UNASSIGNED: The aim of this study was to identify factors associated with coverage in community-directed treatment with ivermectin for onchocerciasis control in savannah and forest areas in the Central African Republic.
UNASSIGNED: A cross-sectional study was conducted in 2 districts where onchocerciasis is endemic. We employed a pretested and validated questionnaire that included questions about the sociodemographic characteristics of the respondents and variables relevant to coverage assessment. Multivariate logistic regression analyses were performed to identify the associations between surveyed mass drug administration (MDA) coverage and the variables considered, while accounting for potential confounding factors. A p-value <0.05 was considered statistically significant.
UNASSIGNED: At the district level, the MDA program achieved a reach of 87.29% (95% CI, 86.03%-88.55%) in Bossangoa and 61.74% (95% CI, 59.56%-63.92%) in Kémo, compared to the reported rates of 90.02% and 91.70%, respectively. Women in both Bossangoa and Kémo were 1.28 times more likely to have taken ivermectin than men (95% CI, 1.12-1.47, p=0.008; 1.09-2.00, p=0.041, respectively). The age groups of 5-14, 15-24, and 25-34 were statistically associated with better distribution coverage in both districts. Individuals with knowledge of onchocerciasis were more likely to receive ivermectin compared to those without knowledge, with adjusted odds ratios of 1.41 (95% CI, 1.11-2.01, p=0.030) and 3.19 (95% CI, 2.91-4.08, p=0.001), respectively.
UNASSIGNED: The authors recommend implementing measures to improve MDA coverage in future campaigns. These measures should include allocating sufficient time for MDA activities, providing health education, and mobilising the entire population.

UNASSIGNED: The prevalence of metabolic syndrome (MetS) in patients infected with Helicobacter pylori, and the factors associated with it are not well understood. This study evaluates MetS and its associated factors among both H pylori-positive and H pylori-negative individuals in Northeast Ethiopia.
UNASSIGNED: A cross-sectional study was conducted between 1 March 2022 to 30 May 2022. A semi-structured questionnaire was used to collect data on sociodemographic, behavioral, and clinical variables. A total of 228 subjects were randomly selected. Blood and stool samples were collected from each subject to measure fasting blood glucose and lipid profiles, and to identify H. pylori infection. Data were entered into Epi. Data 3.1 and analyzed using SPSS version 25. Logistic regression analysis and the Mann-Whitney U-test were performed to determine associated factors and compare median and interquartile ranges.
UNASSIGNED: Of the 228 participants, 114 were H. pylori positive, and 114 were H. pylori negative. Participants (50.9% female) ranged in age from 18 years to 63 years, with a median age of 31 (IQR, 22, 40) years. The overall prevalence of MetS among the participants was 23.2%. We found a statistically significant association between MetS and fasting blood glucose level (AOR, 15.965; 95% CI, 7.605-33.515, p<0.001). Furthermore, there was a statistically significant difference in the median serum levels of low-density lipoprotein cholesterol (p<0.001), triglycerides (p=0.036), systolic blood pressure (<0.001), and total cholesterol (p<0.001) between H. pylori-positive and H. pylori-negative participants.
UNASSIGNED: MetS was prevalent among study participants. There was also a statistically significant association between fasting blood sugar and MetS. In addition, systolic blood pressure, total cholesterol, triglycerides, and low-density lipoprotein levels were significantly different between H. pylori-positive and H. pylori-negative individuals.

