Socioeconomic and Environmental Risk Factors among Rheumatic Heart Disease Patients in Uganda 英文参考文献.docVIP

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Socioeconomic and Environmental Risk Factors among Rheumatic Heart Disease Patients in Uganda 英文参考文献.doc

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SocioeconomicandEnvironmentalRiskFactorsamong RheumaticHeartDiseasePatientsinUganda EmmyOkello1,2*,BarbaraKakande1,2,EliasSebatta1,2,JamesKayima1,MonicaKuteesa4, BonifaceMutatina5,WilsonNyakoojo2,PeterLwabi2,CharlesK.Mondo1,2,RichardOdoi-Adome3, FreersJuergen1 1Division of Cardiology, Department of Medicine, Makerere University, Kampala, Uganda, 2Uganda Heart Institute, Mulago Hospital, Kampala, Uganda, 3School of Pharmacy, Makerere University, Kampala, Uganda, 4Sydney School of Public Health, Sydney, Australia, 5College of Health Sciences, Makerere University, Kampala, Uganda Abstract Background: Although low socioeconomic status, and environmental factors are known risk factors for rheumatic heart diseaseinothersocieties,riskfactorsforrheumaticheartdiseaseremainlesswelldescribedinUganda. AimsandObjective:Theobjectiveofthisstudywastoinvestigatetheroleofsocio-economicandenvironmentalfactorsin thepathogenesisofrheumaticheartdiseaseinUgandanpatients. Methods:Thiswasacasecontrolstudyinwhichrheumaticheartdiseasecasesandnormalcontrolsaged5–60yearswere recruited and investigated for socioeconomic and environmental risk factors such as income status, employment status, distancefromthenearesthealthcentre,numberofpeopleperhouseandspaceareaperperson. Results:486participants(243casesand243controls)tookpartinthestudy.Averageagewas32.37+/214.6yearsforcases and35.75+/212.6yearsforcontrols.Atunivariatelevel,Casestendedtobemoreovercrowdedthancontrols;8.0+/23.0 versus6.0+/23.0personsperhouse.Controlswerebetterspacedat25.2squarefeetversus16.9forcases.Morecontrols than cases wereemployed; 45.3% versus21.1%. Controls lived closer to health centers thanthe cases; 4.8+/23.8 versus 3.3+/212.9kilometers.Atmultivariatelevel,theoddsofrheumaticheartdiseasewas1.7timeshigherforunemployment status (OR=1.7, 95% CI=1.05–8.19) and 1.3times higher for overcrowding (OR=1.35, 95% CI=1.1–1.56). There was interactionbetweenovercrowdingandlongerdistancefromthenearesthealthcentre(OR=1.20,95%CI=1.05–1.4