Factors associated with severe malaria among patients under reference to district hospitals: A cross-sectional study in Rusizi District, Rwanda

Background Severe malaria is a key global public health issue, particularly in Sub-Saharan Africa, which accounts for over 80% of global malaria deaths. Rwanda has experienced about 11-fold annual increase in reported malaria cases since 2012 to 2016. Severe malaria accounted for 13,092 cases in 2015 to 17,248 cases in 2016. Objective To determine factors associated with severe malaria among patients under reference to Gihundwe and Mibilizi Hospitals. Methods A cross-sectional study that included 228 febrile patients diagnosed with malaria at Gihundwe and Mibilizi Hospitals was conducted. Data were collected from patients' files. Logistic regressions were computed to establish determinants of severe anemia. Odds ratio (OR), 95% confidence level (CI) and p-value were reported. Results The proportion of severe malaria was 64.03%. The multivariable logistic regression analysis showed that patients under five years (aOR = 8.169; 95%CI = 3.646- 18.304); being males (aOR = 2.539; 95%CI = 1.299-4.965); farmers (aOR = 2.757; 95%CI = 1.339-5.678) and limited access to health facilities (aOR = 2.740: 95%CI = 1.038-7.232) were the main factors associated with severe malaria. Conclusion Severe malaria was high with various associated factors. There is a need to strengthen malaria control and prevention interventions for young children, men and farmers. Furthermore, beside public health interventions, health facilities should be accessible to people residing in malaria endemic areas.

Mortalidad y factores asociados en pacientes cubanos infectados con VIH-1

Objetivo: Determinar las principales causas de muerte y los factores asociados en los pacientes infectados con el VIH ingresados en el hospital del Instituto de Medicina Tropical "Pedro Kourí" durante los años 2017-2018. Métodos: Se realizó un estudio retrospectivo de casos y controles para determinar las causas de la muerte y algunos factores asociados a ella, en el hospital del Instituto de Medicina Tropical "Pedro Kourí", en el período 2017-2018. Para determinar estos factores se utilizó un análisis multivariado basado en un modelo de regresión logística binaria. Resultados: Las causas de muerte más frecuentes fueron las asociadas al SIDA, fundamentalmente las infecciones oportunistas del sistema respiratorio (41,4%), seguidas por las neoplasias no asociadas al SIDA (25,1%). Los factores que mayor influencia tuvieron sobre la mortalidad fueron la presencia de enfermedad oportunista (OR 14,07 p<0,001) y de neoplasias no asociadas al SIDA (OR 6,76 p=0,005), la alteración de las funciones renal (3,54 p=0,019) y hepática (OR 2,90 p=0,054) y tener mayor carga viral (OR 1,50 p=0,001) y menos tiempo de diagnóstico al momento del ingreso (OR 0,793 p<0,001). El modelo matemático resultante del análisis permitió identificar los principales factores asociados a la mortalidad y explicar su relación con la misma. Conclusiones: Las enfermedades asociadas al SIDA, principalmente las infecciones oportunistas del sistema respiratorio, seguidas por las neoplasias no asociadas al SIDA fueron las causas predominantes de muerte en los pacientes infectados con el VIH que fallecieron en el Instituto de Medicina Tropical "Pedro Kourí" durante el período de estudio. La presencia de neoplasias no asociadas al SIDA, de enfermedades oportunistas, de alteraciones de las funciones renal y hepática, el aumento de la carga viral y el tener menos años de diagnóstico al momento del ingreso, fueron los factores que más contribuyeron a la mortalidad en los pacientes ingresados e infectados con el VIH. El modelo matemático resultante se ajustó bien a los datos y explicó de manera consistente los factores asociados a la mortalidad.

Aim: To determine the main causes of death and associated factors in HIV-infected patients admitted to the Tropical Medicine Institute "Pedro Kourí" hospital during the years 2017-2018. Methods: A retrospective case-control study was carried out to determine the causes of death and some factors associated with it, in the Tropical Medicine Institute "Pedro Kourí" hospital, in the period 2017-2018. To determine these factors, a multivariate analysis based on a binary logistic regression model was used. Results: The most frequent causes of death were those associated with AIDS, mainly opportunistic infections of the respiratory system (41.4%), followed by neoplasms not associated with AIDS (25.1%). The factors that had the greatest influence on mortality were the presence of opportunistic disease (OR 14.07 p <0.001) and neoplasms not associated with AIDS (OR 6.76 p = 0.005), alteration of renal functions (3, 54 p = 0.019) and liver (OR 2.90 p = 0.054) and have a higher viral load (OR 1.50 p = 0.001) and less time to diagnosis at admission (OR 0.793 p <0.001). The mathematical model resulting from the analysis made it possible to identify the main factors associated with mortality and explain their relationship with it. Conclusions: AIDS-associated diseases, mainly opportunistic infections of the respiratory system, followed by non-AIDS-associated neoplasms were the predominant causes of death in HIV-infected patients who died in the Tropical Medicine Institute "Pedro Kourí" during the study period. The presence of neoplasms not associated with AIDS, opportunistic diseases, alterations in kidney and liver functions, increased viral load and having fewer years of diagnosis at the time of admission, were the factors that most contributed to mortality in patients admitted and infected with HIV. The resulting mathematical model fitted the data well and consistently explained the factors associated with mortality.

Influence of Apical Diameter on Filling Material Extrusion during Retreatment - A Micro-CT and CBCT evaluation

Abstract Aim: To investigate whether foraminal widening performed at primary treatment has an effect on the amount of apically extruded obturator material during retreatment and to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting extruded obturator material. Methods: Forty palatal roots of maxillary molars were selected based on micro-CT and divided into two groups (n=20): with foraminal widening (WE) and without foraminal widening (NE). To standardize the apical foramen, all specimens were instrumented to the foramen using the Protaper Next system, up to instrument X3. The WE group was instrumented to the foramen up to instrument X5, and the NE group was instrumented 1 mm lower. The canals were obturated 1 mm below the apical foramen with gutta-percha and AH Plus and stored for 7 days at 37 °C and 95% humidity. Roots were fixed in microtubes filled with 1.5% agar gel. The obturation material was removed with Reciproc R50. Scans of the teeth and agar were performed using micro-CT and CBCT. Comparison between groups and between methods was performed using Mann-Withney test (p ≤0.05). Results: No statistical difference was found when comparing the extruded material between groups using micro-CT (p = 0.589) or CBCT (p = 0.953). CBCT measured a greater volume of extruded material than micro- CT (p = 0.0004). Conclusion: Foraminal widening had no effect on the extrusion of filling material during retreatment. The CBCT favored the evaluation of apically extruded filling material.

