Rural Place Of Residence Research Articles

Spatial distribution and determinants of measles vaccination dropout among under-five children in Ethiopia: A spatial and multilevel analysis of 2019 Ethiopian demographic and health survey.

Each year, vaccine-preventable diseases cost the lives of 8.8 million under-five children. Although vaccination prevents 1-2 million childhood deaths worldwide, measles vaccination dropouts are not well studied in developing countries, particularly in Ethiopia. Therefore, this study aims to assess the spatial distribution of the measles vaccination dropout and its determinants among under-five children in Ethiopia. Data from Ethiopian Demographic and Health Survey 2019 was used for data analysis. The study used a total of 5,753 children. Spatial autocorrelations was used to determine the spatial dependency of measles vaccination dropout. Ordinary interpolation was employed to forecast measles vaccination dropout. Factors associated with measles vaccination dropout were declared significant at p-values <0.05. The data were interpreted using the confidence interval and adjusted odds ratio. A model with the lowest deviance and highest logliklihood ratio was selected as the best-fit model. In Ethiopia, one in three under-five children had measles vaccination dropouts. Factors such as birth interval (AOR = 1.87, 95% CI: 1.30, 2.70), unmarried marital status women (AOR = 3.98, 95% CI: 1.08, 8.45), ≤1 number of under-five children (AOR = 3.86, 95% CI: 2.56, 5.81), rural place of residence (AOR = 2.43, 95% CI: 2.29, 3.11), low community-level ANC utilization (AOR = 3.20, 95% CI: 2.53, 3.56), and residing in Benishangul Gumuz (AOR = 1.80, 95% CI: 1.061, 3.06) had higher odds of measles vaccination dropout. Measles vaccination dropout rates in Ethiopia among under-five children were high compared to the maximum tolerable vaccination dropout level of 10% by the WHO. Both individual and community-level variables were determinants of measles vaccination dropout. The ministry of health in Ethiopia should give attention to those mothers of under-five children who reported underutilization of ANC services and rural residences while designing policies and strategies in areas of high spatial clustering of vaccine dropout in Ethiopia.

Screening for those at risk for anxiety and depression warranting further clinical evaluation among patients presenting to breast services: a single-centre, cross-sectional study

ObjectivesStudies show that anxiety and depression are widespread across patients presenting to outpatient services for medical illnesses. We expect similar or even higher prevalence in patients with breast complaints owing...

Attitudes of women towards intimate partner violence in Guyana: A cross-sectional analytical study.

To assess the attitudes of women towards intimate partner violence (IPV) in Guyana. We used national data from the publicly available Multiple Indicator Cluster Survey (MICS) conducted in Guyana in 2019 for women aged 15 to 49 years. The prevalence of women who agreed that a husband is justified in beating his wife was analyzed. Respondent reasons included if she: "goes out without telling him", "neglects the children", "argues with him", "refuses sex with him", "burns the food", "has another partner", "stays out late/partying", "refuses to cook or clean", "overspends", and/or "he doesn't have access to her cellphone". Descriptive analyses were carried for all the variables. Logistic regression was used to identify factors associated with these 10 respondent reasons, separately and in combination. The overall prevalence of women's attitudes justifying IPV against women if there was a 'yes' response to any of the 10 reasons was 17.9% (95%CI: 16.6-19.3%), and varied from 2.7% if she "goes out without telling him", "burns the food", or "overspends" to 10.0% if she "has another partner". This prevalence ranged from 10.2% in urban areas to 19.3% in rural areas (p<0.001), and from 16.1% in coastal to 30.1% in interior areas (p<0.001). Similarly, 25.9% of women from the poorest household agreed that a husband has the right in beating his wife for any of the 10 reasons compared to 11.6% of the richest women (11.6%) (p<0.001). Rural place of residence, ethnicity, geographic region, level of education, wealth quintile, ever used of a computer, and frequency of listening to the radio were significant factors associated with women's attitudes justifying IPV against women (p<0.05). Over one-sixth of the respondents agreed that a husband was justified in committing IPV against women in Guyana. Public health programs focusing on geographic locations, ethnicity, and economic status must be implemented to change attitudes justifying IPV and reduce this significant public health challenge.

