Stratified Prevalence Research Articles

Characteristics of men and women with medically diagnosed cluster headache in a national integrated healthcare system: A Veterans Health Administration cohort study.

Describe the epidemiology of cluster headache (CH) using Veterans Health Administration (VHA) Electronic Health Record (EHR) data. Epidemiologic studies of CH at the population level are difficult because it has a prevalence of ~0.1%. Hospital system-wide studies are an attractive alternative as they have large numbers of patients and broader populations than headache or neurology clinic-based studies. The VHA is an ideal hospital-based system in which to study CH because it is nationwide, predominantly male, has a strong focus on mood disorders and suicidality, and has accessible individual medical records. Here, we report the first headache study based on an ongoing longitudinal cohort of patients with CH using VHA EHR data. The VHA EHR data were accessed from Fiscal Year 2008 to 2019. Patients with CH consisted of all patients with at least one outpatient visit containing a CH diagnosis code from the International Classification of Diseases (ICD)-9 or -10. We extracted data on demographic features, incidence, and prevalence, as well as pain and psychiatric comorbidities. Of the 1,524,960 distinct patients who presented for headache treatment in the VHA between Fiscal Year 2008-2019, 24,131 had at least one visit with a CH diagnosis. The 1-year period prevalence of a CH diagnosis in the VHA ranges from 0.08% to 0.10% for women and 0.10% to 0.18% for men. A larger proportion of women versus men received a diagnosis of unspecified CH (59.6% [1412/2368] vs. 53.6% [11,663/21,763], p < 0.001). Most patients with CH had both comorbid headache and non-headache pain diagnoses. Headache not-otherwise-specified was the most common comorbid headache disorder at 70.0% (16,885/24,131) and was more common in women (76.1%, 1801/2368) compared to men (69.3%, 15,084/21,763). Other common comorbidities included migraine, depression, tobacco use, and obstructive sleep apnea. Rates of suicidal ideation or attempt were almost 50% higher in women (5-year proportion 9.4%, 222/2368) with CH compared to men (6.6%, 1433/21,763). To our knowledge this is the largest hospital system study of CH to date and reinforces several previous studies. Pain, mental health, and sleep disorders comorbidities are particularly prevalent in this group and were often more common in women compared to men with CH. Future work should examine gender and race stratified prevalence estimates within the VHA and other healthcare systems.

Prevalence and Incidence of Hepatitis E Infection in China

Background and aimsChina is an endemic area for HEV infection. Estimating the prevalence and incidence of HEV infection in China plays a pivotal role in informing public health policies to prevent and control hepatitis E. This study aimed to investigate the prevalence of anti-HEV IgG and incidence of HEV seroconversion in China. MethodsThis study was based on the Meinian health check-up database in China. Participants who underwent testing for anti-HEV IgG at check-up centers in 24 provinces between 2017 and 2022 were included. In the cross-sectional analyses, overall prevalence and stratified prevalence in subpopulations with various characteristics were estimated and standardized according to the 2020 census of the Chinese population. In the longitudinal analyses, the occurrence of anti-HEV IgG positivity during the follow-up was defined as an incident HEV seroconversion. Overall and stratified incidence rates were estimated and expressed as per 100 person-years. Poisson regression was used to explore risk factors associated with HEV seroconversion. Results85,238 and 11,154 participants were included in the cross-sectional and longitudinal analyses, respectively. The prevalence of anti-HEV IgG in the general population was 18.02%. During a median follow-up of 1.2 years, the incidence rate of HEV seroconversion was 1.79 per 100 person-years. Age ≥ 60 years, low socioeconomic status, living in coastal areas, living in areas with high drainage density, and living in areas with high anti-HEV IgG prevalence were independent risk factors for HEV seroconversion. ConclusionsOur findings would help inform policy making for hepatitis E prevention and control in China, as well as in other endemic regions of the world.