Resumo Objetivo: Investigar se o alargamento do foramen realizado durante o tratamento primário tem um efeito na quantidade de material obturador apicalmente extruído durante oretratamento e verificar a sensibilidade da tomografia computorizada de feixe cônico (TCFC) na detecção de material obturador extruído. Métodos: Quarenta raízes palatinas de molares superiores foram selecionadas de acordo com a microtomografia computorizada, e foram divididas em dois grupos (n=20): com alargamento do foraminal (CA) e sem alargamento do foraminal (SA). Para padronizar o forame apical, todas as amostras foram instrumentadas com o sistema ProTaper Next até ao instrumento X3 até o forame. O grupo CA foi instrumentado até ao instrumento X5 até o forame, e o grupo SA foi instrumentado 1 mm aquém. Os canais foram obturados 1 mm abaixo do forame apical com gutta-percha e AH Plus e armazenados durante 7 dias a 37 °C e 95% de umidade. As raízes foram fixadas em microtubos preenchidos com gel de ágar a 1,5%. O material obturador foi removido com Reciproc R50. Os escaneamentos dos dentes e do ágar foram realizados com micro-CT e CBCT. A comparação entre grupos e entre métodos foi realizada utilizando o teste Mann-Withney (p ≤0.05). Resultados: Não foi encontrada diferença estatística ao comparar o material extruído entre grupos utilizando o Micro-CT (p = 0,589) ou TCFC (p = 0,953). Foi medido um volume maior de material extruído com a TCFC do que com a Micro- CT (p = 0,0004). Conclusão: O alargamento foraminal não teve qualquer efeito na extrusão do material obturador durante o retratamento. A TCFC favoreceu a avaliação do material de obturador apicalmente extruído.

Unplanned pregnancy among female students at universities in the Eastern Cape Province, South Africa

Unplanned pregnancy has adverse effects including unsafe and illegal abortions causing maternal morbidity and mortality. Despite the adverse impact of unplanned pregnancy on women's personal life, their families, and society, there is a dearth of knowledge on unplanned pregnancy in institutions of higher education and training in South Africa. As a result, the objective of this study was to assess unplanned pregnancy and underlying factors among unmarried female students in universities in Eastern Cape. This was a cross-sectional survey of 1269 unmarried female students from universities in Eastern Cape selected using multistage cluster sampling. The study found that the prevalence of unplanned pregnancy was 12.31%, Health Science student (AOR: 0.41, 95% CI [0.17, 0.99], p < 0.001) were less likely to experience unplanned pregnancy. Being financially supported by a family (AOR: 0.17, 95% CI: [0.07, 0.43], p< 0.001) and being aged less than or equal to 18 years during the first sexual intercourse (AOR: 6.32, 95% CI: [2.57, 15.54], p < 0.001) were associated with unplanned pregnancy. Rural residence (AOR=3.93; 95% CI: (1.21, 12.84), p <0.001), not using contraceptives (AOR=10.63; 95%CI: 5.29, 21.37, p < 0.001) and having divorced parents (AOR=1.99; 95%CI: 1.14, 3.94), p < 0.001) were associated with unplanned pregnancy compared to their counterparts, respectively. The prevalence of unplanned pregnancy is high among unmarried female students in universities in Eastern Cape. Unplanned pregnancy was influenced by age at first sexual intercourse, non-use of contraceptives, divorced parents, the field of study, and the source of financial support. Universities and stakeholders should work together to support reproductive health programmes to prevent unplanned pregnancy. (Afr J Reprod Health 2022; 26[7]: 29-37).

Factors associated with reduced foetal movements in Iringa, Tanzania

Introduction: Maternal perception of foetal movement ensures foetal wellbeing. Reduced foetal movement is associated with foetal hypoxia, stillbirths, and intrauterine foetal growth restriction (IUFGR). This study aimed at assessing factors that are associated with maternal perception of reduced foetal movements. Method: This was a cross-sectional study that was conducted at Iringa Regional Referral Hospital from 1st January ­ 30th June 2022. A purposive sampling technique was used, and SPSS version 25 software was used for data analysis. Results: 41.3 % of study participants were aged 24 ­ 34 years, with a mean and SD of 29.08 ±7.53. 75% were not employed, 52.8 % of study participants delivered from 37 ­ 42 weeks of gestational age, 66.1% had a posterior placenta and only 24.0 % had an anterior placenta. Women who delivered at 28 ­ 36 weeks of gestational age were about 4 times more likely to experience reduced foetal movement compared to those who delivered at 37 ­ 42 weeks of gestation (AOR=4.162, 95% CI 2.174 - 7.966, p= =0.0067). Conclusion: Reduced foetal movements are associated with lower gestation age at delivery and decreased antenatal clinic attendance in Iringa, Tanzania. All pregnant women should be encouraged to make early antenatal clinic attendance and should attend adequate visits. Healthcare providers should educate and create awareness on methods of assessing foetal movements.

Facteurs associés au faible niveau de fréquentation du centre de santé intégré de Pondila en 2021 / Factors associated with low levels of attendance of the integrated health center of Pondila in 2021

Le système de santé de la République du Congo est caractérisé par un important gap dans l'offre des services de santé entre le milieu urbain et le milieu rural. La communauté rurale de Pondila, dans le département du Kouilou n'échappe pas à cette description, avec un faible taux de fréquentation du CSI de Pondila de 34,22%. Objectif: Cette étude avait pour objectif d'étudier les facteurs associés au faible taux de fréquentation du CSI de Pondila en 2021. Méthodologie : Il s'agit d'une étude transversale analytique qualitative et quantitative sur un échantillon probabiliste représentatif de 347 ménages dans toute l'aire de santé de Pondila. Un modèle de régression logistique a été construit par la méthode de sélection pas à pas descendante avec une probabilité d'entrée de 0,05 et IC à 95%. Résultats : 30,84% des enquêtés ont rapporté ne pas avoir consulté le CSI de Pondila dans les 03 mois précédant l'enquête dans de mauvaises conditions d'accès géographiques et financières. La régression logistique a permis d'établir le faible niveau de fréquentation du CSI et le chômage (OR=16,67 [14,67 à 18,67], p=0,000), le mauvais accueil des bénéficiaires par le personnel soignant (OR=3,15 [1,00 à 9,95], p=0,050) et l'absence de médicaments lors des consultations (OR=3,21 [0,26 à 39,24], p=0,000). Conclusion : Le faible niveau de fréquentation du CSI de Pondila est associé au chômage, au mauvais accueil et à la non disponibilité des médicaments au CSI, au coût élevé des soins et au mauvais état des routes.

