BACKGROUND: Chronic and highly contagious, trachoma is a condition characterized by recurrent bacterial infection with ocular strains of Mycoplasma trachoma. It spreads through fingers, flies, and fomites, especially in situations where there is overcrowding. If untreated, the illness may result in blindness. Trachoma is an ancient disease and has previously been a significant public health problem in many areas of the world, including parts of Europe and North America. There are at least 400 million cases of active trachoma in the world, 8 million of which have resulted in blindness. Trachoma is a serious public health issue that is very common in Ethiopia. Therefore, the objective of this study is to identify the determinants of active trachoma among rural children aged 1-9 years old in Aw-bare woreda, Somali region of Ethiopia.
METHODS: A cross-sectional community-based study involving children aged 1-9 who lived in six selected rural kebeles in the Awbare woreda Somali region and carried out using an ordinal logistic regression model. The study comprised 377 children in total. Our sample youngsters were chosen through a two-stage cluster sampling procedure. Then also chose our sample kebeles by simple random sampling. The main environmental, personal, and demographic factors that influenced the outcomes of active trachoma status were modeled using partial proportional odds modeling and descriptive statistics.
RESULTS: The study showed that the prevalence of active trachoma was found to be 47.7%. The covariate secondary level of education of mother OR = 1.357; 95% CI (1.051, 1.75), P-value = 0.0192, Inside house cooking place of children family OR = 0.789:95% CI (0.687, 0.927), P-value = 0.0031, children stay at home OR = 2.203:95%CI (1.526, 3.473), P-value = 0.0057,rich income family OR = 1.335:95%CI(1.166,1.528),P-value = 0.0001,Amount of water fetched per day OR = 2.129,95%CI(1.780,2.547),P-Vaue = 0.0001 were significant effect on active trachoma. PPOM represents the best fit as it has the smallest AIC and BIC. It is also more parsimonious.
CONCLUSIONS: The mother\'s educational level, the location where the children spent the majority of their time indoors cooking, the fly density during the interview, the family\'s income, the child\'s age in years, the distance to the water source, the quantity of water fetched daily, and the number of people sharing a room have all been found to be significant predictors of the child\'s active trachoma status. Thus, increasing maternal education, access to clean water, and socioeconomic position are all crucial measures in preventing trachoma. Preventing trachoma also involves reducing the number of kids in a room and enhancing activities linked to personal cleanliness, such as giving kids a thorough facial wash to remove debris and discharge from their eyes.

OBJECTIVE: Intracerebral hemorrhage (ICH) is a serious medical condition with high mortality. However, factors leading to long-term mortality after ICH are largely unclear. The aim of this community-based study is to assess predictors of long-term mortality after spontaneous ICH.
METHODS: We identified all patients admitted with spontaneous ICH to hospitals with a certified stroke unit in Brno, the second largest city in the Czech Republic (CR), in 2011, the year of the Czech Population and Housing Census. We reviewed their medical records for risk factors, radiographic parameters, and measures of post-stroke neurological deficit [National Institutes of Health Stroke Scale (NIHSS)]. Using the dates of death from the Czech National Mortality Register, we calculated mortality at 30 days, six months, one year, and three years after the ICH. Multivariate analysis with forward stepwise logistic regression was performed to determine independent predictors of mortality (p < 0.05).
RESULTS: In 2011, 1086 patients with stroke were admitted to the four stroke-certified hospitals in Brno, CR. Of these, 134 had spontaneous ICH, with complete data available in 93 of them entering the final analysis. The mortality at 30 days, 6 months, 1 year, and 3 years post-ICH was 34%, 47%, 51%, and 63%, respectively. The mortality was highest in the first few days post-event, with 50% of patients dying in 255 days and average survival being 884 ± 90 days. Both NIHSS and modified ICH (MICH) score showed to be strong and reliable predictors of short- as well as long-term mortality; the risk of death post-ICH increased with older age and size of ICH. Other risk factors contributing to higher, primarily shorter-term mortality included history of cardiac failure, myocardial infarction, or atrial fibrillation.
CONCLUSIONS: In our community-based study, we found that severity of neurological deficit at admission (NIHSS), combined with age and size of ICH, well predicted short- as well as long-term mortality after spontaneous ICH. A history of cardiac failure, myocardial infarction, or atrial fibrillation at presentation were also predictors of mortality, underscoring the need for optimal cardiac management in patients with ICH.

