Prevalence of common mental disorders in a rural district of Kenya, and socio-demographic risk factors

Association between common mental disorders (CMDs), equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. This paper reports a population-based epidemiological survey of a rural area in Kenya. A random sample of 2% of all adults living in private households in Maseno, Kisumu District of Nyanza Province, Kenya (50,000 population), were studied. The Clinical Interview Schedule-Revised (CIS-R) was used to determine the prevalence of common mental disorders (CMDs). Associations with socio-demographic and economic characteristics were explored. A CMD prevalence of 10.8% was found, with no gender difference. Higher rates of illness were found in those who were of older age and those in poor physical health. We conclude that CMDs are common in Kenya and rates are elevated among people who are older, and those in poor health.     

Depressive symptoms in low-income women in rural Mexico

BACKGROUND: Depression is a leading cause of death and disability worldwide. This paper reports a cross-sectional analysis of demographic, socioeconomic, physical, and psychosocial factors associated with depressive symptoms among poor women in rural Mexico. METHODS: A cross-sectional study of 5457 women, age 20-70 years, were interviewed from a random sample of households from 279 poor communities with fewer than 2500 inhabitants in 7 rural Mexican states. Depressive symptoms were assessed using the Spanish translation of the Center for Epidemiologic Studies-Depression scale. Several other individual- and household-level variables were also obtained. Using hierarchical modeling, linear regression analysis, and population intervention model parameters, we explored correlates of depressive symptoms in this population. RESULTS: Most of the variation in depressive symptoms was at the individual level. Psychosocial factors were most strongly correlated with depressive symptoms; perceived stress, lack of personal control or social support, and low social status exhibited the strongest associations. Using the US-based standard Center for Epidemiologic Studies-Depression cutoff score of 16, 51% of this population fall into the category "at risk" for clinical depression; however, this cutoff may not be the most appropriate in this context. CONCLUSION: This sample of low-income women in rural Mexico reported a relatively high prevalence of depressive symptoms. The analyses suggest that reducing perceived stress would have the largest potential impact on depressive symptoms in this population. However, any interventions should take into account the broad context of the population's overall health. The alleviation of poverty, improvement of educational opportunities, and other interventions to address root causes of poor mental health must also be considered.     

Prevalence and severity of malnutrition and age at menarche; cross-sectional studies in adolescent schoolgirls in western Kenya

OBJECTIVE: Nutritional status is an important marker of overall health and linear growth retardation has serious long-term physiological and economic consequences. Approximately 35 and 29% of preschool children in sub-Saharan Africa are stunted and underweight, respectively. There is relatively little information available about the nutritional status in adolescents, the age group with the highest growth velocity after infancy. We conducted a series of cross-sectional surveys to determine the prevalence and main risk groups for malnutrition and to describe the associations between age, sexual maturation and nutritional status in adolescent schoolgirls in western Kenya. DESIGN: Three cross-sectional surveys; one in Mumias, using random sampling in all schools, and two surveys in Asembo, using a multi-stage random sample design. SETTING: Public primary schools in two different rural malaria endemic areas in western Kenya with high levels of malnutrition in preschool children. SUBJECTS: In all, 928 randomly selected adolescent schoolgirls aged 12-18 y. RESULTS: Overall prevalence of stunting and thinness was 12.1 and 15.6%, respectively. Of the total, 2% were severely stunted. Menarche and start of puberty were delayed by approximately 1.5-2 y compared to a US reference population. The prevalence of stunting and thinness decreased with age and mean height for age z-scores converged towards the median of the US reference curve. Girls who had not yet started menstruating were more likely to be stunted than the girls of the same age who were post-menarche. CONCLUSIONS: Stunting and thinness are common in young adolescent schoolgirls in these poor rural settings in western Kenya, but the prevalence decreases with age, providing observational support that children catch up on incomplete growth attained earlier in life due to a maturational delay of 1.5-2 y allowing prolonged growth.     

