Urban Provinces Research Articles

7604 Examining Disparities in Diabetes Control and Complications: A Comparative Study of Type 2 Diabetes Mellitus Patients in Rural and Urban Saudi Arabia

Abstract Disclosure: S.F. Alqifari: None. O. Alkomi: None. P. Amirthalingam: None. T. Alrasheed: None. M. Muqresh: None. H. Hamad: None. A. Khojah: None. N. Alshehri: None. B. Alhunayhani: None. B. AbuAlhasan: None. N. Alajlan: None. S. Alatawi: None. N. Alsabeelah: None. A. Wasel: None. A. Alqifari: None. Background: The escalating global prevalence of diabetes is also mirrored in Saudi Arabia. Approximately one in four individuals in the country is diagnosed with diabetes, as reported by the World Health Organization (WHO). The Ministry of Health has taken steps to address the needs of patients with diabetes by creating more than 20 specialized diabetes care centers in various regions throughout Saudi Arabia. However, disparities in access and utilization of primary healthcare facilities persist between rural and urban provinces within the country. Highlighting these disparities would bridge healthcare gaps between rural and urban areas to enhance diabetes management, ensure better access to specialized care, and improve the overall well-being of individuals living with Type 2 Diabetes Mellitus (T2DM) in Saudi Arabia. Objectives: This study aims to examine disparities in diabetes control and complications in patients with T2DM in rural and urban Saudi Arabia. Methods: This is an observational retrospective study conducted from November 2022 until May 2023, we collected data from 13 diabetes care centers across Saudi Arabia to assess diabetes control and complications of T2DM among patients who received their care in rural and urban Saudi Arabia. Results: Among 709 patients residing in rural and urban areas, rural area patients' recent HbA1c readings were generally within the range of 7-8%. Among these patients, around 2.6% had a history of heart disease, and 6.08% had experienced cerebrovascular events. Limb numbness was reported by 44.34% of subjects, 47.82% experienced vision complications, and renal impairment was observed in 10.43% of the participants. Additionally, among male patients, 26.41% suffered from erectile dysfunction. Remarkably, 21% of the rural patients reported having been hospitalized due to diabetes complications at least once in the past 12 months. Conclusion: The study findings emphasize the importance of considering regional disparities and socio-environmental factors when managing diabetes and its complications. Additional research is needed to understand the underlying causes and develop targeted interventions for improved diabetes care in rural and urban populations in Saudi Arabia. Presentation: 6/2/2024

The use of herbal medicine for hypertension in rural and urban Thailand: a cross sectional study

IntroductionUsing herbal medicine to treat hypertension is common in Thailand. However, there is variation in the use of herbs between rural and urban areas. This study aims to observe the prevalence of herb use, describe herb users’ behaviours, and describe anti-hypertensive drug compliance among the users. MethodsA cross-sectional survey among hypertensive patients visiting primary care services in Tak (rural) and Chiang Mai (urban) provinces was conducted between March and April 2019. Patients were assessed by using questionnaires that gathered information about patient demographic data, history of hypertension, herb use behaviours, and the concurrent use of standard treatment. ResultsIn total, 400 participants were included in this study—200 from rural and 200 from urban areas. Sixty-two percent were female. The prevalence of herb use was 13.0% in urban areas and 17.5% in the rural areas. Rural participants reported a significantly longer duration of herb use (P < 0.01), and a significantly higher proportion of using unapproved herbal products (91% vs 54%, P < 0.001). Participants mostly use herbs along with standard treatment (86.9%); nevertheless, poor drug compliance was similar in both areas, with rural participants more frequently taking their medications at the wrong time (P = 0.03). ConclusionThere was a trend of higher use of unapproved herbals in rural participants. Drug compliance among herb users was poor. It is recommended that a comprehensive assessment of herb use is conducted during care for hypertensive patients in this and similar contexts.

