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Fulltext Social determinants of smoking in low- and middle-income countries: results from the World Health Survey

Hosseinpoor AR, Parker LA, Tursan d'Espaignet E, Chatterji S

PLoS One, 2011;6(5):e20331.
PMID: 21655299 DOI: 10.1371/journal.pone.0020331

INTRODUCTION: Tobacco smoking is a leading cause of premature death and disability, and over 80% of the world's smokers live in low- or middle-income countries. The objective of this study is to assess demographic and socioeconomic determinants of current smoking in low- and middle-income countries.
METHODS: We used data, from the World Health Survey in 48 low-income and middle-income countries, to explore the impact of demographic and socioeconomic factors on the current smoking status of respondents. The data from these surveys provided information on 213,807 respondents aged 18 years or above that were divided into 4 pooled datasets according to their sex and country income group. The overall proportion of current smokers, as well as the proportion by each relevant demographic and socioeconomic determinant, was calculated within each of the pooled datasets, and multivariable logistic regression was used to assess the association between current smoking and these determinants.
RESULTS: The odds of smoking were not equal in all demographic or socioeconomic groups. Some factors were fairly stable across the four datasets studied: for example, individuals were more likely to smoke if they had little or no education, regardless of if they were male or female, or lived in a low or a middle income country. Nevertheless, other factors, notably age and wealth, showed a differential effect on smoking by sex or country income level. While women in the low-income country group were twice as likely to smoke if they were in the lowest wealth quintile compared with the highest, the association was absent in the middle-income country group.
CONCLUSION: Information on how smoking is distributed among low- or middle-income countries will allow policy makers to tailor future policies, and target the most vulnerable populations.
Study name: World Health Survey (Malaysia is a study site)

Matched MeSH terms: Health Surveys/statistics & numerical data*
Psychometric Evaluation of the Brunei-Malay SF-36 version 2 Health Survey

Alhaji MM, Johan NH, Sharbini S, Abdul Hamid MR, Khalil MAM, Tan J, et al.

Asian Pac J Cancer Prev, 2018 Jul 27;19(7):1859-1865.
PMID: 30049198

Objectives: To culturally adapt the Short Form Health-36 version 2 (SF-36v2) into the Brunei-Malay context and determine its reliability and validity for measuring health-related quality of life (HRQOL) in healthy individuals and patients with chronic kidney disease in Brunei Darussalam. Methods: An iterative multistep strategy involving setting up a bilingual expert panel, pretesting, text revision and back translation was used to prepare the Brunei-Malay SF-36v2 as an adaptation from the Malaysian-Malay SF-36v2. The Brunei-Malay SF-36v2 was then self-administered to a sample of healthy individuals (n=95) and predialysis chronic kidney disease outpatients (n=95) resident in Brunei. The mean (SD) age of the participants was 46.6 (17.8) years. Results: Data completion rate was 100% with minimal floor effects (≤0.21) in all the 8 domains and >15% ceiling effects in 3 of the 8 domain scales. Cronbach’s alpha was >0.70 for all the 8 domain scales. Scaling success was 100% for convergent validity, with 100% item discriminant validity for all domain scales except Social Functioning (94%), Mental Health (85%) and General Health (85%). Principal component analysis of the two-factor dimension explained 68% overall variance and accounted for 81% reliable variance, but the exact SF-36 two-factor summary constructs in the standard algorithm were not replicated in the Bruneian population. Conclusions: The Brunei-Malay SF-36v2 is a valid and reliable instrument for measuring HRQOL in healthy individuals and patients with chronic kidney disease in Brunei. The summary scales should, however, be interpreted with caution. Further studies should be carried out to assess additional psychometric properties of the Brunei-Malay SF-36v2.

Matched MeSH terms: Health Surveys/statistics & numerical data*
Child marriage in Bangladesh: trends and determinants

Kamal SM, Hassan CH, Alam GM, Ying Y

J Biosoc Sci, 2015 Jan;47(1):120-39.
PMID: 24480489 DOI: 10.1017/S0021932013000746

