Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-07-11T22:47:49Z No. of bitstreams: 1 Vers?o final Disserta??o RENATA com Ficha Catalogr?fica (2).pdf: 2528833 bytes, checksum: fa01f07b02b6ab95d9e09ead2c6b3048 (MD5) / Made available in DSpace on 2016-07-11T22:47:49Z (GMT). No. of bitstreams: 1 Vers?o final Disserta??o RENATA com Ficha Catalogr?fica (2).pdf: 2528833 bytes, checksum: fa01f07b02b6ab95d9e09ead2c6b3048 (MD5) Previous issue date: 2015-03-31 / During pregnancy, the occurrence of anemia is high due to the physiological changes to which a woman's body is subjected during fetal development. Even before the institution of the treatment protocol that the Ministry of Health recommended, the maintenance of high levels of prevalence of anemia during pregnancy was observed. Other causal factors still unknown, beyond those already investigated classics, are possibly contributing to this occurrence. OBJECTIVE: To identify socioeconomic, demographic, nutritional, and gynecological-obstetric factors associated with anemia as well as estimate the frequency of different types and levels of severity of anemia in pregnant women. METHOD: This is a cross-sectional study conducted with pregnant women who received prenatal care in the Family Health Units in Santo Ant?nio de Jesus in Bahia. Patients were classified as being diagnosed with anemia or not, according to the World Health Organization (WHO) criteria that consider the value of hemoglobin less than 11 g / dL. Was also performed to diagnose the types of anemia (pernicious, chronic disease, and iron deficiency) and assessment of the severity of anemia (mild, moderate, and severe). Data collection included the application of a questionnaire in which socioeconomic and demographic information was obtained along with reproductive and pregnancy information, and blood collection was also completed for the determination of haematological parameters. Data were analyzed using Stata, version 11, in which the frequency of different types of anemia was estimated and the association between the studied variables and the presence of anemia was assessed by estimating the prevalence ratio (PR), with its respective confidence interval (CI) of 95% and statistical significance level of 5%. RESULTS: They are presented in a scientific paper, "Determinants of Anemia in Pregnant Women Using the Health Family Program," to be submitted to the Portuguese Journal of Public Health. The final sample consisted of 349 pregnant women, and after the regression analysis model was used, the prevalence ratios?both as adjusted gross?found no statistically significant association between the selected features and the main outcome. The prevalence of anemia in the study sample was 22.64%, classified as moderate in Portuguese Journal of Public Health. CONCLUSIONS: No association was found between the investigated factors and anemia. In addition, the most common form of the disease was the anemia of chronic disease, with there being a low prevalence of iron deficiency anemia. Thus, the need exists to investigate other factors besides iron deficiency as well as examine therapeutic strategies targeting anemia in pregnant women, which are more effective than those existing in the health actions aimed at this group. / Durante o per?odo gestacional, a ocorr?ncia da anemia ? alta devido ?s altera??es fisiol?gicas que o corpo da mulher ? submetido para o desenvolvimento fetal. Mesmo diante do protocolo terap?utico preconizado pelo Minist?rio da Sa?de, a manuten??o de n?veis de preval?ncia elevados da anemia durante a gesta??o tem sido observada. Possivelmente, outros fatores causais ainda desconhecidos, al?m daqueles cl?ssicos j? investigados, est?o contribuindo para esta ocorr?ncia. OBJETIVO: Identificar os fatores socioecon?micos, demogr?ficos, nutricionais e gineco-obst?tricos associados ? ocorr?ncia de anemia, al?m de estimar a frequ?ncia de diferentes tipos e gravidade de anemia em gestantes. M?TODO: Trata-se de um estudo de corte transversal desenvolvido com gestantes que realizavam acompanhamento pr?