Tag: pubmed

PLoS One. 2021 Oct 29;16(10):e0259218. doi: 10.1371/journal.pone.0259218. eCollection 2021.

ABSTRACT

BACKGROUND: Nigeria has a high burden of hepatitis B virus (HBV) infection, commonly acquired through vertical transmission. However, there is a lack of an efficient surveillance system for monitoring and understanding the epidemiology of HBV among pregnant women. Building on a previous review on the prevalence of HBV in Nigeria (2000-2013), we conducted a systematic review and meta-analysis of HBV prevalence among pregnant women in Nigeria.

METHODS: Four electronic databases PubMed, Embase, Global Health, and Scopus were systematically searched from January 2014 to February 2021. We also searched the African Journal Online and manually scanned the reference lists of the identified studies for potentially eligible articles. Observational studies that reported the prevalence of HBsAg and/or HBeAg among pregnant women in peer-reviewed journals were included in the study. We performed a meta-analysis using a random-effects model. We defined HBV infection as a positive test to HBsAg.

RESULTS: From the 158 studies identified, 20 studies with a total sample size of 26, 548 were included in the meta-analysis. The pooled prevalence of HBV infection among pregnant women across the studies was 6.49% (95% confidence interval [CI] = 4.75-8.46%; I2 = 96.7%, p = 0.001; n = 20). The prevalence of HBV was significantly lower among pregnant women with at least secondary education compared with those with no education or primary education (prevalence ratio = 0.7, 95% CI = 0.58-0.87; n = 10). However, the prevalence of HBV was not significantly different by age, religion, marital status, or tribe. The prevalence of HBV was not significantly different among pregnant women with previous surgery, blood transfusion, multiple lifetime sex partners, tribal marks, tattoos, scarification, or sexually transmitted infections, compared with those without these risk factors. From a total sample size of 128 (n = 7), the pooled prevalence of HBeAg among HBV-infected pregnant women was 14.59% (95% CI = 4.58-27.99%; I2 = 65.5%, p = 0.01). Subgroup analyses of HBV infection by study region and screening method, and meta-regression analysis of the study year, sample size, and quality rating were not statistically significant.

CONCLUSIONS: There is an intermediate endemicity of HBV infection among pregnant women in Nigeria. Interventions, such as routine antenatal HBV screening, antiviral prophylaxis for eligible pregnant women, and infant HBV vaccination should be scaled up for the prevention of perinatal transmission of HBV infection in Nigeria.

PMID:34714888 | DOI:10.1371/journal.pone.0259218

PLoS One. 2021 Oct 29;16(10):e0259411. doi: 10.1371/journal.pone.0259411. eCollection 2021.

ABSTRACT

BACKGROUND: Tunga penetrans, also known as sand flea, causes Tungiasis in humans and animals. Despite its notoriety as an entomological problem, however, the ectoparasite receives little consideration from public health professionals. It is against this background that this article aims to assess the prevalence of and factors associated with Tunga penetrans infestation among 5-14-year-olds in rural Western Ethiopia.

METHODS: From November to December 2020, 487 children aged 5 to 14 were selected from four primary schools in a cross-sectional study using systematic random sampling. Clinical exams, Interviews with parents/guardians and observations of the housing and classroom environments were used to collect data. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with Tunga penetrans infestation.

RESULT: Tunga penetrans infestation (Tungiasis) was diagnosed in 138 of the 487 children examined, placing the prevalence at 28.3% (95% CI: 24.2%, 32.2%). Mud plastered walls [AOR: 5.83, % CI (3.44-9.88)], having cats in the house [AOR: 5.91, 95% CI (3.51-10.11)], not having separated sleeping quarters for animals [AOR: 4.60, 95% CI (2.69-7.86)], using self-supplied water [AOR: 6.30, 95% CI (3.33-11.93)], walking>30 minutes to school [AOR: 2.37, 95% CI (1.48-3.80)] were associated with Tungiasis.

CONCLUSION: In one way or another, several of the identified factors were linked to poverty. Improved house wall materials, fumigation of mud-plastered houses, dusting or spraying insecticides on domestic animals (such as cats), improved access to water, community education about keeping animals separated from living spaces, and hygiene promotion are all needed, with a focus on locally available, low-cost technologies that the poorest families can afford.

