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Cigarette smoking and associated factors among men in five South Asian countries: A pooled analysis of nationally representative surveys. PLoS One 2022; 17:e0277758. [DOI: 10.1371/journal.pone.0277758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
Smoking is one of the leading causes of premature deaths worldwide. The cigarette is the commonest form of tobacco smoking. This study investigated the factors associated with cigarette smoking among men in five South Asian countries. We analyzed nationally representative cross-sectional study (Demographic and Health Survey) data conducted in Afghanistan, India, Maldives, Nepal, and Pakistan from 2015–2018. Our study population was men aged between 15 and 49 years. The outcome variable was the prevalence of cigarette smoking. We performed both pooled and country-specific analyses using multivariable logistic regression. The prevalence of cigarette smoking among men is the highest (41.2%) in the Maldives and the lowest (20.1%) in Pakistan. Our pooled analysis found that higher age, lower education, lower wealth status, and involvement in any occupations were strongly associated with cigarette smoking (p-value <0.001). However, we did not find a significant association between age and wealth status in Afghanistan, occupations in Nepal and Pakistan, and education in Pakistan with cigarette smoking when country-specific analyses were performed. In this study, socioeconomic position, age, and urban area are strongly associated with cigarette smoking in South Asian countries. The country-specific circumstances should be considered in planning and designing national smoking control strategies and interventions. However, improving access to smoking cessation services could be an effective intervention for all studied countries, Afghanistan, India, Maldives, Nepal, and Pakistan.
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Mishra GA, Pimple SA, Kulkarni VY, Gupta SD, Mujmudar PV. Tobacco Cessation Program among Cab Drivers in Mumbai, India: An Interventional Study. Indian J Community Med 2022; 47:347-351. [PMID: 36438536 PMCID: PMC9693954 DOI: 10.4103/ijcm.ijcm_909_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Tobacco epidemic is one of the biggest public health threats, killing nearly seven million people annually. With implementation of smoke-free public places legislation, cabs in India are smoke free. However, large majority of cab drivers are addicted to tobacco. AIMS The objectives were to measure cab drivers' knowledge, attitude, and practices about tobacco pre and post intervention, educate them regarding hazards of tobacco and need for smoke-free cabs, perform oral cancer screening, and provide assistance to quit tobacco. SUBJECTS AND METHODS This interventional study among cab drivers was conducted in Mumbai during 2015-2018. Different cab unions in Mumbai were contacted and 400 cab drivers were enrolled and interviewed. They were offered health education, oral cancer screening, and tobacco cessation assistance at regular intervals for 1 year. RESULTS About 63.8% of cab drivers used tobacco, mainly in smokeless forms. Almost 94.1% intended to quit, 66.3% had made previous quit attempts, and 69.8% expressed the need of assistance for quitting. One hundred and twelve cab drivers were diagnosed with oral precancers and one with oral carcinoma. About 49.4% of cab drivers quit tobacco and 46.7% reduced tobacco consumption at the end of 1 year. According to multivariate logistic regression analysis, Muslim cab drivers were less likely to quit tobacco as compared to Hindus. CONCLUSION Adherence to smoke-free laws plays a significant role in reducing exposure of cab drivers to secondhand smoke. This program demonstrates the successful implementation of tobacco cessation program that could be replicated among other workforces.
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Affiliation(s)
- Gauravi Ashish Mishra
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sharmila A Pimple
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Vasundhara Y Kulkarni
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Subhadra D Gupta
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Parishi V Mujmudar
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Aye YM, Hong SA, Thepthien B, Tiraphat S. Betel quid chewing and its prevalence and determinants: data from Myanmar Demographic Health and Survey of 2015-2016. J Public Health (Oxf) 2022; 44:e181-e191. [PMID: 33791792 DOI: 10.1093/pubmed/fdab044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/15/2021] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although betel quid chewing with tobacco use is one of the major behavioral risk factors for chronic diseases, the prevalence is rather on the increase in Myanmar. This study determined prevalence of betel quid chewing at the national and subnational levels and its associations with tobacco and sociodemographic factors. METHODS This study is a secondary data analysis of Myanmar demographic health survey 2015-2016 with a total of 11 773 women and 4251 men aged 18-49 years. Chi-square tests and multivariable logistic regression tests were performed. RESULTS Prevalence of betel quid chewing was 61.8% in men and 19.5% in women and by regions it ranged from 34 to 82.2% and from 5-8 to 52.9%, respectively. The prevalence of the concurrent use with tobacco was 25.8 and 2.3%, respectively. Women with older age, low education and low wealth and occupation and living with spouse were associated with betel quid chewing, while low education, living with spouse and Myanmar speaker were associated with men. Tobacco use was inversely and positively associated with betel quid chewing in men and women, respectively (P-interaction <0.0001). CONCLUSION Implementation of culturally sensitive intervention and policies including effective community awareness campaigns for anti-betel quid chewing is strongly recommended in Myanmar.
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Affiliation(s)
- Yin Min Aye
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
| | - S A Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
- Institute for Health and Society, Hanyang University, Seoul 04763, Republic of Korea
| | - B Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
| | - S Tiraphat
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
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Khaild SM, Taha ZI, Ali OI, Mohammed MH, Abdelhai Y, William J. Hypertension and Associated Risk Factors Among the Sudanese Banking Sector in River Nile State: A Descriptive Cross-Sectional Study. Cureus 2022; 14:e24770. [PMID: 35676999 PMCID: PMC9167449 DOI: 10.7759/cureus.24770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background Hypertension is a global entity accounting for one of the most modifiable risk factors for all-cause morbidity and mortality. It is associated with a raised risk of cardiovascular disease, particularly in developing countries. Nevertheless, the banking sector profession lifestyle is sedentary and accompanied by high levels of mental stress, thus at a higher risk of developing hypertension. Objective The objective is to assess the prevalence of hypertension among bank employees and the associated risk factors in River Nile State - Sudan. Methods A descriptive cross-sectional study was performed on Atbara and Al-Damar localities' banks in River Nile state from January to March 2020. Data were collected on demographics, BMI, waist circumference (WC), medical history, family history, nutritional habits, physical activities, medications history, work stress, complaints, and blood pressure. Results Ninety-eight bank employees were enrolled, with elevated blood pressure present in 45(45.9%) participants, of whom 18 (40%) were newly diagnosed. 43.9% were in the age group 31-40 years. High blood pressure was significantly associated with older age >40 years, BMI > 30 kg/m2, WC > 90 cm, diabetes mellitus (DM), smoking, family history, salty diet, reduced daily exercise (30 minutes per day), severe stress at work, with overall P-value = <0.005. Conclusion The prevalence of high blood pressure was remarkably high among bank employees. Risk factors were: age (>40 years), obesity, DM, family history, salty diet intake, severe stress levels at work and sedentary lifestyle.
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Drinking Water Quality and Public Health in the Kathmandu Valley, Nepal: Coliform Bacteria, Chemical Contaminants, and Health Status of Consumers. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:3895859. [PMID: 35190745 PMCID: PMC8858048 DOI: 10.1155/2022/3895859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/21/2022] [Indexed: 12/17/2022]
Abstract
Residents of Nepal’s Kathmandu Valley draw drinking water from tube wells, dug wells, and stone spouts, all of which have been reported to have serious water quality issues. In this study, we analyzed drinking water samples from 35 tube wells, dug wells, stone spouts, and municipal tap water for bacterial and chemical contaminants, including total and fecal coliform, aluminum, arsenic, barium, beryllium, boron, cadmium, cobalt, chromium, copper, fluoride, iron, mercury, manganese, molybdenum, nickel, lead, antimony, selenium, thallium, uranium, vanadium, and zinc. We also asked a sampling of households who used these specific water sources to rate the taste of their water, list any waterborne diseases they were aware of, and share basic health information about household members. This survey provided us with information from 146 households and 603 individuals. We found widespread bacterial contamination of water sources, with 94% of sources having detectable total or fecal coliform. Nepal Drinking Water Quality Standards and World Health Organization (WHO) Drinking-Water Guidelines or health-based values were exceeded for aluminum (max = 0.53 mg/L), arsenic (max = 0.071 mg/L), iron (max = 7.22 mg/L), and manganese (max = 3.229 mg/L). The distribution of water sources with high arsenic, iron, and manganese appeared to be associated with floodplain deposits. Mixed effects logistic regression models were used to examine the interactions between social factors and water contaminants and their effects on household members’ health. Consumers of water sources with both high and low concentrations of manganese were less likely to have a positive attitude towards school than those whose water sources had moderate concentrations of manganese. Social factors, especially education, played a large role in predicting individual health outcomes. Household taste ratings of drinking water were not correlated with iron or manganese concentrations, suggesting that WHO’s reliance on aesthetic criteria for these contaminants instead of formal drinking-water guidelines may not be sufficient to protect public health.
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Fentaw KD, Fenta SM, Biresaw HB. Prevalence and Associated Factors of Substance Use Male Population in East African Countries: A Multilevel Analysis of Recent Demographic and Health Surveys From 2015 to 2019. Subst Abuse 2022; 16:11782218221101011. [PMID: 35645567 PMCID: PMC9130838 DOI: 10.1177/11782218221101011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/29/2022] [Indexed: 11/15/2022]
Abstract
Background: East Africa is still home to one of the world’s highest rates of substance user. Substance use is primarily associated with male behavior and is becoming one of the region’s most public health issues. Methods: The study included data from 11 East African countries’ Demographic and Health Surveys. About 55 307 men were enrolled in the study and multilevel logistic regression model was applied Result: East African countries had a 43.70% prevalence of substance abuse coverage. Education level, age, current working status, marital status, wealth index, media exposure, residence, and nation were all found to be statistically associated with substance use of males. Conclusion: In East African countries, the prevalence of substance abuse among men was high. As a result, substance control programs should focus on the poor, not (least) educated, rural people, and adult age groups, who are the region’s most vulnerable social groups.