-natal em Unidades de Sa?de da Fam?lia no munic?pio de Santo Ant?nio de Jesus, na Bahia. As gestantes foram classificadas com o diagn?stico de anemia ou n?o, de acordo com o crit?rio da OMS que considera o valor da hemoglobina menor que 11 g/dL. Foi tamb?m realizado o diagn?stico para tipos de anemia (perniciosa, de doen?a cr?nica e ferropriva), al?m de avalia??o da gravidade de anemia (leve, moderada e grave). A coleta de dados compreendeu a aplica??o de um question?rio em que foram obtidas informa??es socioecon?mico-demogr?ficas, reprodutivas e gestacionais, assim como a coleta de sangue para dosagem dos par?metros hematol?gicos. Os dados foram analisados no programa Stata, vers?o 11, no qual a frequ?ncia dos diferentes tipos de anemia foi estimada e a associa??o entre as vari?veis estudadas e a presen?a de anemia foi avaliada por meio da estimativa da raz?o de preval?ncia (RP), com seu respectivo intervalo de confian?a (IC) a 95% e n?vel de signific?ncia estat?stica de 5%. RESULTADOS: Est?o apresentados em forma de artigo cient?fico: ?Determinantes da anemia em gestantes usu?rias do Programa de Sa?de da Fam?lia?, a ser submetido ? Revista Portuguesa de Sa?de P?blica. A amostra final foi composta de 349 gestantes e ap?s a realiza??o do modelo de an?lise de regress?o, as raz?es de preval?ncia tanto bruta quanto ajustada n?o encontraram associa??o estatisticamente significante entre as caracter?sticas selecionadas e o desfecho principal. A preval?ncia de anemia, na amostra estudada foi de 22,64%, classificada como moderada em Sa?de P?blica. CONCLUS?ES: N?o foi detectada associa??o entre os fatores investigados e a anemia. Al?m disso, a forma mais frequente da enfermidade foi a anemia de doen?a cr?nica, sendo baixa preval?ncia de anemia ferropriva, havendo assim, a necessidade de investigar outros fatores, para al?m da car?ncia de ferro, visando estrat?gias terap?uticas de anemia em gestantes mais efetivas que as vigentes nas a??es de sa?de destinadas a esse grupo.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-07-14T23:59:58Z No. of bitstreams: 1 Disserta??o Luciana Carneiro de Oliveira (1).pdf: 1315236 bytes, checksum: dbc38b310d1db68fee1ca38f0df7001c (MD5) / Made available in DSpace on 2016-07-14T23:59:58Z (GMT). No. of bitstreams: 1 Disserta??o Luciana Carneiro de Oliveira (1).pdf: 1315236 bytes, checksum: dbc38b310d1db68fee1ca38f0df7001c (MD5) Previous issue date: 2014-03-21 / Overweight is characterized by the accumulation of body above the recommended values and acceptable fat, and today has ceased to be considered an individual problem and last to be treated as a major public health problem affecting both developed and developing countries Although there are reliable and current population information on the characterization of the anthropometric status in adults , referring to regions of the country , few cities have such information from population-based studies . Objective: To describe the prevalence of overweight in adults enrolled in the Family Health Program (FHP) in S?o Francisco do Conde, Bahia, according to sociodemographic, and lifestyle variables . Methods: Epidemiological study of secondary cross-section of a Research and Extension Proposal for Health Surveillance for the detection of minor psychiatric disorders and hypertension in S?o Francisco do Conde, Bahia, 2010. Research conducted with a random sample of individuals aged over 18 years, registered at the Family Health Program. Data were collected through home visits by students of Medicine, State University of Feira de Santana, which form applied previously tested and have carried out measurement of physical parameters (weight, height and waist circunferencia) of the participants . Data were processed and analyzed using the Epi Data 3.1 and SPSS 9.0 (SSAEE / DAS / UEFS). Results: The prevalence of overweight was 58.1 % . Higher in females, among married individuals , among those who reported having more than three children , among those who reported being ex - smokers and self-reported hypertension . Conclusion: The results of this study showed high prevalence of overweight in S?o Francisco do Conde in adults of both sexes , especially in females which justifies the adoption of specific actions aimed at reducing this problem. / O excesso de peso ? caracterizado pelo ac?mulo de gordura corporal acima dos valores recomendados e aceit?veis, sendo considerado na atualidade um importante problema de sa?de p?blica que tem atingindo tanto pa?ses desenvolvidos como os em desenvolvimento. Embora existam informa??es populacionais confi?veis e atuais sobre a caracteriza??o do estado antropom?trico em adultos no Brasil, poucos munic?pios disp?em dessas informa??es a partir de estudos de base populacional. Objetivo: Descrever a preval?ncia do excesso de peso em adultos cadastrados no Programa