Factores asociados a malformaciones congénitas renales y de vías urinarias / Factors associated to renal and urinary tract ´s congenital malformations

Introducción: Las malformaciones congénitas del riñón y del tracto urinario representan entre 20 y 30 por ciento de todas las malformaciones reconocidas en humanos. Objetivo: Identificar los antecedentes patológicos familiares y las enfermedades durante el embarazo asociados a la aparición de defectos congénitos renales. Métodos: Estudio descriptivo prospectivo transversal realizado en 672 niños nacidos entre julio de 2014 y junio de 2015 en Santa Clara, con ultrasonido prenatal normal. A todos los niños durante la consulta médica se les hizo examen físico detallado y previo consentimiento informado del familiar acompañante, se aplicó a estos una encuesta y se registraron variables epidemiológicas, antecedentes familiares de enfermedades renales, morbilidad de la madre durante el embarazo y se realizó un ultrasonido renal para identificar las alteraciones sonográficas sugerentes de algún tipo de anomalías del desarrollo renal. Resultados: En 40 (5,95 por ciento) pacientes se detectó alteración sonográfica. El 27,50 por ciento eran hijos de madres que presentaron alguna enfermedad durante el embarazo. La glucemia elevada afectó 10 por ciento de las madres de los niños con anomalías del desarrollo renal, seguida del bajo peso materno (7,5 por ciento). El hecho de presentar antecedente patológico familiar de enfermedad renal aportó un riesgo de 1,88 y en las de tipo obstructivo el riesgo fue de 5,08. Conclusiones: Las alteraciones sonográficas sugestivas de malformación congénita renal son más frecuentes en los lactantes cuyas madres presentaron concentraciones elevadas de glucosa y bajo peso durante el embarazo. Los niños con antecedentes familiares de malformación renal tienen mayor riesgo de presentar una anomalía del desarrollo renal(AU)

Introduction: Kidney and urinary tract´s malformations represent among 20 and 30 percent of all malformations known in humans. Objective: To identify during pregnancy family pathological history and diseases associated to the onset of renal congenital malformations. Methods: Prospective, descriptive, cross-sectional study carried out to 672 children with normal prenatal ultrasound whom were born from July, 2014 to June 2015 in Santa Clara province. All children during the medical consultation had a detailed physical examination and previous informed concent; it was applied also a survey and the epidemiologic variables, family history of renal diseases, morbility of the mother during pregnancy were recorded, and it was made a renal ultrasound to identify sonographic alterations suggesting any kind of anomaly in the renal development. Results: In 40 patients (5,95 percent), it was detected any sonographic alteration. 27,50 percent were children of mothers that presented any disease during pregnancy. High glycemia affected the 10 percent of mothers of children with anomalies in the renal development, followed by low maternal weight (7,5 percent). The fact of presenting a family pathological history of renal disease implied a risk of 1,88 percent and the risk was of 5,08 percent in the obstructive kind of diseases. Conlusions: Sonographic alterations suggesting renal congenital malformations are more frequent in newborns whose mothers had high concentrations of glycemia and low weight during pregnancy. Children with family history of renal malformations have higher risk of presenting an anomaly of the renal development(AU)

Secular trends in suicidal ideation and associated factors among adolescents

Objectives: Suicide is one of the leading causes of death in adolescence, and the second most common cause of death among young people. The objective of this study was to identify trends in suicidal ideation by sex and ascertain factors associated with this outcome. Methods: Secular trend study with statewide coverage conducted at 5-year intervals, with 4,207 adolescents (2006), 6,264 adolescents (2011) and 6,026 adolescents (2016). Logistic regression was used to evaluate the secular trend of suicidal ideation. Multilevel logistic regressions evaluated the factors associated with suicidal ideation in the survey conducted in 2016. Results: There was a positive trend in suicidal ideation prevalence in 2016 compared to the prevalence in 2006 and 2011, in both boys and girls. Low social support, poor sleep quality, and low parental supervision were associated with suicidal ideation in boys and girls. Exposure to violence and bullying was associated with suicidal ideation only in girls. TV time and computer and videogame time were not associated with suicidal ideation in boys or girls. Conclusion: There is an alarming trend of increased suicidal ideation in adolescents. Several dimensions were associated with suicidal ideation in adolescents, especially social support, sleep quality, and parental supervision.

Factores asociados a la adherencia al targa, en pacientes con vih/sida en el hospital central de las fuerzas policiales / Factors Associated With Adherence To Haart, In Patients With Hiv / Aids In At The Central Hospital Of The Police Forces

Objetivo: Determinar los factores asociados y el grado de adherencia al TARGA en los pacientes con VIH/SIDA en el hospital Central PNP "Luis N. Sáenz" en los meses de octubre a diciembre del 2015. Métodos: Estudio observacional, transversal, analítico y descriptivo donde se evaluó a 123 pacientes con un cuestionario CEAT-VIH. Se realizó la recolección de datos en el programa Microsoft Excel y el análisis estadístico mediante el programa SPSS v.22. Resultados: Donde encontramos que la edad promedio de los todos los pacientes evaluados es 40.11 años. El tiempo de infección de los pacientes evaluados fue un promedio un año y 7 meses. El tiempo de tratamiento con el TARGA consto de un promedio de 20 meses. El 52 % (64 pacientes) de la población estudiada fue algún familiar del titular, ya sea esposa (o), hijo (a) o padres. El género que prevalece en la muestra es masculino con el 63.4 % (78 pacientes). Y la carga viral, el 77.2 % es indetectable (< 400 copias/ml). El grado encontrado fue una adecuada adherencia al TARGA, con una puntuación de 82.51 y al relacionar el grado de adherencia con las características socio-demográficas no son significativas. Pero si se encontró relación el grado de adherencia con la carga viral. Conclusión: La población estudiada tiene una adecuada adherencia al tratamiento antirretroviral y los 5 factores que mide el cuestionario: cumplimento del tratamiento, antecedentes de la falta de adherencia, interacción médico-paciente, creencias del paciente y estrategia para la toma de medicamentos, tienen muy buena influencia en la adherencia al TARGA.

