Community-based Cross-sectional Survey Research Articles

Incomplete immunization uptake and associated factors among children aged 12–23 months in sub-Saharan African countries; multilevel analysis evidenced from latest demography and health survey data, 2023

BackgroundIn 1974, the World Health Organization (WHO) established the Expanded Program on Immunization to control vaccine-preventable diseases, saving millions of lives annually. However, the coverage of basic vaccines recommended by the WHO in Africa was only 75%, which fell short of the goal of 90% by 2015. To formulate effective policies and implementation programs to reduce incomplete vaccination rates, it is important to conduct a study to determine the factors contributing to incomplete immunization among children aged 12–23 months.MethodsThe study was conducted in 16 sub-Saharan African countries, using data extracted from the latest DHS data. It was a community-based cross-sectional survey that used two-stage stratified probability sampling sample designs. The vaccination coverage was assessed using vaccination cards and mother recalls. Multilevel multivariable logistic regression was used to determine the extent of incomplete immunization and the individual and community-level factors associated with partial immunization among children aged 12–23 months. Variables with a p-value less than 0.05 were considered statistically significant predictors of incomplete immunization.ResultA total of 35, 193 weighted samples were used to determine the pooled prevalence of partial immunization. The pooled prevalence of incomplete immunization was 36.06%. In the final model factors significantly associated were: being uneducated mother(AOR:1.75;95%CI:1.48,2.05), being an unemployed mother (AOR:1.16;95%CI:1.09,1.23), no history of family planning utilization (AOR: 1.71; 95% CI: 1.61, 1.84), non-antenatal care (AOR: 1.79; 95% CI: 1.58, 2.04), non-postnatal care (AOR: 1.25; 95%CI: 1.17, 1.35), rural residence(AOR:1.50;95%CI:1.37,1.63), home delivery (AOR: 2.04; 95%CI:1.89, 2.21), having children more than five (AOR: 1.56; 95%CI: 1.13, 2.17), and non-utilization of health insurance (AOR: 1.74; 95%CI: 1.48, 2.05).ConclusionThe pooled prevalence of incomplete immunization was found to be high in this investigation. Based on the findings of the study we recommended that policymakers and stakeholders prioritize enhancing prenatal and postnatal care, contraception, and reducing home birth rates to minimize the rate of incomplete immunization.

Prevalence and predictors of residual antibiotics in children’s blood in community settings in Tanzania

ObjectiveChildren account for a significant proportion of antibiotic consumption in low- and middle-income countries, with overuse occurring in formal and informal health sectors. This study assessed the prevalence and predictors of residual antibiotics in the blood of children in Mbeya and Morogoro regions of Tanzania. MethodsThe cross-sectional community-based survey used two-stage cluster sampling to include children aged under 15 years. For each child, information on recent illness, healthcare-seeking behavior, and use of antibiotics, as well as a dried blood spot sample, were collected. The samples underwent tandem mass spectrometry analysis to quantify the concentrations of 15 common antibiotics. Associations between survey variables and presence of residual antibiotics were assessed using mixed-effects logistic regression. ResultsIn total, 1742 children were surveyed, and 1699 analyzed. The overall prevalence of residual antibiotics in the blood samples was 17.4% (296/1699), the highest among children under the age of five years. The most frequently detected antibiotics were trimethoprim (144/1699; 8.5%), sulfamethoxazole (102/1699; 6.0%), metronidazole (61/1699; 3.6%) and amoxicillin (43/1699; 2.5%). The strongest predictors of residual antibiotics in the blood were observed presence of antibiotics at home (aOR=2.9; 95% CI: 2.0–4.1) and reported consumption of antibiotics in the last two weeks (aOR=2.5; 95% CI: 1.6–3.9). However, half (145/296) of the children who had residual antibiotics in their blood, some with multiple antibiotics, had no reported history of illness or antibiotic consumption in the last two weeks, and antibiotics were not found at home. DiscussionThis study demonstrated a high prevalence of antibiotic exposure among children in Tanzanian communities, albeit likely underestimated, especially for compounds with short half-lives. A significant proportion of antibiotic exposure was unexplained and may have been due to unreported self-medication or environmental pathways. Incorporating biomonitoring into surveillance strategies can help better understand exposure patterns and design antibiotic stewardship interventions.

