Community-based Cross-sectional Survey Research Articles

Diabetes Prevalence and Associated Factors in the Adult Population Aged 25–64 in the Humbo Districts of Woliata Zone

The burden of disease caused by NCDs is quickly growing in emerging nations, with substantial social, economic, and health repercussions. However, data on the prevalence of diabetes and related variables among adults aged 25–64 years in Ethiopia, particularly in drought-stricken areas, is limited. The goal of this study is to find out how common diabetes is and what variables contribute to it in the middle-aged population. From January to February 2020, a community-based cross-sectional survey was undertaken among adults aged 25–64 years in Humbo district, southern Ethiopia. 587 people were chosen using a multi-stage sampling process. Weight, height, and fasting blood glucose levels were all measured. To enter data into a computer, Epi Data version 3.1 was utilized, which was subsequently exported to SPSS version 20 for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed, and statistical significance was determined at a p-value of less than 0.05. Diabetes was found in 5.9% of the research participants (95 percent CI: 3.8–7.8). Age 45–54 (AOR = 4.80, 1.25, 18.32), physical inactivity (AOR = 5.33, 1.37, 20.72), family history of diabetes mellitus (AOR = 6.34, 95 percent CI: 2.43, 16.55), and obesity (AOR = 3.26, 95 percent CI: 1.43, 7.42) were all significantly associated with diabetes, according to multivariable logistic regression. The findings demonstrated the need for implementing educational public policies to encourage population behavior changes in order to prevent and control diabetes.

Naturally acquired antibody response to Plasmodium falciparum and Plasmodium vivax among indigenous Orang Asli communities in Peninsular Malaysia.

Malaria remains a public health problem in many parts of the world. In Malaysia, the significant progress towards the national elimination programme and effective disease notification on malaria has resulted in zero indigenous human malaria cases since 2018. However, the country still needs to determine the extent of malaria exposure and transmission patterns, particularly in high-risk populations. In this study, a serological method was used to measure transmission levels of Plasmodium falciparum and Plasmodium vivax among indigenous Orang Asli communities in Kelantan, Peninsular Malaysia. A community-based cross-sectional survey was conducted in three Orang Asli communities (i.e., Pos Bihai, Pos Gob, and Pos Kuala Betis) in Kelantan from June to July 2019. Antibody responses to malaria were assessed by enzyme-linked immunosorbent assay (ELISA) using two P. falciparum (PfAMA-1 and PfMSP-119) and two P. vivax (PvAMA-1 and PvMSP-119) antigens. Age-adjusted antibody responses were analysed using a reversible catalytic model to calculate seroconversion rates (SCRs). Multiple logistic regression was used to investigate factors associated with malaria exposure. The overall malaria seroprevalence was 38.8% for PfAMA-1, 36.4% for PfMSP-119, 2.2% for PvAMA-1, and 9.3% for PvMSP-119. Between study areas, the proportion of seropositivity for any P. falciparum and P. vivax antigens was significantly highest in Pos Kuala Betis with 34.7% (p < 0.001) and 13.6% (p < 0.001), respectively. For all parasite antigens except for PvAMA-1, the proportion of seropositive individuals significantly increased with age (all p < 0.001). Based on the SCR, there was a higher level of P. falciparum transmission than P. vivax in the study area. Multivariate regression analyses showed that living in Pos Kuala Betis was associated with both P. falciparum (adjusted odds ratio [aOR] 5.6, p < 0.001) and P. vivax (aOR 2.1, p < 0.001) seropositivities. Significant associations were also found between age and seropositivity to P. falciparum and P. vivax antigens. Analysis of community-based serological data helps describe the level of transmission, heterogeneity, and factors associated with malaria exposure among indigenous communities in Peninsular Malaysia. This approach could be an important adjunct tool for malaria monitoring and surveillance in low malaria transmission settings in the country.

Prevalence and Determinants of Early Antenatal Care Visits Among Pregnant Women Attending Antenatal Care in Rural Gambia

An estimated 303,000 maternal deaths occurred worldwide in 2018. The Gambia has a MMR of 400/100,000 live births. In the Gambia, 24% of pregnant women receive antenatal treatment four times. Insufficient knowledge of the value of prenatal care and lack of subsidized ANC services are the main causes of the growing maternal and newborn mortality rate in Gambia. The study's major goal was to investigate factors influencing pregnant women in rural Gambia who attend early prenatal care. A cross-sectional community-based survey using structured questionnaires was used for the investigation. Cluster random sampling was utilized in the study to choose samples from 5 distinct districts. The study found that socioeconomic factors, economic factors, and accessibility to antenatal care service center influenced early ANC Attendance. After multivariate analysis, marital status, number of children, mother's occupation, cultural acceptance, and education level significantly correlate with early ANC attendance. The Foni district's early ANC attendance rate (ANC) was comparatively low compared to WHO criteria and fell short of the national requirement. This finding may explain the high mother and child mortalities observed in the Foni districts. The study found significant knowledge of ANC services, but this did not help increase early ANC attendance rate.

