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Maranhao Neto GA, Pavlovska I, Polcrova A, Mechanick JI, Infante-Garcia MM, Medina-Inojosa J, Nieto-Martinez R, Lopez-Jimenez F, Gonzalez-Rivas JP. The Combined Effects of Television Viewing and Physical Activity on Cardiometabolic Risk Factors: The Kardiovize Study. J Clin Med 2022; 11:jcm11030545. [PMID: 35159997 PMCID: PMC8836375 DOI: 10.3390/jcm11030545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
The aim of the present study was to evaluate the association between television viewing/physical activity (TVV/PA) interactions and cardiometabolic risk in an adult European population. A total of 2155 subjects (25–64 years) (45.2% males), a random population-based sample were evaluated in Brno, Czechia. TVV was classified as low (<2 h/day), moderate (2–4), and high (≥4). PA was classified as insufficient, moderate, and high. To assess the independent association of TVV/PA categories with cardiometabolic variables, multiple linear regression was used. After adjustments, significant associations were: High TVV/insufficient PA with body mass index (BMI) (β = 2.61, SE = 0.63), waist circumference (WC) (β = 7.52, SE = 1.58), body fat percent (%BF) (β = 6.24, SE = 1.02), glucose (β = 0.25, SE = 0.12), triglycerides (β = 0.18, SE = 0.05), and high density lipoprotein (HDL-c) (β = −0.10, SE = 0.04); high TVV/moderate PA with BMI (β = 1.98, SE = 0.45), WC (β = 5.43, SE = 1.12), %BF (β = 5.15, SE = 0.72), triglycerides (β = 0.08, SE = 0.04), total cholesterol (β = 0.21, SE = 0.10), low density protein (LDL-c) (β = 0.19, SE = 0.08), and HDL-c (β = −0.07, SE = 0.03); and moderate TVV/insufficient PA with WC (β = 2.68, SE = 1.25), %BF (β = 3.80, SE = 0.81), LDL-c (β = 0.18, SE = 0.09), and HDL-c (β = −0.07, SE = 0.03). Independent of PA levels, a higher TVV was associated with higher amounts of adipose tissue. Higher blood glucose and triglycerides were present in subjects with high TVV and insufficient PA, but not in those with high PA alone. These results affirm the independent cardiometabolic risk of sedentary routines even in subjects with high-levels of PA.
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Affiliation(s)
- Geraldo A. Maranhao Neto
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Correspondence: ; Tel.: +4-207-345-23179
| | - Iuliia Pavlovska
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic
| | - Anna Polcrova
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 601 77 Brno, Czech Republic
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Maria M. Infante-Garcia
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela;
| | - Jose Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA; (J.M.-I.); (F.L.-J.)
| | - Ramfis Nieto-Martinez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA; (J.M.-I.); (F.L.-J.)
| | - Juan P. Gonzalez-Rivas
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA) Brno, 656 91 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 3001, Venezuela;
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02138, USA
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Maranhao Neto GA, Pavlovska I, Polcrova A, Mechanick JI, Infante-Garcia MM, Hernandez JP, Araujo MA, Nieto-Martinez R, Gonzalez-Rivas JP. Prediction of Cardiorespiratory Fitness in Czech Adults: Normative Values and Association with Cardiometabolic Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10251. [PMID: 34639552 PMCID: PMC8507681 DOI: 10.3390/ijerph181910251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/19/2022]
Abstract
Cardiorespiratory fitness (CRF) is a strong independent predictor of morbidity and mortality. However, there is no recent information about the impact of CRF on cardiometabolic risk specifically in Central and Eastern Europe, which are characterized by different biological and social determinants of health. In this cross-sectional study normative CRF values were proposed and the association between CRF and cardiometabolic outcomes was evaluated in an adult Czechian population. In 2054 participants (54.6% females), median age 48 (IQR 19 years), the CRF was predicted from a non-exercise equation. Multivariable-adjusted logistic regressions were carried out to determine the associations. Higher CRF quartiles were associated with lower prevalence of hypertension, type 2 diabetes (T2D) and dyslipidemia. Comparing subjects within the lowest CRF, we see that those within the highest CRF had decreased chances of hypertension (odds ratio (OR) = 0.36; 95% CI: 0.22-0.60); T2D (OR = 0.16; 0.05-0.47), low HDL-c (OR = 0.32; 0.17-0.60), high low-density lipoprotein (OR = 0.33; 0.21-0.53), high triglycerides (OR = 0.13; 0.07-0.81), and high cholesterol (OR = 0.44; 0.29-0.69). There was an inverse association between CRF and cardiometabolic outcomes, supporting the adoption of a non-exercise method to estimate CRF of the Czech population. Therefore, more accurate cardiometabolic studies can be performed incorporating the valuable CRF metric.
