Urban Adult Population Research Articles

Associations between obstructive sleep apnea and sleep characteristics with chronic kidney disease in rural Pennsylvania

Study objectivesTo examine the association between moderate-severe obstructive sleep apnea (msOSA) and sleep characteristics with chronic kidney disease (CKD) in a population of rural and urban adults in Pennsylvania. MethodsA cross-sectional study of 23,643 adults who underwent polysomnography (PSG) at a rural healthcare system in Pennsylvania between 2009 and 2019. Serum creatinine was abstracted from electronic health records to calculate estimated glomerular filtration rate (eGFR). CKD was defined as an eGFR <60 mL/min/1.73 m2. msOSA was defined as an apnea-hypoxia index (AHI) ≥15 events/hour. Poisson regression was performed to estimate the prevalence ratio (PR) of CKD for various sleep measures while adjusting for age, sex, race, smoking (never, former, current), body mass index, diabetes, and hypertension at time of PSG. ResultsIn this clinically-referred sample comprised of over one-third (35 %) rural individuals, the prevalence of CKD and msOSA was 9.4 % and 32.1 %, respectively. Patients with CKD had more severe OSA based on AHI and intermittent hypoxia profile and presented worse sleep quality across all studied measures. Having OSA was associated with a 13 % higher prevalence of CKD (95%CI: 1.04, 1.22). In addition, for every 5 % increment in sleep efficiency, the prevalence of CKD was 3 % lower (PR = 0.97, 95%CI: 0.96, 0.98). Significant associations that were in the expected direction were observed across most sleep characteristics in adjusted models. ConclusionsModerate-severe OSA, nocturnal hypoxemia, and disruptions to normal sleep duration, continuity, and architecture are associated with increased CKD prevalence in Pennsylvania adults. Management of OSA and/or sleep disturbances may be an opportunity to improve CKD outcomes. The unique health disparities among vulnerable rural populations are deserving of future study.

Skin mycosis distribution, and burden of visits over a decade in Colombia: ecological study

ObjectivesTo describe the sociodemographic distribution of dermatomycosis and the visits burden over a 10-year period of care. MethodsAn ecological study was conducted using data on visits and people treated in the Colombian Health System during 2010-2019 using the International Classification of Diseases, Tenth Revision codes (ICD-10). Departments and geopolitical regions were the units of analysis, and visit burden was reported as frequency, intensity (visits per person), and rate of dermatomycosis visits (per 10,000 visits; 95% confidence interval). ResultsA total of 4,570,593 visits were analyzed. The most used ICD-10 codes were B369 (superficial mycosis, unspecified), B360 (pityriasis versicolor), B354 (Tinea corporis), B359 (dermatophytosis), and B351 (Tinea unguium) (56.5%), with visits primarily involving the adult population (27-59 years; 32.2%), women (43.4%), and urban populations (57.3%). Amazonas department had the highest rate of visits (2.36 per 10,000), while Nariño had the highest intensity of visits (1.94 visits per person). Caribbean region had the highest rate of visits (17.0 per 10,000 visits; 17.0-17.0), followed by the Amazon region (16.3 per 10,000 visits; 16.2-16.4). ConclusionsThe annual visits burden of dermatomycosis in Colombia is high and concentrated in susceptible geographic areas, possibly due to socio-environmental factors. This health problem is overshadowed by chronic diseases and trauma but is often recurrent, and chronic, and induces out-of-pocket costs for treatment.