Abstract P344: Epidemiology and Burden of Patients Living With Overweight/Obesity and Established Atherosclerotic Cardiovascular Disease

Introduction: Obesity is a serious chronic, progressive metabolic disorder associated with increased morbidity and mortality. Compared with individuals of healthy weight, those living with overweight/obesity are at higher risk for atherosclerotic cardiovascular disease (ASCVD). Given the established relationship between obesity and ASCVD, individuals living with overweight/obesity and ASCVD may gain additional benefits by directly treating obesity. Hypothesis: We assessed the hypothesis that comorbidity burden is higher in adults living with overweight/obesity and ASCVD than in those without ASCVD. Methods: This was a retrospective real-world study using Optum Market Clarity, a linked electronic medical record and administrative health care claims data set. Adults living with overweight and ≥1 weight-related comorbidity or obesity were included. The point prevalence of ASCVD was described for the overall study period (1/1/2017 to 6/30/2021). Stratified prevalence analyses were conducted by age group (ie, ≤45 years, 45-64 years, and ≥65 years). Comorbidity burden was assessed as percentage of patients with weight-related comorbidities. Results: The study encompassed 4,773,152 patients eligible for prescription weight management treatment; 245,824 (5.3%) had been diagnosed with ASCVD. Over the study period of 2017-2021, with a median (Q1-Q3) follow-up time of 43.7 (29.0-57.2) months, peripheral arterial disease was the most prevalent (2.5%) ASCVD condition among these patients, followed by ischemic heart disease (2.2%) and ischemic or hemorrhagic stroke (1.3%). Yearly prevalence of peripheral arterial disease, ischemic heart disease, and ischemic or hemorrhagic stroke within the study period ranged from 2.3%-3.8%, 2.0%-3.2%, and 1.2%-1.8%, respectively. These patients, compared with those without ASCVD, had a mean age of 63.8 vs 49.4 years and mean BMI of 33.4 vs 34.7 kg/m 2 , and 52.7% vs 40.8% were male (all P &lt;.001). The prevalence of ASCVD increased with age: patients aged ≥65 years had an overall prevalence of 14.1%, with yearly prevalence ranging from 13.3%-18.8%, compared with 5.5% in patients aged 45 to 64 years, with yearly prevalence ranging from 5.2%-7.8%. Overall, patients with ASCVD had a higher comorbidity burden than patients without ASCVD, including type 2 diabetes (49.7% vs 17.6%), prediabetes (15.5% vs 9.0%), dyslipidemia (75.6% vs 30.4%), obstructive sleep apnea (22.3% vs 10.2%), and chronic kidney disease (21.1% vs 3.7%; all P &lt;.001). Conclusions: ASCVD is prevalent among people living with overweight/obesity, to a greater extent in older and male individuals. People living with ASCVD and overweight/obesity bear a substantially higher comorbidity burden compared with those without ASCVD. Further evidence is needed to support pharmacotherapy-based chronic weight management to lower the cardiovascular disease burden in this population.

Prevalence of and Risk Factors for Hyperuricemia in Urban Chinese Check-Up Population.

Background: The prevalence of hyperuricemia is increasing globally. The health check-up population is a group of people dedicated to disease prevention in public health. This study aims to estimate the current prevalence of hyperuricemia among the health check-up population in economically developed areas of China using a healthcare database. Method: Healthcare data from 48,988 subjects in 12 provinces of China who had an annual health check-up in 2021 were used. Hyperuricemia was defined as a serum urate level > 420 mmol/L and/or a history of physician-diagnosed gout. An alternative definition of serum urate level > 420 mmol/L in men and > 360 mmol/L in women was used. The stratified prevalence of hyperuricemia by sex, age, region, and comorbidity group was reported. The association between hyperuricemia and sex, age, region, and comorbidities was analyzed in the multivariate logistic regression model. Results: In 2021, the sex- and age-adjusted prevalence of hyperuricemia was 13.6% in the total population (24.3% in men and 2.6% in women) based on the definition of serum urate level > 420 mmol/L. Regional prevalence varied considerably across the country, with the highest prevalence found in Fujian and the lowest in Liaoning Province (21.6% vs. 7.3%). Male sex, aging, hypertension, obesity, abdominal obesity, hypertriglyceridemia, and hypercholesterolemia were likely to be associated with hyperuricemia. Conclusions: This is the largest study using a healthcare database to indicate the prevalence of hyperuricemia in a health check-up population in an economically developed area of China. The current prevalence among the Chinese health check-up population was substantial, with a higher prevalence in males and in the eastern region. Hyperuricemia and its comorbidities warrant greater attention in the developed areas of China.

