénea de hogares inmersos en contextos geográficos, sociales y culturales dispares.

This paper seeks to model the effect that different patterns of household composition have on the observed levels of fertility in the municipalities of Mexico in the year 2020; it is a quantitative cross-sectional cohort research based on the application of spatial Bayesian methods. The hypothesis is that the presence of a higher percentage of family households should have an impact on higher municipal fertility rates. The methodology involves the implementation of two latent Gaussian models. One null model, which seeks to determine whether the observed fertility patterns were generated by some socio-demographic mechanism or, on the contrary, arose randomly, and two, a model with covariates whose objective is to replicate the behavior of fertility by evaluating the effect of the proportion of nuclear, extended and compound households present in municipalities. The results obtained from estimation of null model confirm the existence of a direct relationship between increase in the proportion of nuclear and extended households and the increase of municipal fertility. However, it can be concluded that the level of replacement fertility reached by Mexico in the year 2020 is the product of marked differences between municipalities; differences originated by the presence of a heterogeneous typology of households immersed in disparate geographic, social and cultural contexts.

Knowledge Regarding Causes and Ill Effects of Household Air Pollution Among Residents of a Selected Community in Kozhikode (Kerala)

The present study was conducted to assess the knowledge regarding causes and ill effects of household air pollution among residents of selected community in Kozhikode (Kerala). The research design adopted was non-experimental descriptive survey type. The sample was selected using non-probability convenience sampling technique. The data were collected using semi structured questionnaire to assess the knowledge regarding causes and ill effects of household air pollution among residents. The data was tabulated and analysed by descriptive and inferential statistics. The study revealed that majority of the samples (50%) had average knowledge regarding causes and ill effects of household air pollution and 31.7 percent had good knowledge, spiratory illness due to household air pollution.

Atenção primária à saúde infantil: a maior avaliação de base populacional da história do SUS / Primary child health care: the largest population-based assessment in the history of Brazilian National Health System

Resumo Desde 2019, o IBGE vem ocupando no cenário da avaliação de políticas públicas no Brasil um local de protagonismo. Após a Pesquisa Nacional de Saúde (PNS) avaliar os serviços de atenção primária no Sistema Único de Saúde (SUS) prestados aos adultos, em 2022 a Pesquisa Nacional por Amostra de Domicílios Contínua (PNAD-C) investigou o cuidado infantil. Para isso, utilizou uma das versões do Primary Care Assessment Tool (PCAT), desenvolvido e disseminado por Starfield e Shi para avaliar a existência e extensão dos atributos dos serviços de atenção primária à saúde (APS). O público-alvo pesquisado incluiu crianças menores de 13 anos, e os questionários foram respondidos por seus responsáveis/cuidadores. Contemplou todas as 27 unidades da federação do país, em amostras aleatórias probabilísticas, desdobrando-se ainda pelas regiões metropolitanas e capitais do Brasil. Trata-se do maior inquérito domiciliar sobre avaliação da saúde infantil já realizado no Brasil. A partir da PNS-2019 e da PNAD-C em 2022, o IBGE inaugura seu maior legado para a atenção primária à saúde no Brasil no que se refere à avaliação dos usuários do SUS, com todas as unidades da federação (re)conhecendo como a sociedade brasileira avalia os serviços de saúde no primeiro nível de atenção.

Abstract The IBGE has been playing a leading role in the public policy evaluation in Brazil since 2019. After the National Health Survey (PNS) evaluated primary care services in the Unified Health System (SUS) provided to adults, in 2022, the Continuous National Household Sample Survey (PNAD-C) investigated child health. To this end, it adopted one version of the Primary Care Assessment Tool (PCAT), developed and disseminated by Starfield and Shi to assess the existence and extent of the attributes of PHC services. The target audience surveyed included children under 13 years of age, and the questionnaires were answered by their guardians/caregivers. It included all the 27 federative units of the country in random probabilistic samples, also unfolding in the Brazilian metropolitan regions and capitals. This is the largest household survey on child health assessment ever conducted in Brazil. With the PNS-2019 and the PNAD-C in 2022, IBGE inaugurates its greatest legacy for Brazilian primary health care regarding the evaluation of SUS users, with all federative units recognizing and understanding how Brazilian society evaluates health services at the first level of care.

Understanding Sanitation Dynamics in Bihar, India: Evidence from the Field Survey

Background: Although a good number of individual household latrines have been constructed in Bihar during the past few years, still, a huge task remains to be completed. The paper is based on the study of “concurrent monitoring of LSBA/SBM [G] in select districts of Bihar”. Objectives: The aim is to understand different dimensions of the sanitation situation in Bihar. The objective is to suggest policy based on the findings. Materials and Methods: This study is based on primary data collected at the household level and public institutions in six districts of Bihar. Results: The analysis reveals that except a few categories, socioeconomic indicators such as religion, economic condition, or educational attainments have no significant impact on having a latrine at the household level. The variations in the construction of latrines among different districts emphasize that the public program needs to be implemented more effectively. It is also found that women are more vulnerable in a situation of open defecation. Conclusion: The challenge is to encourage people for the sustained use of the constructed latrines. This puts emphasis on changing the behavioral pattern of the people. This requires organizing a continuous awareness generation program with the aim to change the behavior.

