SARS-CoV-2 seroprevalence among children in Latvia: A cross-sectional study

Coronavirus disease 2019 (COVID-19) is a major global health concern. In contrast to adults, the course of the disease has been observed to be mild or even asymptomatic in children. It is therefore both clinically and epidemiologically important to measure the seroprevalence in children and adolescents to discern the overall morbidity of the disease and to compare these findings with similar data collected globally. We conducted a cross-sectional study between March and July of 2022 at the Children Clinical University Hospital in Riga, Latvia, to evaluate the seroprevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Participants aged 0 to 18 years were enrolled during hospitalization for reasons other than COVID-19. The levels of SARS-CoV-2 spike protein and nucleocapsid antibodies were measured in blood samples. The possibility of transplacental antibody transport was evaluated by directly interviewing the mothers of participants aged 18 months and younger. Various demographic and epidemiological risk factors and their association with seroprevalence were analyzed. Positive SARS-CoV-2 nucleocapsid antibodies were designated the main criterion for seropositivity. Of 200 enrolled children, 173 were found to be seropositive, resulting in an overall seroprevalence of 86.5%. The highest seroprevalence was detected in children and adolescents aged 12 to 18 years. With the progression of the COVID-19 pandemic, the seroprevalence in children has increased significantly. We found that almost 1-third of seropositive children in our study population were unaware of being previously infected with SARS-CoV-2 due to an asymptomatic course of the disease. Our study findings pertaining to high seropositivity among children and adolescents might be beneficial for public authorities to adapt epidemiological strategies and prevention measures. The high seroprevalence rate reported here and in many other populations around the world suggests that COVID-19 will likely become one of the many seasonal viral infections.     

Association between serum C-reactive protein levels and pulse wave velocity: a population-based cross-sectional study in a general population

Arterial stiffness as determined by aortic pulse wave velocity (PWV) has been shown to predict cardiovascular events in high-risk subjects such as those with hypertension or end-stage renal disease. Although it is suspected that low-grade inflammation as represented by increased C-reactive protein (CRP) plays an important role in the progression of atherosclerosis, it is not yet known whether serum CRP levels are associated with PWV. To examine the relationship between brachial-ankle PWV (baPWV) and serum CRP levels, several cardiovascular risk factors including these two markers (baPWV and CRP) were measured in 870 participants (mean age 59 years) randomly selected from a general population. Age, male gender, systolic blood pressure, heart rate, diabetes, and serum CRP levels increased with the quartiles divided by baPWV (all, p<0.01). By multiple regression analysis, age (p<0.001), systolic blood pressure (p<0.001), heart rate (p<0.001), body mass index (p<0.001), and CRP (p<0.01) were significant and independent predictors for baPWV. In conclusion, this cross sectional study has demonstrated in the general population that the arterial stiffness marker baPWV was independently correlated with serum CRP levels after adjustment for other established cardiovascular risks factors. This result suggests that baPWV may be a surrogate marker for atherosclerotic vascular damages including an inflammatory component.     

Economic burden attributable to functional bowel disorders in Iran: a cross-sectional population-based study

OBJECTIVE: While few population‐based studies on the economic burden of functional bowel disorders (FBD) have been published from developing countries like Iran, this study aimed to estimate their direct and indirect costs for five groups of patients: irritable bowel syndrome (IBS), functional constipation (FC), unspecified‐FBD (U‐FBD), functional abdominal bloating (FAB) and functional diarrhea (FD). METHODS: Up to 18 180 adults randomly sampled from Tehran, Iran (2006–2007) were interviewed using two questionnaires based on the Rome III criteria to detect FBD patients and to estimate their medical expenses (such as visiting the doctor, drugs, hospitalization and laboratory tests) and productivity loss in the previous 6 months. All costs were converted to dollar purchasing power parity (PPP$) to facilitate cross‐country comparisons. RESULTS: The mean total 6‐month costs were approximately: 160, 147, 103, 96 and 42 PPP$ for IBS, FC, U‐FBD, FAB and FD, respectively. The highest proportion of drug consumption was found in IBS patients. The highest mean duration of absence from work was seen in IBS patients (2.26 days). Overall, doctor visit costs accounted for approximately 1/3 of the total costs for FBD, followed by hospitalization. A higher indirect cost of illness was found in IBS (54 PPP$), whereas it was zero in FD. CONCLUSION: The economic burden of FBD seems to be moderately high in Iran and it imposes a relatively heavy financial burden on the Iranian national health system because of its high prevalence and its impact on quality of life, productivity and waste of resources.     

