Showing papers in "Open Journal of Epidemiology in 2018"

Sero Status Disclosure to Sexual Partner and Associated Factors among Adult HIV Positive Patients in Bale Zone Hospitals, Oromia Region, Ethiopia: Institution Based Cross-Sectional Study

Abstract: Background: Disclosure of HIV sero status is among varies HIV prevention strategy to prevent the spread of HIV. It is the base for accessing care and treatment programs, attains psycho-social support and reduces stigma, adheres to treatment and promotes safer health behavior particularly for couples. Objective: To assess HIV sero status disclosure to sexual partner and associated factors among HIV positive adult patient in Bale Zone hospitals. Method: A cross-sectional study design was conducted among 411 adult HIV positive clients who were selected by using systematic random sampling methods from Bale Zone Hospitals. Data were collected by using pre-tested questionnaire after verbal consent obtained from participants by trained nurse. Multiple logistic regression analysis was done by using SPSS version 20 and P-value of less than 0.05 was taken to declare statistical significance. Result: HIV sero status disclosure to sexual partners was 52.6%. Residence (AOR = 1.62; 95% CI, 1.0, 2.60), receiving pre-test counselling related disclosure (AOR = 6.25; 95% CI, 3.45, 11.33) and knowledge of partner’s HIV sero status (P-Value = 0.001) were significantly associated with HIV sero status disclosure. Fear of stigma and violence by sexual partner were the main reasons suggested for not disclosing HIV sero-status. Conclusion: The level of HIV sero-status disclosure to sexual partner was low. Disclosure of HIV sero status to sexual partner was significantly associated with clients’ place of residence, receiving pre-test counselling about disclosure and Knowledge of partners HIV sero status.

Risk Factors and Diabetes Related Complications Frequency in the Population of the Northeastern Morocco

Abstract: Objectives: Diabetes is one of the most challenging health problems in the 21st century that brings a considerable economic burden on worldwide healthcare resources. Indeed, people with diabetes have a higher lifetime healthcare expenditure due to the long-term complications, which include micro and macrovascular complications. This study sought to estimate the frequency of diabetes complications, and to investigate the associated risk factors. Methodology: Data were obtained from the medical records of 2401 diabetic patients followed at the Reference Center of Diabetes and Chronic Diseases (RCD) in Oujda (Morocco) during the period 2006-2011. Results: Our sample of 2401 diabetic patients include 64.7% women. 32% of patients have one or more complications; retinopathy is the most frequent complication (16.8%), followed by nephropathy (12.4%), cardiovascular diseases (5.4%), neuropathy (3.6%) and diabetes foot (2%). Logistic regression in univariate followed by multivariate analysis has showed that age, duration of diabetes and high albuminuria are the major risk factors for the development of diabetic complications in both type 1 and type 2 diabetes. Conclusions: Nearly one third of diabetic patients were affected by at least one diabetic complication; retinopathy is the most common complication in these patients. Strengthening programs to improve diabetes management and to reduce the risk of these complications should be a high priority in order to control the cost of treatment.

A Reassessment of Birth Defects for Children of Participants of the Air Force Health Study

Abstract: The Air Force Health Study (AFHS), also called the Ranch Hand Study, investigated the impact of exposure to dioxin the toxic contaminant in Agent Orange on health, survival, and reproductive outcomes of male Air Force Vietnam War veterans. It was concluded that available reproductive outcome data did not provide support for an adverse association with paternal dioxin exposure. A more extensive set of AFHS data was used to reassess this conclusion, restricting to the case of birth defects in children fathered after the start of the first Vietnam War tour. Analyses started by repeating published analyses, followed by assessing decisions made in those analyses, for example, of excluding participants with dioxin levels below the detectable limit, using a threshold of 10 parts per trillion for a high dioxin level, and not adjusting for multiple conceptions/children of the same participant. Using data for all participants with measured dioxin levels, both veterans who served in Operation Ranch Hand and other non-Ranch Hand veterans, and after accounting for correlation within children of the same participant, the occurrence for children fathered after the start of the first tour of a major defect, a non-major defect, and multiple defects depended significantly on participants having a high dioxin level. These conclusions were not changed by consideration of covariates. In contrast to prior published analyses, the more extensive AFHS data provided support for an adverse effect of paternal dioxin exposure on birth defects. However, the study had many limitations that could have affected the conclusions.

