Rural Adult Population Research Articles

A first survey on the medicinal plants of the Chazuta valley (Peruvian Amazon)

Aim of the study At present, the Peruvian Amazonian district of Chazuta represents one of the main reservoirs of the San Martin Quechuas (also known as Lamas Quechuas) and their culture. These particular Quechuas, as well as the region of Chazuta, have been seldom studied from an academic point of view. With the objective of contributing to the ethnopharmacological knowledge of the area, a field survey on the use of medicinal plants was performed in the region. Material and methods The information was obtained through interviews to the 6.3% of the district rural adult population (140 individuals, 75% of which was considered Quechua). Results In total, the study recorded 945 medicinal use-reports of 289 plant species collected in Chazuta, which belong to 202 genera in 81 families of vascular plants. Mainly, plant remedies were employed to treat musculoskeletal disorders (29.7% of all the medicinal use-reports), gastrointestinal complaints (13.4%) and skin conditions (12.9%). Conclusions In Chazuta, medicinal plants are used within a context of a traditional medicine that confronts health and illness from an integral vision, in which the medicinal uses of plants, its combination with lifestyle advice, and its participation in the performance of rituals and other practices concerning to what is often named as “the world of spirits” have to be considered.

Prevalence and Associations of Epiretinal Membranes in a Rural Chinese Adult Population: The Handan Eye Study

To determine the prevalence and association of epiretinal membranes (ERMs), as assessed by retinal photography and optical coherence tomography (OCT), in a Chinese population. The Handan Eye Study is a population-based study of eye disease in rural Chinese aged 30+ years. Eligible residents underwent a detailed ophthalmic examination including retinal photography and Stratus OCT. ERMs were defined by a combination of retinal photographs and OCT and classified as cellophane macular reflex (CMR) or preretinal macular fibrosis (PMF) based on retinal photographs characteristics. Of the 6830 persons examined, 6565 (96.1%) had gradable retinal photographs and/or OCT. The mean age was 51.7 +/- 11.6 years. ERMs were present in 3.4% (95% CI: 2.9%-3.8%) of participants, bilateral in 20.3% of the cases. CMR was present in 2.2% and PMF in 0.7%, and ERMs were unclassified in 0.5% (detected by OCT only). ERM prevalence was similar in women and men (3.6% vs. 3.1%), strongly associated with increasing age (P for trend < 0.001). After adjustment for age and sex, primary ERM was associated positively with myopia (OR: 1.58, 95% CI: 1.12-2.23) and inversely with current smoking (OR: 0.61, 95% CI: 0.38-0.97, versus never smoked). Best corrected visual acuity was significantly worse in eyes with primary ERMs (mean LogMAR score lower by 0.07, 95% CI: 0.05-0.10) than eyes without ERMs, after adjustment for age, sex, and lens status. ERMs affect 3.4% of the population 30+ years of age and living in rural China. Idiopathic ERMs were associated with myopia, decreased visual acuity, and inversely associated with smoking.

DYSPNEA REPRODUCIBILITY IN A RURAL BANGLADESH POPULATION

PURPOSE: Dyspnea may signal serious disease with increased morbidity and mortality. The study aim was to determine the reliability of assessing dyspnea through a simple questionnaire among a rural adult population.

Prevalence and Causes of Low Vision and Blindness in a Rural Chinese Adult Population: The Handan Eye Study

