Prevalence of stroke survival in rural communities living in northern Peru.
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ABSTRACT: Background and purpose
Stroke is the leading cause of neurological impairment in the South American Andean region. However, the epidemiology of stroke in the region has been poorly characterized.Methods
We conducted a staged three-phase population-based study applying a validated eight-question neurological survey in 80 rural villages in Tumbes, northern Peru, then confirmed presence or absence of stroke through a neurologist's examination to estimate the prevalence of stroke.Results
Our survey covered 90% of the population (22,278/24,854 individuals, mean age 30±21.28, 48.45% females), and prevalence of stroke was 7.05/1,000 inhabitants. After direct standardization to WHO's world standard population, adjusted prevalence of stroke was 6.94/1,000 inhabitants. Participants aged ≥85 years had higher stroke prevalence (>50/1000 inhabitants) compared to other stratified ages, and some unusual cases of stroke were found among individuals aged 25-34 years. The lowest age reported for a first stroke event was 16.8 years. High blood pressure (aPR 4.2 [2.7-6.4], p>0.001), and sedentary lifestyle (aPR 1.6 [1.0-2.6], p = 0.045) were more prevalent in people with stroke.Conclusions
The age-standardized prevalence of stroke in this rural coastal Peruvian population was slightly higher than previously reported in studies from surrounding rural South American settings, but lower than in rural African and Asian regions. The death rate from stroke was much higher than in industrialized and middle-income countries.
SUBMITTER: Moyano LM
PROVIDER: S-EPMC8321101 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundVector-borne transmission of Trypanosoma cruzi is seen exclusively in the Americas where an estimated 8 million people are infected with the parasite. Significant research in southern Peru has been conducted to understand T. cruzi infection and vector control, however, much less is known about the burden of infection and epidemiology in northern Peru.MethodologyA cross-sectional study was conducted to estimate the seroprevalence of T. cruzi infection in humans (n=611) and domestic animals [dogs (n=106) and guinea pigs (n=206)] in communities of Cutervo Province, Peru. Sampling and diagnostic strategies differed according to species. An entomological household study (n=208) was conducted to identify the triatomine burden and species composition, as well as the prevalence of T. cruzi in vectors. Electrocardiograms (EKG) were performed on a subset of participants (n=90 T. cruzi infected participants and 170 age and sex-matched controls). The seroprevalence of T. cruzi among humans, dogs, and guinea pigs was 14.9% (95% CI: 12.2-18.0%), 19.8% (95% CI: 12.7-28.7%) and 3.3% (95% CI: 1.4-6.9%) respectively. In one community, the prevalence of T. cruzi infection was 17.2% (95% CI: 9.6-24.7%) among participants < 15 years, suggesting recent transmission. Increasing age, positive triatomines in a participant's house, and ownership of a T. cruzi positive guinea pig were independent correlates of T. cruzi infection. Only one species of triatomine was found, Panstrongylus lignarius, formerly P. herreri. Approximately forty percent (39.9%, 95% CI: 33.2-46.9%) of surveyed households were infested with this vector and 14.9% (95% CI: 10.4-20.5%) had at least one triatomine positive for T. cruzi. The cardiac abnormality of right bundle branch block was rare, but only identified in seropositive individuals.ConclusionsOur research documents a substantial prevalence of T. cruzi infection in Cutervo and highlights a need for greater attention and vector control efforts in northern Peru.
| S-EPMC4441511 | biostudies-literature
Project description:BACKGROUND:In Ethiopia guidelines for diagnoses and treatment of leishmaniases are available, but only a few hundred people are diagnosed and receive treatment. A field study has been carried out to determine the status and environmental determinants of cutaneous leishmaniasis (CL) and assess the degree of awareness of the rural communities in affected areas in Tigray, northern Ethiopia. METHODOLOGY / PRINCIPAL FINDINGS:Following a reconnaissance survey that identified endemic foci, a cross sectional door-to-door survey was conducted in 2009 in five rural communities around the towns of Adigrat and Hagereselam in Tigray. In total 9,622 residents of 1,721 households were clinically screened and household heads interviewed regarding the determinants of infection. The χ2 test and logistic regression were used to determine differences in prevalence between localities, age and sex, and to identify environmental determinants of infection. The overall prevalence of localized CL was 2.3% (highest 4.7%), with marked inter-village differences. Another 20.9% had scars from previous infections. While risk was sex-independent, prevalence was significantly higher in the 0-9 (4.5%) and 10-19 (2.5%) age groups and predominantly involved the face (82.1%) and upper limbs (13.1%). Nearly 11% of the households had one or more cases of CL and this was associated with proximity to hyrax habitats. All interviewees were knowledgeable about the lesions but ignorant of the disease's mode of transmission and its association with hyraxes. CONCLUSIONS:The study established that CL is an important public health problem in the study communities, and has been so for a while, as demonstrated by the widespread presence of scars. CL in Tigray appeared to be predominantly of zoonotic nature, mainly transmitted in peri-domestic habitats in proximity to hyrax habitats. Integrated interventions, including awareness creation, are highly recommended.
