Community Prevalence Study Research Articles

Ayurveda Perspective on Visarpa Vyadhi and its Management

Skin is the largest organ of the body which acts as a first line of defense in providing resistance to the body. The aggravation of various Dhatus and Doshas result in skin diseases. More than one-fifty skin related diseases are mentioned in various Ayurvedic texts. They are categorized as Visarpa, Kustha, Shotha, Upadansh etc. Visarpa is a very common disease mentioned in Ayurvedic texts which spreads in body in various directions. It is said to be caused by Varicella zoster virus as per modern concept. It manifests as Daha, Jwara, Anunnatashopha and Vedana. Around 20-30% sufferers of various skin ailments are demonstrated through large community prevalence study. A 40-year-male presented along with the vesicular lesions on his neck region associated with mild fever, itching, and pain on the local lesion. He was administered with 250mg of Kamadudha rasa (plain) twice a day before meals with milk, Chandrakala rasa 250mg twice a day, Paripathadi kwatha 2 tsp twice a day and Shatadhauta ghrita for local application on the lesions. The patient reported on the 5th day with significant relief in the size and shape of the facial lesions and other symptoms. The scars limited to minimal without any inflammatory signs by the 7th day of follow-up. Above medications are two readily available and cost-effective compound Ayurvedic formulations, which can be used in the management of herpes zoster infection, especially in low-resource settings.

Public Awareness of and Support for the Use of Wastewater for SARS-CoV-2 Monitoring: A Community Survey in Louisville, Kentucky.

The majority of sewer systems in the United States and other countries are operated by public utilities. In the absence of any regulation, the public perception of wastewater monitoring for population health biomarkers is an important consideration for a public utility commission when allocating resources for this purpose. We conducted a survey in August 2021 as part of an ongoing COVID-19 community prevalence study in Louisville/Jefferson County, KY, US. The survey comprised seven questions about wastewater awareness and privacy concerns and was sent to approximately 35 000 households randomly distributed within the county. A total of 1220 adults were involved in the probability sample, and data from 981 respondents were used in the analysis. A total of 2444 adults additionally responded to the convenience sample, and data from 1751 respondents were used in the analysis. The samples were weighted to obtain estimates representative of all adults in the county. Public awareness of tracking the virus that causes COVID-19 in sewers was low. Opinions strongly support the public disclosure of monitoring results. Responses showed that people more strongly supported measurements in the largest areas (>50 000 households), typically representing population levels found in a large community wastewater treatment plant. Those with a history of COVID-19 infection were more likely to support highly localized monitoring. Understanding wastewater surveillance strategies and privacy concern thresholds requires an in-depth and comprehensive analysis of public opinion for continued success and effective public health monitoring.

Case Study on Moolakabeejadi Lepa in Dadru Kushta

In recent years; there has been a considerable increase in the incidence of skin problems in the developing countries like India and tropical countries due to less immunity, unhygienic, living conditions, and nutrition. The most exposed part of the body is skin. In cosmetic point of view patient who suffers with any skin diseases leads to experience physical, emotional and socio-economic embarrassment in his/her society because mirror that reflects internal & external pathology in such diseases is skin which helps in diagnosis. In among the various skin infections tinea/ringworm is one which is spreading rapidly and affecting all the age group of population. Skin infection is termed as Twak Vikara or Kushta roga in Ayurveda. In among the Kushta Roga, Dadru termed as a Dadru Kushta. In contemporary medicine, tinea/ringworm which is skin fungal infection is correlated to Dadru Kushta due to similarities in their signs and symptoms. Large community prevalence studies have demonstrated that between 20-30% of the population have various skin problems requiring attention. Present study was conducted on diagnosed patients of Dadru Kushta in patients Moolakabeejadi Lepa was applied. The drugs used in the formulations having Kandughana, Kushtahara, Krimighna, Shodhana and Tridoshahara in their properties. The results revealed highly significant effect of Moolakabeejadi Lepa in various subjective and objective parameters like Raga, Kandu and number of Pidika, number of Mandala after treatment. During follow up period of 15 days the drug effect suggested the sustained effect on the disease.

