Factors influencing the timeliness of care for patients with lung cancer in Bangladesh
- Ansar, Adnan, Lewis, Virginia, McDonald, Christine, Liu, Chaojie, Rahman, Muhammad Aziz
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Background: This study explored the factors associated with timeliness of care in the healthcare seeking pathway among patients with lung cancer in Bangladesh. Methods: A structured questionnaire was used for data collection from 418 patients with lung cancer through face-to-face interviews in three tertiary care hospitals. Log-rank tests were performed to test differences in the length of intervals between points in healthcare by socioeconomic characteristics and care seeking behaviours of the patients. Cox Proportional Hazard (PH) regression analysis was performed to identify the predictors of the intervals after adjustment for variations in other variables. Results: A higher education level was associated significantly (p < 0.05) with a shorter interval between first contact with a healthcare provider (HCP) and diagnosis (median 81 days) and initiation of treatment (median 101 days). Higher monthly household income was associated significantly with a shorter time from first contact and diagnosis (median 91 days), onset of symptom and diagnosis (median 99 days), onset of symptom and treatment (median 122 days), and first contact with any HCP to treatment (median 111 days). Consulting with additional HCPs prior to diagnosis was associated significantly with longer intervals from first contact with any HCP and diagnosis (median 127 days), onset of symptom and diagnosis (median 154 days), onset of symptom and treatment (median 205 days), and first contact with any HCP to treatment (median 174 days). Consulting with informal HCPs was associated significantly with a longer time interval from symptom to treatment (median 171 days). Having more than one triggering symptom was associated significantly with a shorter interval between onset of symptoms and first contact with any HCP. Conclusion: The predictors for timeliness of lung cancer care used in this study affected different intervals in the care seeking pathway. Higher education and income predicted shorter intervals whereas consulting informal healthcare providers and multiple providers were associated with longer intervals. © 2023, The Author(s).
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Background: This study explored the factors associated with timeliness of care in the healthcare seeking pathway among patients with lung cancer in Bangladesh. Methods: A structured questionnaire was used for data collection from 418 patients with lung cancer through face-to-face interviews in three tertiary care hospitals. Log-rank tests were performed to test differences in the length of intervals between points in healthcare by socioeconomic characteristics and care seeking behaviours of the patients. Cox Proportional Hazard (PH) regression analysis was performed to identify the predictors of the intervals after adjustment for variations in other variables. Results: A higher education level was associated significantly (p < 0.05) with a shorter interval between first contact with a healthcare provider (HCP) and diagnosis (median 81 days) and initiation of treatment (median 101 days). Higher monthly household income was associated significantly with a shorter time from first contact and diagnosis (median 91 days), onset of symptom and diagnosis (median 99 days), onset of symptom and treatment (median 122 days), and first contact with any HCP to treatment (median 111 days). Consulting with additional HCPs prior to diagnosis was associated significantly with longer intervals from first contact with any HCP and diagnosis (median 127 days), onset of symptom and diagnosis (median 154 days), onset of symptom and treatment (median 205 days), and first contact with any HCP to treatment (median 174 days). Consulting with informal HCPs was associated significantly with a longer time interval from symptom to treatment (median 171 days). Having more than one triggering symptom was associated significantly with a shorter interval between onset of symptoms and first contact with any HCP. Conclusion: The predictors for timeliness of lung cancer care used in this study affected different intervals in the care seeking pathway. Higher education and income predicted shorter intervals whereas consulting informal healthcare providers and multiple providers were associated with longer intervals. © 2023, The Author(s).
Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019
- Momtazmanesh, Sara, Moghaddam, Sahar, Ghamari, Seyyed-Hadi, Rad, Elaheh, Rezaei, Negar, Shobeiri, Parnian, Aali, Amirali, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abdelmasseh, Michael, Abdoun, Meriem, Abdulah, Deldar, Md Abdullah, Abu, Abedi, Aidin, Abolhassani, Hassan, Abrehdari-Tafreshi, Zahra, Achappa, Basavaprabhu, Adane, Denberu, Adane, Tigist, Addo, Isaac, Adnan, Mohammad, Adnani, Qorinah, Ahmad, Sajjad, Ahmadi, Ali, Ahmadi, Keivan, Ahmed, Ali, Ahmed, Ayman, Rashid, Tarik, Al Hamad, Hanadi, Alahdab, Fares, Ur Rahman, Mohammad Hifz, oh, oi, oj, ok;, Rahman, Mosiur, Rahman, Muhammad Aziz
- Authors: Momtazmanesh, Sara , Moghaddam, Sahar , Ghamari, Seyyed-Hadi , Rad, Elaheh , Rezaei, Negar , Shobeiri, Parnian , Aali, Amirali , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abdelmasseh, Michael , Abdoun, Meriem , Abdulah, Deldar , Md Abdullah, Abu , Abedi, Aidin , Abolhassani, Hassan , Abrehdari-Tafreshi, Zahra , Achappa, Basavaprabhu , Adane, Denberu , Adane, Tigist , Addo, Isaac , Adnan, Mohammad , Adnani, Qorinah , Ahmad, Sajjad , Ahmadi, Ali , Ahmadi, Keivan , Ahmed, Ali , Ahmed, Ayman , Rashid, Tarik , Al Hamad, Hanadi , Alahdab, Fares , Ur Rahman, Mohammad Hifz , oh, oi, oj, ok; , Rahman, Mosiur , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 59, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation. © 2023 The Authors
- Authors: Momtazmanesh, Sara , Moghaddam, Sahar , Ghamari, Seyyed-Hadi , Rad, Elaheh , Rezaei, Negar , Shobeiri, Parnian , Aali, Amirali , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abdelmasseh, Michael , Abdoun, Meriem , Abdulah, Deldar , Md Abdullah, Abu , Abedi, Aidin , Abolhassani, Hassan , Abrehdari-Tafreshi, Zahra , Achappa, Basavaprabhu , Adane, Denberu , Adane, Tigist , Addo, Isaac , Adnan, Mohammad , Adnani, Qorinah , Ahmad, Sajjad , Ahmadi, Ali , Ahmadi, Keivan , Ahmed, Ali , Ahmed, Ayman , Rashid, Tarik , Al Hamad, Hanadi , Alahdab, Fares , Ur Rahman, Mohammad Hifz , oh, oi, oj, ok; , Rahman, Mosiur , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 59, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation. © 2023 The Authors
Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019
- Wu, Dongze, Jin, Yingzhao, Xing, Yuhan, Abate, Melsew, Abbasian, Mohammadreza, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abd-Allah, Foad, Abdelmasseh, Michael, Abdollahifar, Mohammad-Amin, Abdulah, Deldar, Abedi, Aidin, Abedi, Vida, Abidi, Hassan, Aboagye, Richard, Abolhassani, Hassan, Abuabara, Katrina, Abyadeh, Morteza, Addo, Isaac, Adeniji, Kayode, Adepoju, Abiola, Adesina, Miracle, Adnani, Qorinah, Afarideh, Mohsen, Aghamiri, Shahin, Agodi, Antonella, Agrawal, Anurag, Arriagada, Constanza, Ahmad, Antonella, Rahman, Muhammad Aziz, Alif, Sheikh
- Authors: Wu, Dongze , Jin, Yingzhao , Xing, Yuhan , Abate, Melsew , Abbasian, Mohammadreza , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abd-Allah, Foad , Abdelmasseh, Michael , Abdollahifar, Mohammad-Amin , Abdulah, Deldar , Abedi, Aidin , Abedi, Vida , Abidi, Hassan , Aboagye, Richard , Abolhassani, Hassan , Abuabara, Katrina , Abyadeh, Morteza , Addo, Isaac , Adeniji, Kayode , Adepoju, Abiola , Adesina, Miracle , Adnani, Qorinah , Afarideh, Mohsen , Aghamiri, Shahin , Agodi, Antonella , Agrawal, Anurag , Arriagada, Constanza , Ahmad, Antonella , Rahman, Muhammad Aziz , Alif, Sheikh
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 64, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of
- Authors: Wu, Dongze , Jin, Yingzhao , Xing, Yuhan , Abate, Melsew , Abbasian, Mohammadreza , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abd-Allah, Foad , Abdelmasseh, Michael , Abdollahifar, Mohammad-Amin , Abdulah, Deldar , Abedi, Aidin , Abedi, Vida , Abidi, Hassan , Aboagye, Richard , Abolhassani, Hassan , Abuabara, Katrina , Abyadeh, Morteza , Addo, Isaac , Adeniji, Kayode , Adepoju, Abiola , Adesina, Miracle , Adnani, Qorinah , Afarideh, Mohsen , Aghamiri, Shahin , Agodi, Antonella , Agrawal, Anurag , Arriagada, Constanza , Ahmad, Antonella , Rahman, Muhammad Aziz , Alif, Sheikh