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Shrestha G, Phuyal P, Gautam R, Mulmi R, Pradhan PMS. Burden of tobacco in Nepal: a systematic analysis from the Global Burden of Disease Study 1990-2017. BMJ Open 2021; 11:e047847. [PMID: 34426463 PMCID: PMC8383890 DOI: 10.1136/bmjopen-2020-047847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study systematically reviews the data extracted from the Global Burden of Disease Study and sets out to assess the age-specific and sex-specific mortality and disability attributable to different forms of tobacco from 1990 to 2017, for Nepal. DESIGN This cross-sectional study extracted data from the Institute for Health Metrics and Evaluation's Global Burden of Disease database, then was quantitatively analysed to show the trends and patterns of prevalence of tobacco use, deaths and disability-adjusted life-years (DALYs) attributable to tobacco use from different diseases from the year 1990 to 2017 in Nepal. SETTING Nepal. RESULTS In between 1990 and 2015, the age-standardised prevalence of daily tobacco smoking decreased by 33% in males, 48% in females and 28% in both. By 2017, the age-standardised mortality rate and DALYs attributable to tobacco use, including any form, decreased by 34% and 41%, respectively, with tobacco smoking having the most contribution. However, the absolute number of deaths and DALYs increased by 39% and 3%, respectively. An increasing rate of deaths and DALYs attributable to tobacco was noted with an increase in age. Non-communicable diseases were responsible for most deaths and disabilities attributable to tobacco use. CONCLUSION The prevalence of smoking along with the age-standardised mortality rate and DALYs shows a decreasing trend. However, attention should be made to implement a strong plan to control all forms of tobacco including secondhand exposure.
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Affiliation(s)
- Gambhir Shrestha
- Department of Community Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
| | - Prabin Phuyal
- B.P. Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
| | - Rabin Gautam
- World Health Organization Country Office for Nepal, Kathmandu, Nepal
| | - Rashmi Mulmi
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal
| | - Pranil Man Singh Pradhan
- Department of Community Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
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Karki KB, Poudyal A, Shrestha N, Mahato NK, Aryal KK, Sijapati MJ, Bista B, Gautam N, Subedi R, Siddiquee NKA, Gyanwali P, Kuch U, Groneberg DA, Jha AK, Dhimal M. Factors Associated with Chronic Obstructive Pulmonary Diseases in Nepal: Evidence from a Nationally Representative Population-Based Study. Int J Chron Obstruct Pulmon Dis 2021; 16:1109-1118. [PMID: 33907397 PMCID: PMC8068482 DOI: 10.2147/copd.s295321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background The Global Burden of Diseases Study 2017 predicted that chronic obstructive pulmonary disease (COPD) is the second leading cause of death, the fourth leading cause of premature death, and the third cause for DALYs lost in Nepal. However, data on the population-based prevalence of COPD in Nepal are very limited. This study aims to assess the prevalence of COPD and factors associated with the occurrence of COPD in Nepal. Methods From a nationally representative, population-based cross-sectional study on chronic non-communicable diseases, the prevalence of COPD and its associated factors was determined. Of 12,557 participants aged over 20 years, 8945 participants completed a questionnaire and spirometry. Eligible participants were also asked to answer a COPD diagnostic questionnaire for screening COPD cases, and if needed underwent pre-bronchodilator and post-bronchodilator spirometry. COPD was defined as a post-bronchodilator FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratio of <0.70. Multivariate logistic regression was performed to identify factors associated with COPD. Sampling weights were used for all data analyses. Results The prevalence of COPD in Nepal was 11.7% (95% CI: 10.5% to 12.9 %), which increased with age, and higher in those with a low educational level, those who had smoked ≥50 pack-years, persons having a low body mass index (BMI), and residents of Karnali province. Multivariate analysis revealed that being aged 60 years and above, having a low BMI, low educational status, having smoked more than 50 pack-years, provincial distribution, and ethnicity were independent predictors of COPD. Conclusion COPD is a growing and serious public health issue in Nepal. Factor such as old age, cigarette smoking, low educational attainment, low BMI, ethnicity, and locality of residence (province-level variation) plays a vital role in the occurrence of COPD. Strategies aimed at targeting these risk factors through health promotion and education interventions are needed to decrease the burden of COPD.
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Affiliation(s)
- Khem Bahadur Karki
- Nepal Health Research Council (NHRC), Kathmandu, Nepal.,Department of Community Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal.,Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Anil Poudyal
- Nepal Health Research Council (NHRC), Kathmandu, Nepal
| | | | | | - Krishna Kumar Aryal
- Monitoring Evaluation and Operational Research (MEOR) Project, Abt Associates, Kathmandu, Nepal
| | | | | | | | | | | | | | - Ulrich Kuch
- Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - David A Groneberg
- Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | | | - Meghnath Dhimal
- Nepal Health Research Council (NHRC), Kathmandu, Nepal.,Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
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Hasan MM, Quazi A, Sarangapani N, Alam K. Age-specific prevalence and predictors of tobacco consumption among male adults in India: subnational inequality and associated risk factors. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01507-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Khanal GN, Khatri RB. Burden, prevention and control of tobacco consumption in Nepal: a narrative review of existing evidence. Int Health 2021; 13:110-121. [PMID: 32914846 PMCID: PMC7902273 DOI: 10.1093/inthealth/ihaa055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/02/2020] [Accepted: 08/09/2020] [Indexed: 11/23/2022] Open
Abstract
Tobacco consumption is one of the major public health problems in the world. Annually, 27 100 premature deaths are attributed to tobacco-related diseases in Nepal. Despite enacting different policies and strategies, the prevalence of tobacco consumption is still high. This study aims to synthesize prevalence, factors associated with its consumption and the policy initiatives for prevention and control in Nepal. This review includes peer-reviewed studies retrieved from two databases (PubMed and EMBASE) and published from 2000 to 2018, and policy initiatives on tobacco prevention and regulations in Nepal. A total of 32 studies and 5 policy documents were reviewed. Findings suggest that tobacco consumption was higher among men, illiterates, older people, people living in rural and mountainous areas and those who initiated smoking as adolescents. Peer pressure and parental/family smoking were major contributing factors for tobacco initiation. Policy analysis showed that low excise tax, weak monitoring mechanisms, poor compliance to bans on the advertisement and promotion of tobacco, smoke-free zones and insufficient programs on tobacco cessation were the major factors behind weak implementation of tobacco-control policies. Hence, targeted and high-risk group tobacco-cessation interventions, increasing taxation and strict policy implementation are crucial for effective tobacco prevention and control in Nepal.
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Affiliation(s)
| | - Resham Bahadur Khatri
- Center for Research and Development, Surkhet, Nepal.,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Onoh I, Owopetu O, Olorukooba AA, Umeokonkwo CD, Dahiru T, Balogun MS. Prevalence, patterns and correlates of smokeless tobacco use in Nigerian adults: An analysis of the Global Adult Tobacco Survey. PLoS One 2021; 16:e0245114. [PMID: 33406117 PMCID: PMC7787524 DOI: 10.1371/journal.pone.0245114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/22/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The global tobacco epidemic contributes to more than 8 million deaths annually. However, most tobacco control interventions have been driven by an emphasis on smoked tobacco. Globally and more so in Nigeria, less attention has been paid to the similarly harmful smokeless tobacco (SLT) whose use appeals to a different demography. We examined the prevalence, patterns of use and correlates of SLT in Nigerian adults to guide targeted control efforts. METHODS We conducted a secondary analysis of the 2012 Global Adult Tobacco Survey (GATS) data. We obtained data on 9,765 non-institutionalised adults aged 15 years and older. Variables included current SLT use, sociodemographic characteristics and perceived harm of SLT use. We used Chi-square test to examine associations and binary logistic regression to assess predictors of current SLT use. All analyses were conducted with sample-weighted data. RESULTS The prevalence of current SLT use was 1.9% of all adults. About 1.4% were daily users. The main types were snuff by nose (1.6%) and snuff by mouth (0.8%). There were higher odds of current SLT use for those in the South-East region (aOR = 13.99; 95% CI: 4.45-43.95), rural area residents (aOR = 1.56; 95% CI: 1.04-2.35), males (aOR = 4.43; 95% CI: 2.75-7.11), the 45-64 years age-group (aOR = 10.00; 95% CI: 4.12-24.29), those with no formal education (aOR = 2.67; 95% CI: 1.01-7.05), and those with no perception of harm from SLT use (aOR = 3.81, 95% CI: 2.61-5.56). CONCLUSION The prevalence of SLT use among Nigerian adults was low with clearly identified predictors. While a majority were aware of harm from SLT use, an unacceptably high proportion remain unaware. We recommended targeted interventions to increase awareness of the harmful effects of SLT use especially among residents of the South-East, those in rural areas, males, and individuals with no formal education. We also recommended a follow-up survey.