Traffic Air Pollution and Respiratory Health: A Cross-Sectional Study among Bus Drivers in Dakar (Senegal)

Abstract: Introduction: Road traffic exposes bus drivers to the detrimental effects of air pollutants on respiratory health. This study determined the frequency of chronic respiratory illnesses and its related factors among bus drivers in Dakar, Senegal. Methods: This study had a cross-sectional design conducted in a total of 178 bus drivers in Dakar, Senegal. A questionnaire was used to inquire about socio-economic characteristics, occupational factors and respiratory symptoms of bus drivers. Lung function tests were used to determine the presence of asthma and Chronic Obstructive Pulmonary Disease (COPD). The relationship between our variables of interest and respiratory diseases was determined by logistic regression analysis. Results: The results of the study show that 57.9% of bus drivers had a chronic cough, and 65.7% had recurrent cold. Lung function tests showed that 38.8% of bus drivers had asthma and 30.3% COPD. Multivariate analysis found that recurrent cold increased the risk of asthma (OR = 6.3, 95% CI: 1.12 - 35.79) and COPD (OR = 7.7, 95% CI: 1.14 - 52.8). The respiratory health status of bus drivers depended on the work area (OR = 3.2, 95% CI: 1.13 - 9.31). Conclusion: The respiratory symptoms and illnesses observed among bus drivers are associated with their exposure to air pollutants from road traffic.

Disability and Related Factors among Road Traffic Accident Victims in Benin: Study from Five Public and Faith-Based Hospitals in Urban and Suburban Areas

Abstract: Introduction: Road traffic accidents (RTAs) are a major public health issue in developing countries, where roads tend to be built haphazardly and accidents take a heavy toll on victims—including leaving them disabled. This study seeks to identify those factors that cause RTA victims to become disabled as a result of their injuries. Methods: This retrospective community-based study looked at RTA victims treated in five public and faith-based hospitals in Benin. Disability was evaluated using the Washington Group on Disabilities Statistics questionnaire. The independent variables were related to the victim’s socio-demographic traits, the circumstances of the accident, and post-crash response mechanisms. The proportions were compared using the chi-squared test, with a threshold of 5%. Results: The prevalence of disability among road traffic accident victims is 9.59% (CI 95%: 6.86% - 13.20%). The occurrence of disability is associated with age (p = 0.002), occupational group (p = 0.0077), the mode of transport used to transfer the victim (p < 0.001) and the location of the injuries (p = 0.0035). The study also found that people fail to make sufficient use of post-crash response mechanisms. Conclusion: Public policy-makers should therefore focus on stepping up interventions to get more people using both protective equipment and post-crash response services.

Characterization of Clinical and Environmental Isolates of Cryptococcus neoformans/Cryptococcus gattii Complex Maintained in Yeast Culture Collection in São Paulo, Brazil

Abstract: Objective: As isolates of Cryptococcus are frequently kept collection stocks in institutions, sometimes without proper characterization, we sought to determine the genotype profiles, protease and phospholipase activities “in vitro” and the susceptibility testing for azoles and amphotericin B. Methodology: 84 isolates from several regions of Brazil (40 samples from clinical origin and 44 isolates from environmental origin) were maintained at the microorganism’s bank of the Biomedical Science Institute (ICB-USP) of the Sao Paulo University, in Sao Paulo, Brazil. This isolates was submitted fungal strains determination, DNA extraction and purification, determination of genotype by URA5 gene RFLP of CGB-positive isolates, protease and phospholipase activity and susceptibility to antifungals. Results: Of six CGB positive isolates tested by RFLP-PCR, only four presented a genomic profile consistent C. gattii species (VGII), while two other were C. neoformans (VNI and VNIII), indicating the existence of canavanine-resistante C. neoformans isolates in the culture collections. The clinical isolates secreted higher levels of phospholipase and environmental isolates but no differences were observed for the protease levels. Almost all isolates were sensible to azoles and amphotericin B. Conclusion: We point out in this research the existence of C. neoformans strains resistant to canavanine and intrinsic characteristic of C. gatti. These results demonstrate the importance to perform a detailed characterization of isolates kept in culture collections.