Acceptability, Usability, and Performance of Lateral Flow Immunoassay Tests for Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies: REACT-2 Study of Self-Testing in Nonhealthcare Key Workers.

BackgroundSeroprevalence studies are essential to understand the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Various technologies, including laboratory assays and point-of-care self-tests, are available for antibody testing. The interpretation of seroprevalence studies requires comparative data on the performance of antibody tests.MethodsIn June 2020, current and former members of the United Kingdom police forces and fire service performed a self-test lateral flow immunoassay (LFIA), had a nurse-performed LFIA, and provided a venous blood sample for enzyme-linked immunosorbent assay (ELISA). We present the prevalence of antibodies to SARS-CoV-2 and the acceptability and usability of self-test LFIAs, and we determine the sensitivity and specificity of LFIAs compared with laboratory ELISA.ResultsIn this cohort of 5189 current and former members of the police service and 263 members of the fire service, 7.4% (396 of 5348; 95% confidence interval [CI], 6.7–8.1) were antibody positive. Seroprevalence was 8.9% (95% CI, 6.9–11.4) in those under 40 years, 11.5% (95% CI, 8.8–15.0) in those of nonwhite ethnicity, and 7.8% (95% CI, 7.1–8.7) in those currently working. Self-test LFIA had an acceptability of 97.7% and a usability of 90.0%. There was substantial agreement between within-participant LFIA results (kappa 0.80; 95% CI, 0.77–0.83). The LFIAs had a similar performance: compared with ELISA, sensitivity was 82.1% (95% CI, 77.7–86.0) self-test and 76.4% (95% CI, 71.9–80.5) nurse-performed with specificity of 97.8% (95% CI, 97.3–98.2) and 98.5% (95% CI, 98.1–98.8), respectively.ConclusionsA greater proportion of this nonhealthcare key worker cohort showed evidence of previous infection with SARS-CoV-2 than the general population at 6.0% (95% CI, 5.8–6.1) after the first wave in England. The high acceptability and usability reported by participants and similar performance of self-test and nurse-performed LFIAs indicate that the self-test LFIA is fit for purpose for home testing in occupational and community prevalence studies.

Geospatial analysis of antibiotic resistance in the aquatic environment of Bangladesh

BackgroundGeographical information systems (GIS) can play a significant role in understanding the distribution and clustering of drug resistant pathogens. Currently, geospatial analysis using GIS is not widely applied to mapping antimicrobial resistance (AMR) in the environment for development of its mitigation strategies. MethodsWe conducted an observational community prevalence study in rural households, poultry farms and urban markets in Bangladesh. A total of 240 aquatic samples from upstream to downstream surrounding the study settings (drinking water source, waste water and surface water, e.g. rivers and ponds) were collected in summer and winter. Spatial mapping was done (using ArcGIS software) to demonstrate the concentrations of extended-spectrum β-lactamase-producing (ESBL) E. coli count in the aquatic system of each setting. Each data point represents an environmental sample and the data size indicates the concentration of log10 ESBL E. coli. ResultsWe identified ESBL E. coli in all types of environmental samples. Wastewater had the highest prevalence of ESBL E. coli ranging from 90% in rural households to 98% in urban food markets. River water samples had the next highest prevalence (85% positive) followed by pond water (76% positive in rural households and 68% in farms) respectively. Carbapenem-resistant E. coli were less common than ESBL E. coli but plentiful (30%) in waste water samples adjacent to urban markets. Both ESBL E. coli and Carbapenem-resistant E. coli did not vary by season in waste water and pond water, but Carbapenem resistant E.coli were significantly higher in the summer for river water (50% vs 15% , p<0.05).ConclusionOur current study is the first attempt to use spatial mapping in low income settings for assessing the extent of environmental contamination with antibiotic resistant bacteria. Utilization of GIS with microbiological data might be an important monitoring tool for both surveillance and policy context of AMR.

Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study

ObjectiveEpilepsy, a neurological disorder with effective biomedical treatment, remains largely untreated in Uganda. Potential reasons for this treatment gap (TG) include limited access to trained providers and clinics, social stigmata of seizures, cultural beliefs, or lack of public understanding of epilepsy as a treatable condition. The current study aimed to formally evaluate barriers faced by people with epilepsy (PWE) in Uganda when seeking biomedical care. MethodsIn a cross-sectional study, 435 participants drawn from a community prevalence study were enrolled. We included participants reporting a history of recurrent seizures suggestive of epilepsy, who completed a survey about barriers to obtaining care for their symptoms. Principal axis factor analysis (PFA) using a promax rotation was conducted for data reduction. Frequencies of barrier factors were compared across those who did not seek care for epilepsy (n = 228), those who sought care from biomedical facilities (n = 166), and those who sought care from a traditional or pastoral healer (n = 41). ResultsThe PFA yielded a five-factor solution: 1) logistical and actual costs; 2) treatment effectiveness; 3) influence of the opinion of others; 4) doctors' care; and 5) contextual factors impacting decision-making. Variables related to logistical and actual costs were most endorsed. Comparison of groups by care sought did not reveal a difference in endorsement of factors, with the exception that those who sought biomedical care were more likely to endorse factors related to doctors' care compared with those that sought care from traditional or pastoral healers (P = .005). ConclusionsPeople with repetitive seizures in Uganda report several barriers to obtaining biomedical care in Uganda, with those related to practical and actual costs endorsed the most. It is imperative that interventions developed to reduce the TG in Uganda consider these practical issues to improve access to effective epilepsy care.This article is part of the Special Issue “The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda

Do EGMs have a Stronger Association with Problem Gambling than Racing and Casino Table Games? Evidence from a Decade of Australian Prevalence Studies

Although it is often assumed that electronic gaming machines (EGMs) are associated with the highest level of risk, it has proved difficult to find reliable evidence in support of this proposition. In this paper, we analysed statistics from major Australian community prevalence studies for the period 2011-2020 to investigate whether EGMs (in comparison to racing and casino table games) have a stronger association with problem gambling. All prevalence studies reviewed used telephone sampling and the Problem Gambling Severity Index to assess problem gambling. In this paper, we examine the principal hypothesis using several lines of evidence, including whether problem gamblers are more likely to gamble and gamble regularly on EGMs as opposed to racing and casino games and if the EGM-problem gambling association was maintained after controlling for other forms of participation. Results showed that of all gambling activities, EGMs do appear to have the strongest association with problem gambling. Despite having a disproportionately higher level of participation on racing and casino games as compared with other gamblers, problem gamblers are more likely to report regular or weekly participation in EGM gambling and this may be the reason why this activity emerges most strongly as a predictor of problem gambling in multivariate models. This finding is particularly salient, given the very high prevalence of EGM participation, compared to other risky gambling forms. The findings underscore the importance of survey reporting that presents results in a form that can inform policy relevant research relating to the potential impact of different gambling activities.

Community prevalence of chronic respiratory symptoms in rural Malawi: Implications for policy.

BackgroundNo community prevalence studies have been done on chronic respiratory symptoms of cough, wheezing and shortness of breath in adult rural populations in Malawi. Case detection rates of tuberculosis (TB) and chronic airways disease are low in resource-poor primary health care facilities.ObjectiveTo understand the prevalence of chronic respiratory symptoms and recorded diagnoses of TB in rural Malawian adults in order to improve case detection and management of these diseases.MethodsA population proportional, cross-sectional study was conducted to determine the proportion of the population with chronic respiratory symptoms that had a diagnosis of tuberculosis or chronic airways disease in two rural communities in Malawi. Households were randomly selected using Google Earth Pro software. Smart phones loaded with Open Data Kit Essential software were used for data collection. Interviews were conducted with 15795 people aged 15 years and above to enquire about symptoms of chronic cough, wheeze and shortness of breath.ResultsOverall 3554 (22.5%) participants reported at least one of these respiratory symptoms. Cough was reported by 2933, of whom 1623 (55.3%) reported cough only and 1310 (44.7%) combined with wheeze and/or shortness of breath. Only 4.6% (164/3554) of participants with chronic respiratory symptoms had one or more of the following diagnoses in their health passports (patient held medical records): TB, asthma, bronchitis and chronic obstructive pulmonary disease)ConclusionsThe high prevalence of chronic respiratory symptoms coupled with limited recorded diagnoses in patient-held medical records in these rural communities suggests a high chronic respiratory disease burden and unmet health need.

