scholarly journals Care-Seeking for Fever for Children Under the Age of Five Before and After the Free Healthcare Initiative in Burkina Faso: Evidence from Three Population-Based Surveys

2021 ◽  
Vol Volume 14 ◽  
pp. 2065-2077
Author(s):  
Mariamawit Negatou ◽  
Mady Ouedraogo ◽  
Philippe Donnen ◽  
Elisabeth Paul ◽  
Sekou Samadoulougou ◽  
...  
2020 ◽  
Author(s):  
Joel Dofinisery Bognini ◽  
Sekou Samadoulougou ◽  
Mady Ouedraogo ◽  
Tiga David Kangoye ◽  
Carine Van Malderen ◽  
...  

Abstract Background: There are real socioeconomic inequalities between and within countries, leading to disparities in the use of health services. In children under five years of age, this could be responsible for child mortality by depriving children of healthcare. By removing healthcare fees, the Free Healthcare Initiative (FHCI) adopted in Sierra Leone can contribute to reducing these inequities in healthcare-seeking for children. This study aimed to assess the socioeconomic inequalities in healthcare-seeking for children under five years of age before and after the implementation of the FHCI.Methods: We included 1207, 2815, and 1633 children under five years of age with fever from the 2008, 2013, and 2016 nationwide surveys database, respectively. Concentration curves were drawn for the period before (2008) and after (2013 and 2016) the implementation of the FHCI to assess socioeconomic inequalities in healthcare-seeking. Finally, concentration indices were calculated to understand the magnitude of these socioeconomic inequalities.Results: We found that before the implementation of the FHCI, there were inequalities in care-seeking for children under five (concentration index (CIn) = 0.168, standard error (SE) = 0.049) in favor of the wealthy households. These inequalities decreased after the implementation of the FHCI but remained in favor of the rich households (CIn = 0.039, SE = 0.040). There were more disparities in the healthcare-seeking between districts before the implementation of the FHCI. After the initiation of the FHCI, these disparities were reduced, and 12 of the 14 districts had a CIn around the value of equality. Conclusion: Our study observed pro-rich inequalities in care-seeking for children under five years of age before the implementation of the FHCI and a decrease in these inequalities after its implementation, even if it remained pro-rich. To continue to reduce wealth-related inequalities, policy actions can focus on the increase of availability of health services in the districts where the care-seeking was pro-rich.


PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e97521 ◽  
Author(s):  
Idrissa Beogo ◽  
Chieh-Yu Liu ◽  
Yiing-Jenq Chou ◽  
Chuan-Yu Chen ◽  
Nicole Huang

2021 ◽  
Vol 92 (5) ◽  
pp. 519-527
Author(s):  
Yasmina Molero ◽  
David James Sharp ◽  
Brian Matthew D'Onofrio ◽  
Henrik Larsson ◽  
Seena Fazel

ObjectiveTo examine psychotropic and pain medication use in a population-based cohort of individuals with traumatic brain injury (TBI), and compare them with controls from similar backgrounds.MethodsWe assessed Swedish nationwide registers to include all individuals diagnosed with incident TBI between 2006 and 2012 in hospitals or specialist outpatient care. Full siblings never diagnosed with TBI acted as controls. We examined dispensed prescriptions for psychotropic and pain medications for the 12 months before and after the TBI.ResultsWe identified 239 425 individuals with incident TBI, and 199 658 unaffected sibling controls. In the TBI cohort, 36.6% had collected at least one prescription for a psychotropic or pain medication in the 12 months before the TBI. In the 12 months after, medication use increased to 45.0%, an absolute rate increase of 8.4% (p<0.001). The largest post-TBI increases were found for opioids (from 16.3% to 21.6%, p<0.001), and non-opioid pain medications (from 20.3% to 26.6%, p<0.001). The majority of prescriptions were short-term; 20.6% of those prescribed opioids and 37.3% of those with benzodiazepines collected prescriptions for more than 6 months. Increased odds of any psychotropic or pain medication were associated with individuals before (OR: 1.62, 95% CI: 1.59 to 1.65), and after the TBI (OR: 2.30, 95% CI: 2.26 to 2.34) as compared with sibling controls, and ORs were consistently increased for all medication classes.ConclusionHigh rates of psychotropic and pain medications after a TBI suggest that medical follow-up should be routine and review medication use.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e032953
Author(s):  
Seydou Kaboré ◽  
Tieba Millogo ◽  
Joseph Kouesyandé Soubeiga ◽  
Hermann Lanou ◽  
Brice Bicaba ◽  
...  

