Factores sociales y demográficos asociados al embarazo y al embarazo repetido en mujeres adolescentes de Perú / Social and demographic factors associated with pregnancy and repeated pregnancy in adolescent women in Peru

OBJETIVO: Evaluar los factores sociales y demográficos asociados al embarazo y al embarazo repetido en mujeres adolescentes de Perú MÉTODO: Estudio transversal analítico realizado a partir de las encuestas de población ENDES 2009 a 2018 en Perú. Participaron mujeres adolescentes entre 12 y 19 años de edad. Se recogió información de condición de embarazo y características sociales y demográficas. Se aplicó la prueba de χ2 y se calculó la razón de prevalencia ajustada con su intervalo de confianza al 95% usando regresión de Poisson con varianza robusta. RESULTADOS: En el estudio se incluyeron 49 676 mujeres adolescentes. El 12,6% tuvieron un embarazo y el 5,1% tuvieron dos o más embarazos. Se evidenció asociación entre edad, región geográfica, origen étnico, nivel educativo, nivel económico y embarazo adolescente (p < 0,001). Los niveles educativo y económico inferiores presentaron una mayor razón de prevalencia de embarazo adolescente, siendo mayor incluso en situaciones de dos o más embarazos. CONCLUSIONES: En la población de mujeres adolescentes de Perú, el 17,7% estuvieron embarazadas y el 5,1% tuvieron embarazo repetido. Existe asociación entre embarazo adolescente y bajos niveles económico y educativo; esta asociación se incrementa en situaciones de embarazo repetido.

OBJECTIVE: To assess the social and demographic factors associated with pregnancy and repeated pregnancy in adolescent women in Peru. METHOD: Analytical cross-sectional study carried out from the ENDES population surveys 2009 to 2018 in Peru. Adolescent women between 12 and 19 years of age participated. Information on pregnancy status and number of children was collected, as well as social and demographic characteristics. The χ2 test was applied, the adjusted prevalence ratio with its 95% confidence interval was calculated using Poisson regression with robust variance. RESULTS: 49 676 adolescent women were included in the study. The 17.7% had one or more pregnancies and 5.1% two or more pregnancies. The analysis showed an association between geographic region, age, ethnic origin, educational level, economic level and adolescent pregnancy (p < 0.001). The lower levels of educational level and economic level presented a higher prevalence ratio of adolescent pregnancy, being higher even in situations of two or more pregnancies. CONCLUSIONS: In the population of adolescent women in Peru, 17.7% were pregnant and 5.1% had repeated pregnancy. Adolescent pregnancy is associated with low economic and educational levels; this association increases in situations of repeated pregnancy.

Does Economic Instability Affect Healthcare Provision? Evidence Based on the Urban Family Physician Program in Iran / 가정의학회지

BACKGROUND: The main aim of this study was to evaluate the achievements of some important goals of Iran's urban family physician plan. This plan was implemented when the country experienced economic instability. We examine whether an economic crisis affects the efficacy of a healthcare program. METHODS: We used the household income and expenditures survey data for 2011 (before program implementation) and 2012 (after program implementation). Changes in out-of-pocket payments and healthcare utilization were investigated using the propensity score matching estimator. Furthermore, changes in inequality in these two dimensions were examined. RESULTS: No changes in out-of-pocket payments and healthcare utilization were found after the implementation of this program; however, inequality in out-of-pocket payments increased during the reform. CONCLUSION: The urban family physician program was not implemented completely and many of its fundamental settings were not conducted because of lack of necessary healthcare infrastructure and budget limitations. Family physician programs should be implemented under a strong healthcare infrastructure and favorable economic conditions.

Prevalence and treatment follow-up of drug-resistant extra-pulmonary tuberculosis in rural communities in Narshingdi, Bangladesh.

