Publications by authors named "Karl Peltzer"

420 Publications

Prevalence and Associated Factors of Self-rated Oral Health among a National Population-based Sample of Adults in Sudan: Results of the 2016 STEPS Survey.

Oral Health Prev Dent 2021 Jan;19(1):391-397

Purpose: To estimate the prevalence and correlates of self-rated oral health (SROH) among adults in a national population-based survey in Sudan.

Materials And Methods: Nationally representative data were analysed from the cross-sectional 2016 Sudan STEPS survey. In all, 7722 18- to 69-year-old individuals (median age 31 years) were assessed with questions on SROH, physical measurements, and medical conditions.

Results: The prevalence of poor SROH was 8.0%, with 12.4% among females and 4.4% among males. In multivariable logistic regression analysis, ages 50-69 years, higher household income, urban residence, pain in the teeth/mouth, impaired Oral Health Related Quality of Life, dental visit, having overweight or obesity and elevated total cholesterol were positively associated with poor SROH, and male sex, primary or less education and having 20 or more natural teeth were negatively associated with poor SROH. In addition, in the unadjusted analysis, having dentures, hypertension, diabetes, stroke, or heart attack were positively associated with SROH, and engaging in moderate or high physical activity were negatively associated with poor SROH.

Conclusions: Almost one in ten participants reported poor SROH. Several factors associated with poor SROH were found that can aid in designing programmes to improve SROH in Sudan.
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http://dx.doi.org/10.3290/j.ohpd.b1749751DOI Listing
January 2021

Associations of loneliness with poor physical health, poor mental health and health risk behaviours among a nationally representative community-dwelling sample of middle-aged and older adults in India.

Int J Geriatr Psychiatry 2021 Jul 2. Epub 2021 Jul 2.

Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa.

Objectives: Loneliness may negatively impact on health outcomes. The study aimed to estimate the associations between loneliness and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India.

Methods: The sample included 72,262 middle-aged and older adults from a cross-sectional national community-dwelling survey in India in 2017-2018.

Results: Results indicate that the prevalence of moderate loneliness was 20.5%, and severe loneliness was 13.3%. In the adjusted logistic regression analysis, moderate and/or severe loneliness was significantly positively associated with fair or poor self-rated health status, and significantly negatively associated with life satisfaction and cognitive functioning. Furthermore, loneliness was associated with stroke, angina, physical injury, difficulty of Activities of Daily Living, difficulties of Instrumental Activities of Daily Living and multi-morbidity. Loneliness increased the odds of major depressive disorder and insomnia symptoms. The associations between loneliness and current tobacco use and body mass index were negative and between loneliness and physical inactivity and underweight were positive.

Conclusions: Loneliness is associated with poor physical health, poor mental health and health risk behaviour (physical inactivity), emphasising the need to consider loneliness in various physical and mental health contexts.
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http://dx.doi.org/10.1002/gps.5592DOI Listing
July 2021

Multiple behavioural risk factors of non-communicable diseases among adolescents in four Caribbean countries: prevalence and correlates.

Int J Adolesc Med Health 2021 Jun 16. Epub 2021 Jun 16.

Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa.

Objectives: The study assessed the prevalence and associated factors of behavioural risk factors of non-communicable diseases (NCDs) among adolescents in four Caribbean countries.

Content: In all 9,143 adolescents (15 years = median age) participated in the cross-sectional "2016 Dominican Republic, 2016 Suriname, 2017 Jamaica, and 2017 Trinidad and Tobago Global School-Based Student Health Survey (GSHS)". Eight behavioural risk factors of NCDs were assessed by a self-administered questionnaire.

Summary: Prevalence of each behavioural NCD risk factor was physical inactivity (84.2%), inadequate fruit and vegetable intake (82.2%), leisure-time sedentary behaviour (49.6%), daily ≥2 soft drinks intake (46.8%), ever drunk (28.6%), twice or more days a week fast food consumption (27.6%), having overweight/obesity (27.4%), and current tobacco use (13.8%). Students had on average 3.6 (SD=1.4), and 79.0% had 3-8 behavioural NCD risk factors. In multivariable linear regression, psychological distress and older age increased the odds, and attending school and parental support decreased the odds of multiple behavioural NCD risk factors.

Outlook: A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered and several factors independently contributing to multiple behavioural NCD risk factors were identified.
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http://dx.doi.org/10.1515/ijamh-2021-0021DOI Listing
June 2021

Participants' Views on Lifestyle Intervention Program Enhancing Long-Term Health-Related Behaviors Improvement among Prehypertension and/or Prediabetes Mellitus Older Adults: A Qualitative Study Examined in Thailand at Health Promoting Hospitals.

Inquiry 2021 Jan-Dec;58:469580211025209

Faculty of Nursing, Thaksin University, Phatthalung Campus, Thailand.

This study aimed to investigate the view of prediabetes and prehypertension elderly patients living around temple on long-term self-management in proficient way underneath the lifestyle intervention program based on both focus-group discussion and In-depth interview methods to fill the gap in partially successful intervention. 62 participants were selected from 220 participants of the quantitative published study by 2 researchers. The triangulation method was used to put great emphasis on the consistency and the credibility of the results. Almost all of the participants had benefited from the program regarding proper foods, suitable exercise and an inspiration of lifestyle modification. They made changes of eating behavior and exercise behavior during program attendance, however, after the program had finished, they had minimal concern to take care of themselves. Nonetheless, more than half of them demonstrated some health-related behaviors changes due to they gave the value of the suggestion in different aspects. Moreover, high-frequency program attendance was not related to blood results improvement. The knowledge obtained from program intervention together with adequate contact between the patient and the program staff, personal problems solving, personal attitude, practice and acceptable played a key role for long-term lifestyle modification and completely successful intervention.
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http://dx.doi.org/10.1177/00469580211025209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207270PMC
June 2021

Male Partner Involvement and Development of HIV-exposed Infants in Rural South Africa.

AIDS Behav 2021 Jun 7. Epub 2021 Jun 7.

HIV/AIDS, STI and TB Research Programme, Human Sciences Research Council, Pretoria, South Africa.