Prevalence of Prediabetes and Associated Risk Factor Assessment Among Urban Adult Population in North Bihar, India

Background: Type 2 Diabetes Mellitus (T2DM) and Impaired Glucose Tolerance (IGT) are major public health concerns globally, with increasing prevalence in India. The study assessed the prevalence of T2DM and IGT among, and to recognize key associated risk factors. Methods: 1050 persons were involved in the study selected by rigorous random sampling. To diagnose T2DM and IGT, data were gathered via in-person interviews using a pre-made questionnaire, which were then followed by clinical exams and blood testing. Results: The incidence of IGT was 12.48% and T2DM was 9.24%, respectively. In the 61–70 age range, the highest incidence of T2DM (20.86%) and IGT (21.58%) was noted. The incidence of T2DM was somewhat higher in men (9.87%) than in women (8.58%). The incidence rates of T2DM (21.84%) and IGT (36.78%) were considerably greater in those with a positive family record of diabetes. Additionally, there was a substantial correlation found between obesity and hypertension and a higher incidence of T2DM and IGT. Conclusion: The study reveals a considerable incidence of T2DM and IGT in the Sharifganj area of Katihar, with advanced age, male gender, family history of diabetes, obesity, and hypertension identified as key risk factors. Recommendations: Targeted public health interventions, including lifestyle modifications, regular screenings, and health education, are essential to manage and reduce the risk of diabetes in this community. Keywords: Prediabetes,T2DM, Impaired Glucose Tolerance, IGT, Impaired Fasting Glucose, IFG, Risk Factors, Katihar, Bihar.

Accessibility to palliative care services in Colombia: an analysis of geographic disparities

ObjectivesDue to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used accessibility and coverage indicators to measure the geographic barriers to palliative care.MethodsPopulation-based observational study focused on urban areas and adult population from Colombia, which uses three measurements of geographic accessibility to services: a) density of palliative care services per 100,000 inhabitants, b) analysis of geographic distribution by territorial nodes of the country, and c) spatial analysis of palliative care services using Voronoi diagrams. ArcGIS Pro software was used to map services’ locations and identify geographic disparities.ResultsA total of 504 palliative care services were identified, of which 77% were primary health care services. The density of palliative care services in Colombia is 1.8 primary care services per 100,000 inhabitants and 0.4 specialized services per 100,000 inhabitants. The average palliative care coverage is 41%, two regions of the country have a coverage below 30%. Twenty-eight percent of the services provide care for a population greater than 50,000 inhabitants within their coverage area, exceeding the acceptable limit by international standards.ConclusionsPalliative care services are concentrated in three main regions (Bogotá D.C., the Center, and the Caribbean) and are limited in the Orinoquia and Amazonia nodes. Density of specialized palliative care services is extremely low and there are regions without palliative services for adults with palliative needs.

Adult perceptions of cigarettes and e-cigarettes: A Pakistan focus group study

ObjectiveEvidence suggests that the popularity of Reduced Risk Products' (RRPs) is growing globally, and they are being considered as effective aids for tobacco cessation. To explore different policy options for reducing disease burden, this qualitative study investigates the perceptions of the urban adult population regarding the use of e-cigarettes (EC), combustible cigarettes, or both, and the factors influencing their choices. MethodsTwelve focus group discussions (FGDs), involving 132 participants, (68 male, 64 female), aged 18–60, were conducted from August to October 2022 in three metropolitan cities of Pakistan. Thematic analyses were conducted using the NVivo software. The Standards for Reporting Qualitative Research were employed for reporting and conducting purposes. ResultsThe findings indicate that while all participants discussed the health risks associated with combustible cigarettes and EC and expressed intensions to quit, many continued to smoke or vape. Reasons cited included perceived stress relief, alleviation of medical issues, or addiction hindering cessation efforts. Among the youth, EC use gained popularity due to its social acceptability and the inclusion of appealing flavours and fragrances. Additionally, participants managed the higher costs of ECs by sharing and pooling expenses. Some users of combustible cigarettes transitioned to ECs with the expectation of achieving better health outcomes. ConclusionThis study establishes a foundation for undertaking quantitative research to identify pathways for assisting policymakers in mitigating the growing disease burden. Additionally, it aims to contribute to the achievement of Sustainable Development Goals 3a and 3.4 for Pakistan.

