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Jan 2022 DOI 10.14302/issn.2578-8590.ipj-21-4026
Karabayev M.Corresponding author
Fergana Medical Institute of Public Health, Uzbekistan.
A theoretical paper proposes applications of golden proportion principles to physiological diagnostics. It outlines proposed metrics and discusses validation needs and limitations.
Jul 2021 DOI 10.14302/issn.2641-4538.jphi-21-3897
Pamela NanaCorresponding author
Interstate center in public health in Central Africa (CIESPAC)
Background Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject. Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020. Methodology This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05. Bold The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1. Conclusion We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.
Jun 2026 DOI 10.14302/issn.2379-7835.ijn-25-5909
Bisai SamiranCorresponding author
The high prevalence of anemia among children and adolescents in India is still an overwhelming problem. Not only that, there is also a considerable deficiency of various micronutrients such as Vitamin A, Vitamin B12, Vitamin D, serum ferritin, Zinc and Folate etc. in children. These micronutrients have several functional roles for the normal growth and development of children. Unfortunately, recent studies on public health and nutrition intervention have so far focused less on these micronutrition and more on anemia and nutrition. Data for this study obtained from the Comprehensive National Nutrition Survey (CNNS 2016-18), a nationally representative survey covering different age group. Specifically, it includes information on 9767 children aged 1-4 years. Out of these surveyed children biomarker data for hemoglobin, serum ferritin, zinc, folate, vitamin A, vitamin B12 and Vitamin D were collected from 8242 children. Micronutrient deficiencies were identified based on WHO and other established cut-off criteria. Wealth quintiles were computed to identify household economic inequality. The prevalence of anemia at the national level was 40.7%. Among micronutrients, folate (22.9%) and zinc (18.7%) deficiencies were most commonly observed, followed by vitamins A (18.3), vitamin B12 (13.8%) and vitamin D (14.0%). Iron deficiency as measured by ferritin was present in 31.6% of children. It is alarming that nearly one in three children (32.8%) suffer from deficiencies in two or more micronutrients. Clear socioeconomic disparities were observed for all micronutrient deficiencies (MND); children in the poorest groups had significantly higher levels of micronutrient deficiencies than children in the richest groups. Among the states, Gujarat and Madhya Pradesh had the highest overall micronutrient deficiencies, while West Bengal and Kerala had the lowest. This clearly shows that a large proportion of preschool children in India suffer from anemia and MND, with the prevalence being even more alarming in lower socio-economic settings. This study suggests that there is a need to move beyond single-nutrient interventions and implement comprehensive, multi-micronutrient supplementation or food fortification strategies seamlessly into the existing national health and nutrition programs.
Jun 2026 DOI 10.14302/issn.2766-8681.jcsr-26-6296
Jisoli Yahula ManyasaniCorresponding author
Background Acute diarrhea is the major cause of health public problem among paediatric patients in Tanzania. And in Low income countries (LICs), studies have shown, Acute watery Diarrhea (AWD) is the cause of morbidity and mortality which can be prevented by immediate identification and treatment of complications. Methods A prospective cohort study was done between December 2021 and April 2022 to determine the risks, complications, management strategies and predictors of mortality among paediatric patients ≤12 years of age with severe diarrhea. We excluded those who arrived in cardiac arrest at the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH). Proportion was used to summarize the counts and frequency of participants who were at risk of complications and management strategies given and for predictors of outcomes. A Modified Poisson log linear model with a robust estimation test was used to test for significant associations between predictors and outcomes. Multivariate logistic regression was used to adjust for confounders. Results A total 6,570 paediatric patients presented to EMD during study period, and we recruited 144 (2.2%). The median age was 1 (IQR 0.7-2.0) years and most were male 86 (59.7%). Among the study participants with diarrhea, 120 (83.3%) had dehydration, acidosis 60 (42.3%), hypoglycemia 8 (5.6%), hypokalemia 76 (53.1%), and Acute renal failure 11 (7.6%). Those patients with complications received appropriate management, including IV crystalloid solution given to 131 (90.97%), and correction of acidosis 60 (42.3%), hypoglycemia correction with IV dextrose 10% 6 (4.2%), and hypokalemia and infections were corrected with IV potassium chloride 52 (36.1%) and IV antibiotic treatment 84 (58.3%) respectively. Conclusion Pediatric patients under 2 years of age are at high risk of severe diarrhea with dehydration as compared to other ages. Early referral and availability of point care tests are essential in early recognition of accompanied complications.
Jun 2026 DOI 10.14302/issn.2574-4496.jtc-26-6304
Elshafie OmaymaCorresponding author
Objective To evaluate the treatment outcomes of patients with Differentiated thyroid cancer (DTC) who underwent total thyroidectomy followed by RAI therapy at the Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) in Oman. Methods This is a retrospective observational clinical study conducted at SQCCCRC. The study included all patients diagnosed with DTC who were admitted to SQCCCRC between June 2021 and November 2023. A total of 255 patients were identified and met the inclusion criteria for this study. Results The mean age at diagnosis was 39.9 ± 12.4 years (range: 14–79), with 78% of patients being female. The mean BMI was 30.3 ± 6.4 kg/m², with nearly half of the cohort (48.2%) classified as obese (BMI ≥ 30). Most patients had papillary thyroid carcinoma (92.9%), while follicular and Hürthle cell carcinoma accounted for 5.9% and 0.8% of cases, respectively. Based on the American Joint Committee on Cancer (AJCC) staging, 86.3% of the patients were classified as stage I and 3.9% as stage II. Six patients (2.4%) had stage IVB disease. According to American Thyroid Association (ATA) risk stratification the majority were low-risk. Patient age was strongly associated with disease stage. The distribution of metastatic cases varied by region, with the highest proportion observed in Dhofar. Most patients (87.1%) received a single dose of radioactive iodine (RAI), with a median cumulative dose of 3.7 mCi). At six months post-treatment, 70.2% of patients had a TG level < 0.2 ng/mL. Conclusion The outcome of therapy in majority of our patients is favorable with 72% having excellent biochemical response at last follow up. None of the patients with distant metastasis achieved excellent response and a high proportion of them came from the Dhofar governorate, a targeted intervention would be of benefit. Low risk patients require special attention and may need radioactive iodine during follow up, unlike other regions and hence warrant very close follow up and further review to establish the best practice guidelines in our region.
May 2026 DOI 10.14302/issn.2690-4837.ijip-26-6169
Ershova JuliaCorresponding author
Introduction The risk of exposure to M. tuberculosis among healthcare workers (HCW) remains a public health concern worldwide. During the COVID-19 pandemic, the Biomedical Research and Training Institute supported the Zimbabwe Ministry of Health and Child Care in strengthening infection prevention and control (IPC) practices in healthcare facilities (HCF), integrating tuberculosis (TB) infection control (TBIC) into the intervention strategy. We describe the impact of this intervention on TBIC practices and HCW screening outcomes. Methods The strategy, implemented from June 2021–September 2022, included IPC mentorship training, competency assessments, and use of a standardized risk assessment tool for progress monitoring. For the training purposes, the project developed eight practical problem-solving IPC modules including an occupational health component. Trained mentors conducted bi-monthly site support visits (SSV), used a checklist to track compliance, and assessed competencies of HCW at the targeted facilities. Facility-based risk assessments were conducted three times during the project implementation. Results During the intervention, 1,865 HCW from 105 facilities were trained. Availability and use of personal protective equipment improved by 49% and 42%, respectively. The proportion of HCF with designated areas for sputum collection increased by 43%. The proportion of HCF that screened HCW for TB increased by 42% with 3,761 HCW screened during the project period. Fourteen were diagnosed with TB and referred for care, resulting in 372 new cases per 100,000. Conclusion The implemented strategy of training, mentorship, and regular SSV strengthened TBIC measures, improved TB screening practices and case finding among HCW. Improving and maintaining practices is critical for effective TBIC.
Feb 2026 DOI 10.14302/issn.2473-1005.jdoi-25-5935
Romulus Calin FodorCorresponding author
The aim of this article is to present alternative possibilities for corrective intervention using corticobasal implants, following the failure of treatment with two stage implant in cases of extensive edentulism, multi-segmented edentulism, and the development of peri-implantitis 1 at the level of these implants. For this purpose, a case was selected involving a patient treated with two stage implants in a multi-segmented manner, in the distal regions of the maxilla and mandible, where the implants were affected after 12 years by peri-implantitis in proportions ranging from 20% to 100% in different areas of bone, with a predominance in the vestibular area. The decision was made to remove the affected two stage implants, as well as the remaining deciduous teeth, with or without periodontal conditions, but whose position on the arch made improperly rehabilitation, both functionally and aesthetically impossible, and made the second rehabilitation with polished corticobasal and compressive implants in immediate loading 2. Function and aesthetics of the gnathological apparatus were restored through definitive fixed metal-ceramic prosthetics on the support of corticobasal and compressive implants within 4 days from the beginning of the treatment, with the result being monitored over a period of 3 years and 3 months, and this evaluation is to continue over time. From a surgical perspective, for secondary rehabilitation with polished corticobasal and compressive implants, strategic positions in the maxillary and mandibular bones were used as follows: the fusion area of the maxillary bone with the sphenoid bone, the nasal cortex, the sinus cortex the lingual cortex distal to the mylohyoid line, and the interforaminal mandible area.34 These areas correspond to methods described in Consensus Number 6 in the IF The Foundation of Knowledge 5. In conclusion, the treatment with corticobasal, compressive polished implants is successful even in the case of a difficult clinical scenario like the one described for this patient 6. The reduced treatment time, along with the absence of the need for sinus lifts or bone grafts, makes it the ideal solution in any situation. The use of corticobasal implants, with fixation in the second/third cortical layer and an immediate loading protocol, should represent the primary solution in treating cases with poor bone representation, and no only as a “Corrective Intervention with Corticobasal® Implants”7.