Asymptomatic Plasmodium Infection and Associated Factors in Selected Districts of the Kaffa Zone, Southwest Ethiopia: A Cross-Sectional Study.

Malaria remains a serious public health problem, particularly in resource scarce areas of the world. The number of malaria cases has dropped remarkably in Ethiopia over the last decade, and efforts to eliminate the disease are underway. Asymptomatic infections may pose significant challenges to the elimination program. The essence of this study was to assess the prevalence of asymptomatic Plasmodium infection and the associated factors among communities of the selected districts in the Kaffa zone. April to May and September to October 2021, were the two seasons in which the community-based cross-sectional survey was conducted. Capillary blood from a finger prick was examined by light microscopy (LM) and screened using rapid diagnostic tests (RDTs). The participants' sociodemographic characteristics and malaria prevention measures were collected using a pretested semistructured questionnaire. Data entry and analyses were carried out using EpiData and SPSS version 25.0. Logistic regression (bivariate and multivariable) analyses were carried out to assess the possible associations between the dependent variable and the associated factors. 566 study participants were involved in the two cross-sectional surveys, including 234 male and 332 female subjects with a mean age of 18.486 (SD ± 15.167). Thirty-eight blood samples (6.7%) were found to be positive for Plasmodium species tested by both LM and RDT. Last night's use of long-lasting insecticidal net (LLIN) (AOR = 2.448, 95% CI: 1.009 5.938, p=0.048), presence of eave (AOR = 4.144, 95% CI: 1.049-16.363, p=0.043), and house sprayed in the last year (AOR = 5.206, 95% CI: 2.176-12.455, p < 0.001) were among factors that showed significant association with asymptomatic Plasmodium infection. The asymptomatic Plasmodium infection prevalence recorded in the study area was low. Last night's LLIN usage, the presence of an eave, a house sprayed in the last year, and the presence of stagnant water near the home of the study participants were among the factors associated with an increased risk of catching the disease.

Knowledge, attitudes and practice towards yellow fever among nomadic populations: A cross-sectional study in yellow fever outbreak communities in Ghana.

Despite the government and global health initiatives toward yellow fever epidemic control in Ghana, the country continues to witness sporadic outbreaks of yellow fever mostly among the unvaccinated population and suspected migrates(nomadic) who enter the country. Little is known about nomadic knowledge, attitudes and practice regarding this communicable disease in Ghana. We conducted a community-based cross-sectional survey in 22 yellow fever outbreak communities to assess nomadic household heads' knowledge, attitudes and practices (KAP) regarding yellow fever after an outbreak in November 2021 outbreak. Our study results were analyzed using descriptive statistics, bivariate and multivariate logistics regression with dichotomous outcomes. Significant statistics were obtained from multivariate analysis. About 90% of the nomadic had poor knowledge of the signs and symptoms of yellow with only 16% knowing the vector that transmits yellow fever. The most common source of information on yellow fever was the health campaign. Over 80% of household heads surveyed had positive attitudes regarding yellow fever with about 84% worried about the disease outbreak in their community. In a multivariate logistic regression model, age group(AOR = 2.79; 95% CI: 1.31, 5.98, p = 0.008)., gender ideology(AOR = 2.27; 95% CI: 1.14-4.51, p = 0.019), occupation(AOR = 15.65; 95% CI: 7.02, 34.87, p<0.001), source of health information(AOR = 0.27; 95% CI: 0.07, 0.96, p = 0.043), duration of stay in the community(AOR = 1.11; 95% CI: 1.31, 5.98, p = 0.008) and nationality (AOR = 0.22; 95% CI:0.47, 0.47, p<0.001) were associated with positive attitudes towards yellow fever. Close to 74% have a positive practice, with 97.3% controlling mosquitoes in their household. Nationality (AOR = 3.85; 95% CI: 2.26, 6.56, p<0.001), duration of stay in the community (AOR = 1.06; 95% CI: 1.03, 1.10, p = 0.001), and age group(AOR = 040; 95% CI: 0.22, 0.73, p = 0.003) were associated with positive practices. Our findings show that yellow fever KAP was variable with clear knowledge gaps. Regular locally-tailored education and health promotion campaigns should be considered to improve knowledge and preventive practices against this infectious disease.

