National Community-based Survey Research Articles

Dental service utilization in the general adult population in Bangladesh.

With the help of a national community-based survey, the analysis aimed to estimate the number of adults in Bangladesh who used dental services (DSU). The 8185 participants (18-69 years old) in the Bangladesh cross-sectional STEPS survey in 2018 provided national data for analysis. Predisposing, enabling, and need factors for DSU were included in the interview data, physical examinations, and biochemical analyses. To estimate the DSU (last 12 months) predictors, Poisson regression was employed. Seven out of 10 participants (71.0%) had never DSU, 13.2% within the past 12 months, and 15.9% more than 12 months ago. In terms of predisposing factors, the final model showed a negative relationship between past 12-month DSU and living in the northern region (adjusted prevalence ratio-APR: 0.75, 95% CI: 0.59, 0.96). The enabling factors of living in an urban area (APR: 1.19, 95% CI: 1.01, 1.41) and seeing a doctor or other healthcare provider within the previous year (APR: 1.37, 95% CI: 1.08, 1.74) were positively correlated with DSU. In terms of need factors, dental pain (APR: 15.37, 95% CI: 9.68, 24.40), multimorbidity (APR: 1.26, 95% CI: 1.02, 1.55), oral health impact (OHI) speech problem (APR: 1.35, 95% CI: 1.13, 1.63), and OHI felt tense (APR: 1.34, 95% CI: 1.10, 1.64) were positively associated with DSU. A low proportion of participants had DSU in the past 12 months and several associated factors were identified.

Understanding food insecurity, food allergy management and related psychosocial burden---possible determinants of food allergy disparities in a national community-based survey

Food allergy (FA) may be disproportionately prevalent and burdensome among populations of non-White race/ethnicity and/or populations with lower socioeconomic status in the US. To ameliorate health disparities in FA, data are needed regarding barriers to successful management—particularly among patients who are at-risk. Specifically, this study aims to better understand relationships between FA-related psychosocial burden, disease management, and food insecurity (FI).

Changes in Positive Airway Pressure Use in Adults with Sleep-Related Breathing Disorder During the COVID-19 Pandemic: A Cross-Sectional National Community-Based Survey.

PurposeTo better understand: (i) a positive airway pressure (PAP) therapy use during the pandemic, (ii) how PAP use may relate to sleep, health, and COVID-19-related outcomes, and (iii) factors associated with PAP use during the pandemic.MethodsThis study is based on data collected between Apr 2020 and Jan 2021 as part of an online cross-sectional national community-based survey. The included participants were located in North America, 18 years and older, with self-reported sleep-related breathing disorder (SBD) and usage of a PAP device in the last month before the COVID-19 pandemic.ResultsOf all respondents, 7.2% (41/570) stopped using PAP during the pandemic over a median time since the pandemic declaration of 62.0 days (IQR = 8.0). There were no significant differences between individuals who continued and stopped using PAP in the time elapsed since the pandemic declaration, age, sex, education level, occupational status, family income, or the proportions of individuals endorsing symptoms that could be related to COVID-19. Compared to individuals who continued using PAP, those who stopped had significantly shorter sleep time, lower sleep efficiency, and poorer sleep quality. Higher stress levels and living with someone who experienced symptoms that could be attributable to COVID-19 were independently associated with stopping PAP use.ConclusionsIn this survey study, most individuals with SBD continued PAP therapy during the pandemic. However, even 7% of participants who stopped using PAP cannot be ignored. Identifying individuals at risk of discontinuing PAP treatment may help design targeted interventions for people with SBD and health professionals to improve PAP use.

Prevalence and Correlates of Risky Drinking Among the Oldest-Old in China: A National Community-Based Survey.

AimsTo investigate the prevalence and correlates of risky drinking in Chinese elderly people aged 80 and over.MethodsData were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2018. A total of 10,141 respondents aged 80 years or older were included in this analysis. Risky drinking was defined as drinking > 2 drinks per day. The participants were divided into no risky drinking, past risky drinking, and current risky drinking groups. The prevalence of risky drinking, daily dosage, and type of alcohol beverages were assessed. The correlates of risky drinking were analyzed using logistic regression.ResultsThe prevalence of past and current risky drinking was 6.2 and 4.4%, respectively. A total of 12.2% of males and 2.1% of females reported past risky drinking, and 8.9% of males and 1.4% of females reported current risky drinking. The median of the daily dosage of the past risky drinking group was 4.5 and 4 drinks in males and females, respectively, and were 4 and 3.3, respectively, of the current risky drinking group. Strong liquor was the most popular alcohol beverage in all groups. Men who were older or had white-collar work were less likely to be past risky drinkers, while those with smoking in past or current or heart disease were more likely to be past risky drinkers. Women who smoked in the past were more likely to be past risky drinkers. Men with older age or living in the urban areas or with heart disease were less likely to be current risky drinkers. Women with higher education or with heart disease were less likely to be current risky drinkers. Women with current smoking were more likely to have current risky drinking.ConclusionsOur findings indicated that risky drinking among the oldest-old was not rare in China. The correlates of past and current risky drinking were different. Men and women had various correlates of risky drinking as well. Those with higher socioeconomic status seemed less likely to be risky drinking. More attention should be given to risky drinking among the oldest old, and sex-specific intervention may be needed.

