Several studies have shown a decrease in glioma risk associated with a personal history of allergic conditions and the medications used to treat the symptoms. However, few studies have been able to examine risk within histological subgroups of glioma. Case-control data from M. D. Anderson Cancer Center and University of California, San Francisco were pooled to conduct the analysis stratified by histological subtype. A risk prediction model considering inflammation-related variables and antihistamine use was built using logistic regression. Of the subtypes examined, long-term antihistamine use was associated with increased risk of anaplastic gliomas, especially when length of use was considered in conjunction with history of asthma or allergy. Anaplastic cases with no history of asthma or allergy were 2.94 times more likely than controls to report antihistamine use for 10 years or more; whereas anaplastic cases with a history of asthma or allergy were 2.34 times more likely than controls to report antihistamine use for 10 years or more. Furthermore, anti-inflammatory medication use was associated with a protective effect against glioblastoma (OR 5 0.80; 95% CI: 0.65, 0.99), especially among individuals with no history of asthma or allergies. No statistically significant effects of anti-inflammatory drugs or antihistamines were evident for the other histological subtypes. Thus, modulation of the immune system by the use of common drugs, such as antihistamines or nonsteroidal anti-inflammatory drugs, may contribute to the development of certain types of brain tumors.Gliomas account for approximately three-fourths of all primary malignant brain tumors, and, despite extensive study into their etiology, there are few established risk factors.1 Epidemiological studies of gliomas are difficult to conduct both because gliomas are rare, making recruitment difficult for large studies of risk factors, and because the classification of ''glioma'' is a broad grouping that includes several component histologies. These histologic types exhibit characteristic racial/ethnic and gender distributions, and may have distinct molecular profiles, according to recent gene expression studies.2,3 If the subtypes are actually etiologically heterogeneous, real differences in risk factors may be missed by combining subtypes in epidemiologic studies.4 For these reasons, pooled studies from multiple research centers are necessary to acquire enough cases to provide analyses of more detailed case groups, especially when examining rare exposures.One current topic of interest in brain tumor epidemiology is the effect of immune responses on glioma risk. Recent studies suggest an association of self-reported allergy or asthma with lower glioma risk. [5][6][7][8][9][10][11][12][13][14][15] Furthermore, some studies have reported associations between glioma risk and use of over-the-counter medications associated with inflammation, particularly nonsteroidal anti-inflammatory drugs (NSAIDs) and antihistamines. 9,16 These drugs act to alleviate symptoms ...
Summary The Philippines has a long history of rabies control efforts in their dog populations; however, long-term success of such programmes and the goal of rabies elimination have not yet been realized. The Bohol Rabies Prevention and Elimination Program was developed as an innovative approach to canine rabies control in 2007. The objective of this study was to assess canine rabies vaccination coverage in the owned-dog population in Bohol and to describe factors associated with rabies vaccination two years after implementation of the programme. We utilized a cross-sectional cluster survey based on the World Health Organization’s Expanded Programme on Immunization coverage survey technique. We sampled 460 households and collected data on 539 dogs residing within these households. Seventy-seven percent of surveyed households reported owning at least one dog. The human to dog ratio was approximately 4 : 1, and the mean number of dogs owned per household was 1.6. Based on this ratio, we calculated an owned-dog population of almost 300 000. Overall, 71% of dogs were reported as having been vaccinated for rabies at some time in their lives; however, only 64% of dogs were reported as having been recently vaccinated. Dogs in our study were young (median age = 24 months). The odds of vaccination increased with increasing age. Dogs aged 12 – 23 months had 4.6 times the odds of vaccination compared to dogs aged 3 – 11 months (95% CI 1.8 – 12.0; P = 0.002). Confinement of the dog both day and night was also associated with increased odds of vaccination (OR = 2.1; 95% CI 0.9 – 4.9; P = 0.07), and this result approached statistical significance. While the programme is on track to meet its goal of 80% vaccination coverage, educational efforts should focus on the need to confine dogs and vaccinate young dogs.
Knowledge, attitudes, and practices (KAP) regarding rabies in Bohol, Philippines were assessed following introduction of the Bohol Rabies Prevention and Elimination Programme. A cross-sectional questionnaire was administered to 460 households chosen utilizing the WHO's Expanded Programme on Immunization coverage cluster survey technique with population proportionate to size. Scores for KAP were evaluated using linear regression. The majority of households had heard of rabies (94%); however, specific knowledge of rabies was limited. Only 18% knew to report a suspected rabid dog to the authorities. In multivariate analyses, having known someone with rabies had the greatest effect on knowledge scores. Employment (professional or non-professional) had the greatest effect on attitudes scores, and only the knowledge score was significantly associated with higher practices scores. Several factors, notably, personal experience with rabies, affect KAP in Bohol. The programme should continue to focus on education and include personal accounts to underscore why rabies prevention and control is so important.
