Predictors of past quit attempts and duration of abstinence among cigarette smokers

Objective: Despite the widespread awareness of the harms of smoking, millions continue to smoke around the world partly due to the difficulty it takes to quit smoking. Identifying the factors associated with making quit attempts is an essential pillar to reach successful quitting. The purpose of this study is to assess the factors associated with the past quit attempts and their past length of abstinence in a Lebanese sample of cigarette smokers

Methods: This study was conducted between March 2014 and March 2015, involving 382 patients randomly chosen from 5 outpatient clinics in 5 hospitals in Lebanon. A standardized questionnaire was completed including socio-demographic characteristics, smoking behavior, chronic respiratory symptoms, Fagerstrom scale, Mondor scale, packaging perception, quitting behavior and readiness to quit ladder. Results: Smokers who have chronic allergies [ORa = 2.45, p = 0.03], those who have ever stopped smoking for at least one month due to the warnings implemented on the packages [ORa = 4.6, p< 0.0001] and smokers with an intention to quit in 2 months [ORa = 2.49, p < 0.0001] had significantly more past quit attempts

Results: Furthermore, longer quit attempts duration [more than 1 month] were significantly associated with low-nicotine dependent smokers [ORa = 0.56, p = 0.02], higher-motivated smokers [ORa = 1.85, p = 0.01], people with chronic allergies [ORa = 2.07, p = 0.02], smokers who have ever stopped smoking for at least one month due to the warnings [ORa = 3.72, p < 0.0001] and those with an intention to quit in 2 months [ORa = 1.98, p = 0.05]

Conclusion: The promoters of smoking cessation services should consider these factors when designing comprehensive tobacco control initiatives and in service planning

Utilisation des méthodes contraceptives modernes en République Démocratique du Congo: prévalence et barrières dans la zone de santé de Dibindi à Mbuji-Mayi

Introduction: l'objectif de cette étude était de déterminer la prévalence contraceptive moderne et les barrières à l'utilisation des méthodes contraceptives modernes chez les couples de la Zone de Santé Dibindi, à Mbuji-Mayi en République Démocratique du Congo.Méthodes: de Mai à Juin 2015, nous avons réalisé une étude descriptive transversale. Nous avons inclus les femmes âgées de 15 à 49 ans, en union maritale, non enceinte au moment de l'enquête, qui habitaient la Zone de santé Dibindi depuis deux ans et ayant consenti librement de participer à l'étude. La collecte des données a été réalisée par interview libre des femmes. La prévalence contraceptive moderne se référait aux femmes en cours d'utilisation, au moment de l'enquête, des contraceptifs modernes. La comparaison des proportions a été réalisée au seuil de signification de 5%. Le test de Bonferroni a été utilisé pour comparer, deux à deux, les proportions des barrières à l'utilisation des contraceptifs modernes.Résultats: la prévalence contraceptive moderne à Dibindi, en 2015, était de 18,4%. Elle était faible eu égard aux services de planification familiale disponibles dans cette Zone de santé. Plusieurs femmes refusaient d'utiliser les méthodes contraceptives modernes malgré l'information dont elles disposaient à cause de leur désir de maternité, l'interdiction religieuse, l'opposition du conjoint et la crainte des effets secondaires.Conclusion: l'information suffisante et centrée sur chaque cliente ou son couple, sur la planification familiale, devrait être renforcée de façon à éliminer les fausses croyances, ce qui accroitrait l'utilisation des méthodes contraceptives modernes

Paludisme à la première consultation prénatale : prévalence et facteurs associés en milieu rural au Sud Kivu à l'Est de la République Démocratique du Congo