Objective: To determine the associated factors and the degree of adherence to HAART in patients with HIV / AIDS at the PNP Central hospital "Luis N. Saenz" from October to December 2015. Methods: Observational, cross- sectional, analytical and descriptive study where 123 patients with a CEAT-HIV questionnaire were evaluated. Data collection was performed in the Microsoft Excel program and statistical analysis using the SPSS v.22 program. Results: Where we found that the average age of all patients evaluated was 40.11 years. The infection time of the evaluated patients was an average of one year and 7 months. Treatment time with HAART averaged 20 months. Fifty-two percent (64 patients) of the study population were any family members of the holder, either wife (s), child (ren) or parents. The gender that prevails in the sample is male with 63.4% (78 patients). And viral load, 77.2% is undetectable (<400 copies / ml). The grade found was adequate adherence to HAART, with a score of 82.51. And relating the degree of adherence to socio-demographic characteristics are not significant. But if the degree of adherence to viral load was found to be related. Conclusion: In the study population has adequate adherence to antiretroviral treatment and the 5 factors measured by the questionnaire: adherence to treatment, history of lack of adherence, physician-patient interaction, patient's beliefs and strategy for taking medications, have a very good influence on adherence to HAART.

Prevalence of overweight/obesity and its associated factors among secondary school students in semi urban area in Malaysia

@#Introduction: This cross-sectional study aimed to determine the prevalence of overweight and obesity and factors associated among secondary school students in Batang Padang District, Perak, Malaysia. Methods: Out of the 7247 students in the ten selected schools studied, a total of 6248 students (2928 males, 3320 females) took part. A validated self-administered questionnaire was used. Data was analysed using SPSS version 22. Multivariable logistic regression was used to determine the adjusted odd ratio. Results: The prevalence of overweight and obesity was 16.0% and 11.5% respectively. Obesity/overweight was significantly (p<0.05) associated with gender, age, ethnicity, education level of father, education level of mother, physical activity, disordered eating, smoking status, body size perception and body part satisfaction. The multivariable analysis results showed that the odds of being overweight/obesity were higher in males compared to females (OR 1.56, 95%CI: 1.37, 1.77). The results also showed that the odds of being overweight/obesity were highest among those in age group 12 and 13 years and among Malay ethnicity. The odds of overweight/obesity were higher in those who was dissatisfied with their body parts, (OR 1.96, 95%CI: 1.71, 2.25), dissatisfied with their body size (OR: 4.25, 95%CI: 3.60, 5.02), low physical activity (OR 1.23, 95%CI: 1.06, 1.44), current smokers (OR 1.38, 95%CI: 1.07, 1.78) and at risk of having eating disorder (OR: 1.39, 95%CI 1.22, 1.59). Conclusion: The overall prevalence of overweight and obesity is high. The findings from this study can be used by policy makers to plan an integrated intervention program in schools.

Psychological Stress among Grassroot Level Workers in a PHC of Bagalkot District

It is important to study the problems of the grassroot level workers and the levels of stress that they encounter. The stressed Anganwadi and ASHA workers are likely to be unhealthy, poorly motivated, less productive, and less efficient in implementing the various national programs. Objective: The objective was to study the level of stress among the grassroot level workers and the various factors related. Materials and Methods: Study design: This was a cross-sectional study. Setting: This was conducted at PHC of Bagalkot district. Study subjects: Grassroot level workers (Anganwadi [n = 46] and ASHA [n = 29] workers) were selected. Sample size: The sample size was 75. Data collection: Date were collected through self-reporting questionnaire schedule consisting of two schedules: (i) Sociodemographic characteristics and (ii) presumptive stressful life events scale questionnaire. Scores used in the study: Fifty-one life events were found to be experienced by the normal Indian population in the past 1 year. For each life event, a mean stress score was given. The total score was obtained for each by adding all the applicable life events scores. Accordingly, they were categorized into no stress, less/moderate stress, and severe stress. Statistical test used: Analysis was performed using Chi-square test. Results: About 61.33% were Anganwadi and 38.67% were ASHA workers. 70.67% had mental stress in the past 1 year. 8% of the subjects had a family history of mental illness and 25.33% of them were practicing yoga/meditation. 66.67% of the study subjects had experienced severe stress and 26.67% has mild/moderate stress. The factors such as past history of mental illness, socioeconomic status of the participants, house construction, unfulfilled commitments, unemployment of family member, loan, beginning of school, and marital conflict are significantly associated with level of stress. Conclusion and Recommendations: Psychological stress was found to be more among Anganwadi and ASHA workers. They are suggested to practice healthy lifestyles such as yoga and meditation to relieve stress.

Factores asociados a epilepsia en niños en México: un estudio caso-control / Factors associated with epilepsy in children in Mexico: A case-control study

Resumen: Introducción: La epilepsia es la enfermedad neurológica crónica más común en el mundo. En México es considerada dentro de las principales enfermedades vinculadas a la mortalidad por enfermedades no infecciosas de la población infantil. El objetivo del estudio fue identificar los factores asociados a epilepsia en niños derechohabientes del Instituto Mexicano del Seguro Social (IMSS), en Acapulco, México. Métodos: Estudio de casos y controles realizado entre abril de 2010 y abril de 2011. Fueron seleccionados 118 casos de la consulta externa de neurología pediátrica, con criterios diagnósticos de epilepsia de acuerdo a la Liga Internacional Contra la Epilepsia, con máximo dos años de evolución. Los controles fueron seleccionados de las Unidades de Medicina Familiar de donde procedieron los casos. En una encuesta a las madres, se obtuvo información sobre antecedentes heredofamiliares, prenatales, perinatales y posnatales. El análisis bivariado y multivariado se realizó mediante el procedimiento de Mantel-Haenszel. Resultados: Tres factores estuvieron asociados con la epilepsia: el antecedente familiar de epilepsia en familiares de primer grado (Razón de Momios ajustada (RMa) 2.44, IC95% 1.18 - 5.03), la asfixia al nacimiento (RMa 2.20, IC95% 1.16-34.18) y la infección de la vía urinaria en la etapa prenatal (RMa, 1.80 IC95% 1.0 - 3.24). Conclusiones: La asfixia al nacimiento y el reporte de infecciones de vías urinarias durante la gestación fueron factores asociados a epilepsia independientemente del antecedente de epilepsia en familiares de primer grado.

