Determinants of HIV testing among young people aged 18 – 24 years in South Africa

Background

Although recent estimates of the HIV/AIDS burden in South Africa show the particular vulnerability of youth to HIV, HIV testing and its determinants are largely understudied in this age group.

Objective

To investigate the prevalence and determinants of HIV testing among young people aged 18 to 24 years, as part of an evaluation of the impact of loveLife.

Methods

South Africa''s national HIV prevention campaign for young people, on HIV and related risk behaviours. A cross-sectional population-based household survey was conducted using a multistage stratified cluster sampling approach. The total sample included 3123 participants, aged 18–24, 54.6% men and 45.4% women, from four provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga).

Results

The results indicated that over half (52.2%) of the youth reported testing for HIV, with more young females (60.1%) testing for HIV compared to their male counterparts (39.9%). In the multivariate analysis, older age, being female, HIV knowledge, having ever talked to the mother or female guardian about HIV and having ever been pregnant or made someone pregnant were found to be associated with testing for HIV.

Conclusion

There is still room for improving the low proportion of young people who test for HIV. Specific attention needs to be paid to younger males, with lack of HIV knowledge, having never talked to the mother or female guardian about HIV and having never been pregnant or made someone pregnant were less likely to be tested. Outreach at individual and community levels and public health messages targeting these youth should be implemented.     

Determinants of vitamin D status in healthy men and women aged 40–80 years

ObjectivesTo determine the contribution of life style and health related factors on vitamin D status in middle-aged and older men and women.Study designA cross-sectional single-center study in 400 male subjects (40–80 years) and 402 postmenopausal female subjects (56–73 years), conducted in a University Medical Center in the central part of the Netherlands (52 degrees northern latitude).Main outcome measuresMedical history, vitamin D, calcium and alcohol intake, physical activity, Body Mass Index, Blood pressure, smoking, total fat body mass and total lean body mass were measured using DEXA. Laboratory analysis included 25-hydroxyvitamin D (25OHD) and sex hormones.ResultsThirty-six percent of men and 51% of women had 25OHD less than 50 nmol/L. In summertime men had significant higher 25OHD as compared to women (81.5 vs 53.3 nmol/L, P = .000) but this difference disappeared come winter. In a saturated model, male gender (B = .16, P = .008), and season (summer vs winter B = .30, P = .000) remained statistically significant. In men, physical activity and season explained 21% of the variance. In women, household physical activity (B = .13, P = .03), sport physical activity (B = .02, P = .02) and estradiol (B = ?.003, P = .048) remained in the model,.ConclusionIn healthy middle-aged and older men and postmenopausal women, male gender and season were important predictors of vitamin D status. In men, physically activity and season, explained 21% of the variance in vitamin D status. In women, physical activity and estradiol explained 9.3% of the variance in vitamin D.     

Determinants of maximal instantaneous muscle power in women aged 50–75 years

The present study aimed at analysing the age-related decline in maximal muscle power (W˙) in 52 sedentary healthy women aged between 50 and 75 years to determine whether force or velocity is the major determinant. Maximal muscle power was estimated from two types of vertical jumps, squatting (SJ) and counter‐movement (CmJ), performed on a force platform. It was obtained by measuring the vertical force (F _opt) applied to the body centre of gravity and calculating the corresponding vertical velocity ( _opt). An age-related decline in absolute W˙ was statistically significant in all the conditions examined and in both peak W˙ and average power ( ) values. The decrease in _opt was also statistically significant. Also F_opt declined but this reduction was not statistically significant with the exception of the average value in CmJ. Not surprisingly the highest W˙ were obtained in CmJ, and the difference in power production between the two types of jump showed an age-related decrement only in . The main finding of the study was the demonstration that _opt was the critical determinant of the age-related decline in W˙ in healthy elderly women.     

Age distribution of human papillomavirus infection and neutralizing antibodies in healthy Chinese women aged 18–45 years enrolled in a clinical trial