Contexte : Les femmes enceintes constituent un groupe vulnérable face au paludisme. Dans l'objectif de déterminer la prévalence et les facteurs associés au paludisme pendant la grossesse, une étude a été menée dans la zone de santé rurale de Miti-Murhesa, à l'Est de la République Démocratique du Congo (RDC), trois ans après une distribution de Moustiquaires Imprégnées d'Insecticide (MII).Méthodes : Les données de 478 femmes enceintes recueillies à leur première consultation prénatale entre novembre 2010 et juillet 2011 ont été analysées. Les femmes étaient recrutées au deuxième trimestre de la grossesse aux centres hospitaliers de Murhesa et de Lwiro. Un cas de paludisme était défini par une goutte épaisse positive pour le plasmodium. L'altitude de la résidence d'origine de chacune des femmes était mesurée par un GPS. Résultats : A l'admission 9,5% (n = 453) de femmes présentaient une infection palustre. En régression logistique, la fréquence du paludisme était plus élevée chez les primigestes, chez les femmes avec niveau socio-économique bas et chez celles vivant à moins de 1683 m d'altitude ; les rapports de cote ajustés (IC 95%) étaient respectivement de [2,55 (1,05-6,19) ; P = 0,039] ; [4,78 (1,36-16,76) ; P = 0,033] et [2,34 (1,10-5,02) ; P = 0,029].Conclusion : Ces résultats montrent que le paludisme est resté présent chez les femmes enceintes trois ans après une distribution de moustiquaires à Miti-Murhesa. La première grossesse, le niveau socioéconomique bas et la résidence en basse altitude étaient des facteurs significativement associés au paludisme. Ces résultats appellent à intensifier les activités de prévention contre le paludisme dans la communauté de manière à protéger plus efficacement les femmes en âge de procréer

Knowledge and Practices on the Prevention of Anemia in Pregnancy in the Cascades Region (Burkina Faso).

Objectives: To study the knowledge and practices on anemia prevention during pregnancy among health professionals, community health workers and pregnant women. Methods: We carried out a cross-sectional study in antenatal clinics in the Cascades region in Burkina Faso during one month, from May to June 2012. We gathered data on knowledge on the prevention of anemia in pregnancy among health professionals, community health workers, and pregnant women through a questionnaire. Practice performance of health professionals working in these antenatal clinics were gathered through direct observation and was judged satisfactory if they realized 80% of expected acts of antenatal care. For community health workers and pregnant women, recognition of nutritional deficiencies as the predominant cause of anemia in pregnancy, was the main way to assess their knowledge on the subject. Results: A total of 124 health professionals, 77 community health workers and 1763 pregnant women were enrolled. Health professionals knew the definition, the diagnosis and the main causes of anemia in pregnancy respectively in 46.7%, 53.2% and 46.0% of cases. The practice of prenatal consultation was satisfactory in 13.1% of cases. Only 19.5% of community health workers and 19.6% of pregnant women were able to identify nutritional deficiencies as a potential cause of anemia. Conclusions: Any intervention aimed at improving the prevention of anemia in pregnancy in Burkina Faso should focus on the strengthening of the skill of the actors and the knowledge of pregnant women in the field.

Factors Associated with Anemia in Pregnancy in Cascades Region in Burkina Faso.

Objectives: To analyze the factors associated with anemia in pregnancy in the Cascades region in Burkina Faso. Methods: A cross-sectional study was carried out in antenatal clinics of the Cascades region in Burkina Faso during one month from May to June 2012. We collected data on socio-demographics and health characteristics of pregnant women attending these clinics. Hemoglobin was measured to assess anemia. Factors associated with anemia were identified through a multivariate analysis. Results: A total of 1763 pregnant women, irrespectively of pregnancy stage, were enrolled. The mean (SD) hemoglobin level was 10.6 (1.4) g/dl. The prevalence of anemia in pregnancy was 58.9%, 3.2% of them being severe. Factors associated with anemia were the absence of intermittent preventive treatment of malaria with sulfadoxin-pyrimetamin (OR = 1.3, 95% CI: 1.0- 1.7), number of pregnancies >6 (OR = 1.4, 95% CI: 1.1-1.9). Moderate consumption of local alcohol extracted from Palmyra was associated with a lower prevalence of anemia (OR = 0.7, 95% CI: 0.5-0.9). Surprisingly, anemia was not associated with supplementation with folic acid + iron (p = 0.60). Conclusions: Interventions which aim to reduce the prevalence of anemia in pregnancy in Burkina Faso should improve the coverage of the intermittent preventive treatment of malaria and support the limitation of births.

Incidence of catastrophic health expenditures for households: an example of medical attention for the treatment of severe childhood malaria in Kinshasa reference hospitals, Democratic Republic of Congo