de Sa?de da Fam?lia (PSF) do munic?pio de S?o Francisco do Conde, Bahia, segundo vari?veis sociodemogr?ficas e h?bitos de vida. Metodologia: Estudo epidemiol?gico de corte transversal derivado do Projeto de Pesquisa e Extens?o Proposta de Vigil?ncia ? Sa?de para a detec??o de dist?rbios ps?quicos menores e hipertens?o arterial em S?o Francisco do Conde-Bahia, 2010. Pesquisa realizada com amostra aleat?ria de indiv?duos com idade igual ou superior a 18 anos, cadastrados ao Programa de Sa?de da Fam?lia. Os dados foram coletados atrav?s de visitas domiciliares realizadas por estudantes do curso de Medicina da Universidade Estadual de Feira de Santana, que aplicaram formul?rio previamente testado e procederam a aferi??o de medidas antropom?tricas (peso, estatura e circunfer?ncia da cintura) dos participantes. Os dados foram processados e analisados utilizando-se os programas Epi Data 3.1 e SPSS 9.0 (SSAEE/DAS/UEFS). Resultados: A preval?ncia de excesso de peso classificado pelo o ?ndice de Massa Corp?rea (IMC) foi de 58,1%. Estiveram associados com o excesso de peso as vari?veis sexo, idade, situa??o conjugal e n?mero de filhos. Conclus?o: Os resultados do presente estudo evidenciaram alta preval?ncia de excesso de peso em adultos de ambos os sexos no munic?pio de S?o Francisco do Conde, o que justifica a ado??o de a??es espec?ficas que visem a redu??o desse problema.

Perante a importância do Programa Nacional de Controle Erradicação da Brucelose e Tuberculose (PNCEBT) para as cadeias produtivas de carne e leite, para os consumidores de produtos de origem animal, para a imagem que o país projeta nos mercados mundiais e tendo em vista os altos custos inerentes aos procedimentos necessários para se atingir os objetivos do programa, faz-se necessária à realização de estudos que visem elucidar a situação epidemiológica da brucelose no plantel bovino nacional, incluindo-se o rebanho rondoniense, objetivando-se a escolha de condutas e estratégias adequadas e criação de um mecanismo racional de verificação da efetividade das ações implementadas em cada região produtora. Como conseqüência, foi composta uma parceria envolvendo o Ministério da Agricultura, Pecuária e Abastecimento (MAPA) e o Departamento de Medicina Veterinária Preventiva e Saúde Animal da FMVZ-USP para promover a condução de estudos soroepidemiológicos nos Estados. O Estado de Rondônia foi dividido em três regiões homogêneas (circuitos produtores de bovinos), as quais foram caracterizadas epidemiologicamente e onde foram realizados estudos de prevalência. Os resultados indicaram uma prevalência aparente de 34,57% [31,49; 37,65], sendo a prevalência aparente por circuito: circuito 1, 41,48% [35,95; 47,18], no circuito 2, 31,70% [26,52; 37,24] e no circuito 3, 31,61% [26,47; 37,11].A prevalência de fêmeas com idade igual ou superior a 24 meses soropositivas no Estado foi de 6,22% [4,88-7,56]. A prevalência de fêmeas com idade igual ou superior a 24 meses soropositivas por circuito foi: circuito 1 8,33% [5,90-10,76%], circuito 2, 5,95% [4,30-7,61%], circuito 3, 4,60% [2,54-6,65%]. A alta prevalência dos focos apresenta-se distribuída de maneira homogênea entre os circuitos. Os fatores de risco associados à condição de foco foram: histórico de aborto OR= 1,42 [1,04-1,95] e exploração de corte OR= 1,75 [1,30-2,38]. Faz-se importante ressaltar que o presente estudo é inédito para a Unidade Federativa e o conhecimento da situação inicial permitirá acompanhar o andamento do Programa Nacional de Controle e Erradicação da Brucelose e Tuberculose (PNCEBT) e julgar a necessidade de promover correções, evitando o desperdício de tempo e recursos. / Given the importance of the National Program for Control Eradication of Brucellosis and Tuberculosis (PNCEBT) for the production chains of meat and milk to consumers of products of animal origin, for the image that the country designs on world markets and in view of the high costs related to the procedures necessary to achieve the objectives of the program, it is necessary for studies designed to clarify the epidemiological situation of brucellosis in cattle national squad, including the herd Rondoniense, aiming to be the choice of pipelines and strategies creation of an appropriate and rational mechanism for verifying the effectiveness of actions implemented in each producing region. As a result, a partnership was formed involving the Ministry of Agriculture, Livestock and Supply (MAPA) and the