Sample records for countries prevalence management

  1. Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors

    PubMed Central

    Kalaria, Raj N; Maestre, Gladys E; Arizaga, Raul; Friedland, Robert P; Galasko, Doug; Hall, Kathleen; Luchsinger, José A; Ogunniyi, Adesola; Perry, Elaine K; Potocnik, Felix; Prince, Martin; Stewart, Robert; Wimo, Anders; Zhang, Zhen-Xin; Antuono, Piero

    2010-01-01

    Despite mortality due to communicable diseases, poverty, and human conflicts, dementia incidence is destined to increase in the developing world in tandem with the ageing population. Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (≥5%) in certain Asian and Latin American countries, but consistently low (1–3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for ∼30% of the prevalence. Early-onset familial forms of dementia with single-gene defects occur in Latin America, Asia, and Africa. Illiteracy remains a risk factor for dementia. The APOE ε4 allele does not influence dementia progression in sub-Saharan Africans. Vascular factors, such as hypertension and type 2 diabetes, are likely to increase the burden of dementia. Use of traditional diets and medicinal plant extracts might aid prevention and treatment. Dementia costs in developing countries are estimated to be US$73 billion yearly, but care demands social protection, which seems scarce in these regions. PMID:18667359

  2. Estimating prevalence of osteoporosis: examples from industrialized countries.

    PubMed

    Wade, S W; Strader, C; Fitzpatrick, L A; Anthony, M S; O'Malley, C D

    2014-01-01

    In nine industrialized countries in North America, Europe, Japan, and Australia, country-specific osteoporosis prevalence (estimated from published data) at the total hip or hip/spine ranged from 9 to 38 % for women and 1 to 8 % for men. In these countries, osteoporosis affects up to 49 million individuals. Standardized country-specific prevalence estimates are scarce, limiting our ability to anticipate the potential global impact of osteoporosis. This study estimated the prevalence of osteoporosis in several industrialized countries (USA, Canada, five European countries, Australia, and Japan) using the World Health Organization (WHO) bone mineral density (BMD)-based definition of osteoporosis: BMD T-score assessed by dual-energy x-ray absorptiometry ≤-2.5. Osteoporosis prevalence was estimated for males and females aged 50 years and above using total hip BMD and then either total hip or spine BMD. We compiled published location-specific data, using the National Health and Nutrition Examination Survey (NHANES) III age and BMD reference groups, and adjusted for differences in disease definitions across sources. Relevant NHANES III ratios (e.g., male to female osteoporosis at the total hip) were applied where data were missing for countries outside the USA. Data were extrapolated from geographically similar countries as needed. Population counts for 2010 were used to estimate the number of individuals with osteoporosis in each country. For females, osteoporosis prevalence ranged from 9 % (UK) to 15 % (France and Germany) based on total hip BMD and from 16 % (USA) to 38 % (Japan) when spine BMD data were included. For males, prevalence ranged from 1 % (UK) to 4 % (Japan) based on total hip BMD and from 3 % (Canada) to 8 % (France, Germany, Italy, and Spain) when spine BMD data were included. Up to 49 million individuals met the WHO osteoporosis criteria in a number of industrialized countries in North America, Europe, Japan, and Australia.

  3. What do we know about neurogenic bladder prevalence and management in developing countries and emerging regions of the world?

    PubMed

    Przydacz, Mikolaj; Denys, Pierre; Corcos, Jacques

    2017-09-01

    To summarize information on Neurogenic Bladder (NB) epidemiology, management and access to patient treatment in developing countries and emerging regions of the world in order to propose future interventions and help governmental as well as non-governmental organizations design their action plans. Different search methods were used to gather the maximum available data. They included strategic searches; reference checks; grey literature searches (reports, working papers, government documents, civil society information); contacting professional societies, registries, and authors; requesting unpublished data from organizations; and browsing related websites and journals. The incidence and prevalence rates of NB in developing countries are difficult to establish because epidemiological reports are few and far between. The frequency of bladder dysfunction in neurologically impaired populations can be approximately estimated in some of these countries. Similar information paucity affects diagnostic and therapeutic approaches to NB patients living in less-developed regions of the world. The assessment and management of NB seems to vary markedly between countries, and care of patients from emerging regions of the world is often inadequate. Strong concerted efforts are needed on the part of international scientific societies, non-governmental organizations and local governments to work together to change the prognosis for these patients and to improve their quality of life. Copyright © 2017. Published by Elsevier Masson SAS.

  4. Sex differences in the association between countries' smoking prevalence and happiness ratings.

    PubMed

    Drehmer, J E

    2018-05-02

    To examine the cross-sectional relationship between measures of countries' happiness and countries' prevalence of tobacco smoking. Since smoking prevalence differs widely based on sex in some countries and is similar in other countries, it was examined if there was a sex difference in the relationship between smoking prevalence and country-specific happiness ratings. Ecological study design. Countries' age-standardized prevalence estimates of smoking any tobacco product among persons aged 15 years and older (%) for 2015 were obtained from the World Health Organization (WHO) Global Health Observatory. Country-specific scores from the World Happiness Report 2016 Update Ranking of Happiness (2013-15) and the 2015 Gallup Positive Experience Index were matched and correlated to 2015 WHO estimates of tobacco smoking prevalence for males and females. The difference between male and female age-standardized smoking prevalence estimates in each country was calculated by subtracting female prevalence from male prevalence and was then correlated to countries' World Happiness Report scores. The analyses did not control for potential confounders. The association between male age-standardized smoking prevalence estimates and countries' World Happiness Report scores was inversely correlated [r(104) = -0.22, P = 0.03], whereas the association between female age-standardized smoking prevalence estimates and countries' World Happiness Report scores was positively correlated [r(104) = 0.48, P = 0.00]. An inverse correlation was found between the difference in male and female smoking prevalence estimates and countries' World Happiness Report scores [r(104) = -0.50, P = 0.00]. The association between countries' male age-standardized smoking prevalence estimates and the Positive Experience Index scores was inversely correlated [r(99) = -0.37, P = 0.00], whereas the female age-standardized smoking prevalence estimates in countries were not significantly associated with

  5. Surgical management of inflammatory bowel disease: A low prevalence, developing country perspective.

    PubMed

    Nasim, Sana; Chawla, Tabish; Murtaza, Ghulam

    2016-03-01

    To determine the outcomes of surgical management of inflammatory bowel disease. The retrospective case series was conducted at Aga Khan University Hospital, Karachi, and comprised medical record of adult patients operated between January 1986 and December 2010 for inflammatory bowel disease. Outcomes consisted of complications till last follow-up and 30-day mortality (disease or procedure related). Functional status of patients with ileal pouch was determined via telephone. SPSS 16 was used to analyse data. Of the 36 patients whose records were reviewed, 21(58%) were males, and body mass index was less than 23 in 34(91%). A total of 27(75%) patients underwent elective surgery for their condition. Ileal pouch was formed in 9(25%). Overall mortality was 14(38.8%). Overall incidence of complications was 26(72%), with wound infection being the most common early morbidity in 11(30.5%). Late morbidity included pouchitisin 4/9 (44.9%) and strictures 2/36 (5.5%).On telephonic follow-up, 6 of the remaining 7patients (85%) with ileal pouch were satisfied with the functional results of the procedure. The retrospective case series represents results from a developing country with low prevalence of inflammatory bowel disease and hence limited experience.

  6. Prevalence of Hypertension in Low- and Middle-Income Countries

    PubMed Central

    Sarki, Ahmed M.; Nduka, Chidozie U.; Stranges, Saverio; Kandala, Ngianga-Bakwin; Uthman, Olalekan A.

    2015-01-01

    Abstract We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4–35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1–45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0–40.6) and lowest across low-income countries (23.1%, 95% CI 20.1–26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (<65 years) overall and across the geographical regions; however, there was no significant sex-difference in hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P < 0.00001), overweight/obese (46.4% vs 26.3%, P < 0.00001), and urban settlers (32.7% vs 25.2%, P = 0.0005) were also more likely to be hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue

  7. Income inequality and obesity prevalence among OECD countries.

    PubMed

    Su, Dejun; Esqueda, Omar A; Li, Lifeng; Pagán, José A

    2012-07-01

    Using recent pooled data from the World Health Organization Global Infobase and the World Factbook compiled by the Central Intelligence Agency of the United States, this study assesses the relation between income inequality and obesity prevalence among 31 OECD countries through a series of bivariate and multivariate linear regressions. The United States and Mexico well lead OECD countries in both obesity prevalence and income inequality. A sensitivity analysis suggests that the inclusion or exclusion of these two extreme cases can fundamentally change the findings. When the two countries are included, the results reveal a positive correlation between income inequality and obesity prevalence. This correlation is more salient among females than among males. Income inequality alone is associated with 16% and 35% of the variations in male and female obesity rates, respectively, across OECD countries in 2010. Higher levels of income inequality in the 2005-2010 period were associated with a more rapid increase in obesity prevalence from 2002 to 2010. These associations, however, virtually disappear when the US and Mexico have been excluded from the analysis. Findings from this study underscore the importance of assessing the impact of extreme cases on the relation between income inequality and health outcomes. The potential pathways from income inequality to the alarmingly high rates of obesity in the cases of the US and Mexico warrant further research.

  8. Stroke survivors in low- and middle-income countries: A meta-analysis of prevalence and secular trends.

    PubMed

    Ezejimofor, Martinsixtus C; Chen, Yen-Fu; Kandala, Ngianga-Bakwin; Ezejimofor, Benedeth C; Ezeabasili, Aloysius C; Stranges, Saverio; Uthman, Olalekan A

    2016-05-15

    To provide an up-to-date estimate on the changing prevalence of stroke survivors, and examines the geographic and socioeconomic variations in low and middle-income countries (LMICs). We searched MEDLINE, EMBASE, SCOPUS and Web of Science databases and systematically reviewed articles reporting stroke prevalence and risk factors from inception to July 2015. Pooled prevalence estimates and secular trends based on random-effects models were conducted across LMICs, World Bank regions and income groups. Overall, 101 eligible community-based studies were included in the meta-analysis. The pooled crude prevalence of stroke survivors was highest in Latin America and Caribbean (21.2 per 1000, 95% CI 13.7 to 30.29) but lowest in sub-Saharan Africa (3.5 per 1000, 95% CI 1.9 to 5.7). Steepest increase in stroke prevalence occurred in low-income countries, increasing by 14.3% annually while the lowest increase occurred in lower-middle income countries (6% annually), and for every 10years increase in participants' mean age, the prevalence of stroke survivors increases by 62% (95% CI 6% to 147%). The prevalence estimates of stroke survivors are significantly different across LMICs in both magnitude and secular trend. Improved stroke surveillance and care, as well as better management of the underlying risk factors, primarily undetected or uncontrolled high blood pressure (HBP) are needed. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Sexual risk among orphaned adolescents: is country-level HIV prevalence an important factor?

    PubMed Central

    Robertson, Laura; Gregson, Simon; Garnett, Geoff P.

    2010-01-01

    Previous studies from sub-Saharan Africa have found that orphans experience increased sexual risk compared to non-orphans. We developed a theoretical framework for the investigation of determinants of HIV risk and used it to generate specific hypotheses regarding the effect of country-level HIV prevalence on the sexual risk experience of orphans. We expected that countries with high HIV prevalence would experience a higher prevalence of orphanhood. We further hypothesised that orphans in countries with high HIV prevalence would experience increased sexual risk, compared to non-orphans, due to pressure on the extended family network, which is primarily responsible for the care of orphans in sub-Saharan Africa, resulting in poorer standards of care and guidance. We used hierarchical logistic regression models to investigate this hypothesis using cross-sectional, Demographic and Health Survey data from 10 sub-Saharan African countries. We found that countries with high HIV prevalence did indeed have higher prevalence of orphanhood. We also found that, amongst female adolescents, maternal and double orphans were significantly more likely to have started sex than non-orphans in countries with high HIV prevalence but were not at increased risk in low HIV prevalence countries. This effect of country-level HIV prevalence on the sexual risk of orphans was not explained by household level factors such as wealth, overcrowding or age of the household head. The same pattern of risk was not observed for male adolescents — male orphans were not more likely to have started sex than non-orphans. This suggests that orphaned adolescent women are an important target group for HIV prevention and that efforts should be made to integrate prevention messages into existing support programmes for orphans and vulnerable children. PMID:20552462

  10. Prevalence and incidence of epilepsy in the Nordic countries.

    PubMed

    Syvertsen, Marte; Koht, Jeanette; Nakken, Karl O

    2015-10-06

    Updated knowledge on the prevalence of epilepsy is valuable for planning of health services to this large and complex patient group. Comprehensive epidemiological research on epilepsy has been undertaken, but because of variations in methodology, the results are difficult to compare. The objective of this article is to present evidence-based estimates of the prevalence and incidence of epilepsy in the Nordic countries. The article is based on a search in PubMed with the search terms epilepsy and epidemiology, combined with each of the Nordic countries separately. Altogether 38 original articles reported incidence and/or prevalence rates of epilepsy in a Nordic country. Four studies had investigated the prevalence of active epilepsy in all age groups, with results ranging from 3.4 to 7.6 per 1,000 inhabitants. Only two studies had investigated the incidence of epilepsy in a prospective material that included all age groups. The reported incidence amounted to 33 and 34 per 100,000 person-years respectively. A prospective study that only included adults reported an incidence of 56 per 100,000 person-years. We estimate that approximately 0.6% of the population of the Nordic countries have active epilepsy, i.e. approximately 30,000 persons in Norway. Epilepsy is thus one of the most common neurological disorders. The incidence data are more uncertain, but we may reasonably assume that 30-60 new cases occur per 100,000 person-years.

  11. Evidence base for children affected by HIV and AIDS in low prevalence and concentrated epidemic countries: applicability to programming guidance from high prevalence countries.

    PubMed

    Franco, Lynne Miller; Burkhalter, Bart; de Wagt, Arjan; Jennings, Larissa; Kelley, Allison Gamble; Hammink, Marie-Eve

    2009-01-01

    As global commitment grows to protect and support children affected by HIV and AIDS, questions remain about how best to meet the needs of these children in low prevalence settings and whether information from high prevalence countries can appropriately guide programming in these settings. A 2007 search for the evidence in low prevalence settings on situational challenges of HIV and AIDS-affected children and interventions to address these challenges identified 413 documents. They were reviewed and judged for quality of documentation and scientific rigor. Information was compiled across eight types of challenges (health and health care, nutrition and food security, education, protection, placement, psychosocial development, socioeconomic status, and stigma/discrimination); and also assessed was strength of evidence for situational and intervention findings. Results were compared to three programming principles drawn from research in high prevalence countries: family-centered preventive efforts, treatment, and care; family-focused support to ensure capacity to care for and protect these children; and sustaining economic livelihood of HIV and AIDS-affected households. Findings show that children affected by HIV and AIDS in low prevalence settings face increased vulnerabilities similar to those in high prevalence settings. These findings support seeking and testing programmatic directions for interventions identified in high prevalence settings. However, low prevalence settings/countries are extremely diverse, and the strength of the evidence base among them was mixed (strong, moderate, and weak in study design and documentation), geographically limited, and had insufficient evidence on interventions to draw conclusions about how best to reduce additional vulnerabilities of affected children. Information on family, economic, sociocultural, and political factors within local contexts will be vital in the development of appropriate strategies to mitigate vulnerabilities.

  12. Adult physical inactivity prevalence in the Muslim world: Analysis of 38 countries.

    PubMed

    Kahan, David

    2015-01-01

    Physical inactivity surveillance informs policy and treatment options toward meeting the World Health Organization's (WHO) goal of a 10% reduction in its prevalence by 2025. We currently do not know the aggregate prevalence for Muslim-majority countries, many of which have extremely high rates of comorbidities associated with physical inactivity. Based on data for 163, 556 persons in 38 Muslim countries that were collected by the Global Physical Activity Questionnaire and the International Physical Activity Questionnaire, unweighted and weighted physical inactivity prevalence estimates were calculated. I used two-proportion Z tests to determine gender and ethnic differences within the sample and between the sample and 94 non-Muslim countries and odds ratios to determine the magnitude of significant differences. Total physical inactivity prevalence was 32.3% (95% CI: 31.9, 32.7). Prevalence among males and females was 28.8% and 35.5%, respectively. Prevalence among non-Arabs and Arabs was 28.6% and 43.7%, respectively. Females and Arabs were more likely physically inactive than their respective counterparts [OR = 1.36 (1.33, 1.39) and OR = 1.94 (1.90, 1.98)]. Muslim countries were more likely physically inactive [OR = 1.23 (1.22, 1.25)] than non-Muslim ones, which was primarily due to the influence of Arabs [OR = 2.01 (1.97, 2.04)], and in particular female Arabs [OR = 2.22 (2.17, 2.27)]. Physical inactivity prevalence in the Muslim world is higher than non-Muslim countries and the difference is primarily due to higher rates among Arabs.

  13. Does Cyberbullying Prevalence Among Adolescents Relate With Country Socioeconomic and Development Indicators? An Ecological Study of 31 Countries.

    PubMed

    Soares, Sara; Brochado, Sandra; Barros, Henrique; Fraga, Sílvia

    2017-10-01

    In addition to individual characteristics, it is also important to evaluate how the environment may influence the dynamics of cyberbullying. We aim to study the correlation between cyberbullying prevalence among adolescents and selected country-level indicators. We used two different data sources: data from a previously published literature review, to identify information on cyberbullying prevalence across countries, and data from the World Bank databases, to extract information on country-level indicators. A correlation matrix was used to present the association between the selected country-level indicators and the prevalence of cyberbullying. We observed a statistically significant negative correlation between cyberbullying victimization (cybervictims and cyberbully-victims, respectively) and gross domestic product (r = -.474 and -.842), gross national income (r = -.485 and -.758), enrollment in secondary (r = -.446 and -.898) and tertiary education (r = -.222 and -.881), the number of secure Internet servers (r = -.118 and -.794), and the number of Internet users (r = -.190 and -.818). A country's educational level seems to be an important contributor to the occurrence of cyberbullying.

  14. The Prevalence and Management of Systemic Amyloidosis in Western Countries.

    PubMed

    Nienhuis, Hans L A; Bijzet, Johan; Hazenberg, Bouke P C

    2016-04-01

    Amyloidosis has been a mystery for centuries, but research of the last decennia has clarified many of the secrets of this group of diseases. A protein-based classification of amyloidosis helps to understand problems that were part of the obsolete clinical classification in primary, secondary, and familial amyloidosis. All types of amyloid are secondary to some underlying precursor-producing process: each type is caused by a misfolded soluble precursor protein that becomes deposited as insoluble amyloid fibrils. The incidence of amyloidosis is not well documented, but probably falls between 5 and 13 per million per year. Prevalence data are scarce, but one UK study indicates about 20 per million inhabitants. Amyloidosis can be localized (amyloid deposited in the organ or tissue of precursor production) or systemic (amyloid at one or more sites distant from the site of precursor production). The major systemic types of amyloidosis are AL (associated with a light chain-producing plasma cell dyscrasia), AA (associated with longstanding inflammation), wild-type ATTR (associated with normal transthyretin and old age), and hereditary ATTR (associated with a transthyretin mutation) amyloidosis. Imaging techniques, such as cardiac ultrasound, magnetic resonance imaging, bone scintigraphy, and serum amyloid P component scintigraphy, are useful both for diagnosing amyloidosis and for assessing disease severity. Serologic markers are useful for detecting organ disease and disease monitoring during follow-up. Current treatment modalities are directed against the ongoing supply of precursor proteins and thereby aim to stop further accumulation of amyloid. Novel treatment modalities, such as interference with amyloid formation and even removal of amyloid, are being studied. A well-thought and planned monitoring during follow-up helps to assess the effect of treatment and to early detect possible progression of amyloidosis. Clinical management comprises histologic proof of amyloid

  15. Hypertension prevalence, awareness, and control in Arab countries: A systematic review

    PubMed Central

    Tailakh, Ayman; Evangelista, Lorraine S.; Mentes, Janet C.; Pike, Nancy A.; Phillips, Linda R.; Morisky, Donald E.

    2015-01-01

    One billion of the world’s population has hypertension, resulting in four million deaths per year. Data on the prevalence of hypertension in the Arab world are very limited. This review summarizes existing knowledge regarding prevalence, awareness, and control of hypertension in Arab countries. The PubMed, Cochrane Library, Scopus, and CINAHL databases were searched for publications on HTN among Arab people from 1980 to January 2011. Only 13 studies were identified in the literature from 10 Arab countries. The overall estimated prevalence of hypertension was 29.5% (n = 45 379), which indicates a higher prevalence of hypertension among Arabs compared to people from the USA (28%) and sub-Saharan African (27.6%). Awareness of hypertension was reported for 46% of the studies and varied from 18% (Jordan) to 79.8% (Syria). The control rate varied from 56% (Tunisia) to 92% (Egypt and Syria). The prevalence of hypertension was found to increase with age, occurring more frequently in Arab women. PMID:24118852

  16. Prevalence and correlates of adult overweight in the Muslim world: analysis of 46 countries.

    PubMed

    Kahan, D

    2015-04-01

    The primary objectives of the study were to calculate overweight prevalence (body mass index ≥ 25.0) and simple correlations between 10 demographic, social welfare and behavioural variables and overweight prevalence for Muslim countries (populations >50% Muslim; N = 46). Overweight data for a country's total, male and female populations were extracted from the World Health Organization's (WHO) STEPwise country reports and relevant publications. Country-level data for potential correlates were extracted from multiple sources: Central Intelligence Agency (literacy), Gallup Poll (religiosity), United Nations (agricultural employment, food supply, gender inequality, human development), World Bank (automobile ownership, Internet, labour force) and WHO (physical inactivity). The overall, male and female overweight prevalence was 37.4, 33.0 and 42.1%, respectively. Prevalence estimates significantly differed by economic classification, gender and ethnicity. Middle- and upper income countries were 1.54-7.76 (95% confidence interval [CI]: 1.49-8.07) times more likely overweight than low-income countries, females were 1.48 (CI: 1.45-1.50) times more likely overweight than males and Arab countries were 2.92 (CI: 2.86-2.97) times more likely overweight than non-Arab countries. All 10 of the potential correlates were significantly associated with overweight for at least one permutation (total, economic classification, gender, ethnicity). The greater percentage of poorer countries among non-Arab Muslim countries, which compared with Arab countries have not as rapidly been transformed by globalization, nutrition transition and urbanization, may partially explain prevalence differences. Evaluation of correlational data generally followed associations seen in non-Muslim countries but more complex analysis of subnational data is needed. Arab women are a particularly vulnerable subgroup and governments should act within religious and cultural parameters to provide

  17. Socioeconomic Inequalities Persist Despite Declining Stunting Prevalence in Low- and Middle-Income Countries.

    PubMed

    da Silva, Inácio Crochemore M; França, Giovanny V; Barros, Aluisio J D; Amouzou, Agbessi; Krasevec, Julia; Victora, Cesar G

    2018-02-01

    Global stunting prevalence has been nearly halved between 1990 and 2016, but it remains unclear whether this decline has benefited poor and rural populations within low- and middle-income countries (LMICs). We assessed time trends in stunting among children <5 y of age (under-5) according to household wealth and place of residence in 67 LMICs. Stunting prevalence was analyzed in 217 nationally representative Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 67 countries with ≥2 surveys between 1993 and 2014. National estimates were stratified by wealth and area of residence, comparing the poorest 40% with the wealthiest 60%, and those residing in urban and rural areas. Time trends were calculated for LMICs by using multilevel regression models weighted by under-5 population, with stratification by wealth and by residence. Trends in absolute (slope index of inequality; SII) and relative (concentration index; CIX) inequalities were calculated. Mean prevalences in 1993 were 53.7% in low-income and 48.2% in middle-income countries, with annual average linear declines of 0.76 and 0.72 percentage points (pp), respectively. Although similar slopes of declines were observed for the poorest 40% and wealthiest 60% groups in all countries (0.78 and 0.74 pp, respectively), absolute and relative inequalities increased over time in low-income countries (SII increased from -19.3% in 1993 to -23.7% in 2014 and CIX increased from -6.2% to -10.8% in the same period). In middle-income countries, socioeconomic inequalities remained stable. Overall, stunting prevalence decreased more rapidly among rural than for urban children (0.78 and 0.55 pp, respectively). The prevalence of stunting is decreasing. Poor-rich gaps are stable in middle-income countries and slightly increasing in low-income countries. Rural-urban inequalities are decreasing over time.

  18. Educational Attainment and HIV/AIDS Prevalence: A Cross-Country Study

    ERIC Educational Resources Information Center

    Lakhanpal, Manisha; Ram, Rati

    2008-01-01

    Using data for a large cross-country sample, a reasonable model is estimated to judge the effect of adult educational attainment on prevalence of HIV. Three main points are noted. First, there is an indication of a significantly negative effect of educational attainment on HIV prevalence. Second, magnitude of the impact appears sizable. Third, a…

  19. Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries.

    PubMed

    Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Mansingh; Sin, Shwe

    2014-12-18

    Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is limited. We provide country-level prevalence estimates for smoking and smokeless tobacco (SLT) use and assess their social determinants. We analyzed population-based data of the most recent Demographic Health Surveys performed between 2006 and 2013 involving men and women in 30 sub-Saharan African countries. Weighted country-level prevalence rates were estimated for 'current smoking' (cigarettes, pipe, cigars, etc.) and 'current SLT use' (chewing, snuff, etc.). From the pooled datasets for men and women, social determinants of smoking and SLT use were assessed through multivariate analyses using a dummy country variable as a control and by including a within-country sample weight for each country. Among men, smoking prevalence rates were high in Sierra Leone (37.7%), Lesotho (34.1%), and Madagascar (28.5%); low (<10%) in Ethiopia, Benin, Ghana, Nigeria, and Sao Tome & Principe; the prevalence of SLT use was <10% in all countries except for Madagascar (24.7%) and Mozambique (10.9%). Among women, smoking and SLT prevalence rates were <5% in most countries except for Burundi (9.9%), Sierra Leone (6%), and Namibia (5.9%) (smoking), and Madagascar (19.6%) and Lesotho (9.1%) (SLT use). The proportion of females who smoked was lower than SLT users in most countries. Older age was strongly associated with both smoking and SLT use among men and women. Smoking among both men and women was weakly associated, but SLT use was strongly associated, with education. Similarly, smoking among men and women was weakly associated, but SLT use was strongly associated, with the wealth index. Smoking and SLT use were also associated with marital status among both men and women, as well as with occupation (agriculturists and unskilled workers). Prevalence of smoking among women was much

  20. Prevalence and predictors for musculoskeletal discomfort in Malaysian office workers: Investigating explanatory factors for a developing country.

    PubMed

    Maakip, Ismail; Keegel, Tessa; Oakman, Jodi

    2016-03-01

    Musculoskeletal disorders (MSDs) are a major occupational health issue for workers in developed and developing countries, including Malaysia. Most research related to MSDs has been undertaken in developed countries; given the different regulatory and cultural practices it is plausible that contributions of hazard and risk factors may be different. A population of Malaysian public service office workers were surveyed (N = 417, 65.5% response rate) to determine prevalence and associated predictors of MSD discomfort. The 6-month period prevalence of MSD discomfort was 92.8% (95%CI = 90.2-95.2%). Akaike's Information Criterion (AIC) analyses was used to compare a range of models and determine a model of best fit. Contributions associated with MSD discomfort in the final model consisted of physical demands (61%), workload (14%), gender (13%), work-home balance (9%) and psychosocial factors (3%). Factors associated with MSD discomfort were similar in developed and developing countries but the relative contribution of factors was different, providing insight into future development of risk management strategies. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  1. The Prevalence of Syphilis from the Early HIV Period is Correlated With Peak HIV Prevalence at a Country Level.

    PubMed

    Osbak, Kara K; Rowley, Jane T; Kassebaum, Nicholas J; Kenyon, Chris Richard

    2016-04-01

    Could we have predicted national peak HIV based on syphilis prevalence in the 1990s? Earlier studies have shown positive correlations between various sexually transmitted infections at different population levels. In this article, we test the hypothesis that there was a residual variation in the national prevalence rates of syphilis and that these rates could predict subsequent peak HIV prevalence rates. This analysis uses linear regression to evaluate the country-level relationship between antenatal syphilis prevalence (1990-1999) and peak HIV prevalence. Antenatal syphilis data were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low-risk populations. Peak HIV prevalence was calculated based on data taken from the Global Health Observatory Data Repository of the World Health Organization. A moderately strong association is found for the 76 countries with data available (R = 0.53, P < 0.001). The association was weakened but remained significantly positive when we adjusted for the type of syphilis testing used. Syphilis prevalence in the 1990s predicted approximately 53% of the variation in peak HIV prevalence. Populations with generalized HIV epidemics had a higher prevalence of syphilis in the pre-HIV period. This finding provides additional rationale to carefully monitor sexual behavior, sexual networks, and sexually transmitted infection incidence in these populations.

  2. Variations in the Prevalence of Obesity Among European Countries, and a Consideration of Possible Causes

    PubMed Central

    Blundell, John E.; Baker, Jennifer Lyn; Boyland, Emma; Blaak, Ellen; Charzewska, Jadwiga; de Henauw, Stefaan; Frühbeck, Gema; Gonzalez-Gross, Marcela; Hebebrand, Johannes; Holm, Lotte; Kriaucioniene, Vilma; Lissner, Lauren; Oppert, Jean-Michel; Schindler, Karin; Silva, Analiza Mónica; Woodward, Euan

    2017-01-01

    Over the last 10 years the prevalence of obesity across the European continent has in general been rising. With the exception of a few countries where a levelling-off can be perceived, albeit at a high level, this upward trend seems likely to continue. However, considerable country to country variation is noticeable, with the proportion of people with obesity varying by 10% or more. This variation is intriguing and suggests the existence of different profiles of risk or protection factors operating in different countries. The identification of such protection factors could indicate suitable targets for interventions to help manage the obesity epidemic in Europe. This report is the output of a 2-day workshop on the ‘Diversity of Obesity in Europe’. The workshop included 14 delegates from 12 different European countries. This report contains the contributions and discussions of the materials and viewpoints provided by these 14 experts; it is not the output of a single mind. However, such is the nature of scientific analysis regarding obesity that it is possible that a different set of 14 experts may have come to a different set of conclusions. Therefore the report should not be seen as a definitive statement of a stable situation. Rather it is a focus for discussion and comment, and a vehicle to drive forward further understanding and management of obesity in Europe. PMID:28190010

  3. Prevalence and Data Availability of Early Childhood Caries in 193 United Nations Countries, 2007-2017.

    PubMed

    El Tantawi, Maha; Folayan, Morenike O; Mehaina, Mohamed; Vukovic, Ana; Castillo, Jorge L; Gaffar, Balgis O; Arheiam, Arheiam; Al-Batayneh, Ola B; Kemoli, Arthur M; Schroth, Robert J; Lee, Gillian H M

    2018-06-21

    To assess the relationship between health care system and economic factors and early childhood caries (ECC) data availability and prevalence. We estimated ECC data for 193 United Nations countries from studies published between 2007 and 2017. We obtained other variables from the World Health Organization and the World Bank databases. We assessed association with ECC data availability by using logistic regression and with ECC prevalence by using linear regression. We included 190 publications from 88 (45.6%) countries. The mean ECC prevalence was 23.8% and 57.3% in children younger than 36 months and children aged 36 to 71 months, respectively. The odds of ECC data availability were significantly higher for countries with more physicians and more dentists. In children younger than 36 months, ECC prevalence was associated with universal health coverage (B = -6.56). In children aged 36 to 71 months, it was associated with growth of gross national income (B = 0.27). Countries with more physicians and more dentists were more likely to have ECC data. Among those with data, countries with higher economic growth had higher ECC prevalence. (Am J Public Health. Published online ahead of print June 21, 2018: e1-e7. doi:10.2105/AJPH.2018.304466).

  4. Prevalence of metabolic syndrome in Middle-East countries: Meta-analysis of cross-sectional studies.

    PubMed

    Ansarimoghaddam, Alireza; Adineh, Hosein Ali; Zareban, Iraj; Iranpour, Sohrab; HosseinZadeh, Ali; Kh, Framanfarma

    Metabolic syndrome is an important metabolic disorder which impose noticeable burden on health system. We aimed to review and imply the prevalence of it in Middle-East countries. present study was a systematic review to present overview about metabolic disorder in Middle East. Electronic literature search of Medline database and Google scholar were done for English-language articles without time filtering, as well as for population-based or national studies of the prevalence of metabolic syndrome. The fallowing search terms were used simultaneously: prevalence of " metabolic syndrome" and "national study", "prevalence of metabolic syndrome in Middle East", "prevalence of metabolic syndrome" and "name of country", "metabolic syndrome &name of country". Additionally, relevant articles in bibliography were searched. Analysis of data was carried out in STATA version 11.0. out of 456 studies in first-step searching (selecting by title) 59 studies were recruited and reviewed. Prevalence of metabolic syndrome fluctuated by country and time of study. This amount was 2.2-44% in Turkish, 16-41% in Saudi-Arabia, 14-63 in Pakistan, 26-33 in Qatar, 9-36 in Kuwait, 22-50 in Emirate, 6-42 in Iran, and up to 23 in Yemen. Pooled estimate was 25%. Attributable risk for cardiovascular disease, coronary heart disease, and stroke was 15.87, 11.7, and 16.23, respectively. The prevalence rate of metabolic syndrome is high and it is noticeable cause for stroke, coronary heart disease, and cardiovascular disease. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  5. The Prevalence of Phenylketonuria in Arab Countries, Turkey, and Iran: A Systematic Review.

    PubMed

    El-Metwally, Ashraf; Yousef Al-Ahaidib, Lujane; Ayman Sunqurah, Alaa; Al-Surimi, Khaled; Househ, Mowafa; Alshehri, Ali; Da'ar, Omar B; Abdul Razzak, Hira; AlOdaib, Ali Nasser

    2018-01-01

    This paper seeks to identify the prevalence of Phenylketonuria (PKU) in Arab countries, Turkey, and Iran. The study reviewed the existence of comprehensive national newborn screening programs and reported consanguinity rates. A computer based literature search was conducted using relevant keywords to retrieve studies conducted on PKU. A total of 34 articles were included. Prevalence was categorized based on the type of screening method used for PKU diagnoses. The prevalence of classical PKU diagnosed through a comprehensive national newborn screening program ranged from 0.005% to 0.0167%. The highest prevalence was reported in Turkey at 0.0167%, whereas the lowest prevalence was reported in the UAE, 0.005%. The findings of this review emphasize the need for the establishment of more efficient reporting systems in these countries that would help measure Disability-Adjusted Life Year (DALY) in order to estimate the overall societal burden of PKU.

  6. Cultural values and the prevalence of mental disorders in 25 countries: A secondary data analysis.

    PubMed

    Heim, Eva; Wegmann, Iris; Maercker, Andreas

    2017-09-01

    The prevalence of common mental disorders (CMDs, i.e., depression and anxiety) worldwide is substantial, and prevalence rates are higher in high-income than in low- and middle-income countries. This difference might reflect both underlying prevalence rates as well as the measurement model used in cross-national epidemiological studies. Schwartz' cultural values provide a meaningful taxonomy to describe 'culture' and to examine how culture affects both the aetiology and phenomenology of CMDs. The present study examines to what extent Schwartz' cultural values correlate with prevalence rates of CMDs at the country-level. Twenty-five countries were included in this study. Countries were included if data on cultural values and lifetime prevalence rates, from either the World Mental Health Surveys or the Global Burden of Disease Study, were available for at least one CMD. Spearman rank correlations were calculated between prevalence rates and cultural values, controlling for gross national income (GNI) per capita. Affective disorders correlated with cultural values, after controlling for GNI. For anxiety disorders, correlations were lower but still offered meaningful insights. Correlations followed the circular structure of values, meaning that the strength of relationship decreased and increased again when moving around the circle: the strongest positive correlations were found with egalitarianism, and the strongest negative correlations with hierarchy and mastery. The autonomy-embeddedness dimension correlated weakly with the prevalence of CMDs. Diverging prevalence rates between high-income countries and low- and middle-income countries are associated with differences in cultural values. Values might not only relate to the aetiology of mental disorders, but most possibly affect the way in which psychological distress is expressed. As an example, in societies with a strong focus on embeddedness, the fear of stigma might be more pronounced. Cultural values offer a

  7. The impact of measurement differences on cross-country depression prevalence estimates: A latent transition analysis.

    PubMed

    Scorza, Pamela; Masyn, Katherine; Salomon, Joshua A; Betancourt, Theresa S

    2018-01-01

    Depression is currently the second largest contributor to non-fatal disease burden globally. For that reason, economic evaluations are increasingly being conducted using data from depression prevalence estimates to analyze return on investments for services that target mental health. Psychiatric epidemiology studies have reported large cross-national differences in the prevalence of depression. These differences may impact the cost-effectiveness assessments of mental health interventions, thereby affecting decisions regarding government and multi-lateral investment in mental health services. Some portion of the differences in prevalence estimates across countries may be due to true discrepancies in depression prevalence, resulting from differential levels of risk in environmental and demographic factors. However, some portion of those differences may reflect non-invariance in the way standard tools measure depression across countries. This paper attempts to discern the extent to which measurement differences are responsible for reported differences in the prevalence of depression across countries. This analysis uses data from the World Mental Health Surveys, a coordinated series of psychiatric epidemiology studies in 27 countries using multistage household probability samples to assess prevalence and correlates of mental disorders. Data in the current study include responses to the depression module of the World Mental Health Composite International Diagnostic Interview (CIDI) in four countries: Two high-income, western countries-the United States (n = 20, 015) and New Zealand (n = 12,992)-an upper-middle income sub-Saharan African country, South Africa (n = 4,351), and a lower-middle income sub-Saharan African country, Nigeria (n = 6,752). Latent class analysis, a type of finite mixture modeling, was used to categorize respondents into underlying categories based on the variation in their responses to questions in each of three sequential parts of the CIDI

  8. The prevalence of lifetime abuse among older adults in seven European countries.

    PubMed

    Eslami, Bahareh; Viitasara, Eija; Macassa, Gloria; Melchiorre, Maria Gabriella; Lindert, Jutta; Stankunas, Mindaugas; Torres-Gonzalez, Francisco; Barros, Henrique; Ioannidi-Kapolou, Elisabeth; Soares, Joaquim J F

    2016-11-01

    To investigate the lifetime prevalence rate of abuse among older persons and to scrutinize the associated factors (e.g. demographics). This cross-sectional population-based study had 4467 participants, aged 60-84, from seven European cities. Abuse (psychological, physical, sexual, financial and injuries) was measured based on The Revised Conflict Tactics Scale, and the UK survey of abuse/neglect of older people. Over 34 % of participants reported experiencing lifetime psychological, 11.5 % physical, 18.5 % financial and 5 % sexual abuse and 4.3 % reported injuries. Lifetime psychological abuse was associated with country, younger age, education and alcohol consumption; physical abuse with country, age, not living in partnership; injuries with country, female sex, age, education, not living in partnership; financial abuse with country, age, not living in partnership, education, benefiting social/partner income, drinking alcohol; and sexual abuse with country, female sex and financial strain. High lifetime prevalence rates confirm that elder abuse is a considerable public health problem warranting further longitudinal studies. Country of residence is an independent factor associated with all types of elder abuse which highlights the importance of national interventions alongside international collaborations.

  9. The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

    ERIC Educational Resources Information Center

    Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David

    2006-01-01

    Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…

  10. No association between gender inequality and peak HIV prevalence in developing countries - an ecological study.

    PubMed

    Kenyon, Chris R; Buyze, Jozefien

    2015-01-01

    The prevalence of both gender inequality and HIV prevalence vary considerably both within all developing countries and within those in sub-Saharan Africa. We test the hypothesis that the extent of gender inequality is associated with national peak HIV prevalence. Linear regression was used to test the association between national peak HIV prevalence and three markers of gender equality - the gender-related development index (GDI), the gender empowerment measure (GEM), and the gender inequality index (GII). No evidence was found of a positive relationship between gender inequality and HIV prevalence, either in the analyses of all developing countries or those limited to Africa. In the bivariate analyses limited to Africa, there was a positive association between the two measures of gender "equality" and peak HIV prevalence (GDI: coefficient 28, 95% confidence interval (CI) 9.1-46.8; GEM: coefficient 54.8, 95% CI 20.5-89.1). There was also a negative association between the marker of gender "inequality" and peak HIV prevalence (GII: coefficient -66.9, 95% CI -112.8 to -21.0). These associations all disappeared on multivariate analyses. We could not find any evidence to support the hypothesis that variations in the extent of gender inequality explain variations in HIV prevalence in developing countries.

  11. Estimating Contraceptive Prevalence Using Logistics Data for Short-Acting Methods: Analysis Across 30 Countries.

    PubMed

    Cunningham, Marc; Bock, Ariella; Brown, Niquelle; Sacher, Suzy; Hatch, Benjamin; Inglis, Andrew; Aronovich, Dana

    2015-09-01

    Contraceptive prevalence rate (CPR) is a vital indicator used by country governments, international donors, and other stakeholders for measuring progress in family planning programs against country targets and global initiatives as well as for estimating health outcomes. Because of the need for more frequent CPR estimates than population-based surveys currently provide, alternative approaches for estimating CPRs are being explored, including using contraceptive logistics data. Using data from the Demographic and Health Surveys (DHS) in 30 countries, population data from the United States Census Bureau International Database, and logistics data from the Procurement Planning and Monitoring Report (PPMR) and the Pipeline Monitoring and Procurement Planning System (PipeLine), we developed and evaluated 3 models to generate country-level, public-sector contraceptive prevalence estimates for injectable contraceptives, oral contraceptives, and male condoms. Models included: direct estimation through existing couple-years of protection (CYP) conversion factors, bivariate linear regression, and multivariate linear regression. Model evaluation consisted of comparing the referent DHS prevalence rates for each short-acting method with the model-generated prevalence rate using multiple metrics, including mean absolute error and proportion of countries where the modeled prevalence rate for each method was within 1, 2, or 5 percentage points of the DHS referent value. For the methods studied, family planning use estimates from public-sector logistics data were correlated with those from the DHS, validating the quality and accuracy of current public-sector logistics data. Logistics data for oral and injectable contraceptives were significantly associated (P<.05) with the referent DHS values for both bivariate and multivariate models. For condoms, however, that association was only significant for the bivariate model. With the exception of the CYP-based model for condoms, models

  12. Estimating Contraceptive Prevalence Using Logistics Data for Short-Acting Methods: Analysis Across 30 Countries

    PubMed Central

    Cunningham, Marc; Brown, Niquelle; Sacher, Suzy; Hatch, Benjamin; Inglis, Andrew; Aronovich, Dana

    2015-01-01

    Background: Contraceptive prevalence rate (CPR) is a vital indicator used by country governments, international donors, and other stakeholders for measuring progress in family planning programs against country targets and global initiatives as well as for estimating health outcomes. Because of the need for more frequent CPR estimates than population-based surveys currently provide, alternative approaches for estimating CPRs are being explored, including using contraceptive logistics data. Methods: Using data from the Demographic and Health Surveys (DHS) in 30 countries, population data from the United States Census Bureau International Database, and logistics data from the Procurement Planning and Monitoring Report (PPMR) and the Pipeline Monitoring and Procurement Planning System (PipeLine), we developed and evaluated 3 models to generate country-level, public-sector contraceptive prevalence estimates for injectable contraceptives, oral contraceptives, and male condoms. Models included: direct estimation through existing couple-years of protection (CYP) conversion factors, bivariate linear regression, and multivariate linear regression. Model evaluation consisted of comparing the referent DHS prevalence rates for each short-acting method with the model-generated prevalence rate using multiple metrics, including mean absolute error and proportion of countries where the modeled prevalence rate for each method was within 1, 2, or 5 percentage points of the DHS referent value. Results: For the methods studied, family planning use estimates from public-sector logistics data were correlated with those from the DHS, validating the quality and accuracy of current public-sector logistics data. Logistics data for oral and injectable contraceptives were significantly associated (P<.05) with the referent DHS values for both bivariate and multivariate models. For condoms, however, that association was only significant for the bivariate model. With the exception of the CYP

  13. Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

    PubMed

    Sarki, Ahmed M; Nduka, Chidozie U; Stranges, Saverio; Kandala, Ngianga-Bakwin; Uthman, Olalekan A

    2015-12-01

    We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4-35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1-45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0-40.6) and lowest across low-income countries (23.1%, 95% CI 20.1-26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (<65 years) overall and across the geographical regions; however, there was no significant sex-difference in hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P < 0.00001), overweight/obese (46.4% vs 26.3%, P < 0.00001), and urban settlers (32.7% vs 25.2%, P = 0.0005) were also more likely to be hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the

  14. The Global Asthma Network rationale and methods for Phase I global surveillance: prevalence, severity, management and risk factors.

    PubMed

    Ellwood, Philippa; Asher, M Innes; Billo, Nils E; Bissell, Karen; Chiang, Chen-Yuan; Ellwood, Eamon M; El-Sony, Asma; García-Marcos, Luis; Mallol, Javier; Marks, Guy B; Pearce, Neil E; Strachan, David P

    2017-01-01

    The Global Asthma Network (GAN), established in 2012, followed the International Study of Asthma and Allergies in Childhood (ISAAC). ISAAC Phase One involved over 700 000 adolescents and children from 156 centres in 56 countries; it found marked worldwide variation in symptom prevalence of asthma, rhinitis and eczema that was not explained by the current understanding of these diseases; ISAAC Phase Three involved over 1 187 496 adolescents and children (237 centres in 98 countries). It found that asthma symptom prevalence was increasing in many locations especially in low- and middle-income countries where severity was also high, and identified several environmental factors that required further investigation.GAN Phase I, described in this article, builds on the ISAAC findings by collecting further information on asthma, rhinitis and eczema prevalence, severity, diagnoses, asthma emergency room visits, hospital admissions, management and use of asthma essential medicines. The subjects will be the same age groups as ISAAC, and their parents. In this first global monitoring of asthma in children and adults since 2003, further evidence will be obtained to understand asthma, management practices and risk factors, leading to further recognition that asthma is an important non-communicable disease and to reduce its global burden. Copyright ©ERS 2017.

  15. Patients’ management of type 2 diabetes in Middle Eastern countries: review of studies

    PubMed Central

    Alsairafi, Zahra Khalil; Taylor, Kevin Michael Geoffrey; Smith, Felicity J; Alattar, Abdulnabi T

    2016-01-01

    The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle measures. Thirty-four studies were identified following a systematic search of the literature. The studies describe the influence of knowledge, health beliefs, culture, and lifestyle on the management of type 2 diabetes mellitus in the Middle East. Findings indicate a lack of health knowledge about diabetes among populations, which has implications for health behaviors, medication adherence, and treatment outcomes. Many identified health beliefs and cultural lifestyle factors, such as religious beliefs, beliefs about fasting during Ramadan, and sedentary lifestyles played a role in patients’ decisions. For better management of this disease, a collaborative approach between patients, their families, health care professionals, and governments should be adopted. Implementing behavioral strategies and psychological interventions that incorporate all health care professionals in the management process have been shown to be effective methods. Such services help patients change their behavior. However, the utilization of such services and interventions is still limited in Arabian countries. Physicians in the Middle East are the health care professionals most involved in the care process. PMID:27354775

  16. Patients' management of type 2 diabetes in Middle Eastern countries: review of studies.

    PubMed

    Alsairafi, Zahra Khalil; Taylor, Kevin Michael Geoffrey; Smith, Felicity J; Alattar, Abdulnabi T

    2016-01-01

    The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle measures. Thirty-four studies were identified following a systematic search of the literature. The studies describe the influence of knowledge, health beliefs, culture, and lifestyle on the management of type 2 diabetes mellitus in the Middle East. Findings indicate a lack of health knowledge about diabetes among populations, which has implications for health behaviors, medication adherence, and treatment outcomes. Many identified health beliefs and cultural lifestyle factors, such as religious beliefs, beliefs about fasting during Ramadan, and sedentary lifestyles played a role in patients' decisions. For better management of this disease, a collaborative approach between patients, their families, health care professionals, and governments should be adopted. Implementing behavioral strategies and psychological interventions that incorporate all health care professionals in the management process have been shown to be effective methods. Such services help patients change their behavior. However, the utilization of such services and interventions is still limited in Arabian countries. Physicians in the Middle East are the health care professionals most involved in the care process.

  17. Radioactive Waste Management in Non-Nuclear Countries - 13070

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kubelka, Dragan; Trifunovic, Dejan

    2013-07-01

    This paper challenges internationally accepted concepts of dissemination of responsibilities between all stakeholders involved in national radioactive waste management infrastructure in the countries without nuclear power program. Mainly it concerns countries classified as class A and potentially B countries according to International Atomic Energy Agency. It will be shown that in such countries long term sustainability of national radioactive waste management infrastructure is very sensitive issue that can be addressed by involving regulatory body in more active way in the infrastructure. In that way countries can mitigate possible consequences on the very sensitive open market of radioactive waste management services,more » comprised mainly of radioactive waste generators, operators of end-life management facilities and regulatory body. (authors)« less

  18. Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study

    NASA Astrophysics Data System (ADS)

    Arnedo-Pena, Alberto; García-Marcos, Luis; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Inés; González-Díaz, Carlos; García-Merino, Águeda; Busquets-Monge, Rosa; Suárez-Varela, Maria Morales; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo A.; López-Silvarrey, Angel; García-Hernández, Gloria; Fuertes, Jorge

    2013-09-01

    The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

  19. Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study.

    PubMed

    Arnedo-Pena, Alberto; García-Marcos, Luis; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Inés; González-Díaz, Carlos; García-Merino, Agueda; Busquets-Monge, Rosa; Suárez-Varela, Maria Morales; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo A; López-Silvarrey, Angel; García-Hernández, Gloria; Fuertes, Jorge

    2013-09-01

    The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

  20. Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review.

    PubMed

    Carter, Emily; Bryce, Jennifer; Perin, Jamie; Newby, Holly

    2015-08-18

    Harmful practices in the management of childhood diarrhea are associated with negative health outcomes, and conflict with WHO treatment guidelines. These practices include restriction of fluids, breast milk and/or food intake during diarrhea episodes, and incorrect use of modern medicines. We conducted a systematic review of English-language literature published since 1990 to assess the documented prevalence of these four harmful practices, and beliefs, motivations, and contextual factors associated with harmful practices in low- and middle-income countries. We electronically searched PubMed, Embase, Ovid Global Health, and the WHO Global Health Library. Publications reporting the prevalence or substantive findings on beliefs, motivations, or context related to at least one of the four harmful practices were included, regardless of study design or representativeness of the sample population. Of the 114 articles included in the review, 79 reported the prevalence of at least one harmful practice and 35 studies reported on beliefs, motivations, or context for harmful practices. Most studies relied on sub-national population samples and many were limited to small sample sizes. Study design, study population, and definition of harmful practices varied across studies. Reported prevalence of harmful practices varied greatly across study populations, and we were unable to identify clearly defined patterns across regions, countries, or time periods. Caregivers reported that diarrhea management practices were based on the advice of others (health workers, relatives, community members), as well as their own observations or understanding of the efficacy of certain treatments for diarrhea. Others reported following traditionally held beliefs on the causes and cures for specific diarrheal diseases. Available evidence suggests that harmful practices in diarrhea treatment are common in some countries with a high burden of diarrhea-related mortality. These practices can reduce

  1. Coronary artery disease prevalence and outcome in patients hospitalized with acute heart failure: an observational report from seven Middle Eastern countries.

    PubMed

    Salam, Amar M; Sulaiman, Kadhim; Al-Zakwani, Ibrahim; Alsheikh-Ali, Alawi; Aljaraallah, Mohammed; Al Faleh, Husam; Elasfar, Abdelfatah; Panduranga, Prasanth; Singh, Rajvir; Abi Khalil, Charbel; Al Suwaidi, Jassim

    2016-12-01

    The purpose of this study was to report prevalence, clinical characteristics, precipitating factors, management and outcome of patients with coronary artery disease (CAD) among patients hospitalized with heart failure (HF) in seven Middle Eastern countries and compare them to non-CAD patients. Data were derived from Gulf CARE (Gulf aCute heArt failuRe rEgistry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute HF during February-November 2012 in 7 Middle Eastern countries. The prevalence of CAD among Acute Heart Failure (AHF) patients was 60.2% and varied significantly among the 7 countries (Qatar 65.7%, UAE 66.6%, Kuwait 68.0%, Oman 65.9%, Saudi Arabia 62.5%, Bahrain 52.7% and Yemen 49.1%) with lower values in the lower income countries. CAD patients were older and more likely to have diabetes, hypertension, dyslipidemia and chronic kidney disease. Moreover, CAD patients were more likely to have history of cerebrovascular and peripheral vascular disease when compared to non-CAD patients. In-hospital mortality rates were comparable although CAD patients had more frequent re-hospitalization and worse long-term outcome. However, CAD was not an independent predictor of poor outcome. The prevalence of CAD amongst patients with HF in the Middle East is variable and may be related to healthcare sources. Regional and national studies are needed for assessing further the impact of various etiologies of HF and for developing appropriate strategies to combat this global concern.

  2. Prevalence and associated factors of fear of childbirth in six European countries.

    PubMed

    Lukasse, Mirjam; Schei, Berit; Ryding, Elsa Lena

    2014-10-01

    This study set out to compare the prevalence, content and associated factors of fear of childbirth in six European countries. A cross-sectional study of 6870 pregnant women attending routine antenatal care in Belgium, Iceland, Denmark, Estonia, Norway and Sweden (Bidens). Severe fear of childbirth, defined as a Wijma Delivery Expectancy Questionnaire score of ≥85. Eleven percent of all women reported severe fear of childbirth, 11.4% among primiparous and 11.0% among multiparous women. There were significant differences between the countries for prevalence of severe fear of childbirth, varying from 4.5% in Belgium to 15.6% in Estonia for primiparous women and from 7.6% in Iceland to 15.2% in Sweden for multiparous women. After adjusting for age, education and gestational age, only primiparous women from Belgium had significantly less fear of childbirth, AOR 0.35 (0.19-0.52) compared to Norway (largest participating group). Exploratory factor analyses revealed significant differences between the countries for the six factors extracted. FOC appears to be an international phenomenon, existing with similar proportions in the participating European countries, except for primiparous women in Belgium who in our study reported significantly less severe fear of childbirth. Our study suggests that the content of fear of childbirth may differ between countries. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. The impact of HIV prevalence, conflict, corruption, and GDP/capita on treatment cascades: data from 137 countries.

    PubMed

    Levi, Jacob; Pozniak, Anton; Heath, Katherine; Hill, Andrew

    2018-04-01

    In 2014, UNAIDS and partners set the 90-90-90 targets for the HIV treatment cascade. Multiple social, political and structural factors might influence progress towards these targets. We assessed how close countries and regions are to reaching these targets, and compared cascade outcomes with HIV prevalence, gross domestic product (GDP)/capita, conflict and corruption. Country-level HIV cascade data on diagnosis, ART coverage and viral suppression, from 2010 to 2016 were extracted from national reports, published papers and the www.AIDSinfoOnline database, and analysed. Weighted least-squares regression was used to assess predictors of cascade achievement: region, HIV prevalence, GDP/capita, the 2016 Corruption Perceptions Index (CPI), which is an international ranking system, and the 2016 Global Peace Index (GPI), which ranks all countries based on three main categories: societal safety, militarisation and conflict. Data were available for diagnosis for 84 countries, ART coverage for 137 countries, and viral suppression for 94 countries. Regions with the lowest ART coverage were South-east Asia and Pacific (36%), Eastern Europe and Central Asia (17%), and Middle East and North Africa (13%). Lower HIV prevalence was associated with poorer cascade results. Countries with higher GDP/capita achieved higher ART coverage ( P <0.001). Furthermore, countries with lower levels of peace and higher corruption had lower ART coverage ( P <0.001). Countries with a GPI >2.5 all had ART coverage of <40%. Only one country has reached the UNAIDS 90-90-90 targets. International comparison remains difficult due to heterogeneous data reporting. Difficulty meeting UNAIDS targets is associated with lower GDP/capita, lower HIV prevalence, higher corruption and conflict levels.

  4. Prevalence of Body Mass Index Lower Than 16 Among Women in Low- and Middle-Income Countries.

    PubMed

    Razak, Fahad; Corsi, Daniel J; Slutsky, Arthur S; Kurpad, Anura; Berkman, Lisa; Laupacis, Andreas; Subramanian, S V

    2015-11-24

    Body mass index (BMI) lower than 16 is the most severe category of adult undernutrition and is associated with substantial morbidity, increased mortality, and poor maternal-fetal outcomes such as low-birth-weight newborns. Little is known about the prevalence and distribution of BMI lower than 16 in low- and middle-income countries (LMIC). To determine the prevalence and distribution of BMI lower than 16 and its change in prevalence over time in women in LMIC. Cross-sectional data analysis composed of nationally representative surveys from 1993 through 2012 from the Demographic and Health Surveys Program. Women aged 20 through 49 years from 60 LMIC (N = 500,761) and a subset of 40 countries with repeated surveys (N = 604,144) were examined. Wealth was measured using a validated asset index, age was categorized in deciles, education by highest completed level (none, primary, secondary, or greater), and place of residence as urban vs rural. The primary outcome was BMI lower than 16. Analyses assessed the prevalence of BMI lower than 16, its association with sociodemographic factors, and change in prevalence. Logistic regression models were used to calculate odds ratios (ORs), adjusting for survey design and age structure. Among countries examined, the pooled, weighted, and age-standardized prevalence of BMI lower than 16 was 1.8% (95% CI, 1.7% to 1.8%) with the highest prevalence in India (6.2% [95% CI, 5.9% to 6.5%]), followed by Bangladesh (3.9% [95% CI, 3.4% to 4.3%]), Madagascar (3.4% [95% CI, 2.8% to 4.0%], Timor-Leste (2.9% [95% CI, 2.4% to 3.2%]), Senegal (2.5% [95% CI, 1.9% to 3.2%]), and Sierra Leone (2.2% [95% CI, 1.3% to 3.0%]); and 6 countries had prevalences lower than 0.1% (Albania, Bolivia, Egypt, Peru, Swaziland, and Turkey). The prevalence of BMI lower than 16 in women with a secondary or higher education level was 0.51% (95% CI, 0.47% to 0.55%), and in mutually adjusted models, a less than primary education level was associated with an OR of

  5. Genital Chlamydia Prevalence in Europe and Non-European High Income Countries: Systematic Review and Meta-Analysis

    PubMed Central

    Redmond, Shelagh M.; Alexander-Kisslig, Karin; Woodhall, Sarah C.; van den Broek, Ingrid V. F.; van Bergen, Jan; Ward, Helen; Uusküla, Anneli; Herrmann, Björn; Andersen, Berit; Götz, Hannelore M.; Sfetcu, Otilia; Low, Nicola

    2015-01-01

    Background Accurate information about the prevalence of Chlamydia trachomatis is needed to assess national prevention and control measures. Methods We systematically reviewed population-based cross-sectional studies that estimated chlamydia prevalence in European Union/European Economic Area (EU/EEA) Member States and non-European high income countries from January 1990 to August 2012. We examined results in forest plots, explored heterogeneity using the I2 statistic, and conducted random effects meta-analysis if appropriate. Meta-regression was used to examine the relationship between study characteristics and chlamydia prevalence estimates. Results We included 25 population-based studies from 11 EU/EEA countries and 14 studies from five other high income countries. Four EU/EEA Member States reported on nationally representative surveys of sexually experienced adults aged 18–26 years (response rates 52–71%). In women, chlamydia point prevalence estimates ranged from 3.0–5.3%; the pooled average of these estimates was 3.6% (95% CI 2.4, 4.8, I2 0%). In men, estimates ranged from 2.4–7.3% (pooled average 3.5%; 95% CI 1.9, 5.2, I2 27%). Estimates in EU/EEA Member States were statistically consistent with those in other high income countries (I2 0% for women, 6% for men). There was statistical evidence of an association between survey response rate and estimated chlamydia prevalence; estimates were higher in surveys with lower response rates, (p = 0.003 in women, 0.018 in men). Conclusions Population-based surveys that estimate chlamydia prevalence are at risk of participation bias owing to low response rates. Estimates obtained in nationally representative samples of the general population of EU/EEA Member States are similar to estimates from other high income countries. PMID:25615574

  6. Prevalence and trends in the childhood dual burden of malnutrition in low- and middle-income countries, 1990-2012.

    PubMed

    Tzioumis, Emma; Kay, Melissa C; Bentley, Margaret E; Adair, Linda S

    2016-06-01

    To describe trends in country- and individual-level dual burden of malnutrition in children <5 years, and age-stratified (<2 years, ≥2 years) country-level trends, in thirty-six low- and middle-income countries (LMIC). Using repeated cross-sectional nationally representative data, we calculated the prevalence of malnutrition (stunting, wasting, overweight) at each survey wave, annualized rates of prevalence change for each country over time, and trends before and after 2000, for all children <5 years and separately for those country- (ratio of stunting to overweight) and individual-level (coexistence of stunting and overweight) dual burden in children <5 years. Demographic and Health Surveys from thirty-six LMIC between 1990 and 2012. Children <5 years. Overall malnutrition prevalence decreased in children <5 years, driven by stunting decreases. Stunting rates decreased in 78 % of countries, wasting rates decreased in 58 % of countries and overweight rates increased in 36 % of countries. Rates of change differed for children countries yet increases in overweight in more countries. Countries with nearly equal prevalences of stunting and overweight in children <5 years increased from 2000 to the final year. Within a country, 0·3-10·9 % of children <5 years were stunted and overweight, and 0·6-37·8 % of stunted children <5 years were overweight. The dual burden exists in children <5 years on both country and individual levels, indicating a shift is needed in policies and programmes to address both sides of malnutrition. Children <2 years should be identified as a high-risk demographic.

  7. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries.

    PubMed

    Santos-Eggimann, Brigitte; Cuénoud, Patrick; Spagnoli, Jacques; Junod, Julien

    2009-06-01

    Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey. Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50-64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education. The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain. A higher prevalence of frailty in southern countries is consistent with previous findings of a north-south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty.

  8. Slow progress in diarrhea case management in low and middle income countries: evidence from cross-sectional national surveys, 1985-2012.

    PubMed

    Sreeramareddy, Chandrashekhar T; Low, Yue-Peng; Forsberg, Birger Carl

    2017-03-21

    Diarrhea remains to be a main cause of childhood mortality. Diarrhea case management indicators reflect the effectiveness of child survival interventions. We aimed to assess time trends and country-wise changes in diarrhea case management indicators among under-5 children in low-and-middle-income countries. We analyzed aggregate data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys done from 1986 to 2012 in low-and-middle-income countries. Two-week prevalence rates of diarrhea, caregiver's care seeking behavior and three case management indicators were analyzed. We assessed overall time trends across the countries using panel data analyses and country-level changes between two sequential surveys. Overall, yearly increase in case management indicators ranged from 1 · 3 to 2 · 5%. In the year 2012, <50% of the children were given correct treatment (received oral rehydration and increased fluids) for diarrhea. Annually, an estimated 300 to 350 million children were not given oral rehydration solutions, or recommended home fluids or 'increased fluids' and 304 million children not taken to a healthcare provider during an episode of diarrhea. Overall, care seeking for diarrhea, increased from pre-2000 to post-2000, i.e. from 35 to 45%; oral rehydration rates increased by about 7% but the rate of 'increased fluids' decreased by 14%. Country-level trends showed that care seeking had decreased in 15 countries but increased in 33 countries. Care seeking from a healthcare provider increased by ≥10% in about 23 countries. Oral rehydration rates had increased by ≥10% in 15 countries and in 30 countries oral rehydration rates increased by <10%. Very limited progress has been made in the case management of childhood diarrhea. A better understanding of caregiver's care seeking behavior and health care provider's case management practices is needed to improve diarrhea case management in low- and-middle-income countries.

  9. Methods for estimating comparable prevalence rates of food insecurity experienced by adults in 147 countries and areas

    NASA Astrophysics Data System (ADS)

    Nord, Mark; Cafiero, Carlo; Viviani, Sara

    2016-11-01

    Statistical methods based on item response theory are applied to experiential food insecurity survey data from 147 countries, areas, and territories to assess data quality and develop methods to estimate national prevalence rates of moderate and severe food insecurity at equal levels of severity across countries. Data were collected from nationally representative samples of 1,000 adults in each country. A Rasch-model-based scale was estimated for each country, and data were assessed for consistency with model assumptions. A global reference scale was calculated based on item parameters from all countries. Each country's scale was adjusted to the global standard, allowing for up to 3 of the 8 scale items to be considered unique in that country if their deviance from the global standard exceeded a set tolerance. With very few exceptions, data from all countries were sufficiently consistent with model assumptions to constitute reasonably reliable measures of food insecurity and were adjustable to the global standard with fair confidence. National prevalence rates of moderate-or-severe food insecurity assessed over a 12-month recall period ranged from 3 percent to 92 percent. The correlations of national prevalence rates with national income, health, and well-being indicators provide external validation of the food security measure.

  10. Health sector involvement in the management of female genital mutilation/cutting in 30 countries.

    PubMed

    Johansen, R Elise B; Ziyada, Mai Mahgoub; Shell-Duncan, Bettina; Kaplan, Adriana Marcusàn; Leye, Els

    2018-04-04

    For the last decades, the international community has emphasised the importance of a multisectoral approach to tackle female genital mutilation (FGM/C). While considerable improvement concerning legislations and community involvement is reported, little is known about the involvement of the health sector. A mixed methods approach was employed to map the involvement of the health sector in the management of FGM/C both in countries where FGM/C is a traditional practice (countries of origin), and countries where FGM/C is practiced mainly by migrant populations (countries of migration). Data was collected in 2016 using a pilot-tested questionnaire from 30 countries (11 countries of origin and 19 countries of migration). In 2017, interviews were conducted to check for data accuracy and to request relevant explanations. Qualitative data was used to elucidate the quantitative data. A total of 24 countries had a policy on FGM/C, of which 19 had assigned coordination bodies and 20 had partially or fully implemented the plans. Nevertheless, allocation of funding and incorporation of monitoring and evaluation systems was lacking in 11 and 13 of these countries respectively. The level of the health sectors' involvement varied considerably across and within countries. Systematic training of healthcare providers (HCP) was more prevalent in countries of origin, whereas involvement of HCP in the prevention of FGM/C was more prevalent in countries of migration. Most countries reported to forbid HCP from conducting FGM/C on both minors and adults, but not consistently forbidding re-infibulation. Availability of healthcare services for girls and women with FGM/C related complications also varied between countries dependent on the type of services. Deinfibulation was available in almost all countries, while clitoral reconstruction and psychological and sexual counselling were available predominantly in countries of migration and then in less than half the countries. Finally

  11. Pricing Policies And Control of Tobacco in Europe (PPACTE) project: cross-national comparison of smoking prevalence in 18 European countries.

    PubMed

    Gallus, Silvano; Lugo, Alessandra; La Vecchia, Carlo; Boffetta, Paolo; Chaloupka, Frank J; Colombo, Paolo; Currie, Laura; Fernandez, Esteve; Fischbacher, Colin; Gilmore, Anna; Godfrey, Fiona; Joossens, Luk; Leon, Maria E; Levy, David T; Nguyen, Lien; Rosenqvist, Gunnar; Ross, Hana; Townsend, Joy; Clancy, Luke

    2014-05-01

    Limited data on smoking prevalence allowing valid between-country comparison are available in Europe. The aim of this study is to provide data on smoking prevalence and its determinants in 18 European countries. In 2010, within the Pricing Policies And Control of Tobacco in Europe (PPACTE) project, we conducted a face-to-face survey on smoking in 18 European countries (Albania, Austria, Bulgaria, Czech Republic, Croatia, England, Finland, France, Greece, Hungary, Ireland, Italy, Latvia, Poland, Portugal, Romania, Spain and Sweden) on a total of 18 056 participants, representative for each country of the population aged 15 years or older. Overall, 27.2% of the participants were current smokers (30.6% of men and 24.1% of women). Smoking prevalence was highest in Bulgaria (40.9%) and Greece (38.9%) and lowest in Italy (22.0%) and Sweden (16.3%). Smoking prevalence ranged between 15.7% (Sweden) and 44.3% (Bulgaria) for men and between 11.6% (Albania) and 38.1% (Ireland) for women. Multivariate analysis showed a significant inverse trend between smoking prevalence and the level of education in both sexes. Male-to-female smoking prevalence ratios ranged from 0.85 in Spain to 3.47 in Albania and current-to-ex prevalence ratios ranged from 0.68 in Sweden to 4.28 in Albania. There are considerable differences across Europe in smoking prevalence, and male-to-female and current-to-ex smoking prevalence ratios. Eastern European countries, lower income countries and those with less advanced tobacco control policies have less favourable smoking patterns and are at an earlier stage of the tobacco epidemic.

  12. National sex work policy and HIV prevalence among sex workers: an ecological regression analysis of 27 European countries.

    PubMed

    Reeves, Aaron; Steele, Sarah; Stuckler, David; McKee, Martin; Amato-Gauci, Andrew; Semenza, Jan C

    2017-03-01

    Sex workers are disproportionately affected by HIV compared with the general population. Most studies of HIV risk among sex workers have focused on individual-level risk factors, with few studies assessing potential structural determinants of HIV risk. In this Article, we examine whether criminal laws around sex work are associated with HIV prevalence among female sex workers. We estimate cross-sectional, ecological regression models with data from 27 European countries on HIV prevalence among sex workers from the European Centre for Disease Control; sex-work legislation from the US State Department's Country Reports on Human Rights Practices and country-specific legal documents; the rule of law and gross-domestic product per capita, adjusted for purchasing power, from the World Bank; and the prevalence of injecting drug use among sex workers. Although data from two countries include male sex workers, the numbers are so small that the findings here essentially pertain to prevalence in female sex workers. Countries that have legalised some aspects of sex work (n=17) have significantly lower HIV prevalence among sex workers than countries that criminalise all aspects of sex work (n=10; β=-2·09, 95% CI -0·80 to -3·37; p=0·003), even after controlling for the level of economic development (β=-1·86; p=0·038) and the proportion of sex workers who are injecting drug users (-1·93; p=0·026). We found that the relation between sex work policy and HIV among sex workers might be partly moderated by the effectiveness and fairness of enforcement, suggesting legalisation of some aspects of sex work could reduce HIV among sex workers to the greatest extent in countries where enforcement is fair and effective. Our findings suggest that the legalisation of some aspects of sex work might help reduce HIV prevalence in this high-risk group, particularly in countries where the judiciary is effective and fair. European Centre for Disease Prevention and Control. Copyright

  13. Prevalence of Frailty in Middle-Aged and Older Community-Dwelling Europeans Living in 10 Countries

    PubMed Central

    Cuénoud, Patrick; Spagnoli, Jacques; Junod, Julien

    2009-01-01

    Background Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey. Methods Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50–64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education. Results The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain. Conclusions A higher prevalence of frailty in southern countries is consistent with previous findings of a north–south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty. PMID:19276189

  14. Increasing prevalence of diabetes mellitus in a developing country and its related factors.

    PubMed

    Animaw, Worku; Seyoum, Yeshaneh

    2017-01-01

    All countries, irrespective of their developmental stage, face an increasing burden of non-communicable diseases including diabetes mellitus. There is substantial evidence of the existence of the gap in the level of diabetes mellitus and its complications prevention and control measures in developing countries. This study aimed to assess the prevalence of diabetes mellitus in urban and rural dwellers in a low-income country from both younger and older population and to identify factors related. This is a community based comparative cross-sectional study conducted in a low-income country, Ethiopia. The sample size was determined by EPI-Info for two populations; the WHO's STEP-wise approach for non-communicable diseases surveillance in developing countries was employed for sampling, study variable selection and data collection procedures. Fasting blood glucose levels were measured by finger pricking after overnight fasting. Data entry was done by EPI-data computer program version 3.1 and then processed by SPSS version 20. Bivariate and multivariate logistic regression tests were used to assess the associations between diabetes status of individuals and its potential predictor variables. P-value < 0.05 was considered as statistically significant level. The study was conducted on 1405 individuals with age range of 18-97 years old. The mean fasting blood glucose level for study participants was 91.16mg/dl; while it was 94.73mg/dl for urban and 87.71mg/dl for rural dwellers. The prevalence of diabetes mellitus was 3.3%; while it was 2.0% for rural and (4.6%) for urban dwellers. Both the mean blood glucose level and the prevalence of diabetes mellitus were significantly higher for urban residents than rural. More than three-fourths of diabetic cases were newly diagnosed by this study. Urban dwellers, centrally obese, overweight, and hypertensive individuals have higher odds of getting diabetes mellitus. High prevalence of diabetes mellitus involving both old and young

  15. Management of intestinal failure in middle-income countries, for children and adults.

    PubMed

    Gondolesi, Gabriel E; Pattín, Francisco; Nikkoupur, Hamed

    2018-04-01

    Intestinal failure is a life-threatening medical condition that remains as a rare or orphan disease in most countries. The prevalence of intestinal failure and the therapeutic options available in middle-income countries (MIC) remain unclear. We aim to provide an overview on the current differences in management of intestinal failure patients in MIC from Latin America and Asia. In order to fulfil the challenge, and after facing the difficulties of going over a topic with scarce available data, from countries with an extreme variety of social and economic problems, which are closely related to the treatment of intestinal failure patients, we have used both the existing publications and personal surveys to draft this document. Our results have shown that there is still significant disparity among MIC over the last years, concepts such as the need for establishing multidisciplinary dedicated teams as well as the need to evolve first home parenteral nutrition (HPN), then rehabilitation, and finally transplantation, have become important signals of an adequate understanding of this evolving field. The manuscript presents, for the first time, an overview of the different developments and needs to manage intestinal failure patients in MIC from Latin America and Asia. Future discussions will emerge from this manuscript, aiming to pursue the development of registries, guidelines and health policies to continue improving the long-term care of intestinal failure patients in all MIC.

  16. Hospital waste management in developing countries: A mini review.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong

    2017-06-01

    Health care activities can generate different kinds of hazardous wastes. Mismanagement of these wastes can result in environmental and occupational health risks. Developing countries are resource-constrained when it comes to safe management of hospital wastes. This study summarizes the main issues faced in hospital waste management in developing countries. A review of the existing literature suggests that regulations and legislations focusing on hospital waste management are recent accomplishments in many of these countries. Implementation of these rules varies from one hospital to another. Moreover, wide variations exist in waste generation rates within as well as across these countries. This is mainly attributable to a lack of an agreement on the definitions and the methodology among the researchers to measure such wastes. Furthermore, hospitals in these countries suffer from poor waste segregation, collection, storage, transportation and disposal practices, which can lead to occupational and environmental risks. Knowledge and awareness regarding proper waste management remain low in the absence of training for hospital staff. Moreover, hospital sanitary workers, and scavengers, operate without the provision of safety equipment or immunization. Unsegregated waste is illegally recycled, leading to further safety risks. Overall, hospital waste management in developing countries faces several challenges. Sustainable waste management practices can go a long way in reducing the harmful effects of hospital wastes.

  17. Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis.

    PubMed

    Nasreen, Sharifa; Shokoohi, Mostafa; Malvankar-Mehta, Monali S

    2016-01-01

    Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure. To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries. Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity. A total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa. The findings of this study suggest that there is a high burden of LTBI among health care workers in high burden countries. Adequate infection control

  18. Hypertension in Developing Countries: A Major Challenge for the Future.

    PubMed

    Mohsen Ibrahim, M

    2018-05-01

    Outline recent epidemiologic data regarding hypertension in developing countries, distinguish differences from developed countries, and identify challenges in management and future perspectives. Increased sugar intake, air and noise pollution, and low birth weight are emerging hypertension risk factors. The major challenges in management are difficulties in accurate diagnosis of hypertension and adequate blood pressure control. In contrast to developed countries, hypertension prevalence rates are on the rise in developing countries with no improvement in awareness or control rates. The increasing burden of hypertension is largely attributable to behavioral factors, urbanization, unhealthy diet, obesity, social stress, and inactivity. Health authorities, medical societies, and drug industry can collaborate to improve hypertension control through education programs, public awareness campaigns, legislation to limit salt intake, encourage generic drugs, development and dissemination of national guidelines, and involving nurses and pharmacists in hypertension management. More epidemiologic data are needed in the future to identify reasons behind increased prevalence and poor blood pressure control and examine trends in prevalence, awareness, treatment, and control. National programs for better hypertension control based on local culture, economic characteristics, and available resources in the population are needed. The role of new tools for hypertension management should be tested in developing world.

  19. Prevalence of asthma among the adult general population of five Middle Eastern countries: results of the SNAPSHOT program.

    PubMed

    Tarraf, Hesham; Aydin, Omur; Mungan, Dilsad; Albader, Mohammad; Mahboub, Bassam; Doble, Adam; Lahlou, Aaicha; Tariq, Luqman; Aziz, Fayaz; El Hasnaoui, Abdelkader

    2018-05-11

    Asthma is a common chronic respiratory disease leading to morbidity, mortality and impaired quality of life worldwide. Information on asthma prevalence in the Middle East is fragmented and relatively out-dated. The SNAPSHOT program was conducted to obtain updated information. SNAPSHOT is a cross-sectional epidemiological program carried out in five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia, and the United Arab Emirates, the latter three grouped into a Gulf cluster) to collect data on asthma, allergic rhinitis, benign prostatic hyperplasia and bipolar disorder. The survey was carried out by telephone in a random sample of the adult general population with quotas defined according to country demographics. The analysis presented in this paper focuses on asthma. Subjects were screened for asthma based on criteria from the global Asthma Insights and Reality studies. Current prevalence (last 12 months) was estimated. Multivariate logistic regression analyses were used to investigate risk factors related to asthma and the association with allergic rhinitis and other co-morbidities. Quality of life was assessed using the three-level EQ-5D questionnaire. 2124 out of the 33,486 subjects enrolled in the SNAPSHOT program fulfilled the criteria for asthma. The adjusted prevalence of asthma ranged from 4.4% [95% CI: 4.0-4.8%] in Turkey, to 6.7% [95% CI: 6.2-7.2%] in Egypt and 7.6% [95% CI: 7.1-8.0%] in the Gulf cluster. Prevalence was higher (p < 0.0001) in women than men and increased with age (p < 0.0001). Co-morbidities occurred more frequently in asthma subjects compared to the non-asthma population (38% vs. 15% p < 0.0001). Subjects with asthma reported a lower (p < 0.0001) EQ-VAS score (68.2 ± 22.9) compared to the general population (78.1 ± 17.5). The risk factors associated with asthma were age, gender, country, and certain co-morbidities, namely respiratory, cardiovascular, gastrointestinal, nervous, and neurological

  20. Prevalence and trends of overweight and obesity in older adults from 10 European countries from 2005 to 2013.

    PubMed

    Peralta, Miguel; Ramos, Madalena; Lipert, Anna; Martins, João; Marques, Adilson

    2018-03-01

    Overweight and obesity are clinical public-health concerns worldwide. Amongst older adults, the prevalence of overweight and obesity is considered high. The purpose of this study was to provide current data regarding the prevalence and trends of overweight and obesity of adults from 2005 to 2013 in 10 European countries. The data used in the present study were derived from the first, second, fourth and fifth waves of the Survey of Health, Ageing and Retirement in Europe. The present study includes individuals aged ⩾50 years from 10 European countries. Body mass index (BMI) was calculated from self-reported height and weight (kg/m 2 ). The general prevalence of overweight (BMI ⩾25 kg/m 2 ) was slightly above 60% and remained stable between 2005 (60.1%, 95% confidence interval (CI): 59.3-60.9%) and 2013 (60.3%, 95% CI: 59.7-60.9%). On the other hand, the prevalence of obesity (BMI ⩾30 kg/m 2 ) increased significantly (1.6 points, 95% CI: 0.7-2.6) from 17.5% in 2005 to 19.2% in 2013. Although the prevalence of obesity increased in most countries, the only significant increase was observed in Germany (5.8 points, 95% CI: 1.8-9.9). Spain was the only country where the prevalence of obesity decreased significantly (-4.7 points, 95% CI: -8.8 to -0.5). Sex and age differences are reported. Although the prevalence of overweight was stable, the prevalence of obesity rose. Based on the data currently available for Europe, the prevalence of obesity in European older adults has already reached epidemic proportions, which reinforces the need for the development of effective healthy lifestyle programs.

  1. Prevalence of chronic diseases by immigrant status and disparities in chronic disease management in immigrants: a population-based cohort study, Valore Project.

    PubMed

    Buja, Alessandra; Gini, Rosa; Visca, Modesta; Damiani, Gianfranco; Federico, Bruno; Francesconi, Paolo; Donato, Daniele; Marini, Alessandro; Donatini, Andrea; Brugaletta, Salvatore; Baldo, Vincenzo; Bellentani, Mariadonata

    2013-05-24

    For chronic conditions, disparities can take effect cumulatively at various times as the disease progresses, even when care is provided. The aim of this study was to quantify the prevalence of diabetes, congestive heart failure (CHF) and coronary heart disease (CHD) in adults by citizenship, and to compare the performance of primary care services in managing these chronic conditions, again by citizenship. This is a population-based retrospective cohort study on 1,948,622 people aged 16 years or more residing in Italy. A multilevel regression model was applied to analyze adherence to care processes using explanatory variables at both patient and district level. The age-adjusted prevalence of diabetes was found higher among immigrants from high migratory pressure countries (HMPC) than among Italians, while the age-adjusted prevalence of CHD and CHF was higher for Italians than for HMPC immigrants or those from highly-developed countries (HDC). Our results indicate lower levels in all quality management indicators for citizens from HMPC than for Italians, for all the chronic conditions considered. Patients from HDC did not differ from Italian in their adherence to disease management schemes. This study revealed a different prevalence of chronic diseases by citizenship, implying a different burden of primary care by citizenship. Our findings show that more effort is needed to guarantee migrant-sensitive primary health care.

  2. Thirty-year trends in the prevalence and severity of female genital mutilation: a comparison of 22 countries

    PubMed Central

    Heymann, Jody

    2017-01-01

    Introduction Female genital mutilation (FGM) harms women’s health and well-being and is widely considered a violation of human rights. The United Nations has called for elimination of the practice by 2030. Methods We used household survey data to measure trends in the prevalence of FGM in 22 countries. We also examined trends in the severity of the practice by measuring changes in the prevalence of flesh removal, infibulation and symbolic ‘nicking’ of the genitals. We evaluated the extent to which measurement error may have influenced our estimates by observing the consistency of reports for the same birth cohorts over successive survey waves. Results The prevalence of all types of FGM fell in 17 of 22 countries we examined. The vast majority of women who undergo FGM have flesh removed from their genitals, likely corresponding to the partial or total removal of the clitoris and labia. Infibulation is still practised throughout much of sub-Saharan Africa. Its prevalence has declined in most countries, but in Chad, Mali and Sierra Leone the prevalence has increased by 2–8 percentage points over 30 years. Symbolic nicking of the genitals is relatively rare but becoming more common in Burkina Faso, Chad, Guinea and Mali. Conclusion FGM is becoming less common over time, but it remains a pervasive practice in some countries: more than half of women in 7 of the 22 countries we examined still experience FGM. The severity of the procedures has not changed substantially over time. Rigorous evaluation of interventions aimed at eliminating or reducing the harms associated with the practice is needed. PMID:29225952

  3. The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries.

    PubMed

    Manyanga, Taru; El-Sayed, Hesham; Doku, David Teye; Randall, Jason R

    2014-08-28

    The burden caused by the coexistence of obesity and underweight in Low and Middle Income Countries is a challenge to public health. While prevalence of underweight among youth has been well documented in these countries, overweight, obesity and their associated risk factors are not well understood unlike in high income countries. Cross-sectional data from the Global School-based Student Health Survey (GSHS) conducted in seven African countries were used for this study. The survey used a clustered design to obtain a representative sample (n = 23496) from randomly selected schools. 53.6% of the sample was male, and participants ranged in age from 11-17 years old. Body Mass Index (BMI) was calculated using age and sex adjusted self-reported heights and weights. Classification of weight status was based on the 2007 World Health Organization growth charts (BMI-for-age and sex). Multivariable Logistic Regression reporting Odds Ratios was used to assess potential risk factors on BMI, adjusting for age, sex, and country. Statistical analyses were performed with Stata with an alpha of 0.05 and reporting 95% confidence intervals. Unadjusted rates of being underweight varied from 12.6% (Egypt) to 31.9% (Djibouti), while being overweight ranged from 8.7% (Ghana) to 31.4% (Egypt). Obesity rates ranged from 0.6% (Benin) to 9.3% (Egypt). Females had a higher overweight prevalence for every age group in five of the countries, exceptions being Egypt and Malawi. Overall, being overweight was more prevalent among younger (≤12) adolescents and decreased with age. Males had a higher prevalence of being underweight than females for every country. There was a tendency for the prevalence of being underweight to increase starting in the early teens and decrease between ages 15 and 16. Most of the potential risk factors captured by the GSHS were not significantly associated with weight status. The prevalence of both overweight and underweight was relatively high, demonstrating the

  4. Prevalence of Overweight/Obesity and Its Associated Factors among University Students from 22 Countries

    PubMed Central

    Peltzer, Karl; Pengpid, Supa; Samuels, T. Alafia; Özcan, Neslihan Keser; Mantilla, Carolina; Rahamefy, Onja H.; Wong, Mee Lian; Gasparishvili, Alexander

    2014-01-01

    Obesity among young people increases lifetime cardiovascular risk. This study assesses the prevalence of overweight/obesity and its associated factors among a random sample of university students from 22 universities in 22 low, middle income and emerging economy countries. This cross-sectional survey comprised of a self-administered questionnaire and collected anthropometric measurements. The study population was 6773 (43.2%) males and 8913 (56.8%) females, aged 16 to 30 years (mean 20.8 years, SD = 2.6). Body mass index (BMI) was used for weight status. Among men, the prevalence of underweight was 10.8%, normal weight 64.4%, overweight 18.9% and obesity 5.8%, while among women, the prevalence of underweight was 17.6%, normal weight 62.1%, overweight 14.1% and obesity 5.2%. Overall, 22% were overweight or obese (24.7% men and 19.3% women). In multivariate regression among men, younger age, coming from a higher income country, consciously avoiding fat and cholesterol, physically inactivity, current tobacco use and childhood physical abuse, and among women older age, coming from a higher income country, frequent organized religious activity, avoiding fat and cholesterol, posttraumatic stress symptoms and physical childhood abuse were associated overweight or obesity. Several gender specific risk factors identified can be utilized in health promotion programmes. PMID:25050651

  5. Prevalence of overweight/obesity and its associated factors among university students from 22 countries.

    PubMed

    Peltzer, Karl; Pengpid, Supa; Samuels, T Alafia; Özcan, Neslihan Keser; Mantilla, Carolina; Rahamefy, Onja H; Wong, Mee Lian; Gasparishvili, Alexander

    2014-07-21

    Obesity among young people increases lifetime cardiovascular risk. This study assesses the prevalence of overweight/obesity and its associated factors among a random sample of university students from 22 universities in 22 low, middle income and emerging economy countries. This cross-sectional survey comprised of a self-administered questionnaire and collected anthropometric measurements. The study population was 6773 (43.2%) males and 8913 (56.8%) females, aged 16 to 30 years (mean 20.8 years, SD = 2.6). Body mass index (BMI) was used for weight status. Among men, the prevalence of underweight was 10.8%, normal weight 64.4%, overweight 18.9% and obesity 5.8%, while among women, the prevalence of underweight was 17.6%, normal weight 62.1%, overweight 14.1% and obesity 5.2%. Overall, 22% were overweight or obese (24.7% men and 19.3% women). In multivariate regression among men, younger age, coming from a higher income country, consciously avoiding fat and cholesterol, physically inactivity, current tobacco use and childhood physical abuse, and among women older age, coming from a higher income country, frequent organized religious activity, avoiding fat and cholesterol, posttraumatic stress symptoms and physical childhood abuse were associated overweight or obesity. Several gender specific risk factors identified can be utilized in health promotion programmes.

