Open Journal of Epidemiology
ISSN / EISSN : 2165-7459 / 2165-7467
Published by: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 300
Latest articles in this journal
Open Journal of Epidemiology, Volume 12, pp 50-56; https://doi.org/10.4236/ojepi.2022.121004
Introduction: Childhood heart disease consists of congenital and acquired heart disease. The aim of this study was to describe the epidemiological profile and the clinical and aetiological characteristics of childhood heart disease at the Hôpital de la Paix in Ziguinchor. Method: This was a retrospective study from 1 January 2016 to 1 June 2020 in the cardiology and paediatrics departments of the Hôpital de la Paix in Ziguinchor. We included in the study all patients aged 0 - 18 years, hospitalised with heart disease confirmed by cardiac ultrasound. Results: In total, we included 57 patients in the study. The hospital prevalence was 1.6%. The average age was 67.85 ± 65 months. The predominance was male with a sex ratio of 0.96. The majority of mothers (50%) were between 15 and 30 years old. In our study, 8.85% of patients had a history of previous angina. Trisomy 21 was present in 12.35% of our patients. Severe acute malnutrition was found in 21.05% of cases. Lower limb oedema (82.4%) and dyspnoea (59.6%) were the most frequent clinical signs. On cardiac ultrasound, 52.6% of patients had congenital heart disease and 47.4% of patients had acquired heart disease. Ventricular septal defect (33.33%) was the most common congenital heart disease. Among the acquired heart diseases, mitral insufficiency predominated with 70.8% of cases. Infective endocarditis was the main complication observed. Management was mainly drug-based with diuretics and ACE inhibitors. No patient had undergone surgery. The in-hospital evolution was favourable in 85.9% of cases and the mortality rate was 10.5%. Conclusion: Our study showed that congenital heart disease was more frequent than acquired heart disease and that management, particularly surgery, was lacking.
Open Journal of Epidemiology, Volume 12, pp 12-30; https://doi.org/10.4236/ojepi.2022.121002
Background: Research suggests that a small number of persistent violent offenders are responsible for a majority of prison violence and tend to behave violently to a disproportionate amount. However, literature on patterns of violence in juvenile prisoners is limited. Method: In order to explore how subjects engage in violence while incarcerated in the juvenile prison system, the authors will examine both proximal and distal predictors of violent behavior among juveniles in custody. This study adds to the current empirical research by longitudinally examining dynamic risk factors of recurrent violent behavior across a population of juvenile prisoners (Mage = 16.21; 94.8% male) in custody in the Romanian juvenile justice system, starting from their entry date until the end of the follow-up period (Me = 2 years). Results: Results from a series of repeated aggressive events survival analyses show evidence of a long-term deleterious association between pre-incarceration risk factors and poor developmental trajectory associated with violence. Adherence to destructive conduct in prison was consistently influenced by low ability to cope with the prison environment, although education level and family factors also mattered. Implications for prison professionals and forensic practitioners are presented. Conclusion: Recurring aggressive behavior is frequent for individuals who experience complex adverse experiences during childhood, suggesting that screening youths upon their admission into juvenile justice settings should include an assessment of their basic self-regulation needs. A greater focus on longitudinal studies may help improve the screening process and also follow the progress of each juvenile to warrant the efficacy of preventive programs in self-harm, according to their emerging needs.
Open Journal of Epidemiology, Volume 12, pp 31-49; https://doi.org/10.4236/ojepi.2022.121003
Background: Cervical cancer (CC) is the fourth most common cancer in women and those living with HIV have a six times higher risk of cervical cancer compared to those without. The objective of this study was to assess knowledge and perceptions about cervical cancer in women living with HIV/AIDS (WLWHIV) in the municipality of Parakou in Benin. Methods: This was an analytical cross-sectional study conducted among WLWHIV monitored on antiretrovira (ARV) therapy (ART) centers in Parakou. Study participants were selected by systematic random sampling technique. Data collection took place from September 5, 2017 to November 6, 2017. Log-binomial regression was used to identify associated factors. Results: A total of 167 women were recruited into the study. The median age was 35 years [Interquartile range: 41.50 - 30.00]. More than half of the women had no perception of the cause of CC. Only 12.6% of women believed in the preventive capacity of early screening of CC. Among women, 15.6% knew that it can be prevented, but only 9.6% had heard of HPV and 4.8% knew that HPV vaccination is an effective means of preventing CC. The factors associated with the low level of knowledge were the age at first sexual intercourse (≤24 years), the ART follow-up site (private health structure) and the fact of not having visited a maternity hospital in the last 12 months preceding the survey. Conclusion: The perceptions and knowledge about cervical cancer in the population of women living with HIV and monitored on ART in Parakou were inadequate and disproportionate to their vulnerability to this cancer. In order to avoid a double burden on these women, their ART centers must integrate cervical cancer prevention interventions into ART initiation services.