Prevalence of genital HPV infection in urban and rural women in the Eastern Brazilian Amazon

This study investigated the prevalence and risk factors for genital infection with HPV in women from rural and urban areas in two different regions of the Eastern Brazilian Amazon. A cross-sectional survey was performed in Pap screening programs, with a total sample of 444 women (233 urban and 211 rural). Uterine cervical swabs were collected for the detection of HPV DNA with the established PCR assay using MY09-MY11. All volunteers answered an epidemiological questionnaire. Bivariate and multivariate logistic regression analyses were performed to identify risk factors associated with HPV infection. Overall prevalence of HPV infection was 14.6% (15% in urban women and 14.2% in rural). The only factor associated with HPV was marital status in the 13-25-year-old rural population, with higher HPV prevalence among single and divorced women and widows. The findings indicate the need for risk factor control strategies targeted specifically to women in rural and urban areas.     

苏州市居民糖尿病流行现状及危险因素分析

目的了解苏州市居民糖尿病流行现状及影响因素,寻找早期干预措施。方法采用多阶段整群随机抽样的方法,抽取苏州市20岁以上的居民30578名,进行吸烟、饮酒等行为危险因素的问卷调查及测量血压、血糖、身高、体重等。结果苏州市居民糖尿病患病率为8.12%,糖尿病患病率有随年龄增高而上升的趋势;城市的糖尿病患病率高于农村,但50岁以下年龄则是农村高于城市,差异均有统计学意义(P﹤0.01)。糖尿病知晓率、治疗率、控制率分别为73.22%、73.91%、44.99%。Logistic回归分析显示,糖尿病患病的危险因素有高血压、超重与肥胖、饮酒、口味偏甜、睡眠质量差和生活紧张;保护因素为经常体育锻炼、饮食节制。结论苏州地区的糖尿病患病率较高,对糖尿病的防治应采取针对多种危险因素的综合干预措施。     

Examining <Emphasis Type="Italic">Nervios</Emphasis> Among Immigrant Male Farmworkers in the MICASA Study: Sociodemographics,Housing Conditions and Psychosocial Factors

Nervios is a culturally defined condition of psychological stress with important implications for Latino health. Using epidemiological research methods, we examined the prevalence of nervios and associated risk factors, including drug and alcohol use, acculturation, and housing conditions in a population-based study of farm worker families in Mendota, CA (the MICASA Study). A household enumeration procedure was used for sampling, and 843 individuals were interviewed in 2006–2007. In this analysis, we present data on 422 men, 381 accompanied (family) males and 41 unaccompanied males. The prevalence of nervios was 22 %, with no difference in prevalence by household status. Low family incomes, drug use, medium/high acculturation, and poor housing conditions were associated with increased odds of nervios. Self-reported poor/fair health, depressive symptoms, and high perceived stress were also associated with nervios. Since nervios has been shown to be a clinical indicator of psychiatric vulnerability among Latinos, this analysis furthers public health goals of reducing health disparities.     

湖北省35岁以上人群高血压病流行现况调查

目的了解湖北省高血压病的流行现状,为开展高血压人群防治和采取有效的干预措施提供科学依据。方法横断面调查湖北省10个县市13865名35岁以上人群高血压现患和相关危险因素情况。结果湖北省35岁以上人群高血压总患病率为25.1%,男性和女性分别为25.9%和24.4%,农村、城镇、城市分别为32.0%、21.5%和23.6%。超重、肥胖、高血压认知差、年龄增长、中心性肥胖、食用动物油、睡眠时间不足、不参加体育锻炼和农村地区是高血压患病的危险因子。结论高血压防治重点应放在农村地区,防治对象重点是超重、肥胖者、文化程度低的农民和大年龄组的女性人群。     

Morbidity among job applicants in the Metropolitan Region of Salvador, Bahia, Brazil

This cross-sectional study evaluates the pre-employment health status of job applicants, based on prevalence estimates of abnormal laboratory test results, clinical diagnosis, and a physician-signed fit-for-work assessment, which is mandatory in Brazil. The study population was a random sample of 1,237 male workers selected from medical records (1988-1996) from an Occupational Medical Center located in Salvador, the capital of Bahia State, Brazil. The data were from a single pre-employment medical assessment for each individual. The most common diseases were intestinal parasites (51.7%), anemia (12.8%), and hypertension (12.7%). Drivers showed a high prevalence of overweight (38.2%) and hypertension (16.2%). In addition to work-related risks and diseases, occupational hygiene and safety programs need to address prevailing illnesses and risk factors, which in this population are typical of poor living conditions. Special attention should to be given to drivers, who are at increased risk of cardiovascular disease.     

