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Journal Cover Journal of Epidemiology and Global Health
  [SJR: 0.142]   [H-I: 2]   [7 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2210-6006
   Published by Elsevier Homepage  [2801 journals]
  • HIV-infected presumptive tuberculosis patients without tuberculosis: How
           many are eligible for antiretroviral therapy in Karnataka, India'
    • Abstract: Publication date: Available online 25 January 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Ajay M.V. Kumar, Anil Singarajipura, Balaji Naik, Deepak K. Guddemane, Yogesh Patel, Suresh Shastri, Sunil Kumar, Rajesh Deshmukh, B.B. Rewari, Anthony David Harries
      For certain subgroups within people living with the human immunodeficiency virus (HIV) [active tuberculosis (TB), pregnant women, children <5years old, and serodiscordant couples], the World Health Organization recommends antiretroviral therapy (ART) irrespective of CD4 count. Another subgroup which has received increased attention is “HIV-infected presumptive TB patients without TB”. In this study, we assess the proportion of HIV-infected presumptive TB patients eligible for ART in Karnataka State (population 60million), India. This was a cross-sectional analysis of data of HIV-infected presumptive TB patients diagnosed in May 2015 abstracted from national TB and HIV program records. Of 42,585 presumptive TB patients, 28,964 (68%) were tested for HIV and 2262 (8%) were HIV positive. Of the latter, 377 (17%) had active TB. Of 1885 “presumptive TB patients without active TB”, 1100 (58%) were already receiving ART. Of the remaining 785 who were not receiving ART, 617 (79%) were assessed for ART eligibility and of those, 548 (89%) were eligible for ART. About 90% of “HIV-infected presumptive TB patients without TB” were eligible for ART. This evidence supports a public health approach of starting all “HIV-infected presumptive TB patients without TB” on ART irrespective of CD4 count in line with global thinking about ‘test and treat’.


      PubDate: 2016-01-29T15:15:49Z
       
  • Verification of measles elimination in Australia: Application of World
           Health Organization regional guidelines
    • Abstract: Publication date: Available online 27 January 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): H.F. Gidding, N.V. Martin, V. Stambos, T. Tran, A. Dey, G.K. Dowse, H.A. Kelly, D.N. Durrheim, S.B. Lambert
      Background The World Health Organization (WHO) Western Pacific Region (WPR) Guidelines on verification of measles elimination were established in 2012. This article outlines Australia’s approach to addressing the guideline’s five lines of evidence, which led to formal verification of elimination by the WHO Regional Verification Commission (RVC) in March 2014. Methods The criteria were addressed using national measles notifications, data from selected laboratories, the national childhood immunization register, and three national serosurveys (1998/1999, 2002, 2007). Results Australia met or exceeded all indicator targets with either national or sentinel data. Laboratory and epidemiological surveillance were of high quality, with 85% of cases documented as imported/import-related (target 80%); coverage with the first dose of measles vaccine was close to 94% in 2008–2012 and second dose coverage increased to 91% in 2012 (target >95%). There is ongoing commitment by the Australian Government to increase immunization coverage, and the absence of sustained transmission of any single measles genotype was demonstrated. Conclusions This is the first documentation of the successful application of the WPR RVC guidelines. The indicators afford some flexibility but appear to provide appropriate rigor to judge achievement of measles elimination. Our experience could assist other countries seeking to verify their elimination status.


      PubDate: 2016-01-29T15:15:49Z
       
  • Democracy predicts sport and recreation membership: Insights from 52
           countries
    • Abstract: Publication date: Available online 27 January 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Shea M. Balish
      Although evidence suggests sport and recreation are powerful contributors to worldwide public health, sizable gender differences persist. It is unknown whether country characteristics moderate gender differences across countries. The primary purpose of this study was to examine if countries’ levels of democracy and/or gender inequality moderate gender differences in sport and recreation membership across countries. The secondary purpose was to examine if democracy and/or gender inequality predicts overall rates of sport and recreation membership for both males and females. This study involved a nested cross-sectional design and employed the sixth wave (2013) of the world value survey (n Ss =71,901, n countries =52). Multiple hierarchal nonlinear Bernoulli models tested: (1) if countries’ levels of democracy moderate gender differences in sport and recreation membership; and (2) if democracy is associated with increased sport and recreation membership for both males and females. Countries’ level of democracy fully moderated gender differences in sport and recreation membership across countries. Moreover, democracy was positively associated with both male and female membership, even when controlling for individual and country-level covariates. Democratic political regimes may confer health benefits via increased levels of sport and recreation membership, especially for females. Future research should test mediating mechanisms.


      PubDate: 2016-01-29T15:15:49Z
       
  • Extracurricular activities associated with stress and burnout in
           preclinical medical students
    • Abstract: Publication date: Available online 28 November 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Jawad Fares, Zein Saadeddin, Hayat Al Tabosh, Hussam Aridi, Christopher El Mouhayyar, Mohamad Karim Koleilat, Monique Chaaya, Khalil El Asmar
      This study aims to assess the prevalence of stress and burnout among preclinical medical students in a private university in Beirut, Lebanon, and evaluate the association between extracurricular involvement and stress and burnout relief in preclinical medical students. A cross-sectional survey was conducted on a random sample of 165 preclinical medical students. Distress level was measured using the 12-item General Health Questionnaire (GHQ-12) while that of burnout was measured through the Maslach Burnout Inventory-Student Survey (MBI-SS). The MBI-SS assesses three interrelated dimensions: emotional exhaustion, cynicism, and academic efficacy. Extracurricular activities were divided into four categories: physical exercise, music, reading, and social activities. All selected participants responded. A substantial proportion of preclinical medical students suffered from stress (62%) and burnout (75%). Bivariate and multivariate regression analyses revealed that being a female or a 1st year medical student correlated with higher stress and burnout. Music-related activities were correlated with lower burnout. Social activities or living with parents were associated with lower academic efficacy. The high stress and burnout levels call for action. Addressing the studying conditions and attending to the psychological wellbeing of preclinical medical students are recommendations made in the study.


      PubDate: 2015-11-29T06:45:20Z
       
  • Prevalence of pulmonary tuberculosis in Wardha district of Maharashtra,
           Central India
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4, Supplement 1
      Author(s): Pratibha Narang, Deepak K. Mendiratta, Naresh K. Tyagi, Ullhas N. Jajoo, Atul T. Tayade, Pratapsingh H. Parihar, Rahul Narang, Pranav S. Mishra, Sharda M. Anjinappa, Vineet K. Chadha
      A house based survey was conducted during 2007–2009 in a representative sample of population in Wardha district implementing Directly Observed Treatment Short Course strategy for tuberculosis (TB) control since 2001. The objective was to estimate prevalence of bacillary pulmonary TB (PTB) in individuals aged 15years or above, and to estimate trends in prevalence when compared to a previous survey carried out in mid 1980’s. Two sputum samples (one spot, one early morning) collected from individuals having symptoms suggestive of PTB, history of previous anti-TB treatment (ATT) or abnormal pulmonary shadow on Mass Miniature Radiography (MMR) consistent with possibly or probably active tuberculosis were subjected to Ziehl–Neelsen microscopy and culture on Lowenstein–Jensen medium. Of 55,096 individuals registered into the survey, 50,332 (91.4%) were screened by interview for symptoms and history of ATT and/or by MMR. Of them, 4805 were eligible for sputum collection; both specimens were collected in 4285 (89.2%) and only one specimen in 27 (0.6%). A total of 86 bacillary cases were detected during the survey. Prevalence of bacillary PTB was estimated at 188.7 (140.3–236.9) per 100,000 populations. There was a decline of 61% in the prevalence of PTB over a period of 22years.