  6. Prevalence of Child Sexual Abuse in the Nordic Countries: A Literature Review.

    PubMed

    Kloppen, Kathrine; Haugland, Siren; Svedin, Carl Göran; Mæhle, Magne; Breivik, Kyrre

    2016-01-01

    This review examined child sexual abuse in the Nordic countries focusing on prevalence rates and victims' age and relationship to the perpetrator. The results show a prevalence of child sexual abuse (broadly defined) between 3-23% for boys and 11-36% for girls. The prevalence rates for contact abuse were 1-12% for boys and 6-30% for girls, while 0.3-6.8% of the boys and 1.1-13.5% of the girls reported penetrating abuse. The findings suggest an increased risk of abuse from early adolescence. In adolescence, peers may constitute the largest group of perpetrators. The results highlight the need for preventive efforts also targeting peer abuse. Future research should include cross-national and repeated studies using comparable methodology.

  7. Prevalence of foodborne pathogens in food from selected African countries - A meta-analysis.

    PubMed

    Paudyal, Narayan; Anihouvi, Victor; Hounhouigan, Joseph; Matsheka, Maitshwarelo Ignatius; Sekwati-Monang, Bonno; Amoa-Awua, Wisdom; Atter, Amy; Ackah, Nina Bernice; Mbugua, Samuel; Asagbra, Agnes; Abdelgadir, Warda; Nakavuma, Jesca; Jakobsen, Mogens; Fang, Weihuan

    2017-05-16

    Food safety information in the African region is insufficient and fragmented due to lack of surveillance, documentation and reporting, thereby resulting in inefficient utilization of resources, duplication of activities, and lack of synergy among the countries of the region. This paper reviews the prevalence of foodborne pathogens in seven African countries (Benin, Botswana, Ghana, Kenya, Nigeria, Sudan and Uganda) from papers in regional or international journals published between January 2000 and December 2015. One hundred and sixteen publications that dealt with food microbiology were reviewed for general analysis, while 66 papers on contamination of pathogenic bacteria were used for meta-analysis of prevalence. The food items were split into two categories: raw foods and ready-to-eat (RTE) foods (including street food and beverages) for meta-analysis. Majority of the reviewed studies (67.2%, 78/116) dealt with food of animal origin: 38.8% for meat and eggs, 17.2% for dairy products and 11.2% for aquatic products. Only 8.6% examined foods of plant origin (fruits and vegetables). The remaining 24.1% was the composite RTE food and beverages. Enterobacteriaceae, Escherichia coli, Salmonella, Staphylococcus aureus and Listeria monocytogenes were the most frequently reported organisms in those studies. Although the data were highly heterogeneous, a striking feature is high prevalence of the major pathogens in RTE foods, almost as high as in raw foods. E. coli averaged at 37.6% in raw foods and 31.6% in RTE foods. The corresponding prevalence for Salmonella was 19.9% vs 21.7%; S. aureus, 27.8% vs 25.1% and L. monocytogenes, 19.5% vs 6.7%. The average prevalence of foodborne pathogens in these countries was 34.2% (29.0-39.3%). Differences in food types as well as non-uniform protocols for sampling and identification might have contributed to high heterogeneity (I 2 >97%) although some high prevalence data could be factual with extensive varieties of raw and RTE foods

  8. Sickle Cell Disease: Management Options and Challenges in Developing Countries

    PubMed Central

    Ansong, Daniel; Akoto, Alex Osei; Ocloo, Delaena; Ohene-Frempong, Kwaku

    2013-01-01

    Sickle Cell Disease (SCD) is the most common genetic disorder of haemoglobin in sub-Saharan Africa. This commentary focuses on the management options available and the challenges that health care professionals in developing countries face in caring for patients with SCD. In a developing countries like Ghana, new-born screening is now about to be implemented on a national scale. Common and important morbidities associated with SCD are vaso-occlusive episodes, infections, Acute Chest Syndrome (ACS), Stroke and hip necrosis. Approaches to the management of these morbidities are far advanced in the developed countries. The differences in setting and resource limitations in developing countries bring challenges that have a major influence in management options in developing countries. Obviously clinicians in developing countries face challenges in managing SCD patients. However understanding the disease, its progression, and instituting the appropriate preventive methods are paramount in its management. Emphasis should be placed on early counselling, new-born screening, anti-microbial prophylaxis, vaccination against infections, and training of healthcare workers, patients and caregivers. These interventions are affordable in developing countries. PMID:24363877

  9. The HBsAg Prevalence Among Blood Donors From Eastern Mediterranean and Middle Eastern Countries: A Systematic Review and Meta-Analysis.

    PubMed

    Babanejad, Mehran; Izadi, Neda; Najafi, Farid; Alavian, Seyed Moayed

    2016-03-01

    The world health organization (WHO) recommends that all blood donations should be screened for evidence of infections, such as hepatitis B. The present study aimed to determine the prevalence of hepatitis B surface antigen (HBsAg) in blood donors at the eastern Mediterranean region office (EMRO) of the WHO and middle eastern countries. A meta-analysis was carried out based on the results of an electronic literature search of PubMed, Ovid, Scopus, and Google Scholar for articles published from January 1, 2000, to August 31, 2015. In accordance with a significant homogeneity test and a large value of I2, the random effects model was used to aggregate data from the studies and produce the pooled estimates using the "Metan" command. We included 66 eligible studies. The pooled prevalence of HBsAg in blood donors of both EMRO and middle eastern (E and M) countries was 2.03% (95% confidence interval [CI]: 1.79 - 2.26). In addition, the prevalence rates in the EMRO countries was 1.99% (95% CI: 1.84 - 2.14) and 1.62% in the Middle Eastern countries (95% CI: 1.36 - 1.88). The prevalence among blood donors with more than one study was 1.58% in Egypt, 0.58% in Iran, 0.67% in Iraq, 2.84% in Pakistan, 3.02% in Saudi Arabia, 1.68% in Turkey, and 5.05% in Yemen. Based on the WHO classification of hepatitis B virus (HBV) prevalence, the prevalence of HBsAg in blood donors from E and M countries reached an intermediate level. However, there were low prevalence levels in some E and M countries.

  10. Prevalence, correlates and management of type 2 diabetes mellitus in Lebanon: findings from a national population-based study.

    PubMed

    Costanian, Christy; Bennett, Kathleen; Hwalla, Nahla; Assaad, Shafika; Sibai, Abla M

    2014-09-01

    This study aims to examine the prevalence, associated risk factors and complications of diabetes, as well management and preventive care in Lebanon, a small, middle-income country of the Mediterranean region. Using a comprehensive multi-dimensional questionnaire, a cross-sectional national survey of 2195 Lebanese adults aged ≥25 years was conducted based on the WHO STEPwise guidelines. The outcome variable, diabetes, was self-reported. Measures for diabetes management included frequency of blood glucose testing and regular eye and foot exams. Macrovascular and microvascular complications were also recorded. The prevalence of type 2 diabetes was 8.5% (95%CI=7.3-9.7). Factors associated with an increased risk of having diabetes were: being divorced or widowed (OR=2.56; 95%CI=1.07-5.42) compared to single, being obese (OR=1.50, 95%CI=1.00-2.57), and having a family history of diabetes (OR=3.40;95%CI=2.48-5.19). Vigorous physical activity significantly decreased the odds of diabetes (OR=0.42; 95%CI=0.24-0.72). Diabetes management and self-care goals were as follows: 82% were not measuring their blood sugar via dextro on a daily basis, 64.2% did not have a foot exam within the past year, and 52.4% did not obtain the recommended yearly eye exam. The most common complications included heart disease (27.8%) and retinopathy (16.6%). Prevalence of diabetes in Lebanon was comparable to that found in the West, yet remained lower than estimates in other resource-rich neighboring countries. Adherence to management and self-care measures was sub-optimal resulting in high complication rates. Contextual factors play a role in increasing diabetes risk. Population-based interventions to enhance and promote self-management behaviors are essential to improve complication rates. Copyright © 2014. Published by Elsevier Ireland Ltd.

  11. Distribution of malaria exposure in endemic countries in Africa considering country levels of effective treatment.

    PubMed

    Penny, Melissa A; Maire, Nicolas; Bever, Caitlin A; Pemberton-Ross, Peter; Briët, Olivier J T; Smith, David L; Gething, Peter W; Smith, Thomas A

    2015-10-05

    Malaria prevalence, clinical incidence, treatment, and transmission rates are dynamically interrelated. Prevalence is often considered a measure of malaria transmission, but treatment of clinical malaria reduces prevalence, and consequently also infectiousness to the mosquito vector and onward transmission. The impact of the frequency of treatment on prevalence in a population is generally not considered. This can lead to potential underestimation of malaria exposure in settings with good health systems. Furthermore, these dynamical relationships between prevalence, treatment, and transmission have not generally been taken into account in estimates of burden. Using prevalence as an input, estimates of disease incidence and transmission [as the distribution of the entomological inoculation rate (EIR)] for Plasmodium falciparum have now been made for 43 countries in Africa using both empirical relationships (that do not allow for treatment) and OpenMalaria dynamic micro-simulation models (that explicitly include the effects of treatment). For each estimate, prevalence inputs were taken from geo-statistical models fitted for the year 2010 by the Malaria Atlas Project to all available observed prevalence data. National level estimates of the effectiveness of case management in treating clinical attacks were used as inputs to the estimation of both EIR and disease incidence by the dynamic models. When coverage of effective treatment is taken into account, higher country level estimates of average EIR and thus higher disease burden, are obtained for a given prevalence level, especially where access to treatment is high, and prevalence relatively low. These methods provide a unified framework for comparison of both the immediate and longer-term impacts of case management and of preventive interventions.

  12. Prediction of prevalence of chronic kidney disease in diabetic patients in countries of the European Union up to 2025.

    PubMed

    Kainz, Alexander; Hronsky, Milan; Stel, Vianda S; Jager, Kitty J; Geroldinger, Angelika; Dunkler, Daniela; Heinze, Georg; Tripepi, Giovanni; Oberbauer, Rainer

    2015-08-01

    Diabetes and chronic kidney disease (CKD) are a growing burden for health-care systems. The prevalence of diabetes has increased constantly during the last decade, although a slight flattening of end-stage renal disease as a result of diabetes has been observed recently in some European countries. In this study, we project the prevalence of CKD in patients with diabetes in European countries up to the year 2025. We analysed the population with diabetes and development of nephropathy in 12 European countries, which we computed from models published previously and on data from the annual reports of the European Renal Association (1998-2011). The prevalence of CKD stage 5 in patients with diabetes up to the year 2025 was projected by the Lee-Carter algorithm. Those for stage 3 and 4 were then estimated by applying the same ratios of CKD prevalences as estimated in the Austrian population with diabetic nephropathy. The estimated prevalence of CKD in patients with diabetes is expected to increase in all 12 countries up to the year 2025. For CKD stage 3, we estimate for Austria in 2025 a prevalence of 215 000 per million diabetic population (p.m.p.) (95% confidence interval 169 000, 275 000), for CKD4 18 600 p.m.p. (14 500, 23 700) and for CKD5 6900 p.m.p. (5400, 8900). The median prevalence in the considered countries is 132 900 p.m.p. (IQR: 118 500, 195 800), 11 500 (10 200, 16 900) and 4300 (3800, 6300) for CKD stages 3, 4 and 5, respectively. Altogether, these data predict in the years 2012-25 an annual increase of 3.2% in the prevalence of diabetic CKD stage 5. Due to the increase in prevalence of diabetes and CKD5, the costs of renal therapy are expected to rise. We believe that these data may help health-care policy makers to make informed decisions. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  13. Recent trends in the prevalence of under- and overweight among adolescent girls in low- and middle-income countries

    PubMed Central

    Jaacks, Lindsay M.; Slining, Meghan M.; Popkin, Barry M.

    2014-01-01

    Background Most studies of childhood malnutrition in low- and middle-income countries (LMICs) focus on children <5 years, with few focusing on adolescence, a critical stage in development. Objective To evaluate recent trends in the prevalence of under- and overweight among girls (15–18 years) in LMICs. Methods Data are from Demographic and Health Surveys (53 countries) and national surveys conducted in Indonesia, China, Vietnam, Brazil, and Mexico. The most recent surveys with sample sizes ≥50 when stratified by rural-urban status were included: 46.6% of countries had a survey conducted in the past 5 years, while the most recent survey for 10.3% of countries was over 10 years old. The overall rural sample size was 94,857 and urban sample size was 81,025. Under- and overweight were defined using the IOTF sex- and age-specific BMI cut-points. Results South Asia had the highest prevalence of underweight; nearly double that of East Asia & the Pacific and Sub-Saharan Africa, and increasing annually by 0.66% in rural areas. Latin America & the Caribbean had the highest regional prevalence of overweight in both rural and urban settings and this prevalence is increasing annually by about 0.50%. In urban areas, 38% of countries had both an under- and overweight prevalence ≥10%. Conclusions There is substantial variation across and within regions in the burden of under- and overweight, with increasing dual burdens in urban areas. Innovative public health interventions capable of addressing both ends of the malnutrition spectrum are urgently needed. PMID:25558987

  14. Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis.

    PubMed

    Lee, Hwa-Young; Yang, Bong-Min; Kang, Minah

    2015-11-01

    This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country.

  15. [The prevalence of hepatitis A in the Guadalajara province. Is Spain a country with low endemia?].

    PubMed

    González-Praetorius, A; Rodríguez-Avial, C; Fernández, C; Teresa Pérez-Pomata Mf, M; Gimeno, C; Bisquert, J

    2001-11-01

    Spain, together with the other southern European countries, was considered to be an area with a moderate degree of endemia. This fact has consequences for tourists that visit these areas and for vaccination strategies. A prevalence study was proposed in order to get to know the situation of this infection in the Guadalajara province. 284 specimens of serum were taken from patients who were classified according to their age, sex and place of residence (with more or less than 10.000 inhabitants). In these specimens the presence of hepatitis A antibodies were studied, using a Microparticule Enzyme Immunoassay (MEIA) (Abbott). An increase in the prevalence was observed in older people, there is a low prevalence population (prevalence population (>80%) in adults aged between 30 and 74 years. No differences were observed related to sex. In the stratified analysis according to age, differences were observed between the groups from rural and urban origins. The low prevalence of hepatitis A was found among the younger population, as seen in other studies carried out on a national level, and this together with a decrease in the frequency, means that Spain is included among the countries with low endemia. This fact has consequences for tourists who visit our country and for vaccination strategies, due to the increase in the number of adults who are susceptible to the infection.

  16. Cost-effectiveness model for hepatitis C screening and treatment: Implications for Egypt and other countries with high prevalence

    PubMed Central

    Kim, David D.; Hutton, David W.; Raouf, Ahmed A.; Salama, Mohsen; Hablas, Ahmed; Seifeldin, Ibrahim A.; Soliman, Amr S.

    2014-01-01

    Hepatitis C Virus (HCV) infection is a major cause of cirrhosis and liver cancer, and many developing countries report intermediate-to-high prevalence. However, the economic impact of screening and treatment for HCV in high prevalence countries has not been well studied. Thus, we examined the cost-effectiveness of screening and treatment for HCV infection for asymptomatic, average-risk adults using a Markov decision analytic model. In our model, we collected age-specific prevalence, disease progression rates for Egyptians, and local cost estimates in Egypt, which has the highest prevalence of HCV infection (~15%) in the world. We estimated the incremental cost-effectiveness ratio (ICER) and conducted sensitivity analyses to determine how cost-effective HCV screening and treatment might be in other developing countries with high and intermediate prevalence. In Egypt, implementing a screening program using triple-therapy treatment (sofosbuvir with pegylated interferon and ribavirin) was dominant compared to no screening because it would have lower total costs and improve health outcomes. HCV screening and treatment would also be cost-effective in global settings with intermediate costs of drug treatment (~$8,000) and a higher sustained viral response rate (70–80%). PMID:25469976

  17. Menstrual Hygiene Management in Resource-Poor Countries

    PubMed Central

    Kuhlmann, Anne Sebert; Henry, Kaysha; Wall, L. Lewis

    2017-01-01

    Importance Adequate management of menstrual hygiene is taken for granted in affluent countries; however, inadequate menstrual hygiene is a major problem for girls and women in resource-poor countries, which adversely affects the health and development of adolescent girls. Objective The aim of this article is to review the current evidence concerning menstrual hygiene management in these settings. Evidence Acquisition A PubMed search using MeSH terms was conducted in English, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesized, and summarized. Results Most research to date has described menstrual hygiene knowledge, attitudes, and practices, mainly in sub-Saharan Africa and South Asia. Many school-based studies indicate poorer menstrual hygiene among girls in rural areas and those attending public schools. The few studies that have tried to improve or change menstrual hygiene practices provide moderate to strong evidence that targeted interventions do improve menstrual hygiene knowledge and awareness. Conclusion and Relevance Challenges to improving menstrual hygiene management include lack of support from teachers (who are frequently male); teasing by peers when accidental menstrual soiling of clothes occurs; poor familial support; lack of cultural acceptance of alternative menstrual products; limited economic resources to purchase supplies; inadequate water and sanitation facilities at school; menstrual cramps, pain, and discomfort; and lengthy travel to and from school, which increases the likelihood of leaks/stains. Areas for future research include the relationship between menarche and school dropout, the relationship between menstrual hygiene management and other health outcomes, and how to increase awareness of menstrual hygiene management among household decision makers including husbands/fathers and in-laws. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After

  18. Challenges in the management of rheumatoid arthritis in developing countries.

    PubMed

    Mody, Girish M; Cardiel, Mario H

    2008-08-01

    Rheumatoid arthritis (RA) is a systemic autoimmune disease which is characterized by chronic inflammation of the joints. Patients experience chronic pain and suffering, and increasing disability; without treatment, life expectancy is reduced. It is imperative to identify patients early so that control of inflammation can prevent joint destruction and disability. Although great advances have been made in the developed nations, early diagnosis remains a great challenge for developing countries during the Bone and Joint Decade (2000-2010) and beyond. Developing countries face important and competitive social, economic, health- and poverty-related issues, and this frequently results in chronic diseases such as RA being forgotten in health priorities when urgent health needs are considered in an environment with poor education and scarce resources. Epidemiological studies in developing countries show a lower but still important prevalence in different regions when compared to that in Caucasians. It seems that the severity of RA varies among different ethnic groups, and probably starts at a younger age in developing countries. Practising rheumatologists in these regions need to take into account several important problems that include suboptimal undergraduate education, inadequate diagnosis, late referrals, lack of human and technical resources, poor access to rheumatologists, and some deficiencies in drug availability. Infections are very important in RA, and special care is needed in developing countries as some endemic infections include tuberculosis, human immunodeficiency virus (HIV), hepatitis B, and hepatitis C. These infections should be carefully taken into account when medications are prescribed and monitored. This chapter presents published information covering the main challenges faced in these environments, and suggests strategies to overcome these important problems in RA management.

  19. Prevalence of overweight and obesity among adolescents in eight Arab countries: comparison between two international standards (ARABEAT-2).

    PubMed

    Musaiger, Abdulrahman O; Al-Mannai, Mariam; Al-Haifi, Ahmad R; Nabag, Fatima; Elati, Jalila; Abahussain, Nada; Tayyem, Reema; Jalambo, Marwan; Benhamad, Mofida; Al-Mufty, Berivan

    2016-09-20

    The aim of this study was to highlight the prevalence of overweight and obesity among adolescents in eight Arab countries. A school-based cross-sectional study was conducted in eight Arab countries: Iraq, Jordan, Kuwait, Libya, Palestine, Saudi Arabia, Sudan and Tunisia. The total sample included was 6,447 adolescents aged 15-18 years (3,111 males, 3,336 females). The International Obesity Task Force (IOTF) and World Health Organization (WHO) reference standards were used to determine obesity levels. The WHO standard provided lower prevalence of overweight but higher prevalence of obesity than the IOTF standard. According to the IOTF standard, overweight among males was highest in Kuwaiti adolescents (24.8%), followed by Saudi Arabian (23.2%). Among females, the highest prevalence was reported in Kuwaiti adolescents (22.1%), followed by Jordanian (20.0%). Regarding obesity, Kuwaiti adolescents showed the highest prevalence of obesity for both males (28.6%) and females (21.1%). Findings revealed no progress in reducing prevalence of obesity.

  20. Variations in Diabetes Prevalence in Low-, Middle-, and High-Income Countries: Results From the Prospective Urban and Rural Epidemiological Study.

    PubMed

    Dagenais, Gilles R; Gerstein, Hertzel C; Zhang, Xiaohe; McQueen, Matthew; Lear, Scott; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Mony, Prem; Gupta, Rajeev; Kutty, V Raman; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Zatonska, Katarzyna; Oguz, Aytekin; Rosengren, Annika; Kelishadi, Roya; Yusufali, Afzalhussein; Diaz, Rafael; Avezum, Alvaro; Lanas, Fernando; Kruger, Annamarie; Peer, Nasheeta; Chifamba, Jephat; Iqbal, Romaina; Ismail, Noorhassim; Xiulin, Bai; Jiankang, Liu; Wenqing, Deng; Gejie, Yue; Rangarajan, Sumathy; Teo, Koon; Yusuf, Salim

    2016-05-01

    The goal of this study was to assess whether diabetes prevalence varies by countries at different economic levels and whether this can be explained by known risk factors. The prevalence of diabetes, defined as self-reported or fasting glycemia ≥7 mmol/L, was documented in 119,666 adults from three high-income (HIC), seven upper-middle-income (UMIC), four lower-middle-income (LMIC), and four low-income (LIC) countries. Relationships between diabetes and its risk factors within these country groupings were assessed using multivariable analyses. Age- and sex-adjusted diabetes prevalences were highest in the poorer countries and lowest in the wealthiest countries (LIC 12.3%, UMIC 11.1%, LMIC 8.7%, and HIC 6.6%; P < 0.0001). In the overall population, diabetes risk was higher with a 5-year increase in age (odds ratio 1.29 [95% CI 1.28-1.31]), male sex (1.19 [1.13-1.25]), urban residency (1.24 [1.11-1.38]), low versus high education level (1.10 [1.02-1.19]), low versus high physical activity (1.28 [1.20-1.38]), family history of diabetes (3.15 [3.00-3.31]), higher waist-to-hip ratio (highest vs. lowest quartile; 3.63 [3.33-3.96]), and BMI (≥35 vs. <25 kg/m(2); 2.76 [2.52-3.03]). The relationship between diabetes prevalence and both BMI and family history of diabetes differed in higher- versus lower-income country groups (P for interaction < 0.0001). After adjustment for all risk factors and ethnicity, diabetes prevalences continued to show a gradient (LIC 14.0%, LMIC 10.1%, UMIC 10.9%, and HIC 5.6%). Conventional risk factors do not fully account for the higher prevalence of diabetes in LIC countries. These findings suggest that other factors are responsible for the higher prevalence of diabetes in LIC countries. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  1. Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis

    PubMed Central

    Lee, Hwa-Young; Kang, Minah

    2015-01-01

    This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country. PMID:26617451

  2. Public health laboratory quality management in a developing country.

    PubMed

    Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut

    2012-01-01

    The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.

  3. A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

    PubMed

    Brathwaite, Rachel; Addo, Juliet; Smeeth, Liam; Lock, Karen

    2015-01-01

    To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

  4. Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: results from the World Health Survey.

    PubMed

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Mendis, Shanthi; Harper, Sam; Verdes, Emese; Kunst, Anton; Chatterji, Somnath

    2012-06-22

    Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups. Using 2002-04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above are presented for wealth quintiles and five education levels, by sex and country income group. Symptom-based classification was used to determine angina, arthritis, asthma and depression rates, and diabetes diagnoses were self-reported. Socioeconomic inequalities according to wealth and education were measured absolutely, using the slope index of inequality, and relatively, using the relative index of inequality. Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality. Noncommunicable diseases are not necessarily diseases of the wealthy, and showed unequal distribution across socioeconomic groups in low- and middle-income country groups. Disaggregated research is warranted to assess the impact of individual noncommunicable diseases according to socioeconomic indicators.

  5. Diagnosis and Management of Depression in 3 Countries: Results From a Clinical Vignette Factorial Experiment

    PubMed Central

    Link, Carol L.; Stern, Theodore A.; Piccolo, Rebecca S.; Marceau, Lisa D.; Arber, Sara; Adams, Ann; Siegrist, Johannes; von dem Knesebeck, Olaf

    2011-01-01

    Objective: International differences in disease prevalence rates are often reported and thought to reflect different lifestyles, genetics, or cultural differences in care-seeking behavior. However, they may also be produced by differences among health care systems. We sought to investigate variation in the diagnosis and management of a “patient” with exactly the same symptoms indicative of depression in 3 different health care systems (Germany, the United Kingdom, and the United States). Method: A factorial experiment was conducted between 2001 and 2006 in which 384 randomly selected primary care physicians viewed a video vignette of a patient presenting with symptoms suggestive of depression. Under the supervision of experienced clinicians, professional actors were trained to realistically portray patients who presented with 7 symptoms of depression: sleep disturbance, decreased interest, guilt, diminished energy, impaired concentration, poor appetite, and psychomotor agitation or retardation. Results: Most physicians listed depression as one of their diagnoses (89.6%), but German physicians were more likely to diagnose depression in women, while British and American physicians were more likely to diagnose depression in men (P = .0251). American physicians were almost twice as likely to prescribe an antidepressant as British physicians (P = .0241). German physicians were significantly more likely to refer the patient to a mental health professional than British or American physicians (P < .0001). German physicians wanted to see the patient in follow-up sooner than British or American physicians (P < .0001). Conclusions: Primary care physicians in different countries diagnose the exact same symptoms of depression differently depending on the patient's gender. There are also significant differences between countries in the management of a patient with symptoms suggestive of depression. International differences in prevalence rates for depression, and perhaps

  6. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country

    PubMed Central

    Conen, D; Wietlisbach, V; Bovet, P; Shamlaye, C; Riesen, W; Paccaud, F; Burnier, M

    2004-01-01

    Background The prevalence of hyperuricemia has rarely been investigated in developing countries. The purpose of the present study was to investigate the prevalence of hyperuricemia and the association between uric acid levels and the various cardiovascular risk factors in a developing country with high average blood pressures (the Seychelles, Indian Ocean, population mainly of African origin). Methods This cross-sectional health examination survey was based on a population random sample from the Seychelles. It included 1011 subjects aged 25 to 64 years. Blood pressure (BP), body mass index (BMI), waist circumference, waist-to-hip ratio, total and HDL cholesterol, serum triglycerides and serum uric acid were measured. Data were analyzed using scatterplot smoothing techniques and gender-specific linear regression models. Results The prevalence of a serum uric acid level >420 μmol/L in men was 35.2% and the prevalence of a serum uric acid level >360 μmol/L was 8.7% in women. Serum uric acid was strongly related to serum triglycerides in men as well as in women (r = 0.73 in men and r = 0.59 in women, p < 0.001). Uric acid levels were also significantly associated but to a lesser degree with age, BMI, blood pressure, alcohol and the use of antihypertensive therapy. In a regression model, triglycerides, age, BMI, antihypertensive therapy and alcohol consumption accounted for about 50% (R2) of the serum uric acid variations in men as well as in women. Conclusions This study shows that the prevalence of hyperuricemia can be high in a developing country such as the Seychelles. Besides alcohol consumption and the use of antihypertensive therapy, mainly diuretics, serum uric acid is markedly associated with parameters of the metabolic syndrome, in particular serum triglycerides. Considering the growing incidence of obesity and metabolic syndrome worldwide and the potential link between hyperuricemia and cardiovascular complications, more emphasis should be put on the

  7. Gender differences in prevalence of the metabolic syndrome in Gulf Cooperation Council Countries: a systematic review.

    PubMed

    Mabry, R M; Reeves, M M; Eakin, E G; Owen, N

    2010-05-01

    To systematically review studies documenting the prevalence of the metabolic syndrome among men and women in Member States of the Gulf Cooperative Council (GCC; Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates)-countries in which obesity, Type 2 diabetes and related metabolic and cardiovascular diseases are highly prevalent. A search was conducted on PubMed and CINAHL using the term 'metabolic syndrome' and the country name of each GCC Member State. The search was limited to studies published in the English language. The metabolic syndrome was defined according to the Third Adult Treatment Panel (ATPIII) of the National Cholesterol Education Program (NCEP) and/or International Diabetes Federation (IDF) definitions. The methodological quality of each study was evaluated based on four criteria: a national-level population sample; equal gender representation; robustness of the sample size; an explicit sampling methodology. PubMed, CINAHL and reference list searches identified nine relevant studies. Only four were considered high quality and found that, for men, the prevalence of the metabolic syndrome ranged from 20.7% to 37.2% (ATPIII definition) and from 29.6% to 36.2% (IDF definition); and, for women, from 32.1% to 42.7% (ATPIII definition) and from 36.1% to 45.9% (IDF definition). Overall, the prevalence of the metabolic syndrome in the GCC states is some 10-15% higher than in most developed countries, with generally higher prevalence rates for women. Preventive strategies will require identifying socio-demographic and environmental correlates (particularly those influencing women) and addressing modifiable risk behaviours, including lack of physical activity, prolonged sitting time and dietary intake.

  8. The 2005 Workbook: an improved tool for estimating HIV prevalence in countries with low level and concentrated epidemics.

    PubMed

    Lyerla, R; Gouws, E; García-Calleja, J M; Zaniewski, E

    2006-06-01

    This paper describes improvements and updates to an established approach to making epidemiological estimates of HIV prevalence in countries with low level and concentrated epidemics. The structure of the software used to make estimates is briefly described, with particular attention to changes and improvements. The approach focuses on identifying populations which, through their behaviour, are at high risk of infection with HIV or who are exposed through the risk behaviour of their sexual partners. Estimates of size and HIV prevalence of these populations allow the total number of HIV infected people in a country or region to be estimated. Major changes in the software focus on the move away from short term projections and towards developing an epidemiological curve that more accurately represents the change in prevalence of HIV over time. The software continues to provide an output file for use in the Spectrum software so as to estimate the demographic impact of HIV infection at country level.

  9. Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta-analysis of country level data.

    PubMed

    Yoong, Sze Lin; Stockings, Emily; Chai, Li Kheng; Tzelepis, Flora; Wiggers, John; Oldmeadow, Christopher; Paul, Christine; Peruga, Armando; Kingsland, Melanie; Attia, John; Wolfenden, Luke

    2018-06-01

    To describe the prevalence and change in prevalence of electronic nicotine delivery systems (ENDS) use in youth by country and combustible smoking status. Databases and the grey literature were systematically searched to December 2015. Studies describing the prevalence of ENDS use in the general population aged ≤20 years in a defined geographical region were included. Where multiple estimates were available within countries, prevalence estimates of ENDS use were pooled for each country separately. Data from 27 publications (36 surveys) from 13 countries were included. The prevalence of ENDS ever use in 2013-2015 among youth were highest in Poland (62.1%; 95%CI: 59.9-64.2%), and lowest in Italy (5.9%; 95%CI: 3.3-9.2%). Among non-smoking youth, the prevalence of ENDS ever use in 2013-2015 varied, ranging from 4.2% (95%CI: 3.8-4.6%) in the US to 14.0% in New Zealand (95%CI: 12.7-15.4%). The prevalence of ENDS ever use among current tobacco smoking youth was the highest in Canada (71.9%, 95%CI: 70.9-72.8%) and lowest in Italy (29.9%, 95%CI: 18.5-42.5%). Between 2008 and 2015, ENDS ever use among youth increased in Poland, Korea, New Zealand and the US; decreased in Italy and Canada; and remained stable in the UK. There is considerable heterogeneity in ENDS use among youth globally across countries and also between current smokers and non-smokers. Implications for public health: Population-level survey data on ENDS use is needed to inform public health policy and messaging globally. © 2018 The Authors.

  10. Prevalence of wasting among under 6-month-old infants in developing countries and implications of new case definitions using WHO growth standards: a secondary data analysis

    PubMed Central

    Kerac, Marko; Blencowe, Hannah; Grijalva-Eternod, Carlos; McGrath, Marie; Shoham, Jeremy; Cole, Tim J; Seal, Andrew

    2011-01-01

    Objectives To determine wasting prevalence among infants aged under 6 months and describe the effects of new case definitions based on WHO growth standards. Design Secondary data analysis of demographic and health survey datasets. Setting 21 developing countries. Population 15 534 infants under 6 months and 147 694 children aged 6 to under 60 months (median 5072 individuals/country, range 1710–45 398). Wasting was defined as weight-for-height z-score <−2, moderate wasting as −3 to <−2 z-scores, severe wasting as z-score <−3. Results Using National Center for Health Statistics (NCHS) growth references, the nationwide prevalence of wasting in infant under-6-month ranges from 1.1% to 15% (median 3.7%, IQR 1.8–6.5%; ∼3 million wasted infants <6 months worldwide). Prevalence is more than doubled using WHO standards: 2.0–34% (median 15%, IQR 6.2–17%; ∼8.5 million wasted infants <6 months worldwide). Prevalence differences using WHO standards are more marked for infants under 6 months than children, with the greatest increase being for severe wasting (indicated by a regression line slope of 3.5 for infants <6 months vs 1.7 for children). Moderate infant-6-month wasting is also greater using WHO, whereas moderate child wasting is 0.9 times the NCHS prevalence. Conclusions Whether defined by NCHS references or WHO standards, wasting among infants under 6 months is prevalent in many of the developing countries examined in this study. Use of WHO standards to define wasting results in a greater disease burden, particularly for severe wasting. Policy makers, programme managers and clinicians in child health and nutrition programmes should consider resource and risk/benefit implications of changing case definitions. PMID:21288999

  11. Prevalence of and factors associated with burnout among health care professionals in Arab countries: a systematic review.

    PubMed

    Elbarazi, I; Loney, T; Yousef, S; Elias, A

    2017-07-17

    Burnout among healthcare professionals is one of the key challenges affecting health care practice and quality of care. This systematic review aims to (1) estimate the prevalence of burnout among health care professionals (HCP) in Arab countries; and (2) explore individual and work-related factors associated with burnout in this population. Multiple electronic databases were searched for studies published in English or Arabic from January 1980 to November 2014 assessing burnout (using the Maslach Burnout Inventory; MBI) amongst health care professionals (HCP) in Arab countries. Nineteen studies (N = 4108; 49.3% females) conducted on HCP in Bahrain, Egypt, Jordan, Lebanon, Palestine, Saudi Arabia and Yemen were included in this review. There was a wide range of prevalence estimates for the three MBI subscales, high Emotional Exhaustion (20.0-81.0%), high Depersonalization (9.2-80.0%), and low Personal Accomplishment (13.3-85.8%). Gender, nationality, service duration, working hours, and shift patterns were all significantly associated with burnout. Within the constraints of the study and the range of quality papers available, our review revealed moderate-to-high estimates of self-reported burnout among HCP in Arab countries that are similar to prevalence estimates in non-Arabic speaking westernized developed countries. In order to develop culturally appropriate interventions, further research using longitudinal designs is needed to confirm the risk factors for burnout in specific HCP settings and specialties in Arab countries.

  12. Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: Results from the World Health Survey

    PubMed Central

    2012-01-01

    Background Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups. Methods Using 2002–04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above are presented for wealth quintiles and five education levels, by sex and country income group. Symptom-based classification was used to determine angina, arthritis, asthma and depression rates, and diabetes diagnoses were self-reported. Socioeconomic inequalities according to wealth and education were measured absolutely, using the slope index of inequality, and relatively, using the relative index of inequality. Results Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality. Conclusions Noncommunicable diseases are not necessarily diseases of the wealthy, and showed unequal distribution across socioeconomic groups in low- and middle-income country groups. Disaggregated research is warranted to assess the impact of individual noncommunicable diseases according to socioeconomic indicators. PMID:22726343

  13. Human rights protections and HIV prevalence among MSM who sell sex: Cross-country comparisons from a systematic review and meta-analysis.

    PubMed

    Oldenburg, Catherine E; Perez-Brumer, Amaya G; Reisner, Sari L; Mayer, Kenneth H; Mimiaga, Matthew J; Hatzenbuehler, Mark L; Bärnighausen, Till

    2018-04-01

    Laws and policies can affect the HIV risk of key populations through a number of direct and indirect pathways. We investigated the association between HIV prevalence among men who engage in transactional sex and language in the penal code protecting sexual minorities, including men who have sex with men (MSM), and sex workers. HIV prevalence among men who engage in transactional sex was assessed through meta-analysis of published literature and country surveillance reports. Meta-regression was used to determine the association between HIV prevalence and protective laws for sexual minorities and sex workers. Sixty-six reports representing 28 countries and 31,924 individuals were included in the meta-analysis. Controlling for multiple study- and country-level variables, legal protection for sexual minorities was associated with a 10.9% (95% CI: 3.8-18.0%) and sex workers associated with a 7.0% (95% CI: 1.3-12.8%) decrease in country-level HIV prevalence among men who engage in transactional sex. Laws that seek to actively protect sex workers and MSM may be necessary to decrease HIV risk for this key population.

  14. Differences in prevalence of bullying victimization between native and immigrant children in the Nordic countries: a parent-reported serial cross-sectional study.

    PubMed

    Bjereld, Y; Daneback, K; Petzold, M

    2015-07-01

    Bullying among children is a problem with severe consequences for the victim. The present study examined parent-reported bullying victimization among children in the Nordic countries at two points in time, 1996 and 2011, and studied differences in prevalence of bullying victimization between immigrant and native children. Data came from the parent-reported NordChild, carried out in the Nordic countries in 1996 and 2011. NordChild is a serial cross-sectional comparative study. A total of 7107 children aged 7-13 were included in the analyses. The prevalence of bullying victimization in the total Nordic countries was lower in 2011 (19.2%) than 1996 (21.7%). Difference in prevalence of bullying victimization was found both between native and immigrant children, and between countries. The largest difference in prevalence of bullying victimization was measured in Sweden 2011, where 8.6% of the native children were bullied, to be compared with the 27.8% of the immigrant children. Immigrant children had higher odds to be bullied than native children in Norway, Sweden and in the total Nordic countries at both measurements, also when adjusted for potentially confounding factors. The higher prevalence of bullying victimization among immigrant children should be taken into consideration in the design and development of preventive work against bullying. © 2014 John Wiley & Sons Ltd.

  15. A comparative cross-cultural study of the prevalence of late life depression in low and middle income countries

    PubMed Central

    Guerra, M.; Prina, A.M.; Ferri, C.P.; Acosta, D.; Gallardo, S.; Huang, Y.; Jacob, K.S.; Jimenez-Velazquez, I.Z.; Llibre Rodriguez, J.J.; Liu, Z.; Salas, A.; Sosa, A.L.; Williams, J.D.; Uwakwe, R.; Prince, M.

    2016-01-01

    Background Current estimates of the prevalence of depression in later life mostly arise from studies carried out in Europe, North America and Asia. In this study we aimed to measure the prevalence of depression using a standardised method in a number of low and middle income countries (LMIC). Methods A one-phase cross-sectional survey involving over 17,000 participants aged 65 years and over living in urban and rural catchment areas in 13 sites from 9 countries (Cuba, Dominican Republic, Puerto Rico, Mexico, Venezuela, Peru, China, India and Nigeria). Depression was assessed and compared using ICD-10 and EURO-D criteria. Results Depression prevalence varied across sites according to diagnostic criteria. The lowest prevalence was observed for ICD-10 depressive episode (0.3 to 13.8%). When using the EURO-D depression scale, the prevalence was higher and ranged from 1.0% to 38.6%. The crude prevalence was particularly high in the Dominican Republic and in rural India. ICD-10 depression was also associated with increased age and being female. Limitations Generalisability of findings outside of catchment areas is difficult to assess. Conclusions Late life depression is burdensome, and common in LMIC. However its prevalence varies from culture to culture; its diagnosis poses a significant challenge and requires proper recognition of its expression. PMID:26544620

  16. Children concurrently wasted and stunted: A meta‐analysis of prevalence data of children 6–59 months from 84 countries

    PubMed Central

    Khara, Tanya; Mwangome, Martha; Ngari, Moses

    2017-01-01

    Abstract Children can be stunted and wasted at the same time. Having both deficits greatly elevates risk of mortality. The analysis aimed to estimate the prevalence and burden of children aged 6–59 months concurrently wasted and stunted. Data from demographic and health survey and Multi‐indicator Cluster Surveys datasets from 84 countries were analysed. Overall prevalence for being wasted, stunted, and concurrently wasted and stunted among children 6 to 59 months was calculated. A pooled prevalence of concurrence was estimated and reported by gender, age, United Nations regions, and contextual categories. Burden was calculated using population figures from the global joint estimates database. The pooled prevalence of concurrence in the 84 countries was 3.0%, 95% CI [2.97, 3.06], ranging from 0% to 8.0%. Nine countries reported a concurrence prevalence greater than 5%. The estimated burden was 5,963,940 children. Prevalence of concurrence was highest in the 12‐ to 24‐month age group 4.2%, 95% CI [4.1, 4.3], and was significantly higher among boys 3.54%, 95% CI [3.47, 3.61], compared to girls; 2.46%, 95% CI [2.41, 2.52]. Fragile and conflict‐affected states reported significantly higher concurrence 3.6%, 95% CI [3.5, 3.6], than those defined as stable 2.24%, 95% CI [2.18, 2.30]. This analysis represents the first multiple country estimation of the prevalence and burden of children concurrently wasted and stunted. Given the high risk of mortality associated with concurrence, the findings indicate a need to report on this condition as well as investigate whether these children are being reached through existing programmes. PMID:28944990

  17. Population Health Management and the Second Golden Age of Arab Medicine: Promoting Health, Localizing Knowledge Industries, and Diversifying Economies in the GCC Countries.

    PubMed

    Mattke, Soeren; Hunter, Lauren E; Magnuson, Madeline; Arifkhanova, Aziza

    2015-07-15

    Over the past half-century, the Gulf Cooperation Council (GCC) countries-Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates-have experienced rapid economic growth and, with it, dramatic lifestyle changes. Low levels of physical activity and calorie-dense diets have led to an increase in the prevalence of chronic disease, most prominently diabetes. After having successfully controlled communicable diseases and made advanced acute care accessible locally, the GCC countries now face the challenge of orienting their health care systems toward prevention and treatment of chronic diseases. In this study, Dr. Mattke and his colleagues argue that this challenge presents GCC countries with a historic opportunity to reestablish the thought leadership role that Arab medicine had in the Islamic Golden Age. They propose that GCC countries could apply their considerable wealth to design and implement innovative health care systems based on population health management principles and sophisticated health information technology. Taking this path would not only improve prevention and management of chronic disease in the GCC countries but also contribute to the diversification of their economies and localization of knowledge industries.

  18. Useful information for hypertension management reform in community health care: prevalence, awareness, treatment and control among Guangzhou adults.

    PubMed

    Wu, Xueji; Pan, Bingying; Chen, Xiongfei; Zhuang, Xiaoxia; Zhu, Kaixing; Zeng, Lizhong; Dai, Liping; Dong, Xiaomei

    2014-01-01

    Objective data on hypertension prevalence and management in local areas are scarce. We assessed the prevalence of hypertension and its management in Guangzhou adult population. A stratified multistage cluster sampling with probability proportional to size method was used in this survey. Information on a total of 23 939 respondents, aged 15 years old or above, having a gender ratio of 0.997 (male versus female) with completed questionnaire and blood pressure measurement, was obtained. Hypertension was defined as having a mean SBP of at least 140 mm Hg, a DBP of at least 90 mm Hg, and/or the prescription of antihypertensive drugs. Information related to the history of hypertension and treatment of hypertension was collected through a questionnaire. The prevalence of hypertension was 11.8%. Among patients with hypertension, 54.4% were aware of their elevated BP, 49.3% had treatment, and 23.3% achieved targeted BP control. Among those who were aware of their hypertension, 90.4% underwent treatment, and among those who were treated, 43.6% were well controlled. Although the prevalence, awareness and treatment of hypertension varied significantly among adults with several social economics status, the control of hypertension did not show significant differences. Among treated patients, the control of hypertension showed significant differences among adults with education, occupation, insurance and income. It is the first time for Guangzhou to describe epidemic and management of hypertension. A baseline was established, which could provide useful information not only to policymakers but also to developing countries with a close urbanization and aging rate similar to Guangzhou.

  19. Prevalence of angina in women versus men: a systematic review and meta-analysis of international variations across 31 countries.

    PubMed

    Hemingway, Harry; Langenberg, Claudia; Damant, Jacqueline; Frost, Chris; Pyörälä, Kalevi; Barrett-Connor, Elizabeth

    2008-03-25

    In the absence of previous international comparisons, we sought to systematically evaluate, across time and participant age, the sex ratio in angina prevalence in countries that differ widely in the rate of mortality due to myocardial infarction. We searched MEDLINE and EMBASE until February 2006 for healthy population studies published in any language that reported the prevalence of angina (Rose questionnaire) in women and men. We obtained myocardial infarction mortality rates from the World Health Organization. A total of 74 reports of 13,331 angina cases in women and 11,511 cases in men from 31 countries were included. Angina prevalence varied widely across populations, from 0.73% to 14.4% (population weighted mean 6.7%) in women and from 0.76% to 15.1% (population weighted mean 5.7%) in men, and was strongly correlated within populations between the sexes (r=0.80, P<0.0001). Angina prevalence showed a small female excess with a pooled random-effects sex ratio of 1.20 (95% CI 1.14 to 1.28, P<0.0001). This female excess was found across countries with widely differing myocardial infarction mortality rates in women (interquartile range 12.7 to 126.5 per 100,000), was particularly high in the American studies (1.40, 95% CI 1.28 to 1.52), and was higher among nonwhite ethnic groups than among whites. This sex ratio did not differ significantly by participant's age, the year the survey began, or the sex ratio for mortality due to myocardial infarction. Over time and at different ages, independent of diagnostic and treatment practices, women have a similar or slightly higher prevalence of angina than men across countries with widely differing myocardial infarction mortality rates.

  20. Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys.

    PubMed

    Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh; Mir, Imtiyaz Ali; Sin, Shwe

    2014-01-01

    In South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately. Data from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response "yes" to one or more of three questions, such as "Do you currently smoke cigarettes?" Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by 'svy' command. Prevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries. Policymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.

  1. Intimate partner violence among adolescents and young women: prevalence and associated factors in nine countries: a cross-sectional study.

    PubMed

    Stöckl, Heidi; March, Laura; Pallitto, Christina; Garcia-Moreno, Claudia

    2014-07-25

    Little is known about the prevalence of intimate partner violence (IPV) and its associated factors among adolescents and younger women. This study analyzed data from nine countries of the WHO Multi-country Study on Women's Health and Domestic Violence against Women, a population based survey conducted in ten countries between 2000 and 2004. The lifetime prevalence of IPV ranged from 19 to 66 percent among women aged 15 to 24, with most sites reporting prevalence above 50 percent. Factors significantly associated with IPV across most sites included witnessing violence against the mother, partner's heavy drinking and involvement in fights, women's experience of unwanted first sex, frequent quarrels and partner's controlling behavior. Adolescent and young women face a substantially higher risk of experiencing IPV than older women. Adolescence and early adulthood is an important period in laying the foundation for healthy and stable relationships, and women's health and well-being overall. Ensuring that adolescents and young women enjoy relationships free of violence is an important investment in their future.

  2. High prevalence of Mycobacterium tuberculosis mixed infection in the capital of moderate tuberculosis incidence country.

    PubMed

    Hajimiri, Elahe Sadat; Masoomi, Morteza; Ebrahimzadeh, Nayereh; Fateh, Abolfazl; Hadizadeh Tasbiti, Alireza; Rahimi Jamnani, Fatemeh; Bahrmand, Ahmad Reza; Mirsaeidi, Mehdi; Vaziri, Farzam; Siadat, Seyed Davar

    2016-04-01

    Recent studies using molecular epidemiological techniques have demonstrated mixed infection with multiple strains of Mycobacterium tuberculosis especially in countries with high tuberculosis (TB) burden. We aimed to determine the prevalence of mixed infection among patients with TB in the capital of Iran as a country with moderate incidence rate. Samples were collected randomly from January 2011 to December 2013 in Tehran, capital of Iran. A total of 75 M. tuberculosis isolates were genotyped by 24 loci mycobacterial interspersed repetitive unit-variable number tandem repeat typing (MIRU-VNTR) for screening the mixed infection. Twenty patients (20/75) were identified with mixed infection, and the estimated rate of mixed infection was 26.6%. Thirteen out of the 24 loci were able to detect the mixed infection in our study. Mixed infections occur at high prevalence among studied Iranian TB patients. Further research is inevitable to evaluate the association of mixed infection and disease progression and treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Prevalence, Clinical Characteristics, and Management of Functional Constipation at Pediatric Gastroenterology Clinics

    PubMed Central

    Chang, Soo Hee; Park, Kie Young; Kang, Sung Kil; Kang, Ki Soo; Na, So Young; Yang, Hye Ran; Uhm, Ji Hyun

    2013-01-01

    The purpose of this study was to investigate the prevalence, clinical characteristics, and management of functional constipation at pediatric gastroenterology clinics. A prospective survey using the Rome III criteria was distributed to a group of parents of children with a constipation history and its control group in May 2008. The mean prevalence of constipation was 6.4%, which was similar to those in other countries. Statistically significant variables for children without constipation were that more children had a body mass index of below the 10th percentile even though they received more mother's care and ate balanced meals compared to the constipation group. Meanwhile, the constipation group frequently showed a history of constipation in infancy, picky-eating, lack of exercise, and retentive posturing. When analyzed with the Rome III criteria, the children showed greater than 60% rate of hard stools, painful stools, a history of large fecal mass in rectum, and its disappearance of constipation symptoms after passing a large stool. Our study found different approaches amongst pediatric gastroenterologists like rectal examinations, disimpaction, or drug treatment. Several factors addressed in our study can provide better guidelines for clinicians treating constipation and its future research. PMID:24015043

  4. Prevalence, clinical characteristics, and management of functional constipation at pediatric gastroenterology clinics.

    PubMed

    Chang, Soo Hee; Park, Kie Young; Kang, Sung Kil; Kang, Ki Soo; Na, So Young; Yang, Hye Ran; Uhm, Ji Hyun; Ryoo, Eell

    2013-09-01

    The purpose of this study was to investigate the prevalence, clinical characteristics, and management of functional constipation at pediatric gastroenterology clinics. A prospective survey using the Rome III criteria was distributed to a group of parents of children with a constipation history and its control group in May 2008. The mean prevalence of constipation was 6.4%, which was similar to those in other countries. Statistically significant variables for children without constipation were that more children had a body mass index of below the 10th percentile even though they received more mother's care and ate balanced meals compared to the constipation group. Meanwhile, the constipation group frequently showed a history of constipation in infancy, picky-eating, lack of exercise, and retentive posturing. When analyzed with the Rome III criteria, the children showed greater than 60% rate of hard stools, painful stools, a history of large fecal mass in rectum, and its disappearance of constipation symptoms after passing a large stool. Our study found different approaches amongst pediatric gastroenterologists like rectal examinations, disimpaction, or drug treatment. Several factors addressed in our study can provide better guidelines for clinicians treating constipation and its future research.

  5. Childhood asthma prevalence and risk factors in three Eastern European countries--the Belarus, Ukraine, Poland Asthma Study (BUPAS): an international prevalence study.

    PubMed

    Brozek, Grzegorz; Lawson, Joshua; Shpakou, Andrei; Fedortsiv, Olga; Hryshchuk, Leonid; Rennie, Donna; Zejda, Jan

    2016-01-14

    The prevalence of asthma and other allergic diseases among children living in Eastern is not well described. Our objective was to estimate and compare the prevalence of asthma, respiratory symptoms and allergic diseases in children in Belarus, Ukraine, and Poland as well as to identify risk factors for these conditions. We also sought to profile and compare children with asthma between locations. Data were collected as a part of an international, multicenter, cross-sectional study of childhood asthma: The Belarus Ukraine Poland Asthma Study (BUPAS). Subjects were children aged 7-13 years attending primary and secondary schools in the urban and surrounding rural area of Grodno (Belarus), Ternopil (Ukraine) and Silesia Region (Poland). Physician-diagnosed respiratory diseases and symptoms as well as allergic diseases were ascertained using the ISAAC questionnaire completed by the parents. In total there were 4019 children from Belarus (rural: 2018, urban: 2001), 4493 from Ukraine (1972; 2521), and 4036 from Poland (2002, 2034). The overall response rate was 76.7%. Groups were similar in case of gender and age (p > 0.05). Almost all analyzed respiratory and allergic conditions differed significantly between countries including asthma [Poland (rural, urban): 3.5%, 4.1%; Ukraine: 1.4%, 2.1%; Belarus: 1.4%, 1.5%], spastic bronchitis (Poland: 2.7%, 3.2%; Ukraine: 7.5%, 6.5%; Belarus: 6.4%, 7.9%), and chest wheeze in the last year (Poland: 4.8%, 5.2%; Ukraine: 11.5%, 13.0%; Belarus: 10.7%, 10.0%). These differences remained after adjustment for potential confounders. Risk factor associations were generally similar between outcomes. Symptom characteristics of children with asthma between countries were not consistent. The ratio of current wheeze:diagnosis of asthma differed by country: (Rural areas: Belarus: 10.9:1, Ukraine: 17.3:1, Poland: 2.4:1; Urban areas: Belarus: 8.1:1, Ukraine: 7.3:1 Poland: 1.9:1). The findings show large between-country differences and

  6. Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries.

    PubMed

    Lukasse, Mirjam; Schroll, Anne-Mette; Karro, Helle; Schei, Berit; Steingrimsdottir, Thora; Van Parys, An-Sofie; Ryding, Elsa Lena; Tabor, Ann

    2015-05-01

    To assess the prevalence and current suffering of experienced abuse in healthcare, to present the socio-demographic background for women with a history of abuse in healthcare and to assess the association between abuse in healthcare and selected obstetric characteristics. Cross-sectional study. Routine antenatal care in six European countries. In total 6923 pregnant women. Cross-tabulation and Pearson's chi-square was used to study prevalence and characteristics for women reporting abuse in healthcare. Associations with selected obstetric factors were estimated using multiple logistic regression analysis. Abuse in healthcare, fear of childbirth and preference for birth by cesarean section. One in five pregnant women attending routine antenatal care reported some lifetime abuse in healthcare. Prevalence varied significantly between the countries. Characteristics for women reporting abuse in healthcare included a significantly higher prevalence of other forms of abuse, economic hardship and negative life events as well as a lack of social support, symptoms of post-traumatic stress and depression. Among nulliparous women, abuse in healthcare was associated with fear of childbirth, adjusted odds ratio 2.25 (95% CI 1.23-4.12) for severe abuse in healthcare. For multiparous women only severe current suffering from abuse in healthcare was significantly associated with fear of childbirth, adjusted odds ratio 4.04 (95% CI 2.08-7.83). Current severe suffering from abuse in healthcare was significantly associated with the wish for cesarean section, and counselling for fear of childbirth for both nulli- and multiparous women. Abuse in healthcare among women attending routine antenatal care is common and for women with severe current suffering from abuse in healthcare, this is associated with fear of childbirth and a wish for cesarean section. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. Nutritional determinants of worldwide diabetes: an econometric study of food markets and diabetes prevalence in 173 countries.

    PubMed

    Basu, Sanjay; Stuckler, David; McKee, Martin; Galea, Gauden

    2013-01-01

    Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally. Multivariate regression models were used to study how market sizes of major food products (sugars, cereals, vegetable oils, meats, total joules) corresponded to diabetes prevalence, incorporating lagged and cumulative effects. The underlying social determinants of food market sizes and diabetes prevalence rates were also studied, including ageing, income, urbanization, overweight prevalence and imports of foodstuffs. Data were obtained from 173 countries. Population-based survey recipients were the basis for diabetes prevalence and food market data. We found that increased income tends to increase overall food market size among low- and middle-income countries, but the level of food importation significantly shifts the content of markets such that a greater proportion of available joules is composed of sugar and related sweeteners. Sugar exposure statistically explained why urbanization and income have been correlated with diabetes rates. Current diabetes projection methods may estimate future diabetes rates poorly if they fail to incorporate the impact of nutritional factors. Imported sugars deserve further investigation as a potential population-level driver of global diabetes.

  8. Prevalence of arthritis according to age, sex and socioeconomic status in six low and middle income countries: analysis of data from the World Health Organization study on global AGEing and adult health (SAGE) Wave 1.

    PubMed

    Brennan-Olsen, Sharon L; Cook, S; Leech, M T; Bowe, S J; Kowal, P; Naidoo, N; Ackerman, I N; Page, R S; Hosking, S M; Pasco, J A; Mohebbi, M

    2017-06-21

    In higher income countries, social disadvantage is associated with higher arthritis prevalence; however, less is known about arthritis prevalence or determinants in low to middle income countries (LMICs). We assessed arthritis prevalence by age and sex, and marital status and occupation, as two key parameters of socioeconomic position (SEP), using data from the World Health Organization Study on global AGEing and adult health (SAGE). SAGE Wave 1 (2007-10) includes nationally-representative samples of older adults (≥50 yrs), plus smaller samples of adults aged 18-49 yrs., from China, Ghana, India, Mexico, Russia and South Africa (n = 44,747). Arthritis was defined by self-reported healthcare professional diagnosis, and a symptom-based algorithm. Marital status and education were self-reported. Arthritis prevalence data were extracted for each country by 10-year age strata, sex and SEP. Country-specific survey weightings were applied and weighted prevalences calculated. Self-reported (lifetime) diagnosed arthritis was reported by 5003 women and 2664 men (19.9% and 14.1%, respectively), whilst 1220 women and 594 men had current symptom-based arthritis (4.8% and 3.1%, respectively). For men, standardised arthritis rates were approximately two- to three-fold greater than for women. The highest rates were observed in Russia: 38% (95% CI 36%-39%) for men, and 17% (95% CI 14%-20%) for women. For both sexes and in all LMICs, arthritis was more prevalent among those with least education, and in separated/divorced/widowed women. High arthritis prevalence in LMICs is concerning and may worsen poverty by impacting the ability to work and fulfil community roles. These findings have implications for national efforts to prioritise arthritis prevention and management, and improve healthcare access in LMICs.

  9. Solid waste management challenges for cities in developing countries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Abarca Guerrero, Lilliana, E-mail: l.abarca.guerrero@tue.nl; Maas, Ger, E-mail: g.j.maas@tue.nl; Hogland, William, E-mail: william.hogland@lnu.se

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer Stakeholders. Black-Right-Pointing-Pointer Factors affecting performance waste management systems. Black-Right-Pointing-Pointer Questionnaire as Annex for waste management baseline assessment. - Abstract: Solid waste management is a challenge for the cities' authorities in developing countries mainly due to the increasing generation of waste, the burden posed on the municipal budget as a result of the high costs associated to its management, the lack of understanding over a diversity of factors that affect the different stages of waste management and linkages necessary to enable the entire handling system functioning. An analysis of literature on the work done and reported mainly in publicationsmore » from 2005 to 2011, related to waste management in developing countries, showed that few articles give quantitative information. The analysis was conducted in two of the major scientific journals, Waste Management Journal and Waste Management and Research. The objective of this research was to determine the stakeholders' action/behavior that have a role in the waste management process and to analyze influential factors on the system, in more than thirty urban areas in 22 developing countries in 4 continents. A combination of methods was used in this study in order to assess the stakeholders and the factors influencing the performance of waste management in the cities. Data was collected from scientific literature, existing data bases, observations made during visits to urban areas, structured interviews with relevant professionals, exercises provided to participants in workshops and a questionnaire applied to stakeholders. Descriptive and inferential statistic methods were used to draw conclusions. The outcomes of the research are a comprehensive list of stakeholders that are relevant in the waste management systems and a set of factors that reveal the most important causes for the systems' failure. The information provided is

  10. Tackling the tobacco epidemic in the Nordic countries and lower cancer incidence by 1/5 in a 30-year period-The effect of envisaged scenarios changing smoking prevalence.

    PubMed

    Andersson, Therese M-L; Engholm, Gerda; Brink, Anne-Line; Pukkala, Eero; Stenbeck, Magnus; Tryggvadottir, Laufey; Weiderpass, Elisabete; Storm, Hans

    2018-03-29

    Tobacco smoking is a leading cause of cancer and the most preventable cause of cancer worldwide. The aim of this study was to quantify the proportion of the cancer burden in the Nordic countries linked to tobacco smoking and estimate the potential for cancer prevention by changes in smoking prevalence. The Prevent macro-simulation model was used, estimating the future number of cancer cases in the Nordic countries over a 30-year period (2016-2045), for 13 cancer sites, under different scenarios of changing smoking prevalence, and compared to the projected number of cases if constant prevalence prevailed. A total of 430,000 cancer cases, of the 2.2 million expected for the 13 studied cancer sites, could be avoided in the Nordic countries over the 30-year period if smoking was eliminated from 2016 onwards. If prevalence of smoking is reduced to 5% by year 2030 and to 2% by 2040, 230,000 cancer cases could be avoided. The largest proportion of cancers can be avoided in Denmark, where smoking prevalence is the highest, and similar to the prevalence in many European countries. A large amount of cancers could be avoided in the Nordic countries if smoking prevalence was reduced. The results from this study can be used to understand the potential impact and significance of primary prevention programmes targeted towards reducing the prevalence of tobacco smoking in the Nordic countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. The challenge of electronic waste (e-waste) management in developing countries.

    PubMed

    Osibanjo, O; Nnorom, I C

    2007-12-01

    Information and telecommunications technology (ICT) and computer Internet networking has penetrated nearly every aspect of modern life, and is positively affecting human life even in the most remote areas of the developing countries. The rapid growth in ICT has led to an improvement in the capacity of computers but simultaneously to a decrease in the products lifetime as a result of which increasingly large quantities of waste electrical and electronic equipment (e-waste) are generated annually. ICT development in most developing countries, particularly in Africa, depends more on secondhand or refurbished EEEs most of which are imported without confirmatory testing for functionality. As a result large quantities of e-waste are presently being managed in these countries. The challenges facing the developing countries in e-waste management include: an absence of infrastructure for appropriate waste management, an absence of legislation dealing specifically with e-waste, an absence of any framework for end-of-life (EoL) product take-back or implementation of extended producer responsibility (EPR). This study examines these issues as they relate to practices in developing countries with emphasis on the prevailing situation in Nigeria. Effective management of e-waste in the developing countries demands the implementation of EPR, the establishment of product reuse through remanufacturing and the introduction of efficient recycling facilities. The implementation of a global system for the standardization and certification/labelling of secondhand appliances intended for export to developing countries will be required to control the export of electronic recyclables (e-scarp) in the name of secondhand appliances.

  12. Widespread rape does not directly appear to increase the overall HIV prevalence in conflict-affected countries: so now what?

    PubMed Central

    Anema, Aranka; Joffres, Michel R; Mills, Edward; Spiegel, Paul B

    2008-01-01

    Background Sub-Saharan Africa (SSA) is severely affected by HIV/AIDS and conflict. Sexual violence as a weapon of war has been associated with concerns about heightened HIV incidence among women. Widespread rape by combatants has been documented in Burundi, Sierra Leone, Rwanda, Democratic Republic of Congo, Liberia, Sudan and Uganda. To examine the assertion that widespread rape may not directly increase HIV prevalence at the population level, we built a model to determine the potential impact of varying scenarios of widespread rape on HIV prevalence in the above seven African countries. Discussion Our findings show that even in the most extreme situations, where 15% of the female population was raped, where HIV prevalence among assailants was 8 times the country population prevalence, and where the HIV transmission rate was highest at 4 times the average high rate, widespread rape increased the absolute HIV prevalence of these countries by only 0.023%. These projections support the finding that widespread rape in conflict-affected countries in SSA has not incurred a major direct population-level change in HIV prevalence. However, this must not be interpreted to say that widespread rape does not pose serious problems to women's acquisition of HIV on an individual basis or in specific settings. Furthermore, direct and indirect consequences of sexual violence, such as physical and psychosocial trauma, unwanted pregnancies, and stigma and discrimination cannot be understated. Summary The conclusions of this article do not significantly change current practices in the field from an operational perspective. Proper care and treatment must be provided to every survivor of rape regardless of the epidemiological effects of HIV transmission at the population level. Sexual violence must be treated as a protection issue and not solely a reproductive health and psychosocial issue. It is worth publishing data and conclusions that could be misconstrued and may not make much of a

  13. Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori

    PubMed Central

    Bor, Serhat; Kitapcioglu, Gul; Kasap, Elmas

    2017-01-01

    AIM To evaluate the prevalence of gastroesophageal reflux disease (GERD) with additional symptoms, relationship with Helicobacter pylori (H. pylori) of this country-wide study. METHODS Data from 3214 adults were obtained with validated questionnaire. Eight hundred and forty-one subjects were randomized to be tested for H. pylori via the urea breath test. "Frequent symptoms" were defined heartburn and/or regurgitation occurring at least weekly. RESULTS The prevalence of GERD was 22.8%, frequent and occasional heartburn were 9.3%-12.7%, regurgitation were 16.6%-18.7%, respectively. Body mass index (BMI) ≤ 18.5 showed a prevalence of 15%, BMI > 30 was 28.5%. The GERD prevalence was higher in women (26.2%) than men (18.9%) (P < 0001). Overall prevalence of H. pylori was 75.7%. The prevalence was 77.1% in subjects without symptoms vs 71.4% in subjects with GERD (χ2 = 2.6, P = 0.27). Underprivileged with the lowest income people exhibit a higher risk. CONCLUSION GERD is common in Turkey which reflects both Western and Eastern lifestyles with high rate of H. pylori. The presence of H. pylori had no effect on either the prevalence or the symptom profile of GERD. Subjects showing classical symptoms occasionally exhibit more additional symptoms compared with those without classical symptoms. PMID:28210089

  14. Management of Membranous Nephropathy in Western Countries.

    PubMed

    Alfaadhel, Talal; Cattran, Daniel

    2015-09-01

    Idiopathic membranous nephropathy (IMN) is a common cause of nephrotic syndrome (NS) in adults in Western countries. In 2012, the KDIGO (Kidney Disease: Improving Global Outcomes) working group published guidelines for the management of glomerulonephritis, thus providing a template for the treatment of this condition. While being aware of the impact of the clinicians' acumen and that patients may choose a different therapeutic option due to the risks of specific drugs and also of the evolving guidelines, this review details our approach to the management of patients with IMN in a Western center (Toronto). Based on studies published in Europe and North America, we included recent advances in the diagnosis and management of patients with membranous nephropathy similar to our practice population. We highlight the importance of establishing the idiopathic nature of this condition before initiating immunosuppressive therapy, which should include the screening for secondary causes, especially malignancy in the elderly population. The expected outcomes with and without treatment for patients with different risks of progression will be discussed to help guide clinicians in choosing the appropriate course of treatment. The role of conservative therapy as well as of established immunosuppressive treatment, such as the combination of cyclophosphamide and prednisone, and calcineurin inhibitors (CNIs), as well as of newer agents such as rituximab will be reviewed. Appropriate assessment is required to exclude secondary conditions causing membranous glomerulonephritis. The role of antibodies to phospholipase A2 receptor (anti-PLA2R) in establishing the primary disease is growing, though more data are required. The increase in therapeutic options supports treatment individualization, taking into account the availability, benefits and risks, as well as patient preference. (1) The prevalence of IMN is increasing worldwide, particularly in elderly patients, and has been reported in

  15. Simplified training for hazardous materials management in developing countries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Braithwaite, J.

    1994-12-31

    There are thousands of dangerous situations happening daily in developing countries around the world involving untrained workers and hazardous materials. There are very few if any agencies in developing countries that are charged with ensuring safe and healthful working conditions. In addition to the problem of regulation and enforcement, there are potential training problems due to the level of literacy and degree of scientific background of these workers. Many of these workers are refugees from poorly developed countries who are willing to work no matter what the conditions. Training methods (standards) accepted as state of the art in the Unitedmore » States and other developed countries may not work well under the conditions found in developing countries. Because these methods may not be appropriate, new and novel ways to train workers quickly, precisely and economically in hazardous materials management should be developed. One approach is to develop training programs that use easily recognizable graphics with minimal verbal instruction, programs similar to the type used to teach universal international driving regulations and safety. The program as outlined in this paper could be tailored to any sized plant and any hazardous material handling or exposure situation. The situation in many developing countries is critical, development of simplified training methods for workers exposed to hazardous materials hold valuable market potential and are an opportunity for many underdeveloped countries to develop indigenous expertise in hazardous materials management.« less

  16. 2017 Guidelines for the management of arterial hypertension in primary health care in Portuguese-speaking countries.

    PubMed

    Oliveira, Gláucia Maria Moraes de; Mendes, Miguel; Malachias, Marcus Vinícius Bolívar; Morais, João; Filho, Osni Moreira; Coelho, Armando Serra; Capingana, Daniel Pires; Azevedo, Vanda; Soares, Irenita; Menete, Alda; Ferreira, Beatriz; Soares, Miryan Bandeira Dos Prazeres Cassandra; Fernandes, Mário

    2017-11-01

    The World Health Organization goal's to reduce mortality due to chronic non-communicable diseases by 2% per year demands a huge effort from member countries. This challenge for health professionals requires global political action on implementation of social measures, with cost-effective population interventions to reduce chronic non-communicable diseases and their risk factors. Systemic arterial hypertension is highly prevalent in Portuguese-speaking countries, and is a major risk factor for complications such as stroke, acute myocardial infarction and chronic kidney disease, rivaling dyslipidemia and obesity in importance for the development of atherosclerotic disease. Joint actions to implement primary prevention measures can reduce outcomes related to hypertensive disease, especially ischemic heart disease and stroke. It is essential to ensure the implementation of guidelines for the management of systemic hypertension via a continuous process involving educational actions, lifestyle changes and guaranteed access to pharmacological treatment. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Menstrual Hygiene Management in Resource-Poor Countries.

    PubMed

    Kuhlmann, Anne Sebert; Henry, Kaysha; Wall, L Lewis

    2017-06-01

    Adequate management of menstrual hygiene is taken for granted in affluent countries; however, inadequate menstrual hygiene is a major problem for girls and women in resource-poor countries, which adversely affects the health and development of adolescent girls. The aim of this article is to review the current evidence concerning menstrual hygiene management in these settings. A PubMed search using MeSH terms was conducted in English, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesized, and summarized. Most research to date has described menstrual hygiene knowledge, attitudes, and practices, mainly in sub-Saharan Africa and South Asia. Many school-based studies indicate poorer menstrual hygiene among girls in rural areas and those attending public schools. The few studies that have tried to improve or change menstrual hygiene practices provide moderate to strong evidence that targeted interventions do improve menstrual hygiene knowledge and awareness. Challenges to improving menstrual hygiene management include lack of support from teachers (who are frequently male); teasing by peers when accidental menstrual soiling of clothes occurs; poor familial support; lack of cultural acceptance of alternative menstrual products; limited economic resources to purchase supplies; inadequate water and sanitation facilities at school; menstrual cramps, pain, and discomfort; and lengthy travel to and from school, which increases the likelihood of leaks/stains. Areas for future research include the relationship between menarche and school dropout, the relationship between menstrual hygiene management and other health outcomes, and how to increase awareness of menstrual hygiene management among household decision makers including husbands/fathers and in-laws.

  18. A review of risk management process in construction projects of developing countries

    NASA Astrophysics Data System (ADS)

    Bahamid, R. A.; Doh, S. I.

    2017-11-01

    In the construction industry, risk management concept is a less popular technique. There are three main stages in the systematic approach to risk management in construction industry. These stages include: a) risk response; b) risk analysis and evaluation; and c) risk identification. The high risk related to construction business affects each of its participants; while operational analysis and management of construction related risks remain an enormous task to practitioners of the industry. This paper tends towards reviewing the existing literature on construction project risk managements in developing countries specifically on risk management process. The literature lacks ample risk management process approach capable of capturing risk impact on diverse project objectives. This literature review aims at discovering the frequently used techniques in risk identification and analysis. It also attempts to identify response to clarifying the different classifications of risk sources in the existing literature of developing countries, and to identify the future research directions on project risks in the area of construction in developing countries.

  19. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe: 1990-2010.

    PubMed

    Bourne, Rupert R A; Jonas, Jost B; Flaxman, Seth R; Keeffe, Jill; Leasher, Janet; Naidoo, Kovin; Parodi, Maurizio B; Pesudovs, Konrad; Price, Holly; White, Richard A; Wong, Tien Y; Resnikoff, Serge; Taylor, Hugh R

    2014-05-01

    To assess prevalence and causes of blindness and vision impairment in high-income regions and in Central/Eastern Europe in 1990 and 2010. Based on a systematic review of medical literature, prevalence of moderate and severe vision impairment (MSVI; presenting visual acuity <6/18 but ≥3/60 in the better eye) and blindness (presenting visual acuity <3/60) was estimated for 1990 and 2010. Age-standardised prevalence of blindness and MSVI decreased from 0.2% to 0.1% (3.314 million to 2.736 million people) and from 1.6% to 1.0% (25.362 million to 22.176 million), respectively. Women were generally more affected than men. Cataract was the most frequent cause of blindness in all subregions in 1990, but macular degeneration and uncorrected refractive error became the most frequent causes of blindness in 2010 in all high-income countries, except for Eastern/Central Europe, where cataract remained the leading cause. Glaucoma and diabetic retinopathy were fourth and fifth most common causes for blindness for all regions at both times. Uncorrected refractive error, followed by cataract, macular degeneration, glaucoma and diabetic retinopathy, was the most common cause for MSVI in 1990 and 2010. In highly developed countries, prevalence of blindness and MSVI has been reduced by 50% and 38%, respectively, and the number of blind people and people with MSVI decreased by 17.4% and 12.6%, respectively, even with the increasing number of older people in the population. In high-income countries, macular degeneration has become the most important cause of blindness, but uncorrected refractive errors continue to be the leading cause of MSVI.

  20. Can we trust national smoking prevalence figures? Discrepancies between biochemically assessed and self-reported smoking rates in three countries.

    PubMed

    West, Robert; Zatonski, Witold; Przewozniak, Krzysztof; Jarvis, Martin J

    2007-04-01

    National smoking prevalence estimates are the primary basis for assessing progress in tobacco control across the world. They are based on surveys of self-reported cigarette smoking. It has been assumed that this is sufficiently accurate for policy purposes, but this assumption has not been adequately tested. We report data from the 2003 Health Survey for England, the U.S. National Health and Nutrition Examination Survey for 2001-2002, and the 2004 national smoking behaviors survey in Poland as examples of countries at different stages in the "tobacco epidemic." Self-reported cigarette and total tobacco smoking prevalence were assessed by means of the standard questions used in each country. In subsamples, specimens were collected for analysis of cotinine (saliva, N = 1,613 in England; serum, N = 4,687 in the United States; and saliva, N = 388 in Poland) providing an objective means of determining active smoking. A cut point of 15 ng/mL was used to discriminate active smoking from passive smoke exposure. Self-reported cigarette smoking prevalence using the standard methods underestimated true tobacco smoking prevalence by an estimated 2.8% in England, 0.6% in the United States, and 4.4% in Poland. Cotinine concentrations in those misclassified as nonsmokers were indicative of high levels of smoke intake. Underestimation of smoking prevalence was minimal in the United States but significant in England and Poland. A review of methodologies for assessing tobacco smoking prevalence worldwide is urgently needed.

  1. A cross-country comparison of the prevalence of exposure to tobacco advertisements among adolescents aged 13-15 years in 20 low and middle income countries.

    PubMed

    Agaku, Israel T; Adisa, Akinyele O; Akinyamoju, Akindayo O; Agboola, Samuel O

    2013-01-01

    This study assessed the prevalence and influence of exposure to pro-tobacco advertisements among adolescents in 20 low and middle income countries (LMICs). The 2007-2008 Global Youth Tobacco Survey was analyzed for students aged 13-15 years in 20 LMICs. Overall and sex-specific prevalence of exposure to tobacco advertisements in several media, as well as the prevalence of smoking susceptibility (i.e., the lack of a firm commitment among never smokers not to smoke in the future or if offered a cigarette by a friend) were assessed. The variability of the point estimates was assessed using 95% confidence intervals (CI). Logistic regression was used to assess the effect of exposure to multiple (i.e., ≥2) pro-tobacco advertisements on current smoking, adjusting for age and sex (P < 0.05). Data were weighted and analyzed with Stata version 11. Overall country-specific prevalence for different advertisement sources ranged as follows: movies/videos (78.4% in Lesotho to 97.8% in Belize); television programs (48.7% in Togo to 91.7% in the Philippines); newspapers/magazines (29.5% in Togo to 89.7% in the Philippines); and outdoor community events (30.6% in Rwanda to 79.4% in the Philippines). The overall proportion of never smokers who were susceptible to cigarette smoking ranged from 3.7% in Sri Lanka to 70.1% in Kyrgyzstan. Exposure to ≥2 sources of pro-tobacco advertisements was associated with significantly increased odds of cigarette smoking among adolescents in several countries including South Africa (adjusted odds ratio, aOR = 4.11; 95% CI:2.26-7.47), Togo (aOR = 3.77; 95% CI:1.27-11.21), the Former Yugoslav Republic of Macedonia (aOR = 1.42; 95% CI:1.01-1.99), Republic of Moldova (aOR = 1.53; 95% CI:1.11-2.12), Belize (aOR = 13.95; 95% CI:1.91-102.02), Panama (aOR = 5.14; 95% CI: 2.37-11.14) and Mongolia (aOR = 1.52; 95% CI:1.19-1.94). Prevalence of exposure to various pro-tobacco advertisements was high among adolescents in the LMICs surveyed. Enhanced and

  2. The serum bank of EuroPrevall - the prevalence, cost and basis of food allergy across Europe.

    PubMed

    Vieths, Stefan; Reese, Gerald; Ballmer-Weber, Barbara K; Beyer, Kerstin; Burney, Peter; Fernandez-Rivas, Montserrat; Summers, Collin; Ree, Ronald van; Mills, Clare

    2008-10-01

    EuroPrevall is an EU-funded multidisciplinary project including 62 institutions from 22 countries. EuroPrevall studies the prevalence and distribution of food allergies in infants, children, adolescents, and adults in Europe, threshold doses for allergenic foods, the role of the environment in food allergy, the socioeconomic impact of food allergy, and novel diagnostic tools for food allergies. The EuroPrevall serum bank (EPASB), containing samples from approximately 70,000 subjects, is a major tool to achieve these goals. EPASB is coordinated by the Paul-Ehrlich-Institut, Langen, Germany. Local sera collections are administered at the University of Amsterdam (NL), the University Hospital of Manchester (UK), Charité Hospital (DE) and the Paul-Ehrlich-Institut. The EPASB coordinator and managing partners distribute samples for experimental work and regulate access. The overall aim is to provide sera to fulfil EuroPrevall research goals. The EPASB coordinator and managing partners suggest appropriate sera for addressing specific scientific and diagnostic questions. The serum bank will be maintained after termination of the project, but subsequent investigations must be in accordance with the original research goals of EuroPrevall. Thus, the contributors of the sera retain control over their future use. This rule prevents investigation of questions outside the scope of EuroPrevall, e.g. the allergenicity of genetically-modified foods.

  3. Dataset on the prevalence of tobacco smoking in men and women of selected countries whit difference human development.

    PubMed

    Riahi, Mina; Mohammadi, Ali Akbar; Rohani, Hosein; Bidkhori, Mohammad

    2018-06-01

    This study was conducted to investigate the effect of human development index (HDI) on tobacco smoking prevalence in men and women of countries which their data about tobacco smoking were available for 2015. Pearson's correlation coefficient and linear regression were used to investigate the association between HDI and all types of smoking, particularly cigarette. Daily smoking and current smoking were used as tobacco smoking indices. The information about prevalence of tobacco smoking and HDI was obtained from the World Health Organization (WHO) website and United Nations Development Programme (UNDP), respectively. The results showed that there is no statistically significant relationship between HDI and current tobacco smoking in men (B = -0.45_CI 95%: -29.97, 29.06). However, the same association was significant for women (B = 43.87, CI 95%: 24.97-62.78). The results indicated that women in developed countries are more at risk of health effects attributed to tobacco smoking. Countries should focus on socioeconomic factors to prevent the spread of risk factors for non-communicable diseases.

  4. Management of Chronic Hepatitis B Infection in India.

    PubMed

    Amarapurkar, Deepak N; Mada, Kaushal; Kapoor, Dharmesh

    2015-11-01

    Chronic hepatitis B (CHB) infection is a substantial global health problem with highest prevalence observed in the sub-Saharan Africa and East Asia. India lies in the intermediate endemicity zone with prevalence ranging from 0.1% to 11.7%. The predominant route of transmission is horizontal and the most commonly occurring genotypes are A and D. The high mortality and morbidity associated with CHB constitutes significant health and economic burden in developing countries like India. Antiviral agents decrease HBV DNA load and prevent disease progression. Several regional and country expert associations have developed treatment guidelines for appropriate management of CHB; however, various factors like prevalence, disease awareness, immunization status, cost implications, availability of resources, type of transmission and emerging significance of HBV genotypes have influenced the management of CHB in a country. This article focuses on expert’s recommendations on CHB management including initiation, monitoring and termination of treatment with emphasis on borderline cases. The article also throws light on the challenges to optimum management and provides preferred therapeutic approaches in Indian perspective.

  5. Contemporary migration patterns in the prevalence of Helicobacter pylori infection: A systematic review.

    PubMed

    Morais, Samantha; Costa, Ana Rute; Ferro, Ana; Lunet, Nuno; Peleteiro, Bárbara

    2017-06-01

    A rapid growth in the number of international migrants over the past years has occurred with most traveling to more affluent settings. As Helicobacter pylori infects over half of the adult population and its prevalence is higher in developing countries, understanding the prevalence of infection in migrants can provide insight into future trends in the burden and management of infection. We aimed to describe the prevalence of H. pylori among migrants through a systematic literature review. We searched PubMed ® from inception to September 2015 to identify studies reporting the prevalence of H. pylori in international migrants according to country of birth for first-generation, and country of birth and parents' nationality for successive generations. Comparable data from origin and destination populations were obtained from the same studies or, when not present, from a previous systematic review on H. pylori worldwide. A total of 28 eligible studies were identified with data for 29 origin and 12 destination countries. Two studies that evaluated refugees presented prevalences of infection higher than both the origin and destination countries. Otherwise, the prevalences among migrants were generally similar or below that of the origin and higher than the destination. Second- or more generation had lower prevalences compared to first-generation migrants. Our study findings are consistent with what would be expected based on the prevalence of H. pylori worldwide. The results of this review show that migrants are particularly at risk of infection and help to identify gaps in the knowledge of migrants' prevalence of infection globally. © 2017 John Wiley & Sons Ltd.

  6. Prevalence of pain reporting and associated health outcomes across emerging markets and developed countries.

    PubMed

    Goren, Amir; Mould-Quevedo, Joaquín; daCosta DiBonaventura, Marco

    2014-11-01

    The current study represents the first broad, multi-country, population-based survey of pain, assessing the association between pain and health outcomes, plus comparing the burden of pain across emerging and developed countries. Data from the 2011/2012 National Health and Wellness Surveys were used. Respondents reporting pain (neuropathic pain, fibromyalgia, back pain, surgery pain, and/or arthritis pain) vs no pain in emerging (Brazil, China, Russia) vs developed (European Union, Japan, United States) countries were compared on sociodemographic characteristics and measures of quality of life (SF-12v2 and SF-36v2), work productivity and activity impairment, and health care resource use. Respondents included 128,821 without pain and 29,848 with pain in developed countries, and 37,244 without pain and 4,789 with pain in emerging countries. Pain reporting and treatment rates were lower in China (6.2% and 28.3%, respectively) and Japan (4.4% and 26.3%, respectively) than in other countries (≥ 14.3% and 35.8%, respectively). Significant impairments in quality of life, productivity, and resource use were associated with pain across all health outcomes in both developed and emerging countries, with some productivity and physical health status impairments greater with pain in developed countries, whereas mental health status impairment and resource use were greater with pain in emerging countries. Pain was associated with burden across all study outcomes in all regions. Yet, differences emerged in the degree of impairment, pain reporting, diagnosis, treatment rates, and characteristics of patients between emerging and developed nations, thus helping guide a broader understanding of this highly prevalent condition globally. Wiley Periodicals, Inc.