<h3>Purpose</h3> To describe the prevalence and causes of low vision and blindness in a rural population in Northern China. <h3>Design</h3> Population-based, cross-sectional study. <h3>Participants</h3> A study of 6830 Han Chinese aged 30 years and older was conducted between October 2006 and October 2007 in rural Yongnian County in Handan, Northern China. <h3>Methods</h3> Clustered samples of adults aged 30 years or more residing in 13 residential villages were selected randomly and were invited to participate the Handan Eye Study. Participants underwent a comprehensive eye examination, including standardized visual acuity (VA) tests using logarithm of the minimum angle resolution charts. Prevalence was age- and gender-standardized to the 2000 China Census. <h3>Main Outcome Measures</h3> Low vision was defined as VA <20/60 but ≥20/400, and blindness was defined as VA <20/400 following the Modified World Health Organization (WHO) definitions. Primary causes of low vision and blindness were determined by study ophthalmologists according to WHO definitions. <h3>Results</h3> Six thousand eight hundred thirty (90.4%) of 7577 eligible individuals participated in the study, and 6799 (89.7%) had VA data available. Population-weighted prevalence of presenting bilateral blindness was 0.6% and bilateral low vision was 4.7% for persons 30 years of age and older. Based on best-corrected visual acuity (BCVA), the corresponding prevalence of blindness was 0.5% and that of low vision was 1.0%. Blindness and low vision were strongly age related (<i>P</i><0.05). Cataract was the predominant cause of presenting bilateral blindness (36.6%), whereas undercorrected refractive error was the predominant cause of presenting low vision (78.4%). After refractive correction, cataract became the first leading cause of blindness (41.9%), and low vision (48.2%), myopic retinopathy (16.1%), glaucoma (9.7%), and corneal opacity (9.7%) were other common causes of blindness defined using BCVA. <h3>Conclusions</h3> A higher prevalence of blindness and low vision was seen in this rural Chinese sample than has been reported from urban Chinese populations. The estimated numbers with BCVA-defined low vision and blindness in 2020, based on best-corrected vision in rural Chinese adults aged 30 years or more, is expected to be 12.4 million and 2.9 million, respectively. Predominant causes of low vision and blindness in China are treatable. <h3>Financial Disclosure(s)</h3> The authors have no proprietary or commercial interest in any materials discussed in this article.

Prevalence of idiopathic macular hole in adult rural and urban south Indian population

This study was undertaken to evaluate the prevalence of idiopathic macular hole in a defined community in Southern India. In all, 7774 of the 9546 enumerated (81.43%) subjects availed themselves for an ophthalmic assessment which included a detailed ophthalmic examination and fundus photography. All data were entered and stored in a secure computerized database and statistical analysis was performed using spss for Windows. Thirteen subjects comprising six males and seven females were diagnosed with macular holes equating to a risk of 0.17%. Bilateral macular holes were found in two subjects. The mean age of subjects with a macular hole was 67 years. Increasing age and history of cataract surgery was strongly associated with an increased prevalence of macular holes (P < 0.0001). There was no difference in the prevalence of macular hole between the rural and urban communities. The mean logMAR visual acuity of subjects in the eye with a macular hole was 1.31 +/- 0.45 whereas the acuity in the unaffected fellow eye was 0.70 +/- 0.51. The mean spherical equivalent in the subjects with macular hole was -0.56 +/- 1.92 (-4.25 to +1.00). Prevalence rate of idiopathic macular hole in South India appears to be comparable to that seen worldwide.

Prevalence of and Risk Factors for Isolated Systolic Hypertension in the Rural Adult Population of Liaoning Province, China

The prevalence of and associated risk factors for isolated systolic hypertension, as defined by the Joint National Committee (JNC)-6 classification, were investigated in the rural population of Liaoning Province, China. A total of 45,925 people aged 35 years or older were examined in a cross-sectional study. Overall, the prevalence of isolated systolic hypertension was 10.6% (males 10.1%; females 11.2%). The prevalence of isolated systolic hypertension was positively correlated with age, gender, smoking status, alcohol intake, body mass index, salt intake and Mongolian race. This study showed that isolated systolic hypertension was very common in rural Chinese people and that many risk factors are linked with isolated systolic hypertension.

Anisometropia in an Adult Population in Rural Myanmar: The Meiktila Eye Study

Purpose: To determine the prevalence and risk factors for anisometropia in a rural adult population in central Myanmar. Methods: A population-based ophthalmic survey was conducted in rural villages in central Myanmar. Ansiometropia was assessed in subjects with phakic eyes. The severity of anisometropia was defined as the absolute difference of the spherical equivalent between the two eyes. Results: Prevalence of anisometropia (≥1.0 D) in all participants was 35.3% (95% CI 32.7–37.9%); severe anisometropia (≥2.0 D) was present in 18.9 % (95% CI 16.8–21.0%). There was no significant gender difference in anisometropia prevalence or severity. Prevalence and severity of anisometropia were significantly associated with age. Multiple logistic regression analysis revealed that cataract, myopia, but not age, were associated with anisometropia. The between-eye differences in axial length (r = 0.15, p < 0.001) and corneal curvature (r = 0.19, p < 0.001) were significantly correlated with the severity of anisometropia. Conclusions: Prevalence of anisometropia is relatively high in this rural adult population in Myanmar. Myopia and cataract, but not increasing age, are the potential risk factors of anisometropia in this population.