      PubDate: 2015-11-29T06:45:20Z
       
  • Bradford Hill’s criteria, emerging zoonoses, and One Health
    • Abstract: Publication date: Available online 14 November 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): G.V. Asokan, Vanitha Asokan
      Zoonoses constitute more than 60% of infectious diseases and 75% of emerging infectious diseases. Inappropriate overemphasis of specialization of disciplines has ignored public health. Identifying the causes of disease and determining how exposures are related to outcomes in “emerging zoonoses” affecting multiple species are considered to be the hallmarks of public health research and practice that compels the adoption of “One Health”. The interactions within and among populations of vertebrates in the causation and transmissions of emerging zoonotic diseases are inherently dynamic, interdependent, and systems based. Disease causality theories have moved from one or several agents causing disease in a single species, to one infectious agent causing disease in multiple species-emerging zoonoses. Identification of the causative pathogen components or structures, elucidating the mechanisms of species specificity, and understanding the natural conditions of emergence would facilitate better derivation of the causal mechanism. Good quality evidence on causation in emerging zoonoses affecting multiple species makes a strong recommendation under the One Health approach for disease prevention and control from diagnostic tests, treatment, antimicrobial resistance, preventive vaccines, and evidence informed health policies. In the tenets of One Health, alliances work best when the legitimate interests of the different partners combine to prevent and control emerging zoonoses.


      PubDate: 2015-11-19T05:53:53Z
       
  • Challenges and opportunities in detecting Taenia solium tapeworm carriers
           in Los Angeles County California, 2009–2014
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4
      Author(s): Curtis Croker
      Carriers of the pork tapeworm, Taenia solium, are the sole source of neurocysticercosis, a parasitic tissue infection that can be chronic and severe. Identifying T. solium tapeworm carriers is challenging. Many are asymptomatic and go undetected and unreported. In addition, T. solium is difficult to distinguish from other Taenia species of less concern. From 2009 to 2014, 24 taeniasis cases were reported to the Los Angeles County (LAC) Department of Public Health. Twenty reports were received solely from our automated electronic laboratory reporting system (ELR), two from health care providers, and two were generated internally from investigation of households with a reported neurocysticercosis case. Further investigation identified one T. solium carrier originally reported by ELR and one identified from a neurocysticercosis case investigation. These results suggest that T. solium tapeworm carriers can be identified from investigation of ELR reports of unspeciated Taenia cases as well as from households of neurocysticercosis cases.


      PubDate: 2015-11-09T16:43:00Z
       
  • Analyzing seasonality of tuberculosis across Indian states and union
           territories
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4
      Author(s): Pankaj Narula, Praveer Sihota, Sarita Azad, Pietro Lio
      A significant seasonal variation in tuberculosis (TB) is observed in north India during 2006–2011, particularly in states like Himachal Pradesh, Haryana and Rajasthan. To quantify the seasonal variation, we measure average amplitude (peak to trough distance) across seasons in smear positive cases of TB and observe that it is maximum for Himachal Pradesh (40.01%) and minimum for Maharashtra (3.87%). In north India, smear positive cases peak in second quarter (April–June) and reach a trough in fourth quarter (October–December), however low seasonal variation is observed in southern region of the country. The significant correlations as 0.64 (p-value<0.001), 0.54 (p-value<0.01) and 0.42 (p-value<0.05) are observed between minimum temperature and seasonality of TB at lag-1 in north, central and northeast India respectively. However, in south India, this correlation is not significant.


      PubDate: 2015-11-09T16:43:00Z
       
  • Relationship between oral clinical conditions and daily performances among
           young adults in India – A cross sectional study
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4
      Author(s): Ramesh Nagarajappa, Mehak Batra, Sudhanshu Sanadhya, Hemasha Daryani, Gayathri Ramesh
      Objective of the present study was to investigate relationship between oral health-related quality of life using Oral Impacts on Daily Performances (OIDP) scale and specific clinical dental measures. A cross sectional descriptive survey was conducted among 800 students. Oral health status and impacts were assessed using WHO guidelines and OIDP index respectively. Chi square test and multiple logistic regressions were employed for statistical analysis. Participants with caries were significantly (p ⩽0.05) more likely to have an impact on cleaning (OR=2.487) and sleeping and relaxing (OR=8.996). Similarly participants with oral mucosal conditions were more likely to have an impact on eating (OR=3.97), cleaning (OR=2.966) and physical activities (OR=11.190). Dental Aesthetic Index (DAI) impacted on cleaning (OR=2.134), emotional stability (OR=3.957) and social contact (OR=3.21). OIDP Index showed acceptable psychometric properties in the context of an oral health survey. Subjects presented a strong and consistent relationship between dental status and perceived impacts.


      PubDate: 2015-11-09T16:43:00Z
       
  • Hypertension in the Lebanese adults: Impact on health related quality of
           life
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4
      Author(s): Malak Khalifeh, Pascale Salameh, Amal Al Hajje, Sanaa Awada, Samar Rachidi, Wafa Bawab
      Cardiovascular disease is a major cause of morbidity and mortality worldwide, hypertension being one of their most prevalent risk factors. Information on health related quality of life (QOL) of hypertensive individuals in Lebanon is lacking. Our objectives were to evaluate QOL of hypertensive patients compared with non-hypertensive subjects and to suggest possible predictors of QOL in Lebanon. We conducted a case control study among individuals visiting outpatient clinics. Quality of life was assessed using the eight item (SF-8) questionnaire administered face to face to the study population, applied to hypertensive (N =224) and non-hypertensive control (N =448) groups. Hypertensive patients presented lower QOL scores in all domains, particularly in case of high administration frequency and occurrence of drug related side effects. Among hypertensive patients, QOL was significantly decreased with the presence of comorbidities (β =−13.865, p =0.054), daily frequency of antihypertensive medications (β =−8.196, p <0.001), presence of drug side-effects (β =−19.262, p =0.031), older age (β =−0.548, p <0.001), female gender (β =−21.363, p =0.05), lower education (β =−22.949, p =0.006), and cigarettes smoked daily (β =−0.726, p <0.001); regular sport activity (β =23.15, p <0.001) significantly increased quality of life. These findings indicate the necessity for health professionals to take these factors into account when treating hypertensive patients, and to tackle special subgroups with attention to their deteriorated QOL.


      PubDate: 2015-11-09T16:43:00Z
       
  • Association between worldwide dietary and lifestyle patterns with total
           cholesterol concentrations and DALYs for infectious and cardiovascular
           diseases: An ecological analysis
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4
      Author(s): C. Oggioni, H. Cena, J.C.K. Wells, J. Lara, C. Celis-Morales, M. Siervo
      Global dietary and lifestyle trends are primary risk factors for communicable and non-communicable diseases. An ecological analysis was conducted to examine the association of global dietary and lifestyle patterns with total cholesterol concentrations. This study also investigated whether total cholesterol modified the association between dietary and lifestyle habits with disability-adjusted-life-years-lost (DALYs) for infectious and cardiovascular diseases (CVDs). Country-specific mean total cholesterol concentrations and DALYs for infectious and CVDs were obtained. Data were then matched to country-specific food and energy availability for consumption and information on obesity, physical inactivity, urbanization, gross domestic product (GDP), life expectancy and smoking. Stepwise multiple regression models were developed to identify significant predictors of total cholesterol concentrations and DALYs for infectious and CVDs. Life expectancy and egg and meat consumption were significantly associated with cholesterol concentrations. DALYs for infectious diseases were associated with smoking, life expectancy and per capita GDP. Smoking was the only predictor of DALYs for CVDs. The improvement of socio-demographic conditions and economic growth is likely to reduce the burden of communicable diseases in developing countries. A concurring increase in non-communicable diseases is expected, and these results have, yet again, identified smoking as a primary risk factor for CVDs.


      PubDate: 2015-11-09T16:43:00Z
       
  • Leveraging “big data” to enhance the effectiveness of
           “one health” in an era of health informatics
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4
      Author(s): G.V. Asokan, Vanitha Asokan
      Zoonoses constitute 61% of all known infectious diseases. The major obstacles to control zoonoses include insensitive systems and unreliable data. Intelligent handling of the cost effective big data can accomplish the goals of one health to detect disease trends, outbreaks, pathogens and causes of emergence in human and animals.


