Sociodemographic Risk Research Articles

Continuation of Treatment in Children With ADHD: A Multicenter Turkish Sample Study

Objectives: The aim of this study was to investigate the variables that may affect treatment continuation in children aged 6 to 12 years who were newly diagnosed with ADHD. Methods: A total of 132 children diagnosed with ADHD and their parents participated in the study. Sociodemographic and clinical risk factors affecting continuation of treatment were examined using logistic regression analysis. Results: Multiple model examination revealed that greater age increased the risk of treatment discontinuation 1.824 times (p = .003) while a lower total length of paternal education increased the risk of discontinuation (1/0.835) 1.198 times (p = .022). Other variables emerging as significant in the univariate model lost that significance in the multiple model. Conclusions: Understanding the variables associated with medication discontinuation in ADHD in different populations and taking these variables into account in the development of health policies, will be useful in improving the long-term devastating effects of the disorder.

Neisseria gonorrhoeae antimicrobial resistance patterns and associated risk factors in women of childbearing potential in northwestern Ethiopia

BackgroundsNeisseria gonorrhoeae causes gonorrhea and poses public health problems, including antimicrobial resistance. Current data on gonorrhea in prenatal participants in the study area are required. Thus, we aimed to identify gonorrhea prevalence, antimicrobial resistance, and risk factors among antenatal care clinic visitors in northwestern Ethiopia.MethodsA cross-sectional study was conducted from March to August 2022 at the University of Gondar Comprehensive Specialized Hospital. We recruited 278 study participants using convenient sampling techniques. Sociodemographic, clinical and behavioral risk factors were recorded using pre-tested questionnaires. Endocervical swabs were collected by a physician, transported to the microbiology laboratory, immediately inoculated into modified Thayer-Martin medium, and it was incubated at 37 °C for 24–48 hours. Gram staining and biochemical tests were used to identify the organism. AMR testing was performed using disc diffusion and E-test methods. Data were entered in EPI-info version 7 and exported and analyzed in SPSS version 26. A p-value ≤0.05 was considered as statistically significant. Results were presented in words, tables and figure.ResultsOf 278 subjects enrolled, majority (44.6%) were 26–35 years, with a mean age of 29.9 (SD = ±7.2) years, 69.4% were urban residents, and 70.5% were married. Twenty-one (7.6%) participants had gonorrhea. Overall antimicrobial resistance ranged from 19 to 100%. High resistant to tetracycline (100%) and penicillin (85.7%) were observed by both tests. Ciprofloxacin resistance was 52.4% by disc diffusion and 85.7% by E-test. By E-test, all isolates were sensitive to ceftriaxone, cefixime, azithromycin and spectinomycin; however, 7 (33.3%), 9 (42.9%), 9 (42.9%) and 5 (23.8%) isolates showed resistant to these antibiotics with disk method. Prevalence of beta-lactamase producing Neisseria gonorrhoeae was 85.7%. Alcohol consumption (p = 0.032), condom-free sexual practice (p = 0.010), multiple sexual partners (p < 0.001), pelvic pain (p = 0.018), and dysuria (p = 0.021) revealed increased risk of infection.ConclusionsCompared with many previous studies in Ethiopia, we found high prevalence, antimicrobial resistance, and beta-lactamase-positive isolates. Multiple sexual partners, alcohol consumption, not using condom, pelvic pain and dysuria were predictors of this infection. Continuous large-scale monitoring of pathogen is essential for its prevention and control.