Feb 2026
Singhal SunilCorresponding author
Objective The landscape of non-small cell lung cancer (NSCLC) has changed due to liberalized utilization of computed tomography, developments in immunotherapy and targeted treatments, and guidelines encouraging sublobar resections. We analyzed the implications of these advances for surgical procedures over a 16-year period. Methods The National Cancer Database was used to identify NSCLC incident cases from 2004 to 2020. Histology, stage, grade, and treatment were analyzed using descriptive statistics and logistic regression. Results 2,028,553NSCLC patients were identified. Each year was associated with an increase in Stage I for NSCLC (OR1.05, 95%CI 1.05-1.05) and histological subtypes (adenocarcinoma: OR1.03, 95%CI 1.03-1.04; squamous: OR1.02, 95%CI 1.02-1.02; neuroendocrine: OR1.11, 95%CI 1.11-1.12), with no change in adenosquamous histology. A similar increase was observed for well- or moderately-differentiated histology (OR1.04, 95%CI 1.04-1.04). The proportion of patients receiving chemotherapy decreased (OR0.98, 95%CI 0.98-0.98), while more patients were treated with immunotherapy or targeted therapy, including an increase of 14% using immunotherapy or targeted therapy as first-line treatment. There was a decrease in the likelihood of receiving pneumonectomy (OR 0.91, 95%CI 0.91-0.91). Despite guidelines advocating sublobar resections, these procedures only increased by 1.1% per year. Conclusions Over the 16-year study period, there was a significant trend towards diagnosis of Stage I NSCLC. The most pronounced change in treatment patterns has been more patients receiving immunotherapy and less chemotherapy. Despite a promising decrease in pneumonectomies, the frequency of sublobar resections remains stagnant, indicating limited uptage in current practice.
Dec 2025
Gebretsadik Bereka SolomonCorresponding author
Background Fast food consumption is the major cause of obesity and overweight in worldwide affecting more than 2 billion people, especially developing countries and low income countries. It can lead to hyperinsulinemia and development of insulin resistance, high energy density, high glycemic index, and fatty acid composition of fast foods may increase the prevalence of obesity and cardiovascular risk factors Objectives The main aim of this study was, to assess fast food consumption and its association with overweight /obesity among undergraduate students of University Hargeisa, Somaliland, 2023. Methods The study was carried out from May 01 to July 20, 2023 at University of Hargeisa using an institutional based cross-sectional study design to among 260 students. The study participants were selected using a simple random sampling technique. A structured questionnaire was prepared based on review literatures and dig out from related studies. The anthropometric data was taken by data collectors to measure weight and height using a stadiometer. Data was entered and checked for errors using EPI-info version 7.1.5.0 and then, data were exported to statistical package for social sciences (SPSS) software version 21 and STATA software version 14 for data processing and analysis. Descriptive statistics such as; frequencies, means and proportion was used for present the findings. A variable with P-values of less than 0.25 in the binary logistic regression analysis was entered into a multivariable logistic regression analysis to identify the independent predictors of stunting. Finally, variable at P-value less than 0.05 in multivariable logistic regression analysis was considered as a statistically significant variable. Results In this study, the majority 235 (90.4%, CI: 86.5- 93.8) of the study participants were fast food consumers. The study revealed that, from the total study participants 46(17.7%),127(48.8%),84(32.3%), 3(1.2%) were underweight, normal, overweight and obese respectively. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. On multi-variable logistic regression model educational level of the students (AOR = 12.45 (95% CI: 1.7, 14.6)) and frequency of fruit (AOR = 0.76, 95% CI (0.7, 0.8)) and vegetable consumptions (AOR = 0.51, 95% CI (0.47, 0.575)) were found to be significantly associated with fast food consumptions (p < 0.05). Conclusion In this study, of the total 90.4% number of fast food consumers. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. Educational level of the students and frequency of fruit and vegetable consumptions were found to be significantly associated with fast food consumptions. Effort should be made to increase access to fast food-related information and counseling.
Dec 2025 DOI 10.14302/issn.2324-7339.jcrhap-25-5715
Couture LucyCorresponding author
Recruitment for research studies focused on communicable diseases such as HIV (Human Immunodeficiency Virus) has historically been challenging, particularly among populations who have been underrepresented in media messaging, yet maintain a significant vulnerability to new HIV cases, like Black women. This study examines the recruitment strategies utilized in Aim 2 of pilot study at the University of Texas Health Science Center (UTHealth) in Houston, Texas that was funded by the Ujima Mentoring Program to develop, implement, and evaluate a video log (vlog)-based intervention. The overarching goal of the pilot study was to promote the uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women in Harris County, Texas. Aim 2 involved the creation of a culturally relevant vlog for use in Aim 3, which sought to educate and motivate participants to consider PrEP as an HIV prevention strategy. With the growing role of digital platforms in public health outreach, social media was employed alongside traditional recruitment methods such as flyers and word-of-mouth referrals. Despite an expanded online reach, engagement remained low, and participation rates did not increase proportionally to the number of individuals who viewed recruitment materials. The reluctance to participate was largely attributed to stigma surrounding HIV and concerns about being publicly associated with an HIV prevention study based on participants feedback to the research team. Even the availability of research incentives to encourage participation did not significantly improve recruitment accrual goals, particularly among healthcare providers who experienced limitations with eligibility due to institutional policies. This study underscores the need to better understand the social and cultural barriers that prevent Black women and healthcare providers from engaging in HIV prevention research. While digital recruitment strategies can enhance visibility to a larger audience, they must be supported with trust-building efforts, community partnerships, and culturally competent messaging to encourage meaningful participation. These findings point to the critical need for multi-faceted recruitment strategies that go beyond social media campaigns and actively build trust within communities, ensuring that HIV prevention research and interventions are both accessible and culturally resonant.
Dec 2025 DOI 10.14302/issn.2997-2108.jcc-25-5657
M Essam ZahraaCorresponding author
Viral infections contribute to a significant proportion of human cancers, with human papillomavirus (HPV) being one of the most well-established oncogenic viruses. This review summarizes HPV biology, transmission, classification, molecular mechanisms of carcinogenesis, epidemiology of HPV-associated cancers, and current and emerging preventive and therapeutic approaches. particularly HPV-16 and HPV-18, drives malignant transformation through the E6 and E7 oncoproteins, which disrupt tumor suppressor pathways p53 and Rb. Prophylactic vaccination programs have demonstrated remarkable success in reducing HPV-related disease burden, but disparities in coverage remain. Cutting-edge strategies such as CRISPR/Cas9 and RNA-based therapeutics offer promising avenues for treating established infections. Integrating these biomedical advances with robust public health initiatives is essential to ultimately eliminate HPV-associated cancers worldwide (Figure1).
Dec 2025 DOI 10.14302/issn.2997-2108.jcc-25-5518
Steven KikonyogoCorresponding author
Cervical cancer is the fourth most common cancer in women globally, with 660,000 new cases and 350,000 deaths in 2022. The burden is disproportionately high in low- and middle-income countries (LMICs), particularly sub-Saharan Africa. Despite proven interventions like HPV vaccination and screening, uptake remains low. While cervical cancer screening has been studied in the general population, little is known about uptake among refugee women in Uganda, which hosts approximately 1.7 million refugees. This study examines cervical cancer screening uptake and associated factors among refugee women in Uganda. Methods We conducted a cross-sectional secondary analysis of the 2021 Uganda Refugee Population-based HIV Impact Assessment (RUPHIA) survey, focusing on women aged 21–49 in refugee settlements in the West Nile and South-Western regions, which host 90% of Uganda’s refugee population. The primary outcome was self-reported cervical cancer screening status. We used descriptive statistics and logistic regression to identify factors associated with screening uptake. Results Among 731 women, only 72 (9.8%) reported undergoing cervical cancer screening. The mean age of screened women was 37 years (±7), compared to 32 years (±8) for unscreened women. Screening uptake was significantly higher among women aged 31–39 years (AOR = 2.67, 95% CI: 1.32–5.52, p = 0.007), married women (AOR = 12.0, 95% CI: 1.76–163, p = 0.03), and those in polygamous relationships (AOR = 4.76, 95% CI: 1.96–11.1, p < 0.001) Conclusion Cervical cancer screening uptake among refugee women in Uganda is critically low. Integrating culturally sensitive screening programs into refugee health services and addressing socio-economic barriers could improve access and utilization.
Aug 2025 DOI 10.14302/issn.3066-8042.jac-25-5652
Amiri DavoudCorresponding author
Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.
Apr 2025 DOI 10.14302/issn.2379-7835.ijn-25-5463
Fokou ElieCorresponding author
Iron deficiency is a major public health problem worldwide. It affects a significant proportion of the population, and is responsible for around 50% of anemia cases worldwide. Cameroon in general and Lekie Division in particular, is very highlyaffected by this problem. However, early detection of the problem can prevent the fatalities associated to it. The objective of this study was to provide up-to-date, detailed data on the markers of iron status in these populations, so that treatment can be better targeted. A two-month cross-sectional study was conducted in the Lekie Division in collaboration with local health centres in both urban and rural areas. The study sample consisted of 361 participants of all age groups and sexes. A questionnaire was issued to obtain information of the participants socio-demographic status, then 3 to 5ml of blood were collected and a number of markers of the participants iron status were studied. Of all the hematological markers studied, hemoglobin concentration in the study population was below normal in both men and women. Biochemical markers were good for all socio-demographic parameters. The mean values of biochemical and hematological markers in the population of the Lekie Division were good for all socio-demographic parameters, with the exception of hemoglobin concentration, which remains critical, requiring particular attention in this locality, but above all urgent intervention lest the situation aggravates further.
Feb 2025 DOI 10.14302/issn.2641-4538.jphi-25-5420
Nagaraj NitashaCorresponding author
South Asian women in the United States face disproportionate health challenges, including higher rates of intimate partner violence as well as higher rates of Type 2 diabetes and gestational diabetes compared to other racial and ethnic groups. This cross-sectional study examines the association between intimate partner violence (psychological, physical, and sexual) and the diagnosis of gestational diabetes and type 2 diabetes. A web-based survey recruited 2,634 South Asian women in the U.S., collecting data on socio-demographics, intimate partner violence experiences, stress levels, and diabetes diagnosis. Logistic regression models adjusted for significant sociodemographic factors revealed that women with a history of intimate partner violence were 5.82 significantly more likely to report a type 2 diabetes diagnosis and 3.91 more likely to report a gestational diabetes diagnosis. Furthermore, stress as measured by the perceived stress scale, was also higher among women with intimate partner violence, potentially moderating the relationship between intimate partner violence and adverse health outcomes through cortisol dysregulation. Despite high levels of educational attainment and employment, the prevalence of intimate partner violence was alarmingly high (66.7%), highlighting its pervasive impact on socioeconomic strata. These findings underscore the urgent need for culturally tailored interventions addressing intimate partner violence and its health consequences within South Asian communities. Further research is warranted to elucidate causal pathways and inform integrated public health strategies to mitigate disparities in chronic disease and intimate partner violence-related health outcomes.