Abstract 15290: Race Stratified Prevalence and Predictors of Major Adverse Cardiac and Cerebrovascular Events in a Nationwide Multicentric Elderly Cohort Hospitalized With Heart Failure With Preserved Ejection Fraction From 2016-2019

Background: Race-stratified predictors of adverse cardiovascular and cerebral events in heart failure with preserved ejection fraction (HFpEF) have never been described before. Methods: Using the National Inpatient Sample (2016-2019), we identified hospitalizations among elderly (&gt;=65 years) HFpEF patients using relevant ICD-10 codes. Prevalence and trends of MACCE events were identified across sex and race from 2016 to 2019. Logistic regression analysis was used to estimate predictors of MACCE events across different racial groups. P&lt;0.05 is considered significant. Results: Of 6,134,669 total elderly HFpEF, 21% (n=780,615, males=13.5%) had MACCE events during hospitalization. MACCE events showed an uptrend from 2016-2019 across both males, females (13.5% vs.12.2%) and all racial groups with most difference seen in Native Americans (10.7 to 14.8%) and the least in Whites (12.0% to 12.9%) (Fig. 1). After stratification by race, hypertension had the highest odds of predicting a significant MACCE event in Hispanics (OR 2.06), while diabetes in whites (OR 1.05). Paradoxically, hyperlipidemia was associated with significant lower odds of MACCE in whites (OR 0.94), blacks (OR 0.94), and hispanics (OR 0.93), and smoking in whites (OR 0.78), blacks (OR 0.72), hispanics (OR 0.77), and asians (OR 0.77) (Table 1). Conclusion: Cardiovascular events in elderly HFpEF patients increased over the past four years, with Native Americans being the most affected. Hypertension was found to be the strongest predictor in hispanics, whereas in whites it was diabetes. Future studies are warranted to investigate the predictors of MACCE in specific racial groups to curtail worse outcomes.

Prevalence and risk factors for high-risk human papillomavirus infection among women from three southern geopolitical zones of Nigeria.

Human Papillomavirus (HPV) infection is a risk factor for cervical cancer, the fourth most common cancer among women globally. Its burden is the highest in sub-Saharan Africa, with over 90% mortality. Interventions may fail without evidence-based data on stratified prevalence and risk factors among most at-risk women across Nigeria. A cross-sectional comparative study, with participants recruited from the Nigerian Institute of Medical Research's Clinics, NGO outreaches, a cancer screening centre and a university teaching hospital. Questionnaires were self-administered. Trained medics performed sampling at healthcare facilities, and self-sampling was used at outreaches. Nine hundred eighty-five study participants were recruited. About 37% and 27% of the women knew about HPV and its vaccines, respectively, but only 6% confirmed vaccination with HPV vaccines. HPV prevalence was highest among women with unknown marital status (35.9%), single women (33.8%), widowed/divorced/separated women (30.3%), and married/cohabiting women (19.6%). HPV infection was significantly higher among women who take alcohol (odds=1.7 [95% CI: 1.2-2.4]) and women who smoke (odds=2.6 [95% CI: 1.4 - 4.6]. HPV strains detected included HPV16 (1.3%), HPV18 (1.5%), Low Risk (0.2%) and Other High-Risk groups (19.7%). The inverse relationship between prevalence and education suggests interventions improving awareness and prevention would be impactful. Such interventions could also target HIV-positive women, women presenting with sexually-transmitted infections, who smoke and frequently drink alcohol.

Sex-specific prevalence and risk factors of metabolic-associated fatty liver disease among 75,570 individuals in eastern China.

