Do preventive child examinations in general practice reduce the risk of overweight and obesity?

Abstract Background The prevalence of children with overweight and obesity is increasing. General practitioners in Denmark follow children throughout early childhood via the preventive child health examinations. These examinations are offered to all children from birth to the age of five. Thus, the general practitioners have a unique opportunity for early tracing and identification of overweight and obesity, but the impact of the examinations are not examined. Therefore, the aim of this study was to examine the association between attending preventive child health examinations and the risk of overweight and obesity at the age of six both for the total pediatric population and within groups of vulnerable children such as children of parents with low educational level or low household income. Methods A population-based birth cohort study was conducted including all Danish children born from 2000-2012 using the Danish nationwide registers. Data included information on child participation in preventive health examinations at general practice, height and weight at the age of six, and parental information on socioeconomic factors. Results The analyses included 801,444 children. Attending preventive child health examinations were not associated with a lower risk of overweight at the age of six. A lower risk of obesity was seen in children attending the examinations, both in the general population (RR 0.71, 95% CI 0.66-0.76) and within vulnerable groups (low level of maternal education: RR 0.80, 95% CI 0.72-0.89), low household income (RR 0.79, 95% CI 0.72-0.87). The risk of obesity was greater in the vulnerable groups than in the not-vulnerable groups. Conclusions Attending preventive child health examinations were associated with a lower risk of obesity at the age of six, but not overweight. This was seen for both the general pediatric population and within vulnerable groups. The lowest risk of obesity was seen in the not-vulnerable groups. Key messages • The results indicated that attending preventive child health examinations in general practice reduced the risk of obesity at the age of six, but not the risk of overweight. • The lowest risk of obesity was seen in the not-vulnerable groups attending the preventive child health examinations in general practice.


Background:
Data on parameters of actual exposure to SARS-CoV-2 is limited, and specific population groups might be at a higher risk of infection.In line with the growing need for large-scale investigations to determine the presence of antibodies against SARS-CoV-2 among different population groups, we conducted a nationwide assessment in Armenia.

Methods:
We performed a cross-sectional seroepidemiological study among the adult population in Armenia, in May-September 2021.A multi-stage cluster random sampling was performed to recruit the participants across the capital city and regions.The study had two main components: blood sampling, which took place in primary care facilities and a phone survey on sociodemographic characteristics, comorbidities, and previous history of COVID-19.

Results:
The number of participants included in both blood sampling and phone survey was 3483.The nationwide prevalence of SARS-CoV 2 antibodies weighted by age and gender was 66.4% with significantly higher prevalence in urban compared to rural areas (67.3% vs 59.3%, p < 0.001).Only 22.7% (n = 772) of the total sample reported a previous history of PCR confirmed COVID-19, among whom antibodies were detected in 94.2% (n = 727).In the final adjusted model, the seropositivity was associated with being female (OR = 1.60, 95% CI: 1.32; 1.92), employed (OR = 1.41, 95% CI: 1.17; 1.69), and having previous PCR confirmed COVID-19 (OR = 10.6, 95% CI: 7.39; 15.21).Conclusions: Over 66% of the population were seropositive for antibodies against SARS-CoV 2; and over 1=5 of the sample reported a previous PCR diagnosis.Factors associated with increased odds of seropositivity included gender, employment status, and place of residence.Targeted interventions are recommended to minimize the risk of infection among those groups, including vaccination and infection prevention and control measures.

Key messages:
The prevalence of SARS-CoV 2 antibodies is about three times higher than the rate of infection based on PCR confirmed prevalence of COVID-19.Women, people living in urban areas, and those employed are at a higher risk for exposure to SARS-CoV 2.
from birth to the age of five.Thus, the general practitioners have a unique opportunity for early tracing and identification of overweight and obesity, but the impact of the examinations are not examined.Therefore, the aim of this study was to examine the association between attending preventive child health examinations and the risk of overweight and obesity at the age of six both for the total pediatric population and within groups of vulnerable children such as children of parents with low educational level or low household income.

Methods:
A population-based birth cohort study was conducted including all Danish children born from 2000-2012 using the Danish nationwide registers.Data included information on child participation in preventive health examinations at general practice, height and weight at the age of six, and parental information on socioeconomic factors.

Results:
The We included 5,485 participants (64% female).The mean anti-HBsAg increased from 46, 52, 85 to 193IU/l when the 1st dose was administered in the I, II, III or IV trimester of life, respectively.Similarly, the proportion of individuals with titre <10IU/l decreased from 51 to 18% between the two extreme quarters.The risk of a titre <10IU/l decreased with age at the 15th European Public Health Conference 2022