Determinants of zinc utilisation in the management of diarrhoea among under-five children in Nigeria: a population-based, cross-sectional study.

BACKGROUND: Diarrhoea remains the foremost cause of sickness and death among children aged <5 y (under-five) in low- and middle-income countries. The WHO and UNICEF recommend that any child with diarrhoea signs be given zinc tablets as part of the treatment within 24 h. Therefore, we aimed to assess the prevalence and determinants of zinc utilisation for diarrhoea among under-five children in Nigeria. METHODS: The Nigeria Demographic and Health Survey 2018 was used for this study. Data were analysed using IBM SPSS version 25.0. A multilevel analysis technique employing the generalised linear mixed model was used for analysing the data of 3956 under-five children with diarrhoea. RESULTS: Only 29.1% of children who experienced diarrhoea received zinc combined with other forms of treatments during the diarrhoea episode. However, mothers with a secondary or higher level of education had a 40% higher likelihood of zinc utilisation during childhood diarrhoea (AOR, 1.40; 95% CI 1.05 to 2.22). Similarly, children whose mothers were exposed to media were more likely to receive zinc during diarrhoea than those whose mothers were not (AOR, 2.50; 95% CI 1.01 to 3.87). CONCLUSIONS: In this study, the prevalence of zinc use among under-five children with diarrhoea in Nigeria was low. Therefore, appropriate strategies to improve zinc utilisation are needed.

Epidemiological determinants of COVID-19 in the police personnel: A cross-sectional study.

Background: Police are the frontline warriors who themselves are at risk of getting corona infection. This research with considerable sample size is the first of its kind to assess the epidemiological determinants of coronavirus disease 2019 (COVID-19) infection in the police personnel. Material and Methods: The Institutional Ethics Committee (IEC) approval and permission from police authorities were taken. The cross-sectional, descriptive study was planned on randomly selected 375 police personnel in the month of September-November 2020. Police detected with COVID-19 were included and those who were critically ill were excluded from the study. The written informed consent was taken and data was collected by pretested questionnaire. The data were entered and analyzed using SPSS version 21. Results: The mean age of study subjects was 34.25 ± 9.1 years with 84% being males. There was no significant difference in age and sex distribution of study subjects. The most commonly affected police personnel were police constables (222 out of 375) followed by police nayak (42 out of 375). Around 88.2% were symptomatic. Symptoms were fever (64%), weakness (54.4%), cough (38.4%), loss of smell sensation (35.2%), cold (32.3%), shortness of breath (13.9%), diarrhea (11.7%), and pain in the abdomen (6.4%). "Cold" symptom was significantly higher in the younger age group as compared with the older age group. Shortness of breath was significantly higher in males as compared with females (P value < 0.05). The perceived probable sources of infection were from a colleague (33.9%), family member (4.5%), residential society member (2.4%) while performing duty (23.2%), and while traveling in public transport (4%). Regarding preventive measures, almost 99%, 94%, and 87%, followed hand hygiene, mask-wearing, and physical distancing, respectively, prior to getting corona infection. AYUSH self-care practices such as daily drinking of turmeric milk, warm water, and breathing exercises were practiced by 66.9%, 85.9%, and 54.1% of the police personnel, respectively. Conclusions: There is male preponderance for corona infection among police personnel. Breathlessness is common in males as compared with female police. The cold symptom is mostly observed in young police personnel. Police personnel needs to judiciously follow physical distancing and practice general measures recommended by AYUSH.

[Chemical composition of urinary stones and associated factors in the Democratic Republic of Congo]. / Composition chimique des calculs urinaires et caractéristiques épidémiologiques associées en République Démocratique du Congo.

To compare the chemical composition of the upper and lower urinary tract stones in Congolese patients, and to identify factors associated with the different types of stones. Stones from 119 patients originating from the upper tract and 75 from the lower tract were analyzed by infrared spectrophotometry. Among 119 patients with upper tract stones, age ranged from 10 to 81 years with a mean (SD) of 45.8 (13.6) years; males were the majority (55.5%). The main types of stones identified were whewellite (79%). For the 75 patients with lower apparatus stones, age ranged from 4 to 87 years with a mean (SD) of 51.6 (21.6) years; the majority were males (89.3%). The main types of stones were whewellite (44%) and anhydrous uric acid (22.7%). Overall, the factors associated with calcium oxalate included: site [4.95 (95% CI 2.35-10.44)] and diameter [3.03 (95% CI 1.45-6.25)]; patient's place of residence [0.05 (95% CI 0.01-0.29)] was associated with calcium phosphate. Infection stones were associated with; site [0.19 (95% CI 0.06-0.63)] and diameter [0.10 (95% CI 0.03-0.38)]. Finally, age 0.26 (95% CI 0.09-0.71) and stone site [0.23 (95% CI 0.07-0.68)] were associated with uric stones. The epidemiological and chemical profile of upper and lower tract stones were different. Several factors were associated with the chemical and crystalline composition of stones in the Democratic Republic of Congo.

