Impact of pregnancy vaccine uptake and socio-demographic determinants on subsequent childhood Measles, Mumps and Rubella vaccine uptake: A UK birth cohort study

BACKGROUND

We examined the association between socio-demographic determinants and uptake of childhood Measles, Mumps & Rubella (MMR) vaccines and the association between pregnant women's pertussis vaccine uptake and their children's MMR vaccine uptake.

METHODS

We used nationally-representative linked mother-baby electronic records from the United Kingdom's Clinical-Practice-Research-Datalink. We created a birth cohort of children born between 01.01.2000 and 12.12.2020. We estimated the proportion vaccinated with first MMR vaccine by age 2 years and first and second MMR vaccines by age 5 years. We used survival-analysis and Cox proportional hazard models to examine the association between deprivation, ethnicity and maternal age and pertussis vaccination in pregnancy and children's MMR uptake.

RESULTS

Overall, 89.4 % (710,797/795,497) of children had first MMR by age 2 years and 92.6 % (736,495/795,497) by age 5 years. Among children still in the cohort when second MMR was due, 85.9 % (478,480/557,050) had two MMRs by age 5 years. Children from the most-deprived areas, children of Black ethnicity and children of mothers aged < 20 years had increased risk of being unvaccinated compared with children from the least-deprived areas, White children and children of mothers aged 31-40 years: first MMR by 5 years, adjusted Hazard Ratios (HR):0.86 (CI:0.85-0.87), HR:0.87 (CI:0.85-0.88) & HR:0.89 (CI:0.88-0.90) respectively. Deprivation was the determinant associated with the greatest risk of missed second MMR: adjusted HR:0.82 (CI:0.81-0.83). Children of mothers vaccinated in pregnancy were more likely than children of unvaccinated mothers to have MMR vaccines after adjusting for ethnicity, deprivation, and maternal age (First and Second MMRs adjusted HRs:1.43 (CI:1.41-1.45), 1.49 (CI:1.45-1.53).

CONCLUSION

Children from most-deprived areas are less likely to have MMR vaccines compared with children from least-deprived areas. Mothers who take up pregnancy vaccines are more likely to have their children vaccinated with MMR. Healthcare services should promote and facilitate access to both maternal and childhood vaccines during pregnancy.

Socio-economic and socio-demographic determinants of diet diversity among rural pregnant women from Pune, India

Background

Diet diversity signifies the nutrient adequacy of an individual and thus has gained widespread significance in recent times. In developing countries achieving maximum diet diversity, especially among pregnant women from rural areas is challenging although of great importance. However, to do so understanding the primary factors associated with diet diversity is important. This paper, therefore, assessed the socio-demographic and socio-economic determinants of diet diversity among rural pregnant women in India.

Methods

The study consisted of a community-based prospective cohort of n = 204 pregnant women attending primary healthcare centers (PHC) across 14 villages in Mulshi Taluka, Pune, Maharashtra, India. The data was collected using a structured questionnaire through a one-to-one interview method.

Results

The prevalence of low, medium and high diet diversity was 56.4%, 33.3%, and 10.3% respectively. Minimum diversity in the diet was achieved among 73.5% of pregnant women. The mean diet diversity score (DDS) was 3.6 ± 1.3 with starchy staples being (100%) of commonly consumed foods. Young (< 20 years) women (OR = 5.2; CI:1.9- 13.8), housewives (OR = 3; CI:1.4–6.7), husbands working as skilled laborers (OR = 2.5; CI:1.2–5.5) were at significant risk of having low diet diversity scores. Whereas, those living in a joint family (OR = 0.3; CI:0.1–0.6), not owning a house (OR = 0.5; CI:0.2–0.9), and having a poor income (OR = 1.9; CI: 0.9- 3.7) were less likely to have low diet diversity.

Conclusion

Socio-economic and demographic factors (maternal age, mother's occupation, and husband's occupation) influenced the diet diversity among pregnant women. Monotonous diets are commonly seen in developing countries, especially in rural areas which can be a risk factor for poor nutrient adequacy and health of pregnant women. Policies and programs about these determinants of diet diversity should be enacted to replace the poor quality diets to ensure improved diet diversity and nutrient adequacy.

The main factors influencing COVID-19 spread and deaths in Mexico: A comparison between phases I and II

This article investigates the geographical spread of confirmed COVID-19 cases and deaths across municipalities in Mexico. It focuses on the spread dynamics and containment of the virus between Phase I (from March 23 to May 31, 2020) and Phase II (from June 1 to August 22, 2020) of the social distancing measures. It also examines municipal-level factors associated with cumulative COVID-19 cases and deaths to understand the spatial determinants of the pandemic. The analysis of the geographic pattern of the pandemic via spatial scan statistics revealed a fast spread among municipalities. During Phase I, clusters of infections and deaths were mainly located at the country's center, whereas in Phase II, these clusters dispersed to the rest of the country. The regression results from the zero-inflated negative binomial regression analysis suggested that income inequality, the prevalence of obesity and diabetes, and concentration of fine particulate matter (PM 2.5) are strongly positively associated with confirmed cases and deaths regardless of lockdown.