Informing future research for carriage of multiresistant Gram-negative bacteria: problems with recruiting to an English stool sample community prevalence study

ObjectivesThis study aims to highlight problems with recruiting to an English stool sample community prevalence study. It was part of a larger cross-sectional research to determine the risk factors for...

Fetal alcohol spectrum disorders: Prevalence rates in South Africa.

Fetal alcohol spectrum disorder (FASD) is an under-diagnosed condition in South Africa (SA). Fetal alcohol syndrome and FASD community prevalence studies were undertaken in 17 towns in three of the nine provinces in SA. The objective for all the studies was to determine the FASD prevalence rates by assessing the grade 1 learners in all the studies, using international FASD diagnostic criteria. The same methodology was used for all the studies in Gauteng, Western and Northern Cape provinces. Consenting grade 1 learners received anthropometric screening, clinical examinations and neurodevelopmental assessments. Structured interviews were used to assess maternal alcohol consumption during pregnancy. Reported prevalence rates ranged from 29 to 290 per 1 000 live births. FASD rates from studies conducted in SA are among the highest worldwide. FASD affects all communities in SA and is therefore a major public health concern in SA. Multidisciplinary and intersectoral interventions are urgently required to raise awareness about the dangers of prenatal alcohol exposure and the devastating effect of FASD on the lives of children, families and communities.

Beyond medicalization: Self-injuring acts revisited.

For too long, medical/psychiatric and psychological studies, with focus on emotional sensitivity, personality traits, and correlation with psychopathology, have dominated research on self-injuring acts. The phenomenon thus has been defined as a predominantly medical issue. However, a large body of community prevalence studies show self-injuring acts to be a common phenomenon in society, and most of those who self-injure are unknown in psychiatric or other clinical settings. This article describes and analyzes the medicalization of self-injuring acts and argues a need to move research on self-injuring acts out of the medical paradigm. There is a need to explicitly explore the impact of social, cultural, structural, and gendered factors surrounding and influencing self-injuring acts. A non-medical approach, beyond the limits of the medical perspective, would feed research forward and create a more nuanced view on this widespread social phenomenon.

Human cystic and alveolar echinococcosis in the Tibet Autonomous Region (TAR), China.

Human cystic echinococcosis (CE) is known to be endemic in the Tibet Autonomous Region (TAR), China; however, there is relatively little data from hospital records or community prevalence studies, and the situation regarding occurrence of human alveolar echinococcosis (AE) is unclear. Here we review the available reports about human echinococcosis in the seven prefectures of TAR. In addition, two pilot studies by mass screening using ultrasound (with serology) were undertaken (2006/7) in Dangxiong County of Lhasa Prefecture (north central TAR) and Dingqing County of Changdu Prefecture (eastern TAR). In Dangxiong County a prevalence of 9.9% (55/557) for human CE was obtained but no human AE cases were detected. By contrast, in Dingqing County (N= 232 persons screened), 11 CE cases (4.7%) and 12 AE cases (5.2%) (including one mixed CE and AE case) were diagnosed by ultrasound. Hospital records and published reports indicated that CE cases were recorded in all of seven prefectures in Tibet Autonomous Region, and AE cases in four prefectures. Incidence rates of human CE were estimated to range from 1.9 to 155 per 100,000 across the seven prefectures of TAR, with a regional incidence of 45.1 per 100,000. Incidence of AE was estimated to be between 0.6 and 2.8 cases per 100,000. Overall for TAR, human AE prevalence appeared relatively low; however, the pilot mass screening in Dingqing in eastern TAR indicated that human AE disease is a potential public health problem, possibly similar to that already well described in Tibetan communities bordering TAR in north-west Sichuan and south-west Qinghai provinces.