Availability and accessibility of indigenous foods in Gauteng region, South Africa

While South Africa maintains national food security, food insecurity persists at the household level, with not all households having access to sufficient food. Proposals to address this include promoting the consumption of indigenous foods (IF). However, urbanization in the Gauteng region has sparked a nutrition transition, characterized by increased consumption of Western diets, resulting in rising rates of malnutrition and non-communicable diseases. This study sought to assess the availability and accessibility of indigenous foods in the region for residents. A quantitative cross-sectional research survey was conducted in the Gauteng region, involving 746 participants who provided insights into their ways of acquiring indigenous foods and rated their overall availability. Additionally, the survey gathered opinions on IF availability across different settings and collected suggestions for improving IF accessibility. Among a list of 18 South African indigenous foods, between 55.2 and 77.2% of participants did not know where they could be obtained. Acquisition through vendors, with a maximum of 14% of respondents, emerged as relatively more popular compared to food markets, spaza shops, supermarkets, and home gardens. The majority of surveyed participants (55%) perceived indigenous foods as unavailable in the region. Agreement rates for the availability of indigenous foods for sale or serving in various settings were 53.5% for supermarkets, 42% for schools, 44.2% for hospitals, and 37.5% for workplaces. Respondents suggested several strategies to enhance IF accessibility in the region, including marketing, home gardens, farms, supermarkets, education, elders, restaurants, and schools/universities. Overall, there is a need for increased education on the nutritional benefits of indigenous foods and the implementation of policies to improve their accessibility in urbanized provinces like Gauteng.

Time trends and disparities of obesity and related national policies and programs in Nepal: a systematic review

ObjectiveOverweight and obesity prevalence has increased in low-income countries. This study systematically reviewed the obesity trend, disparities, and prevention and control efforts in Nepal. MethodsWe searched PubMed and Google Scholar for articles and reports published between January 1, 2004 and December 31, 2022. Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts. Overweight and obesity were defined using the World Health Organization body mass index cut points. Thirty-two studies and reports were included. ResultsOverall, overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited. The combined overweight and obesity (OW/OB) and obesity rates in women aged 15‒49 years increased from 8.5% to 22.2% and from 0.9% to 5.1% between 2006 and 2016, respectively. OW/OB and obesity rates in men were 17.1% and 2.5% based on data from the 2016 Demographic and Health Survey. OW/OB rate in under-five children increased from 0.6% to 2.8% between 2006 and 2016. Obesity rates for school-age (5‒9 years) boys and girls in 2016 were 2.4% and 2.8%, respectively, and were 1.1% and 1.4% for male and female adolescents aged 10‒19 years, respectively. OW/OB prevalence was much higher among women, residents in urban areas and central provinces, and in higher socioeconomic status groups. Projected prevalence of OW/OB and obesity for 2030 in adults aged 15‒49 was 44.7% and 8.3%, respectively, while it was 2.2% for OW/OB in preschool children. Policies and direct interventions that specifically focused on obesity prevention and control are limited. ConclusionsOW/OB prevalence in Nepal has increased during the past 1.8 decades, disproportionately affecting population groups. Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention. In the future, Nepal needs to develop population-based programs for obesity prevention.

Modern vs traditional indigenous diet preference in Gauteng region, South Africa: A public health concern?

The prevalence of non-communicable diseases still represents a public health concern in South Africa, of which eating habits are some of the main risk factors. A modern diet consisting of the consumption of highly processed foods high in fat, salt and caloric sweeteners and low in fibre is recognised as unhealthy. This study was conducted to assess the penchant of the population for these types of foods rather than traditional indigenous foods known to be healthier. This research was undertaken in the Gauteng region, which is the most urbanized province in the country. This study consisted of a quantitative research survey conducted in 2019 with 1527 participants (Asians, Black, Coloured, Indians and White) aged 18 and above who had lived in the province for at least two years. The results revealed that 30–40 % were neutral on the issue. Despite half (54.4 %) indicating that it was good to mix traditional and modern foods, a clear preference for modern food was noticed for 35.7 % of respondents, with 32.2 % reporting not being concerned that traditional foods have been replaced by modern foods. The traditional indigenous food consumption (TIFC) appeared to depend on monthly total household income, residential area, and settlement category. Participants with specific economic comfort consumed less. Race and number of people in the participants' households also significantly affected the TIFC (p < 0.05). Participants of white ethnicity and those living in a household of a maximum of 02 people displayed the lowest TIFC. In comparison to those who strongly disagree, participants with a neutral opinion about the idea of mixing eating habits were also the most neutral concerning preference for a modern diet (OR: 10.95, 95 % CI 7.00–17.12) and nutrition transition (OR: 14.66, 95 % CI 9.09–23.64). Sensitisation about healthy eating habits among the identified at-risk and target groups is undoubtedly a need in the region to avoid a resurgence of modern diet-related diseases.