A retrospective study of percutaneous cholecystostomy outcomes in a community hospital

Background: The gold standard of treatment for acute cholecystitis (AC) typically involves operative intervention, specifically cholecystectomy. However, initial nonoperative management rather than immediate cholecystectomy has been recommended for critically ill patients. Non-operative interventions, such as percutaneous cholecystostomy (PCT), may represent viable alternatives. The current study examines risk factors associated with worse outcomes of AC among critically ill patients with AC treated conservatively. Methods: This retrospective study examined data from 121 patients with AC presenting to a NYC-area community hospital. Differences in demographic, clinical, and procedural characteristics were examined in relation to post-operative outcomes, including mortality. Results: The sample tended to be older, with 31% of patients identifying as non-Hispanic white. One-third of the sample were admitted to the ICU. The median time between admission placement and PCT was 2 days, the median time PCT was left in place was 42 days. The overall 90-day mortality rate was 21% and 33% among ICU patients. Patients identifying as non-Hispanic white and those with more severe clinical presentation were at higher risk for mortality within 90 days. Admission to intensive care units (ICU) was significantly associated with 90-day mortality. Conclusions: The results of the current study provide a snapshot into the profiles of patients at-risk for negative outcomes following PCT placement. Sociodemographic risk factors and clinical severity were associated with increased risk of mortality among patients seen at a diverse, community hospital. These findings support the use of risk-stratified decision making regarding non-operative treatments of AC.

Application of elastic net regression for modeling COVID-19 sociodemographic risk factors.

COVID-19 has been at the forefront of global concern since its emergence in December of 2019. Determining the social factors that drive case incidence is paramount to mitigating disease spread. We gathered data from the Social Vulnerability Index (SVI) along with Democratic voting percentage to attempt to understand which county-level sociodemographic metrics had a significant correlation with case rate for COVID-19. We used elastic net regression due to issues with variable collinearity and model overfitting. Our modelling framework included using the ten Health and Human Services regions as submodels for the two time periods 22 March 2020 to 15 June 2021 (prior to the Delta time period) and 15 June 2021 to 1 November 2021 (the Delta time period). Statistically, elastic net improved prediction when compared to multiple regression, as almost every HHS model consistently had a lower root mean square error (RMSE) and satisfactory R2 coefficients. These analyses show that the percentage of minorities, disabled individuals, individuals living in group quarters, and individuals who voted Democratic correlated significantly with COVID-19 attack rate as determined by Variable Importance Plots (VIPs). The percentage of minorities per county correlated positively with cases in the earlier time period and negatively in the later time period, which complements previous research. In contrast, higher percentages of disabled individuals per county correlated negatively in the earlier time period. Counties with an above average percentage of group quarters experienced a high attack rate early which then diminished in significance after the primary vaccine rollout. Higher Democratic voting consistently correlated negatively with cases, coinciding with previous findings regarding a partisan divide in COVID-19 cases at the county level. Our findings can assist regional policymakers in distributing resources to more vulnerable counties in future pandemics based on SVI.

Spatial Analysis of Determinants of COVID-19 Vaccine Hesitancy in Portugal.

Vaccine hesitancy tends to exhibit geographical patterns and is often associated with social deprivation and migrant status. We aimed to estimate COVID-19 vaccination hesitancy in a high-vaccination-acceptance country, Portugal, and determine its association with sociodemographic risk factors. We used the Registry of National Health System Users to determine the eligible population and the Vaccination Registry to determine individuals without COVID-19 vaccine doses. Individuals older than five with no COVID-19 vaccine dose administered by 31 March 2022 were considered hesitant. We calculated hesitancy rates by municipality, gender, and age group for all municipalities in mainland Portugal. We used the spatial statistical scan method to identify spatial clusters and the Besag, Yorke, and Mollié (BYM) model to estimate the effect of age, gender, social deprivation, and migrant proportion across all mainland municipalities. The eligible population was 9,852,283, with 1,212,565 (12%) COVID-19 vaccine-hesitant individuals. We found high-hesitancy spatial clusters in the Lisbon metropolitan area and the country's southwest. Our model showed that municipalities with higher proportions of migrants are associated with an increased relative risk (RR) of vaccine hesitancy (RR = 8.0; CI 95% 4.6; 14.0). Social deprivation and gender were not associated with vaccine hesitancy rates. We found COVID-19 vaccine hesitancy has a heterogeneous distribution across Portugal and has a strong association with the proportion of migrants per municipality.

