Prevalence of hypertension and associated risk factors in Benin

BackgroundHypertension is one of the main risk factors of cardiovascular diseases. There has been a lack of data on this risk factor in the general population in Benin. The aim of this study was to determine the prevalence of hypertension and identify the associated risk factors in Benin.MethodsA cross-sectional study was conducted from July to August 2008 in Benin's 12 departments. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. The sample included 6853 subjects 25–64 years of age, randomly selected by five-stage random sampling. Blood pressure was measured using standard procedures. Data was processed and analyzed using EPI DATA and STATA 9.2 software. Prevalence levels were compared using Pearson's chi² and means with the Student t-test. Univariate and multivariate regression analysis, taking the sampling method into account, was used to identify risk factors.ResultsThe sample comprised 49.5% females, the 25- to 34-year-old age group was the largest, and the mean age was 42.7 ± 12.4 years. The prevalence of hypertension was 27.9% [95% CI: 26.3–29.5%], 77.5% of the subjects were unaware of their high blood pressure, and 81.6% had not taken their drugs two weeks before the survey. Prevalence of known hypertension was 6.9%, prevalence of treated hypertension 4.8%, and prevalence of controlled hypertension 1.9%. Age and obesity were significantly associated with hypertension. Department and profession were not associated with hypertension.ConclusionThis study showed a high prevalence of hypertension in the general population in Benin. Better management of this risk factor will contribute to reducing morbidity and mortality due to cardiovascular diseases.     

Infant malnutrition, development rate and its relation to the environment: a pilot study]

The socio-cultural factors that might be influencing the normal psychomotor development of the undernourished infant are studied. The sample consisted of 32 mother-infant dyads: 16 having normal DQ (Group A) and 16 having a below normal DQ (Group B) according to Bailey's Test applied to infants who entered a Nutritional Recuperation Center. Results showed that there were some differences in the infants' backgrounds: infants of Group A were the product of a wished-for pregnancy (p less than .05), and were separated less from their mother's side (p less than .007) than was the case in Group B. No differences were found in the socio-cultural and demographic background of the mothers. The infants' external environment was different in aspects observed within the neighborhood: there were fewer negative aspects in Group A than in Group B (p less than .003) and more positive in Group A than in B (p less than .001). The infant's internal environment as related to the mother was also different. Mothers of Group A perceived more affection from their partner (p less than .008), were more sensitive (to feelings of joy and suffering) (p less than .003) and stimulated their infant (p less than .004) more than those of Group B. These results show that the internal and external environments in which the infant with normal and below normal DQ evolves were different between the two groups. This could explain the differences in psychomotor development among undernourished infants belonging to the lower socioeconomic strata.     

Infant malnutrition is associated with persisting attention deficits in middle adulthood

Infantile malnutrition is known to be associated with cognitive and behavioral impairment during childhood and adolescence. Data pertaining to longer-term effects on behavioral outcomes in adulthood are limited. In this study, we report associations between infantile malnutrition and attention problems in adults at midlife. Attention problems were assessed by the Conners Adult ADHD Rating Scales (CAARS) and the Conners Continuous Performance Test (CPT) in 145 Barbadian adults (aged 37-43 y) who had been followed longitudinally since childhood. Previously malnourished participants (n = 80) had experienced moderate to severe protein-energy malnutrition in the first year of life and were successfully rehabilitated thereafter. They were compared with healthy adults (n = 65) who were former classmates of the index cases and who had been matched for age, sex, and handedness in childhood. Multiple regression analyses showed persisting effects of childhood malnutrition on both the CAARS and the CPT, independent of effects of household standard of living assessed in childhood. The malnutrition effect on the CAARS ratings was independent of IQ, whereas this effect was attenuated for the CPT after adjustment for IQ. Teacher-reported attention problems in childhood predicted attention problems in adulthood, indicating continuity over the life span. Infantile malnutrition may have long-term effects on attentional processes nearly 40 y after the episode, even with excellent long-term nutritional rehabilitation and independent of socioeconomic conditions in childhood and adolescence. This finding has major public health implications for populations exposed to early childhood malnutrition.     

