Visual impairment and associated factors among primary school children in Gurage Zone,Southern Ethiopia

BackgroundVisual impairment is one of the major public health problems worldwide, especially in developing countries.ObjectiveTo determine the prevalence of visual impairment and its associated factors among school children in Gurage Zone, Southern EthiopiaMethodsA cross sectional study was conducted in eight primary schools of Gurage Zone. A total of 1064 pupils, of whom589 boys and 475 girls were selected using multistage sampling technique. Socio-demographic characteristics of the participants were collected using structured questionnaires and visual acuity was measured using Snellen''s chart. Logistic regression analysis was used to determine the associated factors of visual impairment.ResultsThe prevalence of visual impairment was 5.2%. Factors significantly associated with visual impairment were age group of 13–18 years (AOR = 9.44, 95% CI = 3.83 – 23.25), school grade level of 5- 8 (AOR = 2.97, 95% CI = 1.23 – 7.17), rural residents (AOR = 2.59, 95% CI = 1.22 – 5.54), family''s monthly income of less than 2000 Ethiopian Birr (AOR = 2.87, 95% CI = 1.08 – 7.61) and visually impaired parents (AOR = 2.16, 95% CI = 1.06 – 4.39).ConclusionThis study found that the prevalence of visual impairment was 5.2%.     

Seroprevalence of West Nile Virus specific IgG and IgM antibodies in North-Western and Western provinces of Zambia

BackgroundWest Nile Virus (WNV) infection has been reported worldwide, including in Africa but its existence in Zambia is unknown. Symptoms for the virus include headache, myalgia, arthralgia and rash.ObjectivesThis study aimed to determine the seroprevalence of WNV and its correlates.MethodsA cross sectional study was conducted in North-Western and Western provinces of Zambia. Samples were subjected to IgG and IgM antibodies testing against WNV. Logistic regression analyses were conducted to determine magnitudes of association.ResultsA total of 3,625 of persons participated in the survey out of which 10.3% had WNV infection. Farmers were 20% (AOR=0.80; 95% CI [0.64, 0.99]) less likely to have infection compared to students. Meanwhile participants who lived in grass roofed houses were 2.97 (AOR=2.97; 95% CI [1.81, 4.88]) times more likely to be infected than those who lived in asbestos roofed houses. IRS was associated with reduced risk of infection (AOR=0.81; 95% CI [0.69, 0.94]). Travelling to Angola was associated with the infection [AOR=1.40; 95% CI [1.09, 1.81].ConclusionSpraying houses with insecticide residual spray would minimize mosquito-man contact. Furthermore, surveillance at the border with Angola should be enhanced in order to reduce importation of the virus into the country.     

Prevalence,predictors and reasons for home delivery amongst women of childbearing age in Dodoma Municipality in central Tanzania

IntroductionThe objective was to determine the prevalence, predictors and reasons for home delivery amongst women of childbearing age in Dodoma, Tanzania.MethodsA cross-sectional study was conducted amongst women living in Dodoma Municipality. Data were collected using adapted questionnaires and analysed using SPPS version 23. A multivariable logistic regression model was used to assess the independent predictors of home delivery.ResultsA total of 425 women of childbearing age were enrolled in this study. The mean (± SD) age of the participants was 28.7 (±7.1) years. The prevalence of home delivery was 35.5% (n=150, 95% CI 30.9 – 40.2). Women with secondary school and above had 93% less odds of home delivery than women who had no education (AOR=0.0795% CI: 0.03–0.18). Women who lived in rural areas (AOR=3.49, 95% CI: 2.12–5.75), and women living more than 5km from health facilities (AOR=2.67, 95% CI: 1.65–4.37) had higher odds of home delivery. The main reasons for home delivery were transportation cost, and long distance to the nearest health facilities.ConclusionIn this population, the prevalence of home delivery remained to be high. To address this more collaborative multisectoral effort like strengthening health education and strengthening maternity waiting homes are needed.     