Assessment of diabetes risk among adult population using Indian diabetes risk score and to correlate with actual capillary blood sugar level: a cross sectional study

Background: Diabetes is one of the fastest growing health challenges of the 21st century, with the number of adults living with diabetes having more than tripled over the past 20 years. IDRS is pre-screening tool for assessing diabetes mellitus. It is also a non-invasive procedure and less time consuming. Aim were to assess diabetes risk among adult urban population of district Etawah by using Indian Diabetes Risk Score and to correlate it with actual capillary blood sugar status. Methods: The present study was a cross sectional study carried out among 200 adult urban non diabetic population the age group of 30 years and above. The data was collected using predesigned questionnaire followed by capillary blood sugar estimation. The data was collected under following broad heading: socio-demographic profile, Behavioural factor, Indian diabetes risk score and capillary blood sugar estimation. Results: Majority of the participants were in the age group of 35-49 years and Hindu by religion. 62.5% gave history of fast food consumption, nearly half of the participants gave the history of moderate to heavy physical exercise. It was found that 89% of the participants fall under the category of intermediate and high risk category. On application of test of association between IDRS score and actual capillary blood sugar level, strong association exist between the two variables. Conclusions: The present study concludes that IDRS is a powerful tool for screening of high risk group of diabetes. There is a strong association between capillary blood sugar and IDRS score.

Excessive day time sleepiness and its associated factors among adult population in an urban area of southern Rajasthan

Background: Sleep problems have been considered as an unmet public health problem. Sleep problems are mostly under reported and neglected by the Indian population. Very limited studies have been conducted in India on this aspect. Aims and Objectives: The aim of the study was to estimate the prevalence of excessive day time sleepiness (EDS) and its associated factors among urban adult population. Materials and Methods: A community based cross-sectional study was conducted among 409 adults of 20–60 years age group in urban Udaipur. Socio-demographic and other details were obtained using a semi structured questionnaire. Using Epworth Sleepiness Scale, assessment of EDS was assessed. Results: In the present study, mean age of the participants was 40.8 ± 11.3 years. Considering the ESS score of 10 or more, EDS was observed in 60.2% subjects. EDS was associated with age, gender, milk consumption, and mobile use. No significant association was found between EDS with central obesity, body mass index, marital status, literacy, occupation, exercise, smoking, and consumption of alcohol. Conclusion: In the present study, the prevalence of EDS was high. Therefore, early identification of excessive sleep problems and appropriate intervention that address the various determinants of the sleep problems is of prime importance.

Use of antiglaucomatous drugs in the urban adult population : New Insights into the prevalence of glaucoma from the Hamburg City Health Study

Glaucoma is awidespread ophthalmological disease. Knowledge about the spread of the disease in the population is necessary with respect to further questions on comorbidities, risk factors and the provision of care. An analysis of the use of glaucoma medications and the prevalence of glaucoma in an urban adult population was carried out. The Hamburg City Health Study (HCHS) is aprospective, long-term, population-based cohort study that includes arandom sample of 45,000 participants aged between 45and 79years from the general population of Hamburg, Germany. Apart from various medical parameters, data include premedication and the medical history of the participants. The use of antiglaucomatous medication among the first 10,000 study participants was analyzed and the prevalence of glaucoma was estimated according to the use of medications as well as by the self-reported history of glaucoma. Descriptive analysis and logistic regression analysis were performed to analyze the data and to calculate correlations by age and gender. In the study population 319 persons were on medication to lower the intraocular pressure (IOP, mean age 67.1 years, SD = 7.57 years), which is equivalent to an estimated prevalence of 3.35% (95% confidence interval, CI 3.00-3.70%). Apositive correlation was observed between age and the use of IOP-lowering medication, which is statistically highly significant (p = < 0.001). The analysis by gender showed aslightly higher prevalence among women, which was not statistically significant. The estimated prevalence according to glaucoma medication and history were only partly congruent. This estimated prevalence of glaucoma is comparable to other epidemiological studies. The study results cover not only patients with manifest glaucoma but also persons who were treated for ocular hypertension. The inconsistency between the prevalence of glaucoma medication and the diagnosis of glaucoma can be explained by different treatment strategies and also by information deficits.

