Open Journal of Epidemiology, 2018, 8, 226-241
Abstract
Introduction: Road traffic accidents (RTAs) are a major public health issue
in developing countries, where roads tend to be built haphazardly and accidents
take a heavy toll on victims—including leaving them disabled. This
study seeks ...to identify those factors that cause RTA victims to become disabled
as a result of their injuries. Methods: This retrospective community-
based study looked at RTA victims treated in five public and faith-based
hospitals in Benin. Disability was evaluated using the Washington Group on
Disabilities Statistics questionnaire. The independent variables were related to
the victim’s socio-demographic traits, the circumstances of the accident, and
post-crash response mechanisms. The proportions were compared using the
chi-squared test, with a threshold of 5%. Results: The prevalence of disability
among road traffic accident victims is 9.59% (CI 95%: 6.86% - 13.20%). The
occurrence of disability is associated with age (p = 0.002), occupational group
(p = 0.0077), the mode of transport used to transfer the victim (p < 0.001)
and the location of the injuries (p = 0.0035). The study also found that people
fail to make sufficient use of post-crash response mechanisms. Conclusion:
Public policy-makers should therefore focus on stepping up interventions to
get more people using both protective equipment and post-crash response services.
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Barriers to the prompt and effective diagnosis and treatment of malaria exist at both the community and health facility level. Household surveys measure malaria case management at the population level with standard indicators that assess treatment-seeking behavior, access to diagnostic testing, and ...access to appropriate treatment. Performance on these indicators varies widely from country to country. Among countries with Demographic and Health Surveys (DHS) or Malaria Indicator Surveys (MIS) completed between 2014 and 2016, advice and treatment was sought for a median of 47% of children under age 5 with fever.
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This rapid compilation of data analyses provides a ‘stock-take’ of social science and behavioural data related to the on-going outbreak of Ebola in North Kivu, South Kivu and Ituri provinces. Based on data gathered and analysed by organisations working in the Ebola response and in the region mor...e broadly, it explores convergences and divergences between datasets and, when possible, differences by geographic area, demographic group, time period and other relevant variables. Data sources are listed at the end of the document.
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For the 24th consecutive year, PAHO has published the report Health Situation in the Americas: Core Indicators featuring the latest information on key indicators for the Region of the Americas. This 2018 edition includes data on the 82 core indicators for the countries, territories, and sub regions ...of the Americas, grouped into the following categories: demographic-socioeconomic, health status, risk factors, service coverage, and health systems. Information is also presented on 22 indicators of the Sustainable Development Goals (SDGs).
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Ade et al. BMC Health Services Research (2016) 16:5
Background: In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about
the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the
possible b...enefits on improving treatment outcomes. This study aimed to determine the contribution of tracing
activities for those who missed scheduled appointments towards a successful treatment outcome.
Methods: A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients
treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment
outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their
scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed
to explore factors associated with missing a scheduled appointment
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This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent ...class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
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Recent increases in family planning (FP) use have been reported among women of reproductive age in union (WRAU) in Senegal. However, trends have not been monitored among harder-to-reach groups (including adolescents, unmarried and rural poor women), key to understanding whether FP progress is equita...ble. We combined data from six Demographic and Health Surveys conducted in Senegal between 1992/93 and 2014. We examined FP trends over time among WRAU and subgroups, and trends in knowledge of FP and intention to use among women with unmet need for FP. Our results show that percent demand satisfied is lower among rural poor women and adolescents than WRAU, although higher among unmarried women. Marked recent increases have been observed in all subgroups, however fewer than 50% of women in need of FP use modern contraception in Senegal. Knowledge of FP has risen steadily among women with unmet need; however, intention to use FP has remained stable at around 40% since 2005 for all groups except unmarried women (75% of whom intend to use). Significant progress in meeting the need for FP has been achieved in Senegal, but more needs to be done particularly to improve acceptability of FP, and to strategically target interventions toward adolescents and rural poor women.
