Risultati per: GPG: Versione 5.0 (25 Novembre 2019)

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Introduction
Zero-dose children refer to a child who has not yet received any childhood vaccines. Globally, zero-dose children are the major public health problem. In sub-Saharan African countries, one among five children do not have access to vaccines. But the efforts to identify the factors contributing to the zero-dose children are not well addressed in Ethiopia.

Objectives
To assess individual and community-level maternal factors of zero-dose children in Ethiopia using mini-Ethiopian Demographic Health Survey 2019.

Methods
A secondary analysis of a cross-sectional study was used among a total of 3208 participants. STATA-14 was used for descriptive and multilevel binary logistic regression (mixed effects model) analysis. Model selection was conducted using Akaike information criteria. To identify significant factors for zero-dose children, a p value of

The Centers for Disease Control and Prevention (CDC) lowered the recommended age for the 1-time vaccine against pneumonia. Previously recommended for those aged 65 years or older, the agency now advises the pneumococcal vaccination starting at age 50 years.

Objective
This study examined economic inequality in coverage of selected maternal and child healthcare (MCH) indicators in India and its states over the last 15 years.

Design
The study analysed last three rounds of the National Family Health Survey data, conducted during 2005–2006, 2015–2016 and 2019–2021. Bivariate analyses, ratio of richest to poorest, slope index of inequality (SII) and multivariate binary logistic regression analyses were used to examine the coverage as well as inequalities in the outcome indicators for India and its states and at district level.

Primary outcomes
The outcome variables analysed in the study were full antenatal care, institutional delivery, postnatal care of mothers within 48 hours of delivery, and full immunisation among children.

Participants
Women aged 15–49 who had given a birth in the last 5 years before the surveys were unit of analysis for the maternal healthcare indicators, and children aged 12–23 months were unit of the analysis for childhood immunisation.

Results
Over the last 15 years, coverage of the MCH indicators has increased in India and across socioeconomic segment of the population, and the absolute increase was higher among the worse-off segments than the better-off. This led to decline in the inequality in coverage of all the MCH indicators. For instance, the value of SII for institutional births decreased from 0.76 in 2005–2006 to 0.45 in 2015–2016 and further to 0.37 in 2019–2021. Although inequality has decreased, geographic disparities persist across states and districts.

Conclusion
Though substantial improvement was observed, coverage of MCH indicators increased and the economic inequality declined; certain geographies are still characterised with the low coverage and persistent high inequality. This suggests that adding a spatial perspective to the inequality research and targeted strategies is essential for achieving universal access to reproductive healthcare services by 2030 in India.

Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.

Objective
Few epidemiological studies are reported in the published literature on the incidence or prevalence of antiphospholipid syndrome (APS), and available results are heterogeneous. This study aimed to estimate the incidence and prevalence of APS in the USA, overall and by APS subtype.

Design
A retrospective analysis of APS disease incidence and a cross-sectional analysis of disease prevalence.

Setting
Merative MarketScan Commercial Claims and Encounters Database, and the Medicare Supplemental and Coordination of Benefits Database.

Participants
All individuals with claims for at least two antiphospholipid antibody tests undertaken at least 12 weeks apart and a diagnosis claim for APS as a primary or secondary diagnosis on or after the second antibody test, during the period 1 January 2016 to 31 December 2019.

Main outcome measures
Annual incidence and prevalence of APS and APS subtypes.

Results
In total, 1708 cases of APS were identified during the study period (2016–2019), of which 83% were women. The overall annual standardised incidence rate of APS per 100 000 person-years increased slightly over the study period, from 2.31 in 2016 to 2.71 in 2019. In 2019, the estimated annual prevalence of APS per 100 000 persons was 10.42 per 100 000 persons (95% CI 9.96–10.90). Based on this and US census data, we have estimated that 34 000 persons in the USA were affected by APS in 2019.

Conclusions
These data add to the estimates of prevalence and incidence of APS in the literature, all of which have different strengths and limitations of the different data sources and case ascertainment methods.

Objectives
To identify the determinants of traditional birth attendants’ utilisation among reproductive-age women in Ethiopia.

Design
Cross-sectional study design.

Setting
Ethiopia.

Participants
A total of 3979 weighted samples of reproductive-age women were included.

Outcome measure
Traditional birth attendant utilisation.