This study examines the trends and determinants of child marriage among women aged 20-49 in Bangladesh. Data were extracted from the last six nationally representative Demographic and Health Surveys conducted during 1993-2011. Simple cross-tabulation and multivariate binary logistic regression analyses were adopted. According to the survey conducted in 2011, more than 75% of marriages can be categorized as child marriages. This is a decline of 10 percentage points in the prevalence of child marriage compared with the survey conducted in 1993-1994. Despite some improvements in education and other socioeconomic indicators, Bangladeshi society still faces the relentless practice of early marriage. The mean age at first marriage has increased by only 1.4 years over the last one and half decades, from 14.3 years in 1993-1994 to 15.7 years in 2011. Although the situation on risk of child marriage has improved over time, the pace is sluggish. Both the year-of-birth and year-of-marriage cohorts of women suggest that the likelihood of marrying as a child has decreased significantly in recent years. The risk of child marriage was significantly higher when husbands had no formal education or little education, and when the wives were unemployed or unskilled workers. Muslim women living in rural areas have a greater risk of child marriage. Women's education level was the single most significant negative determinant of child marriage. Thus, the variables identified as important determinants of child marriage are: education of women and their husbands, and women's occupation, place of residence and religion. Programmes to help and motivate girls to stay in school will not only reduce early marriage but will also support overall societal development. The rigid enforcement of the legal minimum age at first marriage could be critical in decreasing child marriage.

Matched MeSH terms: Health Surveys/statistics & numerical data
Fulltext The clustering effects of surfaces within the tooth and teeth within individuals

Masood M, Masood Y, Newton JT

J Dent Res, 2015 Feb;94(2):281-8.
PMID: 25421840 DOI: 10.1177/0022034514559408

The objectives of this study were 1) to provide an estimate of the value of the intraclass correlation coefficient (ICC) for dental caries data at tooth and surface level, 2) to provide an estimate of the design effect (DE) to be used in the determination of sample size estimates for future dental surveys, and 3) to explore the usefulness of multilevel modeling of cross-sectional survey data by comparing the model estimates derived from multilevel and single-level models. Using data from the United Kingdom Adult Dental Health Survey 2009, the ICC and DE were calculated for surfaces within a tooth, teeth within the individual, and surfaces within the individual. Simple and multilevel logistic regression analysis was performed with the outcome variables carious tooth or surface. ICC estimated that 10% of the variance in surface caries is attributable to the individual level and 30% of the variance in surfaces caries is attributable to variation between teeth within individuals. When comparing multilevel with simple logistic models, β values were 4 to 5 times lower and the standard error 2 to 3 times lower in multilevel models. All the fit indices showed multilevel models were a better fit than simple models. The DE was 1.4 for the clustering of carious surfaces within teeth, 6.0 for carious teeth within an individual, and 38.0 for carious surfaces within the individual. The ICC for dental caries data was 0.21 (95% confidence interval [CI], 0.204-0.220) at the tooth level and 0.30 (95% CI, 0.284-0.305) at the surface level. The DE used for sample size calculation for future dental surveys will vary on the level of clustering, which is important in the analysis-the DE is greatest when exploring the clustering of surfaces within individuals. Failure to consider the effect of clustering on the design and analysis of epidemiological trials leads to an overestimation of the impact of interventions and the importance of risk factors in predicting caries outcome.

Matched MeSH terms: Dental Health Surveys/statistics & numerical data
Fulltext Prevalence and factors associated with early initiation of breastfeeding among Bangladeshi mothers: A nationwide cross-sectional study

Islam MA, Mamun A, Hossain MM, Bharati P, Saw A, Lestrel PE, et al.

PLoS One, 2019;14(4):e0215733.
PMID: 31022237 DOI: 10.1371/journal.pone.0215733

BACKGROUND: Early initiation of breastfeeding (EIBF) is associated with better health of the mothers and reduced risk of neonatal mortality. The objective of this study was to determine the prevalence of EIBF and associated factors among Bangladeshi mothers.
METHODS: The data was extracted from the Bangladesh Demographic and Health Survey (BDHS)-2014. A total of 4,092 married non-pregnant Bangladeshi mothers who had at least one child aged 2 years or younger were included in this study. A two-level logistic regression model was used to remove the clustering effect for finding the impact of socio-economic and demographic factors on EIBF.
RESULTS: The prevalence of EIBF among Bangladeshi mothers was 51.4% (urban: 47.1% and rural: 53.4%). A two -level logistic regression model showed that mothers living in the Sylhet division (p<0.01) and rural environment (p<0.05) were more likely to practice EIBF. Mothers who were obese or overweight (p<0.01), had secondary (p<0.05) or higher education (p<0.01) were less likely to provide early breastfeeding to their newborn babies compared to their counterparts. Those who delivered by caesarian-section (p<0.01) were less likely to perform EIBF while those who attended an antenatal care clinic more than 3 times (p<0.05) were more likely to do so.
CONCLUSIONS: About half of the Bangladeshi mothers did not start breast-feeding within one hour after birth. This study identified several geographical and socio-demographic factors that were associated with EIBF, and hope that this information will help the government to focus their resources to promote early breastfeeding.

Matched MeSH terms: Health Surveys/statistics & numerical data