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 64, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of
Psychometric properties of the caring efficacy scale among personal care attendants working in residential aged care settings
- Shrestha, Sumina, Wells, Yvonne, While, Christine, Rahman, Muhammad Aziz
- Authors: Shrestha, Sumina , Wells, Yvonne , While, Christine , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 42, no. 3 (2023), p. 491-498
- Full Text:
- Reviewed:
- Description: Objective: This study assessed the psychometric properties of the Caring Efficacy Scale (CES) among personal care attendants providing care to older residents in residential aged care settings. Methods: This cross-sectional study was completed in Australia in 2020–2021. Confirmatory factor analysis (CFA) of the 30-item original CES (Model 1) and 28-item CES validated in registered nurses (Model 2) was conducted to assess the goodness of fit of these models in our study population. Due to unsatisfactory fit indices for both models, exploratory factor analysis (EFA) was conducted to examine the dimensionality and underlying structure of the original CES among personal care attendants. Internal consistency of the final scale and subscales identified was examined using item-total correlations and Cronbach's alpha coefficients. Results: Two hundred and eighty personal care attendants participated in the study. The model fit indices such as Comparative Fit Index and Tucker Lewis Index of both models were less than 0.90, while the Standardised Root Mean Square Residual and Root Mean Square of Approximation values were greater than or equal to 0.08 and 0.06, respectively. The EFA identified a two-factor structure, and 22 items of the 30 in the original scale were retained. Item-total correlations amongst items retained in the scale and subscales were greater than 0.3. Cronbach's alpha for the abbreviated scale was 0.85, with 0.83 and 0.79, respectively, for the two subscales. Conclusions: The modified CES can be used as a robust tool to assess the self-efficacy of personal care attendants in providing care to older residents in residential aged care settings. © 2023 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.
- Authors: Shrestha, Sumina , Wells, Yvonne , While, Christine , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 42, no. 3 (2023), p. 491-498
- Full Text:
- Reviewed:
- Description: Objective: This study assessed the psychometric properties of the Caring Efficacy Scale (CES) among personal care attendants providing care to older residents in residential aged care settings. Methods: This cross-sectional study was completed in Australia in 2020–2021. Confirmatory factor analysis (CFA) of the 30-item original CES (Model 1) and 28-item CES validated in registered nurses (Model 2) was conducted to assess the goodness of fit of these models in our study population. Due to unsatisfactory fit indices for both models, exploratory factor analysis (EFA) was conducted to examine the dimensionality and underlying structure of the original CES among personal care attendants. Internal consistency of the final scale and subscales identified was examined using item-total correlations and Cronbach's alpha coefficients. Results: Two hundred and eighty personal care attendants participated in the study. The model fit indices such as Comparative Fit Index and Tucker Lewis Index of both models were less than 0.90, while the Standardised Root Mean Square Residual and Root Mean Square of Approximation values were greater than or equal to 0.08 and 0.06, respectively. The EFA identified a two-factor structure, and 22 items of the 30 in the original scale were retained. Item-total correlations amongst items retained in the scale and subscales were greater than 0.3. Cronbach's alpha for the abbreviated scale was 0.85, with 0.83 and 0.79, respectively, for the two subscales. Conclusions: The modified CES can be used as a robust tool to assess the self-efficacy of personal care attendants in providing care to older residents in residential aged care settings. © 2023 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.
