Association between uncontrolled diabetes and periodontal disease in US adults: NHANES 2009-2014.

This study examined the relationship between uncontrolled diabetes and periodontal disease (PD) among adults in the United States. We used data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES) with a sample of 6108 adults ages 30 and over. To measure PD status, we used the Centers for Disease Control and Prevention/American Academy of Periodontology's standards. To classify DM status (no DM, DM with HbA1c < 9%, diabetes with HbA1c ≥ 9%),we used self-reported Diabetes Mellitus (DM) diagnosis and laboratory report of HbA1c. Approximately 8.5% of the sample had controlled DM, and 1.7% had uncontrolled DM, for a total of 10.2% DM in the analysis. Multivariate logistic regression showed that compared to those without DM, PD was significantly increased with controlled DM (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) 1.01-1.73, p < 0.05) and even more with uncontrolled DM (aOR = 2.48, 95% CI 1.52-4.04, p < 0.001), after adjusting for covariates. Factors that reduced the prevalence of PD included annual dental visits, female gender, and college education. Factors that significantly increased PD prevalence were cigarette smoking, non-white race, income < 200% Federal Poverty Level, and older age (age > 50 years). In conclusion, uncontrolled DM was significantly associated with higher odds of PD among adults in the US.

COVID-19 infection and mortality among non-pregnant indigenous adults in Mexico 2020-2022: Impact of marginalisation.

Background: Indigenous individuals have higher rates of mortality and poverty in Mexico and more than half are marginalised, and COVID-19 pandemic aggravated the existing burden of health disparities. We aimed to analyse the effects of being indigenous and marginalised on coronavirus (COVID-19) infection fatality in Mexico. Methods: We identified 3 424 690 non-pregnant, COVID-19 positive adults ≥19 years in the Mexico national COVID-19 database with known date of symptom. We used demographic information, indigenous status, marginalisation status, and co-morbidities in binary logistic regression to predict mortality, adjusting for covariates, including hospitalisation, admission to the intensive care unit (ICU), and mechanical ventilation use. We also assessed the interaction between indigenous status and marginalisation. Results: Marginalisation was much higher among indigenous (53.7%) compared to non-indigenous individuals (4.8%). COVID-19 fatalities were approximately 20 years older (64.4 and 63.0 years) than survivors (44.7 and 41.2 years) among indigenous vs non-indigenous individuals, respectively. The unadjusted risk of COVID-19 fatality among indigenous individuals was nearly two-fold (odds ratio (OR) = 1.92)) compared to non-indigenous individuals (OR = 1.05). COVID-19 fatality was higher among highly marginalised individuals (upper quartile) (OR = 1.51; 95% confidence interval (CI) = 1.49-1.54). Marginalised indigenous individuals had a significantly lower likelihood of ICU admission compared to non-indigenous non-marginalised individuals. The likelihood of mechanical ventilation for indigenous individuals was 4% higher compared to non-indigenous individuals. Indigenous marginalised individuals had a significantly lower probability of mechanical ventilation compared to non-indigenous non-marginalised individuals. COVID-19 comorbidity risks of fatality significantly differed between the two groups in the Cox survival analysis. In the fully adjusted model, indigenous individuals were 4% more likely to die from COVID-19 compared to non-indigenous. Conclusions: Indigenous, marginalised individuals with COVID-19 had higher risk of hospitalisation and ICU admission than non-indigenous patients. Marginalised, indigenous individuals were less likely to receive mechanical ventilation compared to non-indigenous, but had a higher risk of COVID-19. Indigenous individuals had a 4% higher COVID-19 mortality risk COVID-19 compared to non-indigenous individuals. Improved community medical care and augmented health services in rural hospitals could mitigate barriers to health care access in indigenous, marginalised populations.

Compliance on existing WASH facilities in community clinics of Bangladesh: A comparative study.

Provisions of water sanitation and hygiene (WASH) facilities are essential to make accessible and sustainable through Community Clinics (CCs) to control infection in primary health care service. However, there is scarcity of literature to observe the scenario. This cross-sectional study with mix-method approach conducted a comparative analysis with a focus on compliance with WASH facilities between two categories of CCs in Meherpur and Kustia District in Bangladesh. There were total 420 respondents out of which 400 were selected purposively from the 20 renovated and non-renovated CCs for quantitative approach and 20 respondents for qualitative approach. Data were collected using face-to-face interview method. The study revealed that all of the renovated CCs had safe drinking water source, functioning toilet, hand washing and dust bin facilities except for a few cases with technical problem in water supply. But the reverse scenario was observed in non-renovated CCs. Compliance on WASH facilities in renovated CCs was two times higher than the non-renovated CCs. Clients aged ≤40 years (AOR = 0.41, renovated CCs), and married (AOR = 4.03, non-renovated CCs) did not comply the use of safe drinking water in CCs. Noncompliance of toilet use (AOR = 12.15, renovated CCs and AOR = 8.96, non-renovated CCs) and hand washing facility use (AOR = 8.46, renovated CCs and AOR = 16.8, non-renovated CCs) significantly found higher among respondents who had no formal education. Non-renovated CCs need to develop their WASH facilities as well as ensure maintenance whereas the renovated CCs need dedicated human resource as well as effective policies to maintain the sustainability.