Double exposure. The combined impact of domestic responsibilities and job strain on common symptoms in employed Swedish women.

BACKGROUND: This study investigated the influence of domestic responsibility and job strain, and especially simultaneous exposure to these factors (i.e. 'double exposure') on common physical and mental symptoms in Swedish women. METHODS: A questionnaire containing items on socio-economic factors, domestic responsibilities, and psychosocial working conditions was sent to a random population of women, 40 to 50 years of age, in a rural Swedish community. The response rate was 81.7% (397 women). Multiple logistic regression analyses were used to test for potential confounding factors and effect modification. Attributable risks were computed based on prevalence data. RESULTS: Women shouldering great domestic responsibility or who experienced job strain were at risk of a high level of common symptoms (OR 1.76; 1.04-2.97 and OR 3.48; 2.05-5.92, respectively). 'Double exposure' considerably increased the odds for common symptoms (OR 6.91; 2.58-18.48), with support for synergy noted. The population attributable risk (PAR) of great domestic responsibility was 10.0% and of job strain it was 26.7% in producing a high level of common symptoms. The corresponding figure for the population of women subjected to 'double exposure' was 11.8% and for the population of women subjected to either single or 'double exposure' the PAR was 30.3%. CONCLUSION: Heavy domestic responsibility and/or a job strain situation are factors that seem to make important contributions to the causes of a high level of common symptoms among salaried women 40 to 50 years of age. 'Double exposure' showed a particularly high risk because of synergy.     

45岁及以上人群糖尿病的流行现状及影响因素研究

目的 了解我国45岁及以上人群糖尿病流行现状及影响因素。方法 本研究数据来源于2015年中国健康与养老追踪调查（China Health and Retirement Longitudinal Survey, CHARLS）项目 5岁及以上人群15 246例为研究对象,分析不同性别糖尿病患病率。采用二元logistics回归分析糖尿病的影响因素。结果 糖尿病患病人数1 613人,糖尿病患病率为10.6%,男性患病率为9.6%,女性患病率为11.4%,χ2 = 13.349,P＜0.001,女性糖尿病患病率高于男性糖尿病患病率。Logistics回归分析显示,居住在农村是危险因素,OR = 1.497,95%CI = 1.252～1.791;慢性病数量大于1为危险因素OR = 4.462,95%CI = 3.463～5.748;健康自评为“一般”（OR = 2.092,95%CI = 1.603～2.728）或者“差”（OR = 1.580,95%CI = 1.344～1.857）为危险因素,血脂异常为因素,OR = 2.043,95%CI = 1.739～2.400。结论 全国糖尿病患病率较高,居住在农村、慢性病数量大于1、健康自评为“一般”或“差”及血脂异常为糖尿病危险因素。     

NEWS

Background: Psychosocial factors such as depressive symptoms should be considered when assessing cardiovascular (CV) risk. Depressive symptoms are suggested to be associated with poor perception of one’s health, i.e. self-rated health (SRH). Thus, assessing SRH could be a practical tool in CV risk prediction. However, SRH may also emphasize physical, mental or social aspects.

Objectives: To assess the relationship of SRH and depressive symptoms, classic CV risk factors and perceived physical health among persons at risk for type 2 diabetes (T2D) and cardiovascular disease (CVD).

Methods: In this cross-sectional study in a primary care population, 2555 persons (mean age 58?±?7, 56% women) at risk for T2D or CVD were evaluated. Generalized linear statistical models were used to evaluate the association of depressive symptoms (Beck’s Depression Inventory score ≥10), CV risk factors, and perception of SRH and physical health (assessed by Short Form Health Survey).

Results: Poor or fair health was reported by 40% of the participants. They had more unhealthy lifestyle habits and CV risk factors than subjects rating their health as at least good. Among those with poor or fair SRH, the prevalence of depressive symptoms was 36% and associated with perception of physical health.

Conclusion: Poor SRH is associated with depressive symptoms and impaired perceived physical health. Assessing SRH might be useful for detecting possible depressive symptoms in patients in CV risk management and diabetes care.     