BACKGROUND: Hypothermia is one of the major causes of newborn death, particularly in low-income nations. This was due to poor thermal care in most of the rural communities. Recent studies show that there was a prevalence discrepancy between urban and rural communities where economic, educational, and life standard differences exist. Therefore, this study aimed to assess the prevalence and factors associated with neonatal hypothermia among neonates in rural and urban areas of the Shebadino woreda, Sidama region, Ethiopia.
METHODS: A comparative community-based cross-sectional study was performed on 682 neonates in the Shebadino Woreda, Sidama Region, southern Ethiopia, in 2023. A multistage sampling technique was used, and the collected data were manually cleaned, coded, and entered into Epi Data version 4.6 before being exported to SPSS version 26 software for analysis. Variables with a p-value < 0.25 in the bivariate logistic regression were further analyzed using multivariable logistic regression. The odds ratio (OR) with 95% CI was used as a measure of association, and variables that had a p-value less than 0.05 in the multivariable logistic regression were considered significantly associated variables.
RESULTS: The overall prevalence of neonatal hypothermia in this study was 51.8% (95% CI: 47.2%-56.3%). It was greater among rural neonates (55.1%) than among urban neonates (48.6%). Bathing before 24 h. (AOR = 3.64, 95% CI: 1.39, 7.16), Placing a cold object near babies\' head (AOR = 2.97, 95% CI: 1.75, 5.03), Neonates who were given traditional medication (Amessa) (AOR = 1.83% CI; 1.04-3.20) and, not separated humans and animals house (AOR = 1.75, 95%, 1.05-2.91) were significantly associated with neonatal hypothermia in rural, while Night time delivery (AOR = 1.81, CI: 1.01-5.62), Neonates who were given traditional medication (Amessa) (AOR = 3.11% CI; 1.85-5.21), and Placing a cold object near babies\' head (AOR = 2.40, 95% CI: 1.37, 3.29 were significantly associated with neonatal hypothermia among urban neonates.
CONCLUSIONS: The Prevalence of neonatal hypothermia in the study area was relatively greater in rural areas than in urban areas. Cost-effective thermal care such as separating humans from animal houses, teaching not to put cold objects near babies, giving special care to newborns for those delivered from women with medical problems, and giving priority to those delivered at night, is needed.

UNASSIGNED: arthritis is a significant public health problem affecting many people globally. Exposure to various risk factors puts individuals at risk of developing arthritis. Therefore, this study aimed to assess the prevalence and predictors of arthritis among residents of a rural set-up in Nyamira County, Kenya.
UNASSIGNED: a community-based cross-sectional study design was employed. Simple random sampling was utilized to select households from a household list. All the residents of the sampled household above 40 years were included. Descriptive analysis was done to describe the study population. Bivariate and multivariate analysis was also done to identify statistically significant arthritis-related variables.
UNASSIGNED: the prevalence of arthritis was 44.6%. Previous joint injury/infection [AOR=2.74; 95%CI=1.59-4.77; p<0.001], being unemployed [AOR=2.77; 95%CI=1.50-5.21; p=0.001], age above 51 years, and hypertension [AOR=1.90; 95%CI=1.03-3.53, p=0.040] were associated with an increased risk of arthritis. Conversely, being male [AOR=0.42; 95% CI=0.22-0.75; p=0.005], standing for > 2 hours [AOR=0.48; 95%CI=0.29-0.81; p=0.006], and constant shifting from sit to stand positions [AOR=0.45; 95% CI=0.26-0.76; p=0.003] were associated with a lower risk of arthritis. Most participants (75%) had an arthritis knowledge score of more than 66%.
UNASSIGNED: the study found a high prevalence of arthritis in the community. Arthritis was strongly associated with various risk factors under study. Therefore, there is a need to take preventive measures for modifiable factors to enhance a reduced prevalence of arthritis.

BACKGROUND: Limited studies have investigated the relationship between Anti-Müllerian hormone (AMH) and metabolic syndrome (MetS), yielding inconclusive results. This study aimed to examine the relationship between AMH levels and MetS and its components in women from a general population.
METHODS: This prospective study recruited 769 women. Generalized Estimating Equation (GEE) models analyzed longitudinal trends of MetS components. Cox proportional hazard models evaluated effect of age-specific AMH tertiles on MetS occurrence, adjusting for confounders.
RESULTS: The GEE analysis indicated that women in the third tertile exhibited higher mean FPG compared to those in the first tertile of age-specific AMH (3 mg/dL; 95% CI: 0.40, 5.60; P = 0.024); however, this association became non-significant after adjustment. Notably, the second tertile showed a significant decrease in FPG mean changes over time (-0.69 mg/dL; 95% CI: -1.31, -0.07; P Interaction = 0.030). Women in the second and third tertiles of age-specific AMH demonstrated lower mean HDL-C compared to the first tertile (-2.96 mg/dL; 95% CI: -4.67, -1.26; P < 0.001 and -2.63 mg/dL; 95% CI: -4.31, -0.96; P = 0.002, respectively). The association between HDL-C changes and the second tertile remained significant after adjustment (-1.91 mg/dL; 95% CI: -3.68, -0.14; P = 0.034). No significant associations were observed between age-specific AMH tertiles and TG and SBP/DBP. Cox models revealed no significant differences in the hazard ratio of MetS between AMH tertiles after adjusting for confounders.
CONCLUSIONS: Despite minor variations in MetS components, AMH levels did not affect MetS risk in women from a general population.