Dietary patterns associated with risk factors for cardiovascular disease in a Brazilian city]

OBJECTIVE: To identify the dietary patterns of individuals living in the urban area of S?o Paulo, Brazil, and to investigate the association between these patterns and biological, sociodemographic, and behavioral risk factors for cardiovascular disease (CVD). METHOD: A cross-sectional epidemiological survey was carried out with a population-based probabilistic sample. The 2,100 participants of both sexes were from 15 to 59 years of age. A sociodemographic, behavioral, clinical, and dietary survey was applied to a systematic subsample of 700 people. Dietary patterns were determined using factor analysis based on a food frequency questionnaire. Covariance analysis was used to determine the associations between dietary patterns and sociodemographic and behavioral variables, and multilinear regression to determine the association between dietary patterns and biological factors. RESULTS: Four patterns were identified: (1) the "cafeteria" pattern (simple sugars and saturated fat), associated with areas of medium sociodemographic and environmental homogeneity, high school and university-level schooling, and alcohol consumption; positively associated with systolic (SAP) and diastolic (DAP) arterial pressure, body mass index (BMI) and waist-to-hip ratio (WHR); and negatively associated with HDL. (2) The "traditional" pattern (including cereals, beans, and infusion beverages) was predominant among women and in the age group over 50 years;associated with alcohol consumption, higher income, and areas of medium homogeneity; positively associated with glucose levels and BMI; and negatively associated with triglycerides and WHR. (3) The "modern" pattern (low intake of fat and simple sugars; fish) was predominant among individuals from high homogeneity areas, with higher income and university schooling;negatively associated with DAP, total cholesterol, glucose levels, and LDL. (4) The "atherogenic" pattern (saturated fat, addition of salt to cooked foods and alcohol consumption) was predominant among males; associated with elementary schooling, smoking, alcohol consumption, and areas of medium and low homogeneity; and positively associated with total cholesterol, triglycerides, glucose levels, BMI, and WHR. CONCLUSIONS: The results indicate an unfavorable trend in the dietary patterns of this population, since three of the four patterns identified (cafeteria, traditional, and atherogenic) are significantly associated with risk factors for CVD.     

Alcohol consumption and associated factors in a city in Northeast Brazil

This cross-sectional study focused on alcohol consumption according to gender, age, income, and schooling in Jequié, Bahia State, Brazil. The random sample consisted of 270 individuals over 14 years of age living in the urban area of Jequié from January to March 2010. Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Of the total sample, 21.8% consumed four or more drinks on a typical day, 14.1% admitted having caused any harm after drinking, and 26.3% reported that someone had already suggested they should stop drinking. Forty percent of men had more than four drinks on a typical day, and 50.5% of young people drank frequently. Distribution of the variables was consistent with higher frequency and greater amounts of alcohol among men and young people. There was a large proportion of heavy episodic alcohol consumption. The study identified vulnerable groups that are still not addicted to alcohol, and that should be targeted for public health promotion and prevention policies.     

广州市中小学生营养不良现状及影响因素分析

目的 了解广州市中小学生营养不良现状并分析影响因素,为改善学生营养状况提供依据。方法 采用多阶段分层整群随机抽样的方法,抽取广州市增城区(农村)和荔湾区(城区)中小学生共1 403名。收集一般情况、生活方式、饮食行为和体格检查数据,并判断营养状况。采用检验比较营养不良率或构成比的差异,采用多因素logistic回归模型分析学生营养不良的影响因素。结果 学生营养不良检出率为8.70%,以消瘦为主(7.84%)。其中,男生营养不良检出率高于女生(P=0.027),城区学生生长迟缓检出率高于农村学生(P=0.020),中重度消瘦检出率随着年龄的增大降低(P=0.029)。多因素logistic回归分析显示男生(OR=1.893, 95%CI: 1.270～2.820)是营养不良的危险因素,甜食摄入频次为1～3次/周(OR=0.277, 95%CI: 0.084～0.909)和4～6次/周(OR=0.275, 95%CI: 0.079～0.954)是营养不良的保护因素。结论 广州市中小学生营养不良情况有所改善,但男生检出率仍较高。提示应重视中小学生营养不良,及时开展均衡膳食、饮食行为等干预,避免不良健康结局。     

慈溪市农村婴幼儿营养不良影响因素及防治措施研究

【目的】 了解慈溪市农村婴幼儿营养不良现状和主要影响因素,为制定农村婴幼儿营养不良的预防策略和干预措施提供科学依据。【方法】 采用多层机械抽样,以农村婴幼儿为研究对象,测量其身长和体重,并对婴幼儿家长进行问卷调查。【结果】 多因素分析显示,男童、双胎、年龄越大、早产、低出生体重、疾病、父母年龄大、文化程度低、父母职业为农民工的婴幼儿易发生营养不良。【结论】 防治农村婴幼儿营养不良需在发展农村经济的同时,加强妇幼保健,降低早产和低出生体重儿的发生率,普及科学育儿知识。     