Pesquisa Nacional de Saúde revela alto percentual de sinais e sintomas de hanseníase no Brasil / National Health Survey reveals high percentage of signs and symptoms of leprosy in Brazil

Resumo A hanseníase é uma doença dermato-neurológica, infecciosa, sistêmica ou localizada, debilitante, causada por Mycobacterium leprae. No Brasil, a magnitude e o alto poder incapacitante mantêm a doença como um problema de saúde pública. Mancha na pele e dormência são sinais e sintomas patognomônicos na hanseníase. A Pesquisa Nacional de Saúde de 2019 (PNS-2019), do Instituto Brasileiro de Geografia e Estatística (IBGE), considerou a seguinte pergunta como proxy para estimar sua magnitude no país. "O(a) sr(a). tem mancha com dormência ou parte da pele com dormência?". No Brasil, 1.921.289 adultos referiram ter mancha ou parte da pele com dormência, sem diferenças regionais. Com relação ao grupo etário, quanto mais velho, maior a prevalência. Por exemplo, entre os de 18 a 29 anos (235.445) e de 30 a 39 anos (236.485), 0,7% possuía a condição, entre 40 e 59 anos (827.887), 1,5%, e entre os idosos, 1,8% (621.472). Poder estimar, em pesquisas de base populacional, com representatividade estatística, uma morbidade referida tal como a hanseníase é fundamental para apoiar a formulação de políticas públicas, notadamente as relativas às ações da atenção primária à saúde. Dessa forma, o IBGE cumpre seu papel constitucional de retratar a realidade da população brasileira e hoje é o principal avaliador externo do Sistema Único de Saúde (SUS) e das políticas públicas instituídas no âmbito federal.

Abstract Leprosy is a debilitating, infectious, systemic or localized dermato-neurological disease caused by Mycobacterium lepra. In Brazil, the magnitude and high disabling power keep the disease as a public health problem. Skin spotting and numbness are pathognomonic signs and symptoms in leprosy. The Instituto Brasileiro de Geografia e Estatística (IBGE) 2019 National Health Survey (PNS-2019) considered the following question as a proxy to estimate its magnitude in the country. "Do you have a spot with numbness or part of the skin with numbness?". In Brazil, 1,921,289 adults reported having a patch or part of the skin with numbness, with no regional differences. As for the age group, the older, the higher the prevalence, for example, between 18 to 29 years old (235,445) and 30 to 39 years old (236,485), 0.7% had the condition, between 40 to 59 years old (827,887), 1.5% and among the elderly, 1.8% (621,472). Being able to estimate, in population-based surveys, with statistical representativeness, a reported morbidity such as leprosy is essential to support the formulation of public policies, notably those related to primary health care actions. In this way, the IBGE fulfills its constitutional role of portraying the reality of the Brazilian population and today it is the main external evaluator of the Unified Health System (SUS) and of public policies developed by the federal level.

Meta-analysis of infection and disease among household contacts of patients with drug-resistant tuberculosis / 中国热带医学

@#Abstract: Objective　To analyze the association between drug resistance and the risk of latent tuberculosis infection and disease among household contacts of patients with pulmonary tuberculosis, and to explore whether the compensatory mutation of drug-resistant Mycobacterium tuberculosis will enhance its pathogenicity or transmission ability. Methods　The English and Chinese databases, including PubMed, web of science, EMBASE, Cochrane library database, CNKI and Wanfang database, were searched by computer from the time of establishment of the database to January 2022. Cohort studies on the risk of infection and disease among household contacts of patients with drug-resistant and sensitive pulmonary tuberculosis were searched and screened according to the inclusion and exclusion criteria. The data were extracted and evaluated by NOS scale, using stata16.0 software meta-analysis to calculate the combined effect of tuberculosis infection and disease risk of family contacts, and carry out heterogeneity test, subgroup analysis and sensitivity analysis. Results　A total of 7 cohort studies involving 9653 TB index cases and 29, 734 house contacts were included. The results of meta-analysis showed that compared with drug-sensitive pulmonary tuberculosis patients, the risk of tuberculosis infection in house contacts of drug-resistant pulmonary tuberculosis patients was increased (OR=1.56, 95%CI=1.25-1.96, P<0.001), but there was no difference in the risk of incidence (RR=1.06, 95%CI=0.80-1.41, P=0.67>0.05). Subgroup analysis showed that the risk of latent tuberculosis infection in house contacts was affected by the study area, and the size of family contacts had an impact on the risk of TB . Sensitivity analysis showed that the results of meta-analysis were robust. Conclusion　Compared with drug sensitive TB patients, household contacts with drug-resistant TB patients had a higher risk of tuberculosis, but there was no difference in the risk of TB among the two groups.