Abstract: Background: Epilepsy is the most common chronic neurological disease in the world. In Mexico, epilepsy is among the diseases more related to mortality due to non-infectious diseases in children. The objective of the study was to identify the factors associated with epilepsy in children entitled to the Mexican Social Security Institute (IMSS), in Acapulco, Mexico. Methods: We carried out a case-control study from April 2010 to April 2011. We selected 118 cases from the database of outpatient pediatric neurology with epilepsy diagnostic with two year of evolution according to the International League Against Epilepsy criteria. We selected 118 controls from the same Medical Units where cases were detected. Data collected throughout an interview with the mothers included information on history of epilepsy among relatives, prenatal, perinatal and postnatal history. Bivariate and multivariate analysis was performed using Mantel-Haenszel process. Results: Multivariate analysis identified three factors associated with epilepsy: family history of epilepsy in first-degree relatives (adjusted Odds ratio (ORa) 2.44, 95%CI 1.18 -5.03), birth asphyxia (ORa 2.20, 95%CI 1.16-34.18), and urinary tract infection in the prenatal stage (ORa, 1.80, 95%CI 1.0 - 3.24). Conclusions: Preventing birth asphyxia and urinary tract infections during pregnancy reduces the risk of epilepsy regardless of the history of epilepsy in first-degree relatives.

Knowledge, Attitude and Practice on Dengue among Adult Population in Felda Sungai Pancing Timur, Kuantan, Pahang

With increasing number of dengue cases in Malaysia, it’s of utmost importance that immediate action be taken to limit the epidemic. Since dengue control is a behavioral problem, the knowledge, attitude and practice in population needs to be studied in order to control the disease. Hence, the aim of this study is to assess knowledge, attitude and practice regarding dengue and its associated factors among adult residents of Felda Sungai Panching Timur (SPT), Kuantan, Pahang, 2014. Method: A cross sectional study was carried out involving 265 adult respondents. A face to face interview questionnaire which was divided into 2 parts (Part A: Sociodemoghraphic; Part B: Knowledge, Attitude and Practice) was used. Data was analyzed using descriptive statistics, simple and multiple logistic regression. Results: 53.2% of the respondents had good knowledge about dengue and it was found that the main source of information from mass media (76.6%). However, only 43.4% were found to have good attitude towards dengue. Multiple Logistic Regression analysis showed there was no association between sociodemographic characteristics with the level of knowledge and attitude towards dengue. There was also no association found between knowledge of dengue and the attitude of the respondents towards dengue. Descriptive analysis on the practice of dengue showed majority of the respondents who had possible breeding site for Aedes mosquitos (water container, drains/gutter roof/flower pots/tires) in their compound practiced good habit in preventing the Aedes mosquitoes from breed. Conclusion: Although knowledge and practice towards dengue is good, their attitude require improvement.

A influência da ingestão de bebida alcoólica e transtornos mentais comuns não psicóticos na pressão arterial dos indígenas Mura / The influence of alcoholic beverages consumption and common mental disorder on arterial blood pressure of the Mura Indigenous

Introdução: A hipertensão arterial é de causa multifatorial, envolvendo hábitos de vida e estilos de vida inadequados como o consumo excessivo de bebida alcoólica que propiciam a elevação dos níveis pressóricos. Além disso, os sintomas relacionados ao transtorno mental comum também podem se associar ao estado de saúde, provocando mais danos ao sujeito com hipertensão arterial. Diante disso, o presente estudo teve como objetivo principal identificar associação entre a ocorrência de hipertensão arterial com o consumo de bebidas alcoólicas e a presença de transtorno mental comum em indígenas das aldeias Muras, residentes em região rural e urbana. Casuística e Métodos: Estudo transversal, de base populacional, com 455 indígenas Mura residentes no município de Autazes, Amazonas, Brasil. Foi aplicada a entrevista semi-estruturada com questões referentes aos dados socioeconômicos e educacionais, hábitos de vida, história clínica, histórico familiar, além dos questionários Alcohol Use Disorders Identification Test (AUDIT) e Self-Reporting Questonnaire (SRQ-20), para avaliar o consumo de álcool e presença de transtorno mental, respectivamente. A pressão arterial foi medida com aparelho automático de braço validado. Foram realizadas três medidas e usada a média das duas últimas medidas. Realizaram-se ainda, medida do peso, altura, circunferência do pescoço, circunferência da cintura, avaliação de bioimpedância; glicemia, triglicérides e colesterol com medida capilar. Na análise bivariada, foi testada a associação entre hipertensos, separadamente, com os dois desfechos: consumo de bebidas alcoólicas e a presença de transtorno mental comum explorando especialmente, os aspectos relacionados à hipertensão arterial. Foi ajustada a regressão de Poisson com variância robusta, para ambos os desfechos, com modelagem em stepwise backward automatizado, tendo como critério de entrada, p<0,20 e de significância no modelo final, p0,05. Utilizou-se como estimativa, as razões de prevalência e respectivos intervalos de confiança de 95%. Resultados: A maioria dos participantes era do sexo feminino (57,8%), com 42,10 (16,74) anos, vivendo com companheiro (74,7%) e cerca de quatro filhos por família, baixo nível de escolaridade Analfabeto/Fundamental incompleto (41,1%) e renda até dois salários mínimos (85,0%). A prevalência de hipertensão arterial foi de 26,6%, tabagismo (20,4%) e ser sedentário/irregularmente ativo (52,8%). O consumo de bebida alcoólica foi de 40,2%, sendo 13,4% classificados como alto risco para dependência alcoólica, e maior na área rural em comparação à urbana (57,3% vs 22,2%) p<0,001. Destacam-se os seguintes aspectos do uso abusivo de álcool: sentimento de culpa/remorso (45,9%); amnésia repentina por não lembrar o ocorrido na noite em que bebeu (31,7%); além de machucar-se ou sentir-se prejudicado por causa da bebida (29,6%); preocupação por parte de parentes, amigos ou profissionais de saúde, que aconselharam o entrevistado a interromper o consumo (51,5%). Não houve associação entre a presença e consumo de bebida alcoólica (23% e 26%). Os indígenas com diagnóstico de hipertensão referida, faziam menos uso de bebida alcoólica (14,2%vs 85,8%, p=0,009), porém nas ocasiões em que bebiam, ingeriam maior quantidade, comparado com os que não referiram hipertensão [55,3(72,2) vs 33,3(62,2) gramas de Etanol p=0,008]. A prevalência de transtorno mental comum foi de 45,7%, com destaque para os seguintes itens: referência de dores de cabeça frequentes (69,5%), sentir-se nervoso, tenso ou preocupado (66,2%), ter se sentido triste ultimamente (56,0%), dormir mal (55,2%) e ter sensações desagradáveis no estômago (42,9%). Além disso, destaca-se que 7,3% referiram ideia de acabar com a própria vida e 4,2% sentiram-se incapazes de desempenhar papel útil. Após análise ajustada a razão de prevalência após análise ajustada (Razão de prevalência, IC-95%), verificou-se associação positiva entre ingestão de bebida alcoólica e sexo masculino (2,72, IC-2,12-3,48), tabagismo (1,29, IC-1,06-1,56) e morar na zona rural (2,09, IC-1,61-2,72). Porém, a ação foi protetora para idade (0,98, IC-0,98-0,99), consumo de alimentos in natura (0,97, IC-0,95-0,99), e ausência de dislipidemias (0,75, IC-0,62-0,9). Entre os que apresentaram transtorno mental comum, a hipertensão arterial identificada esteve presente em 30,3% e o consumo de álcool uma vez ao mês em 22,1%. Após a análise ajustada (Razão de prevalência, IC-95%) verificou-se associação positiva entre o transtorno mental comum e a zona de moradia urbana (1.25, IC-1,02-1,54), não sabia que tinham antecedentes para diabetes (1.56, IC-1,24-1,96) e a ingestão de bebida alcoólica (1.01, IC-1,00-1,02). Porém, foi ação protetora não ter antecedentes pessoais de cardiopatia (0.59, IC-0,48-0,73). Conclusão: Observou-se que a presença de hipertensão arterial, consumo de bebida alcoólica e de transtorno mental comum foram elevados nos indígenas da etnia Mura. Esses achados podem ser decorrentes da aproximação e convivência entre indígenas e não indígenas favorecendo mudanças culturais, especialmente de hábitos e estilos de vida, com aumento do risco de doenças crônicas não transmissíveis.

