Community-based Case-control Study Research Articles

SARS-CoV-2 infection is associated with low back pain: findings from a community-based case-control study

ObjectivesPain is a significant complaint of patients with postacute COVID-19 syndrome; however, little is known about the association between SARS-CoV-2 infection and pain. This study aimed to (1) examine the association between SARS-CoV-2 infection and low back pain (LBP) and (2) identify independent predictors of LBP among survivors of COVID-19.MethodsThis case-control study involved 878 participants aged ≥18 years. Data were collected from February 24 to April 7, 2022, in Bangladesh. LBP was measured using the musculoskeletal subscale of subjective health complaints produced by Eriksen et al. Descriptive analysis was performed to compute LBP prevalence and compare the prevalence across groups. Multiple logistic analyses helped to identify the predictors of LBP for survivors of COVID-19.ResultsOverall, 20% of participants reported LBP; however, the prevalence of LBP was significantly high among patients with postacute COVID-19 compared with their counterparts (24.4% vs 15.7%, P = 0.001). Regression analysis for all participants suggested that SARS-CoV-2 infection was independently associated with LBP (adjusted odds ratio 1.837, 95% confidence interval 1.253–2.692). However, moderate COVID-19 symptom (adjusted odds ratio 1.754, 95% confidence interval 0.984–3.126) was the only statistically significant predictor of LBP among postacute COVID-19 patients.ConclusionSARS-CoV-2 infection was associated with LBP, and moderate COVID-19 symptom was an independently associated factor of LBP. The health care facilities must be prepared to deal with the burden of LBP among patients with postacute COVID-19.

Determinants of Malaria Morbidity Among School-Aged Children Living in East Hararghe Zone, Oromia, Ethiopia: A Community-Based Case-Control Study.

BackgroundUnderstanding the determinants of malaria morbidity offers helpful insights toward the changing malaria situation, which might lead to the adjustment of malaria program activities. Even though the determinants of malaria morbidity remain unknown, school-aged children were the highest malaria morbidity contributors in the East Hararghe Zone. Therefore, this study aimed to assess the determinants of malaria morbidity among school-aged children in the study area from February 1 to May 31, 2020.MethodsA case-control study was conducted among school-aged children living in ten randomly selected low, moderate, and high malaria transmission kebeles. Cases were confirmed as positive for malaria, while controls were confirmed as negative for malaria among randomly selected school-aged children. Rapid diagnostic testing (RDT) and blood film (BF) malaria testing methods were used. Multivariable logistic regression was used to identify association between malaria and its determinants.ResultsThe determinants of malaria infection were having no formal education (adjusted odds ratio (AOR)=4.91, 95% CI: 1.20–20.17), low family wealth index (AOR=2.50, 95% CI: 1.22–5.12), being from rural residence (AOR=2.34, 95% CI: 1.87–4.12), living near to stagnant water (AOR=2.01, 95% CI: 1.14–3.54), having a maximum of three family members (AOR=0.37, 95% CI: 0.18–0.78), using indoor residual spraying (IRS) (AOR=0.15, 95% CI: 0.08–0.29) and long-lasting insecticide-treated net (LLITN) over the last night (AOR=0.19, 95% CI: 0.10–0.35), and living in the house surrounded by cultivated land(AOR=0.24, 95%CI: 0.10-0.60) compared with their counterparts.ConclusionThis study revealed that residence, family size, education, wealth index, stagnant water existence, and using LLITN and IRS had significant association with malaria morbidity. Thus, all concerned bodies, including the community should strengthen working on stagnant water elimination around their house to cut the breeding site of the malaria vector mosquito. Moreover, the findings have an important implication for improving interventions targeting the economic status and literacy of the society that may help in the reduction of the risk of malaria in the school-aged children.

