RESUMO
OBJECTIVE: This study aimed to assess the magnitude and identify associated factors with intimate partner violence (IPV) in Togo. DESIGN: Cross-sectional study. SETTING: Togo. PARTICIPANTS: Women of reproductive age (15-49 years). PRIMARY OUTCOME: Intimate partner violence. METHODS: This study used data from the 2013 Togolese Demographic and Health Survey. A total of 4910 married or partnered women were included. A Generalised Structural Equation Model (GSEM) was performed to identify significant factors associated with IPV. Results of the GSEM were reported as adjusted ORs (aOR) with their corresponding 95% CIs. RESULTS: The pooled prevalence of IPV was 35.5% (95% CI: 34.2% to 36.8%). Emotional violence and physical violence were the most reported forms of IPV (29.7% and 20.2%, respectively), while sexual violence was the least common, with a prevalence of 7.5%. Additionally, the results indicated that the following factors related to women, men and households were significantly associated with IPV in Togo: ethnicity, region, religion, wealth index, working status, age at the first union, having attitudes toward wife-beating, participation in household decision-making, education level, alcohol use and controlling behaviour. CONCLUSION: IPV is a complex and multifactorial phenomenon in Togo. The Togo government as well as women's human rights organisations should consider these factors when designing IPV programmes.
Assuntos
Violência por Parceiro Íntimo , Delitos Sexuais , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Análise de Classes Latentes , Estudos Transversais , Togo/epidemiologia , Fatores de Risco , Prevalência , Parceiros Sexuais/psicologiaRESUMO
The moth pest fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae) is now present throughout much of the Eastern Hemisphere where it poses a significant economic threat to a number of crops. Native to the Western Hemisphere, fall armyworm is one of the primary pests of corn in the Americas and periodically causes significant economic damage to sorghum, millet, cotton, rice, and forage grasses. This broad host range is in part the result of two populations historically designated as host strains (C-strain and R-strain) that differ in their host plant preferences. Reports of infestations in Africa have to date mostly been limited to the C-strain preferred crops of corn and sorghum, with little evidence of an R-strain presence. However, this could reflect a bias in monitoring intensity, with the R-strain perhaps being more prevalent in other crop systems that have not been as routinely examined for the pest. Because knowledge of whether and to what extent both strains are present is critical to assessments of crops at immediate risk, we analyzed specimens obtained from a systematic survey of pasture grass and rice fields, habitats typically preferred by the R-strain, done contemporaneously with collections from corn fields in Ghana and Togo. Substantial larval infestations were only observed in corn, while pheromone trap capture numbers were high only in corn and rice habitats. Little to no fall armyworm were found in the pasture setting. Comparisons with a meta-analysis of studies from South America identified differences in the pattern of strain-specific markers typically found in fall armyworm collected from rice habitats between the two hemispheres. Genetic tests of specimens from rice and corn area traps failed to show evidence of differential mating between strains. These results are consistent with the R-strain being rare or even absent in Africa and, at least for the Ghana-Togo area, this R-strain lack does not appear to be due to limitations in pest monitoring. The implications of these results to the crops at risk in Africa and the accuracy of existing molecular markers of strain identity are discussed.
Assuntos
Camundongos/parasitologia , Milhetes , Oryza , Spodoptera , Animais , Produção Agrícola , Demografia , Feminino , Genes de Insetos/genética , Gana , Masculino , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , América do Sul , Spodoptera/genética , TogoRESUMO
BACKGROUND: Diarrhoea poses serious health problems among under-five children (U5C) in Low-and Medium-Income Countries (LMIC) with a higher prevalence in rural areas. A gap exists in knowledge on factors driving rural-non-rural inequalities in diarrhoea development among U5C in LMIC. This study investigates the magnitude of rural-non-rural inequalities in diarrhoea and the roles of individual-level and neighbourhood-level factors in explaining these inequalities. METHODS: Data of 796,150 U5C, from 63,378 neighbourhoods across 57 LMIC from the most recent Demographic and Health Survey (2010-2018) was analysed. The outcome variable was the recent experience of diarrhoea while independent variables consist of the individual- and neighbourhood-level factors. Data were analysed using multivariable Fairlie decomposition at p < 0.05 in Stata Version 16 while visualization was implemented in R Statistical Package. RESULTS: Two-thirds (68.0%) of the children are from rural areas. The overall prevalence of diarrhoea was 14.2, 14.6% vs 13.4% among rural and non-rural children respectively (p < 0.001). From the analysis, the following 20 countries showed a statistically significant pro-rural inequalities with higher odds of diarrhoea in rural areas than in nonrural areas at 5% alpha level: Albania (OR = 1.769; p = 0.001), Benin (OR = 1.209; p = 0.002), Burundi (OR = 1.399; p < 0.001), Cambodia (OR = 1.201; p < 0.031), Cameroon (OR = 1.377; p < 0.001), Comoros (OR = 1.266; p = 0.029), Egypt (OR = 1.331; p < 0.001), Honduras (OR = 1.127; p = 0.027), India (OR = 1.059; p < 0.001), Indonesia (OR = 1.219; p < 0.001), Liberia (OR = 1.158; p = 0.017), Mali (OR = 1.240; p = 0.001), Myanmar (OR = 1.422; p = 0.004), Namibia (OR = 1.451; p < 0.001), Nigeria (OR = 1.492; p < 0.001), Rwanda (OR = 1.261; p = 0.010), South Africa (OR = 1.420; p = 0.002), Togo (OR = 1.729; p < 0.001), Uganda (OR = 1.214; p < 0.001), and Yemen (OR = 1.249; p < 0.001); and pro-non-rural inequalities in 9 countries. Variations exist in factors associated with pro-rural inequalities across the 20 countries. Overall main contributors to pro-rural inequality were neighbourhood socioeconomic status, household wealth status, media access, toilet types, maternal age and education. CONCLUSIONS: The gaps in the odds of diarrhoea among rural children than nonrural children were explained by individual-level and neighbourhood-level factors. Sustainable intervention measures that are tailored to country-specific needs could offer a better approach to closing rural-non-rural gaps in having diarrhoea among U5C in LMIC.