Background: The arterial hypertension has a multifactorial disorder, including unappropriated habits and lifestyle as the excessive consumption of alcoholic beverages that may increase the blood pressure. Additionally, the symptoms related to the common mental disorder may be also associated with the health status, producing even more damages to the hypertensive subjects. Thus, this study aimed to identify the association of arterial hypertension occurrence with alcoholic beverages consumption and presence of common mental disorder in Indigenous from Mura villages, who live in rural and urban zones. Casuistic and Methods: Its a cross-sectional investigation, with demographic base, conducted with 455 Mura Indigenous from Autazes, Amazon, Brazil. Through a semi-structured interview, we gathered data about sociodemographic and educational profile, lifestyle, clinical records, family antecedents. In this occasion, the Alcohol Use Disorders Identification Test (AUDIT) and the Self-Reporting Questionnaire (SRQ-20) were applied to assess respectively the alcohol consumption and the presence of common mental disorder. The blood pressure was measured with an arm automatic device, validated for this goal, being three measures taken and, from the two last of them, a mean was obtained. Furthermore, we gathered weight, height, neck circumference, waist circumference, bioimpedance, glycemia, triglycerides and cholesterol, capillary measure for the last ones. In the bivariate analysis, we analyzed the association between hypertensive persons and the both outcomes- the alcohol consumption and the presence of common mental disorder, emphasizing the issues hypertension-related issues. The Poison regression, with robust variance, was adjusted for both outcomes, with a modelling in automatized stepwise backward, being p<0,20 the entrance criteria and p<0,05 the significance level for the final model. As estimative, we used the odds ratios and their respective confidence intervals of 95%. Results: Most were females (57,8%), with mean age of 42,2(16,74) years, living with a partner (74,7%), with about four children per family, poor educational level- Illiterate/Incomplete Basic (41,1%) and income of up two minimum wages (85,0%). 26,6% of the sample had hypertension, 20,4% were smokers and 52,8% were sedentary/irregularly active. Alcohol consumption was of 40,2%, with 13,4% showed high risk for alcohol addiction, and the consumption was higher in rural area in comparison with the urban one (57,3% vs 22,2%) p<0,001. We emphasize the following aspects of alcohol abuse: feeling of guilty and remorse (45,9%); abrupt amnesia for not remembering what happened in the night that they had drunk (31,7%); feeling hurt or impaired due to the drink consumption (29,6%); concerns from relatives, friends or healthcare professionals who advised the interviewed to interrupt the consumption (51,5%). There was not association between presence and alcoholic beverages consumption (23% and 26%). Indigenous diagnosed with referred arterial hypertension drank less alcoholic beverages (14,2%vs 85,8% p=0,009), but, when they drank, they had a larger amount than those with referred hypertension [55,3(72,2) vs 33,3(62,2) grams of Ethanol p=0,008]. The common mental disorder was identified in 45,7% of the individuals, being highlighted the following items: reporting of frequent headaches (69,5%), feeling nervous, anxious or worried (66,2%), feeling sad in the last days (56,0%), sleeping badly (55,2%) and having upset stomach (42,9%). Additionally, 7.3% reported the idea of committing suicide, and 4,2% felt themselves unable to play a useful role. We verified positive association between alcoholic beverage consumption and male gender (2.72, CI-2,12-3,48); smoking (1.29, CI-1.06-1.56); and living in rural area (2.09, CI-1.61-2.72). However, the action was protective for the age (0.98, CI-0,98-0,99), intake of natural foods (0.97, CI-0,95-0,99), and absence of dyslipidemias (0.75, CI-0,62-0,9). Among those diagnosed with common mental disorder, the arterial hypertension was found in 30,3% and the alcohol consumption once a month in 22,1%. We observed a positive association of common mental disorder and: living in the urban area (1.25, CI-1,02-1,54); unknowing the antecedents for diabetes (1.56, CI-1,24-1,96); and the alcohol consumption (1.01,CI-1,00-1,02). However, the absence of personal background of heart diseases was not protective (0.59, CI-0,48-0,73). Conclusion: We observed that the presence of arterial hypertension, alcoholic beverages consumption and common mental disorder were high in the Mura ethnicity. This finding may be explained for the approach and interaction among Indigenous and non-Indigenous, which favors cultural changes, especially in habits and lifestyle, increasing the risk of non-transferable chronic diseases.