Prevalence of undernutrition among pregnant women and its differences across relevant subgroups in rural Ethiopia: a community-based cross-sectional study

BackgroundMaternal undernutrition is one of the commonest public health problems in many low- and middle-income countries where generally more than 20% of women are undernourished. It is more common in rural areas due to unclear factors. Therefore, the aim of this study was to investigate the prevalence of undernutrition in general and in subgroups and determine risk factors among pregnant women in rural Ethiopia.MethodsA community-based cross-sectional survey was conducted from April 30 to May 30, 2019 on 550 pregnant women who were randomly selected from six districts in southern Ethiopia. Trained and experienced nurses measured undernutrition using mid-upper arm circumference and collected other data. We used multilevel mixed-effect logistic regression to identify factors associated with undernutrition among pregnant women.ResultsThe prevalence of undernutrition among pregnant women was 38% (95% CI: (34.2–42.3). The odds of undernutrition was higher among women who got pregnant previously (adjusted odds ratio [AOR]: 1.66; 95% CI: 1.02–2.71), who had a history of miscarriage (AOR: 3.18; 95% CI: 1.77–5.70), who practiced food taboos (AOR: 2.23; 95% CI: 1.47–3.39), and who did not get any nutritional counseling during pregnancy (AOR: 2.97; 95% CI: 1.79- 4.95). The prevalence of undernutrition was higher among pregnant women who had multiple risk factors and the difference was statistically significant (p < 0.001).ConclusionUndernutrition is a highly prevalent problem among rural Ethiopian pregnant women, especially with those who avoid food, do not get counseled, and had two or more pregnancies and a history of miscarriage. Improving the integration of nutrition programs with routine healthcare services and encouraging a multi-sectorial intervention strategy would help to reduce maternal undernutrition in the country.

Seroprevalence and socioeconomic impact of the first SARS-CoV-2 infection wave in a small town in Navarre, Spain

The characterization of the antibody response to SARS-CoV-2 and its determinants are key for the understanding of COVID-19. The identification of vulnerable populations to the infection and to its socioeconomic impact is indispensable for inclusive policies. We conducted an age-stratified cross-sectional community-based seroprevalence survey between June 12th and 19th 2020—during the easing of lockdown—in Cizur, Spain. We quantified IgG, IgM and IgA levels against SARS-CoV-2 spike and its receptor-binding domain in a sample of 728 randomly selected, voluntarily registered inhabitants. We estimated a 7.9% seroprevalence in the general population, with the lowest seroprevalence among children under ten (n = 3/142, 2.1%) and the highest among adolescents (11–20 years old, n = 18/159, 11.3%). We found a heterogeneous immune-response profile across participants regarding isotype/antigen-specific seropositivity, although levels generally correlated. Those with technical education level were the most financially affected. Fifty-five percent had visited a supermarket and 43% a sanitary centre since mid-February 2020. When comparing by gender, men had left the household more frequently. In conclusion, few days after strict lockdown, the burden of SARS-CoV-2 infection was the lowest in children under 10. The findings also suggest that a wider isotype-antigen panel confers higher sensitivity. Finally, the economic impact biases should be considered when designing public health measures.

Understanding the association of mass media with the timing of antenatal care in Ethiopia: an impression from the 2016 Ethiopia demographic and health survey

Introduction Although the timing of antenatal care has a high potential of reducing maternal and child health problems and can be improved through different mass media exposure, it has been overlooked and remained a major life-costing delinquent issue. Therefore, the aim of this study is to identify the relationship between mass media exposure and ANC for further insight. Methods We used the 2016 Ethiopian Health and Demography (EDHS) data. EDHS is a community-based cross-sectional survey that applies a two-stage stratified cluster sampling and it is a country-representative. We included 4740 reproductive-age women with complete records in EDHS dataset in this study. We excluded records with missing data from the analysis. We used ordinal logistic regression followed by generalized ordinal logistic to examine mass media relationships with timely antenatal care (ANC). We presented data using numbers, mean, standard deviations, percent or proportions, coefficient of regression, and 95% confidence interval. All analyses were performed using STATA version 15. Result We examined the data of 4740 participants for the history of timely initiation of ANC and found 32.69% (95% CI = 31.34, 34.03) timely ANC. Factors such as watching television (TV) less than once a week [coef. = −0.72, CI: −1.04, −0.38], watching TV at least once a week [coef. = −0.60, CI: −0.84, −0.36], listening to radio [coef. = −0.38, CI: −0.84, −0.25], and use internet every day[coef. = −1.37, CI: −2.65, −0.09], are associated with the timely ANC. Conclusion Despite its association with improving the timing of ANC, our findings showed mothers need additional support on the use of the media and the timing of ANC. In addition to the mass media, other covariates such as educational status, family size, and husband’s desire affected the timely ANC imitation. These need attention during implementation to avert the current. This is also an essential input for policy and decision-makers.