Factors associated with HIV pre-exposure prophylaxis use among Asian men who have sex with men in Sydney and Melbourne, Australia: a cross-sectional study

Asian-born MSM are a priority population as Australia aims to end HIV transmission, but they reported additional barriers to access PrEP and other HIV prevention methods. This study investigates factors associated with PrEP use among Asian MSM in Sydney and Melbourne, Australia, to inform strategies to improve PrEP uptake in this population. This was a sub-analysis of a community-based cross-sectional survey conducted from March to June 2021. We recruited participants online in Sydney and Melbourne, Australia. Univariable and multivariable logistic regression analyses were performed to identify the factors associated with PrEP use in the last six months and lifetime. Latent class analyses were used to identify subgroups of Asian MSM sharing similar characteristics related to their risk practices for HIV. Overall, 870 Asian MSM were included: 288 Oceanian-born Asian MSM and 582 Asian-born MSM. Three latent classes were identified: 1) Asian-born MSM who recently arrived in Australia with limited English, were less likely to use PrEP and at higher risk of HIV infection (e.g., had condomless anal sex with a casual sex partner in the last six months) (4.6%); 2) Asian MSM who were at lower risk of HIV infection and less likely to use PrEP (69.3%) and; 3) Asian MSM who were at substantial risk of HIV infection and more likely to use PrEP (26.1%). Compared to Oceanian-born Asian MSM, those who were born in Southeast Asia (adjusted odds ratio (aOR)=0.5, 95% confidence interval (CI) 0.3-0.7) and South Asia (aOR=0.4, 95% CI 0.2-0.8) were less likely to ever use PrEP. Compared to Oceanian-born Asian MSM, those who were born in Southeast Asia (aOR=0.4, 95% CI 0.3-0.7), Northeast Asia (aOR=0.5, 95% CI 0.3-0.8) and South Asia (aOR=0.4, 95% CI 0.2-0.7) were less likely to use PrEP in the last six months. To end HIV transmission in Australia, it will be necessary to develop strategies to improve PrEP access for the significant minority of Asian-born MSM who are at substantial risk of HIV infection. EPFC and JJO are supported by an Australian National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (EPFC: GNT1172873 and JJO: GNT1193955). CKF is supported by an Australian National Health and Medical Research Council (NHMRC) Leadership Investigator Grant (GNT1172900).

IJCM_413A: A cross sectional study to find out status of post exposure prophylaxis among animal bite cases in Raipur city Chhattisgarh.

Background: Rabies is a viral zoonosis that occurs in more than 100 countries and territories Although a number of carnivores and bat species serve as natural reservoirs, rabies in dogs is the source of 99% human infections and poses a potential threat to more than 3.3 billion people. In humans, rabies is highly fatal once clinical symptoms have developed. According to the World Health Organization, human rabies can be prevented completely by proper post exposure prophylaxis. In India alone, 20,000 deaths (i.e., about 2/100,000 population at risk) and 2 million bites, mostly by dogs, are estimated to occur annually. India has 36% global and 65% Asian rabies burden in terms of cases. Local treatment of wounds is of maximal value when applied immediately after exposure (within minutes if possible). Animal experiments have shown that local wound treatment can reduce the chances of developing rabies by up to 80%. Objectives: To find out the status of post exposure prophylaxis and associated factors among animal bite cases in Raipur city Chhattisgarh. Methodology: Type of study: A community based cross sectional survey Conducted at: Raipur District. Duration of study: Over a period of 3 months (November 2023- January 2024). Study Subjects: General Population. Inclusion criteria: General population, Raipur. Exclusion Criteria: 1) Patients who do not give consent. 2)Unconscious Very ill patients or patients with Mental illness. Results: Total of 1124 participants 41 had animal bite, 63.41% were males and 36.59% were females. Among the biting animals 83% were dogs, while cats were 15% and 2% were monkeys. Out of 41 cases 90.24% had Category II bite while 9.75% had Category III bite. 33 out of 41 i.e. 80.48% victims took Anti Rabies vaccine, while rest 19.52% preferred treatment from traditional healer. Conclusion: Majority of animal bite were of dog bite and were classified under Category II. Improved awareness, forestalling animal rabies, and better access to affordable and potent human rabies vaccines are essential for the elimination of human rabies.