Prevalence and demographic determinants of gastroesophageal reflux disease (GERD) in the Turkish general population: A population-based cross-sectional study

Background/aims: We aimed to establish the prevalence and demographic determinants of gastroesophageal reflux disease in the Turkish general population using the Turkish version of the gastroesophageal reflux disease questionnaire. Material and Methods: A total of 8143 volunteers (mean age: 38.5 (13.3) years; 52.3% males) were included in this cross-sectional questionnaire study conducted via face-to-face administration of the questionnaire forms including items on sociodemographic features, past history of gastric disorders, gastroesophageal reflux disease, the influence of reflux symptoms on patients' lives, physician visits, diagnostic tests, and reflux medications. Results: A past history of gastric symptoms was reported in half of the population. More female participants (p<0.001) had a past history of gastric symptoms that yielded a previous diagnosis of gastroesophageal reflux disease in 19.1% of the population. The likelihood of gastroesophageal reflux disease was low in the majority (75.3%) of the subjects evaluated. Gastroesophageal reflux disease with an inconveniencing or disrupting impact on the patient's life was present in 17.9% and 6.8% of the population. Total gastroesophageal reflux disease-questionnaire scores and reflux prevalence were higher in older age groups (p<0.001). Females were more likely to have gastroesophageal reflux disease prevalence based on reflux symptoms. The impact of gastroesophageal reflux disease on sleep and psychological/emotional well-being was more pronounced in older and female patients, whereas the impact on eating/drinking behaviors and physical-social activities was more marked among females independent of their age (p<0.001). Reflux prevalence was higher in subjects from East Anatolia, Central Anatolia, Mediterranean, and Black Sea regions of Turkey (p<0.001 for each). Conclusions: Prevalence and demographic determinants of gastroesophageal reflux disease are compatible with the profile of the disease in the other Western populations, with a predilection for females and older individuals.     

Predicting the onset of forearm pain: a prospective study across 12 occupational groups

OBJECTIVE: To determine, among workers free of forearm pain, the role of mechanical and psychosocial factors in predicting future onset. METHODS: A prospective cohort study was conducted among 782 newly employed workers from 12 occupational groups. At baseline, a cohort of 782 workers free of forearm pain was identified and measurement was made about physical and psychosocial aspects of their job and working environment. Subjects were recontacted after 1 year to determine new onsets of forearm pain. A sample of those reporting new onset forearm pain underwent a structured examination of the upper limb. RESULTS: One year after baseline, 666 (85%) subjects were followed up. The overall prevalence of new onset forearm pain was 8.3% (n = 55). The strongest mechanical risk factor was frequent repetitive movements of the arm or wrist (odds ratio [OR] 2.9, 95% confidence interval [95% CI] 1.6-5.2). The strongest psychosocial risk factors were work considered monotonous at least half of the time (OR 3.0, 95% CI 1.6-5.7) or work with little autonomy (OR 2.6, 95% CI 1.1-6.1). Three specific independent risk factors (monotonous work, repetitive wrist movement, working with hands above shoulder level) could distinguish groups of subjects at substantially different risks of onset. CONCLUSIONS: Along with repetitive movements of the arms and wrists, mechanical postural factors and psychosocial factors also are important risk factors for onset of forearm pain. Our study emphasizes the multifactorial nature of risks for onset of forearm pain, and provides leads as to possible mechanisms for prevention.     