| S-EPMC6782111 | biostudies-other
Project description:The consequences of poor child development are becoming increasingly recognized. Programs are being put in place around the world to improve child development by providing healthy and stimulating environments for children. However, these programs often have limited reach and little is known about the prevalence of developmental delay in under-developed communities. The current study set-out to better understand the prevalence of developmental delay in rural communities in the Amazon region of Peru. Also, it explores social determinants that are associated with any delay. Cross-sectional study by evaluating developmental delay in children under 4 years utilizing Ages and Stages Questionnaire (ASQ-3). Additionally, conducting a social determinants questionnaire answered by caretakers to identify social drivers for developmental delay. The data was analyzed with multi-variant analysis to measure association. The prevalence of developmental delay in the Amazonian communities was 26.7% (19.3% in communication, 11.4% in gross motor skills, 8% in both) (N = 596). The multivariate logistic regression analysis revealed significant associations between developmental delay and; level of education (OR 0.64, p = 0.009), age of mother during child's birth (OR 0.96, p = 0.002), visits by community health agents (OR 0.73, p = 0.013), and river as primary water source (OR 2.39, p = 0.001). The social determinants questionnaire revealed that 39% of the mothers had their first child before the age of 17, nearly half stopped going to school before the age of 12 (52%), 29% gave birth at home, 13% breast fed for less than 7 months, and 50% of the children had diarrhea in the last month. There is still a great need to improve the conditions for child development in the Amazon region of Peru. One-fourth of the children suffer from developmental delay, which will likely impede their potentials for life unless something is done. The impact of education, age of mother at birth of the child, community health agents, and access to clean drinking water were important findings. Improvements can be made in these areas to create a large, cost-effective impact on the well-being of the communities.
| S-EPMC5638337 | biostudies-literature
Project description:BACKGROUND:Clonorchiasis, caused by the fish-borne trematode Clonorchis sinensis, is a neglected tropical disease and a public health issue in endemic countries. In Vietnam, an in-depth analysis of risk factors for the condition is missing up to now. This study aimed to determine the prevalence of C. sinensis infection and associated risk factors in rural communities in northern Vietnam. METHODOLOGY/PRINCIPAL FINDINGS:A cross-sectional survey was conducted in 4 communes in Yen Bai and Thanh Hoa provinces where clonorchiasis is known to be present and raw fish consumption is a common. Using a simple random sampling approach, stool was collected from 841 participants over 6 years old for coprological examination, and a questionnaire measured knowledge, attitudes, and practices with regard to clonorchiasis in 757 participants over 15 years old. Univariable and multivariable logistic regression models were run to identify risk factors for infection with C. sinensis. The overall prevalence of C. sinensis infection was 40.4%, with commune prevalences ranging between 26.5% and 53.3%. In the final model, males were significantly more likely to be infected with C. sinensis (OR 2.00; 95% CI 1.31-3.05). Recent (i.e. last year) consumption of raw fish (OR 8.00, 95% CI 4.78-13.36), low education level (OR 5.57; 95% CI 2.37-13.07), lack of treatment (OR 1.82, 95% CI 1.15-2.89), being between 19 to 39 years old (OR 6.46; 95% CI 1.25-33.37), and the presence of an unhygienic toilet (OR 2.74, 95% CI 1.53-4.92) were significantly associated with C. sinensis infection. CONCLUSION/SIGNIFICANCE:This study demonstrated a high prevalence of C. sinensis infection in rural communities in northern Vietnam. Thus, control measures including, mass drug administration for those communes should be applied to reduce the prevalence. Moreover, specific health education activities should be developed for risk groups in C. sinensis endemic areas.