Infant and maternal mortality in Albania

Changes in Albanian infant and maternal mortality were studied.All available figures for infant deaths and female deaths, inrelation to delivery over the years 1989–1993 were included.The analysis of trends concerned mortality and abortion figuresas well as indicators of time, place and causes. Infant mortalitydecreased from 98 per 1000 in 1970 to 28 per 1000 in 1990, butsince then has shown a significant increase. In the period since1990 the number of births has diminished each year by 5%, whilstthe number of deliveries in hospital has increased. It appearedthat the infant mortality in hospital increased the first dayafter birth. In general infant deaths occurred more often inthe first week than in the following 3 weeks. There was an increasein death from pulmonary diseases, while infectious diseasesand congenital anomalies showed a decrease. Maternal mortalitydecreased annually, but only mortality caused by abortion decreasedconstantly. There was a large shift In the number of abortionswhich fell into two categories: induced and therapeutical. Thechanges in infant mortality could be related to the deteriorationof the health care system after 1991. On the other hand, errorsin the records could have influenced results. Maternal mortalitydecreased due to better abortion practice, whilst the increasein abortions seemed to indicate that this was an important methodof family planning.     

Infant mortality Social inequality in a Swedish city

Infant mortality rates for geographical areas of Göteborg(Gothenburg), Sweden, were studied for 78,357 infants livingin Göteborg from 1971 to 1985. During this time 637 infantdeaths occurred. The 32 parishes of Göteborg were dividedinto three groups referred to as high, medium and low incomeareas. The difference in infant mortality among the areas wasstatistically significant and increased over time. The relativerisk of Infant death was 1.8 in the medium and 2.0 in the lowcompared to the high income areas in 1981–1985. The infantmortality rate varied from 3.8 to 7.6/1000. The high incomeareas had lower death rates overall, in congenital malformationsand in perinatal conditions. The low income areas had a significantlyhigher rate of sudden infant death syndrome than the other groups.Political and administrative decentralization was implementedin Sweden in the 1980s. Local area research thus has a directrelevance for policy, planning and provision of services. Theresults reflect the social segregation, associated not onlywith economic stratification but also with differences in lifestylesand cultural environment. Further analyses are necessary toprovide Information on preventable risk factors In order todecrease the observed socio-economic differences. The resultscan, however, be used for targeting infant mortality levelsand for the allocation of resources.     

Breast cancer's secondary prevention and associated factors

OBJECTIVE: To evaluate the prevalence of secondary prevention of breast cancer and associated factors. METHODS: A population-based cross-sectional study was conducted in the city of Pelotas, southeastern Brazil, in 2002. The study sample comprised 879 women aged 40 to 69 years. Information was collected on demographic, social, economic, behavioral, biological and care management variables. Statistical analysis based on Poisson regression model was carried out. RESULTS: The prevalence of breast self-examination (BSE) was 83.5% (95% CI: 80.9-85.9). Of them, 80.4% (95% CI: 77.3-83.2) carried out BSE at least once a month. The prevalence of clinical breast examination was 83.3% (95% CI: 80.6-85.7). Mammography was occasionally performed in 70% (95% CI: 66.8-73.0) of the sample. Of these women, 83.7% (95% CI: 80.5-86.6) underwent mammography at least once in the last two years. Sixty-two percent (95% CI: 58.7-65.2) of the women interviewed attended a gynecological visit at least once in the last year. The factors mainly associated to the high prevalence of secondary prevention of breast cancer were: higher social status; greater association of risk factors for breast cancer; family history of breast cancer; hormone replacement therapy and previous breast biopsy or surgery. CONCLUSIONS: Preventive measures for breast cancer have been widely taken in the study sample; however, data points out to some limitations related to efficacy. Social and economic status seems to be a major determinant to gynecological care access and, consequently, access to secondary prevention of breast cancer.     

