Socio-demographic determinants of infectious disease knowledge in Armenia

Abstract Background There is substantial evidence that infectious disease knowledge (IDK) predicts people's behavioral intentions and preventive practices. Since level of IDK varies across socio-economic contexts and imposes a substantial burden on vulnerable groups, we aimed to assess the relationship between socio-demographic factors and IDK in the adult population of Armenia. Methods A cross-sectional nationwide phone survey was conducted in the capital Yerevan and all Armenian provinces in 2021, using a stratified two-stage cluster sampling to complete a sample of 3,483 respondents. The questions on socio-demographic characteristics and IDK were included in a multi-domain structured survey questionnaire. Four questions measured IDK; a summative IDK score (0-4) was used in bivariate and multivariate linear regression analysis. Results Females constituted 71.0% of the sample. The mean age was 49.5 years. About 68% of the study participants had some vocational (12-13 years) or university degree education and 54.4% were employed. About one fifth of the respondents reported family monthly expenditures of less than 100,000 Armenian drams (AMD) ≈ $200, while the majority reported spending 101,000AMD to 400,000 AMD per month. The mean IDK score was 2.48. In the adjusted analysis, being female, holding a higher education level, being employed, having younger age and higher family monthly expenditures were positively associated with IDK score. Conclusions Our findings suggest that there is a gap in IDK affecting specific population groups such as older people, those with incomplete or secondary education, unemployed and financially disadvantaged people. Educational interventions and campaigns should target these groups to minimize the gap and ensure even prerequisites for good health. Key messages • Gender, age, education level, employment status and income level all independently influence population’s infectious disease knowledge. • Health communication campaigns on infectious disease knowledge should particularly target males, older people and socially disadvantaged groups.


Background:
There is substantial evidence that infectious disease knowledge (IDK) predicts people's behavioral intentions and preventive practices.Since level of IDK varies across socio-economic contexts and imposes a substantial burden on vulnerable groups, we aimed to assess the relationship between sociodemographic factors and IDK in the adult population of Armenia.

Methods:
A cross-sectional nationwide phone survey was conducted in the capital Yerevan and all Armenian provinces in 2021, using a stratified two-stage cluster sampling to complete a sample of 3,483 respondents.The questions on socio-demographic characteristics and IDK were included in a multi-domain structured survey questionnaire.Four questions measured IDK; a summative IDK score (0-4) was used in bivariate and multivariate linear regression analysis.

Results:
Females constituted 71.0% of the sample.The mean age was 49.5 years.About 68% of the study participants had some vocational (12-13 years) or university degree education and 54.4% were employed.About one fifth of the respondents reported family monthly expenditures of less than 100,000 Armenian drams (AMD) $200, while the majority reported spending 101,000AMD to 400,000 AMD per month.The mean IDK score was 2.48.In the adjusted analysis, being female, holding a higher education level, being employed, having younger age and higher family monthly expenditures were positively associated with IDK score.

Background:
There is limited evidence on the health of migrant populations in low and middle-income countries (LMICs).Here, we investigated the patterns of mortality risk in migrants and nonmigrants in women and men over the life course.

Methods:
We linked socioeconomic and mortality data from 1st Jan 2011 to 31st Dec 2018 in the 100 Million Brazilian Cohort.We calculated all-cause and cause-specific age-standardised mortality rates according to individuals' migration status.Using Cox regression models, we estimated the age-and sex-adjusted mortality hazard ratios (HR) for internal migrants (i.e., people born in Brazil but living in a different Brazilian state to their state of birth) compared to Brazilian-born non-migrants; and for international migrants (i.e., people born in another country) compared to Brazilian-born individuals.

Results:
We followed 45,051,476 individuals, of whom 6,057,814 were internal migrants and 277,230 were international migrants.Internal migrants had a similar overall risk of all-cause mortality compared to Brazilian non-migrants (aHR = 0.99, 95%CI = 0.98-0.99),with lower mortality from some causes but higher mortality for some non-communicable diseases (NCDs).Compared to Brazilian-born individuals, international migrants had a lower risk of all-cause mortality (aHR = 0.82, 95%CI = 0.80-0.84),with up to 50% lower risk of death attributed to interpersonal violence among international migrant men (aHR = 0.50, 95%CI = 0.40-0.64),but a markedly higher risk of death by avoidable causes related to maternal health among young migrant women (aHR = 2.17, 95%CI = 1.17-4.05).

Conclusions:
Overall, internal migration was not associated with excess allcause mortality, while international migration into Brazil was associated with lower all-cause mortality.Mortality patterns among migrant populations in Brazil show marked variation for specific causes of death, and risks varied by age and sex.

Key messages:
Non-communicable diseases and maternal mortality are disproportionally higher among internal and international migrants, respectively.
Further investigation of the underlying factors associated with higher maternal mortality among international migrant women is key to informing the targeting of social and health interventions. Abstract

Conclusions:
We confirmed social inequalities in the incidence of ABOs as well as mortalities from ABOs.However, the difference in mortality between babies with and without ABOs was greater for advantaged children.Policies to reduce the mortality of children with ABOs as well as those of healthy children among socioeconomically disadvantaged families are required.

Key messages:
Social inequalities in mortality from ABOs were apparent especially in the neonatal period while the incidence of ABOs itself was greater among children from disadvantaged families.Disadvantaged children are more likely to die not only from ABOs but also from other socio-environmental determinants, especially in the post-neonatal period than their counterparts.
Using the Under-5 Infant Birth-Death Cohort Data in Korea, a pooled retrospective birth cohort of all children born in 2012-2014 was built (N = 1,356,584).We analyzed neonatal, postneonatal, and childhood mortality by ABOs and with the interaction of parental SEP using the Cox proportional hazard regression model for survival analyses.We further stratified the analysis both by parental SEP and child age.Multiple logistic regression was performed to confirm the social inequalities in ABO itself.