Association of county-level food deserts and food swamps on postoperative outcomes among patients undergoing colorectal surgery

Although malnutrition has been linked to worse healthcare outcomes, the broader context of food environments has not been examined relative to surgical outcomes. We sought to define the impact of food environment on postoperative outcomes of patients undergoing resection for colorectal cancer (CRC). Patients who underwent surgery for CRC between 2014 and 2020 were identified from the Medicare database. Patient-level data were linked to the United States Department of Agriculture data on food environment. Multivariable regression was used to examine the association between food environment and the likelihood of achieving a textbook outcome (TO). TO was defined as the absence of an extended length of stay (≥75th percentile), postoperative complications, readmission, and mortality within 90 days. A total of 260,813 patients from 3017 counties were included in the study. Patients from unhealthy food environments were more likely to be Black, have a higher Charlson Comorbidity Index, and reside in areas with higher social vulnerability (all P<.01). Patients residing in unhealthy food environments were less likely to achieve a TO than that of patients residing in the healthiest food environments (food swamp: 48.8% vs 52.4%; food desert: 47.9% vs 53.7%; P<.05). On multivariable analysis, individuals residing in the unhealthy food environments had lower odds of achieving a TO than those of patients living in the healthiest food environments (food swamp: OR, 0.86; 95% CI, 0.83-0.90; food desert: OR, 0.79; 95% CI, 0.76-0.82); P<.05). The surrounding food environment of patients may serve as a modifiable sociodemographic risk factor that contributes to disparities in postoperative CRC outcomes.

Do sociodemographic and clinical characteristics affect mortality rates in people with intellectual disability and dysphagia who have a percutaneous endoscopic gastrostomy? A cohort study between 2000 and 2022

AbstractBackgroundPeople with intellectual disability frequently have eating, drinking and swallowing difficulties (dysphagia) and are at greater risk of premature mortality, particularly from aspiration and respiratory infections. The insertion of a percutaneous endoscopic gastrostomy (PEG), as part of a multidisciplinary management plan, may help to maintain and improve nutrition. This study included people with intellectual disability who had ever had a PEG inserted and who presented to the specialist Speech and Language Therapy team in one Greater Manchester borough between 2000 and 2022 and assessed the risk of death and sociodemographic and clinical factors associated with this.MethodsThis was a cohort study using secondary data. Kaplan–Meier estimates were used to construct the probability of mortality curves. Cox proportional hazards were used to compare death rates in the different sociodemographic and clinical characteristic groups and were presented as hazard ratios and 95% confidence intervals.FindingsOf 42 people included in the study, 18 (43%) died from the point of PEG insertion to the end of the study (December 2022). The median (interquartile range) time to death from PEG insertion was 5 (2–10) years, with four people (10%) dying in the first year. Aspiration pneumonia and unspecified pneumonia were responsible for seven (39%) deaths. No significant associations were found between sociodemographic and clinical factors and risk of death.ConclusionIn persons with intellectual disability and a PEG who were followed up between 2000 and 2022, the mortality was around 40% with deaths occurring in the first year and respiratory conditions being an important cause. The lack of association with sociodemographic and clinical characteristics may have been due to a limited sample size. Further research is needed with larger samples and more variables, including quality of life data, to help understand and improve clinical practice in this area.

Unveiling the Burden of Osteoporosis: Exploring the Prevalence and Risk Factors among Postmenopausal Women in North Central Bangladesh.