Scabies Outbreak Investigation and Its Risk Factors in Gumbichu District, East Shewa Zone, Central Ethiopia: Unmatched Case-Control Study

Introduction: Scabies is one of the common public health problems but neglected parasitic diseases caused by Sarcoptes scabies var hominies. Global scabies prevalence was about a 204million cases with 0.21% of total disability-adjusted life years lost. In Ethiopia, scabies is common, especially during natural or man-made disasters. This study was aimed to investigate scabies suspected outbreak and risk factors in Gumbichu District, Central Ethiopia, 2021. Methods: A community-based unmatched case-control study among 96 participants (32 cases and 64 controls) was conducted in the Gumbichu district from July 1-20/2021. Data were collected using a structured questionnaire. Line-listed data were entered into Microsoft Excel for descriptive analyses. Multivariable logistic regression analysis was computed using SPSS version 25 to identify factors associated with scabies. The odds ratio of 95% CI and a p-value less than 0.05 were used to describe the strength of the association and statistical significance. Results: A total of 1231 scabies cases line listed with overall attack rate of 16/1,000 population. The mean age was 14 years, and most affected age group was 5–14 years. Frequency of shower per month [AOR (95% CI) = 6.51(1.26-33.54)], sleeping with scabies patient [AOR (95% CI) = 10.52(3.75-29.53)], contact history [AOR (95%) = 11.44(1.72-76.22)], family size ≥5 [AOR (95% CI) = 8.63(2.42-30.84)], and sharing clothes with scabies cases [AOR (95% CI) = 14.31(3.04-67.35)] were found to be determinant factors of scabies outbreak. Conclusion: Frequency of shower per month, contact history, sleeping with scabies case, family size ≥5, and sharing clothes with scabies case were associated with a high frequency of scabies. Therefore, it is recommended to raise awareness about the transmission, prevention, and control of scabies disease.

Predictors of facility-based delivery utilization in central Ethiopia: A case-control study.

BackgroundImproving access to maternal health services has been a priority for the health sector in low-income countries; the utilization of facility delivery services has remained low. Although Ethiopia provides free maternal health services in all public health facilities utilization of services has not been as expected.ObjectiveThis study examined predictors of facility delivery service utilization in central Ethiopia.MethodsWe conducted a community-based case-control study within the catchment areas of selected public health facilities in central Ethiopia. Women who delivered their last child in a health facility were considered as cases and women who delivered their last child at home were considered as controls. Data were collected using a structured questionnaire. Multivariable logistic regression analysis was used to identify independent predictors of facility delivery utilization.ResultFacility delivery was positive and strongly associated with practicing birth preparedness and complication readiness (BPCR) (AOR = 12.3, 95%CI: 3.9, 39.1); partners’ involvement about obstetric assistance (AOR = 3.1, 95%CI: 1.0, 9.0); spending 30 or less minutes to decide on the place of delivery and 45 or less minutes to walk to health facilities (AOR = 7.4, 95%CI: 2.4, 23.2 and AOR = 8.1, 95%CI: 2.5, 26.9, respectively). Additionally, having knowledge of obstetric complication, attending ≥ 4 antenatal care (ANC) visits, birth order and the use of free ambulance service also showed significant association with facility delivery.ConclusionDespite the availability of free maternal services there are still many barriers to utilization of delivery services. Strengthening efforts to bring delivery services closer to home and enhancing BPCR are necessary to increase institutional delivery service utilization.

Metabolic syndrome and comorbidities in patients with psoriasis: a community-based case-control study from the Nagahama cohort in Japan.

Metabolic syndrome and comorbidities in patients with psoriasis: a community-based case-control study from the Nagahama cohort in Japan.