ObjectiveThe objective of this study was to determine the prevalence and predictors of overweight and obesity in Burkina Faso using a population-based countrywide sample. We hypothesise that there is a significant burden related to overweight/obesity in Burkina Faso.DesignSecondary analysis of a population-based countrywide cross-sectional study.SettingBurkina Faso, all the 13 regions including both rural and urban residential areas.Participants4800 participants of both sexes, aged between 25 and 64 years.Main outcomesOverweight and obesity using body mass index cut-off levels of the WHO.ResultsThe prevalence of overweight and obesity in Burkina Faso were 13.82% (95% CI: 12.25 to 15.55) and 4.84% (95% CI: 3.99 to 5.86), respectively. Among men, the proportional odds of overweight/obesity increase with urban residency (p<0.001), greater age (p<0.002), marital status different from single (p≤0.007) and decrease with current smoking (p=0.009). Among women, the proportional odds of overweight/obesity increase with urban residency (p<0.001), primary educational level (p=0.01), high total blood cholesterol level (p<0.001) and high fasting blood glucose level (p=0.02), and decrease with current smoking (p<0.001).ConclusionOur study showed that nearly one person out of five in the adult population of Burkina has an abnormal weight status with women being more affected than men. Urban residency is a consistent risk factor in both men and women. Alcohol consumption and education were associated with an increased odds in only women. Overnutrition needs to be recognised as an important public health issue in Burkina Faso and nutrition interventions need to be reshaped to account for it.


2021 ◽  
pp. jnnp-2021-326043
Author(s):  
Alis Heshmatollah ◽  
Lisanne J. Dommershuijsen ◽  
Lana Fani ◽  
Peter J. Koudstaal ◽  
M. Arfan Ikram ◽  
...  

ObjectiveAlthough knowledge on poststroke cognitive and functional decline is increasing, little is known about the possible decline of these functions before stroke. We determined the long-term trajectories of cognition and daily functioning before and after stroke.MethodsBetween 1990 and 2016, we repeatedly assessed cognition (Mini-Mental State Examination (MMSE), 15-Word Learning, Letter–Digit Substitution, Stroop, Verbal Fluency, Purdue Pegboard) and basic and instrumental activities of daily living (BADL and IADL) in 14 712 participants within the population-based Rotterdam Study. Incident stroke was assessed through continuous monitoring of medical records until 2018. We matched participants with incident stroke to stroke-free participants (1:3) based on sex and birth year. Trajectories of cognition and daily functioning of patients who had a stroke 10 years before and 10 years after stroke and the corresponding trajectories of stroke-free individuals were constructed using adjusted linear mixed effects models.ResultsDuring a mean follow-up of 12.5±6.8 years, a total of 1662 participants suffered a first-ever stroke. Patients who had a stroke deviated from stroke-free controls up to 10 years before stroke diagnosis in cognition and daily functioning. Significant deviations before stroke were seen in scores of MMSE (6.4 years), Stroop (5.7 years), Purdue Pegboard (3.8 years) and BADL and IADL (2.2 and 3.0 years, respectively).ConclusionPatients who had a stroke have steeper declines in cognition and daily functioning up to 10 years before their first-ever stroke compared with stroke-free individuals. Our findings suggest that accumulating intracerebral pathology already has a clinical impact before stroke.


2021 ◽  
Vol 10 (14) ◽  
pp. 3126
Author(s):  
Jaehyun Lim ◽  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Jin-Hyung Jung ◽  
...  