| S-EPMC7425981 | biostudies-literature
Project description:In this study, the seroprevalence of sparganosis and its relationship with sociodemographic factors in northern Tanzania have been assessed. A total of 216 serum samples from two rural districts, Monduli and Babati, were tested for sparganosis using an enzyme-linked immunosorbent assay. The seroprevalence of anti-sparganum IgG antibodies was 62.5% (95% confidence interval [CI] = 56.1-68.9) in all age groups. There were significant associations between district (relative risk [RR] = 1.95, 95% CI = 1.42-2.69), education (RR = 1.40, 95% CI = 1.15-1.70), and pet ownership with seropositivity (RR = 1.48, 95% CI = 1.02-2.16) based on univariate analysis. However, only the district was significantly associated with seropositivity (odds ratio = 4.20, 95% CI = 1.89-9.32) in binary logistic regression analysis. Providing health education to people residing in sparganosis-endemic areas is likely to improve the efficacy of preventative measures and reduce human disease burden.
| S-EPMC5062792 | biostudies-literature
Project description:BackgroundNeurocysticercosis is a common helminthic infection of the central nervous system and an important cause of adult-onset epilepsy in endemic countries. However, few studies have examined associations between neurologic symptoms, serology and radiographic findings on a community-level.MethodologyWe conducted a population-based study of resident's ?2 years old in a highly endemic village in Peru (pop. 454). We applied a 14 -question neurologic screening tool and evaluated serum for antibodies against Taenia solium cysticercosis using enzyme-linked immunoelectrotransfer blot (LLGP-EITB). We invited all residents ?18 years old to have non-contrast computerized tomography (CT) of the head.Principal findingsOf the 385 residents who provided serum samples, 142 (36.9%) were seropositive. Of the 256 residents who underwent CT scan, 48 (18.8%) had brain calcifications consistent with NCC; 8/48 (17.0%) reported a history of headache and/or seizures. Exposure to T. solium is very common in this endemic community where 1 out of 5 residents had brain calcifications. However, the vast majority of people with calcifications were asymptomatic.ConclusionThis study reports a high prevalence of NCC infection in an endemic community in Peru and confirms that a large proportion of apparently asymptomatic residents have brain calcifications that could provoke seizures in the future.
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Project description:ObjectiveIn recognition that engagement in physical activities for persons living with dementia can be challenging in rural and northern communities, the objective of this study was to explore the factors influencing physical activity participation among persons living with dementia in rural/northern communities and to identify the locally-driven mitigation strategies participants used to address barriers to physical activity.SettingInterviews and focus groups were conducted in two locations in northern British Columbia, Canada including a rural community (<10 000 persons) and a medium-sized geographically isolated city (<80 000 persons). Both communities are located at substantial distances (>700 km) from larger urban centres.ParticipantsTwenty-nine individuals participated including healthcare providers (n=8), community exercise professionals (n=12), persons living with dementia (n=4) and care partners (n=5).ResultsRural and northern contextual factors including aspects of the built and natural environment were the main drivers of physical activity for persons living with dementia. Limited capacity in the health system to support physical activity due to a lack of referrals, poor communication mechanisms and limited resources for programming created challenges for physical activity participation. At the community level, local champions filled gaps in physical activity programming by leveraging informal networks to organise opportunities. Programme-level factors included a lack of consistency in staff, and challenges defining programme scope given limited population size and the fear of stigma for persons living with dementia.ConclusionsEnvironmental context and limited access to specialised programming affect the opportunities for persons living with dementia to engage in physical activities. Rural and northern communities showed resiliency in providing physical activity opportunities yet remained fragile due to human resource challenges. Without reliable resources and sustained support from the health system, local champions remain vulnerable to burnout. Enhancing support for local champions may provide greater stability and support to physical activity promotion in rural and northern communities.