Prevalence and socio-demographic correlates of alcohol consumption: Survey findings from five states in India

AIM

To investigate the association between socio-demographic characteristics and alcohol consumption in India.

METHODS

Analytical data were derived from household surveys conducted by the study team that included 6088 adults in five states of India (male = 3803, female = 2285). The sample was a cross-sectional selected through stratified multistage sampling design. The survey collected data on socio-demographic characteristics of the respondents as well as the pattern of alcohol consumption. Multivariate logistic regression models were fitted to investigate the socio-demographic association with both alcohol consumption and types of alcoholic beverages consumed (distilled spirits, country liquor, home-brewed).

RESULTS

More than one-third of the sample respondents (38.6%, 95%CI = 29.2-48.8%) reported to be current drinkers and approximately one-fifth (21.7%, 95%CI = 4.2-31.7%) were heavy drinkers and 7.4% (95%CI = 4.6-11.6%) were heavy episodic drinkers. In multivariate analyses, age greater than 50 years (OR = 0.70, 95%CI = 0.56-0.86), being female (OR = 0.08, 95%CI = 0.06-0.09), schooling greater than 12 years (OR = 0.61, 95% CI = 0.50-0.75), owning land (OR = 0.74, 95%CI = 0.65-0.86), and living in pucca house (OR = 0.85, 95% CI = 0.74-0.98) were negatively associated with current drinking status. Higher income (OR = 1.30, 95%CI = 1.08-0.57) and living in urban areas (OR = 1.54, 95%CI = 1.33-1.78) were positively associated with current drinking status.

CONCLUSIONS

Substantial differences in the socio-demographic correlates of alcohol consumption and types of alcoholic beverages exist in India. It is recommended that intervention and prevention strategies to curb alcohol consumption should include drinkers' characteristic.

Determinants of aggregate length of hospital stay in the last year of life in Switzerland

Background

In contrast to individual preferences, most people in developed countries die in health care institutions, with a considerable impact on health care resource use and costs. However, evidence about determinants of aggregate length of hospital stay in the last year preceding death is scant.

Methods

Nationwide individual patient data from Swiss hospital discharge statistics were linked with census and mortality records from the Swiss National Cohort. We explored determinants of aggregate length of hospital stay in the last year of life in N = 35,598 inpatients ≥65 years who deceased in 2007 or 2008.

Results

The average aggregate length of hospital stay in the last year of life was substantially longer in the German speaking region compared to the French (IRR 1.36 [95 % CI 1.32–1.40]) and Italian (IRR 1.22 [95 % CI 1.16–1.29]) speaking region of the country. Increasing age, female sex, multimorbidity, being divorced, foreign nationality, and high educational level prolonged, whereas home ownership shortened the aggregate length of hospital stay. Individuals with complementary private health insurance plans had longer stays than those with compulsory health insurance plans (IRR 1.04 [95 % CI 1.01–1.07]).

Conclusions

The aggregate length of hospital stay during the last year of life was substantially determined by regional and socio-demographic characteristics, and only partially explained by differential health conditions. Therefore, more detailed studies need to evaluate, whether these differences are based on patients’ health care needs and preferences, or whether they are supply-driven.

Gynecological morbidities in a population of rural postmenopausal women in pondicherry: uncovering the hidden base of the iceberg

RESEARCH QUESTIONS

(1) What is the prevalence of common gynecological morbidities and gynecological symptoms among postmenopausal women in rural Pondicherry? (2) What are the determinants of postmenopausal gynecological morbidities?

METHODS

STUDY DESIGN

Community-based cross-sectional study.

SETTING

Two villages in Pondicherry, India.

PARTICIPANTS

All postmenopausal women aged 50 years and above in the two villages. The participants were interviewed in their households and motivated for examination. By adopting social mobilization strategies coupled with a "Geriatric-friendly" camp approach, 239 eligible women completed gynecological examination. Bivariate analysis of association between gynecological morbidities and its determinants was done using Chi square test.

RESULTS

Among the study population, the prevalence of at least one gynecological morbidity was 44.4 % (CI 38.0-50.8), whereas the prevalence of at least one gynecological symptom was only 25.9 % (CI 20.3-31.5). Genital prolapse was the most common morbidity which was present in 18.8 % of women. On bivariate analysis, the prevalence of gynecological morbidity was significantly associated with a lower socio-economic status and associated chronic co-morbidities.

CONCLUSIONS

Postmenopausal women harbor a considerable magnitude of gynecological morbidities, and approaches such as geriatric-friendly camps can help in uncovering the full spectrum of gynecological morbidities.