An evaluation of sexual function and health-related quality of life following laparoscopic surgery in individuals living with endometriosis.

What is the relationship between sexual function, health-related quality of life (HRQoL), and laparoscopic surgery in individuals living with endometriosis? A higher number of laparoscopic surgeries is significantly associated with poorer HRQoL and greater levels of sexual dysfunction in individuals with endometriosis. Prior research indicates that endometriosis is associated with lowered HRQoL and sexual function and that these outcomes are influenced by endometriosis-related symptom profiles, medical, and surgical management. A limited number of studies have examined changes in sexual function in individuals with endometriosis following laparoscopic surgery or following repeated surgeries. A cross-sectional community-based online survey was used to examine the relationships between sexual function, HRQoL, and laparoscopic surgery (n = 210). Individuals with a self-reported diagnosis of endometriosis were recruited via online advertising through social media and gynaecology clinics. Endometriosis-specific data (e.g. diagnostic delay, symptom experience) was collected in addition to engagement with laparoscopic surgery, level of HRQoL (EuroQol-5 Dimension: EQ-5D-5L), and sexual function (Female Sexual Function Index: FSFI). Bivariate correlational analyses and hierarchical multiple regression were used to determine the associations between the variables of interest. Individuals with endometriosis have substantially poorer HRQoL in comparison to Australian normative samples, with greater levels of endometriosis-related symptom burden, distress, and pain significantly associated with lower levels of HRQoL. The mean FSFI score was suggestive of clinically significant female sexual dysfunction, with the lowest level of function noted in the domain of sexual pain and the highest level of function noted in the sexual satisfaction domain. A greater number of laparoscopic surgeries was significantly associated with poorer overall HRQoL and greater levels of sexual dysfunction. The cross-sectional nature of the data precludes direct findings of causality and further longitudinal research is recommended. The information pertaining to engagement in laparoscopic surgery was self-report in nature and was not medically verified. The study's findings highlight the pervasive impact of endometriosis on all domains of living, emphasizing the need to extend treatment planning beyond that of physical pain management alone. Early referral for assessment and management of sexual wellbeing is recommended prior to, and post-surgical intervention, with a focus on maintaining post-surgical changes, potentially reducing the need for multiple surgeries. The study was not associated with research funding. Author CN reports grant funding from the Australian Government and Medical Research Future Fund (MRFF) and was a previous employee of CSL Vifor (formerly Vifor Pharma Pty Ltd). N/A.

Health and demographic indicators of selected districts of India: An impact of Swasthya Rakshan Programme (SRP).

Swasthya Rakshan Programme (SRP) provides health care services through Ayurveda, an initiative of the Government of India that aims to survey and create alertness of essential health appliances to ameliorate society from its grassroots level. The present study aimed to survey the prevailing health standards of residents in certain districts of India and to record the prevalence of diseases among them according to their living conditions, food habits, lifestyle, education, occupation and other socio-economic status. Data was collected through a community-based cross-sectional survey conducted from April 2018 to March 2019 in 22 Districts of 19 states in India. A stratified multi-stage sampling design was adopted for the survey. Documentation of demographic profile, food habits, lifestyle, hygiene status, and existing health conditions was assessed. A pre-designed semi-structured questionnaire was used for the collection of the data. Before initiating the programme, written consent was obtained. In this study, from 162 selected villages/colonies/areas, a total of 562,913 population and 81,651 households were surveyed. Sixty-nine thousand three hundred nineteen patients were cared for various ailments through health camps. The study found that the most prevalent disease in the concerned population was 'Sandhivata' (Osteo-arthritis), that is, 43.0%, followed by 'Dourbalya' (Debility), that is, 11.7%. The study includes insightful analyses of comprehensive demographic and health indicators classified by various socio-economic categories. The collected data regarding the prevalence of diseases with their sociodemographic correlations may provide a better understanding of the locality and thus may help in all future health endeavours.

Prevalence and associated factors of occupational injuries in an industrial city in Ghana.