Inequalities in the Universal Right to Health.

Child health inequalities violate children's rights to optimal wellbeing. Different issues worldwide affect children's physical and mental health as well as their development, influencing their future as adults. Inequities are avoidable inequalities. Despite improvements in the past two decades, the ambitious goals of global agendas have, for the most part, remained as expectations with regard to childhood rights, social justice, and health equity in practice. The concept of social determinants of health has become part of the common language in certain settings, but this is still too little to improve health in practice on a global scale, particularly for underprivileged subgroups of the community, as children and adolescents often are. Pediatric health professionals and their organizations are also responsible for guaranteeing children's and adolescents' right to health and better wellbeing, helping to reduce health inequalities.

Conocimientos sobre tabaco y sus riesgos a la salud en Costa Rica: un análisis estructural / Knowledge about tobacco and its health risks in Costa Rica: structural analysis

Resumen Objetivo: Identificar factores asociados al conocimiento sobre el tabaco y los riesgos de su consumo basados en la "Encuesta global de tabaquismo en adultos" realizada en Costa Rica durante el 2015. Métodos: Estudio epidemiológico, observacional de tipo transversal con representación nacional (n = 8 607). Con la base de datos de la "Encuesta global de tabaquismo en adultos", se diseñó un modelo de ecuaciones estructurales y se construyó la variable latente: conocimientos. Como determinantes del conocimiento se usaron las variables: sociodemográficas, económicas, fumado, cesación, exposición a la publicidad y a la información sobre los peligros de fumar incluidas en la encuesta. Resultados: El conocimiento sobre el tabaco y los riesgos del consumo aumentó con la edad, fue superior en hombres y en zonas urbanas. Los fumadores tuvieron menos conocimientos sobre el fumado pasivo y más sobre enfermedades. Conclusiones: La Encuesta global de tabaquismo en adultos permitió medir el nivel de conocimiento sobre los riesgos asociados al tabaco y estudiar sus determinantes socioeconómicos.

Abstract Objective: To identify tobacco knowledge and consumption risk determinants based on the Global Adult Tobacco Survey carried out in Costa Rica in 2015. Methods: Cross-sectional study using a multi-stage cluster sample, nationally representative of Costa Rica (n = 8 607). A structural equation model was conducted. A latent endogenous (dependent) variable called knowledge was constructed. Exogenous (independent) observed variables were: sociodemographic factors, household wealth, prior smoking, cessation attempt, exposure to advertising and to information on the dangers of smoking included in Global Adult Tobacco Survey. Results: Knowledge about tobacco and the risks of consumption increased with age, it was higher in men and in urban areas. Smokers had less knowledge about passive smoking and more about diseases. Conclusions: Global Adult Tobacco Survey allowed to measure the level of knowledge about the risks associated with tobacco and study its socioeconomic determinants.

Epidemiological Determinants of COVID-19-Related Patient Outcomes in Different Countries and Plan of Action: A Retrospective Analysis.

Current development around the pandemic of novel coronavirus disease 2019 (COVID-19) presents a significant healthcare resource burden threatening to overwhelm the available nationwide healthcare infrastructure. It is essential to consider, especially for resource-limited nations, strategizing the coordinated response to handle this crisis effectively and preparing for the upcoming emergence of calamity caused by this yet-to-know disease entity. Relevant epidemiological data were retrieved from currently available online reports related to COVID-19 patients. The correlation coefficient was calculated by plotting dependant variables - the number of COVID-19 cases and the number of deaths due to COVID 19 on the Y-axis and independent variables - critical-care beds per capita, the median age of the population of the country, the number of COVID-19 tests per million population, population density (persons per square km), urban population percentage, and gross domestic product (GDP) expense on health care - on the X-axis. After analyzing the data, both the fatality rate and the total number of COVID-19 cases were found to have an inverse association with the population density with the variable - the number of cases of COVID-19 - achieving a statistical significance (p-value 0.01). The negative correlation between critical care beds and the fatality rate is well-justified, as intensive care unit (ICU) beds and ventilators are the critical elements in the management of complicated cases. There was also a significant positive correlation between GDP expenses on healthcare by a country and the number of COVID-19 cases being registered (p-value 0.008), although that did not affect mortality (p-value 0.851). This analysis discusses the overview of various epidemiological determinants possibly contributing to the variation in patient outcomes across regions and helps improve our understanding to develop a plan of action and effective control measures in the future.