CORRELATION OF AGE WITH COVID-19 IGG ANTIBODIES TITRE IN THE ADULT POPULATION OF MALEGAON: A PROSPECTIVE OBSERVATIONAL STUDY

Introduction: The year 2019 was affected by Pneumonia caused by SARS Cov 2 virus. This major health challenge whole world is facing and IgG antibodies titre has been widely used to assist the diagnostic and prognostic value. Important aspect of aging is decline in immune function. As per the aging process there are changes at humoral and cellular immune responses leading to impaired immune response which in turn leads to risk of infectivity and decreased vaccine responses. The current study's objectives were to assess the SARS-COV-2 antibody titre in the adult urban Malegaon population and to look for a relationship between age and antibody titre.Methods: Individuals who were residing in densely populated Malegaon village where formerly COVID- 19 was declared as hot spot during first wave were included with total sample size of 2454 and their blood samples were collected to get IgG antibodies from 12 January 2022 to 18 January 2022.Results: In this study we found that when the age advances the % of antibody level doesn’t change significantly. In 2454 samples there observed non-significant difference in antibody % and age group (p&gt;0.05)Conclusion: These findings suggest extensive studies are required to bring uniform guideline for developing the vaccine strategy as age and antibodies level remained the same.

Expected long-term impacts of the COVID-19 pandemic on travel behaviour and online activities: Evidence from a Czech panel survey

The outbreak of the COVID-19 pandemic and the counter-pandemic measures have led to a substantial drop in mobility. The interesting question is whether mobility will return to the pre-pandemic levels after the pandemic or whether at least a part of the change in mobility will be long-lasting. In this paper, we investigate the expected long-term effects of the COVID-19 pandemic on work from home and online shopping. Using individual responses from panel data collected among the Czech adult urban population in four waves during 2020 and 2021, we expect a long-term increase in work from home and online shopping relative to the pre-pandemic levels. The number of physical trips to work and shops is expected to decrease. The main determinants of work from home are job type, industry and education. The main determinants of online shopping are age and education. The strength of influence of these determinants on the expected frequency of online activities after the pandemic differs from their impact before the pandemic. The expected modal split for commuting to work and for out-of-home shopping stays virtually unchanged relative to the situation before the pandemic.

The Occurrence of Depression Among Adults With Sickle Cell Disease in Saudi Arabia.

Introduction Sickle cell disease (SCD) is recognized as a widely prevalent genetic disorder that impacts individuals globally and is inherited within families. The primary cause of SCD is a singular genetic mutation that affects the globin chain of the hemoglobin protein. Depression and its symptoms are frequently observed in individuals with SCD. This observation has led to a higher probability of adverse health outcomes. Therefore, the primary objective of this study was to analyze depression among Saudi Arabian adults with sickle cell disease. Method The online survey questionnaire was administered in both Arabic and English to collect essential information regarding SCD distress among the urban adult population in Saudi Arabia, using a cross-sectional study design. Data analysis was conducted using IBM SPSS software version 25 (IBM Corp., Armonk, NY, USA) and Microsoft Excel(Microsoft Corporation, Redmond, WA, USA). The study was designed with a statistical power of 80% at a cut-off value of 0.05 and 0.2. Diverse statistical approaches have been utilized to examine the connection between independent variables, including methods such as Chi-square analysis and Pearson's statistical assessment. Result A total of 685 respondents were included in the survey for this study, with the majority of the participants from the eastern region (31%) and between the age groups of 25 and 30 years (34%) showing a lot of enthusiasm There was a clear dominance of the Saudi population (71%) who spoke Arabic (83%). Female (65%) participants showed more interest in this survey. The collected data were organized comprehensively in tables to facilitate a better understanding of the study's findings. P-values less than 0.05 were considered significant for the obtained results. Conclusion The study has shown that there were a variety of depression entanglements as a result of SCD, but they were handled well with the necessary measures by medical care professionals with much-needed psychological counseling and well-equipped medical facilities.

Prevalence and Determinants of Symptomatic Dry Eye Disease Among Adult Urban Residents of High-Altitude Areas of Southwest Saudi Arabia - A Survey.