Workers are exposed to workplace hazards which increase their risk of occupational injury. Data on occupational injuries and associated factors are important for planning and informing national policy regarding workplace health and safety. This study sought to estimate the prevalence and factors associated with occupational injuries among workers in an industrial city in Ghana. A community-based cross-sectional survey was conducted among 459 workers in the Tema industrial enclave in Ghana from 22nd December 2020 to 27th February 2021. Participants were recruited using a two-stage sampling technique. Eight communities were randomly selected from twenty-five communities in the first stage while households in each community were randomly selected in the second stage. Data on socio-demographic characteristics, occupational health and safety and occupational injuries were collected. Logistic regression was used to examine the relationship between occupational injuries and associated factors. The mean age of the workers was 33.9 (±6.8) years with a range of 21-53 while over 18.1% of them were working at the Port and Harbour. The prevalence of occupational injury among the workers in the preceding twelve months was 64.7%. The mechanism of injury was mainly the use of working tools (45.8%) and hot surfaces, substances or chemicals (14.1%). Being a casual staff (AOR: 2.26, 95%CI: 1.04-4.92), working at Port and Harbour (AOR: 3.77, 95%CI: 1.70-8.39), no health and safety training (AOR: 2.18, 95%CI: 1.08-4.39), dissatisfaction with health and safety measures (AOR: 4.31, 95%CI: 2.12-8.78) and tertiary education (AOR: 0.03, 95%CI: 0.01-0.10) were significantly associated with occupational injuries. The prevalence of occupational injuries in this study was high. Promoting machine tools' safety, health and safety training, and satisfaction with health and safety measures through rewarding workers who do not sustain injuries could be key to employees' health and safety.

Assessing the Incidence of Snakebites in Rural Gabon-A Community-Based, Cross-Sectional Pilot Survey.

Snakebite envenoming (SBE) is a neglected tropical disease (NTD). Community-based studies from sub-Saharan Africa are urgently required as data on the incidence are scarce. This study aimed to determine the lifetime prevalence of snakebites in rural Gabon by preparing the conduct of a larger regional survey. A cross-sectional community-based epidemiological survey in Sindara, Ngounie province, was conducted. Households were interviewed about the history of snakebites of household members to calculate lifetime prevalence. In addition, the average annual incidence rate per 100,000 over the last 5 years was calculated. A total of 771 inhabitants were enrolled, of which 5 (0.65%; 95% confidence interval (95% CI: 0.2-1.5%)) were victims of snakebites. Over the past 5 years, annual incidence was 77 bites per 100,000 (95% CI: 0-620). This study provides a first rough estimate of the incidence of SBE from rural central Gabon, demonstrating the importance of this NTD. Key Contribution: The estimated annual incidence of snakebites found was 77 per 100,000. Snakebites occurred mainly during agricultural activities.

Intimate partner violence and associated factors among married adolescent girls and young women in the pastoralist community of South Ethiopia: is intimate partner violence associated with cultural phenomena?

Violence against women is a major public health problem that affects the physical, sexual, mental, and social wellbeing of more than one-third of all women worldwide. Hence the purpose of this study was to determine the prevalence of physical and sexual intimate partner violence (IPV) and associated factors among married adolescent girls and young women (AGYW) belonging to the pastoralist community of Dassenech district, South Omo Zone, South Ethiopia. A community-based cross-sectional survey was conducted among married AGYW in the Dassenech district from March 1, 2022, to April 1, 2022. A multi-stage sampling technique was adopted to select 545 participants. The data were collected using pre-tested and standardized WHO multi-country study tools. A binary logistic regression model was fitted to identify the independent predictors of physical and sexual intimate partner violence. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the effect size, and finally, a p-value<0.05 was considered statistically significant. The prevalence of physical IPV among AGYW belonging to the pastoralist community of Dassenech district was 44.1% (95% confidence interval (CI): 40%, 48%) and that of sexual IPV was 39.3% (95% CI: 35%, 43%). The husband only deciding for the household (AOR = 11.36; 95% CI: 6.97, 18.53), the father performing the Dimi cultural ceremony (AOR = 3.70; 95% CI: 2.22, 6.14), and frequent quarrels (AOR = 2.06; 95% CI: 1.07, 3.99) are significantly associated with physical IPV. Both partners drinking alcohol (AOR = 3.47; 95% CI: 1.94, 6.20), the husband only deciding for the household (AOR = 11.23; 95% CI: 6.91, 18.27), and frequent quarrels (AOR = 2.29; 95% CI: 1.15, 4.56) were factors significantly associated with sexual IPV. Physical and sexual intimate partner violence is a significant public health problem in the study area. Therefore, interventional measures to change the attitude of cultural leaders, providing education to married men and women on risky sexual behavior, and empowering women need to be prioritized to prevent the occurrence of this problem.