Dec 2024 DOI 10.14302/issn.2379-7835.ijn-24-5352
C. Katusi GodfreyCorresponding author
Introduction Adolescent pregnancy has become a global health concern in recent years, with maintaining dietary diversity being essential to ensure the health of both the mother and fetus. This study aimed to understand the dietary diversity and nutritional status among pregnant adolescents attending antenatal clinic and identify the factors influencing these outcomes. Methodology A hospital based cross-sectional study was done at St Francis Regional Referral Hospital at Ifakara, Tanzania. A total of 131 adolescent pregnant women consented to participate. Data was obtained using questionnaire and 24-hour dietary recall. Results The study revealed that 93.1% (n=122) of adolescent pregnant women met the minimum dietary diversity score based on 24-hour recall period. Similar proportions were observed for age group but vary significantly with the number of children born (p< 0.001), marital status (p = 0.032) and education level (p< 0.001). Additionally, 93.9% (n=123) of adolescent pregnant women had a normal Mid-Upper Arm Circumference (MUAC) and 6.1% (n=8) were undernourished. Similar proportions were observed across age, number of children born, marital status, education status, and occupation. Conclusion Most adolescent pregnant women in this study achieved adequate dietary diversity. However, socio-demographic factors such as age, marital status, and education, as well as challenges like illness and loss of appetite, influenced their dietary diversity and overall nutritional status. Future research should adopt a community-based longitudinal approach to better understand these factors and provide a more comprehensive understanding on the dietary patterns of adolescent pregnant women.
Apr 2024 DOI 10.14302/issn.2641-4538.jphi-24-5044
Li ShujunCorresponding author
Objective To study changes of cell morphology in BALF in children with Mycoplasma pneumoniae pneumonia (MPP). Methods From December 2021 to May 2022, a group of 32 children diagnosed with Acute MPP and admitted for treatment in the Pediatrics Department and PICU of the First Affiliated Hospital of Xinxiang Medical University were selected for our study. These patients underwent bronchoalveolar lavage as part of their clinical assessment. For comparison, we included a control group comprising 10 children who were not infected but had bronchial foreign bodies. We investigated the cellular composition in the bronchoalveolar lavage fluid (BALF) using Wright-Giemsa staining and microscopic evaluation, aiming to understand the relationship between shifts in cell proportions and extra-pulmonary symptoms associated with MPP. Results In this study, a total of 42 cases were enrolled, with 32 cases in the study group and 10 cases in the control group. There were no statistically significant differences in gender, age, height, weight, and BMI between the two groups (p > 0.05). The study group exhibited significantly higher levels of neutrophil percentage (GRA%), CRP, D-dimer, and LDH in blood routine tests compared to the control group (p < 0.05). Furthermore, the proportions of neutrophils (%) and macrophages (%) in BALF were significantly higher in the study group compared to the control group (p< 0.05), while the proportion of lymphocytes (%) in BALF showed no statistically significant difference between the two groups (p> 0.05). Conclusion In the acute phase of MPP in children, BALF is predominantly composed of neutrophils. A lower proportion of lymphocytes in BALF is associated with a higher incidence of extra-pulmonary manifestations and longer hospitalization duration.
Jan 2023 DOI 10.14302/issn.2474-7785.jarh-23-4432
Marks RayCorresponding author
Background Many older adults remain vulnerable to COVID-19 infections. They are also often at risk for frailty and poor health outcomes. Aim This exploratory review examines the correlates of long COVID and frailty and their association insofar as the older adult’s wellbeing may be jeopardized. Methods and procedures Articles that emerged between January 1 2022 and 2023 in major electronic data bases that addressed the current topic of interest were sought using the key words: Long COVID and Frailty. Those deemed relevant were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to remain vulnerable to COVID-19 long term impacts, plus new variants of infection, along with frailty as both an outcome and mediator. Many too are at risk for persistent long COVID-19 complications and a low life quality if more concerted preventive and rehabilitation efforts to avert frailty early on are not forthcoming in a timely manner. Conclusion Prompt and continuing frailty assessments of older adults at risk for COVID-19 or recovering from this disease, especially those with long COVID manifestations who are frail or may become frail are strongly indicated.
Dec 2022 DOI 10.14302/issn.2690-6759.jpar-22-4382
Sylla KhadimeCorresponding author
Département de Parasitologie-Mycologie Faculté de Médecine, Pharmacie et Odontologie, Université Cheikh Anta Diop de Dakar, Sénégal.
Background Intestinal parasitic infections, especially intestinal protozoan parasites remain significant public health problem in Senegal. Several studies have demonstrated the endemicity of the diseases. The study was carried out with the objective of assessing the epidemiolocal profile of intestinal protozoan infection diagnosed among patients attending to Fann University Hospital in Dakar, Senegal. Materials and Method A retrospective study was conducted from 2016 to 2020. Samples were collected from patients attending to the laboratory for parasitological confirmation. Fresh stool samples were observed using direct examination, formal-ether concentration method and modified Zeilh Nielsen staining method. Descriptive analysis was performed using Stata MP 16 software. The significance level was set at 5%. Results Among 3825 patients selected in the study, 1009 were found with at least one intestinal protozoan parasite representing an overall prevalence of 26.4% (CI 95% (24.7– 28)). Mono-parasitic and di-parasitic infection represent 81.6% and 18.2% respectively while polyparasitism was observed in 26 patients representing 2,6%. Among positive samples, 16 (8.7%) were associated with helminths. Blastocystis sp. (40.8%), Entamoeba Coli (38.2%), Endolimax nana (8.2%) and Giardia intestinalis (8.1%) were mainly observed. Trophozoites Entamoeba histolytica was observed with 2.3%. Frequency of intestinal protozoa was higher in the 15 – 30 age group (28.3%) and in male group (26.9%). The parasite carriage was most important during the wet season comparing the dry season (p = 0.65). Asymptomatic patients (29.5%) were more infected than symptomatic patients (23.5%) (p <10-3). The main clinical symptoms were diarrhea, abdominal pain, dysenteric syndrome, fever, dyspeptic disorders, and vomiting. Conclusion These results showed that intestinal protozoan infections remain prevalent in Senegal with a high proportion of asymptomatic who constitute an important reservoir of parasites. Effective control strategies such as water supply, hands washing, and mass deworming campaign could reduce the prevalence of these diseases.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4313
Niyonkuru MathieuCorresponding author
Public Health Department, Mount Kenya University Rwanda
Data quality is defined as a measure of data status that fulfills the following elements: accuracy, completeness, consistency, reliability, and if the data is current. The World Health Organization (WHO) reported that only 40% of all countries have an adequate system to collect information on birth and deaths. Even though the system is there, vital registration systems are inaccurate and incomplete in developing countries. In Rwanda, maternal health related data was over-reported more than other indicators. These are the main reasons for conducting the study to investigate the data quality of four maternal and newborn health indicators reported by Rwandan Western Province health centers. This concurrent-mixed method study included 61 data managers and 12 key informants. Routine data quality assessment tool and structured interview guide were used to collect data. Descriptive statistics were used to get proportion of respondents’ socio-demographic characteristics. The analysis was done for assessing median of data quality index. The results show that 55.7% of data managers were male while 58.3% of responsible of maternity were female. Majority (58.9%) of participants was in age’s category from 33-42, 61.6% have A1 education level and 53.4% have experience less than five years. Data quality index of one out of four (25%) MNH indicators was found below 95% accepted by WHO. The main reasons for insufiscient quality of data are lack of data validation meetings (57.5%) and incompleteness of reporting tools (36.4%). Monthly data validation meetings chaired by HC leaders are important to contribute to high-quality data in healthcare settings. Supportive supervisions done in data quality and management have to be organized in a supportive, and educative way.
Jun 2022 DOI 10.14302/issn.2328-0182.japst-22-4193
Tariku Belay YilkalCorresponding author
School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
The strategy for safe drug discovery and development has limited clinical success as compared to wasted time and resources annually. This is due to the fact that the results of multiphase preclinical trials are less likely to make an accurate early prediction on the safety of test compounds to progress into the clinic as a valuable therapeutic agent. A lot of time and resources has been wasted in the multistage processes of drug discovery and development that does not work at the end of the procedure every year. During pre-marketing stage, for instance, the number of unsuccessful clinical trials are greater than the successful one because of safety issues. A toxicity study at different stages of preclinical and clinical trials is a routine procedure to investigate the undesirable side effects of test compounds being manifested on the natural processes of living things. It deals with the effect and mechanism of toxicity of test compounds that triggers different biological responses on different organ systems. The biological responses that would be manifested as a result of interaction between the receptors and active molecules of a test compound could be desirable pharmacological effect or undesirable side effect or both responses are manifested simultaneously depending on the selectivity or specificity of the molecule of a test compound for its receptor subtype which makes safe drug discovery and development very challenging. The response efficiency of the body (the net outcome of the body’s biological reaction against the side effect) would determine the potency of a test compound to manifest undesirable pharmacologic effect. In other words, the amount of a drug required to cause a biological harm or injury depends on the magnitude of the body’s biological reaction in which the immune response plays a great pharmacological role by neutralizing and harmonizing xenobiotics with the biological molecules. The dose of a test compound at 100 mg/kg body weight, for instance, could be lethal to some of the study animals while it is still non-lethal to some other study animals depending on the response efficiency of the body. The immune system is well connected to each and every biological systems of the body which allows it to detect undesirable side effects being manifested through immunoglobulins signalling and activation mechanisms. This complex communication network helps to localize the diverse side effects of a test compound being manifested on different organ systems into the immune system which makes a toxicity study relatively simple to monitor. The cellular immune system becomes active following the molecule-receptor interaction and start producing antibodies which is also known as immunoglobulins to protect bodily harm and destruction. Under normal biological circumstances, the amount of immunoglobulins produced by the cellular immune system following exposure to a test compound is proportional to the number of harmful molecules interacted with its receptor subtype. Thus, with the reference to the changes in the immune response against the administered dose, it would be able to deal with the diverse undesirable side effects of a test compound being manifested on treated study animals using computational systemic biology.
Dec 2021 DOI 10.14302/issn.2474-7785.jarh-21-4041
Marks RayCorresponding author
Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY 10027, USA.
Background Many older adults are vulnerable to becoming frail. They are also often at risk for falling and serious injuries and poor health outcomes. Aim This exploratory review examines the correlates of frailty, and fear of falling and their association insofar as older adults wellbeing may be jeopardized. Methods and Procedures Articles extracted from major electronic data bases that addressed the current topic of interest were used. Key findings regarding the syndromes of frailty and fear of falling were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to exhibit frailty or become frail as they age. Many too are at risk for falls and fear of future falls, regardless of frailty status. A persistent fear of falls may however, heighten frailty risk or manifestations if not duly addressed in a timely manner. Conclusion Prompt comprehensive assessment of at risk older adults, as well as the frail and pre frail older adult, plus those who have fallen may avert serious injury and long term disability plus excess frailty and its deleterious impacts this syndrome has on aging older adults as well as societies.