An Epidemiological Model to Find out Factors Associated with Nodal Involvement among Indian Oral Cancer Patients

Abstract: In India, the most common cancer among men is cancer of lip-oral and its incidence is further increasing. Nodal metastasis is an important prognostic factor in oral cancer. Previous studies on factors associated with nodal involvement are mainly focused on clinical exploration, and there is very little work in statistical modeling for nodal involvement. Also, the available studies have limited covariates and their varying forms. Further, studies available from India have mainly focused either on occult nodal metastasis only or a specific site of oral or stages. Hence, in order to identify epidemiological determinants of nodal metastasis, objective of this study was to develop a regression model to find out factors associated with nodal involvement and assess its validity. 945 histopathologically proven oral squamous cell carcinoma (OSCC) patients who went under surgery including neck dissection during 1995-2013 at the Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India, were included for model building. Another data of 204 patients available during 2014-2015 was used for the temporal validation of the developed model. To assess the factors associated with nodal involvement, stepwise multivariable logistic regression procedure was used and results are presented as odds ratio and corresponding 95% confidence interval (CI). Pain at the time of presentation [1.34 (1.02 to 1.77)], sub mucous fibrosis (SMF) [0.45 (0.21 to 0.95)], palpable neck node [2.38 (1.69 to 3.35)], tongue [1.63 (1.07 to 2.46)] as compared to buccal mucosa and degree of differentiation [1.41 (1.05 to 1.89)] were found to be significantly associated with nodal involvement. Further, diagnostic performance of the developed model was found to be satisfactory on temporal validation. These data suggest that, Pain at time of presentation, presence of clinical neck node, SMF, degree of differentiation and oral site are the most probable factors associated with nodal involvement in OSCC.

Diabetes and Its Treatment Quality in Benin (West Africa): Analysis of Data from the STEPS Survey 2015

Abstract: Aims: Diabetes is a major public health problem in low and middle-income countries. This study 1) estimated prevalence and factors associated with hyperglycemia in Benin, and 2) assessed the treatment quality of diabetes. Methodology: A cross-sectional research was conducted with two components. The First component has included 4954 subjects aged (18 - 69) randomly selected in Mono/Couffo and Donga regions. Data were collected according to WHO’s STEPS approach. Capillary blood glucose was measured using the automat Cardiocheck® PA. The Second component considered Public Health Centers (PHCs) within the study regions. Health system established for diabetes control, healthcare practices and the level of involvement of the Public Healthcare Providers and community actors in the management of diabetes have been explored. Findings: A total of 4775 subjects participated in the first component with a predominance of women (56.8%), rural residence and aged (<45 years). Prevalence of hyperglycemia was 9.2%. Age ≥ 30 years, Fon ethnic groups and related, obesity, hypercholesterolemia, and inadequate intake of fruits and vegetables were positively associated with hyperglycemia. The second component has underscored a mismatch of facilities, processes and quality healthcare. Conclusion: Diabetes prevalence goes increasingly in Benin when its management is inadequate in PHCs. Prevention and control actions should be strengthened.

Uptake of Cervical Cancer Screening among Women Attending Health Facilities in the City of Bulawayo, 2012

Abstract: Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s. The Ministry of Health and Child Care is relying on screening, which allows early detection of pre-cancerous cells and diagnosis at early stages but many women are not going for the test and no studies have been done to find out why. This study investigated the women’s perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics. Methods: We conducted an analytic cross-sectional study. Women from 18 years and above attending health facilities were included in the study. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. Epi-info version 3.3.2 was used to do bivariate and multivariate analysis. Results: Two hundred women were recruited into the study. The proportion of women who had cervical cancer screening was 52 (26%). Pap smear only had 35 (17.5%) had VIAC only, 13 (6.5%) and Pap smear and VIAC had 4 (2%). Knowledge of cervical cancer and its screening was poor among participants. In multivariate analysis, awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63 - 314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12 - 0.88)] was independently associated to the uptake of cervical cancer screening. Conclusion: This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening. Perceiving multiple sexual partners was associated to the uptake of cervical cancer screening. It is therefore necessary to increase awareness in Bulawayo City and educate the community about other risk factors.

