Search

Background: Soil-transmitted helminth (STH) infection peaks during childhood and varies by sex. The impact of market integration (MI) (increasing production for and consumption from a market-based economy) on these infection patterns, however, is unclear. In this study, STH infection is examined by sex and age among indigenous Shuar inhabiting two regions of Amazonian Ecuador: (1) the modestly market-integrated Upano Valley (UV) and (2) the more traditional Cross-Cutucú (CC) region. Methods: Kato-Katz fecal smears were examined for parasite presence and infection intensity. Factorial ANOVAs and post hoc simple effects analyses were performed by sex to compare infection intensity between regions and age categories (infant/child, juvenile/adolescent, adult). Results: Significant age and regional differences in Ascaris lumbricoides and Trichuris trichiura infection were detected. Overall, infants/children and juveniles/adolescents displayed higher parasite loads than adults. CC females exhibited higher A. lumbricoides loads than UV females, while the opposite pattern was observed for T. trichiura infection in males. Conclusions: Regional infection patterns varied by sex and parasite species, perhaps due to MI-linked environmental and lifestyle changes. These results have public health implications for the identification of individuals at risk for infection and contribute to ongoing efforts to track changes and alleviate STH infection in indigenous populations undergoing MI. [ABSTRACT FROM AUTHOR]

Background: Self-reported (SR) body mass index (BMI) values are often used to determine obesity prevalence. However, individuals frequently overestimate their height and underestimate their weight, resulting in artificially lower obesity prevalence rates. These patterns are especially apparent among older adults and overweight individuals. The present cross-sectional study uses nationally representative datasets from five countries to assess the accuracy of SR BMI values in diverse settings. Methods: Samples of older adults (=50 years old) and comparative samples of younger adults (18-49 years old) were drawn from five middle-income countries (China, India, Mexico, Russian Federation, and South Africa) in the World Health Organization's Study on global AGEing and adult health (SAGE). Participant-reported and researcher-obtained height and weight measures were used to calculate SR and measured BMI, respectively. Paired t-tests assessed differences between SR and measured BMI values by country. Linear regressions examined the contribution of measured weight and age to differences between SR and measured BMI. Results: Significant differences between SR and measured BMI values were observed (p < 0.05), but the direction of these discrepancies varied by country, age, and sex. Measured weight significantly contributed to differences between SR and measured BMI in all countries (p < 0.01). Age did not contribute significantly to variation in BMI discrepancy, except in China (p < 0.001). Conclusions: These results suggest that SR BMI may not accurately reflect measured BMI in middle-income countries, but the direction of this discrepancy varies by country. This has considerable implications for obesity-related disease estimates reliant on SR data. [ABSTRACT FROM AUTHOR]

Background: Chronic diseases contribute a large share of disease burden in low- and middle-income countries (LMICs). Chronic diseases have a tendency to occur simultaneously and where there are two or more such conditions, this is termed as 'multimorbidity'. Multimorbidity is associated with adverse health outcomes, but limited research has been undertaken in LMICs. Therefore, this study examines the prevalence and correlates of multimorbidity as well as the associations between multimorbidity and self-rated health, activities of daily living (ADLs), quality of life, and depression across six LMICs. Methods: Data was obtained from the WHO's Study on global AGEing and adult health (SAGE) Wave-1 (2007/10). This was a cross-sectional population based survey performed in LMICs, namely China, Ghana, India, Mexico, Russia, and South Africa, including 42,236 adults aged 18 years and older. Multimorbidity was measured as the simultaneous presence of two or more of eight chronic conditions including angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, stroke, and vision impairment. Associations with four health outcomes were examined, namely ADL limitation, self-rated health, depression, and a quality of life index. Random-intercept multilevel regression models were used on pooled data from the six countries. Results: The prevalence of morbidity and multimorbidity was 54.2% and 21.9%, respectively, in the pooled sample of six countries. Russia had the highest prevalence of multimorbidity (34.7%) whereas China had the lowest (20.3%). The likelihood of multimorbidity was higher in older age groups and was lower in those with higher socioeconomic status. In the pooled sample, the prevalence of 1+ ADL limitation was 14%, depression 5.7%, self-rated poor health 11.6%, and mean quality of life score was 54.4. Substantial cross-country variations were seen in the four health outcome measures. The prevalence of 1+ ADL limitation, poor self-rated health, and depression increased whereas quality of life declined markedly with an increase in number of diseases. Conclusions: Findings highlight the challenge of multimorbidity in LMICs, particularly among the lower socioeconomic groups, and the pressing need for reorientation of health care resources considering the distribution of multimorbidity and its adverse effect on health outcomes. [ABSTRACT FROM AUTHOR]