Nov 2021 DOI 10.14302/issn.2577-2279.ijha-21-3925
Kumar Sah SurendraCorresponding author
Assistant Professor, Department of Anatomy, Nobel Medical College Teaching Hospital, Biratnagar, Nepal
Introduction The nose is one of the important component of the face which is considered as the major clue for the ethnic origin. The proportion of the nose is determined on the same principal as that of the skull.The external nose extends the nasal cavities onto the front of the face and positions the nares so that they point downwards. The shape of the nose is pyramidal with its apex anterior in position. The upper angle of the nose between the openings of the orbits is continuous with the forehead. Materials and Methods This study was carried out among residents of Ramnagar Gaupalika-7, Sarlahi,Nepal, one of the core region of Madhesh Nepal dated Jan 2021 to April 2021.The cohort consists of independent adults of age group 17-45 and consenting adults from the metropolis. Ethical approval was sought prior to conducting the study from the supervising ethical committee of the Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Written consents were taken from the subjects for the recruitment in the study. Results The present study involved 100 subjects of equal males and females subjects of age groups 17-45 years from Madheshis community of Nepal. The table 1, table 2, table 3 below shows the values obtained for different parameters for males and females. The mean value of nasal height for male and female is 52.59±1.89 and 50.27±2.16 mm and the nasal width for male and female is 37.64±1.72mm and 35.42±2.04mm and the value of mean nasal index for both the sexes are 71.59±2.31and 70.58±3.04 respectively. The dominant type of the nasal morphology in both the sexes are the mesorrhine type and the leptorrhine type as well. Conclusion The human nose is a dominant feature in facial region which differs in anatomy and morphology among racial groups and of the most characteristic differences during the analysis of ethnic and racial differences. The dominant type of the nasal index is the mesorrhine type in both the male and female of the Madheshis community. Hence the data obtained here will be useful for the differentiation of different ethnic groups of Nepal as well as in the field of forensic science and rhinoplastic surgery.
Oct 2021 DOI 10.14302/issn.2641-4538.jphi-21-3950
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
This study aimed to assess factors influencing knowledge and practices of hospital cleaners towards hepatitis B prevention. This was a hospital-based cross-sectional study conducted at in Northern Province of Rwanda. A pretested self-administered questionnaire was used to gather data from study participants. A total of 134 cleaners were recruited in the study. Data were entered using Kobo collect toolbox and exported to Microsoft office excel for data cleaning and to entered in SPSS version 21 for analysis. Descriptive and logistic regression analysis was done and the significance level was 5%. More than a half of respondents were female (51.5%), and had primary level of education (54.5%). Results showed that only 9.7% of respondents had a high level of knowledge about HBV and only 2.2% had good practices on HBV practices. The odds of having high level of knowledge towards HBV prevention was 2.3 times (AOR=2.3, 95%CI: (1.1-27.3); p=0.045) among respondents with high school compared to those with no educational level. Respondents with work experience of 5-7 years were 1.5 times to have high level of knowledge towards HBV prevention than those with work experience of less than one year. Being aged between 20-30 years was associated with 2.5 times more likely to have good practices on HBV prevention than respondents aged less than 20 years. The odds of having good practice towards HBV had found to increase with work experience (AOR=2.3; 95%CI: (1.29-4.3); p=0.014). Considerable proportion of participants lacks the requisite knowledge of post-exposure treatment and prevention of HBV. Training programs on HBV infection, including PEP are highly recommended.
Apr 2021 DOI 10.14302/issn.2379-7835.ijn-21-3780
Khamis Al-AlawyCorresponding author
Mohammad Bin Rashid School of Government, Dubai, UAE
Obesity is a common and preventable Non-Communicable Disease that is of great importance. Population-based interventions are recognised to have a profound effect on improving health outcomes. One of these approaches includes the adoption of the Sugar-Sweetened Beverage (SSB) Tax. Objectives There were three objectives, 1) explore the associations between gender, age, nationality, and change in SSB consumption, 2) explore SSB consumption during Covid-19 lockdown, and 3) inform policy decision making. Methods A cross-sectional survey in the United Arab Emirates. We performed descriptive analysis and chi-square for independence to test the difference between the expected and the observed frequencies in one or more categories. Results Since the introduction of SSB tax, change in SSB consumption by gender, age or nationality was not statistically significant. Further analysis of the proportion of sugar intake per day was statistically significant (P-value <0.001) by nationality. There was no statistically significant change in SSB consumption by age, gender, or nationality during the Covid-19 lockdown. Further analysis within the group that reported change in SSB consumption suggests a majority (80.5%) reported a reduction in SSB consumption. Conclusions Change in SSB consumption by gender, age or nationality was not statistically significant since the introduction of SSB tax, or during Covid-19 lock-down; thus, we accept the Null Hypothesis. Imposing a levy on frequently consumed SSB or revisiting levy by the gram, volume, or type of added sugar (or in combination) may prove to be more effective in reducing SSB consumption. Further research is needed to determine the extent other demographic factors influence SSB consumption as well as the enablers and barriers associated with SSB consumption.
Mar 2021 DOI 10.14302/issn.2474-3585.jpmc-20-3557
E. ADETONA AdesojiCorresponding author
FWACP (LAB. MED), FMCPath, MPH (Health Policy and Management), MBBS; UCH, Ibadan
Background Breast cancer is one of the most common types of cancer affecting women globally. It has shown increasing morbidity and mortality rates over the past years. Several screening methods ranging from simple breast self-examination to a highly sensitive test procedures for early detection and treatment are available, but uptake is a challenge. Lack of a national screening programme in the country makes available regional screening programme unsuccessful. This study aims to assess the factors affecting the uptake of breast cancer screening programme among female staff in a tertiary hospital, Southwest Nigeria. Method This descriptive cross-sectional study involves 375 participants selected by a stratified random sampling technique, with proportional allocation to population size and the use of a semi-structured questionnaire. Respondents were questioned on their basic knowledge of breast cancer symptoms, risk factors and treatment, over a score of 50 and above, were set as the cut-off mark to determine good knowledge of breast cancer. Patients attitudes towards breast cancer screening as well as factors affecting uptake were also measured. Descriptive statistical analysis was done using SPSS-20 while the predictors of the uptake of screening were determined using logistic regression at p ≤ 0.05. Results There were 360 respondents, comprising of 13.3% clinical and 86.7% non-clinical female staff within the age bracket of 20 to 58 years (38.2±0.42 years). Out of the respondents, 97.8% have heard about breast cancer but only 52.3% had been screened while 65.5% had “Good knowledge” of breast cancer. Positive attitude to breast cancer screening was displayed in 52.5% while over 90% claimed to be practicing breast self-examination. Only 36.1% of respondents above 40 years old have had mammography done. Most frequent barriers to screening uptake include cost, poor accessibility to screening facilities, shyness (unfamiliar screener), unavailability of female doctors, careless attitude, fear of cancer and other more pressing family problems. Using logistic Regression at p ≤ 0.05, females with a negative attitude, young unmarried (less than 30years) and lack of easy accessibility to screening facilities were significant factors affecting uptake of breast cancer screening services. Conclusion Due to knowledge-uptake gap of breast cancer screening revealed in this study. It is therefore obvious from these findings that a concerted effort is needed to actively remove these barriers by repeated education, training and re-training strategies among health workers and to improve their uptake and level of advocacy and campaign for breast cancer screening among their patients and clients.
Dec 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3670
K. Ceesay EbrimaCorresponding author
University of Gambia, Banjul, Gambia
Purpose This paper assess the impact of COVID-19 pandemic on Education, Staff development and Training in Africa. Online Research Methodology/Approach The data use in this paper was generated from online survey questionnaire, in which the participants were asked about certain questions in which covid-19 affect their social-economic situation. The questionnaire was design to help Africa to understand covid-19 impacts on their social and economic live. Results The results of this study reveal that coronavirus pandemic affected Africa in a number of ways; 1) 52.2 percent of the respondents said they should open school now in Africa, while 47.8 percent fear they should not open schools 2) 81 percent said before educational institution are closed there is public or official announcement that institutions must be closed due to pandemic—may be 3 months, ……,,…,, one week it depends on the severity of how covid-19 is spreading across the regions in Africa, 10.7 percent of the respondent said it may be and only 8.3 percent said it is not official announced.3) 65.4 percent of the respondents said government implemented an education response for continue of learning in Africa while educational institutions are closed 4) 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government, while 50 percent said television, radio, or podcast broadcast and 17.9 percent said assigning reading and exercises for home study. 5) 45.3 percent out of 100 percent said use of online or digital learning platform are the proportion of children affected by education institution closure. 38.7 percent said the proportion of children affect are the one that concentrate of using television, radio or podcast broadcasts to get academic content. 14.7 percent of the respondents are the proportion of the children affected by educational institute closure if they are assigning reading and exercises for home study. 6) 52.6 percent of the respondents from non-government organization, private schools said use of online or digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes, while 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government. The same thing government said as well. Similar respondents from government as do the non-government or private schools and 35.9 percent respondent said television, radio and podcast broadcast are method for continuity of learning is currently available for children affected by closures of educational institutes-provided by non-governmental organization, private schools etc, whereas 50 percent of the respondents said assigning reading and exercises for home study is the method for continuity of learning is currently available for children affected by closures of educational institutes-provided by government.7) 48.1 percent of the respondents said for the impact of covid-19 pandemic on staff development and training that their enterprise or organization partially suspended operation due to the pandemic and 34.2 percent of the responded said they completely suspended operation because of coronavirus pandemic and 16.5 percent said no closures on in operation for staff development and training because of pandemic. 8)According to the results of this question of the online survey, 49.3 percent said the challenges their enterprise face in delivery staff training programmes and activities using online learning or offline learning during covid-19 was due to infrastructure issues such the problem associated with internet and the like. The survey of the study also confirmed that 32.9 percent twice said limited digital skills of trainers and cost of staff training was a major setback to train staff in their enterprise or organization or department or establishment while 30.1 percent said it is due to limited digital literacy of users are the main challenges face by their department in order to train staff. Policy Implications The implication of the results from this online survey is that it has serious impacts on education closure and staff development and training. As educations are closed due to covid-19 pandemic, it will affect already problems of human capital that are hampering the development of Africa. Due to covid-19 pandemic, the achievement of sustainable development goals on quality education will be seriously halted. The government and the ministry in Africa should work hand in hand to solve the problems of children affected by schools closure after the pandemic by either additional hours or provide more study hours for schools to catch-up with what happened during the pandemic, the study noted. Originality/value The impact of covid-19 on education, staff development and training.