Metabolic-associated fatty liver disease (MAFLD) is a newly proposed definition and there is limited data on MAFLD prevalence. We aimed to investigate the prevalence of MAFLD in an eastern Chinese population. This cross-sectional study included participants from an eastern Chinese population who underwent regular health checkups. Based on current diagnostic criteria, MAFLD was diagnosed in individuals with both hepatic steatosis and metabolic disorders. The overall and stratified prevalence derived based on sex, age, body mass index (BMI), and various metabolic disorders were estimated. Multivariate logistic regression analysis was used to determine the risk factors for MAFLD. Among the 75,570 participants, the overall prevalence of MAFLD was 37.32%, with higher rates in men (45.66%) than in women (23.91%). MAFLD prevalence was highest in men aged 40-49 years (52.21%) and women aged 70-79 years (44.77%). In all the BMI subgroups, the prevalence was higher in men than in women. In both sexes, the prevalence of MAFLD increased as BMI levels increased. Furthermore, MAFLD was associated with metabolic disorders, especially in the female participants with severe obesity (odds ratio 58.318; 95% confidence interval: 46.978-72.397). MAFLD is prevalent in the general adult population in eastern China. Sex-specific differences in MAFLD prevalence were identified based on age, BMI, and metabolic disorders. MAFLD is associated with metabolic disorders, particularly obesity.

Explaining declining hip fracture rates in Norway: a population-based modelling study.

Although age-standardised hip fracture incidence has declined in many countries during recent decades, the number of fractures is forecast to increase as the population ages. Understanding the drivers behind this decline is essential to inform policy for targeted preventive measures. We aimed to quantify how much of this decline could be explained by temporal trends in major risk factors and osteoporosis treatment. We developed a new modelling approach, Hip-IMPACT, based on the validated IMPACT coronary heart disease models. The model applied sex- and age stratified hip fracture numbers and prevalence of pharmacologic treatments and risk/preventive factors in 1999 and 2019, and best available evidence for independent relative risks of hip fracture associated with each treatment and risk/preventive factor. Hip-IMPACT explained 91% (2500/2756) of the declining hip fracture rates during 1999-2019. Two-thirds of the total decline was attributed to changes in risk/preventive factors and one-fifth to osteoporosis medication. Increased prevalence of total hip replacements explained 474/2756 (17%), increased body mass index 698/2756 (25%), and increased physical activity 434/2756 (16%). Reduced smoking explained 293/2756 (11%), and reduced benzodiazepine use explained (366/2756) 13%. Increased uptake of alendronate, zoledronic acid, and denosumab explained 307/2756 (11%), 104/2756 (4%) and 161/2756 (6%), respectively. The explained decline was partially offset by increased prevalence of type 2 diabetes and users of glucocorticoids, z-drugs, and opioids. Two-thirds of the decline in hip fractures from 1999 to 2019 was attributed to reductions in major risk factors and approximately one-fifth to osteoporosis medication. The Research Council of Norway.

Prevalence of Liver Steatosis and Fibrosis in the General Population and Various High-Risk Populations: A Nationwide Study With 5.7 Million Adults in China

This study aimed to estimate the prevalence of liver steatosis and fibrosis in the general population and populations with potential risk factors in China, so as to inform policies for the screening and management of fatty liver disease and liver fibrosis in general and high-risk populations. This cross-sectional, population-based, nationwide study was based on the database of the largest health check-up chain in China. Adults from 30 provinces who underwent a check-up between 2017 and 2022 were included. Steatosis and fibrosis were assessed and graded by transient elastography. Overall and stratified prevalence was estimated among the general population and various subpopulations with demographic, cardiovascular, and chronic liver disease risk factors. A mixed effect regression model was used to examine predictors independently associated with steatosis and fibrosis. In 5,757,335 participants, the prevalence of steatosis, severe steatosis, advanced fibrosis, and cirrhosis was 44.39%, 10.57%, 2.85%, and 0.87%, respectively. Participants who were male, with obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome, or elevated alanine aminotransferase or aspartate aminotransferase had a significantly higher prevalence of all grades of steatosis and fibrosis, and those with fatty liver, decreased albumin or platelet count, and hepatitis B virus infection also had a significantly higher prevalence of fibrosis than their healthy counterparts. Most cardiovascular and chronic liver disease risk factors were independent predictors for steatosis and fibrosis, except for dyslipidemia for fibrosis. Asubstantial burden of liver steatosis and fibrosis was found in China. Our study provides evidence for shaping future pathways for screening and risk stratification of liver steatosis and fibrosis in the general population. The findings of this study highlight that fatty liver and liver fibrosis should be included in disease management programs as targets for screening and regular monitoring in high-risk populations, especially in those with diabetes.