      PubDate: 2015-11-09T16:43:00Z
       
  • Drinking water studies: A review on heavy metal, application of biomarker
           and health risk assessment (a special focus in Malaysia)
    • Abstract: Publication date: December 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 4
      Author(s): Nurul Hafiza Ab Razak, Sarva Mangala Praveena, Ahmad Zaharin Aris, Zailina Hashim
      Malaysia has abundant sources of drinking water from river and groundwater. However, rapid developments have deteriorated quality of drinking water sources in Malaysia. Heavy metal studies in terms of drinking water, applications of health risk assessment and bio-monitoring in Malaysia were reviewed from 2003 to 2013. Studies on heavy metal in drinking water showed the levels are under the permissible limits as suggested by World Health Organization and Malaysian Ministry of Health. Future studies on the applications of health risk assessment are crucial in order to understand the risk of heavy metal exposure through drinking water to Malaysian population. Among the biomarkers that have been reviewed, toenail is the most useful tool to evaluate body burden of heavy metal. Toenails are easy to collect, store, transport and analysed. This review will give a clear guidance for future studies of Malaysian drinking water. In this way, it will help risk managers to minimize the exposure at optimum level as well as the government to formulate policies in safe guarding the population.


      PubDate: 2015-11-09T16:43:00Z
       
  • Prevalence of Lebanese stroke survivors: A comparative pilot study
    • Abstract: Publication date: Available online 24 October 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Nathalie Lahoud, Pascale Salameh, Nadine Saleh, Hassan Hosseini
      Stroke is a leading cause of morbidity and mortality worldwide and its late burden has mainly been attributable to developing countries. Lebanon is one of these countries where epidemiological studies on stroke burden are scarce but necessary. Thus, the present study was conducted to assess the prevalence of stroke survivors among Lebanese inhabitants. A cross-sectional survey was carried out using randomly selected landline phone numbers on all territories to retrieve data on stroke survivors and their sociodemographic characteristics. Results were then standardized over the Lebanese and the World Health Organization (WHO) world populations. A total of 6963 Lebanese inhabitants were included in the study; among these were 56 stroke survivors. This led to an adjusted stroke prevalence of 0.50% [95% confidence interval (CI)=0.33–0.66%] and a world-standardized prevalence of 0.60% (95% CI=0.42–0.78%). A significantly higher stroke prevalence was found among older age groups and more socioeconomically privileged areas. Overall, the study showed a relatively higher prevalence of stroke in this sample of Lebanese inhabitants when compared to other developing countries. However, larger community-based studies with a clinical assessment of stroke cases are needed to confirm our findings.


      PubDate: 2015-10-26T07:53:45Z
       
  • Trends of reported human cases of brucellosis, Kingdom of Saudi Arabia,
           2004–2012
    • Abstract: Publication date: Available online 1 October 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Abdulaziz D. Aloufi, Ziad A. Memish, Abdullah M. Assiri, Scott J.N. McNabb
      Human brucellosis is an important zoonotic disease and is especially concerning in the Kingdom of Saudi Arabia (KSA), where livestock importation is significant. We analyzed reported human brucellosis disease trends in KSA over time to help policymakers understand the magnitude of the disease and guide the design of prevention and control measures. By using data from the national registry from 2004 to 2012, we calculated the cumulative numbers by age group and months. Trends of incidence rates (IRs) by gender, nationality, and region were also calculated. We found that there was a greater number of cases (19,130) in the 15–44years age group than in any other age group. The IRs significantly decreased from 22.9 in 2004 [95% confidence interval (CI)=22.3, 23.5] to 12.5 in 2012 (95% CI=12.1, 13). Males had a significantly greater IR than females. Most cases were reported during spring and summer seasons. The IR of Saudi citizens was significantly greater than that of non-Saudis, but this difference reduced over time. The IRs of Al-Qassim, Aseer, and Hail were in the highest 25th percentile. Young, male Saudi citizens living in highly endemic areas were at greatest risk of acquiring brucellosis. We recommend vaccinating susceptible animals against brucellosis and increasing the public’s awareness of preventive measures.


      PubDate: 2015-10-01T19:23:44Z
       
  • Epidemiology of invasive pneumococcal disease in Saudi Arabian children
           younger than 5years of age
    • Abstract: Publication date: Available online 11 September 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Yagob Almazrou, Atef M. Shibl, Riyadh Alkhlaif, Jean-Yves Pirçon, Sameh Anis, Walid Kandeil, William P. Hausdorff
      This study evaluated the incidence, serotype distribution, and antimicrobial susceptibility of invasive pneumococcal disease (IPD) in Saudi Arabian children. This multicenter, prospective, clinical surveillance study included children under 5years of age, residents of one of the seven study health areas, who were brought to a study hospital with suspicion of IPD. Bacterial isolates from sterile site samples, collected less than 24h after hospital visit/admission, were identified, serotyped, and tested for antibiotic susceptibility. Between June 2007 and January 2009, 631 episodes of suspected IPD were recorded, and 623 were included in the analysis. One child (0.2%) had previously received one dose of a pneumococcal vaccine. Forty-seven episodes were positive for Streptococcus pneumoniae and three for Haemophilus influenzae. The incidence of confirmed IPD cases was estimated to be 2.5–21.6 per 100,000 children (<5years). Among the 46 S. pneumoniae isolates serotyped and tested for antibiotic susceptibility, the most common serotypes were 5 and 23F (20% each), 6B (17%), and 1 and 14 (11% each). Sixty-three percent of isolates were multidrug-resistant. Vaccination of Saudi Arabian children with expanded-coverage conjugate pneumococcal vaccines containing serotypes 1 and 5 could have a substantial impact to prevent IPD in this population.


      PubDate: 2015-09-12T17:25:25Z
       
  • Between-ward disparities in colorectal cancer incidence and screening in
           Washington DC
    • Abstract: Publication date: Available online 4 September 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Sharmila Chatterjee, Amit Chattopadhyay, Paul H. Levine
      This study aims to investigate the incidence and determinants of colorectal cancer (CRC) and its screening in District of Columbia (DC), and identify modifiable risk factors. Data (2000–2009) from the DC Cancer Registry, Behavioral Risk Factor Surveillance System (BRFSS-DC) and Surveillance Epidemiology and End Results (SEER) were used to estimate CRC incidence in eight DC Wards. Risk factors and CRC screening were analyzed using uni-, bi-, and multivariable statistical methods with survey procedures in SAS (version 9.2) including binary, unconditional multivariable logistic regression analysis. Factors measured included stage of diagnosis, age, gender, race/ethnicity, smoking, alcohol, exercise, body weight, health insurance, education, employment, and income. Over the study time, CRC screening increased from 48.4% to 68.6%. Mean age at diagnosis was 67years. CRC incidence is high in DC. Furthermore, CRC incidence rates in DC below 50years age were higher than the SEER18 average. Disparities exist between CRC incidence and screening among DC Wards. Identified risk factors for CRC are smoking, obesity, and low physical activity; screening was less prevalent among the uninsured and low socio-economic group. Local variations in CRC occurrence exist and may vary from average national experiences. Identification of local regions which vary from national trends in disease occurrence is important for comprehensive understanding of the disease in the community.


      PubDate: 2015-09-08T17:03:21Z
       
  • Seasonality and trend analysis of tuberculosis in Lahore, Pakistan from
           2006 to 2013
    • Abstract: Publication date: Available online 28 August 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Aasia Khaliq, Syeda Aadila Batool, M. Nawaz Chaudhry
      Tuberculosis (TB) is a respiratory infectious disease which shows seasonality. Seasonal variation in TB notifications has been reported in different regions, suggesting that various geographic and demographic factors are involved in seasonality. The study was designed to find out the temporal and seasonal pattern of TB incidence in Lahore, Pakistan from 2006 to 2013 in newly diagnosed pulmonary TB cases. SPSS version 21 software was used for correlation to determine the temporal relationship and time series analysis for seasonal variation. Temperature was found to be significantly associated with TB incidence at the 0.01 level with p =0.006 and r =0.477. Autocorrelation function and partial autocorrelation function showed a significant peak at lag 4 suggesting a seasonal component of the TB series. Seasonal adjusted factor showed peak seasonal variation in the second quarter (April–June). The expert modeler predicted the Holt–Winter’s additive model as the best fit model for the time series, which exhibits a linear trend with constant (additive) seasonal variations, and the stationary R 2 value was found to be 0.693. The forecast shows a declining trend with seasonality. A significant temporal relation with a seasonal pattern and declining trend with variable amplitudes of fluctuation was observed in the incidence of TB.