  7. Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries.

    PubMed

    Lloyd, C E; Nouwen, A; Sartorius, N; Ahmed, H U; Alvarez, A; Bahendeka, S; Basangwa, D; Bobrov, A E; Boden, S; Bulgari, V; Burti, L; Chaturvedi, S K; Cimino, L C; Gaebel, W; de Girolamo, G; Gondek, T M; de Braude, M Guinzbourg; Guntupalli, A; Heinze, M G; Ji, L; Hong, X; Khan, A; Kiejna, A; Kokoszka, A; Kamala, T; Lalic, N M; Lecic Tosevski, D; Mankovsky, B; Li, M; Musau, A; Müssig, K; Ndetei, D; Rabbani, G; Srikanta, S S; Starostina, E G; Shevchuk, M; Taj, R; Vukovic, O; Wölwer, W; Xin, Y

    2018-06-01

    To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes. © 2018 Diabetes UK.

  8. Prevalence of fragrance contact allergy in the general population of five European countries: a cross-sectional study.

    PubMed

    Diepgen, T L; Ofenloch, R; Bruze, M; Cazzaniga, S; Coenraads, P J; Elsner, P; Goncalo, M; Svensson, Å; Naldi, L

    2015-12-01

    Contact allergy to fragrances is assessed mostly in clinical populations of patients. Studies in the general population are scarce and vary in their methodology across countries. To determine the prevalence of fragrance contact allergy in the European general population and to assess the clinical relevance of positive patch test reactions to different fragrances. In five European countries (Germany, Italy, the Netherlands, Portugal and Sweden) a random sample from the general population aged 18-74 years was drawn. In total, 12 377 subjects were interviewed in this cross-sectional study and a random sample (n = 3119) was patch tested using the TRUE Test and Finn Chamber techniques. Patch test procedures were harmonized by mandatory training before the study and monitoring during the study. The highest prevalence for contact allergy of 2·6% [95% confidence interval (CI) 2·1-3·2] was found for fragrance mix (FM) I in petrolatum, with a high content of atranol and chloratranol, followed by 1·9% (95% CI 1·5-2·4) for FM II in petrolatum. The conservatively estimated prevalence of fragrance contact allergy was 1·9% (95% CI 1·5-2·5). This is defined as the existence of a positive patch test to FM I or FM II; any of their individual materials; Myroxylon pereirae; sesquiterpene lactones or 3- and 4-hydroxyisohexyl 3-cyclohexene carboxaldehyde that show clinical relevance, defined conservatively as lifetime avoidance of scented products and an itchy skin rash lasting > 3 days in a lifetime. Using the reported lifetime prevalence of any contact dermatitis instead of the lifetime prevalence of any itchy skin rash, the prevalence is 0·8% (95% CI 0·5-1·2). The prevalence rates of contact allergy to fragrances in women are about twice those in men. This study helps to identify targets for prevention of fragrance allergy. © 2015 British Association of Dermatologists.

  9. Prevalence and Characterization of Thyroid Hemiagenesis in Japan: The Fukushima Health Management Survey.

    PubMed

    Suzuki, Satoru; Midorikawa, Sanae; Matsuzuka, Takashi; Fukushima, Toshihiko; Ito, Yuko; Shimura, Hiroki; Takahashi, Hideto; Ohira, Tetsuya; Ohtsuru, Akira; Abe, Masafumi; Suzuki, Shinichi; Yamashita, Shunichi

    2017-08-01

    Thyroid hemiagenesis is a rare congenital variant characterized by the lack of development of one thyroid lobe with no clinical manifestations. This study was performed to determine the prevalence and characteristics of thyroid hemiagenesis in a normal Japanese population. This cross-sectional study was performed from October 9, 2011, to April 30, 2015. In total, 299,908 children and young adults in the Fukushima Health Management Survey were examined to determine the presence of thyroid agenesis or hemiagenesis. Thyroid width, thickness, and length were measured in 292,452 of these subjects. Thyroid agenesis was diagnosed in 13 subjects, and hemiagenesis was detected in 67 subjects (0.02%; 22.3/100,000 individuals). Although there was no significant sex-related difference (p = 0.067), the female:male ratio was 1.67:1.00. Females were significantly dominant in right hemiagenesis, while there was no difference in left hemiagenesis between males and females. The thyroid volumes at the 2.5th and 97.5th percentiles for age and body surface area were determined for each sex. Multivariate regression analysis showed that a large hemithyroid volume was independently associated with the presence of contralateral hemiagenesis (p < 0.001). The prevalence of thyroid hemiagenesis in the present study is in agreement with that reported in other countries. The prevalence of right hemiagenesis was higher in females, and the larger contralateral lobe in patients with rather than without hemiagenesis may have been caused by a compensatory feedback mechanism to prevent hypothyroidism. In addition, the prevalence of hemiagenesis, especially right hemiagenesis, may be affected by sex-related factors similar to those in patients with an ectopic thyroid gland.

  10. The effect of sugar and processed food imports on the prevalence of overweight and obesity in 172 countries.

    PubMed

    Lin, Tracy Kuo; Teymourian, Yasmin; Tursini, Maitri Shila

    2018-04-14

    Studies find that economic, political, and social globalization - as well as trade liberalization specifically - influence the prevalence of overweight and obesity in countries through increasing the availability and affordability of unhealthful food. However, what are the mechanisms that connect globalization, trade liberalization, and rising average body mass index (BMI)? We suggest that the various sub-components of globalization interact, leading individuals in countries that experience higher levels of globalization to prefer, import, and consume more imported sugar and processed food products than individuals in countries that experience lower levels of globalization. This study codes the amount of sugar and processed food imports in 172 countries from 1995 to 2010 using the United Nations Comtrade dataset. We employ country-specific fixed effects (FE) models, with robust standard errors, to examine the relationship between sugar and processed foods imports, globalization, and average BMI. To highlight further the relationship between the sugar and processed food import and average BMI, we employ a synthetic control method to calculate a counterfactual average BMI in Fiji. We find that sugar and processed food imports are part of the explanation to increasing average BMI in countries; after controlling for globalization and general imports and exports, sugar and processed food imports have a statistically and substantively significant effect in increasing average BMI. In the case of Fiji, the increased prevalence of obesity is associated with trade agreements and increased imports of sugar and processed food. The counterfactual estimates suggest that sugar and processed food imports are associated with a 0.5 increase in average BMI in Fiji.

  11. Decentralized approaches to wastewater treatment and management: applicability in developing countries.

    PubMed

    Massoud, May A; Tarhini, Akram; Nasr, Joumana A

    2009-01-01

    Providing reliable and affordable wastewater treatment in rural areas is a challenge in many parts of the world, particularly in developing countries. The problems and limitations of the centralized approaches for wastewater treatment are progressively surfacing. Centralized wastewater collection and treatment systems are costly to build and operate, especially in areas with low population densities and dispersed households. Developing countries lack both the funding to construct centralized facilities and the technical expertise to manage and operate them. Alternatively, the decentralized approach for wastewater treatment which employs a combination of onsite and/or cluster systems is gaining more attention. Such an approach allows for flexibility in management, and simple as well as complex technologies are available. The decentralized system is not only a long-term solution for small communities but is more reliable and cost effective. This paper presents a review of the various decentralized approaches to wastewater treatment and management. A discussion as to their applicability in developing countries, primarily in rural areas, and challenges faced is emphasized all through the paper. While there are many impediments and challenges towards wastewater management in developing countries, these can be overcome by suitable planning and policy implementation. Understanding the receiving environment is crucial for technology selection and should be accomplished by conducting a comprehensive site evaluation process. Centralized management of the decentralized wastewater treatment systems is essential to ensure they are inspected and maintained regularly. Management strategies should be site specific accounting for social, cultural, environmental and economic conditions in the target area.

  12. Geographic Variations in Arthritis Prevalence, Health-Related Characteristics, and Management - United States, 2015.

    PubMed

    Barbour, Kamil E; Moss, Susan; Croft, Janet B; Helmick, Charles G; Theis, Kristina A; Brady, Teresa J; Murphy, Louise B; Hootman, Jennifer M; Greenlund, Kurt J; Lu, Hua; Wang, Yan

    2018-03-16

    Doctor-diagnosed arthritis is a common chronic condition affecting an estimated 23% (54 million) of adults in the United States, greatly influencing quality of life and costing approximately $300 billion annually. The geographic variations in arthritis prevalence, health-related characteristics, and management among states and territories are unknown. Therefore, public health professionals need to understand arthritis in their areas to target dissemination of evidence-based interventions that reduce arthritis morbidity. 2015. The Behavioral Risk Factor Surveillance System is an annual, random-digit-dialed landline and cellular telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Self-reported data are collected from the 50 states, the District of Columbia, Guam, and Puerto Rico. Unadjusted and age-standardized prevalences of arthritis, arthritis health-related characteristics, and arthritis management were calculated. County-level estimates were calculated using a validated statistical modeling method. In 2015, in the 50 states and the District of Columbia, median age-standardized prevalence of arthritis was 23.0% (range: 17.2%-33.6%). Modeled prevalence of arthritis varied considerably by county (range: 11.2%-42.7%). In 13 states that administered the arthritis management module, among adults with arthritis, the age-standardized median percentage of participation in a self-management education course was 14.5% (range: 9.1%-19.0%), being told by a health care provider to engage in physical activity or exercise was 58.5% (range: 52.3%-61.9%), and being told to lose weight to manage arthritis symptoms (if overweight or obese) was 44.5% (range: 35.1%-53.2%). Respondents with arthritis who lived in the quartile of states with the highest prevalences of arthritis had the highest percentages of negative health-related characteristics (i.e., arthritis-attributable activity limitations, arthritis-attributable severe joint pain

  13. Organization of heart failure management in European Society of Cardiology member countries: survey of the Heart Failure Association of the European Society of Cardiology in collaboration with the Heart Failure National Societies/Working Groups.

    PubMed

    Seferovic, Petar M; Stoerk, Stefan; Filippatos, Gerasimos; Mareev, Viacheslav; Kavoliuniene, Ausra; Ristic, Arsen D; Ponikowski, Piotr; McMurray, John; Maggioni, Aldo; Ruschitzka, Frank; van Veldhuisen, Dirk J; Coats, Andrew; Piepoli, Massimo; McDonagh, Theresa; Riley, Jillian; Hoes, Arno; Pieske, Burkert; Dobric, Milan; Papp, Zoltan; Mebazaa, Alexandre; Parissis, John; Ben Gal, Tuvia; Vinereanu, Dragos; Brito, Dulce; Altenberger, Johann; Gatzov, Plamen; Milinkovic, Ivan; Hradec, Jaromír; Trochu, Jean-Noel; Amir, Offer; Moura, Brenda; Lainscak, Mitja; Comin, Josep; Wikström, Gerhard; Anker, Stefan

    2013-09-01

    The aim of this document was to obtain a real-life contemporary analysis of the demographics and heart failure (HF) statistics, as well as the organization and major activities of the Heart Failure National Societies (HFNS) in European Society of Cardiology (ESC) member countries. Data from 33 countries were collected from HFNS presidents/representatives during the first Heart Failure Association HFNS Summit (Belgrade, Serbia, 29 October 2011). Data on incidence and/or prevalence of HF were available for 22 countries, and the prevalence of HF ranged between 1% and 3%. In five European and one non-European ESC country, heart transplantation was reported as not available. Natriuretic peptides and echocardiography are routinely applied in the management of acute HF in the median of 80% and 90% of centres, respectively. Eastern European and Mediterranean countries have lower availability of natriuretic peptide testing for acute HF patients, compared with other European countries. Almost all countries have organizations dealing specifically with HF. HFNS societies for HF patients exist in only 12, while in 16 countries HF patient education programmes are active. Most HFNS reported that no national HF registry exists in their country. Fifteen HFNS produced national HF guidelines, while 19 have translated the ESC HF guidelines. Most HFNS (n = 23) participated in the organization of the European HF Awareness Day. This document demonstrated significant heterogeneity in the organization of HF management, and activities of the national HF working groups/associations. High availability of natriuretic peptide and echocardiographic measurements was revealed, with differences between developed countries and countries in transition.

  14. Waterpipe Tobacco Smoking Prevalence and Correlates in 25 Eastern Mediterranean and Eastern European Countries: Cross-Sectional Analysis of the Global Youth Tobacco Survey.

    PubMed

    Jawad, Mohammed; Lee, John Tayu; Millett, Christopher

    2016-04-01

    Waterpipe tobacco smoking is highly prevalent among young people in some settings. There is an absence of nationally representative prevalence studies of waterpipe tobacco use and dual use with other tobacco products in young people. We conducted a secondary analysis of the Global Youth Tobacco Survey, a nationally representative cross-sectional study of students aged 13-15 years. Of 180 participating countries, 25 included optional waterpipe tobacco smoking questions: 15 Eastern Mediterranean and 10 Eastern European countries. We calculated the prevalence of current (past 30-day) waterpipe tobacco use, including dual waterpipe and other tobacco use, and used logistic regression models to identify sociodemographic correlates of waterpipe tobacco smoking. Individual country results were combined in a random effects meta-analysis. Waterpipe tobacco smoking prevalence was highest in Lebanon (36.9%), the West Bank (32.7%) and parts of Eastern Europe (Latvia 22.7%, the Czech Republic 22.1%, Estonia 21.9%). These countries also recorded greater than 10% prevalence of dual waterpipe and cigarette use. In a meta-analysis, higher odds of waterpipe tobacco smoking were found among males (Adjusted odds ratio [AOR] = 1.37, 95% confidence interval [CI] = 1.18% to 1.59%), cigarette users (AOR = 6.95, 95% CI = 5.74% to 8.42%), those whose parents (AOR = 1.54, 95% CI = 1.31% to 1.82%) or peers smoked (AOR = 3.53, 95% CI = 2.97% to 4.20%) and those whose parents had higher educational attainment (Father, AOR = 1.47, 95% CI = 1.14% to 1.89%; Mother, AOR = 1.62, 95% CI = 1.07% to 2.46%). We report on regional- and country income-level differences. Waterpipe tobacco smoking, including dual waterpipe and cigarette use, is alarmingly high in several Eastern Mediterranean and Eastern European countries. Ongoing waterpipe tobacco smoking surveillance is warranted. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All

  15. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control

    PubMed Central

    Lloyd-Sherlock, Peter; Beard, John; Minicuci, Nadia; Ebrahim, Shah; Chatterji, Somnath

    2014-01-01

    Background This study uses data from the World Health Organization’s Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. Results Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. Conclusions The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor. PMID:24505082

  16. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control.

    PubMed

    Lloyd-Sherlock, Peter; Beard, John; Minicuci, Nadia; Ebrahim, Shah; Chatterji, Somnath

    2014-02-01

    This study uses data from the World Health Organization's Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor.

  17. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review.

    PubMed

    Fisher, Jane; Cabral de Mello, Meena; Patel, Vikram; Rahman, Atif; Tran, Thach; Holton, Sara; Holmes, Wendy

    2012-02-01

    To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4-15.9) antenatally and 19.8% (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3-0.9). CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.

  18. National policies on the management of latent tuberculosis infection: review of 98 countries

    PubMed Central

    Jagger, Ann; Reiter-karam, Silke; Getahun, Haileyesus

    2018-01-01

    Abstract Objective To review policies on management of latent tuberculosis infection in countries with low and high burdens of tuberculosis. Methods We divided countries reporting data to the World Health Organization (WHO) Global Tuberculosis Programme into low and high tuberculosis burden, based on WHO criteria. We identified national policy documents on management of latent tuberculosis through online searches, government websites, WHO country offices and personal communication with programme managers. We made a descriptive analysis with a focus on policy gaps and deviations from WHO policy recommendations. Findings We obtained documents from 68 of 113 low-burden countries and 30 of 35 countries with the highest burdens of tuberculosis or human immunodeficiency virus (HIV)-associated tuberculosis. Screening and treatment of latent tuberculosis infection in people living with HIV was recommended in guidelines of 29 (96.7%) high-burden and 54 (79.7%) low-burden countries. Screening for children aged < 5 years with household tuberculosis contact was the policy of 25 (83.3%) high- and 28 (41.2%) low-burden countries. In most high-burden countries the recommendation was symptom screening alone before treatment, whereas in all low-burden countries it was testing before treatment. Some low-burden countries’ policies did not comply with WHO recommendations: nine (13.2%) recommended tuberculosis preventive treatment for travellers to high-burden countries and 10 (14.7%) for patients undergoing abdominal surgery. Conclusion Lack of solid evidence on certain aspects of management of latent tuberculosis infection results in national policies which vary considerably. This highlights a need to advance research and develop clear, implementable and evidence-based WHO policies. PMID:29531416

  19. Prevalence and psychosocial determinants of nicotine dependence in nine countries of the former Soviet Union.

    PubMed

    Roberts, Bayard; Gilmore, Anna; Stickley, Andrew; Kizilova, Kseniya; Prohoda, Vladimir; Rotman, David; Haerpfer, Christian; McKee, Martin

    2013-01-01

    Despite the high prevalence of smoking in the former Soviet Union (fSU), particularly among men, there is very little information on nicotine dependence in the region. The study aim was to describe the prevalence of nicotine dependence in 9 countries of the fSU and to examine the psychosocial factors associated with nicotine dependence. Cross-sectional, nationally representative surveys using multistage random sampling were conducted in 2010 with men and women aged 18 years and over in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. The main outcome of interest was nicotine dependence using the Fagerström Test for Nicotine Dependence. Multivariate regression analysis was then used to explore the influence of a range of psychosocial factors on higher nicotine dependence. Mean nicotine dependence among men in the region as a whole was 3.96, with high dependence ranging from 17% in Belarus to 40% in Georgia. Among women, mean dependence was 2.96, with a prevalence of high dependence of 11% for the region. Gender (men), younger age of first smoking, lower education level, not being a member of an organization, bad household economic situation, high alcohol dependence, and high psychological distress showed significant associations with higher nicotine dependence. High nicotine dependence among men was recorded in a number of study countries. Findings highlight the need for tobacco programmes to target early age smokers and less educated and poorer groups and suggest common ground for programmes seeking to reduce nicotine dependence, harmful alcohol use, and psychological distress.

  20. Trends in Prevalence of Advanced HIV Disease at Antiretroviral Therapy Enrollment - 10 Countries, 2004-2015.

    PubMed

    Auld, Andrew F; Shiraishi, Ray W; Oboho, Ikwo; Ross, Christine; Bateganya, Moses; Pelletier, Valerie; Dee, Jacob; Francois, Kesner; Duval, Nirva; Antoine, Mayer; Delcher, Chris; Desforges, Gracia; Griswold, Mark; Domercant, Jean Wysler; Joseph, Nadjy; Deyde, Varough; Desir, Yrvel; Van Onacker, Joelle Deas; Robin, Ermane; Chun, Helen; Zulu, Isaac; Pathmanathan, Ishani; Dokubo, E Kainne; Lloyd, Spencer; Pati, Rituparna; Kaplan, Jonathan; Raizes, Elliot; Spira, Thomas; Mitruka, Kiren; Couto, Aleny; Gudo, Eduardo Samo; Mbofana, Francisco; Briggs, Melissa; Alfredo, Charity; Xavier, Carla; Vergara, Alfredo; Hamunime, Ndapewa; Agolory, Simon; Mutandi, Gram; Shoopala, Naemi N; Sawadogo, Souleymane; Baughman, Andrew L; Bashorun, Adebobola; Dalhatu, Ibrahim; Swaminathan, Mahesh; Onotu, Dennis; Odafe, Solomon; Abiri, Oseni Omomo; Debem, Henry H; Tomlinson, Hank; Okello, Velephi; Preko, Peter; Ao, Trong; Ryan, Caroline; Bicego, George; Ehrenkranz, Peter; Kamiru, Harrison; Nuwagaba-Biribonwoha, Harriet; Kwesigabo, Gideon; Ramadhani, Angela A; Ng'wangu, Kahemele; Swai, Patrick; Mfaume, Mohamed; Gongo, Ramadhani; Carpenter, Deborah; Mastro, Timothy D; Hamilton, Carol; Denison, Julie; Wabwire-Mangen, Fred; Koole, Olivier; Torpey, Kwasi; Williams, Seymour G; Colebunders, Robert; Kalamya, Julius N; Namale, Alice; Adler, Michelle R; Mugisa, Bridget; Gupta, Sundeep; Tsui, Sharon; van Praag, Eric; Nguyen, Duc B; Lyss, Sheryl; Le, Yen; Abdul-Quader, Abu S; Do, Nhan T; Mulenga, Modest; Hachizovu, Sebastian; Mugurungi, Owen; Barr, Beth A Tippett; Gonese, Elizabeth; Mutasa-Apollo, Tsitsi; Balachandra, Shirish; Behel, Stephanie; Bingham, Trista; Mackellar, Duncan; Lowrance, David; Ellerbrock, Tedd V

    2017-06-02

    Monitoring prevalence of advanced human immunodeficiency virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/μL) among persons starting antiretroviral therapy (ART) is important to understand ART program outcomes, inform HIV prevention strategy, and forecast need for adjunctive therapies.* , † , § To assess trends in prevalence of advanced disease at ART initiation in 10 high-burden countries during 2004-2015, records of 694,138 ART enrollees aged ≥15 years from 797 ART facilities were analyzed. Availability of national electronic medical record systems allowed up-to-date evaluation of trends in Haiti (2004-2015), Mozambique (2004-2014), and Namibia (2004-2012), where prevalence of advanced disease at ART initiation declined from 75% to 34% (p<0.001), 73% to 37% (p<0.001), and 80% to 41% (p<0.001), respectively. Significant declines in prevalence of advanced disease during 2004-2011 were observed in Nigeria, Swaziland, Uganda, Vietnam, and Zimbabwe. The encouraging declines in prevalence of advanced disease at ART enrollment are likely due to scale-up of testing and treatment services and ART-eligibility guidelines encouraging earlier ART initiation. However, in 2015, approximately a third of new ART patients still initiated ART with advanced HIV disease. To reduce prevalence of advanced disease at ART initiation, adoption of World Health Organization (WHO)-recommended "treat-all" guidelines and strategies to facilitate earlier HIV testing and treatment are needed to reduce HIV-related mortality and HIV incidence.

  1. Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys

    PubMed Central

    Sreeramareddy, Chandrashekhar T.; Pradhan, Pranil Man Singh

    2015-01-01

    Background Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Methods Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for ‘current smoking’ and ‘current use of smokeless tobacco (SLT) products’ among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Findings Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Conclusion Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries. PMID:26131888

  2. Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys.

    PubMed

    Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh

    2015-01-01

    Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for 'current smoking' and 'current use of smokeless tobacco (SLT) products' among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries.

  3. Prevalence, causes and management outcome of intestinal obstruction in Adama Hospital, Ethiopia.

    PubMed

    Soressa, Urgessa; Mamo, Abebe; Hiko, Desta; Fentahun, Netsanet

    2016-06-04

    In Africa, acute intestinal obstruction accounts for a great proportion of morbidity and mortality. Ethiopia is one of the countries where intestinal obstruction is a major cause of morbidity and mortality. This study aims to determine prevalence, causes and management outcome of intestinal obstruction in Adama Hospital in Oromia region, Ethiopia. A hospital based cross-sectional study design was used. Data covering the past three years were collected from hospital medical records of sampled patients. The collected data were checked for any inconsistency, coded and entered into SPSS version 16.0 for data processing and analysis. Descriptive and logistic regression analyses were used. Statistical significance was based on confidence interval (CI) of 95 % at a p-value of < 0.05. 262 patients were admitted with intestinal obstruction. The prevalence of intestinal obstruction was 21.8 % and 4.8 % among patients admitted for acute abdomen surgery and total surgical admissions, respectively. The mortality rate was 2.5 % (6 of 262). The most common cause of small bowel obstruction was intussusceptions in 48 patients (30.9 %), followed by small bowel volvulus in 47 patients (30.3 %). Large bowel obstruction was caused by sigmoid volvulus in 60 patients (69.0 %) followed by colonic tumor in 12 patients (13.8 %). After controlling for possible confounding factors, the major predictors of management outcome of intestinal obstruction were: duration of illness before surgical intervention (adjusted odds ratio (AOR) = 0.49, 95 % CI: 0.25-0.97); intra-operative findings [Viable small bowel volvulus (SBV) (AOR = 0.08, 95 % CI: 0.01-0.95) and viable (AOR = 0.17, 95 % CI: 0.03-0.88)]; completion of intra-operative procedures (bowel resection & anastomosis (AOR = 3.05, 95 % CI: 1.04-8.94); and length of hospital stay (AOR = 0.05, 95 % CI: 0.01-0.16). Small bowel obstruction was more prevalent than large bowel obstruction. Intussusceptions and

  4. Sustainable solid waste management: an integrated approach for Asian countries.

    PubMed

    Shekdar, Ashok V

    2009-04-01

    Solid waste management (SWM) has been an integral part of every human society. The approaches for SWM should be compatible with the nature of a given society, and, in this regard, Asian countries are no exception. In keeping with global trends, the systems are being oriented to concentrate on sustainability issues; mainly through the incorporation of 3R (reduce, reuse and recycle) technologies. However, degree and nature of improvements toward sustainability are varying and depend on the economic status of a country. High-income countries like Japan and South Korea can afford to spend more to incorporate 3R technologies. Most of the latest efforts focus on "Zero Waste" and/or "Zero Landfilling" which is certainly expensive for weaker economies such as those of India or Indonesia. There is a need to pragmatically assess the expectations of SWM systems in Asian countries. Hence, in this paper, we analyze the situation in different Asian countries, and explore future trends. We conceptually evaluate issues surrounding the sustainability of SWM. We propose a multi-pronged integrated approach for improvement that achieves sustainable SWM in the context of national policy and legal frameworks, institutional arrangement, appropriate technology, operational and financial management, and public awareness and participation. In keeping with this approach, a generic action plan has been proposed that could be tailored to suit a situation in a particular country. Our proposed concept and action plan framework would be useful across a variety of country-specific scenarios.

  5. Driving to contract management in health care institutes of developing countries.

    PubMed

    Vatankhah, S; Barati, O; Maleki, M R; Tofighi, Sh; Rafii, S

    2012-04-01

    Public hospitals can privatize management activities by contracting with a private organization or person to perform the work. Management contract is a method which uses private sector for major government projects like hospitals. This study evaluates contract management in health care institutes of developing countries. Information has been collected by reviewing the management contract condition of selected countries. Different forms of public private partnership for private participation in hospitals were surveyed. The effects of management contract is expanding market opportunities to include public sector clients, capturing a market to be protected from competitors and providing a reliable and timely source of revenue. Contracting with non-governmental entities will provide better results than government provision of the same services. Contracting initiatives must be regulated and monitored at the highest level of government by experienced and astute policy makers, economists and operational personnel.

  6. Lifetime and past-year prevalence of children's exposure to violence in 9 Balkan countries: the BECAN study.

    PubMed

    Nikolaidis, George; Petroulaki, Kiki; Zarokosta, Foteini; Tsirigoti, Antonia; Hazizaj, Altin; Cenko, Enila; Brkic-Smigoc, Jelena; Vajzovic, Emir; Stancheva, Vaska; Chincheva, Stefka; Ajdukovic, Marina; Rajter, Miro; Raleva, Marija; Trpcevska, Liljana; Roth, Maria; Antal, Imola; Ispanovic, Veronika; Hanak, Natasha; Olmezoglu-Sofuoglu, Zeynep; Umit-Bal, Ismail; Bianchi, Donata; Meinck, Franziska; Browne, Kevin

    2018-01-01

    Children's exposure to violence is a major public health issue. The Balkan epidemiological study on Child Abuse and Neglect project aimed to collect internationally comparable data on violence exposures in childhood. A three stage stratified random sample of 42,194 school-attending children (response rate: 66.7%) in three grades (aged 11, 13 and 16 years) was drawn from schools in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Former Yugoslavian Republic of Macedonia (FYROM), Greece, Romania, Serbia and Turkey. Children completed the ICAST-C questionnaire, which measures children's exposure to violence by any perpetrator. Exposure rates for psychological violence were between 64.6% (FYROM) and 83.2% (Greece) for lifetime and 59.62% (Serbia) and 70.0% (Greece) for past-year prevalence. Physical violence exposure varied between 50.6% (FYROM) and 76.3% (Greece) for lifetime and 42.5% (FYROM) and 51.0% (Bosnia) for past-year prevalence. Sexual violence figures were highest for lifetime prevalence in Bosnia (18.6%) and lowest in FYROM (7.6%). Lifetime contact sexual violence was highest in Bosnia (9.8%) and lowest in Romania (3.6%). Past-year sexual violence and contact sexual violence prevalence was lowest in Romania (5.0 and 2.1%) and highest in Bosnia (13.6 and 7.7% respectively). Self-reported neglect was highest for both past-year and lifetime prevalence in Bosnia (48.0 and 20.3%) and lowest in Romania (22.6 and 16.7%). Experiences of positive parental practices were reported by most participating children in all countries. Where significant differences in violence exposure by sex were observed, males reported higher exposure to past-year and lifetime sexual violence and females higher exposure to neglect. Children in Balkan countries experience a high burden of violence victimization and national-level programming and child protection policy making is urgently needed to address this.

  7. Nursing ward managers' perceptions of pain prevalence at the aged-care facilities in Japan: a nationwide survey.

    PubMed

    Takai, Yukari; Yamamoto-Mitani, Noriko; Fukahori, Hiroki; Kobayashi, Sayuri; Chiba, Yumi

    2013-09-01

    This study aimed to examine nursing ward managers' perceptions of pain prevalence among older residents and the strategies of pain management at the Health Service Facilities for the Elderly Requiring Care (HSFERC) in Japan and to investigate the factors related to the prevalence. Nursing ward managers in 3,644 HSFERC were asked to participate in this study. Questionnaires were sent to them regarding pain prevalence among the older residents in their wards, their provisions for pain care, and other pain management strategies. The perceived pain prevalence factors were examined statistically. The final sample comprised 439 participants (12.0%). A total of 5,219 residents (22.3%) were recognized as suffering from pain on the investigation day. Only 8 wards (1.8%) used pain management guidelines or care manuals, and 14 (3.2%) used a standardized pain scale. The ward managers' age (p = .008) and nursing experience (p = .006) showed a significant negative association with pain prevalence estimation. Moreover, there was a significant association between the groups' pain prevalence estimation and the nursing managers' beliefs that older adults were less sensitive to pain (p = .01), that pain was common among older people (p = .007), and that the time to treat residents' pain was insufficient (p = .001). The ward managers' perceptions regarding pain prevalence varied; the perceived pain rates were possibly lower than the actual percentages. Insufficient pain management strategies at the HSFERC were also suggested. An appropriate pain management strategy for Japanese aged care and its dissemination are urgently required. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  8. The EuroPrevall birth cohort study on food allergy: baseline characteristics of 12,000 newborns and their families from nine European countries.

    PubMed

    McBride, D; Keil, T; Grabenhenrich, L; Dubakiene, R; Drasutiene, G; Fiocchi, A; Dahdah, L; Sprikkelman, A B; Schoemaker, A A; Roberts, G; Grimshaw, K; Kowalski, M L; Stanczyk-Przyluska, A; Sigurdardottir, S; Clausen, M; Papadopoulos, N G; Mitsias, D; Rosenfeld, L; Reche, M; Pascual, C; Reich, A; Hourihane, J; Wahn, U; Mills, E N C; Mackie, A; Beyer, K

    2012-05-01

    It is unclear why some children develop food allergy. The EuroPrevall birth cohort was established to examine regional differences in the prevalence and risk factors of food allergy in European children using gold-standard diagnostic criteria. The aim of this report was to describe pre-, post-natal and environmental characteristics among the participating countries. In nine countries across four major European climatic regions, mothers and their newborns were enrolled from October 2005 through February 2010. Using standardized questionnaires, we assessed allergic diseases and self-reported food hypersensitivity of parents and siblings, nutrition during pregnancy, nutritional supplements, medications, mode of delivery, socio-demographic data and home environmental exposures. A total of 12,049 babies and their families were recruited. Self-reported adverse reactions to food ever were considerably more common in mothers from Germany (30%), Iceland, United Kingdom, and the Netherlands (all 20-22%) compared with those from Italy (11%), Lithuania, Greece, Poland, and Spain (all 5-8%). Prevalence estimates of parental asthma, allergic rhinitis and eczema were highest in north-west (Iceland, UK), followed by west (Germany, the Netherlands), south (Greece, Italy, Spain) and lowest in central and east Europe (Poland, Lithuania). Over 17% of Spanish and Greek children were exposed to tobacco smoke in utero compared with only 8-11% in other countries. Caesarean section rate was highest in Greece (44%) and lowest in Spain (<3%). We found country-specific differences in antibiotic use, pet ownership, type of flooring and baby's mattress. In the EuroPrevall birth cohort study, the largest study using gold-standard diagnostic criteria for food allergy in children worldwide, we found considerable country-specific baseline differences regarding a wide range of factors that are hypothesized to play a role in the development of food allergy including allergic family history

  9. Prevalence and Characterization of Thyroid Hemiagenesis in Japan: The Fukushima Health Management Survey

    PubMed Central

    Midorikawa, Sanae; Matsuzuka, Takashi; Fukushima, Toshihiko; Ito, Yuko; Shimura, Hiroki; Takahashi, Hideto; Ohira, Tetsuya; Ohtsuru, Akira; Abe, Masafumi; Suzuki, Shinichi; Yamashita, Shunichi

    2017-01-01

    Background: Thyroid hemiagenesis is a rare congenital variant characterized by the lack of development of one thyroid lobe with no clinical manifestations. Methods: This study was performed to determine the prevalence and characteristics of thyroid hemiagenesis in a normal Japanese population. This cross-sectional study was performed from October 9, 2011, to April 30, 2015. In total, 299,908 children and young adults in the Fukushima Health Management Survey were examined to determine the presence of thyroid agenesis or hemiagenesis. Thyroid width, thickness, and length were measured in 292,452 of these subjects. Results: Thyroid agenesis was diagnosed in 13 subjects, and hemiagenesis was detected in 67 subjects (0.02%; 22.3/100,000 individuals). Although there was no significant sex-related difference (p = 0.067), the female:male ratio was 1.67:1.00. Females were significantly dominant in right hemiagenesis, while there was no difference in left hemiagenesis between males and females. The thyroid volumes at the 2.5th and 97.5th percentiles for age and body surface area were determined for each sex. Multivariate regression analysis showed that a large hemithyroid volume was independently associated with the presence of contralateral hemiagenesis (p < 0.001). Conclusion: The prevalence of thyroid hemiagenesis in the present study is in agreement with that reported in other countries. The prevalence of right hemiagenesis was higher in females, and the larger contralateral lobe in patients with rather than without hemiagenesis may have been caused by a compensatory feedback mechanism to prevent hypothyroidism. In addition, the prevalence of hemiagenesis, especially right hemiagenesis, may be affected by sex-related factors similar to those in patients with an ectopic thyroid gland. PMID:28657504

  10. Overview of legislation on sewage sludge management in developed countries worldwide.

    PubMed

    Christodoulou, A; Stamatelatou, K

    2016-01-01

    The need to apply innovative technologies for maximizing the efficiency and minimizing the carbon footprint of sewage treatment plants has upgraded sewage sludge management to a highly sophisticated research and development sector. Sewage sludge cannot be regarded solely as 'waste'; it is a renewable resource for energy and material recovery. From this perspective, legislation on sewage sludge management tends to incorporate issues related to environmental protection, public health, climate change impacts and socio-economic benefits. This paper reviews the existing legislative frameworks and policies on sewage sludge management in various countries, highlighting the common ground as well as the different priorities in all cases studied. More specifically, the key features of legislation regarding sludge management in developed countries such as the USA, Japan, Australia, New Zealand and the European Union (EU27) are discussed.

  11. Service innovation management practices in the telecommunications industry: what does cross country analysis reveal?

    PubMed

    Rahman, Syed Abidur; Taghizadeh, Seyedeh Khadijeh; Ramayah, T; Ahmad, Noor Hazlina

    2015-01-01

    Service innovation management practice is currently being widely scrutinized mainly in the developed countries, where it has been initiated. The current study attempts to propose a framework and empirically validate and explain the service innovation practices for successful performance in the telecommunications industry of two developing countries, Malaysia and Bangladesh. The research framework proposes relationships among organisational culture, operating core (innovation process, cross-functional organisation, and implementation of tools/technology), competition-informed pricing, and performance. A total of 176 usable data from both countries are analysed for the purpose of the research. The findings show that organisational culture tends to be more influential on innovation process and cross-functional organisation in Malaysian telecommunication industry. In contrast, implementation of tools/technology plays a more instrumental role in competition-informed pricing practices in Bangladesh. This study revealed few differences in the innovation management practices between two developing countries. The findings have strategic implications for the service sectors in both the developing countries regarding implementation of innovative enterprises, especially in Bangladesh where innovation is the basis for survival. Testing the innovation management practices in the developing countries perhaps contains uniqueness in the field of innovation management.

  12. Sustainable solid waste management: An integrated approach for Asian countries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shekdar, Ashok V.

    2009-04-15

    Solid waste management (SWM) has been an integral part of every human society. The approaches for SWM should be compatible with the nature of a given society, and, in this regard, Asian countries are no exception. In keeping with global trends, the systems are being oriented to concentrate on sustainability issues; mainly through the incorporation of 3R (reduce, reuse and recycle) technologies. However, degree and nature of improvements toward sustainability are varying and depend on the economic status of a country. High-income countries like Japan and South Korea can afford to spend more to incorporate 3R technologies. Most of themore » latest efforts focus on 'Zero Waste' and/or 'Zero Landfilling' which is certainly expensive for weaker economies such as those of India or Indonesia. There is a need to pragmatically assess the expectations of SWM systems in Asian countries. Hence, in this paper, we analyze the situation in different Asian countries, and explore future trends. We conceptually evaluate issues surrounding the sustainability of SWM. We propose a multi-pronged integrated approach for improvement that achieves sustainable SWM in the context of national policy and legal frameworks, institutional arrangement, appropriate technology, operational and financial management, and public awareness and participation. In keeping with this approach, a generic action plan has been proposed that could be tailored to suit a situation in a particular country. Our proposed concept and action plan framework would be useful across a variety of country-specific scenarios.« less

  13. Nasal polyps in patients with asthma: prevalence, impact, and management challenges

    PubMed Central

    Langdon, Cristobal; Mullol, Joaquim

    2016-01-01

    Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have coexisting asthma under the concept of “United Airway Disease”, being the combination of both diseases, which is one of the most challenging phenotypes to treat. Although clinicians have recognized this difficult-to-treat phenotype for many years, it remained poorly characterized. There is increasing epidemiological evidence linking chronic rhinosinusitis and asthma, but a good understanding of the pathophysiology and the combined management is still lacking. Bronchial asthma is more prevalent in patients who suffer chronic rhinosinusitis, while asthmatic patients have a greater prevalence of CRSwNP than patients without asthma. The effect of CRSwNP treatment, whether medical or surgical, in asthma is today less controversial after some studies have shown improvement of asthma after medical and/or surgical treatment of CRSwNP. However, direct comparisons between surgical and medical treatments are limited. Further randomized clinical trials are, however, still needed to better understand the management when both asthma and CRSwNP occur together. This review aims at summarizing the prevalence, impact, and management challenges regarding both asthma and CRSwNP. PMID:27042129

  14. Prevalence of hepatitis C virus infection among hemodialysis patients in the Middle-East: A systematic review and meta-analysis.

    PubMed

    Ashkani-Esfahani, Soheil; Alavian, Seyed Moayed; Salehi-Marzijarani, Mohammad

    2017-01-07

    To determine hepatitis C virus (HCV) infection prevalence in each country of the Middle-East and the overall prevalence of the region. In this systematic review, we gathered all documents related to HCV infection prevalence among hemodialysis patients in 17 middle-east countries from April 2006 to March 2016. We selected only cross-sectional studies that had proper sampling and measurement methods as well as a valid statistical analysis. After screening of 7311 documents, 56 studies were selected reporting the prevalence of HCV infection among hemodialysis patients from 10 countries of the region. Seven countries including United Arab Emirates, Afghanistan, Qatar, Bahrain, Kuwait, Oman, Israel, and Cyprus did not have any relevant document; thus, their latest reports were just mentioned. We performed the meta-analysis and determined the prevalence rates for each country as well as the whole region. The overall HCV infection prevalence among hemodialysis patients in the region was reported to be 25.3%; Egypt and Syria had the highest reported rates while Iran and Lebanon had the lowest. Further investigations are still needed to provide more reliable databases, find main risk factors, and to improve diagnosis and treatment plans, particularly in higher prevalent countries. Controlling the prevalence and improving the management methods of HCV infection among hemodialysis patients are of a great concern in the Middle-East region.

  15. Prevalence of hepatitis C virus infection among hemodialysis patients in the Middle-East: A systematic review and meta-analysis

    PubMed Central

    Ashkani-Esfahani, Soheil; Alavian, Seyed Moayed; Salehi-Marzijarani, Mohammad

    2017-01-01

    AIM To determine hepatitis C virus (HCV) infection prevalence in each country of the Middle-East and the overall prevalence of the region. METHODS In this systematic review, we gathered all documents related to HCV infection prevalence among hemodialysis patients in 17 middle-east countries from April 2006 to March 2016. We selected only cross-sectional studies that had proper sampling and measurement methods as well as a valid statistical analysis. RESULTS After screening of 7311 documents, 56 studies were selected reporting the prevalence of HCV infection among hemodialysis patients from 10 countries of the region. Seven countries including United Arab Emirates, Afghanistan, Qatar, Bahrain, Kuwait, Oman, Israel, and Cyprus did not have any relevant document; thus, their latest reports were just mentioned. We performed the meta-analysis and determined the prevalence rates for each country as well as the whole region. The overall HCV infection prevalence among hemodialysis patients in the region was reported to be 25.3%; Egypt and Syria had the highest reported rates while Iran and Lebanon had the lowest. Further investigations are still needed to provide more reliable databases, find main risk factors, and to improve diagnosis and treatment plans, particularly in higher prevalent countries. CONCLUSION Controlling the prevalence and improving the management methods of HCV infection among hemodialysis patients are of a great concern in the Middle-East region. PMID:28104991

  16. Prevalence and Clinical Characteristics of Chronic Spontaneous Urticaria in Pediatric Patients.

    PubMed

    Balp, Maria-Magdalena; Weller, Karsten; Carboni, Veruska; Chirilov, Alexandra; Papavassilis, Charis; Severin, Thomas; Tian, Haijun; Zuberbier, Torsten; Maurer, Marcus

    2018-04-21

    Data on the prevalence and disease management of chronic urticaria (CU) and chronic spontaneous urticaria (CSU) in the pediatric population are scarce. The present study assessed the prevalence of CU and CSU, and disease management among pediatric patients (0-17 years). A physician-based online survey was conducted in 5 European countries (United Kingdom, Germany, Italy, France, and Spain) assessing the annual diagnosed prevalence, disease characteristics and treatment patterns in the target population. Results are based on physician responses and analyzed using descriptive statistics. Prevalence estimates were calculated based on the number of CU/CSU pediatric patients seen, treated and referred by the respondents and extrapolated to the total pediatric population from each country. Across 5 European countries, the one-year diagnosed prevalence of CU and CSU in pediatric patients was 1.38% (95% CI, 0.94-1.86) and 0.75% (95% CI, 0.44-1.08), respectively. Angioedema was reported in 6%-14% of patients. A large proportion of CSU pediatric patients (40%-60%) were treated with H1-antihistamines at approved dose and 16% to 51% received H1-antihistamines at higher doses. Approximately 1/3 of pediatric CSU patients remained uncontrolled with H1- antihistamines at approved/higher doses. Other prescribed treatments were oral corticosteroids (10% to 28%) and topical creams (15% to 26%). This study revealed a prevalence of CSU among pediatric population comparable to adults and also suggested an unmet need for approved treatments for inadequately-controlled pediatric CSU patients. It is truly of concern that harmful (oral steroids) or insufficient (topical creams) treatments were frequently used despite of better and guideline recommended alternatives. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Hepatitis B virus burden in developing countries

    PubMed Central

    Zampino, Rosa; Boemio, Adriana; Sagnelli, Caterina; Alessio, Loredana; Adinolfi, Luigi Elio; Sagnelli, Evangelista; Coppola, Nicola

    2015-01-01

    Hepatitis B virus (HBV) infection has shown an intermediate or high endemicity level in low-income countries over the last five decades. In recent years, however, the incidence of acute hepatitis B and the prevalence of hepatitis B surface antigen chronic carriers have decreased in several countries because of the HBV universal vaccination programs started in the nineties. Some countries, however, are still unable to implement these programs, particularly in their hyperendemic rural areas. The diffusion of HBV infection is still wide in several low-income countries where the prevention, management and treatment of HBV infection are a heavy burden for the governments and healthcare authorities. Of note, the information on the HBV epidemiology is scanty in numerous eastern European and Latin-American countries. The studies on molecular epidemiology performed in some countries provide an important contribution for a more comprehensive knowledge of HBV epidemiology, and phylogenetic studies provide information on the impact of recent and older migratory flows. PMID:26576083

  18. Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation

    PubMed Central

    2014-01-01

    Background Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated. Results Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure. Conclusion The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure. PMID:24972489

  19. Differences in diabetes prevalence and inequalities in disease management and glycaemic control by immigrant status: a population-based study (Italy).

    PubMed

    Ballotari, Paola; Caroli, Stefania; Ferrari, Francesca; Romani, Gabriele; Marina, Greci; Chiarenza, Antonio; Manicardi, Valeria; Giorgi Rossi, Paolo

    2015-02-06

    The diabetes prevalence increases at an alarming rate around the world and understanding disparities in occurrence, care management, and health outcomes may be a starting point towards achieving more effective strategies to prevent and manage it. The aims of this study are to compare immigrants and Italians in terms of the differences in diabetes prevalence and to evaluate inequalities in disease management and glycaemic control by using information included in Reggio Emilia diabetes register. We retrieved from the diabetes register subjects aged 20-74 on December 31(st), 2009. Using citizenship, we created three main groups: Italy, High Developed Countries (HDC), and High Migration Pressure Countries (HMPC). These were split into sub-regions of origin. We calculated age-adjusted prevalence by gender and sub-region. Using logistic regression model, we analyzed the association between area of origin and following indicators: 1) not being in care of diabetes clinics; 2) not having glycated haemoglobin (HbA1c) test in 2010; 3) among those tested, having a HbA1c value > = 9% (75 mmol/mol). We found 15,889 Italian and 1,295 HMPC citizens with diabetes. HMPC citizens had higher age-adjusted prevalence of diabetes than Italians (females 5.0% vs 3.6%; males 6.5% vs 5.5%). The excess was mostly due to a strong excess in immigrants from Southern Asia (females 9.7%, males 10.2%) and Northern Africa (females 9.3%, males 5.9%). HMPC citizens were cared for by diabetes clinics in a similar proportion than Italians (OR: 1.08; 95% CI: 0.93-1.25), but had a greater odds of not being tested for HbA1c (OR: 1.51; 95% CI: 1.34-1.71), as well as of having HbA1c values equal to or over 9% (OR: 2.06; 95% CI: 1.80-3.14). The outcomes were poorer in HMPC females for the first two outcomes, while there was no difference for the HbA1c values (Wald test for heterogeneity p = 0.0850; p = 0.0156; p = 0.6635, respectively). Our findings highlight the need for gender-oriented actions for

  20. A case study of polypharmacy management in nine European countries: Implications for change management and implementation

    PubMed Central

    MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F.; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

    2018-01-01

    Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results

  1. A case study of polypharmacy management in nine European countries: Implications for change management and implementation.

    PubMed

    McIntosh, Jennifer; Alonso, Albert; MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

    2018-01-01

    Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change

  2. Transboundary hazardous waste management. Part I: Waste management policy of importing countries.

    PubMed

    Fan, Kuo-Shuh; Chang, Tien Chin; Ni, Shih-Piao; Lee, Ching-Hwa

    2005-12-01

    Mixed metal-containing waste, polychlorinated biphenyls (PCB) containing capacitors, printed circuit boards, steel mill dust and metal sludge were among the most common wastes exported from Taiwan. Before the implementation of the self-monitoring model programme of the Basel Convention (secretariat of the Basel Convention 2001) in the Asia region, Taiwan conducted a comprehensive 4-year follow-up project involving government authorities and the waste disposal facilities of the importing countries. A total of five countries and nine plants were visited in 2001-2002. The following outcomes can be drawn from these investigations. The Chinese government adopts the strategies of 'on-site processing' and 'relative centralization' on the waste management by tightening permitting and increasing site inspection. A three-level reviewing system is adopted for the import application. The United States have not signed the Basel Convention yet; the procedures of hazardous waste import rely on bilateral agreements. Importers are not required to provide official notification from the waste exporting countries. The operation, administration, monitoring and licensing of waste treatment plants are governed by the state environmental bureau. Finland, France and Belgium are members of the European Union. The procedures and policies of waste import are similar. All of the documents associated with transboundary movement require the approval of each government involved. Practically, the notification forms and tracking forms effectively manage the waste movement.

  3. Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 3.

    PubMed

    Liakina, V; Hamid, S; Tanaka, J; Olafsson, S; Sharara, A I; Alavian, S M; Gheorghe, L; El Hassan, E S; Abaalkhail, F; Abbas, Z; Abdou, A; Abourached, A; Al Braiki, F; Al Hosani, F; Al Jaberi, K; Al Khatry, M; Al Mulla, M A; Al Quraishi, H; Al Rifai, A; Al Serkal, Y; Alam, A; Alashgar, H I; Alawadhi, S; Al-Dabal, L; Aldins, P; Alfaleh, F Z; Alghamdi, A S; Al-Hakeem, R; Aljumah, A A; Almessabi, A; Alqutub, A N; Alswat, K A; Altraif, I; Alzaabi, M; Andrea, N; Assiri, A M; Babatin, M A; Baqir, A; Barakat, M T; Bergmann, O M; Bizri, A R; Blach, S; Chaudhry, A; Choi, M S; Diab, T; Djauzi, S; El Khoury, S; Estes, C; Fakhry, S; Farooqi, J I; Fridjonsdottir, H; Gani, R A; Ghafoor Khan, A; Goldis, A; Gottfredsson, M; Gregorcic, S; Hajarizadeh, B; Han, K H; Hasan, I; Hashim, A; Horvath, G; Hunyady, B; Husni, R; Jafri, W; Jeruma, A; Jonasson, J G; Karlsdottir, B; Kim, D Y; Kim, Y S; Koutoubi, Z; Lesmana, L A; Lim, Y S; Löve, A; Maimets, M; Makara, M; Malekzadeh, R; Matičič, M; Memon, M S; Merat, S; Mokhbat, J E; Mourad, F H; Muljono, D H; Nawaz, A; Nugrahini, N; Priohutomo, S; Qureshi, H; Rassam, P; Razavi, H; Razavi-Shearer, D; Razavi-Shearer, K; Rozentale, B; Sadik, M; Saeed, K; Salamat, A; Salupere, R; Sanai, F M; Sanityoso Sulaiman, A; Sayegh, R A; Schmelzer, J D; Sibley, A; Siddiq, M; Siddiqui, A M; Sigmundsdottir, G; Sigurdardottir, B; Speiciene, D; Sulaiman, A; Sultan, M A; Taha, M; Tarifi, H; Tayyab, G; Tolmane, I; Ud Din, M; Umar, M; Valantinas, J; Videčnik-Zorman, J; Yaghi, C; Yunihastuti, E; Yusuf, M A; Zuberi, B F; Gunter, J

    2015-12-01

    Detailed, country-specific epidemiological data are needed to characterize the burden of chronic hepatitis C virus (HCV) infection around the world. With new treatment options available, policy makers and public health officials must reconsider national strategies for infection control. In this study of 15 countries, published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates were gathered from the literature and validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Iran and Lebanon to 4.2% in Pakistan. The largest viraemic populations were in Pakistan (7 001 000 cases) and Indonesia (3 187 000 cases). Injection drug use (IDU) and a historically unsafe blood supply were major risk factors in most countries. Diagnosis, treatment and liver transplant rates varied widely between countries. However, comparison across countries was difficult as the number of cases changes over time. Access to reliable data on measures such as these is critical for the development of future strategies to manage the disease burden. © 2015 John Wiley & Sons Ltd.

  4. Epidemiology of epilepsy in developing countries.

    PubMed Central

    Senanayake, N.; Román, G. C.

    1993-01-01

    Epilepsy is an important health problem in developing countries, where its prevalence can be up to 57 per 1000 population. This article reviews the epidemiology of epilepsy in developing countries in terms of its incidence, prevalence, seizure type, mortality data, and etiological factors. The prevalence of epilepsy is particularly high in Latin America and in several African countries, notably Liberia, Nigeria, and the United Republic of Tanzania. Parasitic infections, particularly neurocysticercosis, are important etiological factors for epilepsy in many of these countries. Other reasons for the high prevalence include intracranial infections of bacterial or viral origin, perinatal brain damage, head injuries, toxic agents, and hereditary factors. Many of these factors are, however, preventable or modifiable, and the introduction of appropriate measures to achieve this could lead to a substantial decrease in the incidence of epilepsy in developing countries. PMID:8490989

  5. Using the STROBE statement to assess reporting in blindness prevalence surveys in low and middle income countries.

    PubMed

    Ramke, Jacqueline; Palagyi, Anna; Jordan, Vanessa; Petkovic, Jennifer; Gilbert, Clare E

    2017-01-01

    Cross-sectional blindness prevalence surveys are essential to plan and monitor eye care services. Incomplete or inaccurate reporting can prevent effective translation of research findings. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement is a 32 item checklist developed to improve reporting of observational studies. The aim of this study was to assess the completeness of reporting in blindness prevalence surveys in low and middle income countries (LMICs) using STROBE. MEDLINE, EMBASE and Web of Science databases were searched on April 8 2016 to identify cross-sectional blindness prevalence surveys undertaken in LMICs and published after STROBE was published in December 2007. The STROBE tool was applied to all included studies, and each STROBE item was categorized as 'yes' (met criteria), 'no' (did not meet criteria) or 'not applicable'. The 'Completeness of reporting (COR) score' for each manuscript was calculated: COR score = yes / [yes + no]. In journals with included studies the instructions to authors and reviewers were checked for reference to STROBE. The 89 included studies were undertaken in 32 countries and published in 37 journals. The mean COR score was 60.9% (95% confidence interval [CI] 58.1-63.7%; range 30.8-88.9%). The mean COR score did not differ between surveys published in journals with author instructions referring to STROBE (10/37 journals; 61.1%, 95%CI 56.4-65.8%) or in journals where STROBE was not mentioned (60.9%, 95%CI 57.4-64.3%; p = 0.93). While reporting in blindness prevalence surveys is strong in some areas, others need improvement. We recommend that more journals adopt the STROBE checklist and ensure it is used by authors and reviewers.

  6. A cross-country comparison of the prevalence of exposure to tobacco advertisements among adolescents aged 13–15 years in 20 low and middle income countries

    PubMed Central

    2013-01-01

    Background This study assessed the prevalence and influence of exposure to pro-tobacco advertisements among adolescents in 20 low and middle income countries (LMICs). Methods The 2007–2008 Global Youth Tobacco Survey was analyzed for students aged 13–15 years in 20 LMICs. Overall and sex-specific prevalence of exposure to tobacco advertisements in several media, as well as the prevalence of smoking susceptibility (i.e., the lack of a firm commitment among never smokers not to smoke in the future or if offered a cigarette by a friend) were assessed. The variability of the point estimates was assessed using 95% confidence intervals (CI). Logistic regression was used to assess the effect of exposure to multiple (i.e., ≥2) pro-tobacco advertisements on current smoking, adjusting for age and sex (P < 0.05). Data were weighted and analyzed with Stata version 11. Results Overall country-specific prevalence for different advertisement sources ranged as follows: movies/videos (78.4% in Lesotho to 97.8% in Belize); television programs (48.7% in Togo to 91.7% in the Philippines); newspapers/magazines (29.5% in Togo to 89.7% in the Philippines); and outdoor community events (30.6% in Rwanda to 79.4% in the Philippines). The overall proportion of never smokers who were susceptible to cigarette smoking ranged from 3.7% in Sri Lanka to 70.1% in Kyrgyzstan. Exposure to ≥2 sources of pro-tobacco advertisements was associated with significantly increased odds of cigarette smoking among adolescents in several countries including South Africa (adjusted odds ratio, aOR = 4.11; 95% CI:2.26-7.47), Togo (aOR = 3.77; 95% CI:1.27-11.21), the Former Yugoslav Republic of Macedonia (aOR = 1.42; 95% CI:1.01-1.99), Republic of Moldova (aOR = 1.53; 95% CI:1.11-2.12), Belize (aOR = 13.95; 95% CI:1.91-102.02), Panama (aOR = 5.14; 95% CI: 2.37-11.14) and Mongolia (aOR = 1.52; 95% CI:1.19-1.94). Conclusion Prevalence of exposure to various pro-tobacco advertisements was high among adolescents

  7. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review

    PubMed Central

    Cabral de Mello, Meena; Patel, Vikram; Rahman, Atif; Tran, Thach; Holton, Sara; Holmes, Wendy

    2012-01-01

    Abstract Objective To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. Methods Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Findings Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4–15.9) antenatally and 19.8% (19.5–20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1–13.2); unintended pregnancy (1.6–8.8); being younger (2.1–5.4); being unmarried (3.4–5.8); lacking intimate partner empathy and support (2.0–9.4); having hostile in-laws (2.1–4.4); experiencing intimate partner violence (2.11–6.75); having insufficient emotional and practical support (2.8–6.1); in some settings, giving birth to a female (1.8–2.6), and having a history of mental health problems (5.1–5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4–1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1–0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3–0.9). Conclusion CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history. PMID:22423165

  8. Lymphoedema management: an international intersect between developed and developing countries. Similarities, differences and challenges.

    PubMed

    Stout, Nicole L; Brantus, Pierre; Moffatt, Christine

    2012-01-01

    Lymphoedema is a chronic swelling condition that contributes to disability, dysfunction and lost quality of life. Significant disparities exist worldwide regarding the availability of resources necessary to identify, treat and manage lymphoedema. This disparity transcends socio-economic status and is a common problem in both developed and developing countries. The overall impact of lymphoedema as a public health problem, however, is underestimated, principally due to the lack of epidemiologic data. These problems pose barriers to optimal identification and management of this disabling, lifelong condition. In 1997, the World Health Organization (50.29) resolved that lymphatic filariasis should be eliminated as a public health problem. A component of this strategy focuses on disability management for those suffering from lymphatic filariasis-related morbidity. This initiative has enhanced lymphoedema awareness in developing countries. However, significant deficits persist in health care providers' knowledge, educational initiatives and basic disease identification and treatment. In developed countries, lymphoedema continues to be an underrecognised condition and assumed to be only cancer-related. Health care resources allocated to treat and manage the disease are insufficient for basic and ongoing care, resulting in disease progression and disability. The International Lymphoedema Framework project, established in 2002, seeks to establish a consensus for best practices in the management of lymphoedema worldwide to reduce this disability burden. A basic global construct for lymphoedema management is needed to decrease morbidity and promote optimal disease management across all cultural and socio-economic boundaries. Many countries are unaware of the importance of lymphoedema management and have not defined a national strategy with respect to this problem. The objective of this article is to define similarities and differences in strategies for lymphoedema management

  9. D-Dimer Use and Pulmonary Embolism Diagnosis in Emergency Units: Why Is There Such a Difference in Pulmonary Embolism Prevalence between the United States of America and Countries Outside USA?

    PubMed

    Pernod, Gilles; Caterino, Jeffrey; Maignan, Maxime; Tissier, Cindy; Kassis, Jeannine; Lazarchick, John

    2017-01-01

    Although diagnostic guidelines are similar, there is a huge difference in pulmonary embolism (PE) prevalence between the United States of America (US) and countries outside the USA (OUS) in the emergency care setting. In this study, we prospectively analyze patients' characteristics and differences in clinical care that may influence PE prevalence in different countries. An international multicenter prospective diagnostic study was conducted in a standard-of-care setting. Consecutive outpatients presenting to the emergency unit and suspected for PE were managed using the Wells score, STA-Liatest® D-Dimers and imaging. The prevalence of PE in the study was 7.9% in low and moderate risk patients. Among the 1060 patients with low or moderate pre-test probability (PTP), PE prevalence was four times higher in OUS (10.7%) than in the US (2.5%) (P < 0.0001). The mean number of imaging procedures performed for one new PE diagnosis was 3.3 in OUS vs 17 in the US (P < 0.001). Stopping investigation in the case of negative D-dimers (DD combined) with low/moderate PTP was more frequent in OUS (92.7%) than in the US (75.7%) (P < 0.01). Moreover, the use of imaging was much higher in the US (44.4% vs 19.2% in OUS) in the case of moderate PTP combined with negative DD. Differences between US and OUS PE prevalence in emergency setting might be explained by differences in patients' characteristics and mostly in care patterns. US physicians performed computed tomographic pulmonary angiography more often than in Europe in cases of low/moderate PTP combined with negative DD. ClinicalTrials.gov NCT01221805.

  10. Use of active management of the third stage of labour in seven developing countries.

    PubMed

    Stanton, Cynthia; Armbruster, Deborah; Knight, Rod; Ariawan, Iwan; Gbangbade, Sourou; Getachew, Ashebir; Portillo, Jose Angel; Jarquin, Douglas; Marin, Flor; Mfinanga, Sayoka; Vallecillo, Jesus; Johnson, Hope; Sintasath, David

    2009-03-01

    To document the use of active management of the third stage of labour for preventing postpartum haemorrhage and to explore factors associated with such use in seven developing countries. Nationally representative samples of facility-based deliveries were selected and observed to determine the use of active management of the third stage of labour and associated factors. Policies on active management were assessed through document review and interviews with relevant professionals. Use of a uterotonic during the third or fourth stages of labour was nearly universal. Correct use of active management of the third stage of labour was found in only 0.5% to 32% of observed deliveries due to multiple deficiencies in practice. In every country except Indonesia, policies regarding active management were conflicting. Developing countries have not targeted decreasing postpartum haemorrhage as an achievable goal; there is little use of active management of the third stage of labour, and policies regarding such management often conflict. Studies are needed to identify the most effective components of active management so that the most efficient package of practices can be promoted.

  11. The relationship between managed bees and the prevalence of parasites in bumblebees

    PubMed Central

    Goulson, Dave; Hughes, William O.H.

    2014-01-01

    Honey bees and, more recently, bumblebees have been domesticated and are now managed commercially primarily for crop pollination, mixing with wild pollinators during foraging on shared flower resources. There is mounting evidence that managed honey bees or commercially produced bumblebees may affect the health of wild pollinators such as bumblebees by increasing competition for resources and the prevalence of parasites in wild bees. Here we screened 764 bumblebees from around five greenhouses that either used commercially produced bumblebees or did not, as well as bumblebees from 10 colonies placed at two sites either close to or far from a honey bee apiary, for the parasites Apicystis bombi, Crithidia bombi, Nosema bombi, N. ceranae, N. apis and deformed wing virus. We found that A. bombi and C. bombi were more prevalent around greenhouses using commercially produced bumblebees, while C. bombi was 18% more prevalent in bumblebees at the site near to the honey bee apiary than those at the site far from the apiary. Whilst these results are from only a limited number of sites, they support previous reports of parasite spillover from commercially produced bumblebees to wild bumblebees, and suggest that the impact of stress from competing with managed bees or the vectoring of parasites by them on parasite prevalence in wild bees needs further investigation. It appears increasingly likely that the use of managed bees comes at a cost of increased parasites in wild bumblebees, which is not only a concern for bumblebee conservation, but which may impact other pollinators as well. PMID:25165632

  12. The relationship between managed bees and the prevalence of parasites in bumblebees.

    PubMed

    Graystock, Peter; Goulson, Dave; Hughes, William O H

    2014-01-01

    Honey bees and, more recently, bumblebees have been domesticated and are now managed commercially primarily for crop pollination, mixing with wild pollinators during foraging on shared flower resources. There is mounting evidence that managed honey bees or commercially produced bumblebees may affect the health of wild pollinators such as bumblebees by increasing competition for resources and the prevalence of parasites in wild bees. Here we screened 764 bumblebees from around five greenhouses that either used commercially produced bumblebees or did not, as well as bumblebees from 10 colonies placed at two sites either close to or far from a honey bee apiary, for the parasites Apicystis bombi, Crithidia bombi, Nosema bombi, N. ceranae, N. apis and deformed wing virus. We found that A. bombi and C. bombi were more prevalent around greenhouses using commercially produced bumblebees, while C. bombi was 18% more prevalent in bumblebees at the site near to the honey bee apiary than those at the site far from the apiary. Whilst these results are from only a limited number of sites, they support previous reports of parasite spillover from commercially produced bumblebees to wild bumblebees, and suggest that the impact of stress from competing with managed bees or the vectoring of parasites by them on parasite prevalence in wild bees needs further investigation. It appears increasingly likely that the use of managed bees comes at a cost of increased parasites in wild bumblebees, which is not only a concern for bumblebee conservation, but which may impact other pollinators as well.

  13. Prevalence and factors associated with the use of alternative (folk) medicine practitioners in 8 countries of the former Soviet Union.

    PubMed

    Stickley, Andrew; Koyanagi, Ai; Richardson, Erica; Roberts, Bayard; Balabanova, Dina; McKee, Martin

    2013-04-11

    Research suggests that since the collapse of the Soviet Union there has been a sharp growth in the use of complementary and alternative medicine (CAM) in some former Soviet countries. However, as yet, comparatively little is known about the use of CAM in the countries throughout this region. Against this background, the aim of the current study was to determine the prevalence of using alternative (folk) medicine practitioners in eight countries of the former Soviet Union (fSU) and to examine factors associated with their use. Data were obtained from the Living Conditions, Lifestyles and Health (LLH) survey undertaken in eight former Soviet countries (Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine) in 2001. In this nationally representative cross-sectional survey, 18428 respondents were asked about how they treated 10 symptoms, with options including the use of alternative (folk) medicine practitioners. Multivariate logistic regression analysis was used to determine the factors associated with the treatment of differing symptoms by such practitioners in these countries. The prevalence of using an alternative (folk) medicine practitioner for symptom treatment varied widely between countries, ranging from 3.5% in Armenia to 25.0% in Kyrgyzstan. For nearly every symptom, respondents living in rural locations were more likely to use an alternative (folk) medicine practitioner than urban residents. Greater wealth was also associated with using these practitioners, while distrust of doctors played a role in the treatment of some symptoms. The widespread use of alternative (folk) medicine practitioners in some fSU countries and the growth of this form of health care provision in the post-Soviet period in conditions of variable licensing and regulation, highlights the urgent need for more research on this phenomenon and its potential effects on population health in the countries in this region.

  14. State of rare disease management in Southeast Asia.

    PubMed

    Shafie, Asrul Akmal; Chaiyakunapruk, Nathorn; Supian, Azuwana; Lim, Jeremy; Zafra, Matt; Hassali, Mohamed Azmi Ahmad

    2016-08-02

    Rare diseases, also referred to as orphan diseases, are characterised by their low prevalence with majority of them are chronically debilitating and life threatening. Given the low prevalence and the widely dispersed but very small patient base for each disease, there may often be a disproportion in the availability of treatments and resources to manage patients, spur research and train experts. This is especially true in Southeast Asian countries that are currently in the process of implementing or revising their universal health coverage schemes. This paper aims to examine the status of rare disease management in Southeast Asian countries. It will serve as the basis for a more active discussion on how countries in the region can address an under-recognised rare disease burden and enhance national and regional capacities. The study consists of literature reviews and key stakeholders interviews in six focus countries, including the Philippines, Singapore, Malaysia, Indonesia, Vietnam, and Thailand and five countries as best practice, comprising of France, Canada, Australia, Taiwan, and South Korea. Rare disease management initiatives across each country were examined based on the World Health Organization's framework for action in strengthening health systems. The results suggest rare disease management remains challenging across Southeast Asia, as many of the focus countries face fundamental issues from basic healthcare systems to funding. Nonetheless, there are substantial improvement opportunities, including leveraging best practices from around the world and organising a multi-stakeholder and regional approach and strategy. Southeast Asian countries have made significant progress in the management of rare disease, but there remain key areas for substantial development opportunities.

  15. Selection strategies for newly registered blood donors in European countries

    PubMed Central

    Lieshout-Krikke, Ryanne W.; Domanovic, Dragoslav; de Kort, Wim; Mayr, Wolfgang; Liumbruno, Giancarlo M.; Pupella, Simonetta; Kurz, Johann; Knutson, Folke; MacLennan, Sheila; Folléa, Gilles

    2017-01-01

    Background Two selection strategies for newly-registered blood donors are available: a single-visit selection called the standard selection procedure (SSP), and a two-stage selection named predonation and donation screening (PDS). This study reviews the selection strategies for newly-registered donors currently applied in European countries. Material and methods We collected data on donor selection procedures, blood donation, laboratory screening and HIV, HCV and HBV positive donors/donations from 2010 to 2013 in 30 European countries by using questionnaires. We grouped the countries according to the applied selection strategy, and for each country, we calculated the 4-year prevalence of confirmed positive results indicating the presence of overall and recent HIV, HCV and HBV infections among first-time and repeat donations and among newly-registered donors. Results Most of the 24 countries (80%) apply the SSP strategy for selection of newly-registered donors. Twenty-two countries (73.3%) employ a nucleic acid amplification testing in addition to the mandatory serological screening. The survey confirms a higher overall prevalence of HIV, HCV and HBV infections among first-time donations and newly-registered donors than among repeat donations. In contrast, the prevalence of recently acquired HIV and HCV infections was lower among first-time donations and newly-registered donors than among repeat donations, but higher for recent HBV infections (6.7/105 vs 2.6/105 in the SSP setting and 4.3/105 vs 0.5/105 in one country using PDS). The relatively low numbers of infected donors selected by PDS impeded accurate assessment of the prevalence of recent infections in first-time donations. Discussion The data from European countries provide inconclusive evidence that applying PDS reduces the risk of donations being made in the diagnostic window of first-time donors. The impact of PDS on the risk of window-period donations and blood donor management needs further

  16. Work-site hypertension prevalence and control in three Central European Countries.

    PubMed

    Fodor, J G; Lietava, J; Rieder, A; Sonkodi, S; Stokes, H; Emmons, T; Turton, P

    2004-08-01

    Compared to Austria, cerebrovascular stroke (CVS) mortality is three times higher in Hungary, and twice as high in Slovakia. We hypothesized that this is due to better treatment and control of hypertension in Austria. To test this hypothesis, we carried out a cross-sectional survey of 'blue collar' employees on work sites in each of these countries. Blood pressure screening was carried out at three work sites in Austria, one in Hungary and one in Slovakia. A standardized protocol was followed in each of these countries. The Bp-TRU(TM) measuring instrument was used to provide accurate reproducible readings and eliminate interobserver error. After the exclusion of missing data and women, the study population included 323 males screened in Austria, 600 in Hungary, and 751 in Slovakia. The mean ages of the respondents ranged from 35 to 42 years. The prevalence of hypertension was 29% in Austria, 28% in Hungary and 40% in Slovakia. Of those identified as hypertensive, 73% in Austria, 45% in Hungary and 67% in Slovakia were newly diagnosed as a result of this screening. Of those treated for hypertension, 10% in Austria, 15% in Hungary and 5% in Slovakia were controlled. The differences in CVS mortality cannot be explained by better control of hypertension in Austria but indicate the involvement of other determinants.

  17. Prevalence of postpartum depression and interventions utilized for its management.

    PubMed

    Anokye, Reindolf; Acheampong, Enoch; Budu-Ainooson, Amy; Obeng, Edmund Isaac; Akwasi, Adjei Gyimah

    2018-01-01

    Postpartum depression is a mood disorder that affects approximately 10-15% of adult mothers yearly. This study sought to determine the prevalence of postpartum depression and interventions utilized for its management in a Health facility in Ghana. A descriptive cross-sectional study design using a quantitative approach was used for the study. The study population included mothers and healthcare workers. Simple random sampling technique was used to select 257 mothers, while a convenience sampling technique was used to select 56 health workers for the study. A Patient Health Questionnaire was used to screen for depression and a structured questionnaire comprising closed-ended questions was used to collect primary data on the interventions for the management of postpartum depression. Data were analyzed using statistical software SPSS version 16.0. Postpartum depression was prevalent among 7% of all mothers selected. The severity ranged from minimal depression to severe depression. Psychosocial support proved to be the most effective intervention ( p  = 0.001) that has been used by the healthcare workers to reduce depressive symptoms. Postpartum depression is prevalent among mothers although at a lower rate and psychosocial support has been the most effective intervention in its management. Postpartum depression may affect socialization behaviors in children and the mother, and it may lead to thoughts of failure leading to deeper depression. Frequent screening exercises for postpartum depression should be organized by authorities of the hospitals in conjunction with the Ministry of Health.

  18. Group assessment of key indicators of sustainable waste management in developing countries.

    PubMed

    Tot, Bojana; Vujić, Goran; Srđević, Zorica; Ubavin, Dejan; Russo, Mário Augusto Tavares

    2017-09-01

    Decision makers in developing countries are struggling to solve the present problems of solid waste management. Prioritisation and ranking of the most important indicators that influence the waste management system is very useful for any decision maker for the future planning and implementation of a sustainable waste management system. The aim of this study is to evaluate key indicators and their related sub-indicators in a group decision-making environment. In order to gain insight into the subject it was necessary to obtain the qualified opinions of decision makers from different countries who understand the situation in the sector of waste management in developing countries. An assessment is performed by 43 decision makers from both developed and developing countries, and the applied methodology is based on a combined use of the analytic hierarchy process, from the multi-criteria decision-making set of tools, and the preferential voting method known as Borda Count, which belongs to social choice theory. Pairwise comparison of indicators is performed with the analytic hierarchy process, and the ranking of indicators once obtained is assessed with Borda Count. Detailed analysis of the final results showed that the Institutional-Administrative indicator was the most important one, with the maximum weight as derived by both groups of decision makers. The results also showed that the combined use of the analytic hierarchy process and Borda Count contributes to the credibility and objectivity of the decision-making process, allowing its use in more complex waste management group decision-making problems to be recommended.

  19. Prevalence and Determinants of Repeat Mammography Among Women from a Developing Country.

    PubMed

    Salinas-Martínez, Ana María; Gaspar-Rivera, Jimena Estefanía; Juárez-Pérez, Oscar; Montañez-Sauceda, José Roberto; Núñez-Rocha, Georgina Mayela; Guzmán-de-la-Garza, Francisco Javier; Mathiew-Quirós, Álvaro

    2017-04-01

    Failures in repeat mammography decrease the potential benefits of screening; however, it is notable that the recent use of mammography is more frequently studied than repeat use. We estimated the prevalence and analyzed determinants for repeat mammography among women from Mexico, a developing country of Latin America. It was a two-stage study with an initial cross-sectional design (n = 1045) and a final case-control design that involved women of at least 45 years of age with no history of breast, ovarian, or uterine cancer. Case subjects were those with three or more mammograms in the last 5 years, with the last one carried out within the last two years (n = 444); control subjects included those who underwent ≥3 mammograms throughout their life with the most recent carried out >2 years ago (n = 444). Through interviews, we evaluated context-dependency, fulfillment of expected outcomes, self-efficacy, and risk perception, among other factors. We estimated the prevalence with 95 % confidence intervals (CI), and odds ratios (OR) using multivariate binary logistic regression. The prevalence of repeat mammography was 40.4 % (95 % CI 37.4-43.4). Self-efficacy demonstrated the highest effect on repeat use (OR 7.7, 95 % CI 4.7-12.6), followed by awareness context-dependency (OR 4.9, 95 % CI 3.3-7.2), the use of Papanicolaou testing (OR 3.5, 95 % CI 2.3-5.2), the fulfillment of expected waiting time outcome (OR 2.4, 95 % CI 1.2-4.7), and context-dependency related to self-referral/health provider referral (OR 2.4, 95 % CI 1.7-3.4), independent of risk perception, age, education, and positive emotional state of mind. The study showed a need for increasing the prevalence of promoting awareness of the determining factors of repeat mammography, which is a necessary component in the early detection of breast cancer.

  20. Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

    PubMed Central

    2010-01-01

    Background The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. Methods A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living (ADL) using the Barthel Index (ten items). To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking) and five basic ADL's (eating, bathing, dressing, transferring and toileting). Results Ten, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9), 14.4% (95% CI 11.9-17.2) and 10.6% (95% CI 8.5-13.1), respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5) of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (≥ 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), stroke (PR 1.5; 95% CI 1.1-2.2), depressive symptomology (PR 1.3; 95% CI 1.1-1.8) and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6). Advancing age (≥ 75 years: PR 3.0; 95% CI 1.7-5.2) being female (PR 2.7; 95% CI 1.2-6.1), presence of arthritis (PR 1.6; 95% CI 1.2-2.1) and depressive symptomology (PR 2.0; 95% CI 1.5-2.7) were significantly associated with functional limitation. Conclusions The prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to developing

  1. Cardiovascular disease risk factors: prevalence and management in adult hemophilia patients.

    PubMed

    Lim, Ming Y; Pruthi, Rajiv K

    2011-07-01

    With increasing longevity, the prevalence of cardiovascular disease (CVD) risk factors in hemophilia patients is expected to increase; however, evidence-based guidelines on management are lacking. The aim of the study was to determine the prevalence and management of CVD risk factors in hemophilia patients. A retrospective study of 58 adult hemophilia patients (≥35 years) attending Mayo Comprehensive Hemophilia Center between 1 January 2006 and 15 October 2009 were reviewed. The prevalence of CVD risk factors was hypertension 65.5%, diabetes 10.3%, smoking 12.5% and obesity 19.6%. A total of 31% did not have a lipid profile on record. Management of risk factors included antihypertensive medications in 84.2% and lipid-lowering agents in 12.1%. During their medical evaluation, four of seven active smokers received smoking cessation counseling and four of 11 obese patients received lifestyle modification advice. Eight patients (13.8%) experienced a CVD event: myocardial infarction (MI) (n=3), coronary artery disease (n=2), both MI and ischemic stroke (n=1) and hemorrhagic strokes (n=2). Only five of eight patients were on low-dose aspirin, of which aspirin was discontinued in one patient after he was diagnosed with hemophilia following a bleeding work-up. Another patient on dual antiplatelet therapy post stent placement developed epistaxis resulting in clopidogrel cessation. Hemophilia patients are at risk for CVD, similar to the general age-matched male population. Screening for CVD risk factors, with preventive dietary and pharmacologic interventions, play a key role in the prevention and long-term management of CVD. Collaborative efforts between primary care providers, cardiologists and hemophilia center specialists remain essential in managing these complex patients.

  2. Reasons for discrepancy between incidence and prevalence of epilepsy in lower income countries: Epilepsia's survey results.

    PubMed

    Mathern, Gary W; Beninsig, Laurie; Nehlig, Astrid

    2015-02-01

    From July to August 2014, Epilepsia conducted an online survey seeking opinions that explained the discrepancy between the incidence and prevalence of epilepsy in lower income countries. Data on cumulative incidence suggest a higher rate of active epilepsy than reported in lifetime prevalence surveys. This study reports the findings of that poll addressing the proposal in our Controversy in Epilepsy series that it could be from increased death rates. The survey consisted of a question addressing possible reasons to explain the discrepancy between the incidence and prevalence of epilepsy. Another four questions addressed demographic information. There were 34 responders who completed the survey. Half (50%) of the responders felt that the discrepancy between cumulative incidence and lifetime prevalence was due to lack of uniform definitions and misclassification of patients in study design, 23.5% said the discrepancy was due to a higher mortality from diseases and conditions such as trauma and infections associated with epilepsy, 23.5% indicated that the stigma of epilepsy prevented people from acknowledging their disease in prevalence surveys, and 2.9% felt it was from poor access to qualified medical personal and utilization of medical treatments that increased death rates directly related to epilepsy. Within the limitations of sample size, the results of this survey support that the discrepancy between the incidence and prevalence of epilepsy in lower income regions of the world is due to problems in acquiring the data and stigma rather than higher mortality from diseases associated with epilepsy and repeated seizures. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  3. Economic and Health Predictors of National Postpartum Depression Prevalence: A Systematic Review, Meta-analysis, and Meta-Regression of 291 Studies from 56 Countries.

    PubMed

    Hahn-Holbrook, Jennifer; Cornwell-Hinrichs, Taylor; Anaya, Itzel

    2017-01-01

    Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence. We conducted a systematic review of all papers reporting PPD prevalence using the Edinburgh Postnatal Depression Scale. PPD prevalence and methods were extracted from each study. Random effects meta-analysis was used to estimate global and national PPD prevalence. To test for country level predictors, we drew on data from UNICEF, WHO, and the World Bank. Random effects meta-regression was used to test national predictors of PPD prevalence. 291 studies of 296284 women from 56 countries were identified. The global pooled prevalence of PPD was 17.7% (95% confidence interval: 16.6-18.8%), with significant heterogeneity across nations ( Q  = 16,823, p  = 0.000, I 2  = 98%), ranging from 3% (2-5%) in Singapore to 38% (35-41%) in Chile. Nations with significantly higher rates of income inequality ( R 2  = 41%), maternal mortality ( R 2  = 19%), infant mortality ( R 2  = 16%), or women of childbearing age working ≥40 h a week ( R 2  = 31%) have higher rates of PPD. Together, these factors explain 73% of the national variation in PPD prevalence. The global prevalence of PPD is greater than previously thought and varies dramatically by nation. Disparities in wealth inequality and maternal-child-health factors explain much of the national variation in PPD prevalence.

  4. Obesity in Arabic-Speaking Countries

    PubMed Central

    Badran, Mohammad; Laher, Ismail

    2011-01-01

    Obesity has reached epidemic proportions throughout the globe, and this has also impacted people of the Arabic-speaking countries, especially those in higher-income, oil-producing countries. The prevalence of obesity in children and adolescents ranges from 5% to 14% in males and from 3% to 18% in females. There is a significant increase in the incidence of obesity with a prevalence of 2%–55% in adult females and 1%–30% in adult males. Changes in food consumption, socioeconomic and demographic factors, physical activity, and multiple pregnancies may be important factors that contribute to the increased prevalence of obesity engulfing the Arabic-speaking countries. PMID:22175002

  5. Effect of the Prevalence of HIV/AIDS and the Life Expectancy Rate on Economic Growth in SSA Countries: Difference GMM Approach.

    PubMed

    Waziri, Salisu Ibrahim; Mohamed Nor, Norashidah; Raja Abdullah, Nik Mustapha; Adamu, Peter

    2015-09-01

    The productivity of countries around the globe is adversely affected by the health-related problems of their labour force. This study examined the effect of the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and life expectancy on the economic growth of 33 Sub-Saharan African (SSA) countries over a period of 11 years (2002-2012). The study employed a dynamic panel approach as opposed to the static traditional approach utilised in the literature. The dynamic approach became eminent because of the fact that HIV/AIDS is a dynamic variable as its prevalence today depends on the previous years. The result revealed that HIV/AIDS is negatively correlated with economic growth in the region, with a coefficient of 0.014, and significant at the 1% level. That is, a 10% increase in HIV/AIDS prevalence leads to a 0.14% decrease in the GDP of the region. Tackling HIV/AIDS is therefore imperative to the developing Sub-Saharan African region and all hands must be on deck to end the menace globally.