Epidemiología de las enteroparasitosis en escolares de Manabí, Ecuador / Epidemiology of enteroparasitosis in schoolchildren from Manabí, Ecuador

Las parasitosis intestinales son infecciones causadas por helmintos, cromistas y protozoarios. En su mayoría, transmitidos por vía fecal-oral, especialmente por ingestión de agua y alimentos contaminados con formas infectantes. El objetivo fue determinar la prevalencia y factores epidemiológicos determinantes de parasitosis intestinales en escolares de dos cantones de Manabí, Ecuador. Se analizaron 793 muestras de heces, con la técnica del examen directo, en niños en edades comprendidas entre 1 y 16 años, de uno u otro sexo. Se determinó una prevalencia general de parasitados de 44,4% (352/793). La prevalencia de parasitosis intestinal por helmintos fue del 0,75%, mientras que por protozoos fue del 44,8%. Las principales especies encontradas fueron los protozoarios complejo Entamoeba 34,7% (125 casos), Entamoeba coli 24,7% (89 casos) y Giardia lamblia 13,6% (49 casos); Blastocystis spp, 12,2%. La sintomatología más frecuente en los parasitados fue el dolor abdominal. El determinante epidemiológico que tuvo significancia estadística fue la ingesta de agua de tubería, botellón y de pozo o río. El Coeficiente de Similaridad de Sorensen fue semejante en cuatro cantones, indicando la similitud en cuanto a especies parasitarias como a factores de riesgo

Intestinal parasitoses are infections caused by helminths, chromists, and protozoa. The majority are transmitted by the fecal - oral route, especially by ingestion of water and food contaminated with infecting forms. The objective was to determine the prevalence and epidemiological determinants of intestinal parasitosis in schoolchildren from two cantons of Manabí, Ecuador. 793 stool samples were analyzed using the direct examination technique in children between the ages of 1 and 16, of either sex. A general prevalence of parasites of 44.4% (352/793) was determined. The prevalence of intestinal parasites due to helminths was 0.75%, while for protozoa, it was 44.8%. The main species found were the protozoan complex Entamoeba 34.7% (125 cases), Entamoeba coli 24.7% (89 cases) and Giardia lamblia 13.6% (49 cases), Blastocystis spp, 12.2%. The most frequent symptomatology in parasites was abdominal pain. The epidemiological determinant that had statistical significance was the intake of water from pipes, bottles and wells or rivers. Coefficient of Similarity of Sorensen was similar in four cantons, indicating the likeness in terms of parasitic species and risk factors

Epidemiological determinants of Chrysomya (Diptera: calliphoridae) infestation in layer farms of Minas Gerais, Brazil / Determinantes epidemiológicos da infestação por Chrysomya (Diptera: Calliphoridae) em granjas avícolas de postura de Minas Gerais, Brasil

Aspects related to the epidemiology of Diptera belonging to genus Chrysomya were studied in order to determine predisposing factors for their occurrence in commercial laying hens farms from the state of Minas Gerais, Brazil. An observational, analytical and sectional survey was conducted to verify the main epidemiological determinants of infestations by Chrysomya spp. Forty-three farms were visited in 2012 and these 13 (30,23%) were infested by Chrysomya putoria, 4 (9,30%) by Chrysomya megacephala and 2 (4,65%) by Chrysomya albiceps and in 2 farms (4,65%) was not possible to identify the species of Chrysomya. The epidemiological determinants for the occurrence of infestations by Chrysomya spp. were investigated using multiple logistic regression models. Housing clustering type and its conditions were important factors involved in epidemiology of these species (OR=5.05, 95% CI = 2.66 to 9.58, p = 0.000). It was also observed that the increase of the humidity of manure leads to increase chances of infestations (OR = 1.81, 95% CI = 1.36 to 2.40, p = 0.000). The presence of the beetle "lesser mealworm" (Alphitobiusdiaperinus) (OR = 0.15, 95% CI = 0.067 to 0.36, p = 0.000) was characterized as a protective factor against infestations, probably due to predation behavior of the beetle. Some regions of the state were characterized as lower risk areas for Chrysomya spp. infestation as compared to other regions. Management measures, such as constant monitoring of water leaks on manure, adequate composting of dead poultry and periodic removal of manure could assist in decreasing the presence of Chrysomya spp. inside the laying houses.