Oct 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3587
Isea RaúlCorresponding author
Fundación Instituto de Estudios Avanzados, Hoyo de la Puerta, Baruta. Venezuela.
The work analyzes the dynamics of transmission of infections by the new coronavirus in twelve European countries, including France, Germany, Italy, Spain, UK, Austria, Croatia, Denmark, Greece, Romania, Czech Republic, and Portugal, whose data from contagion were obtained by Johns Hopkins University until September 24, 2020. The study confirmed that this new coronavirus (SARS-CoV-2) surprised all the countries of the world that had to improve their public health policies to confront this disease according to the results obtained from the calculation of the mantissa. Although the countries were able to improve their policies after the first wave of contagion, Spain and France have the highest proportion of cases that stand out significantly with the rest of the countries in the second wave of infections that the world faces again. Likewise, the beginning of the epidemic outbreak was determined, which could help to track the spread of the disease through European countries (not the first case registered in each country), from which it can be inferred that the outbreak begins in Italy and later the rebound begins in Germany, France, and Spain. Within days, it significantly affects Greece and Austria, reaching Denmark, the Czech Republic, Romania, and Croatia. Finally, the number of people who must be vaccinated to counteract the advance of Covid-19 in these European countries was determined based on the calculation of the Effective Reproductive Number, Rt. The number of people that would have to be vaccinated in all these countries to counteract this disease sums up to 206.830.361.
Oct 2020 DOI 10.14302/issn.2769-2264.jw-20-3530
Kamble SheetalCorresponding author
Assistant Professor, Environmental Science, P P Savani University, Gujarat, India
Industrial revolution brought diversified industries to produce goods to meet the demand of increasing population. Such a rapid growth of industrial sector caused water pollution to a great extent. Dairy industry is not an exception, causing significant water pollution. The dairy sector in India grew at a rate of 6.4 per cent annually in the last four years against the global growth rate 1.7 per cent demonstrating significant increase in milk productivity. Around 80 million rural Indian households are engaged in milk production with very high proportion being landless, small and marginal farmers. But on the other hand, water pollution being caused from these dairy industries is quite significant. Various biological treatment technologies were tried for treating dairy wastewater. An attempt has been made by the authors of the present paper to design aerated lagoon including screen chamber, primary clarifier, quiescent settling zone and sludge disposal with success to treat dairy wastewater.
Oct 2020 DOI 10.14302/issn.2641-4538.jphi-19-3115
D Mwalimu CharlesCorresponding author
Muhimbili University of Health and Allied Sciences - Dar es Salaam
Africa Region has the highest burden of malaria with an estimated of 3.5 million more malaria cases in 2017 compared 212 million cases in reported in 2016. Data collected from 2015 to 2017, shown no global progress in reducing malaria cases. In Mainland Tanzania, malaria control interventions have significantly led to the reduction in malaria prevalence from 18.1% in 2008 to 7.3% in 2017. Despite of these achievements, malaria burden is still highly heterogonous with some regions including urban peripheral areas of Dar es Salaam, presenting persistent malaria transmission ranging from 2 to 57%. Material and Methods A cross- sectional population based survey was carried out in Ilala Municipality in Dar es Salaam; data was collected from 2nd to 31 April, 2019. Multistage cluster sampling was used to select the households where individual member were conveniently selected to participate in the study. Structured questionnaire were administered by the trained researcher assistants to assess individual risk factors for malaria. Rapid Malaria diagnostic test (mRDT) was used to identify individual exposed to malaria infection. Measure of association used was prevalence odds ratio (POR). Multivariate regression model used to determine prevalence odds ratio, variable with p- value < 0.05 were considered as independent risk factor for persistent malaria transmission. Results A total of 830 participants were recruited in the study, mean age was 24yrs ±20.4SD. Majority 489 (58.9%) were female, 459 (55.3%) were >18 yrs old, primary or no education were 687 (82.8%), farmer or unemployed were 639 (77%). Msongola ward contributed 406 (48.9%). Overall malaria prevalence in the study areas was (4.5%). Nets ownership was 141 (16.9%), usage was 121 (85.8%).Low proportion of net ownerships (POR: 7.67, 95% CI: 4.23, 24.6), residing in the households surrounded by mosquito breeding sites POR: 20.07, 95% CI: 7.03, 57.29) and residing in houses with unscreened windows (POR: 1.21, 95% CI: 1.26, 3.40) were independently associated with malaria infection. Conclusion Low nets ownership, residing in the households surrounded by mosquito breeding sites and in households with unscreened windows was independent factors associated with risk of malaria in the areas. Promotion of ITNs coverage, application of biolarvicides through community engagement and house screening was recommended to reduce the risk of malaria infection in the areas.
Sep 2020 DOI 10.14302/issn.2694-1201.jsn-20-3554
Getachew Kumara MitikuCorresponding author
Nekemte Referral Hospital, Oromia, Ethiopia.
Background Traumatic brain injury is an expanding major public health problem and the leading cause of death of the young and productive part of the world’s population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. Only few studies have examined prognostic factors of traumatic brain injury outcome in developing countries including Ethiopia. This study was aimed at defining the peculiar demographic and other associated factors of traumatic brain injury (TBI) outcome among patients treated for head injury at Nekemte Referral Hospital. Objective The main purpose of this study was to describe the magnitude of TBI outcome and assess factors associated with unfavourable outcome of TBI among patients treated for head injury at the surgical side in Nekemte Referral Hospital from July 8, 2016 to July 7, 2018. Methods A retrospective cross-sectional document review was conducted among TBI patients treated for head injury from July 8, 2016 to July 7, 2018 at Nekemte Referral Hospital. Data were collected using a pre-tested data collection format. Data analysis was done using SPSS version 20. Descriptive statistics were computed and association between the dependent and independent variables were assessed by using logistic regression. Odds ratios with 95% confidence interval were computed. Significant association was declared when the p value was <0.05. Results In this study, out of 378 cases 95 (25.1%) were discharged with unfavourable outcome of which 37(9.8%) were neurologic deficits and 58 were deaths giving overall mortality rate of 15.3%. Patient age>60years (AOR: 15.13; 95%CI: 3.575-64.028), time interval from injury to treatment (AOR: 16.054; 95%CI: 5.832-44.194), low GCS (AOR: 18.224; 95%CI: 4.167, 79.695), conservative management (AOR: 20.774; 95%CI: 6.106-70.681), pupils abnormality (AOR: 9.078; 95%CI: AOR: 2.996-27.509) were associated with unfavourable outcome. Conclusions A quarter of patients treated for TBI at Nekemte Referral Hospital are discharged with unfavourable outcomes. Old age, delayed presentation to the hospital, low GCS, conservative management, and pupillary abnormality increase the odds of unfavourable outcome. Timely management of TBI before patients develop secondary brain injury and use of surgical intervention based on CT scan diagnosis will reduce the occurrence of unfavourable outcome.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3444
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background In Ethiopia, the levels of maternal and infant morbidity and mortality are among the highest in the world. This is attributed to, among other factors, none use of modern health care services by women. According to the 2011 Ethiopian Demographic Health Survey, more than seven in ten mothers did not receive antenatal care at all. Objectives The objective of this study was to determine level and identify factors influencing maternal antenatal care services utilization among mothers who gave birth in the last twelve months in Gelemso town west Hararghe Oromia, Ethiopia. Methods A community-based cross sectional study design was conducted on 347 study participants in Gelemso town west Hararghe Oromia Ethiopia from July 15, 2017 to August 15, 2017 G.C.A probability to proportional to size sampling technique was used to select the study population in two urban Kebeles. Data were collected using a pre tested structured questionairs. Descriptive results were presented using frequencies, and numerical summary measures. Bivariate analysis was carried out to assess the association between outcome variable and each in dependent variables. Odds ratio with 95% confidence level was estimated to identify factors associated with Antenatal Care (ANC) utilization using multivariable logistic regression. The statistical significance was declared at p- value < 0.05. Result The response rate this study was 98%. The prevalence of antenatal care service utilization was 64.6%. About 146 (42.1%) of the pregnant mother started antenatal care visit during the second trimester of pregnancy and a significant proportion 289(83.3%) had less than the recommended four visits. Educational status (AOR;15.19:CI 95%,6.006,38.417), husband attitude (AOR;1.995:CI 95%,1.016,3.916), marital status(AOR:4.587:CI 95%,1.888,11.146), planned pregnancy (AOR:4.938:CI 95%,2.514,9.702) were major factors associated with antenatal care service utilization. Conclusion Though more than half mother used antenatal care service in the study setting, two in ten of the mothers did not have the minimum number of visits recommended by World Health Organization. Promotion of information, education and communication in the community should be strengthened is to sustain antenatal care service utilization in the community.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3439
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background Pregnancy and parturition are events of considerable significance in the life cycle of women. Though it is supposed that the quality of care during labor, birth, and postpartum period plays a great role for adverse outcomes of birth, various reports claimed that cesarean delivery carries a higher maternal and fetal morbidity and mortality compared to vaginal delivery. Therefore, this study assessed the Rate, Maternal and Fetal Outcome of Cesarean delivery performed by IESO at Shenen Gibe General Hospital, Jimma south west Ethiopia. Integrated Emergency surgical officer is a health professional qualified and authorized to perform emergency obstetrical-gynecological and emergency general surgical procedures. The training has started in 2010 in 3 universities and 10 affiliated sites with intake of 43 students. The MSc program in integrated emergency surgery is intended to achieve one of the millennium development goals (MDG): reducing the overwhelming maternal mortality ratio and perinatal mortality rate at the local and national level. (1) Methods Hospital based two-year retrospective descriptive cross-sectional study design was employed and data collected from November to December 2019 in shenen Gibe General Hospital ,Jimma south west Ethiopia. A total of 185 mothers who delivered by cesarean delivery from December 2017 to December 2018 and complete data were included in the study. Data were extracted using structured data collection format and cleaned, and entered into Epi data software version 3.1 and exported into SPSS version 26 for further descriptive analysis. Result Among 2115 deliveries in the two years of retrospective data, a total of 186 mothers were delivered by cesarean section, giving cesarean delivery rate 8.8 %. The leading indication for cesarean delivery was fetal distress (24.2%). Among the total cesarean delivery, 22 neonates were died, giving the proportion of neonate mortality rate 16.8%. One mothers were died following cesarean delivery, giving maternal mortality rate following cesarean delivery 12 per 1000 live births. The leading cause for maternal mortality was hemorrhagic shock Conclusion However, cesarean delivery rate in this study was within the WHO recommended range, the health outcome of mothers and neonates’ following cesarean delivery was not acceptable. The neonatal and maternal mortality following cesarean delivery was 16.8% and12 per 1000 live births respectively. The main cause of neonatal death was birth asphyxia.