Visualizing Fit between Dengue and Climatic Variables on Capitals of the Brazilian Northeast Region by Generalized Additive Models

Abstract: Recent analysis indicates that the numbers of dengue cases may be as high as 400 million/year in the world. According to the Ministry of Brazilian Health, in 2015, there were 1,621,797 probable cases of dengue in the country including all classifications except discarded, the highest number recorded in the historical series since 1990. Many studies have found associations between climatic conditions and dengue transmission, especially using generalized models. In this study, Generalized Additive Models (GAM) was used associated to visreg package to understand the effect of climatic variables on capitals of Northeast Brazilian, from 2001 to 2012. From 12 climatic variables, it was verified that the relative humidity was the one that obtained the highest correlation to dengue. Afterwards, GAM associated with visreg was applied to understand the effects between them. Relative humidity explains the dengue incidence at an adjusted rate of 78.0% (in Sao Luis-MA) and 82.3% (in Teresina-PI) delayed in, respectively, -1 and -2 months.

Analysis of the Relationship between Oral Diseases and Glycemic Control of Diabetes in the West African Context: Survey at the Centre Anti-Diabétique d’Abidjan (CADA), Côte d’Ivoire

Abstract: The relationship between diabetes and periodontitis is established and described as a bidirectional influence, whereas that with dental caries is still controversial. The objective of this study was to analyze the relationship between blood glucose control and oral diseases in a population of diabetics followed at the “Centre Anti Diabetique d’Abidjan” (CADA). The dental condition of the diabetics included in this cross-sectional study was assessed by the DMF index, periodontal condition by the CPITN and oral hygiene by the OHIS index. Diabetes data were extracted from CADA patient medical records. Blood glucose control has been defined by an average of the blood glucose values of the last 3 months less than or equal to 1.26 g/l. Regression models were constructed to estimate the risk of diabetes imbalance adjusted for all characteristics collected. The sample of 356 diabetics consisted of 53.7% women with an average age of 55.6 years (range: 12 - 85 years). The average DMF index was 7.9 (Std: 6.6) with an estimated prevalence of caries of 77.0%, that of periodontitis of 53.1%. The proportion of subjects with good glycemic control was estimated at 41.3%. The characteristics associated with glycemic control were: dry mouth (p = 0.005), type of diabetes treatment (p < 0.00014) and duration of diabetes (p = 0.039) and periodontal status assessed with the CPITN (p = 0.014). The results of this study confirmed the link between periodontitis and glycemic control of diabetes described in the literature but didn’t find significant association between dental caries and diabetes.

Determinants of High Blood Pressure and Quality of Management in Three Regions of Benin

Abstract: Objective: The aim of this work was to determine the prevalence, associated factors and quality of high blood pressure (HBP) management in three regions of Benin in 2015. Methodology: This was a cross-sectional study, with two components. The first component included adults aged from 18 to 69 years, selected using a three-stage random sampling within the households. Data were collected thanks to the French version of the WHO STEPS instrument. Anthropometric data, including blood pressure, capillary fasting glucose and total cholesterol were measured according to standard procedures. The second component included Public Health Centers (PHC) selected by a random stratified multi-stage sampling. Data were collected on the structures and the processes of HBP management using the standardized tool for assessing the capacities of management of non-communicable diseases in peripheral health centers provided by the World Health Organization. Results: A total of 4816 participants were included in the first component. The mean age was 35.8 ± 12.7 years. The weighted prevalence of HBP was 27.9% (95% Confidence Interval (CI) [25.6 - 30.2]). It was higher in the 60 - 69 years compared to the lower age groups (Adjusted Odd-ratio (ORa) = 5; 95% CI [3.9 - 6.5)]). HBP was positively associated with urban residence (ORa = 1.26; 95% CI [1.24 - 1.28]), obesity (ORa = 1.46; 95% CI [1.43 - 1.50]), hyperglycemia (ORa = 1.13; 95% CI [1.10 - 1.15)]) and hypercholesterolemia (ORa = 1.64; 95% CI [1.59 - 1.70)]). A total of 27 PHC were included in the second component. Taking blood pressure and other anthropometric measurements was not routine in PHC. Several essential medicines were not available in the PHC. A low level of community involvement in the management of HBP was noted. Conclusion: This study confirms the high prevalence of HBP and shows inadequacies in its management in the targeted PHC. More appropriate prevention and control measures for HBP should be implemented.

