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Singh D, Nasir S, Sharma J, Giménez-Llort L, Shahnawaz MG. Psychological Distress in Low-Income and Economically Marginalized Populations in India: Protective and Risk Factors. Behav Sci (Basel) 2024; 14:92. [PMID: 38392445 PMCID: PMC10886196 DOI: 10.3390/bs14020092] [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: 12/12/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Studies at the juncture of development economics and public health take on considerable responsibility in addressing inequality and related mental health distress. Mental healthcare in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to the Kessler Psychological Distress Scale (K-10) with moderate distress in women (M = 26.30, SD = 9.15) and mild distress in men (M = 21.04, SD = 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and the level of education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews of the six women who scored the highest on the distress scale unveiled three master themes: (1) manifestation of psychological distress, (2) contextual challenges, and (3) sources of strength and resilience. Overall, participants reported a lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental healthcare.
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Affiliation(s)
- Dipti Singh
- Department of Psychology, Jamia Millia Islamia, New Delhi 110025, India
| | - Shagufta Nasir
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Juhi Sharma
- Light Up-Emotions Matter Foundation, New Delhi 110096, India
| | - Lydia Giménez-Llort
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Institut de Neurociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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Sahoo KC, Negi S, Mahapatra P, Samantaray K, Dash GC, Dubey S, Sahay MR, Sahoo RK, Bhattacharya D, Sahoo B, Pani SP, Otmani del Barrio M, Pati S. Gender dimensions of health-related challenges among urban poor during COVID-19 pandemic in low-and middle-income countries: a systematic review and gap analysis. Front Public Health 2023; 11:1170386. [PMID: 37361176 PMCID: PMC10288984 DOI: 10.3389/fpubh.2023.1170386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
The COVID-19 pandemic has varying effects on men, women, and the transgender population. However, there is a paucity of systematic evidence on how gender and other social determinants of health during COVID-19 are affected in resource constraint urban settings. This review describes the gender dimensions of health-related challenges among the urban poor during COVID-19 in LMICs. We searched 11 scholarly online repositories including PubMed, Embase, Web of Science, CINAHL using the domain "slums," "COVID-19", "LMICs" and "gender identities." We used thematic framework analysis to synthesize qualitative data, and meta-analysis to determine the pooled prevalence. We registered in PROSPERO (CRD42020203783). We identified 6490 records, and 37 articles included. The studies reported stress among 74% women and 78% men, depression among 59% women and 62% men, and anxiety among 79% women and 63% men. Men had more stress than women during COVID-19; men are primarily responsible for household sustenance. Women had more anxiety than men, possibly because they are often the primary caregivers for children and the older population. While the severity varies according to gender identity, their vulnerability mostly related to their literacy and economy, highlighting the significance of including all social determinants in future primary studies. Systematic review registration https://www.crd.york.ac.uk/prospero/#recordDetails.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sapna Negi
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kajal Samantaray
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Girish Chandra Dash
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Shubhankar Dubey
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Mili Roopchand Sahay
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Banamber Sahoo
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sanghamitra Pati
- Health Technology Assessment in India, Indian Council of Medical Research (ICMR)-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Mũrage A, Ngunjiri A, Oyekunle A, Smith J. Social determinants of mental health among older adolescent girls living in urban informal settlements in Kenya and Nigeria during the COVID-19 pandemic. Glob Public Health 2023; 18:2264946. [PMID: 37801724 DOI: 10.1080/17441692.2023.2264946] [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: 05/30/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023]
Abstract
The health burden due to mental health has historically been underestimated with focus on communicable diseases and deaths and little consideration of disability and comorbidity effects of poor mental health. Recent data show increasing trends of mental health disorders as a share of global health burdens and vulnerability of adolescents. This paper aims to explore social determinants of mental health as experienced by adolescent girls, drawing attention to gendered risks during the COVID-19 pandemic. Semi-structured interviews with twenty-two adolescent girls in urban informal settlements in Kenya and Nigeria reveal unique environmental, socio-cultural, economic and educational factors that threatened their mental wellbeing. The pandemic exacerbated these determinants. An equitable recovery will require a consideration of not only disproportional mental health outcomes, but also social determinants that contribute to these outcomes. As more than half of the urban population in sub-Saharan Africa reside in informal settlements, this study has implications for youth-focused mental health interventions in these and similar settings.