Determinants of complementary feeding initiation time among 6–23 months children in Gedeo Zone, South Ethiopia: Community-based case-control study

IntroductionAcross the world, nutritional problems related to complementary feeding practices were among the leading killers for most of under-5 children. Timely initiation of complementary feeding was found to be a protective factor for stunting, furthermore, inappropriate timing of complementary feeding initiation was a risk factor for stunting and wasting, respectively. Therefore, this study intended to identify maternal and household determinants of complementary feeding initiation time among children aged 6 to 23 months in Gedeo Zone, South Ethiopia. MethodsA community-based unmatched case-control study was conducted. Multistage sampling technique was used to get a total of 360 (equal proportion of cases and control) children with the age of between 6 and 23 months from their kebeles from March to May 2021. Data was collected by using face-to-face interview with structured questionnaires. It was entered into Epi data version 3.1 and exported to SPSS version 23 for analysis. Variables having p ≤ 0.25 at bivariate analysis were fitted to multivariable analysis. Multivariable logistic regression model was used at 95% confidence interval and with P-Value < 0.05. ResultsIn this study, marital status [AOR = 9.04, 95% CI= (2.32, 35.16)], maternal level of education (AOR = 0.14, 95% CI= (0.03, 0.68)), household feeding decision maker (AOR = 5.37, 95% CI= (1.95, 14.78)), household food insecurity (AOR = 3.35, 95% CI (1.25, 8.95)), household feeding preference [AOR = 2.79, 95% CI (1.21, 6.41)], family perception of breast feeding initiation time (AOR = 2.57, 95% CI (1.23, 5.39)), knowledge [AOR = 3.43 (95% CI (1.68, 4.67))] and perception on availability of health facility (AOR = 5.04, 95% CI (1.82, 13.94)) were determinants of complementary feeding initiation practices. ConclusionsMarital status, maternal level of education, household feeding decision maker, household food insecurity, household feeding preference, family perception of breast feedinginitiation time, knowledge, and perception on availability of health facilities were determinants of complementary feeding initiation practices. Complementary consumption should be promoted among women who have a negative opinion of complementary feeding, and women should be empowered to make better decisions about feeding their babies.

Determinants of long-acting reversible contraceptive use among women in Jawi woreda, North West Ethiopia: A case-control study.

Objectives:The utilization of long-acting reversible contraceptive methods is one of the key factors in protecting women and couples against unwanted pregnancies. The study aimed to assess the determinants of long-acting reversible contraceptive use among women in Northwest Ethiopia.Methods:A community-based unmatched case-control study was conducted from 1 February to 8 March 2017 in Northwest Ethiopia. The cases were women who used long-acting reversible contraceptive methods, and the controls were women who used short-acting contraceptives. Both of them were selected using a systematic sampling method. An interviewer-administered questionnaire was used to collect the data. Epi info and SPSS version 23 were used for data entry and analysis, respectively. Descriptive statistics and association measures were done and presented in texts, tables, and figures.Results:A total of 882 women were interviewed, with a response rate of 99.3%. Women who were between 15 and 24 years old were two times more likely to use long-acting reversible contraceptive methods than those whose age was ⩾35 (adjusted odds ratio = 2, 95% confidence interval: (1.20, 3.50)). A good level of knowledge about long-acting reversible contraceptive methods (adjusted odds ratio = 11.6, 95% confidence interval: (5.42, 24.80)), a negative attitude toward long-acting reversible contraceptive methods (adjusted odds ratio = 0.31, 95% confidence interval: (0.21, 0.46)), membership in the health development army (adjusted odds ratio = 2.8, 95% confidence interval: (2.12, 3.78)), no discussion with a partner about long-acting reversible contraceptive methods (adjusted odds ratio = 2.3, 95% confidence interval: (1.54, 3.49)), and more than 2 years of desire to wait before another pregnancy (adjusted odds ratio = 23.7, 95% confidence interval: (11.63, 48.55)) were determinants of long-acting reversible contraceptive methods use.Conclusion:This study revealed that attitude toward long-acting reversible contraceptive method use, being a member of the women’s health development army, and the desire to space children were determinants of long-acting reversible contraceptive method use. More actions should be taken to increase the utilization of long-acting reversible contraceptive methods by promoting discussion between partners about modern contraceptives and increasing women’s participation in being a member of the health development army.