Early Initiation of Breastfeeding and Its Association in Rural Areas of Burkina Faso

Abstract: Background: The global recommendations of the WHO and UNICEF are that all infants should start breastfeeding within one hour of birth. It is low-cost and has substantial potential to reduce neonatal and early infant morbidity. The objectives of the study were to investigate rate of early initiation of breastfeeding and to identify potential associated factors. Methods: A community based cross-sectional study design was conducted in three districts of Burkina Faso. Cluster sampling was used. The data were collected by using a structured and pretested interview questionnaire. The associations between early initiation and independent variables were tested using the Chi-square test. Crude Odds ratios (COR) with 95% confidence intervals were used. Results: Percentage of children who were put to the breast within one hour of birth was fair (41%). Having more than 2 antenatal care visits was found to be 1.43 times more likely to initiate breastfeeding early, COR: 1.4, 95% CI: [1.14 - 1.81], p < 0.001. Receiving advices, during pregnancy, on early initiation of breastfeeding, child feeding and child growth, were found to be more likely to initiate breastfeeding early, respectively COR: 1.52, 95% CI: [1.25 - 1.80]; 1.39, 95% CI: [1.15 - 1.67] and 1.39, 95% CI: [1.15 - 1.67], with p < 0.001. Mothers having skilled delivery were found to be more likely to initiate breastfeeding early, COR: 1.47, 95% CI: [1.20 - 1.79], p < 0.001. Conclusions: This study demonstrates that delayed initiation of breastfeeding continues to be a problem in rural areas of Burkina Faso, as only four in 10 newborn infants received breast milk within the first hour of birth. The results show that receiving advices on early initiation of breastfeeding, child growth and feeding and skilled delivery were found to be more likely to initiate breastfeeding within one hour of delivery. Therefore improving the skills of health providers and, mother individual counselling and strengthening community-based support, are critical to improve timely initiation of breastfeeding.

Oral Healthcare Renunciation and Socioeconomic Determinants

Abstract: The unequal access to healthcare in general and oral healthcare, in particular, is a true public health concern. Thus, it is important to assess the oral healthcare renunciation and socioeconomic determinants to take appropriate measures. A cross-sectional, descriptive population-based study of 300 households was carried out between April 28, 2016, and May 28, 2016, according to WHO’s guidelines (Protocol 1997), in Senegal adapted form. Results showed that 18.23% of householders report that their household members have foregone oral healthcare. Among those who renounced care, 51.5% did so for care costs (24.2%) or remoteness of health facilities (27.3%) reasons. Therefore, dental treatment renunciation was independently associated to income level, age, sex, marital status, and types of oral healthcare coverage. This study’s analysis shows that oral healthcare renunciation depends primarily on the financial aspect and the remoteness of health structures. Still, there are other important socio-anthropological parameters that should be investigated.

Prevalence of Tobacco Use and Associated Factors among Adults in Benin in 2015: Results of the National Survey of Non-Communicable Disease Risk Factors