Survival Analysis of Recovery of Weight Among Low Birth Weight Infants in Jimma University Medical Center, Jimma, Ethiopia

Background: Globally, it has been known that around 15.5% of infants were below the normal level of weight at their birth and 95% of these infants lived in developing countries. Objectives: The study aimed to model time to normal weight from low weight among low weight infants delivered at Jimma University Medical Center Methods: The retrospective data from all the admitted follow up of low birth weight (LBW) infants, from September 1,2020 to March 30,2022 in JUMC is used in this study. By assessing the overall goodness of fitted models, log-logistic accelerated failure time model which can fit the data well and had smallest akaike information criterion value were selected as the appropriate fit model. Results: Out of 325 LBW infants 286 (88%) were recovered from LBW and 39 (12%) censored. The most important predictors of time to normal weight at 0.05 level of significance were place of residence [φ =0.877 (95% CI: 0.808-0.952)], multiple birth [φ =1.459 (95% CI: 1.316-1.617)],gender [φ =0.870 (95% CI: 0.809-0.936)], history of abortion [φ =1.296 (95% CI: 1.165-1.441)],preterm birth [φ =1.172 (95% CI: 1.070-1.285)], maternal age 20-34 [φ =0.813 (95% CI: 0.727-0.909)] and maternal age &gt;34 [φ =0.798 (95% CI: 0.694-0.917)], ANC follow up [φ =0.816 (95%CI: 0.755-0.883)] and weight at birth 1000-1500 gm [φ =0.773 (95% CI: 0.658-0.910)] and weight at birth 1500-2500 gm [φ =0.700 (95% CI: 0.602-0.815)]. Conclusion: Log-logistic AFT model fits the data well in analyzing time to normal weight among LBW infants data. The duration of time to normal weight of LBW infants significantly affected by the infants’ place of residence, birth status, history of abortion of mothers, gender, preterm, maternal age, number of ANC visits and weight at birth. Therefore, special emphasis should be given for infants who are female, rural place of residence, multiple birth, prematurely birth, infants born from teenage mothers, mother have an abortion, mother have not regular ANC follow up and infants who had &lt;1000 gm birth weight to improve the duration of LBW. The estimated median duration of LBW was 10 days.

Insecticide-treated bed net use and associated factors among households having under-five children in East Africa: a multilevel binary logistic regression analysis

BackgroundEven though malaria is preventable, it remains the leading cause of under-five morbidity and mortality in low-and middle-income countries. Despite the World Health Organization (WHO) recommendations, its advantage, and its free-of-cost access, the utilization of insecticide-treated nets (ITN) is still low in East Africa. Therefore, this study aimed to assess ITN use and associated factors among households having under-five children in East Africa.MethodsThe most recent Demographic and Health Survey (DHS) datasets of East African countries were used. A total of 174,411 weighted samples was used for analysis. Given the hierarchical nature of DHS data, a multilevel binary logistic regression model was fitted to identify factors associated with ITN use. Four models were fitted and a model with the lowest deviance value was chosen as the best-fitted model for the data. Variables with a p-value < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of association.ResultsIn this study, the proportion of ITN use among households having under-five children in East Africa was 46.32% (95% CI 46.08%, 46.55%), ranging from 11.8% in Zimbabwe to 70.03% in Rwanda. In the multivariable analysis, being in the age group 25–34 years, married, widowed, and divorced, primary and post-primary education, wealthy households, having a lower household size, many under-five children, having media exposure, and male-headed households were associated with higher odds of ITN use. Moreover, respondents from a rural place of residence, communities with a higher level of media exposure, communities with lower poverty levels, and communities with higher education levels had higher odds of ITN use.ConclusionIn this study, the proportion of ITN use was relatively low. Both individual and community-level factors were associated with ITN use. Therefore, giving attention, especially to those who had no formal education, the poor, younger age groups, and households with the large family size is advisable to increase awareness about ITN use. Moreover, media campaigns regarding ITN use should be strengthened.

