Multistage Cluster Sampling Research Articles

Relationship Between Health Literacy, Health Protective Behaviour, Quality of Life and Social Health in Older Adults Living in the Community.

The aim of this study was to examine the relationship between health literacy, health protective behaviour, quality of life and social health in older adults living in the community. A cross-sectional study. This observational study was carried out by interviewing 600 older adult people living in a province in the South Marmara region of Turkey using a multi-stage cluster sampling method. The dependent variable of the study was social health perception, and multivariate linear regression analysis was used in the analyses. Reporting of the study followed the STROBE checklist. The social health of the participants is at a medium level. As a result of linear regression analysis, the social health score was found in those who have high school education or higher, those who live with their children and those who live alone to be significantly lower in those with poor general health perception. As age increases, health literacy increases, and quality of life decreases, the social health score decreases (p < 0.05). In this context, steps should be taken to increase social harmony and social support for the older adult; the perceived environment should be improved, and environments that facilitate the lives of the older adult should be created. Determining the level of social health of the older adult and identifying the related factors is important in terms of improving the quality of services to be provided for the older adult. In this context, it is important for health professionals to take initiatives to improve the lifestyle, health literacy and quality of life of the older adult.

Mass drug administration coverage and its determinants for the elimination of onchocerciasis in Ulanga District, Tanzania.

Onchocerciasis remains an important public health problem targeted for elimination in Tanzania. Ulanga District was hyperendemic for onchocerciasis before the intervention, underscoring the need for particularly high coverage in MDA efforts. The district has been implementing MDA through Community Directed Treatment with Ivermectin (CDTI) strategy since 1998. However, there is preliminary evidence of persistent onchocerciasis transmission, which likely sustains the observed high prevalence of Onchocerciasis in both human and vector species. This could be linked to poor treatment coverage. This study was conducted to assess treatment coverage and explore factors that determine drug uptake during MDA program. A cross-sectional study was conducted in Ulanga District, Morogoro, Tanzania, from April to June 2019. Using multistage cluster sampling, 502 participants were randomly selected and interviewed through a structured questionnaire. Modified Poisson regression analysis was used to identify independent factors affecting MDA uptake. The overall response rate was 96% with majority (67%) of respondents being females, and the mean age of the study participants was 37.8 years with a standard deviation (SD) of ± 15 years. The study found that MDA coverage varied across villages: Mawasiliano (68%, CI: 59.3 - 75.6), Uponera (83%, CI; 76.6 - 89.6), Isongo (84.8%, CI: 77.3 - 90.1) and Togo (79%, CI: 70.1 - 85.8). While Uponera and Isongo achieved the WHO-recommended 80% coverage for transmission interruption, Mawasiliano and Togo fell below this threshold. Age significantly influenced drug uptake, with younger individuals (15-24 years) having a lower uptake rate [APR = 2.8, p = 0.008], followed by the 25-34 age group [APR = 2.3, p = 0.04]. Occupation also played a role, as small and medium enterprise (SME) workers [APR = 3.2, p = 0.05] and students [APR = 2.9, p = 0.05] were less likely to participate. Residence duration in the village was a strong predictor of MDA uptake. Individuals living in the village for more than a year were significantly more likely to participate [APR = 2.3, p = 0.00]. Additionally, a lack of awareness about MDA benefits negatively impacted participation, as those uncertain about its benefits were less likely to take the drug [APR = 2.5, p = 0.03]. Similarly, individuals unaware of the correct MDA distribution schedule had lower uptake [APR = 2.5, p = 0.03]. However, those who took Ivermectin for prevention purposes were significantly more likely to participate [APR = 13.4, p = 0.001]. MDA coverage below the WHO optimally recommended coverage has been demonstrated in the villages studied. This implies low drug uptake, delayed interruption of transmission and Onchocerciasis elimination. The findings highlight the need for targeted interventions to improve MDA coverage by focusing on younger individuals, certain occupational groups, and new residents. Strengthening community engagement, improving health communication, and intensifying biannual MDA efforts are recommended to accelerate Onchocerciasis elimination in the district. It also underscores the need for adopting other effective public health interventions such as community mobilization towards slash and clear of potential breeding sites for Onchocerciasis vector.