Diabetes mellitus and its risk factors among a middle-aged population of Iran,a population-based study

Diabetes is a major health problem around the world. The risk of diabetes is increasing worldwide, and its misdiagnosis may have significant public health implications. This study aimed to determine the prevalence of diabetes and its risk factors among the middle-aged population in Shahroud, north of Iran. In the present study, the plasma glucose levels in 5190 subjects aged 40–64 years, participating in the first phase of the Shahroud Eye Cohort Study in 2009, were measured. Non-fasting glucose level greater than or equal to 200 mg/dl and/or the use of blood glucose-lowering drugs were considered as criteria for the diagnosis of diabetes. To determine the risk factors associated with diabetes, simple and multivariate logistic regressions were used. The prevalence of diabetes in men, women, and the total population were 10.4, 13.6, and 12.3 %, respectively. The mean blood glucose levels in men and women were 116.7 and 117.3 mg/dl, respectively. Age (odds ratio (OR)?=?1.04), hypertension (OR?=?2.5), being overweight (OR?=?1.5), and obesity (OR?=?1.5) were positively associated with diabetes. In addition, having an insurance (OR?=?0.48) and male gender (OR?=?0.81) was associated with a reduced risk of diabetes. Based on the results of the present study, the prevalence of diabetes in the studied population is high, and according to the epidemiological transition of diseases, a high percentage of the Iranian population are at risk for cardiovascular diseases. Considering the risk factors identified in the present study, developing effective interventions is essential.     

Minimal change in HSV-2 seroreactivity: a cross-sectional Swedish population study

The prevalence of antibodies to herpes simplex virus type 2 (HSV-2) was determined in sera collected from 2 Swedish cross-sectional populations during 1990/91 and 1996/97. A glycoprotein G2 (gG-2) peptide ELISA was used to analyse 2899 sera from adults. We found a prevalence of 13.0% in 18-70-y-olds in 1990/91 and 16.4% in 31-55-y-olds in 1996/97. Seropositivity to HSV-2 was somewhat higher in women than in men; 14.4% compared to 11.6% in 1990/91 and 18.9% compared to 13.6% in 1996/97. Overall there was a significant difference in female prevalence of HSV-2 compared to prevalence in males of the same age groups (p=0.013). Total antibody prevalence to HSV-1 of 88% in HSV-2 negative individuals above 18 y of age was found. HSV-2 positive individuals were found seropositive to HSV-1 in approximately 95% of the cases. 12% were negative for both HSV-1 and HSV-2 antibodies. In addition, there was no serological sign that the reported increase of HSV-1 as an early sexual disease had reduced the frequency of HSV-2 seropositivity in the sexually most active age groups. In conclusion, our investigation has shown no significant increase of HSV-2 seroprevalence in randomly selected Swedish subjects during the defined time period.     

Cardiovascular disease in asthma and COPD: a population-based retrospective cross-sectional study

We conducted a large population-based retrospective cross-sectional study for determining the extent of clinically recognized chronic obstructive pulmonary disease (COPD) and asthma, and the prevalence of associated cardiovascular diseases (CVDs), using information obtained from the Health Search Database (HSD) owned by the Italian College of General Practitioners (SIMG). Our study provides further evidence that patients with the diagnosis of COPD are at increased association with the diagnosis of most CVDs. It also documents that age clusters between 35 and 54 years are those at highest association of simultaneous presence of the diagnosis of CVD and that of COPD, with a progressive significant reduction in older age clusters. Moreover, it shows that the diagnosis of asthma is modestly associated with the diagnosis of different CV morbidities.     

Serum albumin and blood pressure: a population-based, cross-sectional study

BACKGROUND AND PURPOSE: Information about the association between serum albumin and blood pressure is limited. The purpose of the present paper was to investigate this relationship in different age groups in males and females. METHODS: In the cross-sectional Norwegian Oslo Health Study, the concentration of serum albumin and blood pressure was determined in 5071 men and women 30-75 years of age. The albumin-blood pressure relationship was studied using multiple regression. RESULTS: In general, men had higher albumin values than women, and young subjects had higher albumin values than old. Within all age groups and in both sexes, systolic and diastolic blood pressure increased with increasing albumin concentration within the physiological range. An increase in the albumin concentration over the physiological range from approximately 40 to 50 g/l was associated with an increase in the systolic blood pressure between 5 and 11 mmHg in males, depending on age, and between 6 and 17 mmHg in females. Corresponding increases in diastolic blood pressure were between 3 and 7 mmHg in males, and 4 to 9 mmHg in females. Per one SD increment in the albumin concentration the blood pressure increase was 1-3 mmHg. CONCLUSION: Within the different age groups, irrespective of sex and age, a positive association was found between serum albumin and blood pressure. Since albumin, in contrast to high blood pressure, is considered to be cardioprotective, the two variables probably affect cardiovascular risk by unrelated mechanisms.     