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Nair AR, Shivanna YKG, Illimoottil JP, Rachana A, Mahasampath GS, Abraham S, Kurian S. Common mental disorders among women and its social correlates in an urban marginalized populace in South India. Int J Soc Psychiatry 2022; 68:1394-1402. [PMID: 34130540 DOI: 10.1177/00207640211025556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Common mental disorders (CMD) cause a range of health, social and economic burden, and disorders like depression and anxiety are more prevalent among women. Prevalence and factors contributing to increased vulnerability for CMDs have regional variation. Identification of factors contributing to the vulnerability is essential to both psychiatric epidemiology and in addressing mental health challenges in the community. METHODS This cross-sectional study aimed at understanding the burden of CMD and its association with social determinants of mental health. Women hailing from urban slum attending the outpatient family care facility for their medical problems constituted the sample. Data was collected using a clinical research form with variables such as sociodemographic profile, health profile, and psychosocial profile. The questionnaire had specific questions on indicators of poverty, certain stressors, and support system. Presence of CMD was assessed using Clinical Interview Schedule-Revised (CIS-R), a standard tool for CMD research in primary care settings. A cut off score of 12 and above was considered for detecting CMD. Research ethical principles were adhered to and data was analyzed using SPSS 21.0. RESULTS Among 172 women, 77 (44.8%) were diagnosed to have CMDs. Univariate analysis revealed a significant association between age, marital status, living arrangement, educational level, difficulty with buying food, presence of debt, chronic medical illness, husband's alcohol use, marital satisfaction, experiencing abuse, family support, religious participation, and a diagnosis of CMD. Multivariate analysis showed high burden with nuclear family arrangement, difficulty to buy food, experiencing abuse and, low burden with higher educational level, family support, and religious participation. CONCLUSION Considering the high prevalence and the treatment gap of CMDs in primary setting, family-physician should be sensitized for detection and management of CMDs. Social interventions targeting poverty, women's education and empowerment, and support system are likely to decrease the burden of CMDs in this population.
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Affiliation(s)
- Aiswarya R Nair
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | - Arun Rachana
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Gowri S Mahasampath
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sunil Abraham
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suja Kurian
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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Wang Y, Li H, Teo BSX, Jaharadak AA. Correlation Analysis between Residents' Income Satisfaction and Mental Health Based on Big Data. Occup Ther Int 2022; 2022:8199824. [PMID: 36032183 PMCID: PMC9381262 DOI: 10.1155/2022/8199824] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
This paper presents an in-depth study and analysis of the correlation between satisfaction with rural residents' income and mental health well-being in the context of industrial structure upgrading. Most of the studies on residents' subjective well-being from the perspective of relative income or income inequality have started from the happiness of rural residents and the satisfaction of rural residents' life, and few scholars have focused on the psychological health of rural residents. Subjective well-being is significantly related to external and internal goals in desire. Life satisfaction is significantly and positively correlated with external and internal goals, as well as the six dimensions of desire, except for social identity; positive emotions are significantly and positively correlated with internal goals; negative emotions are only negatively correlated with self-acceptance, and there is a significant positive correlation between income level and desire. In vertical income, there is also a process of judging whether the expected income is achieved. If the expected income growth level is achieved, the income satisfaction will increase. Desire mediates the effect of income level on subjective well-being. Income level influences subjective well-being through internal goals; income level influences life satisfaction and positive emotions through external goals. The relationship between income inequality and mental health is influenced by the characteristics of the population, with women and middle-aged people being the most negatively affected. This relationship is also influenced by income level, with the effect of income inequality on mental health showing a negative effect in the lower and middle-income groups but a positive effect in the higher income groups. Income inequality affects residents' mental health through the mediating effects of a sense of social justice, life stress, and trust in government. Inequality in household wealth can exacerbate the negative effects of income inequality on mental health.