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Affiliation(s)
- Ikenna Onoh
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Oluwatomi Owopetu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Abdulhakeem Abayomi Olorukooba
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Chukwuma David Umeokonkwo
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Tukur Dahiru
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medical Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
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Yadav N, Agrawal C, Patel B, Patel M, Sharma P, Fanda K, Kumar A. Current trends in consumption of smokeless tobacco products among women in selected rural areas - A cross-sectional study. THE SAINT'S INTERNATIONAL DENTAL JOURNAL 2021. [DOI: 10.4103/sidj.sidj_11_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Das Gupta R, Jahan M, Hasan M, Sutradhar I, Sajal IH, Haider SS, Joshi H, Haider MR, Sarker M. Factors associated with tobacco use among Nepalese men aged 15–49 years: Data from Nepal demographic and Health Survey 2016. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sathian B, Menezes RG, Asim M, Mekkodathil A, Sreedharan J, Banerjee I, van Teijlingen ER, Roy B, Subramanya SH, Kharoshah MA, Rajesh E, Shetty U, Arun M, Ram P, Srivastava VK. Cigarette smoking dose-response and suicidal ideation among young people in Nepal: a cross-sectional study. Nepal J Epidemiol 2020; 10:821-829. [PMID: 32257512 PMCID: PMC7112959 DOI: 10.3126/nje.v10i1.28277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 01/10/2023] Open
Abstract
Background Worldwide, tobacco smoking is a major risk factor for morbidity and early mortality among adult population. The present study aimed to find out the association between current smoking and suicidal ideation among young people in Nepal. Materials and Methods A cross-sectional questionnaire-based survey was carried out among 452 youths from Pokhara, Nepal. The present study included both genders (age 18-24 years) who were smokers as well as non-smokers. Results Across the study period, 452 participants were identified after matching for age, and sex (226 in the smoking group and 226 in the non-smoking group). The mean age of participants was 21.6±1.2 years and 58.8% were males. The overall rate of suicidal ideation in our cohort was 8.9%. Smokers were slightly more likely to report suicidal ideation than non-smokers (aOR 1.12). The risk of developing suicidal ideation was 3.56 (95% CI 1.26-10.09) times more in individuals who smoked greater than 3.5 cigarettes per week (p=0.01). Conclusion The rate of suicidal ideation was slightly higher among smokers and a dose-response relationship was identified with the number of cigarettes smoked per week. Being aware of the link between smoking and suicidal ideation may help health care professionals working with young people to address more effectively the issues of mental well-being and thoughts about suicide.
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Affiliation(s)
- Brijesh Sathian
- Surgery Department, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ritesh G Menezes
- Forensic Medicine Division, Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Asim
- Surgery Department, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | | | | | | | - Edwin R van Teijlingen
- Centre for Midwifery, Maternal and Perinatal Health, Bournemouth University, Bournemouth, UK
| | - Bedanta Roy
- Department of Physiology, Quest International University Perak (QIUP), city Campus, Ipoh, Perak Darul Ridzuan, Malaysia
| | | | | | - Elayedath Rajesh
- School of Behavioural Sciences, Mahatma Gandhi University, India
| | - Ullasa Shetty
- Department of Forensic Medicine, A. J. Institute of Medical Sciences, Mangalore, India
| | - M Arun
- Department of Forensic Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - Pradhum Ram
- Division of Cardiovascular Medicine, Emory University Hospital, Atlanta, GA, USA
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Rai BB, Shresthra MK, Thapa R, Essex RW, Paudyal G, Maddess T. Pattern and Presentation of Vitreo-Retinal Diseases: An Analysis of Retrospective Data at a Tertiary Eye Care Center in Nepal. Asia Pac J Ophthalmol (Phila) 2019; 8:481-488. [PMID: 31789651 PMCID: PMC6903420 DOI: 10.1097/01.apo.0000604400.50700.2d] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/18/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE We examined patients presenting in a tertiary eye hospital in Nepal, focusing on information relevant to screening and management programs for vitreo-retinal (VR) disease. DESIGN Retrospective, cross-sectional study. METHODS We reviewed all patients presenting for the first time to the VR-clinic over 1 year. We quantified patient demography, symptoms and duration, systemic diseases, ophthalmological examinations, diagnostic investigations, and final diagnoses. RESULTS Of the 1905 cases, 1148 were male (60.3%). The 25th percentile of ages was 29 and 38 years for male and female, respectively; thus, female presented later (P < 0.0001). Hypertension was the commonest systemic disease (40.8%), followed by diabetes (32.5%). Age-related macular degeneration (AMD) and diabetic retinopathy (DR) affected 447 eyes (11.8%) and 416 eyes (10.9%), respectively. Male and female AMD and DR patients did not differ in age or disease duration. Similarly, age or disease duration for DR did not correlate with severity. Asymmetry of disease severity between eyes with AMD and DR was largest in patients with 1 normal eye. Presenting acuity was asymmetric between eyes (P < 0.0001) with people more often reporting once their right eyes had acuity of 6/18 or worse. CONCLUSIONS The screening of blood pressure and glucose levels combined with fundus photography could prevent many from progressing to life-changing visual impairment and blindness. Later reporting by females began at childbearing age; therefore, education and ocular screening could be usefully coupled in reproductive health programs. Clubbing VR disease screening with other established health programs like diabetes control program, hypertension clinics, school health program, and so on, would provide economical and sustainable approach.
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Affiliation(s)
- Bhim B. Rai
- John Curtin School of Medical Research, Australian National University, ACT, Australia
| | | | - Raba Thapa
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Rohan W. Essex
- ANU Academic Unit of Ophthalmology, ANU Medical School; Department of Ophthalmology, Canberra Hospital, ACT Health, Australia
| | | | - Ted Maddess
- John Curtin School of Medical Research, Australian National University, ACT, Australia
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Efendi F, Aidah FN, Has EMM, Lindayani L, Reisenhofer S. Determinants of smoking behavior among young males in rural Indonesia. Int J Adolesc Med Health 2019; 33:ijamh-2019-0040. [PMID: 34649306 DOI: 10.1515/ijamh-2019-0040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/14/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION A high prevalence of tobacco smoking has been reported among adolescents and young adults, especially men, in lower-middle-income countries such Indonesia. Understanding the extent and determinants of smoking within this population, particularly those living in rural areas where smoking rates are anecdotally higher than in city areas, is essential to inform development of targeted smoking prevention and reduction programs. This study analyzes the prevalence and determinants of smoking behavior among young men in rural Indonesia. METHODS Secondary data analysis of the 2012 Indonesia Demographic and Health Survey: Adolescent Reproductive Health (IDHS ARH) were used. Data from 4811 rural males (15-24 years of age) were selected through two-stage stratified cluster sampling techniques. The chi-square (χ2) test and binary logistic regression were used to determine significant factors associated with tobacco smoking. RESULTS More than half of this population in rural Indonesia were smokers. Significant factors associated with smoking were: age 20-24 years (odds ratio (OR) 2.8, 95% confidence interval (CI) 2.4-3.2), working status (OR = 2.24, 95% CI: 1.95-2.57), low education level (OR = 1.93, 95% CI: 1.52-2.45), access to magazines (OR = 0.78, 95% CI: 0.68-0.89) and access to the radio (OR = 1.28, 95% CI: 1.12-1.48) at least once a week. CONCLUSIONS A significant proportion of adolescents and young men in rural Indonesia smoke tobacco. Exposure to media with likely cigarette advertising (radio and magazines) and access to money via employment in the context of lower socio-economic and education levels elevate the risk of smoking. While Indonesian government campaigns targeting smoking are in place, further work is required to decrease smoking rates and prevent a future smoking-related health crisis for rural Indonesia's young men.
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Affiliation(s)
- Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Jl. Mulyorejo Kampus C Unair, Surabaya 60115, Indonesia, Phone: +62-315913257, Handphone: +6281331533805
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Fitriana Nur Aidah
- Faculty of Nursing, Universitas Airlangga, Jl. Mulyorejo Kampus C Unair, Surabaya, Indonesia
| | - Eka Mishbahatul M Has
- Faculty of Nursing, Universitas Airlangga, Jl. Mulyorejo Kampus C Unair, Surabaya, Indonesia
| | - Linlin Lindayani
- Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat, Bandung, Indonesia
| | - Sonia Reisenhofer
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Shrestha N, Mehata S, Pradhan PMS, Joshi D, Mishra SR. A nationally representative study on socio-demographic and geographic correlates, and trends in tobacco use in Nepal. Sci Rep 2019; 9:2682. [PMID: 30804493 PMCID: PMC6389978 DOI: 10.1038/s41598-019-39635-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/28/2019] [Indexed: 11/17/2022] Open
Abstract
Tobacco control still poses an immense challenge for the government of Nepal. Updated knowledge on the current pattern of tobacco use and its associated factors will be helpful for policy makers to curb the tobacco epidemic. This study fills this gap by, (i) exploring demographic, socio-economic and geographic correlates of current tobacco use using a nationally representative sample of 15-49-year adults from Nepal Demographic Health survey 2016, and (ii) examining the prevalence and trends of both smoking and non-smoking forms of tobacco use in a nationally representative sample of 15-49-year adults drawn from three consecutive Demographic Health Surveys (DHS) between 2006 and 2016.Among males, the prevalence of smokeless tobacco use was higher than that of smoking (40.1% and 27.4% respectively), whereas among females smoking was more common than smokeless tobacco use (prevalence of 5.5% and 3.8% respectively). Both smoking and smokeless tobacco use were associated with older age and lower level of education. Among males, those living in urban areas were more likely to consume any form of tobacco. Residents of terai/plains were more likely to use smokeless tobacco. The concentration curves on cumulative proportion of tobacco use ranked by wealth quintiles showed tobacco use to be highest among the lowest socio-economic groups in both males and females in all three survey years. We found a decreasing trend of tobacco smoking and an increasing trend of smokeless tobacco use over the 10-year period. However, the consumption of both forms of tobacco increased in young males during the same period. Proper monitoring of adherence to directives of the anti-tobacco law should be ensured to curb the increasing burden of tobacco use among young males, and a similar effort is needed to sustain the decline in tobacco uses among other population groups in Nepal.
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Affiliation(s)
- Nipun Shrestha
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
| | | | - Pranil Man Singh Pradhan
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| | - Deepak Joshi
- Health and Nutrition Department, Save the Children, Kathmandu, Nepal
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Smith-Greenaway E, Brauner-Otto S, Axinn W. Offspring education and parental mortality: Evidence from South Asia. SOCIAL SCIENCE RESEARCH 2018; 76:157-168. [PMID: 30268277 PMCID: PMC6408726 DOI: 10.1016/j.ssresearch.2018.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 06/02/2018] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
Decades of research show that education not only confers individual health benefits, but it also spills over to advantage subsequent generations. More recently, research has confirmed that the intergenerational health benefits of education can also flow upward: aging adults with more highly educated children experience better health and higher survival. Research has documented this finding in high-income settings, and also in select low- and middle-income contexts, raising questions about how having an adult child who attended relatively low levels of education can benefit aging parents' well-being. In this study, we use multilevel, long-term panel data on a cohort of older adults from the Chitwan Valley Family Study in rural Nepal to establish whether the association between offspring education and parents' survival is observable in this extremely poor, agrarian context. Extending past studies, we then leverage additional data on older adults to examine the association between offspring education and two theorized mechanisms: older adults' better health behaviors and their greater support in later life.