Elder abuse and health outcomes among community-dwelling older adults in India: results of a national survey in 2017-2018

ABSTRACT The study aimed to estimate the associations between elder abuse and poor physical health, poor mental health, and health risk behaviors in older adults in a national community-based survey in India. The study sample included 31,477 older adults (≥60 years) from a cross-sectional national community dwelling survey in India in 2017–2018. Results indicate that the prevalence of elder abuse in the past 12 months was 5.2%. In the adjusted logistic regression analysis, elder abuse was significantly positively associated with poor mental health and poor well-being (low life satisfaction, not happy, insomnia symptoms, depressive symptoms, loneliness, neurological or psychiatric problems, and lower self-rated health status), poor physical health (bone or joint disease, physical pain, gastrointestinal problems, incontinence, functional disability, underweight, and persistent headaches), fall and health care utilization. In addition, in unadjusted analysis, elder abuse was associated with poorer cognitive functioning, current tobacco use, and dizziness. Elder abuse among older adults in India is associated with poor physical health, poor mental health, and health care utilization, emphasizing the need to consider elder abuse in various physical and mental health contexts.

Trends and factors influencing long-acting contraceptive utilisation among contraceptive users in Ethiopia: repeated cross-sectional study

ObjectivesAlthough nationally representative data are helpful in designing strategies and policies of programmes in a country, there is paucity of evidence with regard to trends and factors influencing utilisation of...

Evaluating temporal patterns of snakebite in Sri Lanka: the potential for higher snakebite burdens with climate change.

BackgroundSnakebite is a neglected tropical disease that has been overlooked by healthcare decision makers in many countries. Previous studies have reported seasonal variation in hospital admission rates due to snakebites in endemic countries including Sri Lanka, but seasonal patterns have not been investigated in detail.MethodsA national community-based survey was conducted during the period of August 2012 to June 2013. The survey used a multistage cluster design, sampled 165 665 individuals living in 44 136 households and recorded all recalled snakebite events that had occurred during the preceding year. Log-linear models were fitted to describe the expected number of snakebites occurring in each month, taking into account seasonal trends and weather conditions, and addressing the effects of variation in survey effort during the study and of recall bias amongst survey respondents.ResultsSnakebite events showed a clear seasonal variation. Typically, snakebite incidence is highest during November–December followed by March–May and August, but this can vary between years due to variations in relative humidity, which is also a risk factor. Low relative-humidity levels are associated with high snakebite incidence. If current climate-change projections are correct, this could lead to an increase in the annual snakebite burden of 31.3% (95% confidence interval: 10.7–55.7) during the next 25–50 years.ConclusionsSnakebite in Sri Lanka shows seasonal variation. Additionally, more snakebites can be expected during periods of lower-than-expected humidity. Global climate change is likely to increase the incidence of snakebite in Sri Lanka.

Social Support and the Mental Health of Older Gay Men: Findings From a National Community-Based Survey.

This study examines different types and sources of social support in relation to psychological distress levels among older Australian gay men. A national community-based survey was conducted involving 242 gay-identified men aged 50 years and older. In univariable regressions, psychological distress was less likely if men were receiving emotional support, practical support, or had a sense of belonging, and also if they had a greater number of close friends and received some or a lot of support from family and gay friends but not from straight friends. Of all these factors, a multivariable regression showed that receiving emotional support was the only significant independent factor. Emotional support appears to play a greater role in the mental health of older gay men than many other types and sources of support. Ensuring access to emotional support may need to be considered when promoting healthier aging among gay men.

Prevalence and Correlates of Sexual Partner Concurrency Among Australian Gay Men Aged 18–39 Years

Mathematical models predict higher rates of HIV and sexually transmitted infections (STIs) in populations with higher rates of concurrent sexual partnerships. Although gay men and other men who have sex with men (MSM) have disproportionately high rates of HIV/STIs, little is known about the prevalence and correlates of sexual concurrency in these populations. This paper reports findings from a national community-based survey of 1,034 Australian gay-identified men aged 18-39years, who gave detailed information about their sexual partners over the past 12months. In all, 237 (23%) reported two or more concurrent sexual partners. For their most recent period of concurrency, 44% reported three or more partners and 66% reported unprotected sex with one or more of their partners. A multivariate logistic regression found sexual concurrency was significantly more likely among men on higher incomes (P=0.02), who first had anal sex at a relatively young age (P=0.03), and who reported a large number of partners in the past 12months (P<0.001). Age, education, HIV status, and other sociodemographic and sexual behavior variables were not significant correlates. However, men who reported sexual concurrency were significantly more likely to have been diagnosed with an STI in the past 12months (P=0.04). Findings from this study suggest sexual concurrency is common among younger Australian gay men. With many of these men not always using condoms, health agencies should consider the potential impact of concurrency on HIV/STI epidemics among gay men and other MSM.