Suicidal ideation, plan and attempt among adolescents in Houston Texas: a trend and cross-sectional analysis of the youth risk behavior survey 2011-2019 in the United States.

We evaluated the trends in the prevalence of suicidal ideation, plan, and attempts among adolescents in Houston, Texas, USA, from 2011 to 2019. Furthermore, we assessed the risk factors associated with suicidal ideation, plan, and attempt among adolescents in Houston in 2019. A cross-sectional analysis of Houston district's Youth Risk Behavior Survey (YRBS) from 2011 to 2019. It included 11,178 adolescents aged 11-15 years in Houston middle schools. The overall and stratified (by gender, race, and ethnicity) prevalence rates were evaluated between 2011and 2019. Factors associated with suicidal ideation, plan, and attempts in 2019 were assessed using multiple logistic regression. Suicidal ideation among adolescents increased by 2.74 % from 23.14 % in 2011-25.88 % in 2019. In 2019, we observed a 4.40 % increase in the prevalence of suicidal ideation from 2017 (21.48 %). The prevalence of suicidal plan increased by 3.76 % in 2019 (17.69 %) from 2011 (13.93 %) and by 3.99 % from 2017 (13.70 %). Suicide attempts among adolescents in Houston fluctuated from 2011 to 2019. However, there was a 1.19 % increase in prevalence in 2019 (11.62 %) compared to 2017 (10.43 %). Suicidal ideation, plan, and attempt were significantly associated with being female, Black, or African American, having ever carried a weapon, being bullied on school property, being bullied online, having ever had a cigarette, having ever had alcohol, having taken cocaine, and having used prescription pain medicine illegally/inappropriately. This study found increasing rates of suicide ideation, plan, and attempts among Houston adolescents in middle schools between 2011 and 2019.

Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): study protocol for a population-representative cross-sectional serosurvey

IntroductionHistoric disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks...

Comparison of the prevalence of opioid use among U.S. adults with cardiac conditions before and during the COVID-19 pandemic.

Limited data are available on the prevalence of prescription opioid use among patients with cardiac conditions who were exposed to increased risks of cardiac events including myocardial failure and cardiac arrest. According to the U.S. National Health Interview Survey, we evaluated the prevalence of opioid use in patients with cardiac conditions who reported prescription opioid use in the past 12 months and 3 months in 2019 and 2020, respectively, and further estimated the prevalence of opioid use for acute pain or chronic pain. We also analyzed the stratified prevalence by demographical characteristics. Our results showed that there was no statistically significant change in the prevalence of opioid use in the past 12 months (26.5% in 2019 vs. 25.7% in 2020) or the past 3 months (66.6% in 2019 vs. 62.5% in 2020) before and during the COVID-19 pandemic. However, there was a significant decline in the prevalence of opioid use for acute pain, from 64.2% (95% confidence interval [CI] 57.6% to 70.3%) in 2019 to 49.6% (95% CI 40.1% to 59.0%) in 2020 (P = 0.012), particularly in the subgroups of men, non-Hispanic white people, adults with education below high school, those with an income-to-poverty ratio ranging from 1.0 to 1.9, and those covered with health insurance. Our findings suggest that monitoring opioid use in the era of living with COVID-19 is important, which will help inform healthcare providers to develop care strategies to reduce health loss for vulnerable individuals.