Male partner involvement (MPI) during the prenatal and postnatal periods has been proven to have a beneficial effect on infant development. Infants born to HIV seropositive mothers with lacking or no prenatal and postnatal male partner support may be at a higher risk for adverse developmental outcomes. This study examined the effect of MPI on cognitive, communicative, fine, and gross motor development in 160 infants born to HIV seropositive mothers attending Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in rural South Africa. Results of the bivariate logistic regression showed that both prenatal (OR 1.13; 95% CI 1.01, 1.26; p < 0.05) and postnatal MPI (at 12 months) (1.19; 1.07, 1.31; p < 0.005) were associated with risk for delayed gross motor development in HIV exposed infants. Decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. Not living together with a male partner (2.01; 1.06, 3.80; p < 0.05) was significantly associated with risk for delayed cognitive development. In the multivariate logistic regression analysis, decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. On the other hand, postnatal MPI (1.30; 1.12, 1.50; p < 0.005) was associated with risk for delayed gross motor development among HIV exposed infants. Increased MPI can have beneficial effects on infants' cognitive development. Interventions in PMTCT programs should promote increased prenatal and postnatal MPI to improve cognitive development in HIV exposed infants.
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http://dx.doi.org/10.1007/s10461-021-03326-5DOI Listing
June 2021

Male Partner Involvement and Development of HIV-exposed Infants in Rural South Africa.

AIDS Behav 2021 Jun 7. Epub 2021 Jun 7.

HIV/AIDS, STI and TB Research Programme, Human Sciences Research Council, Pretoria, South Africa.

Male partner involvement (MPI) during the prenatal and postnatal periods has been proven to have a beneficial effect on infant development. Infants born to HIV seropositive mothers with lacking or no prenatal and postnatal male partner support may be at a higher risk for adverse developmental outcomes. This study examined the effect of MPI on cognitive, communicative, fine, and gross motor development in 160 infants born to HIV seropositive mothers attending Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in rural South Africa. Results of the bivariate logistic regression showed that both prenatal (OR 1.13; 95% CI 1.01, 1.26; p < 0.05) and postnatal MPI (at 12 months) (1.19; 1.07, 1.31; p < 0.005) were associated with risk for delayed gross motor development in HIV exposed infants. Decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. Not living together with a male partner (2.01; 1.06, 3.80; p < 0.05) was significantly associated with risk for delayed cognitive development. In the multivariate logistic regression analysis, decreased postnatal MPI (0.85; 0.75, 0.98; p < 0.05) was significantly associated with risk for delayed cognitive development. On the other hand, postnatal MPI (1.30; 1.12, 1.50; p < 0.005) was associated with risk for delayed gross motor development among HIV exposed infants. Increased MPI can have beneficial effects on infants' cognitive development. Interventions in PMTCT programs should promote increased prenatal and postnatal MPI to improve cognitive development in HIV exposed infants.
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http://dx.doi.org/10.1007/s10461-021-03326-5DOI Listing
June 2021

Underweight and overweight/obesity among adults in Afghanistan: prevalence and correlates from a national survey in 2018.

J Health Popul Nutr 2021 Jun 6;40(1):25. Epub 2021 Jun 6.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: The study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among adults in Afghanistan.

Methods: National cross-sectional survey data of 3779 persons aged 18-69 years were analysed. Multinomial logistic regression was used to estimate factors associated with underweight and overweight/obesity relative to normal weight.

Results: In all, 7.8% of the study sample was underweight (BMI < 18.5 kg/m), 49.5% had normal weight (BMI 18.5-24.9 kg/m), 25.5% overweight (25.0-29.9 kg/m), and 17.2% obesity. In adjusted multinomial logistic regression, factors negatively associated with underweight were male sex (adjusted relative risk ratio (ARRR): 0.30, 95% confidence interval (CI): 0.15-0.58) and hypertension (ARRR: 0.51, 95% CI: 0.27-0.95) and factors positively associated with underweight were sedentary behaviour (ARRR: 1.85, 95% CI: 1.11-3.10) and current tobacco use (ARRR: 2.58, 95% CI: 1.08-6.16). Factors positively associated with overweight/obesity were aged 30-44 years (ARRR: 2.00, CI: 1.51-2.66) and aged 45-69 years (ARRR: 1.58, CI: 1.09-2.31) (compared to 18-29 years) (ARRR: 1.28, CI: 1.14-2.18), hypertension (ARRR: 2.74, CI: 1.89-3.96), and type 2 diabetes (ARRR: 1.82, CI: 1.13-2.94), and high physical activity (ARRR: 0.70, CI: 0.50-0.98) was negatively associated with overweight/obesity.

Conclusion: Almost one in ten adult respondents were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in Afghanistan.
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http://dx.doi.org/10.1186/s41043-021-00251-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8180065PMC
June 2021

Ideal Cardiovascular Health in a Nationally Representative Population-Based Sample of Adults in Malawi.

Glob Heart 2021 Apr 20;16(1):24. Epub 2021 Apr 20.

Department of Psychology, University of the Free State, Bloemfontein, ZA.

Background: Ideal cardiovascular health (ICH) measures four ideal health behaviours (non-smoking, body mass index <25 kg/m, healthy diet, and physical activity) and three health factors (total cholesterol <200 mg/dL, blood pressure <120/<80 mmHg, and fasting blood glucose <100 mg/dL).

Objective: This study aimed to determine the prevalence, distribution, and correlates of ICH among adults in Malawi.

Methods: National cross-sectional survey data of 3,441 persons aged 18-69 years with complete ICH measurements in Malawi in 2017 were analysed.

Results: Almost one in ten (7.4%) of respondents had 0-2 ICH metric), 21.2% 3-4 ICH metrics, and 71.5% 5-7 ICH metrics). Only 3.3% had all seven ICH metrics, 15.3% had intermediate ICH (≥1 metric in the intermediate category and none in the poor category), and 81.5% poor ICH (≥1 metric in poor category). In adjusted logistic regression analysis, older age (50-69 years) (Adjusted Odds Ratio-AOR: 0.25, 95% Confidence Interval-CI: 0.17-0.36) and urban residence (AOR: 0.56, 95% CI: 0.40-0.78) were negatively associated with meeting 5-7 ICH metrics. In addition, in unadjusted analysis, higher education was positively associated with meeting 5-7 ICH metrics.

Conclusion: The proportion of meeting 5-7 ICH metrics was high in Malawian adults. Both high-risk and population-wide intervention programmes targeting older adults and urban residents should be implemented in aiding to improve cardiovascular health in Malawi.

Highlights: The proportion of meeting 5-7 ideal cardiovascular health (ICH) metrics was 71.5% in Malawian adults (18-69 years, median age 32 years).In a sub-group analysis (45-69 years, median age 55 years), 55.9% had 5-7 ideal ICH metrics.ICH was lower with increasing age and among urban residents.
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http://dx.doi.org/10.5334/gh.986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064282PMC
April 2021

Synchronous bone metastasis in lung cancer: retrospective study of a single center of 15,716 patients from Tianjin, China.