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Integrating cardiovascular disease risk factor screening into HIV services in Swaziland: lessons from an implementation science study. AIDS 2018; 32 Suppl 1:S43-S46. [PMID: 29952789 DOI: 10.1097/qad.0000000000001889] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study the feasibility of cardiovascular disease risk factor (CVDRF) screening at an HIV clinic in Swaziland. METHODS A sample of HIV-positive patients at least 40 years on antiretroviral treatment was screened for hypertension, diabetes, hyperlipidemia, and tobacco smoking. RESULTS A total of 1826 patients were screened; 684 (39%) had at least one CVDRF. Screening volume varied markedly, and was limited by staffing, space, and supplies. DISCUSSION CVDRF screening was feasible and prevalence of risk factors in people living with HIV at least 40 years was high.
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Tobacco control policies to promote awareness and smoke-free environments in residence and workplace to reduce passive tobacco smoking in Bangladesh and its correlates. PLoS One 2018; 13:e0198942. [PMID: 29920514 PMCID: PMC6007922 DOI: 10.1371/journal.pone.0198942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/29/2018] [Indexed: 11/19/2022] Open
Abstract
Background Bangladesh is one of the highest tobacco consuming countries in the world, with reported 21.2% of the population as daily smokers, 24.3% as smokeless tobacco users, and 36.3% as adult passive smoker. Given the high prevalence and established harmful effects of passive tobacco smoking, this study aimed to estimate of pattern of smoking policies in residential and work place, and to identify the associated socio-economic and demographic correlates in Bangladesh. Data and methods Secondary data of sample size 9629 collected by the Global Adult Tobacco Survey (GATS) 2010 has been used. Along with descriptive analysis, binary logistic regression model has been used to analyze the socio-demographic and economic correlates to tobacco smoking policy. Results The prevalence of male and female passive tobacco smokers was 74.3% and 25.8% respectively. Among the passive tobacco smokers, 22.2% reported that smoking was allowed at their home and 29.8% reported that there was no such smoking policy at their home. Alternatively, 26.0% passive tobacco smokers reported that smoking was allowed and 27.5% reported that there was no such smoking policy at their work place. Logistic regression analysis indicated that for tobacco smokers group, the odds of allowing smoking at home was 4.85 times higher than the non-smoker respondent (OR = 4.85, 95% CI = 4.13, 5.71), 1.18 times more likely to be allowed at home in rural areas than urban areas (OR = 1.18, 95% CI = 1.06,1.32) and less for college/university completed and (or) higher educated respondent than no formal schooling (OR = 0.35, 95% CI = 0.24, 0.52). On the other hand, smoking was 1.70 times more likely to be allowed at work place for tobacco smokers than their counter part respondent (OR = 1.70, 95% CI = 1.36, 2.14) and was less likely to be allowed for college/university completed and (or) higher educated respondent (OR = 0.26, 95% CI = 0.14, 0.45) than respondent with no formal schooling. Conclusion To reduce the passive smoking, lower educated people and people in urban areas should advocate more about the adverse effect of active and passive tobacco smoking. Also, smoking policy should reform introducing smoking zone at work places and residential buildings.
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Aniwada EC, Uleanya ND, Ossai EN, Nwobi EA, Anibueze M. Tobacco use: prevalence, pattern, and predictors, among those aged 15-49 years in Nigeria, a secondary data analysis. Tob Induc Dis 2018; 16:07. [PMID: 31516407 PMCID: PMC6659557 DOI: 10.18332/tid/82926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 12/29/2017] [Accepted: 01/13/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco use is a major global public health challenge. It is a risk factor for most leading causes of death, and its health impacts span from conception to adulthood. This study aims to analyse tobacco use data from the 2013 Nigerian Demographic and Health Survey (NDHS), assessing the prevalence, pattern, and socio-demographic correlates of tobacco use among Nigerians aged 15-49 years. METHODS A secondary data analysis involving 2013 NDHS was done. Data on 17 322 respondents were extracted from 36 800 participants. This number represents respondents with complete data on outcome variables of interest. Primary Sampling Unit defined on the basis of Enumeration Areas from the 2006 census was used. Head of selected household, all men and women aged 15-49 were studied. Data was collected using questionnaires. A chi-squared test and a binary logistic regression model were used in the analysis. RESULTS Generally, 6.6% of the respondents smoked cigarettes, 1.7% used snuff, 0.4% smoked pipe, and 0.2% chewed tobacco. Based on gender, 6.6% males and 6.3% females smoked cigarettes, 0.3% males and 0.4% females smoked cigarettes as well as used snuff. Predictors of cigarette use included being in age group 25-34 years (AOR 5.8; 95% CI 4.6-7.2), being ≥35 years (AOR 4.1; 95% CI 4.1-6.8), having attained primary education (AOR 1.4; 95% CI 1.2-1.8), living in north region (AOR 1.3; 95% CI 1.1-1.5), as well as being a Moslem (AOR 0.6; 95% CI 0.5-0.7). CONCLUSIONS A minor proportion of both genders uses tobacco with the commonest form being cigarettes. The commonest combination was cigarettes and snuff, even on stratification by gender. The identified predictors were age in categories, educational level and religion.
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Affiliation(s)
- Elias C Aniwada
- Department of Community Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | | | - Edmund N Ossai
- Department of Community Medicine, Ebonyi State University of Science and Technology, Abakaliki, Nigeria
| | - Emmanuel A Nwobi
- Department of Community Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Michael Anibueze
- Department of Public Health Federal Ministry of Health, Abuja, Nigeria
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Abstract
Background COPD is a globally significant public health problem and is the second leading cause of mortality. This study presents the health burden of COPD in Nepal using the Global Burden of Disease (GBD) study 2016 dataset. Methods This study used the data from the GBD repository presenting morbidity and mortality attributed to COPD, by sex and age. In GBD 2016, due to a lack of the primary source of data in Nepal, estimations on morbidity and mortality of COPD were based on its predictive covariates. Years of life lost (YLLs) were calculated based on the cause of death estimations, applying GBD's Cause of Death Ensemble modeling. Likewise, years lived with disability (YLDs) were calculated by multiplying the prevalence of each sequela by the disability weight. Disability-adjusted life years (DALYs) were derived as the sum of YLLs and YLDs. Results Between 1990 and 2016, the estimated age-standardized mortality rate due to COPD was decreasing for both genders, but the decline was much higher among males. Unlike the high rate of incidence among males, the age-standardized DALYs were found to be high among females (2,274.9 [95% UI: 1,702.0-2,881.5] per 100,000). YLLs contributed around 80% of DALYs due to COPD in 2016. Age-standardized YLLs rate was higher among females, with a value of 1,860 (95% uncertainty interval (UI): 1,282.8-2,472.8) vs 1,547.6 (95% UI: 992.1-2,018.5) among the males per 100,000 population. Conclusion The prevalence and incidence of COPD remained almost stationary over the years, but still very high. Though the incidence and prevalence of disease were high among males, the death rate and DALYs were more significant among females throughout the years. If the current situation prevails, the burden of COPD will continue to increase in the country. Hence, comprehensive social, environmental, and behavioral approaches to curtail the risk factors along with early identification, treatment, and management of COPD is of utmost importance.
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Affiliation(s)
| | - Dinesh Neupane
- Nepal Development Society, Chitwan, Nepal
- Global Health Research Center, Duke Kunshan University, Kunshan, People’s Republic of China
| | - Per Kallestrup
- Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus, Denmark
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Neupane PR, Poudel KK, Huang ZB, Steel R, Poudel JK. Distribution of Cancer by Sex and Site in Nepal. Asian Pac J Cancer Prev 2017; 18:1611-1615. [PMID: 28670003 PMCID: PMC6373810 DOI: 10.22034/apjcp.2017.18.6.1611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Cancer is one of the leading causes of death throughout the world. The indicators of cancer by site are significant to identify the problem of cancer. The purpose of this retrospective study is to perform the incidence of all cancers both in males and females over the ten years in Nepal. Methods: The data collected from all the seven hospital based cancer registries of Nepal have taken for the study. This retrospective study has presented the number of cases, frequencies, and crude incidence of all cancers by sex and site. Results: A total of 55,931 cancer cases with known age were registered throughout the hospital based seven cancer registries of Nepal from 2003 to 2012. Throughout the ten years, Lung (incl. trachea and bronchus) cancer (19.08%) was the major cancer in males followed by stomach cancer (7.86%) and Pharynx cancer (5.4%). Similarly, Cervix cancer (21.9%) was the most common cancer in females followed by breast (15.48%) and Lung (incl. trachea and bronchus) cancer (10.47%) over the ten years. This retrospective study presented the distribution of the cancer site over the ten years in Nepal. Conclusion: This retrospective study showed that lung cancer is the major cancer in male while in female cervix uteri is the most common cancer ranging from 2003 to 2012.