Department of Preventive Veterinary Medicine and Animal Health of FMVZ-USP.O State of Rondonia was divided into three homogeneous regions (circuit producers of cattle) which were characterized and where epidemiological studies have been performed prevalence. Os results indicated an apparent prevalence of 34,57% [31,49,- 37,65] and the prevalence of apparent circuit: circuit 1, 41,48% [35,95; -47,18] in circuit 2, 31,70% [26,52, -37,24] and the circuit 3, 31.61% [26.47, -37.11]. The prevalence of females aged more than 24 months seropositive in the state was 6,22% [4, 88-7, 56]. The prevalence of females aged more than 24 months was seropositive for circuit: circuit 1 8.33% [5,90-10,76%], circuit 2, 5,95% [4,30-7,61% ], circuit 3, 4,60% [2,54-6,65%]. The high prevalence of outbreaks appears to be distributed uniformly between the circuits. The risk factors associated with the condition of focus were: a history of abortion [OR = 1.42, (1,04-1,95)] and exploration of cutting [OR = 1.75, (1,30-2,38 ). It is important to note that this study is unprecedented for the Federal Unit and a knowledge of the initial situation will monitor the progress of the National Program for Control and Eradication of Brucellosis and Tuberculosis (PNCEBT) and judge the need to promote correction, avoiding the waste of time and resources.

Thesis (M.A.(Social Work)) -- University of Limpopo, 2019 / Alcohol consumption by young people continues to be a social problem that is associated with major health complications later in life. More youth engage in alcohol consumption frequently with a decreasing age of debut. The current study aimed at exploring and describing the prevalence, patterns and context of youth alcohol consumption in Musina Town, Limpopo Province. A convergence mixed method was employed. This was complemented by an exploratory-descriptive design. Using random stratified and purposive sampling techniques, data was collected from grade 11 learners by way of a survey and a focus group discussion. Data collected from the study show that there is a high prevalence of alcohol use amongst the youth in Musina as almost two thirds (61%) of the survey participants reported to be current alcohol users. Patterns of consumption include drinking during weekends and holidays with binge drinking and drinking until drunkenness being the main forms of alcohol consumption. There was no difference in binge drinking between male and female alcohol drinkers, with 22% of each gender reporting to consume more than five drinks a session. Contexts of alcohol consumption by the youth include drinking at various social gatherings, school, at home, unlicensed liquor outlets, drinking to have fun or as a coping mechanism. Young alcohol consumers have little to no concern about their drinking behaviour, which is exacerbated by alcohol drinking permissive culture and the availability of alcohol. Keywords: Youth, Alcohol consumption, Prevalence, Patterns, Availability

Internet technology has paved new diversion in crime and victimization. There is voluminous data related to cyber victimization of adolescents and college students, however there is dearth of research related to cyber victimization of adult women. The purpose of this systematic review was to investigate the prevalence of cyber victimization of adult women other than by intimate partner or ex-partner and to find out their risk factors as well as consequences. Articles were searched between January, 2010 to April, 2020 from ProQuest, PsycInfo, CINAHL, Web of Science, JSTOR, ASSIA and PubMed databases. A total of 2988 studies were extracted, after initial screening, 275 were left for full text review. A total of 14 studies were finally reviewed and qualitatively assessed according to Standard quality assessment criteria for evaluating primary research papers (Kmet et al., 2004). Three were discarded for not meeting the desired quality rating of > .75. Review comprised of multiethnic and multinational sample of 6019 participants, aged between 17 to 68yrs. Results revealed that women are cyber victimized more as compared to males especially sexual victimization is more prevalent among women than men. The important risk factors identified are age, sexual orientation, lack of social support, low self-esteem, control imbalance, opportunity and risky behaviors. Due to cyber victimization emotional distress, pathological ruminations and depression are reported as consequence.