Air pollutant emissions and sources in Lao People’s Democratic Republic: a provincial scale analysis for years 2013-2019

Recent rapid economic development in Lao People’s Democratic Republic (PDR) has increased national fuel consumption, vehicle fleet, industrial output, waste generation, and agricultural production. This has contributed to national average ambient fine particulate matter (PM2.5) air pollutant levels that are four times higher than World Health Organisation guidelines. Emission inventories are a key tool in understanding the major sources to these air pollution levels, and provide a starting point to identify where mitigation action can be targeted. A national air pollutant emission inventory has not been developed in Lao PDR and, combined with a limited air quality monitoring network means there is limited capacity to develop and track the effectiveness of mitigation actions. This study describes the first air pollutant emission inventory at the national and provincial scale for Lao PDR, covering 2013–2019. Emissions of nine air pollutants, and two greenhouse gases, were quantified using national statistics and international default emission factors. In 2019, national total PM2.5, Nitrogen Oxides (NOx), Black Carbon (BC), Sulphur Dioxide (SO2), Non-Methane Volatile Organic Carbons (NMVOCs), and Ammonia (NH3) were 125, 83, 9.7, 26, 219, and 99 thousand tonnes respectively. Key source sectors include forest fires, residential cooking, agriculture, electricity generation, and transport. However, the contribution of different sources varies across provinces. Forest fires are the primary source determining the spatial trend of particulate air pollution while residential and agricultural emissions contribute more significantly to rural provinces such as Savannakhet. Key sectors in major urban provinces (Vientiane Capital and Xayaboury) are industry, transport and electricity generation. These sectors are also significant sources of greenhouse gases (CO2 and CH4), demonstrating the potential for identification, evaluation and prioritisation of actions that simultaneously improve air quality and achieve Lao PDR’s international climate change commitments.

Determination of land surface temperature and urban heat island effects with remote sensing capabilities: the case of Kayseri, Türkiye

Kayseri, a densely urbanized province in Türkiye, grapples with pressing challenges of air pollution and limited green spaces, accentuating the need for strategic urban planning. This study, utilizing Landsat 8 and Landsat 9 satellite imagery, investigates the evolution of land surface temperatures (LST) and urban heat island (UHI) effects in key districts—Kocasinan, Melikgazi, Talas, and Hacılar—between 2013 and 2022. This research has been complemented with an analysis of the Normalized Difference Vegetation Index (NDVI) and the Normalized Difference Built-Up Index (NDBI), exploring correlations among the LST, UHI, NDVI, and NDBI changes. The findings indicate that a significant portion (65% and 88%) of the study area remained unchanged with respect to the NDVI and NDBI differences. This research’s findings reveal that a substantial portion (65% and 88%) of the study area exhibited consistency in the NDVI and NDBI. Noteworthy increases in the NDVI were observed in 20% of the region, while only 4% exhibited higher NDBI. Strikingly, the UHI displayed strong negative correlations with the NDVI and robust positive correlations with the NDBI. The LST changes demonstrated a reduced temperature range, from 21 to 51 °C in 2013, to 18 to 40 °C in 2022. Localized environmental factors, notably at the National Garden site, showcased the most significant temperature variations. Notably, the UHI exhibited strong negative correlations with the NDVI and strong positive correlations with the NDBI. The study’s results emphasize the interplay among the NDBI, LST, and UHI and an inverse relationship with the NDVI and NDBI, LST, and UHI. These findings hold implications for urban planning and policymaking, particularly in the context of resilient and sustainable land use planning and the UHI mitigation. This research underscores the intricate interplay among the NDBI, LST, and UHI, highlighting an inverse relationship with the NDVI. These findings hold crucial implications for resilient and sustainable urban planning, particularly in mitigating the UHI effects. Despite limited vacant spaces in Kayseri, geospatial techniques for identifying potential green spaces can facilitate swift UHI mitigation measures. Acknowledging Kayseri’s complex dynamics, future research should delve into the UHI responses to urban morphology and design, extending this methodology to analyze the UHI effects in other Turkish cities. This research contributes to a broader understanding of UHI dynamics and sustainable urban planning practices, offering valuable insights for policymakers, urban planners, and researchers alike.