Unsure Last Normal Menstrual Period among Pregnant Women in Low Resource Setting: The Experience from Federal Teaching Hospital Gombe, North-Eastern Nigeria

Background: The proper management of any pregnancy depends on the accurate determination of the gestational age. In resource constrained environment where imaging techniques may not be readily available, accessible and affordable, the knowledge of menstrual period is key. Unfortunately, some of the pregnant women at antenatal clinics do not know their last normal menstrual period (LNMP). Aim/Objectives: This research was designed to ascertain the proportion of women who do not know their LNMP and associated factors. Materials and Methods: This was a descriptive, cross-sectional study involving antenatal attendees at the booking clinic of the Federal Teaching Hospital Gombe. Data such as socio-demographics, knowledge of dates/associated factors and willingness to remember the menstrual period subsequently was collected through a structured questionnaire from 1st March to 31st August 2022 and analysis done with IBM® SPSS® statistical Inc., Armonk, New York, USA software version 25 for analysis. Qui-square used as a test of statistics and the results presented in charts, graphs and tables. Results: Out of the 350 respondents 181(51.7%) knew their LNMP, while 169(48.3%) did not know. However, as much as 70.6% of the respondents knew that LNMP is used to date pregnancy. Reasons for not knowing dates included; not just keeping records of dates (25.4%), ignorance of Gregorian calendar (13.0%), on contraceptives when pregnancy was identified (10.7%), no reason (8.3%), was breastfeeding (6.5%), among several others. Surprisingly, 32% did not know the problems that may arise due to ignorance of LNMP. Majority (90.0%) of the respondents are willing to remember their LNMP in the next pregnancy. Women ≤ 19years and ≥ 40 years (p=0.004), lower level of education (p=0.004), Grand-multiparity (p=0.035), more than 4 living children (p=0.02) and rural dwellers (p=0.001) were more likely not to know their LNMP. Conclusion: The study showed 48.3% of the women were ignorant of their LNMP. The associated factors were extreme of ages, low level of education, grand multi-parity, having more than 4 living children and rural place of residence. Going forward, majority of the women accepted to remember their LNMP.

Prevalence of anemia and its associated factors among women of reproductive age group attending Gaur Provincial Hospital: A cross-sectional study

Background: Anemia is a principal public health concern. Worldwide one-third of women of reproductive age are affected. A 2016 survey showed that 41% of women in Nepal had anemia with the highest prevalence in Pradesh two. A complex interaction among socio-political, biological, and ecological elements determines anemia. Assessing the factors would help in minimizing anemia and its consequences. The study aimed to determine the prevalence of anemia in the reproductive age group and the factors affecting anemia. Methods: A hospital-based cross-sectional study was conducted among women of the reproductive age group (15–45) from 15th April to 15th June 2022 after ethical clearance was obtained from the Nepal health research council (Ref. 2737/2022). Regarding data collection, 375 women participants were selected via a simple random sampling technique. Participants underwent an interview after informed written consent followed by blood sample collection. Through a semi-structured questionnaire, the data was obtained. Then data entry and its analysis were performed via Microsoft Excel 2019 and Statistical Package for Social Sciences version 22.0. Results: The study showed that 229 (61.3%) females of the reproductive age group had anemia. Inadequate nutrition (OR 3.0, 1.9–5.0), breastfeeding (OR 7.3, 4.5–11.9), and rural place of residence (OR 4.2, 2.5–7.0) were significantly associated with anemia, with a corresponding odds ratio at 95% confidence each. Conclusions: The prevalence of anemia was higher among women of the reproductive age group compared to provincial and national prevalence. The interventions should be focused on breastfeeding, nutrition, and rural women to combat anemia.