Background: Osteoporosis affects 30% of women globally between the ages of 40 and 50. This disease is among the top causes of death and disability among the elderly. This study aimed to examine the prevalence of primary osteoporosis and poor bone density in postmenopausal women, as well as their socio demographic, obstetric, and lifestyle risk factors. Aim: The purpose of this study is to investigate at the prevalence of osteoporosis and the risk factors linked with it in postmenopausal women. Methods: The present prospective cross-sectional study was conducted on postmenopausal women who visited orthopedics, gynecology, and medicine outpatient departments between August 2022 and March 2023; 539 women aged 45 to 80 years with verified menopause were recruited. The final recommendation was for 539 women to have bone mineral density testing utilizing dual energy X-ray absorptiometry. Socio-individual, obstetric-medical, short-form physical activity, and anthropometric questionnaires were administered. Chi-square and Student's t-tests were applied to categorical and continuous data, respectively, to assess the differences between the groups. In SPSS 26, P&lt;0.05 was regarded to indicate significant connections. Results: In our study, 38.0% of participants were between56 and 60 years of age. The majority of the individuals (51.9%) were illiterate. 37.7% of respondents reported having six or more children. 3.6% of the sample smoked or chewed tobacco. 61.0 percent of individuals had menopause after the age of 45, and 48.8% of subjects had experienced menopause for more than ten years at the time of enrollment in the research. 83.5% of postmenopausal women were affected by osteoporotic fractures (osteoporosis: 40.0% and osteopenia: 43.5%). The incidence of osteoporosis rose as parity and abortion rates increased. The prevalence of osteoporosis was greater (P&lt; 0.05) among those with a familial history of osteoporosis-related symptoms and fragility fracture, as well as a personal history of fragility fracture. Conclusion: Given the significant prevalence of primary osteoporosis and poor bone density in postmenopausal women, health education is essential for minimizing modifiable risk factors and mitigating the disease's consequences. Central Medical College Journal Vol 7 No 1 January 2023 Page: 32-40

A brief measure of non-drug reinforcement: Association with treatment outcomes during initial substance use recovery

BackgroundTranslational research demonstrates that drug use is inversely associated with availability and engagement with meaningful non-drug reinforcers. Evaluation of non-drug reinforcement in treatment-receiving clinical populations is limited, likely owing to the time intensive nature of existing measures. This study explores the association of non-drug reinforcers with treatment outcomes using a novel, brief measure of past month non-drug reinforcement quantifying three elements: relative frequency, access, and enjoyability. MethodsRespondents enrolled in substance use treatment (residential, intensive outpatient, and medically managed withdrawal) in clinics across the United States (N = 5481) completed standardized assessments of non-drug reinforcement and treatment outcomes (i.e., return to use and life satisfaction) one-month after treatment discharge. Non-drug reinforcement measures (availability, engagement, enjoyability) were used as predictors of return to use and life satisfaction using generalized linear models. ResultsNon-drug reinforcement indices were associated with return to use and life satisfaction in unadjusted models (e.g., 12.4 % versus 58.3 % return to use for those with the highest and lowest availability, respectively). Consistent results were observed in models adjusted for sociodemographic variables and risk factors (i.e., sleep disturbance, anhedonia, stress). Comparisons by drug class generally showed lower non-drug reinforcement among patients reporting heroin or methamphetamine as their primary drug. ConclusionsResults highlight the importance of non-drug reinforcement during the first month following treatment. Rapid measurement of non-drug reinforcement in stepped care settings may illuminate critical deficits in early stages of behavior change, identify those at greatest risk for return to use, and provide targets for treatment to improve recovery trajectories.

Sexual harassment exposure among junior high school students in Norway: prevalence and associated factors.

Sexual harassment is common in most countries and cultures. Less is known about sexual harassment, its risk factors, and psychosocial outcomes among young adolescents. The aim of the study was to examine the 12-month prevalence of sexual harassment exposure, and sociodemographic and psychosocial factors associated with exposure among junior high school students in Norway. A comprehensive cross-sectional study was completed by 83,297 Norwegian adolescents in junior high school in 2021. Data on exposure to sexual harassment were used in combination with sociodemographic measures and psychosocial outcomes: depressive symptoms, loneliness, self-esteem, and well-being. Group differences were analyzed with Chi Square tests, and sociodemographic risk factors were analyzed with logistic regression. Psychosocial outcomes were assessed with multivariate and univariate ANOVAs, and dose-response relationships were assessed with linear regression. Among the adolescents, 32.6% had experienced sexual harassment during the past year. Girls had higher odds of exposure (OR: 1.90, 95% CI: 1.84-1.96), whereas adolescents whose parents had higher education had lower odds (OR: 0.95, 95% CI: 0.90-0.99). Exposure was associated with higher levels of depressive symptoms (partial η2 [ES] = 0.11) and loneliness (ES = 0.07), and with lower self-esteem (ES = 0.06) and well-being (ES = 0.06). Among exposed adolescents, more frequent exposure was associated with poorer outcomes. Exposure to sexual harassment affects one third of junior high school students in Norway. Those who are exposed have poorer psychosocial outcomes, and there is a dose-response relationship between exposure and outcomes. Awareness of sexual harassment among young adolescents, and interventions to prevent and reduce it, are needed.