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Affiliation(s)
- Geraldo A. Maranhao Neto
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
| | - Iuliia Pavlovska
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Department of Public Health, Faculty of Medicine, Masaryk University, 656 91 Brno, Czech Republic
| | - Anna Polcrova
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, 656 91 Brno, Czech Republic
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maria M. Infante-Garcia
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 1060, Venezuela;
| | | | - Miguel A. Araujo
- Department of Physical Education, School of Education, University of Los Andes, Mérida 5101, Venezuela;
| | - Ramfis Nieto-Martinez
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 1060, Venezuela;
- Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
- LifeDoc Health, Memphis, TN 38119, USA
| | - Juan P. Gonzalez-Rivas
- International Clinical Research Center (ICRC), St Anne’s University Hospital (FNUSA), 656 92 Brno, Czech Republic; (I.P.); (A.P.); (M.M.I.-G.); (J.P.G.-R.)
- Foundation for Clinic, Public Health, and Epidemiology Research of Venezuela (FISPEVEN INC), Caracas 1060, Venezuela;
- Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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Tindimwebwa LK, Ajayi AI, Adeniyi OV. Prevalence and determinants of tobacco use amongst South African adults with mental illness in the Eastern Cape. S Afr J Psychiatr 2021; 27:1637. [PMID: 34230866 PMCID: PMC8252167 DOI: 10.4102/sajpsychiatry.v27i0.1637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 04/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background Given the physical and mental health consequences of tobacco use amongst individuals with mental illness, it was imperative to assess the burden of tobacco use in this population. Aim This study examined the patterns and factors associated with tobacco use in individuals attending the outpatient unit. Setting Cecilia Makiwane Hospital Mental Health Department in Eastern Cape province, South Africa. Methods Lifetime (ever use) use and current use of any tobacco products were examined in a cross-sectional study of 390 individuals between March and June 2020. A logistic regression was fitted to determine the correlates of lifetime and current use of any tobacco products. Results The rates of ever use and current use of tobacco products were 59.4% and 44.6%, respectively. Of the participants interviewed, lifetime tobacco use was more prevalent amongst individuals with schizophrenia (67.9%) and cannabis-induced disorders (97.3%) and lower in those with major depressive disorders (36.1%) and bipolar and related disorders (43.5%). Men were six times more likely to have ever used or currently use tobacco products in comparison to women. Also, those who had a salaried job or owned a business were over three times more likely to have ever used or currently use tobacco products compared with those receiving government social grants. Conclusions The prevalence of tobacco use in this study was significantly higher than the general population in the Eastern Cape. Therefore, smoking prevention and cessation interventions targeted at the general population should target this often neglected sub-population in the region.
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Affiliation(s)
- Linda K Tindimwebwa
- Department of Psychiatry, Faculty of Health Sciences, Walter Sisulu University, East London, South Africa.,Cecilia Makiwane Hospital, East London, South Africa
| | - Anthony I Ajayi
- Population Dynamics and Sexual and Reproductive Health Research, African Population and Health Research Centre, Nairobi, Kenya
| | - Oladele V Adeniyi
- Cecilia Makiwane Hospital, East London, South Africa.,Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University, East London, South Africa
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Kulhánek A, Lukavská K, Švancarová I, Fidesová H, Gabrhelík R. Changes in tobacco use patterns and motivation to quit related to the new smoke-free legislation in the Czech Republic. J Public Health (Oxf) 2021; 43:348-354. [PMID: 31832643 DOI: 10.1093/pubmed/fdz156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/14/2019] [Accepted: 10/18/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoke-free policy belongs to key public health instruments to promote health in populations. In 2017, new comprehensive smoke-free law prohibiting smoking in indoor public places was implemented. We aimed to measure changes in tobacco smoking patterns and changes in motivation to quit in adult smokers prior to and after the new smoke-free legislation came into force. METHODS We conducted a prospective cohort study prior to and post the implementation of Act No. 65/2017 Coll. Self-reported questionnaires were administered to 131 adult smokers by trained nurses in general practitioner offices in Prague. We analysed changes in cigarette consumption per day; ratio of cigarettes smoked in pub, street, work and home; and motivation to quit using regression modelling. RESULTS We found a statistically significant decrease in the daily consumption of cigarettes (an average of 1.7 cigarettes per day, P < 0.001, d = 0.34). Smoking in indoor public spaces decreased to almost zero, while tobacco consumption in outdoor public spaces (such as streets and squares) increased by nearly 20%. We observed statistically significant increase of motivation to quit smoking (P = 0.021, d = 0.21). CONCLUSION The study brings valuable indication of the desired public health impact related to key legislative change in the Czech Republic.