Maternal hypertensive disorders and modifiable risk factors among pregnant women in North Central Ethiopia

Even though maternal hypertensive disorders (MHDs) is the second cause of maternal death in Ethiopia, detail and population based study among pregnant women is lacking in the study area. Hence, this study had assesed the prevalence of MHDs and associated risk factors among pregnant women, in North Central Ethiopia, 2023. A community-based cross-sectional study was conducted using the WHO STEPWISE questionnaire among 855 participants through multi-stage cluster sampling in five districts of North Central Ethiopia from May to June 2023. Binary and multivariable logistic regression analyses were performed, and a P-value of < 0.05 was used to declare statistical significance. Seven percent (95% CI 6%, 8%) of pregnant women had MHDs. Pregnant women who had no history of hypertension had 52% lower odds (adjusted odds ratio (AOR = 0.48, 95% CI 0.44, 0.52) than those with a history of hypertension. Pregnant women, who ate processed food that are high in salt sometimes and rarely had 88% and 81% less odds (AOR = 0.12, 95% CI 0.03, 0.47), (AOR = 0.19, 95% CI 0.07, 0.55) than those who ate always, respectively. Women who didn’t know to express blood pressure measurement had 56% lower odds (AOR = 0.44, 95% CI 0.22, 0.89) of maternal hypertensive disorders than those who expressed the measurement. Seven out of hundred pregnant women had MHDs. Previous history of hypertension, women knew how to express their blood pressure measurement and consumed processed foods high in salt rarely and sometimes were factors strongly associated with MHDs. Zonal health departments and their partners should strengthen advocacy for prevention and control of MHDs in the study area.

Large inter-arm systolic blood pressure difference is associated with cognitive impairment in older adults: a cross-sectional study in rural southwest China

BackgroundStudies have shown that both inter-arm blood pressure difference (IABPD) and cognitive impairment are associated with vascular events. However, the relationship between IABPD and cognitive impairment among elderly individuals in rural China remains unclear. This study aims to investigate the association between IABPD and cognitive impairment in rural older adults in Guizhou, southwestern China.MethodsThe study data were obtained from the Cohort Study of the Health Status of Guizhou Rural Older Adults in China (SHGROC). A multi-stage cluster sampling method was employed to select 1,088 rural elderly individuals aged ≥ 60 years from Guizhou Province for questionnaire surveys, physical examinations, and biological sample collection. Cognitive function of participants was assessed using the Mini-Mental State Examination (MMSE). Bilateral blood pressure was measured simultaneously using an automated device, and the IABPD was calculated. Multivariable linear and logistic regression models were used to examine the relationship between IABPD and cognitive impairment.ResultsThe overall prevalence of cognitive impairment in the study sample was 27.85%, and it was more common among participants with an IABPD ≥ 10 mmHg (P &amp;lt; 0.05). Multivariable regression analysis revealed that an inter-arm systolic blood pressure difference (IASBPD) ≥ 10 mmHg was independently associated with lower MMSE scores (β = −1.113; 95% CI: −2.120, −0.106; P = 0.030) and a higher risk of cognitive impairment (OR = 1.902; 95% CI: 1.189, 3.040; P = 0.007). Additionally, a dose-response relationship was observed between IASBPD and the risk of cognitive impairment, with a linear positive correlation. Further subgroup analysis indicated that the relationship between IASBPD and cognitive impairment was modified by sex, smoking, and regular exercise (P for interaction &amp;lt; 0.05).ConclusionIASBPD ≥ 10 mmHg is associated with an increased risk of cognitive impairment in rural Chinese older adults. This suggested that IASBPD may provide a reference for early identification of individuals at risk of cognitive impairment.

Effect of a three-years preventive medicine vocational education program on county-level healthcare workforce development in China: a cross-sectional study