Tuberculosis is a chronic communicable disease. Infections are initially asymptomatic and latent but eventually progresses to active disease, which, if left untreated, may have ≥50% mortality. In 2011, an anti-tuberculosis drug resistance survey in Narsingdi, Bangladesh enrolled both new and retreatment patients. In the study, a number of villages were randomly selected and 152 extra pulmonary tuberculosis (EPTB) patients were identified. All the patients received treatment with standardized first-line drug (FLD) regimens and were investigated to document treatment efficiency. Among the patients, 34 were reported in lower income, 112 in medium income and only 06 in higher income group. Farmers (16.4%) in low income group, and female housewives (41.4%) in medium income group were mostly infected. Silicosis and malnutrition were assumed responsible for high EPTB cases in farmers and housewives respectively. The working youth groups (25-34) were found most vulnerable. Extra pulmonary TB sites of infection was found pleural TB 29.6% patients, glands TB 24.3% patients, abdominal TB 21.0% patients, spinal TV 19.7% patients, tubercular meningitis 436% patients & tubercular pericarditis 0.65% patient. Multi-drug resistant (MDR) EPTB was detected in both new and retreatment patients. Patients with MDR-EPTB who had been declared cured with first-line anti-TB treatment had a high rate of TB recurrence and death. The rate of TB recurrence and death was high four years after MDR-TB patients were judged to have been cured. PTB patients in Bangladesh had high recurrence and death rates even after treatment with standardized FLD regimens, reinforcing the need for early survey, diagnosis and treatment, including assessment of treatment outcomes.

Fishery status of undivided Goalpara District, Assam with reference to socio -economic conditions of fishers.

The studies were conducted during 2008–2010 to evaluate Fishery status and its bearing on socio-economic condition of Fishers Community of undivided Goalpara district of Assam. A total of 97 species belongs to 56 genera of 26 families were recorded from various fish landing centers of the region during study period. Fishers catch fish in the river throughout the year. However, fishing intensity decreased during winter season due to decreasing water level. Fish catching ratio were also found in decreasing trend day by day due to increase in the level of fishing intensity as well as due to increasing numbers of fishers. The results of the co-efficient of correlation calculated from socio-economic data clearly exhibited that incomefamily size; expenditure - family size is highly related to each other in all the fishers groups.

Pattern of Dermatological Cases Attending Skin-VD Outpatient Department in a Medical College Hospital of Bangladesh.

Background: The pattern of skin diseases varies from one country to another and even from region to region of the same country. We are geographically placed in the tropical region with natural outcome of communicable diseases. We conducted this cross sectional study in a tertiary hospital of Bangladesh keeping the proposition in mind that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh. Objectives: To classify the diseases attending the Skin & VD outpatient department of Enam Medical College Hospital (EMCH) and to draw comments and recommendations on the basis of findings. Materials and Methods: All patients irrespective of age and sex attending the OPD of Skin-VD Department of Enam Medical College Hospital during a 2-year time-period (from January 2009 to December 2010) were included in the study. Structured questionnaire, check-list and face-to-face interview (whenever necessary) were used as tools of data collection. Statistical analyses were done by SPSS version Windows 11.1. Results: Total number of patients was 12100. Most of the patients were aged (>18 years; 64.28%), dominated by male (61.63%), married (56.1%), literate (71.11%), coming from far (>5 km; 63.5%) and of middle class origin (59.73%). Out of the total cases, maximum (23.42%) were diagnosed as eczema, followed by infectious diseases (17%), acne (8.69%) and psoriasis (6.36%). Conclusion: In this study we found infectious diseases to occupy the second position next to eczema and our findings nullify the proposition that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh.

Cuestionario socioeconómico aplicado a grupos familiares del distrito capital para investigaciones relacionadas con la salud pública / Socioeconomic questionnaire applied to family groups of the Capital District for research related to public health

La evaluación de aspectos socioeconómicos en comunidades, se hace mediante el método Graffar-Méndez Castella no (1994), éste incluye cuatro variables y no refleja la realidad de la Condición Social de las familias. Se diseño el Cuestionario Condición Socioeconómica (CCSE), con variables que dibujaran una realidad adecuada de lo observado. Se aplicó desde 1996, con transformaciones: 1999, 2004 y 2005, a 959 familias. En el CCSE, se incluyeron aspectos relacionados con características del grupo familiar, ha cinamiento, dependencia, ingreso familiar, tipo y tenencia de la vivienda, número de ambientes, suministro y frecuencia con que se recibe el agua, servicios públicos en la comunidad. A cada una se le asignó un puntaje, cuya suma permitió definir cuatro categorías para la Condición Socioeconómica. Se incorporó el nivel de instrucción del jefe del hogar y de la madre, fuente de ingreso, gastos en alimentación, con el fin de comparar con Graffar, cuartos para dormir y número de servicios en el hogar. El objetivo es dar a conocer un cuestionario, para ser utilizado en investigaciones; se validó mediante formas paralelas, se utilizó el coeficiente alfa de Cronbach, haciendo uso de SPSS para Win dows. Los resultados: Confiabilidad alta (0,80< a < 0,89). Las correlaciones, para la validación, entre condición so - cioeconómica y estrato social, dieron: 2001 (r = 0,85), 155; 2004 (r = 0,70), 157 y 2005 (r = 0,93), 112 familias, to das del Área Metropolitana de Caracas. Se concluye que: el cuestionario es confiable, válido y se puede utilizar.