  6. Effect of the Prevalence of HIV/AIDS and the Life Expectancy Rate on Economic Growth in SSA Countries: Difference GMM Approach

    PubMed Central

    Waziri, Salisu Ibrahim; Nor, Norashidah Mohamed; Abdullah, Nik Mustapha Raja; Adamu, Peter

    2016-01-01

    The productivity of countries around the globe is adversely affected by the health-related problems of their labour force. This study examined the effect of the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and life expectancy on the economic growth of 33 Sub-Saharan African (SSA) countries over a period of 11 years (2002–2012). The study employed a dynamic panel approach as opposed to the static traditional approach utilised in the literature. The dynamic approach became eminent because of the fact that HIV/AIDS is a dynamic variable as its prevalence today depends on the previous years. The result revealed that HIV/AIDS is negatively correlated with economic growth in the region, with a coefficient of 0.014, and significant at the 1% level. That is, a 10% increase in HIV/AIDS prevalence leads to a 0.14% decrease in the GDP of the region. Tackling HIV/AIDS is therefore imperative to the developing Sub-Saharan African region and all hands must be on deck to end the menace globally. PMID:26573032

  7. The situation of waste mobile phone management in developed countries and development status in China.

    PubMed

    Xu, Chengjian; Zhang, Wenxuan; He, Wenzhi; Li, Guangming; Huang, Juwen

    2016-12-01

    With the rapid development of electronic industry and improvement of living standards, a large number of waste mobile phones were generated. According to statistics, approximately 400million waste mobile phones are generated each year in the world, and 25% of that are contributed by China. Irregular disposal of waste mobile phones will do great harm to environment and human health, while at the same time recycling of them has the potential for high profits. Given the enormous quantity, great harm and resource properties, developed countries have taken necessary measures to manage waste mobile phones. As the largest developing country, China has also set out to pay close attention to waste mobile phones. This paper reviewed the situation ofwaste mobile phone management in the developed countries, focused on the development of waste mobile phone management in China, and analyzed existing problems. In light of the successful experience of the developed countries, some suggestions were proposed to promote the waste mobile phone management in China and worked as a valuable reference for other countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Prevalence of Anti-Tuberculosis Drug Resistance in Foreign-Born Tuberculosis Cases in the U.S. and in Their Countries of Origin

    PubMed Central

    Taylor, Allison B.; Kurbatova, Ekaterina V.; Cegielski, J. Peter

    2012-01-01

    Background Foreign-born individuals comprise >50% of tuberculosis (TB) cases in the U.S. Since anti-TB drug resistance is more common in most other countries, when evaluating a foreign-born individual for TB, one must consider the risk of drug resistance. Naturally, clinicians query The Global Project on Anti-tuberculosis Drug Resistance Surveillance (Global DRS) which provides population-based data on the prevalence of anti-TB drug resistance in 127 countries starting in 1994. However, foreign-born persons in the U.S. are a biased sample of the population of their countries of origin, and Global DRS data may not accurately predict their risk of drug resistance. Since implementing drug resistance surveillance in 1993, the U.S. National TB Surveillance System (NTSS) has accumulated systematic data on over 130,000 foreign-born TB cases from more than 200 countries and territories. Our objective was to determine whether the prevalence of drug resistance among foreign-born TB cases correlates better with data from the Global DRS or with data on foreign-born TB cases in the NTSS. Methods and Findings We compared the prevalence of resistance to isoniazid and rifampin among foreign-born TB cases in the U.S., 2007–2009, with US NTSS data from 1993 to 2006 and with Global DRS data from 1994–2007 visually with scatterplots and statistically with correlation and linear regression analyses. Among foreign-born TB cases in the U.S., 2007–2009, the prevalence of isoniazid resistance and multidrug resistance (MDR, i.e. resistance to isoniazid and rifampin), correlated much better with 1993–2006 US surveillance data (isoniazid: r = 0.95, P<.001, MDR: r = 0.75, P<.001) than with Global DRS data, 1994–2007 (isoniazid: r = 0.55, P = .001; MDR: r = 0.50, P<.001). Conclusion Since 1993, the US NTSS has accumulated sufficient data on foreign-born TB cases to estimate the risk of drug resistance among such individuals better than data from the Global DRS

  9. Management of waste electrical and electronic equipment in two EU countries: A comparison

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Torretta, Vincenzo, E-mail: vincenzo.torretta@uninsubria.it; Ragazzi, Marco; Istrate, Irina Aura

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer Review on data regarding WEEE management in Italy and in Romania. Black-Right-Pointing-Pointer Problems that countries that will enter in the EU will have to solve facing with the WEEE management. Black-Right-Pointing-Pointer Pilot experiences useful for the awareness campaign of the population. - Abstract: The paper presents some data regarding waste electrical and electronic (WEEE) management in one of the founding countries of the EU, Italy, and in a recent entry into the EU, Romania. The aim of this research was to analyze some problems that countries entering the EU will have to solve with respect to WEEE management.more » The experiences of Italy and Romania could provide an interesting reference point. The strengths and weaknesses that the two EU countries have encountered can be used in order to give a more rational plan for other countries. In Italy the increase of WEEE collection was achieved in parallel with the increase of the efficiency of selective Municipal Solid Waste collection. In Romania, pilot experiences were useful to increase the awareness of the population. The different interests of the two populations towards recyclable waste led to a different scenario: in Romania all types of WEEE have been collected since its entrance into the EU; in Italy the 'interest' in recycling is typically related to large household appliances, with a secondary role of lighting equipment.« less

  10. Resource availability for the management of maternal sepsis in Malawi, other low-income countries, and lower-middle-income countries.

    PubMed

    Abdu, Mohammed; Wilson, Amie; Mhango, Chisale; Taki, Fatima; Coomarasamy, Arri; Lissauer, David

    2018-02-01

    To assess the availability of key resources for the management of maternal sepsis and evaluate the feasibility of implementing the Surviving Sepsis Campaign (SSC) recommendations in Malawi and other low-resource settings. A cross-sectional study was conducted at health facilities in Malawi, other low-income countries, and lower-middle-income countries during January-March 2016. English-speaking healthcare professionals (e.g. doctors, nurses, midwives, and administrators) completed a questionnaire/online survey to assess the availability of resources for the management of maternal sepsis. Healthcare centers (n=23) and hospitals (n=13) in Malawi showed shortages in the resources for basic monitoring (always available in 5 [21.7%] and 10 [76.9%] facilities, respectively) and basic infrastructure (2 [8.7%] and 7 [53.8%], respectively). The availability of antibiotics varied between Malawian healthcare centers (9 [39.1%]), Malawian hospitals (8 [61.5%]), hospitals in other low-income countries (10/17 [58.8%]), and hospitals in lower-middle-income countries (39/41 [95.1%]). The percentage of SSC recommendations that could be implemented was 33.3% at hospitals in Malawi, 30.3% at hospitals in other low-income countries, and 68.2% at hospitals in lower-middle-income countries. The implementation of existing SSC recommendations is unrealistic in low-income countries because of resource limitations. New maternal sepsis care bundles must be developed that are applicable to low-resource settings. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  11. Obstacles to integrated pest management adoption in developing countries

    PubMed Central

    Parsa, Soroush; Morse, Stephen; Bonifacio, Alejandro; Chancellor, Timothy C. B.; Condori, Bruno; Crespo-Pérez, Verónica; Hobbs, Shaun L. A.; Kroschel, Jürgen; Ba, Malick N.; Rebaudo, François; Sherwood, Stephen G.; Vanek, Steven J.; Faye, Emile; Herrera, Mario A.; Dangles, Olivier

    2014-01-01

    Despite its theoretical prominence and sound principles, integrated pest management (IPM) continues to suffer from anemic adoption rates in developing countries. To shed light on the reasons, we surveyed the opinions of a large and diverse pool of IPM professionals and practitioners from 96 countries by using structured concept mapping. The first phase of this method elicited 413 open-ended responses on perceived obstacles to IPM. Analysis of responses revealed 51 unique statements on obstacles, the most frequent of which was “insufficient training and technical support to farmers.” Cluster analyses, based on participant opinions, grouped these unique statements into six themes: research weaknesses, outreach weaknesses, IPM weaknesses, farmer weaknesses, pesticide industry interference, and weak adoption incentives. Subsequently, 163 participants rated the obstacles expressed in the 51 unique statements according to importance and remediation difficulty. Respondents from developing countries and high-income countries rated the obstacles differently. As a group, developing-country respondents rated “IPM requires collective action within a farming community” as their top obstacle to IPM adoption. Respondents from high-income countries prioritized instead the “shortage of well-qualified IPM experts and extensionists.” Differential prioritization was also evident among developing-country regions, and when obstacle statements were grouped into themes. Results highlighted the need to improve the participation of stakeholders from developing countries in the IPM adoption debate, and also to situate the debate within specific regional contexts. PMID:24567400

  12. Cost-effectiveness analysis of revised WHO guidelines for management of childhood pneumonia in 74 Countdown countries.

    PubMed

    Zhang, Shanshan; Incardona, Beatrice; Qazi, Shamim A; Stenberg, Karin; Campbell, Harry; Nair, Harish

    2017-06-01

    Treatment of childhood pneumonia is a key priority in low-income countries, with substantial resource implications. WHO revised their guidelines for the management of childhood pneumonia in 2013. We estimated and compared the resource requirements, total direct medical cost and cost-effectiveness of childhood pneumonia management in 74 countries with high burden of child mortality (Countdown countries) using the 2005 and 2013 revised WHO guidelines. We constructed a cost model using a bottom up approach to estimate the cost of childhood pneumonia management using the 2005 and 2013 WHO guidelines from a public provider perspective in 74 Countdown countries. The cost of pneumonia treatment was estimated, by country, for year 2013, including costs of medicines and service delivery at three different management levels. We also assessed country-specific lives saved and disability adjusted life years (DALYs) averted due to pneumonia treated in children aged below five years. The cost-effectiveness of pneumonia treatment was estimated in terms of cost per DALY averted by fully implementing WHO treatment guidelines relative to no treatment intervention for pneumonia. Achieving full treatment coverage with the 2005 WHO guidelines was estimated to cost US$ 2.9 (1.9-4.2) billion compared to an estimated US$ 1.8 (0.8-3.0) billion for the revised 2013 WHO guidelines in these countries. Pneumonia management in young children following WHO treatment guidelines could save up to 39.8 million DALYs compared to a zero coverage scenario in the year 2013 in the 74 Countdown countries. The median cost-effectiveness ratio per DALY averted in 74 countries was substantially lower for the 2013 guidelines: US$ 26.6 (interquartile range IQR: 17.7-45.9) vs US$ 38.3 (IQR: US$ 26.2-86.9) per DALY averted for the 2005 guideline respectively. Child pneumonia management as detailed in standard WHO guidelines is a very cost-effective intervention. Implementation of the 2013 WHO guidelines is

  13. Prevalence of thoracic surgical care need in a developing country: results of a cluster-randomized, cross-sectional nationwide survey.

    PubMed

    Zogg, Cheryl K; Kamara, Thaim B; Groen, Reinou S; Mungo, Benedetto; Kushner, Adam L; Molena, Daniela

    2015-01-01

    Developing countries without established surgical capacity face heightened morbidity and mortality from poorly understood, untreated thoracic surgical impairments. This study sought to estimate the prevalence of thoracic surgical need in a low-income country and consider contributing factors involved. Cluster-randomized, cross-sectional nationwide survey using the Surgeons OverSeas Assessment of Surgical Need tool in Sierra Leone from January 9-February 3, 2012. Data were collected and analyzed from 3645 respondents (response rate 98.3%). 273 (7.5%) reported ≥1 chest (including heart, lungs, and mediastinum) or breast surgical problem during their lifetime; 268 (7.4%) reported ≥1 back complaint. Multiple problems could be reported, resulting in a total of 277 chest/breast and 268 back complaints. The majority (184/545) were related to acquired deformities. Most occurred ≥12 months ago (364/545) and continued to impact the participant at the time of the interview (339/545). 322/545 sought care; however, 40% (130/322) did not receive care, predominately due to an inability to pay. Adjusted logistic regression found that chest/breast problems were more common among farm workers, older participants, and individuals with minimal education, while back problems were more common in the same groups and males. The study provides data on the prevalence of thoracic surgical conditions and factors affecting prevalence in one of the world's poorest countries. The results speak to the need for further work to enhance health systems strengthening while offering the opportunity for future training and research in resource-limited settings--an area of thoracic surgery that is not well understood. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Challenges of Human Papillomavirus Infection and Associated Diseases in Low-Resource Countries.

    PubMed

    Nweke, Michael Chukwugoziem; Okolo, Clement Abu; Daous, Yara; Esan, Olukemi Ayotunde

    2018-06-01

    - The prevalence of human papillomavirus (HPV) infection varies worldwide. The high-risk viruses are usually associated with cancers of the cervix, vagina, and vulva in women, cancer of the penis in men, and cancers of the anus, tonsils, oropharynx, and base of the tongue in both sexes. - To review literature about the challenges and burden associated with HPV infection in low-resource (ie, developing) countries, focusing on sub-Saharan Africa. To review the prevention, incidence, prevalence, morbidity, and mortality of HPV infections in sub-Saharan Africa. To review the therapy and management of HPV infections in low-resource countries in comparison to developed countries. - Peer-reviewed literature and experience of some of the authors. - Sub-Saharan Africa has high HPV infection prevalence rates, with predominance of high-risk subtypes 16, 18, and 45. The difficulty of access to health care has led to higher morbidity and mortality related to HPV-related cancers. Improvement in screening programs will help in monitoring the spread of HPV infections. Survival studies can be more informative if reliable cancer registries are improved. HPV vaccination is not yet widely available and this may be the key to curtailing the spread of HPV infections in resource-poor countries.

  15. A systematic review and meta-analysis on the prevalence of Dupuytren disease in the general population of Western countries.

    PubMed

    Lanting, Rosanne; Broekstra, Dieuwke C; Werker, Paul M N; van den Heuvel, Edwin R

    2014-03-01

    Dupuytren disease is a fibroproliferative disease of palmar fascia of the hand. Its prevalence has been the subject of several reviews; however, an accurate description of the prevalence range in the general population--and of the relation between age and disease--is lacking. Embase and PubMed were searched using database-specific Medical Subject Headings; titles and abstracts were searched for the words "Dupuytren," "incidence," and "prevalence." Two reviewers independently assessed the articles using inclusion and exclusion criteria, and rated the included studies with a quality assessment instrument. In a meta-analysis, the median prevalence, as a function of age by sex, was estimated, accompanied by 95 percent prediction intervals. The observed heterogeneity in prevalence was investigated with respect to study quality and geographic location. Twenty-three of 199 unique identified articles were included. The number of participants ranged from 37 to 97,537, and age ranged from 18 to 100 years. Prevalence varied from 0.6 to 31.6 percent. The quality of studies differed but could not explain the heterogeneity among studies. Mean prevalence was estimated as 12, 21, and 29 percent at ages 55, 65, and 75 years, respectively, based on the relation between age and prevalence determined from 10 studies. The authors describe a prevalence range of Dupuytren disease in the general population of Western countries. The relation between age and prevalence of Dupuytren disease is given according to sex, including 95 percent prediction intervals. It is possible to determine disease prevalence at a certain age for the total population, and for men and women separately.

  16. G6PD deficiency prevalence and estimates of affected populations in malaria endemic countries: a geostatistical model-based map.

    PubMed

    Howes, Rosalind E; Piel, Frédéric B; Patil, Anand P; Nyangiri, Oscar A; Gething, Peter W; Dewi, Mewahyu; Hogg, Mariana M; Battle, Katherine E; Padilla, Carmencita D; Baird, J Kevin; Hay, Simon I

    2012-01-01

    Primaquine is a key drug for malaria elimination. In addition to being the only drug active against the dormant relapsing forms of Plasmodium vivax, primaquine is the sole effective treatment of infectious P. falciparum gametocytes, and may interrupt transmission and help contain the spread of artemisinin resistance. However, primaquine can trigger haemolysis in patients with a deficiency in glucose-6-phosphate dehydrogenase (G6PDd). Poor information is available about the distribution of individuals at risk of primaquine-induced haemolysis. We present a continuous evidence-based prevalence map of G6PDd and estimates of affected populations, together with a national index of relative haemolytic risk. Representative community surveys of phenotypic G6PDd prevalence were identified for 1,734 spatially unique sites. These surveys formed the evidence-base for a Bayesian geostatistical model adapted to the gene's X-linked inheritance, which predicted a G6PDd allele frequency map across malaria endemic countries (MECs) and generated population-weighted estimates of affected populations. Highest median prevalence (peaking at 32.5%) was predicted across sub-Saharan Africa and the Arabian Peninsula. Although G6PDd prevalence was generally lower across central and southeast Asia, rarely exceeding 20%, the majority of G6PDd individuals (67.5% median estimate) were from Asian countries. We estimated a G6PDd allele frequency of 8.0% (interquartile range: 7.4-8.8) across MECs, and 5.3% (4.4-6.7) within malaria-eliminating countries. The reliability of the map is contingent on the underlying data informing the model; population heterogeneity can only be represented by the available surveys, and important weaknesses exist in the map across data-sparse regions. Uncertainty metrics are used to quantify some aspects of these limitations in the map. Finally, we assembled a database of G6PDd variant occurrences to inform a national-level index of relative G6PDd haemolytic risk. Asian

  17. Are cannabis prevalence estimates comparable across countries and regions? A cross-cultural validation using search engine query data.

    PubMed

    Steppan, Martin; Kraus, Ludwig; Piontek, Daniela; Siciliano, Valeria

    2013-01-01

    Prevalence estimation of cannabis use is usually based on self-report data. Although there is evidence on the reliability of this data source, its cross-cultural validity is still a major concern. External objective criteria are needed for this purpose. In this study, cannabis-related search engine query data are used as an external criterion. Data on cannabis use were taken from the 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD). Provincial data came from three Italian nation-wide studies using the same methodology (2006-2008; ESPAD-Italia). Information on cannabis-related search engine query data was based on Google search volume indices (GSI). (1) Reliability analysis was conducted for GSI. (2) Latent measurement models of "true" cannabis prevalence were tested using perceived availability, web-based cannabis searches and self-reported prevalence as indicators. (3) Structure models were set up to test the influences of response tendencies and geographical position (latitude, longitude). In order to test the stability of the models, analyses were conducted on country level (Europe, US) and on provincial level in Italy. Cannabis-related GSI were found to be highly reliable and constant over time. The overall measurement model was highly significant in both data sets. On country level, no significant effects of response bias indicators and geographical position on perceived availability, web-based cannabis searches and self-reported prevalence were found. On provincial level, latitude had a significant positive effect on availability indicating that perceived availability of cannabis in northern Italy was higher than expected from the other indicators. Although GSI showed weaker associations with cannabis use than perceived availability, the findings underline the external validity and usefulness of search engine query data as external criteria. The findings suggest an acceptable relative comparability of national (provincial) prevalence

  18. Prevalence of Nutrition and Health-Related Claims on Pre-Packaged Foods: A Five-Country Study in Europe.

    PubMed

    Hieke, Sophie; Kuljanic, Nera; Pravst, Igor; Miklavec, Krista; Kaur, Asha; Brown, Kerry A; Egan, Bernadette M; Pfeifer, Katja; Gracia, Azucena; Rayner, Mike

    2016-03-03

    This study is part of the research undertaken in the EU funded project CLYMBOL ("Role of health-related CLaims and sYMBOLs in consumer behaviour"). The first phase of this project consisted of mapping the prevalence of symbolic and non-symbolic nutrition and health-related claims (NHC) on foods and non-alcoholic beverages in five European countries. Pre-packaged foods and drinks were sampled based on a standardized sampling protocol, using store lists or a store floor plan. Data collection took place across five countries, in three types of stores. A total of 2034 foods and drinks were sampled and packaging information was analyzed. At least one claim was identified for 26% (95% CI (24.0%-27.9%)) of all foods and drinks sampled. Six percent of these claims were symbolic. The majority of the claims were nutrition claims (64%), followed by health claims (29%) and health-related ingredient claims (6%). The most common health claims were nutrient and other function claims (47% of all claims), followed by disease risk reduction claims (5%). Eight percent of the health claims were children's development and health claims but these were only observed on less than 1% (0.4%-1.1%) of the foods. The category of foods for specific dietary use had the highest proportion of NHC (70% of foods carried a claim). The prevalence of symbolic and non-symbolic NHC varies across European countries and between different food categories. This study provides baseline data for policy makers and the food industry to monitor and evaluate the use of claims on food packaging.

  19. Socioeconomic status is associated with global diabetes prevalence.

    PubMed

    Xu, Zhiye; Yu, Dan; Yin, Xueyao; Zheng, Fenping; Li, Hong

    2017-07-04

    The incidence of diabetes is increasing globally. We investigated the relationship between diabetes prevalence and patient socioeconomic status across multiple countries. We searched PubMed to identify population-based surveys reporting diabetes prevalence between 1990 and May 2016. Search results were filtered, and Human Development Index (HDI) values from the United Nations Development Programme were used to assess socioeconomic status for a given nation. Our analysis included 45 national surveys from 32 countries. Diabetes prevalence was positively correlated with national HDI (r = 0.421 P = 0.041) in developing countries, and negatively correlated with HDI (r = -0.442 P = 0.045) in developed countries. Diabetes prevalence trends were the same in women and men, although men were associated with increased diabetes risk in developed countries (r = 0.459 P = 0.048). Thus, diabetes prevalence rises with increasing HDI in developing countries, and this is reversed in developed countries. Ours is the first study to investigate the relationship between diabetes and socioeconomic status at global level using HDI values. These results will aid in evaluating global diabetes prevalence and risk with respect to patient socioeconomic status, and will be useful in the development of policies that help reduce disease incidence.

  20. Food category consumption and obesity prevalence across countries: an application of Machine Learning method to big data analysis

    NASA Astrophysics Data System (ADS)

    Dunstan, Jocelyn; Fallah-Fini, Saeideh; Nau, Claudia; Glass, Thomas; Global Obesity Prevention Center Team

    The applications of sophisticated mathematical and numerical tools in public health has been demonstrated to be useful in predicting the outcome of public intervention as well as to study, for example, the main causes of obesity without doing experiments with the population. In this project we aim to understand which kind of food consumed in different countries over time best defines the rate of obesity in those countries. The use of Machine Learning is particularly useful because we do not need to create a hypothesis and test it with the data, but instead we learn from the data to find the groups of food that best describe the prevalence of obesity.

  1. Diabetes in Algeria and challenges for health policy: a literature review of prevalence, cost, management and outcomes of diabetes and its complications

    PubMed Central

    2014-01-01

    Background Diabetes has become an increasingly prevalent and severe public health issue in Algeria. This article investigates the prevalence, the cost and the management of this disease. Its first objective is to better understand the burden (both from an epidemiological and economic perspective) and management of diabetes. The second objective is to understand the health policy strategy adopted by Algeria in order to respond to the disease. Methods We conducted a literature review of prevalence, costs, management and outcomes of diabetes and its complications. This was complemented by data compilations and results of expert consultations. Results The epidemiology of diabetes is continually evolving and is becoming more problematic. The national evidence suggests that the prevalence of diabetes in Algeria has increased from 6.8% in 1990 to 12.29% in 2005, but is quite higher among certain groups and areas of the country. This disease affects all population groups, especially 35–70 year olds, who constitute a large segment of the working population. There are very few estimates of the cost of diabetes. These include a 1998 study on the total cost of type 1 diabetes (USD 11.6 million, which, inflated to 2013 value, totals to USD 16.6 million), a study on the cost of complications in 2010 (at 2013 value, ranging from USD 141 for first-year treatment of peripheral vascular disease to USD 30,441 for first-year cost of renal transplantation) and the 2013 IDF estimates of total cost of type 1 and type 2 diabetes (USD 513 million). Conclusions As the prevalence of diabetes continues to increase, the financial burden will increasingly weigh heavily on social security resources and the government budget. Future priorities must focus on empowering general practitioners in treating type 2 diabetes, improving screening of diabetes and its complications, tackling the growing obesity epidemic, strengthening health information systems and implementing the national diabetes

  2. Driving and diabetes mellitus in the Gulf Cooperation Council countries: Call for action.

    PubMed

    Hassoun, Ahmed A K; Abdella, Nabila; Arouj, Monira Al; Awadi, Fatehya Al; Futaisi, Abdullah Al; Lamki, Mohammed Al; Madani, Abdulrazzaq Al; Saber, Feryal Al; Nakhi, Abdallah Ben; Beshyah, Salem A; El-Ali, Samer; Fiad, Tarek M; Hussein, Wiam I; Kaddaha, Ghaida; Ksseiry, Iyad; Morcos, Bassem; Saadi, Hussein

    2015-10-01

    The aim of the present article is to increase awareness concerning safe driving for patients with diabetes in the Gulf Cooperation Council (GCC) countries and to provide recommendations concerning the management of these patients. The cognitive, motor, and sensory skills required for driving can be adversely affected by diabetes as well as the side effects of anti-diabetic medications, particularly hypoglycemia. The prevalence of diabetes in the GCC countries is among the highest in the world. As the number of diabetic drivers in these countries continues to increase, the number at risk of having a motor vehicle accident is also expected to increase. We reviewed the available literature concerning driving and diabetes, particularly in relation to the current situation in the GGC countries. Unfortunately, very little published information is available addressing this issue in the GCC countries. Most of the GCC countries lack legislation on driving and diabetes. We have proposed recommendations to help diabetic drivers in the GCC countries as well as to provide guidance to health care professionals managing these patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Dysmenorrhoea among Hong Kong university students: prevalence, impact, and management.

    PubMed

    Chia, C F; Lai, Joyce H Y; Cheung, P K; Kwong, L T; Lau, Fiona P M; Leung, K H; Leung, M T; Wong, Francis C H; Ngu, S F

    2013-06-01

    OBJECTIVE. To evaluate the prevalence of dysmenorrhoea, its impact, and management approaches in Hong Kong university students, and to compare between medical and non-medical students for any potential differences in coping strategies. DESIGN. Cross-sectional questionnaire survey. SETTING. The University of Hong Kong, Hong Kong. PARTICIPANTS. A total of 240 undergraduate (128 medical and 112 non-medical) students. MAIN OUTCOME MEASURES. Data on the presence and severity of dysmenorrhoea, its impact on daily life, management approaches, specific strategies, and their self-perceived effectiveness were obtained and analysed. RESULTS. In these subjects, the prevalence of dysmenorrhoea was 80% (95% confidence interval, 75-85%) with a mean (standard deviation) pain score of 5.0 (1.7). The most common impacts on daily life included reduced ability to concentrate and/or disturbance with study (75%) and changes in normal physical activity (60%). Only 6% sought medical advice, while 70% practised self-management. Pain scores and pain affecting normal physical activities were important predictive factors for self-management and for management based on pharmacological or non-pharmacological means. The commonest specific strategies used were a warm beverage (62%), paracetamol (57%), and sleeping (45%), while the most effective strategies were non-steroidal anti-inflammatory drugs (100%), traditional Chinese medicine (93%), and dietary/nutritional supplements (92%). Regarding the comparison of medical and non-medical students, the former used fewer pharmacological strategies among the various management approaches investigated. CONCLUSION. With data showing dysmenorrhoea as a very common condition having a significant impact in the Hong Kong community, primary care doctors should reassure young women with dysmenorrhoea that it is a common experience in the same age-group. Health education on the existence of effective treatment from medical practitioners could help women whose

  4. A study of postpartum depression in a fast developing country: prevalence and related factors.

    PubMed

    Bener, Abdulbari; Burgut, F Tuna; Ghuloum, Suheila; Sheikh, Javaid

    2012-01-01

    Depression is a common and disabling complication of postpartum women. There is a paucity of research on postpartum depressive disorders and their predictors in women from Arab countries. The aim of this study was to determine the prevalence and identify risk factors of postpartum depression among Arab women in Qatar using Edinburgh Postnatal Depression Scale Score (EPDS). This is a prospective cross-sectional study conducted during the period from January 2010 to May 2011. Primary healthcare centers of the Supreme Council of Health, State of Qatar. A representative sample of 1669 mothers within 6 months after delivery were approached and 1379 (82.6%) mothers participated in this study. The study was based on a face-to-face interview with a designed diagnostic screening questionnaire. Occurrence of postpartum depressive symptoms was assessed by the EPDS. Also, socio-demographic characteristics, medical and family history, and obstetric variables of patients were collected through a designed questionnaire. The diagnostic screening questionnaire was reviewed and calculated the final score which identified the risk cases. The prevalence of postpartum depression among the study sample was 17.6%. Mothers of age above 35 years (49.9% vs. 39.2%; p < 0 .001), low education below intermediate level (51% vs. 35.8%; p < 0.001), housewives (38.7% vs. 29%; p = 0.03), with low monthly income (QR 5000-9999) (43.2% vs. 32.2%; p < 0.001) were significantly at high risk for postpartum depression. Maternal complications (38.7% vs. 26.1%; p < 0.001) and caesarean section (36.2% vs. 28.8%; p = 0.022) were significantly higher among depressed mothers compared to non-depressed women. Financial difficulties (OR = 2.04; p < 0.001), prematurity (OR = 1.64; p = 0.025), poor family support (OR = 1.52; p = 0.016), dissatisfaction in marital life (OR = 1.26; p = 0.005), poor marital relationship (OR = 1.13; p = 0.05) were the main predictors of postpartum depression. This prevalence of

  5. Prevalence of Thinness in Adolescent Girls in Low- and Middle-Income Countries and Associations With Wealth, Food Security, and Inequality.

    PubMed

    Candler, Toby; Costa, Silvia; Heys, Michelle; Costello, Anthony; Viner, Russell M

    2017-04-01

    Adequate nutrition during adolescence is important for optimal physical and cognitive development and for pregnancy either during adolescence or later life. Thinness among adolescent girls in low- and middle-income countries has been little studied. We used body mass index data from 40 countries from the Global School Health Survey to estimate the prevalence of moderate and severe thinness in 12- to 18-year-olds using the World Health Organization 2007 growth reference. Self-report data on going to bed hungry were used as a proxy for household food insecurity. We used multilevel models to assess whether national wealth (gross domestic product), income inequality (Gini index), national gender inequality (Gender Inequality Index), and food security (Global Food Security Index) were associated with undernutrition. Prevalence rates of moderate and severe thinness across 61,603 girls from 40 countries were 6.30% (95% confidence interval [CI]: 5.71-6.95) and 1.34% (1.12-1.59), respectively, with higher rates in Asia. Combined moderate/severe thinness was more common among early (12-14 years) than later adolescents (15-18 years). Going to bed hungry sometimes was associated with increased risk of moderate/severe thinness (odds ratio [OR]: 1.102; 95% CI: 1.007-1.206). A significant inverse relationship was found between thinness and gross domestic product (OR: .94; 95% CI: .88-.99) and Global Food Security Index (OR: .96; 95% CI: .93-.99) but not Gini or Gender Inequality Index. Thinness remains prevalent in adolescent schoolgirls in low- and middle-income countries and poses a significant threat to their health and that of the next generation. Further research is needed to assess potential interventions for this group. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Disparities in Chronic Kidney Disease Prevalence among Males and Females in 195 Countries: Analysis of the Global Burden of Disease 2016 Study.

    PubMed

    Bikbov, Boris; Perico, Norberto; Remuzzi, Giuseppe

    2018-05-23

    Chronic kidney disease (CKD) imposes a substantial burden on health care systems. There are some especially vulnerable groups with a high CKD burden, one of which is women. We performed an analysis of gender disparities in the prevalence of all CKD stages and renal replacement therapy (defined as impaired kidney function [IKF]) in 195 countries. We used estimates produced by the Global Burden of Disease (GBD) Study 2016 revision using a Bayesian-regression analytic tool, DisMoD-MR 2.1. Data on gross domestic product based on purchasing power parity per capita (GDP PPP) was obtained via the World Bank International Comparison Program database. To estimate gender disparities, we calculated the male:female all-age prevalence rate ratio for each IKF condition. In 2016, the global number of individuals with IKF reached 752.7 million, including 417.0 million females and 335.7 million males. The most prevalent form of IKF in both groups was albuminuria with preserved glomerular filtration rate. Geospatial analysis shows a very heterogeneous distribution of the male:female ratio for all IKF conditions, with the most prominent contrast found in kidney transplant patients. The median male:female ratio varies substantially according to GDP PPP quintiles; however, countries with different economic states could have similar male:female ratios. A strong correlation of GDP PPP with dialysis-to-transplant ratio was found. The GBD study highlights the prominent gender disparities in CKD prevalence among 195 countries. The nature of these disparities, however, is complex and must be interpreted cautiously taking into account all possible circumstances. © 2018 S. Karger AG, Basel.

  7. Estimating the global prevalence of transthyretin familial amyloid polyneuropathy

    PubMed Central

    Waddington‐Cruz, Márcia; Botteman, Marc F.; Carter, John A.; Chopra, Avijeet S.; Hopps, Markay; Stewart, Michelle; Fallet, Shari; Amass, Leslie

    2018-01-01

    ABSTRACT Introduction: This study sought to estimate the global prevalence of transthyretin familial amyloid polyneuropathy (ATTR‐FAP). Methods: Prevalence estimates and information supporting prevalence calculations was extracted from records yielded by reference‐database searches (2005–2016), conference proceedings, and nonpeer reviewed sources. Prevalence was calculated as prevalence rate multiplied by general population size, then extrapolated to countries without prevalence estimates but with reported cases. Results: Searches returned 3,006 records; 1,001 were fully assessed and 10 retained, yielding prevalence for 10 “core” countries, then extrapolated to 32 additional countries. ATTR‐FAP prevalence in core countries, extrapolated countries, and globally was 3,762 (range 3639–3884), 6424 (range, 1,887–34,584), and 10,186 (range, 5,526–38,468) persons, respectively. Discussion: The mid global prevalence estimate (10,186) approximates the maximum commonly accepted estimate (5,000–10,000). The upper limit (38,468) implies potentially higher prevalence. These estimates should be interpreted carefully because contributing evidence was heterogeneous and carried an overall moderate risk of bias. This highlights the requirement for increasing rare‐disease epidemiological assessment and clinician awareness. Muscle Nerve 57: 829–837, 2018 PMID:29211930

  8. Diarrhea management in children under five in sub-Saharan Africa: does the source of care matter? A Countdown analysis.

    PubMed

    Carvajal-Vélez, Liliana; Amouzou, Agbessi; Perin, Jamie; Maïga, Abdoulaye; Tarekegn, Hayalnesh; Akinyemi, Akanni; Shiferaw, Solomon; Young, Mark; Bryce, Jennifer; Newby, Holly

    2016-08-19

    Diarrhea remains a high burden disease, responsible for nine percent of deaths in children under five globally. We analyzed diarrhea management practices in young children and their association with the source of care. We used Demographic and Health Survey data from 12 countries in sub-Saharan Africa with high burdens of childhood diarrhea. We classified the quality of diarrhea management practices as good, fair, or poor based on mothers' reports for children with diarrhea, using WHO/UNICEF recommendations for appropriate treatment. We described the prevalence of diarrhea management by type and assessed the association between good management and source of care, adjusting for potential confounders. Prevalence of good diarrhea management is low in 11 of the 12 analyzed surveys, varying from 17 % in Cote d'Ivoire to 38 % in Niger. The exception is Sierra Leone, where prevalence of good practice is 67 %. Prevalence of good management was low even among children taken to health facilities [median 52 %, range: 34-64 %]. Diarrhea careseeking from health facilities or community providers was associated with higher odds of good management than care from traditional/informal sources or no care. Careseeking from facilities did not result systematically in a higher likelihood of good diarrhea management than care from community providers. The odds of good diarrhea management were similar for community versus facility providers in six countries, higher in community than facility providers in two countries, and higher in facility than in community providers in four countries. Many children's lives can be saved with correct management of childhood diarrhea. Too many children are not receiving adequate care for diarrhea in high-burden sub-Saharan African countries, even among those seen in health facilities. Redoubling efforts to increase careseeking and improve quality of care for childhood diarrhea in both health facilities and at community level is an urgent priority.

  9. Screening for gestational diabetes mellitus and its prevalence in Bangladesh.

    PubMed

    Jesmin, Subrina; Akter, Shamima; Akashi, Hidechika; Al-Mamun, Abdullah; Rahman, Md Arifur; Islam, Md Majedul; Sohael, Farzana; Okazaki, Osamu; Moroi, Masao; Kawano, Satoru; Mizutani, Taro

    2014-01-01

    The prevalence of gestational diabetes mellitus (GDM) has important health complications for both mother and child and is increasing all over the world. Although prevalence estimates for GDM are not new in developed and many developing countries, data are lacking for many low-income countries like Bangladesh. To evaluate the prevalence of GDM in Bangladesh. This cross-sectional study included 3447 women who consecutively visited the antenatal clinics with an average gestation age of 26 weeks. GDM was defined according to WHO criteria (fasting plasma glucose [FPG] ≥7.0 mmol/L or 2-h ≥7.8 mmol/L) and the new ADA criteria (FPG ≥5.3 mmol/L or 2-h ≥8.6 mmol/L OGTT). We also calculated overt diabetes as FPG ≥7.0 mmol/L. Prevalence of GDM was 9.7% according to the WHO criteria and 12.9% according to the ADA criteria in this study population. Prevalence of overt diabetes was 1.8%. Women with GDM were older, higher educated, had higher household income, higher parity, parental history of diabetes, and more hypertensive, compared with non-GDM women. This study demonstrates a high prevalence of GDM in Bangladesh. These estimates for GDM may help to formulate new policies to prevent and manage diabetes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Prevalence of Chagas Disease among Solid Organ-Transplanted Patients in a Nonendemic Country.

    PubMed

    Salvador, Fernando; Sánchez-Montalvá, Adrián; Sulleiro, Elena; Moreso, Francesc; Berastegui, Cristina; Caralt, Mireia; Pinazo, María-Jesús; Moure, Zaira; Los-Arcos, Ibai; Len, Oscar; Gavaldà, Joan; Molina, Israel

    2018-03-01

    Reactivation of Chagas disease in the chronic phase may occur after solid organ transplantation, which may result in high parasitemia and severe clinical manifestations such as myocarditis and meningoencephalitis. The aim of the present study is to describe the prevalence of Chagas disease among solid organ-transplanted patients in a tertiary hospital from a nonendemic country. A cross-sectional study was performed at Vall d'Hebron University Hospital (Barcelona, Spain) from April to September 2016. Chagas disease screening was performed through serological tests in adult patients coming from endemic areas that had received solid organ transplantation and were being controlled in our hospital during the study period. Overall, 42 patients were included, 20 (47.6%) were male and median age was 50.5 (23-73) years. Transplanted organs were as follows: 18 kidneys, 17 lungs, and 7 livers. Three patients had Chagas disease, corresponding to a prevalence among this group of solid organ-transplanted patients of 7.1%. All three patients were born in Bolivia, had been diagnosed with Chagas disease and received specific treatment before the organ transplantation. We highly recommend providing screening tests for Chagas disease in patients with or candidates for solid organ transplantation coming from endemic areas, early treatment with benznidazole, and close follow-up to prevent clinical reactivations.

  11. Country differences of psychosocial working conditions in Europe: the role of health and safety management practices.

    PubMed

    Lunau, Thorsten; Dragano, Nico; Siegrist, Johannes; Wahrendorf, Morten

    2017-10-01

    In times of demographic change, maintaining health and employability of older employees is important. In this context, studies show that stressful working conditions differ by countries. Yet, it is unclear if specific national management practices to deal with these conditions contribute towards explaining country differences. This study combines two different data sources. The first one provides detailed information on psychosocial working conditions in 17 European countries, based on 12,284 employees from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA). We link this information to the second data source that provides information on health and safety management practices in each of the countries under study (collected among 17,477 managers at the level of companies in the Enterprise survey on new and emerging risks (ESENER)). We distinguish six different types of risk management procedures in the analysis. Results show that levels of psychosocial risks are generally lower in countries with more developed management practices, in particular if national management practices are marked by (1) procedures to deal with work stress, (2) information about whom to address in case of work-related psychosocial problems, and (3) health and safety services provided by psychologists. The findings underline the importance of a comprehensive psychosocial risk management approach in reducing work-related stress, as lower levels of psychosocial risks are linked to specific psychosocial risk management practices within companies, in particular those pointing to clear responsibilities and coordinated procedures in dealing with psychosocial risks.

  12. Transforming cold chain performance and management in lower-income countries.

    PubMed

    Brison, Mike; LeTallec, Yann

    2017-04-19

    In many countries, one of the common factors limiting full and equitable access to effective immunization is the existence of gaps in cold chain and logistics (CCL) systems. This article focuses on the critical contribution that better management of CCL performance can make in addressing these barriers, as well as some essential practices needed to achieve and sustain these gains. These include (i) an emphasis on continuous improvement in CCL performance indicators, (ii) strong coordination and accountability across multiple stakeholders, and (iii) making the most of limited financial resources. This article is informed by the Clinton Health Access Initiative's (CHAI's) experience working with National Immunization Programs (NIPs) and immunization partners to improve the effectiveness and efficiency of CCL systems (including CCE deployment and maintenance, temperature monitoring and control, stock management and distribution) across ten Gavi-supported "focus" countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Socioeconomic status is associated with global diabetes prevalence

    PubMed Central

    Xu, Zhiye; Yu, Dan; Yin, Xueyao; Zheng, Fenping; Li, Hong

    2017-01-01

    The incidence of diabetes is increasing globally. We investigated the relationship between diabetes prevalence and patient socioeconomic status across multiple countries. We searched PubMed to identify population-based surveys reporting diabetes prevalence between 1990 and May 2016. Search results were filtered, and Human Development Index (HDI) values from the United Nations Development Programme were used to assess socioeconomic status for a given nation. Our analysis included 45 national surveys from 32 countries. Diabetes prevalence was positively correlated with national HDI (r = 0.421 P = 0.041) in developing countries, and negatively correlated with HDI (r = −0.442 P = 0.045) in developed countries. Diabetes prevalence trends were the same in women and men, although men were associated with increased diabetes risk in developed countries (r = 0.459 P = 0.048). Thus, diabetes prevalence rises with increasing HDI in developing countries, and this is reversed in developed countries. Ours is the first study to investigate the relationship between diabetes and socioeconomic status at global level using HDI values. These results will aid in evaluating global diabetes prevalence and risk with respect to patient socioeconomic status, and will be useful in the development of policies that help reduce disease incidence. PMID:28574844

  14. Cost–effectiveness analysis of revised WHO guidelines for management of childhood pneumonia in 74 Countdown countries

    PubMed Central

    Zhang, Shanshan; Incardona, Beatrice; Qazi, Shamim A; Stenberg, Karin; Campbell, Harry; Nair, Harish

    2017-01-01

    Background Treatment of childhood pneumonia is a key priority in low–income countries, with substantial resource implications. WHO revised their guidelines for the management of childhood pneumonia in 2013. We estimated and compared the resource requirements, total direct medical cost and cost-effectiveness of childhood pneumonia management in 74 countries with high burden of child mortality (Countdown countries) using the 2005 and 2013 revised WHO guidelines. Methods We constructed a cost model using a bottom up approach to estimate the cost of childhood pneumonia management using the 2005 and 2013 WHO guidelines from a public provider perspective in 74 Countdown countries. The cost of pneumonia treatment was estimated, by country, for year 2013, including costs of medicines and service delivery at three different management levels. We also assessed country–specific lives saved and disability adjusted life years (DALYs) averted due to pneumonia treated in children aged below five years. The cost-effectiveness of pneumonia treatment was estimated in terms of cost per DALY averted by fully implementing WHO treatment guidelines relative to no treatment intervention for pneumonia. Results Achieving full treatment coverage with the 2005 WHO guidelines was estimated to cost US$ 2.9 (1.9–4.2) billion compared to an estimated US$ 1.8 (0.8–3.0) billion for the revised 2013 WHO guidelines in these countries. Pneumonia management in young children following WHO treatment guidelines could save up to 39.8 million DALYs compared to a zero coverage scenario in the year 2013 in the 74 Countdown countries. The median cost-effectiveness ratio per DALY averted in 74 countries was substantially lower for the 2013 guidelines: US$ 26.6 (interquartile range IQR: 17.7–45.9) vs US$ 38.3 (IQR: US$ 26.2–86.9) per DALY averted for the 2005 guideline respectively. Conclusions Child pneumonia management as detailed in standard WHO guidelines is a very cost–effective intervention

  15. Type II Diabetes Mellitus in Arabic-Speaking Countries

    PubMed Central

    Badran, Mohammad; Laher, Ismail

    2012-01-01

    The global epidemic of diabetes has not spared the Arabic-speaking countries, which have some of the highest prevalence of type II diabetes. This is particularly true of the Arab Gulf, a conglomerate of high income, oil-producing countries where prevalence rates are the highest. The prevalence rates among adults of the Arabic speaking countries as a whole range between 4%–21%, with the lowest being in Somalia and the highest in Kuwait. As economic growth has accelerated, so has the movement of the populations to urban centers where people are more likely to adopt lifestyles that embrace increased high-calorie food consumption and sedentary lifestyles. These factors likely contribute to the increased prevalence of obesity and diabetes in the Arabic speaking countries. PMID:22851968

  16. Marked increase in the prevalence of obesity in children of the Seychelles, a rapidly developing country, between 1998 and 2004.

    PubMed

    Bovet, Pascal; Chiolero, Arnaud; Madeleine, George; Gabriel, Anne; Stettler, Nicolas

    2006-01-01

    There are few data on overweight in children in developing countries. Such data are important to guide public health policy. We assessed trends in the prevalence of overweight and obesity in children from the Seychelles, a middle-income island state in the Indian Ocean. Multiple cross-sectional surveys were conducted each year between 1998 and 2004 on all students of all schools in four selected school grades (creche, 4th, 7th and 10th years of mandatory school). Weight and height were measured and children were asked about walking time and frequency of physical exercise at leisure time. Excess weight categories were defined according to the criteria of the International Obesity Task Force (IOTF) and the U.S. Centers for Disease Control and Prevention (CDC). Data were available for 33 340 observations in 1998-2004, corresponding to 23,459 individual children measured once or several times. Based on IOTF criteria, the prevalence of 'overweight' or 'obesity' increased from 8.7% to 13.5% in boys, and from 11.8% to 18.6% in girls from 1998 to 2004 (P < 0.001). The prevalence of 'obesity' increased from 2.1% to 5.2% in boys and from 3.1% to 6.2% in girls (P < 0.001). Using CDC criteria, the prevalence of 'at risk of overweight' and 'overweight' increased by similar proportions. The shift towards higher values over time was larger in the upper than the lower tail of the BMI distribution. Physical activity decreased over calendar years and was inversely associated with excess weight. The prevalence of excess weight increased markedly over a seven-year period in children in the Seychelles. This is likely to reflect a rapid nutrition transition with increasingly positive energy balance. These findings stress the need for programs and policies aimed at promoting physical activity and healthy nutrition in countries in epidemiological transition.

  17. Prevalence of Nutrition and Health-Related Claims on Pre-Packaged Foods: A Five-Country Study in Europe

    PubMed Central

    Hieke, Sophie; Kuljanic, Nera; Pravst, Igor; Miklavec, Krista; Kaur, Asha; Brown, Kerry A.; Egan, Bernadette M.; Pfeifer, Katja; Gracia, Azucena; Rayner, Mike

    2016-01-01

    This study is part of the research undertaken in the EU funded project CLYMBOL (“Role of health-related CLaims and sYMBOLs in consumer behaviour”). The first phase of this project consisted of mapping the prevalence of symbolic and non-symbolic nutrition and health-related claims (NHC) on foods and non-alcoholic beverages in five European countries. Pre-packaged foods and drinks were sampled based on a standardized sampling protocol, using store lists or a store floor plan. Data collection took place across five countries, in three types of stores. A total of 2034 foods and drinks were sampled and packaging information was analyzed. At least one claim was identified for 26% (95% CI (24.0%–27.9%)) of all foods and drinks sampled. Six percent of these claims were symbolic. The majority of the claims were nutrition claims (64%), followed by health claims (29%) and health-related ingredient claims (6%). The most common health claims were nutrient and other function claims (47% of all claims), followed by disease risk reduction claims (5%). Eight percent of the health claims were children’s development and health claims but these were only observed on less than 1% (0.4%–1.1%) of the foods. The category of foods for specific dietary use had the highest proportion of NHC (70% of foods carried a claim). The prevalence of symbolic and non-symbolic NHC varies across European countries and between different food categories. This study provides baseline data for policy makers and the food industry to monitor and evaluate the use of claims on food packaging. PMID:26950149

  18. Importance Placed on Managerial Leadership Competencies across Countries: What Managers Need to Know

    ERIC Educational Resources Information Center

    Kowske, Brenda J.; Anthony, Kshanika

    2005-01-01

    This study examines the importance placed on managerial competencies across countries. A partial replication of work done 5 years ago, this research demonstrated that various countries' managers have changed the emphasis placed on some managerial competencies. Overall, results showed that many managerial competencies have similar amounts of…

  19. Prevalence and management of helminthiasis among underfives living with HIV/AIDS at Amana Hospital, Tanzania.

    PubMed

    Mwambete, Kennedy D; Tunzo, Jones; Justin-Temu, Mary

    2013-01-01

    This was a cross-sectional study intended to assess the prevalence and management of helminthiasis (HL) among underfives living with HIV/AIDS (ULHA). Clinical histories of ULHA were scrutinized for HIV/AIDS status, antiretroviral therapy (ART), HL prevalence, and their management. About 364 ULHA were studied, 213 (58.5%) were girls and 151 (41.5%) were boys. Of the 364 ULHA, 171 (47.5%) had HL and 64.3% were treated with albendazole (ABZ). Trichuriasis was ascribed to 23.6% of HL. Majority (72.5%) of ULHA had a CD4 count below 200 cells/mm³. Direct association was observed between CD4 counts and HL. About 55% ULHA were on lamivudine (3TC)-stavudine (d4T)-nevirapine (NVP; LSN) combination therapy. The ABZ-LSN combination was frequently used for HIV/AIDS and HL management. High prevalence of HL and vivid correlation between HIV status and HL were observed. The LSN-ABZ combination was frequently employed for management of HIV/AIDS and HL. We recommended prompt diagnosis of HL to avoid acceleration of HIV infection to AIDS.

  20. G6PD Deficiency Prevalence and Estimates of Affected Populations in Malaria Endemic Countries: A Geostatistical Model-Based Map

    PubMed Central

    Howes, Rosalind E.; Piel, Frédéric B.; Patil, Anand P.; Nyangiri, Oscar A.; Gething, Peter W.; Dewi, Mewahyu; Hogg, Mariana M.; Battle, Katherine E.; Padilla, Carmencita D.; Baird, J. Kevin; Hay, Simon I.

    2012-01-01

    Background Primaquine is a key drug for malaria elimination. In addition to being the only drug active against the dormant relapsing forms of Plasmodium vivax, primaquine is the sole effective treatment of infectious P. falciparum gametocytes, and may interrupt transmission and help contain the spread of artemisinin resistance. However, primaquine can trigger haemolysis in patients with a deficiency in glucose-6-phosphate dehydrogenase (G6PDd). Poor information is available about the distribution of individuals at risk of primaquine-induced haemolysis. We present a continuous evidence-based prevalence map of G6PDd and estimates of affected populations, together with a national index of relative haemolytic risk. Methods and Findings Representative community surveys of phenotypic G6PDd prevalence were identified for 1,734 spatially unique sites. These surveys formed the evidence-base for a Bayesian geostatistical model adapted to the gene's X-linked inheritance, which predicted a G6PDd allele frequency map across malaria endemic countries (MECs) and generated population-weighted estimates of affected populations. Highest median prevalence (peaking at 32.5%) was predicted across sub-Saharan Africa and the Arabian Peninsula. Although G6PDd prevalence was generally lower across central and southeast Asia, rarely exceeding 20%, the majority of G6PDd individuals (67.5% median estimate) were from Asian countries. We estimated a G6PDd allele frequency of 8.0% (interquartile range: 7.4–8.8) across MECs, and 5.3% (4.4–6.7) within malaria-eliminating countries. The reliability of the map is contingent on the underlying data informing the model; population heterogeneity can only be represented by the available surveys, and important weaknesses exist in the map across data-sparse regions. Uncertainty metrics are used to quantify some aspects of these limitations in the map. Finally, we assembled a database of G6PDd variant occurrences to inform a national-level index of

  1. Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons

    PubMed Central

    Moore, David J.; Letendre, Scott; Poehlman Roediger, Mollie; Eberly, Lynn; Weintrob, Amy; Ganesan, Anuradha; Johnson, Erica; Del Rosario, Raechel; Agan, Brian K.; Hale, Braden R.

    2013-01-01

    Objective: To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls. Methods: We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV−) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS-defining conditions, and CD4 nadir >200 cells/mm3) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests. Results: HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm3, and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm3). NCI was diagnosed among 38 (19%, 95% confidence interval 14%–25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV− patients. Conclusions: HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment. PMID:23303852

  2. Differences in the management of amblyopia between European countries

    PubMed Central

    Tan, J H Y; Thompson, J R; Gottlob, I

    2003-01-01

    Background: Amblyopia treatment is not standardised and differences between centres and countries have not been systematically investigated. This survey compares the different patterns of orthoptic treatment of amblyopia in the United Kingdom (UK) and three German speaking countries (GSC). Methods: Questionnaires were sent to orthoptists in the UK and the GSC asking for their preferred choices of treatment of amblyopia between the ages of 6 months to 10 years. Results: The following significant differences in management of amblyopia were found: (1) the number of hours of occlusion per week was higher in the GSC, p<0.0001, (2) orthoptists in the GSC treat amblyopia up to an older age. Orthoptists in the GSC and in the UK predicted similar treatment outcomes. Conclusion: Orthoptists in the GSC usually treat patients more intensively and for longer, while the prediction of visual outcome does not differ significantly between countries. These results highlight the lack of standardisation in the treatment of the various types of amblyopia. PMID:12598440

  3. Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model: results for Zimbabwe and Morocco from 1995 to 2016

    PubMed Central

    Korenromp, Eline L; Mahiané, Guy; Rowley, Jane; Nagelkerke, Nico; Abu-Raddad, Laith; Ndowa, Francis; El-Kettani, Amina; El-Rhilani, Houssine; Mayaud, Philippe; Chico, R Matthew; Pretorius, Carel; Hecht, Kendall; Wi, Teodora

    2017-01-01

    Objective To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. Methods The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness. Gonorrhoea prevalence was fitted as a moving average on population surveys (from the country, neighbouring countries and historic regional estimates), with trends informed additionally by urethral discharge case reports, where these were considered to have reasonably stable completeness. Prevalence data were adjusted for diagnostic test performance, high-risk populations not sampled, urban/rural and male/female prevalence ratios, using WHO's assumptions from latest global and regional-level estimations. Uncertainty intervals were obtained by bootstrap resampling. Results Estimated syphilis prevalence (in men and women) declined from 1.9% (95% CI 1.1% to 3.4%) in 2000 to 1.5% (1.3% to 1.8%) in 2016 in Zimbabwe, and from 1.5% (0.76% to 1.9%) to 0.55% (0.30% to 0.93%) in Morocco. At these time points, gonorrhoea estimates for women aged 15–49 years were 2.5% (95% CI 1.1% to 4.6%) and 3.8% (1.8% to 6.7%) in Zimbabwe; and 0.6% (0.3% to 1.1%) and 0.36% (0.1% to 1.0%) in Morocco, with male gonorrhoea prevalences 14% lower than female prevalence. Conclusions This epidemiological framework facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. We estimated ongoing syphilis declines in both Zimbabwe and Morocco. For gonorrhoea, time trends were less certain, lacking recent population-based surveys. PMID:28325771

  4. The concentration of disadvantage and the rise of an urban penalty: urban slum prevalence and the social production of health inequalities in the developing countries.

    PubMed

    Rice, James; Rice, Julie Steinkopf

    2009-01-01

    Urban slums are proliferating in the developing countries. A corollary of this structural transformation is the increasing recognition of an urban penalty wherein slum populations exhibit notable inequalities in health relative to non-slum urban residents and even rural populations. The built urban environment, in turn, is a crucial context within which the social production of disproportionate morbidity and mortality is enacted. The authors develop this assertion and use bivariate and partial correlation analysis to highlight the association of urban slum prevalence, or proportion of the total population living in urban slum conditions, with indicators of mortality and gender parity, measured at the national level. Data for 99 developing countries show that greater urban slum prevalence is strongly correlated with higher levels of infant, child, and maternal mortality. Further, urban slum prevalence exhibits strong, deleterious correlations with gender parity (measured by the gender development index) and fertility rate, factors that have a crucial direct impact in shaping variant mortality levels. Future research is warranted on the social inequalities in health and illness derived from the expansion of urban slum conditions in the developing countries.

  5. Prevalence of Hypertension in Member Countries of South Asian Association for Regional Cooperation (SAARC): Systematic Review and Meta-Analysis

    PubMed Central

    Neupane, Dinesh; McLachlan, Craig S.; Sharma, Rajan; Gyawali, Bishal; Khanal, Vishnu; Mishra, Shiva Raj; Christensen, Bo; Kallestrup, Per

    2014-01-01

    Abstract Hypertension is a leading attributable risk factor for mortality in South Asia. However, a systematic review on prevalence and risk factors for hypertension in the region of the South Asian Association for Regional Cooperation (SAARC) has not carried out before. The study was conducted according to the Meta-Analysis of Observational Studies in Epidemiology Guideline. A literature search was performed with a combination of medical subject headings terms, “hypertension” and “Epidemiology/EP”. The search was supplemented by cross-references. Thirty-three publications that met the inclusion criteria were included in the synthesis and meta-analyses. Hypertension is defined when an individual had a systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, was taking antihypertensive drugs, or had previously been diagnosed as hypertensive by health care professionals. Prehypertension is defined as SBP 120–139 mm Hg and DBP 80–89 mm Hg. The overall prevalence of hypertension and prehypertension from the studies was found to be 27% and 29.6%, respectively. Hypertension varied between the studies, which ranged from 13.6% to 47.9% and was found to be higher in the studies conducted in urban areas than in rural areas. The prevalence of hypertension from the latest studies was: Bangladesh: 17.9%; Bhutan: 23.9%; India: 31.4%; Maldives: 31.5%; Nepal: 33.8%; Pakistan: 25%; and Sri Lanka: 20.9%. Eight out of 19 studies with information about prevalence of hypertension in both sexes showed that the prevalence was higher among women than men. Meta-analyses showed that sex (men: odds ratio [OR] 1.19; 95% confidence interval [CI]: 1.02, 1.37), obesity (OR 2.33; 95% CI: 1.87, 2.78), and central obesity (OR 2.16; 95% CI: 1.37, 2.95) were associated with hypertension. Our study found a variable prevalence of hypertension across SAARC countries, with a number of countries with blood pressure above the global average. We also

  6. Prevalence, risk factors and secondary prevention of stroke recurrence in eight countries from south, east and southeast asia: a scoping review.

    PubMed

    Chin, Y Y; Sakinah, H; Aryati, A; Hassan, B M

    2018-04-01

    In most Asian countries, stroke is one of the major causes of mortality. A stroke event is life-changing for stroke survivors, which results in either mortality or disability. Therefore, this study comprehensively focuses on prevalence, risk factors, and secondary prevention for stroke recurrence identified in South, East, and Southeast Asian countries. This scoping review uses the methodological framework of Arksey and O'Malley. A comprehensive search of academic journals (English) on this topic published from 2007 to 2017 was conducted. A total of 22 studies were selected from 585 studies screened from the electronic databases. First-year stroke recurrence rates are in the range of 2.2% to 25.4%. Besides that, modifiable risk factors are significantly associated with pathophysiological factors (hypertension, ankle-brachial pressure index, atherogenic dyslipidaemia, diabetes mellitus, metabolic syndrome, and atrial fibrillation) and lifestyle factors (obesity, smoking, physical inactivity, and high salt intake). Furthermore, age, previous history of cerebrovascular events, and stroke subtype are also significant influence risk factors for recurrence. A strategic secondary prevention method for recurrent stroke is health education along with managing risk factors through a combination of appropriate lifestyle intervention and pharmacological therapy. To prevent recurrent stroke, health intervention should be geared towards changing lifestyle to embody a healthier approach to life. This is of great importance to public health and stroke survivors' quality of life.

  7. Modeling financial disaster risk management in developing countries

    NASA Astrophysics Data System (ADS)

    Mechler, R.; Hochrainer, S.; Pflug, G.; Linnerooth-Bayer, J.

    2005-12-01

    The public sector plays a major role in reducing the long-term economic repercussions of disasters by repairing damaged infrastructure and providing financial assistance to households and businesses. If critical infrastructure is not repaired in a timely manner, there can be serious effects on the economy and the livelihoods of the population. The repair of public infrastructure, however, can be a significant drain on public budgets especially in developing and transition countries. Developing country governments frequently lack the liquidity, even including international aid and loans, to fully repair damaged critical public infrastructure or provide sufficient support to households and businesses for their recovery. The earthquake in Gujarat, and other recent cases of government post-disaster liquidity crises, have sounded an alarm, prompting financial development organizations, such as the World Bank, among others, to call for greater attention to reducing financial vulnerability and increasing the resilience of the public sector. This talk reports on a model designed to illustrate the tradeoffs and choices a developing country must make in financially managing the economic risks due to natural disasters. Budgetary resources allocated to pre-disaster risk management strategies, such as loss mitigation measures, a catastrophe reserve fund, insurance and contingent credit arrangements for public assets, reduce the probability of financing gaps - the inability of governments to meet their full obligations in providing relief to private victims and restoring public infrastructure - or prevent the deterioration of the ability to undertake additional borrowing without incurring a debt crisis. The model -which is equipped with a graphical interface - can be a helpful tool for building capacity of policy makers for developing and assessing public financing strategies for disaster risk by indicating the respective costs and consequences of financing alternatives.

  8. High fructose corn syrup and diabetes prevalence: a global perspective.

    PubMed

    Goran, Michael I; Ulijaszek, Stanley J; Ventura, Emily E

    2013-01-01

    The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearson's correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%, p=0.03; fasting plasma glucose=5.34 vs. 5.22 mmol/L, p=0.03) despite similarities in obesity and total sugar and calorie availability. These results suggest that countries with higher availability of HFCS have a higher prevalence of type 2 diabetes independent of obesity.

  9. Avoidable Waste in Ophthalmic Epidemiology: A Review of Blindness Prevalence Surveys in Low and Middle Income Countries 2000-2014.

    PubMed

    Ramke, Jacqueline; Kuper, Hannah; Limburg, Hans; Kinloch, Jennifer; Zhu, Wenhui; Lansingh, Van C; Congdon, Nathan; Foster, Allen; Gilbert, Clare E

    2018-02-01

    Sources of avoidable waste in ophthalmic epidemiology include duplication of effort, and survey reports remaining unpublished, gaining publication after a long delay, or being incomplete or of poor quality. The aim of this review was to assess these sources of avoidable waste by examining blindness prevalence surveys undertaken in low and middle income countries (LMICs) between 2000 and 2014. On December 1, 2016 we searched MEDLINE, EMBASE and Web of Science databases for cross-sectional blindness prevalence surveys undertaken in LMICs between 2000 and 2014. All surveys listed on the Rapid Assessment of Avoidable Blindness (RAAB) Repository website ("the Repository") were also considered. For each survey we assessed (1) availability of scientific publication, survey report, summary results tables and/or datasets; (2) time to publication from year of survey completion and journal attributes; (3) extent of blindness information reported; and (4) rigour when information was available from two sources (i.e. whether it matched). Of the 279 included surveys (from 68 countries) 186 (67%) used RAAB methodology; 146 (52%) were published in a scientific journal, 57 (20%) were published in a journal and on the Repository, and 76 (27%) were on the Repository only (8% had tables; 19% had no information available beyond registration). Datasets were available for 50 RAABs (18% of included surveys). Time to publication ranged from <1 to 11 years (mean, standard deviation 2.8 ± 1.8 years). The extent of blindness information reported within studies varied (e.g. presenting and best-corrected, unilateral and bilateral); those with both a published report and Repository tables were most complete. For surveys published and with RAAB tables available, discrepancies were found in reporting of participant numbers (14% of studies) and blindness prevalence (15%). Strategies are needed to improve the availability, consistency, and quality of information reported from blindness prevalence

  10. Acne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/young adults in 7 European countries.

    PubMed

    Wolkenstein, P; Machovcová, A; Szepietowski, J C; Tennstedt, D; Veraldi, S; Delarue, A

    2018-02-01

    Although acne vulgaris is a common skin disorder, limited epidemiological data exist specifically for European populations. To determine the prevalence of self-reported acne among young people in Europe and evaluate the effect of lifestyle on acne. We conducted a cross-sectional population-based online survey in representative samples of individuals aged 15-24 years in Belgium, Czech and Slovak Republics, France, Italy, Poland and Spain (n = 10 521), identified by a quota sampling method based on age, geographic location and socio-professional category. The overall adjusted prevalence of self-reported acne was 57.8% (95% confidence interval 56.9% to 58.7%). The rates per country ranged from 42.2% in Poland to 73.5% in the Czech and Slovak Republics. The prevalence of acne was highest at age 15-17 years and decreased with age. On multivariate analysis, a history of maternal or paternal acne was associated with an increased probability of having acne (odds ratio 3.077, 95% CI 2.743 to 3.451, and 2.700, 95% CI 2.391 to 3.049, respectively; both P < 0.0001), as was the consumption of chocolate (OR 1.276, 95% CI 1.094 to 1.488, for quartile 4 vs. quartile 1). Increasing age (OR 0.728, 95% CI 0.639 to 0.830 for age 21-24 years vs. 15-17 years) and smoking tobacco (OR 0.705, 95% CI 0.616 to 0.807) were associated with a reduced probability of acne. The overall prevalence of self-reported acne was high in adolescents/young adults in the European countries investigated. Heredity was the main risk factor for developing acne. © 2017 European Academy of Dermatology and Venereology.

  11. Environmental performance of household waste management in Europe - An example of 7 countries.

    PubMed

    Andreasi Bassi, Susanna; Christensen, Thomas H; Damgaard, Anders

    2017-11-01

    An attributional life cycle assessment (LCA) of the management of 1ton of household waste was conducted in accordance with ISO 14044:2006 and the ILCD Handbook for seven European countries, namely Germany, Denmark, France, UK, Italy, Poland and Greece, representing different household waste compositions, waste management practices, technologies, and energy systems. National data were collected from a range of sources regarding household waste composition, household sorting efficiency, collection, waste treatments, recycling, electricity and heat composition, and technological efficiencies. The objective was to quantify the environmental performance in the different countries, in order to analyze the sources of the main environmental impacts and national differences which affect the results. In most of the seven countries, household waste management provides environmental benefits when considering the benefits of recycling of materials and recovering and utilization of energy. Environmental benefits come from paper recycling and, to a lesser extent, the recycling of metals and glass. Waste-to-energy plants can lead to an environmental load (as in France) or a saving (Germany and Denmark), depending mainly on the composition of the energy being substituted. Sensitivity analysis and a data quality assessment identified a range of critical parameters, suggesting from where better data should be obtained. The study concluded that household waste management is environmentally the best in European countries with a minimum reliance on landfilling, also induced by the implementation of the Waste Hierarchy, though environmental performance does not correlate clearly with the rate of material recycling. From an environmental point of view, this calls for a change in the waste management paradigm, with less focus on where the waste is routed and more of a focus on the quality and utilization of recovered materials and energy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Chronic kidney disease hotspots in developing countries in South Asia.

    PubMed

    Abraham, Georgi; Varughese, Santosh; Thandavan, Thiagarajan; Iyengar, Arpana; Fernando, Edwin; Naqvi, S A Jaffar; Sheriff, Rezvi; Ur-Rashid, Harun; Gopalakrishnan, Natarajan; Kafle, Rishi Kumar

    2016-02-01

    In many developing countries in the South Asian region, screening for chronic diseases in the community has shown a widely varying prevalence. However, certain geographical regions have shown a high prevalence of chronic kidney disease (CKD) of unknown etiology. This predominantly affects the young and middle-aged population with a lower socioeconomic status. Here, we describe the hotspots of CKD of undiagnosed etiology in South Asian countries including the North, Central and Eastern provinces of Sri Lanka and the coastal region of the state of Andhra Pradesh in India. Screening of these populations has revealed cases of CKD in various stages. Race has also been shown to be a factor, with a much lower prevalence of CKD in whites compared to Asians, which could be related to the known influence of ethnicity on CKD development as well as environmental factors. The difference between developed and developing nations is most stark in the realm of healthcare, which translates into CKD hotspots in many regions of South Asian countries. Additionally, the burden of CKD stage G5 remains unknown due to the lack of registry reports, poor access to healthcare and lack of an organized chronic disease management program. The population receiving various forms of renal replacement therapy has dramatically increased in the last decade due to better access to point of care, despite the disproportionate increase in nephrology manpower. In this article we will discuss the nephrology care provided in various countries in South Asia, including India, Bangladesh, Pakistan, Nepal, Bhutan, Sri Lanka and Afghanistan.

  13. National Prevalence and Trends of HIV Transmitted Drug Resistance in Mexico

    PubMed Central

    Avila-Ríos, Santiago; García-Morales, Claudia; Garrido-Rodríguez, Daniela; Ormsby, Christopher E.; Hernández-Juan, Ramón; Andrade-Villanueva, Jaime; González-Hernández, Luz A.; Torres-Escobar, Indiana; Navarro-Álvarez, Samuel; Reyes-Terán, Gustavo

    2011-01-01

    Background Transmitted drug resistance (TDR) remains an important concern for the management of HIV infection, especially in countries that have recently scaled-up antiretroviral treatment (ART) access. Methodology/Principal Findings We designed a study to assess HIV diversity and transmitted drug resistance (TDR) prevalence and trends in Mexico. 1655 ART-naïve patients from 12 Mexican states were enrolled from 2005 to 2010. TDR was assessed from plasma HIV pol sequences using Stanford scores and the WHO TDR surveillance mutation list. TDR prevalence fluctuations over back-projected dates of infection were tested. HIV subtype B was highly prevalent in Mexico (99.9%). TDR prevalence (Stanford score>15) in the country for the study period was 7.4% (95% CI, 6.2∶8.8) and 6.8% (95% CI, 5.7∶8.2) based on the WHO TDR surveillance mutation list. NRTI TDR was the highest (4.2%), followed by NNRTI (2.5%) and PI (1.7%) TDR. Increasing trends for NNRTI (p = 0.0456) and PI (p = 0.0061) major TDR mutations were observed at the national level. Clustering of viruses containing minor TDR mutations was observed with some apparent transmission pairs and geographical effects. Conclusions TDR prevalence in Mexico remains at the intermediate level and is slightly lower than that observed in industrialized countries. Whether regional variations in TDR trends are associated with differences in antiretroviral drug usage/ART efficacy or with local features of viral evolution remains to be further addressed. PMID:22110765

  14. 1996 hazardous waste management survey in selected Asian countries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nelson, D.; Christie, K.; Tao, Hong-lei

    This report documents the results of a 42-question survey submitted to countries in Asia concerning their hazardous waste management programs and other issues. The same survey questions were distributed in 1992. This report compares the 1992 and 1996 responses. The respondents were Australia, New Zealand, Malaysia, Philippines, Hong Kong, People`s Republic of China, Taiwan, Japan, Korea, Singapore, Thailand, and Indonesia. 7 figs.

  15. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015.

    PubMed

    2017-05-13

    The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed. We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed 38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the Socio-demographic Index (SDI). Worldwide, the age-standardised prevalence of daily smoking was 25·0% (95% uncertainty interval [UI] 24·2-25·7) for men and 5·4% (5·1-5·7) for women, representing 28·4% (25·8-31·1) and 34·4% (29·4-38·6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11·5% of global deaths (6·4 million [95

  16. Lymphoedema of the lower limbs: management problems in a developing country.

    PubMed

    Adigun, A I; Ogundipe, O K

    2008-01-01

    Lymphoedema is a clinical condition involving the extremities that is characterized by accumulation of protein rich fluid within the intercellular space of the skin and the subcutaneous tissue. It most frequently occurs in the extremities. Developing countries are mostly faced with cases of secondary lymphoedema where patients present lately. In addition to swollen limbs, there are lot of skin changes on the affected limb, these create a lot of problems to the managing clinician. We hereby present five cases out of several patients managed to highlight the challenges. We review the case notes of three patients managed by our unit and present the summary of each patient. Majority of our patients present late to the hospital, mainly because of the socio-cultural and spiritual beliefs concerning the aetiology of the condition. Most of them have visited the spiritualist, herbalist and the clergymen for solution. Clinicians in the developing countries are seriously handicapped by lack of modern equipment for both diagnostic and therapeutic management of these clinical conditions. Chronic lymphoedema is a major cause of permanent disability. Excisional surgery such as Charles procedure even though old is still very much relevant in our environment. Patients need to be enlightened on the need for early presentation, adequate post-operative care and prolonged follow-up.

  17. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women

    PubMed Central

    2012-01-01

    Background In 2009 the Uterine Bleeding and Pain Women's Research Study (UBP-WRS) was conducted interviewing 21,479 women across 8 countries in order to gain patient-based prevalence data on uterine pain and bleeding indications and investigate uterine symptoms and women's treatment experiences. This article shows relevant results of the study for the indication uterine fibroids providing data on self-reported prevalence, symptomatology and management of uterine fibroids. Methods 2,500 women (USA: 4,500 women) in each country (Brazil, Canada, France, Germany, Italy, South Korea, the UK, the USA) completed an online survey. Women included were in their reproductive age (age group 15-49 years; USA: 18-49 years) and had ever experienced menstrual bleedings. Quotas were applied for age, region, level of education and household income of respondents. Variables have been analyzed descriptively and exploratory statistical tests have been performed. Results The self-reported prevalence of uterine fibroids ranged from 4.5% (UK) to 9.8% (Italy), reaching 9.4% (UK) to 17.8% (Italy) in the age group of 40-49 years. Women with a diagnosis of uterine fibroids reported significantly more often about bleeding symptoms than women without a diagnosis: heavy bleedings (59.8% vs. 37.4%), prolonged bleedings (37.3% vs. 15.6%), bleeding between periods (33.3% vs. 13.5%), frequent periods (28.4% vs. 15.2%), irregular and predictable periods (36.3% vs. 23.9%). Furthermore women with diagnosed uterine fibroids reported significantly more often about the following pain symptoms: pressure on the bladder (32.6% vs. 15.0%), chronic pelvic pain (14.5% vs. 2.9%), painful sexual intercourse (23.5% vs. 9.1%) and pain occurring mid-cycle, after and during menstrual bleeding (31.3%, 16.7%, 59.7%, vs. 17.1%, 6.4%, 52.0%). 53.7% of women reported that their symptoms had a negative impact on their life in the last 12 month, influencing their sexual life (42.9%), performance at work (27.7%) and

  18. Perspectives, perceptions and experiences in postoperative pain management in developing countries: A focus group study conducted in Rwanda

    PubMed Central

    Johnson, Ana P; Mahaffey, Ryan; Egan, Rylan; Twagirumugabe, Theogene; Parlow, Joel L

    2015-01-01

    BACKGROUND: Access to postoperative acute pain treatment is an important component of perioperative care and is frequently managed by a multidisciplinary team of anesthesiologists, surgeons, pharmacists, technicians and nurses. In some developing countries, treatment modalities are often not performed due to scarce health care resources, knowledge deficiencies and cultural attitudes. OBJECTIVES: In advance of a comprehensive knowledge translation initiative, the present study aimed to determine the perspectives, perceptions and experiences of anesthesia residents regarding postoperative pain management strategies. METHODS: The present study was conducted using a qualitative assessment strategy in a large teaching hospital in Rwanda. During two sessions separated by seven days, a 10-participant semistructured focus group needs analysis was conducted with anesthesia residents at the Centre Hospitalier Universitaire de Kigali (Kigali, Rwanda). Field notes were analyzed using interpretative and descriptive phenomenological approaches. Participants were questioned regarding their perspectives, perceptions and experiences in pain management. RESULTS: The responses from the focus groups were related to five general areas: general patient and medical practice management; knowledge base regarding postoperative pain management; pain evaluation; institutional/system issues related to protocol implementation; and perceptions about resource allocation. Within these areas, challenges (eg, communication among stakeholders and with patients) and opportunities (eg, on-the-job training, use of protocols, routine pain assessment, participation in resource allocation decisions) were identified. CONCLUSIONS: The present study revealed the prevalent challenges residents perceive in implementing postoperative pain management strategies, and offers practical suggestions to overcoming them, primarily through training and the implementation of practice recommendations. PMID:26448971

  19. Cancer Pain Management in Developing Countries.

    PubMed

    Saini, Shalini; Bhatnagar, Sushma

    2016-01-01

    The World Health Organization estimated that more than 60% of the 14 million new cancer cases worldwide in 2012 were reported in the developing part of the world, including Asia, Africa, Central and South America. Cancer survival rate is poorer in developing countries due to diagnosis at late stage and limited access to timely treatment. Since the disease per se cannot be treated even with the best available treatment modalities, what remains important is symptom management and providing comfort care to these patients. The incidence of pain in advanced stages of cancer approaches 70-80%. Lack of preventive strategies, poverty, illiteracy, and social stigma are the biggest cause of pain suffering and patient presenting in advance stage of their disease. The need for palliative care is expanding due to aging of world's population and increase in the rate of cancer in developed and developing countries. A huge gap remains between demand and current palliative care services. Overcoming barriers to palliative care is a major global health agenda that need immediate attention. Main causes of inadequate pain relief remain lack of knowledge among physician and patients, lack of adequate supply of opioids and other drugs for pain relief, strong bureaucracy involved in terms of procurement, and dispensing of opioids. Beside this, poverty and illiteracy remain the most important factors of increased suffering.

  20. Violent behavior and aggression in schizophrenia: Prevalence and risk factors. A multicentric study from three Latin-America countries.

    PubMed

    Caqueo-Urízar, Alejandra; Fond, Guillaume; Urzúa, Alfonso; Boyer, Laurent; Williams, David R

    2016-12-01

    The aim of the present study was (i) to assess the prevalence of Violent Behavior in Schizophrenia (VBS) in a sample of community-dwelling outpatients in three middle-income countries of Latin America and (ii) to determine the clinical and socio-demographical risk factors associated with VBS and aggression level. The study included 253 stabilized outpatients with schizophrenia and their principal caregivers from 3 public ambulatory psychiatric care centers in Bolivia (N=83), Chile (N=85), and Peru (N=85). VBS was defined according to the Overt Aggression Scale (OAS) score and the aggression level was measured by the aggression subscore of the Agitated Behavior Scale of Corrigan. We collected socio-demographic information and clinical data. Multiple linear and logistic regressions were performed to determine which variables were associated with VBS and aggression level. The prevalence of VBS differed statistically between the three countries (p<0.001) with 3.5% in Chile, 14.6% in Peru and 55.4% in Bolivia. After adjustment for confounding factors, VBS was associated with a younger age, a more severe psychotic symptomatology, a lower family income and unemployment. After adjustment for confounding factors, aggression level was associated with a more severe psychotic symptomatology, a lower family income, a younger age at illness onset and higher number of hospitalizations in the last 3years. These results may guide future health policies to specifically provide social support and rehabilitation care to VBS patients in middle-income countries, including psychoeducation and a more integrated work between the treating medical team and the social workers. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Opioid use among same-day surgery patients: Prevalence, management and outcomes

    PubMed Central

    Wilson, Jennifer LC; Poulin, Patricia A; Sikorski, Robert; Nathan, Howard J; Taljaard, Monica; Smyth, Catherine

    2015-01-01

    OBJECTIVES: To determine whether the prevalence of opioid use among patients requiring elective same-day admission (SDA) surgery is greater than the 2.5% prevalence found in the general population. Secondary objectives were to assess compliance with expert recommendations on acute pain management in opioid-tolerant patients and to examine clinical outcomes. METHODS: A retrospective review of 812 systematically sampled adult SDA surgical cases between April 1, 2008 and March 31, 2009 was conducted. RESULTS: Among 798 eligible patients, 148 (18.5% [95% CI 15.9% to 21.2%]) were prescribed opioids, with 4.4% prescribed long-acting opioids (95% CI 3.0% to 5.8%). Use of opioids was most prevalent among orthopedic and neurosurgery patients. Among the 35 patients on long-acting opioids who had a high likelihood of being tolerant, anesthesiologists correctly identified 33, but only 13 (37%) took their usual opioid preoperatively while 22 (63%) had opioids continued postoperatively. Acetaminophen, nonsteroidal anti-inflammatory drugs and pregabalin were ordered preoperatively in 18 (51%), 15 (43%) and 18 (51%) cases, respectively, while ketamine was used in 15 (43%) patients intraoperatively. Acetaminophen, nonsteroidal anti-inflammatory drugs and pregabalin were ordered postoperatively in 31 (89%), 15 (43%) and 17 (49%) of the cases, respectively. No differences in length of stay, readmissions and emergency room visits were found between opioid-tolerant and opioid-naïve patients. CONCLUSION: Opioid use is more common in SDA surgical patients than in the general population and is most prevalent within orthopedic and neurosurgery patients. Uptake of expert opinion on the management of acute pain in the opioid tolerant patient population is lacking. PMID:26357683

  2. The effectiveness of risk management: an analysis of project risk planning across industries and countries.

    PubMed

    Zwikael, Ofer; Ahn, Mark

    2011-01-01

    This article examines the effectiveness of current risk management practices to reduce project risk using a multinational, multi-industry study across different scenarios and cultures. A survey was administered to 701 project managers, and their supervisors, in seven industries and three diverse countries (New Zealand, Israel, and Japan), in multiple languages during the 2002-2007 period. Results of this study show that project context--industry and country where a project is executed--significantly impacts perceived levels of project risk, and the intensity of risk management processes. Our findings also suggest that risk management moderates the relationship between risk level and project success. Specifically, we found that even moderate levels of risk management planning are sufficient to reduce the negative effect risk levels have on project success. © 2010 Society for Risk Analysis.

  3. Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model: results for Zimbabwe and Morocco from 1995 to 2016.

    PubMed

    Korenromp, Eline L; Mahiané, Guy; Rowley, Jane; Nagelkerke, Nico; Abu-Raddad, Laith; Ndowa, Francis; El-Kettani, Amina; El-Rhilani, Houssine; Mayaud, Philippe; Chico, R Matthew; Pretorius, Carel; Hecht, Kendall; Wi, Teodora

    2017-12-01

    To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness. Gonorrhoea prevalence was fitted as a moving average on population surveys (from the country, neighbouring countries and historic regional estimates), with trends informed additionally by urethral discharge case reports, where these were considered to have reasonably stable completeness. Prevalence data were adjusted for diagnostic test performance, high-risk populations not sampled, urban/rural and male/female prevalence ratios, using WHO's assumptions from latest global and regional-level estimations. Uncertainty intervals were obtained by bootstrap resampling. Estimated syphilis prevalence (in men and women) declined from 1.9% (95% CI 1.1% to 3.4%) in 2000 to 1.5% (1.3% to 1.8%) in 2016 in Zimbabwe, and from 1.5% (0.76% to 1.9%) to 0.55% (0.30% to 0.93%) in Morocco. At these time points, gonorrhoea estimates for women aged 15-49 years were 2.5% (95% CI 1.1% to 4.6%) and 3.8% (1.8% to 6.7%) in Zimbabwe; and 0.6% (0.3% to 1.1%) and 0.36% (0.1% to 1.0%) in Morocco, with male gonorrhoea prevalences 14% lower than female prevalence. This epidemiological framework facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. We estimated ongoing syphilis declines in both Zimbabwe and Morocco. For gonorrhoea, time trends were less certain, lacking recent population-based surveys. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  4. Pediatric pain: prevalence, assessment, and management in a teaching hospital

    PubMed Central

    Linhares, M.B.M.; Doca, F.N.P.; Martinez, F.E.; Carlotti, A.P.P.; Cassiano, R.G.M.; Pfeifer, L.I.; Funayama, C.A.; Rossi, L.R.G.; Finley, G.A.

    2012-01-01

    The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients' pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child's pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals. PMID:22983181

  5. The globalization of whitening: prevalence of skin lighteners (or bleachers) use and its social correlates among university students in 26 countries.

    PubMed

    Peltzer, Karl; Pengpid, Supa; James, Caryl

    2016-02-01

    The aim of this study was to investigate the use of skin lighteners and its social correlates in university students from 26 low, middle income, and emerging economy countries. Using anonymous questionnaires, data were collected from 19,624 undergraduate university students (mean age 20.8, SD 2.8) from 27 universities in 26 countries across Asia, Africa, and the Americas. Multivariate logistic regression analysis was used to identify associations between sociodemographic, social, health risk, mental health and abuse, and the use of skin lighteners. Overall, the prevalence of previous 12-month skin lightener use was 24.5, and 16.7% in male and 30.0% in female students. The use of skin lighteners varied by country, ranging from 0% in Turkey to 83.8% in Thailand. In multivariate logistic regression analysis among both men and women, social variables (highly-organized religious activity and lack of personal mastery) and health variables (inconsistent condom use) were associated with skin lightening use. In addition, male students from a lower income country, having a lack of social support, and a history of childhood sexual abuse were more likely to use skin lighteners, and women aged 20-21 years old, residing on the university campus, being a student of health and welfare, and having a lack of personal control, inadequate physical activity, and depressive symptoms were more likely users of skin-lightening products. A high prevalence of skin lightener use was found in this large sample of university students, and social and health-related risk factors were identified. © 2015 The International Society of Dermatology.

  6. Prevalence, Circumstances, and Management of Acute Pesticide Poisoning in Hospitals in Kampala City, Uganda.

    PubMed

    Ssemugabo, Charles; Halage, Abdullah Ali; Neebye, Ruth Mubeezi; Nabankema, Victoria; Kasule, Massy Moses; Ssekimpi, Deogratius; Jørs, Erik

    2017-01-01

    This study was aimed at assessing prevalence, circumstance, and management of acute pesticide poisoning in hospitals in Kampala. It was a retrospective cross-sectional study that involved reviewing of 739 poisoning patient records from 5 hospitals in Kampala. Of the 739 patients, 212 were due to pesticide poisoning resulting in a prevalence of 28.8%. About 91.4% (191/210) of the cases were due to organophosphate poisoning, 63.3% (133/210) were intentional, and 98.1% (206/210) were exposed through ingestion. Diagnosis was majorly based on poisoning history 91.2% (187/205), and clinical features such as airways, breathing, and circulation examination 48.0% (95/198); nausea and vomiting 42.9% (91/212); muscle weakness 29.7% (63/212); excessive salivation 23.1% (49/212); and confusion 20.3% (43/212). More than half of the patients admitted were treated using atropine 52.3% (113/212). The prevalence of acute pesticide poisoning was high with most managed based on physical and clinical examination.