Intimate partner violence (IPV) is an important social problem, but historically the scientific research has focused mostly on the female victims. Several reviews exist on female victims, but no on male victims. The prevalence rates presented in the literature are very heterogeneous, which has been explained by variations in methodology, a lack of a clear recognized definition and a missing golden standard. This thesis reviews prevalence rates in studies on IPV with a male victim, and answers the following questions; (1) What are the total prevalence rates in relation to the different study characteristics and do we see any significant differences within these characteristics? (2) How does the definition of intimate partner violence and study characteristics affect the prevalence rate? (3) What type of relationship do we see between the quality of studies and prevalence rate?A systematic review has been carried out resulting in 49 relevant studies on male victims of IPV. The data from these 49 studies have been extracted based on the operationalization of “definition” in categories of type of violence, type of instrument and number of survey questions and in the operationalization of study quality based on a quality index by Looney et al. (2000). A students t-test and linear regression models was conducted to answer the research questions. This study finds that men are more often victims of psychological violence than physical violence, which is in contrast to female victims. The study also finds that the introduction of each of the definition-variables results in higher prevalence rates. This indicates, that factors related to the definition are important elements in the study of IPV prevalence in male victims.

VERS UNE MODELISATION DE L’INCONTINENCE URINAIRE DES FEMMES Introduction : L’objectif principal était de mieux comprendre l’histoire naturelle de l’incontinence urinaire (IU) féminine grâce à une modélisation de sa prévalence sur ses facteurs de risque, en tenant compte de sa gravité et de ses types. Un objectif secondaire était de travailler sur la classification des circonstances des fuites urinaires.Matériel et méthodes : Nous avons utilisé les données de deux sondages téléphoniques sur une population représentative, Le Baromètre Santé 2010 (3089) et Fecond (5017) ; de deux enquêtes postales au sein de la cohorte GAZEL (3098), l’une générale et l’autre centrée sur les problèmes urinaires ; et enfin d’un sondage internet de volontaires adultes, NutriNet-Santé (85037). L’IU a été définie à partir d'un questionnaire validé, l’ICIQ-UI-SF et à partir d’une liste de problèmes de santé. Nous avons utilisé des modèles binomiaux et multinomiaux de régression logistique, des analyses de correspondances multiples et de classification ascendante hiérarchique.Résultats : La prévalence de l’IU tout venant (quel que soit son type ou sa gravité) variait de 1,5 % à 38,8 % selon les enquêtes et était égale à 17,3 % dans les 2 échantillons représentatifs. La conception de l’enquête, c’est-à-dire la nature de l’échantillon (représentatif ou non), son objectif (centré sur la santé générale ou l’IU), le mode de recueil des données et la mode de définition de l’IU (à partir d’un questionnaire spécifique validé ou basée sur une liste de maladies) étaient susceptibles de modifier à la hausse ou à la baisse les estimations de la prévalence de l’IU.Les fuites les plus fréquentes étaient les fuites à la toux, les fuites avant d’arriver aux toilettes et les fuites lors de l’exercice physique. Les femmes décrivant des circonstances attribuées aux principaux types d’IU, effort, par urgenturie et mixte, formaient un groupe distinct de celles déclarant des circonstances attribuées au type IU autre. De même, les femmes déclarant des circonstances attribuables à une IU d’effort se démarquaient de celles déclarant des circonstances attribuables à une IU par urgenturie. Les circonstances les plus discriminantes pour classer les femmes incontinentes étaient : fuites tout le temps, à la toux, pendant le sommeil et après la miction. Dans toutes les enquêtes nous avons identifié des associations significatives entre presque tous les facteurs de risque disponibles et l’incontinence ; mais certains facteurs étaient liés avec toutes les formes d’IU et d’autres seulement avec certaines formes. De plus nombreuses associations ont été observées