Early Home Visits and Health Outcomes in Low-Income Mothers and Offspring

Individuals with low income may have heightened rates of obesity and hypertension. To determine whether prenatal and infancy home visitation by nurses reduces maternal and offspring obesity and hypertension. This randomized clinical trial of prenatal and infancy nurse home visitation in a public health care system in Memphis, Tennessee, enrolled 742 women with no previous live births and at least 2 sociodemographic risk factors (unmarried, <12 years of education, unemployed) from June 1, 1990, through August 31, 1991. At registration during pregnancy, 727 mothers (98%) were unmarried, and 631 (85%) lived below the federal poverty level. At offspring ages 12 and 18 years, maternal and offspring obesity and hypertension were assessed by staff masked to treatment. The data analysis was performed from July 1, 2021, to October 31, 2023. Women assigned to the control group received free transportation for prenatal care and child developmental screening and referral at child ages 6, 12, and 24 months. Women assigned to nurse visitation received transportation and screening plus prenatal and infant and toddler nurse home visits. Obesity and hypertension among mothers and their offspring at child ages 12 and 18 years, although not hypothesized in the original trial design, were analyzed using post-double selection lasso method. Of the 742 participants randomized (mean [SD] age, 18.1 [3.2] years), interviews were completed with 594 mothers and 578 offspring at child age 12 years and 618 mothers and 629 offspring at child age 18 years. Obesity was assessed for 576 offspring at age 12 years and 605 at age 18 years and for 563 and 598 mothers at child ages 12 and 18 years, respectively. Blood pressure was assessed for 568 offspring aged 12 years and 596 aged 18 years and 507 and 592 mothers at child ages 12 and 18 years, respectively. There were no overall treatment-control differences in offspring obesity or hypertension at ages 12 and 18 years combined, although nurse-visited female offspring, compared with controls, had a lower prevalence of obesity (adjusted relative risk [ARR], 0.449; 95% CI, 0.234-0.858; P = .003) and severe obesity (ARR, 0.185; 95% CI, 0.046-0.748; P < .001). There were reductions at ages 12 and 18 years combined for stage 1 and stage 2 hypertension for nurse-visited vs control group mothers, with differences limited to mothers of females (stage 1: ARR, 0.613 [95% CI, 0.440-0.855; P = .001]; stage 2: ARR, 0.217 [95% CI, 0.081-0.582; P < .001]). For both obesity and hypertension outcomes, there was no intervention effect among male offspring or the mothers of males. Self-reported maternal health aligned with program effects on hypertension. In this clinical trial follow-up at offspring ages 12 and 18, nurse-visited female offspring had lower rates of obesity and mothers of females had lower rates of hypertension than control-group counterparts. These findings suggest that risks for chronic disease among mothers of females and their female offspring who live in extreme poverty may be prevented with prenatal and infant and toddler home visitations by nurses. ClinicalTrials.gov Identifier: NCT00708695.