BACKGROUND: Osteoporosis poses a significant health burden, particularly among postmenopausal women. While obesity in the form of BMI has been implicated in various health conditions, the relationship between waist-hip ratio (WHR) and osteoporosis remains debated. This study aims to estimate the prevalence of osteoporosis risk and explore the association between WHR and osteoporosis risk among postmenopausal women in rural South India.
METHODS: A community-based cross-sectional study was conducted in the Chengalpattu district of Tamil Nadu. The study enrolled 435 postmenopausal women aged 45 years and above and the data were collected on socio-demographic characteristics, anthropometric measurements, and osteoporosis risk assessment using the Osteoporosis Self-assessment Tool for Asian Women (OSTA) scale. Logistic regression analysis was performed to identify factors associated with osteoporosis risk with 95%CI.
RESULTS: The mean (SD) age of participants was 54.5 (8.6) years, 87% were married, 33% were illiterate with mean (SD) WHR of 0.88 (0.1). Around 80.5% of the participants were categorized as low risk, 16.1% as intermediate risk, and 3.5% as high risk based on OSTA scores. Older age, lower educational attainment, and higher waist-hip ratio were significantly associated with increased osteoporosis risk.
CONCLUSIONS: This community-based study found a 20% osteoporosis risk among postmenopausal women using the OSTA scale, with age, lower education, and waist-hip ratio as key determinants. Early identification and interventions, particularly targeting older and obese individuals, are crucial to alleviate the burden and complications of osteoporosis.

Background: The assessment of future risk of cardiovascular diseases (CVD) is strongly recommended for all asymptomatic adults without CVD history. Carotid atherosclerosis (CA) is a preclinical phenotype of CVDs. However, data on estimated future CVD risks with respect to preclinical atherosclerosis are limited. This community-based study aimed to assess the relationships between predicted CVD risks and CA. Methods: We enrolled 3908 subjects aged 40-74 years without CVD history and calculated their 10-year CVD risks using the Framingham Risk Score (FRS) and the Pooled Cohort Equations (PCE). Carotid plaque (CP) at the extracranial carotid arteries was determined by high-resolution B-mode ultrasonography and further classified into mild or advanced CA. Results: The means of FRS for CP-negative and mild and advanced CA were 9.0%, 14.4%, and 22.1%, respectively (p-value < 0.0001). The corresponding values for PCE score were 4.8%, 8.8%, and 15.0%, respectively (p-value < 0.0001). The odds ratios (ORs) of having CP per 5.0% increase in FRS and PCE score were 1.23 (95% CI, 1.19-1.28) and 1.36 (95% CI, 1.28-1.44), respectively. The corresponding values of having advanced CA were 1.24 (95% CI, 1.19-1.29) and 1.38 (95% CI, 1.30-1.48), respectively. Among the models of FRS or PCE plus other conventional CVD risk factors, the FRS + age model had the highest discrimination for the presence of CP (AUROC, 0.7533; 95% CI, 0.7375-0.7691) as well as for the presence of advanced CA (AUROC, 0.8034; 95% CI, 0.7835-0.8232). The calibration of the FRS + age models for the presences of CP and advanced CA was excellent (χ2 = 8.45 [p = 0.49] and 10.49 [p = 0.31], respectively). Conclusions: Estimated future CVD risks were significantly correlated with risks of having CA. Both FRS and PCE had good discrimination for the presences of CP and advanced CA.

