A descriptive analysis of STD prevalence among urban pregnant African-American teens: data from a pilot study.

OBJECTIVE: To assess the prevalence of sexually transmitted diseases (STDs) among a sample of African-American adolescent females at the time of their first prenatal visit and to assess key characteristics of those testing positive for sexually transmitted diseases. The study also determined differences in these characteristics between adolescents who were and those who were not diagnosed with an STD. METHODS: One-hundred-and-seventy pregnant African-American adolescents (aged 14-20 years; mean = 17.5 years) receiving their first prenatal visit were recruited at a prenatal clinic located in a large urban hospital. Biological assessment included nucleic acid amplification testing for gonococcal, chlamydial, and trichomonal infections. Rapid plasma reagin testing assessed infection with syphilis. A self-administered survey and in-depth face-to-face interview were used to collect detailed information assessing adolescents' sociodemographic characteristics, psychosocial indices, and their recent sexual risk behaviors. Data were analyzed using Student's t-tests and contingency table analyses, respectively, for continuous and categorical variables. RESULTS: Overall, 23.5% tested positive for one of the four STDs. Thirteen percent were infected with Chlamydia trachomatis, 1.2% with Neisseria gonorrhoeae, 8.9% with Trichomonas vaginalis, and 1.2% with Treponema pallidum. More than one-half reported recent (past 6 months) treatment for an STD, 30% of these tested positive for at least one of the four STDs assessed. Adolescents testing positive for STDs held favorable attitudes toward condom use, but levels of sexual risk were generally high. There were no sociodemographic, psychosocial, and sexual-risk differences between those testing positive and negative. CONCLUSION: Findings support STD screening efforts targeting pregnant adolescents. Providing clinic-based counseling and prevention education programs to pregnant adolescents regardless of apparent risk factors may also be warranted.     

Nutritional status of pregnant women: prevalence and associated pregnancy outcomes.

INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at approximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI), according to World Health Organization (WHO) criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.     

The prevalence of smoking among pregnant and postpartum women in Israel: a national survey and review

BACKGROUND: Cigarette smoking during pregnancy is a significant health risk to the developing fetus. In order to develop and implement an appropriate preconceptional and prenatal smoking cessation program a national pregnancy risk survey was done. METHODS: The survey was conducted through the Public Health Service's, Mother and Child Health Clinics (MCHC). The nursing staff initiated structured interviews with pregnant women and mothers of newborn infants. Questions included in the survey addressed folic acid utilization, smoking habits, onset of prenatal care and demographic characteristics. RESULTS: Overall, of the 1613 questionnaires received with smoking data, 12.8% of the women had smoked either in the 3 months preceding their current pregnancy and/or during their pregnancy. The smoking prevalence in Jewish women, was significantly greater then that found among Arab women (17.2 and 3.0%, P<.001, OR=7.5, CI=4.2-13.4). The prevalence of smoking for the duration of the pregnancy was 8.0% among Jewish women and 1.8% among Arab women. Among Jewish women, smoking prevalence was significantly associated with education, women who had completed 12 years of education were more likely to be nonsmokers (P=.034, OR=1.8, CI=1.0-3). CONCLUSION: Smoking in the preconceptional and prenatal period is a significant problem among Jewish women. Since less years of education is a significant risk factor, smoking cessation programs should focus on this subgroup of Jewish women.     

Eating problems in female Japanese high school students: a prevalence study.

OBJECTIVES: This study was conducted to estimate the prevalence of eating problems and to identify factors associated with the eating problems among Japanese high school girls. METHODS: This study used a cross-sectional design. The study population was 3,032 female students attending three high schools in Fukushima, Japan. The 26-item version of the Eating Attitudes Test (EAT-26) was administered to assess eating problems. Inquiries were also made regarding possible risk factors for the eating problems. RESULTS: Of the 2,685 subjects, 5.4% had a total EAT-26 score above the cutoff point (20 < or =). Logistic regression analysis demonstrated that older age, higher body mass index, a distorted body image, obsessive-compulsive tendency, and some familial issues were independently related to the eating problems. DISCUSSION: The prevalence of eating problems in the Japanese female population was low compared with reports from Western countries. In addition, distorted body image was suggested to have the greatest influence on eating problems.     

Comparing two prevalence rates in a two-phase design study.

An epidemiological study often uses a two-phase design to estimate the prevalence rate of a mental disease. In a two-phase design study, the first phase assesses a large sample with an inexpensive screening test, and then the second phase selects a subsample for a more expensive diagnostic evaluation. Furthermore, disease status may not be ascertained for all subjects who are selected for disease verification because some subjects are unable to be clinically assessed, while others may refuse. Since not all screened subjects are selected for diagnostic assessments, there is potential for verification bias. In this paper, we propose the maximum likelihood (ML) and bootstrap methods to correct for verification bias for estimating and comparing the prevalence rates under the missing-at-random (MAR) assumption for the verification mechanism. We also propose a method to test this MAR assumption. Finally, we apply our methods to a large-scale prevalence study of dementia disorders.     

High prevalence of overweight in a stable Spanish hemodialysis population: a cross sectional study.