UNASSIGNED: Mitral regurgitation (MR) is one of the common complications of heart failure (HF). The prevalence and characteristics of MR are rarely investigated, especially in the Chinese population.
UNASSIGNED: The purpose of this study was to determine the prevalence and characteristics of non-organic MR in HF patients and subgroups defined by ejection fraction.
UNASSIGNED: A single-center, hospital-based, and retrospective chart review study included patients with heart failure admitted to the cardiovascular department from January 2017 to April 2020. Demographic characteristics, laboratory results, and echocardiogram results before discharge were analyzed in different groups defined by left ventricular ejection fraction (EF) using logistic regression and adjusted for confounders.
UNASSIGNED: Finally, 2418 validated HF patients (age 67.2 ± 13.5 years; 68.03% men) were included. The prevalence of MR was 32.7% in HF, 16.7% in HF with preserve EF patients, 28.4% in HF with mid-range EF patients and 49.7% in HF with reduced EF (HFrEF) patients. In the HF with preserved EF group, multivariable logistic regression showed that 4 factors associated with MR including EF (odds ratio (OR) 0.954 (0.928-0.981), p = 0.001), left ventricular posterior wall thickness in diastolic phase (LVPWd) (OR 0.274 (0.081-0.932), p = 0.038), left atrium (LA) dimension (OR 2.049 (1.631-2.576), p < 0.001) and age (OR 1.024 (1.007-1.041), p = 0.007). In the HF with midrange EF group, multivariable logistic regression showed that 3 factors associated with MR including LA dimension (OR 2.009 (1.427-2.829), p < 0.001), triglycerides (TG) (OR 0.552 (0.359-0.849), p = 0.007) and digoxin (OR 2.836 (1.624-4.951), p < 0.001). In the HFrEF group, multivariable logistic regression showed that 7 factors associated with MR including EF (OR 0.969 (0.949-0.990), p = 0.004), (OR 0.161 (0.067-0.387), p < 0.001), LA dimension (OR 2.289 (1.821-2.878), p < 0.001), age (OR 1.016 (1.004-1.027)), p = 0.009), TG (OR 0.746 (0.595-0.936), p = 0.011), diuretics (OR 0.559 (0.334-0.934), p = 0.026) and ICD (OR 1.898 (1.074-3.354), p = 0.027).
UNASSIGNED: HF patients had a high burden of MR, particularly in the HFrEF group. Worsen cardiac structure (LA dimension and LVPWd) and function (EF), age, and medical treatment strategy played essential roles in MR.

UNASSIGNED: Multimorbidity is a condition that refers to the coexistence of two or more chronic diseases or long-term medical conditions in an individual. It has become one of the key issues in the public health sector, particularly among older adults. So, this study aimed to estimate the prevalence of multimorbidity and its associated factors among older adults.
UNASSIGNED: The present study was a community-based cross-sectional study carried out on the elderly population (≥60 years) in a rural area of the study district, Gujarat. The estimated sample size was 384, and the final sample size was taken as 420, considering the multistage sampling procedure for fair distribution. The eligibility criteria included elderly people ≥60 years old, who were permanent residents (living for ≥6 months) of the study district and willing to participate in the study. Elderly people who were not willing to participate in the study for their reasons were excluded. A multistage sampling procedure was used to choose the study participants. The data collection tools included a pretested, predesigned, semi-structured questionnaire. The questionnaire consisted of two parts: sociodemographic details and morbidity details. Categorical variables were described by frequency and percentage, and numerical variables were described by mean ± SD. Logistic regression analyses were applied to test the relationship of categorized independent and dependent variables, and all tests were two-tailed with statistical significance set at the probability value (P < 0.05).
UNASSIGNED: Out of the 420 study participants, 52.1% were male and 47.9% were female, with a mean age of 70.70 years (SD ± 8.18 years). The prevalence of multimorbidity was 50%, with males having a mean number of morbidities of 1.38 ± 1.06 and females having a mean number of morbidities of 1.44 ± 0.99. As the age increased, the strength of association of multimorbidity also increased. Literacy level, marital status, occupation (business, farmer, housewife), and family history were statistically associated with multimorbidity in the study participants in both bivariate and multivariate analyses (P < 0.05).
UNASSIGNED: The study provides valuable insights into the health status of the elderly population in the rural area and can be used to inform healthcare policies and interventions aimed at improving the health outcomes of this population.

Early childhood caries (ECC) is not merely a problem of the tooth; rather, it has negative impacts on the child\'s growth and development and oral health-related quality of life. The prevalence of ECC varies widely, and more variance is observed between countries than continents, and it changes over time. The current cross-sectional study aimed to determine ECC\'s prevalence, associated factors, and severity. This study was conducted in the Dental Clinic Complex, North Riyadh, KSA. The study sample included 306 participants between 36 and 71 months of age. A questionnaire was developed to collect information from participants. The decaying and filled teeth (DMFT) index was used to estimate the prevalence of caries. The study results revealed the prevalence of ECC to be 76% among 36- to 71-month-old children in North Riyadh. ECC is influenced by socioeconomic factors like maternal occupation, education, oral hygiene habits, and dietary patterns. Also, it was found that exclusively breastfed children have lower ECC odds (68.1% vs. 83.6%, p = 0.001), while the intake of more than three between-meal sugar-containing snacks/beverages per day increases the likelihood of ECC (63.5% vs. 79.8%, p = 0.006). The researchers recommend encouraging breastfeeding as it correlates with lower ECC prevalence, in addition to establishing effective oral hygiene practices for preschool children.