      PubDate: 2015-08-28T16:15:13Z
       
  • Evaluation of home respiratory therapy delivered to patients in the
           Ministry of Health’s Home Medical Program (HMP) and administered
           through the Madinah HMP Cewnter, Kingdom of Saudi Arabia, 2013
    • Abstract: Publication date: Available online 21 August 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Rana A. Alhelali, Scott J.N. McNabb, Ziad A. Memish
      This was an evaluation of home respiratory therapy (HRT) services administered through the Madinah Home Medical Program (MHMP) Center of the Ministry of Health (MoH), Kingdom of Saudi Arabia (KSA). Using a retrospective design and descriptive analyses, we analyzed 83 patient records for the clinical care received, outcomes, and patient satisfaction. We also assessed a subset from an economic perspective. Demographically, 72% were >60years of age, 80% were female, and 90% were Saudi. Asthma accounted for 34% of the diagnosed respiratory diseases, followed by chronic obstructive pulmonary disease (11%). Most patients (71%) required two or three respiratory modalities: 94% used oxygen therapy and 14% were on mechanical ventilation. A full 90% of HMP patients expressed a high level of satisfaction with the HMP overall care, and 43% saw an improvement in their condition. The MHMP lowered healthcare costs for HRT-receiving patients by decreasing the frequency of emergency room (ER) and outpatient visits by 50.8% from 59 to 30 visits. HRT administered through the MHMP Center improved clinical outcomes and increased patient satisfaction while reducing hospital utilization and associated costs. A prospective study is recommended to assess HMP services in comparison with hospitalization.


      PubDate: 2015-08-24T16:00:33Z
       
  • Pilot use of a novel smartphone application to track traveller health
           behaviour and collect infectious disease data during a mass gathering:
           Hajj pilgrimage 2014
    • Abstract: Publication date: Available online 13 August 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Amani S. Alqahtani, Nasser F. BinDhim, Mohamed Tashani, Harold W. Willaby, Kerrie E. Wiley, Anita E. Heywood, Robert Booy, Harunor Rashid
      This study examines the feasibility of using a smartphone application (app) to conduct surveys among travellers during the Hajj pilgrimage, where the use of apps has not been evaluated for infectious disease surveillance. A longitudinal study was conducted among pilgrims at the Hajj 2014 using an iPhone app with separate questionnaires for three study phases covering before, during, and after Hajj. Forty-eight pilgrims from 13 countries downloaded the app. Respondents were aged between 21 and 61 (median 36) years and 58.5% (24/41) were male. Of these, 85% (41/48) completed the first phase, 52% (25/41) completed both the second and third phases, and 25 of these reported meningococcal vaccination, with 36% (9/25) receiving other vaccines. All (25) reported hand hygiene use and 64% (16/25) wore a facemask at some point during the pilgrimage. Four (6%) reported close contact with camels. Respiratory symptoms commenced from the 4th day of Hajj, with sore throat (20%) and cough (12%) being the most common. Three participants (12%) reported respiratory symptoms after returning home. Conducting a prospective survey using a smartphone app to collect data on travel-associated infections and traveller compliance to prevention is feasible at mass gatherings and can provide useful data associated with health-related behaviour.


      PubDate: 2015-08-15T06:06:22Z
       
  • Cardiovascular risk profiles of adults with type-2 diabetes treated at
           urban hospitals in Riyadh, Saudi Arabia
    • Abstract: Publication date: Available online 6 August 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Fatima Y. Al Slail, Omer Abid, Abdullah M. Assiri, Ziad A. Memish, Mohammed K. Ali
      Diabetes mellitus substantially increases cardiovascular disease (CVD) risk. Among Saudi Arabian citizens with diabetes, little is known about the prevalence and control of other CVD risk factors. We extracted data from medical records of a random selection of 422 patients seen between 2008 and 2012 at two diabetic clinics in Riyadh, Saudi Arabia. We calculated the proportion of patients who had additional CVD risk factors: obesity (body mass index⩾30kg/m2), hypertension (BP⩾140/90mmHg), elevated cholesterol fractions, and multiple risk factors). Further, we calculated the proportion of patients meeting the American Diabetes Association’s recommended care targets for each risk factor. Of 422 patients (mean age, 52years), half were women, 56% were obese, 45% had hypertension, and 77% had elevated LDL concentrations. In addition to diabetes, 70% had two or more CVD risk factors. Although 9% met both target HbA1c and BP values, only 3.5% had optimum HbA1c, BP, and lipid values. In Saudi Arabia’s best diabetes clinics, most patients have poor control of their disease. This huge disease burden and related care gaps have important health and financial implications for the country.


      PubDate: 2015-08-10T04:55:39Z
       
  • Study of drug resistance in pulmonary tuberculosis cases in south coastal
           Karnataka
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Parashuram Rao, Kiran Chawla, Vishnu Prasad Shenoy, Chiranjay Mukhopadhyay, Vishwanath Brahmavar, Asha Kamath, Aswini Kumar Mohapatra
      The present cross-sectional study was conducted for the first time from the Udupi district of coastal Karnataka to know the prevalence of drug resistance and comparative analysis of MDR and non-MDR cases of pulmonary tuberculosis. Details of 862 smear positive cases of pulmonary tuberculosis with age ⩾15years from 12 designated microscopy centres of the Udupi district were studied. Initially 2 sputum samples trailed by one follow-up sample were collected from each patient and processed for culture and drug sensitivity on the Lowenstein-Jensen medium. A total resistance of 33.4% was observed that includes the mono-resistance of 22.5%, multidrug resistance (MDR) of 6.3% and extensive drug resistance (XDR) of 0.3%. Significant odds ratio (OR) was observed in category 2 cases (OR 3.9) for the development of MDR tuberculosis. A significant statistical association was observed using Fisher’s exact test while comparing mortality rate (19.3% vs. 1.8%), treatment failure (8.8% vs. 3.8%) and cure rate (68.4% vs. 85.4%) between MDR and non-MDR cases (p <0.001). Category 2 patients are important risk factors for the development of MDR in pulmonary tuberculosis. Due to high mortality and low cure rate in MDR cases it is imperative to know the drug sensitivity report before institution of anti-tubercular treatment.


      PubDate: 2015-07-31T20:58:09Z
       
  • Prospective study of predictors of poor self-rated health in a 23-year
           cohort of earthquake survivors in Armenia
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Anahit Demirchyan, Varduhi Petrosyan, Haroutune K. Armenian, Vahe Khachadourian
      Long-term prospective studies exploring general health outcomes among disaster survivors are rare. Self-rated health (SRH) – a proven correlate of morbidity and mortality prognosis – was used to investigate predictors of perceived health status among a 23-year cohort of survivors of 1988 Spitak earthquake in Armenia. A geographically-stratified subsample of 725 adults from a larger initial cohort was followed during the period of 1990–2012. A logistic regression model identified predictors of SRH. Adjusted relative risks for the long-term predictors of SRH were calculated. The rate of poor SRH among the survivors was 18.8%, fair 56.5%, and good/excellent 24.7%. In the fitted model, long-term risk factors of poor SRH included baseline body mass index, baseline multi-morbidity, number of experienced stressful life events, and perceived poor living standards during the post-earthquake decade, while participation in sports in the early 1990s was a protective factor. Short-term protective factors included socio-economic status score, social support, employment and dignity, while current household size was a risk factor for poor SRH. No association was found between earthquake exposure severity and SRH after 23years. However, the identified predictors included a number of modifiable lifestyle, material and psychological factors. Thus, interventions targeting these factors could have a long-lasting impact on disaster victims’ health status.