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Affiliation(s)
- Yile Wang
- Nanyang Research Institute of Development Strategy, Nanyang Normal University, Nanyang, Henan 473061, China
- Graduate School of Management, Management and Science University, Selangor Sha Anan 40100, Malaysia
| | - Hanbing Li
- Graduate School of Management, Management and Science University, Selangor Sha Anan 40100, Malaysia
| | - Brian Sheng-Xian Teo
- Graduate School of Management, Management and Science University, Selangor Sha Anan 40100, Malaysia
| | - Adam Amril Jaharadak
- Centre of Cyber Security and Big Data, Management and Science University, Selangor Sha Anan 40100, Malaysia
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Rahnemaei FA, Abdi F, Kazemian E, Shaterian N, Shaterian N, Behesht Aeen F. Association between body mass index in the first half of pregnancy and gestational diabetes: A systematic review. SAGE Open Med 2022; 10:20503121221109911. [PMID: 35898952 PMCID: PMC9310335 DOI: 10.1177/20503121221109911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Gestational diabetes mellitus is a more common complication in pregnancy and rising worldwide and screening for treating gestational diabetes mellitus is an opportunity for preventing its complications. Abnormal body mass index is the cause of many complications in pregnancy that is one of the major and modifiable risk factors in pregnancy too. This systematic review aimed to define the association between body mass index in the first half of pregnancy (before 20 weeks of gestation) and gestational diabetes mellitus. Web of Science, PubMed/Medline, Embase, Scopus, ProQuest, Cochrane library, and Google Scholar databases were systematically explored for articles published until April 31, 2022. Participation, exposure, comparators, outcomes, study design criteria include pregnant women (P), body mass index (E), healthy pregnant women (C), gestational diabetes mellitus (O), and study design (cohort, case–control, and cross-sectional). Newcastle–Ottawa scale checklists were used to report the quality of the studies. Eighteen quality studies were analyzed. A total of 41,017 pregnant women were in the gestational diabetes mellitus group and 285,351 pregnant women in the normal glucose tolerance group. Studies have reported an association between increased body mass index and gestational diabetes mellitus. Women who had a higher body mass index in the first half of pregnancy were at higher risk for gestational diabetes mellitus. In the first half of pregnancy, body mass index can be used as a reliable and available risk factor to assess gestational diabetes mellitus, especially in some situations where the pre-pregnancy body mass index is not available.
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Affiliation(s)
- Fatemeh Alsadat Rahnemaei
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Abdi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Elham Kazemian
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Negar Shaterian
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Negin Shaterian
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Behesht Aeen
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Corona was scary, lockdown was worse: A mixed-methods study of community perceptions on COVID-19 from urban informal settlements of Mumbai. PLoS One 2022; 17:e0268133. [PMID: 35522676 PMCID: PMC9075633 DOI: 10.1371/journal.pone.0268133] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 04/23/2022] [Indexed: 11/19/2022] Open
Abstract
The COVID-19 pandemic has magnified the multiple vulnerabilities of people living in urban informal settlements globally. To bring community voices from such settlements to the center of COVID-19 response strategies, we undertook a study in the urban informal settlements of Dharavi, Mumbai, from September 2020-April 2021. In this study, we have examined the awareness, attitudes, reported practices, and some broader experiences of the community in Dharavi with respect to COVID-19. We have used a mixed-methods approach, that included a cross-sectional survey of 468 people, and in-depth interviews and focus group discussions with 49 people living in this area. Data was collected via a mix of phone and face-to-face interviews. We have presented here the descriptive statistics from the survey and the key themes that emerged from our qualitative data. People reported high levels of knowledge about COVID-19, with television (90%), family and friends (56%), and social media (47%) being the main sources of information. The knowledge people had, however, was not free of misconceptions and fear; people were scared of being forcefully quarantined and dying alone during the early days of COVID-19. These fears had negative repercussions in the form of patient-related stigma and hesitancy in seeking healthcare. A year into the pandemic, however, people reported a shift in attitudes from ‘extreme fear to low fear’ (67% reported perceiving low/no COVID risk in October 2020), contributing to a general laxity in following COVID-appropriate behaviors. Currently, the community is immensely concerned about the revival of livelihoods, that have been adversely impacted due to the lockdown in 2020 as well as the continued ‘othering’ of Dharavi for being a COVID hotspot. These findings suggest that urban informal settlements like Dharavi need community-level messaging that counters misinformation and denial of the outbreak; local reinforcement of COVID-appropriate behaviours; and long-term social protection measures.