BMC Cancer 2021 May 26;21(1):613. Epub 2021 May 26.

Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.

Background: This study aimed to describe the incidence, clinical characteristics, and prognosis of lung cancer patients with synchronous bone metastasis (SBM) and to analyze the prognostic factors of the lung cancer patients with SBM.

Methods: A total of 15,716 lung cancer patients who were diagnosed between 2009 to 2018 in the Tianjin Medical University Cancer Institute and Hospital were retrospectively reviewed. Among them, patients with SBM were checked. Both the demographic and clinical characteristics were included as follows: age, gender, marital status, history of smoking, alcohol consumption, family history of tumor, Karnofsky score, lymph node metastasis, histological type. Besides, laboratory data such as alkaline phosphatase, lactate dehydrogenase, carcinoembryonic antigen, squamous cell carcinoma antigen, cytokeratin-19 fragment, and neuron specific enolase were also included. The log-rank test and multivariate Cox regression analysis were employed to reveal the potential prognostic predictors. A further analysis using the Kaplan-Meier was employed to demonstrate the difference on the prognosis of LC patients between adenocarcinoma and non-adenocarcinoma.

Results: Among the included patients, 2738 patients (17.42%) were diagnosed with SBM. A total of 938 patients (34.3%) with SBM were successfully followed and the median survival was 11.53 months (95%CI: 10.57-12.49 months), and the 1-, 2-, and 5-year overall survival rate was 51, 17, and 8%, respectively. Multivariable Cox regression results showed history of smoking and high level of NSE were associated with the poor prognosis, while adenocarcinoma histological type was associated with better survival.

Conclusion: The prevalence of SBM in lung cancer is relatively high with poor survival. The lung cancer patients with SBM showed diverse prognosis. Among all the pathological types, the division of adenocarcinoma suggested different prognosis of the lung cancer patients with SBM. The present study emphasized the importance of pathological diagnosis on prognostic determinants in lung cancer patients with SBM.
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http://dx.doi.org/10.1186/s12885-021-08379-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152068PMC
May 2021

Prevalence and Correlates of Dental Service Utilization among Adults in Solomon Islands.

J Int Soc Prev Community Dent 2021 Mar-Apr;11(2):166-172. Epub 2021 Apr 15.

Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa.

Aims And Objectives: The aim of this study was to assess dental service utilization (DSU) among adults in a Pacific Island country.

Materials And Methods: In a cross-sectional nationally representative survey in Solomon Islands, 2,533 individuals (18-69 years) responded to questions on DSU, sociodemographic and health information in 2015.

Results: More than half of the participants (55.3%) never had DSU, 36.4% had more than 12 months DSU, and 8.3% had past 12 months DSU. In adjusted multinomial logistic regression analysis, older age, ever screened for blood pressure, using toothpaste, and having had pain in teeth, gum, or mouth in the past year were associated with both >12 months and past 12 months DSU. Higher education, ever screened for cholesterol, being divorced, separated, or widowed, poor self-rated oral health (SROH), and experienced difficulty in chewing foods in the past 12 months were associated with >12 months or past 12 months DSU. High physical activity was negatively associated with >12 months DSU.

Conclusion: Less than one in ten participants had past 12 months DSU and several factors were found, which can be targeted in interventions.
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http://dx.doi.org/10.4103/jispcd.JISPCD_400_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118046PMC
April 2021

Prevalence and Correlates of Self-Reported Cardiovascular Diseases Among a Nationally Representative Population-Based Sample of Adults in Ecuador in 2018.

Vasc Health Risk Manag 2021 4;17:195-202. Epub 2021 May 4.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: This study aimed to determine the prevalence and correlates of self-reported cardiovascular diseases (SRCVDs) among adults in Ecuador.

Methods: National cross-sectional survey data of 4638 persons aged 18-69 years in Ecuador were analysed. Research data were collected with an interview-administered questionnaire, physical and biochemical measurements.

Results: The prevalence of SRCVDs was 8.7%, 8.5% among men and 8.9% among women. In adjusted logistic regression analysis, being Montubio (adjusted odds ratio-AOR: 1.66, 95% confidence interval-CI: 1.10-2.50), family alcohol problems (AOR: 1.78, 95% CI: 1.19-2.65), past smoking tobacco (AOR: 1.36, 95% CI: 1.02-1.81), and poor oral health status (AOR: 1.74, 95% CI: 1.19-2.54) were associated with SRCVD. In addition, in unadjusted analysis, older age, alcohol dependence, obesity, and having hypertension were associated with SRCVD.

Conclusion: Almost one in ten persons aged 18-69 years had SRCVD in Ecuador. Several associated factors, including Montubio by ethnicity, family alcohol problems, past smoking, and poor oral health status, were identified, which can be targeted in public health interventions.
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http://dx.doi.org/10.2147/VHRM.S299272DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106477PMC
June 2021

Ideal Cardiovascular Health Behaviours in Nationally Representative School-Based Samples of Adolescents in the Caribbean.

Vasc Health Risk Manag 2021 4;17:187-194. Epub 2021 May 4.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: Ideal cardiovascular health behaviour (CVHB) measures four ideal health behaviours (non-smoking, body mass index <85th Percentile, healthy diet, and physical activity). This study aimed to determine the prevalence, distribution, and correlates of ideal CVHB among adolescents in the Caribbean.

Methods: Nationally representative cross-sectional data of 2016 or 2017 with complete CVHB measurements were analysed from 7556 school adolescents from four Caribbean countries.

Results: The prevalence of 0-1 ideal metrics CVHB was 20.4%, 2 ideal metrics 48.7%, and 3-4 ideal metrics 30.8%. Only 5.0% had all 4 ideal CVHB metrics, 41.0% intermediate CVH (≥1 metric in the intermediate category and none in the poor category), and 54.0% had poor CVH (≥1 metric in poor category). In adjusted logistic regression analysis, compared to students from Dominican Republic, students from Jamaica (Adjusted Odds Ratio-AOR: 1.36, 95% confidence interval-CI: 1.01-1.85), students from Trinidad and Tobago (AOR: 1.46, 95% CI: 1.17-1.82) and male sex (AOR: 1.35, 95% CI: 1.11-1.64) were positively associated with meeting 3-4 ideal CVHB metrics. In addition, in unadjusted analysis, rarely or sometimes experiencing hunger was negatively and high peer and parent support were positively associated with meeting 3-4 ideal CVHB metrics.