Survival Modeling on the Determinants of Time to Recovery from Obstetric Fistula: The Case of Mekelle Hamlin Fistula Center, Ethiopia

An obstetric fistula is an abnormal opening between the vagina, rectum, and/or bladder. Obstetric fistula has a devastating impact on women's physical, social, and psychological health. Despite the numerous health consequences in developing countries, including Ethiopia, there have been few studies on the determinants of time to recovery from obstetric fistula. Therefore, this study is aimed at addressing the gap. A retrospective cohort study was employed to include 328 randomly selected records of women admitted for obstetric fistula treatment at Mekelle Hamlin Fistula Center from January 2015 to 2020. Data collected from the medical records was coded and entered into SPSS software version 20 and exported to STATA 10 and R statistical software for data cleaning and data analysis. The Kaplan-Meier and log-rank tests were computed to explore the data. The log-logistic inverse Gaussian shared frailty model was employed using a 95% CI, and variables with a p value < 0.05 were declared as determinants of recovery time. Of 328 fistula patients, 293 (89.33%) were physically cured. The Kaplan-Meier result showed that the overall mean and median survival time of time to recovery from obstetric fistula patients at Mekelle Hamlin Fistula Center is 42 and 33 days, respectively. In a log-logistic inverse Gaussian shared frailty model analysis, extensive fistula size (AHR : 1.282; 95% CI = 1.175-1.388), secondary and above education level (AHR : 0.830; 95% CI = 0.693-0.967), rural residence (AHR : 1.357; 95% CI = 1.236-1.479), and physiotherapy use (AHR : 0.801, 95% CI = 0662-0.940, 95% CI = 1.175-1.388) were statistically significant predictors of recovery from obstetrics fistula. Rural place of residence, home delivery, and large and extensive size of the fistula prolong the timing of healing from the obstetric fistula. However, having tall height, physiotherapy treatment, secondary and above-educated women, and RVF type of fistula has a short time of healing for obstetric fistula in Mekelle Hamlin Fistula Center. Therefore, we recommend that health professionals promote institutional delivery and physiotherapy, shorten the duration of catheterization, and manage urine incontinence. In addition, we recommend that the regional health bureau promotes female education and pregnancy after 18 years. The survival probability of patients with obstetric fistulas is better predicted by the log-logistic inverse Gaussian shared frailty model. Therefore, it would be good for future researchers to take this model into account.

Trends of unmet need for family planning among currently married reproductive age women in Ethiopia: A multivariate decomposition analysis.

Despite decreasing the percentage of women with unmet needs, Ethiopian women still have a higher unmet need for family planning due to different factors. Therefore, addressing the unmet need for FP provides an opportunity for policymakers in all sectors to respond to the expressed fertility preferences of their population. This study aimed to analyze trends and determinants of changes in unmet needs over time among married women of reproductive age in Ethiopia. The study used data from three consecutive Demographic and Health Surveys conducted in Ethiopia (2005, 2011, and 2016). These nationally representative household surveys cover all Ethiopia region and city administrations with population health and other relevant indicators). The study included a total weighted sample of 8642 in 2005, 10204 in 2011, and 9824 in 2016 in the final analysis. Factors contributing to the change in unmet need rate were examined using logit-based multivariate decomposition analysis. Among married women, unmet needs declined from 33.8% (95% confidence interval (CI):32.8,34.8) in 2005 to 21.0%(95%CI:20.2,21.9) in 2016. In decomposition analysis, the difference in coefficients was responsible for 90% of the overall change in the unmet need rate. In particular, being at the age of 25-49 years, rural place of residence, agrarian regions, and having more than four children were significant predictors of the increase in unmet need rate. Unmet needs among women have shown a remarkable decline over the last decade in Ethiopia. Policy and program interventions better targeting younger, agrarian regions and rural dwellers would help to maintain a declining trend in unmet needs.

Association between Health Literacy and Prevalence of Obesity, Arterial Hypertension, and Diabetes Mellitus.

Background: Health literacy (HL) is linked to many health outcomes, including self-management of chronic diseases. The aim of this study was to assess the association of health literacy with the prevalence of obesity, arterial hypertension (AH), and type 2 diabetes mellitus (T2DM). Methods: This cross-sectional, single-center study included 500 patients (42.2% male and 57.8% females; median age, 63 years (interquartile range, 42–73)) hospitalized at General County Hospital in Požega, Croatia, between July and October 2020. The Short Assessment of Health Literacy for Croatian Adults (SAHLCA-50) questionnaire was used. Descriptive statistics (median with interquartile range (IQR), frequency, and percentages) and binary logistic regression were utilized. Results: Patients with AH had an inadequate level of health literacy as compared to those without AH (32 vs. 40 points; Mann–Whitney U test, p < 0.001). Patients with T2DM scored 31 points versus 39 points in patients without T2DM (Mann–Whitney U test, p < 0.001). Patients suffering from both AH and T2DM scored 31 points versus 33 points in those with either AH or T2DM and 41 points in patients without AH and T2DM (Kruskal–Wallis test, p < 0.001). There were no statistically significant differences in SAHLCA-50 scores according to the patient body mass index. Conclusions: An inadequate level of health literacy is significantly associated with AH and T2DM but not with obesity. Male gender, low level of education, rural place of residence, retirement, and older age are significant predictors of inadequate health literacy.

