Epidemiology of elderly dependency in Tunisia. HSHS study 7

AIM

Measure the functional autonomy of elderly people and identify its components and determinants in the HSHS (Hammam-Sousse Sahloul Heart Study) population (phase 2009, Tunisia).

METHODS

This study was concerned with the quality of life of elderly people aged 65 years or more, living at home from the HSHS cohort divided into two groups: young-old (65-74 years old) and old-old (≥75 years old). The autonomy was assessed using the "Activities of Daily Living" (ADL) scale ranging from 0 to 6, the "Instrumental Activities of Daily Living" (IADL) scale ranging from 0 to 8 and, the combined scale ranging from zero to 14, iso-weighted at one point per activity. Autonomy in daily activities was retained for an ADL score=6, and an IADL score (F=8; H=5). Subjects with an overall score (sum of ADL and IADL) of 10-14 points were considered globally autonomous.

RESULTS

The population study was predominantly female (sex-ratio=0,6) with an important proportion of old-old (M=43%, F=37%). Autonomy rates were by ADL (M=57.4%, F=36.1%, p < 10-2), IADL (M=16%, F=23.9%), and by combined score (M=60.6%, F=69%, p=NS). The typology of dependency was dominated by transferring (M=35%, F=61%) and bathing (M=14%, F=19%) for ADL activities, and shopping (M=36%, F=49%) and the use of means of transport (M=22%, F=43%) for IADL activities. After adjustment, autonomy in daily activities was attributed to two independent factors: male sex (ORa=3.98, CI95% [1.328-11.971]) and age group 65-75 (ORa=4.04, CI95% [2.039- 8.025]). Autonomy in instrumental activities was associated with age group (ORa=31.5, CI95% [4.087-233.514]). Finally, overall autonomy (current and instrumental) was associated independently after logistic regression, with four independent factors, two of which were not modifiable: being female (ORa=3.1, CI95% [1.2-8.1]) and 65 to 75 years (ORa=6.2, CI95% [3.1-12.3]) and two modifiable factors: no recent hospitalization (ORa=3.8, CI95% [1.4-10.4]) and a sufficient level of physical activity (ORa=2.6, CI95% [1.3-5.3]).

CONCLUSION

The physical dependency rate of the elderly is very high in Tunisia. The promotion of physical activity, the extension of similar studies and the development of could improve the support of these people.

'Mycoplasma hominis does not share common risk factors with other genital pathogens': Findings from a South African pregnant cohort

Background

The role of Mycoplasma hominis (M. hominis) as a genital tract pathogen was still debatable. This study identified the risk factors associated with the prevalence of M. hominis in South African pregnant women.

Methods

This was a cross-sectional analysis of n = 221 prenatal patients attending a Durban hospital during November 2017 to April 2018. M. hominis was detected from urine samples using the quantitative polymerase chain reaction. The population characteristics were described using frequencies stratified by the infection status of M. hominis. In addition, a univariate analysis was used to assess the relationship between each risk factor and infection status. The analysis further considered logistic regression to assess the influence of these risk factors univariately and in the presence of other factors. The coinfection rate between M. hominis and bacterial vaginosis (BV), Trichomonas vaginalis (T. vaginalis), Mycoplasma genitalium (M. genitalium) and Candida species was also determined. All the tests were conducted at 5% level of significance.

Results

The prevalence of M. hominis in this study population was 48% (106/221). In the univariate analysis, factors significantly associated with M. hominis positivity included having past abnormal vaginal discharge (p = 0.037), having current abnormal vaginal discharge (p = 0.010) and a borderline significance (p = 0.052), which were noted for previous pre-term delivery. However, none of these factors were sustained in the multivariate analysis. There was a statistically significant association between M. hominis and BV positivity (p < 0.001). Similarly, M. hominis and M. genitalium positivity was significant (p = 0.006).

Conclusion

This study showed that M. hominis does not share common risk factors with known genital tract pathogens in a population of pregnant women and therefore cannot be considered a genital tract pathogen.

Analysis of major risk factors affecting those working in the agrarian sector (based on a sociological survey)

INTRODUCTION

Issues related to labour potential, its state and problems have consistently been a focus of attention for the International Labour Organisation (ILO). Its respective analysis shows that labour potential problems remain unresolved in many countries of the world. According to the World Health Organisation (WHO), adverse working conditions are among major factors of occupational disease development in Europe and the reason for disabilities of economically active population during 2.5% of their lifetime. The aim of the present study is to identify and analyse major risk factors, which have a bearing on people working in agriculture in the course of exercising their occupation, with account of forms of ownership of agricultural enterprises.

MATERIAL AND METHODS

Carried out was a cross-sectional study involving a sociological survey of 412 respondents - those working in agriculture - who made up the primary group and the control group. The study revealed 21 risk factors, 9 of which were work-related. A modified elementary cybernetic model of studying impact efficiency was developed with the view of carrying out a structural analysis of the sample group and choosing relevant methodological approaches.

RESULTS

It has been established that harmful factors related to working environment and one's lifestyle are decisive in the agrarian sector, particularly for workers of privately owned businesses. For one out of three respondents harmful working conditions manifested themselves as industrial noise (31.7±3.4), vibration (29.0±2.1) trunk bending and constrained working posture (36.6±3.4). The vast majority of agricultural workers (91.6±2.5) admitted they could not afford proper rest during their annual leave; male respondents abused alcohol (70.6±3.0) and smoking (41.4±2.0 per 100 workers).

CONCLUSION

The research established the structure of risk factors, which is sequentially represented by the following groups: behavioral (smoking, drinking of alcohol, rest during annual leave, physical culture), working environment and work activities (occupation, work experience, safety measures, working environment, organization and management), socioeconomic (education, financial situation).