BACKGROUND: The sero-epidemiological characteristics of SARS-CoV-2 infections in Mali are not yet well understood. This study assessed SARS-CoV-2 antibody seroprevalence and factors associated with antibody responses in the general population of Bamako, the capital city and epicenter of COVID-19, to assess the magnitude of the pandemic and contribute to control strategy improvements in Mali.
METHODS: A cross-sectional survey was conducted in September 2022 to collect sociodemographic information, clinical characteristics, comorbid factors, and blood samples. ELISA was performed to determine anti-Spike (anti-S) and anti-RBD antibody levels. A total of 3601 participants were enrolled in REDCap. R-Studio was used for the statistical analysis. The chi-squared (χ2) test was used to compare the proportions across different groups. Logistic regression models were used to elucidate factors associated with antibody responses.
RESULTS: The sex ratio for female-to-male was 3.6:1. The most representative groups were the 20-29-year-olds (28.9%, n = 1043) and the 30-39-year-olds (26.9%, n = 967). The COVID-19 vaccine coverage among the participants was 35.8%, with vaccines from Covishield AstraZeneca (13.4%), Johnson & Johnson (16.7%), Sinovac (3.9%), and BioNTech Pfizer (1.8%). Overall, S protein and RBD antibody seroprevalences were remarkably high in the study population (98% and 97%, respectively). Factors such as youth (1-9 years old) and male sex were associated with lower SARS-CoV-2 antibody responses, whereas COVID-19 vaccinations were associated with increased antibody responses.
CONCLUSIONS: This serosurvey demonstrated the high seroprevalence of SARS-CoV-2 antibodies and highlighted the factors influencing antibody responses, while clearly underlining an underestimation of the pandemic in Mali.

BACKGROUND: Smoking significantly burdens human health, contributing to an increasing incidence of mortality and morbidity. This study aims to explore the prevalence of smoking, cessation, and the association between various risk factors and smoking intensity measured in pack-years among Chinese adults.
METHODS: During 2020-2021, the China Stroke High-risk Population Screening and Intervention Program (CSHPSIP) invited participants aged ≥40 years from 31 provinces in mainland China. This cross-sectional study presents the standardized prevalence of smoking and cessation across various demographics, including age, sex, residence, income, education level, BMI, and geographical region of residence. Multivariable logistic regression was used to examine the associations between smoking pack-years and related factors.
RESULTS: Among 524741 participants (mean age: 61.9 ± 10.9 years; 41.1% male; 58.9% female), standardized smoking prevalence was 19.3% (95% CI: 19.2-19.4), with men (37.2%; 95% CI: 37.0-37.4) displaying significantly higher rates than women (1.3%; 95% CI: 1.2-1.3). Smoking cessation rate stood at 11.2% (95% CI: 11.0-11.4), with 11.3% (95% CI: 11.1-11.5) for men and 8.4% (95% CI: 7.5-9.2) for women. Urban residents and those with advanced education had lower smoking rates and higher cessation rates. Additionally, the dose-response relationship indicated a more pronounced association between higher smoking pack-years and elevated health risks, including hypertension (AOR=1.30; 95% CI: 1.24-1.36), diabetes (AOR=1.26; 95% CI: 1.20-1.33), hyperlipidemia (AOR=1.22; 95% CI: 1.16-1.28), heart disease (AOR=1.40; 95% CI: 1.26-1.54), and stroke (AOR=1.23; 95% CI: 1.10-1.36).
CONCLUSIONS: This comprehensive study emphasizes the profound impact of smoking on health in Chinese adults, indicating the critical need for tailored cessation programs, particularly for middle-aged individuals, men, rural residents, and those with lower level of education.