我国农村老年人抑郁症状性别差异及影响因素研究

目的 了解我国农村老年人抑郁的性别差异及影响因素,为缩小农村老年人抑郁性别差异、促进两性健康公平提供参考依据。方法 利用2015年中国健康与养老追踪调查（China health and retirement longitudinal study,CHARLS）数据库中抑郁相关数据进行Fairlie分解,分析农村老年人抑郁现状及性别差异。结果 农村老年人抑郁患病率为39.09%,女性高于男性（47.82% vs 32.43%）,差异有统计学意义（χ2=97.05,P<0.001）。多因素回归分析表明,地域、睡眠时长、日常生活能力（activity of daily living,ADL）、自评健康、疼痛是男女两性抑郁的共同影响因素,婚姻状况、社会活动是男性抑郁的影响因素。Fairlie分解结果显示,农村老年人抑郁性别差异中的72.06%是可观测因素造成的,另外27.94%是性别属性造成的。结论 农村老年男性抑郁患病率低于老年女性。生活方式、生理健康、疼痛是造成农村老年人抑郁性别差异的主要因素。     

Public housing, public health: health needs of public housing tenants

OBJECTIVES: To determine the health needs of public housing tenants, measured in terms of self-reported health status, health risk factors and expressed need for health risk reduction intervention. METHOD: Face-to-face interviews were conducted with a randomly selected sample of public housing tenants in the Hunter Region of New South Wales. RESULTS: Of 463 contactable tenants, 329 consented to participate in the study. Participants were 2.5 times more likely to rate their health as fair or poor relative to the community generally, and visited a doctor twice as often. The prevalence of smoking was more than twice that of the community generally, and the prevalence of falls was approximately three times greater. Risk of injury due to domestic violence was approximately six times greater, and the risk of injury due to violence in other locations was more than double that in the community. Between a quarter and a half of the participants requested support to reduce their health risks. CONCLUSIONS: The findings suggest that public housing tenants are one of the more severely health-compromised groups in the Australian community. IMPLICATIONS: An urgent need exists for public health initiatives that are directed at improving not only the current markedly poorer health status of public housing tenants, but also the greater prevalence of health risk factors that predict a likely continuation of such differentials into the future.     

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence.     

Damp housing and adult health: results from a lifestyle study in Worcester, England.

STUDY OBJECTIVE--To explore the relationship between damp housing and adult health using two separate measures of ill health and taking into account the confounding effects of health related lifestyles and social factors. DESIGN AND SETTING--Analysis of responses gathered in a cross sectional, postal questionnaire survey of a randomly selected sample of 5347 residents of Worcester. PARTICIPANTS--Altogether 2353 people aged 16 to 64 years responded to the survey (adjusted response 52%). RESULTS--Nine per cent of respondents lived in housing which they reported to be damp. Rates were highest among young women. People who lived in damp housing were more likely to report long standing illness, disability, or infirmity; the increased prevalence could not be attributed to any particular medical condition. Perceived ill health, as measured by the sleep, energy, and social isolation dimensions of the Nottingham Health Profile, was also more common in this group. These associations could not be explained by lifestyle factors; the relationship proved strongest among people in non-manual social classes living in owner occupied housing. The prevalence of ill health increased as the severity of dampness increased. CONCLUSION--Self reported damp housing and ill health in adults were strongly associated, most noticeably among people in non-manual social classes living in owner occupied housing. The association met many of the epidemiological criteria necessary for suggesting causality: alternative explanations are discussed.     

The prevalence of symptoms attributed to electromagnetic field exposure: a cross-sectional representative survey in Switzerland

Summary. Objectives To investigate health risk perception as well as to assess the prevalence of self-reported symptoms attributed to electromagnetic fields (EMF) and other environmental exposures in the general population of Switzerland. Methods Between May and June 2004, telephone interviews of a representative sample of the Swiss population (n = 2 048, >14 years old) about: 1) health symptoms attributed to five environmental factors (one of which was EMF), 2) health risk perception related to 12 environmental risk factors (five of which were different EMF sources). Results We found a prevalence of 5% (95% CI 4–6%) for electromagnetic hypersensitivity (EHS) in our study sample. The most common health complaints among EHS individuals were sleep disorders (43%) and headaches (34%), which were mostly attributed to power lines and mobile phone handsets. In addition, 53 percent (95% CI 51–55%) were worried about adverse health effects from EMF, without attributing their own health symptoms to them. Conclusions The large proportion of the population who is concerned or attributes own symptoms to EMF may cause societal conflicts given the ubiquity of EMF in our everyday life. Submitted: 27 May 2005; Accepted: 6 March 2006     

An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China

Background

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Since only limited data on the Chinese population, which is the largest in the world, is available, we conducted an epidemiological study on the prevalence and risk factors of AF in mainland China.