Feb 2020 DOI 10.14302/issn.2379-7835.ijn-20-3199
BUTNARIU MonicaCorresponding author
Banat’s University of Agricultural Sciences and Veterinary Medicine “King Michael I of Romania” from Timisoara, Timis, Romania
The need to understand the relation of man to food, determines the existence of appropriate behavior as well as an attitude in accordance with the modalities that determine human development and evolution, under this structural aspect. A proper diet is the one that provides the amount of nutrients corresponding to personal needs. The food pyramid is the scheme we refer to most in order to know the proportions of foods recommended for consumption. It is a pyramid divided into "layers", each corresponding to a category of foods and the respective quantity.
Sep 2019 DOI 10.14302/issn.2641-4538.jphi-19-2995
Chaudhary Nagaraj NitashaCorresponding author
The George Washington University, Milken Institute School of Public Health, Department of Prevention and Community Health
Despite the gains India has made in recent decades, it remains a country with vast gender inequities. Gender sensitization and empowerment programs aimed at young people, precisely at the time when they are forming their gender attitudes, has the potential to diminish gender inequity in the long-term. This study represents data from 36 qualitative in-depth interviews conducted amongst adolescent boys and girls enrolled in grade 7 in northern India, in schools that serve under-resourced communities. The interviews asked questions related to positive youth development, gender roles, violence, and locus of control. The results of the qualitative analysis provide insights into how adolescents perceive gender discrimination in their families and communnites. The majority of expectations for boys revolved around physical labor, while, for girls, gender roles were primarily focused on stopping education early to get married and take care of the household and children. Many of the responses from both boys and girls on privileges/restrictions were related to daughters not being fully educated while sons often were. Furthermore, when comparing between boys and girls (attributes) and understanding superiority, many participants noted there is a clear preference of boys compared to girls. Girls also had higher proportion of violence codes compared to boys, perhaps because many girls felt they were hit more frequently than boys. The results of this qualitative analysis provide direction for both future research as well as the development of gender sensitization interventions specifically designed for adolescents.
Sep 2019 DOI 10.14302/issn.2641-4538.jphi-19-3005
Rutayisire ErigeneCorresponding author
Mount Kenya University, School of Health Sciences, Department of Public Health, P.O. Box 5826, Kigali Campus, Rwanda
Background Globally, about 10 to 25% of the volume of bio-medical waste from hospitals and healthcare institutions presents a serious health risks to patients, healthcare personnel, and anybody who comes in contact with it. The waste management practices in Rwanda healthcare facilities are poor and need improvement. Objectives To assess the knowledge and practices regarding bio-medical waste management among healthcare personnel at Kabgayi district hospital in Southern Province of Rwanda. Materials and Methods A cross-sectional study design was conducted. A total of 200 healthcare personnel were selected randomly out of 400 target population including doctors, nurses, social workers, and cleaners. Structured questionnaire was used to collect data. Descriptive analysis using frequency and proportions were used. Chi-Square test was used to determine the association between the variables and level of significance was set at p ≤ 0.05. Results The study found that about half (49.0%) of healthcare personnel had good knowledge about waste management. We found that the majority of healthcare personel 133(66.5%) had poor practices towards bio-medical waste management. The factors associated with good practice were better knowledge on bio-medical waste management (p=0.013) and older age group (p=0.001). Conclusion/Recommendations The level of in both knowledge and practice towards bio-medical waste management among healthcare personnel was low. Continuing education and training programmes and short courses on bio-medical waste management should be carried out to improve the knowledge and practices towards bio-medical waste management among healthcare personnel.
Jul 2019 DOI 10.14302/issn.2997-2108.jcc-19-2889
Adetona A.ECorresponding author
College of Medicine, University of Ibadan / University College Hospital, Ibadan. Nigeria
Background This study aim to assess the factors affecting uptake of cervical cancer screening programmes among female staff of the University College Hospital (UCH), Ibadan in 2014. Method A descriptive cross-sectional study involving 375 participants selected using a stratified random sampling technique with proportional allocation to population size and interviewed using a pre-tested self-administered semi-structured questionnaire. Information on their basic knowledge on cervical cancer were scored to determine good knowledge. Patients’ attitudes toward cervical cancer screening as well as factors affecting uptake were also assessed. Data analysis was done in 2014 using descriptive statistics while screening uptake predictors were determined using logistic regression at p ≤0.05. Results Completed questionnaires were returned by 360 respondents; 13.3% were clinical while 86.7% were non-clinical staff of age range 20 to 58 years (38.2±0.42 years). Majority of the respondents, (95.5%), had heard about cervical cancer with 61.9% having “good knowledge”, but only few (34.2%) had been screened. Averagely, 47.5% displayed positive attitude to cervical cancer screening with Pap smear being the most reported screening procedure. The common barriers to screening uptaking include indecision, inadequate information and feeling of good health. Others were staff hostility, lack of privacy, and cost. Using logistic Regression at p ≤0.05, females with negative attitude and those with children were less likely to uptake cervical cancer screening services. Conclusion The knowledge-uptake gaps of cervical cancer screenings were high as revealed in this study. Therefore, there is a need to further educate eligible women on uptake of cervical cancer screening.
Jul 2019 DOI 10.14302/issn.2379-7835.ijn-19-2721
Habulembe Mugode RaiderCorresponding author
National Food and Nutrition Commission, Lusaka, Zambia
Introduction In the past several decades, Zambia has suffered high levels of under nutrition particularly stunting among children below 5 years of age. Although appropriate complementary feeding practices are reported to reduce child deaths by 6%, they have not received the adequate attention from programme officers and caregivers in terms of implementation. Objectives The objective was to investigate issues surrounding the common complementary feeding practices practised by caregivers of children below five years in health facilities and areas where high rates of malnutrition admission come from. Design A cross sectional research using both qualitative and quantitative methods. The study used mostly proportions based mostly on global indicators on complementary feeding. Qualitative data was also analysed according to themes of global complementary feeding indicators Setting The study was conducted in five hospitals, namely Arthur Davison, Solwezi Central, Kabwe and Livingstone General, and University Teaching Hospital. Subjects The target populations were mothers whose children were admitted for malnutrition and those with children 0-59 months living in communities with the highest number of malnourished cases admitted to selected hospitals Results About45.2% (190) of caregivers introduced liquids before six months of age and 7.6% (32) after 6 months attributing child thirst, medication and advice from health worker as the main reasons. Slightly above half (54.2% of 224) of mothers/caregivers used cups to feed their babies. The use of feeding bottles was still common (8.2% of 34). Responsibility to feed the child is mostly left to the mother (86.4%, 362). In addition, children were being feed about 2.67 (SD 0-72) per day. Conclusions Child feeding practices were still poor. This contributes to poor child growth and health. More interventions should be planned to improve child care behaviour.
Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2825
M. Chaudhary SanjeevCorresponding author
Associate Professor, Department of Community Medicine, Government Medical College, Nagpur
Background Concordance or husband wife agreement on various factors like sleep, substance use, dietary supplement use, and diseases like obesity and hypertension has been extensively studied worldwide. But the data regarding concordance of stress among married couples in India is lacking. Objective The prime objective of this study was to find out proportion of concordance of stress among married couples in Nagpur, Central India. Methods This was a community based cross sectional study conducted in an urban area of Nagpur. 260 couples in whom both husband and wife were of the age 30 years or more were included. Stress among couples was assessed by Presumptive stressful life events scale (PSLES). Results 82.3% concordance of stress was observed. Getting married, birth of daughter, death of close family member, illness of family member, gain of new family member and going on pleasure trip or pilgrimage were most common events reported by both spouses. Pregnancy of wife was the most common event reported by husbands. Four husbands reported death of spouse as a life event. None of the spouses reported extra marital relation of spouse and conflict over dowry as life time events. Conclusions Concordance of stress was very high among couples. This suggests role of shared marital environmental factors, which could affect stress concordance among couples.
May 2019 DOI 10.14302/issn.2644-0105.jbfb-19-2752
K. Bai YeonCorresponding author
Associate Professor, Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey 07043
The proportion of mothers in the workforce has increased over the past 40 years. Examination of factors associated with a working/student mother’s milk expression is needed to provide effective lactation support. The purpose of this study was to examine the role of maternal assets in the relationships between the theory constructs, intention, and behavior of breast milk expression. Using a cross-sectional design framed under the theory of planned behavior, all female personnel associated with a higher education institute in northern New Jersey were invited to participate in the online survey, Milk Expression on Campus. Attitude toward breast milk expression, subjective norm, perceived behavioral control, intention, and behavior of breast milk expression on campus as well as maternal assets such as income, education, living status, and campus role were measured. Maternal assets had no moderation role but showed a significant and meaningful mediation effect on the relationship between perceived behavioral control and the intention to express breast milk on campus, with effect size R2=3.59%, 95% CI (-.1061, -.0047). There was no mediation effect of the asset on the relationship between intention and the behavior of breast milk expression, 95% CI (-.0984, .0232). Future breastfeeding support and promotion may direct its attention to provide systematic social and clinical support to enhance working/student maternal assets, e.g. family education, access to lactation services, or peer-based support programs, thereby helping mothers achieve their breastfeeding goals.
Feb 2019 DOI 10.14302/issn.2639-3166.jar-18-2576
Haroun Mohamed Adam AbubakerCorresponding author
Cotton mealybug (Phenacoccussolenopsis) is a serious devastating pest which goes on a wide array of plant families. The pest spread all over the world from cool to dry hot regions. The main objective of this study was to investigate the food preference and behavior of P. solenopsis Tinseley (Hemiptera:Pseudococcidae) towards selected host plants in Khartoum State, Sudan, where a multi-choice experiment under laboratory conditions was adopted. Eight plant species were screened for attractiveness and food preference to Cotton mealybug. Where the proportions of the 1st, 2nd and 3rd nymphal instars and the adult females were recorded at 2, 8 and 24 hours after release, and compared with Chinese rose (Rosa chinensis) the control. The result revealed that the proportions of the 1st, 2nd and 3rd nymphal instars and adult females were maximum on plants of family Malvaceae, particularly the Okra (Hibiscus esculentus) followed by Cotton (Gossypium sp.) and Hambouk (Abutilon pannosum) as compared with the control. However, in contrast, the proportions were very low on unpalatable plants like Zaleya (Locally known as Raba) (Zaleyapentandra) and Eggplant (Solanum melongenaL.). However, in contrast, the proportions were very low on unpalatable plants like Zaleya (Locally known as Raba) (Zaleya pentandra) and Eggplant (SolanummelongenaL.). In conclusion, the most favorable host plants of the Cotton mealybug belonging to the family Malvaceae, while the families of Solanaceae [Egg plant (SolanummelongenaL.)] and Aizoaceae (Raba) were found to be the least preferred host plants.