This study aimed to estimate the incidence of catastrophic health expenditures faced by households in Kinshasa with children affected by severe malaria. A total of 1350 children below the age of 15 year who were hospitalized due to severe malaria were included in the study. We analyzed the incidence of households facing catastrophic expenditures according to two thresholds: 40% of the household's capacity to pay and 10% of the household's total consumption. Based on the [40% of the capacity to pay] threshold, the incidence of catastrophic health expenditures reached 81.1%, and this estimate reached 46.4% for the [10% above total consumption] threshold. Regarding the >/= 40% capacity to pay threshold, the incidences of catastrophic expenditures was higher among households with children who were admitted to state hospitals [adjusted odds ratio [aOR] 3.7] and private hospitals [aOR 59.1], for poor households [aOR 13], for households with medium socioeconomic statuses [aOR 3.2], for female-headed households [aOR 2.9], for households with children affected by the neurological form [aOR 4.8] and respiratory distress [aOR 3.6], and for households who opted for a pre-hospital resort [aOR 2.7]. Similar results were obtained when the 10% above the total consumption threshold was applied. Greater government financing of medical attention would lead to a reduction in the catastrophic health expenditures faced by the poorest households

Treatment-seeking Paths in the Management of Severe Malaria in Children under 15 Years of Age Treated in Reference Hospitals of Kinshasa, Democratic Republic of Congo

Background: In the Democratic Republic of Congo (DRC), few studies have focused on treatment-seeking paths selected by caretakers for the management of severe childhood malaria in an urban environment. The present study aims at describing the treatment-seeking paths according to the characteristics of households, as well as the subsequent impact on pre-hospitalisation delay and malarial fatality and on the main syndromes associated with severe childhood malaria. Methods: This descriptive study included data collected at nine hospitals in Kinshasa between January and November 2011. A total of 1,350 children, under 15 years of age and hospitalised for severe malaria, were included in the study. Results: Regarding the management of malaria, 31.5% of households went directly to the health centre or hospital while 68.5% opted for self-medication, church and/or traditional healing therapy. The most frequent first-line option was self-medication, adopted by more than 61.5% of households. Nevertheless, rational self-medication using antimalarial drugs recommended by the WHO (artemisinin-based combinations) was reported for only 5.5% of children. Only 12.5% of households combined 2 or 3 traditional options. The following criteria influenced the choice of a modern <i>vs</i>. traditional path: household socioeconomic level, residential environment, maternal education level and religious beliefs. When caretakers opted for traditional healing therapy, the pre-hospitalisation delay was longer and the occurrence of respiratory distress, severe anaemia and mortality was higher. Conclusion: The implementation of a malaria action plan in the Democratic Republic of Congo should take into account the diversity and pluralistic character of treatment-seeking behaviours in order to promote the most appropriate options (hospital and rational self-medication) and to avoid detrimental outcomes.

The Epidemiological Use of Hospital Data for Suicide Surveillance in Belgium.

Aims: Investigating the E codes related to suicide and self-inflicted injuries through the prevalence, the patient characteristics, the methods and means employed and the characteristics of the hospital stays; and compare them with the others E codes group. Study Design: Retrospective hospital-based analytical study. Place and Duration of Study: This study was based on the 2010 data of 13 Belgian hospitals. Methodology: Based on 16406 cases of patients with a least an E code (ICD-9-CM); Pearson’s chi-squaretests, simple logistic regressions and Wilcoxon rank sum tests were used to assess the variations between distributions of the investigated factors according to the injury’s groups. Results: Among all the E codes, prevalence of suicide and self-inflicted injury was equal to 10.6%. The poisoning was the major reported diagnosis. There were significantly Original Research Article British Journal of Medicine & Medical Research, 4(26): 4407-4430, 2014 4408 more discharges without consent in the suicide group than in the others. The length of stay was lowest in the suicide group compared to the others E codes group. The several median costs were always highest among the men, but, regarding the median percentage of the pharmaceutical products, the value was highest among the women. Conclusion: The epidemiological use of hospital data is complementary to the use of both the population-based data and the death certificates; each data source participating to a better comprehension and a better surveillance of the complex continuum of suicidality.

Treatment-seeking paths in the management of severe malaria in children under 15 years of age attended in reference hospitals of Kinshasa, Democratic Republic of Congo