P4.029 Concurrent Sexual Partnerships in a National Sample of Australian Gay Men

Concurrent sexual partnerships, where individuals have two or more sexual partners at the same time, are major contributors to the transmission of sexually transmitted infections (STIs). Yet, very little is...

Cytogenetic and comorbidity profile of Down syndrome in Mansoura University Children′s Hospital, Egypt

BACKGROUND:Down syndrome (DS) is the most common chromosomal disorder. It has three chromosomal patterns.AIM:To determine the cytogenetic and comorbidity profiles of DS in the Genetic Unit of Mansoura University Children's Hospital, Mansoura, Egypt.MATERIALS AND METHODS:A retrospective analysis was performed on the case records of 712 cytogenetically diagnosed cases of DS at the Genetic Unit of Mansoura University Children's Hospital, Egypt, during a 10-year period.RESULTS:About 19% of the cases had one or more cardiac anomalies and about 8% were hypothyroid. Nondisjunction was the most common type of abnormality, followed by translocation and lastly mosaic: 96.1, 3.1, and 0.8%, respectively. Hypothyroidism was significantly more common in translocation and mosaic karyotypes than in the nondisjunction karyotypes. First and second birth orders were significantly higher in the translocation and mosaic groups than in the nondisjunction group. Mothers are significantly older at the index pregnancy in the nondisjunction group than in the other two groups. We compared our findings with those of previous studies.CONCLUSION:Knowing karyotype of DS will help in genetic counseling of the parents. Wide-scale national community-based survey with DS registry could help in estimating the size of the problem.

Parents as agents of change in childhood obesity – from research to practice

The home environment is undoubtedly the most important setting in relation to shaping children's eating and physical activity behaviors. Family-based behavioral treatment is the most well-established intervention for the treatment of childhood obesity. Historically, family based interventions target the obese child and at least one or both parents. Presented here is a review of the literature on parents as exclusive agents of change, with the addition of some recent results indicating the effectiveness of this approach when implemented in public health programs. Targeting parents as the exclusive mediator has resulted in a better reduction in children's percentage overweight, and improvement in the obesogenic environment and behaviors, in comparison to a setting in which parents attended sessions with the obese child, or only children attended sessions. The findings from these studies were subsequently implemented in a national community-based survey. Both children's and parents' weight status were significantly improved, although only parents attended the group sessions. A significant reduction in the obesogenic load at home was also found. Permissive parenting style was associated with less reduction in obesogenic load at home (p < 0.01) and with less weight loss (p < 0.05). Omitting the obese child from direct intervention and targeting parents only is a cost-effective approach with integrated messages for the management of weight-related problems.

Long-term reliability and validity of alcoholism diagnoses and symptoms in a large national telephone interview survey.

The long-term reliability and validity of telephone lay interview assessments of alcoholism were examined in the context of a large national community-based survey of over 8,000 male Vietnam era veterans. A subsample of 146 men was interviewed twice by telephone using the same structured interview an average of 15 months apart to evaluate the long-term reliability of alcoholism symptoms and diagnoses. In addition, a search of Department of Veterans Affairs patient treatment files of inpatient hospitalizations between 1970 and 1993 yielded a subsample of 89 interviewed men with a past discharge diagnosis of alcohol dependence. The test-retest reliability of alcohol abuse and alcohol dependence diagnoses was good, with kappa coefficients of 0.74 and 0.61, respectively. The reliability of individual alcoholism symptoms was fair to good, with kappas of 0.46 to 0.67. Ninety-six percent of individuals identified by Department of Veterans Affairs patient treatment files as having an alcohol dependence diagnosis were correctly diagnosed by the telephone interview. The results of the present study provide additional evidence for the long-term reliability and validity of lifetime alcoholism diagnoses, and suggest that the reliability and validity of telephone interview assessments of alcoholism are as good as that of an in-person interview. Telephone administration of structured psychiatric interviews appears to be an attractive alternative to in-person interviewing for gathering information about alcoholism and alcohol-related problems.

Drug treatment presentations at a treatment centre in southern Nigeria (2015-2018): Findings and implications for policy and practice.

Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.