Knowledge, Attitudes, and Practice Around HIV/AIDS and other STIs Among Syrians: A Cross-Sectional Study

Background: Over 1 million new Sexual transmitted disease (STIs) are acquired daily throughout the globe, according to WHO data, with the majority of cases being asymptomatic. In Syria, statistics on STI awareness, attitude, and practice are few, and there is little information on Syrians' sexual and reproductive health concerns. The present research aims to determine which individuals factors best predict knowledge, attitudes, and behaviours about HIV/AIDS and other STIs in a Syrian population.&#x0D; &#x0D; Method: In the Syrian governorates between August 15 and September 16, 2022, a descriptive community-based cross-sectional survey was carried out. Syrian nationality, male or female, aged at least 18 years, citizen of any Syrian governorate, and willingness to engage in the survey were the study's inclusion criteria. Based on a previous study, a modified online semi-structured questionnaire was made on Google Form and used to collect the data. The questionnaire was divided into five main section that socio-demographic information, knowledge and practice relating STIs, knowledge and practice relating HIV/AIDS, attitude toward HIV/AIDS and attitude toward STIs.&#x0D; &#x0D; Results: The research involved 1076 individuals in total. More over half (55%) of them were women, with the majority (86%) of them being between the ages of 18 and 30. Only 739 respondents (67%) were aware of voluntary counselling and testing (VCT), and only 35% were aware of the means by which HIV infection may be prevented. The most often mentioned AIDS/HIV-related statistic was that those who have several sex partners have a greater chance of contracting HIV (92%). Furthermore, just 66% and 44%, respectively, of respondents knew how STDs are transmitted. In general, individuals' understanding of STDs was rated at 56%. Furthermore, 50% of the individuals had a positive attitude about the STD information. We used a logistic model to tease out the role of demographics and found that men were 1.43 times more likely to be aware of AIDS/HIV than women were. Additionally, residents of cities were 1.42 times more likely than residents of rural areas to be knowledgeable about STDs.&#x0D; &#x0D; Conclusion: According to this research, Syrians' knowledge, attitudes, and behaviors about STIs, HIV, and other diseases were generally insufficient. This provides definitive evidence that HIV programmes need to verify that Syrian people have access to basic information about HIV/AIDS and other STIs. As a result, the health organizations should conduct both international and local helpful interventions in order to address this medical problem and enhance the awareness of the Syrian community about HIV/AIDS and other STIs illnesses as soon as possible.

Public visibility of tuberculosis diagnosis and treatment facilities in rural Puducherry, mixed method design

Objectives: To study the specific issues on the diagnosis and treatment to be addressed in TB advocacy, communication and social mobilization activities. Early diagnosis and initiation of appropriate treatment is the mainstay in the prevention and control of tuberculosis (TB). We present findings from an operational research study on visibility of TB diagnosis and treatment among people in rural Puducherry. Materials and Methods: Study area and study setting: The present study was undertaken in the villages of Thirubhuvani Primary Health Center (PHC) in rural Pondicherry by the Department of Community Medicine, Sri Manakula Vinayagar Medical College. Study design: An exploratory sequential mixed method design where qualitative methods (Focus Group Discussion [FGD]) followed by quantitative methods (Community-based cross-sectional survey) were used. Sample size and sampling: Qualitative: FGD was conducted to assess the perceptions and practices of rural people related to TB. We conducted eight FGD, four each with men and women. It was held with the purposively selected men and women (8−12 members) from different socioeconomic strata. Quantitative: Probability proportional to size method was used to select 30 clusters from the villages of Thirubhuvani PHC. In each cluster, 12 households were selected by random walk method and head of the family who is assumed to act as decision maker in that household was interviewed using pre-designed and pre-tested questionnaire. However, we could study the required sample as calculated, the final sample studied was 348. Results: Qualitative: As per the responses emerged from the FGD, four categories are symptoms and mode of transmission, treatment, problems faced, and others. The 12 codes emerged are symptoms, mode of spread, risk factors, availability, effect home remedies health system related, family and community, financial, advantages at government hospitals, media for awareness, and recommendation. Quantitative: Among the 348 people studied, 203 were male and 145 were female. The major source of information of TB received by the community was from family, friends, neighbors, and colleagues. We found that majority of them have correctly responded that weight loss (97.1%) and cough that lasts longer than 2 weeks (27.5%) as the symptoms of TB. However, they have also commented wrongly that rash as one the symptom (76.1%) of TB, the measures for preventing TB are by avoiding hand shaking (26.4) avoid sharing foods (74.7). Smokers and alcoholic are at-risk for TB infection. Most of the participants expressed that they will feel fear (95.1), sadness or hopelessness (94.8), embarrassment (96.8), shame (89.6), and surprise (65.2) if they have contacted TB. The participants also reported TB diagnosis and treatment are free of cost (95.1) and will approach health facility (96.8) if they had symptoms of TB. The 95% of them have informed that TB is curable and treatment is available at government hospital (97.7) and available free of cost (92.2). Conclusion: Hence, a strategy for wide, consistent, and regular dissemination of information on TB is needed for better public visibility of TB diagnosis and treatment facilities in rural Pondicherry.