Assuntos
Países em Desenvolvimento , Diarreia , Burundi , Camboja , Camarões , Pré-Escolar , Diarreia/epidemiologia , Egito , Feminino , Honduras , Humanos , Índia , Indonésia , Lactente , Libéria , Masculino , Mali , Mianmar , Namíbia , Nigéria , Ruanda , Fatores Socioeconômicos , África do Sul , Togo , Uganda , IêmenRESUMO
OBJECTIVES: Currently, there is little data on the mental health consequences of the COVID-19 pandemic in low- and middle-income countries (LMICs). This study aims to examine the pooled and separate prevalence and determinants of depression during the pandemic in samples from four LMICs. METHODS: Participants (N= 1267, 40.9% women) were recruited from the Democratic Republic of the Congo (DRC), Haiti, Rwanda, and Togo. They completed an online cross-sectional survey on sociodemographics, exposure and stigmatization related to COVID-19, the Hopkins Symptom Checklist depression subscale, and the Connor-Davidson Resilience Scale-2. RESULTS: The pooled prevalence for depression symptoms was 24.3% (95% CI: 22.08-26.79%), with significant differences across countries. Younger age, gender (women), and high levels of exposure and stigmatization related to COVIID-19, and resilience were associated with depression in the pooled data. There were significant variations at the country level. Stigmatization (but not exposure to COVID-19 and resilience) was a strong predictor among the four countries. CONCLUSIONS: The prevalence of depression symptoms in the LMICs are similar to those reported in China and in most high-income countries during the pandemic. The findings emphasize the need for implementing non-fear-based education programs during epidemics to reduce stigmatization.
Assuntos
Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , SARS-CoV-2 , Estigma Social , Adulto , Ansiedade/psicologia , COVID-19/epidemiologia , Estudos Transversais , República Democrática do Congo/epidemiologia , Escolaridade , Feminino , Haiti/epidemiologia , Humanos , Renda , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Pobreza , Prevalência , Ruanda/epidemiologia , Estereotipagem , Togo , Adulto JovemRESUMO
OBJECTIVE: Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. METHODS: A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. RESULTS: Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 (ß = 0.06, p = .005), stigmatization related to COVID-19 (ß = 0.03, p < .001), and resilience (ß = -0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries (ß = 0.02, p < .00; ß = 0.05, p = .013; ß = 0.03, p = .021; ß = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). CONCLUSIONS: The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.
Assuntos
Ansiedade/epidemiologia , COVID-19/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Resiliência Psicológica , Estigma Social , Adulto , Ansiedade/etiologia , Congo/epidemiologia , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Fatores de Risco , Ruanda/epidemiologia , Togo/epidemiologiaRESUMO
ABSTRACT BACKGROUND: The digestive pathologies are frequent in the elderly and often have a latent and atypical symptomatology. OBJECTIVE: To assess the epidemiological and evolutionary current data on digestive diseases in the elderly, and look for factors associated with length of hospital stay. METHODS: Retrospective study of 10 years, including patients aged 60 and over hospitalized for digestive diseases in the Gastroenterology Department of the Campus Teaching Hospital of Lome, Togo. RESULTS: Of 5933 hospitalized patients, there were 1054 patients (17.8%) aged 60 years and over with a digestive pathology (526 men and 528 women). The average age was 69.5 years ±7.9 ranging from 60 to 105 years. The average length of hospital stay was 7.45 days ±6.2 ranging from 1 to 44 days. HIV prevalence was 2.4%. In order of decreasing frequency, there were hepatobiliary pathologies (54.3%) with a predominance of cirrhosis and liver cancer, eso-gastroduodenal pathologies (23.1%) with predominance of ulcers, gastric cancer and esophageal cancer, intestinal pathologies (8.7%) with a predominance of food poisoning, pancreatic pathologies (4.2%) with a predominance of pancreatic cancer and peritoneal pathologies (1.4%). Gastric cancer was the second digestive cancer found after liver cancer. Pancreatic head cancer was the second disease after gastric cancer which need a transfer in a surgical ward (P=0.031). There were 204 deaths (19.4%). The longest duration of hospitalization was due to gastric cancer (9.16 days). CONCLUSION: Hepatobiliary diseases were the most frequent and associated with a high death rate and a long hospital stay.