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Affiliation(s)
- Adam Kulhánek
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Kateřina Lukavská
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.,Department of Psychology, Faculty of Education, Charles University, Czech Republic
| | - Iveta Švancarová
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Hana Fidesová
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
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Lomia N, Berdzuli N, Pestvenidze E, Sturua L, Sharashidze N, Kereselidze M, Topuridze M, Antelava T, Stray-Pedersen B, Stray-Pedersen A. Socio-Demographic Determinants of Mortality from Chronic Noncommunicable Diseases in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014). Int J Womens Health 2020; 12:89-105. [PMID: 32161506 PMCID: PMC7051896 DOI: 10.2147/ijwh.s235755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/27/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Worldwide, noncommunicable diseases (NCDs) are the leading cause of premature death of women, taking the highest toll in developing countries. This study aimed to identify key socio-demographic determinants of NCD mortality in reproductive-aged women (15-49 years) in Georgia. Materials and Methods The study employed the verbal autopsy data from the second National Reproductive Age Mortality Survey 2014. Univariate and multivariate logistic regression models were fitted to explore the association between each risk factor and NCD mortality, measured by crude and adjusted odds ratio (AOR) with respective 95% confidence intervals (95% CI). Results In the final sample of 843 women, 586 (69.5%) deaths were attributed to NCDs, the majority of which occurred outside a hospital (72.7%) and among women aged 45-49 years (46.8%), ethnic Georgians (85.2%), urban residents (60.1%), those being married (60.6%), unemployed (75.1%) or having secondary and higher education (69.5%), but with nearly equal distribution across the wealth quintiles. After multivariate adjustment, the odds of dying from NCDs were significantly higher in women aged 45-49 years (AOR=17.69, 95% CI= 9.35 to 33.50), those being least educated (AOR=1.55, 95% CI= 1.01 to 2.37) and unemployed (AOR=1.47, 95% CI= 1.01 to 2.14) compared, respectively, to their youngest (15-24 years), more educated and employed counterparts. Strikingly, the adjusted odds were significantly lower in "other" ethnic minorities (AOR=0.29, 95% CI= 0.14 to 0.61) relative to ethnic Georgians. Contrariwise, there were no significant associations between NCD mortality and women's marital or wealth status, place of residence (rural/urban) or place of death. Conclusion Age, ethnicity, education, and employment were found to be strong independent predictors of young women's NCD mortality in Georgia. Further research on root causes of inequalities in mortality across the socioeconomic spectrum is warranted to inform equity- and life course-based multisectoral, integrated policy responses that would be conducive to enhancing women's survival during and beyond reproduction.
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Affiliation(s)
- Nino Lomia
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nino Berdzuli
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ekaterine Pestvenidze
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lela Sturua
- Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Nino Sharashidze
- Department of Clinical and Research Skills, Faculty of Medicine, Iv. Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Maia Kereselidze
- Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Marina Topuridze
- Health Promotion Division, Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Babill Stray-Pedersen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Arne Stray-Pedersen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
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Current status of secondary prevention in Czech coronary patients in the EUROASPIRE V Study. COR ET VASA 2019. [DOI: 10.33678/cor.2019.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Movsisyan NK, Vinciguerra M, Lopez-Jimenez F, Kunzová Š, Homolka M, Jaresova J, Cífková R, Sochor O. Kardiovize Brno 2030, a prospective cardiovascular health study in Central Europe: Methods, baseline findings and future directions. Eur J Prev Cardiol 2017; 25:54-64. [DOI: 10.1177/2047487317726623] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Atherosclerotic cardiovascular disease is highly prevalent in Eastern and Central Europe, where the incidence is the highest in the world. The Kardiovize Brno 2030 study was designed as a prospective cohort study to investigate the complex relationships of cardiovascular disease and outcomes with a range of biological, psychosocial, environmental, behavioral, and economic factors in an urban population of the Czech Republic. Methods We randomly selected a 1% sample of the city of Brno residents aged 25–64 years stratified by sex and age. The study assessed traditional and novel cardiovascular disease risk factors, including sociodemographic and smoking status, physical activity, diet, depression, stress, body fat, cardio-ankle vascular index, and intima media thickness, complemented by blood tests; biological samples were stored for future analyses. Results The study enrolled 2160 participants (54.8% women), with a mean age of 47 ± 11.3 years. They were mostly full-time employed (75.6%) and married (62.1%). Hyperlipidemia was highly prevalent (70.7% in men, and 67.1% in women, NS). Hypertension and diabetes mellitus were more prevalent in men than in women (54.3% vs. 38.7% and 7.1% vs. 3.5%, respectively, P < 0.001 for both). A total of 25.3% of men and 21.9% of women smoked, whereas 20.0% and 43.0% of men and 18.1% and 26.6% of women were obese and overweight, respectively. Conclusions Cardiovascular risk factors are highly prevalent in the city of Brno, an urban population from Central Europe. The Kardiovize Brno 2030 study will provide unique multidimensional and longitudinal cardiovascular health data from a region where epidemiological studies are scarce.