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Barakoti R, Ghimire A, Pandey AR, Baral DD, Pokharel PK. Tobacco Use during Pregnancy and Its Associated Factors in a Mountain District of Eastern Nepal: A Cross-Sectional Questionnaire Survey. Front Public Health 2017. [PMID: 28634580 PMCID: PMC5459881 DOI: 10.3389/fpubh.2017.00129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Tobacco using among women is more prevalent in Nepal as compared to other South-East Asian countries. The effect of its use is seen not only on the pregnant women, but also health of the growing fetus is compromised. Currently, little is known about the tobacco use among women especially during pregnancy in Nepal. This study explored the tobacco use prevalence and its associated factors during pregnancy. Materials and methods A cross-sectional study was conducted in Sankhuwasabha, a mountain district of eastern Nepal. Representative sample of 436 women of reproductive age group with infant were selected by stratified simple random sampling. Data were collected by face-to-face interviews of selected participants. Data were analyzed with SPSS version 16.0. Binary logistic regression was used to analyze the relationship among variables. Results The study revealed that the prevalence of tobacco use during pregnancy was 17.2%. Only one fifth of the research participants were asked to quit tobacco by health workers during last pregnancy. Multivariable analyses revealed that illiteracy (AOR: 2.31, CI: 1.18–4.52), more than two parity (AOR: 2.45, CI: 1.19–5.07), alcohol use during last pregnancy (AOR: 3.99, CI: 1.65–9.68), and having tobacco user within family (AOR: 2.05, CI: 1.11–3.78) are more likely to use tobacco during pregnancy. Conclusion Tobacco use during pregnancy was widely prevalent. Tobacco-focused interventions are required for antenatal women to promote cessation among user and prevent initiation with focus on overcoming problems like illiteracy, high parity, alcohol use, and having other tobacco user family members in family.
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Affiliation(s)
- Ramesh Barakoti
- Public Health Section, Group for Technical Assistance, Lalitpur, Nepal
| | - Anup Ghimire
- Department of School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Dharani Dhar Baral
- Department of School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Paras K Pokharel
- Department of School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Bishwajit G, Tang S, Yaya S, Feng Z. Burden of asthma, dyspnea, and chronic cough in South Asia. Int J Chron Obstruct Pulmon Dis 2017; 12:1093-1099. [PMID: 28435242 PMCID: PMC5388281 DOI: 10.2147/copd.s133148] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Asthma, dyspnea, and chronic cough are well-established risk factors of COPD and often associated with exacerbation of the disease, which is a leading cause of morbidity and mortality in South Asian countries. OBJECTIVE The aims of this study were to, 1) measure the prevalence of asthma, dyspnea, and chronic cough, and 2) assess the relationship between these respiratory problems and self-reported health status among South Asians. METHODS Data for this research came from the World Health Survey (2002-2003) conducted by the World Health Organization. Subjects were 35,929 men and women, aged 18 years and older, selected from Bangladesh, India, Nepal, Pakistan, and Sri Lanka. Crude prevalence rates of asthma, dyspnea, and chronic cough were presented as percentages, and the results of their association with subjective health status were presented as odds ratios and corresponding 95% CIs. RESULTS Prevalence of daily smoking was highest in Bangladesh (39.9%) and lowest in Sri Lanka (14.1%). Prevalence of asthma was highest in India (6.3%), while Nepal had the highest prevalence of dyspnea (11.3%) and chronic cough (15.3%). Overall prevalence of asthma and dyspnea was higher among women, while that of chronic cough was higher among men. Significant differences were observed in the prevalence rates of all the conditions among regular, occasional, and nonsmokers. A majority of the men and women who had asthma, dyspnea, and chronic cough had higher likelihood of reporting poor health status compared to those who did not have these diseases. CONCLUSION Findings suggest that prevalence rates of asthma, dyspnea, and chronic cough were considerably high in all the countries and were significantly associated with poor subjective health. Being a high COPD-prone region, programs targeted to address these diseases could help reduce the burden of COPD and respiratory disease-related mortalities in South Asia.
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Affiliation(s)
- Ghose Bishwajit
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.,Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
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Mia MN, Hanifi SMA, Rahman MS, Sultana A, Hoque S, Bhuiya A. Prevalence, pattern and sociodemographic differentials in smokeless tobacco consumption in Bangladesh: evidence from a population-based cross-sectional study in Chakaria. BMJ Open 2017; 7:e012765. [PMID: 28122830 PMCID: PMC5278241 DOI: 10.1136/bmjopen-2016-012765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The health hazards associated with the use of smokeless tobacco (SLT) are similar to those of smoking. However, unlike smoking, limited initiatives have been taken to control the use of SLT, despite its widespread use in South and Southeast Asian countries including Bangladesh. It is therefore important to examine the prevalence of SLT use and its social determinants for designing appropriate strategies and programmes to control its use. OBJECTIVE To investigate the use of SLT in terms of prevalence, pattern and sociodemographic differentials in a rural area of Bangladesh. DESIGN Population-based cross-sectional household survey. SETTING AND PARTICIPANTS A total of 6178 individuals aged ≥13 years from 1753 households under the Chakaria HDSS area were interviewed during October-November 2011. METHODS The current use of SLT, namely sadapatha (dried tobacco leaves) and zarda (industrially processed leaves), was used as the outcome variable. The crude and net associations between the sociodemographic characteristics of respondents and the outcome variables were examined using cross-tabular and multivariable logistic regression analysis, respectively. RESULTS 23% of the total respondents (men: 27.0%, women: 19.3%) used any form of SLT. Of the respondents, 10.4% used only sadapatha,13.6% used only zarda and 2.2% used both. SLT use was significantly higher among men, older people, illiterate, ever married, day labourers and relatively poorer respondents. The odds of being a sadapatha user were 3.5-fold greater for women than for men and the odds of being a zarda user were 3.6-fold greater for men than for women. CONCLUSIONS The prevalence of SLT use was high in the study area and was higher among socioeconomically disadvantaged groups. The limitation of the existing regulatory measures for controlling the use of non-industrial SLT products should be understood and discussion for developing new strategies should be a priority.
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Affiliation(s)
- Mohammad Nahid Mia
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - S M A Hanifi
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - M Shafiqur Rahman
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Amena Sultana
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Shahidul Hoque
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Abbas Bhuiya
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
- Future Institute, Dhaka, Bangladesh
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Poudel KK, Huang Z, Neupane PR, Steel R. Prediction of the Cancer Incidence in Nepal. Asian Pac J Cancer Prev 2017; 18:165-168. [PMID: 28240512 PMCID: PMC5563094 DOI: 10.22034/apjcp.2017.18.1.165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: The burden of cancer will increase both in males and females in Nepal. Due to the unavailability of a population based cancer registry it is difficult to precisely predict of future incidence rates. However, using hospital-based data to predict the cancer incidence in Nepal it was found that it will certainly increase both in males and females from 2013 to 2020. Material and Methods: For this research we used the cases from the first national cancer registry report (2003) to the cases of the most recent (2012) accumulated by all the hospital based cancer registries in Nepal. We used simple linear regression to analyze the data and thereby obtained a simple linear regression equation. Result: In 2020 the highest incidence rate will be for males 38.5 per 100,000 and for females, 41.4. The present study demonstrated that female cancer incidence will be higher than that in males in Nepal. Conclusion: This study provided evidence of future trends, which will feature an increasing rate of cancer in Nepal.
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Fillman T, Shimizu-Furusawa H, Ng CFS, Parajuli RP, Watanabe C. Association of cadmium and arsenic exposure with salivary telomere length in adolescents in Terai, Nepal. ENVIRONMENTAL RESEARCH 2016; 149:8-14. [PMID: 27155138 DOI: 10.1016/j.envres.2016.04.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Cadmium and arsenic are ubiquitous metals commonly found in the environment which can harm human health. A growing body of research shows telomere length as a potential biomarker of future disease risk. Few studies have examined the effects of metals on telomere length and none have focused on adolescents. OBJECTIVES In this study, the impact of cadmium and arsenic on salivary telomere length was studied in adolescents in Terai, Nepal. METHODS Adolescents aged 12-16 years old (n=351)were recruited where questionnaire interviews and both saliva and urine collection took place. Telomere length was determined by quantitative polymerase chain reaction using DNA extracted from saliva. Urinary cadmium and arsenic concentration were measured by inductively coupled plasma mass spectrometry. Multivariable linear regression was used to examine associations between urinary metals and salivary telomere length. RESULTS The geometric means and standard deviations of cadmium and arsenic were 0.33±0.33μg/g creatinine and 196.0±301.1μg/g creatinine, respectively. Urinary cadmium concentration was negatively associated with salivary telomere length after adjustment for confounders (β=-0.24, 95% CI -0.42,-0.07). Arsenic showed positive associations with telomere length but did not reach statistical significance. CONCLUSIONS This is the first study to demonstrate that cadmium may shorten adolescent telomeres, even at exposure levels that may be considered low. These results agree with prior experimental and adult epidemiological studies, and also help identify the mechanism of DNA damage by cadmium. This study expanded current evidence on the harmful effects of cadmium exposure on telomere length even to adolescents.
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Affiliation(s)
- Toki Fillman
- Department of Human Ecology, School of International Health, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Hana Shimizu-Furusawa
- Department of Human Ecology, School of International Health, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Chris Fook Sheng Ng
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
| | - Rajendra Prasad Parajuli
- Basu Laboratory, CINE Building, Macdonald Campus, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada.
| | - Chiho Watanabe
- Department of Human Ecology, School of International Health, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
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Duncan DT, Rienti M, Kulldorff M, Aldstadt J, Castro MC, Frounfelker R, Williams JH, Sorensen G, Johnson RM, Hemenway D, Williams DR. Local spatial clustering in youths' use of tobacco, alcohol, and marijuana in Boston. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:412-21. [PMID: 27096932 DOI: 10.3109/00952990.2016.1151522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Understanding geographic variation in youth drug use is important for both identifying etiologic factors and planning prevention interventions. However, little research has examined spatial clustering of drug use among youths by using rigorous statistical methods. OBJECTIVES The purpose of this study was to examine spatial clustering of youth use of tobacco, alcohol, and marijuana. METHODS Responses on tobacco, alcohol, and marijuana use from 1,292 high school students ages 13-19 who provided complete residential addresses were drawn from the 2008 Boston Youth Survey Geospatial Dataset. Response options on past month use included "none," "1-2," "3-9," and "10 or more." The response rate for each substance was approximately 94%. Spatial clustering of youth drug use was assessed using the spatial Bernoulli model in the SatScan™ software package. RESULTS Approximately 12%, 36%, and 18% of youth reported any past-month use of tobacco, alcohol, and/or marijuana, respectively. Two clusters of elevated past tobacco use among Boston youths were generated, one of which was statistically significant. This cluster, located in the South Boston neighborhood, had a relative risk of 5.37 with a p-value of 0.00014. There was no significant localized spatial clustering in youth past alcohol or marijuana use in either the unadjusted or adjusted models. CONCLUSION Significant spatial clustering in youth tobacco use was found. Finding a significant cluster in the South Boston neighborhood provides reason for further investigation into neighborhood characteristics that may shape adolescents' substance use behaviors. This type of research can be used to evaluate the underlying reasons behind spatial clustering of youth substance and to target local drug abuse prevention interventions and use.