SARS-CoV-2 Infection is Associated with Low Back Pain: Findings from a Multicenter Community-Based Case-Control Study

SARS-CoV-2 Infection is Associated with Low Back Pain: Findings from a Multicenter Community-Based Case-Control Study

Role of Polygenic Risk Score in the Familial Transmission of Bipolar Disorder in Youth

Establishing genetic contributions to the transmission of bipolar disorder (BD) from parents to offspring may inform the risk of developing this disorder and further serve to validate BD in youth. To evaluate the specific association of BD polygenic risk scores (PRSs) on the familial transmission and validity of pediatric BD. This community-based case-control longitudinal study (Pittsburgh Biological Offspring Study) included parents with BD I/II and their offspring and parents without BD (healthy or non-BD psychopathology) and their offspring. Participants were recruited between March 2001 and May 2007, and analysis took place from December 2020 to September 2021. PRSs for BD, major depressive disorder, schizophrenia, and attention-deficit/hyperactivity disorder. Participants were prospectively evaluated using standardized interviews blind to parental diagnosis. DNA was extracted from saliva and genotyped. PRSs were constructed based on independent large-scale genome-wide association studies. A total of 156 parents with BD I/II and 180 parents without BD (mean [SD] age, 39.6 [7.9] years; 241 female [72%]) as well as 251 offspring of parents with BD and 158 offspring of parents without BD (mean [SD] age, 10.4 [4.7] years; 213 female [52%]) of European ancestry were analyzed. Participants were assessed a mean of 6.7 times during a mean (SD) of 13 (3.4) years of follow-up (84% retention). More offspring of parents with BD developed BD (58 [23.1%] vs 8 [5.1%]; P < .001) and depression (126 [50.2%] vs 52 [32.9%]; P < .001) compared with offspring of parents without BD. BD PRS was higher in both parents and offspring with BD than parents and offspring without BD (parents: odds ratio, 1.50; 95% CI, 1.19-1.89; P < .001; explained 4.8% of the phenotypic variance vs offspring: hazard ratio, 1.34; 95% CI, 1.03-1.7; P = .02; explained 5.0% of the phenotypic variance). BD PRS did not differ across BD subtypes. In a model combining parental and offspring BD PRS, the parental BD PRS association with offspring BD was fully mediated by offspring BD PRS (hazard ratio, 1.40; 95% CI, 1.05-1.86; P = .02). Parental BD had a stronger direct association than parental or offspring BD PRS with offspring BD risk (hazard ratio, 5.21; 95% CI, 1.86-14.62; P = .002), explaining 30% of the variance. Parental and offspring BD PRS explained 6% of the BD onset variance beyond parental diagnosis. There were no significant between-group differences in PRSs for major depressive disorder, schizophrenia, and attention-deficit/hyperactivity disorder in parents or offspring and they were not significantly associated with BD onset. The findings of this study add to the extant clinical validation of BD in youth. Parental BD and offspring BD PRS independently associated with the risk of BD in offspring. Although this is promising, the association of BD PRS was relatively small and cannot be used alone to determine BD risk until further developments occur.

Determinants of diarrheal diseases among under five children in Jimma Geneti District, Oromia region, Ethiopia, 2020: a case-control study