PMID:34714881 | DOI:10.1371/journal.pone.0259411

PLoS One. 2021 Oct 29;16(10):e0259288. doi: 10.1371/journal.pone.0259288. eCollection 2021.

ABSTRACT

BACKGROUND: The objective of this study was to compare the prognostic impact of sarcopenia in patients with head and neck cancer (HNC) treated with surgery or radiation.

METHODS: We systematically searched electronic databases to identify articles reporting the impact of sarcopenia on the prognosis of patients with HNC. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) were extracted and pooled. HR according to treatment modality were estimated using random-effects models. Statistical analyses were carried out using the Comprehensive Meta-Analysis software.

RESULTS: In total, 18 studies enrolling 3,233 patients were included. Sarcopenia was associated with poor OS in both surgery and radiotherapy groups (hazard ratio [HR] 2.50, 95% confidence interval [CI] 1.95-3.21; HR 1.63, 95% CI 1.40-1.90, respectively). The HR was significantly higher in the surgery group than in the radiotherapy group (p = 0.004), with similar results obtained for DFS (HR 2.59, 95% CI 1.56-4.31; HR 1.56, 95% CI 1.24-1.97 for the surgery and radiotherapy groups, respectively) and DSS (HR 2.96, 95% CI 0.73-11.95; HR 2.67, 95% CI 1.51-4.73 for the surgery and RT groups, respectively).

CONCLUSIONS: Sarcopenia was a poor prognostic factor for HNC, regardless of the treatment modality. However, the adverse effects of sarcopenia on survival were more prominent in the surgery group than in the radiotherapy group. Sarcopenia assessment is required for appropriate treatment decision-making.

PMID:34714876 | DOI:10.1371/journal.pone.0259288

PLoS One. 2021 Oct 29;16(10):e0259307. doi: 10.1371/journal.pone.0259307. eCollection 2021.

ABSTRACT

Participation and activity post stroke can be limited due to adverse weather conditions. This study aimed to: Quantify and compare summer and winter participation and activity, and explore how community dwelling people with stroke describe their feelings about their level of participation and activity by season. This embedded mixed-methods observational study took place in a city with weather extremes. Community dwelling individuals at least one year post-stroke, able to walk ≥50 metres +/- a walking aide were included. Evaluations and interviews occurred at participants’ homes in two seasons: Reintegration to Normal living Index (RNL), Activities-specific Balance Confidence (ABC) and descriptive outcomes. Participants wore activity monitors for one week each season. Analysis included descriptive statistics, non-parametric tests and an inductive approach to content analysis. Thirteen individuals participated in quantitative evaluation with eight interviewed. Mean age 61.5 years, 62% female and mean 6.2 years post-stroke. No differences between winter-summer values of RNL, ABC, or activity monitor outcomes. However, participants felt they could do more and were more independent in summer. The winter conditions such as ice, snow, cold and wind restricted participation and limited activities. Nonetheless, many participants were active and participated despite the winter challenges by finding other ways to be active, and relying on social supports and personal motivation. The qualitative findings explained unexpected quantitative results. Participants described many challenges with winter weather, but also ways they had discovered to participate and be active despite these challenges. Changes to future studies into seasonal differences are suggested.

PMID:34714877 | DOI:10.1371/journal.pone.0259307

PLoS One. 2021 Oct 29;16(10):e0258164. doi: 10.1371/journal.pone.0258164. eCollection 2021.

ABSTRACT

This paper uses publicly available data and various statistical models to estimate the basic reproduction number (R0) and other disease parameters for Ghana’s early COVID-19 pandemic outbreak. We also test the effectiveness of government imposition of public health measures to reduce the risk of transmission and impact of the pandemic, especially in the early phase. R0 is estimated from the statistical model as 3.21 using a 0.147 estimated growth rate [95% C.I.: 0.137-0.157] and a 15-day time to recovery after COVID-19 infection. This estimate of the initial R0 is consistent with others reported in the literature from other parts of Africa, China and Europe. Our results also indicate that COVID-19 transmission reduced consistently in Ghana after the imposition of public health interventions-such as border restrictions, intra-city movement, quarantine and isolation-during the first phase of the pandemic from March to May 2020. However, the time-dependent reproduction number (Rt) beyond mid-May 2020 does not represent the true situation, given that there was not a consistent testing regime in place. This is also confirmed by our Jack-knife bootstrap estimates which show that the positivity rate over-estimates the true incidence rate from mid-May 2020. Given concerns about virus mutations, delays in vaccination and a possible new wave of the pandemic, there is a need for systematic testing of a representative sample of the population to monitor the reproduction number. There is also an urgent need to increase the availability of testing for the general population to enable early detection, isolation and treatment of infected individuals to reduce progression to severe disease and mortality.

