Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study.
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ABSTRACT:
SUBMITTER: Mactaggart I
PROVIDER: S-EPMC5890974 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Although the association between disability and multidimensional poverty has been consistently found in several studies in Low- and Middle-Income Countries. None of these studies so far has used an extended and internationally comparable questionnaire (extended Washington Group Questionnaire) and a clinical screening of disability. The purpose of this article is to calculate, compare and analyse the levels of multidimensional poverty of people with and without disabilities in Guatemala (national), in one district of Cameroon (Fundong Health District, North West Cameroon) and in one district in India (Mahbubnagar District, Telangana State). We used a case-control study approach; adults with disabilities identified in a population-based disability survey using the Washington Group Extended Questionnaire were matched to age-sex matched controls without disabilities and interviewed about their levels of access and use of different social services. Following the Alkire-Foster method, the levels of multidimensional poverty between cases and control were computed and compared. Additionally, we analysed how disability and other individual characteristics are associated with being poor in each country. The results showed that people with disabilities in all three-study settings face significantly higher levels of poverty and the intensity of their poverty is higher. In the case of Cameroon, differences in the levels of deprivation between people with and without disabilities were smaller than those observed in India and Guatemala. This might suggest that in countries with higher levels of human, economic and social development people with disabilities are being left behind by public policies aiming to reduce poverty and deprivation in basic indicators. In addition, indicators related to health contributed the most to the levels of multidimensional poverty for people with disabilities. These findings provide important evidence about the association of multidimensional poverty and disability and underline the importance of including indicators capturing individual deprivations to analyse poverty for this group.
| S-EPMC7212179 | biostudies-literature
Project description:BACKGROUND:Persons with speech, language, and/or voice disabilities (collectively referred to as communication disabilities (CD)) represent 10% of the US population, yet their healthcare outcomes have not been described. Generally, research shows that persons with disabilities have poorer health and healthcare outcomes than their non-disabled peers. OBJECTIVES:To examine the health and healthcare outcomes of persons with CD compared to persons without CD. DESIGN:Retrospective cohort study of the 2012 National Health Interview Survey, which contained the first supplemental questions on CD. We compared proportional differences in outcomes; logistic and ordered logistic regression assessed the outcome measures across CD categories, controlling for demographics, non-communication disabilities, and chronic conditions. Findings are weighted to permit national inferences. PARTICIPANTS:Adults (??18 years old) were divided into 4 mutually exclusive groups: people with voice disabilities only; speech/language disabilities only; speech/language and voice disabilities; and people without CD. MAIN MEASURES:Chronic health conditions; self-rated health; access to care; unmet needs for care; healthcare utilization. KEY RESULTS:Adults with CD more frequently had ??1 chronic condition (voice 67.9%, speech/language 68.6%, speech/language and voice 79.9%, no CD 50.1%, p?<?0.001) and reported fair/poor health (voice 19.5%, speech/language 32.5%, speech/language and voice 48.3%, no CD 11.2%, p?<?0.001) compared to those without CD. Adults with CD more frequently utilized healthcare compared to those without CD. However, persons with CD endorsed greater difficulties accessing care than those without CD, including identifying a usual source of care, trouble finding a physician, and delaying or foregoing care (e.g., delayed due to availability of care: voice 26.1%, speech/language 37.2%, speech/language and voice 30.8% no CD 16.1%, p?<?0.001). CONCLUSIONS:Persons with CD are medically complex and experience greater challenges accessing healthcare than persons without CD. Healthcare providers need support and tools to provide equitable care that addresses the medical needs of persons with CD.
| S-EPMC6258615 | biostudies-literature
Project description:Research synthesis is an important approach to summarizing a body of literature. Usually, the goal is to determine the effectiveness of an intervention, to determine the strength of association between two factors, to determine the prevalence of a condition, or to scope the literature. Research synthesis methods can also be used to appraise the quantity and quality of research output from institutions or countries. In the latter case, standard quantitative systematic review methodologies would not apply and investigators must borrow strategies from qualitative syntheses and bibliometric analyses to develop a complete and meaningful appraisal of the literature from a given country.In this paper, we use the example of Cameroon to highlight some of the challenges and opportunities of appraising a body of country-specific literature. A comprehensive and exhaustive search of the literature was conducted to identify health-related literature from Cameroon published from 2005 to 2014. Titles were screened in duplicate.A total of 8624 studies were retrieved of which 721 were retained. The main challenges were making a choice of synthesis approach; selecting the right databases, data storage and management; and sustaining the team. Key opportunities include enhanced networking, a detailed appraisal of funding sources, international collaborations, language of publication, and issues with study design. The product is a comprehensive and informative body of evidence that can be used to inform policy with regards to international collaboration, location of research studies, language of publication, knowledge areas of focus, and gaps.Knowledge synthesis approaches can be adapted for appraisal of country-specific research and offer opportunities for in-depth appraisal of research output.