RESUMO CONTEXTO: As patologias digestivas são frequentes no idoso e têm geralmente uma sintomatologia latente e atípica. OBJETIVO: Avaliar os dados epidemiológicos e de evolução sobre as doenças digestivas nos idosos, e procurar fatores associados ao período de permanência hospitalar. MÉTODOS: Estudo retrospectivo de 10 anos, incluindo pacientes com idades de 60 ou mais, hospitalizados para doenças digestivas no Departamento de Gastroenterologia do Hospital Universitário de Ensino de Lomé, Togo. RESULTADOS: De 5933 pacientes hospitalizados, havia 1054 pacientes (17,8%) com idade de 60 anos ou mais com uma patologia digestiva (526 homens e 528 mulheres). A idade média foi de 69,5 anos ± 7,9 variando de 60 a 105 anos. A duração média da estadia hospitalar foi de 7,45 dias ±6,2 variando de 1 a 44 dias. A prevalência do HIV foi de 2,4%. Em ordem de diminuição da frequência, houve patologias hepatobiliares (54,3%) com predominância de cirrose e câncer hepático, patologias do esôfago-gastroduodenal (23,1%) com predominância de úlceras, câncer gástrico e câncer esofágico, patologias intestinais (8,7%) com predominância de intoxicação alimentar, patologias pancreáticas (4,2%) com predominância de câncer pancreático e patologia peritoneal (1,4%). O câncer gástrico foi o segundo câncer digestivo encontrado após o câncer de fígado. Câncer de cabeça pancreática foi a segunda doença após o câncer gástrico, que necessitou transferência para a enfermaria cirúrgica (P=0,31). Houve 204 mortes (19,4%). A maior duração da internação foi devido ao câncer gástrico (9,16 dias). CONCLUSÃO: As doenças hepatobiliares foram as mais frequentes e associadas a uma elevada taxa de mortalidade e a uma longa estadia hospitalar.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Doenças do Sistema Digestório/epidemiologia , Tempo de Internação/estatística & dados numéricos , Togo/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Idoso Fragilizado , Doenças do Sistema Digestório/classificação , Hospitalização , Hospitais de Ensino , Hospitais Universitários , Pessoa de Meia-IdadeRESUMO
ABSTRACT BACKGROUND: Gastroesophageal varices and associated bleeding are a major cause of morbidity and mortality in cirrhotic patients. OBJECTIVE: To evaluate the potential role of the biomarkers HMGB1 (High Mobility Group Box 1) and IL-6 (Interleukin-6) as predictors of infection, acute kidney injury and mortality in these patients. METHODS: It is a prospective, observational study that included 32 cirrhotic patients with variceal bleeding. RESULTS: The subjects'mean age was 52±5 years and 20 (62.5%) were male. The average MELD was 17.53±5 and the average MELD-Na was 20.63±6.06. Thirty patients (93.3%) patients were Child-Pugh class B or C. Infection was present in 9 subjects (28.1%), acute kidney injury was present in 6 (18.1%) and 4 (12.5%) patients died. The median serum levels of HMGB1 were 1487 pg/mL (0.1 to 8593.1) and the median serum level of IL-6 was 62.1 pg/mL (0.1 to 1102.4). The serum levels of HMGB1 and IL-6 were significantly higher in patients who developed infection, acute kidney injury and death (P<0.05). The Spearman's correlations for HMGB1 and IL-6 were 0.794 and 0.374 for infection, 0.53 and 0.374 for acute kidney injury and 0.467 and 0.404 for death, respectively. CONCLUSION: Serum levels of HMGB1 and IL-6 were higher in patients with the three studied outcomes. HMGB1 serum levels showed a high correlation with infection and a moderate correlation with acute kidney injury and death, while IL-6 showed a moderate correlation with infection and death and a low correlation with acute kidney injury.