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Lancet Glob Health 2020; 8: e341–51
Francophone Africa still carries a high burden of communicable and neonatal diseases, probably due to the weakness of health-care systems and services, as evidenced by the almost complete attribution of DALYs to YLLs. To cope with this burden of disease, franco...phone Africa should define its priorities and invest more resources in health-system strengthening and in the quality and quantity of health-care services, especially in rural and remote areas. The region could also be prioritised in terms of technical and financial assistance focused on achieving these goals, as much as on demographic investments including education and family planning
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Interactive Map
You’ve probably noticed that the map has been evolving along with the virus. Now, it sports new layers of data—including a close-up section on the US, with details on testing, hospitalizations, and country-level demographic data.
The map provides “more nuance on what’s h...appening to support decision-making.
For example, the new details can help prepare hospitals to better anticipate staffing and resource shortages
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The National AIDS Control Council (NACC) continues to strengthen partnerships with all stakeholders in the response to HIV and AIDS in Kenya. While recognizing that there is no single preventive approach to reverse the spread of HIV, the faith sector comprising of Faith Communities (FCs) a...nd Faith-Based Organizations (FBOs) have demonstrated sustained motivation and moral authority with resources and outreach capability to significantly reduce new HIV infections. In addition, they have the power to influence policy changes to address societal, cultural and structural factors that impede individuals’ capacity to prevent HIV infection. According to Kenya Demographic Health Survey (2014), over 97% of the Kenya population was reported to ascribe to religious affiliation.
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Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the na...tional demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.
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Rumors emerge when people feel left out of the discussion, when their questions cannot be answered by authorities or their doubts are dismissed by official sources. But also, rumors present an opportunity – to understand the questions, concerns and anxieties communities may have about this pandemi...c.
During the COVID-19 pandemic, Internews has followed its rumour-tracking methodology, including social media listening, to identify those rumors that are posing additional risks to the communities, ensuring content is collected from diverse demographic groups.
Internews produces and distributes rumor bulletins through its Rooted in Trust and its H2H (humanitarian-to-humanitarian network) projects. Rooted in Trust has collected close to 6,000 rumors from seven countries in 12 languages, and collects data across seven major social media platforms and a wide range of feedback collection channels. H2H is a collaboration to support responders at every level by analyzing information gaps and addressing them with evidence-based content in relevant languages, formats, and channels.
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The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria are part of a group of agencies working together to accelerate progress towards the health-related SDGs through the Global Action Plan for Healthy Lives and Well-being for All. Understanding patterns of inequal...ities in these diseases is essential for taking strategic, evidence-informed action to realize our shared vision of ending the epidemics of HIV, TB and malaria.
This report presents the first comprehensive analysis of the magnitude and patterns of socioeconomic, demographic and geographic inequalities in disease burden and access to services for prevention and treatment.
The results confirm there have been improvements in service coverage and decreased disease burden at the national level over the past decade. But they also reveal an uncomfortable reality: unfair inequalities between population subgroups within countries are widespread and have remained largely unchanged over the past decade. For some disease indicators, inequalities are even worsening.
Moreover, the report points to the persistent lack of available data to fully understand inequality patterns in HIV, TB and malaria. Collecting data to improve the monitoring of inequalities in these diseases is vital to develop targeted responses for impact.
There are, encouragingly, isolated successes in reducing inequities. Change is possible when deliberate action is taken to reach disadvantaged populations.
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Current Environmental Health Reports volume 7, pages 363–370 (2020)
Climate change has direct impacts on human health, but those impacts vary widely by location. Local health impacts depend on a large number of factors including specific regional climate impacts, demographics and human vulnerabil...ities, and existing local adaptation capacity. There is a need to incorporate local data and concerns into climate adaptation plans and evaluate different approaches.