| S-EPMC5549358 | biostudies-other
Project description:ObjectivesTo assess access to adequate water, sanitation and hygiene (WASH) among people with disabilities at the household and individual level.DesignCross-sectional surveys.SettingData were included from five district-level or regional-level surveys: two in Bangladesh (Bangladesh-1, Bangladesh-2), and one each in Cameroon, Malawi and India.Participants99 252 participants were sampled across the datasets (range: 3567-75 767), including 2494 with disabilities (93-1374).OutcomePrevalence of access to WASH at household and individual level.Data analysisAge/sex disaggregated disability prevalence estimates were calculated accounting for survey design. The Unicef/WHO Joint Monitoring Programme definitions were used to classify facilities as improved/unimproved. Multivariable logistic regression was undertaken to compare between households with/without a person with a disability, and to identify predictors of access among people with disabilities.ResultsThere were no differences in access to improved sanitation or water sources between households with/without members with disabilities across the datasets. In Bangladesh-2, households including a person with a disability were more likely to share facilities with other households (OR 1.3, 95% CI 1.1 to 1.5). Households with people with disabilities were more likely to spend >30 min (round-trip) collecting drinking water than households without in both Cameroon (OR 1.8, 95% CI 1.0 to 3.4) and India (OR 2.3, 95% CI 1.2 to 4.7). Within households, people with disabilities reported difficulties collecting water themselves (23%-80% unable to) and accessing the same sanitation facilities as other household members, particularly without coming into contact with faeces (up to 47% in Bangladesh-2). These difficulties were most marked for people with more severe impairments.ConclusionsPeople with disabilities may not have poorer access to WASH at the household level, but may have poorer quality of access within their households. Further programmatic work is needed to ensure WASH facilities are inclusive of people with disabilities.
| S-EPMC5988144 | biostudies-literature
Project description:BackgroundBuruli ulcer is an infectious disease involving the skin, caused by Mycobacterium ulcerans. This disease is associated with areas where the water is slow-flowing or stagnant. However, the exact mechanism of transmission of the bacillus and the development of the disease through human activities is unknown.Methodology/principal findingsA case-control study to identify Buruli ulcer risk factors in Cameroon compared case-patients with community-matched controls on one hand and family-matched controls on the other hand. Risk factors identified by the community-matched study (including 163 pairs) were: having a low level of education, swamp wading, wearing short, lower-body clothing while farming, living near a cocoa plantation or woods, using adhesive bandages when hurt, and using mosquito coils. Protective factors were: using bed nets, washing clothes, and using leaves as traditional treatment or rubbing alcohol when hurt. The family-matched study (including 118 pairs) corroborated the significance of education level, use of bed nets, and treatment with leaves.Conclusions/significanceCovering limbs during farming activities is confirmed as a protective factor guarding against Buruli ulcer disease, but newly identified factors including wound treatment and use of bed nets may provide new insight into the unknown mode of transmission of M. ulcerans or the development of the disease.
| S-EPMC2154388 | biostudies-literature
Project description:Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness on high BP and temporary increasing screening for hypertension worldwide. We here provide the results of the 2017 MMM (MMM17) edition in Cameroon. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017 nationwide. BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. The campaign was advertised through various media and screening stations were set-up in local markets, churches, and outpatient departments of health facilities. In all, 16 093 individuals were screened during MMM17, of whom 4595 (29.2%) had hypertension. A total of 2742 (19.8%) of individuals not receiving anti-hypertensive medication were found to be hypertensive. Of those on medication, 1048 (57.2%) had uncontrolled BP. After adjusting for age, sex, and use of BP lowing medications, systolic and diastolic BPs were significantly higher in people on anti-hypertensive treatment, with higher waist circumference. MMM17 was the largest BP screening campaign undertaken in Cameroon, and although treatment and control rates are higher than previously reported, they are still well below optimum levels. MMM has highlighted the need for routine population-based surveys and suggests that opportunistic screening can identify significant numbers with raised BP.
| S-EPMC6479431 | biostudies-literature
Project description:ObjectivesTo evaluate associations between traumatic brain injury (TBI) and presence of health conditions, and to compare associations of health and cognition between TBI cases and controls.MethodsThis matched case-control study used data from the TBI Model Systems National Database (TBI cases) and Midlife in the United States II and Refresher studies (controls). 248 TBI cases were age-, sex-, race-, and education-matched without replacement to three controls. Cases and controls were compared on prevalence of 18 self-reported conditions, self-rated health, composite scores from the Brief Test of Adult Cognition by Telephone.ResultsThe following conditions were significantly more prevalent among TBI cases versus controls: anxiety/depression (OR = 3.12, 95% CI: 2.20, 4.43, p < .001), chronic sleeping problems (OR = 2.76, 95% CI: 1.86, 4.10, p < .001), headache/migraine (OR = 2.61, 95% CI: 1.50, 4.54, p = .0007), and stroke (OR = 6.42, 95% CI: 2.93, 14.10, p < .001). The relationship between self-rated health and cognition significantly varied by TBI (pinteraction = 0.002).ConclusionIndividuals with TBI have greater odds of selected neurobehavioral conditions compared to their demographically similar uninjured peers. Among persons with TBI there was a stronger association between poorer self-rated health and cognition than controls. TBI is increasingly conceptualized as a chronic disease; current findings suggest post-TBI health management requires cognitive supports.