Conclusion: The proportion of meeting 3-4 ideal CVHB metrics was low among adolescents in four Caribbean countries. Both high-risk and school-wide intervention programmes should be implemented in aiding to improve CVHB in Caribbean countries. Several factors associated with ideal CVHB were identified, which can be targeted in school health interventions.
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http://dx.doi.org/10.2147/VHRM.S302168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106475PMC
June 2021

Trends of 20 Health Risk Behaviours Among Adolescents in Morocco: Results of Three National Cross-Sectional School Surveys of 2006, 2010 and 2016.

Int J Gen Med 2021 30;14:1611-1619. Epub 2021 Apr 30.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: This study aimed to estimate the trends of 20 health risk behaviours among adolescents in Morocco.

Methods: Cross-sectional data from 13,109 adolescents (14 years median age) that took part in three waves (2006, 2010, and 2016) of the "Morocco Global School-Based Student Health Survey (GSHS)" were analysed.

Results: Among both boys and girls, five health risk behaviours (being physically attacked, annual injury, passive smoking, zero days walking or biking to school, and poor hand hygiene after toilet use) significantly declined over time, as well as among boys the involvement in physical fighting. Inadequate fruit intake and current tobacco use increased among both boys and girls over time, and among girls bullying victimization and among boys poor hand hygiene prior to eating increased over time.

Conclusion: More health risk behaviours decreased than increased in this study of three cross-sectional surveys over a period of 10 years. Additional school health promotion is needed.
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http://dx.doi.org/10.2147/IJGM.S283137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8096452PMC
April 2021

Overweight and Obesity among Adults in Iraq: Prevalence and Correlates from a National Survey in 2015.

Int J Environ Res Public Health 2021 04 15;18(8). Epub 2021 Apr 15.

Department of Psychology, University of the Free State, Bloemfontein 9300, South Africa.

This study aimed to estimate the prevalence and correlates of overweight and obesity among adults in Iraq. Data from a 2015 nationally representative cross-sectional survey of 3916 persons 18 years or older (M (median) age = 40 years, IQR (interquartile range) age = 29-52 years; men: M = 41 years, IQR = 29-54 years; women: M = 40 years, IQR = 30-51 years) who responded to a questionnaire, and physical and biochemical measures were analysed. Multinomial logistic regression was utilised to predict the determinants of overweight and obesity relative to under or normal weight. The results indicate that 3.6% of the participants were underweight (body mass index (BMI) <18.5 kg/m), 30.8% had normal weight (BMI 18.5-24.9 kg/m), 31.8% were overweight (25.0-29.9 kg/m), and 33.9% had obesity (BMI ≥30.0 kg/m). In the adjusted multinomial logistic regression, being aged 40-49 years (compared to 18-39 years old) (adjusted relative risk ratio (ARRR): 4.47, confidence interval (CI): 3.39-5.91), living in an urban residence (ARRR: 1.28, CI: 1.14-2.18), and having hypertension (ARRR: 3.13, CI: 2.36-4.17) were positively associated with obesity. Being male (ARRR: 0.47, CI: 0.33-0.68), having more than primary education (ARRR: 0.69, CI: 0.50-0.94), and having a larger household size (five members or more) (ARRR: 0.45, CI: 0.33-0.60) were negatively associated with obesity. Approximately two in three adult participants were overweight/obese, and sociodemographic and health risk factors were found that can be utilised in targeting interventions.
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http://dx.doi.org/10.3390/ijerph18084198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071354PMC
April 2021

The Prevalence and Associated Factors of Cancer Screening Uptake Among a National Population-Based Sample of Adults in Marshall Islands.

Cancer Control 2021 Jan-Dec;28:1073274821997497

Department of Psychology, 37702University of the Free State, Bloemfontein, South Africa.

Background: The study aimed to estimate the prevalence and associated factors of cancer screening among men and women in the general population in Marshall Islands.

Methods: The national cross-sectional sub-study population consisted of 2,813 persons aged 21-75 years (Median = 37.4 years) from the "2017/2018 Marshall Islands STEPS survey". Information about cancer screening uptake included Pap smear or Vaginal Inspection with Acetic Acid (=VIA), clinical breast examination, mammography, faecal occult blood test (FOBT), and colonoscopy.

Results: The prevalence of past 2 years mammography screening was 21.7% among women aged 50-74 years, past year CBE 15.9% among women aged 40 years and older, past 3 years Pap smear or VIA 32.6% among women 21-65 years, past year FOBT 21.8% among women and 22.3% among men aged 50-75 years, and past 10 years colonoscopy 9.1% among women and 7.3% among men aged 50-75 years. In adjusted logistic regression, cholesterol screening (AOR: 1.91, 95% CI: 1.07-3.41) was associated with past 2 years mammography screening among women aged 50-74 years. Blood pressure screening (AOR: 2.39, 95% CI: 1.71-3.35), glucose screening (AOR: 1.59, 95% CI: 1.13-2.23), dental visit in the past year (AOR: 1.51, 95% CI: 1.17, 1.96), binge drinking (AOR: 1.88, 95% CI: 1.07-3.30), and 2-3 servings of fruit and vegetable consumption a day (AOR: 1.42, 95% CI: 1.03-1.95) were positively and high physical activity (30 days a month) (AOR: 0.56, 95% CI: 0.41-0.76) was negatively associated with Pap smear or VIA screening among women aged 21-65 years. Higher education (AOR: 2.58, 95% CI: 1.02-6.58), and cholesterol screening (AOR: 2.87, 95% CI: 1.48-5.59), were positively and current smoking (AOR: 0.09, 95% CI: 0.01-0.65) was negatively associated with past 10 years colonoscopy uptake among 50-75 year-olds.

Conclusion: The study showed a low cancer screening uptake, and several factors were identified that can assist in promoting cancer screening in Marshall Islands.
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http://dx.doi.org/10.1177/1073274821997497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204481PMC
April 2021

Maternal Health Outcomes and Male Partner Involvement Among HIV Infected Women in Rural South Africa.

Matern Child Health J 2021 Jun 17;25(6):919-928. Epub 2021 Apr 17.

HIV/AIDS, STIs, & TB Research Programme, Human Sciences Research Council, 134 Pretorius Street, Pretoria, 0001, South Africa.

Introduction: This study aimed to investigate the association between Male Partner Involvement (MPI) and maternal health outcomes among women attending Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in rural South Africa. The association between Male Partner Participation in the main study (MPP) and maternal health outcomes among these women was also investigated.