  7. Prevalence, Circumstances, and Management of Acute Pesticide Poisoning in Hospitals in Kampala City, Uganda

    PubMed Central

    Ssemugabo, Charles; Halage, Abdullah Ali; Neebye, Ruth Mubeezi; Nabankema, Victoria; Kasule, Massy Moses; Ssekimpi, Deogratius; Jørs, Erik

    2017-01-01

    This study was aimed at assessing prevalence, circumstance, and management of acute pesticide poisoning in hospitals in Kampala. It was a retrospective cross-sectional study that involved reviewing of 739 poisoning patient records from 5 hospitals in Kampala. Of the 739 patients, 212 were due to pesticide poisoning resulting in a prevalence of 28.8%. About 91.4% (191/210) of the cases were due to organophosphate poisoning, 63.3% (133/210) were intentional, and 98.1% (206/210) were exposed through ingestion. Diagnosis was majorly based on poisoning history 91.2% (187/205), and clinical features such as airways, breathing, and circulation examination 48.0% (95/198); nausea and vomiting 42.9% (91/212); muscle weakness 29.7% (63/212); excessive salivation 23.1% (49/212); and confusion 20.3% (43/212). More than half of the patients admitted were treated using atropine 52.3% (113/212). The prevalence of acute pesticide poisoning was high with most managed based on physical and clinical examination. PMID:28904524

  8. Future of management of multiple sclerosis in the middle East: a consensus view from specialists in ten countries.

    PubMed

    Aljumah, Mohammed; Alroughani, Raed; Alsharoqi, I; Bohlega, Saeed A; Dahdaleh, Maurice; Deleu, Dirk; Esmat, Khaled; Khalifa, Ahmad; Sahraian, Mohammad A; Szólics, Miklós; Altahan, Abdulrahman; Yamout, Bassem I; Rieckmann, Peter; Daif, Abdulkader

    2013-01-01

    The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: "Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS." These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East.

  9. Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective.

    PubMed

    Zhu, Yeyi; Zhang, Cuilin

    2016-01-01

    Despite the increasing epidemic of diabetes mellitus affecting populations at different life stages, the global burden of gestational diabetes mellitus (GDM) is not well assessed. Systematically synthesized data on global prevalence estimates of GDM are lacking, particularly among developing countries. The hyperglycemic intrauterine environment as exemplified in pregnancies complicated by GDM might not only reflect but also fuel the epidemic of type 2 diabetes mellitus (T2DM). We comprehensively reviewed available data in the past decade in an attempt to estimate the contemporary global prevalence of GDM by country and region. We reviewed the risk of progression from GDM to T2DM as well. Synthesized data demonstrate wide variations in both prevalence estimates of GDM and the risk of progression from GDM to T2DM. Direct comparisons of GDM burden across countries or regions are challenging given the great heterogeneity in screening approaches, diagnostic criteria, and underlying population characteristics. In this regard, collaborative efforts to estimate global GDM prevalence would be a large but important leap forward. Such efforts may have substantial public health implications in terms of informing health policy makers and healthcare providers for disease burden and for developing more targeted and effective diabetes prevention and management strategies globally.

  10. Gulf Cooperation Council-dialysis outcomes and practice patterns study: An overview of anemia management trends at the regional and country specific levels in the Gulf Cooperation Council countries.

    PubMed

    Abouchacra, Samra; Obaidli, Ali; Al-Ghamdi, Saeed M G; Al Wakeel, Jamal; Al Salmi, Issa; Al Ghareeb, Sumaya; Al Azmi, Mohammad; Elsayed, Mohammed; Bieber, Brian A; Pisoni, Ronald L

    2016-11-01

    The Gulf Cooperation Council-Dialysis Outcomes and Practice Patterns Study (GCC-DOPPS) marks the joining of the six Gulf region countries including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates to the main DOPPS study in 2012. The current review is a descriptive reporting on results related to the management of anemia from these countries. Our data demonstrate consistent anemia management patterns across the GCC countries allowing the achievement of international treatment levels. Overall, the majority of hemodialysis patients were prescribed appropriate erythropoiesis-stimulating agents (ESAs) and supplemental iron, enabling the attainment of mean hemoglobin (Hb) level of 10.9 g/dL. Comparisons of the individual country profiles reveal individual differences in the choice and mode of ESA and iron administration. However, all countries displayed good compliance with guideline recommendations. The same challenges as elsewhere are faced in the GCC, with respect to optimizing Hb levels and judiciously using ESA and iron supplements. Some opportunities exist for focused efforts to fine tune inter-facility variability in anemia management based on continued data tracking. The latter is vital in enabling adopting new trends to further improve not only anemia management but also the wholesome care of dialysis patients.

  11. Institutional frameworks for management of epizoonotic emergencies in six countries in the Eastern Africa region: a situational analysis.

    PubMed

    Bazeyo, W; Mayega, Roy W; Nabukenya, I; Keyyu, J; Mamuya, S; Tabu, S J; Senna, L; Mohammad, M; Rugigana, E; Alingi, A; Mapatano, M; Kiguli, J; Orach, C G; Burnham, G; Killewo, J

    2013-06-01

    The Eastern Africa region is a hot-spot for epidemics of emerging zoonotic diseases ('epizoonotics'). However, the region's capacity for response to epidemics of zoonotic origin has not been documented. This paper presents a multi-country situational analysis on the institutional frameworks for management of zoonotic epidemics in the Eastern Africa region. A multi-country assessment of 6 country teams was conducted (Uganda, Kenya, Tanzania, Ethiopia, DRC and Rwanda). It involved a review of records and interviews with key informants from agencies with a stake in the management of zoonotic and disasters in general in the respective countries. Qualitative data were analyzed for key emerging themes. There are many socio-cultural risk factors to epidemic prone zoonotic diseases in the region. Countries have varying levels of preparedness for zoonotic emergencies. All 6 countries have a framework for disaster management. However, technical response to epidemics is managed by the line sectors, with limited Inter-sectoral collaboration. Some sectors were disproportionately more prepared than others. Surveillance systems are mostly passive and inadequate for early detection. All 6 countries have built reasonable capacity to respond to avian influenza, but not other zoonotic emergencies. Most countries lack personnel at the operational levels, and veterinary public health services are ill-facilitated. There is need to strengthen veterinary public health services at all levels, but with a 'one health' approach. There is also need to establish 'risk-based surveillance' hot spots for zoonotic epidemics and to build community resilience 'epizoonotic' diseases.

  12. Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life, and Prevalence According to Age, Gender, and Country.

    PubMed

    Canuto, Alessandra; Weber, Kerstin; Baertschi, Marc; Andreas, Sylke; Volkert, Jana; Dehoust, Maria Christina; Sehner, Susanne; Suling, Anna; Wegscheider, Karl; Ausín, Berta; Crawford, Mike J; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Muñoz, Manuel; Quirk, Alan; Rotenstein, Ora; Santos-Olmo, Ana Belén; Shalev, Arieh; Strehle, Jens; Wittchen, Hans-Ulrich; Schulz, Holger; Härter, Martin

    2018-02-01

    Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life. The study used a cross-sectional multicenter survey. The study sample comprised 3,142 men and women aged 65 to 84 years, living in five European countries and Israel. Anxiety disorders were assessed using computer-assisted face-to-face interviews with an age-appropriate diagnostic interview (CIDI65+). The prevalence of anxiety disorders was 17.2%. Agoraphobia was the most frequent disorder (4.9%), followed by panic disorder (3.8%), animal phobia (3.5%), general anxiety disorder (3.1%), post-traumatic stress disorder (1.4%), social phobia (1.3%), and obsessive-compulsive disorder (0.8%). The prevalence rate of any anxiety disorder dropped by 40% to 47% in adults aged 75-84 years compared with those aged 65-74 years. Women were twice as likely to present with agoraphobia or general anxiety disorder as men. Only panic disorder and phobia were associated with comorbid major depression. The negative relationship with quality of life was limited to agoraphobia and generalized anxiety disorder. The age-appropriate CIDI65+ led to higher prevalence rates of anxiety disorders in the elderly, yet to weaker associations with comorbidities and impaired quality of life compared with previous studies. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. Distribution and prevalence of major risk factors of noncommunicable diseases in selected countries: the WHO Inter-Health Programme.

    PubMed Central

    Berrios, X.; Koponen, T.; Huiguang, T.; Khaltaev, N.; Puska, P.; Nissinen, A.

    1997-01-01

    The Inter-Health Programme was launched in 1986 by WHO, with the collaboration of a coordination centre (National Public Health Institute, Finland) to control and prevent chronic noncommunicable diseases (CNCDs) among adults. Programmes for action were organized based on the concept that most major CNCDs share common risk factors and that those that are lifestyle related are modifiable through efficient interventions using multifactorial strategies involving community participation and behaviour changes carried out at the primary health care level. Twelve countries from all WHO Regions have joined the programme. A baseline survey was undertaken in all countries with a common protocol, following the criteria and methods employed in the MONICA Project. Altogether 36815 men and women aged 35-64 years were included in the present analysis from the following Inter-Health countries: Chile, China, Cyprus, Finland, Lithuanian SSR, Malta, Mauritius, Russian SFSR, United Republic of Tanzania, and USA. In addition to individual country analysis, centralized analysis was carried out at the Finnish National Public Health Institute and the Department of Community Health, Kuopio University, Finland. Reported here are the mean values of blood pressure, body mass index, and serum total cholesterol as well as specific prevalences of smoking, hypertension, obesity, and hypercholesterolaemia. PMID:9185361

  14. Prevalence and intensity of soil-transmitted helminthiasis, prevalence of malaria and nutritional status of school going children in honduras.

    PubMed

    Mejia Torres, Rosa Elena; Franco Garcia, Dora Nelly; Fontecha Sandoval, Gustavo Adolfo; Hernandez Santana, Adriana; Singh, Prabhjot; Mancero Bucheli, Sandra Tamara; Saboya, Martha; Paz, Mirian Yolanda

    2014-10-01

    Many small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children. A cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%). Biannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease.

  15. Prevalence and Intensity of Soil-Transmitted Helminthiasis, Prevalence of Malaria and Nutritional Status of School Going Children in Honduras

    PubMed Central

    Mejia Torres, Rosa Elena; Franco Garcia, Dora Nelly; Fontecha Sandoval, Gustavo Adolfo; Hernandez Santana, Adriana; Singh, Prabhjot; Mancero Bucheli, Sandra Tamara; Saboya, Martha; Paz, Mirian Yolanda

    2014-01-01

    Background Many small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children. Methods and Findings A cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%). Conclusions Biannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease. PMID:25330010

  16. Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling.

    PubMed

    McCoy, Dana Charles; Peet, Evan D; Ezzati, Majid; Danaei, Goodarz; Black, Maureen M; Sudfeld, Christopher R; Fawzi, Wafaie; Fink, Günther

    2016-06-01

    The development of cognitive and socioemotional skills early in life influences later health and well-being. Existing estimates of unmet developmental potential in low- and middle-income countries (LMICs) are based on either measures of physical growth or proxy measures such as poverty. In this paper we aim to directly estimate the number of children in LMICs who would be reported by their caregivers to show low cognitive and/or socioemotional development. The present paper uses Early Childhood Development Index (ECDI) data collected between 2005 and 2015 from 99,222 3- and 4-y-old children living in 35 LMICs as part of the Multiple Indicator Cluster Survey (MICS) and Demographic and Health Surveys (DHS) programs. First, we estimate the prevalence of low cognitive and/or socioemotional ECDI scores within our MICS/DHS sample. Next, we test a series of ordinary least squares regression models predicting low ECDI scores across our MICS/DHS sample countries based on country-level data from the Human Development Index (HDI) and the Nutrition Impact Model Study. We use cross-validation to select the model with the best predictive validity. We then apply this model to all LMICs to generate country-level estimates of the prevalence of low ECDI scores globally, as well as confidence intervals around these estimates. In the pooled MICS and DHS sample, 14.6% of children had low ECDI scores in the cognitive domain, 26.2% had low socioemotional scores, and 36.8% performed poorly in either or both domains. Country-level prevalence of low cognitive and/or socioemotional scores on the ECDI was best represented by a model using the HDI as a predictor. Applying this model to all LMICs, we estimate that 80.8 million children ages 3 and 4 y (95% CI 48.1 million, 113.6 million) in LMICs experienced low cognitive and/or socioemotional development in 2010, with the largest number of affected children in sub-Saharan Africa (29.4.1 million; 43.8% of children ages 3 and 4 y), followed by

  17. The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS).

    PubMed

    Clark, P; Cons-Molina, F; Deleze, M; Ragi, S; Haddock, L; Zanchetta, J R; Jaller, J J; Palermo, L; Talavera, J O; Messina, D O; Morales-Torres, J; Salmeron, J; Navarrete, A; Suarez, E; Pérez, C M; Cummings, S R

    2009-02-01

    In the first population-based study of vertebral fractures in Latin America, we found a 11.18 (95% CI 9.23-13.4) prevalence of radiographically ascertained vertebral fractures in a random sample of 1,922 women from cities within five different countries. These figures are similar to findings from studies in Beijing, China, some regions of Europe, and slightly lower than those found in the USA using the same standardized methodology. We report the first study of radiographic vertebral fractures in Latin America. An age-stratified random sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico were included. In all cases a standardized questionnaire and lateral X-rays of the lumbar and thoracic spine were obtained after informed consent. A standardized prevalence of 11.18 (95% CI 9.23-13.4) was found. The prevalence was similar in all five countries, increasing from 6.9% (95% CI 4.6-9.1) in women aged 50-59 years to 27.8% (95% CI 23.1-32.4) in those 80 years and older (p for trend < 0.001). Among different risk factors, self-reported height loss OR = 1.63 (95% CI: 1.18-2.25), and previous history of fracture OR = 1.52 (95% CI: 1.14-2.03) were significantly (p < 0.003 and p < 0.04 respectably) associated with the presence of radiographic vertebral fractures in the multivariate analysis. In the bivariate analyses HRT was associated with a 35% lower risk OR = 0.65 (95% CI: 0.46-0.93) and physical activity with a 27% lower risk of having a vertebral fracture OR = 0.73 (95% CI: 0.55-0.98), but were not statistically significant in multivariate analyses We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.

  18. Prevalence and Pattern of Antibiotic Resistant Strains of Helicobacter Pylori Infection in ASEAN

    PubMed

    Vilaichone, Ratha Korn; Quach, Duc Trong; Yamaoka, Yoshio; Sugano, Ken; Mahachai, Varocha

    2018-05-26

    Objective: Antibiotic resistance has significantly impact on eradication rates for H. pylori infection and remains important cause of treatment failure worldwide including ASEAN countries. The aim of this study was to survey the prevalence and antibiotic resistant pattern of H. pylori infection in ASEAN. Methods: This study was a survey among 26 experts from 9 ASEAN countries including Thailand, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore and Vietnam whom attended a meeting to develop the ASEAN consensus on H. pylori management in Bangkok in November 2015. A questionnaire was sent to each member of the consensus meeting. The detail of the questionnaire included information about prevalence of H. pylori infection, facilities to perform H. pylori culture, molecular testing for antibiotic resistance and antibiotic resistance rate in their countries. Results: H. pylori infection remain common in ASEAN ranging from 20% in Malaysia, 21-54% in Thailand and 69% in Myanmar. Most of ASEAN countries can perform H. pylori cultures and antibiotic susceptibility tests except Laos and Cambodia. In ASEAN countries, metronidazole resistant H pylori is quite common whereas amoxicillin resistance remain rare. Clarithromycin resistance results in a significant decrease in H. pylori eradication rate with clarithromycin-containing regimens. The prevalence of clarithromycin resistance varies in ASEAN countries being high in Vietnam (30%) and Cambodia (43%), moderate to high in Singapore (17%) and low in Malaysia (6.8%), Philippine (2%) and Myanmar (0%). In Thailand, clarithromycin resistance tends to higher in large cities (14%) than in rural areas (~3.7%). Conclusion: ASEAN countries should develop a standard protocol for regular susceptibility testing of H. pylori so that clinicians would be better able to choose reliably effective empiric therapies. The wide range of antibiotic resistance in ASEAN countries suggests that the preferred first line regimen should

  19. Cross-country Association of Press Freedom and LGBT freedom with prevalence of persons living with HIV: implication for global strategy against HIV/AIDS.

    PubMed

    Chen, Xinguang; Elliott, Amy L; Wang, Shuang

    2018-01-01

    Human behaviors are affected by attitudes and beliefs, which in turn are shaped by higher-level values to which we have ascribed. In this study, we explore the relationship between two higher-level values, press freedom and LGBT freedom, and HIV infection with national data at the population level. Data were the number of persons living with HIV (PLWH, n  = 35,468,911) for 148 countries during 2011-15, press freedom index (PFI) determined by the Reporters Without Borders, and LGBT freedom index (LGBT-FI) based on laws regulating same-sex relationships and expression. PLWH prevalence (1/1000), PFI and LGBT-FI were mapped first. Multiple regression was thus used to associate the logarithm of PLWH prevalence with PFI, LGBT-FI and PFI × LGBT-FI interaction, controlling for per capita GDP and weighted by population size. Global prevalence of PLWH during 2011-15 was 0.51 per 1000 population. The prevalence showed a geographic pattern moving from high at the south and west ends of the world map to low at the north and east. Both PFI and LGBT-FI were positively associated with PLWH prevalence with a negative interaction between the two. More people are infected with HIV in countries with higher press freedom and higher LGBT freedom. Furthermore, press freedom can attenuate the positive association between levels of LGBT freedom and risk of HIV infection. This study demonstrated the urgency for and provided data supporting further research to investigate potential cultural and socioecological mechanisms underpinning the complex relationship among press freedom, LGBT freedom and HIV infection, with data collected at the individual level.

  20. Chronic widespread pain prevalence in the general population: A systematic review.

    PubMed

    Andrews, P; Steultjens, M; Riskowski, J

    2018-01-01

    Chronic widespread pain (CWP) is a significant burden in communities. Understanding the impact of population-dependent (e.g., age, gender) and contextual-dependent (e.g. survey method, region, inequality level) factors have on CWP prevalence may provide a foundation for population-based strategies to address CWP. Therefore, the purpose of this study was to estimate the global prevalence of CWP and evaluate the population and contextual factors associated with CWP. A systematic review of CWP prevalence studies (1990-2017) in the general population was undertaken. Meta-analyses were conducted to determine CWP prevalence, and study population data and contextual factors were evaluated using a meta-regression. Thirty-nine manuscripts met the inclusion criteria. Study CWP prevalence ranged from 1.4% to 24.0%, with CWP prevalence in men ranging from 0.8% to 15.3% and 1.7% to 22.1% in women. Estimated overall CWP prevalence was 9.6% (8.0-11.2%). Meta-regression analyses showed gender, United Nations country development status, and human development index (HDI) influenced CWP prevalence, while survey method, region, methodological and reporting quality, and inequality showed no significant effect on the CWP estimate. Globally CWP affects one in ten individuals within the general population, with women more likely to experience CWP than men. HDI was noted to be the socioeconomic factor related to CWP prevalence, with those in more developed countries having a lower CWP prevalence than those in less developed countries. Most CWP estimates were from developed countries, and CWP estimates from countries with a lower socioeconomic position is needed to further refine the global estimate of CWP. This systematic review and meta-analysis updates the current global CWP prevalence by examining the population-level (e.g. age, gender) and contextual (e.g. country development status; survey style; reporting and methodologic quality) factors associated with CWP prevalence. This analyses

  1. Growing Epidemic of Coronary Heart Disease in Low- and Middle-Income Countries

    PubMed Central

    Gaziano, Thomas A.; Bitton, Asaf; Anand, Shuchi; Abrahams-Gessel, Shafika; Murphy, Adrianna

    2010-01-01

    Coronary heart disease (CHD) is the single largest cause of death in the developed countries and is one of the leading causes of disease burden in developing countries. In 2001, there were 7.3 million deaths due to CHD worldwide. Three-fourths of global deaths due to CHD occurred in the low and middle-income countries. The rapid rise in CHD burden in most of the low and middle and income countries is due to socio-economic changes, increase in life span and acquisition of lifestyle related risk factors. The CHD death rate, however, varies dramatically across the developing countries. The varying incidence, prevalence, and mortality rates reflect the different levels of risk factors, other competing causes of death, availability of resources to combat CVD, and the stage of epidemiologic transition that each country or region finds itself. The economic burden of CHD is equally large but solutions exist to manage this growing burden. PMID:20109979

  2. Industrial-waste management in developing countries: the case of Lebanon.

    PubMed

    el-Fadel, M; Zeinati, M; el-Jisr, K; Jamali, D

    2001-04-01

    This paper presents a critical assessment of the existing Lebanese industrial sector, namely the current status and classification of industrial establishments based on a comparative synthesis and analysis of recent nationwide surveys and studies pertaining to industrial-waste management. Characterisation of solid and liquid industrial wastes generated, including hazardous wastes, is presented together with current and projected waste loads, recycling opportunities, and export/import practices. Institutional capacity and needs pertaining to the enforcement of relevant environmental legislation, staffing and resources, monitoring schemes, and public participation are critically evaluated. Finally, realistic options for industrial-waste management in the context of country-specific institutional economic and technical limitations are outlined. The industrial sector in Lebanon consists of small-scale industries (84% employ less than 10 persons), primarily involved in light manufacturing (96%). These industries which are distributed among 41 ill-defined zones and deficient in appropriate physical infrastructure, generate solid, liquid, and hazardous waste estimated at 346,730 tons/year, 20,169,600 m3/year and between 3000 to 15,000 tons/year, respectively. Although the growth of this sector contributes significantly to the socio-economic development of the country (industry accounts for 17% of the gross domestic product), in the absence of a comprehensive environmental management plan, this expansion may not be sustained into the coming millennium. The anticipated expansion will inevitably amplify adverse environmental impacts associated with industrial activities due to rising waste volumes and improper waste handling and disposal practices. These impacts are further aggravated by a deficient institutional framework, a lack of adequate environmental laws, and lax enforcement of regulations governing industrial-waste management.

  3. Prevalence, clinical features and management of pediatric magnetic foreign body ingestions.

    PubMed

    Tavarez, Melissa M; Saladino, Richard A; Gaines, Barbara A; Manole, Mioara D

    2013-01-01

    Foreign body (FB) ingestions are frequent in children. Whereas the majority of FBs pass spontaneously through the gastrointestinal tract, ingestion of magnetic FBs pose a particular risk for obstruction due to proximate attraction through the intestinal wall. We aimed to identify the prevalence, clinical presentation, and management of magnetic FB ingestions at our tertiary care institution. We performed a retrospective chart review of medical records of patients presenting to the pediatric Emergency Department (ED) or admitted to the hospital with FB ingestions from June 2003-July 2009. From those cases, patients with magnetic FB ingestions were identified. During the study period, 337,839 patients presented to the ED; 38 cases of magnetic FB ingestion were identified (prevalence 0.01%). Abdominal radiography was obtained in all cases. Ingestion of a single magnet occurred in 30 of 38 cases (79%). Of those, 4 patients underwent endoscopic removal due to signs of FB impaction in the esophagus or pylorus; no complications were noted. Ingestion of multiple magnets (range 2-6) occurred in 8 of 38 cases. Four of the 8 patients with multiple magnetic FBs (50%) presented with signs of peritonitis and required operative repair of multiple intestinal perforations. No deaths were identified. Although ingestion of a single magnetic FB may, in most cases, be managed as a simple FB ingestion, the ingestion of multiple magnetic FB is associated with a high risk of complication and requires aggressive management. We propose an algorithm for management of children with magnetic FB ingestions. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. The behavior of multiple independent managers and ecological traits interact to determine prevalence of weeds.

    PubMed

    Coutts, Shaun R; Yokomizo, Hiroyuki; Buckley, Yvonne M

    2013-04-01

    Management of damaging invasive plants is often undertaken by multiple decision makers, each managing only a small part of the invader's population. As weeds can move between properties and re-infest eradicated sites from unmanaged sources, the dynamics of multiple decision makers plays a significant role in weed prevalence and invasion risk at the landscape scale. We used a spatially explicit agent-based simulation to determine how individual agent behavior, in concert with weed population ecology, determined weed prevalence. We compared two invasive grass species that differ in ecology, control methods, and costs: Nassella trichotoma (serrated tussock) and Eragrostis curvula (African love grass). The way decision makers reacted to the benefit of management had a large effect on the extent of a weed. If benefits of weed control outweighed the costs, and either net benefit was very large or all agents were very sensitive to net benefits, then agents tended to act synchronously, reducing the pool of infested agents available to spread the weed. As N. trichotoma was more damaging than E. curvula and had more effective control methods, agents chose to manage it more often, which resulted in lower prevalence of N. trichotoma. A relatively low number of agents who were intrinsically less motivated to control weeds led to increased prevalence of both species. This was particularly apparent when long-distance dispersal meant each infested agent increased the invasion risk for a large portion of the landscape. In this case, a small proportion of land mangers reluctant to control, regardless of costs and benefits, could lead to the whole landscape being infested, even when local control stopped new infestations. Social pressure was important, but only if it was independent of weed prevalence, suggesting that early access to information, and incentives to act on that information, may be crucial in stopping a weed from infesting large areas. The response of our model to both

  5. Utilization rates of knee-arthroplasty in OECD countries.

    PubMed

    Pabinger, C; Lothaller, H; Geissler, A

    2015-10-01

    The number of knee arthroplasties and the prevalence of obesity are increasing exponentially. To date there have been no published reviews on utilization rates of knee arthroplasty in OECD countries. We analysed economic, medical and population data relating to knee arthroplasty surgeries performed in OECD countries. Gross domestic product (GDP), health expenditures, obesity prevalence, knee arthroplasty utilization rates and growth in knee arthroplasty rates per 100,000 population were assessed for total population, for patients aged 65 years and over, and patients aged 64 years and younger. Obesity prevalence and utilization of knee arthroplasty have increased significantly in the past. The mean utilization rate of knee arthroplasty was 150 (22-235) cases per 100,000 total population in 2011. The strongest annual increase (7%) occurred in patients 64 years and under. Differences between individual countries can be explained by economic and medical patterns, with countries with higher medical expenditures and obesity prevalence having significantly higher utilization rates. Countries with lower utilization rates have significantly higher growth in utilization rates. The future demand for knee prostheses will increase x-fold by 2030, with exact rates dependant upon economic, social and medical factors. We observed a 10-fold variation in the utilization of knee arthroplasty among OECD countries. A significant and strong correlation of GDP, health expenditures and obesity prevalence with utilization of knee arthroplasty was found. Patients aged 64 years and younger show a two-fold higher growth rate in knee arthroplasty compared to the older population. This trend could result in a four-fold demand for knee arthroplasty in OECD countries by 2030. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  6. How the United States exports managed care to developing countries.

    PubMed

    Waitzkin, H; Iriart, C

    2001-01-01

    As their expansion slows in the United States, managed care organizations will continue to enter new markets abroad. Investors view the opening of managed care in Latin America as a lucrative business opportunity. As public-sector services and social security funds are cut back, privatized, and reorganized under managed care, with the support of international lending agencies such as the World Bank, the effects of these reforms on access to preventive and curative services will hold great importance throughout the developing world. Many groups in Latin America are working on alternative projects that defend health as a public good, and similar movements have begun in Africa and Asia. Increasingly, this organizing is being recognized not only as part of a class struggle but also as part of a struggle against economic imperialism--which has now taken on the new appearance of rescuing less developed countries from rising health care costs and inefficient bureaucracies through the imposition of neoliberal managed-care solutions exported from the United States.

  7. The prevalence and significance of displacement for wilderness recreation management and research

    Treesearch

    Ingrid E. Schneider

    2007-01-01

    The concept of visitor displacement has important implications for wilderness management and research. Research on actual displacement of wilderness visitors is extremely limited, but this displacement likely follows patterns found for general recreationists: visitors employ a variety of coping responses and displacement is prevalent. Understanding if and when visitors...

  8. Building co-management as a process: problem solving through partnerships in Aboriginal country, Australia.

    PubMed

    Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

    2012-06-01

    Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to 'care for country'. From this evolving process we have identified the key components of a relationship building strategy, 'the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

  9. Building Co-Management as a Process: Problem Solving Through Partnerships in Aboriginal Country, Australia

    NASA Astrophysics Data System (ADS)

    Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

    2012-06-01

    Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to `care for country'. From this evolving process we have identified the key components of a relationship building strategy, `the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

  10. Utilizing Healthcare Developments, Demographic Data with Statistical Techniques to Estimate the Diarrhoea Prevalence in India.

    PubMed

    Srivastava, Shweta; Vatsalya, Vatsalya; Arora, Ashoo; Arora, Kashmiri L; Karch, Robert

    2012-03-22

    Diarrhoea is one of the leading causes of morbidity and mortality in developing countries in Africa and South Asia such as India. Prevalence of diarrheal diseases in those countries is higher than developed western world and largely has been associated with socio-economic and sanitary conditions. However, present available data has not been sufficiently evaluated to study the role of other factors like healthcare development, population density, sex and regional influence on diarrheal prevalence pattern. Study was performed to understand the relationship of diarrheal prevalence with specific measures namely; healthcare services development, demographics, population density, socio-economic conditions, sex, and regional prevalence patterns in India. Data from Annual national health reports and other epidemiological studies were included and statistically analyzed. Our results demonstrate significant correlation of the disease prevalence pattern with certain measures like healthcare centers, population growth rate, sex and region-specific morbidity. Available information on sanitation like water supply and toilet availability and socioeconomic conditions like poverty and literacy measures could only be associated as trends of significance. This study can be valuable for improvisation of appropriate strategies focused on important measures like healthcare resources, population growth and regional significances to evaluate prevalence patterns and management of the diarrhoea locally and globally.

  11. Prevalence of common mental disorders in general practice attendees across Europe.

    PubMed

    King, Michael; Nazareth, Irwin; Levy, Gus; Walker, Carl; Morris, Richard; Weich, Scott; Bellón-Saameño, Juan Angel; Moreno, Berta; Svab, Igor; Rotar, Danica; Rifel, J; Maaroos, Heidi-Ingrid; Aluoja, Anu; Kalda, Ruth; Neeleman, Jan; Geerlings, Mirjam I; Xavier, Miguel; de Almeida, Manuel Caldas; Correa, Bernardo; Torres-Gonzalez, Francisco

    2008-05-01

    There is evidence that the prevalence of common mental disorders varies across Europe. To compare prevalence of common mental disorders in general practice attendees in six European countries. Unselected attendees to general practices in the UK, Spain, Portugal, Slovenia, Estonia and The Netherlands were assessed for major depression, panic syndrome and other anxiety syndrome. Prevalence of DSM-IV major depression, other anxiety syndrome and panic syndrome was compared between the UK and other countries after taking account of differences in demographic factors and practice consultation rates. Prevalence was estimated in 2,344 men and 4,865 women. The highest prevalence for all disorders occurred in the UK and Spain, and lowest in Slovenia and The Netherlands. Men aged 30-50 and women aged 18-30 had the highest prevalence of major depression; men aged 40-60 had the highest prevalence of anxiety, and men and women aged 40-50 had the highest prevalence of panic syndrome. Demographic factors accounted for the variance between the UK and Spain but otherwise had little impact on the significance of observed country differences. These results add to the evidence for real differences between European countries in prevalence of psychological disorders and show that the burden of care on general practitioners varies markedly between countries.

  12. Worldwide prevalence of hypospadias.

    PubMed

    Springer, A; van den Heijkant, M; Baumann, S

    2016-06-01

    Hypospadias is a common congenital malformation. Surgical repair and management of the long-term consequences require a substantial amount of socioeconomic resources. It is generally accepted that genetic and environmental factors play a major role in the etiology of hypospadias. There have been contradictory reports on rising hypospadias rates, and regional and ethnical differences. The exact prevalence of hypospadias is of major interest for healthcare providers, clinical medicine, and research. To review the literature regarding the worldwide prevalence of hypospadias. Pubmed, EMBASE and Google were systematically screened for: hypospadias, congenital malformation, anomaly, incidence, prevalence, and epidemiology. Exclusion criteria were surgical and risk-factor studies. To give an additional comprehensive overview, prevalence data were harvested from the Annual Report of the International Clearinghouse Centre for Birth Defects Surveillance and Research. Prevalence was reported as per 10,000 live births. Data were available from 1910 to 2013. The median study period was 9 years (range: 1-36 years). Approximately 90,255,200 births have been screened in all studies. The mean prevalence were: Europe 19.9 (range: 1-464), North America 34.2 (6-129.8), South America 5.2 (2.8-110), Asia 0.6-69, Africa 5.9 (1.9-110), and Australia 17.1-34.8. There were major geographical, regional, and ethnical differences, with an extreme heterogeneity of published studies. Numerous studies showed an increasing prevalence; on the other hand, there were a lot of contradictory data on the prevalence of hypospadias. The summary table shows contradictory data from the five largest international studies available. There was huge literature available on the prevalence of hypospadias. Most data derived from Europe and North America. Many methodological factors influenced the calculation of an accurate prevalence, and even more of the true changes in prevalence over time (no generally accepted

  13. Can we determine whether physical limitations are more prevalent in the US than in countries with comparable life expectancy?

    PubMed

    Glei, Dana A; Goldman, Noreen; Ryff, Carol D; Weinstein, Maxine

    2017-12-01

    We evaluate the variability in estimates of self-reported physical limitations by age across four nationally representative surveys in the US. We consider its implications for determining whether, as previous literature suggests, the US estimates reveal limitations at an earlier age than in three countries with similar life expectancy: England, Taiwan, and Costa Rica. Based on cross-sectional data from seven population-based surveys, we use local mean smoothing to plot self-reported limitations by age for each of four physical tasks for each survey, stratified by sex. We find substantial variation in the estimates in the US across four nationally-representative surveys. For example, one US survey suggests that American women experience a walking limitation 15 years earlier than their Costa Rican counterparts, while another US survey implies that Americans have a 4-year advantage. Differences in mode of survey may account for higher prevalence of limitations in the one survey that used a self-administered mail-in questionnaire than in the other surveys that used in-person or telephone interviews. Yet, even among US surveys that used the same mode, there is still so much variability in estimates that we cannot conclude whether Americans have better or worse function than their counterparts in the other countries. Seemingly minor differences in question wording and response categories may account for the remaining inconsistency. If minor differences in question wording can result in such extensive variation in the estimates within a given population, then lack of comparability is likely to be an even greater problem when examining results across countries that do not share the same language or culture. Despite the potential utility of self-reported physical function within a survey sample, our findings imply that absolute estimates of population-level prevalence of self-reported physical limitations are unlikely to be strictly comparable across countries-or even

  14. Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.

    PubMed

    Bernabé-Ortiz, Antonio; White, Peter J; Carcamo, Cesar P; Hughes, James P; Gonzales, Marco A; Garcia, Patricia J; Garnett, Geoff P; Holmes, King K

    2009-02-03

    Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially

  15. Obesity Prevention in the Nordic Countries.

    PubMed

    Stockmarr, Anders; Hejgaard, Tatjana; Matthiessen, Jeppe

    2016-06-01

    Previous studies have shown that mean BMI and prevalences of overweight/obesity and obesity have increased over the last decades in the Nordic countries, despite highly regulated societies with a focus on obesity prevention. We review recent overweight/obesity and obesity prevention initiatives within four of the five Nordic countries: Sweden, Denmark, Finland, and Iceland. Moreover, we analyze the current situation based on monitoring data on BMI collected in 2011 and 2014, and obtain overall estimates of overweight/obesity and obesity prevalences for the Nordic Region. Data analysis shows that obesity in adults has increased from 2011 to 2014, while no significant changes were found for children. No significant increases were found for mean BMI and overweight/obesity prevalence. Obesity prevention initiatives among the Nordic countries are highly similar although minor differences are present, which is rooted in transnational Nordic cooperation and comparable societal structures.

  16. Asthma Prevalence, Management, and Education in New York State Elementary Schools: A Survey of School Nurses

    ERIC Educational Resources Information Center

    Kielb, Christine; Lin, Shao; Hwang, Syni-an

    2007-01-01

    A survey of school nurses was conducted in New York State elementary schools to assess asthma and asthma management in students. The survey contained questions about asthma morbidity, management and education, obstacles to management, and school indoor air quality. The reported prevalence of asthma among students was 8.5%. Of the students with…

  17. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey

    PubMed Central

    Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P.; Guerra, Mariella; Huang, Yueqin; Jacob, K. S.; Jimenez-Velazquez, Ivonne Z.; Llibre Rodriguez, Juan J.; Sosa, Ana L.; Uwakwe, Richard; Williams, Joseph D.; Jotheeswaran, A. T.; Liu, Zhaorui; Lopez Medina, A. M.; Salinas-Contreras, Rosa Maria; Prince, Martin J.

    2016-01-01

    Background Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Methods Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7mmol/L). Results Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Conclusions Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control

  18. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey.

    PubMed

    Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jimenez-Velazquez, Ivonne Z; Llibre Rodriguez, Juan J; Sosa, Ana L; Uwakwe, Richard; Williams, Joseph D; Jotheeswaran, A T; Liu, Zhaorui; Lopez Medina, A M; Salinas-Contreras, Rosa Maria; Prince, Martin J

    2016-01-01

    Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7 mmol/L). Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control.

  19. A study of variations in the reported haemophilia B prevalence around the world.

    PubMed

    Stonebraker, J S; Bolton-Maggs, P H B; Michael Soucie, J; Walker, I; Brooker, M

    2012-05-01

    The objectives of this article were to study the reported prevalence of haemophilia B (HB) on a country-by-country basis and to analyse whether the prevalence of HB varied by national economy. The prevalence of HB is the proportion of diagnosed, reported cases of HB in a population at a specific point of time. We collected data on the HB prevalence for 105 countries from the World Federation of Hemophilia annual global surveys. Our results showed that the HB prevalence varied considerably among countries, even among the wealthiest of countries. The HB prevalence (per 100 000 males) for the highest income countries was 2.69 ± 1.61 (mean ± SD), whereas the prevalence for the rest of the world was 1.20 ± 1.33 (mean ± SD). Ireland had the highest reported HB prevalence of 8.07 per 100 000 males. There was a strong trend of increasing HB prevalence (per 100 000 males) over time. Prevalence data reported from the WFH compared well with prevalence data from the literature. The WFH annual global surveys have some limitations, but they are the best available source of worldwide haemophilia data. Prevalence data are extremely valuable information for the planning efforts of national healthcare agencies in setting priorities and allocating resources for the treatment of HB. © 2011 Blackwell Publishing Ltd.

  20. Exploring substance use normalization among adolescents: a multilevel study in 35 countries.

    PubMed

    Sznitman, Sharon R; Kolobov, Tanya; Bogt, Tom Ter; Kuntsche, Emmanuel; Walsh, Sophie D; Boniel-Nissim, Meyran; Harel-Fisch, Yossi

    2013-11-01

    The substance use normalization thesis predicts that adolescent substance users are less likely to report substance use risk factors in high than in low prevalence countries. This study tests whether national population-level alcohol, cigarette and cannabis prevalence rates moderate the strength of the relationship between individual level social and behavioral risk factors and individual level alcohol, cigarette and cannabis use. Data from 2009/2010 Health Behaviour in School-Aged Children Study (N = 68,045, age = 15) from 35 countries was analyzed using logistic Hierarchical Linear Modeling. As expected based on low cannabis prevalence rates in all countries studied, no evidence of normalization was found for recent cannabis use. Also in line with the normalization thesis, results show that for substance use that reaches above 40% in at least some of the countries studied (drunkenness, alcohol and cigarette use), adolescents who reported use are less likely to report social and behavioral risk factors in high prevalence countries than in low prevalence countries. However, support for the normalization thesis was only partial in that results show that in models where evidence for normalization was found, there are risk factors that predict substance use to an equal degree regardless of country level prevalence rates. The current research shows that the normalization thesis is a useful framework for understanding the contextual aspects of adolescent alcohol, tobacco, and cannabis use. The study has implications for drug prevention as it suggests that selective prevention efforts may be particularly useful in low prevalence countries where screening based on risk factors may usefully identify adolescents at most risk for developing drug use problems. This approach may be less useful in high prevalence countries where screening based on risk factors is less likely to satisfactorily identify those at risk for developing drug use problems. Copyright © 2013 Elsevier

  1. Childhood overweight, obesity, and the metabolic syndrome in developing countries.

    PubMed

    Kelishadi, Roya

    2007-01-01

    The incidence of chronic disease is escalating much more rapidly in developing countries than in industrialized countries. A potential emerging public health issue may be the increasing incidence of childhood obesity in developing countries and the resulting socioeconomic and public health burden faced by these countries in the near future. In a systematic review carried out through an electronic search of the literature from 1950-2007, the author compared data from surveys on the prevalence of overweight, obesity, and the metabolic syndrome among children living in developing countries. The highest prevalence of childhood overweight was found in Eastern Europe and the Middle East, whereas India and Sri Lanka had the lowest prevalence. The few studies conducted in developing countries showed a considerably high prevalence of the metabolic syndrome among youth. These findings provide alarming data for health professionals and policy-makers about the extent of these problems in developing countries, many of which are still grappling with malnutrition and micronutrient deficiencies. Time trends in childhood obesity and its metabolic consequences, defined by uniform criteria, should be monitored in developing countries in order to obtain useful insights for primordial and primary prevention of the upcoming chronic disease epidemic in such communities.

  2. Socioeconomic position, macroeconomic environment and overweight among adolescents in 35 countries.

    PubMed

    Due, P; Damsgaard, M T; Rasmussen, M; Holstein, B E; Wardle, J; Merlo, J; Currie, C; Ahluwalia, N; Sørensen, T I A; Lynch, J; Borraccino, A; Borup, I; Boyce, W; Elgar, F; Gabhainn, S N; Krølner, R; Svastisalee, C; Matos, M C; Nansel, T; Al Sabbah, H; Vereecken, C; Valimaa, R

    2009-10-01

    It is important to understand levels and social inequalities in childhood overweight within and between countries. This study examined prevalence and social inequality in adolescent overweight in 35 countries, and associations with macroeconomic factors. International cross-sectional survey in national samples of schools. A total of 11-, 13- and 15-year-olds from 35 countries in Europe and North America in 2001-2002 (N=162 305). The main outcome measure was overweight based on self-reported height and weight (body mass index cut-points corresponding to body mass index of 25 kg/m(2) at the age of 18 years). Measures included family and school affluence (within countries), and average country income and economic inequality (between countries). There were large variations in adolescent overweight, from 3.5% in Lithuanian girls to 31.7% in boys from Malta. Prevalence of overweight was higher among children from less affluent families in 21 of 24 Western and 5 of 10 Central European countries. However, children from more affluent families were at higher risk of overweight in Croatia, Estonia and Latvia. In Poland, Lithuania, Macedonia and Finland, girls from less affluent families were more overweight whereas the opposite was found for boys. Average country income was associated with prevalence and inequality in overweight when considering all countries together. However, economic inequality as measured by the Gini coefficient was differentially associated with prevalence and socioeconomic inequality in overweight among the 23-high income and 10-middle income countries, with a positive relationship among the high income countries and a negative association among the middle income countries. The direction and magnitude of social inequality in adolescent overweight shows large international variation, with negative social gradients in most countries, but positive social gradients, especially for boys, in some Central European countries. Macroeconomic factors are

  3. Waste management barriers in developing country hospitals: Case study and AHP analysis.

    PubMed

    Delmonico, Diego V de Godoy; Santos, Hugo H Dos; Pinheiro, Marco Ap; de Castro, Rosani; de Souza, Regiane M

    2018-01-01

    Healthcare waste management is an essential field for both researchers and practitioners. Although there have been few studies using statistical methods for its evaluation, it has been the subject of several studies in different contexts. Furthermore, the known precarious practices for waste management in developing countries raise questions about its potential barriers. This study aims to investigate the barriers in healthcare waste management and their relevance. For this purpose, this paper analyses waste management practices in two Brazilian hospitals by using case study and the Analytic Hierarchy Process method. The barriers were organized into three categories - human factors, management, and infrastructure, and the main findings suggest that cost and employee awareness were the most significant barriers. These results highlight the main barriers to more sustainable waste management, and provide an empirical basis for multi-criteria evaluation of the literature.

  4. Postpartum management of diabetes pregnancy.

    PubMed

    Hossain, Nazli

    2016-09-01

    Diabetes mellitus has assumed the role of an epidemic. Previously considered a disease of affluent developed countries, it has become more common in developing countries. Pakistan is included among the countries with a high prevalence of diabetes. In this scenario, postpartum management of a woman with diabetes mellitus becomes more important as in this period counseling and educating a woman is essential. Counselling includes life style modifications to prevent future risks involving all the systems of the body. This review article discusses management of diabetes mellitus in postpartum period, guidelines for postpartum screening of women with gestational diabetes mellitus, risks involved in future life and stresses upon the need of local population based studies. Primary care providers and gynaecologists must realize the importance of postpartum screening for diabetes mellitus and provide relevant information to women as well.

  5. Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries

    PubMed Central

    Drain, Paul K; Halperin, Daniel T; Hughes, James P; Klausner, Jeffrey D; Bailey, Robert C

    2006-01-01

    Background Both religious practices and male circumcision (MC) have been associated with HIV and other sexually-transmitted infectious diseases. Most studies have been limited in size and have not adequately controlled for religion, so these relationships remain unclear. Methods We evaluated relationships between MC prevalence, Muslim and Christian religion, and 7 infectious diseases using country-specific data among 118 developing countries. We used multivariate linear regression to describe associations between MC and cervical cancer incidence, and between MC and HIV prevalence among countries with primarily sexual HIV transmission. Results Fifty-three, 14, and 51 developing countries had a high (>80%), intermediate (20–80%), and low (<20%) MC prevalence, respectively. In univariate analyses, MC was associated with lower HIV prevalence and lower cervical cancer incidence, but not with HSV-2, syphilis, nor, as expected, with Hepatitis C, tuberculosis, or malaria. In multivariate analysis after stratifying the countries by religious groups, each categorical increase of MC prevalence was associated with a 3.65/100,000 women (95% CI 0.54-6.76, p = 0.02) decrease in annual cervical cancer incidence, and a 1.84-fold (95% CI 1.36-2.48, p < 0.001) decrease in the adult HIV prevalence among sub-Saharan African countries. In separate multivariate analyses among non-sub-Saharan African countries controlling for religion, higher MC prevalence was associated with a 8.94-fold (95% CI 4.30-18.60) decrease in the adult HIV prevalence among countries with primarily heterosexual HIV transmission, but not, as expected, among countries with primarily homosexual or injection drug use HIV transmission (p = 0.35). Conclusion Male circumcision was significantly associated with lower cervical cancer incidence and lower HIV prevalence in sub-Saharan Africa, independent of Muslim and Christian religion. As predicted, male circumcision was also strongly associated with lower HIV

  6. Prevalence of depression and anxiety among undergraduate university students in low- and middle-income countries: a systematic review protocol.

    PubMed

    January, James; Madhombiro, Munyaradzi; Chipamaunga, Shalote; Ray, Sunanda; Chingono, Alfred; Abas, Melanie

    2018-04-10

    Depression and anxiety symptoms are reported to be common among university students in many regions of the world and impact on quality of life and academic attainment. The extent of the problem of depression and anxiety among students in low- and middle-income countries (LMICs) is largely unknown. This paper details methods for a systematic review that will be conducted to explore the prevalence, antecedents, consequences, and treatments for depression and anxiety among undergraduate university students in LMICs. Studies reporting primary data on common mental disorders among students in universities and colleges within LMICs will be included. Quality assessment of retrieved articles will be conducted using four Joanna Briggs critical appraisal checklists for prevalence, randomized control/pseudo-randomized trials, descriptive case series, and comparable cohort/case control. Meta-analysis of the prevalence of depression and anxiety will be conducted using a random effects model which will generate pooled prevalence with their respective 95% confidence intervals. The results from this systematic review will help in informing and guiding healthcare practitioners, planners, and policymakers on the burden of common mental disorders in university students in LMICs and of appropriate and feasible interventions aimed at reducing the burden of psychological morbidity among them. The results will also point to gaps in research and help set priorities for future enquiries. PROSPERO CRD42017064148.

  7. Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review.

    PubMed

    Chung, A; Backholer, K; Wong, E; Palermo, C; Keating, C; Peeters, A

    2016-03-01

    Recent obesity trends in children and adolescents suggest a plateau. However, it is unclear whether such trends have been experienced across socioeconomic groups. We analysed whether recent trends in child and adolescent overweight and obesity differ by socioeconomic position (SEP) across economically advanced countries. Eligible studies reported overweight and obesity prevalence in children and/or adolescents (2-18 years), for at least two time points since 1990, stratified by SEP. Socioeconomic differences in trends in child and adolescent overweight and obesity over time were analysed. Differences in trends between SEP groups were observed across a majority of studies. Over half the studies indicated increasing prevalence among low SEP children and adolescents compared to a third of studies among children and adolescents with a high SEP. Around half the studies indicated widening socioeconomic inequalities in overweight and obesity. Since 2000 a majority of studies demonstrated no change or a decrease in prevalence among both high and low SEP groups. However around 40% of studies indicated widening of socioeconomic inequalities post-2000. While our study provides grounds for optimism, socioeconomic inequalities in overweight and obesity continue to widen. These findings highlight the need for greater consideration of different population groups when implementing obesity interventions. © 2015 World Obesity.

  8. Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries.

    PubMed

    Andall-Brereton, Glennis; Brown, Eulynis; Slater, Sherian; Holder, Yvette; Luciani, Silvana; Lewis, Merle; Irons, Beryl

    2017-06-08

    To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

  9. Prevalence of Diabetes and Intermediate Hyperglycemia Among Adults From the First Multinational Study of Noncommunicable Diseases in Six Central American Countries

    PubMed Central

    Barcelo, Alberto; Gregg, Edward W.; Gerzoff, Robert B.; Wong, Roy; Perez Flores, Enrique; Ramirez-Zea, Manuel; Cafiero, Elizabeth; Altamirano, Lesbia; Ascencio Rivera, Melanie; de Cosio, Gerardo; de Maza, Martha Dinorah; del Aguila, Roberto; Emanuel, Englebert; Gil, Enrique; Gough, Ethan; Jenkins, Valerie; Orellana, Patrícia; Palma, Ruben; Palomo, Ruben; Pastora, Martha; Peña, Rodolfo; Pineda, Elia; Rodriguez, Bismark; Tacsan, Luis; Thompson, Loraine; Villagra, Lucy

    2012-01-01

    OBJECTIVE The increasing burdens of obesity and diabetes are two of the most prominent threats to the health of populations of developed and developing countries alike. The Central America Diabetes Initiative (CAMDI) is the first study to examine the prevalence of diabetes in Central America. RESEARCH DESIGN AND METHODS The CAMDI survey was a cross-sectional survey based on a probabilistic sample of the noninstitutionalized population of five Central American populations conducted between 2003 and 2006. The total sample population was 10,822, of whom 7,234 (67%) underwent anthropometry measurement and a fasting blood glucose or 2-h oral glucose tolerance test. RESULTS The total prevalence of diabetes was 8.5%, but was higher in Belize (12.9%) and lower in Honduras (5.4%). Of the screened population, 18.6% had impaired glucose tolerance/impaired fasting glucose. CONCLUSIONS As this population ages, the prevalence of diabetes is likely to continue to rise in a dramatic and devastating manner. Preventive strategies must be quickly introduced. PMID:22323417

  10. Type 2 diabetes self-management education programs in high and low mortality developing countries: a systematic review.

    PubMed

    Dube, Loveness; Van den Broucke, Stephan; Housiaux, Marie; Dhoore, William; Rendall-Mkosi, Kirstie

    2015-02-01

    Although self-management education is a key factor in the care for diabetes patients, its implementation in developing countries is not well documented. This systematic review considers the published literature on diabetes self-management education in high and low mortality developing countries. The aim is to provide a state of the art of current practices and assess program outcomes, cultural sensitivity, and accessibility to low literate patients. The Cochrane Library, PubMed, MEDLINE, PsycInfo, and PsycArticles databases were searched for peer-reviewed articles on type 2 diabetes published in English between 2009 and 2013. The World Bank and WHO burden of disease criteria were applied to distinguish between developing countries with high and low mortality. Information was extracted using a validated checklist. Three reviews and 23 primary studies were identified, 18 of which were from low mortality developing countries. Studies from high mortality countries were mostly quasi-experimental, those from low mortality countries experimental. Interventions were generally effective on behavior change and patients' glycemic control in the short term (≤9 months). While 57% of the studies mentioned cultural tailoring of interventions, only 17% reported on training of providers, and 39% were designed to be accessible for people with low literacy. The limited studies available suggest that diabetes self-management education programs in developing countries are effective in the short term but must be tailored to conform to the cultural aspects of the target population. © 2014 The Author(s).

  11. Prevalence of latent TB infection and TB disease among adolescents in high TB burden countries in Africa: a systematic review protocol.

    PubMed

    Bunyasi, Erick Wekesa; Schmidt, Bey-Marrie; Abdullahi, Leila Hussein; Mulenga, Humphrey; Tameris, Michele; Luabeya, Angelique; Shenje, Justin; Scriba, Thomas; Geldenhuys, Hennie; Wood, Robin; Hatherill, Mark

    2017-03-10

    Almost a third of the world population has latent tuberculosis (TB) infection (LTBI), ∼10 million of whom develop TB disease annually, despite existence of effective, but lengthy, preventive and curative drug regimens. Although adolescents appear to have a very high force of LTBI, their reported incidence of TB disease is less than that of their corresponding general population. The few available studies on adolescent TB infection and disease prevalence are not sufficient to address the apparent discordance between rates of infection and disease in high TB burden countries in Africa. Therefore, we aim to perform a systematic review to examine the relationship between adolescent LTBI and TB disease, benchmarked against national TB disease burden data. A comprehensive literature search will be performed for cross-sectional studies and screening data in cohort studies to determine the prevalence of LTBI and TB disease among adolescents in high TB burden countries in Africa in the following databases: PubMed , Scopus , Cochrane library , Web of Science , Africa Wide , CINAHL and the Africa Index Medicus . This will be supplemented by a search of reference lists of selected articles for potentially relevant articles. We will restrict our search to articles published in the English language between 1990 and 2016 among adolescents in order to obtain estimates reflective of the mature HIV epidemic in most high TB burden countries in Africa that occurred over this critical period. Primary end points are: prevalence of LTBI and TB disease. We will use the random-effects or fixed-effects modelling for our meta-analysis based on heterogeneity estimates. No ethics approval is required given that this is a systematic review. Findings will be disseminated in a peer-reviewed journal in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). CRD42015023495. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  12. A Management Tool Kit on Training Needs Assessment and Programme Design: An Integrated Resource for Management Development in Transition Countries. Companion.

    ERIC Educational Resources Information Center

    European Training Foundation, Turin (Italy).

    This document presents a management tool kit on training needs assessment and program design for countries in transition to a market economy. Chapter 1 describes the tool's development within the framework of the project called Strengthening of Partnership between Management Training Institutions and Companies, Ukraine-Kazakhstan-Kyrgyzstan.…

  13. Childhood intussusception: A prospective study of management trend in a developing country.

    PubMed

    Ogundoyin, Olakayode Olaolu; Olulana, Dare Isaac; Lawal, Taiwo Akeem

    2015-01-01

    The management of intussusception has evolved universally from the use of hydrostatic reduction through operative reduction to the use of pneumatic reduction for the acute and uncomplicated cases and surgical reduction for the complicated cases. However, the process of evolution has been very slow in the developing countries, especially sub-Saharan Africa, due to lack of requisite facilities and expertise to manage these patients nonoperatively. This study examined the trends in the management of childhood intussusception in a developing country, compared operative and nonoperative modalities of treatment, and assessed the impact of delayed presentation on the outcome of management. This was a prospective study of the management of children with intussusception at the University College Hospital, Ibadan, Nigeria. Fifty-five consecutive cases of intussusception that presented to the Children Emergency Unit of the University College Hospital between January 2005 and December 2011 were prospectively studied. Details of sex, age of the patients, clinical presentation, duration of symptoms, mode of treatment, and incidence of recurrence were recorded and analyzed. The median age was 7 months. Moreover, the duration of symptoms varied from 1 to 21 days with a mean of 4 days. Twenty-two patients (40%) had attempted hydrostatic reduction; this was successful in 14 patients (63.6%), whereas 8 patients (36.4%) had failed reduction. In all, 41 patients (74.6%) had operative management of intussusceptions; primary operative intervention was carried out in 33 patients (60%) and secondary surgical management in 8 patients (14.5%) with failed hydrostatic reduction. At surgery, manual reduction of intussusception was carried out on 17 patients (30.9%) and resection of devitalized bowel with end to end anastomosis was carried out on the remaining 24 patients (43.6%). The incidence of surgical intervention for intussusception was 74.6%, mortality was 3.6%, and recurrence rate was 3

  14. CKD Prevalence Varies across the European General Population

    PubMed Central

    Stel, Vianda S.; Gambaro, Giovanni; Hallan, Stein; Völzke, Henry; Ärnlöv, Johan; Kastarinen, Mika; Guessous, Idris; Vinhas, José; Stengel, Bénédicte; Brenner, Hermann; Chudek, Jerzy; Romundstad, Solfrid; Tomson, Charles; Gonzalez, Alfonso Otero; Bello, Aminu K.; Ferrieres, Jean; Palmieri, Luigi; Browne, Gemma; Capuano, Vincenzo; Van Biesen, Wim; Zoccali, Carmine; Gansevoort, Ron; Navis, Gerjan; Rothenbacher, Dietrich; Ferraro, Pietro Manuel; Nitsch, Dorothea; Wanner, Christoph; Jager, Kitty J.

    2016-01-01

    CKD prevalence estimation is central to CKD management and prevention planning at the population level. This study estimated CKD prevalence in the European adult general population and investigated international variation in CKD prevalence by age, sex, and presence of diabetes, hypertension, and obesity. We collected data from 19 general-population studies from 13 European countries. CKD stages 1–5 was defined as eGFR<60 ml/min per 1.73 m2, as calculated by the CKD-Epidemiology Collaboration equation, or albuminuria >30 mg/g, and CKD stages 3–5 was defined as eGFR<60 ml/min per 1.73 m2. CKD prevalence was age- and sex-standardized to the population of the 27 Member States of the European Union (EU27). We found considerable differences in both CKD stages 1–5 and CKD stages 3–5 prevalence across European study populations. The adjusted CKD stages 1–5 prevalence varied between 3.31% (95% confidence interval [95% CI], 3.30% to 3.33%) in Norway and 17.3% (95% CI, 16.5% to 18.1%) in northeast Germany. The adjusted CKD stages 3–5 prevalence varied between 1.0% (95% CI, 0.7% to 1.3%) in central Italy and 5.9% (95% CI, 5.2% to 6.6%) in northeast Germany. The variation in CKD prevalence stratified by diabetes, hypertension, and obesity status followed the same pattern as the overall prevalence. In conclusion, this large-scale attempt to carefully characterize CKD prevalence in Europe identified substantial variation in CKD prevalence that appears to be due to factors other than the prevalence of diabetes, hypertension, and obesity. PMID:26701975

  15. Information technology and public health management of disasters--a model for South Asian countries.

    PubMed

    Mathew, Dolly

    2005-01-01

    This paper highlights the use of information technology (IT) in disaster management and public health management of disasters. Effective health response to disasters will depend on three important lines of action: (1) disaster preparedness; (2) emergency relief; and (3) management of disasters. This is facilitated by the presence of modern communication and space technology, especially the Internet and remote sensing satellites. This has made the use of databases, knowledge bases, geographic information systems (GIS), management information systems (MIS), information transfer, and online connectivity possible in the area of disaster management and medicine. This paper suggests a conceptual model called, "The Model for Public Health Management of Disasters for South Asia". This Model visualizes the use of IT in the public health management of disasters by setting up the Health and Disaster Information Network and Internet Community Centers, which will facilitate cooperation among all those in the areas of disaster management and emergency medicine. The suggested infrastructure would benefit the governments, non-government organizations, and institutions working in the areas of disaster and emergency medicine, professionals, the community, and all others associated with disaster management and emergency medicine. The creation of such an infrastructure will enable the rapid transfer of information, data, knowledge, and online connectivity from top officials to the grassroots organizations, and also among these countries regionally. This Model may be debated, modified, and tested further in the field to suit the national and local conditions. It is hoped that this exercise will result in a viable and practical model for use in public health management of disasters by South Asian countries.

  16. Potential health gains and health losses in eleven EU countries attainable through feasible prevalences of the life-style related risk factors alcohol, BMI, and smoking: a quantitative health impact assessment.

    PubMed

    Lhachimi, Stefan K; Nusselder, Wilma J; Smit, Henriette A; Baili, Paolo; Bennett, Kathleen; Fernández, Esteve; Kulik, Margarete C; Lobstein, Tim; Pomerleau, Joceline; Boshuizen, Hendriek C; Mackenbach, Johan P

    2016-08-05

    Influencing the life-style risk-factors alcohol, body mass index (BMI), and smoking is an European Union (EU) wide objective of public health policy. The population-level health effects of these risk-factors depend on population specific characteristics and are difficult to quantify without dynamic population health models. For eleven countries-approx. 80 % of the EU-27 population-we used evidence from the publicly available DYNAMO-HIA data-set. For each country the age- and sex-specific risk-factor prevalence and the incidence, prevalence, and excess mortality of nine chronic diseases are utilized; including the corresponding relative risks linking risk-factor exposure causally to disease incidence and all-cause mortality. Applying the DYNAMO-HIA tool, we dynamically project the country-wise potential health gains and losses using feasible, i.e. observed elsewhere, risk-factor prevalence rates as benchmarks. The effects of the "worst practice", "best practice", and the currently observed risk-factor prevalence on population health are quantified and expected changes in life expectancy, morbidity-free life years, disease cases, and cumulative mortality are reported. Applying the best practice smoking prevalence yields the largest gains in life expectancy with 0.4 years for males and 0.3 year for females (approx. 332,950 and 274,200 deaths postponed, respectively) while the worst practice smoking prevalence also leads to the largest losses with 0.7 years for males and 0.9 year for females (approx. 609,400 and 710,550 lives lost, respectively). Comparing morbidity-free life years, the best practice smoking prevalence shows the highest gains for males with 0.4 years (342,800 less disease cases), whereas for females the best practice BMI prevalence yields the largest gains with 0.7 years (1,075,200 less disease cases). Smoking is still the risk-factor with the largest potential health gains. BMI, however, has comparatively large effects on morbidity. Future

  17. Socioeconomic disparities in type 2 diabetes mellitus prevalence and self-management behaviors in rural southwest China.

    PubMed

    Le, Cai; Rong, Su; Dingyun, You; Wenlong, Cui

    2016-11-01

    This study examines how socioeconomic factors are associated with prevalence and self-management of diabetes among ethnic minority groups in the rural Yunnan province, which has the most ethnic minority groups per province in southwest China. A cross-sectional survey was carried out in 2014 in a rural southwest population consisting of 5532 consenting individuals aged ⩾35years. Information about participants' demographic characteristics, as well as diabetes diagnosis, treatment, and self-management behaviors, were obtained using a standard questionnaire. Fasting blood sugar levels were recorded for each individual. A socioeconomic position (SEP) index was constructed using principal component analysis. The age-standardized prevalence of diabetes in the study population was 4.8%. In persons with diabetes, 23.1% regularly self-monitored blood glucose, 43.2% adhered to taking prescribed anti-diabetic drugs or insulin injections, and 63.1% took at least one measure to control blood glucose. Individual educational level was found to be negatively associated with the prevalence of diabetes, whereas individuals with greater household assets and higher SEP were more likely to be suffered from diabetes. Persons with diabetes with greater household assets, higher level of education, and higher SEP had a greater probability of regularly self-monitoring blood glucose, compliance to prescribed medicines, and taking measures to control diabetes. Access to medical services was positively associated with regularly self-monitoring blood glucose and compliance to prescribed medicines. Socioeconomic disparities in diabetes prevalence and self-management do exist. Future interventions to further control diabetes and improve diabetes management must be tailored to address socioeconomic factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. [Prevalence and differentiating aspects related to gender with regard to the bullying phenomenon in poor countries].

    PubMed

    Romera Félix, Eva M; Del Rey Alamillo, Rosario; Ortega Ruiz, Rosario

    2011-11-01

    There is a large body of scientific knowledge about school violence and bullying in Europe and some other regions of the so-called developed world. However, improvement is scarce in poor and developing regions, as in the case of Latin America and, in particular, Nicaragua. The goal of this work was to determine the prevalence of the bullying phenomenon in Nicaraguan primary schools, to analyze the eventual relationships between the different forms of violence used by the students and to explore, in relation to these aspects, the similarities and differences between boys and girls. For this purpose, we surveyed 3042 pupils of primary school (50.3% girls) using the "Cuestionario sobre Convivencia, Violencia y Experiencias de Riesgo" (COVER, in English, Questionnaire about Living Together, Violence and Risk Experiences). We found that the level of involvement in bullying is significantly higher than in developed countries, that boys are more involved than girls in verbal, physical and psychological bullying, and that there are no differences with regard to social exclusion. The results are discussed, comparing them with studies conducted in different countries but with similar methodologies.

  19. Prevalence of arthritis in India and Pakistan: a review.

    PubMed

    Akhter, Ehtisham; Bilal, Saira; Kiani, Adnan; Haque, Uzma

    2011-07-01

    Recent studies of rheumatoid arthritis worldwide suggest that prevalence of arthritis is higher in Europe and North America than in developing countries. Prevalence data for major arthritis disorders have been compiled in West for several decades, but figures from the third world are just emerging. A coordinated effort by WHO and ILAR (International League Against Rheumatism) has resulted in collecting data for countries like Philippines, China, Malaysia, Indonesia, and rural South Africa but the information about prevalence of arthritis in India and Pakistan is scarce. Since both countries, i.e., India and Pakistan, share some ethnic identity, we reviewed published literature to examine the prevalence of arthritis in these countries. Medline and Pubmed were searched for suitable articles about arthritis from 1980 and onwards. Findings from these articles were reviewed and summarized. The prevalence, clinical features, and laboratory findings of rheumatoid arthritis are compiled for both India and Pakistan. Data collected from these two countries were compared with each other, and some of the characteristics of the disease were compared with Europe and North America. It is found to be quite similar to developed countries. Additionally, juvenile rheumatoid arthritis is of different variety than reported in West. It is more of polyarticular onset type while in West pauciarticular predominates. Additionally, in systemic onset, JRA uveitis and ANA are common finding in developed countries; on the other hand, they are hardly seen in this region. Although the prevalence of arthritis in Pakistan and India is similar to Western countries, there are inherent differences (clinical features, laboratory findings) in the presentation of disease. The major strength of the study is that it is the first to pool reports to provide an estimate of the disease in the Indian subcontinent. Scarcity of data is one of the major limitations. This study helps to understand the pattern of

  20. Preparing the Host Country Workforce for Expatriate Managers: The Neglected Other Side of the Coin.

    ERIC Educational Resources Information Center

    Vance, Charles M.; Ring, Peter Smith

    1994-01-01

    Using an instructional systems development approach, ways to prepare the host country workforce for the assignment of an expatriate manager are discussed. The model is based on a number of perspectives: exchange theory, participatory management, corporate social responsibility, communication theory, and strategic human resource planning. (SK)

  1. PREPARE: the prevalence of perioperative anaemia and need for patient blood management in elective orthopaedic surgery: a multicentre, observational study.

    PubMed

    Lasocki, Sigismond; Krauspe, Rüdiger; von Heymann, Christian; Mezzacasa, Anna; Chainey, Suki; Spahn, Donat R

    2015-03-01

    Patient blood management (PBM) can prevent preoperative anaemia, but little is known about practice in Europe. To assess the pre and postoperative prevalence and perioperative management of anaemia in patients undergoing elective orthopaedic surgery in Europe. An observational study; data were collected from patient records via electronic case report forms. Seventeen centres in six European countries. Centres were stratified according to whether they had a PBM programme or not. One thousand five hundred and thirty-four patients undergoing major elective hip, knee or spine surgery [49.9% hip, 37.2% knee, 13.0% spine; age 64.0 years (range 18 to 80), 61.3% female]. Prevalence of preoperative (primary endpoint) and postoperative anaemia [haemoglobin (Hb) <13 g dl (male), Hb <12 g dl (female)], perioperative anaemia management, time to first blood transfusion and number of transfused units. Data are shown as mean (SD) or median (interquartile range). Anaemia prevalence increased from 14.1% preoperatively to 85.8% postoperatively. Mean Hb decrease was 1.9 (1.5) and 3.0 (1.3) g dl in preoperatively anaemic and nonanaemic patients, respectively (P < 0.001). In PBM (n = 7) vs. non-PBM centres, preoperative anaemia was less frequent (8.0 vs. 18.5%; P < 0.001) and iron status was assessed more frequently (ferritin 11.0 vs. 2.6%, transferrin saturation 11.0 vs. 0.1%; P < 0.001). Perioperative anaemia correction (mainly transfusion) was given to 34.3%. Intraoperatively, 14.8% of preoperatively anaemic and 2.8% of nonanaemic patients received transfusions [units per patient: 2.4 (1.5) and 2.2 (1.4), median time to first intraoperative transfusion: 130 (88, 158) vs. 179 (135, 256) min; P < 0.001]. Postoperative complications were more frequent in preoperatively anaemic vs. nonanaemic patients (36.9 vs. 22.2%; P = 0.009). Most patients who underwent elective orthopaedic surgery had normal preoperative Hb levels but became anaemic after the

  2. Prevalence of metastasis at diagnosis of osteosarcoma: an international comparison

    PubMed Central

    Marko, Tracy A.; Diessner, Brandon J.; Spector, Logan G.

    2016-01-01

    Background Osteosarcoma is the most common primary malignant bone tumor in many countries, with metastatic disease responsible for most patient deaths. This study compares the prevalence of metastatic osteosarcoma at diagnosis across countries to inform the critical question of whether diagnostic delay or tumor biology drives metastases development prior to diagnosis. Procedure A literature search of the PubMed database was conducted to compare the prevalence of metastatic disease at the time of OS diagnosis between countries. A pooled prevalence with 95% confidence intervals was calculated for each study meeting inclusion criteria. Studies were grouped for analysis based on human development index (HDI) scores. Results Our analysis found an 18% (95% CI: 15%, 20%) average global pooled proportion of metastasis at osteosarcoma diagnosis. The average prevalence of metastasis at diagnosis increased as HDI groupings decreased, with very high HDI, high HDI, and medium/ low HDI groups found to be 15% (95% CI: 13%, 17%), 20% (95% CI: 14%, 28%), and 31% (95% CI: 15%, 52%), respectively. Conclusions Our evidence suggests there is a biological baseline for metastatic OS at diagnosis, which is observed in countries with very high HDI. In countries with medium/ low HDI, where there are more barriers to accessing healthcare, the higher prevalence of metastasis may result from treatment delay or an artificial prevalence inflation due to patients with less severe symptoms not presenting to clinic. Additional research in countries with medium/ low HDI may reveal that earlier detection and treatment could improve patient outcomes in those countries. PMID:26929018

  3. Association between stricter alcohol advertising regulations and lower hazardous drinking across European countries.

    PubMed

    Bosque-Prous, Marina; Espelt, Albert; Guitart, Anna M; Bartroli, Montserrat; Villalbí, Joan R; Brugal, M Teresa

    2014-10-01

    To analyse the association between alcohol advertising restrictions and the prevalence of hazardous drinking among people aged 50-64 years in 16 European countries, taking into account both individual and contextual-level factors (alcohol taxation, availability, etc.). Cross-sectional study based on SHARE project surveys. A total of 27 773 subjects, aged 50-64 years, from 16 European countries who participated in wave 4 of the SHARE (Survey of Health, Ageing and Retirement in Europe) project. We estimated the prevalence of hazardous drinking (through adaptation of the SHARE questions to the scheme used by the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) for each country. To determine whether the degree of advertising restrictions was associated with prevalence of hazardous drinking, we fitted robust variance multi-level Poisson models, adjusting for various individual and contextual variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were obtained. The observed prevalence of hazardous drinking was 24.1%, varying by sex and country. Countries with greater advertising restrictions had lower prevalence of hazardous drinking: 30.6% (95% CI = 29.3-31.8) in countries with no restrictions, 20.3% (95% CI = 19.3-21.2) in countries with some restrictions and 14.4% (95% CI = 11.9-16.8) in those with greatest restrictions. The PR found (with respect to countries with greatest restrictions) were 1.36 (95% CI = 0.90-2.06) for countries with some restrictions and 1.95 (95% CI = 1.31-2.91) for those with no advertising restrictions. The extent of advertising restrictions in European countries is associated inversely with prevalence of hazardous drinking in people aged 50-64 years. © 2014 Society for the Study of Addiction.

  4. Assessment of the waste electrical and electronic equipment management systems profile and sustainability in developed and developing European Union countries.

    PubMed

    Ibanescu, Dumitrita; Cailean Gavrilescu, Daniela; Teodosiu, Carmen; Fiore, Silvia

    2018-03-01

    The assessment of waste management systems for electrical and electronic equipment (WEEE) from developed economies (Germany, Sweden and Italy) and developing countries (Romania and Bulgaria), is discussed covering the period 2007-2014. The WEEE management systems profiles are depicted by indicators correlated to WEEE life cycle stages: collection, transportation and treatment. The sustainability of national WEEE management systems in terms of greenhouse gas emissions is presented, together with the greenhouse gas efficiency indicator that underlines the efficiency of WEEE treatment options. In the countries comparisons, the key elements are: robust versus fragile economies, the overall waste management performance and the existence/development of suitable management practices on WEEE. Over the life cycle perspective, developed economies (Germany, Sweden and Italy) manage one order of magnitude higher quantities of WEEE compared to developing countries (Romania and Bulgaria). Although prevention and reduction measures are encouraged, all WEEE quantities were larger in 2013, than in 2007. In 2007-2014, developed economies exceed the annual European collection target of 4 kg WEEE/capita, while collection is still difficult in developing countries. If collection rates are estimated in relationship with products placed on market, than similar values are registered in Sweden and Bulgaria, followed by Germany and Italy and lastly Romania. WEEE transportation shows different patterns among countries, with Italy as the greatest exporter (in 2014), while Sweden treats the WEEE nationally. WEEE reuse is a common practice in Germany, Sweden (from 2009) and Bulgaria (from 2011). By 2014, recycling was the most preferred WEEE treatment option, with the same kind of rates performance, over 80%, irrespective of the country, with efforts in each of the countries in developing special collection points, recycling facilities and support instruments. The national total and the

  5. Prevalence of dengue virus infection in US travelers who have lived in or traveled to dengue-endemic countries.

    PubMed

    Sanchez-Vegas, Carolina; Hamer, Davidson H; Chen, Lin H; Wilson, Mary E; Benoit, Christine; Hunsperger, Elizabeth; Macleod, William B; Jentes, Emily S; Ooi, Winnie W; Karchmer, Adolf W; Kogelman, Laura; Yanni, Emad; Marano, Nina; Barnett, Elizabeth D

    2013-01-01

    Dengue virus (DENV) infections may occur in travelers. To determine prevalence of anti-DENV IgG antibody in travelers who lived in or visited dengue-endemic countries and to describe risk factors and characteristics associated with infection and subsequent anti-DENV IgG antibody presence. Participants were enrolled from travel clinics of the Boston Area Travel Medicine Network from August 2008 through June 2009. Demographic information, trip duration, travel history, and a blood sample were collected. Serum samples were tested for anti-DENV IgG antibody by indirect IgG enzyme-linked immunosorbent assay (ELISA), and antibody-mediated virus neutralization by plaque reduction neutralization test (PRNT) for anti-DENV IgG antibody-positive and selected negative samples. Participants were stratified into group 1: born in dengue-endemic countries; group 2: born in nonendemic countries but lived continuously for ≥1 year in a dengue-endemic country; group 3: born in nonendemic countries and traveled to a dengue-endemic country for ≥2 weeks but <1 year. Six hundred travelers were enrolled. Anti-DENV IgG antibody was identified in 113 (19%) when tested by ELISA (51% in group 1, 40% in group 2, and 6.9% in group 3) and in 71 (12%) by PRNT (42% primary monotypic and 58% heterotypic reactive responses). Sensitivity and specificity of the ELISA based on PRNT results were 85% to 100% and 79% to 94%, assuming up to 15% misclassification of ELISA negative results. Presence of anti-DENV IgG antibody by ELISA was associated with years lived in dengue-endemic countries and birthplace in the Caribbean for group 1, receipt of Japanese encephalitis vaccine in group 3, and self-reported history of dengue in all three groups. Nineteen percent of participants who were born, lived in, or traveled to dengue-endemic countries had anti-DENV IgG antibody by ELISA; 12% had antibodies by PRNT, 85% of whom had no history of dengue. Presence of DENV antibodies was associated with years

  6. Prevalence and management of urinary tract endometriosis: a clinical case series.

    PubMed

    Gabriel, Boris; Nassif, Joseph; Trompoukis, Pantelis; Barata, Sonia; Wattiez, Arnaud

    2011-12-01

    To report on the prevalence, surgical management, and outcome of urinary tract endometriosis (UTE) in a cohort of 221 patients undergoing laparoscopic surgery for severe endometriosis. UTE can cause significant morbidity, such as silent kidney or progressive renal function loss. Its frequency is underestimated and data on laparoscopic management are scarce. Between 2007 and 2010, 43 patients were eligible for this single-center, retrospective study. The inclusion criterion was the presence of UTE (ie, bladder and/or ureteral endometriosis). All patients were operated laparoscopically. The prevalence of UTE was 19.5% (43/221). There was no correlation between bladder and ureteral endometriosis (P >.05). Ureteral endometriosis was associated with patient's age (P <.01). Patients with bladder, but not ureteral, involvement complained more frequently about dysuria, hematuria, and urinary tract infections. Intraoperative and magnetic resonance imaging (MRI) findings revealed a moderate to good correlation. UTE was not associated with rectovaginal or bowel endometriosis, but rather with involvement of the uterosacral ligaments (P <.01). Twenty-two patients with bladder endometriosis were treated by mucosal skinning and 11 patients underwent partial cystectomy. Superficial ureteral excision was performed in 4 patients, whereas resection with ureteroureterostomy was done in 9 patients. There was no difference regarding the intra- and postoperative complications in patients with or without UTE. In severe pelvic endometriosis, involvement of the urinary tract is quite common. Laparoscopic management is feasible and safe. Because of the lack of specific symptoms, the preoperative diagnosis of ureteral endometriosis still remains a challenge. Pelvic MRI represents a useful preoperative diagnostic tool. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Socioeconomic position, macroeconomic environment and overweight among adolescents in 35 countries

    PubMed Central

    Due, P; Damsgaard, MT; Rasmussen, M; Holstein, BE; Wardle, J; Merlo, J; Currie, C; Ahluwalia, N; Sørensen, TIA; Lynch, J

    2012-01-01

    Objective It is important to understand levels and social inequalities in childhood overweight within and between countries. This study examined prevalence and social inequality in adolescent overweight in 35 countries, and associations with macroeconomic factors. Design International cross-sectional survey in national samples of schools. Subjects A total of 11-, 13- and 15-year-olds from 35 countries in Europe and North America in 2001–2002 (N = 162 305). Measurements The main outcome measure was overweight based on self-reported height and weight (body mass index cut-points corresponding to body mass index of 25 kg/m2 at the age of 18 years). Measures included family and school affluence (within countries), and average country income and economic inequality (between countries). Results There were large variations in adolescent overweight, from 3.5% in Lithuanian girls to 31.7% in boys from Malta. Prevalence of overweight was higher among children from less affluent families in 21 of 24 Western and 5 of 10 Central European countries. However, children from more affluent families were at higher risk of overweight in Croatia, Estonia and Latvia. In Poland, Lithuania, Macedonia and Finland, girls from less affluent families were more overweight whereas the opposite was found for boys. Average country income was associated with prevalence and inequality in overweight when considering all countries together. However, economic inequality as measured by the Gini coefficient was differentially associated with prevalence and socioeconomic inequality in overweight among the 23-high income and 10-middle income countries, with a positive relationship among the high income countries and a negative association among the middle income countries. Conclusion The direction and magnitude of social inequality in adolescent overweight shows large international variation, with negative social gradients in most countries, but positive social gradients, especially for boys, in some

  8. Malaria prevalence metrics in low- and middle-income countries: an assessment of precision in nationally-representative surveys.

    PubMed

    Alegana, Victor A; Wright, Jim; Bosco, Claudio; Okiro, Emelda A; Atkinson, Peter M; Snow, Robert W; Tatem, Andrew J; Noor, Abdisalan M

    2017-11-21

    One pillar to monitoring progress towards the Sustainable Development Goals is the investment in high quality data to strengthen the scientific basis for decision-making. At present, nationally-representative surveys are the main source of data for establishing a scientific evidence base, monitoring, and evaluation of health metrics. However, little is known about the optimal precisions of various population-level health and development indicators that remains unquantified in nationally-representative household surveys. Here, a retrospective analysis of the precision of prevalence from these surveys was conducted. Using malaria indicators, data were assembled in nine sub-Saharan African countries with at least two nationally-representative surveys. A Bayesian statistical model was used to estimate between- and within-cluster variability for fever and malaria prevalence, and insecticide-treated bed nets (ITNs) use in children under the age of 5 years. The intra-class correlation coefficient was estimated along with the optimal sample size for each indicator with associated uncertainty. Results suggest that the estimated sample sizes for the current nationally-representative surveys increases with declining malaria prevalence. Comparison between the actual sample size and the modelled estimate showed a requirement to increase the sample size for parasite prevalence by up to 77.7% (95% Bayesian credible intervals 74.7-79.4) for the 2015 Kenya MIS (estimated sample size of children 0-4 years 7218 [7099-7288]), and 54.1% [50.1-56.5] for the 2014-2015 Rwanda DHS (12,220 [11,950-12,410]). This study highlights the importance of defining indicator-relevant sample sizes to achieve the required precision in the current national surveys. While expanding the current surveys would need additional investment, the study highlights the need for improved approaches to cost effective sampling.

  9. Investigating factors influencing construction waste management efforts in developing countries: an experience from Thailand.

    PubMed

    Manowong, Ektewan

    2012-01-01

    Rapid economic growth and urbanization in developing countries lead to extensive construction activities that generate a large amount of waste. A challenge is how to manage construction waste in the most sustainable way. In the developing world, research on construction waste management is scarce and such academic knowledge needs to be responsive to actual practices in the industry in order to be implemented. As construction projects involve a number of participants and stakeholders, their participation and commitment can have a major influence on the goals of green and sustainable construction for urban development. This study provides a significant step in conducting a very first research of this kind in Thailand by aiming to investigate the level of construction stakeholders' commitment as well as the achievement of construction waste management in order to improve short-term practices and to establish a long-term strategic construction waste management plan. In this study, a structural equation model was employed to investigate the influence of factors that are related to environmental aspects, social aspects, and economic aspect of construction waste management. Concern about health and safety was found to be the most significant and dominant influence on the achievement of sustainable construction waste management. Other factors affecting the successful management of construction waste in Thai construction projects were also identified. It is perceived that this study has potential to contribute useful guidelines for practitioners both in Thailand and other developing countries with similar contexts.

  10. Low-Cost Rescue Robot for Disaster Management in a Developing Country: Development of a Prototype Using Locally Available Technology

    NASA Technical Reports Server (NTRS)

    Mahmud, Faisal; Hossain, S. G. M.; Bin, Jobair

    2010-01-01

    The use of robots in different fields is common and effective in developed countries. In case of incident management or emergency rescue after a disaster, robots are often used to lessen the human effort where it is either impossible or life-threatening for rescuers. Though developed countries can afford robotic-effort for pro-disaster management, the scenario is totally opposite for developing and under-developed countries to engage such a machine-help due to high cost of the machines and high maintenance cost as well. In this research paper, the authors proposed a low-cost "Rescue-Robot" for pro-disaster management which can overcome the budget-constraints as well as fully capable of rescue purposes for incident management. Here, all the research works were performed in Bangladesh - a developing country in South Asia. A disaster struck structure was chosen and a thorough survey was performed to understand the real-life environment for the prototype. The prototype was developed considering the results of this survey and it was manufactured using all locally available components and facilities.

  11. Control of hypertension with medication: a comparative analysis of national surveys in 20 countries.

    PubMed

    Ikeda, Nayu; Sapienza, David; Guerrero, Ramiro; Aekplakorn, Wichai; Naghavi, Mohsen; Mokdad, Ali H; Lozano, Rafael; Murray, Christopher J L; Lim, Stephen S

    2014-01-01

    To examine hypertension management across countries and over time using consistent and comparable methods. A systematic search identified nationally representative health examination surveys from 20 countries containing data from 1980 to 2011 on blood pressure measurements, the diagnosis and treatment of hypertension and its control with antihypertensive drugs. For each country, the prevalence of hypertension (i.e. systolic blood pressure ≥ 140 mmHg or antihypertensive use) and the proportion of hypertensive individuals whose condition was diagnosed, treated or controlled with medications (i.e. systolic pressure < 140 mmHg) were estimated. The age-standardized prevalence of hypertension varied between countries: for individuals aged 35 to 49 years, it ranged from around 12% in Bangladesh, Egypt and Thailand to around 30% in Armenia, Lesotho and Ukraine; for those aged 35 to 84 years, it ranged from 20% in Bangladesh to more than 40% in Germany, the Russian Federation and Turkey. The age-standardized percentage of hypertensive individuals whose condition was diagnosed, treated or controlled was highest in the United States of America: for those aged 35 to 49 years, it was 84%, 77% and 56%, respectively. Percentages were especially low in Albania, Armenia, the Islamic Republic of Iran and Turkey. Although recent trends in prevalence differed in England, Japan and the United States, treatment coverage and hypertension control improved over time, particularly in England. Globally the proportion of hypertensive individuals whose condition is treated or controlled with medication remains low. Greater efforts are needed to improve hypertension control, which would reduce the burden of noncommunicable diseases.

  12. Migration of health-care workers from developing countries: strategic approaches to its management.

    PubMed Central

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario

    2004-01-01

    Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. PMID:15375449

  13. Migration of health-care workers from developing countries: strategic approaches to its management.

    PubMed

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario

    2004-08-01

    Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration.

  14. National Economic Burden Associated with Management of Periodontitis in Malaysia

    PubMed Central

    Ayob, Rasidah; Abd Muttalib, Khairiyah

    2016-01-01

    Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted. PMID:27092180

  15. National Economic Burden Associated with Management of Periodontitis in Malaysia.

    PubMed

    Mohd Dom, Tuti Ningseh; Ayob, Rasidah; Abd Muttalib, Khairiyah; Aljunid, Syed Mohamed

    2016-01-01

    Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective. Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis. Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis. Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

  16. [The Prevalence and Management of Pediculosis Capitis in Turkey: A Systematic Review].

