1
|
Masango BZ, Ferrandiz-Mont D, Chiao C. Voluntary medical male circumcision and educational gradient in relation to HIV infection among sexually active adult men in Eswatini: evidence from the national surveys in 2006-2007 and 2016. Int Health 2024; 16:208-218. [PMID: 37702181 PMCID: PMC10911536 DOI: 10.1093/inthealth/ihad070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/01/2023] [Accepted: 08/18/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND To address knowledge gaps, this study examined social determinants, such as education attainment and HIV prevention, among sexually active men (SAM), with a focus on voluntary medical male circumcision (VMMC). METHODS Two nationally representative surveys, the Eswatini Demographic and Health Survey 2006 and the Eswatini HIV Incidence Measurement Survey 2016, were used to estimate whether or not VMMC at the individual and community levels contributes to HIV disparities to any meaningful extent. Multilevel logistic regression models further explored the educational gradient in HIV infection for 2006-2007 and 2016 with regard to VMMC among SAM, while adjusting for household poverty, sexual practices and individual characteristics. RESULTS Among SAM with tertiary education, HIV prevalence declined from 25.0% in 2006-2007 to 10.5% in 2016. A 51% decrease in HIV prevalence was found to be associated with an increase in VMMC (adjusted odds ratio 0.49; 95% CI 0.40 to 0.60). Compared with SAM with tertiary education, those who had a lower level of education were more likely to have HIV infection and this education gradient effect had become particularly profound in 2016. CONCLUSIONS VMMC began to be promoted in 2008 in Eswatini and results suggest its effect, along with the education attainment effect, significantly resulted in a meaningful reduction in HIV prevalence among SAM by 2016.
Collapse
Affiliation(s)
| | - David Ferrandiz-Mont
- Public Health Surveillance and Emergency Response Department of Vallès Occidental and Vallès Oriental, Public Health Agency of Catalonia, Sant Cugat del Vallès, Barcelona 08173, Spain
| | - Chi Chiao
- Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan, ROC
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan, ROC
| |
Collapse
|
2
|
Forcadell-Díez L, Rius C, Salobral R, Sánchez-Valdivia N, Mendioroz J, Godoy P, Badiella Jarque E, Ferrandiz-Mont D, Moreno Cervera D, Jordan Suriñach B, Vilalta-Carrera A, Guadalupe-Fernández V, Mateo Basilio J, Farràs Tapiol S, Pérez G. A large outbreak of COVID-19 linked to an end of term trip to Menorca (Spain) by secondary school students in summer 2021. PLoS One 2023; 18:e0280614. [PMID: 36735702 PMCID: PMC9897546 DOI: 10.1371/journal.pone.0280614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/20/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in young people from Catalonia (Spain) who travelled to Menorca (Spain) in summer 2021. This outbreak appeared when governments relaxed Covid-19 preventive measures: the mask usage and the opening of nightlife. It was related to a super-disseminating mass event: Sant Joan festivities in Ciutadella. The aim of this article is to describe an outbreak of COVID-19 in young people aged 17-19 years from Catalonia travelling to Menorca. METHODS This is an observational study of a COVID-19 outbreak. The study population comprised Catalonian youth aged 17-19 years who travelled to Menorca from 15 June to 10 July. Epidemiological descriptive indicators were obtained. Descriptive and geographical statistics were carried out. Bivariate Moran's I test was used to identify spatial autocorrelation between the place of residence and deprivation. The outbreak control method was based on identifying and stopping chains of transmission by implementing the test-trace-isolate-quarantine (TTIQ) strategy. RESULTS We identified 515 confirmed cases infected in Menorca, 296 (57.5%) in girls and 219 (42.5%) in boys, with a total of 2,280 close contacts. Of them, 245 (10.7%) were confirmed as cases. The cases were diagnosed between 15 June and 10 July. None of the persons with confirmed infection died or required hospitalisation. The attack rate was 27.2%. There was an inverse relationship between deprivation and number of confirmed cases (p<0.005), there were clusters of confirmed cases in the most socioeconomic favoured areas. DISCUSSION The outbreak is related with young people from socioeconomic favoured areas who travelled to Menorca in summer 2021. Failure to comply with preventive measures in binge-drinking events and during holidays may have favoured SARS-CoV-2 transmission. The interauthority coordination and establishment of a clear line of leadership allowed continuous communication between institutions, which were key to managing this complex COVID-19 outbreak.