Economic Burden of Tuberculosis for Patients and their Households in Cochabamba, Bolivia

Background: Patients with tuberculosis usually incur large costs directly related to their disease. Additional indirect costs also increase the economic burden of households creating barriers of access and adherence. Because TB affects the poorest segment of society the effects can be more serious for poor people. Indirect costs are poorly documented in Bolivia. We therefore conducted a study to determine the socioeconomic impact of TB on patients and their households.&#x0D; Methods: A cross-sectional survey was carried out on 2017 in Cochabamba, Bolivia, included all patients who were on TB treatment within the health network. The generic survey instrument proposed by WHO for tuberculosis patients cost surveys was used. The most important direct medical and direct non-medical payments were calculated in a disaggregated manner. The calculation of indirect costs was carried out through the results-based approach where the loss of income was calculated from the report of household income. Catastrophic cost was determined and multivariable logistic regression was run to assess which factors were independently associated.&#x0D; Results: The indirect costs during an entire illness episode had a median of USD 768.1 corresponding to 63.4% of the total cost for all patients. In the case of multidrug-resistant TB (MDR TB) patients, the median cost was USD 6454.8 corresponding to 54.3% of their total costs. Direct non-medical costs had a median for all patients of USD 408.7 (33.7%), and of USD 5399.6 (45.4%) for MDR TB patients. The most important non-medical costs were those linked to directly observed treatment (DOT) with a median of USD 419.8 during intensive phase and of USD 108.6 during continuation phase for transport costs. Food and drinks costs had a median of USD 94.5 during intensive phase and of USD 54.8 during continuation phase; consumption of nutritional supplements had a median cost of USD 249.1 and additional food outside the regular diet had a median cost of USD 519 for all patients. Catastrophic costs were incurred by 43.9% of TB patients. These catastrophic costs were observed in 50% of the population aged over 55 years, in 60% of MDR-TB patients, and in 63% of poor patients. Using logistic regression, factors associated with a higher risk of catastrophic costs were to live in an urban province (OR = 1.82 1.11 to 2.98, P = 0.002), to be older than 55 years (OR = 1.21 1.07 to 1.38, P = 0.005), and to have a low economic income (OR = 0.83 0.69 to 0.99, P = 0.049).&#x0D; Conclusions: Patients with TB treated in health services face a great financial burden. Indirect cost was higher than direct costs in a complete TB episode, especially in MDR-TB patients. During the treatment, the most important costs were those related to transport and food when patients went to DOT; nutritional supplements and additional food to the regular diet accounted also for a non-negligible cost. Almost half of patients suffer a catastrophic cost, especially those who came from an urban province, those who were older than 55 years, and those having a low economic income.&#x0D; &#x0D;

Before dinner: The health value of gaseous fuels

In this paper, we study the impact of gaseous fuels used for cooking on the middle-aged and elderly's health in China. By using 2011, 2013, 2015, and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS), we find that gaseous fuel use reduces the probability of respiratory disease in middle-aged and elderly adults. Health effects are stronger for the people aged between 45 and 79, female, high-income, urban, and gas-importing province groups. The quantification of health benefits allows to find that from 2010 to 2018, the reduction in the number of respiratory illnesses due to gaseous fuel use ranges from 22.905 to 23.721 million people, resulting in treatment cost savings of between 9.29 and 14.47 billion RMB ($26.4 - $34.2 billion). The monetary valuation of indoor clean air according to self-rated health find that for each additional unit of indoor clean air, middle-aged and elderly adults are willing to pay a price of 4.5 RMB ($1.06). We provide new evidence of the considerable health and welfare effects of gaseous fuels.