To estimate the prevalence and determinants of Ocular Surface Disease Index (OSDI) score based dry eye disease (DED) among the adult urban population of four cities located at high altitudes in Southwest Saudi Arabia. This cross-sectional survey was held in 2023. OSDI questionnaire was used to collect the responses of the adult participants. The score was further graded into none, mild, moderate, and severe DED to estimate age-sex-adjusted DED prevalence. The OSDI score was correlated to demographic (age group, gender, education, occupation, city) and risk factors like smoking and co-morbidities. Of the 401 adults, 388 (response rate of 97.8%) participated. The age-sex-adjusted prevalence of mild, moderate, and severe DED was 21.7%, 13.1%, and 32%, respectively. The median ODSI score was 22.9 [Interquartile range (IQR) 10.4; 47.9)]. The score was significantly higher in females (Mann-Whitney U-test P = 0.038), residents of Taif city (KW P = 0.05), those with primary/middle school education (Kruskal-Wallis P = 0.004), comorbidities like hypertension, asthma (KW P < 0.001) and risk factors like past refractive surgeries, arthritis (KW P = 0.013). Education status (P <0.001) [B = -9.0 95%] and presence of comorbidity (P = 0.022), [B = -0.823] were significant predictors of DED. The prevalence of DED and severe grade was high. The level of education and presence of comorbidities significantly influenced DED in the adult urban Saudi population of cities at high altitudes.

Rapid increase of SARS-CoV-2 seroprevalence during the second half of the COVID-19 pandemic year 2020 in the adult urban Albanian population

BackgroundThis study aims to assess the changes in COVID-19 seroprevalence among the adult urban population of Albania between July and December 2020, when the Wuhan strain of SARS-CoV-2 virus was still prevalent in the country. MethodsTwo independent, randomly selected samples of individuals aged 20–70 years residing in Metropolitan Tirana, Albania, were collected in June–July and December 2020. ELISA method was used for serological testing to determine IgG antibodies anti-S1-SARS-CoV-2. Results: The proportion of individuals classified as seropositive in early July was 7.5% (95% CI: 4.3%–10.7%), which increased 6.5 times in late December 2020, reaching 48.2% (95% CI: 44.8%–51.7%). The increasing seroprevalence rates in the study mirrored the trend of detected COVID-19 cases from June to December 2020 in Albania. However, they demonstrate a much higher cumulative incidence of the SARS-COV-2 infection in the community than the reported COVID-19 cases. Conclusion: The rapid increase in SARS-CoV-2 seroprevalence observed in Tirana City by the end of 2020 was likely a result of several factors, including the very low infection exposure between March–May 2020 when the entire city was in a lockdown, followed by the high susceptibility of the population due to naïve immunity. Despite the high observed seroprevalence at the end of December 2020, COVID-19 incidence continued to increase in Albania through 2021 and 2022 following the new virus variant surges.

Utilisation of Oral Health Services and Associated Factors in a Sub-Urban Population in Western Uganda

Aim: To determine the prevalence and factors affecting the level of utilization of oral health services in a sub urban adult population in Ishaka-Western Uganda. Methods: A community-based cross-sectional study was conducted among 384 study participants. Data was collected using pre-tested and structured questionnaires. Data was entered in Epi-info computer software version 3.5.1 and exported to STATA Version 14.0 for analysis. Univariate analysis and modified Poisson regression were done to identify factors associated with utilization of oral health services. Crude prevalence ratios with 95% confidence interval were used to determine the level of significance at bivariate meanwhile adjusted prevalence ratios were calculated at multivariate analysis to establish independent significant factors. Results: The mean age of the study participants was 30.22 ± 9.97. It was observed that 36.72% of the study participants had utilized oral health services. Factors affecting utilization of oral health services that were statistically significant were level of education (tertiary level of education versus none) (P&lt;0.001), average monthly income of &gt;1,000,0000 Shilings (about $300) versus &lt;501,000 ( about $150) (P&lt;0.001), no phobia for dental procedures (P=0.035), perception that oral health visits are important (P=0.017) and positive attitude of attending health workers ( P=0.028). Conclusion: This study has shown that the level of utilization of oral health services in the studied suburban adult population was poor. The level of education, income and phobia for dental procedures were associated with the utilization of oral health services. It is recommended that oral health promotion strategies be deployed in order to increase awareness and access to oral health care. Keywords: Oral health services, community-based cross-sectional study, Uganda