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Affiliation(s)
- Narine K Movsisyan
- International Clinical Research Center, St Anne’s University Hospital, Czech Republic
| | - Manlio Vinciguerra
- International Clinical Research Center, St Anne’s University Hospital, Czech Republic
| | | | - Šárka Kunzová
- International Clinical Research Center, St Anne’s University Hospital, Czech Republic
- Department of Public Health, Masaryk University, Czech Republic
| | - Martin Homolka
- International Clinical Research Center, St Anne’s University Hospital, Czech Republic
| | - Jana Jaresova
- International Clinical Research Center, St Anne’s University Hospital, Czech Republic
| | - Renata Cífková
- International Clinical Research Center, St Anne’s University Hospital, Czech Republic
- Center for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Czech Republic
| | - Ondřej Sochor
- International Clinical Research Center, St Anne’s University Hospital, Czech Republic
- Department of Cardiovascular Medicine, Mayo Clinic, USA
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Al-Rahamneh MJ, Al-Rahamneh A, Guillén-Grima F, Arnedo-Pena A, Aguinaga-Ontoso I. Mortality trends for tuberculosis in European Union countries, 2000-2010. Enferm Infecc Microbiol Clin 2017; 36:342-351. [PMID: 28733107 DOI: 10.1016/j.eimc.2017.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 05/03/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The objective of this study was to update and analyze tuberculosis (TB) mortality data in the European Union between 2000 and 2010 separately for men and women and try to detect if there have been any changes in trends in each country and the association with the economic situation and inequalities. METHODS Data were extracted for tuberculosis deaths in 2000-2010 for 29 European Union countries and for Switzerland, via the World Health Organization (WHO) European detailed mortality database (DMDB), using the Mortality tabulation list 1 (MTL1) codes for men and women separately for one age group (20-85+). We estimated age-standardised mortality rates, and analyzed data using the Joinpoint Regression Program for men and women separately in the European Union overall and by individual country for each year. RESULTS Between 2000 and 2010, there were 68,771 recorded tuberculosis deaths in the European Union and the mortality rates were higher for men than women in the entire study zone. Overall, TB mortality rates declined linearly for both genders, but more in women than in men (from 5.43/100,000 in 2000 to 2.59/100,000 in 2010 in men and from 1.37/100,000 in 2000 to 0.51/100,000 in 2010 in women). There was decline in both genders for the entire study period, with a significant Estimated Annual Percentage Change (EAPC) of -8.1 for women and -7 for men when alpha<0.05 and with a 95% confidence interval (CI). A higher tuberculosis mortality was associated with lower economic resources and greater inequalities. CONCLUSIONS TB mortality rates in the European Union decreased overall in 2000-2010 for both genders. Men have higher TB mortality rates than women in all countries. Our findings were consistent with the downward TB mortality trend in many other countries worldwide.
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Affiliation(s)
- Moad J Al-Rahamneh
- Public University of Navarra, Department of Health Sciences, Avda. Barañain s/n, Pamplona, Navarra 31008, Spain.
| | - Anas Al-Rahamneh
- Citius-Center for Research on Information Technologies, Santiago de Compostela, A Coruña, Spain
| | - Francisco Guillén-Grima
- Public University of Navarra, Department of Health Sciences, Avda. Barañain s/n, Pamplona, Navarra 31008, Spain; Clínica Universitaria de Navarra, Department of Preventive Medicine, Pamplona, Navarra, Spain; Servicio Navarro de Salud-Osasunbidea-IdiSNA, Navarra Institute for Health Research, 31002 Pamplona, Spain
| | - Alberto Arnedo-Pena
- Public University of Navarra, Department of Health Sciences, Avda. Barañain s/n, Pamplona, Navarra 31008, Spain
| | - Inés Aguinaga-Ontoso
- Public University of Navarra, Department of Health Sciences, Avda. Barañain s/n, Pamplona, Navarra 31008, Spain
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