Malaria infection among adults residing in a highly endemic region from the Democratic Republic of the Congo.

Adults infected with Plasmodium spp. in endemic areas need to be re-evaluated in light of global malaria elimination goals. They potentially undermine malaria interventions but remain an overlooked aspect of public health strategies. This study aimed to estimate the prevalence of Plasmodium spp. infections, to identify underlying parasite species, and to assess predicting factors among adults residing in an endemic area from the Democratic Republic of Congo (DRC). A community-based cross-sectional survey in subjects aged 18years and above was therefore carried out. Study participants were interviewed using a standard questionnaire and tested for Plasmodium spp. using a rapid diagnostic test and a nested polymerase chain reaction assay. Logistic regression models were fitted to assess the effect of potential predictive factors for infections with different Plasmodium spp. Overall, 420 adults with an estimated prevalence of Plasmodium spp. infections of 60.2% [95% CI 55.5; 64.8] were included. Non-falciparum species infected 26.2% [95% CI 22.2; 30.5] of the study population. Among infected participants, three parasite species were identified, including Plasmodium falciparum (88.5%), Plasmodium malariae (39.9%), and Plasmodium ovale (7.5%) but no Plasmodium vivax. Mixed species accounted for 42.3% of infections while single-species infections predominated with P. falciparum (56.5%) among infected participants. All infected participants were asymptomatic at the time of the survey. Adults belonging to the "most economically disadvantaged" households had increased risks of infections with any Plasmodium spp. (adjusted odds ratio, aOR = 2.87 [95% CI 1.66, 20.07]; p < 0.001), compared to those from the "less economically disadvantaged" households. Conversely, each 1year increase in age reduced the risk of infections with any Plasmodium spp. (aOR = 0.99 [95% CI 0.97, 0.99]; p = 0.048). Specifically for non-falciparum spp., males had increased risks of infection than females (aOR = 1.83 [95% CI 1.13, 2.96]; p = 0.014). Adults infected with malaria constitute a potentially important latent reservoir for the transmission of the disease in the study setting. They should specifically be taken into account in public health measures and translational research.

Prevalence of hypertension, diabetes mellitus, and their risk factors in an informal settlement in Freetown, Sierra Leone: a cross-sectional study

BackgroundNoncommunicable diseases (NCDs), especially hypertension and diabetes mellitus are on the increase in sub-Saharan Africa (SSA). Informal settlement dwellers exhibit a high prevalence of behavioural risk factors and are highly vulnerable to hypertension and diabetes. However, no study has assessed the prevalence of hypertension, diabetes, and NCDrisk factors among informal settlement dwellers in Sierra Leone. We conducted a study in June 2019 to determine the prevalence of hypertension, diabetes, and NCD risk factors among adults living in the largest Sierra Leonean informal settlement (KrooBay).Methods and materialsWe conducted a community-based cross-sectional survey among adults aged ≥ 35 years in the KrooBay community. Trained healthcare workers collected data on socio-demographic characteristics and self-reported health behaviours using the World Health Organization STEPwise surveillance questionnaire for chronic disease risk factors. Anthropometric, blood glucose, and blood pressure measurements were performed following standard procedures. Logistics regression was used for analysis and adjusted odd ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension.ResultsOf the 418 participants, 242 (57%) were females and those below the age of 45 years accounted for over half (55.3%) of the participants. The prevalence of smoking was 18.2%, alcohol consumption was 18.8%, overweight was 28.2%, obesity was 17.9%, physical inactivity was 81.5%, and inadequate consumption of fruits and vegetables was 99%. The overall prevalence of hypertension was 45.7% (95% CI 41.0-50.5%), systolic hypertension was 34.2% (95% CI 29.6–38.8%), diastolic blood pressure was 39.9% (95% CI 35.2–44.6), and participants with diabetes were 2.2% (95% CI 0.7–3.6%). Being aged ≥ 55 years (AOR = 7.35, 95% CI 1.49–36.39) and > 60 years (AOR 8.05; 95% CI 2.22–29.12), separated (AOR = 1.34; 95% 1.02–7.00), cohabitating (AOR = 6.68; 95% CL1.03-14.35), vocational (AOR = 3.65; 95% CI 1.81–7.39 ) and having a university education (AOR = 4.62; 95% CI 3.09–6.91) were found to be independently associated with hypertension.ConclusionThe prevalence of hypertension,and NCD risk factors was high among the residents of the Kroobay informal settlement. We also noted a low prevalence of diabetes. There is an urgent need for the implementation of health education, promotion, and screening initiatives to reduce health risks so that these conditions will not overwhelm health services.