Results
This study found a high prevalence (29.76%) of Ethiopian mothers using traditional birth attendants for delivery, based on data from the 2019 Ethiopian Demographic and Health Survey. Mothers with higher education (adjusted OR (AOR)=0.11, 95% CI: 0.01 to 0.62), who had four or more antenatal care visits (AOR=0.34, 95% CI: 0.21 to 0.54), communities with lower levels of education (AOR=2.21, 95% CI: 1.30 to 3.73), communities with higher poverty levels (AOR=1.71, 95% CI: 1.99 to 2.96) and those from peripheral regions (AOR=3.41, 95% CI: 1.77 to 6.56) were found to be predictors of traditional birth attendants.

Conclusion
This study indicates a high prevalence (29.76%) of Ethiopian mothers using traditional birth attendants, highlighting the need for targeted interventions to promote skilled birth attendance. Policymakers should focus on implementing educational programmes targeting reproductive-age women and improving access to quality antenatal care. Specific initiatives could include community-based educational workshops and subsidies for transportation to healthcare facilities. Furthermore, mothers in remote and border districts should receive specialised attention in terms of resource allocation, including skilled personnel and enhanced healthcare access.

Background
The main aim of sanitation is to prevent human contact with faecal pathogens to decrease occurrences of diseases. However, no region in the world is on the right track to accomplish Sustainable Development Goal (SDG) 6.2 for universal access to sanitation. Sub-Saharan Africa, including Ethiopia, is significantly behind in meeting the 2030 SDG 6.2 targets. Hence, this study focused on the spatial and temporal analysis of sanitation in Ethiopia based on four demographic health surveys.

Design
This research was undertaken among households in Ethiopia based on a weighted sample size. Variables with a p

Objectives
Leukaemias and lymphomas are among the most prevalent and significant cancers in Australasia and Oceania. This study aims to examine the burden of leukaemias/lymphomas and its temporal trend in Australasia and Oceania from 2010 to 2019.

Design
Epidemiological study

Methods
Data from the Global Burden of Disease (GBD) 2019 were used to examine the burden of leukaemia/lymphoma key subtypes (acute lymphocytic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL), chronic myeloid leukaemia (CML), Hodgkin-lymphoma (HL) and non-Hodgkin’s lymphoma (NHL)) by sex and 5 year age groups (from

Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.

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Objective
To describe temporal trends in the incidence and disability-adjusted life years (DALYs) of rheumatoid arthritis (RA) across sociodemographic index (SDI) quintiles and sexes from 1990 to 2019.

Methods
Data on RA incidence and DALYs with a 95% uncertainty interval from 1990 to 2019 were extracted from the Global Burden of Disease 2019. Subsequently, trends across SDI quintiles and sexes from 1990 to 2019 were determined using joinpoint regression and age–period–cohort analyses.

Results
A significant upward trend in the global age-standardised incidence rate (ASIR) of RA was observed for both sexes from 1990 to 2019 (average annual per cent change (AAPC): 0.214, 95% CI 0.179 to 0.249, p

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Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Circulation, Volume 150, Issue Suppl_1, Page A4147614-A4147614, November 12, 2024. Background:The risk of stroke in Adult Congenital Heart Disease (ACHD) is well established. However, the prevalence and impact of stroke in young ACHD-related admissions stratified by median household income remain underexplored.Methods:The National Inpatient Sample (2019) was utilized to identify the rate of stroke admissions among young (18-44 years) ACHD patients. We also evaluated comorbidities and outcomes (all-cause mortality [ACM], length of stay [LOS], disposition,&charges) based on the median household income quartiles and compared two cohorts of lowest (0-25th percentile) and highest (75-100thpercentile) median household income (LMHI vs HMHI).Results:Of 41950 young (18-44 years) ACHD patients, 5360 patients had stroke (12.8%). Patients in the LMHI group were relatively older (median age 36 years vs 35 years) and had a greater proportion of males (53.8% vs 46.0%) when compared to patients in the HMHI group. Patients admitted with stroke were of greater proportion in the LMHI group (13.2% vs 12.1%) compared to the HMHI group. Comorbidities like alcohol abuse (4.7% vs. 2.3%), depression (9.8% vs. 7.0%), hypertension (13.0% vs. 5.6%), obesity (21.2% vs. 18%), drug abuse (12.3% vs 4.2%), and tobacco use disorder (30.4% vs 11.2%) were higher for LMHI when compared to HMHI. Regarding in-hospital outcomes, ACM (3.7 vs. 1.9%) and discharge to home (71.6 vs. 66.5) were higher with HMHI, whereas the LMHI cohort demonstrated fewer routine discharges, higher transfers to other facilities, and prolonged LOS (5 vs. 3 days, p