Erythrocyte volume and blood pressure in a cross-sectional population-based study

A reduction in mean erythrocyte volume has been reported in some strains of genetically hypertensive rat, and more recently it has been suggested that a similar alteration might be found in human essential hypertension. The relationship between erythrocyte volume and blood pressure was therefore studied in a random sample of an untreated male working population (n = 317; age 45.1 +/- 6.4 years, mean +/- s.d.). Neither systolic nor diastolic blood pressures were found to be related to erythrocyte volume (r = 0.022 and r = -0.014, respectively); in fact, erythrocyte volume was not different across quintiles of blood pressure. Smokers (n = 171) had lower blood pressure and a greater erythrocyte volume than non-smokers or ex-smokers (n = 144; 91.6 +/- 4.7 versus 88.2 +/- 5.5 fl; P less than 0.001), and heavy drinkers (greater than 110 g ethanol/day) had higher blood pressure and a greater erythrocyte volume compared with the rest of the study population (P less than 0.01). However, after adjustment of erythrocyte volume for these two potentially confounding factors, again no statistical association was found with blood pressure. The present study, therefore, does not support the hypothesis of a negative association between erythrocyte volume and blood pressure, whereas it confirms that the smoking habit and habitual alcohol intake are strong determinants of erythrocyte volume.     

Declining hepatitis A seroprevalence in adults in Catalonia (Spain): a population-based study

Background  

One of the main uses of seroprevalence studies it to evaluate vaccination programmes. In 1998, a programme of universal vaccination of preadolescents in schools with the hepatitis A vaccine was begun in Catalonia. The objective of this study was to investigate the prevalence and risk factors of hepatitis A virus infection (HAV) in a sample of the adult population of Catalonia in 2002 and to evaluate the changes with respect to a survey carried out in 1996.     

Ethnic differences in the relationships between obesity and glucose-metabolic abnormalities: a cross-sectional population-based study

OBJECTIVES: To evaluate whether body mass index (BMI) and other anthropometric indices of visceral obesity vary by ethnic group in their distribution and their relationship to metabolic abnormalities. DESIGN: Cross-sectional study. PARTICIPANTS: Canadian men and women, aged 35-75 years, of South Asian (n=342), Chinese (n=317), European (n=326) and Aboriginal (n=301) descent were recruited using stratified random sampling. PRIMARY MEASURES: Anthropometric indices (BMI, waist to hip ratio (WHR) and waist circumference (WC)), metabolic markers (fasting glucose, HbA1c, the ratio of total cholesterol/HDL) and clinical markers (systolic blood pressure) were assessed. RESULTS: In subjects with BMI<30 kg/m2, the mean marker levels in people with elevated WC (>88 cm in women, >102 cm in men) vs people with normal WC were 6.16 vs 5.34 mmol/l for fasting glucose, 6.05 vs 5.66% for HbA1c and 5.46 vs 4.68 for the ratio of total cholesterol to HDL (P<0.001 in each case). At nearly every given level of BMI, non-European ethnic groups displayed significantly higher marker levels than Europeans. For example, for a given BMI, age and sex, the difference between European and non-European groups in HbA1c levels was 0.53% (95% confidence interval (CI): 0.37-0.69) for South Asians, 0.37% (95% CI: 0.2-0.54) for Chinese and 0.95% (95% CI: 0.78-1.12) for Aboriginal People. CONCLUSIONS: Uniform cut-points for the classification of obesity using BMI, WHR or WC result in marked variation in the levels of glucose-metabolic abnormalities between ethnic groups. Existing action thresholds for these anthropometric indices do not apply to non-European ethnic groups and warrant revision.     