Socio-economic Correlates of Intestinal Helminthiasis Infestation in Children with Human Immunodeficiency Virus Presenting in the University of Nigeria Teaching Hospital, Ituku-ozalla, Enugu

Background: Children infected with Human Immunodeficiency virus (HIV) may be more prone to helminthic infestation and this may be modified by their socio-demographic and hygiene-related variables. Objectives: This study was aimed at eliciting the various socioeconomic correlates that affect helminth infections among children with HIV and comparing it with their normal counterparts who had no HIV. Methods: A cross-sectional study where a total of 140 subjects including 70 HIV-infected children and 70 children without HIV infection. They were consecutively recruited from the Paediatric HIV clinic and matched for age and sex with. Results: Socio-economic class, area of residence, hygienic practices such as method of feacal disposal, hand washing practices and footwear practices were significantly associated with helminthic infestation at the bivariate level of analysis (p &lt; 0.05). Using bivariate analysis, of the independent variables that were significant at the bivariate analysis, only lower socioeconomic class was an independent predictor of helminthic infestation (AOR = 6.403, 95% CI: 1.303 to 31.469) Conclusion: Socio-demographic and hygiene-related risk factors are similar in HIV-positive and negative children. However, lower socioeconomic status is an independent predictor of helminthic intestinal infestation after controlling for potential confounders such as age and gender.

Development and validation of a structured questionnaire for assessing risk factors of medication non-adherence among pulmonary tuberculosis patients in Indonesia.

Background: Medication non-adherence is a significant concern in tuberculosis (TB) treatment, requiring a precise understanding of the associated risk factors. However, there is a lack of appropriate means to assess the risk factors among TB patients in Indonesia, leading to the development and validation of a structured questionnaire for this purpose. Method: This study unfolded in two distinct phases, namely, the first included questionnaire construction through framework development, item generation, item screening, and pretesting (in 50 patients). The second comprised questionnaire validation with 346 participants using confirmatory factor analysis (CFA) and structural equation modeling-partial least squares (SEM-PLS). Additionally, reliability testing was conducted using Cronbach's alpha and composite reliability statistical techniques. Results: In the development phase, 168 items were defined, consisting of sociodemographic characteristics (8 items) and risk factors for medication non-adherence (160 items). Expert evaluation reduced the number of items to 60, which decreased to 22 after performing a pilot study. Subsequent SEM-PLS modeling resulted in the identification of 14 valid items, representing five major risk factors, namely, socioeconomics (4 items), healthcare team (4 items), condition (3 items), therapy (2 items), and patient (1 item). Only condition-related factors were found to influence non-adherence, and all constructs showed good reliability based on Cronbach's alpha (>0.6) and composite reliability (0.7) values. Conclusion: The final 22 items that emerged from this rigorous process indicated a valid and robust questionnaire for assessing risk factors of medication non-adherence among pulmonary tuberculosis patients in Indonesia. The developed questionnaire was positioned to be a valuable tool for healthcare professionals, policymakers, and scientists in creating patient-centered strategies and interventions to address non-adherence.

Attachment styles, mental health, and trauma during the first wave of COVID-19 pandemic in an Italian adult population.

The COVID-19 pandemic has negatively impacted adults' mental health around the world. Various studies highlighted the role of sociodemographic risk factors, including age, gender, and level of education, in increasing this impact. Although insecure attachment styles are considered a vulnerability factor for psychopathology and difficulties in coping with stressful situations, few studies have examined the role of attachment styles in relation to psychological responses to the COVID-19 pandemic. This study aims to investigate the role of attachment styles in affecting psychopathological problems and post-traumatic symptoms during the COVID-19 pandemic in a sample of Italian adults (N=1548). During the first lockdown in Italy, the Attachment Style Questionnaire, the Impact of Event Scale-Revised, and Symptom Checklist 90-Revised were administered to the participants to assess attachment styles, trauma-related symptoms, and psychopathological problems. The results showed that 41% of the participants had symptoms of clinical and subclinical relevance during the pandemic. Anxious and avoidant insecure attachment styles predicted psychopathological problems and post-traumatic symptoms, whereas secure attachment style was a protective factor. Our results highlighted the significant role played by the quality of attachment styles on adult mental health during the pandemic, providing valuable elements for targeted psychological support interventions.