Abstract: Introduction: Tobacco use and exposure to tobacco smoke are one of the most preventable causes of death and disability worldwide. The risk is even higher among daily tobacco consumers. The World Health Organization (WHO) recommended that surveillance of major risk factors for non- communicable diseases (NCDs), such as smoking, be imperative to predicting the future burden of NCDs, identifying adequate interventions to decrease future burden and monitor trends. In 2015, a survey on NCD risk factors was conducted in Benin to estimate the prevalence of major NCD risk factors. We analyzed the data from this survey to estimate the prevalence and risk factors associated with daily tobacco consumption in Benin. Methods: A nationwide representative sample of the population was constituted in the 12 departments of Benin. The WHO STEPS wise tool was used to collect data on behavioral and demographic characteristics, including daily tobacco consumption. Tobacco consumption was subdivided into three categories: The daily consumption of tobacco, the daily consumption of smoked tobacco and non-smoked tobacco. Multivariate analysis through the weighted logistic regression was used to identify potential factors associated with daily consumption of tobacco. Results: Over the 5.126 surveyed subjects, 7.49% were daily tobacco consumers, with 3.85% being daily users of smoked tobacco and 4.36% being daily consumers of non-smoked tobacco. Men were more likely to be daily consumers of tobacco compared to women (OR = 7.42; 95%CI = [4.98; 11.06]). Compared to respondents aged 18 to 24, those aged 45 to 54 were five times more likely to consume tobacco (OR = 5.58; 95%IC = [2.71; 11.47]). Respondents residing in the departments of Atacora, Couffo and Borgou were respectively 4.28 times, 3.93 times and 2.63 times more likely to consume tobacco compared to those residing in the department of Alibori. Respondents with no education were more likely to consume tobacco daily compared to respondents who had finished high school or were in university (OR = 3.73; 95%CI = [1.36; 10.23]. Respondents who were overweight were less likely to be daily users of tobacco compared to people with normal weight status (OR = 0.57; 95%CI = [0.34; 0.96]). Conclusion: There is a relatively high prevalence of smoking in Benin, where one out of 8 people, consumes tobacco products daily. Being elderly, male, having no formal education, residing in Atacora, Borgou or Couffo were significantly associated with daily smoking. Prevention actions should thus target those sub-groups of the population.

Practices and Knowledge on the Prevention of Cervical Cancer in Elderly Women

Abstract: Cancer is a public health problem, primarily in developing countries. Elderly women are more prone to contracting different diseases, including sexual related neoplasms. The aim of this study was to determine the strategies used and knowledge regarding the prevention of cervical cancer in elderly women. This is a cross-sectional observational study. The sample was comprised of elderly women residents from the Brazilian Northeastern city who attended a coexistence group for elder people. After sample, calculation was obtained N of 209 participants. Associations between the independent and dependent variables were analyzed using the chi-squared test, considering p ≤ 0.05 as significant. The following programs were used for statistical analyses: Excel (Microsoft Office®), to tabulate the data and prepare the tables and Bioestat® 5.3 to test the associations. The prevalent age range was 60 to 70 years; most of the subjects were retired and had secondary schooling. Although a large number of those interviewed knew about cervical cancer, their knowledge was insufficient to take preventive measures. It is important that the elderly undergo a Pap smear, since the number of increasing cervical cancer cases is known to increase in this age range. In the coming decades, Brazil will have a significant elderly population, reaffirming the growing need for educational campaigns related to the health of elderly women, encouraging self-care and prevention in old age.

Exclusive Breastfeeding Practice and Its Factors in Rural Areas of Burkina Faso

Abstract: Background: The recommendation of the WHO and UNICEF is that all infants should be exclusively breastfed up to 6 months of age. Identifying associated factors to exclusively breastfeeding is crucial to improve this key public health intervention. The objectives of the study were to investigate rates of exclusive breastfeeding and to identify potential associated factors. Methods: A Community based cross-sectional study design was conducted in three health districts. Cluster sampling was used. For the community based cross-sectional study, a total of 1832 infants was included. Exclusive breastfeeding have been investigated among the 563 under 6 month’s infants. The associations between exclusive breastfeeding and independent variables were tested using the Chi-square test. Crude Odds ratios with 95 % confidence intervals were used to investigate the factors independently associated with exclusively breastfeeding. Results: Proportion of infant 0 - 5.9 months of age who are fed exclusively with breastmilk was 40.0%. Ear of age for mother was found to be more likely to practice exclusive breastfeeding, COR [95CI%] = 2.11 [1.24 - 3.60] for 15 - 20 years of age and 2.0 [1.22 - 3.26]. Receiving advices, on exclusive breastfeeding was found to be more likely to practice exclusive breastfeeding, COR: 2.07, 95% CI: [1.44 - 2.98]. Mothers who have practice early initiation to breastfeeding were found to be more likely to practice exclusive breastfeeding COR: 1.62, 95% CI: [1.15 - 2.27]. Skilled delivery was found to be more likely to practice exclusive breastfeeding than non-skilled deliveries, COR: 1.66, 95% CI: [1.16 - 2.35]. Low numbers of living children by mother, young children, were found to be more likely to practice exclusive breastfeeding. Conclusions: Exclusive breastfeeding continues to be low in rural areas of Burkina Faso. As Exclusive breastfeeding is associated to lower morbidity and mortality risk, improving the skills of health providers to give adequate feeding support to the mothers is critical for promoting exclusively breastfeeding.