Background: It is unclear whether exercise would reduce dementia in patients with a new diagnosis of atrial fibrillation (AF). Therefore, we aimed to evaluate the association between the change in physical activity (PA) before and after new-onset AF and the risk of incident dementia. Methods: Using the Korean National Health Insurance Service database, we enrolled a total of 126,555 patients with newly diagnosed AF between 2010 and 2016, who underwent health examinations within two years before and after their diagnosis of AF. The patients were divided into four groups: persistent non-exercisers, exercise starters, exercise quitters, and exercise maintainers. Results: Based on a total of 396,503 person-years of follow-up, 5943 patients were diagnosed with dementia. Compared to persistent non-exercisers, exercise starters (adjusted hazard ratio (aHR) 0.87; 95% confidence interval (CI) 0.81–0.94), and exercise maintainers (aHR 0.66; 95% CI 0.61–0.72) showed a lower risk of incident dementia; however, the risk was similar in exercise quitters (aHR 0.98; 95% CI 0.92–1.05) (p-trend < 0.001). There was a J-shaped relationship between the dose of exercise and the risk of dementia, with the risk reduction maximized at 5–6 times per week of moderate-to-vigorous PA among exercise starters. Conclusion: Patients who initiated or continued regular exercise after diagnosis of AF were associated with a lower risk of dementia than persistent non-exercisers, with no risk reduction associated with exercise cessation. Our findings may provide evidence for the benefit of exercise prescription to patients with new-onset AF to prevent incident dementia regardless of their current exercise status.


2018 ◽  
Vol 34 (S1) ◽  
pp. 130-131
Author(s):  
Jian Sun ◽  
Tania Stafinski ◽  
Fernanda Inagaki Nagase ◽  
Devidas Menon

Introduction:Many population-based studies identify surgical complications using hospital discharge abstract databases (DAD). With DAD, however, complications occurring after the discharge date cannot be followed up. This study used physician claims data to identify the complications of partial nephrectomy, and to compare the rates of complications of open, laparoscopic, and robot-assisted nephrectomies.Methods:Physician claims, DAD, and ambulatory care data from April 2003 to March 2016 were provided by Alberta Health. DAD and ambulatory care data were used to extract information on patients with kidney cancer who underwent partial nephrectomy. All physician claims within 30 days before and after surgery for the cohort were extracted. The numbers of the same International Classification of Diseases, Ninth Revision (ICD-9), codes before and after surgery were compared. If a number increased after surgery, this diagnosis was initially identified as a complication. All diagnoses with neoplasms were excluded. The incidence rates of complications for the three surgery groups were calculated. Chi-squared tests were conducted for the following nephrectomy comparisons: laparoscopic versus open; robot-assisted versus open; and robot-assisted versus laparoscopic.Results:A total of 1,890 kidney cancer patients had partial nephrectomies. Among them, 1,080, 411, and 399 had open, laparoscopic, and robot-assisted nephrectomies, respectively. One patient who had two different nephrectomies on the same day was excluded from analysis. The robot-assisted group had lower rates of digestive complications (ICD-9: 537–578, 787, 789, 998.6) and infections (ICD-9: 004–041, 998.5) than the open group, and higher rates of genitourinary complications (ICD-9: 584–599, 788, 997.5) than the laparoscopy group. The robot-assisted group had lower rates than the open group for most of the complication categories, but the differences were not statistically significant.Conclusions:Robot-assisted surgery appears to be superior to open surgery, but no better than laparoscopic surgery, in terms of minimizing the risk of complications following partial nephrectomy.


2007 ◽  
Vol 43 (1) ◽  
pp. 13-26 ◽  
Author(s):  
Raymond H. Baillargeon ◽  
Mark Zoccolillo ◽  
Kate Keenan ◽  
Sylvana Côté ◽  
Daniel Pérusse ◽  
...  

Ophthalmology ◽  
2021 ◽  
Author(s):  
Kevin D. Chodnicki ◽  
Laurel B. Tanke ◽  
Jose S. Pulido ◽  
David O. Hodge ◽  
James P. Klaas ◽  
...  

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