Hypertension among persons living with HIV/AIDS and its association with HIV-related health factors

BackgroundHuman Immunodeficiency Virus (HIV) infection remains a public health concern in many countries. The increased life expectancy in the post-Antiretroviral Therapy (ART) era has led to an increased risk of cardiovascular disease and death among Persons Living with HIV (PLHIV). Hypertension remains a significant risk factor for cardiovascular disease among PLHIV. Some studies have suggested associations between hypertension among PLHIV and HIV-related health factors.ObjectiveTo determine the prevalence of hypertension among PLHIV on antiretroviral medications and examine its association with HIV-related health factors.MethodsA cross-sectional study was conducted among attendants at an adult HIV clinic. 362 study participants were selected by systematic sampling. Data on hypertension diagnosis, HIV-related health factors, sociodemographic and other traditional cardiovascular risk factors were collected using a standardized questionnaire and patient chart review. Multivariate logistic regression model was used to determine the association between hypertension and HIV-related factors, adjusting for other risk factors for hypertension.ResultsThe mean age of participants was 47.9 years and majority of participants were female (77.1%). 42% of study participants had been on antiretroviral medications for > 10 years. The prevalence of hypertension was 17.4%. Age > 50 years was associated with higher odds of hypertension (aOR: 3.75, 95%CI 1.68, 8.55, p-value: 0.002). BMI in overweight and obese categories, and a history of comorbid medical conditions (diabetes, hyperlipidemia) were also associated with higher odds of hypertension (aOR: 3. 76, 95%CI 1.44, 9.81, p-value: 0.007), (aOR: 3.17, 95%CI 1.21, 8.32, p-value: 0.019) and (aOR: 14.25, 95%CI 7.41, 27.41, p-value: < 0.001) respectively. No HIV-related health factors were associated with hypertension.ConclusionHypertension was a common condition among PLHIV on antiretroviral medications. No HIV-related health factors were associated with hypertension. Traditional risk factors associated with hypertension were increased age > 50 years, increased BMI, and a history of comorbid medical conditions.

Postpartum depression among primigravida mothers in Kabul, Afghanistan

Introduction: Postpartum depression (PPD) is a prevalent mental health issue affecting women post-childbirth, particularly primigravida mothers. This study aims to explore the prevalence and risk factors of PPD among primigravida mothers in Kabul, Afghanistan, a low- and middle-income country with limited research on PPD among primigravida mothers. Materials and Methods: A descriptive cross-sectional study design was employed, and data were collected from 200 primigravida mothers who gave birth in Rabia Balkhi and Malalai Hospitals in Kabul. A structured questionnaire was utilized to gather data on socio-demographic characteristics, PPD symptoms, and risk factors, which were analyzed using descriptive statistics and SPSS. Results: The study findings revealed that 42.5% of the primigravida mothers in Kabul experienced symptoms of PPD according to EPDS scores. This prevalence rate was higher than global estimates and previous studies in high-income countries. Risk factors associated with PPD among primigravida mothers in Kabul included a history of depression or mental health problems (55.5%), job loss or financial difficulties (74.5%), trauma related to natural disasters or war (63%), experiences of physical or verbal abuse (34.5%), lack of social support or feelings of isolation (23%), and difficulties adjusting to motherhood (48.5%). Conclusion: The study highlights the prevalence and risk factors of Postpartum Depression among primigravida mothers in Kabul, Afghanistan, emphasizing the need for interventions to support new mothers' mental health, including prioritizing screening, providing targeted support, and addressing socioeconomic and environmental challenges, through investment in mental health services and public health campaigns.

Seroincidence of SARS-CoV-2 infection prior to and during the rollout of vaccines in a community-based prospective cohort of U.S. adults

This study used repeat serologic testing to estimate infection rates and risk factors in two overlapping cohorts of SARS-CoV-2 N protein seronegative U.S. adults. One mostly unvaccinated sub-cohort was tracked from April 2020 to March 2021 (pre-vaccine/wild-type era, n = 3421), and the other, mostly vaccinated cohort, from March 2021 to June 2022 (vaccine/variant era, n = 2735). Vaccine uptake was 0.53% and 91.3% in the pre-vaccine and vaccine/variant cohorts, respectively. Corresponding seroconversion rates were 9.6 and 25.7 per 100 person-years. In both cohorts, sociodemographic and epidemiologic risk factors for infection were similar, though new risk factors emerged in the vaccine/variant era, such as having a child in the household. Despite higher incidence rates in the vaccine/variant cohort, vaccine boosters, masking, and social distancing were associated with substantially reduced infection risk, even through major variant surges.