ObjectivesData from clinical trials of human papillomavirus (HPV) vaccines showed that women naïve (negative for both type-specific antibodies and DNA) to vaccine types would derive benefit from vaccination; therefore, an understanding of the proportion of naïve women in different age groups is important for developing HPV vaccination strategies.MethodsFrom November 2012 to April 2013, a total of 7372 healthy women aged 18–45 years were recruited in five provinces in China. Cervical specimens and serum samples were collected for each woman at entry. Cervical specimens were first tested by the HPV DNA enzyme immunoassay method; if positive, the specimens were then tested by reverse hybridization line probe assay and HPV-16 and HPV-18 specific polymerase chain reactions. Neutralizing antibodies against HPV-16 or HPV-18 were tested with a pseudovirion-based neutralization assay.ResultsThe overall prevalence of high-risk HPV DNA was 14.8% (1088/7367, 95% CI 14.0–15.6), and the seroprevalence of neutralizing antibodies against HPV-16 and HPV-18 was 12.6% (925/7367) and 4.9% (364/7367), respectively. In younger women (18–26 years) and middle-aged women (27–45 years), 83.8% (3116/3719) and 81.4% (2968/3648) were naïve to both HPV-16 and HPV-18 (both neutralizing antibodies and DNA were negative), respectively. In addition, 98.5% (3664/3719) and 98.0% (3575/3648) of the younger or middle-aged women were naïve to at least one HPV type (HPV-16 or HPV-18).DiscussionThis study revealed that the majority of Chinese women aged 18–26 years and 27–45 years were naïve to both HPV-16 and HPV-18 and would thus derive full benefit from bivalent HPV vaccination.     

Trends in thin body stature among Japanese female adolescents, 2003–2012

Background: The past decades have witnessed a steady increase in thin body stature associated with unhealthy dieting among Japanese female adolescents. The most recent trends in thinness, however, have not been reported.

Aim: To describe changes in the distribution of body mass index (BMI) of Japanese female adolescents, from 2003–2012.

Subjects and methods: This study examined BMI distribution changes in 2541 relatively affluent Japanese girls, aged 12.5–17.5 years, during 2003–2012. The 2003 and 2004 data were combined and compared to the combined 2011 and 2012 data. Tukey mean-difference plots were used to study the direction and magnitude of shifts in BMI distributions.

Results: Prevalence of thinness (BMI <5th percentile of the 1978–1981 references) has progressively increased from 2.0–5.7% in 2003–2004 to 3.5–7.8% in 2011–2012 in Japanese girls. The downward shift in BMI was larger in 12.5–14.5 year olds than in 15.5–17.5 year olds and more prominent in the lower BMI spectrum.

Conclusion: The trend towards thinness has continued in Japanese girls during the past decade. The distribution of BMI suggests thinner and younger sub-groups of girls are more susceptible to this trend.     

Trends in thin body stature among Japanese male adolescents, 2003–2012

Background: The desire for thin body stature and unhealthy eating behaviours have spread among Japanese boys. The prevalence of thinness in boys is expected to increase; however, recent trends have not been reported.

Aim: To describe changes in the distribution of body mass index (BMI) of Japanese boys, from 2003 to 2012.

Subjects and methods: BMI distribution changes were studied in 2599 relatively affluent Japanese children and adolescents, aged 12.5–17.5 years, during 2003–2012. The 2003 and 2004 data were combined and compared to the combined 2011 and 2012 data. Tukey mean-difference plots were used to study the direction and magnitude of shifts in BMI distributions.

Results: Prevalence of thinness has progressively increased from 2.8–4.7% in 2003–2004 to 5.1–7.6% in 2011–2012 in Japanese boys. Tukey plots showed that the increases in the prevalence of thinness are related to shifts in the entire distribution of BMI in the sample.

Conclusion: Thin body stature was documented in increasing proportion of Japanese male adolescents. BMI z-scores decreased across the entire BMI centile spectrums, indicating that the whole school population may be at risk of thinness.     

Muscle strength and soft tissue composition as measured by dual energy x-ray absorptiometry in women aged 18–87 years

Dual energy x-ray absorptiometry (DEXA) offers the possibility of assessing regional soft tissue composition, i.e. lean mass (LM) and fat mass : LM may be considered a measure of muscle mass. We examined age-related differences in LM, percentage fat (%fat) and muscle strength in 100 healthy non-athletic women aged 18–87 years. Relationships between muscle strength and leg LM in 20 elite female weight lifters and in 18 inactive women with previous hip fractures were also studied. The LM and %fat of the whole body, trunk, arms and legs were derived from a whole body DEXA scan. Isokinetic knee extensor strength (KES) and flexor strength (KFS) at 30°?·?s^–1 were assessed using an isokinetic dynamometer. The women aged 71–87 years had 35% lower KES and KFS than the women aged 18–40 years (P P r _partial?=??0.74, P r _partial?=?0.65, P r?=??0.70, P P P 相似文献   

The contribution of family history to the burden of diagnosed diabetes,undiagnosed diabetes,and prediabetes in the United States: analysis of the National Health and Nutrition Examination Survey, 2009–2014

PurposeGiven the importance of family history in the early detection and prevention of type 2 diabetes, we quantified the public health impact of reported family health history on diagnosed diabetes (DD), undiagnosed diabetes (UD), and prediabetes (PD) in the United States.MethodsWe used population data from the National Health and Nutrition Examination Survey 2009–2014 to measure the association of reported family history of diabetes with DD, UD, and PD.ResultsUsing polytomous logistic regression and multivariable adjustment, family history prevalence ratios were 4.27 (confidence interval (CI): 3.57, 5.12) for DD, 2.03 (CI: 1.56, 2.63) for UD, and 1.26 (CI: 1.09, 1.44) for PD. In the United States, we estimate that 10.1 million DD cases, 1.4 million UD cases, and 3.9 million PD cases can be attributed to having a family history of diabetes.ConclusionThese findings confirm that family history of diabetes has a major public health impact on diabetes in the United States. In spite of the recent interest and focus on genomics and precision medicine, family health history continues to be an integral component of public health campaigns to identify persons at high risk for developing type 2 diabetes and early detection of diabetes to prevent or delay complications.     