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Ghazanfarpour M, Kashani ZA, Pakzad R, Abdi F, Rahnemaei FA, Akbari PA, Roozbeh N. Effect of electromagnetic field on abortion: A systematic review and meta-analysis. Open Med (Wars) 2021; 16:1628-1641. [PMID: 34761114 PMCID: PMC8569282 DOI: 10.1515/med-2021-0384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/07/2021] [Accepted: 10/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background The increasing use of new technologies by pregnant women inevitably exposes them to the risks of the electromagnetic fields (EMFs). According to the World Health Organization, EMFs are the major sources of pollutants which harm human health. This study was aimed to evaluate the effects of EMF exposure on abortion. Methods Web of Science, Cochrane Library, MEDLINE, PubMed, EMBASE, Scopus, and Google Scholar were searched until 2021. Pooled odds ratio (OR) with 95% confidence interval (CI) was estimated using a random-effects model. Heterogeneity was explored using Cochran’s Q test and I2 index. A meta-regression method was employed to investigate the factors affecting heterogeneity between the studies. The Newcastle-Ottawa scale was used to assess the credibility of the studies. Results Eligible studies (N = 17) were analyzed with a total of 57,693 participants. The mean maternal age (95% CI) was 31.06 years (27.32–34.80). Based on meta-analysis results, the pooled estimate for OR of EMF with its effects was 1.27 (95% CI: 1.10–1.46). According to the results of meta-regression, sample size had a significant effect on heterogeneity between studies (p: 0.030), but mother’s age and publication year had no significant effect on heterogeneity (p-value of bothwere >0.05). No publication bias was observed. Conclusion Exposure to EMFs above 50 Hz or 16 mG is associated with 1.27× increased risk of abortion. It may be prudent to advise women against this potentially important environmental hazard. Indeed, pregnant women should receive tailored counselling.
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Affiliation(s)
| | | | - Reza Pakzad
- Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Fatemeh Abdi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bander Abbas, Iran
- School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Alsadat Rahnemaei
- Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pouran Akhavan Akbari
- Department of Midwifery, Nursing and Midwifery Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bander Abbas, Iran
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Pitcairn CFM, Laverty AA, Chan JJL, Oyebode O, Mrejen M, Pescarini JM, Machado DB, Hone TV. Inequalities in the prevalence of major depressive disorder in Brazilian slum populations: a cross-sectional analysis. Epidemiol Psychiatr Sci 2021; 30:e66. [PMID: 34670640 PMCID: PMC8546499 DOI: 10.1017/s204579602100055x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
AIMS The mental health of slum residents is under-researched globally, and depression is a significant source of worldwide morbidity. Brazil's large slum-dwelling population is often considered part of a general urban-poor demographic. This study aims to identify the prevalence and distribution of depression in Brazil and compare mental health inequalities between slum and non-slum populations. METHODS Data were obtained from Brazil's 2019 National Health Survey. Slum residence was defined based on the UN-Habitat definition for slums and estimated from survey responses. Doctor-diagnosed depression, Patient Health Questionnaire (PHQ-9)-screened depression and presence of undiagnosed depression (PHQ-9-screened depression in the absence of a doctor's diagnosis) were analysed as primary outcomes, alongside depressive symptom severity as a secondary outcome. Prevalence estimates for all outcomes were calculated. Multivariable logistic regression models were used to investigate the association of socioeconomic characteristics, including slum residence, with primary outcomes. Depressive symptom severity was analysed using generalised ordinal logistic regression. RESULTS Nationally, the prevalence of doctor diagnosed, PHQ-9 screened and undiagnosed depression were 9.9% (95% confidence interval (CI): 9.5-10.3), 10.8% (95% CI: 10.4-11.2) and 6.9% (95% CI: 6.6-7.2), respectively. Slum residents exhibited lower levels of doctor-diagnosed depression than non-slum urban residents (8.6%; 95% CI: 7.9-9.3 v. 10.7%; 95% CI: 10.2-11.2), while reporting similar levels of PHQ-9-screened depression (11.3%; 95% CI: 10.4-12.1 v. 11.3%; 95% CI: 