COVID-19 Infections and Deaths between Rural and Urban Provinces of Zimbabwe, 2020: A Spatial Variations Analysis

Zimbabwe continues to record new COVID-19 cases as is the case in other countries. Although the Ministry of Health in Zimbabwe continues to publish daily situation reports (SitRep), and regular surveillance updates, no review of existing data has been done to establish the regional trends of the disease over time. This desk review study seeks to analyze the trends (province by province) of the COVID-19 in Zimbabwe for year 2020 in order to establish if spatial variations in infection rates and deaths exist. Ultimately, the aim is to come up with appropriate context-specific prevention and control measures. The study also seeks to establish whether or not there is a difference in COVID-19 infection rates and deaths between urban and rural provinces of Zimbabwe. A historical research design that made use of available secondary data on COVID-19 in Zimbabwe was used. COVID-19 statistics for year 2020 as provided by the Zimbabwe Ministry of Health and Child Care were accessed from the website and reviewed. A hypothesis test to determine if there was a difference in COVID-19 attack rates between urban and rural provinces of Zimbabwe was also done. An independent samples t-test using Microsoft excel was done on cumulative COVID-19 cases data for the entire year 2020. The study revealed that spatial variations in COVID-19 infections and deaths between urban and rural provinces of Zimbabwe existed. Urban provinces recorded more COVID-19 cases in 2020 compared to rural provinces. Keywords: COVID-19, Infection rate, Psychological distress, Spatial, Variations, Vaccine hesitancy.

Temporal Trends, Socio-Economic Inequalities in Obesity and Responses by Federal Government, Nepal: A Systematic Review of Observational Studies, Policies, Strategies and Plans, 2005-2019

Introduction: Obesity has risen to epidemic proportions in low-income countries like Nepal, where maternal and child under-nutrition has reduced steadily. However, synthesised evidence on transition to obesity remains unavailable. We assessed trends and disparities in obesity occurrence, and examined central government’s policies and programmes. Methods: We searched PubMed and Google Scholar for articles published between January 1, 2005 and April 10, 2019, and websites of Demographic and Health Survey, Non-Communicable Diseases Risk Factor Survey, and Micronutrient Status Survey. We synthesised obesity and overweight prevalence data from the selected studies, narratively; and disaggregated latest proportions from nation-wide surveys by gender, geographical location and household wealth quintile. We charted obesity related actions from policies, strategies and plans; obtained through the websites of health ministry and government’s planning commission. Results: Twenty studies with data from 79,082 men and women aged 15 years or more and 11,866 children under five years, were included. Obesity or overweight among men and women increased from 20.0% in 2004 to 36.1% in 2016. Obesity alone rose from 5.3% to 7.5%. National average prevalence of childhood obesity or overweight remained very low. Overweight and obesity were more common among women, inhabitants of urban areas and central provinces, and the affluent. Governmental policies, strategies and plans on nutrition were primarily designed to control under-nutrition, with implications for preventing obesity. Conclusion: Overweight and obesity increased substantially between 2005 and 2019, disproportionately affecting socio-economic and geographical groups. Governmental nutritional strategies should consider addressing obesogenic environments.

Work-life balance in the Zimbabwe Retail Sector: Testing a job-engagement and job-satisfaction model

Orientation: This study focuses on the relationship between work-life balance (WLB), job engagement, and job satisfaction (JS) among employees in the retail sector in Bulawayo urban Province, Zimbabwe.Research purpose: The purpose of this study was to validate the relationship between WLB, job engagement and JS.Motivation for the study: The motivation for the research stemmed from the dearth of studies from the global south that examined the causal relationship between three aforementioned variables within the retail sector.Research design, approach and method: A descriptive survey design was employed in a study that involved 108 employees from the retail sector in Bulawayo province. Adapted standardised closed questionnaires were used for data collection. The study was developed and tested, using structural equation modelling, a model that can be used to explain the effect of the three variables on each other.Main findings: The study established a statistically significant relationship between WLB and job engagement. It was also found that WLB plays a major role in facilitating positive JS outcomes. However, a weak association was established between JS and dedication – a dimension of job engagement.Practical/managerial implications: Striking a balance between employees’ career and personal life directly impacts their JS and job engagement levels.Contribution/value-add: This study’s findings shed light on the complex dynamics between the three variables that are helpful for organisations seeking to enhance employee well-being and optimise performance of their workforce.