avec l’IU grave, c’est-à-dire quotidienne, qu’avec l’IU hebdomadaire. Nous avons observé plus d’associations significatives avec l’IU mixte et l’IU autre qu’avec l’IU d’effort et l’IU par urgenturie. Les plus fortes associations ont été observées pour la dépression et l’obésité, liées avec presque toutes les formes d’IU. Les variables obstétricales étaient souvent liées à l’IU mixte. Conclusion : Le questionnaire ICIQ-UI-SF est approprié pour estimer la prévalence de l’incontinence urinaire dans des échantillons représentatifs mais il apparaît insuffisant pour définir tous les types d’IU. Nos résultats ont objectivé qu’il est possible d’utiliser les circonstances des fuites d’urine pour identifier des groupes spécifiques de femmes incontinentes, et que certaines circonstances peu utilisées en cliniques sont pourtant très discriminantes. Il y a probablement des travaux à faire et à poursuivre pour explorer dans quelle mesure les circonstances des fuites ont une valeur pronostique ou prédictive de réponse au traitement. Grâce à la modélisation, où nous avons pris en compte le type et la gravité de l’IU, nous avons pu constater quelles modalités de l’IU sont liées à certains facteurs de risque et quelles modalités ne le sont pas. / TOWARDS A MODELLING OF FEMALE URINARY INCONTINENCE Introduction: The main objective was to better understand the natural history of the female urinary incontinence (UI) through modelling of its prevalence by risk factors, while taking into account its severity and its type. A secondary objective was to work on the classification of the circumstances of urinary leakage.Methods: Data came from two telephone surveys of a representative population, The Health Barometer 2010 and Fecond; two mail surveys within the cohort GAZEL, one general and the other centred on urinary problems; and an Internet survey of adult volunteers, NutriNet-Health. We defined UI from a validated questionnaire, the ICIQ-UI-SF, and from a list of diseases. We used binomial and multinomial logistic regression models, multiple correspondence analysis and hierarchical clustering.Results: The prevalence of any UI ranged from 1.5% to 38.8%. In both representative samples it was 17.3%. The design of the survey, i.e. the sampling (representative or not), its objective (centred on general health or UI-centred), the data collection mode and UI definition (symptom-based or perception-based) were likely to change either upwards or downwards the estimates of the prevalence of UI.The most frequent circumstances were leaks during coughing, leakage before getting to the toilet and leaks during physical exercise. Women describing circumstances attributable to stress, urge or mixed types of incontinence formed a separate group from those reporting leakage circumstances attributable to other UI. Similarly, women declaring circumstances attributable to stress UI stood out from those declaring circumstances attributable to urge UI. The most discriminating circumstances to classify incontinent women were: leaks all the time, leaks during coughing, leaks during sleep and leaks after urination.In all the surveys included in our work we have identified significant associations between almost all available risk factors and incontinence, but some factors were associated with all forms of incontinence and others only with few forms. In addition, more associations were observed with severe UI (i.e. daily UI), than with weekly UI. Among UI types, we observed more significant associations with mixed UI and other UI than with stress and urge UI. The strongest associations were found for depression and obesity with almost all forms of UI. Obstetric variables were often associated with mixed UI.Conclusion: Precise estimates of UI prevalence should be based on non–UI-focused surveys among representative samples and using a validated standardised symptom-based questionnaire, as ICIQ-UI-SF, but it appears to be insufficient to define all types of UI. We found that it is possible to use the circumstances of urine leaks for identifying specific groups of incontinent women. But we need to explore to what extent the circumstances of urinary leakage have prognostic or predictive value for response to treatment. With modelling, as we took into account UI type and severity, we identified which UI modalities are related to certain risk factors and which are not.