10.8-11.8). In adjusted regression models, slum residence was associated with a lower likelihood of doctor diagnosed (adjusted odds ratio (adjusted OR): 0.87; 95% CI: 0.77-0.97) and PHQ-9-screened depression (adjusted OR: 0.87; 95% CI: 0.78-0.97). Slum residents showed a greater likelihood of reporting less severe depressive symptoms. There were significant ethnic/racial disparities in the likelihood of reporting doctor-diagnosed depression. Black individuals were less likely to report doctor-diagnosed depression (adjusted OR: 0.66; 95% CI: 0.57-0.75) than white individuals. A similar pattern was observed in Mixed Black (adjusted OR: 0.72; 95% CI: 0.66-0.79) and other (adjusted OR: 0.63; 95% CI: 0.45-0.88) ethnic/racial groups. Slum residents self-reporting a diagnosis of one or more chronic non-communicable diseases had greater odds of exhibiting all three primary depression outcomes. CONCLUSIONS Substantial inequalities characterise the distribution of depression in Brazil including in slum settings. People living in slums may have lower diagnosed rates of depression than non-slum urban residents. Understanding the mechanisms behind the discrepancy in depression diagnosis between slum and non-slum populations is important to inform health policy in Brazil, including in addressing potential gaps in access to mental healthcare.
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Affiliation(s)
| | - Anthony A. Laverty
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | | | | | - Matías Mrejen
- São Paulo School of Business Administration, Fundação Getulio Vargas, São Paulo, Brazil
- Instituto de Estudos para Políticas de Saúde (IEPS), São Paulo, Brazil
| | - Julia M. Pescarini
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, Brazil
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas V. Hone
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Shaterian N, Abdi F, Ghavidel N, Alidost F. Role of cesarean section in the development of neonatal gut microbiota: A systematic review. Open Med (Wars) 2021; 16:624-639. [PMID: 33869784 PMCID: PMC8035494 DOI: 10.1515/med-2021-0270] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 02/06/2023] Open
Abstract
Background The delivery mode is one of the factors affecting the type of colonization of the human gut. Gut colonization affects all stages of the human life cycle, and the type of gut microbiome can contribute to immune system function, the development of some diseases, and brain development; and it has a significant impact on a newborn’s growth and development. Methods Terms defined as MeSH keywords were searched by the databases, and web search engines such as PubMed, ClinicalTrials.gov, Embase, Scopus, ProQuest, Web of Science, and Google Scholar were searched between 2010 and 2020. The quality of each study was assessed according to the Newcastle–Ottawa scale, and seven eligible and high-quality studies were analyzed. Finding The abundances of Bacteroides and Bifidobacterium during the first 3 months of life; Lactobacillus and Bacteroides during the second 3 months of life; Bacteroides and Bifidobacterium during the second 6 months of life; and Bacteroides, Enterobacter, and Streptococcus after the first year of life were higher in vaginal delivery-born infants. While infants born by cesarean section (CS) had higher abundances of Clostridium and Lactobacillus during the first 3 months of life, Enterococcus and Clostridium during the second 3 months of life, and Lactobacillus and Staphylococcus after the first year of life. Discussion Delivery mode can affect the type of the human intestinal microbiota. The CS-born babies had lower colonization rates of Bifidobacterium and Bacteroides, but they had higher colonization rates of Clostridium, Lactobacillus, Enterobacter, Enterococcus, and Staphylococcus. Given the effect of microbiota colonization on neonatal health, it is therefore recommended to conduct further studies in order to investigate the effect of the colonization on the delivery mode and on baby’s growth and development. Application to practice The aim of this study was to investigate the role of CS in the development of the neonatal gut microbiota.
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Affiliation(s)
- Negin Shaterian
- Student Research Committee, Nursing and Midwifery faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Nooshin Ghavidel
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farzane Alidost
- Student Research Committee, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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