Urban-rural differences in seasonal malaria chemoprevention coverage and characteristics of target populations in nine states of Nigeria: a comparative cross-sectional study.

Differences between urban and rural contexts in terms of sociodemographic characteristics, geographical features and risk perceptions may lead to disparities in coverage and related outcomes of community-based preventive interventions, such as seasonal malaria chemoprevention (SMC). This study investigated urban-rural differences in SMC coverage and other programme outcomes, as well as child and caregiver characteristics of target populations in nine implementing states in Nigeria during the 2022 SMC round. This is a comparative cross-sectional study based on comprehensive end-of-round household surveys conducted in nine states where SMC was delivered in Nigeria in 2022. Data of 11,880 caregiver-child pairs were included in the analysis. Rural-urban differences in SMC outcomes and child and caregiver characteristics were assessed, first by using Pearsons' chi-square test for independence for categorical variables. Univariate multilevel mixed-effect logistic regression models, with random intercepts for cluster units, were used to quantify the strength of association between location and each SMC coverage and related outcomes. Significant urban-rural differences were observed in caregivers' sociodemographic characteristics, such as age, gender, level of education, occupation status and health-seeking behaviour for febrile childhood illnesses. Disparities were also seen in terms of SMC coverage and related outcomes, with lower odds of the receipt of Day 1 dose direct observation of the administration of Day 1 dose by community distributors, receipt of the full three-day course of SMC medicines and receipt of SMC in all cycles of the annual round among children residing in urban areas, compared with those residing in rural areas. Similarly, urban-dwelling caregivers had lower odds of being knowledgeable of SMC and believing in the protective effect of SMC than rural-dwelling caregivers. Findings highlight observable urban-rural disparities in SMC programme delivery and related outcomes, as well as target population characteristics, underscoring the need for context-specific strategies to ensure optimal delivery of SMC and improve programme implementation outcomes in urban settings.

Timing of sexual debut and associated sociodemographic and HIV risk factors among young people in Eswatini.

Young people in sub-Saharan Africa and specifically in Eswatini (previously Swaziland), continue to be disproportionately affected by HIV despite having equitable access to antiretroviral treatment. Early sexual debut is one of the many factors linked to HIV infection that is discussed in the context of general public health. Monitoring this behavior is essential for developing preventative, evidence-based interventions. This study aims to describe the early and/or typical sexual debut among young people in Eswatini and examines sociodemographic and HIV risk factors associated with early and typical sexual debut timing. We analyzed cross-sectional secondary data from the 2016/17 Swaziland HIV Incidence Measurement Survey (SHIMS), which had a representative sample of 2,383 young people aged 18-24. Respondents were selected using a two-stage stratified probability sampling design. We applied descriptive statistics and multivariable multinomial logistic regressions to examine the data. Out of the 2,383 respondents, 71.3% had sexual experience, with 4.1% and 26.5% reporting early sexual debut (<15 years) and typical sexual debut (<18 years), respectively. Our study found that age, sex, education, marital status, wealth, sexual partners in the past 12 months, and alcohol use were significantly associated with early and/or typical sexual debut. It is crucial to consider the sociodemographic factors and HIV risk factors of young people when designing programs and interventions aimed at preventing early sexual debut or transition. This approach is necessary to promote better sexual and reproductive health in alignment with sustainable development goals.

Supplemental Material for A Systematic Review and Bayesian Meta-Analysis of 30 Years of Stress Generation Research: Clinical, Psychological, and Sociodemographic Risk and Protective Factors for Prospective Negative Life Events

Supplemental Material for A Systematic Review and Bayesian Meta-Analysis of 30 Years of Stress Generation Research: Clinical, Psychological, and Sociodemographic Risk and Protective Factors for Prospective Negative Life Events