Malaria knowledge, attitude, and practice among communities involved in a seasonal malaria chemoprevention study in Nanyumbu and Masasi districts, Tanzania.

Utilization of malaria interventions is influenced by, among other things, the level of knowledge and attitude that the community has toward the infection as well as the available interventions. This study assessed malaria knowledge, attitudes, and practices on malaria infection and interventions in Masasi and Nanyumbu districts, Tanzania. A community-based cross-sectional survey was conducted between August and September 2020, among the heads of households having at least one under-five child. Information on knowledge, attitudes, and practices on malaria infection and interventions was gathered from the heads of the households using a structured questionnaire. The knowledge level was classified into low, moderate, and high. Attitudes were classified into positive and negative, whereas the practices were classified into good and poor. Children aged between 3 and 59 months were screened for malaria infection using a malaria rapid diagnostic test (mRDT). The proportion of the households' heads with high level of knowledge was the primary outcome. Proportions were compared using Chi-square or fisher's test, and logistic regression analysis was used as appropriate. A total of 1,556 household heads were interviewed, 1,167 (75.00%) were male, and according to marital status, 1,067 (68.57%) were couples. All the household heads had some knowledge of malaria, but 47.33% (736/1,555) and 13.83% (215/1,555) of them had moderate and high knowledge, respectively. The level of knowledge on malaria was significantly influenced by gender [adjusted odds ratio (aOR) = 0.72, 95.00% confidence interval (CI) = 0.56-0.94, p = 0.017], level of education (aOR = 1.50, 95.00% CI = 1.04-2.16, p = 0.03), and the occupation of the household head (aOR = 1.90, 95.00% CI = 1.22-2.96, p = 0.004). Majority of the households [83.87% (1,305/1,556)] had bed nets hanging on the sleeping spaces. Of the household heads possessing bed nets, 85.10% (514/604), 79.62% (586/736), and 95.35% (205/215) of them had a low, moderate, and high level of knowledge on malaria infection, respectively (trend x 2 = 31.53, p < 0.001). The majority [95.04% (1,474/1,551)] of the household heads perceived sleeping under the bed net to be beneficial. Furthermore, 15.56% (94/604), 14.67% (108/736), and 7.44% (16/215) of the household heads with low, moderate, and high knowledge, respectively, had children with malaria infection (trend x 2 = 9.172, p = 0.01). The study population had a good level of knowledge about malaria infection, and a good attitude toward malaria interventions, and the majority of them were using bed nets.

Confidence in COVID-19 vaccine effectiveness and safety and its effect on vaccine uptake in Tanzania: A community-based cross-sectional study

ABSTRACT COVID-19 is a major public health threat associated with increased disease burden, mortality, and economic loss to countries and communities. Safe and efficacious COVID-19 vaccines are key in halting and reversing the pandemic. Low confidence in vaccines has been one of the factors leading to hesitancy. We aimed to assess the COVID-19 vaccine confidence (safety and effectiveness), associated factors, and its effects on vaccine uptake among general community members in Tanzania. This was a community-based cross-sectional survey conducted from December 2021 to April 2022 in six regions of Tanzania mainland and two regions in Zanzibar. Participants were interviewed using an electronic questionnaire. Multiple logistic regression models estimated odds ratios (ORs) and 95% confidence interval (CI) for factors associated with vaccine confidence. All analyses were performed using SPSS version 25.0. The study enrolled 3470 general Tanzanian community members; their mean age was 40.3 (standard deviation ±14.9) years, and 34% were males. The proportion of COVID-19 vaccine confidence was 54.6%. Geographical region, residence area, COVID-19 disease risk perception, and good knowledge of COVID-19 vaccines were significantly associated with COVID-19 vaccine confidence. Confidence in COVID-19 vaccines was associated with over three times higher odds of vaccine uptake. Confidence in COVID-19 vaccines was low in Tanzania. Innovative community engagement strategies and region-specific interventions are needed to improve comprehensive knowledge and address community perceptions and attitudes toward COVID-19 vaccines.

Household coverage of ivermectin distribution in birnin kudu local government area of Jigawa State, Nigeria.