BackgroundThis study aims to analyze the demand and supply of these professionals within healthcare institutions at the county level after the Chinese government launched a three-year vocational education program of preventive medicine in 2016.MethodsA national cross-sectional design and multistage cluster sampling method were employed for this study. At the county level, a total of 132 Centers for Disease Control and Prevention (CDCs), 346 medical institutions, 20 medical colleges and 1,083 graduate students were selected. Self-designed questionnaires were used to assess the demand and supply of these professionals. Descriptive statistics were applied to describe key data features.ResultsThe county-level CDCs and medical institutions required an average annual total of 15,007 preventive medicine professionals. However, vocational colleges have only enrolled 2,025 of these students per year. Moreover, approximately two-thirds of the provinces continued to face significant demand for preventive medicine professionals, Additionally, medical institutions prioritized clinical skills while the CDCs emphasized preventive expertise as essential qualities for preventive medicine professionals. The requirement for personal qualities were consistently of the utmost importance in healthcare institutions. Furthermore, the self-assessments conducted among graduate students in medical institutions have revealed a relative insufficiency of their professional skills.ConclusionsThere was a general shortage of professionals in vocational preventive medicine education in China; however, certain provinces exhibited a surplus supply relative to demand, and prospective graduates primarily secure employment within medical institutions. The enhancement and refinement of professional skills are imperative in order to align with the specific demands of the preventive medicine position.

Keratoconus Profile in the Elderly Population: Prevalence, Keratoconus Indices, and Patterns of Keratoconus.

To assess the prevalence and associated characteristics of keratoconus (KCN) among individuals aged 60 years and older. In this study, total of 160 clusters and 20 strata were identified in Tehran, Iran through a multistage cluster sampling technique. Participants aged 60 years and older were included in the study. Corneal imaging used the Pentacam AXL. The diagnosis of KCN in this study was determined based on the measurements obtained from axial topography, pachymetry, and the elevation data from the Pentacam's refractive 4-maps. The prevalence of KCN was determined to be 5.36% [95% confidence interval (CI), 4.52-6.2], with rates of 5.04% (95% CI, 3.88-6.2) in males and 5.68% (95% CI, 4.47-6.9) in females. The prevalence of KCN increased from 4.6% (95% CI, 3.29-5.92) among individuals aged 60 to 64 years to 6.92% (95% CI, 3.18-10.67) in those aged 80 years and older. A multiple regression analysis indicated that advancing age (odds ratio = 1.03; P < 0.001) and illiteracy (odds ratio = 1.65; P < 0.001) were significant factors associated with KCN in the elderly population. Besides, the predominant curvature pattern observed in KCN was the asymmetric bowtie with inferior steepening (18.91%), whereas the symmetric bowtie was the least common (0.29%). The prevalence of KCN is notably high among the elderly population and tends to rise with advancing age. Findings from the current study underscore the critical role of corneal topography and tomography in guiding clinical decisions for older patients, particularly in the context of intraocular lens power calculations.

Knowledge of Secondary School Teachers on Factors that Promote and Hinder the Early Detection and Prevention of Childhood Sexual Abuse

Introduction: School teachers have an important role in the early detection and prevention of children from being sexually abused and exploited. The aim of this study was to assess the factors that influence the early detection and prevention of child sexual abuse (CSA) among schoolteachers in Babcock University High School, Ilishan Remo, Ogun State. Method: This study was a cross-sectional descriptive study involving 53 permanent teachers selected from the database of the school’s registry. This cross-sectional study was conducted between February and March 2021. Multistage cluster sampling technique was employed to obtain study participants from a list of sampling frames collated from the registry. Data collected was analyzed electronically using SPSS version 23. Frequency and percentage tables were generated for the demographic characteristics of the respondents. Statistical significance for association was tested using chi-square with a p-value less than 0.05 considered statistically significant. Results: 98.1% of the respondents had good knowledge concerning child sexual abuse. We found a significant relationship between factors influencing and hindering the early detection of CSA among schoolteachers (r = 0.731, p = 0.003). Also, there was a significant association between these influencing factors that encouraged early detection and level of knowledge about CSA of teachers (p = 0.001, X2 = 23.463). Conclusion: CSA remains a problem in our schools and indeed in the wider society. Teachers should be equipped with tools and knowledge to identify signs of sexual abuse. There should be proper, discrete reporting channels in schools to ensure that students who are victims of abuse are protected and properly safeguarded.

