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Scandinavian Journal of Primary Health... Jun 2022In epidemiological studies it is often necessary to describe morbidity. The aim of the present study is to construct and validate a morbidity index based on the...
OBJECTIVES
In epidemiological studies it is often necessary to describe morbidity. The aim of the present study is to construct and validate a morbidity index based on the International Classification of Primary Care (ICPC-2).
DESIGN AND SETTING
This is a cohort study based on linked data from national registries. An ICPC morbidity index was constructed based on a list of longstanding health problems in earlier published Scottish data from general practice and adapted to diagnostic ICPC-2 codes recorded in Norwegian general practice 2015 - 2017.
SUBJECTS
The index was constructed among Norwegian born people only ( = 4 509 382) and validated in a different population, foreign-born people living in Norway ( = 959 496).
MAIN OUTCOME MEASURES
Predictive ability for death in 2018 in these populations was compared with the Charlson index. Multiple logistic regression was used to identify morbidities with the highest odds ratios (OR) for death and predictive ability for different combinations of morbidities was estimated by the area under receiver operating characteristic curves (AUC).
RESULTS
An index based on 18 morbidities was found to be optimal, predicting mortality with an AUC of 0.78, slightly better than the Charlson index (AUC 0.77). External validation in a foreign-born population yielded an AUC of 0.76 for the ICPC morbidity index and 0.77 for the Charlson index.
CONCLUSIONS
The ICPC morbidity index performs equal to the Charlson index and can be recommended for use in data materials collected in primary health care.Key pointsThis is the first morbidity index based on the International Classification of Primary Care, 2 edition (ICPC-2)It predicted mortality equal to the Charlson index and validated acceptably in a different populationThe ICPC morbidity index can be used as an adjustment variable in epidemiological research in primary care databases.
Topics: Cohort Studies; Family Practice; General Practice; Humans; Morbidity; Primary Health Care
PubMed: 35822650
DOI: 10.1080/02813432.2022.2097617 -
BMJ Open Feb 2020More than two decades of conflict and natural disasters in Somalia have resulted in one of the longest running humanitarian crises in the world. Nutrition data have been...
BACKGROUND
More than two decades of conflict and natural disasters in Somalia have resulted in one of the longest running humanitarian crises in the world. Nutrition data have been collected over the years despite challenges to inform programmatic action. This paper explores malnutrition and morbidity trends in Somalia during the last decade, disaggregated by geographical zone and livelihood system.
METHODS
We used data from 291 cross-sectional surveys conducted in children aged 6-59 months between 2007 and 2016 in Somalia. Wasting, morbidity and stunting prevalences over time were analysed by geographic area, livelihood system and season. Logistic regressions were used to test trends.
RESULTS
The wasting trends show a striking peak in 2011, more marked in southern and central Somalia and coinciding with the famine declaration. The trend declines slightly thereafter although not consistently across all zones and livelihoods, and it raises again in 2016 especially among internally displaced persons (IDPs). Stunting declined for all groups and in all zones but with more consistent patterns in northern Somalia.Morbidity also showed a declining trend, although with multiple peaks depicting disease outbreaks.Pastoralist showed the lowest stunting estimates overall, while agrarian populations showed the lowest prevalence of wasting and morbidity. IDPs were the most affected by all outcomes. Seasonality affected the three outcomes differently by livelihood system. Stunting rates increased after the 2011 famine for all age groups within children under 5 years.
CONCLUSIONS
Despite the continuous complex situation in Somalia, there has been a sustained decline in stunting and morbidity in the last decade. Wasting trends have remained at very high levels especially in north-east and the south zones of Somalia. The findings support the importance of performing trend analyses disaggregated by zone and livelihood groups within countries to better identify priorities for programme intervention.
Topics: Child, Preschool; Cross-Sectional Studies; Famine; Female; Growth Disorders; Humans; Infant; Logistic Models; Male; Malnutrition; Morbidity; Nutrition Surveys; Nutritional Status; Prevalence; Seasons; Somalia; Wasting Syndrome
PubMed: 32071180
DOI: 10.1136/bmjopen-2019-033148 -
Journal of Obstetrics and Gynaecology :... Dec 2023A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria...
A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statement Psychiatric morbidity has immense effects on a woman's quality of life, social functioning, obstetric outcome, and economic productivity. Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability.