Open Journal of Epidemiology, Volume 12, pp 125-133; https://doi.org/10.4236/ojepi.2022.122011
Background: School is a space where children are exposed to the social and psychosocial environment that can affect their health. In Senegal, the prevalence of dental caries is high in classic schools according to fragmented data, and unknown in the koranic school (Daaras). Objective: The objective is to describe the disparity of dental caries in the schoolchildren (talibes) of Daara of Koki. Method: A cross-sectional study was carried out on 400 talibes aged 7 to 12 years. Dental caries and socio-demographic data were, respectively, collected by clinical examination and questionnaire. Results: The sex ratio was 9, the mean age of 9.9 ± 1.5 years and the mean length of stay in the Daara was 2.3 ± 1.1 years. The prevalence of dental caries was 47.4%. The average mixed DFMT index was 1.1 ± 1.5. The prevalence was 51.2% among boys, 60% among eight-year-old children and 37.4% among twelve-year-old children. By length of stay, the prevalence was 52.9% at the start and 22.2% at the end with a significant downward trend (p < 0.0001). Conclusion: The study showed an unequally distributed of caries among talibes of Koki’s Daara. She suggests that oral health promotion policies are needed in Koranic schools and must rely on koranic teachers.
Open Journal of Epidemiology, Volume 12, pp 146-157; https://doi.org/10.4236/ojepi.2022.122013
Background: Prostate cancer is the second most frequent cancer in men after lung cancer, it accounts for 3.8% of all deaths caused by cancer in men worldwide. This study aimed at determining the prevalence, grades and management of prostate cancer among male patients admitted with cancer at Oncology Department of Bugando Medical Centre. Methodology: This was a hospital-based retrospective cross-section study that retrieved data from 384 medical files of male patients admitted with cancer in Oncology wards at Bugando Medical Centre from January 2017 to December 2020. Results: The prevalence of prostate cancer was 39.84% (153 of 384 male patients). The mean age of patients with prostate cancer was 64.85 years ± 14.59 years. Two third of the patients’ prostate cancer were graded at presentation and of these, 52.58% (51 of 97) were having a high grade prostate cancer of Gleason scores 8, 9 or 10. Treatment involved hormonal therapy, chemotherapy and Radiotherapy whereby 49.48% (n = 190) were treated with hormonal therapy (Goserelin and Bicalutamide), 32.03% (n = 123) with combination of hormonal and chemotherapy, (Goserelin, bicalutamide and docetaxel or paclitaxel), 15.69% (n = 60) with combination of radiotherapy and hormonal therapy and 2.6% (n = 11) with chemotherapy alone (Docetaxel). Conclusion: The study found high prevalence of prostate cancer among male patients, majority with high grade form and limited options of treatment. Frequent screening and awareness programs should be conducted to enable early detection to reduce its morbidity and mortality. Patient on treatment should be followed up to determine their response to treatments.