2010－2017年西藏山南市孕产妇死亡率趋势及影响因素分析

目的 分析山南市2010－2017年孕产妇死亡率变化趋势及影响因素。 方法 采用回顾性分析方法,运用WHO孕产妇死亡十二格评审表,对2010－2017年山南市死亡孕产妇的死亡报告卡及个案调查报告进行分析。 结果 2010－2017年山南市孕产妇死亡总体呈逐年下降趋势,其中2015年死亡率(从2010年度的194.98/10万降至38.03/10万)为最低,但是2017年偶然的呈现上升现象(2017年为105.22/10万,同年自治区为102/10万,全国为19.6 /10万)。同期住院分娩率以年均12.15%在提高,从2010年的61.37%上升到2017年度99.37%,住院分娩率与孕产妇死亡率呈负相关。孕产妇死亡前三位原因依次是产科出血、妊娠期高血压疾病和脑溢血。2010－2017年山南市孕产妇死亡总数为39例,直接产科原因死亡病例占76.92%(30/39),其中38.46%死于产科出血。WHO十二格表评审结果为个人和家庭知识技能原因占74.36%、医疗机构知识技能因素占61.53%、个人态度有关占30.77%、医疗保健机构管理占15.39%。 结论 要加大健康教育及孕妇保健管理力度,引导老百姓崇尚科学、唤醒自我健康意识;加强医疗专业技术队伍培训,强化针对死因病种的专题培训,进一步提升本地区高危孕产妇救治技术能力、筛查能力和适时转诊能力等;是降低本地区孕产妇死亡率的关键措施。     

Prevalence of obesity and associated risk factors in a Turkish population (trabzon city, Turkey)

OBJECTIVE: To estimate the prevalence of overweight and obesity (general and central) in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption), and hypertension in the adult population. RESEARCH METHODS AND PROCEDURES: A sample of households was systematically selected from the central province of Trabzon and its five towns, namely, Sürmene, Vakfikebir, Ma?ka, Hayrat, and Tonya. A total of 5016 subjects (2728 women and 2288 men) were included in the study. Individuals more than 20 years old were selected from their family health cards. Demographic factors, socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure and diastolic blood pressure levels were measured for all subjects. Study procedures were carried out in the local health centers in each town over an 8-month period. Obesity was defined as BMI > or = 30 kg/m2 and overweight as BMI = 25.0 to 29.9 kg/m2. RESULTS: The prevalence of obesity was 23.5%: 29.4% in women and 16.5% in men. The combined prevalence of both overweight and obesity was 60.3%. The prevalence of abdominal obesity was 29.4%: 38.9% among women and 18.1% among men. The prevalence of obesity increased with age, being highest in the 60- to 69-year-old age group (40.8%) but lower again in the 70+ age group. Obesity was associated positively with marital status, parity, cessation of cigarette smoking, alcohol consumption, and household income and inversely with level of education, cigarette use, and physical activity. Also, obesity was associated positively with hypertension. DISCUSSION: In the Trabzon Region, 60.3% of the adult population presents with some excess weight. Obesity is a major public health problem that requires generalized interventions to prevent it among the adult population.     

马鞍山市孕妇妊娠相关焦虑变化及其影响因素的纵向研究

目的探讨孕期妊娠相关焦虑的动态变化,分析妊娠相关焦虑的影响因素。方法收集马鞍山市妇幼保健院孕妇一般人口统计学指标和孕期暴露资料,采用自编的《妊娠相关焦虑量表》评定孕妇不同妊娠时期的妊娠相关焦虑状况,并运用广义估计方程分析妊娠相关焦虑的影响因素。结果 990名孕妇孕早期、中期、晚期妊娠相关焦虑问卷总得分分别为(20.3±4.9)、(19.6±4.6)和(18.9±4.4),差异有统计学意义(F=63.10,P<0.001)。孕早期、中期、晚期妊娠相关焦虑检出率分别为21.0%、17.7%和13.6%,差异有统计学意义(χ2=18.74,P<0.001)。广义估计方程结果显示,孕妇高中文化程度(OR=1.36,95%CI 1.05~1.75)、家庭人均月收入<2500元(OR=1.33,95%CI 1.01~1.75)、意外妊娠(OR=2.60,95%CI 2.05~3.29)、有流产史(OR=1.30,95%CI 1.06~1.60)、孕期阴道流血(OR=1.61,95%CI1.22~2.12)、孕期发热(OR=1.69,95%CI 1.17~2.46)和孕期营养剂使用(OR=1.43,95%CI 1.08~1.88)是妊娠相关焦虑的危险因素。结论孕妇妊娠相关焦虑随着妊娠进展呈下降趋势;妊娠相关焦虑的发生与孕妇的文化程度、家庭经济状况、意外妊娠、流产史、阴道流血及发热等因素相关。     

Santiago, a terror-stricken city]