Assessment of the relationship between life events with psychosocial competence of students in selected secondary schools in Northern and Central Uganda

IntroductionAs they grow, young people transit through adolescence; a particularly challenging phase. Many go through without difficulties but some experience maladaptive responses in form of conduct and adjustment problems, pubertal challenges and life stress. Published research from the developed societies demonstrates consistent associations between young people''s exposure to life events, psychosocial competence (PSC) and mental health problems. However, comparable research from income-constrained societies remains scarce. The purpose of this study was to determine the prevalence of life events in secondary school students and describe the relationship between life events and PSC in the same population.MethodsThis was a cross-sectional study. Participants were 2,902 randomly selected in Central and Northern Uganda. They responded to self-administered questionnaires on socio-demographics, life events and PSC.ResultsNorthern Ugandan students were more likely to be susceptible to stress-related illness associated with major life events (p = < 0.01). Among students with a high susceptibility to stress related illness, those with low scores on self-efficacy (p = < 0.001), accurate self-assessment (p = < 0.001) and self-confidence (p = < 0.001) were mostly from the North. Students from Northern Uganda had experienced more negative events. Students with higher scores on empathy, emotional awareness, accurate self- assessment and self-confidence tended to have low distress. Students that had a low susceptibility to stress related illness (AOR = 1.97; 95% CI: 1.57 – 2.48); high scores on self-efficacy (AOR 1.37; 95% CI: 1.09 – 1.74), self-confidence (AOR 1.32; 95% CI: 1.02 – 1.72), and accurate self-assessment (AOR 2.19; 95% CI: 1.70 – 2.80) were mostly from northern Uganda.ConclusionIt is important to help students to cope with negative life events since an association exists between negative life events and PSC domains. PSC domains of empathy, emotional awareness, accurate self-assessment and self-confidence seem to be associated with lower distress levels, implying that these should be reinforced.     

Pattern and risk factors for childhood injuries in Dar es Salaam,Tanzania

BackgroundInjuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania.MethodsThis case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were collected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively.ResultsA total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3–2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0–2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1–2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1–2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0–2.1) were independent risk factors for childhood injury.ConclusionFalls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, overcrowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries.     

Recreational Drug Use,Polydrug Use and Sexual Behaviors Among Men Who Have Sex With Men in Southwestern China: A Cross-Sectional Study

Abstract

Although recreational drug use is associated with risky sexual behaviors and HIV infection among men who have sex with men (MSM), it is unclear to what extent these behaviors and outcomes differ between single-drug users and polydrug users in China. This is a cross-sectional study conducted from July to September 2016 among MSM in three cities of Sichuan Province, China. Multinomial logistic regression was performed to examine factors correlated with single-drug and polydrug use. A total of 1,122 participants were included in the study. Overall, 28% of MSM have ever used recreational drugs, of whom 64.0% were single-drug users, and 36.0% were polydrug users. Factors associated with both single-drug and polydrug use included: receptive sexual role (single-drug use: AOR = 1.79, 95% CI: 1.05–3.07; polydrug use: AOR = 6.00, 95% CI: 2.54–14.17), engaging in group sex (AOR = 2.23, 95% CI: 1.28–3.87; AOR = 4.68, 95% CI: 2.41–9.08), frequent alcohol use (AOR = 3.11, 95% CI: 1.75–5.52; AOR = 6.41, 95% CI: 2.50–16.47), seeking partners mainly by Internet (AOR = 4.87, 95% CI: 3.31–7.17; AOR = 4.58, 95% CI: 2.58–8.14), history of STIs (AOR = 1.86, 95% CI: 1.08–3.21; AOR = 3.32, 95% CI: 1.77–6.26) and HIV infection (AOR = 1.76, 95% CI: 1.02–3.02; AOR = 3.19, 95% CI: 1.62–6.26). Our findings suggest the urgent need for HIV and STIs prevention programs among MSM in China to integrate strategies that mitigate recreational drug use.     

Prevalence of overweight/obesity and its associated factors among a sample of Moroccan type 2 diabetes patients