| S-EPMC9207915 | biostudies-literature
Project description:Introduction: Alcoholic beverages have a proven impact on neuronal development and other areas of the body, primarily the heart, kidneys and liver, which is why their consumption in children is prohibited. However, there are traditional drinks that have alcohol content (Chicha de Jora-Clarito); artisanal drinks of traditional origin with alcoholic content in Peru. The aim of this study was to characterize the consumption of traditional alcoholic beverages in children of a rural village in Northern Peru. Methods: This study was an analytical cross-sectional study. Mothers were recruited by census sampling and reported the consumption by their children of two traditional drinks with alcoholic content: Chicha de Jora (Ch) and Clarito (Cl), which are derived from the fermentation of maize. The frequency of consumption, accessibility and perception of consumption risk were described. Results: Data were collected about 300 children, 61% (183) of whom consumed Ch. and 31% (92) of whom consumed Ch and Cl. Regarding drink accessibility, the majority of mothers said that these drinks were cheap (Ch: 69.0% and Cl: 60.7%). Additionally, the vast majority of families sometimes consumed or always consumed such beverages (Ch: 81.3% and CI: 65.7%). One in three mothers perceived Ch and Cl as being nutritious and helping their children grow. 25% of mothers perceived that there was no risk to their children from the consumption of the beverages, whereas >60% said that there could be a risk due to the beverages' alcohol content. Conclusions: Our study found that traditional beverages containing alcohol are consumed frequently by children in a village in Northern Peru. Mothers provide accessibility to the beverages and perceive the risk the drinks have, which will more accurately evaluate this risk. We advise that future studies concerning the intervention of these attitudes are performed, for a better future and development of children.
| S-EPMC6259489 | biostudies-literature
Project description:Rates of obesity among children have been rising in recent years. Information on the prevalence of obesity in children living in rural communities is needed. We report the prevalence of overweight and obesity in children enrolled in grades 4 to 6 who live in rural areas of Louisiana, USA.These data were collected as baseline assessment for the Louisiana (LA) Health project. Height, weight, and estimates of body fat (using body impedance analysis) were collected on 2 709 children. Average age was 10.5 years and the sample composition was 57.3% girls, 61.7% African-American, 36.0% Caucasian, and 2.3% other minority. A majority of children (77%) met the criterion for poverty status.The distribution of body mass index (BMI) percentile was highly skewed toward obesity. The most frequent BMI percentile scores were 98(th) and 99(th) percentile. Using Centers for Disease Control and Prevention (CDC) norms, the overall prevalence of obesity was 27.4%, and for overweight was 45.1%, of which 17.7% were between the 85(th) and 95(th) percentile. The prevalence of childhood overweight and obesity were much higher than the national norm and this increased prevalence was observed in both genders and in Caucasian and African-American children.The prevalence of childhood overweight and obesity was found to be much higher in rural and primarily poor (77%) children living in Louisiana when compared with national norms. This observation suggests that rural children from Louisiana may be experiencing an epidemic of obesity that exceeds national prevalence estimates.
| S-EPMC2725211 | biostudies-literature
Project description:IntroductionRecurrent parasitic infections may influence the immune response to vaccines. In the Partnership for Research on Ebola VACcinations extended follow-UP and clinical research capacity build-UP (PREVAC-UP) study being undertaken in Mambolo, northern Sierra Leone, participants are being followed up to assess the potential impact of exposure to malaria and/or helminth infections on long-term immune response to two Ebola vaccines. To support the development of the assays that will be used in this evaluation, a parasitological survey was conducted in Mambolo between November 2019 and February 2020.MethodsHealthy individuals aged ≥1 year who were resident in Mambolo Chiefdom were selected using a stratified sampling approach and questionnaires were administered to explore their sociodemographic characteristics. Microscopy was used to detect malaria parasites, intestinal helminths and urinary schistosome infections. Rapid blood tests were used to detect infections with Onchocerca volvulus and Wuchereria bancrofti. We estimated the overall prevalence of these infections and used adjusted logistic regression models to explore risk factors for malaria and hookworm infection.ResultsEight hundred and fifteen (815) residents, 50.9% of whom were female were surveyed. Overall, 309 (39.1%) of 791 persons tested for malaria had a positive blood slide; Plasmodium falciparum was the dominant species. Helminth infection was detected in 122 (15.0%) of 815 stool samples including three mixed infections. The helminth infections comprised 102 (12.5%) cases of hookworm, 11 (1.3%) cases of Trichuris trichiura, 10 (1.2%) cases of Schistosoma mansoni and two (0.2%) cases of Ascaris lumbricoides. Being male (OR = 2.01, 95% CI 1.15-3.50) and residing in a non-riverine community (OR = 4.02, 95%CI 2.32-6.98) were the factors associated with hookworm infection. Onchocerca volvulus and Wuchereria bancrofti infections were found in 3.3% and 0.4% of participants respectively.ConclusionMalaria and hookworm are the most prevalent parasite infections and those most likely to influence long-term immune response to Ebola vaccines among the trial participants.
| S-EPMC9258822 | biostudies-literature