Topics: Pregnancy; Female; Humans; Nigeria; Cross-Sectional Studies; Quality of Life; Pregnant Women; Morbidity; Prevalence
PubMed: 37140084
DOI: 10.1080/01443615.2023.2205503 -
Danish Medical Journal Sep 2013The epidemiology and prognosis of ''fainting'' or syncope has puzzled physicians over the years. Is fainting dangerous? This is a question often asked by the... (Review)
Review
The epidemiology and prognosis of ''fainting'' or syncope has puzzled physicians over the years. Is fainting dangerous? This is a question often asked by the patient--and the answer is ''it depends on a lot of things''. The diverse pathophysiology of syncope and the underlying comorbidites of the patients play an essential role. In epidemiology these factors have major impact on the outcome of the patients. Until recently, even the definition of syncope differed from one study to another which has made literature reviews difficult. Traditionally the data on epidemiology of syncope has been taken from smaller studies from different clinical settings with wide differences in patient morbidity. Through the extensive Danish registries we examined the characteristics and prognosis of the patients hospitalized due to syncope in a nationwide study. The aims of the present thesis were to investigate: 1) the use, validity and accuracy of the ICD-10 diagnosis of syncope R55.9 in the National Patient Registry for the use of this diagnosis in the epidemiology of syncope, 2) diagnostics used and etiology of a random selection of patients who had a discharge diagnosis of R55.9, 3) the incidence, prevalence and cardiovascular factors associated with the risk of syncope, 4) the prognosis in healthy individuals discharged after syncope, and 5) the prognosis of patients after syncope and evaluation of the CHADS2 score as a tool for short- and long-term risk prediction. The first studies of the present thesis demonstrated that the ICD-10 discharge diagnosis could reliably identify a cohort of patients admitted for syncope and that the discharge code carried a high number of unexplained cases despite use of numerous tests. The last studies showed that syncope is a common cause for hospital contact in Denmark and that the risk of syncope is tightly associated with cardiovascular co-morbidities and use of pharmacotherapy. Furthermore in patients with no co-morbidities (or healthy individuals), syncope is a significant and independent prognostic factor of adverse cardiovascular outcome and death compared to the background population. Lastly, evaluation of the CHADS2 score, as a tool for risk stratification, showed that it provided additional prognostic information on short- and long-term cardiovascular mortality in syncope patients compared to controls.
Topics: Age Factors; Cardiovascular Diseases; Comorbidity; Denmark; Humans; Incidence; International Classification of Diseases; Prevalence; Prognosis; Registries; Risk Assessment; Severity of Illness Index; Sex Factors; Syncope
PubMed: 24001470
DOI: No ID Found -
Respirology (Carlton, Vic.) Aug 2016Co-morbidities in idiopathic pulmonary fibrosis are common. These co-morbidities include obstructive sleep apnoea, gastro-oesophageal reflux disease, pulmonary... (Review)
Review
Co-morbidities in idiopathic pulmonary fibrosis are common. These co-morbidities include obstructive sleep apnoea, gastro-oesophageal reflux disease, pulmonary hypertension and depression. The presence of co-morbidities among patients with idiopathic pulmonary fibrosis contributes to worse quality of life, morbidity and mortality. Despite the high prevalence of certain co-morbidities in idiopathic pulmonary fibrosis, the optimal screening and management of many of these conditions remains unclear. The impact of co-morbidities on this patient population is becoming more apparent. Their relevance will only increase as significant effort is being made to develop novel therapeutics that will alter the disease trajectory of patients with idiopathic pulmonary fibrosis. The purpose of this review is to focus on the epidemiology, pathophysiology, diagnosis and management of select co-morbidities, including obstructive sleep apnoea, gastro-oesophageal reflux disease, pulmonary hypertension and depression, in idiopathic pulmonary fibrosis.
Topics: Comorbidity; Depression; Disease Management; Gastroesophageal Reflux; Humans; Hypertension, Pulmonary; Idiopathic Pulmonary Fibrosis; Prevalence; Sleep Apnea, Obstructive
PubMed: 26365251
DOI: 10.1111/resp.12622 -
BMC Psychiatry Jun 2021Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some...
BACKGROUND
Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some cases may occur in the summer with remission in the autumn-winter. In this study the authors evaluated the association between seasonal changes in mood and behavior with psychiatric disturbance.
METHOD
Descriptive, cross-sectional study. Participants, students attending higher education and vocational courses (N = 324), were evaluated with the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Screening Scale for Mental Health (ER80).
RESULTS
Among the respondents, 12.7% showed seasonal affective disorder (SAD), 29.0% showed subsyndromal seasonal affective disorder (s-SAD) and 58.3% did not show significant seasonal affective symptomatology. As for psychiatric morbidity, 36.6% of subjects with SAD and 13.8% of those with s-SAD were considered "psychiatric cases" whereas for subjects without SAD this value was only 3.2%.
CONCLUSIONS
There is a statistically significant association between psychiatric morbidity and seasonal affective disorder. This association corroborates the importance of the Seasonal Pattern Assessment Questionnaire in screening for seasonal fluctuations in mood and behavior related disorders, and the clinical need for recognition of these conditions, particularly associated suffering and disabilities.
Topics: Cross-Sectional Studies; Humans; Morbidity; Prevalence; Seasonal Affective Disorder; Seasons
PubMed: 34187417
DOI: 10.1186/s12888-021-03313-z -
Medical Sciences (Basel, Switzerland) May 2021Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of... (Review)
Review
Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson's disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.
Topics: Aged; Comorbidity; Humans; Morbidity; Quality of Life; Sleep; Sleep Wake Disorders
PubMed: 34063838
DOI: 10.3390/medsci9020031 -
Psychiatria Danubina 2020The aim of this study was to explore the co-morbidity between Major Depressive Disorder (MDD) and Schizophrenia (SZ) among a large number of patients describing their...