EPA-0450 – Caregiving in dementia and in old age depression: preliminary results from the 10/66 drg prevalence study in portugal

The burden of neuropsychiatric disorders in the elderly is high, considering patients, their families, and close or extended networks. In Portugal, the 10/66-Dementia Research Group population-based research programmes are running since 2011, with the community prevalence study. The protocol allows for valid diagnoses of dementia and depression, using comprehensive assessments which include the Geriatric Mental State- AGECAT. We aimed to analyse informal caregiving arrangements and the psychological experience of caregiving in a subsample drawn from the ongoing 10/66 studies. We report on 580 residents aged 65 + years of a defined catchment area in Portugal (Mora). Assessments included questionnaires on demographic and caregiving issues, the Self-Report Questionnaire (SRQ) on psychological distress and the Zarit Burden Interview (ZBI) on the caregiving experience. In this subsample, 94 participants were in need of informal caregiving (dementia accounted for 28 cases, depression for 31, and other chronic physical/psychiatric conditions for the remainder). Most primary caregivers were family relatives (mostly wives and daughters) and were living with the patient. A large number were elderly people themselves (mean age 64.1±16.3years). Median scores were 3 on the SRQ (range 0-16) and 8 on the ZBI (range 0-66). Those who were caring for participants with more severe disabilities scored significantly higher on both measures. These preliminary results of the 10/66 epidemiological community studies support previous suggestions that caregiver strain is also high in subgroups of community samples. Most overburdened families (and individual caregivers) lacked appropriate, tailored interventions. Final results will be available soon.

EPA-0420 – Unmet needs in portuguese elderly people: data from services research and the 10/66 prevalence surveys on dementia and depression

The healthcare needs of the elderly are seldom assessed in practice. Research in clinical populations with neuropsychiatric disorders generally unravels high levels of unmet needs. Although there are Portuguese studies in needs assessment, explorations of community or social services’ scenarios have been scarce. By gathering data from health and social services research, and from an epidemiological survey in the same region, we aimed to better characterize the unmet needs of Portuguese elderly. We report on studies with old age people in Seixal, near Lisbon: 1) the Camberwell Assessment of Need for the Elderly was used for auditing a non-profit organization, with day-centre and home support services (n=95), and in a survey of family carers of dementia outpatients (n=116); 2) the 10/66 DRG community prevalence study (n=670) used comprehensive assessments to provide psychiatric diagnoses, data on health and psychosocial needs, and the use of services. In the social service audit, unmet needs were mainly related to food, company, physical health and daytime activities. Domiciliary care users had more unmet needs than day centre users (p<0.001). Informal caregivers of dementia patients reported information and psychological distress needs. Finally, these 10/66 DRG study partial results highlighted a high prevalence of depression (20.4%; 95%CI 17.4-23.7) and huge health services’ utilization needs. Systematic assessments of needs for care generally unravel high proportions of health and psychosocial problems lacking adequate interventions, in clinical and community populations. This may provide a more consistent basis for health services planning.

Childhood Obesity in the Asian American and Pacific Islander Communities: Critical Data Needs and Research Priorities

Asian American, Native Hawaiian, and Pacific Islanders (AANHPIs) have some of the fastest-growing rates of obesity of all ethnic groups (Harrison et al., 2005). Preventing childhood obesity among AANHPIs is a challenge constrained by resource and research gaps. These include the lack of national prevalence data, insufficient funding support, limited knowledge of risk factors associated with childhood obesity, particularly in these populations, and the lack of programmatic evaluations. The finding of this literature review shows that only 0.11 percent of PubMed articles on childhood obesity focused on AANHPIs. Recommendations to advance what is known about AANHPI and childhood obesity include targeting community prevalence studies, community needs assessments, risk factor studies, and program evaluations; training and mentoring junior researchers; and creating a national clearing-house to compile research literature and evidence-based practices.