      PubDate: 2015-07-31T20:58:09Z
       
  • Symptom clusters on primary care medical service trips in five regions in
           Latin America
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Christopher Dainton, Charlene Chu
      Short-term primary care medical service trips organized by the North American non-governmental organizations (NGOs) serve many communities in Latin America that are poorly served by the national health system. This descriptive study contributes to the understanding of the epidemiology of patients seen on such low-resource trips. An analysis was conducted on epidemiologic data collected from anonymized electronic medical records on patients seen during 34 short-term medical service trips in five regions in Ecuador, Guatemala, and the Dominican Republic between April 2013 and April 2014. A total of 22,977 patients were assessed by North American clinicians (physicians, nurse practitioners, physician assistants) on primary care, low-resource medical service trips. The majority of patients were female (67.1%), and their average age was 36. The most common presenting symptoms in all regions were general pain, upper respiratory tract symptoms, skin disorders, eye irritation, dyspepsia, and nonspecific abdominal complaints; 71–78% of primary care complaints were easily aggregated into well-defined symptom clusters. The results suggest that guideline development for clinicians involved in these types of medical service trips should focus on management of the high-yield symptom clusters described by these data.


      PubDate: 2015-07-31T20:58:09Z
       
  • Smoking motivators are different among cigarette and waterpipe smokers:
           The results of ITUPP
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Hamidreza Roohafza, Kamal Heidari, Tahereh Alinia, Razieh Omidi, Masoumeh Sadeghi, Elham Andalib, Ali Ajami, Nizal Sarrafzadegan
      The present study explores different drivers of cigarette and water pipe smoking among middle and high school students in Isfahan province. A questionnaire-based cross-sectional study was conducted. Trained staff collected questionnaires and saliva samples for response accuracy evaluation. Prevalence by demographic, parental and educational factors was calculated. Logistic regression was applied to compare behavior drivers of those who purely smoked cigarettes or a waterpipe. Waterpipe smokers were considered as the reference category. This study reported ORs along 95% confidence intervals; 5408 questionnaires were returned. The sample age was 15.37±01.70 on average. The self-reported prevalence of cigarette and waterpipe experimentation was 11.60% (n =624) and 20.70% (n =1,109), respectively; and 5.08% (n =311), 11.06% (n =619) for smokers, and 13.30% (n =711) for the whole sample. Psychological factors were the most important driver for cigarette smoking; bad event happening with odds of 2.38 (95% CI: 1.29–4.39); angriness 2.58 times (95% CI: 1.51–4.43); and distress by 2.49 times (95% CI: 1.42–4.40). Habitual situations were strong predictors of cigarette smoking, but not a predictor of waterpipe smoking, such as smoking after a meal (OR =3.11, 95% CI: 1.67–5.77); and smoking after waking up (OR =2.56, 95% CI: 1.42–4.40). Comprehensive and multifaceted preventive programs must tailor identified factors and increase family’s awareness.


      PubDate: 2015-07-31T20:58:09Z
       
  • Prevalence and correlates of tobacco use among school-going adolescents in
           Madagascar
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Sreenivas P. Veeranki, Hadii M. Mamudu, Rijo M. John, Ahmed E.O. Ouma
      Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents’ tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13–15years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors. Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females’ tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents’ tobacco use.


      PubDate: 2015-07-31T20:58:09Z
       
  • Estimating the potential impact fraction of hypertension as the main risk
           factor of stroke: Application of the distribution shift method
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Azam Biderafsh, Manoochehr Karami, Javad Faradmal, Jalal Poorolajal
      Few published studies have assessed the impact of quantitative risk factors such as high blood pressure on stroke. The aim of this study was to quantify the potential impact fraction (PIF) of hypertension on stroke in Hamadan Province, western Iran. Avoidable burden of stroke associated with high blood pressure was calculated using distribution shift at different scenarios. Data on the prevalence of high blood pressure among residents of Hamadan province older than 19years were extracted from non-communicable diseases risk factors surveillance system in 2009. Five mmHg hypothetical reduction in systolic blood pressure above 140mmHg, leads to 3.5% (PIF=0.035) reduction in the total burden to stroke. This value may reach 7%, if systolic blood pressure decreases 10mmHg. In addition, 5mmHg hypothetical reduction in diastolic blood pressure above 82mmHg, leads to 4.87% reduction in the total burden to stroke. PIF more than 10mmHg modification on distribution of diastolic blood pressure was estimated as 9.38%. According to these findings, policy makers are advised to implement interventions on hypertension based on the distribution shift method rather than the proportion shift one.


      PubDate: 2015-07-31T20:58:09Z
       
  • Spatial and non-spatial determinants of successful tuberculosis treatment
           outcomes: An implication of Geographical Information Systems in health
           policy-making in a developing country
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Goodarz Kolifarhood, Davoud Khorasani-Zavareh, Shaker Salarilak, Alireza Shoghli, Nasim Khosravi
      This retrospective study aimed to address whether or to what extent spatial and non-spatial factors with a focus on a healthcare delivery system would influence successful tuberculosis (TB) treatment outcomes in Urmia, Iran. In this cross-sectional study, data of 452 new TB cases were extracted from Urmia TB Management Center during a 5-year period. Using the Geographical Information System (GIS), health centers and study subjects’ locations were geocoded on digital maps. To identify the statistically significant geographical clusters, Average Nearest Neighbor (ANN) index was used. Logistic regression analysis was employed to determine the association of spatial and non-spatial variables on the occurrence of adverse treatment outcomes. The spatial clusters of TB cases were concentrated in older, impoverished and outskirts areas. Although there was a tendency toward higher odds of adverse treatment outcomes among urban TB cases, this finding after adjusting for distance from a given TB healthcare center did not reach statistically significant. This article highlights effects of spatial and non-spatial determinants on the TB adverse treatment outcomes, particularly in what way the policies of healthcare services are made. Accordingly, non-spatial determinants in terms of low socio-economic factors need more attention by public health policy makers, and then more focus should be placed on the health delivery system, in particular men’s health.


      PubDate: 2015-07-31T20:58:09Z
       
  • Barriers related to non-adherence in a mammography breast-screening
           program during the implementation period in the interior of São Paulo
           State, Brazil
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): René Aloisio da Costa Vieira, Tânia Silveira Lourenço, Edmundo Carvalho Mauad, Valter Gonçalves Moreira Filho, Stela Verzinhasse Peres, Thiago Buosi Silva, Maria do Rosário Dias de Oliveira Lattore
      Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40–69years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn’t done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.


      PubDate: 2015-07-31T20:58:09Z
       
  • Fall-related injuries in a low-income setting: Results from a pilot injury
           surveillance system in Rawalpindi, Pakistan
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Junaid A. Bhatti, Umar Farooq, Mudassir Majeed, Jahangir S. Khan, Junaid A. Razzak, Muhammad M. Khan
      This study assessed the characteristics and emergency care outcomes of fall-related injuries in Pakistan. This study included all fall-related injury cases presenting to emergency departments (EDs) of the three teaching hospitals in Rawalpindi city from July 2007 to June 2008. Out of 62,530 injury cases, 43.4% (N =27,109) were due to falls. Children (0–15years) accounted for about two out of five of all fall-related injuries. Compared with women aged 16–45years, more men of the same age group presented with fall-related injuries (50% vs. 42%); however, compared with men aged 45years or more, about twice as many women of the same age group presented with fall-related injuries (16% vs. 9%, P <0.001). For each reported death due to falls (n =57), 43 more were admitted (n =2443, 9%), and another 423 were discharged from the EDs (n =24,142, 91%). Factors associated with death or inpatient admission were: aged 0–15years (adjusted odds ratio [aOR]=1.35), aged 45years or more (aOR=1.94), male gender (aOR=1.15), falls occurring at home (aOR=3.38), in markets (aOR=1.43), on work sites (aOR=4.80), and during playing activities (aOR=1.68). This ED-based surveillance study indicated that fall prevention interventions in Pakistan should target children, older adult women, homes, and work sites.