The chain mediating effect of self-respect and self-control on peer relationship and early adolescent phone dependence

This paper analyzes the influence of peer relationship on mobile phone dependence of middle school students, and probes into the chain mediating role of Self-respect and self-control. Using multi-stage random stratified cluster sampling method, 2311 middle school students in Wuling Mountain District were selected to explore the relationship between peer relationship and mobile phone dependence, Self-respect and self-control by using peer relationship scale, mobile phone dependence Scale, Self-respect scale and self-control scale. Correlation analysis showed that peer relationship, Peer relationship was positively correlated with Self-respect and self-control (r = 0.399, r = 0.291, P < 0.01), while peer relationship was negatively correlated with mobile phone dependence (r=- 0.227, P < 0.01). Mobile phone dependence was negatively correlated with Self-respect and self-control (r=- 0.409, r=- 0.629, P < 0.01). Self-respect was positively correlated with self-control (r = 0.519, P < 0.01). The structural equation model shows that Self-respect and self-control play a partial mediating role in the relationship between peer relationship and mobile phone dependence, in which the mediating effect size of Self-respect is - 0.098 (effect size 18.63%, 95%CI=- 0.140~- 0.059), and the mediating effect size of self-control is - 0.131 (effect size 24.90%, 95%CI=- 0.188~- 0.073); The chain mediating effect size of Self-respect and self-control was − 0.252 (effect size 47.91%, 95%CI = - 0.293~- 0.434). We should actively intervene the problem of mobile phone dependence of middle school students, improve Self-respect and self-control ability through good peer relationship, effectively improve their health behavior, and promote mental health.

Predictors of youth unemployment duration and impact evaluation of job creation program in East Gojjam Zone

Youth unemployment in the East Gojjam Zone is a critical issue. This study focuses on identifying the factors that influence unemployment duration and evaluating the impact of job creation programs on the well-being of youth in this region. We employed Cox regression to analyze the determinants of unemployment duration and used propensity score matching to assess the welfare effects of job creation initiatives. Our multistage cluster sampling revealed a youth unemployment rate of 33.3% (95% CI: 27.3–39.3). Over half of the unemployed youth transitioned to employment within four years, with 25% securing jobs within two years. Participation in job creation programs led to an average earnings increase of 1,069.716 birr, though retention in these programs was low at 49%. The findings reveal a connection between prolonged unemployment, skill mismatches, financial constraints, limited work experience, weak social networks, low income, and a preference for public-sector employment. To effectively address these challenges, interventions must focus on improving job accessibility, aligning vocational training with labor market needs, promoting financial inclusion, and enhancing social support systems.

Prevalence of significant anxiety symptoms and associated factors among adult people with HIV/AIDS in care and treatment clinic centers in Kilimanjaro region, Tanzania: a cross-sectional study

BackgroundPeople with human immunodeficiency virus (PWH) are more prone to generalized anxiety disorder. There is a limited understanding of the prevalence of significant anxiety symptoms and its associated risk factors among adult PWH in the Tanzanian context. This study aims to determine the prevalence of significant anxiety symptoms and related risk factors among adult PWH attending care and treatment clinics in Moshi Municipality, Kilimanjaro Region.MethodsWe used a multistage random cluster sampling approach to select participants at four Care and treatment centers (CTCs) of Kilimanjaro Christian Medical Centre, Mawenzi Regional Referral Hospital, Majengo, and Pasua Health Centre, by location at tertiary, secondary, and primary health care levels. The seven-item Generalized Anxiety Disorder (GAD-7) screening tool assessed levels of generalized anxiety symptoms with significance set at scores ≥ 10. Sociodemographic, clinical, and psychosocial characteristics were collected using a semi-structured questionnaire. Bivariate analyses determined factors associated with significant anxiety symptoms (GAD-7 ≥ 10) at p-values 0.20 for inclusion in the multivariate model. Adjusted prevalence ratios with confidence intervals are reported with significance set at a p-value of < 0.05.ResultsOut of 593 PWH participants, 12.48% screened positive for significant anxiety symptoms. Participants treated at the tertiary health facility level (aPR = 2.91, 95% CI: 2.48–3.41, P-value = 0.001), early adulthood 25–44 years (aPR = 1.75, 95% CI: 1.27–2.42, P-value = 0.001), with higher anxiety sensitivity (aPR = 3.28, 95% CI: 2.08–5.19, P-value = 0.001), and higher levels of perceived social support (aPR = 2.09; 95% CI: 1.34–3.27, P-value = 0.001) showed a higher likelihood of significant generalized anxiety symptoms.ConclusionsSignificant anxiety symptoms were common among adult PWH. Integrating routine generalized anxiety screening and raising PWH’s and primary caregivers’ awareness of GAD is recommended.Trial registrationClinical trial number not applicable.