Background: Diabetes is the seventh leading cause of death in the United States. More and more people have suffered from diabetes and its serious complications including heart disease, blindness, etc. The U.S. Department of Veterans Affairs (VA) reported that nearly 25% of veterans, enrolled in the Veterans Health Administration (VHA),have diabetes, which is much higher than the general population. Objective: This study aimed to estimate the prevalence of diabetes in the U.S. veterans using the up-to-date National Health and Nutrition Examination Survey (NHANES) data since VHA has a relatively low coverage (less than 30% of veterans each year were enrolled). Methods: Five biennial cross sectional surveys (NHANES) from 2005-2014 were used in this study. Total 2,940 veterans were included to estimate the prevalence of diabetes. Total diabetes was defined as any participant who had at least one of four conditions: (1) a hemoglobin A1c at least 6.5%, (2) fasting plasma glucose (FPG) at least 126mg/dL, (3)a 2-hour plasma glucose (PG) at least 200mg/dL, (4) diagnosed with diabetes by a doctor or other health professional. Results: The overall prevalence of total diabetes(including diagnosed and undiagnosed diabetes), undiagnosed diabetes and obesity were 20.54%, 3.37% and 40.68%, respectively. The family poverty level and education were significantly associated with the presence of diabetes with p=0.005 and 0.03,respectively. Highest prevalence diabetes and obesity existed in veterans aged 65yrs and over and 45-64yrs, respectively. The overall prevalence trend of diabetes significantly increased from 15.52% (95%CI: 12.36-18.68%) in 2005-2006 to 20.54% (95%CI:15.92-25.17%) (p=0.04 for trend test) and prevalence significantly increased in male veterans (p=0.04) and those who did not finish high school education (p=0.04) and who had college education (p=0.03). Conclusion: In 2013-2014, the estimated prevalence of diabetes was 20.54% among U.S. veterans, with higher prevalence among participants who were 65 years old or older, and had low socioeconomic status (including less education and poverty status).

Background Malaria remains a serious epidemic threat in the Lowveld region of Mpumalanga Province. In order to appropriately target interventions to achieve substantial reductions in malaria morbidity and mortality, there is a need to assess the impact of current control interventions such as indoor residual spraying (IRS) for vector control. This study aimed to assess long-term changes in the burden of malaria in Mpumalanga Province during the past eight years (2001-2009) and whether IRS and climate variability had an effect on these changes. Methods All malaria cases and deaths notified to the Malaria Control Programme, Department of Health was reviewed for the period 2001 to 2009. Data were retrieved from the provincial Integrated Malaria Information System (IMIS) database. Climate and population data were obtained from the South Africa Weather Service and Statistics South Africa, respectively. Descriptive statistics were computed to determine any temporal changes in malaria morbidity and mortality. Autoregressive integrated moving average (ARIMA) models were developed to assess the effect of climatic factors on malaria. Results Within the eight-year period of the study, a total of 35,191 cases and 164 deaths-attributed to malaria were notified in Mpumalanga Province. There was a significant decrease in the incidence of malaria in Mpumalanga Province from 385 in 2001/02 to 50 cases per 100,000 population in 2008/09 (P < 0.005). The overall incidence and case fatality rates were 134 cases per 100,000 and 0.54%, respectively. Malaria incidence and case fatality rate by gender showed significant differences, higher in males than in L.M. Ngomane University of Pretoria, 2012 iv females (166.9 versus 106.4; P < 0.001; CFR 0.41% versus 0.55%). The incidence of malaria increased from age 5-14 years (70), reaching a peak at age 25-34 years (190), declining thereafter (50 in those >65 years). Mortality due to malaria was higher in those >65 years, the mean CFR reaching a 2.1% peak. Almost half (47.8%) of the notified cases originated from Mozambique and Mpumalanga Province itself constituted 50.1%. The distribution of malaria varied across the districts, highest in Ehlanzeni district (96.5%), lowest in