Body Mass Index and the Prevalence of Prehypertension and Hypertension in a Chinese Rural Population

To evaluate the status of overweight and obesity in a Chinese rural adult population and describe relationships between body mass index (BMI) and blood pressure according to JNC-7. The study was conducted in 2004-2006, used a multistage cluster sampling method to select a representative sample. A total of 45,925 adults, age 35 years or older, were examined. Height, weight and blood pressure were obtained by trained doctors. Overweight and obesity were defined according to the World Health Organization classification and Chinese definition. The prevalence of overweight and obesity were 16.3% and 1.3% in males, and 24.4% and 2.7% in females (p for gender differences <0.05) according to the World Health Organization classification; The prevalence of overweight and obesity were 29.5% and 5.3% according to the Chinese definition.The prevalence of elevated blood pressure (prehypertension and hypertension) and mean levels of systolic and diastolic blood pressure increased as BMI increased. Multivariate logistic regression revealed that overweight and obesity were risk factors for prehypertension and hypertension whether in males or females. Overweight and obesity has become very prevalent in the Chinese rural adult population. It is a great health problem. Our study quantifies the strong associations of BMI and elevated blood pressure. It is time to pay more attention to overweight and obese in the county of China.

Risk Factors for Signs and Symptoms of TMD in a Rural Adult Southeast Tanzanian Population

The aim of this study was to determine some risk factors for signs and symptoms of temporomandibular disorders (TMD) in a rural adult population of Southeast Tanzania. Two hundred and eighteen adults aged 40+ years participated in the study. Joint clicking was significantly higher (p<0.024) in the adults aged 60+ years than in the younger age group. Limited jaw opening was higher in females than males (χ2 = 46.4 on 2df; p<0.001), and there was a significant association between the type of toothbrush and limitation in jaw opening (χ2 = 156.6 on 4df; p<0.001). The results suggest that the use of miswaki (chewing sticks) and advanced age are risk factors for the high prevalence of signs and symptoms of TMD in this rural population. Further studies are recommended to control for other confounding factors such as socio-economic status.

Cut-off values for waist circumference in rural Iraqi adults for the diagnosis of metabolic syndrome

The determination of cutoff points for healthy waist circumference (WC) is of paramount importance for prevention, optimum management, and prognostication of obesity, the metabolic syndrome (MetS), type 2 diabetes mellitus, and coronary heart disease. The aim of this project was to establish the cutoff level for WC in rural Basrah in Iraq, one of the eastern Mediterranean and Middle East (Arab) populations. This was a community-based, cross-sectional survey for establishing the normal value for WC among a rural district population in Basrah (Abu-Al-khasib), Iraq. A stratified sampling procedure was used for sample selection. The cutoff level yielding maximum sensitivity and specificity for predicting the presence of multiple risk factors was 97 cm in men and 99 cm in women. Sensitivity and specificity using these cutoff values were 70% and 50%, respectively, in men and 70% and 45%, respectively, in women. We propose the optimal cutoff point for WC for the diagnosis of MetS in the Iraqi adult rural population as 99 cm in women and 97 cm in men.

Prevalence of myelinated retinal nerve fibres in urban and rural adult Chinese populations: the Beijing Eye Study

To determine the prevalence of myelinated retinal nerve fibres in the elderly Chinese population. The Beijing Eye Study, a population-based, cross-sectional cohort study, included 4439 subjects out of the 5324 invited to participate (response rate 83.4%) with an age of > 40 years. The present investigation consisted of 8663 eyes of 4378 (98.6%) subjects for whom readable fundus photographs were available. Myelinated retinal nerve fibres were detected in 35 eyes (29 subjects) with a prevalence rate of 0.4 +/- 6.3%[95% confidence interval (CI): 0.27, 0.54] per eye and 0.7 +/- 8.1% (95% CI: 0.42, 0.90) per subject. The myelinated nerve fibres were located most often in the temporal inferior region, followed by the temporal superior region and the nasal region. Prevalence of myelinated nerve fibres was not associated statistically with age, gender, refractive error, visual acuity (VA), intraocular pressure, cataract, glaucoma and age-related macular degeneration. Myelinated retinal nerve fibres are present in about seven out of 1000 elderly Chinese in northern China, without association to VA, refractive error, glaucoma and macular degeneration.