Dietary Energy Consumption Pattern and Intake of Cholesterol and Dietary Fibre among 11-13 Year-old Children in the City of Colombo

Childhood obesity is rising in the city of Colombo and the composition of children’s diet, which has a direct link to it, has not been adequately investigated. Hence a cross-sectional study was conducted recruiting 634 school-children (11-13 year-old) using multistage stratified cluster sampling technique to assess dietary energy contribution from macronutr ients, saturated fat (SF) and added sugar. In addition, cholesterol and fibre intake were estimated. Food and bevera ges consumed were recorded using a three-day diet-diary. Results indicated that, % energy from carbohydrate (%CHO) and cholesterol intake were within the recommend ation while % energy from protein (%Protein) was below the recommendation. Intake of fibre was approxim ately 1/4th of the recommend level and energy from SF (%SF) and added sugar was above the recommendation, irrespectiv e of gender, food security status and school type. The % energy contribution from fat (%Fat) among national school (NS ) children was above the recommended level, while that of provincial school (PS) children remained within the recom mendation. Boys consumed a higher %Protein, %Fat and %SF and cholesterol than girls (p&lt;0.05) while girls had more %CHO and %energy from added sugar (p&lt;0.05). Food-secure children consumed higher %Fat than food-insecure children (p&lt;0.05). PS children had more %CHO and less %Prot ein, %Fat and %SF than NS children (p&lt;0.05). In conclusion, 11-13 year old-children in Colombo city consume desirable level of CHO and cholesterol, although their dietary energy consumption from protein is inadequate. However, they consu me undesirably high level of SF and added sugar while dietary fibre intake is very low.

Factors Related to Parental Perceptions and Awareness of Adolescent Cyberbullying in Selangor, Malaysia

INTRODUCTION: The rise of digital technology has heightened concerns about adolescent cyberbullying, emphasizing the importance of parental perceptions and awareness. This study assessed parental perceptions and awareness of adolescent cyberbullying and identified associated factors among secondary school parents in Selangor, Malaysia. MATERIALS AND METHODS: A cross-sectional study was conducted from June-September 2023 involving 522 parents, selected through multistage cluster sampling. Data were collected using the validated 33-item Parental Perception and Awareness of Cyberbullying Questionnaire (KEPS-I). Multiple linear regression analyses identified associated factors. RESULTS: The overall mean score for parental perceptions and awareness was 3.96 (SD=0.44). Parents demonstrated the highest awareness in cyberbullying prevention strategies but scored lowest in knowledge of internet and social media platforms. Younger parents exhibited greater awareness, likely due to their familiarity with digital technology (adjusted b=-0.475, P&lt;0.001). Parents who used the internet daily were also more aware (adjusted b=5.670, P=0.041), while non Bumiputera parents showed lower scores, reflecting gaps in digital literacy or access to information (adjusted b=-3.035, P=0.037). Only 2.5% of parents reported their child’s experience with cyberbullying, indicating possible underreporting. CONCLUSION: Gaps in digital literacy, particularly among older and non-Bumiputera parents, highlight the need for targeted educational initiatives and school policies to improve parental awareness and intervention strategies. Future research should evaluate digital literacy programs and explore adolescent perspectives to better address underreporting and strengthen prevention efforts.

Longitudinal changes in the intraocular pressure and their related factors among adults aged 40 to 64 years

To determine the five-year changes in intraocular pressure (IOP) and their related factors among individuals aged 40 to 64 years. The present report is part of the Shahroud Eye Cohort study. The sampling process for this study utilized a multi-stage cluster sampling method within Shahroud, Iran. Optometric and ophthalmologic examinations included measurement of uncorrected and best-corrected visual acuity, non-cycloplegic autorefraction and slit-lamp biomicroscope. IOP was measured using a Goldman tonometer. A total of 7384 eyes from 3855 individuals were examined in this report. The average five-year change in IOP was −0.06±2.23 mmHg (95% confidence interval: −0.14 to 0.02). The 25, 75, 95, and 99th percentiles of five-year IOP changes were −1, 1, 4, and 5 mmHg, respectively. According to the multivariate generalized estimating equation (GEE) model, the five-year changes in IOP were positively associated with female gender (coefficients(β)=0.139; P=0.036), blood pressure (β=0.40; P<0.001), diabetes (β=0.539; P<0.001), body mass index (β=0.023; P<0.001), axial length (β=0.104;P<0.007), central corneal thickness (β=0.010; P<0.001), mean keratometry (β=0.0067; P<0.001), and lens thickness at baseline (β=0.182; P<0.047). Moreover, baseline IOP exhibited an inverse association with five-year changes in IOP (β=−0.808; P<0.001). Despite a 4 mmHg increase in IOP observed in 5% of the study participants, the average change in IOP over five years was deemed not clinically or statistically significant. Nevertheless, biometric indices are important for anticipating variations in IOP.