Childhood Obesity in the Asian American and Pacific Islander Communities: Critical Data Needs and Research Priorities

Asian American, Native Hawaiian, and Pacific Islanders (AANHPIs) have some of the fastest-growing rates of obesity of all ethnic groups (Harrison et al., 2005). Preventing childhood obesity among AANHPIs is a challenge constrained by resource and research gaps. These include the lack of national prevalence data, insufficient funding support, limited knowledge of risk factors associated with childhood obesity, particularly in these populations, and the lack of programmatic evaluations. The finding of this literature review shows that only 0.11 percent of PubMed articles on childhood obesity focused on AANHPIs. Recommendations to advance what is known about AANHPI and childhood obesity include targeting community prevalence studies, community needs assessments, risk factor studies, and program evaluations; training and mentoring junior researchers; and creating a national clearing-house to compile research literature and evidence-based practices.

Screening for mental health problems in adults with learning disabilities using the Mini PAS‐ADD Interview

Accessible summaryThis study interviewed the key workers of 96 adults with learning disabilities using the Mini PAS‐ADD Interview to identify whether they had a potential mental health problem. Prevalence rates of mental health across the UK and in other countries have been published but such figures are not known in Northern Ireland. This study found: 33.3% of the sample was identified to have a potential mental health problem. This sample was found to score higher on the sub‐scales of depression and psychosis compared with other prevalence studies. The community informants (i.e. nurses and social workers) were found to be competent in using the Mini PAS‐ADD Interview as identified by the sample of in‐depth psychiatric interviews undertaken by a psychiatrist. SummaryPrevalence rates vary considerably regarding the mental health of people with learning disabilities. This variation is a consequence of the assessment methods used to identify such clinical conditions and also different populations studied. The aim of this study was to screen for mental health problems in adults with mild‐to‐moderate learning disabilities. This study took place in one region of the UK providing community‐based services to 96 adults with mild‐to‐moderate learning disabilities. Using the Mini PAS‐ADD Interview schedule, a number of specifically trained interviewers, interviewed staff who supported these adults with learning disabilities in their particular work/day care setting to determine whether or not participants had a potential mental health problem. This study found a 33.3% prevalence rate of mental health problems in this community sample. This sample was found to score higher on the sub‐scales of depression and psychosis compared with other prevalence studies. The Mini PAS‐ADD Interview was found have an overall sensitivity of 1 (100%); its specificity was 77%. The results of this study fall between previous community prevalence studies that range from 14% to 50%. The practical issues of the screening process are discussed. Methodological limitations are also highlighted in accurately predicting prevalence rates of mental health problems in the learning disability population by clinical staff.

Hospitalization Patterns for Psychiatric Disorders Across the Lifespan in Australia From July 1998 to June 2005

Hospitalization Patterns for Psychiatric Disorders Across the Lifespan in Australia From July 1998 to June 2005

Trauma Exposure and Posttraumatic Stress Disorder in the Elderly: A Community Prevalence Study

Little prevalence data exist on trauma exposure and posttraumatic stress disorder (PTSD) in the elderly. The authors examined lifetime exposure to trauma and 12-month PTSD in a large community sample. Data were drawn from the Australian National Survey of Mental Health. Of the total 10,641 participants, 1,792 were over the age of 65. The Composite International Diagnostic Interview provided trauma exposure and diagnostic status. A curvilinear pattern of lifetime exposure to trauma across the lifespan was obtained for women, whereas men showed a linear increase. This difference was explained by combat exposure. PTSD prevalence reduced with age and participants over 65 reported negligible rates. Around 10% of the elderly reported reexperiencing symptoms. PTSD rates are lower in older age cohorts, although reasons for this are unclear. With 10% reporting reexperiencing symptoms associated with past events, however, greater awareness of treatments that target traumatic memories may be beneficial.

Sleep problems in a Down syndrome population

Objective:To determine the prevalence of sleep problems in children with Down syndrome.Design and setting:A community prevalence study in a child population of 100 000 in England.Participants:58 children with Down syndrome...