Open Journal of Epidemiology, Volume 12, pp 185-206; https://doi.org/10.4236/ojepi.2022.122016
Background: Despite the evidence about the increasing prevalence of dyslipidemia among adult obese Cameroonians, little is known about the Low-Density Lipoprotein (LDL) particles which influence lipid metabolism and affect cardiovascular status. The present study aims to assess the relationship between adiposity, LDL particles size and cardiovascular risk (CVR) among adult obese Cameroonians. Methods: A cross-sectional study was conducted from September 2015 to March 2016 on apparently healthy adults (n = 1006), aged 20 - 70 years and living in the West and North-West regions of Cameroon. Anthropometric measurements, blood pressure (BP), fasting blood glucose (FBG) and lipid profile markers were analyzed and LDL particle phenotypes (LDL phenotype A; LDL phenotype I; LDL phenotype B) were characterized using small, dense LDL-cholesterol (sdLDL-c) levels. Abdominal fat accumulation (AFA) was defined as waist circumference (WC) ≥ 88 cm (men) and ≥90 cm (women) and the CVR was assessed using Framingham score method. Results: In the overall population, 36.6% were overweight, 33.1% were obese and 69.1% were overweight/obese with AFA. The prevalence of LDL phenotype B was 19.8%, 37.5% and 42.8% respectively in normal-weight, overweight and obese. Among the obese, sdLDL and triglycerides levels correlated significantly with WC (r = 0.768; p < 0.05 and r = 0.768; p < 0.05 respectively) and body mass index (BMI) (r = 0.895; p < 0.01 and r = 0.676; p < 0.01 respectively). The risk of having LDL phenotype B in overweight/obese patients with higher CVR was three times greater in overweight/obese patients with AFA (OR: 3.1; CI 95% (0.8 - 9.1); p = 0.007) as compared to those without AFA (OR: 1.6; CI 95% (0.8 - 2.9); p = 0.021). Conclusion: Among obese Cameroonians, anthropometric markers of adiposity (BMI and WC) were strongly correlated to LDL phenotype B which was associated with high CVR dependently of AFA. SdLDL particles could exacerbate the CVR in obese Cameroonians subjects.
Open Journal of Epidemiology, Volume 12, pp 221-230; https://doi.org/10.4236/ojepi.2022.123018
Background: Cardiovascular diseases (CVDs) are the leading cause of death globally. An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke. Over three quarters of CVD deaths take place in low- and middle-income countries. We have studied the pattern of mortality due to cardiovascular in the six countries of the Arabian Gulf and its association with obesity over the 29 years 1990 to 2019. Methods: We used the linear mixed effect models to investigate the pattern of CVD mortality over the year 1990 to 2019, together with the pattern of change in one of the most important risk factors that is obesity, and its association with CVD mortality over the same period. Conclusions: Although there were fluctuations in the pattern of mortality and the prevalence of obesity over the specified period, there has been a steady decline in the per-100,000 number of deaths and the prevalence of obesity. However, there was a strong association between the two variables. From the fitted models we estimated that a one percent increase in obesity is associated with an average increase in cardiovascular deaths of 2.7 deaths per 100,000.
Open Journal of Epidemiology, Volume 12, pp 68-74; https://doi.org/10.4236/ojepi.2022.121006
Introduction: The incidence of bladder cancer in women has steadily increased in recent years. The objective of our work is to study the epidemiological profile of bladder cancer in women in our population and the factors favoring its occurrence. Methods: This is a retrospective study carried out at the Mohamed Center VI for cancer treatment, involving 27 women during a two-year period from January 2019 to December 2020. We studied the epidemiological characteristics in these patients, the risk factors and the revealing symptoms. Results: The average age of patients was 67.5 years old and 66.66% of the patients were over 65 years old. One patient had in her antecedents a tumor of the upper excretory tract and 2 patients had an associated renal tumor. The notion of smoking was found in 3 patients. The time to treatment was less than 6 months in 44.4% of cases, between 6 and 12 months in 18.5% of cases, and more than a year in 37% of cases. The symptoms were marked by hematuria in 96.3% of cases, and irritative disorders in 81.4% of cases. In our series; the tumor was unifocal in 77.77% of the cases, and multifocal in the remainder of the cases. Urethrohydronephrosis was found in 74% of cases. Histologically, it was an urothelial carcinoma in 81.48% of cases. The tumor was locally advanced in 11.11% of cases, and metastatic in 11.11% of cases. Lymph node involvement was found in 33.33% of cases. 48.1% of cases underwent surgery. The operative procedure consisted of a partial cystectomy in 46.1% of cases, and only 18.5% was suitable for trimodal treatment. Conclusion: Few studies have addressed the epidemiology of bladder cancer in women due to the low incidence, but it is currently increasing steadily in recent years. These modifications are explained by the change in social habits in women.