Avaliação do hábito tabágico e fatores associados ao tabagismo na gestação / Evaluation of smoking habit and its associated factors in pregnancy

O tabagismo é considerado um problema de saúde pública, e, durante a gestação, traz problemas ainda maiores, como complicações obstétricas e efeitos nocivos para o recém-nascido. O objetivo foi avaliar o hábito tabágico e fatores associados ao tabagismo na gestação. Trata-se de estudo transversal, que incluiu 241 puérperas, no Serviço de Ginecologia e Obstetrícia da Maternidade do Hospital Regional de São José ­ Dr. Homero Miranda Gomes, em São José, Santa Catarina. Os dados foram coletados por questionários autoaplicados, além de buscas nos prontuários das puérperas e recém-nascidos. Os dados foram analisados pelo SPSS 16.0, utilizou-se o teste qui-quadrado (χ2 ) ou prova exata de Fisher, foi calculado OddsRatio (OR), o nível de significância foi valor de p < 0,05. O tabagismo foi mais frequente em gestantes usuárias de álcool (100%), com poucas consultas de pré-natal (31,9%) e multíparas (37,7%). O fumo ocasionou no recém-nascido: prematuridade (p=0,003), baixo peso ao nascer (p=0,035) e baixo perímetro cefálico (p<0,001). A prevalência do tabagismo materno ativo foi 24,5% e passivo, 42,3%. Conclui-se que não há nenhuma novidade em afirmar que o cigarro pode estimular o desenvolvimento de diversas doenças; ainda assim, muitas pessoas insistem em manter o vício. O que agrava a situação, no caso das gestantes, é que elas não estão prejudicando apenas o próprio organismo, mas também o de uma criança

Smoking is considered a public health problem, and during pregnancy it brings even greater problems and obstetric complications like harm to the new born effects. The goal was to evaluate the smoking habit and its associated factors during pregnancy. This is a cross-sectional study with a sample of 241 post partum women at the Department of Obstetrics and Gynecology, Maternity Hospital Regional de São José ­ Dr. Homero Miranda Gomes - in São José, Santa Catarina. Data were collected by selfadministered questionnaire sand in the records of the mothers and newborns. Data were analyzed by SPSS 16.0, it was used the chi-square test (χ2) or Fisher exact test, it was calculated Odds Ratio (OR) with level of significance at p < 0.05. Smoking was more frequent in women alcohol users (100%), with few prenatal visits (31.9%) and multiparous (37.7%). Maternal smoking caused in newborns, prematurity (p=0.003), low birth weight (p=0.035) and low head circumference (p<0.001). The prevalence of active maternal smoking was 24.5 % and passive, 42.3%. It was concluded that there is nothing new in stating that cigarettes can stimulate the development of many diseases; yet many people insist on maintaining the addiction. What aggravates the situation in pregnant women, is that they are not only harming themselves, but also their children.

Prótese total convencional ofertada no serviço público de saúde em Belo Horizonte: satisfação, uso e qualidade / Conventional complete denture offered in public health in Belo Horizonte: satisfaction, uso and quality

Este estudo transversal avaliou as próteses totais convencionais (PTC) ofertadas na Atenção Primária em Saúde da cidade de Belo Horizonte, Brasil, descrito em dois artigos. A amostra foi composta por 231 indivíduos usuários de PTC bimaxilar no período de agosto de 2010 a novembro de 2011. Os participantes responderam a um questionário com perguntas sobre condições sociodemográficas, uso e não uso das PTC, número de próteses utilizadas e tempo de edentulismo. Para quantificar a qualidade técnica e satisfação do usuário foi usada metodologia proposta por Sato et al. (1998 e 2000) respectivamente. O grau de reabsorção do rebordo mandibular foi verificado por meio da metodologia de Cawoold e Howell. Os instrumentos foram testados em estudo piloto. Para avaliação da concordância da examinadora foi utilizado o coeficiente Kappa, cujos valores foram de 0,81 para qualidade das PTC e 0,97 para avaliação da reabsorção do rebordo residual. No artigo 1 foi verificada a associação entre satisfação do usuário e qualidade técnica da PTC. A amostra dividida em dois grupos com base no grau de satisfação: grupo 1= insatisfeitos (satisfação <70) e grupo 2= satisfeitos (satisfação ¿ 70). Os grupos foram comparados em relação às variáveis de interesse pelos testes de qui-quadrado e Mann-Whitney. A correlação entre satisfação e qualidade técnica foi avaliada por meio de correlação de Spearman. O escore da satisfação geral foi de 73,18, enquanto o escore da qualidade geral foi de 54,97. A satisfação se associou a todos os critérios que compuseram a qualidade das PTC (p<0,05). A retenção da prótese mandibular apresentou o pior desempenho na avaliação da satisfação e qualidade técnica. Entretanto, a estabilidade e extensão da prótese mandibular apresentaram maior correlação com a satisfação geral...

This cross-sectional study evaluated the conventional dentures (PTC) offered in primary health care in the city of Belo Horizonte, Brazil, described in two articles. The sample consisted of 231 individuals PTC users bimaxillary offered in primary health care in the city of Belo Horizonte-Brazil, from August 2010 to November 2011. The participants answered a questionnaire with questions on sociodemographic conditions, use and non-use of PTC, number of prostheses that have used and edentulism time. To quantify the technical quality and user satisfaction was used methodology proposed by Sato et al. (1998 and 2000) respectively. The degree of resorption of the jaw edge was measured using the methodology Cawoold and Howell. The instruments were tested in a pilot study. To assess the concordance of the examination we used the Kappa coefficient, with values of 0.81 for quality of PTC and 0.97 for evaluation of residual ridge resorption. In the first article was to determine the association between user satisfaction and technical quality of the PTC, the sample was divided into two groups based on the degree of satisfaction: Group 1 = dissatisfied (satisfaction <70) and group 2 = satisfied (satisfaction ≥ 70). The groups were compared regarding the variables of interest using ...