Collapse
Affiliation(s)
- Lluís Forcadell-Díez
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- * E-mail:
| | - Cristina Rius
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Raúl Salobral
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Jacobo Mendioroz
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Pere Godoy
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Elisabet Badiella Jarque
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - David Ferrandiz-Mont
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Daniel Moreno Cervera
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Berta Jordan Suriñach
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Alba Vilalta-Carrera
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Víctor Guadalupe-Fernández
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Julia Mateo Basilio
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Sergi Farràs Tapiol
- Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública, Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - Gloria Pérez
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| |
Collapse
|
3
|
Deji-Abiodun O, Ferrandiz-Mont D, Mishra V, Chiao C. A multilevel analysis of the social determinants associated with symptoms of acute respiratory infection among preschool age children in Pakistan: A population-based survey. PLoS One 2021; 16:e0260658. [PMID: 34914709 PMCID: PMC8675759 DOI: 10.1371/journal.pone.0260658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/12/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As advocated by WHO in "Closing the Health Gap in a Generation", dramatic differences in child health are closely linked to degrees of social disadvantage, both within and between communities. Nevertheless, research has not examined whether child health inequalities include, but are not confined to, worse acute respiratory infection (ARI) symptoms among the socioeconomic disadvantaged in Pakistan. In addition to such disadvantages as the child's gender, maternal education, and household poverty, the present study also examined the linkages between the community environment and ARI symptoms among Pakistan children under five. Furthermore, we have assessed gender contingencies related to the aforementioned associations. METHODS Using data from the nationally representative 2017-2018 Pakistan Demographic and Health Survey, a total of 11,908 surviving preschool age children (0-59 months old) living in 561 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between ARI symptoms and individual-level and community-level social factors. RESULTS The social factors at individual and community levels were found to be significantly associated with an increased risk of the child suffering from ARI symptoms. A particularly higher risk was observed among girls who resided in urban areas (AOR = 1.42; p<0.01) and who had a birth order of three or greater. DISCUSSIONS Our results underscore the need for socioeconomic interventions in Pakistan that are targeted at densely populated households and communities within urban areas, with a particular emphasis on out-migration, in order to improve unequal economic underdevelopment. This could be done by targeting improvements in socio-economic structures, including maternal education.
Collapse
Affiliation(s)
- Oluwafunmilade Deji-Abiodun
- Department of Medicine and Center for Global Health, University of Chicago, Chicago, IL, United States of America
| | - David Ferrandiz-Mont
- Public Health Surveillance and Emergency Response Department of Vallès Occidental and Vallès Oriental, Public Health Agency of Catalonia, Sant Cugat del Vallès, Barcelona, Spain
| | - Vinod Mishra
- United Nations Population Division, New York City, NY, United States of America
| | - Chi Chiao
- Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
4
|
Masango BZ, Ferrandiz-Mont D, Chiao C. Associations Between Early Circumcision, Sexual and Protective Practices, and HIV Among a National Sample of Male Adults in Eswatini. AIDS Behav 2021; 25:973-982. [PMID: 33025391 DOI: 10.1007/s10461-020-03056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 10/23/2022]
Abstract
To reduce HIV incidence in countries such as Eswatini (Swaziland), UNAIDS has recommended male circumcision as one possible effective strategy. We analyzed the 2016s Swaziland HIV Incidence Measurement Survey to explore the association between early circumcision and HIV history among 2964 sexually active adult males aged 15 to 64 years old. Early circumcision was defined as circumcision practiced at an age of 15 years old or younger. Results from logistic regression and OLS regression found that male adults with early circumcision are more likely to have multiple sexual partners and to use condoms. Multiple partners and condom use at last sex encounter remained associated with a higher odds of being HIV positive after controlling for all factors. Nevertheless, early circumcision is significantly associated with a lower odds of being HIV positive (AOR 0.53, p < 0.01). These findings suggest that HIV prevention may benefit when early male circumcision is carried out.