Long-term tendency and risk factors for stroke in Bishkek

Objective: This retrospective study was designed to describe the morbidity, mortality rates and risk factors in adult urban population Bishkek, Kyrgyz Republic for the period 2004–2019 using data from the Stroke Registry. Methods: The data were derived from Stroke Registry between 2004 and 2019 in Bishkek through examination of records of patients admitted to hospitals and those receiving treatment at home prescribed by doctors of Registry. A retrospective epidemiological study of the long-term dynamics of the morbidity and mortality rates between 2004 and 2019 was performed. The growth (drawdown) rate was calculated using the least-squares method to align the time series. A comparative analysis of the rates was carried out by calculating the long-term average annual level of incidence by gender and age. Ethical approval was not necessary for the preparation of this article. Results: The most common type of stroke registered for the population of Bishkek was ischemic stroke (IS) (68.5%), followed by hemorrhagic stroke (HS) (21.4%) and cryptogenic stroke (10.1%). During the analyzed period of time there has been a moderate decrease in the incidence of IS (4,0%) and a notable decrease of HS (9,0%) and cryptogenic (26,9%) strokes. As for stroke mortality in long-term dynamics, we could observe an essential decrease in this indicator in all strokes (IS-13.0%, HS 13.6%, cryptogenic ones-37.7%). The most remarkable risk factor for stroke was arterial hypertension (86.5%). Cardiovascular pathology of another origin was detected in 32.7% of patients. Conclusion: Our results further help to understand what changes have been in the long-term dynamics of the incidence and mortality of stroke in Kyrgyzstan, in relation to which risk factors for stroke should be taken more action. There is a need to continue to strengthen prevention at the population level, to assess and manage the risk of cardiovascular disease in primary healthcare. Such measures will help prevent complications and support efforts to prevent relapse and disability.

Arsenic exposure incurs hyperglycemia mediated by oxidative damage in urban adult population: A prospective cohort study with three repeated measures

The associations and potential mechanisms of low to moderate arsenic exposure with fasting plasma glucose (FPG) and type 2 diabetes mellitus (T2DM) are still unclear. To assess the effects of short-term and long-term arsenic exposure on hyperglycemia and the mediating effect of oxidative damage on such association, three repeated-measures studies with 9938 observations were conducted in the Wuhan-Zhuhai cohort. The levels of urinary total arsenic, FPG, urinary 8-iso-prostaglandin F2alpha (8-iso-PGF2α), urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), and plasma protein carbonyls (PCO) were measured. Generalized linear mixed models were used to evaluate the exposure-response relationships of urinary total arsenic with FPG and the prevalent risks of impaired fasting glucose (IFG), T2DM, and abnormal glucose regulation (AGR). Cox regression models were applied to assess the associations of arsenic exposure with incident risks of IFG, T2DM, and AGR. Mediation analyses were performed to assess the mediating effects of 8-iso-PGF2α, 8-OHdG, and PCO. In cross-sectional analyses, each one-unit increase in natural log-transformed urinary total arsenic was associated with a 0.082 (95% CI: 0.047 to 0.118) mmol/L increase in FPG, as well as a 10.3% (95% CI: 1.4%–20.0%), 4.4% (95% CI: 5.3%–15.2%), and 8.7% (95% CI: 1.2%–16.6%) increase in prevalent risks of IFG, T2DM, and AGR, respectively. In longitudinal analyses, arsenic exposure was further associated with the annual increased rate of FPG with a β (95% CI) of 0.021 (95% CI: 0.010 to 0.033). The incident risks of IFG, T2DM, and AGR were increased without statistical significance when arsenic levels increased. Mediation analyses showed that 8-iso-PGF2α and PCO mediated 30.04% and 10.02% of the urinary total arsenic-associated FPG elevation, respectively. Our study indicated that arsenic exposure was associated with elevated level and progression rate of FPG among general Chinese adults, where lipid peroxidation and oxidative protein damage might be the potential mechanisms.