    PubMed

    Özkan, Özlem; Hamzaoğlu, Onur; Yavuz, Melike

    2015-06-01

    This study aimed to examine scientific articles performed in Turkey on the prevalence and management of PK (diagnosis, contagion, prevention, treatment) from a critical perspective. The population of the systematic review consisted of total 63 published and unpublished theses or dissertations and peer-reviewed articles published in Turkish or English in national or foreign scientific journals from studies performed in Turkey between 1982 and 2012 years. It reached 578,938 people in 63 studies. Seventy-eight percent of the studies were related to the prevalence of PK and/or associated factors. The number of the studies was limited regarding diagnosis, prevention, contagion, treatment compliance, difficulties and causes of failure. Of the studies, 90.5% had been performed in public schools, almost exclusively elementary schools. The prevalence of PK was 0.3-34.1%, 0-35.4%, and it was 0.3-34.1% in elementary school children. It increased with years of education. It was double that of the boys in the girls (p<0.05). The prevalence among the subjects with low economic status were 1.9-42.3%, and it increased with worsening economic status (p<0.05). The prevalence reached up to 44.1% among children with illiterate mother. Basic recommendations include increasing the number of studies on the diagnosis, prevention, contagion, treatment compliance and efficacy, treatment failures and difficulties; public health workers also should prioritize investigation of head lice infestation.

  17. Prevalence of prostatitis-like symptoms in a managed care population.

    PubMed

    Clemens, J Quentin; Meenan, Richard T; O'Keeffe-Rosetti, Maureen C; Gao, Sara Y; Brown, Sheila O; Calhoun, Elizabeth A

    2006-08-01

    We calculated the prevalence of symptoms typically associated with chronic prostatitis/chronic pelvic pain syndrome in men in a managed care population in the Pacific Northwest. A questionnaire mailing to 5,000 male enrollees 25 to 80 years old in the Kaiser Permanente Northwest (Portland, Oregon) health plan was performed. The questionnaires included screening questions about the presence, duration and severity of pelvic pain, and the National Institutes of Health Chronic Prostatitis Symptom Index. Chronic prostatitis/chronic pelvic pain syndrome symptoms were defined in 2 ways: 1) presence of any of the following for a duration of 3 or more months: pain in the perineum, testicles, tip of penis, pubic or bladder area, dysuria, ejaculatory pain; and 2) perineal and/or ejaculatory pain, and a National Institutes of Health Chronic Prostatitis Symptom Index total pain score of 4 or more. Prevalence estimates were age adjusted to the total Kaiser Permanente Northwest male population. A total of 1,550 questionnaires were returned. The prevalence of chronic prostatitis/chronic pelvic pain syndrome symptoms was 7.5% for definition 1 and 5.9% for definition 2. Mean National Institutes of Health Chronic Prostatitis Symptom Index scores were 17 for definitions 1 and 2. Of those with prostatitis-like symptoms, 30% met criteria for having both definitions present. The prevalence of prostatitis-like symptoms using either of the 2 diagnoses was 11.2%. This population based study indicates that approximately 1 in 9 men have prostatitis-like symptoms. Application of 2 different definitions for prostatitis-like symptoms identified unique groups of men, with limited overlap in the groups.

  18. Schistosomiasis Prevalence and Intensity of Infection in Latin America and the Caribbean Countries, 1942-2014: A Systematic Review in the Context of a Regional Elimination Goal

    PubMed Central

    2016-01-01

    Background In 2012 the World Health Assembly adopted resolution WHA65.21 on elimination of schistosomiasis, calling for increased investment in schistosomiasis control and support for countries to initiate elimination programs. This study aims to analyze prevalence and intensity of Schistosoma mansoni infection in children in Latin America and the Caribbean countries and territories (LAC), at the second administrative level or lower. Methodology A systematic review of schistosomiasis prevalence and intensity of infection was conducted by searching at PubMed, LILACS and EMBASE. Experts on the topic were informally consulted and institutional web pages were reviewed (PAHO/WHO, Ministries of Health). Only SCH infection among children was registered because it can be a ‘proxi-indicator’ of recent transmission by the time the study is conducted. Principal Findings One hundred thirty two full-text articles met the inclusion criteria and provided 1,242 prevalence and 199 intensity of infection data points. Most of them were from Brazil (69.7%). Only Brazil published studies after 2001, showing several 'hot spots' with high prevalence. Brazil, Venezuela, Suriname and Saint Lucia need to update the epidemiological status of schistosomiasis to re-design their national programs and target the elimination of Schistosoma mansoni transmission by 2020. In Antigua and Barbuda, Dominican Republic, Guadeloupe, Martinique, Montserrat and Puerto Rico schistosomiasis transmission may be interrupted. However the compilation of an elimination dossier and follow-up surveys, per WHO recommendations, are needed to verify that status. Hence, the burden of subtle SCH chronic infection may be still present and even high in countries that may have eliminated transmission. Heterogeneity in the methodologies used for monitoring and evaluating the progress of the schistosomiasis programs was found, making cross-national and chronological comparisons difficult. Conclusions There is a need for

  19. Schistosomiasis Prevalence and Intensity of Infection in Latin America and the Caribbean Countries, 1942-2014: A Systematic Review in the Context of a Regional Elimination Goal.

    PubMed

    Zoni, Ana Clara; Catalá, Laura; Ault, Steven K

    2016-03-01

    In 2012 the World Health Assembly adopted resolution WHA65.21 on elimination of schistosomiasis, calling for increased investment in schistosomiasis control and support for countries to initiate elimination programs. This study aims to analyze prevalence and intensity of Schistosoma mansoni infection in children in Latin America and the Caribbean countries and territories (LAC), at the second administrative level or lower. A systematic review of schistosomiasis prevalence and intensity of infection was conducted by searching at PubMed, LILACS and EMBASE. Experts on the topic were informally consulted and institutional web pages were reviewed (PAHO/WHO, Ministries of Health). Only SCH infection among children was registered because it can be a 'proxi-indicator' of recent transmission by the time the study is conducted. One hundred thirty two full-text articles met the inclusion criteria and provided 1,242 prevalence and 199 intensity of infection data points. Most of them were from Brazil (69.7%). Only Brazil published studies after 2001, showing several 'hot spots' with high prevalence. Brazil, Venezuela, Suriname and Saint Lucia need to update the epidemiological status of schistosomiasis to re-design their national programs and target the elimination of Schistosoma mansoni transmission by 2020. In Antigua and Barbuda, Dominican Republic, Guadeloupe, Martinique, Montserrat and Puerto Rico schistosomiasis transmission may be interrupted. However the compilation of an elimination dossier and follow-up surveys, per WHO recommendations, are needed to verify that status. Hence, the burden of subtle SCH chronic infection may be still present and even high in countries that may have eliminated transmission. Heterogeneity in the methodologies used for monitoring and evaluating the progress of the schistosomiasis programs was found, making cross-national and chronological comparisons difficult. There is a need for updating the schistosomiasis status in the historically

  20. Socioeconomic Status and Stroke Prevalence in Morocco: Results from the Rabat-Casablanca Study

    PubMed Central

    Engels, Thomas; Baglione, Quentin; Audibert, Martine; Viallefont, Anne; Mourji, Fouzi; El Alaoui Faris, Mustapha

    2014-01-01

    Background Stroke is a growing public health concern in low- and middle- income countries. Improved knowledge about the association between socioeconomic status and stroke in these countries would enable the development of effective stroke prevention and management strategies. This study presents the association between socioeconomic status and the prevalence of stroke in Morocco, a lower middle-income country. Methods Data on the prevalence of stroke and stroke-related risk factors were collected during a large population-based survey. The diagnosis of stroke in surviving patients was confirmed by neurologists while health, demographic, and socioeconomic characteristics of households were collected using structured questionnaires. We used Multiple Correspondence Analysis to develop a wealth index based on characteristics of the household dwelling as well as ownership of selected assets. We used logistic regressions controlling for multiple variables to assess the statistical association between socioeconomic status and stroke. Findings Our results showed a significant association between household socioeconomic status and the prevalence of stroke. This relationship was non-linear, with individuals from both the poorest (mainly rural) and richest (mainly urban) households having a lower prevalence of stroke as compared to individuals with medium wealth level. The latter belonged mainly to urban households with a lower socioeconomic status. When taking into account the urban population only, we observed that a third of poorest households experienced a significantly higher prevalence of stroke compared to the richest third (OR = 2.06; CI 95%: 1.09; 3.89). Conclusion We conclude that individuals from the most deprived urban households bear a higher risk of stroke than the rest of the population in Morocco. This result can be explained to a certain extent by the higher presence of behavioral risk factors in this specific category of the population, which leads in

  1. Added value of molecular assay Xpert MTB/RIF compared to sputum smear microscopy to assess the risk of tuberculosis transmission in a low-prevalence country.

    PubMed

    Opota, O; Senn, L; Prod'hom, G; Mazza-Stalder, J; Tissot, F; Greub, G; Jaton, K

    2016-07-01

    Airborne precautions are required at hospital admission for patients with suspected pulmonary tuberculosis. The isolation is maintained until 3 serially collected sputum smears are acid-fast bacilli negative, a time- and labor-intensive method with limited sensitivity and specificity, which has a great impact on patient flow management. We evaluated the possibility of replacing the result of microscopy by the semiquantitative result of the molecular point-of-care test Xpert MTB/RIF to assess patients' transmission risk to quickly guide airborne isolation decisions in low-endemic countries. The performance of the Xpert MTB/RIF, used as a first-line test, was compared to the results of microscopy for specimens (n=242) collected from May 2010 to December 2014 in Lausanne, Switzerland. The sensitivity and specificity of Xpert MTB/RIF were 91.5% (65/71) and 99.6% (170/171), respectively, vs. 64.8% (46/71) and 94.2% (161/171) for microscopy. Samples with negative Xpert MTB/RIF were all smear negative for Mycobacterium tuberculosis (negative predictive value, 100%). The semiquantitative results of Xpert MTB/RIF-high, medium, low or very low-were found to correlate with acid-fast bacilli detection: positive predictive value of 100% (6/6), 96.5% (27/28), 52.2% (12/23) and 11.1% (1/9) respectively. Finally, when including clinical criteria, we identified 11 smear-negative but Xpert MTB/RIF-positive patients with a significant transmission potential. In conclusion, our data support the introduction of an Xpert MTB/RIF-based strategy as a replacement of smear microscopy for a faster and more accurate management of tuberculosis patients' transmission risk in a low-prevalence country. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Meso level influences on long term condition self-management: stakeholder accounts of commonalities and differences across six European countries.

    PubMed

    Rogers, Anne; Vassilev, Ivaylo; Pumar, Maria J Jesús; Todorova, Elka; Portillo, Mari Carmen; Foss, Christina; Koetsenruijter, Jan; Ratsika, Nikoleta; Serrano, Manuel; Knutsen, Ingrid A Ruud; Wensing, Michel; Roukova, Poli; Patelarou, Evridiki; Kennedy, Anne; Lionis, Christos

    2015-07-08

    European countries are increasingly adopting systems of self -care support (SMS) for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes. To date the focus of policy for engendering greater self- management in the population has been focused in the main on the actions and motivations of individuals. Less attention has been paid to how the broader influences relevant to SMS policy and practice such as those related to food production, distribution and consumption and the structural aspects and economics relating to physical exercise and governance of health care delivery systems might be implicated in the populations ability to self- manage. This study aimed to identify key informants operating with knowledge of both policy and practice related to SMS in order to explore how these influences are seen to impact on the self-management support environment for diabetes type 2. Ninety semi-structured interviews were conducted with key stakeholder informants in Bulgaria, Spain, Greece, Norway, Netherlands and UK. Interviews were transcribed and analysed using thematic and textual analysis. Stakeholders in the six countries identified a range of influences which shaped diabetes self-management (SM). The infrastructure and culture for supporting self- management practice is viewed as driven by political decision-makers, the socio-economic and policy environment, and the ethos and delivery of chronic illness management in formal health care systems. Three key themes emerged during the analysis of data. These were 1) social environmental influences on diabetes self-management 2) reluctance or inability of policy makers to regulate processes and environments related to chronic illness management 3) the focus of healthcare system governance and gaps in provision of self-management support (SMS). Nuances in the salience and content of these themes between partner countries related to the presence and articulation of

  3. Management information systems in maternal and child health/family planning programs: a multi-country analysis.

    PubMed

    Keller, A

    1991-01-01

    A diagnosis was conducted of management information systems (MIS) for maternal and child health and family planning programs in 27 African, 5 Asian, and 8 Latin American and Caribbean countries. The diagnosis covered the collection and use of information on physical infrastructure, human resources, equipment/supplies, services provided, coverage attained, and program quality and impact. It was found that many programs do not produce certain basic input and output indicators and that even among those that do, information is too infrequently brought to bear on management decision-making. Constraints under which the MIS operate in these countries are identified, and some rudimentary calculations of what would be required to improve MIS functioning are made.

  4. Assessing the impact of fisheries co-management interventions in developing countries: a meta-analysis.

    PubMed

    Evans, Louisa; Cherrett, Nia; Pemsl, Diemuth

    2011-08-01

    Co-management is now established as a mainstream approach to small-scale fisheries management across the developing world. A comprehensive review of 204 potential cases reveals a lack of impact assessments of fisheries co-management. This study reports on a meta-analysis of the impact of fisheries co-management in developing countries in 90 sites across 29 case-studies. The top five most frequently measured process indicators are participation, influence, rule compliance, control over resources, and conflict. The top five most frequently measured outcome indicators are access to resources, resource well-being, fishery yield, household well-being, and household income. To deal with the diversity of the 52 indicators measured and the different ways these data are collected and analysed, we apply a coding system to capture change over time. The results of the meta-analysis suggest that, overall fisheries co-management delivers benefits to end-users through improvements in key process and outcome indicators. However, the dataset as a whole is constituted primarily of data from the Philippines. When we exclude this body of work, few generalisations can be made about the impact of fisheries co-management. The lack of comparative data suitable for impact assessment and the difficulties in comparing data and generalising across countries and regions reiterates calls in other fields for more systematic approaches to understanding and evaluating governance frameworks. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991-2014.

    PubMed

    Amugsi, Dickson Abanimi; Dimbuene, Zacharie T; Mberu, Blessing; Muthuri, Stella; Ezeh, Alex C

    2017-10-27

    To examine the prevalence and trends in overweight and obesity among non-pregnant urban women in Africa over the past two and a half decades. Cross-sectional surveys conducted between 1991 and 2014. Demographic and Health Surveys (DHS), repeated cross-sectional data collected in 24 African countries. Adult non-pregnant women aged 15-49 years. The earlier DHS collected anthropometric data on only those women who had children aged 0-5 years. The main analyses were limited to this subgroup. The participants were classified as overweight (25.0-29.9 kg/m 2 ) and obese (≥30.0 kg/m 2 ). The prevalence of overweight and obesity among women increased in all the 24 countries. Trends were statistically significant in 17 of the 24 countries in the case of obesity and 13 of the 24 for overweight. In Ghana, overweight almost doubled (p=0.001) while obesity tripled (p=0.001) between 1993 and 2014. Egypt has the highest levels of overweight and obesity at 44% (95% CI 42%, 46.5%) and 39% (95% CI 36.6%, 41.8%), respectively, in 2014 and the trend showed significant increase (p=0.005) from 1995 levels. Also, obesity doubled in Kenya, Benin, Niger, Rwanda, Ivory Coast and Uganda, while tripled in Zambia, Burkina Faso, Mali, Malawi and Tanzania. Ethiopia and Madagascar had the lowest prevalence of both obesity and overweight, with overweight ranging from 7% to 12% and obesity from 1% to 4%. Overweight and obesity are increasing among women of reproductive age in urban Africa, with obesity among this age group having more than doubled or tripled in 12 of the 24 countries. There is an urgent need for deliberate policies and interventions to encourage active lifestyles and healthy eating behaviour to curb this trend in urban Africa. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Psychiatric Symptoms in Patients with Cushing's Syndrome: Prevalence, Diagnosis and Management.

    PubMed

    Santos, Alicia; Resmini, Eugenia; Pascual, Juan Carlos; Crespo, Iris; Webb, Susan M

    2017-05-01

    Cushing's syndrome (CS) results from chronic exposure to cortisol excess, produced by the adrenal cortex. Hypercortisolism predisposes to psychiatric and neurocognitive disorders, mainly to depression and anxiety disorders. Screening tools to identify psychiatric symptoms are available for clinicians in their daily practice, although a specific diagnosis should be performed by specialists. Even if psychiatric symptoms improve after remission of hypercortisolism, complete recovery may not be achieved. Given the burden of these symptoms, psychiatric or psychological monitoring and treatment should be offered through all phases of CS, with a multidisciplinary approach. The aim of this article is to review data on the prevalence, diagnosis and management of psychiatric symptoms seen in patients with CS and to propose therapeutic approaches that may be followed in clinical practice. The prevalence of different psychiatric disorders has been described in both the active phase and after CS remission. Patients may not talk spontaneously about psychiatric symptoms they present, thus clinicians should ask directly about them. We recommend the use of screening tools in clinical practice to detect and treat these symptoms promptly. Even if reference endocrinologists cannot perform a definite psychiatric diagnosis, it will be important to ask patients directly about the presence of symptoms and refer if necessary to a psychiatrist. Additionally, patient information and educational programmes could be useful to manage psychiatric symptoms and to improve quality of life in patients with CS.

  7. Improving integration for integrated coastal zone management: an eight country study.

    PubMed

    Portman, M E; Esteves, L S; Le, X Q; Khan, A Z

    2012-11-15

    Integrated coastal zone management (ICZM) is a widely accepted approach for sustainable management of the coastal environment. ICZM emphasizes integration across sectors, levels of government, uses, stakeholders, and spatial and temporal scales. While improving integration is central to progress in ICZM, the role of and the achievement of integration remain understudied. To further study these two points, our research analyzes the performance of specific mechanisms used to support ICZM in eight countries (Belgium, India, Israel, Italy, Portugal, Sweden, UK, and Vietnam). The assessment is based on a qualitative comparative analysis conducted through the use of two surveys. It focuses on five ICZM mechanisms (environmental impact assessment; planning hierarchy; setback lines; marine spatial planning, and regulatory commission) and their role in improving integration. Our findings indicate that certain mechanisms enhance specific types of integration more effectively than others. Environmental impact assessment enhances science-policy integration and can be useful to integrate knowledge across sectors. Planning hierarchy and regulatory commissions are effective mechanisms to integrate policies across government levels, with the latter also promoting public-government integration. Setback lines can be applied to enhance integration across landscape units. Marine spatial planning is a multi-faceted mechanism with the potential to promote all types of integration. Policy-makers should adopt the mechanisms that are suited to the type of integration needed. Results of this study also contribute to evidence-based coastal management by identifying the most common impediments related to the mechanisms of integration in the eight studied countries. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Transferring disease management and health promotion programs to other countries: critical success factors.

    PubMed

    Azarmina, Pejman; Prestwich, Graham; Rosenquist, Joel; Singh, Debbie

    2008-12-01

    Governments and health service providers around the world are under pressure to improve health outcomes while containing rising healthcare costs. In response to such challenges, many regions have implemented services that have been successful in other countries-but 'importing' initiatives has many challenges. This article summarizes factors found to be critical to the success of adapting a US disease management and health promotion programme for use in Italy and the UK. Using three illustrative case studies, it describes how in each region the programme needed to adapt (i) the form and content of the disease management service, (ii) the involvement and integration with local clinicians and services and (iii) the evaluation of programme outcomes. We argue that it is important to implement evidence-based practice by learning lessons from other countries and service initiatives, but that it is equally important to take into consideration the '3Ps' that are critical for successful service implementation: payers, practitioners and patients.

  9. Strengthening public health pesticide management in countries endemic with malaria or other major vector-borne diseases: an evaluation of three strategies.

    PubMed

    van den Berg, Henk; Yadav, Rajpal S; Zaim, Morteza

    2014-09-18

    Public health pesticides has been the mainstay control of vectors of malaria and other diseases, and public health pests, but there is increasing concern over how these pesticides are being managed. Poor pesticide management could lead to risks to human health and the environment, or diminish the effectiveness of interventions. Strategies for strengthening the management of public health pesticides, from manufacture to disposal, should be evaluated to propose future directions. The process and outcomes of three strategies were studied in five regions of the WHO (African Region, Eastern Mediterranean Region, South-East Asia Region, Western Pacific Region, and American Region) and 13 selected countries. These strategies are: regional policy development, in-depth country support and thematic support across countries. Consensus, frameworks and action plans on public health pesticide management were developed at regional level. Country support for situation analysis and national action planning highlighted weaknesses over the entire spectrum of pesticide management practices, mainly related to malaria control. The thematic support on pesticide quality control contributed to structural improvements on a priority issue for malaria control across countries. The three strategies showed promising and complementary results, but guidelines and tools for implementation of the strategies should be further improved. Increased national and international priority should be given to support the development of policy, legislation and capacity that are necessary for sound management of public health pesticides.

  10. Prevalence and Correlates of HIV Disclosure Among Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Britto, Carl; Mehta, Kayur; Thomas, Rwituja; Shet, Anita

    2018-01-01

    Objective Disclosure of HIV status among children and adolescents living with HIV has both beneficial and challenging aspects. To address existing knowledge gaps and update the literature on childhood disclosure, we conducted a systematic review on caregivers’ perceptions and practices of HIV disclosure in low- and middle-income countries (LMICs). Methods Standard databases were searched for studies conducted in LMICs, published in English between 2004 and 2015. Excluded articles were reviews or case reports, and those not reporting childhood disclosure. Data regarding prevalence, correlates and impact of disclosure, were presented as frequencies. Results Two authors independently screened 982 articles. After applying eligibility criteria, 22 articles representing 12 countries and 2,843 children were reviewed. The proportion of fully disclosed children ranged from 1.7% to 41.0%. Up to 49.5% children were provided “deflected” information (use of a non-HIV-related reason for explaining illness and health care visits). Factors associated with full disclosure included antiretroviral treatment initiation and caregivers’ felt need for maintaining optimal adherence. Barriers to disclosure included fear of negative psychological reactions and inadvertent disclosure to others. Caregivers perceived a strong need for active participation from health care providers to aid the process of disclosure. Conclusions Full disclosure of HIV status was not common among children and adolescents in LMICs, while the practice of deflected disclosure was prominent. Caregivers perceived the need for support from health care providers during the disclosure process. Evidence-based guidelines incorporating the developmental status of the child, locally prevalent cultures, and caregiver perceptions are prerequisite to enhancing disclosure in these settings. PMID:27262128

  11. Prevalence and severity of dysmenorrhoea, and management options reported by young Australian women.

    PubMed

    Subasinghe, Asvini K; Happo, Lina; Jayasinghe, Yasmin L; Garland, Suzanne M; Gorelik, Alexandra; Wark, John D

    2016-11-01

    Little is known about the severity of dysmenorrhoea and attitudes towards its management in young females. The aim of this study was to evaluate the prevalence and severity of dysmenorrhoea in women aged 16-25 years. Participants were recruited via targeted Facebook advertising and asked to complete an online questionnaire covering medications, menstruation and lifestyle-related themes. A follow-up questionnaire on dysmenorrhoea was also administered. The prevalence of dysmenorrhoea was 88% (n = 247, mean age 21.5 years, SD 2.6). Only 34% of participants reported consulting a healthcare provider about their pain, whereas 86% consulted other sources. Pain medication was used by 58% of the participants. Dysmenorrhoea was associated with interference with daily activities (P DISCUSSION: Dysmenorrhoea is highly prevalent among these women, with most indicating moderate to severe pain and a significant adverse impact on daily activities. Most women did not obtain information about dysmenorrhoea from healthcare providers, indicating the need for general practitioners to provide accurate information about dysmenorrhoea to young females.

  12. Age-related prevalence and met need for correctable and uncorrectable near vision impairment in a multi-country study.

    PubMed

    He, Mingguang; Abdou, Amza; Ellwein, Leon B; Naidoo, Kovin S; Sapkota, Yuddha D; Thulasiraj, R D; Varma, Rohit; Zhao, Jialiang; Kocur, Ivo; Congdon, Nathan G

    2014-01-01

    To estimate the prevalence, potential determinants, and proportion of met need for near vision impairment (NVI) correctable with refraction approximately 2 years after initial examination of a multi-country cohort. Population-based, prospective cohort study. People aged ≥35 years examined at baseline in semi-rural (Shunyi) and urban (Guangzhou) sites in China; rural sites in Nepal (Kaski), India (Madurai), and Niger (Dosso); a semi-urban site (Durban) in South Africa; and an urban site (Los Angeles) in the United States. Near visual acuity (NVA) with and without current near correction was measured at 40 cm using a logarithm of the minimum angle of resolution near vision tumbling E chart. Participants with uncorrected binocular NVA ≤20/40 were tested with plus sphere lenses to obtain best-corrected binocular NVA. Prevalence of total NVI (defined as uncorrected NVA ≤20/40) and NVI correctable and uncorrectable to >20/40, and current spectacle wearing among those with bilateral NVA ≤20/63 improving to >20/40 with near correction (met need). Among 13 671 baseline participants, 10 533 (77.2%) attended the follow-up examination. The prevalence of correctable NVI increased with age from 35 to 50-60 years and then decreased at all sites. Multiple logistic regression modeling suggested that correctable NVI was not associated with gender at any site, whereas more educated persons aged >54 years were associated with a higher prevalence of correctable NVI in Nepal and India. Although near vision spectacles were provided free at baseline, wear among those who could benefit was <40% at all but 2 centers (Guangzhou and Los Angeles). Prevalence of correctable NVI is greatest among persons of working age, and rates of correction are low in many settings, suggesting that strategies targeting the workplace may be needed. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  13. Epidemiology of posttraumatic stress disorder: prevalence, correlates and consequences

    PubMed Central

    Atwoli, Lukoye; Stein, Dan J.; Koenen, Karestan C.; McLaughlin, Katie A.

    2015-01-01

    Purpose of review This review discusses recent findings from epidemiological surveys of traumatic events and posttraumatic stress disorder (PTSD) globally, including their prevalence, risk factors, and consequences in the community. Recent findings A number of studies on the epidemiology of PTSD have recently been published from diverse countries, with new methodological innovations introduced. Such work has not only documented the prevalence of PTSD in different settings, but has also shed new light on the PTSD conditional risk associated with specific traumatic events, and on the morbidity and comorbidities associated with these events. Summary Recent community studies show that trauma exposure is higher in lower-income countries compared with high-income countries. PTSD prevalence rates are largely similar across countries, however, with the highest rates being found in postconflict settings. Trauma and PTSD-risk factors are distributed differently in lower-income countries compared with high-income countries, with sociodemographic factors contributing more to this risk in high-income than low-income countries. Apart from PTSD, trauma exposure is also associated with several chronic physical conditions. These findings indicate a high burden of trauma exposure in low-income countries and postconflict settings, where access to trained mental health professionals is typically low. PMID:26001922

  14. Low Yield of Chest Radiography in General Inpatients and Outpatients with "Positive PPD" Results in a Country with Low Prevalence of TB.

    PubMed

    Eisenberg, Ronald L; Heidinger, Benedikt H

    2017-07-01

    The purpose of this study was to assess the frequency and spectrum of abnormalities on routine screening chest radiographs among inpatients and outpatients with "positive purified protein derivative (PPD)" in a large tertiary care academic medical center in a country with low prevalence of tuberculosis (TB). The reports of all chest radiographs of general inpatients and outpatients referred for positive PPD (2010-2014) were evaluated for the frequency of evidence of active or latent TB and the spectrum of imaging findings. The results of additional chest radiographs and computed tomography scans were recorded, as were additional relevant clinical histories and symptoms. Of the 2518 patients who underwent chest radiography for positive PPD, the radiographs were normal in 91.3%. The vast majority of the abnormal radiographs demonstrated findings consistent with old tuberculous disease. There were three cases (0.1%) of active TB, all of which were either recent immigrants from an endemic area or had other relevant histories or clinical symptoms suggestive of the disease. Universal chest radiography in general inpatient and outpatient populations referred for positive PPD is of low yield for detecting active disease in a country with low prevalence of TB. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  15. Comparison of medicines management strategies in insurance schemes in middle-income countries: four case studies.

    PubMed

    Kaplan, Warren A; Ashigbie, Paul G; Brooks, Mohamad I; Wirtz, Veronika J

    2017-01-01

    Many middle-income countries are scaling up health insurance schemes to provide financial protection and access to affordable medicines to poor and uninsured populations. Although there is a wealth of evidence on how high income countries with mature insurance schemes manage cost-effective use of medicines, there is limited evidence on the strategies used in middle-income countries. This paper compares the medicines management strategies that four insurance schemes in middle-income countries use to improve access and cost-effective use of medicines among beneficiaries. We compare key strategies promoting cost-effective medicines use in the New Rural Cooperative Medical Scheme (NCMS) in China, National Health Insurance Scheme in Ghana, Jamkesmas in Indonesia and Seguro Popular in Mexico. Through the peer-reviewed and grey literature as of late 2013, we identified strategies that met our inclusion criteria as well as any evidence showing if, and/or how, these strategies affected medicines management. Stakeholders involved and affected by medicines coverage policies in these insurance schemes were asked to provide relevant documents describing the medicines related aspects of these insurance programs. We also asked them specifically to identify publications discussing the unintended consequences of the strategies implemented. Use of formularies, bulk procurement, standard treatment guidelines and separation of prescribing and dispensing were present in all four schemes. Also, increased transparency through publication of tender agreements and procurement prices was introduced in all four. Common strategies shared by three out of four schemes were medicine price negotiation or rebates, generic reference pricing, fixed salaries for prescribers, accredited preferred provider network, disease management programs, and monitoring of medicines purchases. Cost-sharing and payment for performance was rarely used. There was a lack of performance monitoring strategies in all

  16. Diet intake and caries prevalence in four-year-old children living in a low-prevalence country.

    PubMed

    Ohlund, I; Holgerson, P L; Backman, B; Lind, T; Hernell, O; Johansson, I

    2007-01-01

    Preventive measures have dramatically decreased the prevalence of dental caries in children. However, risk factors for the disease in children living in low-prevalence areas remain elusive. In the present study we evaluated associations between dental caries, saliva levels of mutans streptococci and lactobacilli, and diet with special emphasis on the intake of fermentable carbohydrates and dairy products in 4-year-old children living in an area where the overall caries prevalence was low. Dietary intake was recorded in 234 infants as part of the Study of Infant Nutrition in Umeå, Sweden (SINUS). Of these the parents of 124 children gave consent to participate in a follow-up at 4 years of age. Dietary intake, height and weight, dental caries, oral hygiene, including tooth brushing habits, presence of plaque and gingival inflammation, fluoride habits and numbers of mutans streptococci and lactobacilli in saliva were recorded. Using multivariate stepwise logistic regression, caries experience was negatively associated with intake frequency of cheese (OR = 0.67; 95% CI = 0.44-0.98) and positively associated with the salivary level of mutans streptococci (OR = 1.57; 95% CI = 1.21-2.03). Caries experience was not correlated with intake frequency or amounts of carbohydrate-containing foods, with any other particular food, or with daily intake of energy, carbohydrate or any other macro- or micronutrient. We conclude that cheese intake may have a caries-protective effect in childhood populations where the overall caries prevalence and caries experience are low and the children are regularly exposed to fluoride from toothpaste.

  17. Prevalence of overweight and obesity among migrants in Switzerland: association with country of origin.

    PubMed

    Marques-Vidal, Pedro; Vollenweider, Peter; Waeber, Gérard; Paccaud, Fred

    2011-07-01

    Migrants tend to present higher overweight and obesity levels, but whether this relationship applies to all nationalities has seldom been studied. The present study aimed to assess the prevalence of overweight and obesity according to nationality in adults. Cross-sectional population-based samples. Five-year nationwide interview surveys (Swiss Health Surveys - SHS) from 1992 to 2007 (n 63 766) and a local examination survey (CoLaus Study in Lausanne 2004-2006, n 6743). Participants were separated into Swiss, French, German, Italian, Portuguese, Spanish nationals, those from the former Republic of Yugoslavia and from other European and other countries. Compared with Swiss nationals, German and French nationals presented a lower prevalence of overweight and obesity, whereas nationals from Italy, Spain, Portugal and the former Republic of Yugoslavia presented higher levels. Adjusting the SHS data for age, gender, education, smoking, leisure-time physical activity and survey year, a lower risk for overweight and obesity was found for German (OR = 0·80, 95 % CI 0·70, 0·92) and French (OR = 0·74, 95 % CI 0·61, 0·89) nationals, whereas higher risks were found for participants from Italy (OR = 1·45, 95 % CI 1·33, 1·58), Spain (OR = 1·36, 95 % CI 1·15, 1·61), Portugal (OR = 1·25, 95 % CI 1·06, 1·47) and the former Republic of Yugoslavia (OR = 1·98, 95 % CI 1·69, 2·32). Similar findings were observed in the CoLaus Study for Italian (OR = 1·63, 95 % CI 1·29, 2·06), Spanish (OR = 1·54, 95 % CI 1·17, 2·04) and Portuguese (OR = 1·49, 95 % CI 1·16, 1·91) participants and for those from the former Republic of Yugoslavia (OR = 5·34, 95 % CI 3·00, 9·50). Overweight and obesity are unevenly distributed among migrants in Switzerland. Migrants from Southern Europe and from the former Republic of Yugoslavia present higher prevalence rates. This suggests that preventive messages should be tailored to these specific populations.

  18. Report: transboundary hazardous waste management. part II: performance auditing of treatment facilities in importing countries.

    PubMed

    Chang, Tien-Chin; Ni, Shih-Piao; Fan, Kuo-Shuh; Lee, Ching-Hwa

    2006-06-01

    Before implementing the self-monitoring model programme of the Basel Convention in the Asia, Taiwan has conducted a comprehensive 4-year follow-up project to visit the governmental authorities and waste-disposal facilities in the countries that import waste from Taiwan. A total of nine treatment facilities, six of which are reported in this paper, and the five countries where the plants are located were visited in 2001-2002. France, Belgium and Finland primarily handled polychlorinated biphenyl capacitors, steel mill dust and metal waste. The United States accepted metal sludge, mainly electroplating sludge, from Taiwan. Waste printed circuit boards, waste wires and cables, and a mixture of waste metals and electronics were the major items exported to China. Relatively speaking, most treatment plants for hazardous waste paid close attention to environmental management, such as pollution control and monitoring, site zoning, system management regarding occupational safety and hygiene, data management, permits application, and image promotion. Under the tight restrictions formulated by the central environment agency, waste treatment plants in China managed the environmental issues seriously. For example, one of the treatment plants had ISO 14001 certification. It is believed that with continuous implementation of regulations, more improvement is foreseeable. Meanwhile, Taiwan and China should also continuously enhance their collaboration regarding the transboundary management of hazardous waste.

  19. Country- and individual-level socioeconomic determinants of depression: multilevel cross-national comparison.

    PubMed

    Rai, Dheeraj; Zitko, Pedro; Jones, Kelvyn; Lynch, John; Araya, Ricardo

    2013-03-01

    The prevalence and correlates of depression vary across countries. Contextual factors such as country-level income or income inequalities have been hypothesised to contribute to these differences. To investigate associations of depression with socioeconomic factors at the country level (income inequality, gross national income) and individual (education, employment, assets and spending) level, and to investigate their relative contribution in explaining the cross-national variation in the prevalence of depression. Multilevel study using interview data of 187 496 individuals from 53 countries participating in the World Health Organization World Health Surveys. Depression prevalence varied between 0.4 and 15.7% across countries. Individual-level factors were responsible for 86.5% of this variance but there was also reasonable variation at the country level (13.5%), which appeared to increase with decreasing economic development of countries. Gross national income or country-level income inequality had no association with depression. At the individual level, fewer material assets, lower education, female gender, economic inactivity and being divorced or widowed were associated with increased odds of depression. Greater household spending, unlike material assets, was associated with increasing odds of depression (adjusted analysis). The variance of depression prevalence attributable to country-level factors seemed to increase with decreasing economic development of countries. However, country-level income inequality or gross national income explained little of this variation, and individual-level factors appeared more important than contextual factors as determinants of depression. The divergent relationship of assets and spending with depression emphasise that different socioeconomic measures are not interchangeable in their associations with depression.

  20. The changing global distribution and prevalence of canine transmissible venereal tumour

    PubMed Central

    2014-01-01

    Background The canine transmissible venereal tumour (CTVT) is a contagious cancer that is naturally transmitted between dogs by the allogeneic transfer of living cancer cells during coitus. CTVT first arose several thousand years ago and has been reported in dog populations worldwide; however, its precise distribution patterns and prevalence remain unclear. Results We analysed historical literature and obtained CTVT prevalence information from 645 veterinarians and animal health workers in 109 countries in order to estimate CTVT’s former and current global distribution and prevalence. This analysis confirmed that CTVT is endemic in at least 90 countries worldwide across all inhabited continents. CTVT is estimated to be present at a prevalence of one percent or more in dogs in at least 13 countries in South and Central America as well as in at least 11 countries in Africa and 8 countries in Asia. In the United States and Australia, CTVT was reported to be endemic only in remote indigenous communities. Comparison of current and historical reports of CTVT indicated that its prevalence has declined in Northern Europe, possibly due to changes in dog control laws during the nineteenth and twentieth centuries. Analysis of factors influencing CTVT prevalence showed that presence of free-roaming dogs was associated with increased CTVT prevalence, while dog spaying and neutering were associated with reduced CTVT prevalence. Our analysis indicated no gender bias for CTVT and we found no evidence that animals with CTVT frequently harbour concurrent infectious diseases. Vincristine was widely reported to be the most effective therapy for CTVT. Conclusions Our results provide a survey of the current global distribution of CTVT, confirming that CTVT is endemic in at least 90 countries worldwide. Additionally, our analysis highlights factors that continue to modify CTVT’s prevalence around the world and implicates free-roaming dogs as a reservoir for the disease. Our analysis

  1. [Prevalence of allergic rhinitis in Durango, Mexico].

    PubMed

    Cisneros Pérez, Vicente; Alvarado Esquivel, Cosme

    2004-01-01

    Allergic rhinitis has become the most frequent chronic disease of upper airways and its prevalence is increasing importantly in countries with systems of western life. To determine the prevalence of allergic rhinitis and its subtypes in inhabitants of Durango, Mexico. Through a descriptive, cross-sectional study, 1,320 inhabitants of Durango were studied. They were chosen randomly and accepted voluntarily to participate. A modification of the Middleton diary symptom questionnaire was used as a tool to determine the prevalence. The prevalence of allergic rhinitis in the general population was of 7.6% (95% CI 6.2-9.2). The prevalence of seasonal rhinitis was of 5.5% (95% CI 4.4-6.9), of perennial rhinitis, 2.1% (95% CI 1.4-3.0), for medical diagnosis, 4.3% (95% CI 3.4-5.8), and for survey, 3.3% (95% CI 2.4-4.4). The highest frequency was found in persons of 5-9 years old (12.5%) and in women (5.1%). The prevalence of allergic rhinitis in Durango, Mexico, is similar to the national mean prevalence, but lower than that reported in developed countries.

  2. Adolescent suicidal behaviours in 32 low- and middle-income countries

    PubMed Central

    Gariépy, Geneviève; Sentenac, Mariane; Elgar, Frank J

    2016-01-01

    Abstract Objective To estimate prevalence of suicidal ideation and suicidal ideation with a plan in each surveyed country and to examine cross-national differences in associated risk factors. Methods We analysed data of students aged 13–17 years who participated in the 2003–2012 Global School-based Health Surveys in 32 countries, of which 29 are low- and middle-income. We used random effects meta-analysis to generate regional and overall pooled estimates. Multivariable logistic regression was used to estimate risk ratios for the associated risk factors. Population attributable fractions were estimated based on adjusted risk ratios and the prevalence of the determinants within each exposure level. Findings Across all countries, the pooled 12-month prevalence of suicide ideation were 16.2% (95% confidence interval, CI: 15.6 to 16.7) among females and 12.2% (95% CI: 11.7 to 12.7) among males and ideation with a plan were 8.3% (95% CI: 7.9 to 8.7) among females and 5.8% (95% CI: 5.5 to 6.1) among males. Suicide ideation in the WHO Region of the Americas was higher in females than males, with an estimated prevalence ratio of 1.70 (95% CI: 1.60 to 1.81), while this ratio was 1.04 (95% CI: 0.98 to 1.10) in the WHO African Region. Factors associated with suicidal ideation in most countries included experiences of bullying and physical violence, loneliness, limited parental support and alcohol and tobacco use. Conclusion The prevalence of adolescent suicidal behaviours varies across countries, yet a consistent set of risk factors of suicidal behaviours emerged across all regions and most countries. PMID:27147764

  3. Prevalence of type 2 diabetes in the Arab world: impact of GDP and energy consumption.

    PubMed

    Meo, S A; Usmani, A M; Qalbani, E

    2017-03-01

    Diabetes Mellitus (DM) is a rapidly growing and most challenging health issue of the 21st century. This study aimed to investigate the prevalence of type-2 DM and its association with Gross Domestic Product (GDP) and energy consumption in the Arab world countries. We identified 88 articles through systematic searches including Institute of Scientific Information (ISI) Web of Science, PubMed and EMBASE databases published between 1980-2015. The related literature was searched by using the keywords including diabetes mellitus, prevalence, incidence, epidemiology of type-2 diabetes mellitus (T2DM), and names of the individual Arab world countries. The articles were selected and investigated for the prevalence of T2DM. No limitations were imposed in the design of the study or publication language. Finally, 50 peer-reviewed publications were included and the rest were excluded. Arab world countries with the highest prevalence of T2DM are: Kingdom of Saudi Arabia 31.6%, Oman 29%, Kuwait 25.4%, Bahrain 25.0% and United Arab Emirates 25.0%. The lowest prevalence was found in Mauritania (4.7%) and Somalia (3.9%). The highest prevalence was observed in Gulf Cooperation Council (GCC) countries (25.45%) whilst non-GCC countries had the lowest prevalence (12.69%). The combined mean prevalence of T2DM in both GCC and Non-GCC Arab countries was 16.17%. The prevalence of T2DM was found to be significantly associated with higher Gross Domestic Product (GDP) (p=0.020) and energy consumption (p=0.017). In the Arab world, the countries with the highest prevalence of type 2 diabetes mellitus are: Saudi Arabia, Oman, Kuwait, Bahrain and UAE, whilst the countries with the lowest prevalence are Mauritania and Somalia. This prevalence was significantly associated with high GDP per capita and energy consumption. Arab states must incorporate diabetes preventive policies on a war-footing basis to minimize the burden of the disease.

  4. Stress velopharyngeal incompetence: prevalence, treatment, and management practices.

    PubMed

    Malick, Deonne; Moon, Jerry; Canady, John

    2007-07-01

    Stress velopharyngeal incompetence is the unwanted coupling of the oral and nasal cavities while brass and woodwind musicians play their instruments. This study investigated both (1) the prevalence of stress velopharyngeal incompetence in college musicians, delineating symptoms and situations possibly associated with the condition; and (2) physicians' experiences with musicians exhibiting stress velopharyngeal incompetence, including typical treatment and management techniques. Questionnaires were distributed to 297 brass or woodwind student musicians at three public universities and to 998 plastic surgeons and otolaryngologists. The musician questionnaire focused on demographic data and identification of symptoms that might indicate the presence of stress velopharyngeal incompetence. The physician questionnaire addressed demographics of the physician and his or her practice, familiarity and experience with stress velopharyngeal incompetence, and treatment and management suggestions for individuals experiencing the condition. Thirty-four percent of the responding musicians reported symptoms of stress velopharyngeal incompetence, most often after 30 minutes of playing. Forty-five percent of the responding physicians reported being familiar with the term stress velopharyngeal incompetence, although only 27% reported ever having seen a patient with the condition. The seven most frequently reported intervention strategies were referral to a speech language pathologist (47.50%), sphincter pharyngoplasty (30.00%), pharyngeal flap (26.88%), referral to a cleft palate team (24.38%), watch and wait (18.75%), posterior wall fat injection (12.50%), and palatal lift (10.00%). Stress velopharyngeal incompetence is a potentially career-ending (or career-preventing) problem that currently may be undertreated and that is in need of more systematic study both in terms of its physiologic underpinnings and its management.

  5. American Contact Dermatitis Society Contact Allergy Management Program: An Epidemiologic Tool to Determine Relative Prevalence of Contact Allergens.

    PubMed

    Scheman, Andrew; Severson, David

    2016-01-01

    Data on the prevalence of contact allergy in North America are currently reported by groups of academic contact allergy specialists at select academic centers. Sampling of data from numerous centers across North America, including practices performing more limited patch testing, would provide a broader perspective of contact allergen prevalence in North America. The American Contact Dermatitis Society Contact Allergy Management Program is an ideal tool for collection of epidemiologic data regarding contact allergy prevalence in North America. The aim of the study was to identify the relative prevalence of contact allergy to common contact allergens in North America. Mapping of Contact Allergy Management Program (CAMP) data was performed to allow analysis of how frequently searches were performed for various contact allergens. The number of searches performed for specific allergens provides a measure of the relative prevalence of contact allergy to these allergens. The top 35 allergens for the period from November 18, 2012 to November 18, 2013 are reported. Although these data are useful, specific recommendations for minor alterations to CAMP are discussed, which will allow future CAMP data to be stratified and more powerful. With minor modifications, CAMP can provide a quantum leap in the reporting of contact allergy epidemiologic data in North America.

  6. Exposure to psychosocial work factors in 31 European countries.

    PubMed

    Niedhammer, I; Sultan-Taïeb, H; Chastang, J-F; Vermeylen, G; Parent-Thirion, A

    2012-04-01

    Although psychosocial work factors are recognized as major occupational risk factors, little information is available regarding the prevalence of exposure to these factors and the differences in exposure between countries. To explore the differences in various psychosocial work exposures between 31 European countries. The study was based on a sample of 14,881 male and 14,799 female workers from the 2005 European Working Conditions Survey. Eighteen psychosocial work factors were studied: low decision latitude (skill discretion and decision authority), high psychological demands, job strain, low social support, iso-strain, physical violence, sexual harassment, bullying, discrimination, work-family imbalance, long working hours, high effort, job insecurity, low job promotion, low reward and effort-reward imbalance. Covariates were age, number of workers in household, occupation, economic activity, self-employed/employee, public/private sector and part/full time work. Statistical analysis was performed using multilevel logistic regression analysis. Significant differences in all psychosocial work factors were observed between countries. The rank of the countries varied according to the exposure considered. However, some countries, especially Denmark, Netherlands and Norway, displayed a significantly lower prevalence of exposure to four factors or more, while some Southern and Eastern countries, especially Czech Republic, Greece, Lithuania and Turkey, had a higher prevalence. Differences in psychosocial work exposures were found between countries. This study is the first to compare a large set of psychosocial work exposures between 31 European countries. These findings may be useful to guide prevention policies at European level.

  7. Spatial prediction of Plasmodium falciparum prevalence in Somalia

    PubMed Central

    Noor, Abdisalan M; Clements, Archie CA; Gething, Peter W; Moloney, Grainne; Borle, Mohammed; Shewchuk, Tanya; Hay, Simon I; Snow, Robert W

    2008-01-01

    Background Maps of malaria distribution are vital for optimal allocation of resources for anti-malarial activities. There is a lack of reliable contemporary malaria maps in endemic countries in sub-Saharan Africa. This problem is particularly acute in low malaria transmission countries such as those located in the horn of Africa. Methods Data from a national malaria cluster sample survey in 2005 and routine cluster surveys in 2007 were assembled for Somalia. Rapid diagnostic tests were used to examine the presence of Plasmodium falciparum parasites in finger-prick blood samples obtained from individuals across all age-groups. Bayesian geostatistical models, with environmental and survey covariates, were used to predict continuous maps of malaria prevalence across Somalia and to define the uncertainty associated with the predictions. Results For analyses the country was divided into north and south. In the north, the month of survey, distance to water, precipitation and temperature had no significant association with P. falciparum prevalence when spatial correlation was taken into account. In contrast, all the covariates, except distance to water, were significantly associated with parasite prevalence in the south. The inclusion of covariates improved model fit for the south but not for the north. Model precision was highest in the south. The majority of the country had a predicted prevalence of < 5%; areas with ≥ 5% prevalence were predominantly in the south. Conclusion The maps showed that malaria transmission in Somalia varied from hypo- to meso-endemic. However, even after including the selected covariates in the model, there still remained a considerable amount of unexplained spatial variation in parasite prevalence, indicating effects of other factors not captured in the study. Nonetheless the maps presented here provide the best contemporary information on malaria prevalence in Somalia. PMID:18717998

  8. Spatial prediction of Plasmodium falciparum prevalence in Somalia.

    PubMed

    Noor, Abdisalan M; Clements, Archie C A; Gething, Peter W; Moloney, Grainne; Borle, Mohammed; Shewchuk, Tanya; Hay, Simon I; Snow, Robert W

    2008-08-21

    Maps of malaria distribution are vital for optimal allocation of resources for anti-malarial activities. There is a lack of reliable contemporary malaria maps in endemic countries in sub-Saharan Africa. This problem is particularly acute in low malaria transmission countries such as those located in the horn of Africa. Data from a national malaria cluster sample survey in 2005 and routine cluster surveys in 2007 were assembled for Somalia. Rapid diagnostic tests were used to examine the presence of Plasmodium falciparum parasites in finger-prick blood samples obtained from individuals across all age-groups. Bayesian geostatistical models, with environmental and survey covariates, were used to predict continuous maps of malaria prevalence across Somalia and to define the uncertainty associated with the predictions. For analyses the country was divided into north and south. In the north, the month of survey, distance to water, precipitation and temperature had no significant association with P. falciparum prevalence when spatial correlation was taken into account. In contrast, all the covariates, except distance to water, were significantly associated with parasite prevalence in the south. The inclusion of covariates improved model fit for the south but not for the north. Model precision was highest in the south. The majority of the country had a predicted prevalence of < 5%; areas with > or = 5% prevalence were predominantly in the south. The maps showed that malaria transmission in Somalia varied from hypo- to meso-endemic. However, even after including the selected covariates in the model, there still remained a considerable amount of unexplained spatial variation in parasite prevalence, indicating effects of other factors not captured in the study. Nonetheless the maps presented here provide the best contemporary information on malaria prevalence in Somalia.

  9. School-Based Management Committees in Low-Income Countries: Can They Improve Service Delivery?

    ERIC Educational Resources Information Center

    Abadzi, Helen

    2013-01-01

    With the advent of school-based management, citizen committees in low-income countries or areas are often expected to oversee the functioning of schools, health centres, and other community resources. However, studies of their effectiveness show mixed results. Though members of such committees may be able to repair buildings, they often cannot…

  10. Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants.

    PubMed

    Giebel, Clarissa M; Sutcliffe, Caroline; Renom-Guiteras, Anna; Arve, Seija; Hallberg, Ingalill Rahm; Soto, Maria; Zabalegui, Adelaida; Hamers, Jan; Saks, Kai; Challis, David

    2015-04-01

    Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

  11. Asthma prevalence and severity in low-resource communities.

    PubMed

    Cruz, Álvaro A; Stelmach, Rafael; Ponte, Eduardo V

    2017-06-01

    The prevalence of asthma was thought to be low in most low-income countries, but several reports have indicated this is not always true. This is a narrative review of recent publications on the burden of asthma in low and middle-income countries (LMIC) and underprivileged communities from developed countries. Several studies have reported a low prevalence of asthma is LMIC, but indicate it is increasing. In the last few years, however, many surveys demonstrated this may not always be true. An analysis of the International Study for Asthma and Allergy in Childhood phase III database indicated although the prevalence of asthma among children and adolescents is higher in the developed countries, symptoms of asthma are often more severe in less affluent nations. The rate of uncontrolled asthma is also higher among underprivileged communities of developed countries. Secondary analysis of data generated by the WHO's world health survey performed among adults of 70 countries indicate symptoms of asthma are less frequent in middle-income countries and more frequent in the extremes, low income and high income. This sort of U shaped distribution suggests the disease (or syndrome) comprise more than one major phenotype related to diverse underlying mechanisms. In fact, recent reports show symptoms of asthma among the poor are associated with unhygienic living conditions, which may reduce the risk of atopy but increase the risk of nonatopic wheezing. Urbanization and exposure to air pollution also seem to contribute to an increasing prevalence severity of asthma in LMIC. Access to proper diagnosis and treatment with controller medications for asthma, specially with inhaled corticosteroids is feasible and cost-effective, reduce symptoms, health resource utilization, improves quality of life, and reduce mortality in low-resource settings. Prevalence of asthma was thought to be low in low-income countries, but several reports have indicated this is not always true. Under

  12. Safely Managed Sanitation for All Means Fecal Sludge Management for At Least 1.8 Billion People in Low and Middle Income Countries.

    PubMed

    Berendes, David M; Sumner, Trent A; Brown, Joe M

    2017-03-07

    Although global access to sanitation is increasing, safe management of fecal waste is a rapidly growing challenge in low- and middle-income countries (LMICs). The goal of this study was to evaluate the current need for fecal sludge management (FSM) in LMICs by region, urban/rural status, and wealth. Recent Demographic and Health Survey data from 58 countries (847 685 surveys) were used to classify households by sanitation facility (facilities needing FSM, sewered facilities, ecological sanitation/other, or no facilities). Onsite piped water infrastructure was quantified to approximate need for wastewater management and downstream treatment. Over all surveyed nations, 63% of households used facilities requiring FSM, totaling approximately 1.8 billion people. Rural areas had similar proportions of toilets requiring FSM as urban areas. FSM needs scaled inversely with wealth: in the poorest quintile, households' sanitation facilities were almost 170 times more likely to require FSM (vs sewerage) than in the richest quintile. About one out of five households needing FSM had onsite piped water infrastructure, indicating domestic or reticulated wastewater infrastructure may be required if lacking for safe management of aqueous waste streams. FSM strategies must be included in future sanitation investment to achieve safe management of fecal wastes and protect public health.

  13. Financial implications of compliance with EU waste management goals: Feasibility and consequences in a transition country.

    PubMed

    Mihajlović, Višnja; Vujić, Goran; Stanisavljević, Nemanja; Batinić, Bojan

    2016-09-01

    This paper outlines the approach that can assist decision makers to have first preliminary insights regarding costs of complying with requested European Union municipal waste management goals in transition and developing countries. Serbia, as a joining member of European Union, must confront itself with the challenges resulting from European Union waste management directives. Implementation of waste separation units and the construction of sanitary landfills is already in place in Serbia. However, new waste management practice will need additional transformation and will require implementation of waste treatment technologies for additional management of generated waste. Implementation of analyzed best available technology/techniques for waste treatment can support the country's effort in reaching the policy goals. However, the question here is how much will the implementation of additional waste treatments influence the overall waste management costs? Results of the scenario's financial viability show that composting and sanitary landfill are the most viable solutions regarding the costs, even under increasing discount rates. Although different discount rates influence the overall gate fees and net present values, the level of affordability for different scenarios remains the same. © The Author(s) 2016.

  14. Training for Public Administration and Management in Developing Countries. A Review. World Bank Staff Working Papers Number 584. Management and Development Series Number 11.

    ERIC Educational Resources Information Center

    Paul, Samuel

    Public administration and management training (PAMT) in developing countries has expanded and diversified in the past three decades. Five preconditions have been identified as necessary to ensure the effectiveness of that training: training policies and management of institutions, the educational system, the stock of educated personnel, personnel…

  15. Lower urinary tract symptoms in Parkinson's disease: Prevalence, aetiology and management.

    PubMed

    McDonald, Claire; Winge, Kristian; Burn, David J

    2017-02-01

    Lower urinary tract symptoms (LUTS) are common in Parkinson's disease (PD), effecting 27-85% of patients with PD. Irritative symptoms predominate and urodynamic studies confirm high prevalence of detrusor overactivity in PD. LUTS are present early in PD and are more common in PD than in age matched controls. The assessment of LUTS in PD is complicated by coexisting bradykinesia and cognitive impairment. Although LUTS become more troublesome as PD progresses it remains unclear if LUTS severity correlates with motor symptoms and/or duration of PD. The underlying cause of LUTS in PD remains to be fully elucidated. Animal and human studies suggest the net effect of the basal ganglia is to supress micturition. Although LUTS are a common in PD, few studies have examined the assessment and management of LUTS specifically in patients with PD. Pilot studies have suggested that bladder training, antimuscarinic drugs and intravesical botulinum toxin maybe helpful but these trials have been small and frequently lacked a suitable control group making them vulnerable to the placebo effect. Furthermore the adverse effects of antimuscarinic drugs on cognitive and gastrointestinal function may limit the use of these drugs in PD. In this review we summarise the literature describing the prevalence of LUTS in PD, discuss the emerging data delineating the underlying pathophysiology of LUTS and examine interventions helpful in the management of LUTS in people with PD. Copyright © 2016. Published by Elsevier Ltd.

  16. Hospitalizations for communicable diseases in a developing country: prevalence and trends-Monastir, Tunisia, 2002-2013.

    PubMed

    Ben Fredj, Manel; Sriha Belguith, Asma; Abroug, Hela; Dhouib, Wafa; El Mhamdi, Sana; Ben Salah, Arwa; Bouanene, Inès; Amara, Amal; Bhiri, Sana; Sahtout, Mounira; Loussaief, Chawki; Soussi Soltani, Mohamed

    2017-02-01

    In spite of the epidemiological transition, communicable diseases remain a public health problem and represent a significant cause of morbidity and mortality worldwide, especially in developing countries. This study aimed to determine the crude and standardized prevalence rates of hospitalizations for communicable disease (HCD) and to assess trends in HCD by age and sex at a university hospital in Tunisia over a period of 12 years (2002-2013). All cases of HCD from 2002 to 2013 in the university hospital departments were included. Data collected from the regional register of hospital morbidity were used. The discharge diagnoses were coded according to the International Classification of Diseases, 10th revision (ICD-10). HCD represented 17.45% of all hospitalizations during the study period (34 289/196 488; 95% confidence interval 17.28-17.62%). The median age at the time of admission was 31 years (interquartile range (IQR) 15-52 years). The median hospital length of stay (LOS) was 5days (IQR 3-9 days). The crude prevalence rate (CPR) was 5.41 per 1000 inhabitants. The CPR was highest among patients aged ≥65 years. The four communicable disease categories that represented 70% of all HCD were abdominal infection, skin infection, genitourinary infection, and lower respiratory tract infection. The majority of HCD decreased over time; however, there was a significant increase in HIV diseases, tuberculosis, and viral hepatitis. This study provides evidence of the epidemiological transition, showing a decline in communicable diseases, which needs to be sustained and improved. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Pneumocystis jirovecii pneumonia in developing countries*

    PubMed Central

    De Armas Rodríguez, Y.; Wissmann, G.; Müller, A.L.; Pederiva, M.A.; Brum, M.C.; Brackmann, R.L.; Capó De Paz, V.; Calderón, E.J.

    2011-01-01

    Pneumocystis pneumonia (PcP) is a serious fungal infection among immunocompromised patients. In developed countries, the epidemiology and clinical spectrum of PcP have been clearly defined and well documented. However, in most developing countries, relatively little is known about the prevalence of pneumocystosis. Several articles covering African, Asian and American countries were reviewed in the present study. PcP was identified as a frequent opportunistic infection in AIDS patients from different geographic regions. A trend to an increasing rate of PcP was apparent in developing countries from 2002 to 2010. PMID:21894262

  18. Disease management programme for diabetes mellitus in Nepal.

    PubMed

    Dulal, R K; Karki, S

    2009-01-01

    The prevalence of diabetes in elderly is being out-numbered and continuously rising. Individuals expect miracles from their health care providers as everything is curable in the eyes of the patient. Disease Management Programme for diabetes mellitus is sensible from the medical and economic point of view since it organizes care in multidisciplinary, multicomponent, proactive approach focusing on the whole course of a disease, using evidence-based standards of care that reduce health care costs and hospital stay. In Nepal, health care professionals today need to be aware that the patients are more and more aware about their disease and technology and their increased awareness demand innovative services. Authenticated data used for the purpose of projection were drawn purely from urban or rural hospital-based. To estimate the prevalence of diabetes mellitus (DM), the data in pairs (i.e. prevalence and year) were fed into IDL - an inbuilt mathematical software program for best-fit regression. Literatures on DM prevalence and Disease Management Programme were examined. The overall projection for the DM prevalence in Nepal suggests that the prevalence of diagnosed DM will be 12.73%, 15.11% and 17.49% in 2010, 2015 and 2020 respectively. Diabetes disease management programme appeared to be helpful in reduction of health care costs and hospital stay. If the attributing factor for DM remains as it is today, many new cases of DM will be added each year. There is a need of effective disease management programme in the country. The increased level of awareness among the patients demands innovative services in future.

  19. The prevalence and determinants of catastrophic health expenditures attributable to non-communicable diseases in low- and middle-income countries: a methodological commentary.

    PubMed

    Goryakin, Yevgeniy; Suhrcke, Marc

    2014-11-07

    Non-communicable diseases (NCDs), while traditionally considered a "rich world"-problem, have been spreading fast in low and middle income countries and by now account for a large share of mortality and ill-health in these countries, too. In addition to the disease burden, NCDs may also impose a substantial economic cost. One way in which NCDs might impact people's economic well-being may be via the out-of-pocket expenditures required to cover treatment and other costs associated with suffering from an NCD. In this commentary, we identify and discuss the methodological challenges related to cross-country comparison of-out-of-pocket and catastrophic out-of-pocket health care expenditures, attributable to NCDs, focussing on low and middle income countries. There is significant evidence of substantial cost burden placed by NCDs on patients living in low and middle income countries, with most of it being heavily concentrated among low socioeconomic status groups. However, a large variation in definition of COOPE between studies prevents cross-country comparison. In addition, as most studies tend to be observational, causal inferences are often not possible. This is further complicated by the cross-sectional nature of studies, small sample sizes, and/or limited duration of follow-up of patients. Most evidence for certain conditions (e.g., cancer) tends to be collected in high-income countries only. The definitions for COOPEs should be standardized as much as possible, to enable comparison of COOPE prevalence between countries. Prospective study design using larger samples representative of broader sections of local population, collecting better data on both direct and indirect treatment costs is also needed.

  20. Chagas disease in European countries: the challenge of a surveillance system.

    PubMed

    Basile, L; Jansa, J M; Carlier, Y; Salamanca, D D; Angheben, A; Bartoloni, A; Seixas, J; Van Gool, T; Canavate, C; Flores-Chavez, M; Jackson, Y; Chiodini, P L; Albajar-Vinas, P

    2011-09-15

    A study of aggregate data collected from the literature and official sources was undertaken to estimate expected and observed prevalence of Trypanosoma cruzi infection, annual incidence of congenital transmission and rate of underdiagnosis of Chagas disease among Latin American migrants in the nine European countries with the highest prevalence of Chagas disease. Formal and informal data sources were used to estimate the population from endemic countries resident in Europe in 2009, diagnosed cases of Chagas disease and births from mothers originating from endemic countries. By 2009, 4,290 cases had been diagnosed in Europe, compared with an estimated 68,000 to 122,000 expected cases. The expected prevalence was very high in undocumented migrants (on average 45% of total expected cases) while the observed prevalence rate was 1.3 cases per 1,000 resident migrants from endemic countries. An estimated 20 to 183 babies with congenital Chagas disease are born annually in the study countries. The annual incidence rate of congenital transmission per 1,000 pregnancies in women from endemic countries was between none and three cases. The index of under diagnosis of T. cruzi infection was between 94% and 96%. Chagas disease is a public health challenge in the studied European countries. Urgent measures need to be taken to detect new cases of congenital transmission and take care of the existing cases with a focus on migrants without legal residency permit and potential difficulty accessing care.

  1. The scope of cell phones in diabetes management in developing country health care settings.

    PubMed

    Ajay, Vamadevan S; Prabhakaran, Dorairaj

    2011-05-01

    Diabetes has emerged as a major public health concern in developing nations. Health systems in most developing countries are yet to integrate effective prevention and control programs for diabetes into routine health care services. Given the inadequate human resources and underfunctioning health systems, we need novel and innovative approaches to combat diabetes in developing-country settings. In this regard, the tremendous advances in telecommunication technology, particularly cell phones, can be harnessed to improve diabetes care. Cell phones could serve as a tool for collecting information on surveillance, service delivery, evidence-based care, management, and supply systems pertaining to diabetes from primary care settings in addition to providing health messages as part of diabetes education. As a screening/diagnostic tool for diabetes, cell phones can aid the health workers in undertaking screening and diagnostic and follow-up care for diabetes in the community. Cell phones are also capable of acting as a vehicle for continuing medical education; a decision support system for evidence-based management; and a tool for patient education, self-management, and compliance. However, for widespread use, we need robust evaluations of cell phone applications in existing practices and appropriate interventions in diabetes. © 2011 Diabetes Technology Society.

  2. The Scope of Cell Phones in Diabetes Management in Developing Country Health Care Settings

    PubMed Central

    Ajay, Vamadevan S; Prabhakaran, Dorairaj

    2011-01-01

    Diabetes has emerged as a major public health concern in developing nations. Health systems in most developing countries are yet to integrate effective prevention and control programs for diabetes into routine health care services. Given the inadequate human resources and underfunctioning health systems, we need novel and innovative approaches to combat diabetes in developing-country settings. In this regard, the tremendous advances in telecommunication technology, particularly cell phones, can be harnessed to improve diabetes care. Cell phones could serve as a tool for collecting information on surveillance, service delivery, evidence-based care, management, and supply systems pertaining to diabetes from primary care settings in addition to providing health messages as part of diabetes education. As a screening/diagnostic tool for diabetes, cell phones can aid the health workers in undertaking screening and diagnostic and follow-up care for diabetes in the community. Cell phones are also capable of acting as a vehicle for continuing medical education; a decision support system for evidence-based management; and a tool for patient education, self-management, and compliance. However, for widespread use, we need robust evaluations of cell phone applications in existing practices and appropriate interventions in diabetes. PMID:21722593

  3. Cachexia research in Japan: facts and numbers on prevalence, incidence and clinical impact.

    PubMed

    Konishi, Masaaki; Ishida, Junichi; Springer, Jochen; Anker, Stefan D; von Haehling, Stephan

    2016-12-01

    Even though most clinical data on cachexia have been reported from Western countries, cachexia may be a growing problem in Asia as well, as the population in this area of the world is considerably larger. Considering the current definitions of obesity and sarcopenia in Japan, which are different from the ones in Western countries, the lack of a distinct cachexia definition in Japan is strinking. Only one epidemiological study has reported the prevalence of cachexia using weight loss as part of the definition in patients with stage III or IV non-small cell lung cancer. Although the reported prevalence of 45.6% is within the range of that in Western countries (28-57% in advanced cancer), we cannot compare the prevalence of cachexia in other types of cancer, heart failure, chronic obstructive pulmonary disease (COPD), and kidney disease (CKD) between Japan and Western countries. In patients with heart failure, one third of Japanese patients has a body mass index <20.3 kg/m 2 whereas the prevalence of underweight is 13.6% in reports from Western countries. These results may suggest that there are more cachectic heart failure patients in Japan, or that using the same definition like Western countries leads to gross overestimation of the prevalence of cachexia in Japan. The rate of underweight patients in COPD has been reported as 31-41% in COPD and seems to be high in comparison to the prevalence of cachexia in Western countries (27-35%). The reported lowest quartile value of BMI (19.6 kg/m 2 ) in CKD may match with the prevalence of cachexia in Western countries (30-60%). The number of clinical trials targeting cachexia is very limited in Japan so far.

  4. The implementation of quality management systems in hospitals: a comparison between three countries

    PubMed Central

    Wagner, C; Gulácsi, L; Takacs, E; Outinen, M

    2006-01-01

    Background Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. Methods The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. Results A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. Conclusion The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be

  5. Prevalence of renal uric acid stones in the adult.

    PubMed

    Trinchieri, Alberto; Montanari, Emanuele

    2017-12-01

    The aim of this study was to estimate uric acid renal stone prevalence rates of adults in different countries of the world. PubMed was searched for papers dealing with "urinary calculi and prevalence or composition" for the period from January 1996 to June 2016. Alternative searches were made to collect further information on specific topics. The prevalence rate of uric acid stones was computed by the general renal stone prevalence rate and the frequency of uric acid stones in each country. After the initial search, 2180 papers were extracted. Out of them, 79 papers were selected after the reading of the titles and of the abstracts. For ten countries, papers relating to both the renal stone prevalence in the general population and the frequency of uric stones were available. Additional search produced 13 papers that completed information on 11 more countries in 5 continents. Estimated prevalence rate of uric acid stones was >0.75% in Thailand, Pakistan, Saudi Arabia, Iran, South Africa (white population), United States and Australia; ranged 0.50-0.75% in Turkey, Israel, Italy, India (Southern), Spain, Taiwan, Germany, Brazil; and <0.50% in Tunisia, China, Korea, Japan, Caribe, South Africa (blacks), India (Northern). Climate and diet are major determinants of uric acid stone formation. A hot and dry climate increases fluid losses reducing urinary volume and urinary pH. A diet rich in meat protein causes low urinary pH and increased uric acid excretion. On the other hand, uric acid stone formation is frequently associated with obesity, metabolic syndrome and diabetes type 2 that are linked to dietary energy excess mainly from carbohydrate and saturated fat and also present with low urine pH values. An epidemic of uric acid stone formation could be if current nutritional trends will be maintained both in developed countries and in developing countries and the areas of greater climatic risk for the formation of uric acid stones will enlarge as result of the "global

  6. Prevalence of youth gambling and potential influence of substance use and other risk factors across 33 European countries: First results from the 2015 ESPAD study.

    PubMed

    Molinaro, Sabrina; Benedetti, Elisa; Scalese, Marco; Bastiani, Luca; Fortunato, Loredana; Cerrai, Sonia; Canale, Natale; Chomynova, Pavla; Elekes, Zsuzsanna; Feijão, Fernanda; Fotiou, Anastasios; Kokkevi, Anna; Kraus, Ludwig; Rupšienė, Liudmila; Monshouwer, Karin; Nociar, Alojz; Strizek, Julian; Lazar, Tanja Urdih

    2018-05-28

    Although generally prohibited by national regulations, underage gambling has become popular in Europe, with relevant cross-country prevalence variability. This study aimed to estimate the prevalence of underage gambling in Europe stratified by type of game and on-line/off-line mode and to examine the association with individual and family characteristics and substance use. Our study used data from the 2015 ESPAD cross-sectional study, a survey using self-administered anonymous questionnaires. 33 European countries. 16-year-old students (N=93,875; F=50.8%). The primary outcome measure was prevalence of past-year gambling activity. Key predictors comprised individual behaviors, substance use and parenting (regulation, monitoring and caring). 22.6% of 16-year-old students in Europe gambled in the past year: 16.2% on-line, 18.5% off-line. High prevalence variability was observed across countries both for mode and types of game. With the exception of cannabis, substance use shows the higher association with gambling, particularly binge drinking (OR:1.46, 95% CI:1.39-1.53), lifetime use of inhalants (OR:1.57, 95% CI:1.47-1.68) and other substances (OR:1.78, 95% CI:1.65-1.92). Among life habits, the following showed a positive association: truancy at school (OR:1.26, 95% CI:1.18-1.35), going out at night (OR:1.32, 95% CI:1.26-1.38), participating in sports (OR:1.30, 95% CI:1.24-1.37). A negative association was found with reading books for leisure (OR:0.82%, 95% CI:0.79-0.86), parents' monitoring of Saturday night activities (OR:0.81, 95% CI:0.77-0.86) and restrictions on money provided by parents as a gift (OR:0.89, 95% CI:0.84-0.94). Underage gambling in Europe appears to be positively associated with alcohol, tobacco and other substance use (but not cannabis), as well as with other individual behaviors like truancy, going out at night and active participation in sports, and is negatively associated with reading for pleasure, parental monitoring of evening activities

  7. Tackling cancer control in the Gulf Cooperation Council Countries.

    PubMed

    Al-Othman, Saleh; Haoudi, Abdelali; Alhomoud, Samar; Alkhenizan, Abdullah; Khoja, Tawfik; Al-Zahrani, Ali

    2015-05-01

    Cancer is a major health problem in both high income and middle-to-low income countries, and is the second leading cause of death in the world. Although more than a third of cancer could be prevented and another third could be cured if diagnosed early, it remains a huge challenge to health-care systems worldwide. Despite substantial improvements in health services some of the countries in the Gulf region, the burden of non-communicable diseases is a major threat, primarily due to the rapid socioeconomic shifts that have led to unfavourable changes in lifestyle such as increased tobacco use, decreased physical activity, and consumption of unhealthy food. In the Gulf Cooperation Council states (United Arab Emirates, Bahrain, Saudi Arabia, Oman, Qatar, and Kuwait), advanced breast cancer, colorectal cancer, leukaemia, thyroid cancer, and non-Hodgkin lymphomas are the most common cancers affecting younger populations compared with other countries. By contrast with cancer prevalence in developed countries, prostate, lung, and cervical cancers are not among the most common cancers in the Gulf region. In view of the increased cost of cancer management worldwide, integrated approaches between primary, secondary, and tertiary health-care systems with special focus on prevention and early detection is an essential step in the countries' efforts in the fight against cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Epidemiological studies of cognitive impairment and dementia across Eastern and Middle European countries (epidemiology of dementia in Eastern and Middle European Countries).

    PubMed

    Kiejna, A; Frydecka, D; Adamowski, T; Bickel, H; Reynish, E; Prince, M; Caracciolo, B; Fratiglioni, L; Georges, J

    2011-02-01

    To determine the availability and the consistency of prevalence findings of epidemiological studies on cognitive impairment and dementia conducted in Eastern and Middle Europe. We adopted a stepwise multimethod study approach consisting of iterative literature searches for epidemiological articles published between 1990 and 2006 and subsequent data analyses of published material, reanalyses of existing accessible epidemiological data sets and expert inquiries in Eastern and Middle European countries. Systematic computer-assisted searches used the keywords: "dementia", "Alzheimer", "cognitive impairment", "incidence", "prevalence", "epidemiology" in combination with the name of the relevant countries or "Europe" in English and Polish language. We supplemented the literature search with a review of the references in the articles that were identified during the initial search. We were able to find few regional and country-specific epidemiological studies of various kinds (population-based, cohort, cross-sectional studies) and conducted on different restricted population groups of patients (from neurological units, out-patients units, residential homes). No studies were identified from most of the countries taken under consideration and the ones we found were characterized by an immense diversity with a considerable degree of clinical and methodological variations. The few studies that there are suggest prevalence rates of dementia in Eastern Europe similar to those in Western Europe. There is strong need for epidemiological studies in Eastern and Middle Europe, as well as for greater coordination and standardization of methods to improve the quality and comparability of epidemiological data to determine the prevalences' rates of dementia in all the EU countries. Copyright © 2010 John Wiley & Sons, Ltd.

  9. Determining Prevalence of Acute Bilirubin Encephalopathy in Developing Countries

    ClinicalTrials.gov

    2015-11-11

    Demonstrate BIND II Score of >=5, is Valid for Detecting Moderate to Severe ABE in Neonates <14 Days Old.; Demonstrate Community-BIND Instrument, a Modified BIND II, is a Valid and Reliable Tool for Detecting ABE.; Demonstrate That Community-BIND Can be Used for Acquiring Population-based Prevalence of ABE in the Community.

  10. The status of IT service management in health care - ITIL® in selected European countries.

    PubMed

    Hoerbst, Alexander; Hackl, Werner O; Blomer, Roland; Ammenwerth, Elske

    2011-12-21

    Due to the strained financial situation in the healthcare sector, hospitals and other healthcare providers are facing an increasing pressure to improve their efficiency and to reduce costs. These trends challenge health care organizations to introduce innovative information technology (IT) based supportive processes. To guarantee that IT supports the clinical processes perfectly, IT must be managed proactively. However, until now, there is only very few research on IT service management especially on ITIL® implementations in the health care context. The current study aims at exploring knowledge about and acceptance of IT service management (especially ITIL®) in hospitals in Austria and its neighboring regions Bavaria (Germany), Slovakia, South Tyrol (Italy) and Switzerland. Therefore highly standardized interviews with the respective head of information technology (CIO, IT manager) were conducted for selected hospitals from the different regions. In total 75 hospitals were interviewed. Data gathered was analyzed using descriptive statistics and where necessary methods of qualitative content analysis. In most regions, two-thirds or more of the participating IT managers claim to be familiar with the concepts of IT service management and of ITIL®. IT managers expect from ITIL® mostly better IT services, followed by an increased productivity and a reduction of IT cost. But only five hospitals said to have implemented at least parts of ITIL®, and eight hospitals stated to be planning to do this in the next two years. When it comes to ITIL®, Switzerland and Bavaria seem to be ahead of the other countries. There, the highest levels of knowledge, the highest number of implementations or plans of an implementation as well as the highest number of ITIL® certified staff members were observed. The results collected through this study indicate that the idea of IT services and IT service management is still not widely recognized in hospitals in the countries and regions

  11. A descriptive survey study of violence management and priorities among psychiatric staff in mental health services, across seventeen european countries.

    PubMed

    Cowman, Seamus; Björkdahl, Anna; Clarke, Eric; Gethin, Georgina; Maguire, Jim

    2017-01-19

    In mental health services what is commonplace across international frontiers is that to prevent aggressive patients from harming themselves, other patients or staff, coercive measures and foremost, violence management strategies are required. There is no agreement, recommendations or direction from the EU on which measures of coercion should be practiced across EU countries, and there is no overall one best practice approach. The project was conceived through an expert group, the European Violence in Psychiatry Research Group (EViPRG). The study aimed to incorporate an EU and multidisciplinary response in the determination of violence management practices and related research and education priorities across 17 European countries. From the EVIPRG members, one member from each country agreed to act as the national project coordinator for their country. Given the international spread of respondents, an eDelphi survey approach was selected for the study design and data collection. A survey instrument was developed, agreed and validated through members of EVIPRG. The results included a total of 2809 respondents from 17 countries with 999 respondents who self-selected for round 2 eDelphi. The majority of respondents worked in acute psychiatry, 54% (n = 1511); outpatient departments, 10.5% (n = 295); and Forensic, 9.3% (n = 262). Other work areas of respondents include Rehabilitation, Primary Care and Emergency. It is of concern that 19.5% of respondents had not received training on violence management. The most commonly used interventions in the management of violent patients were physical restraint, seclusion and medications. The top priorities for education and research included: preventing violence; the influence of environment and staff on levels of violence; best practice in managing violence; risk assessment and the aetiology and triggers for violence and aggression. In many European countries there is an alarming lack of clarity on matters of procedure

  12. A snapshot of current gestational diabetes management practices from 26 low-income and lower-middle-income countries.

    PubMed

    Utz, Bettina; Kolsteren, Patrick; De Brouwere, Vincent

    2016-08-01

    To identify screening and management practices for gestational diabetes mellitus (GDM) in low-income and lower-middle-income countries. A cross-sectional survey was conducted between November 12, 2014 and May 11, 2015. Questionnaires were distributed to gynecologists, endocrinologists, and medical doctors who were representatives of national professional societies or were involved in providing care to patients with GDM in low-income or lower-middle-income countries in Africa, South Asia, and Latin America. The data were descriptively analyzed. Questionnaires were sent to 182 individuals and 77 healthcare providers from 26 countries completed the survey. The results demonstrated high diversity in screening and management practices. Only 52 (68%) participants reported that any guidelines were available in their setting. Management of GDM was found to take place mainly at the tertiary level and reported practices, including the frequency of post-diagnosis follow-up, modalities of glucose surveillance, and treatment and practices surrounding delivery, varied and did not always reflect the most recent evidence. Attempts to ensure greater adherence to latest consensus guidelines are required, and should be accompanied by systemic changes to improve the detection and management of GDM at primary- and secondary-level healthcare facilities to facilitate patient access to GDM screening and treatment. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management.

    PubMed

    Myers, Jonathan; Lee, Matthew; Kiratli, Jenny

    2007-02-01

    Cardiovascular disease is a growing concern for the spinal cord-injured (SCI) population. For long-term SCI, morbidity and mortality from cardiovascular causes now exceeds that caused by renal and pulmonary conditions, the primary causes of mortality in previous decades. Although risk estimates commonly used for ambulatory individuals have not been established from follow-up studies in SCI, nearly all risk factors tend to be more prevalent in SCI subjects compared with ambulatory subjects. These risks include a greater prevalence of obesity, lipid disorders, metabolic syndrome, and diabetes. Daily energy expenditure is significantly lower in SCI individuals, not only because of a lack of motor function, but also because of a lack of accessibility and fewer opportunities to engage in physical activity. Autonomic dysfunction caused by SCI is also associated with several conditions that contribute to heightened cardiovascular risk, including abnormalities in blood pressure, heart rate variability, arrhythmias, and a blunted cardiovascular response to exercise that can limit the capacity to perform physical activity. Thus, screening, recognition, and treatment of cardiovascular disease should be an essential component of managing individuals with SCI, and judicious treatment of risk factors can play an important role in minimizing the incidence of cardiovascular disease in these individuals. This article reviews the cardiovascular consequences of chronic SCI, including the prevalence of cardiovascular disease and risk factors unique to these individuals, and provides a synopsis of management of cardiovascular disease in this population.

  14. Call Home? Mobile Phones and Contacts with Mother in 24 Countries

    PubMed Central

    Gubernskaya, Zoya; Treas, Judith

    2016-01-01

    This paper explores how the diffusion of mobile phones is associated with communication between adult children and their mothers. The paper analyzes 2001 International Social Survey Program (ISSP) data from 24 countries (N = 12,313) combined with the country-level data on the prevalence of mobile phones. Net of individual-level predictors and country wealth, adult children who resided in countries with high prevalence of mobile phones contacted their mothers more frequently. High prevalence of mobile phones was also associated with larger differences in maternal contact by gender and smaller differences by education. These findings suggest that any impact of new communication technology on intergenerational relations is complex. Although mobile phones point to higher levels of at-a-distance contact with mothers and narrower socio-economic disparities related to access and affordability of communication technology, they are also linked to wider contact disparities following gendered cultural expectations. PMID:27795577

  15. Call Home? Mobile Phones and Contacts with Mother in 24 Countries.

    PubMed

    Gubernskaya, Zoya; Treas, Judith

    2016-10-01

    This paper explores how the diffusion of mobile phones is associated with communication between adult children and their mothers. The paper analyzes 2001 International Social Survey Program (ISSP) data from 24 countries (N = 12,313) combined with the country-level data on the prevalence of mobile phones. Net of individual-level predictors and country wealth, adult children who resided in countries with high prevalence of mobile phones contacted their mothers more frequently. High prevalence of mobile phones was also associated with larger differences in maternal contact by gender and smaller differences by education. These findings suggest that any impact of new communication technology on intergenerational relations is complex. Although mobile phones point to higher levels of at-a-distance contact with mothers and narrower socio-economic disparities related to access and affordability of communication technology, they are also linked to wider contact disparities following gendered cultural expectations.

  16. Prevalence of retinopathy of prematurity in Latin America.

    PubMed

    Carrion, Juliana Zimmermann; Fortes Filho, João Borges; Tartarella, Marcia Beatriz; Zin, Andrea; Jornada, Ignozy Dorneles

    2011-01-01

    The purpose of this work was to review the studies published over the last 10 years concerning the prevalence of retinopathy of prematurity (ROP) in Latin American countries, to determine if there was an improvement in ROP prevalence rates in that period, and to identify the inclusion criteria for patients at risk of developing ROP in the screening programs. A total of 33 studies from ten countries published between 2000 and 2010 were reviewed. Prevalence of any ROP stage in the regions considered ranged from 6.6% to 82%; ROP severe enough to require treatment ranged from 1.2% to 23.8%. There was no routine screening for ROP, and there was a lack of services for treatment of the disease in many countries. Inclusion criteria for patients in the studies ranged between birth weight ≤ 1500 g and ≤ 2000 g and gestational age ≤ 32 and <37 weeks. Use of different inclusion criteria regarding birth weight and gestational age in several Latin American studies hindered comparative analysis of the published data. Highly restrictive selection criteria for ROP screening in relation to birth weight and gestational age should not be used throughout most Latin American countries because of their different social characteristics and variable neonatal care procedures. The studies included in this review failed to provide adequate information to determine if the prevalence of ROP has decreased in Latin America.

  17. Geostatistical Model-Based Estimates of Schistosomiasis Prevalence among Individuals Aged ≤20 Years in West Africa

    PubMed Central

    Schur, Nadine; Hürlimann, Eveline; Garba, Amadou; Traoré, Mamadou S.; Ndir, Omar; Ratard, Raoult C.; Tchuem Tchuenté, Louis-Albert; Kristensen, Thomas K.; Utzinger, Jürg; Vounatsou, Penelope

    2011-01-01

    Background Schistosomiasis is a water-based disease that is believed to affect over 200 million people with an estimated 97% of the infections concentrated in Africa. However, these statistics are largely based on population re-adjusted data originally published by Utroska and colleagues more than 20 years ago. Hence, these estimates are outdated due to large-scale preventive chemotherapy programs, improved sanitation, water resources development and management, among other reasons. For planning, coordination, and evaluation of control activities, it is essential to possess reliable schistosomiasis prevalence maps. Methodology We analyzed survey data compiled on a newly established open-access global neglected tropical diseases database (i) to create smooth empirical prevalence maps for Schistosoma mansoni and S. haematobium for individuals aged ≤20 years in West Africa, including Cameroon, and (ii) to derive country-specific prevalence estimates. We used Bayesian geostatistical models based on environmental predictors to take into account potential clustering due to common spatially structured exposures. Prediction at unobserved locations was facilitated by joint kriging. Principal Findings Our models revealed that 50.8 million individuals aged ≤20 years in West Africa are infected with either S. mansoni, or S. haematobium, or both species concurrently. The country prevalence estimates ranged between 0.5% (The Gambia) and 37.1% (Liberia) for S. mansoni, and between 17.6% (The Gambia) and 51.6% (Sierra Leone) for S. haematobium. We observed that the combined prevalence for both schistosome species is two-fold lower in Gambia than previously reported, while we found an almost two-fold higher estimate for Liberia (58.3%) than reported before (30.0%). Our predictions are likely to overestimate overall country prevalence, since modeling was based on children and adolescents up to the age of 20 years who are at highest risk of infection. Conclusion/Significance We

  18. International Cooperation for the Training of Water Managers from Developing Countries

    NASA Astrophysics Data System (ADS)

    Aswathanarayana, U.