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Affiliation(s)
- Dustin T Duncan
- a Department of Population Health , New York University School of Medicine , New York , NY , USA.,b College of Global Public Health , New York University , New York , NY , USA.,c Center for Drug Use and HIV Research , New York University College of Nursing , New York , NY , USA.,d Population Center , New York University College of Arts and Science , New York , NY , USA.,e Center for Data Science , New York University , New York , NY , USA
| | - Michael Rienti
- f Department of Geography , University at Buffalo, State University of New York , Buffalo , NY , USA.,g Center for Health and Social Research , SUNY Buffalo State, Buffalo , NY , USA
| | - Martin Kulldorff
- h Department of Medicine , Brigham and Women's Hospital and Harvard Medical School , Boston , MA , USA
| | - Jared Aldstadt
- f Department of Geography , University at Buffalo, State University of New York , Buffalo , NY , USA
| | - Marcia C Castro
- i Department of Global Health and Population , Harvard T.H. Chan School of Public Health , Boston , MA , USA.,j Harvard Center for Population and Development Studies , Harvard University , Cambridge , MA , USA
| | - Rochelle Frounfelker
- k Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - James H Williams
- a Department of Population Health , New York University School of Medicine , New York , NY , USA
| | - Glorian Sorensen
- l Center for Community-based Research , Dana-Farber Cancer Institute , Boston , MA , USA.,m Lung Cancer Disparities Center , Harvard T.H. Chan School of Public Health , Boston , MA USA.,n Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Renee M Johnson
- n Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - David Hemenway
- o Department of Health Policy and Management , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - David R Williams
- k Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA.,m Lung Cancer Disparities Center , Harvard T.H. Chan School of Public Health , Boston , MA USA.,p Departments of African and African American Studies, and Sociology , Harvard University , Cambridge , MA , USA
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Sinha DN, Suliankatchi RA, Amarchand R, Krishnan A. Prevalence and Sociodemographic Determinants of Any Tobacco Use and Dual Use in Six Countries of the WHO South-East Asia Region: Findings From the Demographic and Health Surveys. Nicotine Tob Res 2016; 18:750-6. [PMID: 26729735 DOI: 10.1093/ntr/ntv286] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 12/23/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Tobacco control is an important strategy to reduce the disease burden caused by several noncommunicable diseases. An in-depth understanding of the sociodemographic variations in tobacco use is an important step in achieving effective tobacco control. AIMS We aimed to estimate the age-standardized prevalence of any tobacco use and dual tobacco use and determine their association with sociodemographic variables in six countries (Bangladesh, Indonesia, India, Maldives, Nepal, and Timor Leste) of the WHO South-East Asia Region. METHODS The main outcome variables "any tobacco use" and "current dual use" were created from the latest available Demographic and Health Surveys data for each country. The prevalence estimates were weighted using sample weights and age standardized using the WHO standard population. Associations between the sociodemographic variables and tobacco use were calculated by performing multivariable logistic regression analysis. Analyses were performed in Stata 12 using "svyset" and "svy" commands. RESULTS The highest prevalence of any tobacco use among men was in Indonesia (76.4%) and among women in Nepal (15.7%). Also, Nepal had the highest prevalence of dual tobacco use in both men (17.9%) and women (1.5%). With regard to sociodemographic determinants, despite the inter-country variations, any and dual tobacco use were significantly associated with age, higher education, greater wealth, rural residence, and ever-married marital status. The poor and uneducated had a higher odds ratio for these practices. CONCLUSION Prevalence of dual tobacco use and its underlying socioeconomic disparities should be taken into account for the planning of tobacco control activities in the region. IMPLICATIONS The dual tobacco use phenomenon is being increasingly recognized as a distinct entity in the fight against tobacco addiction. When compared with single product users, dual users have a greater risk of developing tobacco related diseases and are less likely to quit their habits. However, this phenomenon has not been studied adequately in the South-East Asia region. In this context, this study has provided a detailed and comprehensive view of dual tobacco use and its sociodemographic determinants in six countries of the region. This study recommends that tobacco control interventions should be targeted specifically at the disadvantaged sections of the society, such as the poor and the uneducated, who are more likely to engage in "dual" as well as "any" tobacco use. This study could prove as an important reference and tool for policy making in the South-East Asia region.
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Affiliation(s)
- Dhirendra N Sinha
- Tobacco Free Initiative Unit, World Health Organization, Regional Office for South-East Asia, New Delhi, India;
| | - Rizwan A Suliankatchi
- Department of Community Medicine, Velammal Medical College Hospital and Research Institute, Madurai, India
| | - Ritvik Amarchand
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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Al-Tayar B, Tin-Oo MM, Sinor MZ, Alakhali MS. Prevalence and association of smokeless tobacco use with the development of periodontal pocket among adult males in Dawan Valley, Yemen: a cross-sectional study. Tob Induc Dis 2015; 13:35. [PMID: 26539068 PMCID: PMC4632360 DOI: 10.1186/s12971-015-0061-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/22/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The traditional type of smokeless tobacco used in the Arabian Peninsula, particularly common in Yemen, is called shammah. This study aims to determine the prevalence of shammah use and its association with the development of periodontal pockets. Other associated factors with the development of periodontal pocket were also determined. METHODS This cross-sectional study included 346 adult males aged 18 years old to 68 years old. Socio-demographic characteristics, oral hygiene practices, and shammah use history were surveyed by using a structured interview questionnaire. The clinical assessment for the presence or absence of periodontal pockets was assessed on the basis of community periodontal index. The chi-square test was used to assess significant differences in study groups in terms of the presence of periodontal pockets. Multivariable logistic regression was selected to assess potential associated factors with the development of periodontal pockets. RESULTS Among the 346 adult males, 248 (71.7 %), 30 (8.6 %), and 68 (19.7 %) males never used shammah, were former shammah users, and were current shammah users, respectively. The significant associated factors with the development of periodontal pocket were age group (30 years old and above) (Adjusted Odds Ratio (AOR) = 2.03, 95 % CI: 1.13, 3.65; P = 0.018), low family income category (AOR = 2.35, 95 % CI: 1.39, 3.99; P = 0.001), former shammah user (AOR = 2.66, 95 %: CI: 1.15, 6.15; P = 0.022), and current shammah user (AOR = 6.62, 95 %: CI: 3.59, 12.21; P = 0.001). CONCLUSIONS The results revealed that periodontal pockets were significantly associated with age group (30 years old and above), low family income category, former shammah use, and current shammah use. The findings of the current study highlighted the need to develop comprehensive shammah prevention programs and reduce periodontal disease and other shammah-associated diseases.
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Affiliation(s)
- Badr Al-Tayar
- />School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
| | - Mon Mon Tin-Oo
- />School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
| | - Mohd Zulkarnian Sinor
- />School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
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Aryal UR, Bhatta DN, Shrestha N, Gautam A. Assessment of nicotine dependence among smokers in Nepal: a community based cross-sectional study. Tob Induc Dis 2015; 13:26. [PMID: 26309428 PMCID: PMC4549004 DOI: 10.1186/s12971-015-0053-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 08/20/2015] [Indexed: 11/25/2022] Open
Abstract
Background The Fagerström Test for Nicotine Dependence (FTND) and Heaviness of Smoking Index (HSI) are extensively used methods to measure the severity of nicotine dependence among smokers. The primary objective of the study was to assess the nicotine dependence amongst currently smoking Nepalese population. Methods A community based cross-sectional study was conducted between August and November 2014. Information was collected using semi-structured questionnaire from three districts of Nepal. Data on demographic characteristics, history of tobacco use and level of nicotine dependence were collected from 587 smokers through face to face interviews and self-administered questionnaires. Non-parametric test were used to compare significant differences among different variables. Results The median age of respondents was 28 (Inter-Quartile Range: 22–40) years and the median duration of smoking was 10 (5–15) years. Similarly, the median age for smoking initiation was 16 (13–20) years and the median smoking pack year was 4.2 (1.5–12). One third of the respondents consumed smokeless tobacco products. Half of the respondents wanted to quit smoking. The median score for FTND and HSI was 4 (2–5) and 2 (0–3) respectively. There was significant difference in median FTND score with place of residence (p = 0.03), year of smoking (p = 0.03), age at smoking initiation (p = 0.02), smoking pack year (p < 0.001) and consumption of smokeless products (p < 0.05). Similarly, there was also significant difference in median HSI score with year of smoking (p = 0.002), age of smoking initiation (p < 0.001), smoking pack year (p < 0.001), and consumption of smokeless products (p < 0.05). As per FTND test score, two in ten current smokers had high nicotine dependence (FTND > 6), and HSI scored that three in ten current smokers had high nicotine dependence (HSI > 3). Conclusion Our finding revealed that nicotine dependence is prevalent among Nepalese smoking population. Further studies are required for assurance of tools through bio-markers. Next, smoking cessation program need to be developed considering level of nicotine dependence and pattern of tobacco use.