Epidemiologic Profile of Severe Acute Respiratory Infection in Brazil During the COVID-19 Pandemic: An Epidemiological Study.

BackgroundThe COVID-19 is a significant public health issue, and monitoring confirmed cases and deaths is an essential epidemiologic tool. We evaluated the features in Brazilian hospitalized patients due to severe acute respiratory infection (SARI) during the COVID-19 pandemic in Brazil. We grouped the patients into the following categories: Influenza virus infection (G1), other respiratory viruses' infection (G2), other known etiologic agents (G3), SARS-CoV-2 infection (patients with COVID-19, G4), and undefined etiological agent (G5).MethodsWe performed an epidemiological study using data from DataSUS (https://opendatasus.saude.gov.br/) from December 2019 to October 2021. The dataset included Brazilian hospitalized patients due to SARI. We considered the clinical evolution of the patients with SARI during the COVID-19 pandemic according to the SARI patient groups as the outcome. We performed the multivariate statistical analysis using logistic regression, and we adopted an Alpha error of 0.05.ResultsA total of 2,740,272 patients were hospitalized due to SARI in Brazil, being the São Paulo state responsible for most of the cases [802,367 (29.3%)]. Most of the patients were male (1,495,416; 54.6%), aged between 25 and 60 years (1,269,398; 46.3%), and were White (1,105,123; 49.8%). A total of 1,577,279 (68.3%) patients recovered from SARI, whereas 701,607 (30.4%) died due to SARI, and 30,551 (1.3%) did not have their deaths related to SARI. A major part of the patients was grouped in G4 (1,817,098; 66.3%) and G5 (896,207; 32.7%). The other groups account for <1% of our sample [G1: 3,474 (0.1%), G2: 16,627 (0.6%), and G3: 6,866 (0.3%)]. The deaths related to SARI were more frequent in G4 (574,887; 34.7%); however, the deaths not related to SARI were more frequent among the patients categorized into the G3 (1,339; 21.3%) and G5 (25,829; 4.1%). In the multivariate analysis, the main predictors to classify the patients in the G5 when compared with G4 or G1-G4 were female sex, younger age, Black race, low educational level, rural place of residence, and the use of antiviral to treat the clinical signs. Furthermore, several features predict the risk of death by SARI, such as older age, race (Black, Indigenous, and multiracial background), low educational level, residence in a flu outbreak region, need for intensive care unit, and need for mechanical ventilatory support.ConclusionsThe possible COVID-19 underreporting (G5) might be associated with an enhanced mortality rate, more evident in distinct social groups. In addition, the patients' features are unequal between the patients' groups and can be used to determine the risk of possible COVID-19 underreporting in our population. Patients with a higher risk of death had a different epidemiological profile when compared with patients who recovered from SARI, like older age, Black, Indigenous, and multiracial background races, low educational level, residence in a flu outbreak region, need for intensive care unit and need for mechanical ventilatory support.