    2007-12-01

    Water is the key to the well being of a community. On one hand, water security is linked to food security, as food cannot be grown without water. On the other hand, water security is linked to environmental security, as water is needed to maintain the health of a community. International cooperation is proposed for the training in Hyderabad, India, with international faculty, of ~ 300 water managers from the developing countries at an estimated cost of ~USD 3300/- per candidate (including ~ USD 1800/- for international travel), through ten interactive and customized training programmes during the period of five years, to enable them to address two crucial issues affecting the poor in the developing countries, namely, access to affordable water and coping with water scarcity. Ways of Good governance and geographical targeting of poverty alleviation programmes are built into each training programme. Each training programme will be for about three weeks (inclusive of field work). Each course will have a component common to all, plus a component customized to the biophysical and socioeconomic situation in a candidate's country. Ten course manuals will be produced. which can later be published commercially as low-cost volumes, for the benefit of the readership in the Developing countries . Each candidate will be provided his own computer, and software, and individual faculty adviser. On the basis of the training received, a candidate should be able to carry with him at the end of the course a draft outline of techno-socio-economic action plan for his country/area in respect of the theme of the course, prepared by himself/herself. A copy of this outline would be provided to the World Bank, and relevant organizations for follow- up activity

  19. Solid waste management in Asian countries: a review of solid waste minimisation (3'r) towards low carbon

    NASA Astrophysics Data System (ADS)

    Ali, N. E.; Sion, H. C.

    2014-02-01

    The amount of solid-waste generated in Asian countries has increased tremendously, mainly due to the improvement in living standards, rapid developments in technology, growth in economy and population in the cities. Solid waste management is a global issue and major challenge facing Asian countries and neglecting its management may have negative consequences on the environment. Waste composition data proves the developed countries to have generated more recyclable materials while developing countries produce more organic and less recyclable waste such as paper, plastic and aluminium. In this regard, increase in number of landfills and disposal sites, will have an impact on GHG (greenhouse gas) emissions and pollutants to air and water. Alternative methods should therefore be taken to reduce the volume of waste. Most Asian countries have adopted the 3R (reduce, reuse, recycle) concept in order to reduce solid waste and their governments have implemented laws and regulations in order to support this. Implementation of 3R is the major contributor to the solid waste minimization and it can improve the quality of environmental sustainability and reduction of carbon dioxide emission in to the atmosphere. Based on our review, most of the countries practicing the 3R concept in tandem with laws and regulations perform better than those that just practice the 3R concept without any laws and regulations. The paper suggests that every country must focus on the laws and regulations relating to solid waste minimization so that it could be easily implemented as outlined.

  20. Prevalence and management of back pain in adolescent idiopathic scoliosis patients: A retrospective study

    PubMed Central

    Théroux, Jean; Le May, Sylvie; Fortin, Carole; Labelle, Hubert

    2015-01-01

    BACKGROUND: Back pain (BP) has often been associated with adolescent idiopathic scoliosis (AIS), which is a three-dimensional deviation of the vertebral column. In adolescents, chronic pain appears to be a predictor of health care utilization and has a negative impact on physical, psychological and family well-being. In this population, BP tends to be persistent and may be a predictor of BP in adulthood. OBJECTIVE: To document the prevalence and management of BP in AIS patients. METHODS: A retrospective chart review of AIS patients who were referred to Sainte-Justine University Teaching Hospital (Montreal, Quebec) from 2006 to 2011 was conducted. RESULTS: A total of 310 randomly selected charts were reviewed. Nearly one-half of the patients (47.3%) mentioned that they experienced BP, most commonly in the lumbar (19.7%) and thoracic regions (7.7%). The type of BP was documented in only 36% (n=112) of the charts. Pain intensity was specified in only 21% (n=65) of the charts. In approximately 80% (n=248) of the charts, no pain management treatment plan was documented. CONCLUSIONS: The prevalence of BP was moderately high among the present sample of adolescents with AIS. An improved system for documenting BP assessment, type, treatment plan and treatment effectiveness would improve pain management for these patients. PMID:25831076

  1. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland.

    PubMed

    Marques-Vidal, Pedro; Paccaud, Fred

    2012-03-28

    In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs). We thus aimed at assessing geographical levels of CVRFs in Switzerland. Swiss Health Survey for 2007 (N = 17,879). Seven administrative regions were defined: West (Leman), West-Central (Mittelland), Zurich, South (Ticino), North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview. After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman) and Italian (Ticino) speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]). Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions. In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved.

  2. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland

    PubMed Central

    2012-01-01

    Background In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs). We thus aimed at assessing geographical levels of CVRFs in Switzerland. Methods Swiss Health Survey for 2007 (N = 17,879). Seven administrative regions were defined: West (Leman), West-Central (Mittelland), Zurich, South (Ticino), North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview. Results After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman) and Italian (Ticino) speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]). Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions. Conclusions In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved. PMID:22452881

  3. Human Resource Management in Public Higher Education in the Tempus Partner Countries. A Tempus Study. Issue 10

    ERIC Educational Resources Information Center

    Dubosc, Flora; Kelo, Maria

    2011-01-01

    The aim of this study is to give an overview of the ways in which human resources are managed in public higher education institutions in the Tempus Partner Countries. It is based on a survey addressed to individuals involved in Tempus projects and on information gathered at the level of the national authorities. In all the countries covered by the…

  4. Detection of Human Papillomavirus among Women with Atypical Squamous Cells of Undetermined Significance Referred to Colposcopy: Implications for Clinical Management in Low and MiddleIncome Countries.

    PubMed

    de Abreu, Andre Lp; Gimenes, Fabricia; Malaguti, Natalia; Pereira, Monalisa W; Uchimura, Nelson S; Consolaro, Marcia El

    2016-01-01

    To determine the prevalence of human papillomavirus (HPV) among women with atypical squamous cells of undetermined significance (ASC-US) referred to colposcopy and the implications for clinical management in low- and middle-income countries (LMIC), the present study was conducted. We included 200 women living in Maringa÷Brazil referred to colposcopy service between August 2012 and March 2013 due to an abnormal cytology from ASC-US until high-grade intraepithelial lesion (HSIL). HPV was detected and genotyped by polymerase chain reaction (PCR). The mean age was 36.8±10.5 years, and women with and without ASC-US had similar mean ages (37.4±11.5 and 36.4±9.96 years, respectively). The highest prevalence of ASC-US occurred at 20-24 years (40%). HPV-DNA was positive in 164 (82.0%) women.Of the 57 women with ASC-US, 30 (52.6%) were HPV-DNA-positive and 21 (70%) were high-risk HPV-positive (HR-HPV); the latter was similar to women without ASC-US (76.9%) but with other abnormal cytological findings present. Our data demonstrated that performing tests for HR-HPV can be used for management of women with ASC-US to support the decision of which women should be referred for an immediate or later colposcopy. The same conclusions can be applied to other LMICs for which HPV testing for primary screening has not been adopted.

  5. Trends in HIV prevalence in blood donations in Europe, 1990-2004.

    PubMed

    Likatavicius, Giedrius; Hamers, Françoise F; Downs, Angela M; Alix, Jane; Nardone, Anthony

    2007-05-11

    The comparison of HIV prevalence among blood donations in European countries provides an indication of the relative safety of the blood supply in different countries and over time. Data between 1990 and 2004 on annual numbers of blood donations and HIV prevalence in blood donations were collected from national correspondents in the 52 countries of the World Health Organization European Region. Data are presented for three geographic areas: West, Centre and East. Since 1990, the number of blood donations has declined by 43% in the East and by 26% in the Centre, while remaining relatively stable in the West. In 2004, the number of blood donations was more than twice as high in the West in comparison with the East and the Centre. Over the same period, HIV prevalence among blood donations increased dramatically in the East, remained stable in the Centre and declined in the West. Since 2001, HIV prevalence levels of more than 10 per 100 000 donations were reported from six countries in the East (with a high of 128/100 000 in Ukraine), whereas in the rest of Europe the reported national HIV prevalence levels were lower than 10/100 000 donations. The prevalence of HIV was much lower among donations from repeat donors than from first-time donors. In some eastern European countries public health interventions, such as deferring individuals at risk of HIV infection from donating blood and constituting a pool of regular donors, are urgently needed to assure the safety of the blood supply.

  6. Oral health and welfare state regimes: a cross-national analysis of European countries

    PubMed Central

    Guarnizo-Herreño, Carol C; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

    2013-01-01

    Very little is known about the potential relationship between welfare state regimes and oral health. This study assessed the oral health of adults in a range of European countries clustered by welfare regimes according to Ferrera's typology and the complementary Eastern type. We analysed data from Eurobarometer wave 72.3, a cross-sectional survey of 31 European countries carried out in 2009. We evaluated three self-reported oral health outcomes: edentulousness, no functional dentition (<20 natural teeth), and oral impacts on daily living. Age-standardized prevalence rates were estimated for each country and for each welfare state regime. The Scandinavian regime showed lower prevalence rates for all outcomes. For edentulousness and no functional dentition, there were higher prevalence rates in the Eastern regime but no significant differences between Anglo-Saxon, Bismarckian, and Southern regimes. The Southern regime presented a higher prevalence of oral impacts on daily living. Results by country indicated that Sweden had the lowest prevalences for edentulousness and no functional dentition, and Denmark had the lowest prevalence for oral impacts. The results suggest that Scandinavian welfare states, with more redistributive and universal welfare policies, had better population oral health. Future research should provide further insights about the potential mechanisms through which welfare-state regimes would influence oral health. PMID:23659239

  7. Childrearing Discipline and Violence in Developing Countries

    ERIC Educational Resources Information Center

    Lansford, Jennifer E.; Deater-Deckard, Kirby

    2012-01-01

    The present study examined the prevalence and country-level correlates of 11 responses to children's behavior, including nonviolent discipline, psychological aggression, and physical violence, as well as endorsement of the use of physical punishment, in 24 countries using data from 30,470 families with 2- to 4-year-old children that participated…

  8. Aiding refugees in the aftermath of civil war. Country focus: Sudan.

    PubMed

    1996-10-01

    There are an estimated 150,000 people infected with HIV in Sudan, including 3000 children; a prevalence of 0.6%. In 1995, 196 of 22,278 blood donors screened were HIV seropositive. This latter figure is high compared to other survey findings. The long civil war in the country has caused an estimated 1.9 million people to be displaced in and around Khartoum, the capital. The majority of these people live in four camps which will most likely remain inhabited and where they are for many more years. The UK branch of the Save the Children Fund is funding a 2-year, $12,000 project to raise awareness in the camps of the HIV/AIDS epidemic. A survey will assess the level of condom use and determine which traditional practices may facilitate transmission of HIV. Communication channels and preferred sources of information in the camps will then be identified. Camp health workers will be trained in counseling, health education, and sexually transmitted disease and HIV/AIDS case management. Volunteer health workers and community motivators will be recruited from among the refugees. Sudan's health infrastructure needs to be improved in order to prevent any increase in the incidence and prevalence of HIV/AIDS in the country.

  9. Prevalence of human papillomavirus in cancer of the oropharynx by gender.

    PubMed

    Combes, Jean-Damien; Chen, Alyce A; Franceschi, Silvia

    2014-12-01

    Oropharyngeal cancer (OPC) is more frequent in men than women mainly due to the heavier and longer duration of smoking in men. Human papillomavirus (HPV) has a role in the rising incidence of OPC in the United States and other high-income countries. To determine whether there is a difference in the proportion of HPV-attributable OPC between men and women, we systematically retrieved HPV prevalence data from 63 studies reporting separately on OPC by gender. The male/female (M/F) ratios of HPV prevalence in OPC across different countries and the corresponding M/F ratios of cumulative lung cancer risk (a proxy for smoking) were compared. The United States had the highest M/F ratios of HPV prevalence in OPC (1.5). The lowest M/F ratios (≤0.7) were found in Asia and some European countries (e.g., France). The countries in which the M/F ratio of HPV prevalence in OPC was ≥1.0 had the most similar lung cancer risks for men and women. When HPV prevalence data were applied to age-standardized OPC incidence rates in the United States, Australia, the United Kingdom, and France, the M/F ratio for the HPV-positive OPC incidence rates was rather stable (around 4) in all countries. In contrast, the M/F ratio for the HPV-negative OPC incidence rates reached 10.2 in France versus <3 elsewhere. We showed that HPV prevalence in OPC differs by gender and country mainly as a consequence of the vast international variation in male smoking habits. Nevertheless, HPV-positive OPC may affect men more heavily than women in different populations for reasons that are unclear. ©2014 American Association for Cancer Research.

  10. Racial and Ethnic Differences in the Prevalence, Management and Outcomes in Patients with Atrial Fibrillation: A Systematic Review.

    PubMed

    Ugowe, Francis E; Jackson, Larry R; Thomas, Kevin L

    2018-05-23

    Atrial Fibrillation (AF) is the most common cardiac arrhythmia in the United States (US) and is associated with increased morbidity, mortality, and healthcare expenditures. In this work, our aim was to assess for racial and ethnic differences in the epidemiology, management and outcomes of patients with AF. A search of relevant studies from January 1, 2007 to December 30, 2017 was conducted using PubMed, EMBASE, and Web of Science and supplemented by manual searches of the bibliographies of retrieved articles. We identified 152 studies of which 64 were subsequently included. We found underrepresented racial and ethnic groups (UREGs) have a higher prevalence of established risk factors associated with the development of AF, but an overall lower incidence and prevalence of AF compared with non-Hispanic whites (NHW). Moreover, racial and ethnic differences exist in detection, awareness and AF-associated symptoms. Non-white populations also experience decreased use of rhythm control modalities and anticoagulation for stroke prevention. Lastly, among those with AF, UREGs suffer increased morbidity and mortality relative to white groups. Racial and ethnic differences exist in the prevalence, quality of life, management and outcomes of individuals with AF; however, the mechanisms for these differences have yet to be fully elucidated. Racial and ethnic differences in AF warrant further analysis to understand the factors contributing to the differences in prevalence and management to ensure the delivery of high quality care that prevents stroke, reduces deaths and decreases expenses associated with caring for underrepresented populations with AF. Copyright © 2018. Published by Elsevier Inc.

  11. The Prevalence and Management of Diabetic Nephropathy in Asia

    PubMed Central

    Tomino, Yasuhiko; Gohda, Tomohito

    2015-01-01

    treatment of such patients. Facts from East and West The prevalence of DN is increasing in Asia and Western countries alike. The deletion (D) allele of the angiotensin-converting enzyme gene is associated with progression to end-stage renal disease in Asian patients with DN, but this association is uncertain in Europeans. An association between DN and polymorphism of the gene coding for acetyl coenzyme A carboxylase β has been reported in Asian and Western populations. Both in Japan and the US, criteria for diagnosis are a 5-year history of diabetes and persistent albuminuria. Renal biopsy should be done in patients with severe hematuria, cellular casts and - in the US - hepatitis and HIV to rule out other pathologies. Diabetic retinopathy is considered a key criterion in Japan, but the absence of it does not rule out DN in the US. Enlargement of the kidney is observed as a diagnostic criterion in Japan. The differential use of renal biopsy as diagnostic tool might account for a different prevalence between Asian countries. Some Japanese diabetic patients showed typical histological alterations for DN with a normal ACR and GFR. The clinical classification is similar between Japan and the US including five stages based on ACR and GFR. The Japanese guidelines do not include blood pressure values for the classification of DN. Guidelines for DN treatment are evolving quickly both in Asia and Western countries based on the numerous clinical trials performed worldwide. Targeting the angiotensin system for its hemodynamic and nonhemodynamic effects is a common approach. DPP-4 inhibitors are widely used in Japan and might have a higher glucose-lowering effect in Asian patients due to their specific diet. A randomized, double-blind placebo-controlled study has been launched to assess the efficacy of the Chinese herbal tea extract Shenyan Kangfu in DN. PMID:27536665

  12. Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need

    PubMed Central

    2014-01-01

    With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876

  13. Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants.

    PubMed

    Goldhaber-Fiebert, Jeremy D; Jeon, Christie Y; Cohen, Ted; Murray, Megan B

    2011-04-01

    A growing body of evidence supports the role of type 2 diabetes as an individual-level risk factor for tuberculosis (TB), though evidence from developing countries with the highest TB burdens is lacking. In developing countries, TB is most common among the poor, in whom diabetes may be less common. We assessed the relationship between individual-level risk, social determinants and population health in these settings. We performed individual-level analyses using the World Health Survey (n = 124,607; 46 countries). We estimated the relationship between TB and diabetes, adjusting for gender, age, body mass index, education, housing quality, crowding and health insurance. We also performed a longitudinal country-level analysis using data on per-capita gross domestic product and TB prevalence and incidence and diabetes prevalence for 1990-95 and 2003-04 (163 countries) to estimate the relationship between increasing diabetes prevalence and TB, identifying countries at risk for disease interactions. In lower income countries, individuals with diabetes are more likely than non-diabetics to have TB [univariable odds ratio (OR): 2.39; 95% confidence interval (CI): 1.84-3.10; multivariable OR: 1.81; 95% CI: 1.37-2.39]. Increases in TB prevalence and incidence over time were more likely to occur when diabetes prevalence also increased (OR: 4.7; 95% CI: 1.0-22.5; OR: 8.6; 95% CI: 1.9-40.4). Large populations, prevalent TB and projected increases in diabetes make countries like India, Peru and the Russia Federation areas of particular concern. Given the association between diabetes and TB and projected increases in diabetes worldwide, multi-disease health policies should be considered.

  14. Prevalence of anaesthesia information management systems in university-affiliated hospitals in Europe.

    PubMed

    Balust, Jaume; Egger Halbeis, Christoph B; Macario, Alex

    2010-02-01

    An increasing number of studies suggest that anaesthesia information management systems (AIMS) improve clinical care. The purpose of this web survey study was to assess the prevalence of AIMS in European university-affiliated anaesthesia departments and to identify the motivations for and barriers to AIMS adoption. A survey was e-mailed to 252 academic anaesthesia chairs of 294 university-affiliated hospitals in 22 European countries, with 41 e-mails returned as undeliverable, leaving the final sample equal to 211. Responders provided information on demographics, the other information technology systems available in their hospitals, and current implementation status of AIMS. Adopters were asked about motivations for installing AIMS, whereas nonadopters were asked about barriers to AIMS adoption. Eighty-six (29%) of 294 hospitals responded. Forty-four of the 86 departments (51%) were considered AIMS adopters because they were already using (n = 15), implementing (n = 13) or selecting an AIMS (n = 16). The 42 remaining departments (49%) were considered nonadopters as they were not expecting to install an AIMS owing to lack of funds (n = 27), other reasons (n = 13) such as lack of support from the information technology department, or simply did not have a plan (n = 2). The top ranked motivators for adopting AIMS were improved clinical documentation, improvement in patient care and safety, and convenience for anaesthesiologists. AIMS adopters were more likely than nonadopters to already have other information technology systems deployed throughout the hospital. At least 44 (or 15%) of the 294 university-affiliated departments surveyed in this study have already implemented, are implementing, or are currently selecting an AIMS. The main barrier identified by AIMS nonadopters is lack of funds.

  15. Fungal infection in Latin American countries.

    PubMed

    Rios-Fabra, A; Moreno, A R; Istúriz, R E

    1994-03-01

    Fungal infections remain a frequent health problem in Latin American countries. Although these diseases exhibit an extraordinary heterogeneity, they have certain features in common. Most patients belong to low socioeconomic groups and live in rural areas. This article presents a general view of the most prevalent subcutaneous mycoses, with emphasis on epidemiology, clinical manifestations, laboratory diagnosis, and treatment options in the developing countries of Latin America.

  16. Prevalence and Management of Systemic Hypertension in Athletes.

    PubMed

    Caselli, Stefano; Vaquer Sequì, Antonia; Lemme, Erika; Quattrini, Filippo; Milan, Alberto; D'Ascenzi, Flavio; Spataro, Antonio; Pelliccia, Antonio

    2017-05-15

    The aim of the present study was to evaluate the prevalence, determinants, and clinical management of systemic hypertension in a large cohort of competitive athletes: 2,040 consecutive athletes (aged 25 ± 6 years, 64% men) underwent clinical evaluation including blood test, electrocardiogram, exercise test, echocardiography, and ophthalmic evaluation. Sixty-five athletes (3%) were identified with hypertension (men = 57; 87%) including 5 with a secondary cause (thyroid dysfunction in 3, renal artery stenosis in 1, and drug induced in 1). The hypertensive athletes had greater left ventricular hypertrophy and showed more often a concentric pattern than normotensive ones. Moreover, they showed a mildly reduced physical performance and were characterized by a higher cardiovascular risk profile compared with normotensive athletes. Multivariate logistic regression analysis showed that family hypertension history (odds ratio 2.05; 95% confidence interval 1.21 to 3.49; p = 0.008) and body mass index (odds ratio 1.32; 95% confidence interval 1.23 to 1.40; p <0.001) were the strongest predictors of hypertension. Therapeutic intervention included successful lifestyle modification in 57 and required additional pharmacologic treatment in 3 with essential hypertension. Secondary hypertension was treated according to the underlying disorder. After a mean follow-up of 18 ± 6 months, all hypertensive athletes had achieved and maintained optimal control of the blood pressure, without restriction to sport participation. In conclusion, the prevalence of hypertension in athletes is low (3%) and largely related to family history and overweight. In the vast majority of hypertensives, lifestyle modifications were sufficient to achieve an optimal control of blood pressure values. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Sugar consumption and global prevalence of obesity and hypertension: an ecological analysis.

    PubMed

    Siervo, Mario; Montagnese, Concetta; Mathers, John C; Soroka, Katrina R; Stephan, Blossom C M; Wells, Jonathan C K

    2014-03-01

    The nutrition transition model provides an integrated approach to analyse global changes in food consumption and lifestyle patterns. Whether variability in food availability for consumption, lifestyle and sociodemographic factors is associated with the worldwide prevalence distribution of overweight, obesity and hypertension is unclear. Ecological analysis. Country-specific prevalence estimates of overweight, obesity and hypertension were obtained. Prevalence estimates were then matched to year- and country-specific food and energy availability for consumption of cereals, sugar, sweeteners and honey, vegetable oils, fruits, starchy roots, pulses, total vegetables, alcoholic beverages, total meat, animal fat, eggs, milk, and fish and seafood. The per capita Gross Domestic Product (GDP), urbanization rates and prevalence of physical inactivity for each country were also obtained. The overweight, obesity and hypertension databases included information from 128, 123 and seventy-nine countries, respectively. Consumption of sugar and animal products were directly associated with GDP and urbanization rates. In a multivariate regression model, physical inactivity (B = 0·01, se = 0·005, P = 0·003), cereal consumption (B = -0·02, se = 0·006, P < 0·001) and sugar consumption (B = 0·03, se = 0·01, P = 0·03) were significant predictors of obesity prevalence. Midpoint age (B = 0·21, se = 0·10, P = 0·02), prevalence of overweight (B = 0·18, se = 0·08, P = 0·02) and consumption of cereals (B = -0·22, se = 0·10, P = 0·02) were significant predictors of hypertension. Women appeared to have a significant obesity excess compared with men. High sugar consumption and sedentary lifestyle are associated with increased obesity prevalence. The non-linear association of sugar consumption with prevalence of obesity suggests that effective strategies to reduce its consumption may have differential effects in countries at different stages of the nutrition transition.

  18. A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis

    PubMed Central

    Farrag, Nesrine S.; Cheskin, Lawrence J.; Farag, Mohamed K.

    2017-01-01

    Obesity rates are rising globally, but there is evidence that young people in the Middle East and North Africa (MENA) region are at particularly high risk. We systematically searched the literature to map the MENA region for prevalence of childhood overweight and obesity, and examine the underlying risk factors and adverse effects associated with obesity in this region. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND (“last five years” [PDat]). Studies demonstrated an increasing prevalence of obesity among many countries in the MENA region, especially in the Gulf area. Notably, in Kuwait, prevalence rates of overweight and obesity were 25.6% and 34.8% among young males and 20.8% and 20.5% among females. A meta-analysis revealed that physical inactivity, increased screen time, and higher social status were risk factors for childhood obesity. Childhood and adolescent obesity is a major challenge facing countries of the MENA region. Further research is needed to fully investigate the role of nutrition and other specific risk factors and evaluate various interventions to manage this pervasive and growing health problem. PMID:29354689

  19. A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis.

    PubMed

    Farrag, Nesrine S; Cheskin, Lawrence J; Farag, Mohamed K

    2017-01-01

    Obesity rates are rising globally, but there is evidence that young people in the Middle East and North Africa (MENA) region are at particularly high risk. We systematically searched the literature to map the MENA region for prevalence of childhood overweight and obesity, and examine the underlying risk factors and adverse effects associated with obesity in this region. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies demonstrated an increasing prevalence of obesity among many countries in the MENA region, especially in the Gulf area. Notably, in Kuwait, prevalence rates of overweight and obesity were 25.6% and 34.8% among young males and 20.8% and 20.5% among females. A meta-analysis revealed that physical inactivity, increased screen time, and higher social status were risk factors for childhood obesity. Childhood and adolescent obesity is a major challenge facing countries of the MENA region. Further research is needed to fully investigate the role of nutrition and other specific risk factors and evaluate various interventions to manage this pervasive and growing health problem.

  20. Self-management of type 2 diabetes in gulf cooperation council countries: A systematic review.

    PubMed

    Al Slamah, Thamer; Nicholl, Barbara I; Alslail, Fatima Y; Melville, Craig A

    2017-01-01

    This study aimed to systematically review intervention studies on self-management of type 2 diabetes in Gulf Cooperation Council (GCC) countries to determine the most effective self-management strategies for individuals with type 2 diabetes in this region. A search strategy was developed using multiple databases: Medline and Embase (via Ovid), CINAHL (via EBSCO), and PubMed. Study and intervention characteristics, intervention structure, content, cultural adaptation, and outcomes were extracted from the included studies. To be included in the review the studies should have met the following criteria: have examined the effectiveness of at least one intervention involving a type 2 DSME programme, have involved participants over 18 years old diagnosed with type 2 diabetes, have taken place to in a GCC country, have a study design that was observational, quasi-experimental or controlled, have reported at least one individual and have a quantitative outcome. A narrative data synthesis was used to describe the studies and comment on their methodological quality. Of the 737 retrieved papers, only eight met the inclusion criteria. Only one study was a randomised controlled trial. A statistically significant improvement in HbA1c was reported in five of the eight studies. There was a significant improvement in physical activity levels as reported in four of the eight studies. Only three studies referred to aspects of cultural design or adaptation of the intervention implemented. Self-management interventions may have a positive impact on HbA1 levels in patients with type 2 diabetes in the GCC area. A greater emphasis placed on culturally appropriate self-management programmes may improve the effectiveness of self-management interventions for adults with type 2 diabetes in the GCC.

  1. Sustainable solutions for solid waste management in Southeast Asian countries.

    PubMed

    Ngoc, Uyen Nguyen; Schnitzer, Hans

    2009-06-01

    Human activities generate waste and the amounts tend to increase as the demand for quality of life increases. Today's rate in the Southeast Asian Nations (ASEANs) is alarming, posing a challenge to governments regarding environmental pollution in the recent years. The expectation is that eventually waste treatment and waste prevention approaches will develop towards sustainable waste management solutions. This expectation is for instance reflected in the term 'zero emission systems'. The concept of zero emissions can be applied successfully with today's technical possibilities in the agro-based processing industry. First, the state-of-the-art of waste management in Southeast Asian countries will be outlined in this paper, followed by waste generation rates, sources, and composition, as well as future trends of waste. Further on, solutions for solid waste management will be reviewed in the discussions of sustainable waste management. The paper emphasizes the concept of waste prevention through utilization of all wastes as process inputs, leading to the possibility of creating an ecosystem in a loop of materials. Also, a case study, focusing on the citrus processing industry, is displayed to illustrate the application of the aggregated material input-output model in a widespread processing industry in ASEAN. The model can be shown as a closed cluster, which permits an identification of opportunities for reducing environmental impacts at the process level in the food processing industry. Throughout the discussion in this paper, the utilization of renewable energy and economic aspects are considered to adapt to environmental and economic issues and the aim of eco-efficiency. Additionally, the opportunities and constraints of waste management will be discussed.

  2. Sustainable solutions for solid waste management in Southeast Asian countries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Uyen Nguyen Ngoc; Schnitzer, Hans

    2009-06-15

    Human activities generate waste and the amounts tend to increase as the demand for quality of life increases. Today's rate in the Southeast Asian Nations (ASEANs) is alarming, posing a challenge to governments regarding environmental pollution in the recent years. The expectation is that eventually waste treatment and waste prevention approaches will develop towards sustainable waste management solutions. This expectation is for instance reflected in the term 'zero emission systems'. The concept of zero emissions can be applied successfully with today's technical possibilities in the agro-based processing industry. First, the state-of-the-art of waste management in Southeast Asian countries will bemore » outlined in this paper, followed by waste generation rates, sources, and composition, as well as future trends of waste. Further on, solutions for solid waste management will be reviewed in the discussions of sustainable waste management. The paper emphasizes the concept of waste prevention through utilization of all wastes as process inputs, leading to the possibility of creating an ecosystem in a loop of materials. Also, a case study, focusing on the citrus processing industry, is displayed to illustrate the application of the aggregated material input-output model in a widespread processing industry in ASEAN. The model can be shown as a closed cluster, which permits an identification of opportunities for reducing environmental impacts at the process level in the food processing industry. Throughout the discussion in this paper, the utilization of renewable energy and economic aspects are considered to adapt to environmental and economic issues and the aim of eco-efficiency. Additionally, the opportunities and constraints of waste management will be discussed.« less

  3. Prevalence of autosomal dominant polycystic kidney disease in the European Union.

    PubMed

    Willey, Cynthia J; Blais, Jaime D; Hall, Anthony K; Krasa, Holly B; Makin, Andrew J; Czerwiec, Frank S

    2017-08-01

    Autosomal dominant polycystic kidney disease (ADPKD) is a leading cause of end-stage renal disease, but estimates of its prevalence vary by >10-fold. The objective of this study was to examine the public health impact of ADPKD in the European Union (EU) by estimating minimum prevalence (point prevalence of known cases) and screening prevalence (minimum prevalence plus cases expected after population-based screening). A review of the epidemiology literature from January 1980 to February 2015 identified population-based studies that met criteria for methodological quality. These examined large German and British populations, providing direct estimates of minimum prevalence and screening prevalence. In a second approach, patients from the 2012 European Renal Association‒European Dialysis and Transplant Association (ERA-EDTA) Registry and literature-based inflation factors that adjust for disease severity and screening yield were used to estimate prevalence across 19 EU countries (N = 407 million). Population-based studies yielded minimum prevalences of 2.41 and 3.89/10 000, respectively, and corresponding estimates of screening prevalences of 3.3 and 4.6/10 000. A close correspondence existed between estimates in countries where both direct and registry-derived methods were compared, which supports the validity of the registry-based approach. Using the registry-derived method, the minimum prevalence was 3.29/10 000 (95% confidence interval 3.27-3.30), and if ADPKD screening was implemented in all countries, the expected prevalence was 3.96/10 000 (3.94-3.98). ERA-EDTA-based prevalence estimates and application of a uniform definition of prevalence to population-based studies consistently indicate that the ADPKD point prevalence is <5/10 000, the threshold for rare disease in the EU. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA.

  4. Health information and communication system for emergency management in a developing country, Iran.

    PubMed

    Seyedin, Seyed Hesam; Jamali, Hamid R

    2011-08-01

    Disasters are fortunately rare occurrences. However, accurate and timely information and communication are vital to adequately prepare individual health organizations for such events. The current article investigates the health related communication and information systems for emergency management in Iran. A mixed qualitative and quantitative methodology was used in this study. A sample of 230 health service managers was surveyed using a questionnaire and 65 semi-structured interviews were also conducted with public health and therapeutic affairs managers who were responsible for emergency management. A range of problems were identified including fragmentation of information, lack of local databases, lack of clear information strategy and lack of a formal system for logging disaster related information at regional or local level. Recommendations were made for improving the national emergency management information and communication system. The findings have implications for health organizations in developing and developed countries especially in the Middle East. Creating disaster related information databases, creating protocols and standards, setting an information strategy, training staff and hosting a center for information system in the Ministry of Health to centrally manage and share the data could improve the current information system.

  5. Status of pesticide management in the practice of vector control: a global survey in countries at risk of malaria or other major vector-borne diseases.

    PubMed

    van den Berg, Henk; Hii, Jeffrey; Soares, Agnes; Mnzava, Abraham; Ameneshewa, Birkinesh; Dash, Aditya P; Ejov, Mikhail; Tan, Soo Hian; Matthews, Graham; Yadav, Rajpal S; Zaim, Morteza

    2011-05-14

    It is critical that vector control pesticides are used for their acceptable purpose without causing adverse effects on health and the environment. This paper provides a global overview of the current status of pesticides management in the practice of vector control. A questionnaire was distributed to WHO member states and completed either by the director of the vector-borne disease control programme or by the national manager for vector control. In all, 113 countries responded to the questionnaire (80% response rate), representing 94% of the total population of the countries targeted. Major gaps were evident in countries in pesticide procurement practices, training on vector control decision making, certification and quality control of pesticide application, monitoring of worker safety, public awareness programmes, and safe disposal of pesticide-related waste. Nevertheless, basic conditions of policy and coordination have been established in many countries through which the management of vector control pesticides could potentially be improved. Most countries responded that they have adopted relevant recommendations by the WHO. Given the deficiencies identified in this first global survey on public health pesticide management and the recent rise in pesticide use for malaria control, the effectiveness and safety of pesticide use are being compromised. This highlights the urgent need for countries to strengthen their capacity on pesticide management and evidence-based decision making within the context of an integrated vector management approach.

  6. Interventions for hiring, retaining and training district health systems managers in low- and middle-income countries.

    PubMed

    Rockers, Peter C; Bärnighausen, Till

    2013-04-30

    District managers are playing an increasingly important role in determining the performance of health systems in low- and middle-income countries as a result of decentralization. To assess the effectiveness of interventions to hire, retain and train district health systems managers in low- and middle-income countries. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We also searched online resources of international agencies, including the World Bank, to find relevant grey literature. Searches were conducted in December 2011. District health systems managers are those persons who are responsible for overseeing the operations of the health system within a defined, subnational geographical area that is designated as a district. Hiring and retention interventions include those that aim to increase the attractiveness of district management positions, as well as those related to hiring and retention processes, such as private contracting. Training interventions include education programs to develop future managers and on-the-job training programs for current managers. To be included, studies needed to use one of the following study designs: randomized controlled trial, nonrandomized controlled trial, controlled before-and-after study, and interrupted time series analysis. We report measures of effect in the same way that the primary study authors have reported them. Due to the varied nature of interventions included in this review we could not pool data across studies. Two studies met our inclusion criteria. The findings of one study conducted in Cambodia provide low quality evidence that private contracts with international nongovernmental organizations (NGOs) for district health systems management ('contracting-in') may improve health care access and utilization. Contracting-in increased use of antenatal care by 28% and use of public facilities by 14%. However, contracting

  7. Syphilis in Drug Users in Low and Middle Income Countries

    PubMed Central

    Coffin, Lara S.; Newberry, Ashley; Hagan, Holly; Cleland, Charles M.; Des Jarlais, Don C.; Perlman, David C.

    2009-01-01

    Background Genital ulcer disease (GUD), including syphilis, is an important cause of morbidity in low and middle income (LMI) countries and syphilis transmission is associated with HIV transmission. Methods We conducted a literature review to evaluate syphilis infection among drug users in LMI countries for the period 1995–2007. Countries were categorized using the World Bank Atlas method (The World Bank, 2007) according to 2006 gross national income per capita. Results Thirty-two studies were included (N=13,848 subjects), mostly from Southeast Asia with some from Latin America, Eastern Europe, Central and East Asia, North Africa and the Middle East but none from regions such as Sub-Saharan Africa. The median prevalence of overall lifetime syphilis (N=32 studies) was 11.1% (interquartile range: 6.3% to 15.3%) and of HIV (N=31 studies) was 1.1% (interquartile range: 0.22% to 5.50%). There was a modest relation (r=0.27) between HIV and syphilis prevalence. Median syphilis prevalence by gender was 4.0% (interquartile range: 3.4% to 6.6%) among males (N=11 studies) and 19.9% (interquartile range: 11.4% to 36.0%) among females (N=6 studies). There was a strong relation (r= 0.68) between syphilis prevalence and female gender that may be related to female sex work. Conclusion Drug users in LMI countries have a high prevalence of syphilis but data are limited and, in some regions, entirely lacking. Further data are needed, including studies targeting the risks of women. Interventions to promote safer sex, testing, counseling and education, as well as health care worker awareness, should be integrated in harm reduction programs and health care settings to prevent new syphilis infections and reduce HIV transmission among drug users and their partners in LMI countries. PMID:19361976

  8. Prevalence of retinopathy of prematurity in Latin America

    PubMed Central

    Carrion, Juliana Zimmermann; Filho, João Borges Fortes; Tartarella, Marcia Beatriz; Zin, Andrea; Jornada, Ignozy Dorneles

    2011-01-01

    The purpose of this work was to review the studies published over the last 10 years concerning the prevalence of retinopathy of prematurity (ROP) in Latin American countries, to determine if there was an improvement in ROP prevalence rates in that period, and to identify the inclusion criteria for patients at risk of developing ROP in the screening programs. A total of 33 studies from ten countries published between 2000 and 2010 were reviewed. Prevalence of any ROP stage in the regions considered ranged from 6.6% to 82%; ROP severe enough to require treatment ranged from 1.2% to 23.8%. There was no routine screening for ROP, and there was a lack of services for treatment of the disease in many countries. Inclusion criteria for patients in the studies ranged between birth weight ≤1500 g and ≤2000 g and gestational age ≤32 and <37 weeks. Use of different inclusion criteria regarding birth weight and gestational age in several Latin American studies hindered comparative analysis of the published data. Highly restrictive selection criteria for ROP screening in relation to birth weight and gestational age should not be used throughout most Latin American countries because of their different social characteristics and variable neonatal care procedures. The studies included in this review failed to provide adequate information to determine if the prevalence of ROP has decreased in Latin America. PMID:22174577

  9. Estimating the scale of chronic hepatitis C virus infection in the EU/EEA: a focus on migrants from anti-HCV endemic countries.

    PubMed

    Falla, A M; Ahmad, A A; Duffell, E; Noori, T; Veldhuijzen, I K

    2018-01-16

    Increasing the proportion diagnosed with and on treatment for chronic hepatitis C (CHC) is key to the elimination of hepatitis C in Europe. This study contributes to secondary prevention planning in the European Union/European Economic Area (EU/EEA) by estimating the number of CHC (anti-HCV positive and viraemic) cases among migrants living in the EU/EEA and born in endemic countries, defining the most affected migrant populations, and assessing whether country of birth prevalence is a reliable proxy for migrant prevalence. Migrant country of birth and population size extracted from statistical databases and anti-HCV prevalence in countries of birth and in EU/EEA countries derived from a systematic literature search were used to estimate caseload among and most affected migrants. Reliability of country of birth prevalence as a proxy for migrant prevalence was assessed via a systematic literature search. Approximately 11% of the EU/EEA adult population is foreign-born, 79% of whom were born in endemic (anti-HCV prevalence ≥1%) countries. Anti-HCV/CHC prevalence in migrants from endemic countries residing in the EU/EEA is estimated at 2.3%/1.6%, corresponding to ~580,000 CHC infections or 14% of the CHC disease burden in the EU/EEA. The highest number of cases is found among migrants from Romania and Russia (50-60,000 cases each) and migrants from Italy, Morocco, Pakistan, Poland and Ukraine (25-35,000 cases each). Ten studies reporting prevalence in migrants in Europe were identified; in seven of these estimates, prevalence was comparable with the country of birth prevalence and in three estimates it was lower. Migrants are disproportionately affected by CHC, account for a considerable number of CHC infections in EU/EEA countries, and are an important population for targeted case finding and treatment. Limited data suggest that country of birth prevalence can be used as a proxy for the prevalence in migrants.

  10. The prevalence of ABCB1:c.227_230delATAG mutation in affected dog breeds from European countries.

    PubMed

    Firdova, Zuzana; Turnova, Evelina; Bielikova, Marcela; Turna, Jan; Dudas, Andrej

    2016-06-01

    Deletion of 4-base pairs in the canine ABCB1 (MDR1) gene, responsible for encoding P-glycoprotein, leads to nonsense frame-shift mutation, which causes hypersensitivity to macrocyclic lactones drugs (e.g. ivermectin). To date, at least 12 purebred dog breeds have been found to be affected by this mutation. The aim of this study was to update information about the prevalence of ABCB1 mutation (c.227_230delATAG) in predisposed breeds in multiple European countries. This large scale survey also includes countries which were not involved in previous studies. The samples were collected in the period from 2012 to 2014. The overview is based on genotyping data of 4729 individuals. The observed mutant allele frequencies were 58.5% (Smooth Collie), 48.3% (Rough Collie), 35% (Australian Shepherd), 30.3% (Shetland Sheepdog), 28.1% (Silken Windhound), 26.1% (Miniature Australian Shepherd), 24.3% (Longhaired Whippet), 16.2% (White Swiss Shepherd) and 0% (Border Collie). The possible presence of an ABCB1 mutant allele in Akita-Inu breed has been investigated with negative results. This information could be helpful for breeders in optimization of their breeding strategy and for veterinarians when prescribing drug therapy for dogs of predisposed breeds. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms.

    PubMed

    Halbreich, Uriel; Karkun, Sandhya

    2006-04-01

    The prevalence of postpartum depression (PPD) is currently considered to be 10-15%. Most studies were performed with a brief unidimensional instruments (mostly the Edinburgh Postnatal Depression Scale-EPDS) with focus on depression and not on other symptoms and disorders. Most cited studies were conducted in Western economically developed countries. We reviewed the literature on prevalence of postpartum depression and depressive symptoms in a wide range of countries. 143 studies were identified reporting prevalence in 40 countries. It is demonstrated that there is a wide range of reported prevalence of PPD ranging from almost 0% to almost 60%. In some countries like Singapore, Malta, Malaysia, Austria and Denmark there are very few reports of PPD or postpartum depressive symptoms, whereas in other countries (e.g. Brazil, Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea) reported postpartum depressive symptoms are very prevalent. We believe that the widely cited mean prevalence of PPD-10-15% is not representative of the actual global prevalence and magnitude of the problem, due to the wide range of reports. The variability in reported PPD might be due to cross-cultural variables, reporting style, differences in perception of mental health and its stigma, differences in socio-economic environments (e.g. poverty, levels of social support or its perception, nutrition, stress), and biological vulnerability factors. The elucidation of the underlying processes of this variability as well as the diversity of postpartum normal versus abnormal expressions of symptoms may contribute to better understanding of the diversified ante, peri- and postpartum phenomena.

  12. Educational inequalities in obesity and gross domestic product: evidence from 70 countries.

    PubMed

    Kinge, Jonas Minet; Strand, Bjørn Heine; Vollset, Stein Emil; Skirbekk, Vegard

    2015-12-01

    We test the reversal hypothesis, which suggests that the relationship between obesity and education depends on the economic development in the country; in poor countries, obesity is more prevalent in the higher educated groups, while in rich countries the association is reversed-higher prevalence in the lower educated. We assembled a data set on obesity and education including 412,921 individuals from 70 countries in the period 2002-2013. Gross domestic product (GDP) per capita was used as a measure of economic development. We assessed the association between obesity and GDP by education using a two-stage mixed effects model. Country-specific educational inequalities in obesity were investigated using regression-based inequality indices. The reversal hypothesis was supported by our results in men and women. Obesity was positively associated with country GDP only among individuals with lower levels of education, while this association was absent or reduced in those with higher levels of education. This pattern was more pronounced in women than in men. Furthermore, educational inequalities in obesity were reversed with GDP; in low-income countries, obesity was more prevalent in individuals with higher education, in medium-income and high-income countries, obesity shifts to be more prevalent among those with lower levels of education. Obesity and economic development were positively associated. Our findings suggest that education might mitigate this effect. Global and national action aimed at the obesity epidemic should take this into account. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review.

    PubMed

    Ranasinghe, P; Mathangasinghe, Y; Jayawardena, R; Hills, A P; Misra, A

    2017-01-21

    The Asia-Pacific region is home to nearly half of the world's population. The region has seen a recent rapid increase in the prevalence of obesity, type-2 diabetes and cardiovascular disease. The present systematic review summarizes the recent prevalence and trends of Metabolic Syndrome (MetS) among adults in countries of the Asia-Pacific Region. Data on MetS in Asia-Pacific countries were obtained using a stepwise process by searching the online Medline database using MeSH terms 'Metabolic Syndrome X' and 'Epidemiology/EP'. For the purpose of describing prevalence data for the individual countries, studies that were most recent, nationally representative or with the largest sample size were included. When evaluating secular trends in prevalence in a country we only considered studies that evaluated the temporal change in prevalence between similar populations, prospective studies based on the same population or National surveys conducted during different time periods. This literature search yielded a total of 757 articles, and five additional article were identified by screening of reference lists. From this total, 18 studies were eligible to be included in the final analysis. Of the 51 Asia-Pacific countries (WHO) we only located data for 15. There was wide between country variation in prevalence of MetS. A national survey from Philippines conducted in 2003 revealed the lowest reported prevalence of 11.9% according to NCEP ATP III criteria. In contrast, the highest recorded prevalence in the region (49.0%) came from a study conducted in urban Pakistan (Karachchi, 2004). Most studies reported a higher prevalence of MetS in females and urban residents. Data on secular trends were available for China, South Korea and Taiwan. An increase in the prevalence of MetS was observed in all three countries. Despite differences in methodology, diagnostic criteria and age of subjects studied, the Asia-Pacific region is facing a significant epidemic of MetS. In most countries

  14. Oral health and welfare state regimes: a cross-national analysis of European countries.

    PubMed

    Guarnizo-Herreño, Carol C; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

    2013-06-01

    Very little is known about the potential relationship between welfare state regimes and oral health. This study assessed the oral health of adults in a range of European countries clustered by welfare regimes according to Ferrera's typology and the complementary Eastern type. We analysed data from Eurobarometer wave 72.3, a cross-sectional survey of 31 European countries carried out in 2009. We evaluated three self-reported oral health outcomes: edentulousness, no functional dentition (<20 natural teeth), and oral impacts on daily living. Age-standardized prevalence rates were estimated for each country and for each welfare state regime. The Scandinavian regime showed lower prevalence rates for all outcomes. For edentulousness and no functional dentition, there were higher prevalence rates in the Eastern regime but no significant differences between Anglo-Saxon, Bismarckian, and Southern regimes. The Southern regime presented a higher prevalence of oral impacts on daily living. Results by country indicated that Sweden had the lowest prevalences for edentulousness and no functional dentition, and Denmark had the lowest prevalence for oral impacts. The results suggest that Scandinavian welfare states, with more redistributive and universal welfare policies, had better population oral health. Future research should provide further insights about the potential mechanisms through which welfare-state regimes would influence oral health. © 2013 Eur J Oral Sci.

  15. Cost and economic burden of adverse events associated with metastatic melanoma treatments in five countries.

    PubMed

    Vouk, Katja; Benter, Ursula; Amonkar, Mayur M; Marocco, Alessia; Stapelkamp, Ceilidh; Pfersch, Sylvie; Benjamin, Laure

    2016-09-01

    To estimate per-event cost and economic burden associated with managing the most common and/or severe metastatic melanoma (MM) treatment-related adverse events (AEs) in Australia, France, Germany, Italy, and the UK. AEs associated with chemotherapy (dacarbazine, paclitaxel, fotemustine), immunotherapy (ipilimumab), and targeted therapy (vemurafenib) were identified by literature review. Medical resource use data associated with managing AEs were collected through two blinded Delphi panel cycles in each of the five countries. Published costs were used to estimate per-event costs and combined with AEs incidence, treatment usage, and MM prevalence to estimate the economic burden for each country. The costliest AEs were grade 3/4 events due to immunotherapy (Australia/France: colitis; UK: diarrhea) and chemotherapy (Germany/Italy: neutropenia/leukopenia). Treatment of AEs specific to chemotherapy (Australia/Germany/Italy/France: neutropenia/leukopenia) and targeted therapy (UK: squamous cell carcinoma) contributed heavily to country-specific economic burden. Economic burden was estimated assuming that each patient experienced an AE only once. In addition, the context of settings was heterogeneous and the number of Delphi panel experts was limited. Management costs for MM treatment-associated AEs can be substantial. Results could be incorporated in economic models that support reimbursement dossiers. With the availability of newer treatments, establishment of a baseline measure of the economic burden of AEs will be crucial for assessing their impact on patients and regional healthcare systems.

  16. Substance Use During Imprisonment in Low- and Middle-Income Countries

    PubMed Central

    Mundt, Adrian P; Baranyi, Gergő; Gabrysch, Caroline; Fazel, Seena

    2018-01-01

    Abstract Substance use disorders are among the most common health problems of people involved with the criminal justice system. Scaling up addiction services in prisons is a global public health and human rights challenge, especially in poorly resourced countries. We systematically reviewed the prevalence of substance use in prison populations in low- and middle-income countries. We searched for studies reporting prevalence rates of nicotine, alcohol, illicit drug, and injection drug use during imprisonment in unselected samples of imprisoned people in low- and middle-income countries. Data meta-analysis was conducted and sources of heterogeneity were examined by meta-regression. Prevalence of nicotine use during imprisonment ranged from 5% to 87%, with a random-effects pooled estimate of 56% (95% confidence interval (CI): 45, 66) with significant geographical heterogeneity. Alcohol use varied from 1% to 76% (pooled prevalence, 16%, 95% CI: 9, 25). Approximately one-quarter of people (25%; 95% CI: 17, 33; range, 0–78) used illicit drugs during imprisonment. The prevalence of injection drug use varied from 0% to 26% (pooled estimate, 1.6%, 95% CI: 0.8, 3.0). Lifetime substance use was investigated in secondary analyses. The high prevalence of smoking in prison suggests that policies regarding smoking need careful review. Furthermore, the findings underscore the importance of timely, scalable, and available treatments for alcohol and illegal drug use by people involved with the criminal justice system. PMID:29584860

  17. Estimating infertility prevalence in low-to-middle-income countries: an application of a current duration approach to Demographic and Health Survey data

    PubMed Central

    Cox, Carie M.; Tunçalp, Özge; McLain, Alexander C.; Thoma, Marie E.

    2017-01-01

    Abstract STUDY QUESTION Can infertility prevalence be estimated using a current duration (CD) approach when applied to nationally representative Demographic and Health Survey (DHS) data collected routinely in low- or middle-income countries? SUMMARY ANSWER Our analysis suggests that a CD approach applied to DHS data from Nigeria provides infertility prevalence estimates comparable to other smaller studies in the same region. WHAT IS KNOWN ALREADY Despite associations with serious negative health, social and economic outcomes, infertility in developing countries is a marginalized issue in sexual and reproductive health. Obtaining reliable, nationally representative prevalence estimates is critical to address the issue, but methodological and resource challenges have impeded this goal. STUDY DESIGN, SIZE, DURATION This cross-sectional study was based on standard information available in the DHS core questionnaire and data sets, which are collected routinely among participating low-to-middle-income countries. Our research question was examined among women participating in the 2013 Nigeria DHS (n = 38 948). Among women eligible for the study, 98% were interviewed. PARTICIPANTS/MATERIALS, SETTING, METHODS We applied a CD approach (i.e. current length of time-at-risk of pregnancy) to estimate time-to-pregnancy (TTP) and 12-month infertility prevalence among women ‘at risk’ of pregnancy at the time of interview (n = 7063). Women who were 18–44 years old, married or cohabitating, sexually active within the past 4 weeks and not currently using contraception (and had not been sterilized) were included in the analysis. Estimates were based on parametric survival methods using bootstrap methods (500 bootstrap replicates) to obtain 95% CIs. MAIN RESULTS AND THE ROLE OF CHANCE The estimated median TTP among couples at risk of pregnancy was 5.1 months (95% CI: 4.2–6.3). The estimated percentage of infertile couples was 31.1% (95% CI: 27.9–34.7%)—consistent with other

  18. Estimating infertility prevalence in low-to-middle-income countries: an application of a current duration approach to Demographic and Health Survey data.

    PubMed

    Polis, Chelsea B; Cox, Carie M; Tunçalp, Özge; McLain, Alexander C; Thoma, Marie E

    2017-05-01

    Can infertility prevalence be estimated using a current duration (CD) approach when applied to nationally representative Demographic and Health Survey (DHS) data collected routinely in low- or middle-income countries? Our analysis suggests that a CD approach applied to DHS data from Nigeria provides infertility prevalence estimates comparable to other smaller studies in the same region. Despite associations with serious negative health, social and economic outcomes, infertility in developing countries is a marginalized issue in sexual and reproductive health. Obtaining reliable, nationally representative prevalence estimates is critical to address the issue, but methodological and resource challenges have impeded this goal. This cross-sectional study was based on standard information available in the DHS core questionnaire and data sets, which are collected routinely among participating low-to-middle-income countries. Our research question was examined among women participating in the 2013 Nigeria DHS (n = 38 948). Among women eligible for the study, 98% were interviewed. We applied a CD approach (i.e. current length of time-at-risk of pregnancy) to estimate time-to-pregnancy (TTP) and 12-month infertility prevalence among women 'at risk' of pregnancy at the time of interview (n = 7063). Women who were 18-44 years old, married or cohabitating, sexually active within the past 4 weeks and not currently using contraception (and had not been sterilized) were included in the analysis. Estimates were based on parametric survival methods using bootstrap methods (500 bootstrap replicates) to obtain 95% CIs. The estimated median TTP among couples at risk of pregnancy was 5.1 months (95% CI: 4.2-6.3). The estimated percentage of infertile couples was 31.1% (95% CI: 27.9-34.7%)-consistent with other smaller studies from Nigeria. Primary infertility (17.4%, 95% CI: 12.9-23.8%) was substantially lower than secondary infertility (34.1%, 95% CI: 30.3-39.3%) in this population

  19. Erectile dysfunction management options in Nigeria.

    PubMed

    Afolayan, Anthony Jide; Yakubu, Musa Toyin

    2009-04-01

    In Nigeria, the prevalence of erectile dysfunction (ED) among patients attending primary care clinics, age-standardized to the U.S. population in 2000 is 57.4%. This is considered high enough to warrant the attention of scientist for critical studies and analysis. The high ED prevalence is associated with etiologies such as psychosexual factors, chronic medical conditions, and some lifestyles. ED constitutes a major public health problem, influencing the patient's well-being and quality of life. It also leads to broken homes and marriages, psychological, social, and physical morbidity. To give an account of various ED management options in Nigeria. Review of peer-reviewed literature, questionnaire, and ethnobotanical survey to some indigenous herb sellers and herbalists. Cross cultural perspectives of ED management in Nigeria. The review suggests that traditional (phytotherapy, zootherapy, and occultism) and nontraditional, orthodox practice (drug therapy, psychological, and behavioral counseling) are applicable to ED management in Nigeria. This review should help in creating awareness into various options available for managing ED in the country, but does not recommend self medication of any form, be it the use of orthodox or herbal remedy.

  20. Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

    PubMed

    2018-04-05

    Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. NCT02179112.

  1. Management of multiple sclerosis patients in central European countries: current needs and potential solutions

    PubMed Central

    Berger, Thomas; Adamczyk-Sowa, Monika; Csépány, Tünde; Fazekas, Franz; Hojs Fabjan, Tanja; Horáková, Dana; Illes, Zsolt; Klimová, Eleonóra; Leutmezer, Fritz; Rejdak, Konrad; Rozsa, Csilla; Šega Jazbec, Saša; Szilasiová, Jarmila; Turčáni, Peter; Vachová, Marta; Vécsei, László; Havrdová, Eva

    2018-01-01

    Multiple sclerosis (MS) experts in Europe are facing rapidly rising demands of excellence due to the increasing complexity of MS therapy and management. A central European expert board of MS experts met to identify needs and obstacles with respect to raising quality of MS care in central and Eastern European countries. There are substantial variations across countries regarding delivery of care and its cost structure, as well as access to treatment. To date, Eastern European countries are often less able to afford reimbursement of immunomodulatory agents than Western countries. Overall, approximately 40% of working-age patients are not working due to MS. Costs rise steeply with increasing disability; indirect costs constitute the bulk of the financial burden in patients with severe MS. Magnetic resonance imaging (MRI) assessment is meanwhile obligatory as the diagnostic interface in the management of MS patients. Recommended measures directed at improving quality of care include the collection of patient data in registries, enhanced education of healthcare professionals, implementation of national strategies aiming at reducing regional variation, optimization of approval processes, and removal of administrative barriers. Local partnerships with authorities such as those that represent the interests of employees can contribute to leverage the importance of epidemiological data. The need for education extends to (neuro)radiologists who are responsible for reporting MRI findings in expert quality. Dissemination of the Magnetic Resonance Imaging in MS (MAGNIMS) protocol would be an important step in this context. Also, clinical freedom of choice is rated as essential. Physicians should have access to a range of treatment options due to the complexity of disease. Guidelines such as the upcoming EAN-ECTRIMS clinical practice guideline also aim at providing a basis for argumentation in negotiations with national health authorities. PMID:29511382

  2. Multidisciplinary management of hepatoblastoma in children: Experience from a developing country.

    PubMed

    Shanmugam, Naresh; Scott, Julius Xavier; Kumar, Vimal; Vij, Mukul; Ramachandran, Priya; Narasimhan, Gomathy; Reddy, Mettu Srinivas; Kota, Venugopal; Munirathnam, Deenadayalan; Kelgeri, Chayarani; Sundaram, Karthick; Rela, Mohamed

    2017-03-01

    Advances in chemotherapy, liver resection techniques, and pediatric liver transplantation have vastly improved survival in children with hepatoblastoma (HB). These are best managed by a multidisciplinary team (MDT) in a setting where all treatment options are available. Until recently, this was difficult to achieve in India. All children (<16 years) with HB treated in a pediatric liver surgery and transplantation unit between January 2011 and July 2016 were reviewed. Data regarding the clinical presentation, preoperative management, surgical treatment, postoperative course, and outcomes were extracted from a prospectively managed database. Thirty children were treated for HB during the study period. Nine children were PRETEXT 4, 7 were PRETEXT 3, 13 were PRETEXT 2, and 1 was PRETEXT 1 (where PRETEXT is pretreatment extension). All children received a neoadjuvant chemotherapy before surgery followed by an adjuvant chemotherapy. Nineteen children had complete resection, while six underwent primary living donor liver transplantation. There were six mortalities including five children who poorly responded to chemotherapy with progressive tumor extension. At a median follow-up of 30 months, two children who underwent resection and one child who underwent liver transplant had disease recurrence. Improved outcomes can be achieved in children with HB even in countries with limited resources when they are managed by MDTs with expertise in pediatric oncology, liver resection, and liver transplantation. © 2016 Wiley Periodicals, Inc.

  3. Self-management of type 2 diabetes in gulf cooperation council countries: A systematic review

    PubMed Central

    Nicholl, Barbara I.; Alslail, Fatima Y.; Melville, Craig A.

    2017-01-01

    Aims This study aimed to systematically review intervention studies on self-management of type 2 diabetes in Gulf Cooperation Council (GCC) countries to determine the most effective self-management strategies for individuals with type 2 diabetes in this region. Methods A search strategy was developed using multiple databases: Medline and Embase (via Ovid), CINAHL (via EBSCO), and PubMed. Study and intervention characteristics, intervention structure, content, cultural adaptation, and outcomes were extracted from the included studies. To be included in the review the studies should have met the following criteria: have examined the effectiveness of at least one intervention involving a type 2 DSME programme, have involved participants over 18 years old diagnosed with type 2 diabetes, have taken place to in a GCC country, have a study design that was observational, quasi-experimental or controlled, have reported at least one individual and have a quantitative outcome. A narrative data synthesis was used to describe the studies and comment on their methodological quality. Results Of the 737 retrieved papers, only eight met the inclusion criteria. Only one study was a randomised controlled trial. A statistically significant improvement in HbA1c was reported in five of the eight studies. There was a significant improvement in physical activity levels as reported in four of the eight studies. Only three studies referred to aspects of cultural design or adaptation of the intervention implemented. Conclusions Self-management interventions may have a positive impact on HbA1 levels in patients with type 2 diabetes in the GCC area. A greater emphasis placed on culturally appropriate self-management programmes may improve the effectiveness of self-management interventions for adults with type 2 diabetes in the GCC. PMID:29232697

  4. Cigarette smoking and cigarette marketing exposure among students in selected African countries: Findings from the Global Youth Tobacco Survey.

    PubMed

    Zhao, Luhua; Palipudi, Krishna M; Ramanandraibe, Nivo; Asma, Samira

    2016-10-01

    To investigate cigarette smoking prevalence and exposure to various forms of cigarette marketing among students in 10 African countries. We used data collected during 2009-2011 from the Global Youth Tobacco Survey (GYTS), a school-based cross-sectional survey of students aged 13-15years, to measure the prevalence of cigarette smoking and exposure to cigarette marketing; comparisons to estimates from 2005 to 2006 were conducted for five countries where data were available. Current cigarette smoking ranged from 3.4% to 13.6% among students aged 13-15 in the 10 countries studied, although use of tobacco products other than cigarettes was more prevalent in all countries except in Cote D'Ivoire. Cigarette smoking was higher among boys than girls in seven out of the 10 countries. Among the five countries with two rounds of surveys, a significant decrease in cigarette smoking prevalence was observed in Mauritania and Niger; these two countries also experienced a decline in three measures of cigarette marketing exposure. It is also possible that smoking prevalence might have risen faster among girls than boys. Cigarette smoking among youth was noticeable in 10 African countries evaluated, with the prevalence over 10% in Cote D'Ivoire, Mauritania, and South Africa. Cigarette marketing exposure varied by the types of marketing; traditional venues such as TV, outdoor billboards, newspapers, and magazines were still prominent. Published by Elsevier Inc.

  5. Status of pesticide management in the practice of vector control: a global survey in countries at risk of malaria or other major vector-borne diseases

    PubMed Central

    2011-01-01

    Background It is critical that vector control pesticides are used for their acceptable purpose without causing adverse effects on health and the environment. This paper provides a global overview of the current status of pesticides management in the practice of vector control. Methods A questionnaire was distributed to WHO member states and completed either by the director of the vector-borne disease control programme or by the national manager for vector control. In all, 113 countries responded to the questionnaire (80% response rate), representing 94% of the total population of the countries targeted. Results Major gaps were evident in countries in pesticide procurement practices, training on vector control decision making, certification and quality control of pesticide application, monitoring of worker safety, public awareness programmes, and safe disposal of pesticide-related waste. Nevertheless, basic conditions of policy and coordination have been established in many countries through which the management of vector control pesticides could potentially be improved. Most countries responded that they have adopted relevant recommendations by the WHO. Conclusions Given the deficiencies identified in this first global survey on public health pesticide management and the recent rise in pesticide use for malaria control, the effectiveness and safety of pesticide use are being compromised. This highlights the urgent need for countries to strengthen their capacity on pesticide management and evidence-based decision making within the context of an integrated vector management approach. PMID:21569601

  6. Stroke in Arab countries: a systematic literature review.

    PubMed

    Benamer, Hani T S; Grosset, Donald

    2009-09-15

    Stroke is second only to ischaemic heart disease as a cause of death, and over a third of stroke deaths occur in developing countries. Arab countries constitute populations with a similar lifestyle and diet that may influence stroke risk, type and survival after stroke, as well as other characteristics in comparison to Western and Oriental populations. Therefore, a review of published reports of stroke in Arab countries was undertaken to provide a background for designing future stroke studies in Arab populations. Thirty-one articles related to incidence, prevalence, types, risk factors and outcome of stroke in Arab countries were identified by keyword searching of Medline and Embase, and review of references in all relevant papers. Studies were available for Saudi Arabia (n=16), Qatar (n=4), Libya (n=3), Kuwait (n=2), Jordan (n=1), United Arab Emirates (n=1), Bahrain (n=1), Tunisia (n=1), Iraq (n=1), and Sudan (n=1). The publication dates ranged from 1983-2008. The annual stroke incidence ranged from 27.5 to 63 per 100,000 population and prevalence was between 42 and 68 per 100,000 population. Ischaemic stroke was the commonest subtype in all series. However, one series from Sudan had a 41% rate of intracerebral haemorrhage, which is more similar to East Asian countries. Non-lacunar infarction occurred more frequently than lacunar infarcts in all but two series. Hypertension, diabetes mellitus, hyperlipidaemia, and cardiac disease were the commonest risk factors. The case-fatality rate at 30 days was between 10 and 17.5%. Therefore, the incidence and prevalence of stroke in Arab countries are lower than the Western world but within the range reported in Chinese populations. Stroke types and risk factors are similar, but an apparently higher rate of lacunar infarction in some settings needs further investigation. There is therefore a significant opportunity for further evaluation of stroke in Arab countries, especially in unstudied areas such as the populous

  7. Individual and country-level effects of cannabis-related perceptions on cannabis use. A multilevel study among adolescents in 32 European countries.

    PubMed

    Piontek, Daniela; Kraus, Ludwig; Bjarnason, Thoroddur; Demetrovics, Zsolt; Ramstedt, Mats

    2013-04-01

    The present article investigated individual and aggregated effects of cannabis-related perceptions and other cannabis-related indicators on 12-month cannabis use prevalence and frequency among 15-16 year olds using multilevel analysis across 32 European countries. Data on cannabis use, perceptions of availability, risks and friends' use as well as socio-demographic characteristics were taken from the 2007 European School Survey Project on Alcohol and Other Drugs. At the country level, aggregated measures of the perceptions were used. Data on cannabis price and 12-month cannabis use prevalence in the total population were taken from the World Drug Report. The analytical sample comprised 86,107 students (82.5% of the overall 2007 international database). Strong and persistent individual-level effects were identified for perceived availability, perceived harm, and the number of cannabis using friends. The effects on cannabis use prevalence and frequency were more pronounced than country-level effects. At the country level, aggregated perceived peer consumption and population prevalence were significant predictors, whereas price was not found to be related to both outcome variables. The association between perceived friends' use and cannabis use was moderated by aggregated perceived availability. Proximal influences related to the immediate social situation seem to be more strongly associated with cannabis use than do distal influences related to social contexts, emphasizing the importance of personal attitudes and perceptions in substance use behavior. Prevention programs may focus on informing adolescents about the potential risks of cannabis and on correcting misperceptions of social norms. Policy measures may target on reducing visibility of drug use. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. The IDF Diabetes Atlas methodology for estimating global prevalence of hyperglycaemia in pregnancy.

    PubMed

    Linnenkamp, U; Guariguata, L; Beagley, J; Whiting, D R; Cho, N H

    2014-02-01

    Hyperglycaemia is one of the most prevalent metabolic disorders occurring during pregnancy. Limited data are available on the global prevalence of hyperglycaemia in pregnancy. The International Diabetes Federation (IDF) has developed a methodology for generating estimates of the prevalence of hyperglycaemia in pregnancy, including hyperglycaemia first detected in pregnancy and live births to women with known diabetes, among women of childbearing age (20-49 years). A systematic review of the literature for studies reporting the prevalence of gestational diabetes was conducted. Studies were evaluated and scored to favour those that were representative of a large population, conducted recently, reported age-specific estimates, and case identification was based on blood test. Age-specific prevalence data from studies were entered to produce estimates for five-year age groups using logistic regression to smooth curves, with age as the independent variable. The derived age-specific prevalence was adjusted for differences in diagnostic criteria in the underlying data. Cases of hyperglycaemia in pregnancy were derived from age-specific estimates of fertility and age-specific population estimates. Country-specific estimates were generated for countries with available data. Regional and global estimates were generated based on aggregation and extrapolation for 219 countries and territories. Available fertility rates and diabetes prevalence estimates were used to estimate the proportion of hyperglycaemia in pregnancy that may be due to total diabetes in pregnancy - pregnancy in women with known diabetes and diabetes first detected in pregnancy. The literature review identified 199 studies that were eligible for characterisation and selection. After scoring and exclusion requirements, 46 studies were selected representing 34 countries. More than 50% of selected studies came from Europe and North America and Caribbean. The smallest number of identified studies came from sub

  9. Magnitude of anthropogenic phosphorus storage in the agricultural production and the waste management systems at the regional and country scales.

    PubMed

    Chowdhury, Rubel Biswas; Chakraborty, Priyanka

    2016-08-01

    Based on a systematic review of 17 recent substance flow analyses of phosphorus (P) at the regional and country scales, this study presents an assessment of the magnitude of anthropogenic P storage in the agricultural production and the waste management systems to identify the potential for minimizing unnecessary P storage to reduce the input of P as mineral fertilizer and the loss of P. The assessment indicates that in case of all (6) P flow analyses at the regional scale, the combined mass of annual P storage in the agricultural production and the waste management systems is greater than 50 % of the mass of annual P inflow as mineral fertilizer in the agricultural production system, while this is close to or more than 100 % in case of half of these analyses. At the country scale, in case of the majority (7 out of 11) of analyses, the combined mass of annual P storage in the agricultural production and the waste management systems has been found to be roughly equivalent or greater than 100 % of the mass of annual P inflow as mineral fertilizer in the agricultural production system, while it ranged from 30 to 60 % in the remaining analyses. A simple scenario analysis has revealed that the annual storage of P in this manner over 100 years could result in the accumulation of a massive amount of P in the agricultural production and the waste management systems at both the regional and country scales. This study suggests that sustainable P management initiatives at the regional and country scales should put more emphasis on minimizing unwanted P storage in the agricultural production and the waste management systems.

  10. The prevalence of metabolic syndrome in Latin America: a systematic review.

    PubMed

    Márquez-Sandoval, F; Macedo-Ojeda, G; Viramontes-Hörner, D; Fernández Ballart, J D; Salas Salvadó, J; Vizmanos, B

    2011-10-01

    To assess the available data on the prevalence of metabolic syndrome (MS) in Latin-American countries. Systematic review. Searches were carried out in PubMed, ISIWeb, SCielo and Redalyc, using 'metabolic syndrome x' and 'prevalence' as keywords for titles and/or abstracts. Articles selected were cross-sectional studies in Latin-American countries, whose main objective was to study MS and whose study population is described below. MS must be determined using Adult Treatment Panel III criteria. Twelve studies with these criteria were selected, one of which was multi-centric. Latin America. Apparently healthy subjects aged 18-65 years (including young adult, mature adult and elderly populations) of both genders. The general prevalence (weighted mean) of MS in Latin-American countries was 24·9 (range: 18·8-43·3) %. MS was slightly more frequent in women (25·3 %) than in men (23·2 %), and the age group with the highest prevalence of MS consisted of those over 50 years of age. The most frequent components of MS were low HDL cholesterol levels (62·9 %) and abdominal obesity (45·8 %). Similar outcomes were obtained from the multi-centre study on Latin-American populations analysed. The present review brings us closer to an understanding of the prevalence of MS in Latin-American countries. However, it is not possible to know the full scope of the problem, partly because data from some countries are not available, and because the methodological differences among the studies published up to the present limit a joint analysis of their results.

  11. Managing menstruation in the workplace: an overlooked issue in low- and middle-income countries.

    PubMed

    Sommer, Marni; Chandraratna, Sahani; Cavill, Sue; Mahon, Therese; Phillips-Howard, Penelope

    2016-06-06

    The potential menstrual hygiene management barriers faced by adolescent girls and women in workplace environments in low- and middle-income countries has been under addressed in research, programming and policy. Despite global efforts to reduce poverty among women in such contexts, there has been insufficient attention to the water and sanitation related barriers, specifically in relation to managing monthly menstruation, that may hinder girls' and women's contributions to the workplace, and their health and wellbeing. There is an urgent need to document the specific social and environmental barriers they may be facing in relation to menstrual management, to conduct a costing of the implications of inadequate supportive workplace environments for menstrual hygiene management, and to understand the implications for girls' and women's health and wellbeing. This will provide essential evidence for guiding national policy makers, the private sector, donors and activists focused on advancing girls' and women's rights.

  12. The low prevalence of female smoking in the developing world: gender inequality or maternal adaptations for fetal protection?

    PubMed Central

    Hagen, Edward H.; Garfield, Melissa J.; Sullivan, Roger J.

    2016-01-01

    Background: Female smoking prevalence is dramatically lower in developing countries (3.1%) than developed countries (17.2%), whereas male smoking is similar (32% vs 30.1%). Low female smoking has been linked to high gender inequality. Alternatively, to protect their offspring from teratogenic substances, pregnant and lactating women appear to have evolved aversions to toxic plant substances like nicotine, which are reinforced by cultural proscriptions. Higher total fertility rates (TFRs) in developing countries could therefore explain their lower prevalence of female smoking. Objective: To compare the associations of TFR and gender inequality with national prevalence rates of female and male smoking. Methods: Data from a previous study of smoking prevalence vs gender inequality in 74 countries were reanalysed with a regression model that also included TFR. We replicated this analysis with three additional measures of gender equality and 2012 smoking data from 173 countries. Results: A 1 SD increase in TFR predicted a decrease in female smoking prevalence by factors of 0.58–0.77, adjusting for covariates. TFR had a smaller and unexpected negative association with male smoking prevalence. Increased gender equality was associated with increased female smoking prevalence, and, unexpectedly, with decreased male smoking prevalence. TFR was also associated with an increase in smoking prevalence among postmenopausal women. Conclusions: High TFR and gender inequality both predict reduced prevalence of female smoking across nations. In countries with high TFR, adaptations and cultural norms that protect fetuses from plant toxins might suppress smoking among frequently pregnant and lactating women. PMID:27193200

  13. Characterization of urban waste management practices in developing Asian countries: A new analytical framework based on waste characteristics and urban dimension.

    PubMed

    Aleluia, João; Ferrão, Paulo

    2016-12-01

    This paper characterizes municipal solid waste (MSW) management practices in developing Asia, with a focus on low and middle-income countries. The analysis that is conducted supports a proposed framework that maps out the trends observed in the region in relation to two parameters, waste compositions and urban dimension, which was prepared based on a set of national and urban case studies. The management of MSW in developing Asian countries is driven, first and foremost, by a public health imperative: the collection and disposal of waste in order to avoid the spread of disease vectors from uncollected waste. This comes, however, at a high cost, with local government authorities in these countries spending up to 50% of their budgets in the provision of these services. Little or no value is derived from waste, which is typically seen as a liability and not as a resource that can be harnessed. On the other hand, in many cities in developing Asia there is an informal sector that ekes out a living from the recovery of recyclable materials found in waste. Members of this "informal waste sector" are especially active in areas that are not served by formal waste collection systems, such as slums or squatter areas. A distinctive element shared among many cities in developing Asian countries concerns the composition of the municipal solid waste. MSW in those countries tends to be richer in biodegradable organic matter, which usually accounts for more than 50% of the total waste composition, suggesting that biological methods are more appropriate for treating this organic fraction. Conversely, thermal combustion technologies, which are extensively applied in high-income countries, are technically and economically challenging to deploy in light of the lower calorific value of waste streams which are rich in organics and moisture. Specific approaches and methods are therefore required for designing adequate waste management systems in developing Asian countries. In addition

  14. The magnitude and trends of under- and over-nutrition in Asian countries.

    PubMed

    Ke-You, G; Da-Wei, F

    2001-06-01

    In order to understand the magnitude and trends of both under- and over-nutrition problems in Asian countries, we reviewed data available in a number of selected countries. In general, the prevalence of under-nutrition is declining in this region but is still heavy in many countries. The trends varied with complexity of individual countries. In China, the prevalence of underweight, stunting and wasting was 21.6%, 30.5% and 2.6% in children of 0-4 years old (90,662 subjects, 1987) . Another large-scale survey in 1992 (176,976 subjects) presented a prevalence of 17.1% , 33.5% and 4.5%, respectively. Recent studies showed a remarkable improvement in both underweight and stunting. The National Student Survey in 1995, however, showed that the prevalence of under-nutrition was 26.9% for schoolboys and 38.3% for schoolgirls (7-18 yr). There was an increase of 4.7% and 3 .5%, respectively, compared with the results of a similar survey conducted in 1985. The proportion of malnutrition in Chinese adults (BMI < 18.5) was 11.6% in 1982 and 9.0% in 1992 for urban areas, and 12.9% and 8.0% for rural areas, indicating a descending trend over the 10 years. The prevalence of underweight was the highest, over 50% among children below 6 years old, in both Bangladesh and India, between 50% and 20% in Malaysia, the Philippines, Thailand and Vietnam, and below 20% in Mongolia, Kazakhstan and Fiji. It showed a declining trend from the 1970s to the 1990s with an average annual reduction of 0.8 to 1.9 percentage points in these countries. The problem of over-nutrition is emerging quickly in this region, not only in some better-off countries but also in countries in economy transition. In China, the prevalence of overweight and obesity in young adults (BMI > 25) was increased from 9.7% to 14.9% for urban areas and from 6.15% to 8.4% for rural areas in a 10-year period (1982 - 1992), and the prevalence of overweight jumped from 3.38% and 2.75% in 1985 to 7.18% and 8.65% in 1995 for

  15. Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries.

    PubMed

    Knevel, Rjm; Gussy, M G; Farmer, J

    2017-05-01

    The purpose of this study was to scope the literature that exists about factors influencing oral health workforce planning and management in developing countries (DCs). The Arksey and O'Malley method for conducting a scoping review was used. A replicable search strategy was applied, using three databases. Factors influencing oral health workforce planning and management in DCs identified in the eligible articles were charted. Four thousand citations were identified; 41 papers were included for review. Most included papers were situational analyses. Factors identified were as follows: lack of data, focus on the restorative rather than preventive care in practitioner education, recent increase in number of dental schools (mostly private) and dentistry students, privatization of dental care services which has little impact on care maldistribution, and debates about skill mix and scope of practice. Oral health workforce management in the eligible studies has a bias towards dentist-led systems. Due to a lack of country-specific oral health related data in developing or least developed countries (LDCs), oral health workforce planning often relies on data and modelling from other countries. Approaches to oral health workforce management and planning in developing or LDCs are often characterized by approaches to increase numbers of dentists, thus not ameliorating maldistribution of service accessibility. Governments appear to be reducing support for public and preventative oral healthcare, favouring growth in privatized dental services. Changes to professional education are necessary to trigger a paradigm shift to the preventive approach and to improve relationships between different oral healthcare provider roles. This needs to be premised on greater appreciation of preventive care in health systems and funding models. © 2016 The Authors. International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

  16. Sex chromosome trisomies in Europe: prevalence, prenatal detection and outcome of pregnancy

    PubMed Central

    Boyd, Patricia Anne; Loane, Maria; Garne, Ester; Khoshnood, Babak; Dolk, Helen

    2011-01-01

    This study aims to assess prevalence and pregnancy outcome for sex chromosome trisomies (SCTs) diagnosed prenatally or in the first year of life. Data held by the European Surveillance of Congenital Anomalies (EUROCAT) database on SCT cases delivered 2000–2005 from 19 population-based registries in 11 European countries covering 2.5 million births were analysed. Cases included were livebirths diagnosed to 1 year of age, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly (TOPFA). In all, 465 cases of SCT were diagnosed between 2000 and 2005, a prevalence of 1.88 per 10,000 births (95% CI 1.71–2.06). Prevalence of XXX, XXY and XYY were 0.54 (95% CI 0.46–0.64), 1.04 (95% CI 0.92–1.17) and 0.30 (95% CI 0.24–0.38), respectively. In all, 415 (89%) were prenatally diagnosed and 151 (36%) of these resulted in TOPFA. There was wide country variation in prevalence (0.19–5.36 per 1000), proportion prenatally diagnosed (50–100%) and proportion of prenatally diagnosed resulting in TOPFA (13–67%). Prevalence of prenatally diagnosed cases was higher in countries with high prenatal detection rates of Down syndrome. The EUROCAT prevalence rate for SCTs diagnosed prenatally or up to 1 year of age represents 12% of the prevalence expected from cytogenetic studies of newborn babies, as the majority of cases are never diagnosed or are diagnosed later in life. There is a wide variation between European countries in prevalence, prenatal detection and TOPFA proportions, related to differences in screening policies as well as organizational and cultural factors. PMID:20736977

  17. Sex chromosome trisomies in Europe: prevalence, prenatal detection and outcome of pregnancy.

    PubMed

    Boyd, Patricia Anne; Loane, Maria; Garne, Ester; Khoshnood, Babak; Dolk, Helen

    2011-02-01

    This study aims to assess prevalence and pregnancy outcome for sex chromosome trisomies (SCTs) diagnosed prenatally or in the first year of life. Data held by the European Surveillance of Congenital Anomalies (EUROCAT) database on SCT cases delivered 2000-2005 from 19 population-based registries in 11 European countries covering 2.5 million births were analysed. Cases included were livebirths diagnosed to 1 year of age, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly (TOPFA). In all, 465 cases of SCT were diagnosed between 2000 and 2005, a prevalence of 1.88 per 10,000 births (95% CI 1.71-2.06). Prevalence of XXX, XXY and XYY were 0.54 (95% CI 0.46-0.64), 1.04 (95% CI 0.92-1.17) and 0.30 (95% CI 0.24-0.38), respectively. In all, 415 (89%) were prenatally diagnosed and 151 (36%) of these resulted in TOPFA. There was wide country variation in prevalence (0.19-5.36 per 1000), proportion prenatally diagnosed (50-100%) and proportion of prenatally diagnosed resulting in TOPFA (13-67%). Prevalence of prenatally diagnosed cases was higher in countries with high prenatal detection rates of Down syndrome. The EUROCAT prevalence rate for SCTs diagnosed prenatally or up to 1 year of age represents 12% of the prevalence expected from cytogenetic studies of newborn babies, as the majority of cases are never diagnosed or are diagnosed later in life. There is a wide variation between European countries in prevalence, prenatal detection and TOPFA proportions, related to differences in screening policies as well as organizational and cultural factors.

  18. Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Russian Federation, the Western countries of the former Soviet Union, Caucasus region and Central Asia.

    PubMed

    Rogovskaya, Svetlana I; Shabalova, Irina P; Mikheeva, Irina V; Minkina, Galina N; Podzolkova, Nataly M; Shipulina, Olga Y; Sultanov, Said N; Kosenko, Iren A; Brotons, Maria; Buttmann, Nina; Dartell, Myassa; Arbyn, Marc; Syrjänen, Stina; Poljak, Mario

    2013-12-31

    Limited data are available on the burden of human papillomavirus (HPV) and its associated diseases in the Russian Federation, the Western Countries of the former Soviet Union (Belarus, Republic of Moldova, Ukraine), the Caucasus region and Central Asia (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan). Both the incidence and mortality rate of cervical cancer are higher in these countries than in most Western European countries. In this article, we review available data on HPV prevalence and type distribution in women with normal cytology, women from the general population, cervical precancerous lesions and cervical cancer, as well as data on national policies of cervical cancer screening and HPV vaccination initiatives in these countries. Based on scarce data from the 12 countries, the high-risk HPV (hrHPV) prevalence among 5226 women with normal cytology ranged from 0.0% to 48.4%. In women with low-grade cervical lesions, the hrHPV prevalence among 1062 women varied from 29.2% to 100%. HrHPV infection in 565 women with high-grade cervical lesions ranged from 77.2% to 100% and in 464 invasive cervical cancer samples from 89.8% to 100%. HPV16 was the most commonly detected hrHPV genotype in all categories. As the HPV genotype distribution in cervical diseases seems to be similar to that found in Western Europe the implementation of HPV testing in screening programs might be beneficial. Opportunistic screening programs, the lack of efficient call-recall systems, low coverage, and the absence of quality assured cytology with centralized screening registry are major reasons for low success rates of cervical cancer programs in many of the countries. Finally, HPV vaccination is currently not widely implemented in most of the twelve countries mainly due to pricing, availability, and limited awareness among public and health care providers. Country-specific research, organized nationwide screening programs, registries and well

  19. Food allergy: is prevalence increasing?

    PubMed

    Tang, Mimi L K; Mullins, Raymond J

    2017-03-01

    It is generally accepted that the prevalence of food allergy has been increasing in recent decades, particularly in westernised countries, yet high-quality evidence that is based on challenge confirmed diagnosis of food allergy to support this assumption is lacking because of the high cost and potential risks associated with conducting food challenges in large populations. Accepting this caveat, the use of surrogate markers for diagnosis of food allergy (such as nationwide data on hospital admissions for food anaphylaxis or clinical history in combination with allergen-specific IgE (sIgE) measurement in population-based cohorts) has provided consistent evidence for increasing prevalence of food allergy at least in western countries, such as the UK, United States and Australia. Recent reports that children of East Asian or African ethnicity who are raised in a western environment (Australia and United States respectively) have an increased risk of developing food allergy compared with resident Caucasian children suggest that food allergy might also increase across Asian and African countries as their economies grow and populations adopt a more westernised lifestyle. Given that many cases of food allergy persist, mathematical principles would predict a continued increase in food allergy prevalence in the short to medium term until such time as an effective treatment is identified to allow the rate of disease resolution to be equal to or greater than the rate of new cases. © 2017 Royal Australasian College of Physicians.