Methods: The study utilized data collected from 535 HIV infected women in a randomized controlled trial between 2015 and 2016. Maternal health outcome data (delivery mode, pregnancy systolic and diastolic blood pressure, pregnancy body mass index, pregnancy CD4 count, and pregnancy viral load) were collected from the women's antenatal record forms accessed from the primary healthcare facilities. Bivariate and multivariable logistic regression models were used to estimate the association between socio-demographic characteristics of the women, MPI, and MPP with maternal health outcomes.

Results: The mean age of the women was 29.03 years (SD = 5.89). No significant associations were found between MPI and any of the maternal health outcomes contrary to what was hypothesized. Both the bivariate and multivariate analysis indicated a significant association between MPP and higher pregnancy viral load, contrary to the study hypothesis. Insignificant associations were found between MPP and both pregnancy CD4 count and pregnancy blood pressure. The only significant association between maternal health outcomes and socio-demographic characteristics, was between educational attainment and higher pregnancy CD4 count in both the bivariate and multivariate analysis.

Conclusion For Practice: The study showed no significant support for MPI in improving maternal health outcomes of women in PMTCT in rural South Africa. Future studies should include additional maternal health outcomes for investigation.
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http://dx.doi.org/10.1007/s10995-020-03071-6DOI Listing
June 2021

Prenatal and Postnatal Intimate Partner Violence and Associated Factors Among HIV-Infected Women in Rural South Africa: A Longitudinal Study.

Violence Against Women 2021 Apr 7:1077801221992872. Epub 2021 Apr 7.

Human Sciences Research Council, Pretoria, South Africa.

Intimate partner violence (IPV) has been highlighted as one of the challenges to the effectiveness of the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs in rural areas in South Africa. This study aimed at assessing the prevalence of prenatal and postnatal physical as well as psychological IPV, and corresponding time-invariant and time-varying predictors, among HIV-positive women attending PMTCT services in rural South Africa. The Conflict Tactics Scale (CTS) was used to assess IPV at four time points prenatal and postnatal. This study highlighted high levels of physical and psychological IPV experienced by HIV-infected women during pregnancy and in the first year after childbirth. Time-invariant predictors and time-varying predictors of physical IPV and psychological IPV were individual, social, and behavioral factors. Multi-dimensional evidence-based interventions are needed to deal with the high levels of prenatal and postnatal physical as well as psychological IPV experienced by these women.
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http://dx.doi.org/10.1177/1077801221992872DOI Listing
April 2021

Fertility intentions of women living with HIV and their male partners during the perinatal period in rural South Africa.

Int J STD AIDS 2021 Jul 26;32(8):740-750. Epub 2021 Mar 26.

Department of Psychiatry and Behavioral Sciences, 5452University of Miami Miller School of Medicine, Miami, FL, USA.

Understanding the fertility intentions of people living with HIV can guide safer conception planning and prevention of mother-to-child transmission (PMTCT). Most research has addressed fertility intentions among women, rather than couples, at a single time point. This clinical trial of a PMTCT intervention in rural Mpumalanga province, South Africa, examined longitudinal fertility intentions among perinatal women living with HIV and their male partners. Study assessments and intervention and control sessions were conducted prenatally and postpartum. Longitudinal predictors of participants' ( = 360 men, = 917 women) fertility intentions were similar between sexes. Younger age and male involvement in perinatal care were associated with reporting fertility intentions at both baseline and 12 months postpartum. Having an HIV-positive infant and discussing pregnancy plans with a healthcare provider by 12 months postpartum were associated with incident fertility intentions after reporting no plans for further children at baseline. Results highlight the important role of healthcare providers to educate men and women on issues surrounding conception, as well as the potential for incorporating PMTCT and safer conception education into HIV clinical services.
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http://dx.doi.org/10.1177/0956462420987447DOI Listing
July 2021

Prevalence and correlates of hazardous, harmful or dependent alcohol use and drug use amongst persons 15 years and older in South Africa: Results of a national survey in 2017.

Afr J Prim Health Care Fam Med 2021 Mar 23;13(1):e1-e8. Epub 2021 Mar 23.

ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand; and, Department of Research Administration and Development, University of Limpopo, Polokwane.

Background: Harmful alcohol and illicit drug use significantly contribute the burden of disease.

Aim: This study aimed to assess the prevalence and correlates of hazardous, harmful or dependent alcohol (HHDA) use and drug use amongst persons 15 years and older in South Africa.

Setting: Population-based survey.

Method: In a national cross-sectional 2017 survey, 39 210 persons 15 years and older (Median = 34 years) responded to a questionnaire on substance and health variables. The prevalence of HHDA use was 10.3% and past 3-month drug use 8.6%.

Results: In adjusted logistic regression analysis, men of middle age (25-34 year olds) with higher education, urban residence, drug use and psychological distress were positively associated and Indian or Asian and white population groups were negatively associated with HHDA. Women of middle age (25-34 year old) and mixed race, residing on rural farms and urban areas, with drug use and psychological distress were positively associated and older age (55 years and older) and Indians or Asians were negatively associated with HHDA. In adjusted logistic regression analysis, men, having Grade 8-11 education, mixed race, being unemployed, and the HHDA used were positively associated and middle and older age (25 years and older) and being a student or learner were negatively associated with past 3-month any drug use. Women, who were mixed race, Indians or Asians, with the HHDA use were positively associated and older age (45 years and older) were negatively associated with the past 3-month drug use.

Conclusion: About one in 10 participants with several sociodemographic and health indicators was identified to be associated with HHDA and any drug use.
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http://dx.doi.org/10.4102/phcfm.v13i1.2847DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008028PMC
March 2021

Prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa: results of a national survey in 2017.

Subst Abuse Treat Prev Policy 2021 Mar 20;16(1):25. Epub 2021 Mar 20.

Department of Research Administration and Development, University of Limpopo, Sovenga, 0727, South Africa.

Background: The study aimed to assess the prevalence and correlates of non-daily and daily cannabis use among persons 15 years and older in South Africa.

Method: In a national cross-sectional 2017 survey, 39,207 persons 15 years and older (Median = 34 years) responded to a questionnaire on cannabis use and health variables. Multinominal logistic regression was used to assess the determinants of nondaily and daily cannabis use among the general population and logistic regression for the determinants of daily cannabis use among active cannabis users.