Prevalence and clinical risk factors of dental caries in Syrian children: a cross-sectional study

This study aimed to estimate dental caries’ prevalence and potential risk factors among schoolchildren aged 8–12 in Damascus, Syria. The study was cross-sectional and conducted between February 2023 and April 2024, the target population was 1,052 children selected using multi-stage cluster sampling. Dental caries were determined using the DMFT/dmft index, while additional information on sociodemographic status, and attitude towards oral hygiene practices, were collected via a structured questionnaire. Data analyses were conducted using the Statistical Package for Social Sciences (SPSS). The overall prevalence of dental caries was 90.8%. Males had a slightly higher prevalence (91.9%) than girls (89.8%). Children aged [10–12] years showed the highest caries prevalence (91.7%). The mean DMFT/dmft score was 2.07 ± 1.91/3.74 ± 2.25, respectively. Caries prevalence was significantly associated with the type of school attended, family size, socioeconomic status, and parental education. Additionally, the frequency of tooth brushing, dental flossing, and irregular dental visits were significantly linked to higher caries incidence. It was found that caries experience remains high in the children in Damascus, with many associated factors including their sociodemographic factors and oral behaviors. We confirm that visiting the dentist regularly, using dental floss, and brushing regularly decreased the prevalence of dental caries among children.

Consumption of carbonated soft drinks and association with health behaviours and mental health among adolescents in Malaysia: findings from 2022 Adolescent Health Survey (AHS)

BackgroundThe consumption of carbonated soft drinks has risen substantially and has been associated with weight gain, chronic disease, and oral health issues. This study seeks to examine the relationship between carbonated soft drink consumption, health behaviours and mental health among Malaysian adolescents.MethodsThe 2022 Adolescent Health Survey (AHS) 2022 was a nationwide study involving Malaysian students aged 13 to 17 years old. It used a multistage stratified cluster sampling method to ensure a representative sample. Data collection was performed via a validated self-administered questionnaire. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with the consumption of carbonated soft drinks.ResultsThe prevalence of carbonated soft drink consumption at least once daily in the past 30 days was 32.4% (95% CI: 30.93, 33.87). The results revealed that the consumption of carbonated soft drinks was highest among males and young adolescents. Multivariate logistic regression analysis indicated that health-related behaviours associated with high soft drink consumption included consuming fast food at least three days per week, drinking alcohol, drinking fewer than six glasses of plain water, and being physically inactive. In addition, a greater intake of carbonated soft drinks was positively associated with depression and suicide attempts.ConclusionThis study provides compelling evidence that the consumption of carbonated soft drinks was associated with health-related behaviours and poor mental health among Malaysian adolescents.

Maternal alcohol consumption during pregnancy and associated factors among pregnant women in Tanzania: evidence from the 2022 Tanzania Demographic and Health Survey