RESUMO CONTEXTO: Varizes esofagogástricas são a maior causa de morbimortalidade em pacientes cirróticos. OBJETIVO: Avaliar o papel de biomarcadores, High Mobility Group Box 1 (HMGB 1) e interleucina-6 (IL-6) como preditores de infecção, injúria renal aguda e mortalidade nestes pacientes. MÉTODOS: Estudo prospectivo, observacional que incluiu 32 pacientes com cirrose hepática na fase aguda do sangramento. RESULTADOS: A média de idade dos pacientes foi de 52±5 anos sendo 20 (62,5%) do gênero masculino. A média do MELD foi de 17,53±5 e a média do MELD-Na 20,63±6,06. Trinta (93,3%) pacientes foram classificados como Child B ou C. Complicação infecciosa esteve presente em 9 (28,1%) pacientes, injúria renal aguda em 6 (18,1%) e 4 (12,5%) evoluíram para o óbito. A mediana do nível sérico de HMGB 1 foi de 1487 pg/mL (0,1- 8593,1) e da IL-6 foi de 62,1pg/mL (0,1-1102,4). Os níveis séricos de HMGB 1 e IL-6 foram significativamente maiores nos pacientes que evoluíram com infecção, injúria renal aguda e óbito (P<0,05). Os valores da correlação de Spearman para os níveis séricos de HMGB 1 e IL-6 foram de 0,794 e 0,374 para infecção, 0,53 e 0,374 para injuria renal aguda e 0,467 e 0,404 para óbito, respectivamente. CONCLUSÃO: Níveis séricos de HMGB 1 e IL-6 foram maiores nos três desfechos estudados. Níveis séricos de HMGB 1 apresentaram alta correlação para com o desfecho infecção e moderada correlação para com injúria renal aguda e óbito, enquanto os níveis séricos de IL-6 apresentaram moderada correlação para com infecção e óbito e baixa correlação para com injúria renal aguda.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Doenças do Sistema Digestório/epidemiologia , Tempo de Internação/estatística & dados numéricos , Togo/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Idoso Fragilizado , Doenças do Sistema Digestório/classificação , Hospitalização , Hospitais de Ensino , Hospitais Universitários , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The digestive pathologies are frequent in the elderly and often have a latent and atypical symptomatology. OBJECTIVE: To assess the epidemiological and evolutionary current data on digestive diseases in the elderly, and look for factors associated with length of hospital stay. METHODS: Retrospective study of 10 years, including patients aged 60 and over hospitalized for digestive diseases in the Gastroenterology Department of the Campus Teaching Hospital of Lome, Togo. RESULTS: Of 5933 hospitalized patients, there were 1054 patients (17.8%) aged 60 years and over with a digestive pathology (526 men and 528 women). The average age was 69.5 years ±7.9 ranging from 60 to 105 years. The average length of hospital stay was 7.45 days ±6.2 ranging from 1 to 44 days. HIV prevalence was 2.4%. In order of decreasing frequency, there were hepatobiliary pathologies (54.3%) with a predominance of cirrhosis and liver cancer, eso-gastroduodenal pathologies (23.1%) with predominance of ulcers, gastric cancer and esophageal cancer, intestinal pathologies (8.7%) with a predominance of food poisoning, pancreatic pathologies (4.2%) with a predominance of pancreatic cancer and peritoneal pathologies (1.4%). Gastric cancer was the second digestive cancer found after liver cancer. Pancreatic head cancer was the second disease after gastric cancer which need a transfer in a surgical ward (P=0.031). There were 204 deaths (19.4%). The longest duration of hospitalization was due to gastric cancer (9.16 days). CONCLUSION: Hepatobiliary diseases were the most frequent and associated with a high death rate and a long hospital stay.
Assuntos
Doenças do Sistema Digestório/epidemiologia , Tempo de Internação/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Doenças do Sistema Digestório/classificação , Feminino , Idoso Fragilizado , Hospitalização , Hospitais de Ensino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Togo/epidemiologiaRESUMO
The fall armyworm (Spodoptera frugiperda, J.E. Smith) is a noctuid moth that is a major and ubiquitous agricultural pest in the Western Hemisphere. Infestations have recently been identified in several locations in Africa, indicating its establishment in the Eastern Hemisphere where it poses an immediate and significant economic threat. Genetic methods were used to characterize noctuid specimens infesting multiple cornfields in the African nation of Togo that were tentatively identified as fall armyworm by morphological criteria. Species identification was confirmed by DNA barcoding and the specimens were found to be primarily of the subgroup that preferentially infests corn and sorghum in the Western Hemisphere. The mitochondrial haplotype configuration was most similar to that found in the Caribbean region and the eastern coast of the United States, identifying these populations as the likely originating source of the Togo infestations. A genetic marker linked with resistance to the Cry1Fa toxin from Bacillus thuringiensis (Bt) expressed in transgenic corn and common in Puerto Rico fall armyworm populations was not found in the Togo collections. These observations demonstrate the usefulness of genetic surveys to characterize fall armyworm populations from Africa.