Results: Results indicate that 5.0% of the participants engaged in non-daily and 2.8% in daily cannabis use in the past 3 months. In adjusted multinomial logistic regression analysis, male sex, Grade 8-11 education, Coloureds, alcohol use disorder, never married, and other drug use were positively associated with daily cannabis use while not in not labour force was negatively associated with daily cannabis use. Moreover, male sex, never married, alcohol use disorder, and other drug use were positively, while physical multimorbidity was negatively associated with nondaily cannabis use. In adjusted logistic regression, compared to nondaily cannabis users, daily cannabis users were more likely male and were less likely not in the labour force and were less likely using other drugs.

Conclusion: About one in ten participants had used cannabis in the past 3 months in South Africa. Several sociodemographic and health indicators were identified that were associated with non-daily and/or daily cannabis use.
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http://dx.doi.org/10.1186/s13011-021-00364-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980317PMC
March 2021

Nomogram for predicting overall survival in colorectal cancer with distant metastasis.

BMC Gastroenterol 2021 Mar 4;21(1):103. Epub 2021 Mar 4.

Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China.

Background: Colorectal cancer (CRC) is a major cancer burden, and prognosis is determined by many demographic and clinicopathologic factors. The present study aimed to construct a prognostic nomogram for colorectal cancer patients with distant metastasis.

Methods: Colorectal cancer patients with distant metastasis diagnosed between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results database. Cox proportional hazards regression was used to identify independent prognostic factors. A nomogram was constructed to predict survival, and validation was performed.

Results: A total of 7099 stage IV colorectal cancer patients were enrolled in the construction cohort. The median overall survival was 20.0 (95% CI 19.3-20.7) months. Age at diagnosis, marital status, race, primary tumour site, tumour grade, CEA level, T stage, N stage, presence of bone, brain, liver and lung metastasis, surgery for primary site and performance of chemotherapy were independent prognostic factors. The nomogram was constructed and the calibration curve showed satisfactory agreement. The C-index was 0.742 (95% CI 0.726-0.758). In the validation cohort (7098 patients), the nomogram showed satisfactory discrimination and calibration with a C-index of 0.746 (95% CI 0.730-0.762).

Conclusion: A series of factors associated with the survival of CRC patients with distant metastasis were found. Based on the identified factors, a nomogram was generated to predict the survival of stage IV colorectal cancer patients. The predictive model showed satisfactory discrimination and calibration, which can provide a reference for survival estimation and individualized treatment decisions.
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http://dx.doi.org/10.1186/s12876-021-01692-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934422PMC
March 2021

Maternal and infant antiretroviral therapy adherence among women living with HIV in rural South Africa: a cluster randomised trial of the role of male partner participation on adherence and PMTCT uptake.

SAHARA J 2021 Dec;18(1):17-25

Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam.

'Mother-to-child transmission of HIV' can occur during the period of pregnancy, childbirth, or breastfeeding. 'Prevention of mother-to-child transmission of HIV' (PMTCT) in Mpumalanga Province, South Africa, is especially vital as the prevalence of HIV is 28.2% in women aged 15-49. PMTCT interventions resulted in a drop of MTCT rates in Mpumalanga from ∼2% in 2015 to 1.3% in 2016. This randomised controlled trial in Mpumalanga examined the potential impact of a lay healthcare worker administered intervention, 'Protect Your Family', on maternal and infant adherence, and to assess the relative influence of male partner involvement on infant and maternal adherence. This cluster randomised controlled trial used a two-phase and two-condition (experimental or control) study design where participants ( = 1399) did assessments both during pregnancy and post-postpartum. Only women participated in Phase 1, and both female and male partners participated in Phase 2. Results indicated that male involvement was associated with self-reported maternal or infant antiretroviral therapy (ART) adherence, but the intervention was not associated with ART adherence. Self-reported adherence was associated with depression, age, and partner HIV status. The study results provide support for the involvement of men in the antenatal clinic setting during pregnancy. Results also support further research on the meaning and assessment of male involvement and clarification of the constructs underlying the concept in the sub-Saharan African context. Outcomes provide support for male involvement and treatment of depression as adjuncts to improve uptake of both maternal and infant medication as part of the PMTCT protocol.
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http://dx.doi.org/10.1080/17290376.2020.1863854DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919911PMC
December 2021

Sexual risk behaviour and its correlates among adolescents in Mozambique: results from a national school survey in 2015.

SAHARA J 2021 Dec;18(1):26-32

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

The study aimed to assess the prevalence and correlates of sexual risk behaviours among adolescents in Mozambique. In the cross-sectional 'Global School-Based Health Survey (GSHS)', 1918 students aged 11-18 years from Mozambique responded to a questionnaire in 2015. More than half (57.4%) of the students ever had sex, 68.4% among boys and 45.8% among girls. Among students who ever had sex, 41.5% had early sexual debut (<14 years), 57.9% had multiple sexual partners, 25.0% had not used a condom and 42.0% had not used birth control at last sex, and 59.4% engaged in multiple sexual risk behaviour. In adjusted logistic regression analysis, alcohol use, school truancy, older age and male sex were associated with multiple sexual risk behaviours. A large number of adolescents in Mozambique reported sexual risk behaviours, emphasising the need for interventions.
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http://dx.doi.org/10.1080/17290376.2020.1858947DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919870PMC
December 2021

Chronic conditions, multimorbidity, and quality of life among patients attending monk healers and primary care clinics in Thailand.

Health Qual Life Outcomes 2021 Feb 23;19(1):61. Epub 2021 Feb 23.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: The study aimed to assess chronic diseases, multimorbidity, and QoL among patients attending two different treatment settings in Thailand.

Methods: In all, 1409 attendees of three monk healer or three health centres were assessed with self-reported measures on chronic conditions and Quality of Life (QoL).

Results: Results indicate that the most common chronic conditions were common mental disorder (25.2%), followed by hypertension (22.8%), high blood cholesterol (18.0%), fatigue disorder (14.4%), diabetes (14.0%), migraine headaches (13.7%), sleeping problem (12.2%), and ulcer (11.0%). In all, 40.6% had multimorbidity (two or more chronic conditions) (42.4% in the monk healer and 38.9% in the primary care setting). In ANCOVA analysis, adjusted for sex, age, employment status, marital status, education, economic status, comorbidity, and health care setting, the poorest overall QoL was found among clients with common mental disorders (58.5 mean score), followed by emphysema or asthma (60.2), sleeping problem (61.5), migraine headaches (62.7), fatigue disorder (63.3), substance use disorder (63.6) and ulcer (64.3). The overall QoL was poorer among monk healer clients (66.5) than primary care patients (68.8). In adjusted logistical regression analysis, being a monk healer attendee, older age (55-93 years), and high debt were positively, and being employed and better overall quality of life were negatively associated with multimorbidity, overall, for the monk healer and primary care setting. In adjusted linear regression analyses, primary health care attenders, older age, were employed and post-secondary education increased the odds of better overall QoL.