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Affiliation(s)
- Umesh Raj Aryal
- Department of Community Medicine, Kathmandu Medical College, Sinamangal, Kathmandu Nepal
| | - Dharma Nand Bhatta
- Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand ; Department of Public Health, Nobel College, Pokhara University, Sinamangal, Kathmandu Nepal
| | - Nirmala Shrestha
- Department of Community Medicine, Kathmandu Medical College, Sinamangal, Kathmandu Nepal
| | - Anju Gautam
- Department of Public Health, Nobel College, Pokhara University, Sinamangal, Kathmandu Nepal
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Smoking Prevalence and Associated Factors as well as Attitudes and Perceptions towards Tobacco Control in Northeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015. [PMID: 26206569 PMCID: PMC4515736 DOI: 10.3390/ijerph120708606] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectives: The present study aimed to investigate the prevalence of smoking and environmental tobacco smoke (ETS), the associated factors of current smoking among adults, and their attitudes and perceptions towards tobacco control. Methods: A population-based cross-sectional survey was conducted in 2012 using a self-reported questionnaire. A representative sample of adults aged 18–79 years was collected in the Jilin Province of Northeast China by a multistage stratified random cluster sampling design. Descriptive data analysis was conducted, and 95% confidence intervals (CI) of prevalence/frequency were calculated to enable comparisons between the alleged differences and similarities. Multivariable logistic regressions were used to examine the risk factors associated with current smoking. Results: 21,435 adults responded to the survey (response rate: 84.9%). The overall prevalence of ever smoking, current smoking, and former smoking or smoking cessation was 39.1% (95% CI: 38.3–39.9), 31.8% (95% CI 31.1–32.6), and 7.3% (95% CI: 6.9–7.7), respectively. The proportion of ETS exposure among adult non-smokers in Jilin Province was 61.1% (95% CI: 60.1–62.1), and 23.1% (95% CI: 22.3–24.0) of the non-smokers reported daily ETS exposure. The proportion of ETS exposure at home was 33.4% (95% CI: 32.5–34.4), but the proportion of ETS exposure at restaurants was lower (6.5%) (95% CI: 6.0–7.1). More than 90% of the participants had positive attitudes and perceptions towards tobacco control, but 23.2% (95% CI: 22.5–24.0) of them did not agree with the perception of “smoking is fully quit in public places”, and almost half of the adults (49.5%) (95% CI: 48.7–50.3) did not agree with the perception of “hazards of low-tar cigarettes are equal to general cigarettes”. Conclusions: Smoking and exposure to ETS are prevalent among adults from the Jilin Province of Northeast China. Our findings suggest that tobacco control should be advocated in Northeast China. Anti-smoking campaigns and legislation should be built into the public health curriculum and government policy.
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Mishra SR, Neupane D, Bhandari PM, Khanal V, Kallestrup P. Burgeoning burden of non-communicable diseases in Nepal: a scoping review. Global Health 2015; 11:32. [PMID: 26178459 PMCID: PMC4504073 DOI: 10.1186/s12992-015-0119-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/01/2015] [Indexed: 11/23/2022] Open
Abstract
In the last decades, prevalence of non-communicable diseases (NCDs) has escalated in Nepal. This study reviews existing evidence on the burden of non-communicable diseases in Nepal using the framework developed by Arksey and O'Malley for scoping reviews. A total of 110 articles were identified from database searches, and four from additional searches. The titles and abstracts were reviewed using predetermined screening criteria. We limited our search to existing literature in English language and included all studies regardless of year of study. Both observational and interventional studies were included. Studies conducted outside Nepal and studies not reporting prevalence of NCDs were excluded. Additionally, we searched reference lists of included publications. All previous reports of Step Wise Surveillance to NCDs (STEPS Surveys) were included in the review. Finally, a total of 60 articles were included in this review. Limited studies on population-based prevalence of mental illness, chronic respiratory diseases, cardiovascular diseases, and road traffic accidents were found. There were limitations in the studies related to generalizability due to small sample sizes, non-random sampling and lack of studies from certain region of country. Nevertheless, high prevalence of hypertension and diabetes was found. Similarly, hospital-based studies reported high burden of cardiovascular diseases among outpatient contacts. Population-based cancer registries do not exist in Nepal. However, existing studies report 8,000-10,000 cancer deaths annually in Nepal. The most common cancer site in males was the lung, followed by the oral cavity and gastric, while the first three in females were cervix uteri, breast and lung. Prevalence of psychiatric morbidity was also high. Despite alarming burden of NCDs, the country's response is weak. Nepal needs to build non-communicable disease programmes with focus on disease prevention and management as well as awareness activities in urban and rural settings at community level.
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Affiliation(s)
- Shiva Raj Mishra
- Nepal Development Society (NEDS), Bharatpur-10, Chitwan, Nepal.
- School of Population Health, University of Western Australia, Crawley, Australia.
| | - Dinesh Neupane
- Nepal Development Society (NEDS), Bharatpur-10, Chitwan, Nepal.
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
| | | | - Vishnu Khanal
- Nepal Development Society (NEDS), Bharatpur-10, Chitwan, Nepal.
- School of Public Health, Curtin University, Bentley, Australia.
| | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
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Sreeramareddy CT, Pradhan PM, Sin S. Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries. BMC Med 2014; 12:243. [PMID: 25518855 PMCID: PMC4296681 DOI: 10.1186/s12916-014-0243-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 11/21/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is limited. We provide country-level prevalence estimates for smoking and smokeless tobacco (SLT) use and assess their social determinants. METHODS We analyzed population-based data of the most recent Demographic Health Surveys performed between 2006 and 2013 involving men and women in 30 sub-Saharan African countries. Weighted country-level prevalence rates were estimated for 'current smoking' (cigarettes, pipe, cigars, etc.) and 'current SLT use' (chewing, snuff, etc.). From the pooled datasets for men and women, social determinants of smoking and SLT use were assessed through multivariate analyses using a dummy country variable as a control and by including a within-country sample weight for each country. RESULTS Among men, smoking prevalence rates were high in Sierra Leone (37.7%), Lesotho (34.1%), and Madagascar (28.5%); low (<10%) in Ethiopia, Benin, Ghana, Nigeria, and Sao Tome & Principe; the prevalence of SLT use was <10% in all countries except for Madagascar (24.7%) and Mozambique (10.9%). Among women, smoking and SLT prevalence rates were <5% in most countries except for Burundi (9.9%), Sierra Leone (6%), and Namibia (5.9%) (smoking), and Madagascar (19.6%) and Lesotho (9.1%) (SLT use). The proportion of females who smoked was lower than SLT users in most countries. Older age was strongly associated with both smoking and SLT use among men and women. Smoking among both men and women was weakly associated, but SLT use was strongly associated, with education. Similarly, smoking among men and women was weakly associated, but SLT use was strongly associated, with the wealth index. Smoking and SLT use were also associated with marital status among both men and women, as well as with occupation (agriculturists and unskilled workers). CONCLUSIONS Prevalence of smoking among women was much lower than in men, although the social patterns of tobacco use were similar to those in men. Tobacco control strategies should target the poor, not/least educated, and agricultural and unskilled workers, who are the most vulnerable social groups in sub-Saharan Africa.
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Affiliation(s)
- Chandrashekhar T Sreeramareddy
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, 43000, Malaysia.
| | - Pranil Mansingh Pradhan
- Department of Community Health Sciences, Patan Academy of Health Sciences (PAHS), P. O. Box 26500, Lagankhel-5, Lalitpur, Kathmandu, 44700, Nepal.
| | - Shwe Sin
- Department of Preclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, 43000, Malaysia.
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Kamath KP, Mishra S, Anand PS. Smokeless tobacco use as a risk factor for periodontal disease. Front Public Health 2014; 2:195. [PMID: 25368861 PMCID: PMC4202691 DOI: 10.3389/fpubh.2014.00195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 09/30/2014] [Indexed: 12/21/2022] Open
Affiliation(s)
- Kavitha P Kamath
- Department of Oral Pathology, People's Dental Academy , Bhopal , India
| | - Supriya Mishra
- Department of Periodontics, Maitri College of Dentistry and Research Centre , Anjora , India
| | - Pradeep S Anand
- Department of Dentistry, ESIC Medical College Hospital , Parippally , India
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Sreeramareddy CT, Pradhan PMS, Mir IA, Sin S. Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys. Popul Health Metr 2014; 12:22. [PMID: 25183954 PMCID: PMC4151025 DOI: 10.1186/s12963-014-0022-0] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 08/11/2014] [Indexed: 02/08/2023] Open
Abstract
Background In South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately. Methods Data from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response “yes” to one or more of three questions, such as “Do you currently smoke cigarettes?” Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by ‘svy’ command. Results Prevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries. Conclusion Policymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.
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Affiliation(s)
- Chandrashekhar T Sreeramareddy
- Department of Population Medicine, Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - Pranil Man Singh Pradhan
- Consultant Senior Public Health Officer (Influenza Surveillance Project), Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Imtiyaz Ali Mir
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
| | - Shwe Sin
- Department of Pre-clinical Sciences, Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
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Khanal V, Sauer K, Karkee R, Zhao Y. Factors associated with small size at birth in Nepal: further analysis of Nepal Demographic and Health Survey 2011. BMC Pregnancy Childbirth 2014; 14:32. [PMID: 24438693 PMCID: PMC3898999 DOI: 10.1186/1471-2393-14-32] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 01/16/2014] [Indexed: 11/10/2022] Open
Abstract
Background The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children. Methods Data from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling. Results A total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams). The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males. Conclusion One in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal.
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Affiliation(s)
- Vishnu Khanal
- School of Public Health, Curtin University, Perth, Australia.