Collapse
|
5
|
Ferrandiz-Mont D, Chiao C. Is left-behind status related to differences in sexual health of Armenian mothers? Evidence from the Demographic and Health Survey in 2010 and 2015. PLoS One 2020; 15:e0228344. [PMID: 32012185 PMCID: PMC6996842 DOI: 10.1371/journal.pone.0228344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022] Open
Abstract
Background Migration caused by poverty is a growing public health issue around the world. Migrants are at heightened risk of HIV/STIs and yet the vulnerability to poor sexual health of their left-behind partners, in relation to their household wealth, remain understudied. This investigation examines differences in sexual health from 2010 to 2015 among Armenian mothers, with a specific focus on their left-behind migration status and household wealth. Methods and findings Using the population-based Demographic and Health Surveys from Armenia, multilevel logistic models were used to examine the various relationships between sexual health, left-behind status, and household wealth. The multivariate analysis results showed that self-reported sexually transmitted infection (STI) symptoms (AOR = 1.45; p<0.01) and intimate partner violence (IPV) (AOR = 1.45; p<0.01) increased from 2010 to 2015; furthermore, negotiation power over sex (AOR = 0.77; p<0.01) declined among Armenian mothers. Left-behind mothers (LBMs) were more likely to report STI symptoms than their non-LBM counterparts (AOR = 1.61; p<0.01). In addition, significant differences in sexual health between LBMs and non-LBMs with different levels of household wealth were observed. The poorest wealth quintiles were associated with a higher likelihood of self-reported STI symptoms (AOR = 1.74; p<0.05) and IPV (AOR = 1.78; p<0.01), as well as a lower likelihood of utilizing HIV testing (AOR = 0.48; p<0.01) and negotiating power over sex (AOR = 0.47; p<0.01). Conclusions This study strives to fill gaps in the literature related to the relationship between left-behind status, household wealth, and sexual health among Armenian mothers in a context of economic expansion. Among these mothers, poor sexual health outcomes increased from 2010 to 2015. Both low household wealth and a left-behind status were associated with adverse sexual health outcomes. These findings suggest future campaigns aimed at improving the sexual health of Armenian mothers need to be migration-status appropriate and socioeconomic-sensitive.
Collapse
Affiliation(s)
- David Ferrandiz-Mont
- Institute of Public Health, International Health Program, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chi Chiao
- Institute of Health and Welfare Policy, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
6
|
Abstract
Introduction Exact etiology and proper treatment of eczema are still unknown. The hygiene hypothesis and epidermal barrier dysfunction hypothesis attempted to give some plausible explanations for these issues but they still remain unclear. The identification of factors, including hygiene practices, related to eczema symptoms (ES) could shed some light on these matters. Therefore, this study aimed to determine risk factors related to ES and the ES prevalence in two disparate areas in terms of urbanization in Aceh, Indonesia. Methods A cross‐sectional study with convenience sampling was conducted among schoolchildren living in urban and rural Aceh. Data on ES, socio‐demographic characteristics, environmental factors, partial ablution and other hygiene related factors were collected by parental questionnaires. In addition, children's anthropometric measurements were also collected. Results The prevalence of current ES in the study population was 21%. When stratifying by residency, the prevalence of ES in urban and rural area was 20.93% versus 21.05%. Partial ablution was independently associated with a reduced risk of ES (OR = 0.36; 95% CI 0.13–0.96). Important risk factors for ES were paternal history of allergic disease (OR = 4.09%; 95% CI 1.51–11.11) and belonging to the older group of schoolchildren (10–13 years old) (OR = 2.57; 95% CI 1.03–6.40). Conclusions There were no significant differences in the prevalence of ES between urban and rural settings, and partial ablution had a protective effect on ES. These findings support the epidermal barrier dysfunction hypothesis as a possible pathway of eczema.
Collapse
Affiliation(s)
- David Ferrandiz-Mont
- International Health Program, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Nur Wahyuniati
- Faculty of Medicine, Department of Parasitology, Syiah Kuala University, Aceh, Indonesia
| | - Hsin-Jen Chen
- International Health Program, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| | - Mulyadi Mulyadi
- Faculty of Medicine, Department of Pulmonology and Respiratory Medicine, Syiah Kuala University, Aceh, Indonesia
| | - Tjut Mariam Zanaria
- Faculty of Medicine, Department of Parasitology, Syiah Kuala University, Aceh, Indonesia
| | - Dar-Der Ji
- International Health Program, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.,Department of Tropical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
| |
Collapse
|