Methods

This population-based study conducted by cluster sampling comprised 29079 participants forming 14 cohorts from 13 provinces across China, where the population was nearly 1 billion. Every participant underwent electrocardiogram and physical examinations and responded to the interviewer-led questionnaire(s). Univariate and multiple statistical analyses were conducted to explore the relationship between AF prevalence and risk factors.

Results

The age-standardized prevalence of AF in China (≥30 y) was 0.65%, and it increased with age. Men showed a higher prevalence of AF than women (0.91% [age-standardized, 0.66%] vs. 0.65% [0.63%], P = 0.013); several significant risk factors (age, hyperthyroidism, coronary heart disease, and rheumatic heart disease) were identified for AF in the general population. Stroke prevalence was much higher in AF patients than in non-AF people (12.95% vs. 2.28%, P < 0.001). AF was confirmed to be a significant independent risk factor for stroke prevalence in the studied population (OR = 2.776, [1.814, 4.248], P < 0.001). We found that AF patients received poor treatment (2.7%, warfarin; 39.7%, aspirin).

Discussion

This study conducted on a large sample size demonstrates that AF prevalence in mainland China is slightly lower than that in Western countries and similar to that in Asian areas, and confirms that AF is a serious public health problem in China. We identified several potential risk factors, but their associations with AF still need to be further studied.Key words: Atrial Fibrillation, Prevalence, Epidemiological Study, Stroke, Logistic Regression     

Trajectory and socioeconomic predictors of depression in a prospective study of residents of New York City

PURPOSE: Past research has demonstrated the high prevalence of depression in the general population. However, few longitudinal studies have characterized the patterns of depression in a large, representative sample of the general population. We monitored symptoms of depression and assessed the factors associated with changing symptoms of depression in a population-based cohort over a 30 month period. METHODS: Using telephone surveys, we recruited 2752 adult residents of New York City in 2002. Persons were re-contacted after baseline for telephone interviews at 6 months, 18 months, and 30 months. RESULTS: Among study participants, symptoms of depression were common, often resolved within 6 months, but tended to recur. Participants with a past history of depressive symptoms were more at risk of later developing depression, even if they were asymptomatic at baseline. Factors significantly associated with subsequent symptoms included less social support at baseline, income below a threshold of $50,000, life stressors, poor health, and being separated. Lower levels of social support and lifetime stressors were only significantly associated with symptoms in participants with multiple episodes of depression. The influence of recent stressful events was also higher among participants with multiple episodes of depression. CONCLUSION: In the general population depression has a good immediate prognosis but a recurring nature. Poor physical health and low levels of social support appear to increase the risk of later episodes of depression. The influence of social risk factors may be greater for persons with higher susceptibility to depression.     

海南省3887名农村已婚妇女健康现状及影响因素分析

目的:了解海南省农村已婚妇女健康现状,为制定相关政策和预防措施提供数据支持。方法:采取整群抽样的方法对海南省10个市县的3 887名60岁以下已婚农村妇女进行健康体检和问卷调查,对体检结果和调查数据进行描述性分析、χ2检验和非条件Logistic回归分析。结果:体检妇女的两周患病率是6.97%,低于全国平均水平;不同年龄组、不同地区妇女患病率差异有统计学意义,对妇女组患病有影响的因素是地区、文化程度、就医机构、去医疗保健机构距离、医疗保险类型、家庭饮用水类型和饮酒情况等。体检检出最多的是泌尿生殖系统疾病。结论:海南省农村已婚妇女健康状况处于一般水平,泌尿生殖系统疾病是影响妇女人群的常见多发疾病。距离医疗保健机构的路程远和饮酒是妇女健康的危险因素,应加大对农村居民的健康教育,广泛宣传已婚妇女泌尿生殖系统疾病等常见病及多发病的防治知识,提高已婚妇女自我保健意识和预防能力,是降低已婚妇女妇科病患病率最有效的途径。