Morbidity status and changes in difficulty in activities of daily living among older adults in India: A panel data analysis

IntroductionThe study explored the socioeconomic and demographic factors that determine the onset of difficulty, recovery from difficulty and difficulty remaining in functional activity in later years of life. Additionally, the study examined the effects of several combinations of chronic diseases on the changes in later-life functional difficulty.MethodsWe used data from two rounds of India Human Development Survey (IHDS) conducted during 2004–2005 and 2011–2012. A sample of 13,849 respondents aged 55 years and above with a seven year follow-up was considered for this study. The Katz Index of Independence in activities of daily living (ADL) was used to measure the functional disability as an outcome variable. Multinomial logistic regression has been conducted to fulfil the study objectives.ResultsThe overall functional difficulty among older adults was 27.3% and onset of functional difficulty (23.5%) was higher than the recovery from difficulty (2.1%) and remaining with difficulty (1.7%). Onset of functional difficulty in second round was higher among women (27.3%) than men (19.3%). Bivariate and multivariate analyses showed that single and multi-morbidity had a positive significant association with all categories of functional difficulty. Female sex, increasing age and rural place of residence had positive association with onset of difficulty and difficulty remaining in second round. The combinations of morbidities were also found to have positive significant association with functional difficulty i.e., the relative risk (RR) of onset of difficulty in second round is higher among those who had diabetes with high blood pressure (RR-1.7; CI: 1.4–2.0), cataracts with high blood pressure (RR-2.0; CI: 1.5–2.6) and cataracts with asthma (RR-3.1; CI: 2.1–4.6) compared to those with no diabetes and cataract but with high blood pressure or asthma, respectively.ConclusionThe findings suggest that the risk of onset of functional difficulty is higher among older individuals with single and multiple morbidities compared to their healthy counterparts. It is also found that functional difficulty increased with age and was more prevalent in older women and rural residents, suggesting the need for appropriate policy interventions with special focus on the vulnerable senior adults.

Prevalence and predictors of water-borne diseases among elderly people in India: evidence from Longitudinal Ageing Study in India, 2017–18

BackgroundIndia suffers from a high burden of diarrhoea and other water-borne diseases due to unsafe water, inadequate sanitation and poor hygiene practices among human population. With age the immune system becomes complex and antibody alone does not determine susceptibility to diseases which increases the chances of waterborne disease among elderly population. Therefore the study examines the prevalence and predictors of water-borne diseases among elderly in India.MethodData for this study was collected from the Longitudinal Ageing Study in India (LASI), 2017–18. Descriptive statistics along with bivariate analysis was used in the present study to reveal the initial results. Proportion test was applied to check the significance level of prevalence of water borne diseases between urban and rural place of residence. Additionally, binary logistic regression analysis was used to estimate the association between the outcome variable (water borne diseases) and the explanatory variables.ResultsThe study finds the prevalence of water borne disease among the elderly is more in the rural (22.5%) areas compared to the urban counterparts (12.2%) due to the use of unimproved water sources. The percentage of population aged 60 years and above with waterborne disease is more in the central Indian states like Chhattisgarh and Madhya Pradesh followed by the North Indian states. Sex of the participate, educational status, work status, BMI, place of residence, type of toilet facility and water source are important determinants of water borne disease among elderly in India.ConclusionElderly people living in the rural areas are more prone to waterborne diseases. The study also finds state wise variation in prevalence of waterborne diseases. The elderly people might not be aware of the hygiene practices which further adhere to the disease risk. Therefore, there is a need to create awareness on basic hygiene among this population for preventing such bacterial diseases.

Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study.

Institutional delivery at birth is an important indicator of improvements in maternal health, which remains one of the targets of sustainable development goals intended to reduce the maternal mortality ratio. The purpose of the present study was to identify the determinants of utilization of institutional delivery in Zambia. A population-based cross-sectional study design was used to examine 9841 women aged 15–49 years from the 2018 Zambia Demographic and Health Survey. A multiple logistic regression was applied to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to identify determinants of utilization of institutional delivery. Sociodemographic factors were significantly associated with institutional delivery: woman’s (OR: 1.76; 95% CI: 1.04–2.99) and husband’s (OR: 1.83; 95% CI: 1.09–3.05) secondary/higher education, higher wealth index (OR: 2.31; 95% CI: 1.27–4.22), and rural place of residence (OR: 0.55; 95% CI: 0.30–0.98). Healthcare-related factors were also significantly associated with institutional delivery: 5–12 visits to antenatal care (OR: 2.33; 95% CI: 1.66–3.26) and measuring blood pressure (OR: 2.15; 95% CI: 1.32–2.66) during pregnancy. To improve institutional delivery and reduce maternal and newborn mortality, policymakers and public health planners should design an effective intervention program targeting these factors.