The global impact of tobacco control policies on smokeless tobacco use : a systematic review
- Chugh, Aastha, Arora, Monika, Jain, Neha, Vidyasagaran, Aishwarya, Readshaw, Anne, Sheikh, Aziz, Eckhardt, Jappe, Siddiqi, Kamran, Chopra, Mansi, Mishu, Masuma, Kanaan, Mona, Rahman, Muhammad Aziz, Mehrotra, Ravi, Huque, Rumana, Forberger, Sarah, Dahanayake, Suranji, Khan, Zohaib, Boeckmann, Melanie, Dogar, Omara
- Authors: Chugh, Aastha , Arora, Monika , Jain, Neha , Vidyasagaran, Aishwarya , Readshaw, Anne , Sheikh, Aziz , Eckhardt, Jappe , Siddiqi, Kamran , Chopra, Mansi , Mishu, Masuma , Kanaan, Mona , Rahman, Muhammad Aziz , Mehrotra, Ravi , Huque, Rumana , Forberger, Sarah , Dahanayake, Suranji , Khan, Zohaib , Boeckmann, Melanie , Dogar, Omara
- Date: 2023
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 11, no. 6 (2023), p. e953-e968
- Full Text:
- Reviewed:
- Description: Background: Smokeless tobacco, used by more than 300 million people globally, results in substantial morbidity and mortality. For smokeless tobacco control, many countries have adopted policies beyond the WHO Framework Convention on Tobacco Control, which has been instrumental in reducing smoking prevalence. The impact of these policies (within and outside the Framework Convention on Tobacco Control) on smokeless tobacco use remains unclear. We aimed to systematically review policies that are relevant to smokeless tobacco and its context and investigate their impact on smokeless tobacco use. Methods: In this systematic review, we searched 11 electronic databases and grey literature between Jan 1, 2005, and Sept 20, 2021, in English and key south Asian languages, to summarise smokeless tobacco policies and their impact. Inclusion criteria were all types of studies on smokeless tobacco users that mentioned any smokeless tobacco relevant policies since 2005, except systematic reviews. Policies issued by organisations or private institutions were excluded as well as studies on e-cigarettes and Electronic Nicotine Delivery System except where harm reduction or switching were evaluated as a tobacco cessation strategy. Two reviewers independently screened articles, and data were extracted after standardisation. Quality of studies was appraised using the Effective Public Health Practice Project's Quality Assessment Tool. Outcomes for impact assessment included smokeless tobacco prevalence, uptake, cessation, and health effects. Due to substantial heterogeneity in the descriptions of policies and outcomes, data were descriptively and narratively synthesised. This systematic review was registered in PROSPERO (CRD42020191946). Findings: 14 317 records were identified, of which 252 eligible studies were included as describing smokeless tobacco policies. 57 countries had policies targeting smokeless tobacco, of which 17 had policies outside the Framework Convention on Tobacco Control for smokeless tobacco (eg, spitting bans). 18 studies evaluated the impact, which were of variable quality (six strong, seven moderate, and five weak) and reported mainly on prevalence of smokeless tobacco use. The body of work evaluating policy initiatives based on the Framework Convention on Tobacco Control found that these initiatives were associated with reductions in smokeless tobacco prevalence of between 4·4% and 30·3% for taxation and 22·2% and 70·9% for multifaceted policies. Two studies evaluating the non-Framework policy of sales bans reported significant reductions in smokeless tobacco sale (6·4%) and use (combined sex 17·6%); one study, however, reported an increased trend in smokeless tobacco use in the youth after a total sales ban, likely due to cross-border smuggling. The one study reporting on cessation found a 13·3% increase in quit attempts in individuals exposed (47·5%) to Framework Convention on Tobacco Control policy: education, communication, training, and public awareness, compared with non-exposed (34·2%). Interpretation: Many countries have implemented smokeless tobacco control policies, including those that extend beyond the Framework Convention on Tobacco Control. The available evidence suggests that taxation and multifaceted policy initiatives are associated with meaningful reductions in smokeless tobacco use. Funding: UK National Institute for Health Research. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
- Authors: Chugh, Aastha , Arora, Monika , Jain, Neha , Vidyasagaran, Aishwarya , Readshaw, Anne , Sheikh, Aziz , Eckhardt, Jappe , Siddiqi, Kamran , Chopra, Mansi , Mishu, Masuma , Kanaan, Mona , Rahman, Muhammad Aziz , Mehrotra, Ravi , Huque, Rumana , Forberger, Sarah , Dahanayake, Suranji , Khan, Zohaib , Boeckmann, Melanie , Dogar, Omara