BackgroundGlobally, in 2017, there were nearly 1.7 billion cases of childhood diarrheal diseases, and it is the second most important cause of morbidity and mortality among under-five children in low-income countries, including Ethiopia. Sanitary conditions, poor housing, an unsanitary environment, insufficient safe water supply, cohabitation with domestic animals that may carry human pathogens, and a lack of food storage facilities, in combination with socioeconomic and behavioral factors, are common causes of diarrhea disease and have had a significant impact on diarrhea incidence in the majority of developing countries.MethodsA community-based unmatched case-control study was conducted on 407 systematically sampled under-five children of Jimma Geneti District (135 with diarrhea and 272 without diarrhea) from May 01 to 30, 2020. Data was collected using an interview administered questionnaire and observational checklist adapted from the WHO/UNICEF core questionnaire and other related literature. Descriptive, bivariate, and multivariate binary logistic regression analyses were done by using SPSS version 20.0.ResultSociodemographic determinants such as being a child of 12–23 months of age (AOR 3.3, 95% CI 1.68–6.46; P < 0.05) and mothers’/caregivers’ history of diarrheal diseases (AOR 7.38, 95% CI 3.12–17.44; P < 0.05) were significantly associated with diarrheal diseases among under-five children. Environmental and behavioral factors such as lack of a hand-washing facility near a latrine (AOR 5.22, 95% CI 3.94–26.49; P < 0.05), a lack of hand-washing practice at critical times (AOR 10.6, 95% CI 3.74–29.81; P < 0.05), improper domestic solid waste disposal (AOR 2.68, 95% CI 1.39–5.18; P < 0.05), and not being vaccinated against rotavirus (AOR 2.45, 95% CI 1.25–4.81; P < 0,05) were found important determinants of diarrheal diseases among under-five children.ConclusionThe unavailability of a hand-washing facility nearby latrine, mothers’/caregivers’ history of the last 2 weeks’ diarrheal diseases, improper latrine utilization, lack of hand-washing practice at critical times, improper solid waste disposal practices, and rotavirus vaccination status were the determinants of diarrheal diseases among under-five children identified in this study. Thus, promoting the provision of continuous and modified health information programs for households on the importance of sanitation, personal hygiene, and vaccination against rotavirus is fundamental to decreasing the burden of diarrheal disease among under-five children.

Community-based case control study on the risk of fall among elderly in Kaniyambadi block, Vellore, Tamil Nadu, India

BackgroundFall injuries are a major cause of morbidity and disability in elderly. The magnitude of association of risk factors, the economic burden, and other consequences of fall in the elderly is less studied in India. MethodsA Community based matched case-control study was conducted among elderly ≥60 years, elders with a history of fall in the past 1 year was identified as cases. One control per case were selected, each case and control were matched for age and gender. Both groups were randomly selected from older people (age ≥60) living in Kaniyambadi block identified by door-to-door survey. Univariate analysis, stratified analysis and multivariate analysis was performed. ResultsHaving 141 cases of fall among 776 elders contacted, 18.17% (15.6-21.1) was estimated as the incidence of fall. The independent risk factors were identified as dizziness OR 2 (1.3 to 3.8) times and difficulty in walking OR 3 (1.7 to 5.9) times more likely for fall. Certain risk factors were found to be different in men and women. Among the 141 falls 110 (78%) had economic burden due to fall. Rs. 2370 was the mean expense for a fall, maximum of Rs 33,000 to a minimum of Rs 10 were spent because of falling. ConclusionThis study was one of the first community bases case-control studies in India on the risk of fall in elderly people. The study provides the important information on risk and protective factors for fall in rural Indians. The information could be used to develop targeted interventions to prevent the fall in this vulnerable age group.

Association between anxiety symptoms and atrial fibrillation in a community cohort of Chinese older adults: a case-control study

BackgroundThe association between anxiety and atrial fibrillation (AF) remains unclear. Moreover, this association has rarely been studied in Chinese individuals aged 60 years or older. This study investigated the association between anxiety and AF in a community-based case-control study of older adult residents in urban China.MethodsThe cases and controls were from a community-based study conducted in the Jingansi community in Shanghai, China, between January 2010 and December 2012. A total of 3622 residents aged 60 years or older without severe vision, hearing, or speaking impairments were eligible to participate in the physical examinations and questionnaire survey. AF was assessed based on a previous physician’s diagnosis, electrocardiogram, ambulatory electrocardiogram, or echocardiogram. Anxiety was evaluated using the Zung Self-Rating Anxiety Scale (ZSAS). Using the AF group as a reference, the control group consisted of randomly selected age- and sex-matched individuals in a 1:5 ratio (case:control = 1:5). The association between anxiety and AF in the AF group and the multifactor-matched control group was explored using logistic regression.ResultsIn the AF and control groups, after adjusting for a history of coronary heart disease, valvular heart disease, hypertension, stroke, hyperlipidemia, and diabetes, as well as depression score, ZSAS scores (odds ratio 1.07; 95% confidence interval 1.02–1.12; p = 0.003), and anxiety symptoms (odds ratio 3.94; 95% confidence interval 1.06–14.70; p = 0.041) were associated with AF.ConclusionsAnxiety symptoms were associated with AF in a Chinese older population. This suggests that older adults who have anxiety symptoms may need psychological intervention or treatment in daily life and care.