Mental health, challenging behaviour, diagnosis, and access to employment for people with intellectual disabilities in Norway.

Studies have found that presence of challenging behaviours and mental health problems limits employment for people with intellectual disabilities. This study investigates the associations between age, gender, living condition, level of intellectual disability, diagnoses, behaviour, mental health, and employment in adults with intellectual disabilities in Norway. A cross-sectional community-based survey including 214 adult participants (56% men) with intellectual disabilities. In our sample, 25% had no organised day activity, 27% attended non-work day care, 19% attended sheltered employment, or day care with production, without pay and 29% worked in paid sheltered employment. One participant attended mainstream employment. Moderate and severe/profound level of intellectual disability, possible organic condition and irritability significantly reduced the odds of employment (paid and unpaid). Findings suggest unequal access to the sheltered employment that was meant to be inclusive. More individualised evaluation of prerequisites is suggested to further facilitate employment for this group.

Early childhood development and nutritional status in urban Ethiopia.

Early childhood development (ECD) is crucial for better health and well-being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem-solving and personal-social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community-based cross-sectional survey design, 627 mother-child (12-36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ-3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem-solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non-stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition.

Child-eating behaviour as predictor of anthropometric status of preschool children aged 2–4 years in Umuahia South LGA Abia State, Nigeria

Introduction and objectiveEating behaviour at the childhood level plays a vital role in the outcome of the nutritional status and the overall health of an individual. The study was focused on the association between anthropometric status and child eating behaviour.MethodologyA community-based cross-sectional survey purposively enrolled consenting participants from 256 households with preschool children aged 2–4 years. The parents/legal guardians were interviewed on the eating behaviour of their children using a validated semi-structured child-eating behaviour scale, and anthropometric measurement of the children were taken. WHO Anthro-software for child growth standards was used to categorize anthropometric status of the preschool children. Paired sample t-test was performed to compare child-eating behaviour by gender, while regression and correlation analysis was performed to determine the extent to which child-eating behaviour predicted anthropometric status at 5% level of significance.ResultsMean comparison of child eating behaviour by gender showed significant difference (P < 0.05) between male and female children in their eating behaviour with respect to enjoyment of food and satiety responsiveness. Some of the children were wasted (26.6%), stunted (20.7%) and underweight (16.4%). A significant association (P < 0.05) was observed between body mass index-for-age and food fussiness behaviour of the children. There was also a significant difference (P < 0.05) between weight-for-age and food fussiness behaviour of the children.ConclusionThe study showed that child eating behaviour may have contributed to the anthropometric status of the children, however, differences in their eating behaviours by gender was observed.

Association of altitude and frailty in Chinese older adults: using a cumulative frailty index model.