BackgroundObesity constitutes a major risk factor for the development of diabetes, and has been linked with poor glycaemic control among type 2 diabetic patients.AimsThis study examines the prevalence of overweight/obesity and associated factors in type 2 diabetic patients in the Beni-Mellal Khenifra region in Morocco.MethodsA questionnaire-based cross-sectional study was conducted in 2017 among 975 diabetes patients attending primary health centres. Demographic and clinical data were collected through face-to-face interviews. Anthropometric measurements, including body weight, height and waist circumference, were taken using standardized techniques and calibrated equipment.ResultsThe prevalence of overweight was 40.4%, the general obesity was 28.8% and the abdominal obesity was 73.7%. Using multivariate analysis, we noted that the general obesity was associated with female sex (AOR= 3,004, 95% CI: 1.761–5.104, P<0.001), increased age (AOR=2.192, 95% CI: 1.116–4.307, P<0.023) and good glycaemic control (AOR=1.594, 95% CI: 1.056–2.407, P=0.027), whereas abdominal obesity was associated wih female sex (AOR=2.654, 95% CI: 1.507–4.671, P<0.001) and insulin treatment (AOR=2.927, 95% CI: 1.031–8.757, P=0.048).ConclusionOverweight, general obesity and abdominal obesity were high among participants, especially among women. Taken together, these findings urge the implementation of a roadmap for this diabetic subpopulation to have a new lifestyle.     

A multilevel analysis of the determinants of handwashing behavior among households in Eswatini: a secondary analysis of the 2014 multiple indicator cluster survey

IntroductionHandwashing with soap has received considerable attention due to its importance in the prevention and interruption of the transmission of diseases. Regardless of the positive effects of handwashing with soap, developing countries still have a low rate of handwashing.ObjectiveThe study aimed to determine the individual, household and community-level factors associated with handwashing behavior among households in EswatiniMethodsUsing the Eswatini Multiple Indicator Cluster Survey conducted in 2014, a secondary analysis was done of the households surveyed. A total of 1,520 households nested in communities with complete data on handwashing practices were included in the analysis. Univariate, bivariate analysis and multivariate multilevel logistic regression were used to establish the factors that were associated with handwashing behavior.ResultsThe prevalence of handwashing among households was 56% in 2014. Households whose heads were aged 35–54 and 55 years and older were more likely to practice handwashing (AOR=1.88, 95% CI:1.39, 2.54); and (AOR=1.77, 95% CI: 1.205, 2.62) compared to those aged 15–34 years. Households with a pit latrine or no toilet facility at all, were less likely to practice handwashing (AOR=0.24, 95% CI: 0.17, 0.35); (AOR=0.28, 95% CI: 0.11, 0.71) respectively compared to those with a flush toilet. Region of residence was a community-level variable associated with lower odds of handwashing, with those from the Hhohho (AOR=0.22, 95% CI: 0.14, 0.35) and Manzini region (AOR=0.42, 95% CI: 0.27, 0.67) compared to Lubombo region. Households from communities where access to mass media was high were more likely to practice handwashing (AOR =1.47, 95% CI: 1.05, 2.03) compared to those from communities where access to mass media was lowConclusionHouseholds headed by young adults, with pit latrine or no toilet facility at all and lived in the Hhohho and Manzini regions and with low access to mass media, should be targeted for interventions aimed at improving handwashing practices.     

Exclusive breastfeeding practice and its associated factors among children aged 6–23 months in Woldia Town,Northwest Ethiopia

BackgroundInappropriate practice of exclusive breastfeeding (EBF) is still a major problem worldwide.ObjectiveTo identify exclusive breastfeeding practice and its associated factors among children aged 6–23 months in Woldia TownMethodsA Community based cross-sectional study was carried out.Interviewer-administered questionnaire was utilized to collect the data. The questionnaire was adapted from the 2016 Ethiopia Demographic and Health Survey. Hosmer-Lemeshow model was fitted at a P-value of 0.91. Finally, Variables having P-Value <0.05 with 95% CI was considered as significant factors.ResultThe prevalence of exclusive breastfeeding practice was 46.2% (95% CI: 42.0, 49.8). Being employed mothers (AOR=0.62,95% CI:0.44,0.87), being head of a household (AOR=0.52,95% CI:0.32,0.83), not g getting husband support (AOR:0.5,95%CI:0.34,0.74), not fed colostrum''s (AOR:0.36,95%CI:0.23,0.57), not affected by traditional belief (AOR:3.59, 95% CI:2.09–6.17) shows significant association with Exclusive breast feeding practice.ConclusionThe prevalence of exclusive breast feeding practice was relatively lower than the National prevalence. Some demographic variable and traditional beliefs were significantly associated with exclusive breast feeding. Designing model policies that empower the role of women and eradicating bad traditional beliefs in the community is fundamental step.     