      PubDate: 2015-07-31T20:58:09Z
       
  • Foot ailments during Hajj: A short report
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): Shruti Sridhar, Samir Benkouiten, Khadidja Belhouchat, Tassadit Drali, Ziad A. Memish, Philippe Parola, Philippe Brouqui, Philippe Gautret
      A study of ailments of the feet in pilgrims of Hajj revealed that 31% of them suffered from blisters, and the prevalence was five times higher in females. The presence of comorbidity (diabetes, obesity and advanced age) warrants immediate attention to them to avoid serious complications.


      PubDate: 2015-07-31T20:58:09Z
       
  • Volunteering to improve health worldwide. Current trends in Out of
           Programme Experience/Training in the UK 2014
    • Abstract: Publication date: September 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 3
      Author(s): T. Bharucha, A. Traianou, M. Keniger, G. Chisholm, G. Lewis, J. Roland, M. Stark, C.S. Brown



      PubDate: 2015-07-31T20:58:09Z
       
  • Evaluation of medication adherence in Lebanese hypertensive patients
    • Abstract: Publication date: Available online 29 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Amal Al-Hajje, Sanaa Awada, Samar Rachidi, Salam Zein, Wafa Bawab, Zeinab El-Hajj, Mayssam Bou Zeid, Mohammad Yassine, Pascale Salameh
      Controlling hypertension is essential in cardiovascular disease. Poor medication adherence is associated with poor disease outcomes, waste of healthcare resources, and contributes to reduced blood pressure control. This study evaluates treatment adherence to antihypertensive therapy in Lebanese hypertensive patients by estimating the proportion of adherent hypertensive patients using a validated tool and investigates what factors predict this behavior. A questionnaire-based cross-sectional study was conducted on a random sample of 210 hypertensive outpatients selected from clinics located in tertiary-care hospitals and from private cardiology clinics located in Beirut. Adherence level was measured using a validated 8-item Modified Morisky Medication Adherence Scale (MMMAS). Among 210 patients, 50.5% showed high adherence, 27.1% medium adherence, and 22.4% low adherence to medication. Mean MMMAS score was 6.59±2.0. In bivariate analyses, having controlled blood pressure (p =0.003) and taking a combination drug (p =0.023) were predictors of high adherence. Forgetfulness (p <0.01), complicated drug regimen (p =0.001), and side effects (p =0.006) were predictors of low adherence after multiple liner regression. Logistic regression results showed that calcium channel blockers (p =0.030) were associated with increased adherence levels. In conclusion, developing multidisciplinary intervention programs to address the factors identified, in addition to educational strategies targeting healthcare providers, are necessary to enhance patient adherence.


      PubDate: 2015-07-31T20:58:09Z
       
  • Body shape dissatisfaction is a ‘normative discontent’ in a
           young-adult Nigerian population: A study of prevalence and effects on
           health-related quality of life
    • Abstract: Publication date: Available online 29 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Chukwunonso E.C.C. Ejike
      This study investigates the prevalence of weight misperception, weight preference, and body shape dissatisfaction (BSD) among young-adult Nigerians and assesses the impact of these factors on population quality-of-life (QOL). Relevant anthropometric data were collected according to internationally accepted protocols. Weight perception, weight preference, and BSD were measured using Stunkard silhouettes, while QOL was determined by subjective self-reporting. The results show that 26.7% of the population (18.8% for males and 34.5% for females) misperceived their weight. Among overweight participants, 56.6% (males) and 38.3% (females) thought they were thinner, while 11.5% (males) and 43.3% (females) thought they were heavier. Thin and obese males misperceived their weights more than their female counterparts. BSD was found in 62% of the population (52% for males and 71% for females) and was highest among obese participants (91.9%) and lowest among normal-weight participants (58.2%), irrespective of sex. In participants with BSD, QOL was worse in thin and normal-weight respondents who preferred to be heavier and in overweight respondents who preferred to be thinner. The high prevalence of weight misperception may lead to inappropriate weight loss habits, while BSD, a normative discontent in this population, negatively impacts subject QOL.


      PubDate: 2015-07-31T20:58:09Z
       
  • Central coordination of humanitarian aid in Nepal
    • Abstract: Publication date: Available online 28 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Maryam Alfa-Wali, Kaji Sritharan



      PubDate: 2015-07-31T20:58:09Z
       
  • A longitudinal cohort study of the relationship between
           Thimerosal-containing hepatitis B vaccination and specific delays in
           development in the United States: Assessment of attributable risk and
           lifetime care costs
    • Abstract: Publication date: Available online 9 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): David A. Geier , Janet K. Kern , Brian S. Hooker , Paul G. King , Lisa K. Sykes , Mark R. Geier
      Epidemiological evidence suggests a link between mercury (Hg) exposure from Thimerosal-containing vaccines and specific delays in development. A hypothesis-testing longitudinal cohort study (n =49,835) using medical records in the Vaccine Safety Datalink (VSD) was undertaken to evaluate the relationship between exposure to Hg from Thimerosal-containing hepatitis B vaccines (T-HBVs) administered at specific intervals in the first 6months of life and specific delays in development [International Classification of Disease, 9th revision (ICD-9): 315.xx] among children born between 1991 and 1994 and continuously enrolled from birth for at least 5.81years. Infants receiving increased Hg doses from T-HBVs administered within the first month, the first 2months, and the first 6months of life were significantly more likely to be diagnosed with specific delays in development than infants receiving no Hg doses from T-HBVs. During the decade in which T-HBVs were routinely recommended and administered to US infants (1991–2001), an estimated 0.5–1million additional US children were diagnosed with specific delays in development as a consequence of 25μg or 37.5μg organic Hg from T-HBVs administered within the first 6months of life. The resulting lifetime costs to the United States may exceed $1 trillion.


      PubDate: 2015-07-14T19:15:02Z
       
  • Achieving high seroprevalence against polioviruses in Sri
           Lanka—Results from a serological survey, 2014
    • Abstract: Publication date: Available online 9 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Deepa Gamage , Paba Palihawadana , Ondrej Mach , William C. Weldon , Steven M. Oberste , Roland W. Sutter
      The immunization program in Sri Lanka consistently reaches >90% coverage with oral poliovirus vaccines (OPV), and no polio supplementary vaccination campaigns have been conducted since 2003. We evaluated serological protection against polioviruses in children. A cross-sectional community-based survey was performed in three districts of Sri Lanka (Colombo, Badulla, and Killinochi). Randomly selected children in four age groups (9–11months, 3–4years, 7–9years, and 15years) were tested for poliovirus neutralizing antibodies. All 400 enrolled children completed the study. The proportion of seropositive children for poliovirus Type 1 and Type 2 was >95% for all age groups; for poliovirus Type 3 it was 95%, 90%, 77%, and 75% in the respective age groups. The vaccination coverage in our sample based on vaccination cards or parental recall was >90% in all age groups. Most Sri Lankan children are serologically protected against polioviruses through routine immunization only. This seroprevalence survey provided baseline data prior to the anticipated addition of inactivated poliovirus vaccine (IPV) into the Sri Lankan immunization program and the switch from trivalent OPV (tOPV) to bivalent OPV (bOPV).


      PubDate: 2015-07-14T19:15:02Z
       
  • Health conditions for travellers to Saudi Arabia for the pilgrimage to
           Mecca (Hajj) – 2015
    • Abstract: Publication date: Available online 13 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Homoud Alqarni , Ziad A. Memish , Abdullah M. Assiri



      PubDate: 2015-07-14T19:15:02Z
       
  • The psychology of health and well-being in mass gatherings: A review and a
           research agenda
    • Abstract: Publication date: Available online 9 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Nick Hopkins , Steve Reicher
      Mass gatherings bring large numbers of people into physical proximity. Typically, this physical proximity has been assumed to contribute to ill health (e.g., through being stressful, facilitating infection transmission, etc.). In this paper, we add a new dimension to the emerging field of mass gatherings medicine. Drawing on psychological research concerning group processes, we consider the psychological transformations that occur when people become part of a crowd. We then consider how these transformations may have various consequences for health and well-being. Some of these consequences may be positive. For example, a sense of shared identity amongst participants may encourage participants to view others as a source of social support which in turn contributes to a sense of health and well-being. However, some consequences may be negative. Thus, this same sense of shared identity may result in a loss of disgust at the prospect of sharing resources (e.g., drinking utensils) which could, in turn, facilitate infection transmission. These, and related issues, are illustrated with research conducted at the Magh Mela (North India). We conclude with an agenda for future research concerning health practices at mass gatherings.