| S-EPMC9205640 | biostudies-literature
Project description:ImportanceImproving equity in organ transplant access for people with intellectual and developmental disabilities (IDD) is a topic of social discourse in mainstream media, state legislation, and national legislation. However, few studies have compared evaluation rates, transplant rates, and outcomes among adults with and without IDD.ObjectiveTo compare rates of kidney transplant and transplant-specific outcomes between propensity-score matched groups of adults with end-stage kidney disease (ESKD [also referred to as end-stage renal disease (ESRD)]) with and without co-occurring IDD.Design, setting, and participantsThis retrospective cohort study included all Medicare inpatient and outpatient standard analytical files from 2013 through 2020. A total of 1 413 655 adult Medicare beneficiaries with ESKD were identified. Propensity-score matching was used to balance cohorts based on age, sex, race, follow-up duration, and Charlson Comorbidity Index. The matched cohorts consisted of 21 384 adults with ESKD (10 692 of whom had IDD) and 1258 kidney transplant recipients (629 of whom had IDD). Data were analyzed between June 1, 2022, and August 1, 2022.ExposureIDD.Main outcomes and measuresEvaluation for kidney transplant, receipt of kidney transplant, perioperative complications, readmission, mortality, graft rejection, and graft failure.ResultsOf the 21 384 propensity-score matched adults with ESKD, the median (IQR) age was 55 (43-65) years, 39.2% were male, 27.4% were Black, 64.1% were White, and 8.5% identified as another race or ethnicity. After propensity score matching within the ESKD cohort, 633 patients with IDD (5.9%) received a kidney transplant compared with 1367 of adults without IDD (12.8%). Adults with IDD were 54% less likely than matched peers without IDD to be evaluated for transplant (odds ratio, 0.46; 95% CI, 0.43-0.50) and 62% less likely to receive a kidney transplant (odds ratio, 0.38; 95% CI, 0.34-0.42). Among matched cohorts of kidney transplant recipients, rates of perioperative complications, readmission, and graft failure were similar for adults with and without IDD.Conclusions and relevanceUsing the largest cohort of adult kidney transplant recipients with IDD to date, the study team found that rates of evaluation and transplant were lower despite yielding equivalent outcomes. These data support consideration of adults with IDD for kidney transplant and underscore the urgent need for antidiscrimination initiatives to promote the receipt of equitable care for this population.
| S-EPMC9932938 | biostudies-literature
Project description:We assessed cardiovascular disease (CVD) risk factor prevalence and risk stratification amongst adults on antiretroviral therapy in South Africa. Of the 175 patients screened, 37.8% had high blood pressure (HBP), 15.4% were current smokers, 10.4% had elevated cholesterol, and 4.1% had diabetes, but very few (3.6%) had a 10-year CVD risk >10%. One-third of those with HBP, 40% of those with diabetes, and two-thirds of those with high cholesterol had not previously been diagnosed. Although participants were adherent with chronic HIV care, screening for and management of CVDRF were suboptimal, representing a missed opportunity to reduce non-AIDS morbidity and mortality.
| S-EPMC4598081 | biostudies-literature
Project description:BackgroundThe current evidence for occupational therapy practice, teaching, and research is replicated and implemented significantly from high-income countries in India. Therefore, a systematic review and an evaluation of existing evidence for occupational therapy (OT) to reduce disabilities including impairments, activity limitations, and participation restriction in persons with disabilities (PWD) in India are warranted.ObjectivesThe objective of this review was to evaluate the effectiveness of OT interventions for reducing disabilities in PWD in India.Study designSystematic review.MethodsWe searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, AMED, and Web of Science. A hand search was also carried out in selected Indian journals, OT-specific databases, and repositories, such as Indian Journal of Occupational Therapy, Indian Journal of Physiotherapy and Occupational Therapy, OT Seekers, World Federation of Occupational Therapy Bulletin, Asia Pacific Occupational Therapists Regional Group, and clinical trials registers. The search was restricted to published studies conducted in India during 2000-2021. We included randomized controlled trials (RCTs) of an occupational therapy intervention delivered by OTs for PWD, where the effects of the intervention were evaluated using any relevant disability outcome measure. Studies without access to full text were excluded. Two review authors independently completed screening, and one author reviewed the full text of the screened studies. Another pair of authors extracted data from included studies for prespecified disability outcomes, and two authors assessed the risk of bias in the included studies.ResultsWe identified seven RCTs of occupational therapy interventions for PWD in India with 305 participants in total. All seven studies were very different in terms of their objective, participants, comparison, and outcomes. Allocation concealment and blinding and risk of bias were high in five trials. All the trials reported impairment outcomes with a statistically significant difference between the experimental arm and the control arm in terms of their primary outcomes except one. Given the sample size and the risk of bias in each of the included trials, the effect size has to be understood and interpreted with utmost caution.ConclusionOverall, this review establishes the paucity of evidence for occupational therapy for PWD in India. Building the capacity for rigorous and relevant scientific research in occupational therapy would enable bridging the gaps in evidence for occupational therapy in India.
| S-EPMC7612085 | biostudies-literature