Prevalence and associated factors of HIV-TB co-infection among HIV patients: a retrospective Study

BackgroundTB/HIV co-infection is a major public health problem in many parts of the world. But the prevalence of co-infection was varies among countries.This study was designed to assess prevalence of TB/HIV co-infection and to determine its factors.MethodsA retrospective study was done among HIV-positive patients at Hiwot Fana hospital from December, 2014 to 2018. The study participants were selected by simple random sampling. Patients with incomplete chart reviews were excluded and demographic, clinical and laboratory information were analyzed using SPSS and STATA. Uni-vitiate and bivariate logistic regressions were applied.ResultsFive hundred fourteen patients were enrolled in this study. Of these, 187(37.4%) had TB. Bivariate logistic analysis showed that HIV patients with regards to marital status[AOR = 2.6; 95%CI = 1.19–2.89], education status [AOR = 3.74; 95%CI = 2.47–5.66], weight less than 50kg [AOR = 2.54; 95% CI = 1.35 – 4.81], CD4 level < 200cells/mm³ [AOR = 4.57; 95%CI = 2.38– 6.86] and patient who were at WHO clinical stage III [AOR = 7.8; 95%CI = 5.15 – 8.55] were significantly associated with TB/HIV co-infection.ConclusionThe prevalence of TB among HIV patients was high and predicted by marital, education status, weight, CD4 cell count and WHO clinical stage III.     

Determinants of early marriage among female children in Amhara Region,Ethiopia

BackgroundEarly Marriage is one of the global problems that undermine the personal development and the rights of women seriously. It is delicate among the developing countries such as Ethiopia. It has major consequences for public health, national security, social development, human rights, economic development, and gender equality.MethodsThe analyzed data were obtained from the 2016 EDHS and 1120 samples were considered in this analysis. Both bivariate and multivariable binary logistic regression model were used to identify the determinants of early marriage practice.ResultsThe prevalence of early marriage practice was 48.57% in the study area. The odds of early marriage practice were 2.04(AOR=2.04, 95% CI: 1.88, 2.45) times higher among rural residents compared to urban. The odds of early marriage practice was 0.94(AOR=0.94, 95%CI: 0.57, 1.98) times lower among women who had primary education compared to uneducated women. Those who did not know the legal marital age were 1.61(AOR=1.61, 95%CI: 1.26, 2.07) times more likely to practice early marriage compared to parents who knew the legal marital age.ConclusionEducation level, family monthly income, residence, literacy level and knowledge of legal marital were significant determinants of early marriage practice.     

Magnitude of post-operative mortality and associated factors among patients who underwent surgery in Wolaita Sodo teaching and referral hospital,SNNPR region,Ethiopia

BackgroundEach year 4.2 million people around the world die within 30 days of surgery and postoperative deaths account for 7.7 % of all deaths. So this study aimed to asses'' magnitude of postoperative mortality and associated factors among patients who underwent surgery in Wolaita Sodo University Teaching referral Hospital.MethodRetrospective cross sectional design was carried out from April 15–30 2019. Card review was done on 384 participants by using Systematic sampling technique. Entered to Epi Data; exported to SPSS for analysis. Variables with p-value < 0.25 in bivariate analysis were entered to multivariate logistic regression. Statistical significance is determined at p-value < 0.05.ResultsThe magnitude of postoperative mortality was 5.7%. Using surgical check list (AOR= 0.18; 95% CI 0.05 to 0.61), having comorbid condition (AOR= 4.45; 95% CI 1.39 to 14.19), and don''t having blood transfusion (AOR= 0.07; 95% CI 0.02 to 0.22) and general anesthesia (AOR= 4.37; 95% CI 1.17 to 16.30) are factors of post-operative mortality.ConclusionThe magnitude of postoperative mortality was high. Surgical check list, comorbidity, blood transfusion and general anesthesia are factors. The hospital should encourage using of surgical check list and work on comorbid patients to decrease the mortality.     