OBJECTIVE: In the general population, the prevalence of overweight is high and is considered a mortality risk factor. In maintenance hemodialysis (MHD) patients reports regarding overweight and its predictors are scarce. Our aim was to evaluate the prevalence and predictors of overweight in MHD patients, supplemented with additional follow-up data on mortality. METHODS: Retrospective, observational, cross-sectional study of 190 white, noncomplicated patients on MHD recruited from 5 Spanish dialysis centers. Three anthropometric indexes were scored (relative body weight, skinfold thickness, and midarm muscle circumference), and body mass index (BMI) and dietary intake during a 5-day period were recorded. Patient survival was evaluated during a mean follow-up period of 25 +/- 20 months. RESULTS: Undernutrition (score < 7) was detected in only 15% of patients, and no patient had severe malnutrition (score < 4). The percentage of patients scored below 7, was similar in nondiabetics and type 2 diabetic patients, whereas it was significantly higher in type 1 diabetics (P =.002). Notably, 38% of patients (38% of nondiabetics, 50% of type 2 diabetics, and none of the type 1 diabetics) were overweight (BMI > or = 25 kg/m(2)). To evaluate the predictors of overweight, a stepwise logistic regression analysis was performed entering age, sex, time on dialysis, caloric intake normalized for ideal energy requirements, and protein intake. Overweight was independently influenced only by ageing (odds ratio [OR], 1.04; confidence interval [CI], 1.02-1.07; P =.0007) and female gender (OR, 2.05; CI, 1.09-3.86; P <.0001). By Cox proportional multivariate analysis, survival was positively influenced by BMI (RR, 0.88, CI, 0.79-0.97; P <.01). As expected, albumin also had a positive influence whereas age and diabetes had a negative influence on survival. This preliminary result suggests that a higher BMI may exert a protective role on survival. CONCLUSION: Overweight represents the predominant nutritional abnormality in our MHD population, especially in the elderly, women, and type 2 diabetics.     

HCV prevalence in pregnant women in the UK

The objective of the study was to assess the prevalence and epidemiology of hepatitis C virus (HCV) infection in pregnant women in the North Thames region, and in the UK in general. Demographic data were linked to neonatal samples prior to anonymization and testing by anti-HCV EIA, and with RIBA 3 confirmation. Risk factors for maternal infection were explored. Area-specific seroprevalence rates were multiplied into population sizes to estimate HCV prevalence in pregnant women in the UK. A total of 241/126,009 samples were confirmed anti-HCV positive, and a further 40 were indeterminate, representing a seroprevalence of 0.19-0.22%; 51% of maternal HCV infections were in UK-born women (71% of the population), and 22% in women from continental Europe (5% of the population). Among European-born women, HCV prevalence was associated with birth in continental Europe, partner not being notified at birth registration, partner born in a different region to the mother, and inner city residence. Four of the 241 anti-HCV positive samples (1.7%) were also anti-HIV-1 positive. It was estimated that each year an estimated 1150 out of 730,000 pregnancies in the UK would involve a woman infected with HCV (uncertainty range 660-1850), a prevalence of 0.16% (0.09-0.25%). On the basis of reported rates of mother-to-child transmission of HCV, this would represent approximately 70 paediatric HCV infections per year.     

HIV-infected pregnant adolescents and youth: results from a European cohort study

Abstract

Globally the HIV epidemic mainly affects young people, particularly young females who are vulnerable to acquisition of HIV as a result of their biological and social susceptibility. Women represent an increasing proportion of newly diagnosed HIV cases in Western and Eastern Europe, reaching 35% and 40%, respectively, in 2004. In the European Collaborative Study (ECS), HIV-infected pregnant women are enrolled and their infants followed-up prospectively. By the end of 2005, 5956 women had enrolled, of whom 1912 (32%) were aged?<?25 years at delivery. Enrolments of youth declined in Western European centres from 59% in 1985 to 18% in 2005. In Ukraine, youth enrolments declined from 52% in 2001 to 43% in 2005. Median ages of the young and older sub-cohorts were 22.3 and 29.9 years, respectively. Injecting drug use (IDU) was more common in the older than younger sub-cohorts [42% (n?=?1684) vs. 35% (n?=?675), p?<?0.001]. However, young IDUs were more likely to be currently using injecting drugs than older IDUs (59% vs. 38%, p?<?0.001), to report current sharing of injecting equipment (22% vs. 13%, p?=?0.001) and to report an IDU sex partner (59% vs. 48%, p?<?0.02). Young HIV-infected pregnant women in Europe are a heterogeneous group, possibly less identifiable as being at risk of HIV infection. They will have diverse needs for services during and after pregnancy, including harm reduction services and psychosocial support, in addition to a universal need for prevention of mother-to-child transmission services.     

Hospital-acquired infections in Italy: a region wide prevalence study

Between October and December 2000, a region-wide prevalence study of hospital-acquired infections (HAI) was conducted in all public hospitals (59 facilities with ca. 16000 beds; 560000 admission yearly) in Piemonte Region, Italy, and in the one hospital of the neighbouring autonomous region of Valle d'Aosta. The study population comprised a total of 9467 patients hospitalized for at least 24 h. The prevalence of HAI was 7.84%, with marked differences in prevalence among the participating hospitals (range: 0-47.8%). The higher relative frequency of urinary tract infections (UTI; 52.7%) was due to the inclusion of urine cultures obtained on the day of the study from asymptomatic UTI in catheterized patients. A significant correlation was found with major risk factors related to medical procedures (urinary catheter, mechanical ventilation, surgical drainage, intravascular catheters). Patients with HAI were found to be older and to have a greater mean length of stay in hospital. Multiple logistic regression analyses showed that lack of independence, indwelling urinary catheter and mechanical ventilation were the risk factors more significantly associated with HAI. The use of antibiotics, in particular prophylactic agents used in surgery (cephalosporins, glycopeptides), provided an incentive for corrective intervention in antibiotic administration and in training of healthcare workers.