The evaluation of aspects socioeconomic in communities, one becomes by means of the Graffar-Méndez Castellano me thod (1994), this one includes four variables and it does not reflect reality of the Social Condition of the families. Design Questionnaire Socioeconomic Condition (QSEC), with variables that drew a reality adapted of the observed thing. It was applied from 1996, with transformations: 1999, 2004 and 2005, to 959 families. In the QSEC, they included re lated aspects with characteristics of the familiar group, overcrowding, dependency, familiar entrance, type and pos session of the house, number of atmospheres, provision and frequency whereupon the water is received, services public in the com munity. To each one a score was assigned to him, whose sum allowed to define four categories for Socioeco no mic Condition. One got up the level of instruction of the head of the home and the mother, source of entrance, ex pen ses in feeding, with the purpose of comparing with Graf far, quarters to sleep and number of services in the home. Objective it is to present a questionnaire, to be used in in vestigations; it was validated by means of parallel forms, the coefficient was used alpha of Cronbach, doing use of SPSS for Win dows. Results: High trustworthiness (0,80 < a < 0,89). The correlations, for the validation, between so cioeco nomic condition and social layer, gave: 2001 (r = 0.85), 155; 2004 (r = 0.70), 157 and 2005 (r = 0.93), 112 families, all of the Me tropolitan Area of Caracas. It concludes that: the questionnaire is reliable, valid and it is possible to be used.

Industrialization and public health with special reference to the tuberculosis problem in the Philippines

In the light of what we know at present, we are inclined to attribute more weight to the influence of the environmental factors in the development of tuberculosis than the constitutional factors. It is particularly the industrial factor or, in more precise terms, the occupational factor (since it refers to all groups of working men, not only to those occupied in industry, but also in agriculture, fishery, transportation, domestic service and the like), which seems to be correlated with the death rate from tuberculosis. The influences of this factor are different and depend to a considerable extent on the sociological structure of the country. They are unfavorable in certain unhealthy industries and industrially young countries. At the period of beginning industrialization, when the steadily increasing industrial and agricultural development has not as yet been sufficiently controlled by adequate measures (legislation and medico-social sanitation), we find in general a marked tendency toward deteriorating health among the masses and while machinery in general goes on improving the human machines apeears to be under-going positive deterioration (4)On the other hand, there is reason to believe that industry on the whole exerts a beneficial influence on the health of the community (though many industrial categories have their own specific risks) provided that the technical progress is steadily accompanied by social progress and systematic improvements of general sanitationAs to present tuberculosis situation in the Philippines, we believe that it is positivey correlated with the sociologic structure of the country. Increasing tuberculosis figures and high incidence, reflected by high mortality rates, are medico-social phenomena common to countries which, socio-economically speaking are just entering the phase of beginning industrialization. As in so many problems of public health, it is certain that there are multiple factors operating but we are of the belief that in the Philippines, as a prevalently agricultural country in the stage of beginning industrialism, this condition is one of the determining elements in the present tuberculosis situationIn the anti-tuberculosis campaign, in our opinion, the stress should be laid not only on special measures of campaigning against the tubercle bacillus but also on improvements of the social, occupational and hygienic conditions in all areasFrom the very moment industrialization starts, the health of a modern nation depends as much on conditions inside as outside the factory gatesThe conclusion to be drawn from these considerations and the practical measures to bring about further studies of the problems will be discussed in a later paper. We believe, however that the viewpoints discussed in this preliminary paper may be of some actual interest even now in view of the inttense and progressive efforts, supported by governmental and private initiative, to industrialize large part of the Philippines Islands in the near future. (Summary)