Fine-scale mapping of urban malaria exposure under data scarcity: an approach centred on vector ecology

BackgroundAlthough malaria transmission has experienced an overall decline in sub-Saharan Africa, urban malaria is now considered an emerging health issue due to rapid and uncontrolled urbanization and the adaptation of vectors to urban environments. Fine-scale hazard and exposure maps are required to support evidence-based policies and targeted interventions, but data-driven predictive spatial modelling is hindered by gaps in epidemiological and entomological data. A knowledge-based geospatial framework is proposed for mapping the heterogeneity of urban malaria hazard and exposure under data scarcity. It builds on proven geospatial methods, implements open-source algorithms, and relies heavily on vector ecology knowledge and the involvement of local experts.MethodsA workflow for producing fine-scale maps was systematized, and most processing steps were automated. The method was evaluated through its application to the metropolitan area of Dakar, Senegal, where urban transmission has long been confirmed. Urban malaria exposure was defined as the contact risk between adult Anopheles vectors (the hazard) and urban population and accounted for socioeconomic vulnerability by including the dimension of urban deprivation that is reflected in the morphology of the built-up fabric. Larval habitat suitability was mapped through a deductive geospatial approach involving the participation of experts with a strong background in vector ecology and validated with existing geolocated entomological data. Adult vector habitat suitability was derived through a similar process, based on dispersal from suitable breeding site locations. The resulting hazard map was combined with a population density map to generate a gridded urban malaria exposure map at a spatial resolution of 100 m.ResultsThe identification of key criteria influencing vector habitat suitability, their translation into geospatial layers, and the assessment of their relative importance are major outcomes of the study that can serve as a basis for replication in other sub-Saharan African cities. Quantitative validation of the larval habitat suitability map demonstrates the reliable performance of the deductive approach, and the added value of including local vector ecology experts in the process. The patterns displayed in the hazard and exposure maps reflect the high degree of heterogeneity that exists throughout the city of Dakar and its suburbs, due not only to the influence of environmental factors, but also to urban deprivation.ConclusionsThis study is an effort to bring geospatial research output closer to effective support tools for local stakeholders and decision makers. Its major contributions are the identification of a broad set of criteria related to vector ecology and the systematization of the workflow for producing fine-scale maps. In a context of epidemiological and entomological data scarcity, vector ecology knowledge is key for mapping urban malaria exposure. An application of the framework to Dakar showed its potential in this regard. Fine-grained heterogeneity was revealed by the output maps, and besides the influence of environmental factors, the strong links between urban malaria and deprivation were also highlighted.

Evaluation of missed influenza vaccination opportunities in the emergency department