886Serum folate and risk of disabling dementia: Community-based nested case-control study

Abstract Background Folate regulates homocysteine metabolism and high blood homocysteine level has been associated with risk of dementia. Accordingly, serum folate is hypothesized to decrease the risk of dementia but epidemiological evidence, especially for Japanese, is scant. The aim of this study was to examine associations between serum folate and risk of disabling dementia within a Japanese cohort over 20 years of follow-up. Methods We performed an intracohort case-control study nested in a community-based cohort, the Circulatory Risk in Communities Study (CIRCS), involving 13934 Japanese individuals aged 40-84 years at the baseline period of 1984-2005. Serum folate was measured in 511 cases of incident disabling dementia, and in 1022 controls whose age (±1 years), sex, area, and baseline year were matched with the cases. The diagnosis of disabling dementia was performed by attending physicians under the National Long-Term Care Insurance System in Japan. Conditional odds ratios of disabling dementia according to quintiles of serum folate were calculated using conditional logistic regression models. Results Serum folate was inversely associated with risk of disabling dementia. The multivariate odds ratios (95% confidence intervals) were 0.62(0.43-0.88), 0.71(0.49-1.00), 0.63(0.43-0.91), and 0.51(0.34-0.76) for persons with the second, third, fourth, and highest quintiles of serum folate, respectively, compared with the lowest quintiles (P for trend = 0.19). Conclusions Low serum folate level was associated with increased risk of disabling dementia among Japanese. Key messages e Low folate intake may have an adverse effect on developing dementia.

The Relationship of Tobacco, Alcohol, and Betel Quid with the Formation of Oral Potentially Malignant Disorders: A Community-Based Study from Northeastern Thailand

This study’s objective was to describe the relationship between the main risk factors for oral cancer, including tobacco (in the form of cigarettes, smokeless tobacco (SLT), secondhand smoking (SS)), alcohol, and betel quid (BQ), and the occurrence of oral potentially malignant disorders (OPMDs). A community-based case-control study was conducted with a population of 1448 adults aged 40 years or above in northeastern Thailand. Patients aged 60 years or above (OR 1.79, p < 0.001) and female patients (OR 2.17, p < 0.001) had a significant chance of having OPMDs. Our multivariate analysis showed that the most potent risk factor for OPMDs occurrence was betel quid (BQ) (adjusted OR 4.65, p < 0.001), followed by alcohol (OR 3.40, p < 0.001). Even former users were at risk of developing OPMDs. The synergistic effect between these main risk factors was significantly shown in the group exposed to SLT, SS, BQ, and alcohol. The most potent synergistic effect was found in the group exposed to SLT, BQ and alcohol with the OR = 20.96.

Increased Systolic Blood Pressure Mediates the Relationship Between Urate and Gout Risk in Indonesia: A Novel Application of a Partial Least Squares-Structural Equation Model.

Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout. We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model. A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting. We found that a 1 mg/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48-7.09) and an AOR of 4.44 (95% CI: 3.07-6.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (β = 0.05; 95% CI Bias Corrected [0.02-0.08], p < 0.001). Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.

Predictors of Partial Immunization Among Children Aged 12-23 Months in Yirga Cheffe District, South Ethiopia - A Community-Based Unmatched Case-Control Study.