Treatment of allergic rhinitis reduces acute asthma exacerbation risk among asthmatic children aged 2–18 years

Background/purposeAsthma and allergic rhinitis (AR) frequently coexist in the same individuals in childhood and adolescence. We evaluated whether AR had an impact on acute exacerbation (AE) and whether intranasal corticosteroid (INCS) and second-generation antihistamines (SGH) for AR modified the association of AR with AE in asthmatics aged 2–6 years and 7–18 years.MethodsUsing the National Health Research Institutes (NHRI) Database 2005 of Taiwan, we investigated patients who had been diagnosed with asthma in the years 2000 through 2012 and who had then been followed-up with for at least one year. The risk factors of AE were evaluated using multiple Cox proportional hazards regression analysis.ResultsThe incidence of AE was higher in the preschool group than the older group (adj. HR: 1.68, 95% CI: 1.44–1.95). The AR with INCS and/or SGH group was found to have a lower risk of AE than the non-AR group (adj. HR: 0.32, 0.44 and 0.30), but the AR without treatment group did not have a significant difference with the non-AR group. After propensity score matching, the use of INCS and/or SGH was associated with a significant reduction in the occurrence of AE among AR patients aged 2–6 years old (adj. HR: 0.38, 0.57 and 0.45) and 7–18 years old (adj. HR: 0.50, 0.52 and 0.35).ConclusionThe preschool patients had a higher incidence of AE than the older patients in general. Adequate treatment with INCS and/or SGH in asthma with AR patients is important for reducing the incidence of AE of asthma.     

Trends in ESBLs and PABLs among enteric Salmonella isolates from children in Gwangju,Korea: 2014–2018

ObjectivesNon-typhoid Salmonella infection is a major agent of food-borne outbreaks as well as individual cases worldwide. However, few studies on drug-resistant Salmonella strains, especially those recovered from young children, are available. Therefore, we determined the prevalence and characteristics of cephalosporin-resistant Salmonella isolates in the south-west region of Korea over a five-year period.MethodsNon-duplicate Salmonella clinical isolates were recovered from diarrhoeagenic patient specimens at 12 hospitals in Gwangju, Korea between January 2014 and December 2018. Antimicrobial susceptibility testing and molecular features of cephalosporin-resistant isolates were determined.ResultsA total of 652 Salmonella isolates were collected and 48 cefotaxime-resistant Salmonella isolates (7.4%), that belonged to nine Salmonella serovars, were identified. These were S. Enteritidis, S. Typhimurium, S. I 4,[5],12:i:-, S. Virchow, S. Agona, S. Bareilly, S. Infantis, S. Newport, and S. Schleissheim. The prevalence rate increased from 5.3% in 2014 to 10.3% in 2018. S. Virchow (44.4%) showed significantly high resistant rate compared to the other serovars. PGFE genotyping revealed high genetic homogeneities among each Salmonella serovars, suggesting clonal dissemination of cephalosporin-resistant strains.ConclusionsProgressive increases in carriage rates and the possibility of community outbreaks by cephalosporin-resistant Salmonella in young children may pose tangible public health threats.     

Secular change in the growth status of urban and rural schoolchildren aged 6–13 years in Oaxaca,southern Mexico

Background: Populations in the state of Oaxaca in southern Mexico are at high risk for malnutrition and marginalization.

Aim: The study compared secular changes in the growth status of urban and rural schoolchildren in the Valley of Oaxaca between the 1970s and 2000.

Subjects and methods: Cross-sectional surveys of boys and girls aged 6–13 years (n = 1472) were carried out in an urban colonia populares in 1972 and 2000 and a rural indigenous community in 1978 and 2000. Height, sitting height and weight were measured; leg length, sitting height ratio, BMI, and prevalence of stunting, underweight, overweight and obesity were calculated. Sex-specific ANCOVA controlling for age was used.