      PubDate: 2015-07-09T17:31:35Z
       
  • Predictive factors for percutaneous and mucocutaneous exposure among
           healthcare workers in a developing country
    • Abstract: Publication date: Available online 9 July 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Zeynep Türe , Ayşegül Ulu Kiliç , Fatma Cevahir , Dilek Altun , Esra Özhan , Emine Alp
      The aim of this study is to determine the risk factors for percutaneous and mucocutaneous exposures in healthcare workers (HCW) in one of the largest centers of a middle income country, Turkey. This study has a retrospective design. HCWs who presented between August 2011 and June 2013, with Occupational Exposures (OEs) (cases) and those without (controls) were included. Demographic information was collected from infection control committee documents. A questionnaire was used to ask the HCWs about their awareness of preventive measures. HCWs who work with intensive work loads such as those found in emergency departments or intensive care units have a higher risk of OEs. Having heavy workloads and hours increases the risk of percutaneous and mucocutaneous exposures. For that reason the most common occupation groups are nurses and cleaning staff who are at risk of OEs. Increasing work experience has reduced the frequency of OEs.


      PubDate: 2015-07-09T17:31:35Z
       
  • Effect of age and gender in the prevalence of excessive daytime sleepiness
           among a sample of the Saudi population
    • Abstract: Publication date: Available online 19 June 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Abdulhamid Fatani , Khalid Al-Rouqi , Jamal Al Towairky , Anwar E. Ahmed , Sarah Al-Jahdali , Yosra Ali , Abdullah Al-Shimemeri , Abdullah Al-Harbi , Salim Baharoon , Mohammad Khan , Hamdan Al-Jahdali
      The aim of this study is to assess whether the effect of gender on the excessive daytime sleepiness (EDS) is influenced by two confounders (age and hours of sleep per night). A cross-sectional study was conducted at King Abdulaziz Medical City-Riyadh (KAMC-R). A total of 2095 respondents answered a questionnaire that included questions regarding gender, age, hours of sleep per night, and daytime sleepiness using the Epworth Sleepiness Scale (ESS). The prevalence of EDS was 20.5% (females 22.2%, males 19.5%, p-value=0.136). The EDS did not differ between genders, age groups, or hours of sleep per night (<6 vs. ⩾6h). However, stratified statistical analysis shows that the prevalence of EDS did differ according to gender (25.3% in females, 19.0% in males, p-value=0.036) in respondents with shorter hours of sleep per night. EDS was strongly related to female gender and young age (ages⩽29years) in respondents with short hours of sleep. This study reveals that one out of five of the general Saudi population has EDS. The effect of gender on EDS appeared to be influenced by hours of sleep per night. High EDS strongly related to female gender with short hours of sleep.


      PubDate: 2015-06-24T13:57:54Z
       
  • Do socio-demographic factors still predict the choice of place of
           delivery: A cross-sectional study in rural North India
    • Abstract: Publication date: Available online 11 June 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Jyotiranjan Sahoo , Satyavir Singh , V.K. Gupta , Suneela Garg , Jugal Kishore
      Improving maternal health is one of the goals to be achieved under the Millennium Development Goal (MDG), especially MDG-5. One of the predictors of maternal health is place of child birth. This study was carried out to determine the prevalence of home delivery and different socio-demographic factors associated with them. This study was a community-based cross-sectional study. Women who delivered a baby in the past 1year were included in this study. A total of 300 women responded (93.2%) and gave consent to participate in the study. Prevalence of home delivery was 37.7%. Bivariate analysis showed that religion, caste, education of women and their partners, occupation of the spouse, monthly family income and socioeconomic status had a significant association with the choice of place of delivery. But multivariate regression analysis showed only religion, caste, education of spouse and monthly income to be significant factors in determining place of delivery. The findings of this study suggest that individual countries have to formulate interventions which will target marginalized or vulnerable populations with reference to caste, religion and wealth. A significant improvement in reaching the 5th MDG can be achieved if the first three MDG goals are focused on, i.e., eradication of poverty, achieving universal education and women empowerment.


      PubDate: 2015-06-19T02:14:31Z
       
  • Prevalence of self-reported sleep duration and sleep habits in type 2
           diabetes patients in South Trinidad
    • Abstract: Publication date: Available online 11 June 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Rishi Ramtahal , Claude Khan , Kavita Maharaj-Khan , Sriram Nallamothu , Avery Hinds , Andrew Dhanoo , Hsin-Chieh Yeh , Felicia Hill-Briggs , Mariana Lazo
      The present study aims to determine the prevalence of self-reported sleep duration and sleep habits and their associated factors in patients with type 2 diabetes in Trinidad. This was a cross-sectional multicenter study. There were 291 patients with type 2 diabetes studied. Sleep habits were assessed using the Epworth Sleepiness Scale (ESS) and the National Health and Nutrition Examination Survey sleep disorder questionnaire. Demographic, anthropometric and biochemical data were also collected. The sample had a mean age of 58.8years; 66.7% were female. The mean BMI was 28.9kg/m2. The prevalence of Excessive Daytime Sleepiness (EDS) was 11.3%. The prevalence of patients with short sleep (⩽6h) was 28.5%. The prevalence of patients with poor sleep was 63.9%. Poor sleep was associated with age, intensive anti-diabetic treatment and longer duration of diabetes. Short sleep was associated with intensive anti-diabetic treatment and BMI, while EDS was associated with increased BMI. In a sample of patients with type 2 diabetes, a high prevalence of self-reported sleep duration and unhealthy sleep habits was found. There needs to be an increased awareness of sleep conditions in adults with type 2 diabetes by doctors caring for these patients.


      PubDate: 2015-06-19T02:14:31Z
       
  • Can pricing deter adolescents and young adults from starting to drink: An
           analysis of the effect of alcohol taxation on drinking initiation among
           Thai adolescents and young adults
    • Abstract: Publication date: Available online 13 June 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Bundit Sornpaisarn , Kevin D. Shield , Joanna E. Cohen , Robert Schwartz , Jürgen Rehm
      The objective of this study is to assess the relationship between alcohol taxation changes and drinking initiation among adolescents and young adults (collectively “youth”) in Thailand (a middle-income country). Using a survey panel, this study undertook an age-period-cohort analysis using four large-scale national cross-sectional surveys of alcohol consumption performed in Thailand in 2001, 2004, 2007 and 2011 (n =87,176 Thai youth, 15–24years of age) to test the hypothesis that changes in the inflation-adjusted alcohol taxation rates are associated with drinking initiation. Regression analyses were used to examine the association between inflation-adjusted taxation increases and the prevalence of lifetime drinkers. After adjusting for potential confounders, clear cohort and age effects were observed. Furthermore, a 10% increase of the inflation-adjusted taxation rate of the total alcohol market was significantly associated with a 4.3% reduction in the prevalence of lifetime drinking among Thai youth. In conclusion, tax rate changes in Thailand from 2001 to 2011 were associated with drinking initiation among youth. Accordingly, increases in taxation may prevent drinking initiation among youth in countries with a high prevalence of abstainers and may reduce the harms caused by alcohol.