Prevalence and determinants of asphyxia neonatorum among live births at Debre Tabor General Hospital,North Central Ethiopia: a cross-sectional study

BackgroundMore than one third of the neonatal deaths at Neonatal Intensive Care Unit of Debre Tabor General Hospital (DTGH) are attributable to birth asphyxia. Most of these neonates are referred from maternity ward of the hospital. However, there is no recent evidence on the prevalence and specific determinants of birth asphyxia at DTGH. Besides, public health importance of factors like birth spacing weren''t addressed in the prior studies.MethodsA cross sectional study was conducted on a sample of 240 newborns at delivery ward. The collected data were cleaned, coded and entered into Epi -data version 4.2 and exported to Stata version 14. Binary logistic regression model was considered and statistical significance was declared at P< 0.05 using adjusted odds ratio.ResultsThe prevalence of asphyxia neonatorum was 6.7 % based on the fifth minute APGAR score. From multi-variable logistic regression analysis, antenatal obstetric complications (AOR = 2.63, 95% CI: 3.75, 14.29), fetal malpresentation (AOR = 3.17, 95% CI: 1.21, 15.20), premature rupture of fetal membranes (AOR = 6.56, 95% CI: 3.48, 18.12) and meconium stained amniotic fluid (AOR = 2.73, 95% CI: 1.76, 14.59) were significant predictors.ConclusionThe prevalence of fifth minute asphyxia neonatorum was relatively low. Fortunately, its predictors are modifiable. Thus, we can mitigate the problem even with our limited resources such as enhancing the existing efforts of antenatal and intra-partum care, which could help early detection and management of any obstetric and neonatal health abnormality.”     

Evolution of the prevalence of hepatitis C virus infection and hepatitis C virus genotype distribution in human immunodeficiency virus-infected patients in Italy between 1997 and 2015

ObjectivesTo analyse the variation of hepatitis C virus (HCV) prevalence and genotype distribution and their determinants in people living with human immunodeficiency virus (HIV) who entered care between 1997 and 2015.MethodsHIV-infected patients enrolled in ICONA who were tested for HCV antibodies (HCV-Ab) were included.ResultsOverall 3407 of 12 135 (28.1%) were HCV-Ab+; and 735 of 12 135 (6.1%) were HBsAg+. Among patients whose HCV genotype was known, the most represented were genotypes 1 and 3. The prevalence of HCV infection decreased from 49.2% (2565/5217) during 1997–2002 to 10.2% (556/5466) during 2009–2015. The frequency of genotype 1a increased from 29.0% (264/911) to 43.0% (129/300), whereas genotype 3 decreased from 38.5% (351/911) to 27.0% (81/300). Independent predictors of HCV-Ab+ status were being female (adjusted OR (AOR) 1.23, 95% CI 1.04–1.50, p = 0.01), risk category (versus injecting drug users: men who have sex with men AOR 0.01, 95% CI 0.01–0.01, p <0.001; heterosexuals AOR 0.01, 95% CI 0.01–0.01, p <0.001; other/unknown AOR 0.02, 95% CI 0.01–0.02, p <0.001), being cared for in Central Italy (versus being cared for in Northern Italy: AOR 0.85, 95% CI 0.73–0.98, p <0.001), being Italian-born (AOR 1.44, 95% CI 1.16–1.80, p = 0.001) and being enrolled in less recent calendar years (versus 1997–2002: 2009–2015 AOR 0.23, 95% CI 0.19–0.27, p <0.001; 2003–2008 AOR 0.49, 95% CI 0.41–0.61, p <0.001).ConclusionsThe prevalence of HCV infection in HIV-infected patients entering into care in Italy significantly declined in more recent calendar years. After adjusting for risk factors and calendar years, HCV co-infection was more frequent in females and in those born in Italy.     

Level of utilization and provider-related barriers to the use of hydroxyurea in the treatment of sickle cell disease patients in Jos,North-Central Nigeria

BackgroundHydroxyurea is underutilized by sickle cell health-care providers in Nigeria despite available evidence of its effectiveness in reducing the manifestations and complications of sickle cell disease (SCD).ObjectivesTo assess the level of utilization and provider-related barriers to the use of hydroxyurea in SCD therapy in Jos, Nigeria.MethodsA cross-sectional study conducted among 132 medical doctors providing care for SCD patients. Data on sociodemographics, utilization and barriers to hydroxyurea use were obtained. The barriers were fed cumulatively into the logistic regression model as predictors of utilization.ResultsOf the 132 care providers, 88 (67%) had been in medical practice for ≥6years. The level of utilization of hydroxyurea was 24.2%. The significant barriers that predicted the non-utilization of hydroxyurea included lack of expertise (OR=5.1; 95% CI=2.65–9.05), lack of clinical guidelines (OR=3.84; 95% CI=2.37–14.33), fear of side-effects (OR=0.50; 95% CI=0.22–0.68) and doubt about its effectiveness (OR=0.30; 95% CI=0.20–0.90).ConclusionThe level of utilization of hydroxyurea in the treatment of SCD among the care providers is sub-optimal with the lack of expertise in its use identified as the most prominent barrier. There is an urgent need for the training of sickle cell care-providers and the development of clinical guidelines on hydroxyurea use.     