The population is aging exponentially and the resulting frailty is becoming increasingly evident. We aimed to explore the association between altitude and frailty, and to identify associated factors for frailty. This is a community-based cross-sectional survey. 1,298 participants aged ≥60 years from three different altitudes were included in the study. To quantify frailty, we constructed a frailty index (FI) and a frailty score (FS). The FI was divided into non-frailty, prefrailty, and frailty. The Odds Ratios and confidence intervals (ORs, 95%CIs) were used to evaluate the association between altitude and FI and FS in multivariate ordinal logistic regression and linear regression. There were 560 (53.1%) participants in the prefrailty and 488 (37.6%) in the frailty group. The FS increased with higher altitude (P for trend <0.001). Multivariate ordinal logistic regression analysis revealed an association between altitude and frailty, OR = 1.91 (95% CI: 1.38-2.64) in mid-high altitude and 2.49 (95% CI:1.40-4.45) in high altitude. The same trend of association was found in the univariate analysis. The FS increased by 1.69 (95% CI: 0.78-2.60) at mid-high altitude and 3.24 (95%CI:1.66-4.81) at high altitude compared to medium altitude. The study indicates that high altitude exposure is an associated factor for frailty in older adults. This association become stronger with higher altitudes. As a result, it is essential to conduct early frailty screening for residents living at high altitudes.

Descriptive epidemiology of muscle-strengthening activities in Japanese middle-aged and older adults: the Hisayama Study

IntroductionData on the prevalence of muscle-strengthening activities in Asia have been limited. Using data from a community-based cross-sectional survey of a general adult population in Japan, whose age and occupational...

Interstate migration and its association with the prevalence of stunting in under-five children of the migrant families in Delhi-NCR, India: a cross-sectional study

Background: Interstate migration in India is increasing every year. Children of the migrant families often face poor living conditions and insufficient nutrition, as a result of various socio-economic determinants. This study aimed to understand the association between rural-to-urban migration and under-five stunting, and the various determinants involved. This study allows researchers to make pre and post pandemic comparison of stunting among migrant children in Delhi, since it was carried-out post the second wave of the COVID-19 pandemic. Methods: A community-based cross-sectional survey was carried-out in the bhatti mines area of south Delhi, using a systemic sampling method. 100 households each of migrants and non-migrants were approached, and height of the under-five children was measured. Stunting was estimated using WHO child growth standards. Information on demography and socio-economic determinants was collected from the mothers using a questionnaire. Results: Stunting was recorded in 62% of the migrant under-five children and 27% in the non-migrant children, with a significant difference between the two groups (p value &lt;0.001), indicating a significant association between migration and stunting. Source of drinking water (p&lt;0.05) and recurring episodes of diarrhea (p&lt;0.05) were also found to be strongly associated with under-five stunting. Conclusions: Under-five nutritional deficits lead to compromised immunity and delay in physical and mental growth and development. It is important to recognize and address the diverse needs of the under-five migrant population’s health in order to avoid stunting and other serious manifestations.

Prevalence of undiagnosed metabolic syndrome using three different definitions and identifying associated risk factors among apparently healthy adults in Karachi, Pakistan: a cross-sectional survey in the year 2022

ObjectiveTo determine the prevalence and associated risk factors of undiagnosed metabolic syndrome (MetS) using three different definitions among apparently healthy adults of Karachi, Pakistan.MethodsThis community-based cross-sectional survey was conducted in Karachi, Pakistan, from January 2022 to August 2022. A total of 1065 healthy individuals aged 25–80 years of any gender were consecutively included. MetS was assessed using the National Cholesterol Education Program for Adult Treatment Panel (NCEP-ATP) III guidelines, International Diabetes Federation (IDF), and modified NCEP-ATP III.ResultsThe prevalence of MetS was highest with the modified NCEP-ATP III definition at 33.9% (95% CI: 31–36), followed by the IDF definition at 32.2% (95% CI: 29–35). In contrast, the prevalence was lower at 22.4% (95% CI: 19–25) when using the NCEP ATP III definition. The risk of MetS significantly increases with higher BMI, as defined by the IDF criteria (adjusted OR [ORadj] 1.13, 95% CI 1.09–2.43), NCEP-ATP III criteria (ORadj 1.15, 95% CI 1.11–1.19), and modified NCEP-ATP III criteria (ORadj 1.16, 95% CI 1.12–1.20). Current smokers had significantly higher odds of MetS according to the IDF (ORadj 2.72, 95% CI 1.84–4.03), NCEP-ATP III (ORadj 3.93, 95% CI 2.55–6.06), and modified NCEP-ATP III (ORadj 0.62, 95% CI 0.43–0.88). Areca nut use was associated with higher odds of MetS according to both IDF (ORadj 1.71, 95% CI 1.19–2.47) and modified NCEP-ATP III criteria (ORadj 1.58, 95% CI 1.10–2.72). Furthermore, low physical activity had significantly higher odds of MetS according to the NCEP-ATP III (ORadj 1.36, 95% CI 1.01–1.84) and modified NCEP-ATP III criteria (ORadj 1.56, 95% CI 1.08–2.26).ConclusionOne-third of the healthy individuals were diagnosed with MetS based on IDF, NCEP-ATP III, and modified NCEP-ATP III criteria. A higher BMI, current smoking, areca nut use, and low physical activity were significant factors.