Periodontal status according to community Peridontal Index among 40+ years adults in Mtwara rural settings

Objective: To study the periodontal health status of Mtwara adult population aged 40+ years. Design: A cross-sectional descriptive study Settings: Mtwara Rural district Main outcome measures: Presence of gingival bleeding on gentle probing, dental calculus, probing periodontal pocket depth (PPD): 4-5 mm or 6+ mm, according to Community Periodontal Index (CPI). Results: A total of 201 adults (males 115 (55.8%) and females 86 (44.2%)), aged 40+ years were recruited. Based on hierarchical CPI scoring (Score 0-4), no participant had healthy periodontal tissues or gingival bleeding as highest CPI score. The prevalence for calculus was 13.9% and there were more males than females that had calculus (p=0.019). The prevalence of PPD 4-5 mm and 6+ mm were 41.8% and 44.3%, respectively. The mean number of sextants with PPD 4-5 mm was higher in males than in females (p=0.009), but for PPD 6+ mm, there was no difference. Conclusion: The findings of this study population have shown an extremely high prevalence of gingival bleeding, high prevalence of calculus and periodontal disease but of low severity. The Mtwara Rural adult population aged 40+ years should be considered at increased risk for destructive periodontal disease, and hence need to plan for a preventive intervention. Keywords: Gingival bleeding, Calculus, Periodontal pockets, Community Periodontal Index, Mtwara Rural. Tanzania Medical Journal Vol. 19 (1) 2004: pp.

Predictors of Falls in a Multiethnic Population of Older Rural Adults With Diabetes

Falls are a recognized danger for older adults with diabetes. Persons in rural communities with diabetes may face additional risks from falling due to environmental and activity differences. Data were obtained in a cross-sectional survey of a stratified random sample of 691 community-dwelling adults (42.7% white, 31.4% African American, and 25.9% Native American) at least 65 years old with two or more Medicare claims for diabetes in 1998-2000, living in two rural counties in North Carolina. Falls data were self-reported for the previous year. Demographic data, foot-related symptoms, diabetes medications, and other health characteristics were reported. Three hundred two persons (43.7%) reported falling at least once, including 171 (26.2%) who experienced two or more (frequent) falls. Frequent fallers were more likely to be male (odds ratio [OR] = 1.76; 95% confidence interval [CI] = 1.17, 2.66), report tingling or numbness in feet (OR = 1.75; 95% CI = 1.13, 2.70), have had a stroke (OR = 1.81; 95% CI = 1.19, 2.76), have longer duration of diabetes (OR = 1.21; 95% CI = 1.00, 1.47), have lower physical functioning (OR = 0.97; 95% CI = 0.96, 0.99) and mobility (OR = 0.89; 95% CI = 0.82, 0.96), and take a greater number of prescription medications (OR = 1.07; 95% CI = 1.01, 1.13). For rural older adults with diabetes, falls history should be screened to identify those at risk. Further research should investigate unique environmental factors contributing to falls for rural elderly persons.

Household food insecurity and other effects on the Healthy Eating Index (HEI) and Dietary Reference Intakes (DRI) in an adult rural population in the Mississippi Delta

Household food insecurity and other effects on the Healthy Eating Index (HEI) and Dietary Reference Intakes (DRI) in an adult rural population in the Mississippi Delta

Ultrasound verification of bladder damage is associated with known biomarkers of bladder cancer in adults chronically infected with Schistosoma haematobium in Ghana

Long-term infection with urinary schistosomiasis has been associated with development of bladder cancer. However, bladder cancer is difficult to diagnose without invasive measures such as cystoscopy, thus there is little information on the epidemiological extent of the problem. Studies have been either case-control studies or case examinations in different geographical areas, estimating a schistosome-associated bladder cancer incidence of 3-4 cases per 100,000. We have used three indicators to examine the potential bladder cancer problem in an adult rural population in Ghana endemic for urinary schistosomiasis: (i) parasitological positivity; (ii) age prevalence of bladder damage from ultrasound scans; and (iii) detection of biomarkers associated with the presence of bladder cancer. Biomarkers were BLCA-4 test (urine) and nuclear morphometry or quantitative nuclear grading (QNG) of epithelial cells (urine sediment), which quantifies DNA ploidy status and nuclear morphometric descriptors, both of which can detect the presence of bladder cancer. Our data show an increasing association between age, severe bladder abnormalities and the occurrence of these biomarkers. Sixty-two of 73 cytopathology Papanicolaou-stained smears were seen to have squamous metaplasia. Although further investigations are needed, we suggest that schistosome-associated bladder cancer is an important public health concern in areas where Schistosoma haematobium is prevalent.