To assess community-directed treatment coverage with Ivermectin (CDTI) in Onchocerciasis-endemic communities in Birnin Kudu local government area (LGA) Jigawa state. This was a community-based multistaged cross-sectional survey based on probability proportional to size. The study involved the administration of a questionnaire on 2021 respondents from 207 households. Also, 30 Community Leaders and Community Directed Distributors (CDDs) were purposively selected for interview from the communities visited. Overall, 2021 respondents from the 2031 sampled population took part in the study giving a response rate of 99.6%. Slightly above half, 1130 (55.9%) were males. The geographic and therapeutic coverage of mass drug administration of Ivermectin achieved in the LGA was 100% and 79.9%, respectively. The key factors affecting coverage includes the unavailability of drugs (48.8%), absenteeism of some of the household members (31%), and inadequate incentives to the CDDs by the government and poor record keeping by the CDDs. This study found that the minimum geographic and therapeutic coverage of Ivermectin distribution was achieved by CDD as recommended by the World Health Organization for the control of onchocerciasis. For this to be sustained and to achieve elimination, there must be an adequate supply of ivermectin, training of CDDs, retraining of CDDs, adequate supervision in record keeping, and health education to the community.

Personal and driving related characteristics as predictors of risky driving behavior among drivers in Debre Tabor Town, Northwest Ethiopia: A mixed method study

ObjectiveThis study aimed to assess the risky driving behavior and associated factors amongdrivers in DebreTabor town, Ethiopia, 2020. MethodsThis study was a mixed type community-based cross-sectional survey of 564 and 11 participants for quantitative and qualitative study by using a self-administered questionnaire and an interview method, respectively, and the analysis was carried out in 2021. ResultsEighty-two-point one percent (82.1%) of drivers were engaged in risky driving behavior. Driving at night, never attending religious events/ceremonies, driving >8 h/day,believing income is insufficient,weak law enforcement, training institutions problem, being Bajaj driver, and being anon-governmental-driver were significantly associated with risky driving behavior. ConclusionRisky driving behavior was high among drivers. Being non-governmental driver was the protective factor of risky driving behavior however the rest variables were the risk factors for risky driving behavior. To overcome the problem, appropriate law enforcement measures should be taken.

Vulnerability to human immunodeficiency virus infection and associated factors among married women in northwest Ethiopia: a cross-sectional study.

This study investigated the vulnerability to human immunodeficiency virus (HIV) infection and associated factors among married women in northwest Ethiopia. A community-based cross-sectional survey (n=657) was conducted from April 1 to 15,2020, in Metema District, northwest Ethiopia, in four randomly selected kebele administrations (thelowest level of local government). The inclusion criteria were married women aged ≥18 years residing with their husbands. Logistic regression analysis was conducted to identify factors associatedwith married women's vulnerability to HIV infection. Participants were on average 33.70±9.50 years and nearly one-fourth (n=148, 22.5%) wereidentified as vulnerable to HIV infection (i.e., experienced sexually transmitted disease symptoms oran extramarital affair of either spouse within the past 12 months). Only 18.9% reported sexual communication with their husband. Respondents who did not discuss the risk of HIV infection withtheir husbands had fivefold odds of vulnerability (adjusted odds ratio [AOR], 5.02; 95% confidenceinterval [CI], 1.43-17.5). Those who did not have premarital sex (AOR, 0.20; 95% CI, 0.05-0.77)had no worries about HIV infection (AOR, 0.27; 95% CI, 0.08-0.94), sufficient income (AOR,0.56; 95% CI, 0.16-0.86), and less than four children (AOR, 0.69; 95% CI, 0.50-0.97) had decreased odds of being vulnerable to HIV than their counterparts. Not discussing risk of HIV infection with husband was a major factor of vulnerabilityto HIV infection as was premarital sex, worry about HIV, income, and number of children. Measuresto strengthen couple's sexual communication and support economical stability is important for decreasing HIV vulnerability.

FAMILY DEPENDENCE AND ITS ASSOCIATION WITH SELF-REPORTED HEALTH AMONG OLDER ADULTS IN EASTERN NEPAL

Abstract Historically, filial piety (caring for one’s parents) has been prevalent in Nepal. The demographic transition has resulted in a burgeoning population of older adults, but limited institutional support is available to address their socio-economical and health needs. As such, the family has remained the paramount source of support to meet the health, social and economic needs of Nepali older adults. In this study, we explored the relationship between family dependency (conceptualized as the source of family support) and self-reported health among Nepali older adults. A community-based cross-sectional survey was conducted in two districts (Sunsari and Morang) of eastern Nepal. Using a multistage cluster random sampling design 847 older adults (≥ 60 years) were interviewed. Self-reported health was assessed in terms of a five-item Likert scale dichotomized into poor and good health. Two independent variables of interest were dependency on family for living and for daily activities. Binary logistic regression drew the inferences while adjusting for important confounders. About 29.4% of the participants reported poor health, 77% reported dependency on family for living and 46% reported dependency for daily activities. Those dependent on family for living had 46% higher odds of good health but the statistical significance was lost after adjusting for control variables. Likewise, those dependent on family for daily activities were three times more likely (OR: 3.22; 95%CI: 2.15 - 4.83) to report good health than their counterparts after controlling for confounders. Our findings emphasize the importance of family support for the health of older adults in Nepal.