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Khanal V, Adhikari M, Karki S. Social determinants of tobacco consumption among Nepalese men: findings from Nepal Demographic and Health Survey 2011. Harm Reduct J 2013; 10:40. [PMID: 24359118 PMCID: PMC3880042 DOI: 10.1186/1477-7517-10-40] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 12/16/2013] [Indexed: 12/23/2022] Open
Abstract
Background In the 20th century, 100 million people across the globe lost their lives due to consumption of tobacco. Every year 15,000 deaths in Nepal are attributable to tobacco smoking and using other products of tobacco. This study aimed to establish the proportion and the social determinants of tobacco use among Nepalese men based on the Nepal Demographic and Health Survey (NDHS), 2011. Methods This study used the NDHS 2011 data. The prevalence of cigarette smoking, other forms of tobacco 16 smoking and use of tobacco in any form is reported as a percentage (%). The significance of association of the statistically significant variables established using Chi-square test was further tested by using multiple logistic regression. Results Of the 4121 participants, the prevalence of consuming any form of tobacco was 51.9% [95% confidence interval (CI) (49.6%- 54.3%)]; chewing/sniffing tobacco was 34.8% (95% CI: 32.4%- 37.3%) and tobacco smoking was 33.6% (95% CI 31.3%-36.0%). Men with no education [Odds Ratio (OR) 3.477; 95% CI (2.380-5.080)], from an older age group (36–49) [OR 2.399; 95% CI (1.858-3.096)] who were from a manual occupation [OR 1.538; 95% CI (1.188-1.985)], who were married[OR 1.938; 95% CI ( 1.552-2.420)], and who were from the Terai region [OR 1.351; 95% CI (1.083-1.684)] were more likely to consume tobacco. Men who watched television at least once a week [OR 0.642; 95% CI (0.504-0.819)] were less likely to consume tobacco. Conclusions The current study showed that over half of Nepalese men consume tobacco. There is an urgent need to fully implement Nepal’s Tobacco Control and Regulation Act which will ban smoking in public places; enforced plain packaging and display of health warnings over 75% of the packaging, and has banned selling of tobacco products to those under 18 years of age. There is a need to increase the social unacceptability of tobacco in Nepal by raising awareness through different electronic and cultural media. Anti-tobacco campaigns should focus on those who are less educated, have manual occupations, are in poorer economic groups, and are from the Terai region of Nepal.
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Affiliation(s)
- Vishnu Khanal
- Sanjeevani College of Medical Sciences, Butwal, Nepal.
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The pattern of respiratory disease morbidity and mortality in a tertiary hospital in southern-eastern Nigeria. Pulm Med 2013; 2013:581973. [PMID: 24455244 PMCID: PMC3877625 DOI: 10.1155/2013/581973] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/24/2013] [Accepted: 11/13/2013] [Indexed: 12/21/2022] Open
Abstract
Background. Respiratory complaints are commonly encountered in medicine and respiratory diseases place a high burden on healthcare infrastructure. Healthcare planning should be based on adequate information: this study will help us to analyze the pattern of respiratory disease admissions in the medical wards in a developing country. Methods. The medical records of patients admitted into the medical wards over a 5-year period were retrieved and reviewed. Information obtained included demography, diagnosis, comorbid conditions, and risk factors for respiratory disease. Results. Three thousand four hundred and ninety patients were admitted into the medical wards with 325 (9.3%) of them diagnosed with a respiratory condition. There were 121 females and 204 males. The average age of the patients was 40.7 ± 14.7 years. Only 7% of the patients smoked cigarette. The commonest respiratory conditions were tuberculosis (66.8%) and pneumonia (24.9%). The commonest comorbidity was HIV infection (39.7%). Tuberculosis/HIV coinfection rate was 50.7%. HIV infection was the single most important predictor of an adverse outcome (OR 5.1, 95% CI 2.05–12.7, P < 0.001). Conclusion. Infective conditions make up a large percentage of respiratory diseases in low income countries with HIV infection constituting a significant risk factor for a poor disease outcome.
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Agbor MA, Azodo CC, Tefouet TSM. Smokeless tobacco use, tooth loss and oral health issues among adults in Cameroon. Afr Health Sci 2013; 13:785-90. [PMID: 24250322 DOI: 10.4314/ahs.v13i3.38] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tobacco use in smokeless and smoked forms is preventable cause of mortality and morbidity worldwide. OBJECTIVE To determine the prevalence of smokeless tobacco use and the association with tooth loss and oral health problems among adults in Cameroon. METHODS Adults dwelling in the Fokoue area of West Region of Cameroon were studied. RESULTS Out of the 226 participants studied, 119 of them reported smokeless tobacco use giving a prevalence of 52.7% with majority-74 (62.2%) chewing it. Three-quarters (77.3%) of the respondents use it more than than thrice-daily and more than half of them respondents have been using it for 6-10 years. The smokeless tobacco users were more of those aged 50-59 years, females, farmers, those with less than post-primary education, non alcohol consumers and those that have not received previous dental care than smokeless tobacco users. However, it was only age (p=0.006) and educational attainment (p=0.009) that were significantly associated with smokeless tobacco use. Smokeless tobacco user were more likely to have poor oral hygiene, dental caries, gingival recession, leukoplakia, erythroplakia, abnormal growth, tooth wear lesion, experienced tooth loss and edentulousnss than non smokeless tobacco users. However, the significantly associated lesions with smokeless tobacco use were tooth loss (p=0.008), edentulousness (p=0.016), gingival recession (p=0.006) and leukoplakia (p=0.001). CONCLUSION The prevalence of smokeless tobacco use was high among adults in Cameroon and it was associated with more likelihood of oral health problems. There is therefore a need for health education on the health consequences of the smokeless tobacco use with demonstrations by the dentist.
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Affiliation(s)
- M A Agbor
- Department of Community Dentistry, University of the Western Cape, Cape Town, South Africa
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Khanal V, Adhikari M, Sauer K, Zhao Y. Factors associated with the introduction of prelacteal feeds in Nepal: findings from the Nepal Demographic and Health Survey 2011. Int Breastfeed J 2013; 8:9. [PMID: 23924230 PMCID: PMC3750657 DOI: 10.1186/1746-4358-8-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 08/05/2013] [Indexed: 01/27/2023] Open
Abstract
Background A prelacteal feed is any food except mother’s milk provided to a newborn before initiating breastfeeding. Prelacteal feeding is a major barrier to exclusive breastfeeding. It is a prevalent practice in Nepal. Little is known about the factors associated with providing prelacteal feeds to the Nepalese newborn. This study explored the factors associated with providing prelacteal feeds to children under three years in Nepal using the Nepal Demographic and Health Survey (NDHS) 2011. Methods This study utilised the NDHS 2011 child dataset which is a nationally representative study. The rates of providing prelacteal feeds were reported as a proportion. Complex Sample Analysis method was used to account for the cluster design and sample weight of the study. Chi-square tests and multiple logistic regression were used to analyse the factors associated with providing prelacteal feeds. Results A sample of 3948 mothers were included in the study. A total of 841 [26.5% (95% CI: 23.1%–30.3%)] weighted proportion) of mothers reported of providing prelacteal feeds to their newborn infants. Plain water (n = 75), sugar/glucose (n = 35), gripe water (n = 3), sugar/salt solution (n = 3), fruit juice (n = 3), infant formula (n = 96), tea (n = 3) and other milk other than breast milk (n = 556) were some of the types of prelacteal feeds reported. The multiple regression analysis showed that the mothers who had no education, were not working, were from the middle wealth quintile, who had not attended four antenatal care visits, were first time mothers and who were from the Terai/Plain region were more likely to provide prelacteal feeds. Conclusions Given that one in four infants were provided with prelacteal feeds, there is a need to implement breastfeeding promotion programs to increase the practice of exclusive breastfeeding and reduce prelacteal feeding practices. Breastfeeding counseling at antenatal clinics and peer support for exclusive breastfeeding should be included as part of breastfeeding promotion programs. Mobilisation of female community health volunteers for peer counseling is also a feasible option for Nepal.
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Affiliation(s)
- Vishnu Khanal
- School of Public Health, Curtin University, Perth, WA, Australia.
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Pradhan PMS, Niraula SR, Ghimire A, Singh SB, Pokharel PK. Tobacco use and associated factors among adolescent students in Dharan, Eastern Nepal: a cross-sectional questionnaire survey. BMJ Open 2013; 3:bmjopen-2012-002123. [PMID: 23418297 PMCID: PMC3585970 DOI: 10.1136/bmjopen-2012-002123] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The tobacco use among the youth, in both smoking and smokeless forms, is quite high in the South East Asian region. Tobacco use is a major proven risk factor and contributes substantially to the rising epidemic of non-communicable diseases. OBJECTIVES To estimate the prevalence of tobacco use and determine associated factors among adolescent students of Dharan municipality. DESIGN Cross-sectional study. SETTING Secondary and higher secondary schools of Dharan municipality in Sunsari district of Nepal. PARTICIPANTS Students in middle (14-15 years) and late adolescence (16-19 years) from grades 9, 10, 11 and 12 were included. PRIMARY OUTCOME MEASURE Ever tobacco use which was defined as one who had not used any form of tobacco in the past 1 month but had tried in the past. METHODOLOGY Self-administered questionnaire adapted from Global Youth Tobacco Survey was used to assess tobacco use among the representative sample of 1312 adolescent students selected by stratified random sampling from July 2011 to July 2012. RESULTS Out of 1454 students, 1312 students completed the questionnaires with a response rate of 90.23%. Prevalence of ever use of any tobacco product was 19.7% (95% CI 17.7 to 21.6). More than half of the tobacco users (51.9%) consumed tobacco in public places whereas almost a third (75.6%) of the consumers purchased tobacco from shops. Multivariate analysis showed that tobacco use was associated with late adolescence (OR: 1.64; 95% CI 1.17 to 2.28), male gender (OR: 12.20; 95% CI 7.78 to 19.14), type of school (OR=1.72; 95% CI 1.01 to 2.94), Janajati ethnicity (OR: 2.05; 95% CI 1.39 to 3.01) and receiving pocket money ≥Nepalese rupees 500/month (OR: 1.45; 95% CI 1.04 to 2.03). CONCLUSIONS Tobacco-focused interventions are required for school/college going students to promote cessation among users and prevent initiation, focussing on late adolescence, male gender, government schools, Janajati ethnicity and higher amount of pocket money.
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Affiliation(s)
- Pranil Man Singh Pradhan
- School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
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