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Environmental Research Volume 151, November 2016, Pages 115-123
Dengue is the world’s most important arboviral disease in terms of number of people affected. Over the past 50 years, incidence increased 30-fold: there were approximately 390 million infections in 2010. Globalization, trade, travel,... demographic trends, and warming temperatures are associated with the recent spread of the primary vectors Aedes aegypti and Aedes albopictus and of dengue. Overall, models project that new geographic areas along the fringe of current geographic ranges for Aedes will become environmentally suitable for the mosquito’s lifecycle, and for dengue transmission. Many endemic countries where dengue is likely to spread further have underdeveloped health systems, increasing the substantial challenges of disease prevention and control. Control focuses on management of Aedes, although these efforts have typically had limited effectiveness in preventing outbreaks. New prevention and control efforts are needed to counter the potential consequences of climate change on the geographic range and incidence of dengue, including novel methods of vector control and dengue vaccines.
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The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the ...move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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The escalation of the war in Ukraine began on 24 February 2022, causing thousands of civilian
casualties; destroying civilian infrastructure, including hospitals, and triggering the fastest-
growing displacement crisis in Europe since World War II. The demographic profile of Ukraine,
combined wit...h the implementation of martial law and conscription policies, led to an awareness
of gender- and age-related factors within the regional humanitarian response that recognised
the pre-crisis situation of persons of all genders and diversities and how the war and subsequent
regional crisis were compounding the risks that they face.
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Leishmaniasis is a major vector-borne disease caused by obligate intramacrophage protozoa of the genus Leishmania, and transmitted by the bite of phlebotomine female sand flies of the genera Phlebotomus and Lutzomyia, in the old and new worlds, respectively. Among 20 well-recognized Leishmania speci...es known to infect humans, 18 have zoonotic nature, which include agents of visceral, cutaneous, and mucocutaneous forms of the disease, in both the old and new worlds. Currently, leishmaniasis show a wider geographic distribution and increased global incidence. Environmental, demographic and human behaviors contribute to the changing landscape for zoonotic cutaneous and visceral leishmaniasis. The primary reservoir hosts of Leishmania are sylvatic mammals such as forest rodents, hyraxes and wild canids, and dogs are the most important species among domesticated animals in the epidemiology of this disease. These parasites have two basic life cycle stages: one extracellular stage within the invertebrate host (phlebotomine sand fly), and one intracellular stage within a vertebrate host. Co-infection with HIV intensifies the burden of visceral and cutaneous leishmaniasis by causing severe forms and more difficult to manage. The disease is endemic to Ethiopia, and the clinical signs are not pathognomic. The visceral form (Kala-azar) may be confused with other similar conditions such as malaria, tropical splenomegaly, schistosomiasis, milliary tuberculosis, and brucellosis. Similarly, cutaneous leishmaniasis should be differentiated from disease like tropical ulcers, impetigo and leprosy. There are several methods of laboratory diagnosis of leishmaniasis, including parasitological, immunological and molecular. Different forms of treatments are available including oral, parenteral, and topical medications such as pentavalent antimonials, liposomal amphotericin B, miltefosine and paromomycin. Methods of control are largely limited to destruction of animal reservoirs, treatment of infected humans, and management of sand fly populations. Development of an effective vaccine against leishmaniasis has been largely unsuccessful and hinders its prevention.
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Since the launch of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in 2000, more than 910 million people have received preventive chemotherapy for lymphatic filariasis (LF) and many thousands have received care for chronic manifestations of the disease. To achieve this, millions of c...ommunity drug distributors (CDDs), community members and health personnel have worked together each year to ensure that at-risk communities receive preventive chemotherapy through mass drug administration (MDA). The successes of 20 y of partnership with communities is celebrated, including the application of community-directed treatment, the use of CDDs and integration with other platforms to improve community access to healthcare. Important challenges facing the GPELF moving forward towards 2030 relate to global demographic, financing and programmatic changes. New innovations in research and practice present opportunities to encourage further community partnership to achieve the elimination of LF as a public health problem. We stress the critical need for community ownership in the current Covid-19 pandemic, to counter concerns in relaunching MDA programmes for LF.
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Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infecti...ons are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
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