Neonatal outcomes associated with maternal recto-vaginal colonization with extended-spectrum β-lactamase producing Enterobacteriaceae in Nigeria: a prospective,cross-sectional study

ObjectivesThe objective of this study was to assess the prevalence of maternal recto-vaginal extended-spectrum β-lactamase producing Enterobacteriacea (ESBL-E) colonization, identify risk factors for maternal and neonatal ESBL-E colonization, and subsequent impact on neonatal mortality.MethodsA prospective, cross-sectional study was conducted at the University of Abuja Teaching Hospital from April 2016 to May 2017. Maternal–neonatal pairs were screened for ESBL-E exposure at time of delivery. Neonatal mortality was assessed at 28 days.ResultsA total of 1161 singleton deliveries were evaluated. In total, 9.7% (113/1161) of mothers and 4.3% (50/1161) of infants had ESBL-E-positive cultures at delivery. Maternal antibiotic exposure was associated with ESBL-E recto-vaginal colonization (18.6% (21/113) vs. 8.4% (88/1048), p < 0.001)). Maternal ESBL-E colonization (adjusted odds ratio (AOR) 14.85; 95% CI 7.83–28.15) and vaginal delivery (AOR 6.35; 95% CI 2.63–17.1) were identified as a risk factor for positive ESBL-E neonatal surface cultures. Neonatal positive ESBL-E surface cultures were a risk factor for neonatal mortality (stillbirths included, AOR 4.84; 95% CI 1.44–16.31). The finding that maternal ESBL-E recto-vaginal colonization appeared protective in regards to neonatal mortality (AOR 0.22; 95% CI .06–0.75) requires further evaluation.ConclusionsMaternal ESBL-E recto-vaginal colonization is an independent risk factor for neonatal ESBL-E colonization and neonates with positive ESBL-E surface cultures were identified as having increased risk of neonatal mortality.     

Severe lower limb cellulitis: defining the epidemiology and risk factors for primary episodes in a population-based case-control study

ObjectiveTo describe the epidemiology and risk factors for primary episodes of severe lower leg cellulitis (LLC).MethodsThis was a longitudinal cohort study using state-wide data linkage of adults presenting to Western Australian (WA) hospitals with a first ever LLC from January 2002 to December 2013. The study aimed at determining risk factors, medical records from the index patient, together with comparable data from controls matched by age, sex, postcode, and month of admission.ResultsDuring the period, 36 276 patients presented with their first episode of LLC. The incidence increased by 4.7% per annum, reaching 204.8 (95% CI 198.6–211.1) per 100 000 population by December 2013. Analysis of 29 062 case-control pairs showed several conditions with lower limb pathology were independently associated with LLC, including varicose veins (AOR 2.95, 95% CI 2.50–3.48, p < 0.001), lymphoedema (AOR 2.65, 95% CI 1.71–4.10, p < 0.001), tinea pedis (AOR 3.05, 95% CI 1.45–6.42, p 0.003), and saphenous vein harvest during coronary artery bypass grafting (AOR 1.74, 95% CI 1.32–2.30, p < 0.001). Also associated with LLC was obesity (AOR 2.05, 95% CI 1.82–2.31, p < 0.001), renal disease (AOR 1.28, 95% CI 1.14–1.44, p < 0.001), rheumatologic conditions (AOR 2.12, 95% CI 1.72–2.60, p < 0.001), hemiplegia/paraplegia (AOR 1.31, 95% CI 1.13–1.52, p < 0.001), and liver disease (AOR 1.77, 95% CI 1.51–2.06, p < 0.001).ConclusionsLLC presents a major burden to the health sector and is increasing with an ageing population. Given the high rates of recurrence, long-term morbidity, and economic impact, efforts to reduce primary episodes should be incorporated into the infectious diseases and healthy ageing research agenda.     