- Date: 2023
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 11, no. 6 (2023), p. e953-e968
- Full Text:
- Reviewed:
- Description: Background: Smokeless tobacco, used by more than 300 million people globally, results in substantial morbidity and mortality. For smokeless tobacco control, many countries have adopted policies beyond the WHO Framework Convention on Tobacco Control, which has been instrumental in reducing smoking prevalence. The impact of these policies (within and outside the Framework Convention on Tobacco Control) on smokeless tobacco use remains unclear. We aimed to systematically review policies that are relevant to smokeless tobacco and its context and investigate their impact on smokeless tobacco use. Methods: In this systematic review, we searched 11 electronic databases and grey literature between Jan 1, 2005, and Sept 20, 2021, in English and key south Asian languages, to summarise smokeless tobacco policies and their impact. Inclusion criteria were all types of studies on smokeless tobacco users that mentioned any smokeless tobacco relevant policies since 2005, except systematic reviews. Policies issued by organisations or private institutions were excluded as well as studies on e-cigarettes and Electronic Nicotine Delivery System except where harm reduction or switching were evaluated as a tobacco cessation strategy. Two reviewers independently screened articles, and data were extracted after standardisation. Quality of studies was appraised using the Effective Public Health Practice Project's Quality Assessment Tool. Outcomes for impact assessment included smokeless tobacco prevalence, uptake, cessation, and health effects. Due to substantial heterogeneity in the descriptions of policies and outcomes, data were descriptively and narratively synthesised. This systematic review was registered in PROSPERO (CRD42020191946). Findings: 14 317 records were identified, of which 252 eligible studies were included as describing smokeless tobacco policies. 57 countries had policies targeting smokeless tobacco, of which 17 had policies outside the Framework Convention on Tobacco Control for smokeless tobacco (eg, spitting bans). 18 studies evaluated the impact, which were of variable quality (six strong, seven moderate, and five weak) and reported mainly on prevalence of smokeless tobacco use. The body of work evaluating policy initiatives based on the Framework Convention on Tobacco Control found that these initiatives were associated with reductions in smokeless tobacco prevalence of between 4·4% and 30·3% for taxation and 22·2% and 70·9% for multifaceted policies. Two studies evaluating the non-Framework policy of sales bans reported significant reductions in smokeless tobacco sale (6·4%) and use (combined sex 17·6%); one study, however, reported an increased trend in smokeless tobacco use in the youth after a total sales ban, likely due to cross-border smuggling. The one study reporting on cessation found a 13·3% increase in quit attempts in individuals exposed (47·5%) to Framework Convention on Tobacco Control policy: education, communication, training, and public awareness, compared with non-exposed (34·2%). Interpretation: Many countries have implemented smokeless tobacco control policies, including those that extend beyond the Framework Convention on Tobacco Control. The available evidence suggests that taxation and multifaceted policy initiatives are associated with meaningful reductions in smokeless tobacco use. Funding: UK National Institute for Health Research. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
Tobacco retailer density and smoking behaviour : how are exposure and outcome measures classified? A systematic review
- Baker, John, Lenz, Katrin, Masood, Mohd, Rahman, Muhammad Aziz, Begg, Stephen
- Authors: Baker, John , Lenz, Katrin , Masood, Mohd , Rahman, Muhammad Aziz , Begg, Stephen
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: To date only a limited number of reviews have focused on how exposure and outcome measures are defined in the existing literature on associations between tobacco retailer density (‘density’) and smoking behaviour (‘smoking’). Therefore this systematic review classified and summarised how both density and smoking variables are operationalised in the existing literature, and provides several methodological recommendations for future density and smoking research. Methods: Two literature searches between March and April 2018 and April 2022 were conducted across 10 databases. Inclusion and exclusion criteria were developed and keyword database searches were undertaken. Studies