BackgroundMaternal alcohol consumption remains a significant public health concern. The consumption is associated with an increased risk of miscarriage, stillbirth, and Fetal Alcohol Spectrum Disorders, which can impair fetal growth and lead to low birth weight. This study aims to investigate the prevalence of alcohol use among pregnant women and identify associated factors utilising data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS).MethodsThis analytical cross-sectional survey design utilised secondary data from the 2022 TDHS-MIS. The survey employed a multistage cluster sampling method to generate representative national and sub-national health and health-related indicators between February and July 2022. A total of 1,182 pregnant women were included in the analysis. Data analysis involved descriptive statistics and binary logistic regression using STATA version 18.5 to assess factors associated with maternal alcohol consumption. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were computed to estimate the strength of the association between independent variables and alcohol use.ResultsThe mean age of the participants was 27.3 years (standard deviation: 6.9). The overall prevalence of alcohol consumption during pregnancy among pregnant women in Tanzania was 3.9% (95% CI: 2.8–5.4). Factors associated with alcohol consumption were women aged 25–34 (aOR = 5.17, 95%CI: 1.62–16.51) and more than 35 years of age (aOR = 20.89, 95%CI: 6.55–66.62), women who were never married (aOR = 7.89, 95%CI: 2.20-28.25), On the other hand, women living in the western zone (aOR = 0.20, 95%CI: 0.04–0.88).ConclusionThe study reveals a notable prevalence of alcohol consumption during pregnancy in Tanzania. Key demographic factors influencing alcohol use include maternal age, marital status, and prominent regional disparities, notably lower rates in Zanzibar compared to the western zone. These findings highlight the necessity for targeted public health initiatives to educate pregnant women. This was a cross-sectional survey, which limited the causal relationship among the observed factors.

Factors associated with total cholesterol and blood glucose levels among Afghan people aged 18-69 years old: Evidence from a national survey.

The objective of this study was to determine the associated factors of total cholesterol (TC) and blood glucose (BG) levels in people aged 18-69 years old in Afghanistan. This was an analytical cross-sectional study using data from the National Survey of Non-Communicable Disease STEPs 2018 (NCD STEPS) in Afghanistan. The total sample size in the original study was 3,972 and a multi-stage cluster sampling method was used. Total cholesterol and blood glucose were the outcome variables for this study; simple and multiple linear regression was performed to find the associated factors for the outcome variables using a designed-based modeling incorporating sampling techniques and weights. The result of univariate linear regression analysis indicates that age, marital status, hypertension, and BMI are positively associated with TC and BG levels while education, salt intake, and any type of physical activity are negatively associated with TC and BG levels (p-values<0.05). Each year of age increases TC by 0.42 mg/dl and BG by 0.48 mg/dl; ever-married individuals have higher TC (21.8 mg/dl) and BG (8.8 mg/dl) levels; hypertension increases TC by 16.8 mg/dl and BG by 14.5 mg/dl; and higher BMI is associated with increased TC (1.3 mg/dl) and BG (0.9 mg/dl). Moreover, multivariate analysis using multiple linear regression indicates the same result; however, the results of marital status and gender are not significant with BG level and results of education levels, salt intake and any type of physical activity are not significant with TC levels. The finding of this study shows that total cholesterol and blood glucose increase in people of older age categories, married people, people with hypertension, overweight, and obesity; while decreases in people with higher education categories, people who always take salt, and people who do physical exercise.

Magnitude of substance use and associated factors among Wallaga University undergraduate students, Western Ethiopia, 2024.

Substance use among undergraduate university students has been recognized as a global public health issue; however, little attention is given to addressing this issue. Limited research has been conducted on substance use and its associated factors in the western part of Ethiopia, including our study area, with the same study population. Therefore, this study aimed to assess the magnitude of substance use and its associated factors among undergraduate students at Wallaga University in Western Ethiopia in 2024. An institutional-based cross-sectional study was conducted involving 674 undergraduate students at Wallaga University from 25 March 2024 to 2 May 2024. Multistage cluster sampling was used for the sampling procedures, and data were collected using a self-administered questionnaire developed using the World Health Organization (WHO) ASSIST V3.0 tool. The collected data were entered into EpiData v.4.6 and analyzed using Statistical Package for the Social Sciences (SPSS) v.26. Variables with a p-value of <0.25 in the bivariate analysis were entered into multivariable logistic regression. Adjusted odds ratios and the corresponding 95% confidence intervals (CIs) were used to quantify the degree of association. A p-value of ≤0.05 was considered statistically significant in the final model. A total of 674 students were included in the analysis, achieving a response rate of 94%. The mean age of the study participants was 22.66 ± 2.21 years (SD). The magnitude of current substance use was 29.5% (29.5, 95%CI: 25.96-33.04%). The current use of alcohol, khat, and tobacco was reported by 145 (22.8%) participants, 94 (14.8%) participants, and 16 (2.5%) participants, respectively. Factors such as being male (AOR =1.95, 95%CI: 1.27-2.78), having pocket money greater than 1,000 ETB (AOR = 2.27, 95%CI: 1.20-4.28), being a natural science student (AOR = 1.80, 95%CI: 1.17-2.78), having a mother who is a merchant (AOR = 1.96, 95%CI:1.09-3.51), and having a family member with a history of substance use (AOR = 2.93, 95%CI:2.02-4.24) were independently associated with substance use. The overall magnitude of substance use among undergraduate students at Wallaga University was high. Factors such as sex, religion, monthly pocket money, department stream, mother's occupation, and having a family member with a history of substance use were independently associated with substance use. Therefore, Wallaga University, along with its stakeholders such as the community around the campus area, students' families, and NGOs working on substance use, should collaborate to tackle the problem effectively. Generally, substance use among students demands special attention; therefore, preventive measures and control strategies should be implemented to avoid substance use among students.