Key predictors of undernutrition among children 6–59 months in the Buea Health District of the Southwest region of Cameroon: a cross sectional community-based survey

BackgroundAccording to the 2018 Demographic and Health Survey, undernutrition remains a public health problem among Cameroonian children under-five. This varies across the country, greatest in areas with ongoing humanitarian crisis, such as the Southwest region. However, data on the burden of undernutrition in the Southwest region is sparse. This study aimed to assess the prevalence and predictors of undernutrition among children under-five in the Buea health district of the Southwest region of Cameroon.MethodsThis was a community based cross-sectional study of 321 children under-five/caretaker pairs, surveyed from households selected using multistage randomized sampling. Data were collected by trained data collectors, with the aid of a structured, pre-tested questionnaire that captured information on sociodemographic characteristics, food security, dietary diversity and anthropometric measurements. The weight, height/length and mid upper arm circumference (MUAC) were measured using standardized instruments. Stunting, Wasting and Underweight of children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. Data was analysed using SPSS version 27.0. Predictors of malnutrition were obtained using multivariate logistic regression, adjusting for potential confounders.ResultsOverall, 31.8% (102/321) of the children were undernourished (26.5% stunted, 1.6% underweight, 3.7% wasted). Drinking water from inappropriate sources (OR: 2.32, 95% CI: 1.30–4.15) and a Dietary Diversity Score < 4 (OR: 2.59, 95%CI: 1.46–4.61) were independently associated with increased risk of stunting. Children of the male sex were more likely to be wasted than females (OR: 5.34, 95%CI: 1.09–26.14).ConclusionChildhood undernutrition, particularly stunting is common in the Buea Health District. Risk factors of undernutrition identified are potentially modifiable, highlighting the need for nutrition specific and sensitive interventions to improve dietary diversity, and the need to improve access to safe drinking water, and educate caretakers on the importance of clean potable water, good sanitation and hygiene for the proper growth and development of their children.

Utilization of Nutritional Supplementation Services and Their Predictors in Pregnant and Lactating Women Living in an Urban Resettlement Colony of Delhi, India: A Cross-Sectional Study.

Introduction Maternal undernutrition during pregnancy and lactating has adverse health consequences for the mother and her child. The Integrated Child Development Services (ICDS) scheme by the Government of India provides supplementary nutrition services to all pregnant and lactating women but its utilization is suboptimal due to inefficient distribution through the health system and beneficiary concerns regarding its usefulness. This study was conducted with the objective of assessing the utilization of nutrition-related ICDS services by pregnant and lactating women in urban poor settlements of Delhi and the sociodemographic factors associated with non-utilization. Materials and methods This was a community-based cross-sectional survey in an urban resettlement colony and slum area located in the northeast district of Delhi. The data collection was conducted from January to May 2022. Eligible participants included pregnant women in their second or third trimester of pregnancy and lactating mothers in their first six months of the postpartum period who were residents of the study setting.Data were collected using face-to-face interviews using a pre-tested and self-designed questionnaire. The primary outcome was the proportion of women utilizing ICDS take-home rations (THR) in the previous month. Results A total of 365 participants were recruited in this study including 208 pregnant and 157 lactating women having a median (IQR) age of 25 (22-28) years.A total of 211 (57.8%) participants reported a history of utilization of ICDS supplementary nutrition services during their current pregnancy or postpartumwith 154 (42.2%) having received THR in the previous month. Among the currently pregnant women, 84 (40.4%) had utilized ICDS THR while in the currently lactating women, 70 (44.6%) had utilized THR in the previous month.On adjusted analysis, multigravid women were less likely to have utilized ICDS compared to primigravida women. Reasons for non-utilization of the ICDS supplementary nutrition services by the mothers were temporary disruption due to cessation of ICDS services by protesting Anganwadi workers (over demand for increased honorarium), difficult access to Anganwadi center, the poor perceived taste of the food provided as THR, and perception by the mothers that they did not require THR. Most women reported sharing the THR with their family members. All pregnant and lactating women were found to be calorie and protein deficient in this study when applying the recommended intake values. No association was observed between the utilization of ICDS in the previous month and the presence of calorie deficiency in both pregnant (p=0.35) and lactating (p=0.24) women. Conclusions More than four in ten eligible pregnant and lactating women in an urban resettlement colony in Delhidid not utilize ICDS supplementary nutrition services with similar rates of utilization in both pregnant and lactating women. Women living in joint families and consequently larger households were less likely to utilize ICDS services. A majority of pregnant and lactating women were calorie and protein deficient even on applying non-pregnant cut-off requirements. The ICDS scheme needs to strengthen information, education, and communication (IEC) strategies and interventions to improve its acceptability and utilization by this vulnerable population.