Study Objective To assess the level of HPV knowledge among low income, minority mothers with a child between the ages of 9 – 17 years. Design Women who sought care at a university-based clinic and had at least one child aged 9 to 17 years were approached. A total of 638 mothers were recruited. Only those who had heard of HPV were included in the correlation analyses (n = 468). Main Outcome Measures HPV knowledge was assessed utilizing a self-administered questionnaire consisting of 20 questions. Results There were differences between those who had heard of HPV and those who had not. More of those who had not heard of HPV were Hispanic (63%), low-income (89%), and did not graduate high school (59%). Of those who had heard of HPV, the majority did not answer 50% of questions correctly. Few knew the vaccine could prevent genital warts (19.7%). Factors independently associated with HPV knowledge included age, personal history of HPV, cervical dysplasia or cervical cancer, acquiring knowledge from ≥2 sources, having known someone with HPV or cervical cancer, having seen a brochure on the vaccine, and having seen an advertisement for the vaccine. Conclusions Knowledge regarding HPV is low among low-income women with children in the target age range for HPV vaccination. Increased awareness should focus on genital warts and other cancers, since this population has virtually no knowledge of other health outcomes related to HPV infection. Educational programs tailored to this population need to be developed to increase vaccination.
Effective and rapid decision making during a pandemic requires data not only about infections, but also about human behavior. Mobile phone surveys (MPS) offer the opportunity to collect real-time data on behavior, exposure, knowledge, and perception, as well as care and treatment to inform decision making. The surveys aimed to collect coronavirus disease 2019 (COVID-19) related information in Ecuador and Sri Lanka using mobile phones. In Ecuador, a Knowledge, Attitudes and Practices (KAP) survey was conducted. In Sri Lanka, an evaluation of a novel medicine delivery system was conducted. Using the established mobile network operator channels and technical assistance provided through The Bloomberg Philanthropies Data for Health Initiative (D4H), Ministries of Health fielded a population-based COVID-19-specific MPS using Surveda, the open source data collection tool developed as part of the initiative. A total of 1,185 adults in Ecuador completed the MPS in 14 days. A total of 5,001 adults over the age of 35 in Sri Lanka completed the MPS in 44 days. Both samples were adjusted to the 2019 United Nations Population Estimates to produce population-based estimates by age and sex. The Ecuador COVID-19 MPS found that there was compliance with the mitigation strategies implemented in that country. Overall, 96.5% of Ecuadorians reported wearing a face mask or face covering when leaving home. Overall, 3.8% of Sri Lankans used the service to receive medicines from a government clinic. Among those who used the medicine delivery service in Sri Lanka, 95.8% of those who used a private pharmacy received their medications within one week, and 69.9% of those using a government clinic reported the same. These studies demonstrate that MPS can be conducted quickly and gather essential data. MPS can help monitor the impact of interventions and programs, and rapidly identify what works in mitigating the impact of COVID-19.
Background: In 2016, after 8 years of twice-annual nationwide preventive chemotherapy (PC) administration to school-age children (SAC), the Bangladesh Ministry of Health & Family Welfare (MOHFW) sought improved impact and intervention monitoring data to assess progress toward the newly adopted goal of eliminating soil-transmitted helminthiasis (STH) as a public health problem. Methods: We surveyed four Bangladeshi districts between August and October 2017. We conducted a multi-stage, cluster-sample, household survey which produced equal-probability samples for preschool-age children (PSAC; 1-4 years), SAC (5-14 years), and adults (≥ 15 years). Standardized questionnaires were administered, using Androidbased smart phones running an Open Data Kit application. Stool samples were collected and testing for STH prevalence and infection intensity used the Kato-Katz technique. Results: In all, 4318 stool samples were collected from 7164 participants. Estimates of STH prevalence by risk group in three of the four surveyed districts ranged from 3.4 to 5.0%, all with upper, 1-sided 95% confidence limits < 10%. However, STH prevalence estimates in Sirajganj District ranged from 23.4 to 29.1%. Infections in that district were spatially focal; four of the 30 survey clusters had > 50% prevalence in at least one risk group. Among all tested specimens, Ascaris lumbricoides was the most common STH parasite [8.2% (n = 352)], followed by Trichuris trichiura [0.9% (n = 37)], and hookworm [0.6% (n = 27)]. In each district, PC coverage among SAC was above the 75% program target but did not exceed 45% among PSAC in any district. Improved sanitation at home, school, or work was over 90% in all districts.
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