PMID:34714857 | DOI:10.1371/journal.pone.0258164

PLoS One. 2021 Oct 29;16(10):e0259280. doi: 10.1371/journal.pone.0259280. eCollection 2021.

ABSTRACT

BACKGROUND: The bidirectional relationship between health behavior and subjective well-being has previously been studied sparsely, and mainly for individual health behaviors and regression models. In the present study, we deepen this knowledge focusing on the four principal health behaviors and using structural equation modeling with selected covariates.

METHODS: The follow-up data (n = 11,804) was derived from a population-based random sample of working-age Finns from two waves (2003 and 2012) of the Health and Social Support (HeSSup) postal survey. Structural equation modeling was used to study the cross-sectional, cross-lagged, and longitudinal relationships between the four principal health behaviors and subjective well-being at baseline and after the nine-year follow-up adjusted for age, gender, education, and self-reported diseases. The included health behaviors were physical activity, dietary habits, alcohol consumption, and smoking status. Subjective well-being was measured through four items comprising happiness, interest, and ease in life, and perceived loneliness.

RESULTS: Bidirectionally, only health behavior in 2003 predicted subjective well-being in 2012, whereas subjective well-being in 2003 did not predict health behavior in 2012. In addition, the cross-sectional interactions in 2003 and in 2012 between health behavior and subjective well-being were statistically significant. The baseline levels predicted their respective follow-up levels, the effect being stronger in health behavior than in subjective well-being.

CONCLUSION: The four principal health behaviors together predict subsequent subjective well-being after an extensive follow-up. Although not particularly strong, the results could still be used for motivation for health behavior change, because of the beneficial effects of health behavior on subjective well-being.

PMID:34714864 | DOI:10.1371/journal.pone.0259280

PLoS One. 2021 Oct 29;16(10):e0258304. doi: 10.1371/journal.pone.0258304. eCollection 2021.

ABSTRACT

The annual assessment of Family Planning (FP) indicators, such as the modern contraceptive prevalence rate (mCPR), is a key component of monitoring and evaluating goals of global FP programs and initiatives. To that end, the Family Planning Estimation Model (FPEM) was developed with the aim of producing survey-informed estimates and projections of mCPR and other key FP indictors over time. With large-scale surveys being carried out on average every 3-5 years, data gaps since the most recent survey often exceed one year. As a result, survey-based estimates for the current year from FPEM are often based on projections that carry a larger uncertainty than data informed estimates. In order to bridge recent data gaps we consider the use of a measure, termed Estimated Modern Use (EMU), which has been derived from routinely collected family planning service statistics. However, EMU data come with known limitations, namely measurement errors which result in biases and additional variation with respect to survey-based estimates of mCPR. Here we present a data model for the incorporation of EMU data into FPEM, which accounts for these limitations. Based on known biases, we assume that only changes in EMU can inform FPEM estimates, while also taking inherent variation into account. The addition of this EMU data model to FPEM allows us to provide a secondary data source for informing and reducing uncertainty in current estimates of mCPR. We present model validations using a survey-only model as a baseline comparison and we illustrate the impact of including the EMU data model in FPEM. Results show that the inclusion of EMU data can change point-estimates of mCPR by up to 6.7 percentage points compared to using surveys only. Observed reductions in uncertainty were modest, with the width of uncertainty intervals being reduced by up to 2.7 percentage points.

PMID:34714856 | DOI:10.1371/journal.pone.0258304

PLoS One. 2021 Oct 29;16(10):e0259156. doi: 10.1371/journal.pone.0259156. eCollection 2021.