BACKGROUND: Delays in surgery start times can lead to poor patient outcomes and considerable increases in healthcare expenditures. This is especially true in developing countries that often face systemic inefficiencies, such as a shortage of operating rooms and trained surgical personnel. With substantial effects on patient outcomes, healthcare efficiency, and resource allocation, identifying delays in first-case elective surgery is a crucial area of research.
METHODS: A multicenter observational study was conducted at three comprehensive and specialized hospitals in the Amhara region of Ethiopia from May 1 to October 30, 2023. The primary aim of the study was to determine the occurrence of late first-case start times, defined as a patient being in the operating room at or after the hospital\'s incision time of 2:30 a.m. The secondary aim was to discover potential root causes of delayed first-case start times. All patients scheduled for elective surgery as the first case on the operating list throughout the study period were included in the study. Every emergency, day case, after-hours case, and canceled case was excluded.
RESULTS: A total of 530 surgical patients were included during the study window from May 1 to October 1, 2023. Of these, 41.5% were general surgeries, 20.4% were gynecology and obstetrics surgeries, and 13.2% were orthopedic surgery procedures. Before the procedure started, nine (1.7%) of the participants had prolonged discussion with a member of the surgical team. Patients who arrived in the operating room waiting area at or after 2:30 a.m. were 2.5 times more likely to experience a first-case start time delay than those who arrived before or at 2:00 a.m. (AOR = 2.50; 95% CI: 1.13-5.14). Furthermore, participants with abnormal investigation results were 2.4 times more likely to have a late first-case start time (AOR = 2.41; 95% CI: 1.06, 5.50). Moreover, the odds of a late first-case start time were increased by 10.53 times with the surgeon being in the operating room at or after 2:30 a.m. (AOR = 10.53; 95% CI: 5.51, 20.11).
CONCLUSIONS: The research highlights a significant occurrence of delayed start times for the first elective surgical procedures. Therefore, directing attention to aspects such as ensuring patients and surgical teams arrive promptly (by or before 2:00 a.m.) and timely evaluation and communication of investigative findings before the scheduled surgery day could facilitate efforts to maximize operating room efficiency and enhance patient health outcomes.

BACKGROUND: Corona virus disease 2019 (COVID-19) is an extremely contagious viral infection caused by the severe acute respiratory syndrome coronavirus 2. Understanding the willingness of the community to receive the COVID-19 vaccine will help in the development and implementation of effective COVID-19 vaccination promotion programs. Therefore, we aimed to assess the level of COVID-19 vaccine acceptance and associated factors among residents of Dire Dawa Administration, Eastern Ethiopia.
METHODS: A community-based cross-sectional study was conducted among 840 residents in Dire Dawa Administration from May 18th to June 18th, 2021. Multistage cluster sampling followed by systematic random sampling was used to select respondents. A pretested interviewer-administered structured questionnaire was used to collect the data from respondents. Bivariable and multivariable logistic regression were used to identify predictors of COVID-19 vaccine acceptance. The odds ratio (OR), along with a 95% confidence interval (CI), was used to estimate the strength of the association.
RESULTS: Out of 840 respondents recruited, the proportion of COVID-19 vaccine acceptance was found to be 54.4% (457/840); (95% CI: 51.0%, 57.7%) Being male [AOR = 1.85, 95% CI: (1.35, 2.54), P < 0.001], not having a current habit of substance use [AOR = 2.38, 95% CI: (1.73, 3.26), P < 0.001], having a monthly income of less than 51.31 USD [AOR = 0.19, 95% CI: (0.04, 0.88), P = 0.001]; and not having a prior history of vaccination experience [AOR = 0.40, 95% CI: (0.29, 0.54), P < 0.001] were significantly associated with COVID-19 vaccine acceptance.
CONCLUSIONS: This study reveals that the proportion of COVID-19 vaccine acceptance among residents of Dire Dawa Administration, Eastern Ethiopia, was 54.4%. Factors like being male and not having a current habit of substance use were positively associated, whereas having a monthly income of less than 51.31 USD and not having a prior history of vaccination experience were negatively associated with COVID-19 vaccine acceptance. Health information dissemination and economic empowerment are crucial to improving COVID-19 vaccine acceptance among the community. This study provides valuable data for policymakers to plan early vaccination programs and tackle the challenges identified in the study.

BACKGROUND: Infection is the most common complication of pediatric patients with nephrotic syndrome. The factors associated with infection in nephrotic syndrome are lacking. The objective of the study was to identify the prevalence and associated factors among children with nephrotic syndrome aged 2 to 18 years.
METHODS: We conducted a hospital-based retrospective cross-sectional study. The data collector installed an Epi5 collector electronic data-collecting tool from Google Play. Then, we exported the data to Stata version 15.1 for analysis. The mean, standard deviation, frequency, and percentage were used for descriptive statistics. The logistic regression model was used to identify the factors associated with infection.
RESULTS: In this study, the prevalence of infection among nephrotic syndrome children is 39.8% (95%CI: 30.7, 49.7). The types of infection identified were pneumonia, urinary tract infection, diarrheal disease, cutaneous fungal infection, intestinal parasitic infection, and sepsis. The presence of hematuria increased the odds of infection by 5-times. On the other hand, low level of serum albumin increased the odds of infection by 7%. Being a rural resident increased the odds of infection by 3.3-times as compared to urban.
CONCLUSIONS: Serum albumin level, presence of hematuria, and rural residence were significantly associated with infection. We recommended a longitudinal incidence study on large sample size at multicenter to strengthen this finding.