Aspectos relacionados à epidemiologia das infestações por dípteros do gênero Chrysomyaforam estudados com o objetivo de determinar os fatores predisponentes para sua ocorrência em granjas comerciais de postura do estado de Minas Gerais, Brasil. Foi realizado um estudo observacional, analítico e seccional para verificar os principais determinantes epidemiológicos das infestações por Chrysomya spp. Foram visitadas 43 granjas avícolas em 2012 e dessas 13 (30,23%) apresentaram infestação por Chrysomya putoria, 4 (9,30%) por Chrysomya megacephala, 2 (4,65%) por Chrysomya albiceps e em 2 granjas (4,65%) não foi possível identificar as espécies de Chrysomya. A verificação dos determinantes epidemiológicos foi realizada utilizando modelos de regressão logística múltipla. Diferenças entre os núcleos das granjas avícolas e que não foram avaliadas neste estudo, apresentaram-se importantes na epidemiologia destas moscas (OR=5.05 95% IC = 2.66 a 9.58, p = 0.000). Observou-se também que o aumento na umidade do esterco dos aviários aumenta as chances de ocorrência de infestações (OR = 1.81, 95% IC = 1.36 a 2.40, p = 0.000). A presença de coleópteros popularmente conhecidos como "Cascudinhos", Alphitobiusdiaperinus (OR = 0.15, 95% IC = 0.067 a 0.36, p = 0.000), foi caracterizada como um fator protetor contra infestações, provavelmente devido ao comportamento predador deste coleóptero. Algumas regiões do estado apresentaram menores chances de ocorrência de infestações por Chrysomya spp. quando comparadas a outras regiões. Algumas medidas de manejo, como monitoramento constante de vazamentos de água no esterco, compostagem adequada de aves mortas e remoção periódica do esterco, poderiam auxiliar na diminuição da presença de Chrysomya spp. no interior dos galpões de postura.

Predictors of quality of life of people receiving intensive community-based care.

PURPOSE: Intensive community-based care (ICBC) is a home-treatment approach aiming to support people 'living in the community' with severe psychiatric and addiction problems. Although subjective quality of life (SQOL) is an increasingly important outcome measure in health care, little is known on ICBC clients' SQOL. METHODS: Clients of three ICBC teams (N = 523) participated in the study. Upon intake, clients filled out a SQOL measure and indicated whether they had a good friend, partner, and children, as well as their experiences with crime. Professional caregivers filled in a measure on problem severity. RESULTS: Regression was used to examine to what extent the included variables contributed to explaining variance in ICBC clients' SQOL. Determinants in the model significantly predicted client SQOL and explained 37 % of the variance. 'Symptomatology' (depressive symptoms) and 'social problems' (living conditions) negatively influenced the SQOL, while having a partner, a good friend, and an overall lower problem severity positively influenced SQOL. CONCLUSIONS: SQOL among ICBC clients is related to psychopathology, in contrast to previous knowledge. It is dependent upon symptom specificity, living conditions, and social circumstances and therefore presumably on program characteristics. This study provides insight into well-being among ICBC clients and is therefore relevant to involved healthcare professionals.

Two years post-tsunami in Thailand: who still needs assistance?

BACKGROUND: On 26 December 2004, 280 000 people lost their lives in the Asia-Pacific region. A massive earthquake struck Indonesia, triggering a tsunami that affected several countries, including Thailand. This tsunami had important implications for the health status of Thai citizens and health planning, and thus there is a need to study its long-term impact. METHODS: This cohort study identified determinants of health service utilization (outpatient services, inpatient services, home care, medications and informal care) 1 and 2 years post-tsunami in Thailand. A two-part model with a multivariate logistic regression for each part was used to identify determinants of the propensity and intensity of utilization. RESULTS: Of 1943 participants, 1889 (97.2%) participated at 1 year and 1814/1889 (96.0%) at 2 years. Common determinants of health service utilization in post-tsunami settings were age, marital status, education level, employment status, number of health conditions and (physical and mental) health status. CONCLUSIONS: Knowing the determinants of health service use, health providers may be able to establish programmes for, or to carefully monitor populations, who are more likely to use services. The study results may be used to inform requests for health resources or to assist the development of guidelines for long-term disaster recovery planning.

Contact behaviour of children and parental employment behaviour during school closures against the pandemic influenza A (H1N1-2009) in Japan.

OBJECTIVES: To identify epidemiological determinants of the contact behaviour of children and their impact on parental employment, during school closures that took place over the course of the 2009 pandemic influenza (H1N1-2009) in Japan. METHODS: A retrospective survey was conducted in Japanese households between October 2009 and May 2010 by administration of a standardized questionnaire. Demographic and behavioural variables were explored, in association with the frequency with which children left the home and the risk of parents being absent from work during school closures. RESULTS: Data from 882 eligible households were analysed. A total of 181/882 (20.5%) of households reported that children left the home for nonessential reasons during school closures. No impact on parental working hours was reported by 742/882 (84.1%) of households. Univariate analyses showed that the frequency with which children left the home was dependent on age, extent of school closure and requirement for special childcare arrangements. CONCLUSIONS: A greater understanding of age-dependent behaviours, during school closures as a consequence of a pandemic, is required. Consideration of a public policy to permit a paid leave of absence from work for parents during school closures may be beneficial; the cost-effectiveness of such a measure should be assessed in future.