were imported into Covidence. Cross-sectional studies that met the inclusion criteria were extracted and a quality assessment was undertaken. Studies were categorised according to the density measure used, and smoking was re-categorised using a modified classification tool. Results: Large heterogeneity was found in the operationalisation of both measures in the 47 studies included for analysis. Density was most commonly measured directly from geocoded locations using circular buffers at various distances (n = 14). After smoking was reclassified using a smoking classification tool, past-month smoking was the most common smoking type reported (n = 26). Conclusions: It is recommended that density is measured through length-distance and travel time using the street network and weighted (e.g. by the size of an area), or by using Kernel Density Estimates as these methods provide a more accurate measure of geographical to tobacco and e-cigarette retailer density. The consistent application of a smoking measures classification tool, such as the one developed for this systematic review, would enable better comparisons between studies. Future research should measure exposure and outcome measures in a way that makes them comparable with other studies. Implications: This systematic review provides a strong case for improving data collection and analysis methodologies in studies assessing tobacco retailer density and smoking behaviour to ensure that both exposure and outcome measures are clearly defined and captured. As large heterogeneity was found in the operationalisation of both density and smoking behaviour measures in the studies included for analysis, there is a need for future studies to capture, measure and classify exposure measures accurately, and to define outcome measures in a manner that makes them comparable with other studies. © 2023, BioMed Central Ltd., part of Springer Nature.
- Authors: Baker, John , Lenz, Katrin , Masood, Mohd , Rahman, Muhammad Aziz , Begg, Stephen
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: To date only a limited number of reviews have focused on how exposure and outcome measures are defined in the existing literature on associations between tobacco retailer density (‘density’) and smoking behaviour (‘smoking’). Therefore this systematic review classified and summarised how both density and smoking variables are operationalised in the existing literature, and provides several methodological recommendations for future density and smoking research. Methods: Two literature searches between March and April 2018 and April 2022 were conducted across 10 databases. Inclusion and exclusion criteria were developed and keyword database searches were undertaken. Studies were imported into Covidence. Cross-sectional studies that met the inclusion criteria were extracted and a quality assessment was undertaken. Studies were categorised according to the density measure used, and smoking was re-categorised using a modified classification tool. Results: Large heterogeneity was found in the operationalisation of both measures in the 47 studies included for analysis. Density was most commonly measured directly from geocoded locations using circular buffers at various distances (n = 14). After smoking was reclassified using a smoking classification tool, past-month smoking was the most common smoking type reported (n = 26). Conclusions: It is recommended that density is measured through length-distance and travel time using the street network and weighted (e.g. by the size of an area), or by using Kernel Density Estimates as these methods provide a more accurate measure of geographical to tobacco and e-cigarette retailer density. The consistent application of a smoking measures classification tool, such as the one developed for this systematic review, would enable better comparisons between studies. Future research should measure exposure and outcome measures in a way that makes them comparable with other studies. Implications: This systematic review provides a strong case for improving data collection and analysis methodologies in studies assessing tobacco retailer density and smoking behaviour to ensure that both exposure and outcome measures are clearly defined and captured. As large heterogeneity was found in the operationalisation of both density and smoking behaviour measures in the studies included for analysis, there is a need for future studies to capture, measure and classify exposure measures accurately, and to define outcome measures in a manner that makes them comparable with other studies. © 2023, BioMed Central Ltd., part of Springer Nature.
Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18 : a geospatial modelling study
- Frostad, Joseph, Nguyen, QuynhAnh, Baumann, Mathew, Blacker, Brigette, Marczak, Laurie, Deshpande, Aniruddha, Wiens, Kirsten, LeGrand, Kate, Johnson, Kimberly, Abbasi-Kangevari, Mohsen, Abdoli, Amir, Abolhassani, Hassan, Abreu, Lucas, Abrigo, Michael, Abu-Rmeileh, Niveen, Adekanmbi, Victor, Agrawal, Anurag, Ahmed, Muktar, Al-Aly, Ziyad, Alanezi, Fahad, Alcalde-Rabanal, Jacqueline, Alipour, Vahid, Altirkawi, Khalid, Alvis-Guzman, Nelson, Alvis-Zakzuk, Nelson, Amegah, Adeladza, Amini, Saeed, Amiri, Fatemeh, Amugsi, Dickson, Rahman, Muhammad Aziz
- Authors: Frostad, Joseph , Nguyen, QuynhAnh , Baumann, Mathew , Blacker, Brigette , Marczak, Laurie , Deshpande, Aniruddha , Wiens, Kirsten , LeGrand, Kate , Johnson, Kimberly , Abbasi-Kangevari, Mohsen , Abdoli, Amir , Abolhassani, Hassan , Abreu, Lucas , Abrigo, Michael , Abu-Rmeileh, Niveen , Adekanmbi, Victor , Agrawal, Anurag , Ahmed, Muktar , Al-Aly, Ziyad , Alanezi, Fahad , Alcalde-Rabanal, Jacqueline , Alipour, Vahid , Altirkawi, Khalid , Alvis-Guzman, Nelson , Alvis-Zakzuk, Nelson , Amegah, Adeladza , Amini, Saeed , Amiri, Fatemeh , Amugsi, Dickson , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 10, no. 10 (2022), p. e1395-e1411
- Full Text:
- Reviewed:
- Description: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Frostad, Joseph , Nguyen, QuynhAnh , Baumann, Mathew , Blacker, Brigette , Marczak, Laurie , Deshpande, Aniruddha , Wiens, Kirsten , LeGrand, Kate , Johnson, Kimberly , Abbasi-Kangevari, Mohsen , Abdoli, Amir , Abolhassani, Hassan , Abreu, Lucas , Abrigo, Michael , Abu-Rmeileh, Niveen , Adekanmbi, Victor , Agrawal, Anurag , Ahmed, Muktar , Al-Aly, Ziyad , Alanezi, Fahad , Alcalde-Rabanal, Jacqueline , Alipour, Vahid , Altirkawi, Khalid , Alvis-Guzman, Nelson , Alvis-Zakzuk, Nelson , Amegah, Adeladza , Amini, Saeed , Amiri, Fatemeh , Amugsi, Dickson , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 10, no. 10 (2022), p. e1395-e1411
- Full Text:
- Reviewed:
- Description: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
Psychological impact of COVID-19 on healthcare workers : cross-sectional analyses from 14 countries
- Ghozy, Sherief, Cross, Wendy, Islam, Shariful, Al-Mawali, Adhra Hilal, AlQurashi, Alaa Ashraf, Hamza, Amr, Joseph, Bindu, Banik, Biswajit, Elsori, Deena H., Sultana, Farhana, Yasmin, Farhana, Mahmud, Ilias, Lam, Louisa, Hammoud, Majeda, Salehin, Masudus, Keblawi, Mohammed Ali, Eltewacy, Nael Kamel, Al Laham, Nahed, El-Khazragy, Nashwa, Oli, Natalia, Tungpunkom, Patraporn, Almustanyir, Sami, Chair, Sek, Alif, Sheikh, Al-Madhoun, Sondos, Chien, Wai Tong, Rahman, Muhammad Aziz
- Authors: Ghozy, Sherief , Cross, Wendy , Islam, Shariful , Al-Mawali, Adhra Hilal , AlQurashi, Alaa Ashraf , Hamza, Amr , Joseph, Bindu , Banik, Biswajit , Elsori, Deena H. , Sultana, Farhana , Yasmin, Farhana , Mahmud, Ilias , Lam, Louisa , Hammoud, Majeda , Salehin, Masudus , Keblawi, Mohammed Ali , Eltewacy, Nael Kamel , Al Laham, Nahed , El-Khazragy, Nashwa , Oli, Natalia , Tungpunkom, Patraporn , Almustanyir, Sami , Chair, Sek , Alif, Sheikh , Al-Madhoun, Sondos , Chien, Wai Tong , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: Glob. Ment. Health Vol. 9, no. (2022), p. 328-338
- Full Text:
- Reviewed:
- Description: Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. A total of 2447 HCWs participated 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20% the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63% the lowest rate was reported in Libya (28%) and the highest in Syria (76%). COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.