Quit history, intentions to quit, and reasons for considering quitting among tobacco users in India: Findings from the Tobacco Control Policy Evaluation India Wave 1 Survey.

BACKGROUND: Global Adult Tobacco Survey India 2009–2010 revealed that more than one‑third (35%) of adults in India use tobacco in some form: 21% use smokeless tobacco, 9% smoke, and 5% are mixed users (they smoke and use smokeless tobacco), and the quit rate is very low. In an effort to decrease prevalence of tobacco use, it is thus important to understand the factors that are related to intention to quit among Indian tobacco users. Research has shown consistently that intention to quit is a strong predictor of future quitting. The present study reports the factors encouraging quitting tobacco products in India. SUBJECTS AND METHODS: Cross‑sectional data from Wave 1 of the International Tobacco Control Policy Evaluation India Survey conducted in four cities and surrounding rural areas (i.e. Mumbai [Maharashtra], Patna [Bihar], Indore [Madhya Pradesh], and Kolkata [West Bengal]) between August 2010 and December 2011 were analyzed. A total of 8051 tobacco users (15+ years) were randomly sampled from 8586 households: 1255 smokers, 5991 smokeless users, and 805 mixed (smoke and smokeless) users. Validated, standardized questions were asked about current tobacco use, intention to quit, and factors encouraging quitting. RESULTS: Overall, 19.6% of tobacco users intended to quit. Smokers had less intention to quit as compared to smokeless tobacco users whereas mixed users had more intention to quit (odds ratio [OR] =1.48, 95% confidence interval [CI] =1.12–1.97) compared to smokeless tobacco users. Highly educated people were more likely to report intention to quit (OR = 1.82, 95% CI = 1.09–3.02) compared to less educated. Advice by doctors to quit tobacco had a strong impact on intention to quit (OR = 1.68, CI = 1.29–2.15). Tobacco users who were exposed to antitobacco messages at work places (OR = 1.74, CI = 1.23–2.46), at restaurants (OR = 1.65, CI = 1.12–2.43), bars (OR = 1.81, CI = 1.07–3.06), on public transportation (OR = 2.14, CI = 1.49–3.08) and on tobacco packages (OR = 1.77, CI = 1.29–2.14) also expressed greater intention to quit tobacco use. CONCLUSION: Around one‑fifth of tobacco users in India intended to quit tobacco use. Higher education, doctor’s advice, and antitobacco messages were positively associated with users’ intention to quit tobacco.

Factores asociados con la mortalidad por meningitis neumocócica en hospitales de La Habana / Factors associated with mortality due to pneumococcal meningitis in Havana hospitals

Introducción: la meningitis neumocócica constituye un serio problema de salud por su alta morbilidad, letalidad y graves secuelas. Objetivos: identificar algunos factores de riesgo asociados con la mortalidad por meningitis neumocócica. Métodos: se realizó un estudio de caso-control en 7 hospitales de La Habana (enero de 2002-diciembre de 2011) de 45 pacientes (0-86 años de edad), con meningitis neumocócica confirmada: 15 fallecidos (casos) y 30 sobrevivientes (controles), a partir de la vigilancia nacional de síndromes neurológicos bacterianos, historias clínicas, movimientos hospitalarios, tarjetas de enfermedades de declaración obligatoria y registros de laboratorio. Se midió la asociación (análisis bivariado y multivariado) de algunos factores con la muerte a través de la oportunidad relativa y su intervalo de confianza a 95 por ciento, considerando asociación cuando fue mayor o igual que 2. Resultados: la letalidad general resultó de 33,3 por ciento. La media entre el inicio de los síntomas y la consulta médica fue de 2,4 días; entre la consulta y el ingreso 0,5 días; entre el ingreso y el diagnóstico 0,4 días, y entre el diagnóstico y el tratamiento 0,2 días. La estadía hospitalaria media fue de 12,2 días. El análisis bivariado y multivariado mostró asociación significativa de la inconsciencia al ingreso, con la muerte. Otras variables se asociaron con el desenlace fatal pero no fueron significativas. Conclusiones: estar inconsciente al momento del ingreso es un factor de riesgo para la muerte por meningitis neumocócica, en los pacientes con esta enfermedad de los hospitales investigados en La Habana

Introduction: pneumococcal meningitis is a critical public health problem with a high rate of morbidity and mortality and serious sequelae. Objectives: identify some risk factors associated with mortality due to pneumococcal meningitis. Methods: a case-control study was conducted of 45 patients aged 0-86 with confirmed pneumococcal meningitis cared for in seven Havana hospitals from January 2002 to December 2011. Of the 45 patients studied, 15 had died (cases) and 30 had survived (controls). The study was based on national bacterial neurological syndrome surveillance data, medical records, hospital movements, notifiable disease cards and laboratory records. Association (bivariate and multivariate analysis) of some factors with death was measured through odds ratio with a confidence interval of 95 percent, considering it an association if greater than or equal to 2. Results: overall case-fatality rate was 33.3 percent. Mean time between the onset of symptoms and medical consultation was 2.4 days; between consultation and admission 0.5 day; between admission and diagnosis 0.4 day; and between diagnosis and treatment 0.2 day. Mean hospital stay was 12.2 days. Bivariate and multivariate analysis revealed a significant association between unconsciousness at admission and death. Other variables were associated with death as well, but they were not significant. Conclusions: being unconscious at admission is a risk factor for death due to pneumococcal meningitis in patients with this disease in the Havana hospitals studied

Prevalence of Smoking and Its Associated Factors among University Staff

Globally, one person dies every six seconds as a result of tobacco use. This makes tobacco use the cause of every one out of 10 deaths in adults and the single largest and leading cause of preventable death in the world. The objective of this study was to determine the prevalence of smoking among staff of Universiti Putra Malaysia. For the purpose of this study an analytical cross sectional study design was used and a standardized, pre-tested, while a validated well-structured questionnaire was used for data collection. The prevalence of smoking was found to be 10.0% (26.5% among males and 0.5% among females). In addition, signifi cant associations were found between smoking and gender, religion, marital status, highest educational level, occupation, and family income (p < 0.05). In particular, gender and educational level were signifi cant predictors of smoking. In conclusion, the prevalence of smoking among university staff was shown to be considerably lower than that stated for the national level. However, the University could aim at achieving zero prevalence in the years to come.