Analysis the Results of Control and Elimination of Coal-Burning-Borne Endemic Fluorosis in Chongqing City

Abstract: Objective: Discuss the analysis of the results of control and elimination of coal-burning fluorosis in Chongqing, and evaluate the effect of prevention and control. Methods: Dean’s method was used to investigate the fluorosis for the local children whose ages ranged from 8 to 12 years old, the use of improved stoves in residential households, the drying of corn and pepper for human consumption, and the results were evaluated and discussed according to the national standard for the control and elimination of coal-burning fluorosis. Results: The prevalence rate of dental fluorosis borne-disease in children whose ages ranged from 8 to 12 years old was about 11.28% in 661 historically diseased villages in 100 townships and in 13 districts and counties of Chongqing city. The correct utilization rates of improved stoves, qualified improved stoves, and qualified stoves were 100%, 98.82%, and 99.45%, respectively. The correct drying rates of corn and pepper for human consumption were 99.88% and 99.75% respectively. There are 24 uncontrolled villages, 225 controlled villages, and 412 villages in eliminated disease zones in administrative villages. There are 4 villages and counties in uncontrolled, 4 in controlled, and 5 eliminated areas in districts and counties. Conclusion: Fluorosis borne-disease caused by coal-burning in Chongqing has reached the control and elimination targets of the twelfth Five-year plan.

Study of the Determinants of the Use of Breast Cancer Screening in Women 35 to 65 Years in the Region of Thies (Senegal)

Abstract: Introduction: In Senegal, breast cancer is the second most common cancer of women after cervical cancer. It is a cancer accessible to clinical and radiological screening. The objective of this study was to study the determinants of the use of breast cancer screening among women aged 35 to 65 in the Thies region in 2015. Material and Methods: It was a descriptive and analytical cross-sectional study. It was conducted with a sample of women selected using a two-stage cluster survey. The study used a questionnaire to collect data on the individual characteristics of women, knowledge, attitudes and practice on breast cancer and quality of care in an individual interview at the homes of women after consent. The data was entered on the Epi Info 3.5.3 software and analyzed with the R 3.3.3 software. A description of qualitative variables across proportions and quantitative variables by mean and standard deviation was performed. Parametric or non-parametric tests were used to examine the association between the dependent variable (breast cancer screening) and explanatory variables (predisposing factors, resources, health needs) according to their applicability conditions and at a risk α equal 5%. Finally, all variables with p less than 0.25 were used to construct an explanatory model by simple logistic regression. Results: The study involved 960 women aged 35 to 65 years. The average age was 43.8 years with a standard deviation of 8.3 years. The rate of breast cancer screening was 25.7%. Educated women (OR adjusted = 1.89 [1.25 - 2.85]), women who resided in urban settings (adjusted OR = 1.79 [1.05 - 3.04]), those who experienced at least one risk factor for breast cancer (OR adjusted = 2.71 [1.81 - 4.06]) were more likely to use screening breast cancer. In contrast, women with low socioeconomic status (adjusted OR = 0.66 [0.45 - 0.97]) were less likely to be screened. Conclusion: Level of education, knowledge of breast cancer and having received screening advice are factors to consider in improving the rate of breast cancer screening in Thies, and the most important remains public awareness.