The general purpose of this article is to determine how citizens' fear of lack of safety affects the use of public spaces. In an evaluation such as this, it is necessary to analyze two types of relationships pertaining to violence: the one between victimization and a perception of being unsafe, and the one that exists between social attitudes and the peaceful resolution of national conflicts. To this end, an analysis was performed of different variables--victimization, feeling unsafe, use of physical spaces, attitudes toward the established political and social institutions and toward the resolution of national conflicts--and of potential associations between these variables. The data for the study came from a survey of 1,200 persons between 18 and 70 years old who were residents of Santiago. Results show that Santiago's citizens live in fear and that their perception of a lack of safety has grown more intense, despite the fact that victimization rates remained relatively stable over the years preceding the survey. Fear is associated with an abandonment of both physical and sociopolitical public spaces, as well as with seeking refuge in private spaces and private life. There is a widespread attitude in favor of resolving conflicts through non-peaceful means, and such an attitude is more often associated with feeling unsafe, having negative attitudes toward democracy, and lacking hope in the nation's future. The results of this study support the notion that, in order to overcome their fear, people tend to adapt to reality by adopting a conformist attitude, taking on standard beliefs and behaviors, and overestimating the use of force as a way of resolving their differences.     

Infant temperament at 6-9 months old: validation of the French version of the Infant Characteristics Questionnaire and factors associated with measurement]

BACKGROUND: The aim of the study was to assess the validity of the French version of the Infant Characteristics Questionnaire (ICQ), which was developed by Bates in 1979 to investigate the parental perceptions of infant temperament at 6 months of age. METHODS: The French version was established after translation/back-translation, and tested on a sample of 794 mothers, who gave birth in 1995 in four French Departments and who returned the questionnaire which was mailed 6 months after the birth. RESULTS: The non-response rate of each item was very low (< 2%). Factor analysis resulted in the same four factors as in the American data: fussy/difficult, unadaptable, unpredictable, dull. However, some of the items did not have similar factor loadings. Thus new factor scores were defined for the French version of the ICQ. Internal consistency, as measured by the Cronbach coefficient, was satisfactory (> 0.7) for the factors fussy/difficult and unadaptable. It was lower, but acceptable (> 0.6) for the two other factors. The infant's temperament was not related to birth parameters. In contrast, some factor scores were significantly associated with parity, mother's education, as well as her health and the infant's health after leaving the maternity ward. CONCLUSIONS: The French version of the ICQ is well accepted and has a good validity. This scale provides a useful instrument for research, especially for epidemiological studies on infant health and development, as well as their determinants.     

开封市学龄前儿童屈光异常及其影响因素调查分析

目的 探讨开封市学龄前儿童屈光异常情况及其影响因素,为指导儿童眼保健提供依据. 方法 采取整群随机抽样方法抽取25所幼儿园7 862例3～6岁儿童进行屈光度筛查,屈光异常者进一步检查诊治;同时以问卷形式进行屈光异常影响因素调查分析. 结果 （1）屈光异常者中共散瞳验光1 733例,确诊弱视81.3％.弱视屈光类型远视、近视、混合散光分别为75.9％、5.2％、18.9％.3年变化趋势为,远视成分逐年降低,近视有所增加,尤其混合散光所占比例明显增加.（2）影响屈光异常有母亲孕期的烟酒接触史、胎龄、窒息史及出生体重、家族史、父母眼保健知识及收入状况、视电子视频产品及户外活动的时间和开夜灯睡眠. 结论 加强婚前遗传咨询,重视围产期保健,减少出生缺陷,培养孩子良好的用眼习惯,定期对学龄前儿童进行视力和屈光筛查,早期采取防治措施,对指导儿童眼保健,降低儿童眼病的发生率起重要作用.     

泰安市大学生亚健康状况及其影响因素分析

了解大学生发生亚健康状况及其发生的影响因素,为制定亚健康防治措施提供依据.方法 自制亚健康调查表,在泰安市4所大学中随机抽取一~四年级在校学生共1 396名进行问卷调查.结果 泰安市大学生亚健康现患率为54.1%,其中男生为53.7%,女生为54.5%,差异无统计学意义(P>0.05);一~四年级学生亚健康的现患率分别为46.1%,54.5%,60.6%和52.7%,差异有统计学意义(P<0.05);医科学生亚健康现患率为49.4%,农科学生为64.9%,文科学生为57.8%,工科学生为51.4%,理科学生为60.8%,不同专业类型学生亚健康现患率差异有统计学意义(P<0.05).经Logistic回归分析,年级是影响学生亚健康发生的主要因素.结论 医学生的健康状况好于其他学科学生,以躯体健康状况最为明显;大学生的亚健康现患率随年级增高而增高;目前高校大学生总体亚健康状况好于其他职业人群.