      PubDate: 2015-06-19T02:14:31Z
       
  • Household wealth, residential status and the incidence of diarrhoea among
           children under-five years in Ghana
    • Abstract: Publication date: Available online 10 June 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Akwasi Kumi-Kyereme , Joshua Amo-Adjei
      This study examines the impact that the joint effect of household wealth quintile and urban–rural residence has on the incidence of diarrhoea among Ghanaian children. Data for this paper were drawn from the Ghana Micro Indicator Cluster Survey (MICS) of 2006. Descriptive and logistic regression was applied to analyse data on 3466 children. Rural residents are less likely, albeit insignificant, to report diarrhoea compared with those in urban areas. Significant wealth gradients are manifested in childhood experiences of diarrhoea. However, an interaction of wealth with residence does not show significant disparities. Controlling for other important covariates of childhood, the odds of diarrhoea incidence were significantly higher among: the rural poorer (OR=4.869; 95% CI=0.792, 29.94), the rural middle (OR=7.477; 95% CI=1.300, 42.99), the rural richer (OR=6.162; 95% CI=0.932, 40.74) and the rural richest (OR=6.152; 95% CI=0.458, 82.54). Apart from residential status and wealth quintile, female children (OR=0.441; 95% CI=0.304, 0.640), older children (OR=0.968; 95% CI=0.943, 0.993), having a mother with secondary and higher education (OR=0.313; 95% CI) had lesser odds of experiencing diarrhoea. The findings show that there is a need to apportion interventions intended to improve child health outcomes even beyond residential status and household wealth position.


      PubDate: 2015-06-11T00:26:27Z
       
  • Association of lipoprotein lipase gene with coronary heart disease in
           Sudanese population
    • Abstract: Publication date: Available online 27 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Muzamil M. Abdel Hamid , Safa Ahmed , Awatif Salah , Etayeb M.A. Tyrab , Lemya M. Yahia , Elbagire A. Elbashir , Hassan H. Musa
      Cardiovascular disease is stabilizing in high-income countries and has continued to rise in low-to-middle-income countries. Association of lipid profile with lipoprotein lipase gene was studied in case and control subject. The family history, hypertension, diabetes mellitus, smoking and alcohol consumption were the most risk factors for early-onset of coronary heart disease (CHD). Sudanese patients had significantly (P <0.05) lower TC and LDL-C levels compared to controls. Allele frequency of LPL D9N, N291S and S447X carrier genotype was 4.2%, 30.7% and 7.1%, respectively. We conclude that lipoprotein lipase polymorphism was not associated with the incidence of CHD in Sudan.


      PubDate: 2015-05-31T19:02:40Z
       
  • Role of patient-reported outcomes and other efficacy endpoints in the drug
           approval process in Europe (2008–2012)
    • Abstract: Publication date: Available online 29 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Dipika Bansal , Anil Bhagat , Fabrizio Schifano , Kapil Gudala
      The present study aimed at systematically reviewing the role and extent of patient-reported outcomes (PROs) usage within the package of scientific evidence considered for marketing authorization (MA). All regulatory information published by the European Medicines Agency (EMA) for products authorized between January 2008 and December 2012 and appearing in the European Public Assessment Report (EPAR) database was examined for efficacy endpoints. The endpoints here considered included: PROs, clinician reported outcomes (CROs), and laboratory reported outcomes (LROs). LROs were the most frequently reported endpoints. Out of the 180 products here selected, 99 (55%), 67 (37%), and 30 (17%), respectively, used LROs, CROs and PROs as primary endpoints (PEs). PROs as any endpoints were used in 82 (46%) products. Out of these, PROs were documented as PE in 30 (37%), with 27 (33%) products having used PROs both as primary and non-PEs. PRO usage was most frequently identified with nervous system and antineoplastic agents. During the study period, the use of all the three types of endpoints appeared to be static. Both the regulatory bodies and the industry should ensure complete and clear reporting of all endpoints used, including PROs, to improve transparency.


      PubDate: 2015-05-31T19:02:40Z
       
  • An assessment of the occupational and environmental health needs in seven
           Southeastern European and West-Central Asian countries
    • Abstract: Publication date: Available online 8 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Alexandru Coman , Răzvan M. Cherecheş , Marius I. Ungureanu , Emanuela O. Marton Vasarhelyi , Marissa A. Valentine , Tara Sabo-Attwood , Gregory C. Gray
      Eastern European and Central Asian countries are undergoing rapid socioeconomic and political reforms. Many old industrial facilities are either abandoned, or use outdated technologies that severely impact the environment. Emerging industries have less regulation than in developed countries and environmental and occupational problems seem to be increasing. Under a US National Institutes of Health pilot grant, we developed an interdisciplinary One Health research network in Southeastern Europe and West-Central Asia to identify environmental and occupational problems. From 2012 to 2014, this GEOHealth Hub engaged 11 academic centers and 16 public health institutions in eight different countries: Albania, Armenia, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Romania, and the United States with a goal of strengthening environmental and occupational research and training capacities. Employing face-to-face interviews and large group meetings, we conducted an evidenced-based needs and opportunities assessment focused on aquatic health, food safety, and zoonotic diseases. Comprehensive reviews of the published literature yielded priority research areas for each of the seven GeoHealth Hub countries including heavy metal and pesticide contamination, tick-borne diseases, rabies, brucellosis, and inadequate public health surveillance.


      PubDate: 2015-05-12T13:22:58Z
       
  • First and second line drug resistance among treatment naïve cases
           pulmonary tuberculosis patients in a district under Revised National
           Tuberculosis Control Programme (RNTCP) in New Delhi
    • Abstract: Publication date: Available online 2 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Vithal Prasad Myneedu , Ritu Singhal , Khalid Umer Khayyam , Prem Prakash Sharma , Manpreet Bhalla , Digamber Behera , Rohit Sarin
      There is limited information of level of drug resistance to first-line and second line anti-tuberculosis agents in treatment naïve pulmonary tuberculosis (PTB) patients from the Indian region. Therefore, the present prospective study was conducted to determine the antimicrobial susceptibility to first-line and second line anti-TB drug resistance in such patients. Sputum samples from consecutive treatment naïve PTB cases registered in Lala Ram Sarup (LRS) district, under RNTCP containing 12 Directly Observed Treatment Centre’s (DOTS), were enrolled using cluster sampling technology. A total of 453 samples were received from July 2011 to June 2012. All samples were cultured on solid medium followed by drug susceptibility to first and second line anti-tubercular drugs as per RNTCP guidelines. Primary multi-drug resistance (MDR) was found to be 18/453; (4.0%). Extensively drug resistance (XDR) was found in one strain (0.2%), which was found to be resistant to other antibiotics. Data of drug resistant tuberculosis among treatment naïve TB patients are lacking in India. The presence of XDR-TB and high MDR-TB in small population studied, calls for conducting systematic multi-centric surveillance across the country.


      PubDate: 2015-05-02T21:47:09Z
       
  • Energy drink usage among university students in a Caribbean country:
           Patterns of use and adverse effects
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Sandra D. Reid , Jonathan Ramsarran , Rachel Brathwaite , Sarika Lyman , Ariane Baker , D’Andra C. Cornish , Stefan Ganga , Zahrid Mohammed , Avinash T. Sookdeo , Cathrine K. Thapelo
      Objective There has been little inquiry addressing whether or not concerns about adverse effects of energy drink usage are relevant in the Caribbean. This survey investigated energy drink usage and adverse consequences among tertiary level students in Trinidad and Tobago. Methods A cross-sectional survey of 1994 students from eight institutions was conducted using a de novo questionnaire based on findings from a focus group of students. Chi-squared analyses and logistic regression were used to assess relationships between energy drink usage, adverse effects and other factors affecting energy drink use, and to verify predictors of energy drink use. Results Prevalence of use was 86%; 38% were current users. Males were more likely to use, used more frequently and at an earlier age. Energy drinks were used most commonly to increase energy (50%), combat sleepiness (45%) and enhance academic performance (40%), and occurred during sports (23%) and mixed with alcohol (22.2%). The majority (79.6%) consumed one energy drink per sitting; 62.2% experienced adverse effects, most commonly restlessness (22%), jolt and crash (17.1%) and tachycardia (16.6%). Awareness of adverse effects was associated with no use (p =0.004), but adverse effects were not a deterrent to continued use. Conclusion Energy drink usage is prevalent among students. The use is not excessive, but associated with high rates of adverse effects and occurs in potentially dangerous situations like during exercise and with alcohol. There is a need to educate students about the potential adverse effects of energy drinks.


      PubDate: 2015-05-02T21:47:09Z
       
 
 
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