Prevalence and associated factors of denture use among older adults living in rural and urban areas of China: a national cross-sectional study

BackgroundsTooth loss, often considered as an inevitable result of ageing, is one of the most frequently stated problems with older adults worldwide, which entails a negative impact on physical and mental health, as well as quality of life. However, there is urban-rural gap among older adults in both oral health condition and dental service utilization. The study focused on the urban-rural gap in Chinese older population, aiming to describe their tooth loss and denture use status, and explore the associated factors, hoping to provide insights into improving the oral healthcare system in China and other developing countries.MethodsThis cross-sectional study used data collected from May to September in 2020. A stratified, multi-stage cluster sampling design was used to produce nationally representative samples of 2709 adults aged 60 years and older. The dependent variable was denture use of the participant. Determinants included demographic characteristics, health status, social support, oral health knowledge and health service utilization. Descriptive analysis was conducted to describe the sample characteristics, and Generalized Linear Mixed Model was used to identify independent factors associated with denture use among older adults in rural and urban China respectively.ResultsThere were significant urban-rural differences in tooth loss, denture use and health service utilization among Chinese older adults. Urban participants’ denture use was associated with oral health knowledge (OR = 1.29, 95%CI = 1.07–1.56). Rural participants’ denture use was associated with oral health knowledge (OR = 1.23, 95%CI = 1.02–1.47), dental checkup in the last six months (OR = 1.19, 95%CI = 1.00-1.40), and social support (OR = 1.22, 95%CI = 1.03–1.44).ConclusionsGreater efforts should be made to enhance oral health education and emphasize the importance of regular dental checkups among older population. Targeted focus on different aspects of oral health based on the characteristics of different populations is suggested. Policymakers should be aware of the urban-rural disparity in distribution and utilization of oral health services.

Clinical And Microbiological Aspects Of Catheter Related Blood Stream Infection In Dialysis Population And Their Short-Term Outcome

Objective: To investigate the clinical and microbiological aspects of CRBSIs in the dialysis population of Pakistan and evaluate their short-term outcomes. Study Design: Quantitative, cross-sectional study Place and Duration of Study:Five different dialysis centers /clinics located in four different regions of Pakistan from December 2023-May 2024. Methodology: A multistage cluster sampling technique was employed to select a representative sample of dialysis centers from various provinces in Pakistan. Within each selected dialysis center, a systematic random sampling method was used to recruit participants who met the inclusion criteria.A self-administered, structured questionnaire was developed to collect data on participants’ demographic characteristics, comorbidities, catheter-related factors. Results: Out of 350 participants included in the trial , 89 patients (25.4%) had experienced at least one episode of CRBSI in the previous six months. Blood cultures were positive in 82.0% of cases, with Gram-positive bacteria being the most commonly isolated pathogens (67.4%). Staphylococcus aureus was the most frequently identified pathogen (28.1%). The mean duration of hospitalization for patients with CRBSI was 14.2 days (SD 5.6). The overall mortality rate among patients with CRBSI was 16.9%. Several factors were found to be significantly associated with the incidence of CRBSI, including a history of previous CRBSI (p &lt; 0.001), catheter-related factors such as duration of catheter use (p = 0.002) and lack of catheter care education (p = 0.017), and comorbidities such as diabetes mellitus (p = 0.002) and cardiovascular disease (p = 0.039). Conclusion: Especially in poor and medium income countries like Pakistan, our results highlight the need of ongoing efforts to prevent and control CRBSIs in the dialysis population. Keywords : Catheter related blood stream infection, dialysis,short term outcome.