Open Journal of Epidemiology, Volume 12, pp 134-145; https://doi.org/10.4236/ojepi.2022.122012
Background: Discontinuation remains a legitimate threat to the long-term success of antiretroviral therapy (ART) scale-up in Zimbabwe. Furthermore, the characteristics associated with ART discontinuation and trends are poorly understood in developing countries like Zimbabwe. We analysed the HIV/AIDS data to describe the characteristics associated with ART discontinuation and the trends from 2015 to 2019. Methods: We conducted an analytical cross- sectional study using secondary data from Electronic Patient Management System (ePMS) in Kadoma City. We interviewed eighteen health care workers to find the reasons for ART discontinuation. Data were analysed using Microsoft Office Excel 2016 and Epi info 7 version 126.96.36.199. Microsoft office excel was used to generate linear graphs to demonstrate the trends in ART discontinuation in Kadoma City in 2015-2019. Epi info 7 was used to generate frequencies, means, prevalence odds ratios p-values, and 95% confidence intervals (CI) and significance testing. Backward stepwise logistic regression analysis was done to determine the independent factors associated with discontinuation. Results: A total number of 2833 patients were enrolled on ART from 2015 to 2019. One hundred and seventy-three 173/2833 (6.1%) discontinued ART, 415/2833 (14.7%) transferred out, 69/2833 (2.4%) died and 2176/2833 (76.8%) were retained on ART. Out of those who discontinued ART, sixty-five percent (112/173) were females. Approximately two-thirds had immunological failure 110/173 (64%). The trend in ART discontinuation decreased over the years but was not statistically significant (R2 = 0.57, p > 0.05). ART discontinuation was independently associated with being <40 years of age (adjusted pOR = 2.3, [95% CI: 1.6 - 3.2], p = 0.001), having never attended school (adjusted pOR = 3.9, [95% CI: 2.5 - 6.0], p = 0.003) and having immunological failure (adjusted pOR = 6.2, [95% CI: 4.5 - 8.6], p = 0.0001). The reasons mentioned by the health care workers which cause people living with HIV (PLHIV) to discontinue ART were health state not improving 13/18 (72.2%), participating in artisanal mining activities 11/18 (61.1%), change in marital status 9/18 (50.0%), medical side effects of ART 8/18 (44.4%), living far from health facilities 5/18 (27.8%) and relocating to neighbouring countries 3/18 (16.7%). Conclusion: We concluded that the characteristics associated with ART discontinuation were having never attended school, being less than forty years of age and having immunological failure. The reasons why patients discontinue ART were health state not improving, participating in artisanal mining activities, change in marital status, medical side effects of ART, living far from health facilities, and relocating to neighbouring countries. We recommended continuous provision of health education, enhanced adherence counselling sessions to those with unsuppressed viral loads and investigating the cause of virologic failure.
Open Journal of Epidemiology, Volume 12, pp 107-124; https://doi.org/10.4236/ojepi.2022.122010
Background: In 2017, 900 million people in the world did not have sustainable access to safe drinking water (SDW). In addition, between 2016 and 2020, the global population with safely managed drinking water at home increased from 70 percent to 74 percent. Drinking water insecurity is the daily situation of people in developing countries. The lack of SDW supply is at the root of many diseases, including diarrheal diseases. Kassouala is a village in the municipality of Tchaourou without access to SDW, but having benefited from the drilling of a well in September 2018. The objective of this study was to study the effect of access to safe drinking water on the frequency of diarrheal diseases in Kassouala between January 2018 and July 2019. Methods: We conducted a quasi-experimental study in Kassouala using the natural experiments of the village of Bérétou as a control group for estimating the effect of a causal nature. There were double temporal (January 2018-July 2019) and geographical (Kassouala-Bérétou) comparisons based on data collected from health care registers. A population-based comparability survey of the two villages was conducted among 170 households in each village (experimental village, control village). A two-stage cluster sampling procedure was used to select the survey participants. Data were collected from heads of household by semi-structured questionnaire. We used Pearson or Mantel-Haenszel chi-square tests, as appropriate, and the “difference-in-difference” method to assess the effect. Results: In Kassouala, the proportion of households with access to safe drinking water had increased to 78.88%, whereas it was nil in 2018 before the well drilling, and the frequency of diarrheal diseases decreased significantly from January 2018 before drilling to July 2019 after drilling (57.11% to 44.64%; p < 0.0001). In Bétérou, on the other hand, a control village, used as counterfactual village, a significant increase was noted (31.48% vs. 50%; p < 0.0001). The difference-in-difference was estimated at -30.99% with a degree of statistical significance estimated at p < 0.0001 accounting for the decrease in the frequency of diarrhea in Kassoula relates to SDW accessibility to the population due to the drilling of the well. Conclusion: Access to safe drinking water in Kassouala has a causal effect on the reduction of diarrheal diseases. However, for the supply of drinking water to be integrated into the community development plan of Tchaourou, it is necessary to support the scaling up of this intervention, which would be considered as a pilot, of a community participation program.