In the classroom but absent: Evidence of sickness presenteeism among teachers at four public schools.

Objective: Evidence regarding sickness presenteeism (SP) in low-and middle-income countries and in vulnerable groups such as teachers is relatively scarce. To provide evidence addressing this research gap, we examined the prevalence and predictors, and estimated the productivity loss impairment due to SP among teachers in Leon, Nicaragua. Methods: This was a cross-sectional study. Four public schools in Leon, Nicaragua, were selected, and 132 teachers were included in the final sample. Predictors influencing SP were identified through multivariable logistic regression. By using the Work Productivity and Activity Impairment Questionnaire, we converted the productivity loss impairment to 2018 US dollars (1 US dollar = 31.78 Cordobas). Results: Overall, the prevalence of SP was 65.2% (95% C.I.: 56.53-72.87), and no differences were found in sociodemographic characteristics. We observed a negative relationship between director/supervisor support and SP (p<0.001). Moreover, teachers without suitable household conditions for resting had a 1.28 times higher probability of SP (95% C.I.: 1.03-1.59). The median percentage time missed for all health reasons was 14.3%. The median percentage productivity loss impairment due to health conditions was 30%. The median per-capita cost of SP during the prior week was 20 US dollars, and the overall cost was 1805 US dollars. Conclusion: Among teachers, SP has a relatively high prevalence and is associated with a high economic toll. Interventions aimed at promoting healthful lifestyles are needed.

Prevalence, awareness, treatment, and control of hypertension in a small northern town in Nicaragua: The Elieth-HIFARI study.

BACKGROUND AND AIMS: Hypertension is considered the most important risk factor for cardiovascular disease and is associated with high levels of morbidity, mortality, and health care expenditure. The negative effects of hypertension and its complications are preventable if those at risk are appropriately treated and controlled. Continually monitoring the epidemiological trends of hypertension is essential to formulate and evaluate public health measures to limit its negative effects. The herein presented Elieth-HIFARI study sought to estimate the prevalence of hypertension, as well as the prevalence of related awareness, treatment, and control in a small town in Central America. METHODS: A population survey to assess cardiovascular risk was conducted (n = 577, 55.3% women, mean age 42.4 years) in the municipality of San Rafael del Norte in northern Nicaragua, between November 2016 and March 2017, based on the STEPwise method by the World Health Organization and the recommendations by the World Hypertension League. RESULTS: The overall prevalence of hypertension, awareness, treatment, and control was 28.1%, 72.2%, 68.5%, and 36.4%, respectively. Men had a lower prevalence of all indicators (22.5%, 60.3%, 53.4%, and 24.1%, respectively) compared with women (32.6%, 78.8%, 76.9%, and 43.3%, respectively). The median systolic blood pressure was 118.5 mm Hg (20.5 interquartile range [IQR]) (men: 123.0 mm Hg vs women: 115.5 mm Hg, Mann-Whitney U test P < .001), and the mean diastolic blood pressure was 78.0 mm Hg (13 IQR) (men: 77.0, women: 78.0). CONCLUSION: Hypertension is highly prevalent in San Rafael del Norte, while control rates are low despite the relatively higher levels of awareness and treatment. Furthermore, women have much higher prevalence of hypertension than men, along with higher awareness, treatment, and control. However, the control rate for those treated for hypertension was low, irrespective of sex.

Fatal occupational injuries in Nicaragua, 2005.

We attempt to estimate the rate of fatal occupational injuries (FOI) in Nicaragua for 2005, using 10 incomplete data sources. Based on the 173 identified FOIs, the crude empirical FOI rate estimate was 8.3 per 100,000 employed (12.3 men; 1.8 women) and highest in the 25-29 age group (15). The overall rate, corrected by capture-recapture modeling, was 11.6. Manufacturing represented a high rate (11.7); the formal economy rate (12.3) was higher than the informal economy (6); mining (110.3) and electricity (76.2) had the highest industry rates; and the most common agents of FOIs were motor vehicles. With 10 major sources, the extent of FOIs remains grossly underestimated and biased across worker strata. The FOIs among informal and agricultural workers tend to remain invisible, as there is no systematic surveillance by any agency. Changes in legislation and implementation are necessary to correct the situation.

[Factors related to sickness absenteeism among nursing personnel]. / Fatores relacionados ao absenteísmo por doença em profissionais de enfermagem.

OBJECTIVE: To analyze short-term leaves among the healthcare staff of a university hospital. METHODS: Study population included 965 nursing professionals active on 1 January 2000. Leaves up to 30 days in one year were analyzed. Sickness leaves (one-year aggregate), service demand, and diagnoses were described. Relative risk was estimated through multivariate analysis, using negative binomial distribution. RESULTS: About 65% of workers generated 1,988 appointments, of which 68.6% lead to absence from work. The greatest demand occurred among nursing technicians, women, and statutory workers (OR=1.61; 1.47; 1.53 respectively). Over half the studied population (57.6%) had at least one absence. This corresponds to 87.8% of workers who had physician appointments. These workers generated a total 1,364 leaves of absence--1.41 per worker--and 5,279 workdays were missed. Multivariate analysis was carried out considering each gender separately. An effect was found only for work regime (RR=1.45 e RR=2.43) for both men and women. CONCLUSIONS: A relationship exists between absenteeism and work regime. It is necessary to include other variables, such as time working for the company, shift, and number of children.

Fatores relacionados ao absenteísmo por doença em profissionais de enfermagem / Factors related to sickness absenteeism among nursing personnel

OBJETIVO: Analisar os afastamentos de curta duraçäo de profissionais de enfermagem de um hospital universitário. MÉTODOS: A populaçäo estudada foi de 965 profissionais de enfermagem de um hospital universitário e que estavam em atividade em primeiro de janeiro de 2000.Foram analisados afastamentos do trabalho desse grupo por até 30 dias em um ano civil. Foi feita a descriçäo dos afastamentos por doença (agregados em um ano), da demanda pelo serviço e dos diagnósticos. Por meio de análise multivariável foi estimado o risco relativo utilizando a distribuiçäo de erro binomial negativa. RESULTADOS: Cerca de 65 por cento dos trabalhadores geraram 1.988 consultas, das quais 68,6 por cento resultaram em afastamento do trabalho. Os grupos com maior demanda foram técnicos de enfermagem, mulheres e estatutários (OR=1,61; 1,47; 1,53 respectivamente). Os diagnósticos mais freqüentes foram os relacionados ao aparelho respiratório. Para afastamentos, näo foram encontradas diferenças para gênero e idade. Pelo menos um afastamento foi concedido a 57,6 por cento da populaçäo, o que corresponde a 87,8 por cento dos trabalhadores atendidos. Estes geraram um total de 1.364 afastamentos, 1,41 por trabalhador e 5.279 dias perdidos. A análise multivariável, ao considerar separadamente os sexos, mostrou efeito apenas do vínculo empregatício (RR=1,45 e RR=2,43) para mulheres e homens. CONCLUSÕES: Existe relaçäo entre afastamento e vínculo empregatício. Faz-se necessário incluir outras variáveis, como tempo na empresa, turno e carga reprodutiva, em futuras pesquisas.