Assessment of Quality of Life in Men Treated for Infertility in Poland.

The aim of this study was to assess the quality of life (QoL) of men treated for infertility in Poland. This cross-sectional study was conducted using the Abbreviated World Health Organization Quality of Life questionnaire (WHOQoL-BREF), Fertility Quality of Life tool (FertiQoL) and an author-constructed questionnaire. The study included 1200 men treated for infertility without the use of assisted reproductive technology (non-ART), intrauterine insemination (IUI) and in vitro fertilization (IVF). The control group consisted of 100 healthy men with confirmed fertility. The quality of life assessed by the WHOQoL-BREF questionnaire was significantly lower in study groups in the Environmental domain, compared to the control group (p = 0.009). Statistically significant differences were found in the case of FertiQoL subscales: Emotional, Mind-Body, Relational, and Treatment Environment, depending on applied treatment. Men whose partners were treated without the use of ART assessed their QoL significantly more negatively than those treated with IUI. Reproductive problems and type of their treatment influenced the quality of life of the affected men. Non-ART treatment, rural place of residence, and increased BMI were associated with lower QoL.

A CROSS-SECTIONAL STUDY OF THE QUALITY OF LIFE IN PATIENTS WITH SCHIZOPHRENIA.

Background: Few studies have examined the quality of life (QoL) for people with. It examined the level of satisfaction with their QoL in people with schizophrenia had as well as the relationships between sociodemographic characteristics and QoL. Aims: The present study aimed to evaluate the QOL in outpatients with schizophrenia. Study Design: Cross-sectional study Methodology:A cross-sectional study, in the form of an inquiry, was conducted in 400 outpatients, in the psychiatric department after obtaining detailed written consent from the participants and permission from the ethics committee. We used the WHOQOL BREF. Statistics: Categorical variables were analysed with the Chi-squared tests. Signicance levels for all analyses were set at P = 0.05. Results: In this study, the data showed that among the 400 participants 84% were having a fair level of quality of life, 12% have a satisfactory level of quality of life, and 4% of them were having a good quality of life. Conclusions: The study revealed that the good and satisfactory quality of life of schizophrenic patients is associated with the marital status, education status, occupation, joint family type, rural place of residence and correct follow-up and continuation of the prescribed medicine and regular follow-ups is also important to improve the quality of life.

IMPACT OF ROAD TRAFFIC INJURY ON JOB LOSS AND FINANCIAL COSTS: A PILOT STUDY FROM A TERTIARY CARE CENTRE

Introduction: Global studies have shown that majority of those affected in road traffic accidents (RTA) are young and bread winners of their families. Depending on the part afflicted, most non-fatal injuries have either temporary disability or life-long sequels, which require job modification, rehabilitation and integration back into work and society. However, despite recovery the traumatic experience and disability impact the affected individual and their family. Through this pilot study, an attempt was made to understand the impact of RTA on an individual’s financial status, cost cutting behaviour and sleep affection. Methods: Data was collected during follow-up of patients who were treated for traumatic injuries. Patients were assessed by a selfdesigned questionnaire regarding their financial burdens arising out of injury and treatment, sacrifices in regular life, return to work and losses incurred due to the trauma. Results: A total of 162 patients volunteered to be a part of the study and 76.5% earned below ₹25,000 per month. Data indicated 25% had to pledge their valuables to pay for hospital charges, 79% cut costs on luxury goods and 75% cut on non-essential and recreational activities. At the end of one-month post-accident, more than 43% of participants needed to spend more than thirty minutes to fall asleep and 21% had disturbed sleep. Conclusion: Lower economic status, rural place of residence, lack of insurance and treatment at private health facilities are the key drivers for increased risk of high healthcare expenditure on road traffic injuries. On an individual basis, these cause costly rehabilitation, difficult work atmosphere, sacrifices in personal life and delayed comeback to societal living.