Perceived Social Stigma of Cutaneous Leishmaniasis in Hubuna, Saudi Arabia.

Cutaneous Leishmaniasis (CL) is a vector-borne skin infection that remains prevalent in regions with poor socioeconomic conditions. Stigmatization occurs when individuals with physical or psychological disorders interact with societal stereotypes. The aim of this study was to explore the perceived social stigma surrounding CL among people residing in Hubuna, Saudi Arabia. This cross-sectional community-based survey recruited 618 individuals aged 18 years and above using the snowball sampling technique to reach hidden cases within the target population. Data was collected using a self-administered questionnaire and the Explanatory Model Interview Catalogue for Perceived Social Stigma (EMIC-SS-12) was used to assess the level of perceived social stigma. It includes questions on demographic variables, behaviors, and experiences. The analysis was performed using SPSS. The study included 618 participants, the majority of whom were women and girls (54.2%), with a mean age of 28 ± 12.7 years. The median score for perceived social stigma was 26.0. Only 2.1% (n = 13) of participants had the highest EMIC-SS-12 score of 36, while 7.6% (n = 47) scored zero. The mean score for overall perceived social stigma was 1.89 ± 0.91, while the mean score for experienced stigma was 1.99 ± 1.02. Univariate analysis showed that sex, employment, location of lesions, and number of lesions were insignificantly associated with stigmatization (P-value < 0.05), because these associations were uncertain because the CI includes or very close to 1. The study reveals insights into stigmatization associated with CL in the Habuna area of Saudi Arabia. It found that the median of perceived social stigma was 26. Factors such as sex, employment status, and location of the lesion are uncertainly associated with stigma. It is crucial to explore negative behaviors and perceptions and develop suitable health education programs.

Enrollment and clients’ satisfaction with a community-based health insurance scheme: a community-based survey in Northwest Ethiopia

BackgroundAlthough the Ethiopian government has implemented a community-based health insurance (CBHI) program, community enrollment and clients’ satisfaction have not been well investigated in Gondar Zuria district, Northwest Ethiopia. This study assessed CBHI scheme enrollment, clients’ satisfaction, and associated factors among households in the district.MethodsA community-based cross-sectional survey assessed CBHI scheme enrollment and clients’ satisfaction among households in Gondar Zuria district, Northwest Ethiopia, from May to June 2022. A systematic random sampling method was used to select the study participants from eligible households. A home-to-home interview using a structured questionnaire was conducted. Data were analysed using the statistical packages for social sciences version 26. Logistic regression was used to identify variables associated with enrollment and clients’ satisfaction. A p-value < 0.05 was considered statistically significant.ResultsOut of 410 participants, around two-thirds (64.9%) of the participants were enrolled in the CBHI scheme. Residency status (AOR = 1.38, 95% CI: 1.02–5.32; p = 0.038), time taken to reach a health facility (AOR = 1.01, 95% CI: 1.00–1.02; p = 0.001), and household size (AOR = 0.77, 95% CI: 0.67–0.88; p < 0.001) were significantly associated with CBHI scheme enrollment. Two-thirds (66.5%) of enrolled households were dissatisfied with the overall services provided; in particular, higher proportions were dissatisfied with the availability of medication and laboratory tests (88.7%). Household size (AOR = 1.31, 95% CI: 1.01–2.24; p = 0.043) and waiting time to get healthcare services (AOR = 3.14, 95% CI: 1.01–9.97; p = 0.047) were predictors of clients’ satisfaction with the CBHI scheme services.ConclusionAlthough a promisingly high proportion of households were enrolled in the CBHI scheme, most of them were dissatisfied with the service. Improving waiting times to get health services, improving the availability of medications and laboratory tests, and other factors should be encouraged.