BACKGROUND
The aim of this study was to explore the co-morbidity between Major Depressive Disorder (MDD) and Schizophrenia (SZ) among a large number of patients describing their clinical characteristics and rate of prevalence.
SUBJECTS AND METHODS
A cohort-study was carried out on 396 patients affected by MDD and SZ who consecutively attended the Department of Psychiatry, Rumeilah Hospital in Qatar. We employed the World Health Organization - Composite International Diagnostic Interview (WHO-CIDI) and the Structured Clinical Interview for DSM-5 (SCID-5) for diagnoses. Patients were also grouped in MDD patients with and without co-morbid SZ (MDD vs MDD/SZ) for comparisons.
RESULTS
A total of 396 subjects were interviewed. MDD patients with comorbid SZ (146(36.8%)) were 42.69±14.33 years old whereas MDD without SZ patients (250 (63.2%)) aged 41.59±13.59. Statistically significant differences between MDD with SZ patients and MDD without SZ patients were: higher BMI (Body Mass Index) (p=0.025), lower family income (p=0.004), higher rate of cigarette smoking (p<0.001), and higher level of consanguinity (p=0.023). Also, statistically significant differences were found in General Health Score (p=0.017), Clinical Global Impression-BD Score (p=0.042), duration of illnesses (p=0.003), and Global Assessment of Functioning (p=0.012). Rates of anxiety dimensions (e.g.: general anxiety, agoraphobia, somatisation, etc.), mood dimensions (e.g.: major depression, mania, oppositional defiant behaviour, Bipolar disorder), Attention Deficit Hyperactivity Disorder, psychotic and personality dimensions were higher among MDD with SZ patients than MDD without SZ.
CONCLUSION
This study confirms that MDD with SZ is a common comorbidity especially among patients reporting higher level of consanguinity. MDD/SZ comorbidity presents unfavourable clinical characteristics and higher levels of morbidity at rating scales.
Topics: Adult; Cohort Studies; Comorbidity; Depressive Disorder, Major; Female; Humans; Male; Prevalence; Schizophrenia; Schizophrenic Psychology
PubMed: 32303036
DOI: 10.24869/psyd.2020.78 -
Indian Journal of Public Health 2023Horticulture or working in plant nursery is one of the main occupations in few areas of the southern part of West Bengal. It is considered as a hazardous health sector... (Observational Study)
Observational Study
BACKGROUND
Horticulture or working in plant nursery is one of the main occupations in few areas of the southern part of West Bengal. It is considered as a hazardous health sector worldwide as it possesses several physical, chemical, and biological risks.
OBJECTIVES
The present study aimed to estimate the occupational health hazards and morbidity profile among the nurserymen living in a rural area of West Bengal and to determine the factors associated with occupational health hazards and morbidity of the participants.
MATERIALS AND METHODS
An observational descriptive, cross-sectional study was conducted from September 2021 to November 2021among 132 nurserymen in a subcenter of South 24 Parganas district of West Bengal through interview using a predesigned, pretested, and structured schedule. Data were analyzed using the SPSS version 25.0. Bivariate and multivariate logistic regression was used to determine the factors associated with health hazards and morbidity.
RESULTS
Different types of occupational hazards experienced by the participants were physical (100%), biological (91.6%), ergonomical (91%), chemical (85.6%), and psychological (31.8%). Most common occupation-related morbidity reported was skin rash (82.6%) followed by headache (78%), neck pain (78%), and low back pain (59.8%). Multivariate logistic regression revealed that age ≥60 years, daily working hours of ≥7 h and presence of chronic disease were statistically significant covariates of hazards. Female gender and working span of >10 years were significant covariates of "high morbidity" (P < 0.05).
CONCLUSION
One or more types of occupational hazards were experienced by the respondents. Future interventions to address hazards and morbidities of the workers along with the development of preventive measures are the need of the hour.
Topics: Humans; Middle Aged; Occupational Health; Cross-Sectional Studies; India; Morbidity; Logistic Models
PubMed: 37459013
DOI: 10.4103/ijph.ijph_711_23 -
Cardiology Clinics Feb 2017Infective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of 25% and significant debilitating morbidities. Although much has been reported on... (Review)
Review
Infective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of 25% and significant debilitating morbidities. Although much has been reported on contemporary IE in high-income countries, conclusions on the state of IE in low- and middle-income countries (LMICs) are based on studies conducted before the year 2000. Furthermore, unique challenges in the diagnosis and management of IE persist in LMICs. This article reviews IE studies conducted in LMICs documenting clinical experiences from the year 2000 to 2016. Presented are the causes of IE, management of patients with IE, and prevailing challenges in diagnosis and treatment of IE in LMICs.
Topics: Developing Countries; Endocarditis; Humans; Morbidity; Poverty; Socioeconomic Factors
PubMed: 27886786
DOI: 10.1016/j.ccl.2016.08.011