Adverse Neonatal Outcomes and Associated Risk Factors: A Case-Control Study

BackgroundAdverse neonatal outcomes have a significant effect on perinatal and neonatal survival and the risk of developmental disabilities and illnesses throughout future lives. Hence, the objective of this study was to identify adverse neonatal outcomes and associated risk factors.MethodInstitutional based unmatched case-control study was conducted among 206 neonates. Neonates who had adverse outcomes were cases with their index mothers and those neonates who hadn’t had adverse outcomes were controls with their index mothers. Sociodemographic, potential neonatal risk factors, and clinical data were taken from the mothers and medical records. Data were entered into Epi Info v7 and analyzed using SPSS v23. Bivariate and multivariable logistic regression analyses were used to adjust for confounding factors of adverse neonatal outcomes. Frequencies, means, standard deviations, percentages, and cross-tabulations were used to summarize the descriptive statistics of the data.ResultsIn this study, low birth weight (61.5%), preterm birth (57.7%), and low Apgar score at fifth minutes (53.9%) were the major identified adverse neonatal outcomes. Based on the multivariable logistic regression analysis, rural place of residence (AOR = 5.992 to 95% CI [1.011-35.809]), low monthly income (AOR = 4.364), middle monthly income (AOR = 4.364), and emergency cesarean section (AOR = 9.969) were the potential risk factors for adverse neonatal outcomes.ConclusionsThe adverse neonatal outcomes & the risk factors identified in this research have the potential to harm the health of the neonates. Thus, it needs emphasis to tackle the problems and save the life of the newborn through better and strengthened ANC follow-up, accesses to health care.

Factors associated with psychiatric disorders and treatment seeking behaviour among older adults in India

Since untreated or undertreated late-life mental disorders is associated with grave consequences including poor quality of life and increased mortality rates, this study investigates the associated factors of psychiatric disorders and its treatment seeking among older adults in India. Data for this study were derived from the Longitudinal Ageing Study in India (LASI) conducted during 2017–2018. The effective sample size was 31,464 older adults aged 60 years and above. Descriptive statistics and bivariate analysis were used to present the preliminary results. Chi-square test was used to find the significance level for bivariate association. Additionally, the Heckprobit selection model was employed to fulfil the objectives. It was revealed that about 2.8% of older adults had psychiatric disorder and of those who were suffering from psychiatric disorder, 41.3% (out of 2.8%) sought medical treatment. It was found that older adults who ever worked but currently not working, who had low level of life satisfaction, had poor self-rated health, had difficulty in activities of daily living (ADL) and instrumental ADL and had symptoms of psychological distress had higher probability of suffering from psychiatric disorder in reference to their counterparts. Older adults from oldest-old age group, who were females, from poorest wealth quintile, from Scheduled Tribe and from eastern region had lower probability of seeking treatment for psychiatric disorder in reference to their counterparts. The findings of the present study urge that greater attention be devoted at detecting and preventing late-life psychiatric disorder particularly among those who are at greater risk vis., male gender, working status as “ever worked but currently not working”, having low life satisfaction, poor SRH, ADL and IADL difficulties, higher psychological distress, belonging to higher wealth quintile and rural place of residence.

Risk factors of postpartum depression.

Background:Postpartum depression (PPD) is one of the most common puerperal psychiatric illnesses impairing quality of life and mental health of the mother and also the child.Aim:The aim is to study the prevalence and risk factors of PPD.Materials and Methods:This cross-sectional observational study was done on a sample of 295 mothers who delivered and were followed up at a tertiary care hospital. The mothers were administered Edinburgh Postnatal Depression Scale, and demographic, psychosocial, and clinical data were collected.Results:The age of the participant mothers ranged from 18 to 35 years and age at marriage ranged from 21 to 24 years. In most of the mothers, the parity was 2 and they had institutional vaginal delivery. The prevalence of PPD in this population of mothers was 30.84%. The factors that had a statistically significant association with PPD included: lower educational status of mother, lower family income, rural place of residence, higher parity, preterm delivery, and adverse events in newborn.Conclusion:PPD is a common mental health problem in the postpartum period. Sociodemographic factors such as low educational status of mothers, rural population, and low monthly family income were found to be associated with PPD. Primipara status, preterm delivery, and adverse events in newborn were also significantly associated.