  20. Prevalence and management of diabetes in immigrants resident in the Lombardy Region: the importance of ethnicity and duration of stay.

    PubMed

    Marzona, Irene; Avanzini, Fausto; Tettamanti, Mauro; Vannini, Tommaso; Fortino, Ida; Bortolotti, Angela; Merlino, Luca; Genovese, Stefano; Roncaglioni, Maria Carla

    2018-04-01

    To describe the prevalence and management of diabetes among immigrants according to ethnic group and duration of stay, compared to Italian citizens. Diabetic immigrant and Italian residents aged 20-69 years in the administrative database of the Lombardy Region. Immigrants were classified by region of origin and as long-term residents (LTR) and short-term residents (STR). Age- and sex-adjusted prevalence and indicators of diabetes management were calculated for immigrants by region of origin and by length of stay using Cox proportional models. In 2010 19,992 immigrants (mean age 49.1 ± 10.8, 53.7% males) and 195,049 Italians (mean age 58.7 ± 9.3, 61.1 males) with diabetes were identified. Immigrants had a higher adjusted diabetes prevalence than Italians (OR 1.48; 95% CI 1.45-1.50). STR received significantly fewer recommended cardiovascular drugs (antiplatelets, statins and ACE-inhibitors/ARBs) than Italians, although prescription was higher among LTR from some ethnic groups. Immigrants were less likely to be seen by a diabetologist and to do at least one HbA1c test per year. Although the recommended tests/visits were more often done for the LTR than the STR, in the majority of ethnic groups these indicators were still far from optimal. The prevalence and management of diabetes differ between immigrants and Italians, although some improvement can be seen among LTR.

  1. Prevalence of Trypanosoma cruzi infection among Bolivian immigrants in the city of São Paulo, Brazil

    PubMed Central

    Luna, Expedito JA; Furucho, Celia R; Silva, Rubens A; Wanderley, Dalva M; Carvalho, Noemia B; Satolo, Camila G; Leite, Ruth M; Silveira, Cassio; Silva, Lia MB; Aith, Fernando M; Carneiro, Nivaldo; Shikanai-Yasuda, Maria A

    2016-01-01

    With the urbanisation of the population in developing countries and the process of globalisation, Chagas has become an emerging disease in the urban areas of endemic and non-endemic countries. In 2006, it was estimated that the prevalence of Chagas disease among the general Bolivian population was 6.8%. The aim of the present study was to determine the prevalence of Trypanosoma cruzi infection among Bolivian immigrants living in São Paulo, Brazil. This study had a sample of 633 volunteers who were randomly selected from the clientele of primary care units located in the central districts of São Paulo, Brazil. Infection was detected by two different ELISA assays with epimastigote antigens, followed by an immunoblot with trypomastigote antigens as a confirmatory test. The prevalence of the infection was 4.4%. Risk factors independently associated with the infection were: a history of rural jobs in Bolivia, knowledge of the vector involved in transmission, and having relatives with Chagas disease. Brazil has successfully eliminated household vector transmission of T. cruzi, as well as its transmission by blood transfusion. The arrival of infected immigrants represents an additional challenge to primary care clinics to manage chronic Chagas disease, its vertical transmission, and the blood derivatives and organ transplant programs. PMID:27849221

  2. Prevalence of Trypanosoma cruzi infection among Bolivian immigrants in the city of São Paulo, Brazil.

    PubMed

    Luna, Expedito Ja; Furucho, Celia R; Silva, Rubens A; Wanderley, Dalva M; Carvalho, Noemia B; Satolo, Camila G; Leite, Ruth M; Silveira, Cassio; Silva, Lia Mb; Aith, Fernando M; Carneiro, Nivaldo; Shikanai-Yasuda, Maria A

    2017-01-01

    With the urbanisation of the population in developing countries and the process of globalisation, Chagas has become an emerging disease in the urban areas of endemic and non-endemic countries. In 2006, it was estimated that the prevalence of Chagas disease among the general Bolivian population was 6.8%. The aim of the present study was to determine the prevalence of Trypanosoma cruzi infection among Bolivian immigrants living in São Paulo, Brazil. This study had a sample of 633 volunteers who were randomly selected from the clientele of primary care units located in the central districts of São Paulo, Brazil. Infection was detected by two different ELISA assays with epimastigote antigens, followed by an immunoblot with trypomastigote antigens as a confirmatory test. The prevalence of the infection was 4.4%. Risk factors independently associated with the infection were: a history of rural jobs in Bolivia, knowledge of the vector involved in transmission, and having relatives with Chagas disease. Brazil has successfully eliminated household vector transmission of T. cruzi, as well as its transmission by blood transfusion. The arrival of infected immigrants represents an additional challenge to primary care clinics to manage chronic Chagas disease, its vertical transmission, and the blood derivatives and organ transplant programs.

  3. Comparative Comparison of Implementing School-Based Management in Developed Countries in the Historical Context: From Theory to Practice

    ERIC Educational Resources Information Center

    Moradi, Saeid; Beidokhti, Aliakbar Amin; Fathi, Kourosh

    2016-01-01

    This paper aims to study the comparative comparison of implementing school-based management in developed countries in the historical context: from theory to practice. School-based management is not by itself and objective but a valuable tool in order to reach sagacity, capabilities and the enthusiasm from most people having shares in school.…

  4. Work related complaints of neck, shoulder and arm among computer office workers: a cross-sectional evaluation of prevalence and risk factors in a developing country.

    PubMed

    Ranasinghe, Priyanga; Perera, Yashasvi S; Lamabadusuriya, Dilusha A; Kulatunga, Supun; Jayawardana, Naveen; Rajapakse, Senaka; Katulanda, Prasad

    2011-08-04

    Complaints of arms, neck and shoulders (CANS) is common among computer office workers. We evaluated an aetiological model with physical/psychosocial risk-factors. We invited 2,500 computer office workers for the study. Data on prevalence and risk-factors of CANS were collected by validated Maastricht-Upper-extremity-Questionnaire. Workstations were evaluated by Occupational Safety and Health Administration (OSHA) Visual-Display-Terminal workstation-checklist. Participants' knowledge and awareness was evaluated by a set of expert-validated questions. A binary logistic regression analysis investigated relationships/correlations between risk-factors and symptoms. Sample size was 2,210. Mean age 30.8 ± 8.1 years, 50.8% were males. The 1-year prevalence of CANS was 56.9%, commonest region of complaint was forearm/hand (42.6%), followed by neck (36.7%) and shoulder/arm (32.0%). In those with CANS, 22.7% had taken treatment from a health care professional, only in 1.1% seeking medical advice an occupation-related injury had been suspected/diagnosed. In addition 9.3% reported CANS-related absenteeism from work, while 15.4% reported CANS causing disruption of normal activities. A majority of evaluated workstations in all participants (88.4%,) and in those with CANS (91.9%) had OSHA non-compliant workstations. In the binary logistic regression analyses female gender, daily computer usage, incorrect body posture, bad work-habits, work overload, poor social support and poor ergonomic knowledge were associated with CANS and its' severity In a multiple logistic regression analysis controlling for age, gender and duration of occupation, incorrect body posture, bad work-habits and daily computer usage were significant independent predictors of CANS. The prevalence of work-related CANS among computer office workers in Sri Lanka, a developing, South Asian country is high and comparable to prevalence in developed countries. Work-related physical factors, psychosocial factors and

  5. Television food advertising and the prevalence of childhood overweight and obesity: a multicountry comparison.

    PubMed

    Goris, Janny M; Petersen, Solveig; Stamatakis, Emmanuel; Veerman, J Lennert

    2010-07-01

    To estimate the contribution of television (TV) food advertising to the prevalence of obesity among 6-11-year-old children in Australia, Great Britain (England and Scotland only), Italy, The Netherlands, Sweden and the United States. Data from contemporary representative studies on the prevalence of childhood obesity and on TV food advertising exposure in the above countries were entered into a mathematical simulation model. Two different effect estimators were used to calculate the reduction in prevalence of overweight and obesity in the absence of TV food advertising in each country; one based on literature and one based on experts' estimates. Six- to eleven-year-old children in six Western countries. Estimates of the average exposure of children to TV food advertising range from 1.8 min/d in The Netherlands to 11.5 min/d in the United States. Its contribution to the prevalence of childhood obesity is estimated at 16%-40% in the United States, 10%-28% in Australia and Italy and 4%-18% in Great Britain, Sweden and The Netherlands. The contribution of TV advertising of foods and drinks to the prevalence of childhood obesity differs distinctly by country and is likely to be significant in some countries.

  6. Prevalence of childhood asthma in Ulaanbaatar, Mongolia in 2009.

    PubMed

    Yoshihara, Shigemi; Munkhbayarlakh, Sonomjants; Makino, Sohei; Ito, Clyde; Logii, Narantsetseg; Dashdemberel, Sarangerel; Sagara, Hironori; Fukuda, Takeshi; Arisaka, Osamu

    2016-01-01

    Bronchial asthma is a common but important chronic disease in children in all over the world. To take measures against prevalence of childhood asthma, many researchers have surveyed the actual statuses of childhood asthma in developed countries, but in most Asia-Pacific developing countries including Mongolia such surveys have never been sufficiently conducted until now. We have thought that this survey, though performed in 2009, will give important and meaningful information even now in taking measures to prevent prevailing bronchial asthma in children in Mongolia or the countries under similar statuses. The asthma prevalence and patient background information in Mongolian children aged 6-7 living in Ulaanbaatar were examined using a written questionnaire modified for their parents from that prepared by the International Study of Asthma and Allergies in Childhood (ISAAC). The estimated prevalence of asthma in Mongolian children was 20.9%. The following 3 risk factors were found to be related to asthma: (1) having allergic rhinitis symptoms, (2) mothers' smoking, and (3) history of severe respiratory infection before 1-year-old. The asthma prevalence in Mongolian children was higher than that in the world and Asia-Pacific countries reported by ISAAC. The higher prevalence was probably attributable to households' (especially mothers) smoking in draft-free houses designed for the cold area and severe air-pollution due to rapid industrialization and urbanization in Mongolia. Smoking prohibition in the mother (including family members) and a reduction of exposure to air pollutants are urgently needed to prevent developing childhood asthma. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  7. Low prevalence of abdominal aortic aneurysm in the Seychelles population aged 50 to 65 years.

    PubMed

    Yerly, Patrick; Madeleine, George; Riesen, Walter; Bovet, Pascal

    2013-03-01

    The prevalence of abdominal aortic aneurysm (AAA) and its risk factors are well known in Western countries but few data are available from low- and middle- income countries. We are not aware of systematically collected population- based data on AAA in the African region. We evaluated the prevalence of AAA in a population- based cardiovascular survey conducted in the Republic of Seychelles in 2004 (Indian Ocean, African region). Among the 353 participants aged 50 to 64 years and screened with ultrasound, the prevalence of AAA was 0.3% (95% CI: 0- 0.9) and the prevalence of ectatic dilatations of the abdominal aorta was 1.5% (95% CI: 0.2- 2.8). The prevalence of AAA in the general population seemed lower in Seychelles than in Western countries, despite a high prevalence in Seychelles of risk factors of AAA, such as smoking (in men), high blood pressure and hypercholesterolaemia.

  8. Do We Really Know the Prevalence of MIH?

    PubMed

    Hernandez, M; Boj, J R; Espasa, E

    2016-01-01

    To analyze the existing variability on molar incisor hypomineralization prevalence in the literature; to distinguish the various molar incisor hypomineralization prevalence rates in different countries, areas, and regions of the world; and to know the valid diagnostic criteria used for the correct identification of molar incisor hypomineralization prevalence. A literature review from Medline and Cochrane Library online databases was performed using five terms individually or in combination. Articles not reporting diagnostic criteria employed and articles not written English were excluded. The results were analyzed by country, region, year of study, sample size, range of age, and prevalence rate. A total of 37 articles in English were selected from 1987 to 2014 and from those only 14 employed the EAPD's 2003 diagnostic criteria. The reported age range varied from 5.5 to 17 years; the most frequently range used was 7 to 9 years. A wide prevalence range from 2.8% to 44% was found and 82.61% of the articles reported calibrated examiners. Comparison among the results of the studies is difficult due to the use of different indexes and diagnostic criteria, the analysis variability, selection methods, and different age groups. In reality, we are probably far from knowing the real MIH prevalence.

  9. Modelling a critical infrastructure-driven spatial database for proactive disaster management: A developing country context

    PubMed Central

    Baloye, David O.

    2016-01-01

    The understanding and institutionalisation of the seamless link between urban critical infrastructure and disaster management has greatly helped the developed world to establish effective disaster management processes. However, this link is conspicuously missing in developing countries, where disaster management has been more reactive than proactive. The consequence of this is typified in poor response time and uncoordinated ways in which disasters and emergency situations are handled. As is the case with many Nigerian cities, the challenges of urban development in the city of Abeokuta have limited the effectiveness of disaster and emergency first responders and managers. Using geospatial techniques, the study attempted to design and deploy a spatial database running a web-based information system to track the characteristics and distribution of critical infrastructure for effective use during disaster and emergencies, with the purpose of proactively improving disaster and emergency management processes in Abeokuta.

  10. Cancer-Related Pain and Pain Management: Sources, Prevalence, and the Experiences of Children and Parents.

    PubMed

    Twycross, Alison; Parker, Roslyn; Williams, Anna; Gibson, Faith

    2015-01-01

    Advances in treatment mean children are increasingly cared for by their parents at home, leading to a shift in responsibility from health care professionals to parents. Little is known about parents' pain management experiences and the etiology of pain experienced by children with cancer especially when at home. A rapid review of the literature was undertaken investigating children's cancer-related pain, with emphasis on the management of pain outside the health care setting. Electronic databases were searched and a quality assessment was conducted. Forty-two articles were included. Despite advances in pain management techniques, children with cancer regularly cite pain as the most prevalent symptom throughout the cancer trajectory. The source of pain is usually treatment side effects or painful procedures. Parents find dealing with their child's pain distressing and demanding and may hold misconceptions about pain management. Findings indicate a need for more robust research into parental pain management leading to the development of effective pain management resources for parents. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  11. A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder.

    PubMed

    Dückers, Michel L A; Alisic, Eva; Brewin, Chris R

    2016-10-01

    Determinants of cross-national differences in the prevalence of mental illness are poorly understood. To test whether national post-traumatic stress disorder (PTSD) rates can be explained by (a) rates of exposure to trauma and (b) countries' overall cultural and socioeconomic vulnerability to adversity. We collected general population studies on lifetime PTSD and trauma exposure, measured using the WHO Composite International Diagnostic Interview (DSM-IV). PTSD prevalence was identified for 24 countries (86 687 respondents) and exposure for 16 countries (53 038 respondents). PTSD was predicted using exposure and vulnerability data. PTSD is related positively to exposure but negatively to country vulnerability. Together, exposure, vulnerability and their interaction explain approximately 75% of variance in the national prevalence of PTSD. Contrary to expectations based on individual risk factors, we identified a paradox whereby greater country vulnerability is associated with a decreased, rather than increased, risk of PTSD for its citizens. © The Royal College of Psychiatrists 2016.

  12. Prevalence and Survival Patterns of Patients with Bone Metastasis from Common Cancers in Thailand.

    PubMed

    Phanphaisarn, Areerak; Patumanond, Jayantorn; Settakorn, Jongkolnee; Chaiyawat, Parunya; Klangjorhor, Jeerawan; Pruksakorn, Dumnoensun

    2016-01-01

    Bone metastasis is a single condition but presents with various patterns and severities. Skeletal- related events (SREs) deteriorate overall performance status and reduce quality of life. However, guidelines for early detection and management are limited. This study includes a survey of the prevalence of bone metastasis in cases with common cancers in Thailand as well as a focus on survival patterns and SREs. A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University. The prevalence of bone metastasis from each type of primary cancer was noted and time-to-event analysis was performed to estimate cancer survival rates after bone metastasis. There were 29,447 cases of the ten most common cancers in Thailand, accounting for 82.2% of the entire cancer registry entries during the study period. Among those cases, there were 2,263 with bone metastases, accounting for 7.68% of entries. Bone metastasis from lung, liver, breast, cervix and prostate are common in the Thai population, accounting for 83.4% of all positive cases. The median survival time of all was 6 months. Of the bone metastases, 48.9% required therapeutic intervention, including treatment of spinal cord and nerve root compression, pathological fractures, and bone pain. The frequency of the top five types of bone metastasis in Thailand were different from the frequencies in other countries, but corresponded to the relative prevalence of the cancers in Thailand and osteophilic properties of each cancer. The results of this study support the establishment of country specific guidelines for primary cancer identification with skeletal lesions of unknown origin. In addition, further clinical studies of the top five bone metastases should be performed to develop guidelines for optimal patient management during palliative care.

  13. Prevalence of primary headache disorders in Fayoum Governorate, Egypt.

    PubMed

    El-Sherbiny, Naglaa A; Masoud, Mohamed; Shalaby, Nevin M; Shehata, Hatem S

    2015-01-01

    There is abundance of epidemiological studies of headache in developed and western countries; however, data in developing countries and in Egypt are still lacking. This study aims to detect the prevalence of primary headache disorders in both urban and rural sectors in Fayoum governorate, Egypt. A total of 2600 subjects were included using multi-stage stratified systematic random sampling, with respondent rate of 91.3 %. A pre-designed Arabic version, interviewer-administered, pilot tested structured questionnaire was developed according to The International Classification of Headache Disorders, 3rd edition (beta version), and this questionnaire was validated and the strength of agreement in headache diagnosis was good. The 1-year headache prevalence was 51.4 %, which was more prevalent in urban dwellers. The most common primary headache type was episodic tension type headache (prevalence; 24.5 %), followed by episodic migraine (prevalence; 17.3 %), both types peaked in midlife. Headache disorders were more common in females with exception of cluster headache that showed the expected male dominance. The risk of chronic headache increased more than one fold and half when the participants were females, married, and in those with high education. More than 60 % of our participants did not seek medical advice for their headaches problem; this percentage was higher in rural areas. Primary headache disorders are common in Egypt; prevalence rate was comparable with western countries with exception of episodic tension headache. Still headache is under-estimated and under-recognized in Egypt and this problem should be targeted by health care providers.

  14. Epidemiology of internet behaviors and addiction among adolescents in six Asian countries.

    PubMed

    Mak, Kwok-Kei; Lai, Ching-Man; Watanabe, Hiroko; Kim, Dong-Il; Bahar, Norharlina; Ramos, Milen; Young, Kimberly S; Ho, Roger C M; Aum, Na-Rae; Cheng, Cecilia

    2014-11-01

    Internet addiction has become a serious behavioral health problem in Asia. However, there are no up-to-date country comparisons. The Asian Adolescent Risk Behavior Survey (AARBS) screens and compares the prevalence of Internet behaviors and addiction in adolescents in six Asian countries. A total of 5,366 adolescents aged 12-18 years were recruited from six Asian countries: China, Hong Kong, Japan, South Korea, Malaysia, and the Philippines. Participants completed a structured questionnaire on their Internet use in the 2012-2013 school year. Internet addiction was assessed using the Internet Addiction Test (IAT) and the Revised Chen Internet Addiction Scale (CIAS-R). The variations in Internet behaviors and addiction across countries were examined. The overall prevalence of smartphone ownership is 62%, ranging from 41% in China to 84% in South Korea. Moreover, participation in online gaming ranges from 11% in China to 39% in Japan. Hong Kong has the highest number of adolescents reporting daily or above Internet use (68%). Internet addiction is highest in the Philippines, according to both the IAT (5%) and the CIAS-R (21%). Internet addictive behavior is common among adolescents in Asian countries. Problematic Internet use is prevalent and characterized by risky cyberbehaviors.

  15. Prevalence of gestational diabetes mellitus in Europe: A meta-analysis.

    PubMed

    Eades, Claire E; Cameron, Dawn M; Evans, Josie M M

    2017-07-01

    Estimates of the prevalence of gestational diabetes vary widely. It is important to have a clear understanding of the prevalence of this condition to be able to plan interventions and health care provision. This paper describes a meta-analysis of primary research data reporting the prevalence of gestational diabetes mellitus in the general pregnant population of developed countries in Europe. Four electronic databases were systematically searched in May 2016. English language articles reporting gestational diabetes mellitus prevalence using universal screening in general pregnant population samples from developed countries in Europe were included. All papers identified by the search were screened by one author, and then half screened independently by a second author and half by a third author. Data were extracted by one author. Values for the measures of interest were combined using a random effects model and analysis of the effects of moderator variables was carried out. A total of 3258 abstracts were screened, with 40 studies included in the review. Overall prevalence of gestational diabetes mellitus was 5.4% (3.8-7.8). Maternal age, year of data collection, country, area of Europe, week of gestation at testing, and diagnostic criteria were found to have a significant univariate effect on GDM prevalence, and area, week of gestation at testing and year of data collection remained statistically significant in multivariate analysis. Quality category was significant in multivariate but not univariate analysis. This meta-analysis shows prevalence of GDM that is at the upper end of previous estimates in Europe. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Prevalence of Nonalcoholic Fatty Liver Disease and Economy.

    PubMed

    Zhu, Jin-Zhou; Dai, Yi-Ning; Wang, Yu-Ming; Zhou, Qin-Yi; Yu, Chao-Hui; Li, You-Ming

    2015-11-01

    Nonalcoholic fatty liver disease (NAFLD) is a growing health issue around the world. This study is to investigate whether adult prevalence of NAFLD correlates with national economic status. Literature search on PubMed database was conducted to identify eligible records fully published before September 2014. Gross national income (GNI) per capita was chosen to evaluate national economic status. Pearson coefficient, linear regression, and unpaired t test were performed in the statistical analyses. Twenty-one population-based surveys (seven in East Asia, five in South Asia, three in Middle East, and six in Europe) were included. The pooled prevalence of NAFLD was 24.24%, and the global prevalence was positively correlated with GNI per capita (r = 0.4782, P = 0.0283). Europe witnessed a higher prevalence (28.04%) than Middle East (12.95%, P = 0.0092) and East Asia (19.24%, P = 0.0083). Male presented a higher prevalence than female (P = 0.019), especially in Europe (P = 0.0132) and in Caucasians (P = 0.0383). Furthermore, male prevalence and rural prevalence individually were correlated with economic status (r = 0.5725, P = 0.0257 and r = 0.7389, P = 0.0060). Lastly, the urban (23.93%) witnessed a higher prevalence than the rural or the urban + rural (12.65%, P = 0.0141) in the countries of GNI per capita <$10,000. This study suggested that countries with higher economic status tend to present a higher prevalence of NAFLD. It is believed to provide a distinctive epidemiologic perspective to global situation of NAFLD.

  17. The low prevalence of female smoking in the developing world: gender inequality or maternal adaptations for fetal protection?

    PubMed

    Hagen, Edward H; Garfield, Melissa J; Sullivan, Roger J

    2016-01-01

    Female smoking prevalence is dramatically lower in developing countries (3.1%) than developed countries (17.2%), whereas male smoking is similar (32% vs 30.1%). Low female smoking has been linked to high gender inequality. Alternatively, to protect their offspring from teratogenic substances, pregnant and lactating women appear to have evolved aversions to toxic plant substances like nicotine, which are reinforced by cultural proscriptions. Higher total fertility rates (TFRs) in developing countries could therefore explain their lower prevalence of female smoking. To compare the associations of TFR and gender inequality with national prevalence rates of female and male smoking. Data from a previous study of smoking prevalence vs gender inequality in 74 countries were reanalysed with a regression model that also included TFR. We replicated this analysis with three additional measures of gender equality and 2012 smoking data from 173 countries. A 1 SD increase in TFR predicted a decrease in female smoking prevalence by factors of 0.58-0.77, adjusting for covariates. TFR had a smaller and unexpected negative association with male smoking prevalence. Increased gender equality was associated with increased female smoking prevalence, and, unexpectedly, with decreased male smoking prevalence. TFR was also associated with an increase in smoking prevalence among postmenopausal women. High TFR and gender inequality both predict reduced prevalence of female smoking across nations. In countries with high TFR, adaptations and cultural norms that protect fetuses from plant toxins might suppress smoking among frequently pregnant and lactating women. © The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

  18. Diabetes self-management arrangements in Europe: a realist review to facilitate a project implemented in six countries.

    PubMed

    Kousoulis, Antonis A; Patelarou, Evridiki; Shea, Sue; Foss, Christina; Ruud Knutsen, Ingrid A; Todorova, Elka; Roukova, Poli; Portillo, Mari Carmen; Pumar-Méndez, María J; Mujika, Agurtzane; Rogers, Anne; Vassilev, Ivaylo; Serrano-Gil, Manuel; Lionis, Christos

    2014-10-02

    Self-management of long term conditions can promote quality of life whilst delivering benefits to the financing of health care systems. However, rarely are the meso-level influences, likely to be of direct relevance to these desired outcomes, systematically explored. No specific international guidelines exist suggesting the features of the most appropriate structure and organisation of health care systems within which to situate self-management approaches and practices. This review aimed to identify the quantitative literature with regard to diabetes self-management arrangements currently in place within the health care systems of six countries (The United Kingdom, The Netherlands, Norway, Spain, Bulgaria, and Greece) and explore how these are integrated into the broader health care and welfare systems in each country. The methodology for a realist review was followed. Publications of interest dating from 2000 to 2013 were identified through appropriate MeSH terms by a systematic search in six bibliographic databases. A search diary was maintained and the studies were assessed for their quality and risk of bias. Following the multi-step search strategy, 56 studies were included in the final review (the majority from the UK) reporting design methods and findings on 21 interventions and programmes for diabetes and chronic disease self-management. Most (11/21, 52%) of the interventions were designed to fit within the context of primary care. The majority (11/21, 52%) highlighted behavioural change as an important goal. Finally, some (5/21, 24%) referred explicitly to Internet-based tools. This review is based on results which are derived from a total of at least 5,500 individuals residing in the six participating countries. It indicates a policy shift towards patient-centred self-management of diabetes in a primary care context. The professional role of diabetes specialist nurses, the need for multidisciplinary approaches and a focus on patient education emerge as

  19. Health Care Provision for People with Diabetes and Postgraduate Training of Diabetes Specialists in Eastern European Countries

    PubMed Central

    Doničová, Viera; Brož, Jan; Sorin, Iocara

    2011-01-01

    Background In many eastern European countries, information is limited regarding (1) prevalence of diabetes and its complications, (2) health care provisions for diabetes, (3) diabetes management, and (4) the structure of postgraduate training in diabetes for doctors and nurses. These have been reviewed here. Methods Source material was derived from publications and through personal communication with diabetes specialists in leading clinical centers in Bulgaria, the Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, and Ukraine. Results In many countries, information about diabetes prevalence is incomplete or inaccurate with many undiagnosed cases but varies from 7.7–9.6%. Diabetic complications and adverse outcomes (blindness, amputation, and chronic renal failure) are common, with a high mortality resulting from cardiovascular disease. State-funded and private systems often exist side by side. Diabetes care is provided by diabetologists, endocrinologists, internal medicine physicians, and general practitioners, but their involvement varies considerably between countries and some have too few specialists who are located only in large centers. Specialized dietetics and foot care services are, in general, poorly developed. Insulin is freely available although analogs may incur a cost to the patient, while newer drugs (glucagon-like peptide-1 agonists, dipeptidyl peptidase-4 inhibitors) are either expensive or unavailable. Glucose monitoring is often rationed. Postgraduate training in diabetes is now well established in most countries and specialist training for nurses is being developed. Conclusions Continuing disparities with western European countries are related mainly to deficient economic resources and inadequate financial investment. Some countries have introduced national programs to improve diabetes care with better clinical outcomes being obtained following treatment initiatives. PMID:22027305

  20. Regulating the sustainability of forest management in the Americas: Cross-country comparisons of forest legislation

    Treesearch

    Kathleen McGinley; Raquel Alvarado; Frederick Cubbage; Diana Diaz; Pablo J. Donoso; Laercio Antonio Jacovine Goncalves; Fabiano Luiz de Silva; Charles MacIntyre; Elizabeth Monges Zalazar

    2012-01-01

    Based on theoretical underpinnings and an empirical review of forest laws and regulations of selected countries throughout the Americas, we examine key components of natural forest management and how they are addressed in the legal frameworks of Argentina, Brazil, Chile, Costa Rica, Guatemala, Nicaragua, Paraguay, Uruguay, and the U.S. We consider forest policy...

  1. Sytematic review and meta-analysis of prevalence of hepatitis B in India.

    PubMed

    Batham, Ashish; Narula, Dherian; Toteja, Tanmay; Sreenivas, V; Puliyel, Jacob M

    2007-09-01

    To evaluate the point prevalence of Hepatitis B in India. Meta-analysis of data on point prevalence from different parts of the country. Searches were made in Medline, Cochrane Library and Best bets and previous reviews. A limited hand search of cross references was also done. Finally a consultation with experts was held to enlarge the references base. Studies reporting prevalence of HBsAg were selected. Data from high risk groups were excluded. 54 papers reporting data on 61 populations were identified. The true prevalence for each study was calculated from the reported prevalence using the specificity and sensitivity of the test employed. The true prevalence in non-tribal populations is 2.4% (95% CI: 2.2%-2.7%). True prevalence among tribal populations is 15.9% (CI: 11.4%-20.4%). These figures may be useful in estimation of the burden of the disease in the country and for projecting the cost-benefits of immunization.

  2. Population aging, macroeconomic changes, and global diabetes prevalence, 1990-2008.

    PubMed

    Sudharsanan, Nikkil; Ali, Mohammed K; Mehta, Neil K; Narayan, K M Venkat

    2015-01-01

    Diabetes is an important contributor to global morbidity and mortality. The contributions of population aging and macroeconomic changes to the growth in diabetes prevalence over the past 20 years are unclear. We used cross-sectional data on age- and sex-specific counts of people with diabetes by country, national population estimates, and country-specific macroeconomic variables for the years 1990, 2000, and 2008. Decomposition analysis was performed to quantify the contribution of population aging to the change in global diabetes prevalence between 1990 and 2008. Next, age-standardization was used to estimate the contribution of age composition to differences in diabetes prevalence between high-income (HIC) and low-to-middle-income countries (LMICs). Finally, we used non-parametric correlation and multivariate first-difference regression estimates to examine the relationship between macroeconomic changes and the change in diabetes prevalence between 1990 and 2008. Globally, diabetes prevalence grew by two percentage points between 1990 (7.4 %) and 2008 (9.4 %). Population aging was responsible for 19 % of the growth, with 81 % attributable to increases in the age-specific prevalences. In both LMICs and HICs, about half the growth in age-specific prevalences was from increasing levels of diabetes between ages 45-65 (51 % in HICs and 46 % in LMICs). After age-standardization, the difference in the prevalence of diabetes between LMICs and HICs was larger (1.9 % point difference in 1990; 1.5 % point difference in 2008). We found no evidence that macroeconomic changes were associated with the growth in diabetes prevalence. Population aging explains a minority of the recent growth in global diabetes prevalence. The increase in global diabetes between 1990 and 2008 was primarily due to an increase in the prevalence of diabetes at ages 45-65. We do not find evidence that basic indicators of economic growth, development, globalization, or urbanization were related

  3. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study.

    PubMed

    Tu, Karen; Chen, Zhongliang; Lipscombe, Lorraine L

    2008-05-20

    Researchers have predicted that there will be a relative increase of 24% in the prevalence of hypertension in developed countries from 2000 to 2025. Hypertension is a leading risk factor for death, stroke, cardiovascular disease and renal disease. Thus, accurate estimates of the prevalence of hypertension in a population have important implications for public policy. We sought to assess whether the estimated increase in the prevalence of hypertension has been underestimated. We performed a population-based cohort study using linked administrative data for adults aged 20 years and older in Ontario, Canada's most populous province with more than 12 million residents. Using a validated case-definition algorithm for hypertension, we examined trends in prevalence from 1995 to 2005 and in incidence from 1997 to 2004. The number of adults with hypertension more than doubled from 1995 to 2005. The age- and sex-adjusted prevalence increased from 153.1 per 1000 adults in 1995 to 244.8 per 1000 in 2005, which was a relative increase of 60.0% (p < 0.001). The age- and sex-adjusted incidence of hypertension increased from 25.5 per 1000 adults in 1997 to 32.1 per 1000 in 2004, which was a relative increase of 25.7% (p < 0.001). Our findings indicate that the rise in hypertension prevalence will likely far exceed the predicted prevalence for 2025. Public health strategies to prevent and manage hypertension and its sequelae are urgently needed.

  4. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study

    PubMed Central

    Tu, Karen; Chen, Zhongliang; Lipscombe, Lorraine L.

    2008-01-01

    Background Researchers have predicted that there will be a relative increase of 24% in the prevalence of hypertension in developed countries from 2000 to 2025. Hypertension is a leading risk factor for death, stroke, cardiovascular disease and renal disease. Thus, accurate estimates of the prevalence of hypertension in a population have important implications for public policy. We sought to assess whether the estimated increase in the prevalence of hypertension has been underestimated. Methods We performed a population-based cohort study using linked administrative data for adults aged 20 years and older in Ontario, Canada's most populous province with more than 12 million residents. Using a validated case-definition algorithm for hypertension, we examined trends in prevalence from 1995 to 2005 and in incidence from 1997 to 2004. Results The number of adults with hypertension more than doubled from 1995 to 2005. The age-and sex-adjusted prevalence increased from 153.1 per 1000 adults in 1995 to 244.8 per 1000 in 2005, which was a relative increase of 60.0% (p < 0.001). The age-and sex-adjusted incidence of hypertension increased from 25.5 per 1000 adults in 1997 to 32.1 per 1000 in 2004, which was a relative increase of 25.7% (p < 0.001). Interpretation Our findings indicate that the rise in hypertension prevalence will likely far exceed the predicted prevalence for 2025. Public health strategies to prevent and manage hypertension and its sequelae are urgently needed. PMID:18490638

  5. A narrative literature review of depression following traumatic brain injury: prevalence, impact, and management challenges.

    PubMed

    Juengst, Shannon B; Kumar, Raj G; Wagner, Amy K

    2017-01-01

    Depression is one of the most common conditions to emerge after traumatic brain injury (TBI), and despite its potentially serious consequences it remains undertreated. Treatment for post-traumatic depression (PTD) is complicated due to the multifactorial etiology of PTD, ranging from biological pathways to psychosocial adjustment. Identifying the unique, personalized factors contributing to the development of PTD could improve long-term treatment and management for individuals with TBI. The purpose of this narrative literature review was to summarize the prevalence and impact of PTD among those with moderate to severe TBI and to discuss current challenges in its management. Overall, PTD has an estimated point prevalence of 30%, with 50% of individuals with moderate to severe TBI experiencing an episode of PTD in the first year after injury alone. PTD has significant implications for health, leading to more hospitalizations and greater caregiver burden, for participation, reducing rates of return to work and affecting social relationships, and for quality of life. PTD may develop directly or indirectly as a result of biological changes after injury, most notably post-injury inflammation, or through psychological and psychosocial factors, including pre injury personal characteristics and post-injury adjustment to disability. Current evidence for effective treatments is limited, although the strongest evidence supports antidepressants and cognitive behavioral interventions. More personalized approaches to treatment and further research into unique therapy combinations may improve the management of PTD and improve the health, functioning, and quality of life for individuals with TBI.

  6. Parasites, democratization, and the liberalization of values across contemporary countries.

    PubMed

    Thornhill, Randy; Fincher, Corey L; Aran, Devaraj

    2009-02-01

    The countries of the world vary in their position along the autocracy-democracy continuum of values. Traditionally, scholars explain this variation as based on resource distribution and disparity among nations. We provide a different framework for understanding the autocracy-democracy dimension and related value dimensions, one that is complementary (not alternative) to the research tradition, but more encompassing, involving both evolutionary (ultimate) and proximate causation of the values. We hypothesize that the variation in values pertaining to autocracy-democracy arises fundamentally out of human (Homo sapiens) species-typical psychological adaptation that manifests contingently, producing values and associated behaviours that functioned adaptively in human evolutionary history to cope with local levels of infectious diseases. We test this parasite hypothesis of democratization using publicly available data measuring democratization, collectivism-individualism, gender egalitarianism, property rights, sexual restrictiveness, and parasite prevalence across many countries of the world. Parasite prevalence across countries is based on a validated index of the severity of 22 important human diseases. We show that, as the hypothesis predicts, collectivism (hence, conservatism), autocracy, women's subordination relative to men's status, and women's sexual restrictiveness are values that positively covary, and that correspond with high prevalence of infectious disease. Apparently, the psychology of xenophobia and ethnocentrism links these values to avoidance and management of parasites. Also as predicted, we show that the antipoles of each of the above values--individualism (hence, liberalism), democracy, and women's rights, freedom and increased participation in casual sex--are a positively covarying set of values in countries with relatively low parasite stress. Beyond the cross-national support for the parasite hypothesis of democratization, it is consistent with

  7. A systematic review of the worldwide prevalence of survivors of poliomyelitis reported in 31 studies

    PubMed Central

    Balalla, Shivanthi; Theadom, Alice; Jackman, Gordon; Feigin, Valery L

    2017-01-01

    Background Accurate prevalence figures estimating the number of survivors of poliomyelitis (disease causing acute flaccid paralysis) following poliovirus infection are not available. We aim to undertake a systematic review of all literature concerning the prevalence of survivors of poliomyelitis. Methods Electronic databases were searched from 1900 up to May 2016 for peer-reviewed studies using a population-based approach witha defined denominator and some form of diagnostic or clinical verification of polio. Exclusion criteria were any prevalence data that were unable to be extracted or calculated and studies reporting on incidence only. The quality of each included study was assessed using an existing tool modified for use in prevalence studies. Average crude prevalence rates were used to calculate worldwide estimates. Results Thirty-one studies met criteria with 90% of studies conducted in low-income to lower middle-income countries. Significant variability in the prevalence of survivors of poliomyelitis was revealed, in low- income to lower middle-income (15 per 100 000 in Nigeria to 1733 in India) and upper-middle to high-income countries (24 (Japan) to 380 per 100 000 (Brazil). The total combined prevalence of survivors of poliomyelitis for those studies at low to moderate risk of bias ranged from 165 (high-income countries) to 425 (low-income to lower middle-income countries) per 100 000 person-years. Historical lameness surveys of children predominated, with wide variation in case definition and assessment criteria, and limited relevance to current prevalence given the lack of incidence of poliovirus infection in the ensuing years. Conclusions These results highlight the need for future epidemiological studies of poliomyelitis to examine nationally representative samples, including all ages and greater focus on high-income countries. Such efforts will improve capacity to provide reliable and more robust worldwide prevalence estimates. PMID:28694346

  8. Prevalence of Amblyopia in School-Aged Children and Variations by Age, Gender, and Ethnicity in a Multi-Country Refractive Error Study.

    PubMed

    Xiao, Ou; Morgan, Ian G; Ellwein, Leon B; He, Mingguang

    2015-09-01

    To estimate the age-, gender-, and ethnicity-specific prevalence of amblyopia in children aged 5 to 15 years using data from the multi-country Refractive Error Study in Children (RESC). Population-based, cross-sectional study. Among 46 260 children aged 5 to 15 years who were enumerated from 8 sites in the RESC study, 39 551 had a detailed ocular examination and a reliable visual acuity (VA) measurement in 1 or both eyes. Information on ethnicity was available for 39 321 of these participants. This study focused on findings from the 39 321 children. The examination included VA measurements, evaluation of ocular alignment and refractive error under cycloplegia, and examination of the external eye, anterior segment, media, and fundus. The proportion of children aged 5 to 15 years with amblyopia in different ethnic cohorts. Amblyopia was defined as best-corrected visual acuity (BCVA) of ≤20/40 in either eye, with tropia, anisometropia (≥2 spherical equivalent diopters [D]), or hyperopia (≥+6 spherical equivalent D), after excluding children with fundus or anterior segment abnormalities. The overall prevalence of amblyopia was 0.74% (95% confidence interval, 0.64-0.83) with significant (P < 0.001) variation across ethnic groups: 1.43% in Hispanic, 0.93% in Chinese, 0.62% in Indian, 0.52% in Malay, 0.35% in Nepali, and 0.28% in African children. Amblyopia was not associated with age or gender. The most common cause of amblyopia was anisometropia. In this study, the prevalence of amblyopia varied with ethnicity and was highest in Hispanic children and lowest in African children. Most cases were unilateral and developed before the age of 5 years. The impact of changes of definitions on prevalence estimates is discussed. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  9. The Double Burden of Undernutrition and Overnutrition in Developing Countries: an Update.

    PubMed

    Abdullah, Asnawi

    2015-09-01

    Many developing countries have achieved a remarkable improvement in nutrition status in the past decades. However, the prevalence of undernutrition remains a serious problem. At the same time, the prevalence of obesity is increasing substantially, and in some countries, it has approached that of developed countries. This article provides an update on this double burden of malnutrition (DBMN) in developing nations. One hundred countries (lower, middle-lower, and upper-middle income countries) were selected and analysed, and to support the analysis, a systematic review of current published studies was performed. The results show that DBMN already exists in almost all developing countries and that the DBMN ratio (i.e., overweight/underweight) has increased as income per capita has increased. DBMN may manifest within the community, household, or individual. In addition to common factors, poor nutrition in early childhood is suggested as another important driving factor behind the rising obesity rate in most developing countries. A life-course approach has been proposed to prevent undernutrition and overnutrition and should be integrated into the development of health systems to control double burden in developing countries.

  10. Prevalence and clinical profile of microcephaly in South America pre-Zika, 2005-14: prevalence and case-control study

    PubMed Central

    Dolk, Helen; Lopez-Camelo, Jorge S; Mattos, Daniel; Poletta, Fernando A; Dutra, Maria G; Carvalho, Flavia M; Castilla, Eduardo E

    2017-01-01

    Objective To describe the prevalence and clinical spectrum of microcephaly in South America for the period 2005-14, before the start of the Zika epidemic in 2015, as a baseline for future surveillance as the Zika epidemic spreads and as other infectious causes may emerge in future. Design Prevalence and case-control study. Data sources ECLAMC (Latin American Collaborative Study of Congenital Malformations) database derived from 107 hospitals in 10 South American countries, 2005 to 2014. Data on microcephaly cases, four non-malformed controls per case, and all hospital births (all births for hospital based prevalence, resident within municipality for population based prevalence). For 2010-14, head circumference data were available and compared with Intergrowth charts. Results 552 microcephaly cases were registered, giving a hospital based prevalence of 4.4 (95% confidence interval 4.1 to 4.9) per 10 000 births and a population based prevalence of 3.0 (2.7 to 3.4) per 10 000. Prevalence varied significantly between countries and between regions and hospitals within countries. Thirty two per cent (n=175) of cases were prenatally diagnosed; 29% (n=159) were perinatal deaths. Twenty three per cent (n=128) were associated with a diagnosed genetic syndrome, 34% (n=189) polymalformed without a syndrome diagnosis, 12% (n=65) with associated neural malformations, and 26% (n=145) microcephaly only. In addition, 3.8% (n=21) had a STORCH (syphilis, toxoplasmosis, other including HIV, rubella, cytomegalovirus, and herpes simplex) infection diagnosis and 2.0% (n=11) had consanguineous parents. Head circumference measurements available for 184/235 cases in 2010-14 showed 45% (n=82) more than 3 SD below the mean, 24% (n=44) between 3 SD and 2 SD below the mean, and 32% (n=58) larger than −2 SD. Conclusion Extrapolated to the nearly 7 million annual births in South America, an estimated 2000-2500 microcephaly cases were diagnosed among births each year before the Zika

  11. Prevalence, Characteristics, Management, and Outcome of Pulmonary Tuberculosis in HIV-Infected Children in the TREAT Asia Pediatric HIV Observational Database (TApHOD)

    PubMed Central

    Sudjaritruk, Tavitiya; Maleesatharn, Alan; Prasitsuebsai, Wasana; Fong, Siew Moy; Le, Ngoc Oanh; Le, Thanh Thuy Thi; Lumbiganon, Pagakrong; Kumarasamy, Nagalingeswaran; Kurniati, Nia; Hansudewechakul, Rawiwan; Yusoff, Nik Khairulddin Nik; Razali, Kamarul Azahar Mohd; Kariminia, Azar; Sohn, Annette H.

    2013-01-01

    Abstract A multicenter, retrospective, observational study was conducted to determine prevalence, characteristics, management, and outcome of pulmonary tuberculosis (PTB) in Asian HIV-infected children in the TREAT Asia Pediatric HIV Observational Database (TApHOD). Data on PTB episodes diagnosed during the period between 12 months before antiretroviral therapy (ART) initiation and December 31, 2009 were extracted. A total of 2678 HIV-infected children were included in TApHOD over a 13-year period; 457 developed PTB, giving a period prevalence of 17.1% (range 5.7–33.0% per country). There were a total of 484 PTB episodes; 27 children had 2 episodes each. There were 21 deaths (4.3%). One third of episodes (n=175/484) occurred after ART initiation at a median of 14.1 months (interquartile range [IQR] 2.5–28.8 months). The median (IQR) CD4+ values were 9.0% (3.0–16.0%) and 183.5 (37.8–525.0) cells/mm3 when PTB was diagnosed. Most episodes (n=424/436, 97.3%) had abnormal radiographic findings compatible with PTB, whereas half (n=267/484, 55.2%) presented with clinical characteristics of PTB. One third of those tested (n=42/122, 34.4%) had bacteriological evidence of PTB. Of the 156 episodes (32.2%) that were accompanied with extrapulmonary TB, pleuritis was the most common manifestation (81.4%). After treatment completion, most episodes (n=396/484, 81.9%) were recorded as having positive outcomes (cured, treatment completed and child well, and improvement). The prevalence of PTB among Asian HIV-infected children in our cohort was high. Children with persistent immunosuppression remain vulnerable to PTB even after ART initiation. PMID:24206012

  12. Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review.

    PubMed

    Workneh, Mahteme Haile; Bjune, Gunnar Aksel; Yimer, Solomon Abebe

    2017-01-01

    The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health concern. There is mounting evidence from different countries on the burden of TB and DM comorbidity. The objective of this systematic review was to summarize the existing evidence on prevalence and associated/risk factors of TBDM comorbidity at global and regional levels. Ovid Medline, Embase, Global health, Cochrane library, Web of science and Scopus Elsevier databases were searched to identify eligible articles for the systematic review. Data were extracted using standardized excel form and pilot tested. Median with interquartile range (IQR) was used to estimate prevalence of TBDM comorbidity. Associated/risk factors that were identified from individual studies were thematically analyzed and described. The prevalence of DM among TB patients ranged from 1.9% to 45%. The overall median global prevalence was 16% (IQR 9.0%-25.3%) Similarly, the prevalence of TB among DM patients ranged from 0.38% to 14% and the overall median global prevalence was 4.1% (IQR 1.8%-6.2%). The highest prevalence of DM among TB patients is observed in the studied countries of Asia, North America and Oceania. On the contrary, the prevalence of TB among DM patients is low globally, but relatively higher in the studied countries of Asia and the African continents. Sex, older age, urban residence, tobacco smoking, sedentary lifestyle, poor glycemic control, having family history of DM and TB illness were among the variables identified as associated/risk factors for TBDM comorbidity. This systematic review revealed that there is a high burden of DM among TB patients at global level. On the contrary, the global prevalence of TB among DM patients is low. Assessing the magnitude and risk/associated factors of TBDM comorbidity at country/local level is crucial before making decisions to undertake TBDM integrated services.

  13. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection.

    PubMed

    Zamani, M; Ebrahimtabar, F; Zamani, V; Miller, W H; Alizadeh-Navaei, R; Shokri-Shirvani, J; Derakhshan, M H

    2018-04-01

    The epidemiology of Helicobacter pylori infection is poorly understood. To establish the reported regional and national prevalence of H. pylori infection, stratified by age and gender. All relevant English publications from 2000 to 2017 cited by PubMed and Scopus were retrieved using comprehensive combinations of keywords. The overall prevalence of H. pylori was estimated using both random effect and fixed effect meta-analyses, and presented as prevalence rate (% and 95% CI). The analyses were extended by separation into gender and age groups. A total of 14 056 records were obtained initially. After applying exclusion criteria in several steps, 183 studies were selected. Analysis of 410 879 participants from 73 countries in six continents revealed an overall prevalence of 44.3% (95% CI: 40.9-47.7) worldwide. This rate ranged from 50.8% (95% CI: 46.8-54.7) in developing countries compared with 34.7% (95% CI: 30.2-39.3) in developed countries. The global H. pylori infection rate was 42.7% (95% CI: 39-46.5) in females compared to 46.3% (95% CI: 42.1-50.5) in males. The prevalence in adults (≥18 years) was significantly higher than in children (48.6% [95% CI: 43.8-53.5] vs 32.6% [95% CI: 28.4-36.8], respectively). There was a statistically nonsignificant decrease in the prevalence in 2009-2016 compared with the 2000-2009 period. The observed differences between countries appear to be due to economic and social conditions. H. pylori infection can be a benchmark for the socioeconomic and health status of a country. Further studies are suggested to investigate the natural history of the acquisition of H. pylori infection from childhood into adult life. © 2018 John Wiley & Sons Ltd.

  14. Prevalence and associated risk factors of violence against conflict–affected female adolescents: a multi–country, cross–sectional study

    PubMed Central

    Stark, Lindsay; Asghar, Khudejha; Yu, Gary; Bora, Caroline; Baysa, Asham Assazenew; Falb, Kathryn L

    2017-01-01

    Background Over half of displaced civilians in humanitarian emergencies are children, and these settings pose unique threats to children’s safety with long–lasting consequences. Our study broadens the limited evidence on violence against adolescent girls in emergencies by estimating prevalence and predictors of violence among adolescent girls aged 13–14 in South Kivu, Democratic Republic of the Congo (DRC), and aged 13–19 in refugee camps in the Benishangul–Gumuz region of Ethiopia. Methods Survey data were collected from a sample of 1296 adolescent girls using Computer–Assisted Personal Interview and Audio Computer–Assisted Self–Interview programming. Predictors of violence were modeled using multivariable logistic regression. Results The majority of adolescent girls (51.62%) reported experiencing at least one form of violence victimization in the previous 12 months: 31.78% reported being hit or beaten, 36.79% reported being screamed at loudly or aggressively, and 26.67% experienced unwanted sexual touching, forced sex, and/or sexual coercion. Across both countries, ever having a boyfriend and living with an intimate partner were strong predictors of violence. Fewer years of education completed in DRC, and young age in Ethiopia, were also associated with reported victimization. Conclusions Prevalence of violence against adolescent girls is high in these two conflict–affected contexts. Findings indicate a need for programs targeting younger populations, broader efforts to address different forms of victimization, and increased recognition of intimate partners and caregivers as perpetrators of violence in conflict–affected settings. PMID:28607672

  15. Physician perspectives on the burden and management of asthma in six countries: The Global Asthma Physician Survey (GAPS).

    PubMed

    Chapman, Kenneth R; Hinds, David; Piazza, Peter; Raherison, Chantal; Gibbs, Michael; Greulich, Timm; Gaalswyk, Kenneth; Lin, Jiangtao; Adachi, Mitsuru; Davis, Kourtney J

    2017-11-23

    Despite recognition of asthma as a growing global issue and development of global guidelines, asthma treatment practices vary between countries. Several studies have reported patients' perspectives on asthma control. This study presents physicians' perspectives and strategies for asthma management. Physicians seeing ≥4 adult patients with asthma per month in Australia, Canada, China, France, Germany, and Japan were surveyed (N=1809; ≈300 per country). A standardised questionnaire was developed for this study and administered by telephone, online or face-to-face. Statistics were weighted to account for the sampling scheme. Physicians estimated that 71% of their adult patients received maintenance medication, with adherence monitored by 76-97% of physicians. Perceived major barriers to patient adherence included: patients taking treatment as needed; acceptance of symptoms; and patients not perceiving treatment benefits. Written action plans (37%) and technology (15%) were seldom employed by physicians to aid patients' asthma management. Physicians rarely (10%) used validated patient-reported questionnaires to monitor asthma control, instead monitoring selected symptoms, exacerbations, and/or lung function measurements. Awareness of single maintenance and reliever therapy (SMART/MART) varied among countries (56-100%); although most physicians (72%) had prescribed SMART/MART, the majority (91%) co-prescribed a short-acting bronchodilator at least some of the time. These results show that physicians generally do not employ standardised tools to monitor asthma control or to manage its treatment and that despite high awareness of SMART/MART, the strategy appears to be commonly misapplied. Better education for patients and physicians is required to improve asthma management and resulting patient outcomes.

  16. [Prevalence of trachoma in Brazilian schoolchildren].

    PubMed

    Lopes, Maria de Fátima Costa; Luna, Expedito José de Albuquerque; Medina, Norma Helen; Cardoso, Maria Regina Alves; Freitas, Helen Selma de Abreu; Koizumi, Inês Kazue; Bernardes, Neusa Aparecida Ferreira Alves; Guimarães, José Alfredo

    2013-06-01

    To estimate the prevalence and describe the distribution of trachoma among schoolchildren in Brazilian municipalities. Cross-sectional study, using cluster sampling, of the schoolchildren population of the Brazilian municipalities with Human Development Index - Municipal lower than the national average. This trachoma prevalence survey was conducted by the Ministry of Health, in the period 2002-2007. There were 119,531 schoolchildren selected from 2,270 schools located in 1,156 municipalities. The selected schoolchildren underwent an external ocular examination, with a magnifying glass (2.5X), to detect clinical signs of trachoma according to the WHO criteria. The prevalence of trachoma, by state and national level, and their respective 95% confidence intervals were estimated. Chi-square and Chi-square for trends tests were used to compare categorical variables. There were 6,030 cases of trachoma detected, resulting in a prevalence of 5.0% (95%CI 4.5;5.4). There was no significant difference between the sexes. The prevalence of trachoma was 8.2% among children under 5 years of age, decreasing among higher age groups (p < 0.01). There was a significant difference in prevalence between urban and rural areas, 4.3% versus 6.2% respectively (p < 0.01). Cases were detected in 901 municipalities (77.7% of the sample), in all regions of the country. In 36.8% of the selected municipalities, the prevalence was higher than 5%. The study shows that trachoma is a significant public health problem in Brazil, contradicting the belief that the disease had been controlled in the country. The survey provides a baseline for evaluating planned interventions aimed at achieving the goal of global certification of elimination of trachoma as a cause of blindness in Brazil by 2020.

  17. Disparity in ST-segment Elevation Myocardial Infarction Practices and Outcomes in Arabian Gulf Countries (Gulf COAST Registry)

    PubMed Central

    Zubaid, Mohammad; Rashed, Wafa; Alsheikh-Ali, Alawi A.; Garadah, Taysir; Alrawahi, Najib; Ridha, Mustafa; Akbar, Mousa; Alenezi, Fahad; Alhamdan, Rashed; Almahmeed, Wael; Ouda, Hussam; Al-Mulla, Arif; Baslaib, Fahad; Shehab, Abdulla; Alnuaimi, Abdulla; Amin, Haitham

    2017-01-01

    Objectives: The objective of this study is to describe contemporary management and 1-year outcomes of patients hospitalized with ST-segment elevation myocardial infarction (STEMI) in Arabian Gulf countries. Methods: Data of patients admitted to 29 hospitals in four Gulf countries [Bahrain, Kuwait, Oman, United Arab Emirates (UAE)] with the diagnosis of STEMI were analyzed from Gulf locals with acute coronary syndrome (ACS) events (Gulf COAST) registry. This was a longitudinal, observational registry of consecutive citizens, admitted with ACS from January 2012 to January 2013. Patient management and outcomes were analyzed and compared between the four countries. Results: A total of 1039 STEMI patients were enrolled in Gulf COAST Registry. The mean age was 58 years, and there was a high prevalence of diabetes (47%). With respect to reperfusion, 10% were reperfused with primary percutaneous coronary intervention, 66% with fibrinolytic therapy and 24% were not reperfused. Only one-third of patients who received fibrinolytic therapy had a door-to-needle time of 30 min or less. The in-hospital mortality rate was 7.4%. However, we noted a significant regional variability in mortality rate (3.8%-11.9%). In adjusted analysis, patients from Oman were 4 times more likely to die in hospital as compared to patients from Kuwait. Conclusions: In the Gulf countries, fibrinolytic therapy is the main reperfusion strategy used in STEMI patients. Most patients do not receive this therapy according to timelines outlined in recent practice guidelines. There is a significant discrepancy in outcomes between the countries. Quality improvement initiatives are needed to achieve better adherence to management guidelines and close the gap in outcomes. PMID:28706594

  18. Specificities of Ischemic Stroke Risk Factors in Arab-Speaking Countries.

    PubMed

    Abboud, Halim; Sissani, Leila; Labreuche, Julien; Arauz, Antonio; Bousser, Marie-Germaine; Bryer, Alain; Chamorro, Angel; Fisher, Marc; Ford, Ian; Fox, Kim M; Hennerici, Michael G; Lavados, Pablo M; Massaro, Ayrton; Mattle, Heinrich P; Munoz Collazos, Mario; Rothwell, Peter M; Steg, Philippe Gabriel; Vicaut, Eric; Yamouth, Bassem; Amarenco, Pierre

    2017-01-01

    Stroke is largely preventable, and therefore, a better understanding of risk factors is an essential step in reducing the population stroke rate and resulting disease burden in Arab countries. We performed 2 separate analyses in 2 similar populations of patients with noncardioembolic ischemic stroke. This first involved 3,635 patients in the Outcomes in Patients with TIA and Cerebrovascular disease (OPTIC) registry (followed for 2 years), with baseline collection of the usual risk factors and 5 socioeconomic variables (unemployment status, residence in rural area, living in fully serviced accommodation, no health-insurance coverage, and low educational level). The second involved patients in the PERFORM trial (n = 19,100 followed up for 2 years), with baseline collection of the usual risk factors and 1 socioeconomic variable (low educational level). The primary outcome was a composite of nonfatal stroke, nonfatal myocardial infarction, or cardiovascular death. Stroke risk factors were more prevalent in patients in Arab countries. The incidence of major cardiovascular events (MACE; age- and gender-adjusted) was higher in Arab countries (OPTIC, 18.5 vs. 13.3%; PERFORM, 18.4 vs. 9.7%; both p ≤ 0.0001). These results remained significant after adjustment on risk factors and were attenuated in OPTIC after further adjustment on socioeconomic variables (hazard ratio 1.24; 95% CI 0.98-1.55; p = 0.07). Key Messages: Patients with ischemic stroke living in Arab countries had a lower mean socioeconomic status, a much higher prevalence of diabetes mellitus, and a higher rate of MACE compared with patients from non-Arab countries. This finding is partly explained by a higher prevalence of risk factors and also by a high prevalence of poverty and low educational level. © 2017 S. Karger AG, Basel.

  19. Governance, Management and Accountability: The Experience of the School System in the English-Speaking Caribbean Countries

    ERIC Educational Resources Information Center

    Hutton, Disraeli M.

    2015-01-01

    This paper seeks to explore the implementation of three of the critical elements required to improve performance in the education system: governance, accountability and management. The paper examines the education reform processes conducted by five Caribbean countries: Jamaica, Cayman Islands, Guyana, Belize, Trinidad and Tobago, along with those…

  20. Prevalence and management of familial hypercholesterolaemia in coronary patients: An analysis of EUROASPIRE IV, a study of the European Society of Cardiology.

    PubMed

    De Backer, Guy; Besseling, Joost; Chapman, John; Hovingh, G Kees; Kastelein, John J P; Kotseva, Kornelia; Ray, Kausik; Reiner, Željko; Wood, David; De Bacquer, Dirk

    2015-07-01

    Familial hypercholesterolaemia (FH) is a hereditary disorder predisposing to premature coronary heart disease (CHD) and is until now mainly diagnosed clinically on the basis of a classical phenotype. Its prevalence varies and is estimated around 1 in 200-500; in patients with established CHD the prevalence is less well documented. In EUROASPIRE IV data were collected in coronary patients from 24 European countries by means of a standardized interview, bioclinical examination and venous blood sampling. Potential FH was estimated using an adapted version of the Dutch Lipid Clinic Network Criteria. Among the 7044 patients eligible for analysis, the prevalence of potential FH was 8.3%; 7.5% in men and 11.1% in women. The prevalence was inversely related to age with a putative prevalence of 1:5 in those with CHD <50 yrs of age in both sexes. Even among women aged 70 the prevalence was 1:10. Irrespective of age and gender, prevalence differed substantially between European regions; potential FH patients were more likely to smoke, had higher triglycerides levels and their blood pressure was less well controlled. The use of cardioprotective drugs and the prevalences of diabetes, obesity and central obesity were similar. The prevalence of potential FH in coronary patients is high; the results underscore the need to promote identification of FH in CHD patients and to improve their risk factor profile. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Study of socio-demographic factors affecting prevalence of hypertension among bank employees of Surat City.

    PubMed

    Momin, Mohmmedirfan H; Desai, Vikas K; Kavishwar, Abhay B

    2012-01-01

    Cardiovascular diseases including hypertension are increasing in developing countries especially among high-risk group people like bank employees. A cross-sectional study of 1493 bank employees of Surat city was conducted during August, 2004 to September, 2005 to study the prevalence of hypertension among bank employees and the effects of socio-demographic factors on prevalence of hypertension. Data were analyzed using epi 6 software. The χ[2] -test was applied as a nonparametric test of statistical significance. Prevalence of hypertension was 30.4% and prehypertension was 34.5%. Out of 455 found as hypertensive, 258 (56.70%) were not having any symptoms at the time of examination. Prevalence was high among persons with age 50 years and above (48.5%); among male (32.5%) as compared to female (23.1%); among employees having small family size; among separated/divorcee person (40.0%). Prevalence of hypertension increased with seniority of the official position of bank employee with highest prevalence among managers (45.9%). Prevalence of hypertension was noted highest among the higher socioeconomic group; SEC I (35.0%) followed by class II (20.4%). Effects of different risk factors of hypertension were observed here. This study may help in identifying the common profile of hypertensive or persons at risk, which may further help in identifying the risk group and planning the group specific IEC interventions.

  2. Stroke Prevalence, Mortality and Disability-Adjusted Life Years in Children and Youth Aged 0-19 Years: Data from the Global and Regional Burden of Stroke 2013.

    PubMed

    Krishnamurthi, Rita V; deVeber, Gabrielle; Feigin, Valery L; Barker-Collo, Suzanne; Fullerton, Heather; Mackay, Mark T; O'Callahan, Finbar; Lindsay, M Patrice; Kolk, Anneli; Lo, Warren; Shah, Priyanka; Linds, Alexandra; Jones, Kelly; Parmar, Priya; Taylor, Steve; Norrving, Bo; Mensah, George A; Moran, Andrew E; Naghavi, Mohsen; Forouzanfar, Mohammed H; Nguyen, Grant; Johnson, Catherine O; Vos, Theo; Murray, Christopher J L; Roth, Gregory A

    2015-01-01

    There is increasing recognition of stroke as an important contributor to childhood morbidity and mortality. Current estimates of global childhood stroke burden and its temporal trends are sparse. Accurate and up-to-date estimates of childhood stroke burden are important for planning research and the resulting evidence-based strategies for stroke prevention and management. To estimate the prevalence, mortality and disability-adjusted life years (DALYs) for ischemic stroke (IS), hemorrhagic stroke (HS) and all stroke types combined globally from 1990 to 2013. Stroke prevalence, mortality and DALYs were estimated using the Global Burden of Disease 2013 methods. All available data on stroke-related incidence, prevalence, excess mortality and deaths were collected. Statistical models and country-level covariates were employed to produce comprehensive and consistent estimates of prevalence and mortality. Stroke-specific disability weights were used to estimate years lived with disability and DALYs. Means and 95% uncertainty intervals (UIs) were calculated for prevalence, mortality and DALYs. The median of the percent change and 95% UI were determined for the period from 1990 to 2013. In 2013, there were 97,792 (95% UI 90,564-106,016) prevalent cases of childhood IS and 67,621 (95% UI 62,899-72,214) prevalent cases of childhood HS, reflecting an increase of approximately 35% in the absolute numbers of prevalent childhood strokes since 1990. There were 33,069 (95% UI 28,627-38,998) deaths and 2,615,118 (95% UI 2,265,801-3,090,822) DALYs due to childhood stroke in 2013 globally, reflecting an approximately 200% decrease in the absolute numbers of death and DALYs in childhood stroke since 1990. Between 1990 and 2013, there were significant increases in the global prevalence rates of childhood IS, as well as significant decreases in the global death rate and DALYs rate of all strokes in those of age 0-19 years. While prevalence rates for childhood IS and HS decreased

  3. Food allergy prevalence and management at an overnight summer camp.

    PubMed

    Redmond, Margaret; Kempe, Erin; Strothman, Kasey; Wada, Kara; Scherzer, Rebecca; Stukus, David R

    2016-06-01

    In recent years, increased awareness of food allergy management has focused on the school setting. A lack of awareness and relevant literature prompted evaluation of the camp experience. To characterize the prevalence of food allergies among children attending an overnight summer camp and to evaluate the knowledge and comfort of camp personnel before and after a training session. The database for the 2014 season at Flying Horse Farms was reviewed for information pertaining to food allergies and provision of epinephrine and treatment plans. Camp personnel completed surveys regarding food allergy knowledge and comfort. Surveys were redistributed 30 days after the training session. Among 445 campers, 15% reported at least one food allergy, with 8.5% reporting allergy to 1 of the top 8 food allergens. Only 32% of campers with food allergy supplied an epinephrine autoinjector, and 0% provided written treatment plans. Before training, 84% of personnel desired additional information about food allergies. Knowledge of food allergies among personnel was high at baseline but increased after training in regard to epinephrine use for anaphylaxis and postepinephrine management. Staffers who reported feeling very comfortable caring for campers with food allergy increased from 16% to 46% after the training session; comfort in treating a food allergy emergency increased from 2% to 29%. Management of food allergies at overnight summer camps warrants similar education and preparation strategies as those implemented in schools. Camp personnel should receive annual training regarding food allergies and anaphylaxis. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. Regional variation in asthma symptom prevalence in Latin American children.

    PubMed

    Mallol, Javier; Solé, Dirceu; Baeza-Bacab, Manuel; Aguirre-Camposano, Viviana; Soto-Quiros, Manuel; Baena-Cagnani, Carlos

    2010-08-01

    This study investigates the distribution pattern of asthma symptom prevalence in Latin American children aged 13-14 years. A randomized, cross-sectional and multicentric study on the prevalence and severity of asthma symptoms (lifetime asthma, current wheezing, and frequent sleep disturbance by wheezing) was conducted in 165,917 schoolchildren from 56 centers in 17 Latin American countries, as part of the International Study of Asthma and Allergies in Childhood (ISAAC), Phase Three. The prevalence of lifetime asthma prevalence ranged from 1.2% to 33.1%, whereas current wheezing went from 3.9% to 30.8% and frequent sleep disturbance from 0.6% to 6.1%. An important proportion of centers (55%) reported a prevalence of asthma symptoms over 15%. There was no significant correlation between asthma symptom prevalence and latitude, altitude, or tropical setting. At country level, the prevalence of asthma was not associated with gross national income (GNI), proportion of population under the poverty line, or ancestry. This study suggests that ecological interactions, probably typical for each locality, may be the main determinants for the large variability of asthma prevalence in Latin America. The high prevalence of asthma symptoms found in children living in areas with low socioeconomic development would challenge the protective role against asthma of factors related to low hygiene and poverty; contrarily, in this region they would act as risk factors.

  5. Technological Innovation and Developmental Strategies for Sustainable Management of Aquatic Resources in Developing Countries

    NASA Astrophysics Data System (ADS)

    Agboola, Julius Ibukun

    2014-12-01

    Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

  6. Technological innovation and developmental strategies for sustainable management of aquatic resources in developing countries.

    PubMed

    Agboola, Julius Ibukun

    2014-12-01

    Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

  7. A Systematic Review of the Effects of Behavioral Counseling on Sexual Risk Behaviors and HIV/STI Prevalence in Low- and Middle-Income Countries.

    PubMed

    Zajac, Kristyn; Kennedy, Caitlin E; Fonner, Virginia A; Armstrong, Kevin S; O'Reilly, Kevin R; Sweat, Michael D

    2015-07-01

    The purpose of this study was to assess the effectiveness of behavioral counseling interventions in reducing sexual risk behaviors and HIV/STI prevalence in low- and middle-income countries. A systematic review of papers published between 1990 and 2011 was conducted, identifying studies that utilized either a multi-arm or pre-post design and presented post-intervention data. Standardized methods of searching and data abstraction were used, and 30 studies met inclusion criteria. Results are summarized by intervention groups: (a) people living with HIV; (b) people who use drugs and alcohol; (c) serodiscordant couples; (d) key populations for HIV prevention; and (e) people at low to moderate HIV risk. Evidence for the effectiveness of behavioral counseling was mixed, with more rigorously designed studies often showing modest or no effects. Recommendations about the use of behavioral counseling in developing countries are made based on study results and in light of the field's movement towards combination prevention programs.

  8. Prevalence and management of dementia in primary care practices with electronic medical records: a report from the Canadian Primary Care Sentinel Surveillance Network.

    PubMed

    Drummond, Neil; Birtwhistle, Richard; Williamson, Tyler; Khan, Shahriar; Garies, Stephanie; Molnar, Frank

    2016-01-01

    The proportion of Canadians living with Alzheimer disease and related dementias is projected to rise, with an increased burden on the primary health care system in particular. Our objective was to describe the prevalence and management of dementia in a community-dwelling sample using electronic medical record (EMR) data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), which consists of validated, national, point-of-care data from primary care practices. We used CPCSSN data as of Dec. 31, 2012, for patients 65 years and older with at least 1 clinical encounter in the previous 2 years. A validated case definition for dementia was used to calculate the national and provincial prevalence rates, to examine variations in prevalence according to age, sex, body mass index, rural or urban residence, and select comorbid conditions, and to describe patterns in the pharmacologic management of dementia over time at the provincial level. The age-standardized prevalence of dementia among community-dwelling patients 65 years and older was 7.3%. Prevalence estimates increased with age; they also varied between provinces, and upward trends were observed. Dementia was found to be associated with comorbid diabetes, depression, epilepsy and parkinsonism. Most of the patients with dementia did not have a prescription for a dementia-related medication recorded in their EMR between 2008 and 2012 inclusive. Those who had a prescription were most often prescribed donepezil by their primary care provider. Overall prevalence estimates for dementia based on EMR data in this sample managed in primary care were generally in line with previous estimates based on administrative data, survey results or clinical sources.

  9. National prevalence of coronary heart disease and its relationship with human development index: A systematic review.

    PubMed

    Zhu, Ke-Fu; Wang, Yu-Ming; Zhu, Jin-Zhou; Zhou, Qin-Yi; Wang, Ning-Fu

    2016-03-01

    Coronary heart disease has become a major health concern over the past several decades. Several reviews have assessed the effects of socioeconomic status on the coronary heart disease epidemic in communities and countries, but only a few reviews have been performed at a global level. This study was to explore the relationship between the prevalence of coronary heart disease and socioeconomic development worldwide using the Human Development Index. Systematic review. The data in this study were collected from the MEDLINE database. Cross-sectional studies reporting the prevalence of coronary heart disease until November 2014 were collected. The Human Development Index was sourced from the United Nations Development Programme Database and was used to measure the socioeconomic achievements of countries. Each country was classified as a developing or developed country based on its level of development according to the Human Development Index value. Based on the data analysis on the global level, coronary heart disease prevalence had no association with the national Human Development Index (rho = 0.07). However, there was a positive association between coronary heart disease prevalence and the national Human Development Index in developing countries, although a negative association existed in developed countries (rho = 0.47 and -0.34, respectively). In addition, the past decades have witnessed a growing coronary heart disease epidemic in developing countries, with reverse trends observed in developed countries (P = 0.021 and 0.002, respectively). With the development of socioeconomic status, as measured by the Human Development Index, the prevalence of coronary heart disease is growing in developing countries, while declining in developed countries. Future research needs to pay more attention to the reasonable allocation of medical resources and control of coronary heart disease risk factors. © The European Society of Cardiology 2015.

  10. Understanding the prevalence of lifetime abstinence from alcohol: An ecological study.

    PubMed

    Probst, Charlotte; Manthey, Jakob; Rehm, Jürgen

    2017-09-01

    The level of alcohol consumption and related burden in a country are strongly impacted by the prevalence of abstinence from alcohol use. The objective of this study was to characterize the association of lifetime abstinence from alcohol use with economic wealth (as measured in the gross domestic product [GDP]) and Muslim religion on a country level. An ecological study was performed using aggregate data of 183 countries for the year 2010. Lifetime abstinence among men and women was predicted using fractional response regression models with the natural logarithm of GDP-PPP (purchasing power parity) and the proportion of Muslim population as predictors. The models were further adjusted by the country's median age and World Health Organization region. Precision of prediction was investigated. Descriptive analyses showed a strong negative association between GDP-PPP and lifetime abstinence in countries without a Muslim majority and a GDP-PPP up to 20,000 international dollars. Regression models confirmed the negative association with GDP-PPP and showed a strong positive association between lifetime abstinence and the proportion of Muslim population. Stratified sensitivity analyses showed that in countries without a Muslim majority only GDP-PPP showed a statistically significant association whereas in Muslim majority countries only the proportion of Muslims was associated with the prevalence of lifetime abstinence. Particularly in countries with a lower GDP and without Muslim majority the prevalence of lifetime abstinence from alcohol use is strongly negatively associated with GDP-PPP. Future research should analyze the accordance in trends of GDP and lifetime abstinence over time. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences.

    PubMed

    de Vries, Gerard; Tsolova, Svetla; Anderson, Laura F; Gebhard, Agnes C; Heldal, Einar; Hollo, Vahur; Cejudo, Laura Sánchez-Cambronero; Schmid, Daniela; Schreuder, Bert; Varleva, Tonka; van der Werf, Marieke J

    2017-04-19

    In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months' evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes. This study was conducted to identify and better understand the contribution of health system components to successful treatment of multidrug-resistant tuberculosis. We selected four European Union countries to provide for a broad range of geographical locations and levels of treatment success rates of the multidrug-resistant tuberculosis cohort in 2009. We conducted semi-structured interviews following a conceptual framework with representatives from policy and planning authorities, healthcare providers and civil society organisations. Responses were organised according to the six building blocks of the World Health Organization health systems framework. In the four included countries, Austria, Bulgaria, Spain, and the United Kingdom, the following healthcare system factors were perceived as key to achieving good treatment results for patients with multidrug-resistant tuberculosis: timely diagnosis of drug-resistant tuberculosis; financial systems that ensure access to a full course of treatment and support for multidrug-resistant tuberculosis patients; patient-centred approaches with strong intersectoral collaboration that address patients' emotional and social needs; motivated and dedicated healthcare workers with sufficient mandate and means to support patients; and cross-border management of multidrug-resistant tuberculosis to secure continuum of care between countries. We suggest that the following actions may improve the success of treatment for multidrug-resistant tuberculosis patients: deployment of rapid molecular diagnostic tests; development of context-specific treatment

  12. Drivers and challenges for implementing ISO 14001 environmental management systems in an emerging Gulf Arab country.

    PubMed

    Waxin, Marie-France; Knuteson, Sandra L; Bartholomew, Aaron

    2017-11-13

    Worldwide, ISO 14001 certification for organizations has become the norm, but the Arab world accounts for an insignificant portion of all the certified organizations. There is a dearth of research on environmental management systems (EMS) in Arab and emerging countries and in public organizations. The objectives of this research are to: (1) examine the key drivers and challenges related to implementation of ISO 14001 certified EMS in the United Arab Emirates, an emerging Arab country and (2) compare and contrast these drivers and challenges between private and public organizations. We adopt an explorative, qualitative methodology, using semi-structured interviews with environmental managers in 11 organizations (6 private and 5 public) from different industrial sectors. Drivers of EMS certification were mostly similar between private and public organizations, with some differences. Compliance with regulations and standards, and increasing environmental performance were the main drivers for ISO 14001 certification in both private and public organizations. Commitment to sustainability was more important for public organizations. Cost reduction, competitors, leadership commitment and customers' demands were shared drivers, but more stressed by private organizations. Local community and employees' pressures were reported by private organizations only. The challenges to ISO 14001 implementation were similar for private and public organizations. They were: a lack of qualified human resources, practical challenges associated with implementation, a lack of regulations, a lack of support from management, and high costs. Our findings have implications for managers, academics, consultants, and policy makers in the UAE and other emerging markets.

  13. Aquaculture research and management in the telecoupled Belt and Road Initiative countries and beyond

    NASA Astrophysics Data System (ADS)

    Yang, W.; Ying, Z.; Marín, T.

    2017-12-01

    Due to the continuous growth in aquatic product consumption, globally the total production of aquatic products has increased by 20% in the past two decades. In 2014, for the first time, the production of aquatic products for direct human consumption from aquaculture surpassed that of wild catch. In 2016, the total production of global aquatic products reached 170 million tons, of which 45% comes from the aquaculture sector. More importantly, over 80% of the global aquaculture production occurs in the Belt and Road Initiative countries. Particularly, China alone contributes to two third of the global share. The rapid expansion and intensification of aquaculture have many environmental and socioeconomic impacts both at the cultivation places and also in places where feed is produced; however, these telecoupled processes and effects are largely unknown in a quantitative manner. Here, we apply the telecoupling framework to analyze the aquaculture trade among China and other Belt and Road Initiative countries and beyond. The integrated telecoupling framework helps to demonstrate the environmental and socioeconomic interactions among the feed (and aquatic product) sending, receiving, and spillover systems. It also provides a platform to model the telecoupled processes and effects across multiple remotely connected systems. Moreover, the application of the framework reveals many research gaps and management needs on aquaculture research and management.

  14. Is the burden of overweight shifting to the poor across the globe? Time trends among women in 39 low- and middle-income countries (1991-2008).

    PubMed

    Jones-Smith, J C; Gordon-Larsen, P; Siddiqi, A; Popkin, B M

    2012-08-01

    Overweight prevalence has increased globally; however, current time trends of overweight prevalence by social class in lower income countries have not been fully explored. We used repeated cross-sectional, nationally representative data from the Demographic and Health Surveys on women aged 18-49 years with young children (n=421,689) in 39 lower-income countries. We present overweight (body mass index ≥ 25 kg m⁻²) prevalence at each survey wave, prevalence difference and prevalence growth rate for each country over time, separately by wealth quintile and educational attainment. We present the correlation between nation wealth and differential overweight prevalence growth by wealth and education. In the majority of countries, the highest wealth and education groups still have the highest prevalence of overweight and obesity. However, in a substantial number of countries (14% when wealth is used as the indicator of socioeconomic status and 28% for education) the estimated increases in overweight prevalence over time have been greater in the lowest- compared with the highest-wealth and -education groups. Gross domestic product per capita was associated with a higher overweight prevalence growth rate for the lowest-wealth group compared with the highest (Pearson's correlation coefficient: 0.45). Higher (vs lower) wealth and education groups had higher overweight prevalence across most developing countries. However, some countries show a faster growth rate in overweight in the lowest- (vs highest-) wealth and -education groups, which is indicative of an increasing burden of overweight among lower wealth and education groups in the lower-income countries.

  15. Global Associations between UVR Exposure and Current Eczema Prevalence in Children from ISAAC Phase Three.

    PubMed

    Fuertes, Elaine; Flohr, Carsten; Silverberg, Jonathan I; Standl, Marie; Strachan, David P

    2017-06-01

    We sought to examine the relationship globally between UVR dose exposure and current eczema prevalences. ISAAC Phase Three provided data on eczema prevalence for 13- to 14-year-olds in 214 centers in 87 countries and for 6- to 7-year-olds in 132 centers in 57 countries. Linear and nonlinear associations between (natural log transformed) eczema prevalence and the mean, maximum, minimum, standard deviation, and range of monthly UV dose exposures were assessed using linear mixed-effects regression models. For the 13- to 14-year-olds, the country-level eczema prevalence was positively and linearly associated with country-level monthly mean (prevalence ratio = 1.31 [95% confidence interval = 1.05-1.63] per kJ/m 2 ) and minimum (1.25 [1.06-1.47] per kJ/m 2 ) UVR dose exposure. Linear and nonlinear associations were also observed for other metrics of UV. Results were similar in trend, but nonsignificant, for the fewer centers with 6- to 7-year-olds (e.g., 1.24 [0.96-1.59] per kJ/m 2 for country-level monthly mean UVR). No consistent within-country associations were observed (e.g., 1.05 [0.89-1.23] and 0.92 [0.71-1.18] per kJ/m 2 for center-level monthly mean UVR for the 13- to 14- and 6- to 7-year-olds, respectively). These ecological results support a role for UVR exposure in explaining some of the variation in global childhood eczema prevalence. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. The prevalence of colorectal adenomas in asymptomatic Korean men and women.

    PubMed

    Yang, Moon Hee; Rampal, Sanjay; Sung, Jidong; Choi, Yoon-Ho; Son, Hee Jung; Lee, Jun Haeng; Kim, Young-Ho; Chang, Dong Kyung; Rhee, Poong-Lyul; Rhee, Jong Chul; Guallar, Eliseo; Cho, Juhee

    2014-03-01

    Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significantly higher prevalence of adenomas compared with participants of average risk (36.9% vs. 26.9%; age- and sex-adjusted prevalence ratio = 1.16; 95% confidence interval, 1.09-1.22). The prevalence of adenomas increased annually in both men and women. In this large study of asymptomatic Korean men and women participating in a colonoscopy screening program, the prevalence of colorectal adenomas was comparable and possibly higher than previously reported in Western countries. Cost-effectiveness studies investigating the optimal age for starting colonoscopy screening and etiological studies to identify the reasons for the increasing trend in colorectal adenomas in Koreans are needed. ©2014 AACR.

  17. Potential of integrated continuous surveys and quality management to support monitoring, evaluation, and the scale-up of health interventions in developing countries.

    PubMed

    Rowe, Alexander K

    2009-06-01

    Well-funded initiatives are challenging developing countries to increase health intervention coverage and show impact. Despite substantial resources, however, major obstacles include weak health systems, a lack of reasonably accurate monitoring data, and inadequate use of data for managing programs. This report discusses how integrated continuous surveys and quality management (I-Q), which are well-recognized approaches in wealthy countries, could support intervention scale-up, monitoring and evaluation, quality control for commodities, capacity building, and implementation research in low-resource settings. Integrated continuous surveys are similar to existing national cross-sectional surveys of households and health facilities, except data are collected over several years by permanent teams, and most results are reported monthly at the national, province, and district levels. Quality management involves conceptualizing work as processes, involving all workers in quality improvement, monitoring quality, and teams that improve quality with "plan-do-study-act" cycles. Implementing and evaluating I-Q in a low-income country would provide critical information on the value of this approach.

  18. Childhood intermittent and persistent rhinitis prevalence and climate and vegetation: a global ecologic analysis.

    PubMed

    Fuertes, Elaine; Butland, Barbara K; Ross Anderson, H; Carlsten, Chris; Strachan, David P; Brauer, Michael

    2014-10-01

    The effect of climate change and its effects on vegetation growth, and consequently on rhinitis, are uncertain. To examine between- and within-country associations of climate measures and the normalized difference vegetation index with intermittent and persistent rhinitis symptoms in a global context. Questionnaire data from 6- to 7-year-olds and 13- to 14-year-olds were collected in phase 3 of the International Study of Asthma and Allergies in Childhood. Associations of intermittent (>1 symptom report but not for 2 consecutive months) and persistent (symptoms for ≥2 consecutive months) rhinitis symptom prevalences with temperature, precipitation, vapor pressure, and the normalized difference vegetation index were assessed in linear mixed-effects regression models adjusted for gross national income and population density. The mean difference in prevalence per 100 children (with 95% confidence intervals [CIs]) per interquartile range increase of exposure is reported. The country-level intermittent symptom prevalence was associated with several country-level climatic measures, including the country-level mean monthly temperature (6.09 °C; 95% CI, 2.06-10.11°C per 10.4 °C), precipitation (3.10 mm; 95% CI, 0.46-5.73 mm; per 67.0 mm), and vapor pressure (6.21 hPa; 95% CI, 2.17-10.24 hPa; per 10.4 hPa) among 13- to 14-year-olds (222 center in 94 countries). The center-level persistent symptom prevalence was positively associated with several center-level climatic measures. Associations with climate were also found for the 6- to 7-year-olds (132 center in 57 countries). Several between- and within-country spatial associations between climatic factors and intermittent and persistent rhinitis symptom prevalences were observed. These results provide suggestive evidence that climate (and future changes in climate) may influence rhinitis symptom prevalence. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. [Prevalence of iron deficiency].

    PubMed

    Dupont, C

    2017-05-01

    Studies of prévalence in iron deficiency separate iron depletion (defined as decreased blood ferritin) and iron deficiency anemia (defined as blood decrease in both ferritin and hemoglobin). In Europe, most studies are outdated. Prevalence of iron depletion varies from 7 to 18 % and 24 to 36% in toddlers and adolescents, respectively. Prevalence of iron deficiency anemia varies from 2 to 8.5% and 7 to 10% in toddlers and adolescents. In French speaking African countries, Demography Health Surveys show that 80% of children aged 0 to 2 years are anemic, severely for 5 to 9% of them. © 2017 Elsevier Masson SAS. Tous droits réservés.

  20. Aggression in Dating Relationships Compared by Country of Origin

    ERIC Educational Resources Information Center

    Seligowski, Antonia; West, Doe

    2009-01-01

    Aims: The purpose of this study was to analyze prevalence levels of aggression in dating relationships and to compare this by country of origin. The study also seeks more understanding of the violence experienced by men in these countries. Method: A convenience sample was used; study participants were 194 females and 168 males ranging in age from…