Dehydroepiandrosterone-sulfate serum levels and common age-related diseases: results from a cross-sectional Italian study of a general elderly population

The association of low serum dehydroepiandrosterone sulfate (DHEAS) levels with age, lifestyle, general health status indicators, and specific diseases was investigated in 436 men and 544 women of 65-97 yr old. In both sexes low serum DHEAS levels were associated with age, alcohol intake, number of current medications, and decreased thyroid function. Low DHEAS was also associated with low serum albumin in men and low systolic blood pressure in women. Compared to healthy men (n=106) age-adjusted serum DHEAS levels were significantly lower in men with atrial fibrillation, chronic obstructive lung disease, dementia, parkinsonism, cancer, diabetes, hypothyroidism, and in institutionalized men. Compared to healthy women (n=100) age-adjusted serum DHEAS levels were significantly lower in women with occlusive arterial disease, chronic obstructive lung disease, and osteoporosis. After controlling for differences in lifestyle and general health status parameters, low DHEAS levels remained statistically associated only with atrial fibrillation in men and osteoporosis in women, and it cannot be excluded that these association were spurious, due to multiple comparisons. These data suggest that in elderly people low serum DHEAS levels are more a non-specific indicator of aging and health status than a risk indicator of specific diseases.     

Normal fasting plasma glucose levels and type 2 diabetes: the high-risk and population strategy for occupational health promotion (HIPOP-CHP) study

The objective of this study is to ascertain if higher normal fasting glucose levels are also an independent risk of developing diabetes in an Asian population, and we thus analysed data from a cohort of healthy Japanese workers. We used data from the non-randomised trial on health promotion intervention, High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study. Diabetes cases and those who had fasting blood glucose levels equal to or greater than 100 mg/dl at baseline were excluded, and the Cox proportional-hazards model was used for the analysis. During the four-year follow-up of 2212 participants, we found 37 diabetes cases. In the multivariable model, people with blood glucose levels in the 4th quartile had a higher risk of diabetes than those in the bottom quartile; the multivariable-adjusted odds ratio was 2.52. The risk of diabetes abruptly rose in persons with blood glucose levels higher than 94 mg/dl (fourth quartile). A significant linear trend was not observed in the 1st to 3rd quartiles (p=0.726). In conclusion, higher fasting glucose level was associated with the risk of diabetes, and we found a threshold in the association between fasting blood glucose levels and risk of diabetes in an Asian population.     

The economic costs of diabetes: a population-based study in Tehran, Iran

Aim/hypothesis  The aim of the study was to determine the annual healthcare expenditures of an individual with diabetes in Tehran, between March 2004 and March 2005. Methods  This prevalence-based ‘cost-of-illness’ study was conducted in two phases. In the first phase, 23,707 randomly selected individuals were interviewed to gather a cohort of participants with diabetes. In the second phase, 710 diabetic patients and 904 age- and sex-matched controls were followed up for 1 year at intervals of 3 months and the direct (physician services, medications and devices, hospitalisation, laboratory, paraclinical and transport) and indirect (loss of productivity) expenditures were recorded. The excess costs of a person with diabetes were estimated through comparison with matched controls. The estimates were also extrapolated to the total population of Tehran and Iran. The costs were converted from the Iranian rial to the US dollar (exchange rate September 2004). Results  Total annual direct costs of diabetic and control participants were $152.3 ± 14.5 and $52.0 ± 5.8, respectively, which is indicative of 2.92 times higher costs in diabetic patients. The most expensive components of direct costs were medications and devices, and hospitalisation in diabetic patients (28.7% and 28.6%, respectively). Total indirect costs were $39.6 ± 2.4 and $16.7 ± 1.1 in diabetic and non-diabetic individuals. The aggregate annual direct costs of diabetes were estimated to be $112.424 ± 10.732 million and $590.676 ± 65.985 million in Tehran and Iran, respectively. Diabetes complications contributed 53% of the aggregate excess direct costs of diabetes. Conclusions/interpretation  Diabetes is an expensive medical problem in Iran and planning of national programmes for its control and prevention is necessary.