Background: In the Democratic Republic of Congo (DRC), fewstudies have focused on treatment-seeking paths selected by caretakers for themanagement of severe childhood malaria in an urban environment. The presentstudy aims at describing the treatment-seeking paths according to thecharacteristics of households, and the subsequent impact on pre-hospitalisationdelay and malarial fatality, as well as on the main syndromes associated withsevere childhood malaria. Methods: This descriptive study included data collected in nine hospitals ofKinshasa between January and November 2011. A total of 1,350 children, under 15years of age and hospitalised for severe malaria, were included in the study. Results: Regarding the management of malaria, 31.5% of households directly wentto the health centre or hospital while 68.5% of them opted for self-medication,church and/or traditional healing therapy. The most frequent first-line optionwas self-medication, adopted by more than 61.5% of households. Nevertheless,rational self-medication relying on the use of antimalarial drugs recommendedby the WHO (artemisinin-based combinations), was only reported for 5.5% ofchildren. Only 12.5% of households combined 2 or 3 traditional options. Thefollowing criteria influenced the choice of a modern <i>vs.</i> a traditional path: household socioeconomic level, residentialenvironment, mother educational level and religious beliefs. When caretakersopted for traditional healing therapy, the pre-hospitalisation delay was longerwhile the occurrence of respiratory distress, severe anaemia and mortality wasmore frequent. Conclusion: The implementation of a malaria action plan  in the Democratic Republic of Congo shouldtake into account the diversity and pluralistic character of treatment-seekingbehaviours, in order to promote the most appropriate options (hospital andrational self-medication) and avoid the deadliest severe forms.

Waterpipe smoking and dependence are associated with chronic bronchitis: a case-control study in Lebanon

Waterpipe smoking and its association with chronic bronchitis has not been assessed in Lebanon. This case-control study in Beirut in 2009/2010 evaluated this relationship: 274 cases of chronic bronchitis and 559 controls without the condition aged >/=40 years were enrolled. Data were collected by questionnaire on: sociodemographic characteristics, respiratory symptoms, smoking [waterpipe and cigarette] and nicotine dependence. ANOVA, Student, Kruskal-Wallis, chi-squared and Fisher exact tests were used when applicable and logistic regression analysis was carried out. Previous waterpipe smoking [OR = 6.4], previous mixed smoking [OR = 38.03] and current mixed smoking [OR = 7.68] were significantly associated with chronic bronchitis [P < 0.001 for all] but current exclusive waterpipe smoking was not [OR = 1.87, 95% CI: 0.74-4.72]. Current waterpipe dependence was significantly associated with chronic bronchitis [OR = 3.74, P < 0.001]. After adjustment for covariates/confounders, ever waterpipe smoking > 20 WP-years [P < 0.001] was significantly associated with chronic bronchitis

Accouchees avec statut serologique VIH inconnu a Lubumbashi; RD Congo: proportion et determinants

Introduction: Beaucoup d'enfants vivant avec le VIH ont été infectés par leurs mères. Pour prévenir la transmission verticale les femmes doivent d'abord connaître leur statut sérologique VIH .L'objectif de cette étude était de déterminer la proportion de statut VIH inconnu à la naissance et d'identifier les facteurs associés. Méthodes: C'est une étude transversale réalisée dans 10 structures sanitaires de Lubumbashi de Juin à Septembre 2010. La taille de l'échantillon était de 602 accouchées. Les statistiques descriptives usuelles et la régression logistique ont été utilisées. Résultats: Parmi les accouchées, 52,5 % ignoraient leur statut sérologique. Parmi elles, 62,9 % accepteraient de faire le test VIH à la maternité. La proportion des femmes avec un statut sérologique VIH inconnu était significativement plus élevée chez celles qui n'avaient pas suivi de CPN (Odds Ratio ajusté (ORa) = 5,8; Intervalle de Confiance (IC) 95 % : 1,7-19,8) ; chez celles qui avaient un bas niveau d'instruction (ORa = 1,5 ; IC 95% : 1,1-2,1) et chez celles qui ne savaient pas que la transmission verticale du VIH pouvaient se faire au moment de l'accouchement (ORa = 1,5 ; IC 95 % : 1,0-2,4). Conclusion: La proportion de femmes qui accouchent sans connaître leur statut sérologique au VIH est encore importante, malgré le fait que le dépistage du VIH soit proposé lors des CPN. Dans les zones à haute séroprévalence de VIH, aucune femme ne devrait accoucher sans être dépistée au VIH. Ce serait une opportunité manquée

Prevalence et determinants de la malnutrition des enfants ages de moins de 5 ans dans le quartier Bongonga de Lubumbashi