Feb 2019 DOI 10.14302/issn.2637-6075.jpae-19-2586
E H RadwanCorresponding author
Zoology department, Faculty of Science, Damanhour University, Egypt.
Melia azedarach extract were applied by feeding the adult female flies on diets mixed with the extracts at different doses. The concentrations of Melia azedarach utilized were 1.8, 2.4 and 3.6%. The gonotrophic cycles of length of 90, 753, 67.6 and 84, 72, 68 hours were obtained after feeding at age 24 hours with diet mixed with doses of 1.8, 2.4 and 3.6% fruit extract; respectively. 98 & 96 hours were the length of gonotrophic cycle in the control groups. The length of 86.7, 72.3, 57.3 and 89.3, 75, 61 hours were obtained after feeding adults at age 48 hours with diets mixed with different doses of fruit extract of the same plant 97.3 and 98.7 hours were the length of the control groups. Proportions of the egg hatching reached 69, 55.3, 49 and 72.9, 64.2, 52 in groups of eggs obtained from 24 hours adults feeding with diets mixed with doses of 1.8, 2.4 and 3.6% fruit extract; respectively. Also 68.7, 53.3,48 5 and 81 2, 70, 56.3 were the proportions of egg hatching obtained from groups at age 48 hours after feeding with diets mixed with the same doses. 85, 77.6, 62.2 and 92.6, 88.9, 84.9 were the proportions of the egg hatching obtained from groups feeding with diets mixed with doses of 1.8, 2.4 and 3.6% fruit extract of Melia azedarach; respectively. The pupae showed larval-pupal intermediates which failed to complete the pupal period and died after emerging from the third larval instar.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-19-2608
W. Harvey PeterCorresponding author
Conjoint Clinical Professor, Deakin University, School of Medicine, Faculty of Health
In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.
Jan 2019 DOI 10.14302/issn.2643-6655.jcap-18-2541
S.O OyamakinCorresponding author
Department of Statistics, University of Ibadan, Nigeria
Many researchers have devoted considerable attention to the impact of individual-level factors on child mortality, but little is known about how family and community characteristics affect health of children. Trend in child mortality as well as its determinants, has long been the subject of academic and policy debates. In spite of this, the problem of child mortality remains as daunting as ever. In fact, advancement in medical sciences and the upsurge in information and telecommunication technology equipment have not significantly reduced child mortality in the country, unlike in the West. The Multilevel proportional hazards model for data that are hierarchically clustered at three levels was applied to the study of covariates of child mortality in Nigeria. This study merges two parallel developments of statistical tools for data analysis: statistical methods known as hazard models that are used for analyzing event-duration data and statistical methods for analyzing hierarchically clustered data known as multilevel models. These developments have rarely been integrated in research practice and the formalization and estimation of models for hierarchically clustered survival data remain largely uncharted. The model was estimated using the Newton-Raphsons numerical search approach. The model accounts for hierarchical clustering with three random effects or frailty effects. We assume that the random effects are independent and follow the Exponential and Weibull distribution. The results indicate that bio-demographic factors are more important in infancy while socioeconomic factors and household and environmental conditions have a greater effect in childhood. Furthermore, there is significant variation in child mortality risks even after controlling for measured determinants of mortality. Also, factors that fall under family and community level are more significant indicating that child survival is most controlled or determined by family and community factors and variables at the child level is not weighty. This suggests that there may exits unobserved or unobservable factors related to mortality.
Jan 2019 DOI 10.14302/issn.2641-9181.ijnr-18-2530
Ozcelik FatihCorresponding author
University of Health Sciences, Faculty of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
Nowadays, obesity is seriously threatening healthy life in all societies, especially in developed societies. Obesity is showing its likely effects through biologically active substances called adipokines. The most familiar of these is leptin. Leptin is synthesized in directly proportional to the amount of adipose tissue and reduced appetite by stimulating the satiety center. This status is like a protective mechanism that tries to reverse severe pathological process. Similar to this behavior of leptin, thyroid hormones are increasing in the advanced stages of obesity, increasing the resting energy expenditure (REE). The accelerating oxidative phosphorylation causes the use of energy as heat, the energy that has not transformed into ATP, together with ATP synthesis. This situation, the significant portion of energy provides to consumed instead of storing as fat. In addition, finding that T3 accelerates glucose transport and the TCA cycle without changing the rate of ATP synthesis in skeletal muscles suggests that thyroid hormones may be an effective tool in standing against obesity. In addition of that, the presence of studies indicating that thyroid hormones have an increasing tendency in the advanced stages of obesity is likely thought to be a rescuer mechanism to increase the effectiveness of suppressed thyroid hormones. On the contrary of these ideas, having been reported suppressing 5’-deiodinease enzyme activity in chronic diseases causes anxiety about the effectiveness of thyroid hormones in obesity. Based on available information, we aimed to prepare a review evaluating of this adaptive condition of thyroid hormones.
Jan 2019 DOI 10.14302/issn.2641-4538.jphi-18-2545
Ferreira Bento SilvanaCorresponding author
Women´s Hospital “Professor Doutor José Aristodemo Pinotti” – Centro de Atenção Integral à Saúde da Mulher (CAISM), State University of Campinas, Brazil
This is a cross sectional study of a sample of civil servants from the interior of São Paulo state, carried out with the purpose of evaluating the occurrence of unwanted pregnancies, the proportion which were terminated, the reason given for having or not having an abortion and which factors were associated to the decision whether or not to terminate an unwanted pregnancy. Just over one fifth declared to have experienced an unwanted pregnancy and over half of them were aborted. The reasons to abort concentrate on interferance with their life expectancy: “to continue studying or working” “being single”, “too young to get married” and “to become a father or mother”. Also important were fear of parents and rejection by the respondents'partner. Among those who did not terminate the unwanted pregnancy religion acted as a barrier among almost one third and the legal barrier for almost one fourth. Not having a permanent partner, being in use of behavioral or barrier method of contraception and higher education were associated with higher incidence of abortion of the unwanted pregnancy, but in multiple regression, only higher education remain significantly associated. Our results showed that once the unwanted pregnancy occur, more than half of them will be aborted, confirming the need to concentrate the efforts in reducing unwanted pregnancies if we want to prevent abortion.
Dec 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2333
Joseph Afe AbayomiCorresponding author
Community Medicine Department, Equitable Health Access Initiative, Lagos, Nigeria
Introduction: The introduction of preexposure prophylaxis (PrEP) against incident HIV infection has changed the epidemiology of disease as continuous treatment with tenofovir and emtricitabine among high risk groups can reduce the relative risk for incident HIV infection by over 90%.However,despite the approved use of TDF+FTC, as a fixed dose combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg, for oral PrEP since 2012 , it does not appear to have become widely accepted and in use among healthcare workers especially those in low income countries. Researches are therefore needed to consider the awareness and practice of health workers towards the availability of PrEP services in this part of the world. Healthcare workers are expected to be promoters of the use of PrEP services. Method: A cross sectional questionnaire-based study conducted in southern Nigerian over a 6 months period. Data were collected from 250 healthcare workers using interviewer-administered questionnaires. The data analysis was done using statistical package for the social sciences (SPSS) for windows version 20.0 software (SPSS Inc; Chicago, IL, USA). Frequency counts were generated for all variables and statistical test of significance was performed with chi-square test. Significance was fixed at P < 0.05 and highly significance if P < 0.01. Results: A high proportion of the respondents(>60%) were highly educated healthcare workers(majorly Nurses and medical doctors) and about half (55%) having at least 10yrs working experience in the health sector with most especially on the HIV program(>90%), majority (94%) of the health workers were aware about ARV pre-exposure prophylaxis but very few ( 6% )could give the standard definition for PrEP as the use of ARV drugs by HIV negative persons to prevent the acquisition of HIV.Most(67%) of them gave wrong definition for PrEP and worse still about one fifth (20%) had no idea what PrEP was all about. Most (70%) could not correctly identify all the ARV drugs in a standard PrEP regimen while about 35% had no idea at all of the approved ARVs used for PrEP. Though PrEP services was not available at any of the facilities where the respondents were working ,the approved drugs(TDF+FTC) for PrEP were available at about 40% of the health facilities(public and private) and 15% community pharmacies in the vicinity of the respondents . Only 60% of the respondents were willing to access PrEP service for themselves if indicated while 35% would not use such services even if it is indicated for reasons which include concern about adverse effects and safety.Awareness of PrEP was significantly associated with the ability of the healthcare workers to identify the correct ARV regimen, ARV dosages and also correct indication for PrEP. Awareness was also associated with the knowledge of the correct proven efficacy for PrEP(>95%) and high likelihood of seeing a patient placed on PrEP and willingness to use PrEP based on personal indication Conclusion: The level of awareness of PrEP among healthcare workers was very high at about 90% yet many(60%) could not give correct standard definitions of PrEP, PrEP ARV regimen, dosages and level of efficacy of PrEP. Also none of the respondent had PrEP services available either at their center or any known referral centers. This is unacceptable in a country with second highest HIV burden in the world and has adopted PrEP in her national HIV guideline with ongoing PrEP demonstration studies. The few healthcare workers who were able to mentioned this information were more likely to have seen a patient placed on PrEP and were more willing to use PrEP based on personal indication. Recommendations: There is need to deepen the and knowledge of PrEP among healthcare workers especially those in poor resource settings by engaging them through update courses outreach, educational resources, campaigns/seminars and workshops and various job aids. All healthcare service providers should be very comfortable to carry out HIV risk assessment of their clients and provide PrEP to those indicated directly or indirectly through referral
Oct 2018 DOI 10.14302/issn.2641-4538.jphi-18-2426
P ChastonayCorresponding author
Department of Medicine, University of Fribourg, Fribourg, Switzerland.