ABSTRACT

Maps of bottom type are essential to the management of marine resources and biodiversity because of their foundational role in characterizing species’ habitats. They are also urgently needed as countries work to define marine protected areas. Current approaches are time consuming, focus largely on grain size, and tend to overlook shallow waters. Our random forest classification of almost 200,000 observations of bottom type is a timely alternative, providing maps of coastal substrate at a combination of resolution and extents not previously achieved. We correlated the observations with depth, depth-derivatives, and estimates of energy to predict marine substrate at 100 m resolution for Canada’s Pacific shelf, a study area of over 135,000 km2. We built five regional models with the same data at 20 m resolution. In addition to standard tests of model fit, we used three independent data sets to test model predictions. We also tested for regional, depth, and resolution effects. We guided our analysis by asking: 1) does weighting for prevalence improve model predictions? 2) does model resolution influence model performance? And 3) is model performance influenced by depth? All our models fit the build data well with true skill statistic (TSS) scores ranging from 0.56 to 0.64. Weighting models with class prevalence improved fit and the correspondence with known spatial features. Class-based metrics showed differences across both resolutions and spatial regions, indicating non-stationarity across these spatial categories. Predictive power was lower (TSS from 0.10 to 0.36) based on independent data evaluation. Model performance was also a function of depth and resolution, illustrating the challenge of accurately representing heterogeneity. Our work shows the value of regional analyses to assessing model stationarity and how independent data evaluation and the use of error metrics can improve understanding of model performance and sampling bias.

PMID:34714844 | DOI:10.1371/journal.pone.0259156

PLoS One. 2021 Oct 29;16(10):e0259126. doi: 10.1371/journal.pone.0259126. eCollection 2021.

ABSTRACT

INTRODUCTION: Take-Home Naloxone programs have been introduced across North America in response to rising opioid overdose deaths. There is currently limited real-world data on bystander naloxone administration, overdose outcomes, and evidence related to adverse events following bystander naloxone administration.

METHODS: The research team used descriptive statistics from Take-Home Naloxone administration forms. We explored reported demographic variables and adverse events among people who received by-stander administered naloxone in a suspected opioid overdose event between August 31, 2012 and December 31, 2018 in British Columbia. We examined and contextualized differences across years given policy, program and drug toxicity changes. We used multivariate logistic regression to examine whether an association exists between number of ampoules of naloxone administered and the odds that the recipient will experience withdrawal symptoms.

RESULTS: A large majority (98.1%) of individuals who were administered naloxone survived their overdose and 69.2% had no or only mild withdrawal symptoms. Receiving three (Adjusted Odds Ratio (AOR) 1.64 (95% Confidence Interval (CI): 1.08-2.48)) or four or more (AOR 2.19 (95% CI: 1.32-3.62)) ampoules of naloxone was significantly associated with odds of moderate or severe withdrawal compared to receiving one ampoule of naloxone.

CONCLUSIONS: This study provides evidence from thousands of bystander reversed opioid overdoses using Take-Home Naloxone kits in British Columbia, and suggests bystander-administered naloxone is safe and effective for opioid overdose reversal. Data suggests an emphasis on titration during bystander naloxone training in situations where the person experiencing overdose can be adequately ventilated may help avoid severe withdrawal symptoms. We identified a decreasing trend in the likelihood of moderate or severe withdrawal over the study period.

PMID:34714854 | DOI:10.1371/journal.pone.0259126

PLoS One. 2021 Oct 29;16(10):e0258206. doi: 10.1371/journal.pone.0258206. eCollection 2021.

ABSTRACT

The Carpathian Basin represents the cradle of human agricultural development during the Neolithic period, when large parts were transformed into ‘cultural landscapes’ by first farmers from the Balkans. It is assumed that an Early Neolithic subsistence economy established along the hydrologic systems and on Chernozem soil patches, which developed from loess deposits. However, recent results from soil chemistry and geoarchaeological analyses raised the hypothesis that extensive Chernozem coverage developed from increased land-use activity and that Early Neolithic ‘cultural’ groups were not restricted to loess-covered surfaces but rather preferred hydromorphic soils that formed in the floodplains. This article performs multivariable statistics from large datasets of Neolithic sites in Hungary and allows tracing Early to Late Neolithic site preferences from digital environmental data. Quantitative analyses reveal a strong preference for hydromorphic soils, a significant avoidance of loess-covered areas, and no preference for Chernozem soils throughout the Early Neolithic followed by a strong transformation of site preferences during the Late Neolithic period. These results align with socio-cultural developments, large-scale mobility patterns, and land-use and surface transformation, which shaped the Carpathian Basin and paved the way for the agricultural revolution across Europe.

PMID:34714837 | DOI:10.1371/journal.pone.0258206