Conclusion: Multimorbidity was higher among clients attending monk healers than those attending primary care facilities and QoL was poorer among clients seeking care from monk healers than those attending primary care. High multimorbidity was found and major chronic conditions were found to have poor QoL. Determinants of multimorbidity and QoL in two different treatment settings provide information to improve the management of chronic conditions.
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http://dx.doi.org/10.1186/s12955-021-01707-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903786PMC
February 2021

Chronic conditions, multimorbidity, and quality of life among patients attending monk healers and primary care clinics in Thailand.

Health Qual Life Outcomes 2021 Feb 23;19(1):61. Epub 2021 Feb 23.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: The study aimed to assess chronic diseases, multimorbidity, and QoL among patients attending two different treatment settings in Thailand.

Methods: In all, 1409 attendees of three monk healer or three health centres were assessed with self-reported measures on chronic conditions and Quality of Life (QoL).

Results: Results indicate that the most common chronic conditions were common mental disorder (25.2%), followed by hypertension (22.8%), high blood cholesterol (18.0%), fatigue disorder (14.4%), diabetes (14.0%), migraine headaches (13.7%), sleeping problem (12.2%), and ulcer (11.0%). In all, 40.6% had multimorbidity (two or more chronic conditions) (42.4% in the monk healer and 38.9% in the primary care setting). In ANCOVA analysis, adjusted for sex, age, employment status, marital status, education, economic status, comorbidity, and health care setting, the poorest overall QoL was found among clients with common mental disorders (58.5 mean score), followed by emphysema or asthma (60.2), sleeping problem (61.5), migraine headaches (62.7), fatigue disorder (63.3), substance use disorder (63.6) and ulcer (64.3). The overall QoL was poorer among monk healer clients (66.5) than primary care patients (68.8). In adjusted logistical regression analysis, being a monk healer attendee, older age (55-93 years), and high debt were positively, and being employed and better overall quality of life were negatively associated with multimorbidity, overall, for the monk healer and primary care setting. In adjusted linear regression analyses, primary health care attenders, older age, were employed and post-secondary education increased the odds of better overall QoL.

Conclusion: Multimorbidity was higher among clients attending monk healers than those attending primary care facilities and QoL was poorer among clients seeking care from monk healers than those attending primary care. High multimorbidity was found and major chronic conditions were found to have poor QoL. Determinants of multimorbidity and QoL in two different treatment settings provide information to improve the management of chronic conditions.
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http://dx.doi.org/10.1186/s12955-021-01707-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903786PMC
February 2021

Prevalence and correlates of multiple non-communicable disease risk factors among adults in Zambia: results of the first national STEPS survey in 2017.

Pan Afr Med J 2020 24;37:265. Epub 2020 Nov 24.

Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa.

Introduction: the prevalence of Non-Communicable Diseases (NCDs) is increasing in African countries. This study aimed to estimate the prevalence and correlates of multiple NCD risk factors (NCDRF) among the adult population in Zambia.

Methods: nationally representative cross-sectional data from 4,302 individuals aged 18-69 years of the "2017 Zambia STEPS survey" were analysed.

Results: the prevalence of insufficient fruit and vegetable consumption was 90.4%, followed by overweight/obesity (24.4%), low physical activity (19.5%), hypertension (18.9%), daily tobacco use (10.7%), sedentary behaviour (8.9%), suicidal behaviour (8.5%), alcohol dependence (7.4%), raised total cholesterol (7.4%), and diabetes (6.2%). The distribution of NCDRF was 41.5% 0-1 NCDRF, 48.2% 2-3, 10.4% 4-10, and 26.7% 3-10 NCDRF. In adjusted ordinal logistic regression analysis, compared to persons aged 18-34 years, individuals aged 50-69 years were 3.58 times (AOR: 3.58, 95% CI: 3.95-4.49) more likely to have a higher number of NCDRF. Women were 24% (AOR: 1.24, 95% CI: 1.03-1.49) more likely than men to have a higher number of NCDRF. Persons living in urban locations were 71% (AOR: 1.74, 95% CI: 1.43-2.16) more likely than persons living in rural locations to have a higher number of NCDRF, and compared to individuals with lower than primary education, persons with more than primary education were 20% (AOR: 0.80, 95% CI: 0.65-0.98) less likely to have a higher number of NCDRF.

Conclusion: more than one in four study participants had three to ten NCDRF and several associated factors were found that can aid to target interventions.
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http://dx.doi.org/10.11604/pamj.2020.37.265.25038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864270PMC
February 2021

Prevalence and correlates of multiple non-communicable disease risk factors among adults in Zambia: results of the first national STEPS survey in 2017.

Pan Afr Med J 2020 24;37:265. Epub 2020 Nov 24.

Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa.

Introduction: the prevalence of Non-Communicable Diseases (NCDs) is increasing in African countries. This study aimed to estimate the prevalence and correlates of multiple NCD risk factors (NCDRF) among the adult population in Zambia.

Methods: nationally representative cross-sectional data from 4,302 individuals aged 18-69 years of the "2017 Zambia STEPS survey" were analysed.

Results: the prevalence of insufficient fruit and vegetable consumption was 90.4%, followed by overweight/obesity (24.4%), low physical activity (19.5%), hypertension (18.9%), daily tobacco use (10.7%), sedentary behaviour (8.9%), suicidal behaviour (8.5%), alcohol dependence (7.4%), raised total cholesterol (7.4%), and diabetes (6.2%). The distribution of NCDRF was 41.5% 0-1 NCDRF, 48.2% 2-3, 10.4% 4-10, and 26.7% 3-10 NCDRF. In adjusted ordinal logistic regression analysis, compared to persons aged 18-34 years, individuals aged 50-69 years were 3.58 times (AOR: 3.58, 95% CI: 3.95-4.49) more likely to have a higher number of NCDRF. Women were 24% (AOR: 1.24, 95% CI: 1.03-1.49) more likely than men to have a higher number of NCDRF. Persons living in urban locations were 71% (AOR: 1.74, 95% CI: 1.43-2.16) more likely than persons living in rural locations to have a higher number of NCDRF, and compared to individuals with lower than primary education, persons with more than primary education were 20% (AOR: 0.80, 95% CI: 0.65-0.98) less likely to have a higher number of NCDRF.