Association between dental prosthesis and periodontal disease in a rural Brazilian community

The aim of this study was to describe the periodontal conditions and to analyze the association between the wearing of fixed/removable partial dentures and periodontal disease in a representative adult rural population in southeast Brazil. Cross-sectional study of a representative sample comprising 200 individual aged 34-44 years. Data were collected by clinical examinations in accordance with the World Health Organization Basic Methods Criteria, which included the Community Periodontal Index and dental prosthesis exam. A descriptive analysis and the chi-square statistic were performed. In total, 40.5% of the individuals wore partial denture and 59.5% were non-users of denture. The prevalence of periodontal disease was 100%. The subjects scored either calculus (44.5%) or shallow pockets (47%), and only a small proportion was recorded as having deep pockets (8.5%). All denture wearer displayed periodontal problem in the sextant where the denture were recorded. The statistical analysis indicated that wearing partial dentures was found to be associated with considerable periodontal disease (X 2 = 10.75; p=0.0014). The periodontal condition of the study population can be considered unsatisfactory. The wearing of partial dental prosthesis was associated with periodontal disease, and a significant percentage of cases might have been prevented if plaque control interventions had been implemented.

Prevalence of cardiovascular diseases and associated risk factors in a rural black population of South Africa

To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa. A cross-sectional study. A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed. There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure > or =140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years. There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.

Self-monitoring of Blood Glucose in a Multiethnic Population of Rural Older Adults With Diabetes

The purpose of the study was to describe self-monitoring of blood glucose (SMBG) practices of 698 older adults with type 2 diabetes in the rural Southeast, to identify characteristics differentiating testers from nontesters, and to identify personal and support-related predictors of monitoring frequency. The ELDER (Evaluating Long-term Diabetes Self-management Among Elderly Rural Adults) study was a population-based, cross-sectional survey of African American, Native American, and white Medicare recipients > or =65 years with diagnosed diabetes. Data were obtained through in-home interviews. Multiple logistic regression models were used to identify factors associated with SMBG and frequency of monitoring. Seventy-seven percent of respondents practiced SMBG in the previous week; 40% tested every day in that week. No ethnic differences were seen. Significant independent predictors of any SMBG were medication regimen (taking oral agents or insulin with or without oral agents) and health care provider (HCP) recommendation to test. Among those monitoring, significant independent predictors of SMBG frequency were medication regimen, HCP recommendation to test, duration of diabetes, and receiving help with testing, which was negatively associated with monitoring frequency. Among rural older persons with diabetes, HCP recommendation significantly affected practicing SMBG and SMBG frequency. These findings suggest points of intervention by diabetes educators with this vulnerable population. Further research is needed to determine how older adults use SMBG data in their self-care regimen.

Self-monitoring of Blood Glucose in a Multiethnic Population of Rural Older Adults With Diabetes

Self-monitoring of Blood Glucose in a Multiethnic Population of Rural Older Adults With Diabetes

HIV/AIDS/STD Knowledge, Attitudes, Beliefs and Behaviours in a Rural South African Adult Population

The aim of the study was to evaluate data on behavioural indicators in relation to HIV/AIDS/STD prevention and occurrence in a rural adult population in South Africa. A representative community sample of adults (n=398) using a three-stage cluster sampling method was chosen for a household survey, and qualitative data were obtained from adults using ten focus group discussions. The survey sample included 398 adults: 155 (38.9%) male and 243 (61.1%) female, whose ages ranged from 25 to 49 years ( M=37.1 years, SD=12.6). The questionnaire included 71 items on HIV-related knowledge, attitudes, beliefs and behaviours. The results indicated a mean HIV/AIDS knowledge score of 6.77 (range: 0 to 9), indicating a moderately adequate knowledge. HIV/AIDS knowledge was identified as a predictor for HIV-risk behaviour. Forty-six percent of the men and 21.4% of the women indicated that they had had a non-regular sexual partner in the last 12 months, and 53.4% of the women and 45.6% men said that they had never used a condom with their non-regular, non-commercial partner during the preceding 12 months. Among female adult women, 15.4% reported having been victims of enforced sex during the last 12 months. There was a high incidence of self-reported genital discharge/ulcers/sores within the preceding 12 months among the participants (19.7% in men and 11% in women). The study's findings are discussed in relation to implications for health education.