Prevalence of and risk factors for chronic kidney disease in ten metropolitan areas of China: a cross-sectional study using three kidney damage markers

Introduction To estimate the up-to-date prevalence of chronic kidney disease among the health check-up population in economically developed areas of China using estimated glomerular filtration rate, urinary albumin creatinine ratio, and kidney ultrasound. Methods Healthcare data from 38,093 subjects in 10 megalopolises of China who had an annual health check-up in 2021 were used. The overall and stratified prevalence of chronic kidney disease by sex, age, region and comorbidity group was reported. The association between chronic kidney disease and covariates of demographics, and comorbidities were analyzed in the multivariable-adjusted logistic regression model. Results A total of 3837 CKD cases were detected meeting any of the three CKD diagnostic criteria, with a crude prevalence of 10.1% in the study population. Using one criterion of decreased glomerular filtration rate, albuminuria and kidney structural abnormalities alone detected 204 (5.3%), 3289 (85.7%) and 563 (14.7%) cases, respectively. The addition of kidney ultrasound detected 427 (11.1%) structural abnormality cases without decreased GFR and albuminuria. The most common abnormalities were renal masses, hydronephrosis due to obstruction and congenital anomalies of kidney and urinary tract. Female, older age, low city-tier, hypertension, diabetes, obesity, hypertriglyceridemia as well as early disease stages such as pre-hypertension, impaired fasting glucose and overweight were significantly associated with chronic kidney disease. Conclusion Kidney ultrasound helps to amplify the detection of CKD patients, which is a supplement to kidney function and urine protein.

Trend of metabolic risk factors among the population aged 25-64 years for non-communicable diseases over time in Vietnam: A time series analysis using national STEPs survey data.

The study aims to examine the trends of 4 metabolic NCDs risk factors including raised blood pressure, increased blood glucose, elevated blood lipids and overweight/obesity over the last 10 years in Vietnam as well as examine these trends among different sub-population by geographical area, gender, and age groups. The study combined the national representative data from three rounds of STEPs survey in Vietnam conducted in 2010, 2015, and 2020 on people aged 25-64 years. The overall prevalence of each metabolic factor together with 95% CI for each time point as well as the stratified prevalence by rural/urban, male/female, and 4 separated age groups were calculated and considered the sampling weight. Cochran-Armitage test for trend was used to test for the differences in the prevalence over time. The prevalence of hypertension, overweight/obesity, hyperglycemia, and hyperlipidemia among the population aged 25-64 years old was 28.3, 20.57, 6.96, and 15.63%, respectively in the year 2020. All NCD metabolic risk factors examined in this analysis show significantly increasing trends over time. For most age groups, the increasing burden of NCD metabolic risk factors was more significant during the period 2015-2020 compared to the period 2010-2015. Male population and population aged 55-64 experienced the most dramatic changes in the burden of all NCD metabolic risk factors. To reverse the increasing trend of NCD metabolic factors in Vietnam, intervention, and policy need to apply a comprehensive life course approach.

Gender and rural-urban differences in hypertension among youth in India: Insights from a large scale survey, 2015-16.

Hypertension is considered one of the most persistent public health issues and the single largest contributor to avoidable morbidity and mortality in India. This study aims to investigate the prevalence and risk factors of hypertension in youths (15-29 years) by gender and rural-urban place of residence. Data from the fourth round of the National Family and Health Survey - 2015-16 (n = 395,207) was utilised for the study. After estimation of the stratified prevalence of hypertension by various characteristics, multivariable logistic regression analysis was conducted to assess the correlates of hypertension. The results revealed that the prevalence of hypertension in youths at the national level varied from 9.16% (Meghalaya) to 3.34% (Delhi). The stratified analysis suggests pronounced gender differences in the prevalence of hypertension among youth with insignificant rural-urban differences, although the prevalence was higher in urban areas. Overall, the prevalence of hypertension was found higher for male youths living in urban areas (7.82%) and females in rural areas (5.08%). Concurrently, results from regression analysis also suggest higher odds of hypertension for males residing in urban areas for a variety of demographic, socioeconomic, and health-risk factors. Advancing age, having no education, living in the northeast region, being overweight/obese and high blood glucose level was significantly associated with a greater likelihood of hypertension for both the gender and place of residence. Public health awareness regarding blood pressure needs to be tailored differently for both males and females considering the place of residence. The study suggests that more research should focus on blood pressure/hypertension among children, adolescents and youth since they point towards adult blood pressure patterns.