Contexte : L'etat nutritionnel des enfants est un indicateur mondial de son bien-etre et indirectement celui de sa communaute. Les objectifs de ce travail consistent a evaluer l'etat nutritionnel des enfants ages de moins de cinq ans du quartier Bongonga de Lubumbashi; en RD Congo; et ses determinants. Methodes : Une enquete transversale a ete menee; dans des menages; aupres de 1963 enfants. Outre les variables anthropometriques; les conditions de vie ont egalement ete relevees. Une regression logistique a ete appliquee. Resultats : Les prevalences etaient de 33;5de retard de croissance et 3;8d'emaciation. En regression logistique; le niveau d'etude de la mere (moins de 7 ans); l'absence d'un robinet d'eau potable dans la parcelle; l'age superieur a 11 mois et la duree de sejour de l'enfant dans le quartier inferieure a 3 mois etaient significativement associes a un risque accru de retard de croissance. Le niveau bas d'etude de la mere et l'age de l'enfant (12 mois ou plus) etaient significativement associes du retard de croissance severe. Par ailleurs; l'anorexie; la diarrhee; la souffrance et l'age de l'enfant (moins de 12 mois) etaient les determinants significatifs d'une emaciation. Conclusion : Comparee a la classification de l'Organisation Mondiale de la Sante; la prevalence du retard de croissance est elevee et celle de l'emaciation basse. Afin de reduire la mortalite; la morbidite et contribuer au bien-etre de la population; il faut integrer ces facteurs dans toute intervention

Malnutrition proteino-energetique et morbidite liee au paludisme chez les enfants de 0-59 mois dans la region du Kivu; Republique Democratique du Congo

Dans la region du Kivu a l'Est de la Republique Democratique du Congo; la malnutrition et le paludisme sont responsables d'une morbidite et mortalite importantes. La relation entre paludisme et malnutrition est controversee et cette association n'a; jusqu'a present; pas ete exploree dans cette region du Kivu. Nous avons analyse les donnees de 5695 enfants ages de zero a cinq ans recueillies a l'admission a l'hopital pediatrique de Lwiro entre novembre 1992 et fevrier 2004. Les indices poids pour age (PPA) et poids pour taille (PPT) exprimes en ecart type par rapport a la mediane de reference ont ete calcules (Z score). L'association entre les indicateurs de la malnutrition proteino- energetique et le paludisme a ete mesuree par les rapports de prevalence en analyse univariee et les OR ajustes derives d'un modele de regression logistique. La prevalence du paludisme a l'admission etait de 35;8(n=5695). Les indices PPT et PPA et l'albumine serique etaient associes a la morbidite liee au paludisme. En regression logistique; des OR eleves de paludisme ont ete observes pour des valeurs elevees des indicateurs anthropometriques [Z score PPT - 2: OR (IC a 95) 1;7 (1;4-2;2)] [Z score PPA - 2: OR (IC a 95) 1;3 (1;1-1;6)] et biologiques [albumine serique = 23g/L : OR (IC a 95) 1;6 (1;2-2;1)] de l'etat nutritionnel. Nos analyses mettent en evidence une association inverse entre la malnutrition et la prevalence de l'infection palustre

Nivel de endemia de la infección por Trypanosoma cruzi en el lugar de residencia de la madre y desarrollo de la enfermedad de Chagas congénita en Bolivia / Endemic level of congenital Trypanosoma cruzi infection in the areas of maternal residence and the development of congenital Chagas disease in Bolivia

In Bolivia, the prevalence of infection by T. cruzi in women in fertile age can vary between 20 and 60%. The present study made in the Maternity Germin Urquidi of Cochabamba - Bolivia, it has demonstrated, that 19.9% of the mothers who go to this hospitable center to be taken care of in the childbirth, they are carrying of the infection and that 4,6% of them, they are going to transmit, by transplacentaria route, the infection to its babies. Of the 71 children born with congenital Chagas, only 47,8 % present/display some type of alteration or of development(Apgar to 1 minute low, BPN, prematuridad, pathological dismadurez) or signs (SDR, hepatomegalia, esplenomegalia, neurological signs, cardiomegalia, anasarca, petequias). When investigating the effect of the differences in the vectorial density (low, medium and high) of the zone of maternal residence, on the transmission of the infection of the mother infected to the fetus, we concluded that the rate of transmission of the congenital infection of T. cruzi is not modified by the level of endemicidad of the zone of maternal residence. By another infected new born sides whose mothers reside in zones of high endemicidad present/display, most frequently and of significant way, Apgar to 1 minute < to 7, low weight when being born and prematuridad or an association of these alterations with respiratory syndrome of distress or anasarca, when one compares them with new born of resident mothers in the zones of loss or medium endemicidad, mortality in this group is greater. These results suggest calls to account it of the mothers, in areas of high endemicidad, she is associate with a serious increase in the risk of Disease of newborn severe and mortal congenital Chagas in.