Characteristics of Acute Nongonococcal Urethritis in Men Differ by Sexual Preference

Nongonococcal urethritis (NGU) is a common clinical syndrome, but no etiological agent is identified in a significant proportion of cases. Whether the spectrum of pathogens differs between heterosexual men (MSW) and men who have sex with men (MSM) is largely unstudied but of considerable clinical relevance. A retrospective review was done using the electronic medical record database of Melbourne Sexual Health Centre, Australia. Cases were first presentations of symptomatic acute NGU with ≥5 polymorphonuclear leukocytes (PMNL)/high-powered field (HPF) on urethral Gram stain between January 2006 and December 2011. First-stream urine was tested for Chlamydia trachomatis and Mycoplasma genitalium by PCR. Demographic, laboratory, and behavioral characteristics of cases were examined by univariate and multivariable analyses. Of 1,295 first presentations of acute NGU, 401 (32%; 95% confidence interval [CI] of 29 to 34%) had C. trachomatis and 134 (11%; 95% CI of 9 to 13%) had M. genitalium detected. MSM with acute NGU were less likely to have C. trachomatis (adjusted odds ratio [AOR] = 0.4; 95% CI of 0.3 to 0.6) or M. genitalium (AOR = 0.5; 95% CI of 0.3 to 0.8) and more likely to have idiopathic NGU (AOR = 2.4; 95% CI of 1.8 to 3.3), to report 100% condom use for anal/vaginal sex (AOR = 3.6; 95% CI of 2.7 to 5.0), or to have engaged in sexual activities other than anal/vaginal sex (AOR = 8.0; 95% CI of 3.6 to 17.8). Even when C. trachomatis or M. genitalium was detected, MSM were more likely than MSW to report consistent condom use (OR = 4.7; 95% CI of 2.6 to 8.3). MSM with acute NGU are less likely to have the established bacterial sexually transmitted infections (STIs) and more likely to report protected anal sex or sexual activity other than anal sex prior to symptom onset than MSW. These data suggest that the etiologic spectrum of pathogens differs between MSM and MSW in acute NGU and that relatively low-risk practices are capable of inducing acute NGU.     

Prevalence and risk factors of wheeze and eczema in 1‐year‐old children: the Butajira birth cohort,Ethiopia

Background The rising global prevalence of asthma and other allergic conditions has been linked to potential aetiological factors influencing the developing immune system. Objective To investigate the prevalence and associated risk factors for wheeze and eczema in 1‐year‐old children in a birth cohort from Butajira, Ethiopia. Methods In 2005/6, a population‐based cohort of 1065 pregnant women was established. At 1 year of age, data on wheeze and eczema in the children were collected from the mother via an interview‐administered questionnaire, along with numerous demographic and lifestyle factors. A stool sample was also obtained from the child for geohelminth analysis. Results The prevalence of wheeze was 11.5% (103/899) and eczema 8.6% (77/899). Independent predictors of wheeze were maternal allergic history [adjusted OR (AOR)=3.00, 95% CI 1.23–7.36], paternal allergic history (AOR=2.59, 95% CI 1.08–6.25), increasing household size (P for trend=0.023; AOR=3.54, 95% CI 1.31–9.56 for 7+ vs. 1–3 individuals) and paracetamol use by the child (overall P<0.001; AOR 11.04, 95% CI 4.30–28.31 for 4+ tablets in past month vs. never). Factors independently associated with eczema were maternal allergic history (AOR=3.68, 95% CI 1.54–8.77), household size (overall P=0.035; AOR=0.45, 95% CI 0.23–0.87 for 4–6 individuals relative to 1–3) and place of sleeping (overall P<0.001; AOR=0.29, 95% CI 0.10–0.82 for floor vs. bed/platform). Conclusion These findings support the hypothesis that eczema in early life in these children is a manifestation of allergy, while wheezing is probably due to infection as well as allergy. Cite this as: Y. Belyhun, A. Amberbir, G. Medhin, B. Erko, C. Hanlon, A. Venn, J. Britton and G. Davey, Clinical & Experimental Allergy, 2010 (40) 619–626.