Abstract MP23: Does Predictors Of Overweight/obesity Among Women Vary Based On The Residential Setting? A Multilevel Analysis Of Repeated Cross-sectional Data In Nigeria

Background: Overweight/obesity is increasingly becoming a major public health problem in Nigeria despite the persistence of underweight burden. A major contributor of this is the urban sprawl experienced in the country with approximately half of the Nigerian population living in urban areas. Evidence suggests that similar socio-demographic factors could have different influences on an individual’s nutrition status by virtue of their residential setting. Yet, little is known about this phenomenon in the Nigerian context. Objectives: This study aimed to explore the following objectives: 1) to determine whether the anticipated increase in overweight/obesity prevalence is subsequently paralleled by substantial decrease in undernutrition in the last decade; and 2) to examine both the individual and household predictors’ overweight/obesity among women of reproductive age in rural and urban Nigeria. Methods: We used data acquired from the 2008, 2013 and 2018 Nigeria Demographic and Health Surveys (DHS). Our outcome was defined using standard Body Mass Index (BMI) categories calculated from height and weight measurements of the study participants. The national and stratified (urban/rural) prevalence estimates of underweight (BMI &lt;18.5 Kg/m 2 ), overweight (BMI 25 - 29.9 Kg/m 2 ), and obese (BMI ≥ 30 Kg/m 2 ) were computed for each survey. Afterwards, the underweight subjects were excluded from the study. Two-level (individual and household) logistic regression models were applied to examine the influence of individual and household characteristics on women’s overweight/obese status. Results: Findings show a steady increase in both the prevalence of overweight and obesity from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, respectively, while underweight prevalence was averagely 12% across each survey. Regardless of the residential setting, age, marital status, education, occupation, household wealth and survey year were consistently associated with increased risk of overweight/obesity, whereas breastfeeding showed a protective association with overweight/obesity. Having multiple children and living in female-headed homes were unique risk factors for overweight/obesity among urban women while ethnicity, media exposure and state of residence were unique risk factors for overweight/obesity among rural women. Conclusion: Public health interventions aimed at lowering the risk of overweight/obesity should embrace the differences in risk factors that exists between rural and urban dwellers.

Gender Differences in Outpatient Peripheral Artery Disease Management in Germany: A Population Based Study 2009–2018

Peripheral artery disease (PAD) is a major risk factor for morbidity and death. Despite clear guideline recommendations regarding outpatient treatment and pharmacotherapy, implementation is inadequate. Gender differences are becoming increasingly important, especially in patients with atherosclerosis. Gender stratified PAD prevalence and differences in treatment by specialised outpatient care and pharmacotherapy were analysed in 70.1 million statutorily insured patients/year in Germany between 2009 and 2018. This was based on claims data according to §295 of the social code (SGB V) and drug prescription data according to §300 SGB V. Diagnosis of PAD was defined according to ICD I70.2-9 coding. Statistical analysis was performed with the chi square test for trend and two way ANOVA. In total, 17 633 970 patients with PAD were identified, of whom 47% were female. Prevalence of PAD in Germany increased between 2009 and 2018 and was higher in male patients. Only a minority of 37.1% presented to a vascular specialist. Interestingly, female patients were both less likely to present to a vascular specialist and to receive guideline recommended pharmacotherapy. Overall prescription rates of statins and antiplatelet drugs increased between 2009 and 2018, however. PAD stages were stratified by intermittent claudication (IC) and chronic limb threatening ischaemia (CLTI). In CLTI even fewer patients received a statin, with the gender gap increasing. The results demonstrate gender based differences in pharmacotherapy and specialised outpatient care of patients with PAD. While overall outpatient treatment by vascular specialists and guideline recommended medical therapy of PAD are low, women and patients with CLTI remain undertreated.

IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021

AimsTo provide up-to-date estimates of undiagnosed diabetes mellitus (UDM) prevalence - both globally, and by region/country, for the year 2021. MethodsData sources reporting diabetes prevalence were identified through a systematic search in the peer-reviewed and grey literature. The prevalence of undiagnosed diabetes was estimated from the data from each country where data was available. For countries without in-country data, the prevalence of undiagnosed diabetes was approximated by extrapolating the average of the estimates from countries with data sources within the same International Diabetes Federation (IDF) region and World Bank income grouping. We then applied these stratified prevalence estimates of UDM from each country to the number of adults in each strata and summed the counts to generate the number of adults with UDM (aged 20–79 years) for 215 countries and territories. ResultsIn 2021, almost one in two adults (20–79 years old) with diabetes were unaware of their diabetes status (44.7%; 239.7 million). The highest proportions of undiagnosed diabetes (53.6%) were found in the Africa, Western Pacific (52.8%) and South-East Asia regions (51.3%), respectively. The lowest proportion of undiagnosed diabetes was observed in North America and the Caribbean (24.2%). ConclusionsDiabetes surveillance needs to be strengthened to reduce the prevalence of UDM, particularly in low- and middle-income countries.

HPV Genotype Specific and Age Stratified Immediate Prevalence of Cervical Precancers and Cancers in Women with NILM/hrHPV+: A Single Center Retrospective Study of 26,228 Cases.

PurposeTo investigate the prevalence of precancers [high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS)] and cancers [squamous cell carcinoma (SCC) and adenocarcinoma (ADC)] in various high-risk human papillomavirus (hrHPV) genotypes or age groups among women with negative for intraepithelial lesion or malignancy (NILM) and hrHPV-positive pap results.Materials and MethodsIn total, 26,228 women with NILM/hrHPV+ were included in the study. Among them, 5893 had immediate follow-up biopsy results available and were selected for further prevalence analysis.ResultsAbout 7.6% and 0.7% women with NILM/hrHPV+ had HSIL and AIS, respectively. The prevalence of HSIL+ squamous lesions is significantly higher in HPV-16+ group than that in other genotype groups (p < 0.0001). The prevalence of AIS+ glandular lesions is significantly higher in HPV-18/45+ groups than women in other genotype groups (p < 0.0001). In addition, the prevalence of HSIL+ lesions was significantly higher in age 25–39 years group than that in age 40–65 years group and >65 years group (p < 0.0001). Overall, the prevalence of HSIL+ in younger women was significantly higher than that in older women when using a cutoff age of 40 years (9.3% vs 5.9%, p < 0.0001) or 50 years (8.6% vs 4.9%, p < 0.0001). No significant difference in AIS+ prevalence was found among different age groups (p = 0.611). Interestingly, the prevalence of SCC and ADC in older women (≥40 years, 0.3% and 0.3%, respectively) was significantly higher than that in younger women (<40 years, 0% and 0.07%) (p = 0.001 for SCC; p = 0.02 for ADC).ConclusionThe significant risk of cervical precancers and cancers still exists in women with NILM/hrHPV+, notably the older patient group had a lower risk of cervical precancer, but higher risk of cancer. Therefore, HPV genotyping can be an effective supplemental tool to cytology, and patient age also needs to be considered in the clinical management of patient.

Epidemiology of COVID-19 scenario in India

There was an outbreak of a new Coronavirus infection in Wuhan, Hubei Province, China in late December 2019, which caused acute respiratory syndrome of unknown etiology. The World Health Organization (WHO) named the viral causal agent as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) or COVID-19, and declared this infection as a pandemic on the 11th of March, 2020. The first case of COVID-19 infection in India was reported on late January, 2020, and since then the numbers of confirmed cases have been increasing; thus the government had announced total lockdown of all activities. Most people infected with the COVID-19 virus experience mild to moderate respiratory illness, and recover without the need for special treatments. The elderly people and those with medical problems such as; cardiovascular disease, diabetes, chronic respiratory disease and cancer; are more likely to develop severe illness. Globally, corona virus cases rose to more than 500,000 for the first time on the 27th of October, 2020. Within two weeks and since 30th of October, 2020, COVID-19 cases had risen by almost 25 %, and about 400,000 daily cases were reported worldwide. The United States (US) was leading the global corona virus crisis with 8.9 million recorded infections and nearly 228,000 deaths worldwide. Asia had surpassed 10 million infections of the new corona virus on the 31of October, 2020, and India reported an average of 48,000 cases daily with a total of 8 million cases. The aim of this review was to explore the epidemiological prevalence of COVID-19 in India along with age and gender stratified prevalence of this viral infection.