Conclusion: more than one in four study participants had three to ten NCDRF and several associated factors were found that can aid to target interventions.
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http://dx.doi.org/10.11604/pamj.2020.37.265.25038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864270PMC
February 2021

Prevalence and correlates of dental service utilisation among a national general adult population sample in Sudan.

BMC Oral Health 2021 02 11;21(1):61. Epub 2021 Feb 11.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: Prompt dental service utilisation (DSU) is needed for the prevention and treatment of oral diseases, and it is therefore important to determine the facilitators and barriers of DSU. There is, however, scarce information available on DSU in Sudan. Therefore, this study aimed to investigate the prevalence and associated factors of DSU in a general population-based survey among 18-69 year-old persons in Sudan.

Methods: Cross-sectional nationally representative data of 7,722 18-69 year-old persons (36 years median age) from the 2016 Sudan Stepwise approach to surveillance (STEPS) survey were analysed. Using questionnaire, anthropometric and biochemical measures, predisposing, enabling and health and lifestyle factors of DSU were assessed. Multinomial logistic regression was conducted to estimate the predictors of DSU (> 12 months and past 12 months, with never DSU as the reference category).

Results: About two-thirds of the participants (64.6%) had never DSU, 22.0% had more than 12-month DSU, and 13.4% had past 12- month DSU. Among those who had ever DSU, the main reason for the last DSU was pain or trouble with teeth, gums, or mouth (66.9%), treatment or follow-up treatment 22.3%, and routine check-up treatment 5.0%. In adjusted multinomial logistic regression analysis, higher education (p < 0.001), urban residence (p < 0.001), screened for blood pressure (p < 0.001), raised total cholesterol (p < 0.05), poor SROH (p < 0.001), pain in teeth or mouth (p < 0.001), and not working because of teeth or mouth (p < 0.01) were positively and not knowing their household income (p < 0.01), high physical activity (p < 0.05), and having 20 or more teeth (p < 0.001), were negatively associated with both > 12 months and past 12 months DSU. Higher household income (p < 0.001), overweight/obesity (p < 0.05), using tooth paste (p < 0.001), and difficulty chewing (p < 0.001), were positively, and male sex (p < 0.01), and teeth cleaning twice or more times a day (p < 0.05), were negatively associated with > 12 months or past 12 months DSU.

Conclusion: More than one in ten participants had past 12 months DSU and several factors were detected which could be targeted in intervention activities. Study findings suggest to improve oral health awareness, in particular stressing the relevance of regular dental check-ups, by using different modalities of oral health promotion.
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http://dx.doi.org/10.1186/s12903-021-01422-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879665PMC
February 2021

Tobacco Use and Its Association with Mental Morbidity and Health Compromising Behaviours in Adolescents in Indonesia.

Asian Pac J Cancer Prev 2021 Jan 1;22(1):31-35. Epub 2021 Jan 1.

Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa.

Background: Limited evidence has been established on associations between tobacco use and mental morbidity and health compromising behaviours. The study aimed to investigate the associations between tobacco use, mental problems, and health risk behaviour among adolescents attending school in Indonesia.

Methods: Nationally representative data were studied from 11,124 adolescents that took part in the cross-sectional "Indonesia Global School-Based Student Health Survey (GSHS) in 2015".

Results: The prevalence of current tobacco use was 12.8%. In adjusted logistic regression analysis, compared to non-current or never tobacco users, current tobacco use was associated with eight of eight mental problem indicators (lonely, anxiety, no close friend, suicidal ideation, suicide plan, suicide attempt and current alcohol use), two of four dietary risk behaviours (soft drink and fast food consumption) and seven of ten other health risk behaviours (in a physical fight, bullied, injury, ever sex, school truancy, and two sub-optimal hand hygiene behaviours).

Conclusion: Compared to nontobacco users, current tobacco users had significantly higher mental problem indicators and health risk behaviours. Multiple comorbidity with tobacco use should be targeted in interventions.
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http://dx.doi.org/10.31557/APJCP.2021.22.1.31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184187PMC
January 2021

The prevalence and correlates of substance use disorders among patients of two different treatment settings in Thailand.

Subst Abuse Treat Prev Policy 2021 Jan 13;16(1):10. Epub 2021 Jan 13.

Department of Psychology, University of the Free State, Bloemfontein, South Africa.

Background: Monk healers provide an accessible and popular service in Southeast Asia, but little is known on the substance use status of their clients. This investigation intended to assess and compare the rate and correlates of substance use disorders in two different treatment settings (monk healers = MH and primary health care = PHC) in Thailand.

Methods: In a cross-sectional study, 1024 patients (591 of MH and 613 of PHC) responded to screening measures of the "World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test Lite", and two common mental disorders (major depression and generalized anxiety disorder) from November 2018 to February 2019. Logistic regression was used to estimate the determinants of any substance use disorder in the MH and PHC setting.

Results: The prevalence of substance use disorder was higher in MH clients than PHC patients: any substance use disorder 11.7% (95% Confidence Interval-CI: 9.3-14.5%) vs 5.4% (95% CI: 3.9-7.5%), tobacco use disorder 7.6% (95% CI: 5.7-9.9%) vs 2.5% (95% CI: 1.5-4.0%), alcohol use disorder 10.0% (95% CI: 8.4-13.6%) vs 4.3% (95% CI: 3.0-6.3%), any drug use disorder 4.2% (95% CI: 2.8-6.1%) vs 0.3% (95% CI: 0.08-1.3%), and any past three months drug use 8.2% (95% CI: 6.2-10.7%) vs 1.5, 95% CI: 0.8-2.8%). In adjusted logistic regression analysis, among MH clients, male sex (Adjusted Odds Ratio-AOR: 9.52, 95% Confidence Interval-CI: 5.06-17.92) was positively, and were married (AOR: 0.32, 95% CI: 0.16-0.61) and high social support (AOR: 0.40, 95% CI: 0.16-0.99) were negatively associated with any substance use disorder. Among PHC patients, male sex (AOR: 7.05, 95% CI: 2.99-16.63) was positively and age (AOR: 0.95, 95% CI: 0.92-0.98) was negatively associated with any substance use disorder.

Conclusion: The proportion of substance use disorders among MH attendees was more than twice that of PHC attenders in Thailand, calling for collaboration in controlling substance use disorders between the two treatment systems.
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http://dx.doi.org/10.1186/s13011-021-00345-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805213PMC
January 2021
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