BackgroundSeasonal influenza is associated with significant healthcare resource utilization. An estimated 490,000 hospitalizations and 34,000 deaths were attributed to influenza during the 2018–2019 season. Despite robust influenza vaccination programs in both the inpatient and outpatient setting, the emergency department (ED) represents a missed opportunity to vaccinate patients at high risk for influenza who do not have access to routine preventive care. Feasibility and implementation of ED-based influenza vaccination programs have been previously described but have stopped short of describing the predicted health resource impact. The goal of our study was to describe the potential impact of an influenza vaccination program in an urban adult emergency department population using historic patient data. MethodsThis was a retrospective study of all encounters within a tertiary care hospital-based ED and three freestanding EDs during influenza season (defined as October 1 – April 30) over a two-years, 2018–2020. Data was obtained from the electronic medical record (EPIC®). All ED encounters during the study period were screened for inclusion using ICD 10 codes. Patients with a confirmed positive influenza test and no documented influenza vaccine for the current season were reviewed for any ED encounter at least 14 days prior to the influenza-positive encounter and during the concurrent influenza season. These ED visits were deemed a missed opportunity to provide vaccination and potentially prevent the influenza-positive encounter. Healthcare resource utilization, including subsequent ED encounters and inpatient admissions, were evaluated for patients with a missed vaccination opportunity. ResultsA total of 116,140 ED encounters occurred during the study and were screened for inclusion. Of these, 2115 were influenza-positive encounters, which represented 1963 unique patients. There were 418 patients (21.3%) that had a missed opportunity to be vaccinated during an ED encounter at least 14 days prior to the influenza-positive encounter. Of those with a missed vaccination opportunity, 60 patients (14.4%) had subsequent influenza-related encounters, including 69 ED visits and 7 inpatient admissions. ConclusionPatients presenting to the ED with influenza frequently had opportunities to be vaccinated during prior ED encounters. An ED-based influenza vaccination program could potentially reduce influenza-related burden on healthcare resources by preventing future influenza-related ED encounters and hospitalizations.

A study to assess the prevalence of -hypertension among males residing in the community –Area

One in three adults has raised blood pressure worldwide, a condition that causes around half of all deaths from stroke and heart disease and it’s a growing public health problem. Studies show that for every known person with hypertension there are two persons with either undiagnosed hypertension or pre hypertension.Research design: one group pre test post test design, sample: Male Sample Size: 236. The total number of study participants was 236 and their mean age was 53.7 ± 12.4 years. Around two-third (66.5%) were females. Majority (81.8%) of them were married. Only 18.6% were graduates &amp; above. More than half of them (57.2%) were housewives and only 18.2% were having regular income. Around 47.9% were in high socio economic status (SES) and only 16.9% were in low SES. Majority (90.3%) of them were non-vegetarians.In this study, the results had showed that the prevalence of hypertension had significantly increased with time and is very high (52.1%) in the urban adult population of Puducherry in South India.

Consumption of Sugary Drinks among Urban Adults in Colombia: Association with Sociodemographic Factors and Body Adiposity.

Calories from sugar-sweetened beverages (SSBs) contribute to the development of noncommunicable diseases. There is limited knowledge of the intake of SSBs and their correlates in developing countries. Thus, this study aimed to estimate the consumption of multiple SSBs and their sociodemographic correlates in an urban adult population from Colombia, South America. This was a probabilistic, population-level study of adults aged 18 to 75 from five cities representing different regions of Colombia. Dietary intake was assessed employing a 157-item semiquantitative food frequency questionnaire that inquired about intake over the last year. The consumption of regular soda, low-calorie soda, homemade and industrialized fruit juices, energy drinks, sport drinks, malt drinks and traditional sugar cane infusion ("agua de panela") was analyzed for the total sample and subgroups defined by sociodemographic and clinical factors of interest. The study included 1491 individuals (female: 54.2%, mean age: 45.3, overweight: 38.0%, obese: 23.3%). Sugary beverages contributed, on average, 287 Cal/d among women and 334 Cal/d among men, representing 8.9% of total daily calories (TDC). Women in the lowest SEL consumed 10.6% of their TDC from sugary drinks, as opposed to 6.6% for those in a high SEL. For men, this difference was not present (p-value for interaction = 0.039). Interestingly, a higher educational level correlated with a lower consumption of calories from sugary drinks only among men. Fruit juices were by far the main source of sugary drinks, and their consumption did not change sizably by sex and socioeconomic or educational level. Among women, there was a negative association between socioeconomic level (SEL) and consumption of regular soda, a 50% difference between extreme levels. The intake of low-calorie soda was much higher among men than women, and it more than tripled in the highest vs. lowest SEL among men. The consumption of energy drinks was heavily concentrated in men of low SEL. Colombian urban adults obtain a considerable proportion of their calories from sugary drinks, especially vulnerable groups such as women with lower education. Given the recent acceleration of the obesity epidemic in Latin America, strategies to limit the intake of such liquid calories may provide important public health benefits.