Dynamic changes and driving factors of rural settlements at the county level in a rapidly urbanizing province of China from 2000 to 2020

Urbanization and industrialization in developing countries has contributed to great changes in rural settlements, which presents an increasing threat to rural sustainability. Spatiotemporal changes in rural settlements at the county level are significant to land use planning and are not clear in the highly urbanized regions. This study considered Jiangsu, one of the most urbanized provinces of China, as an example and investigated the spatial variation in rural settlements and their socioeconomic driving factors during the period of 2000–2020 using mixed geographic weighted regression. The results showed that the area of rural settlements in the highly urbanized province expanded from 2000 to 2015 following a decrease in the rural population, but then began to decrease from 2015. There were obvious spatial differences in the rural settlements in the counties of Jiangsu Province. The area of rural settlements in the different counties maintained a positive association with the rural population and cropland but had a negative correlation with the rural production value in 2000. By 2020, the area of rural settlements was only positively associated with the rural population. The correlation between the area of rural settlements and rural population continually decreased from 2000 to 2020. The area of rural settlements had no significant association with the area of urban settlements. The expansion of rural settlements mainly occurred at the expense of cropland. The decrease in the rural settlements was accompanied by an increase in the urban settlements and an expansion of cropland. The policy implications arising from this study are presented to provide guidance for rural development at the county level and ensure rural sustainability.

The Reasonableness and Spatial Differences of the Food Consumption Structure of Urban and Rural Residents in China, 2015-2021.

Based on residents' food consumption data from 31 provinces in China from 2015-2021, this study analyzes the deviation in food consumption from nutrition targets and the spatial distribution characteristics of urban and rural residents in China from 2015-2021, and finds that there are irrationalities in the structure of food consumption of Chinese residents as well as regional differences in consumption. The food consumption of Chinese residents deviates from the recommended values of the Chinese Food Guide Pagoda to a certain extent, with large differences between urban and rural areas and provinces. Therefore, a new concept of food security with nutrition as the target should be established to guide residents' food consumption scientifically and rationally, and to adopt focused attention and targeted measures for regions with serious imbalances in food consumption.

Factors affecting the development of a healthy city in Suburban areas, Thailand

Pathum Thani Province is one of the provinces surrounding the Bangkok Metropolitan Area (BMA) that has received the spillover growth and expansion of the city of Bangkok. However, this has resulted in urban changes into sprawling characterized by clusters of peri-urbanization interspersed along major transportation corridors that has absorbed provincial municipal centers within almost a hundred-kilometer radius from the center. The results of this uncontrolled, unplanned sprawl with weak or ineffective land use or transportation planning have detrimental effects on the overall well-being of the residents and the quality of life in the metropolitan area. This study uses the healthy city concept to analyze the factors that affect the health of the population by using Pathum Thani Province as the case study of 1055 structured questionnaires in face-to-face interviews. After data collection, the data was used in a Structural Equation Model (SEM) to analyze the factors that affect the health of the population in this highly urbanized province. The result of the study showed that factors affecting urban health have components relative to health issues, social and economic, physical, and environmental factors. Finally, this approach could help to quantify the complex interactions involved in health and wellbeing in relation to the constantly changing urban environment of sprawling areas to help guide policy decisions for achieving the development of a healthy city.

Assessment of urban flood resilience based on a systematic framework

Urban flooding can seriously threaten urban ecological security and human life, and therefore urban flood resilience (UFR) is important for urban safety and stability. To comprehensively evaluate urban system performance during the entire process of rainfall, runoff, flooding, and drainage, we developed a systematic framework for UFR assessment covering runoff simulation, flood estimation, and resilience assessment, which broadly corresponded to the phases of resistance, adaptation, and recovery. The UFR in the phases of resistance, adaptation, and recovery was simulated and assessed using a system performance curve (SPC) and technically combining with the hybrid flood model while mainly considering the total simulation time and inundated urban proportion in SPC. Because the extent of urban flooding can be influenced by climate change and the rate of urbanization, we chose the corresponding representative factors of precipitation and infiltration rate and considered 21 simulation scenarios (seven rainfall return periods and three infiltration rates) for which UFR was quantified according to urban system performance. The effectiveness of this framework was demonstrated in application to a typical highly urbanized area (i.e., Dongguan, China). The following results were derived: (1) The inundated area under the pessimistic scenario (i.e., S19) would be nearly four times greater than that under the optimistic scenario (i.e., S3); (2) The values of UFR in Dongguan were 0.9494–0.9863, locating at the high and very high level; (3) The lowest UFR value was 0.6552 in the Shuixiang New City district; and (4) The rainfall return period was the main factor influencing UFR under relatively short rainfall return periods (i.e., S1–S9), while infiltration rate was the principal influencing factor under relatively long rainfall return periods (i.e., S10–S21). The proposed systematic framework could be applied in other cities and large-scale regions like urban agglomerations and provinces.