BackgroundUniversal age-specific immunization is one of the areas where preventive public health policy has become successful. Despite the increase in global immunization coverage, however, many children around the world, especially in developing countries, are still left unvaccinated. The study aimed at assessing the determinants of partial immunization among children 12–23 months of age in Yirga Cheffe, Gedeo, Ethiopia.MethodologyA community-based unmatched case-control study design was conducted. Using a simple random sampling technique, 328 samples (164 cases and 164 controls) were selected. Index case was defined as a child aged 12 to 23 months who missed at least one dose of vaccine from the scheduled dose. The odds ratio (OR) and 95% confidence interval (CI) were used to calculate the association, and the level of significance was set at p 0.05.The ResultThe study showed that 40% of children were fully vaccinated, and the prevalence of those with partial vaccination was 46%. The likelihood of having incomplete vaccination was 45% higher in children whose mothers had no antenatal coverage (ANC) visit during pregnancy [OR=0.55, (95% CI; 0.297, 1.035)]. Lack of knowledge about the schedule of the vaccination has negatively affected the success of full vaccination (OR=2.3; 95% CI=1.01, 5.56).ConclusionThe study revealed that significant numbers of children are not fully vaccinated. Despite appreciable efforts by the Federal Ministry of Health to improve complete immunization coverage, there are still bottlenecks that need to be tackled in enhancing coverage. We recommend the expansion of ANC and providing education on vaccination schedule and importance to minimize the burden of partial vaccinations and its sequelae.

Evaluation of association of psychosocial stress and hypertension in adults &gt;30 years of age

Background: Hypertension has multifactorial causation. Stress has chronically been cited as an imperative cause of hypertension among other risk factors such as sleep abnormalities. The interrelation between psychosocial stress and hypertension has been significant though the exact association remains debatable. Objective: The objective of the study was to evaluate the association of psychosocial stress and other factors such as family and social support, sleep abnormalities, physical activity, and addiction with hypertension in adults &gt;30 years of age. Materials and Methods: Age- and sex-matched community-based case–control study with 90 incident hypertensive cases aged (&gt;30) and 90 controls were selected from rural populations in central India. Study participants were examined and interviewed regarding their sociodemographic characteristics, psychosocial stress, family and social support, quality of sleep, addiction, and physical activity using four structured and validated questionnaires. Data analysis was done by binomial logistic regression with SPSS (version 21). Results: Psychosocial stress was significantly associated with incident hypertension (adjusted odds ratio [AOR] =8.198, 95% confidence interval [C.I.] 2.85–23.52). Participants having compromised family and social support (AOR = 3.0, 95% C.I: 1.41–6.34), poor quality of sleep (AOR = 4.429, 95% C.I: 1.78–10.96), and low physical activity (AOR = 2.92, 95% C.I: 1.22–6.98) had higher odds of developing hypertension. Sedentary occupation, lower socioeconomic status, and body mass index ≥23 kg/m2 each had an association with hypertension. Conclusion: This study highlights a significant number of undiagnosed or untreated cases of psychosocial distress in the community. Thus, calling for immediate attention toward psychosocial stress as an important etiological determinant of hypertension.

Risk factors of pulmonary tuberculosis: A community-based case control study

Studies on risk factors of tuberculosis help to focus on risk of tuberculosis and take appropriate policy action which help to eliminate tuberculosis. Hence present study was carried out to study risk factors of pulmonary tuberculosis. Community-based case-control studywas carried out among 78 age and sex matched cases and controls. Cases were incident cases of pulmonary tuberculosis aged 18-45 years of either sex. Data on housing condition was recorded with direct observation. Cases and controls were comparable for age, sex, presence of diabetes, HIV and immuno-compromised status. Mean body mass index was significantly low in cases as compared to controls (18.06 vs. 22.05; p&lt;0.0001). On binomial logistic regression odds of tuberculosis was 5.544 (95%CI=2.513-12.232; P=0.000) among those exposed to indoor air pollution after controlling for other factors. We conclude that exposure to indoor air pollution was significantly associated with risk of pulmonary tuberculosis

Prevalence and risk factors of mcr-1-positive volunteers after colistin banning as animal growth promoter in China: a community-based case–control study