BACKGROUND: The BE-FAST (balance, eyes, face, arms, speech, and time) mnemonic helps to identify stroke symptoms, which has been publicized through social media in Thailand for a while. Timely access to medical care enhances the likelihood of receiving efficacious treatment, thereby mitigating the adverse consequences of the stroke. Thus, stroke awareness in the general population, especially in the population at risk, is crucial. The purpose of the study was to evaluate stroke awareness and the level of knowledge about stroke in Thailand.
METHODS: Adult participants aged at least 40 years, without a history of stroke, were included, with exclusions limited to those unwilling to participate. Data were gathered from the survey during two community visits and through an electronic survey via Google Forms (Google LLC, Mountain View, California, United States). A pre-tested questionnaire was divided into three parts: symptoms of acute stroke, vascular risk factors, and response. Demographics were compared between participants with good and poor knowledge of stroke awareness.
RESULTS: A total of 281 participants were included, with a mean age of 58 years and 60% (n=169) of participants having at least one vascular risk factor. Of the responders, 133 (47%) had good knowledge of stroke awareness. Older age (age > 50 years, OR 0.326, 95%CI 0.173-0.615, p-value = 0.001), higher education (> 6 years, OR 0.266, 95%CI 0.139-0.508, p-value < 0.001)), and being female (OR 0.474, 95%CI 0.252-0.891, p-value = 0.020) were related to good stroke knowledge. Participants with good knowledge of stroke awareness also had good knowledge of vascular risk factors (84%; n=112), knew that they should come to the hospital immediately (74%; n=98), and also correctly identified the emergency calling number (90%; n=119).
CONCLUSIONS: Only half of the participants had good knowledge of stroke awareness. There is a need for improvement in the distribution of knowledge about stroke in Thailand.

BACKGROUND: Although longer working hours are associated with lower sleep quality, it is still necessary to work a certain number of hours to make a living. In this study, we investigated the relationship between working hours and sleep quality in a community setting. We then explored how to manage work style while maintaining the sleep quality of workers without markedly reducing working hours.
METHODS: 4388 day-time workers in various occupations living in Ota ward in Tokyo were included in the analysis. The relationship between working hours and sleep quality measured by the Athens Insomnia Scale was examined by ANOVA and linear regression models. Effect modification by work style (work end time, shift in working start and end time, current work from home status, change in work place) on the relationship between working hours and sleep quality was investigated by multivariate linear regression models.
RESULTS: Longer working hours were significantly associated with lower sleep quality. The magnitude of the relationship between long working hours and low sleep quality was significantly larger when work end time was later (p for trend of interaction < 0.01) and when working start and end time were shifted later (vs no change, p for interaction = 0.03). The relationship was marginally greater when the proportion of work from home was increased (vs no change, p for interaction = 0.07).
CONCLUSIONS: A relationship between longer working hours and lower sleep quality was observed among workers. Leaving work earlier or optimizing the work environment at home may diminish the adverse effect of long working hours on sleep quality.

BACKGROUND: Many studies have reported that the Omicron variant is less pathogenic than the Delta variant and the wild-type. Epidemiological evidence regarding the risk of severe COVID-19 from the wild-type to the Omicron variant has been lacking.
METHODS: Study participants were COVID-19 patients aged 18 and older without previous COVID-19 infection who were notified to the Nara Prefecture Chuwa Public Health Center from January 2020 to March 2023, during the periods from the wild-type to the Omicron variant. The outcome variable was severe COVID-19 (i.e., ICU admission or COVID-19-related death). The explanatory variable was SARS-CoV-2 variant type or the number of COVID-19 vaccinations. Covariates included gender, age, risk factors for aggravation, and the number of general hospital beds per population. The generalized estimating equations of negative binomial regression models were used to estimate the adjusted incidence proportion (AIP) with 95% confidence interval (CI) for severe COVID-19.
RESULTS: Among 77,044 patients included in the analysis, 14,556 (18.9%) were unvaccinated and 520 (0.7%) developed severe COVID-19. Among unvaccinated patients, the risk of severe COVID-19 increased in the Alpha/Delta variants and decreased in the Omicron variant compared to the wild-type (AIP [95% CI] was 1.55 [1.06-2.27] in Alpha/Delta and 0.25 [0.15-0.40] in Omicron), but differed by age. Especially in patients aged ≥80, there was no significant difference in the risk of severe COVID-19 between the wild-type and the Omicron variant (AIP [95% CI] = 0.59 [0.27-1.29]). Regarding the preventive effect of vaccines, among all study participants, the number of vaccinations was significantly associated with the prevention of severe COVID-19, regardless of variant type. After stratified analyses by age, patients aged ≥80 remained a significant association for all variant types. On the other hand, the number of vaccinations had no association in Omicron BA.5 of patients aged 18-64.
CONCLUSIONS: Patients aged ≥80 had less reduction in risk of severe COVID-19 during the Omicron variant period, and a greater preventive effect of vaccines against severe COVID-19, compared to younger people. Our findings suggest that booster vaccination is effective and necessary for older people, especially aged ≥80.