Nkangala (<1%) and Gert Sibande (<1%). A notable decline in malaria case notification was observed following the increased IRS coverage from 2006/07 to 2008/09 malaria seasons. A distinct seasonal transmission pattern was found to be significantly related to changes in rainfall patterns (P = 0.007). Conclusion Decades of continuous IRS with insecticides have proved to be successful in reducing the burden of malaria morbidity and mortality in Mpumalanga Province between 2001 and 2009. A decline of above 50% in malaria morbidity and mortality was observed following expanded IRS coverage. These results highlight the need to continue with IRS together with other control strategies until interruption in local malaria transmission is completely achieved and alternative vector control strategies implemented. Efforts need to be directed towards the control of imported cases, interruption of local transmission and focus on research into sustainable and cost-effective combination of control interventions. / Dissertation (MSc)--University of Pretoria, 2012. / School of Health Systems and Public Health (SHSPH) / Unrestricted

Background and Objective: Suicide is a leading cause of death and a critical public health problem among adolescents worldwide. However, adolescent suicidal behaviour is a neglected public health issue, especially in low- and middle-income countries, such as Bangladesh. There is evidence from developed countries showing that suicidal ideation (SI) among adolescents is related to social indicators as well as individual risk factors. Scarce evidence from studies inlow- and middle-income countries suggests that social factors may influence adolescent SI. In Bangladesh, only a few studies have focused on the social determinants of suicide, and the present study is the first to examine the prevalence and social determinants of suicidal ideation among adolescents in rural Bangladesh. Therefore, the present thesis assessed the effects of socioeconomic status (SES) on adolescent SI. Methods: The present thesis is based on two studies, which used data from a cross-sectional survey conducted in 2013 among 2,476 adolescents aged 14-19 years selected randomly in arural community in Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district, an area surveyed within the Injury Prevention Program of the Centre for Injury Prevention and Research, Bangladesh (CIPRB). Study I estimated the prevalence of suicidal ideation among adolescents and investigated what factors were associated with suicidal ideation. Study II examined the relationship between parental socio-economic factors and suicidal thoughts among adolescents. Results: Study I showed that life time prevalence of suicidal ideation was 5% among adolescents. The majority of adolescents with suicidal ideation were female (67, 5.3%), unmarried (106, 5.5%) and students (86, 6.2%). Suicidal ideation was significantly associated with age, education, occupation and living with parents or others. Respondents aged 18-19 years, had a Secondary school certificate (SSC) and Higher Secondary school certificate (HSC) or higher, were day labourers, living without parent had odds ratios of 2.31 (CI 1.46-3.65), 2.38(CI 1.51-3.77), 4.15 (CI 2.41-7.14), .28 (CI 0.13-0.60) and 1.80 (CI 1.07-3.03), respectively. In study 2, results demonstrated that suicidal ideation was more common among adolescents with parents from the low-income group (5.5%). In addition, adolescent SI was found to be significantly associated with parental education, marital status and house ownership. Adolescents whose parents received an SSC or higher had an SI odds ratio of 2.10 (CI 1.21-3.64) and 1.92 (CI 1.15-3.23) for mothers and fathers respectively. Suicidal ideation among adolescents with single parents was higher with an odds ratio of 3.00 (CI 1.75-5.19) in comparison to adolescents who had both parents. Adolescents whose parents owned a house had an odds ratio of 0.14 (0.05, 0.35). Conclusion: The thesis found that the prevalence of lifetime suicidal ideation among adolescents is moderately high in a rural community of Bangladesh. Furthermore, it was observed that personal characteristics such as parental marital status, education and homeownership were statistically significantly associated with suicidal ideation among adolescentseven after adjusting for potential confounders.