- Authors: Ghozy, Sherief , Cross, Wendy , Islam, Shariful , Al-Mawali, Adhra Hilal , AlQurashi, Alaa Ashraf , Hamza, Amr , Joseph, Bindu , Banik, Biswajit , Elsori, Deena H. , Sultana, Farhana , Yasmin, Farhana , Mahmud, Ilias , Lam, Louisa , Hammoud, Majeda , Salehin, Masudus , Keblawi, Mohammed Ali , Eltewacy, Nael Kamel , Al Laham, Nahed , El-Khazragy, Nashwa , Oli, Natalia , Tungpunkom, Patraporn , Almustanyir, Sami , Chair, Sek , Alif, Sheikh , Al-Madhoun, Sondos , Chien, Wai Tong , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: Glob. Ment. Health Vol. 9, no. (2022), p. 328-338
- Full Text:
- Reviewed:
- Description: Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. A total of 2447 HCWs participated 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20% the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63% the lowest rate was reported in Libya (28%) and the highest in Syria (76%). COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.
Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17
- Wiens, Kirsten, Lindstedt, Paulina, Blacker, Brigette, Johnson, Kimberly, Baumann, Mathew, Schaeffer, Lauren, Abbastabar, Hedayat, Abd-Allah, Foad, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abegaz, Kedir, Abejie, Ayenew, Abreu, Lucas, Abrigo, Michael, Abualhasan, Ahmed, Accrombessi, Manfred, Acharya, Dilaram, Adabi, Maryam, Adamu, Abdu, Adebayo, Oladimeji, Adedoyin, Rufus, Adekanmbi, Victor, Adetokunboh, Olatunji, Adhena, Beyene, Afarideh, Mohsen, Ahmad, Sohail, Ahmadi, Keivan, Ahmed, Anwar, Ahmed, Muktar, Rahman, Muhammad Aziz
- Authors: Wiens, Kirsten , Lindstedt, Paulina , Blacker, Brigette , Johnson, Kimberly , Baumann, Mathew , Schaeffer, Lauren , Abbastabar, Hedayat , Abd-Allah, Foad , Abdelalim, Ahmed , Abdollahpour, Ibrahim , Abegaz, Kedir , Abejie, Ayenew , Abreu, Lucas , Abrigo, Michael , Abualhasan, Ahmed , Accrombessi, Manfred , Acharya, Dilaram , Adabi, Maryam , Adamu, Abdu , Adebayo, Oladimeji , Adedoyin, Rufus , Adekanmbi, Victor , Adetokunboh, Olatunji , Adhena, Beyene , Afarideh, Mohsen , Ahmad, Sohail , Ahmadi, Keivan , Ahmed, Anwar , Ahmed, Muktar , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 8, no. 8 (2020), p. e1038-e1060
- Full Text:
- Reviewed:
- Description: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Wiens, Kirsten , Lindstedt, Paulina , Blacker, Brigette , Johnson, Kimberly , Baumann, Mathew , Schaeffer, Lauren , Abbastabar, Hedayat , Abd-Allah, Foad , Abdelalim, Ahmed , Abdollahpour, Ibrahim , Abegaz, Kedir , Abejie, Ayenew , Abreu, Lucas , Abrigo, Michael , Abualhasan, Ahmed , Accrombessi, Manfred , Acharya, Dilaram , Adabi, Maryam , Adamu, Abdu , Adebayo, Oladimeji , Adedoyin, Rufus , Adekanmbi, Victor , Adetokunboh, Olatunji , Adhena, Beyene , Afarideh, Mohsen , Ahmad, Sohail , Ahmadi, Keivan , Ahmed, Anwar , Ahmed, Muktar , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: The Lancet Global Health Vol. 8, no. 8 (2020), p. e1038-e1060
- Full Text:
- Reviewed:
- Description: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
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