Results: Both urban and rural children experienced significant secular gains in linear dimensions, body weight and the BMI between the 1970s and 2000. Estimated rates of secular gain overlapped considerably between urban and rural children. Secular gains in the BMI are significantly greater in urban than rural boys and girls. Urban–rural differences in linear dimensions and body weight in 2000 compared to the 1970s do not differ in either sex, but urban–rural differences in the BMI are greater in boys and girls in 2000 compared to the 1970s. The prevalence of stunting declined while that of overweight and obesity increased.

Conclusions: Significant secular increases in body size occurred between the 1970s and 2000, but there was considerable overlap between urban and rural children. Only secular gains in the BMI were significantly greater in urban than rural boys and girls and the magnitudes of urban–rural differences in the BMI were greater in 2000 than in the 1970s.     

Mycobacterium Tuberculosis infection among the elderly in 20 486 rural residents aged 50–70 years in Zhongmu County,China

ObjectivesElderly individuals in rural China have been known to be at increased risk of contracting tuberculosis (TB) and developing active disease. This study aims to estimate the burden of mycobacterium tuberculosis (MTB) infection and to identify potential targeted subgroups for infection control.MethodsAs part of the investigation of an interventional study, 50- to 70-year-old rural residents in Zhongmu County were targeted for MTB infection testing using QuantiFERON-TB Gold In-Tube (QFT). Questionnaires and physical examinations were conducted to acquire their demographic information and health status.ResultsA total of 20 486 individuals were included in the analysis. The prevalence of QFT positivity was 20.79% (4259/20 486) and 50 participants (0.24%) had indeterminate results. A positive dose–response relation was found for QFT positivity with smoking intensity. Compared with non-drinkers, the risk of MTB infection was lower among participants with moderate alcohol consumption (<10 g/day) with adjusted odds ratio (OR) of 0.82 (95% CI 0.71–0.94). In addition, gender of male, with a history of previous TB or silicosis, and hepatitis B/C virus infection were associated with increased risk of MTB infection. An indeterminate QFT result was related to being underweight (adjusted OR 3.18; 95% CI 1.09–9.26).ConclusionsOur results indicate a high burden of MTB infection among the elderly in this rural area. Smokers, individuals with a history of previous TB or silicosis, and those with hepatitis B/C virus infection should be prioritized for MTB infection control to reduce the risk of disease development from a new infection.     

Prevalence and Morbidity of Primary Immunodeficiency Diseases,United States 2001–2007

Purpose

Few studies have estimated population prevalence and morbidity of primary immunodeficiency diseases (PIDD). We used administrative healthcare databases to estimate the prevalence of PIDD diagnoses in the United States from 2001 to 2007.

Methods

MarketScan databases compile claims from commercial health insurance plans and Medicaid, recording individual diagnoses for outpatient encounters and hospital stays. We used a cross sectional survey to estimate prevalence of PIDD using related ICD-9 codes (279.0, 279.1, 279.2, 279.8, 279.9, 288.1 and 288.2). Persons with secondary immunodeficiency diagnoses were excluded from analysis.

Results

Between 2001 and 2007, prevalence of any PIDD diagnosis increased from 38.9 to 50.5 per 100,000 among privately insured and from 29.1 to 41.1 per 100,000 among publicly insured persons. B cell defects predominated. Prevalence was more than twice as high among Whites as among Blacks or Hispanics.

Conclusion

In this large database, we found a higher prevalence of diagnosed PIDD than has been reported previously from registries. Increased awareness may have contributed to the increasing prevalence.     

Low utilization of HIV testing during pregnancy: What are the barriers to HIV testing for women in rural India?

INTRODUCTION: Sixty percent of India's HIV cases occur in rural residents. Despite government policy to expand antenatal HIV screening and prevention of maternal-to-child transmission (PMTCT), little is known about HIV testing among rural women during pregnancy. METHODS: Between January and March 2006, a cross-sectional sample of 400 recently pregnant women from rural Maharashtra was administered a questionnaire regarding HIV awareness, risk, and history of antenatal HIV testing. RESULTS: Thirteen women (3.3%) reported receiving antenatal HIV testing. Neither antenatal care utilization nor history of sexually transmitted infection (STI) symptoms influenced odds of receiving HIV testing. Women who did not receive HIV testing, compared with women who did, were 95% less likely to have received antenatal HIV counseling (odds ratio = 0.05, 95% confidence interval: 0.02 to 0.17) and 80% less aware of an existing HIV testing facility (odds ratio = 0.19, 95% confidence interval: 0.04 to 0.75). CONCLUSIONS: Despite measurable HIV prevalence, high antenatal care utilization, and STI symptom history, recently pregnant rural Indian women report low HIV testing. Barriers to HIV testing during pregnancy include lack of discussion by antenatal care providers and lack of awareness of existing testing services. Provider-initiated HIV counseling and testing during pregnancy would optimize HIV prevention for women throughout rural India.