Knowledge and Compliance of COVID-19 Health Protocols among Pregnant Women in Urban and Rural West Java Province

Knowledge and Compliance of COVID-19 Health Protocols among Pregnant Women in Urban and Rural West Java Province

Territory Differences in Adaptation to Heat among Persons Aged 65 Years and Over in Spain (1983–2018)

Climate change is currently regarded as the greatest global threat to human health, and its health-related consequences take different forms according to age, sex, socioeconomic level, and type of territory. The aim of this study is to ascertain the differences in vulnerability and the heat-adaptation process through the minimum mortality temperature (MMT) among the Spanish population aged ≥65 years by territorial classification. A retrospective, longitudinal, ecological time-series study, using provincial data on daily mortality and maximum daily temperature across the period 1983-2018, was performed, differentiating between urban and nonurban populations. The MMTs in the study period were higher for the ≥65-year age group in urban provinces, with a mean value of 29.6 °C (95%CI 29.2-30.0) versus 28.1 °C (95%CI 27.7-28.5) in nonurban provinces. This difference was statistically significant (p < 0.05). In terms of adaptation levels, higher average values were obtained for nonurban areas, with values of 0.12 (95%CI -0.13-0.37), than for urban areas, with values of 0.09 (95%CI -0.27-0.45), though this difference was not statistically significant (p < 0.05). These findings may contribute to better planning by making it possible to implement more specific public health prevention plans. Lastly, they highlight the need to conduct studies on heat-adaptation processes, taking into account various differential factors, such as age and territory.

Optimising diagnosis and treatment of tuberculosis infection in community and primary care settings in two urban provinces of Viet Nam: a cohort study

ObjectivesTo end tuberculosis (TB), the vast reservoir of 1.7–2.3 billion TB infections (TBIs) must be addressed, but achieving global TB preventive therapy (TPT) targets seems unlikely. This study assessed the...

Burden of Respiratory Diseases Attributable to Household Air Pollution in Nepal: National and Provincial Estimates

Background: Household air pollution (HAP) is widespread in Nepal particularly in rural poor households where use of unprocessed biomass fuels (wood, animal dung and crop residues) for cooking is abundant. Studies have shown that health effects associated with HAP are primarily respiratory and cardiovascular diseases which are amongst the top burden of diseases in Nepal.&#x0D; Objective: The study is conducted to estimate Attributable Fraction (AF) and corresponding Attributable Burden (AB) of diseases such as childhood pneumonia, acute respiratory infection/pneumonia and COPD/asthma which can be associated with HAP in Nepal, nationally and sub-nationally.&#x0D; Materials and Methods: Estimates on fuel use in Nepal disaggregated by rural and urban areas and provinces are obtained from Nepal Multiple Indicator Cluster Survey (NMICS), 2019 published by Central Bureau of Statistics (CBS). The corresponding total disease burdens of Nepal related to respiratory diseases are obtained from the Department of Health Services (DoHS) for 2019/20. Estimates of model coefficients of the targeted respiratory diseases that can be attributed to HAP are obtained from several studies conducted previously in Nepal. Methodology adopted by World Health Organization (WHO) for estimation of AF and AB is applied in the present analysis.&#x0D; Results: The estimated AF and AB of childhood pneumonia, ARI/pneumonia and COPD/asthma are obtained as 34.6% (95% CI = 7.4%-56.4%) and 7.3 (96% CI = 1.5-11.8) per 1000 under five children, 42.5% and 63.6 per 1000 population and 54.8% and 10.3 per 1000 population, respectively. AFs are found substantially higher (1.3-1.5 times) in rural Nepal compared to urban Nepal. Provincially, Karnali is found worst affected with highest attributions (45.3% - 65.6%) for the accounted burden of diseases and Bagmati found least affected with lowest attributions (18.7% - 34.6%) for the year 2019/20.&#x0D; Conclusion: HAP is found to be a potential risk factor with high attributions for the occurrence of respiratory ailments in Nepal.