ObjectivesChina banned the use of colistin as animal growth promoter in April 2017. Herein, we report the prevalence of mcr-1 in the intestine of healthy humans and risk factors associated with mcr-1 carriage after the implementation of the ban. MethodsWe recruited 719 healthy volunteers from Shenzhen City from 1 March 2018 to 31 December 2019 to investigate the prevalence of mcr-1 in human intestine, and undertook a case–control study to ascertain the risk factors associated with the mcr-1-positive population. A further comparative study was conducted to identify differences between genetic characteristics of mcr-1-positive and mcr-1-negative Escherichia coli. ResultsOverall, 56 (7.8%, 95% CI 5.9%–10.0%, n = 719) individual faecal samples were positive for mcr-1, and prevalence of mcr-1 among individuals in 2019 (2.4%, 95% CI 8.7%–15.0%, 7/294) was significantly lower than that in 2018 (11.5%, 95% CI 1.0%–4.8%, 49/425) (p < 0.0001). After the colistin ban, animal-derived food (pork and chicken meat) was no longer a risk factor for mcr-1 carriage in human intestine, whereas a higher intake of fish and seafood (>75 g/day) and whole grains (>150 g/day) was associated with higher and lower risk of mcr-1 carriage, respectively (OR 2.175, 95% CI 1.047–4.517; OR 0.045, 95% CI 0.004–0.567). Compared with mcr-1-negative E. coli, the mcr-1-positive E. coli had different patterns of resistance genes and genetic heterogeneity. ConclusionsOur study implicates aquatic food as beeing associated with mcr-1 carriage in the healthy population, even after the ban on colistin. Dietary modification (e.g. whole grains) may help to combat mcr-1-positive bacterial colonization of the gut.

Dose-Effect Relationship Between Gastric Cancer and Common Digestive Tract Symptoms and Diagnoses in Anhui, China.

BackgroundEarly prevention and diagnosis are key to reducing the huge burden of gastric cancer (GC). Nearly half of the population worldwide are suffering from some form of digestive tract conditions (symptoms/diagnoses, DTCs) but their relations with GC are not well understood. We aim to explore the relationships (especially dose–effect relationships) between GC and DTCs.MethodsThis study used data from a community-based case–control study in Anhui, China during 2016–2019 and performed multivariate conditional logistic regression modeling of the associations between GC and DTCs.ResultsA total of 2255 participants (451 cases and 1804 controls) completed the study. Statistically significant relations (P<0.05) were found between GC and the presence of gastroesophageal reflux [odds ratio (OR)=1.41], odynophagia (OR=1.87), stomach discomfort (OR=1.86), poor appetite (OR=2.01) and Helicobacter pylori (H. pylori) infection (OR=4.39). When the DTCs were divided into duration grades, all these ORs presented an increasing trend (P<0.05), being 1.89 to 2.45 for gastroesophageal reflux, 1.63 to 3.78 for stomach discomfort, 2.36 to 5.29 for poor appetite, and 3.95 to 10.03 for H. pylori infection. When the DTCs were divided into severity grades, the ORs also witnessed an increasing trend (P<0.05), being 1.69 to 2.52 for gastroesophageal reflux, 2.44 to 3.56 for stomach discomfort, and 2.22 to 2.75 for poor appetite. When the DTCs were divided into duration-severity grades, the ORs displayed a much steeper increasing trend, being 0.49 to 4.96 for gastroesophageal reflux, 1.50 to 6.33 for odynophagia, 0.47 to 3.32 for stomach discomfort, and 0.40 to 10.47 for poor appetite. In contrast, the ORs for the lower DTCs were generally tested without statistical significance.ConclusionThe study revealed consistent dose–effect associations between GC and duration of gastroesophageal reflux, stomach discomfort, poor appetite, and H. pylori infection; severity of gastroesophageal reflux, stomach discomfort and poor appetite; and duration-severity of gastroesophageal reflux, odynophagia, stomach discomfort and poor appetite. These should inform future prevention, diagnosis and further research in patients with GC.