Prevalence, Patterns, and Risk Factors of Work-Related Musculoskeletal Diseases Among Teachers in the Eastern Province, Saudi Arabia: A Community-Based Retrospective Cross-Sectional Survey.

Background and objective Work-related musculoskeletal diseases (WMSDs) are one of the most common occupational health concerns among teachers. They referto a variety of degenerative and inflammatory disorders that can be triggered by the work environment of the people affected. Teachers' health is substantially significant as it impacts their productivity at work. The aim of this study was to determine the prevalence, patterns, implications, and risk factors of WMSDs among teachers in the Eastern Province of Saudi Arabia. Methods This study involved a survey based on a cross-sectional questionnaire that was distributed to 404 random school teachers located in the Eastern province of Saudi Arabia. Information such as sociodemographic characteristics,workplace characteristics, characteristics of WMSDs experienced, associated factors, and impact of the symptoms experienced was collected. Questions related to symptoms were obtained from the Nordic Musculoskeletal Questionnaire and Örebro Musculoskeletal Pain Screening Questionnaire(ÖMPSQ). The collected data were then analyzed using the SPSS Statistics version 23.0 (IBM Corp., Armonk, NY). Results Among the participants, back pain, shoulder pain, and knee pain were the most reported symptoms of WMSDs in the past 12 months, while elbow pain was the least experienced; 41.1%had pain, discomfort, or numbness that prevented them from performing regular daily activities. The regression analysis revealed a relationship between moderate to severe pain and a pain duration of more than 12 months (p=0.001). Additionally, those who were able to perform lighter work and were not having depression had a low probability of pain persistence and were able to carry out their usual work while experiencing pain (p=0.002). Conclusions In the Eastern province of Saudi Arabia, WMSDs were commonly reported by school teachers. The prevalenceofWMSDs among teacherswas 41.1%. The pain was described as disabling and causing a negative impact on performance. The most common locations of symptoms were the back, shoulder, and knees. Risk factors for severe pain were female gender, sleeping for six to sevenhours, and pain located in the neck shoulder, elbow, hand, thigh/hips, back, knees, and ankles. Furthermore, severe pain was associated with pain duration of more than 12 months, affecting sleep, causing anxiety, and mild depression. The impact of severe pain seriously affected the daily activities of teachers.

Performance of antigen detection for HRP2-based malaria rapid diagnostic tests in community surveys: Tanzania, July–November 2017

BackgroundMalaria rapid diagnostic tests (RDTs) based on the detection of the Plasmodium falciparum histidine-rich protein 2 (HRP2) antigen are widely used for detection of active infection with this parasite and are the only practical malaria diagnostic test in some endemic settings. External validation of RDT results from field surveys can confirm appropriate RDT performance.MethodsA community-based cross-sectional survey was conducted between July and November 2017 enrolling participants of all ages in households from 15 villages in four border regions of Tanzania: Geita, Kigoma, Mtwara and Ruvuma. All participants had an RDT performed in the field and provided a blood sample for later laboratory multiplex antigen detection of HRP2. In assessing the continuous HRP2 levels in participant blood versus RDT result, dose–response logistic regression provided quantitative estimates for HRP2 limit of detection (LOD).ResultsFrom the 15 study villages, 6941 persons were enrolled that had a RDT at time of enrollment and provided a DBS for later laboratory antigen detection. RDT positive prevalence for the HRP2 band by village ranged from 20.0 to 43.6%, but the magnitude of this prevalence did not have an effect on the estimated LOD of RDTs utilized in different villages. Overall, HRP2 single-target tests had a lower LOD at the 95% probability of positive RDT (4.3 ng/mL; 95% CI 3.4–5.4) when compared to pLDH/HRP2 dual target tests (5.4 ng/mL; 4.5–6.3), though this difference was not significant. With the exception of one village, all other 14 villages (93.3%) showed RDT LOD estimates at 90% probability of positive RDT between 0.5 and 12.0 ng/mL.ConclusionsBoth HRP2-only and pLDH/HRP2 combo RDTs utilized in a 2017 Tanzania cross-sectional survey of border regions generally performed well, and reliably detected HRP2 antigen in the low ng/mL range. Though single target tests had lower levels of HRP2 detection, both tests were within similar ranges among the 15 villages. Comparison of quantitative HRP2 detection limits among study sites can help interpret RDT testing results when generating population prevalence estimates for malaria infection.