Over the past century, the proportion of Swiss residents aged 65 or older rose from 5.8% to 17.8%; during the same period, the proportion aged over 80 rose from 0.5% to 5.0%. Although the majority of older people in Switzerland enjoy good health, disease prevalence rises with age. Almost half (49%) of people over 65 living at home report at least one chronic illness. Among the 65- to 79-year-olds living at home, 25.2% suffer from several chronic diseases; among people in the 80s, this figure reaches 41.3%. People aged over 80 are also particularly at risk for falls (30%). In addition, between 15% and 25% of the elderly suffer from at least one mental illness. Close to 30% of healthcare costs are attributable to people over the age of 75, who make up only 8% of the total population. Given the public health importance of the issue a health promotion project targeting the elderly – the VIA Project -, based on successful local programs, is being implemented throughout the country. The overall goal of the VIA project is to promote the health of older people and to strengthen their self-determination and independence.
Sep 2018 DOI 10.14302/issn.2377-2549.jndc-18-2177
Michałowski TadeuszCorresponding author
The Generalized Electron Balance (GEB) concept, related to electrolytic redox systems, is considered according to principles of Generalized Approach to Electrolytic Systems (GATES). Two equivalent Approaches (I and II) to GEB are presented. The Approach I, when perceived in convention of the card game, is based on the common pool of electrons as money, introduced by electron-active elements, named as players; electron-non-active elements are called there as fans. The GEB obtained according to Approach II results from the linear combination f12 = 2∙f(O) – f(H) of elemental balances: f1 = f(H) for H, and f2 = f(O) for O. Very important properties of f12 are presented here in details, and illustrated by a redox system where comproportion- ation reactions occur
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2263
FA MagajiCorresponding author
Jos University Teaching Hospital, Jos, Nigeria.
Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2236
FA MagajiCorresponding author
Jos University Teaching Hospital, Jos, Nigeria.
Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.
Aug 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2178
N. Rousanoglou ElissavetCorresponding author
Sports Biomechanics Lab, Section of Sport Medicine & Biology of Exercise, School of Physical Education & Sport Science, National & Kapodistrian University of Athens, Greece.
Several studies examine the musculoskeletal pain (MSP) in university students sustaining physical load as part of their compulsory learning. However, only two somewhat outdated cross-sectional studies examine the physical education teacher (PET) students. This study aimed to explore the neck, shoulder and low back MSP prevalence in Greek PET students in a series of academic years. The Nordic Musculoskeletal Questionnaire was used to record the past 12-month neck, shoulder and, low back pain, across three academic years (n = 479). The year association to MSP prevalence was examined with the cross-tabulation analysis (using the column proportion test for the year comparison) and, the gender association to MSP prevalence with the χ2 test (SPSS 22.0, p ≤ 0.05). The year association to MSP prevalence was not significant (p > 0.05). The overall prevalence was 67.6%, with multiple pain at 25.7% and, the low back presenting the highest prevalence (40.9%). Women reported a higher prevalence of neck (36%) and low back (47%) pain (p ≤ 0.05). The majority of pain and time loss duration was 1-7 days. The low back required higher medical attention (19.0%) than the neck (9.2%) and the shoulder (12.9%). The recurrent pain was at 30%, with the previous injury/accident rate at 5.8%, 14.4% and 14.6% for the neck, shoulder and low back. Our PET students present an alarming MSP prevalence. Due to their distinct work demands as PE teachers, entering working life with the healthiest possible musculoskeletal system is of critical importance. Thus, university authorities should consider strategies for the prevention of MSP risk.
Apr 2018 DOI 10.14302/issn.2578-8590.ipj-18-2078
Kakitsuba NaoshiCorresponding author
Department of Environment and Technology, School of Science and Technology, Meijo University, Nagoya, Japan
Background: The core interthreshold zone (CIZ) is defined as the range between core temperature (Tc) at the onset of shivering and the Tc at the onset of sweating under consistent mean skin temperatures of 28°C to 30°C. A previous study demonstrated a diurnal change in the CIZ for male subjects and its relationship to the cutaneous sensation threshold zone (CSZ). In the present study, diurnal changes in the CIZ and the CSZ for young Japanese female subjects were investigated using the same experimental protocol from the study of male subjects and the sex differences in these responses were then examined. Methods: The CIZ and the CSZ were measured in 10 female subjects who participated in three experiments in a single day during the morning, afternoon, and evening in the summer of 2014 (single-day experiment), and six female subjects who participated in the same experiments on the morning of day 1, the afternoon of day 2, and the evening of day 3 during the summer of 2016 (multiple-day experiment). Air temperature was controlled at 25°C. Each subject wore a suit perfused with 25°C water at a rate of 600 cc/min, and exercised at 50% of their maximum work rate on an ergometer for 10–15 min until their sweating rate increased. They then remained seated, without exercising, until their oxygen uptake increased. Rectal temperature, skin temperature at seven sites, the forehead-sweating rate, and oxygen uptake were continuously monitored throughout the experiment. Cutaneous warm and cold sensation thresholds were measured at three sites using 1-cm2 and 2-cm2 probes. Results: The results from the single-day experiment demonstrated that the CIZ was proportional to core temperature prior to exercise (Tc-init) whereas the results from the multiple-day experiment demonstrated that the CIZ increased continuously from morning to evening despite almost a constant Tc-init. The CIZ appeared to be proportional to the CSZ measured with the 2-cm2 probe. When compared with the results from the previous study of men, no significant sex difference was observed between the CIZ of 0.25±0.07°C for female subjects and 0.21±0.05°C for male subjects. Conclusion: No significant sex difference or diurnal variation in the CIZ was confirmed. Continuous increase in the CIZ from morning until evening is expected in both men and women under a normal Tc circadian rhythm.
Feb 2018 DOI 10.14302/issn.2329-9487.jhc-18-1932
Erne PaulCorresponding author
Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
The aim of this study was to assess the use of ambulatory acoustic cardiography during the initial data collection of the longitudinal study of a rural population in Switzerland (n=297, mean age 48.9 ±16.5 years, 57% female). Ambulatory acoustic cardiography non-invasively can assess sleep disordered breathing (SDB) and provides markers of left ventricular systolic and diastolic dysfunction. The percentage of the third heart sound detected during sleep decreased significantly across age groups (age < 40 years, 40-60 years, > 60 years) for both genders (males, p=0.04; females, p=0.02). The percentage of a fourth heart sound detected exhibited an increasing trend for both genders with age suggesting increased diastolic dysfunction with aging. Mean electromechanical activation time (EMAT) during sleep was within the normal range across age groups and both genders (male 93.7 ± 11.6 ms, female 94.6 ± 13.0 ms), and did not vary significantly with age. A large proportion of subjects had a high likelihood of sleep disordered breathing (17.6%). Baseline characteristics categorized by SDB severity indicate increasing age, male gender and being overweight (BMI ≥ 25) to be associated with greater SDB severity. Acoustic cardiography findings categorized by SDB severity reveal increased nocturnal non-dipping heart rate, presence of atrial fibrillation, prolonged QRS duration and QTc interval, increased percentage of fourth heart sound detected, and longer EMAT to be significantly associated with greater SDB severity. Overall, acoustic cardiography detected a very low prevalence of systolic dysfunction, age-related increases in diastolic dysfunction and a moderate prevalence of sleep disordered breathing.
Jan 2018 DOI 10.14302/issn.2474-3585.jpmc-17-1836
Róbert PókaCorresponding author
University of Debrecen, Faculty of Medicine, Department of Obstetrics and Gynecology.
Objective: Demographic analysis of intrauterine deaths in North-Eastern Hungary with national and international comparison. Materials and Methods: The authors collected data from the National Bureau of Statistics’ 1996-2014 database to assess frequency, gestational age, maternal age and education for six counties of the region. 722 individual cases were analyzed. A regional survey was initiated to collect more detailed data on living environment in the region between 2010 and 2014 through community midwifery services records. Results: Data over 20 years showed most intrauterine deaths (Perinatal mortality, Late fetal death, Stillbirth] occurred between 24th and 36th weeks of which 35% occurred in the North-Eastern region of Hungary. The causes of intrauterine deaths were placental abruption, cord accident, placental insufficiency, malformations and intrauterine infection. Detailed analysis regarding attendance at either the Obstetricians or the community midwifery services, the patient’s medical history and the patients’ compliance were reported, compliance in 1% completely lacked. Gravidity and multiparity were associated risk factors. A significant proportion was associated with teenage pregnancy, low maternal education, smoking risks, unemployment, dependence on social support, unhygienic environment and smaller accommodations. Lack of cooperation during antenatal care was significant. Conclusion: Frequency and distribution of intrauterine deaths in North-Eastern Hungary show a similar picture as those of socio-economic indices. The unfavorable trend came to an end in 2015, however the national statistics did not show any improvement. The solution to the problem seems to be independent of the service provision, therefore, socio-economic development of affected counties is warranted, and financial incentives and/or government aid provided during pregnancy may improve future perinatal outcomes.
Nov 2017 DOI 10.14302/issn.2575-1212.jvhc-17-1795
Luciana dos Santos AndreaCorresponding author
Institute of Agricultural Sciences and Technologies, Federal University of Mato Grosso, Highway MT-270, no number, zip code: 78735-902, Rondonópolis, Mato Grosso, Brazil;
The aim of this study was to establish the digestible threonine (dig. Thr) requirements and the ideal proportion between Thr and Lys for Isa Brown laying hens on productive traits and egg quality characteristics from 55- to 58- and 59- to 61 weeks of age. Increased levels of L-Thr were added to a basal diet that contained 3.7 g/kg of dig. Thr. Therefore, diets containing 3.7, 4.0, 4.3, 4.6, 4.9 and 5.2 g/kg of dig. Thr and a relation between Thr and Lys of 0.58, 0.63, 0.67, 0.72, 0.77 and 0.81, respectively were provided to laying hens. A total of 216 hens were distributed in a randomized design among the 6 experimental diets. There were 9 replicates per treatment, and 4 birds per replicate. Data were analyzed by repeated measures analysis using the MIXED procedure of SAS. The main effects (dig. Thr level and experimental period) and their interaction were studied. Neither the dig. Thr level nor the experimental period had effect on performance traits and egg quality. Also, commercial egg grading was not influenced by period. However, there was a quadratic effect (P<0.001) of dig. Thr level within each scale egg weight. In conclusion, diets containing more than 3.7 g/kg of dig. Thr do not improve laying hens productivity at 55- to 61-week-old.
Sep 2017 DOI 10.14302/issn.2474-7785.jarh-17-1724
Wanby PärCorresponding author
Section of Endocrinology, Department of Internal Medicine, Kalmar County Hospital, Kalmar, Sweden
Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.
Jul 2017 DOI 10.14302/issn.2476-1710.jdt-17-1564
Caroline Krefis AnneCorresponding author
Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
The objective of this first part of our study was to investigate associations of road traffic noise, socioeconomic and -demographic risk factors, and health access on depression on borough level. We investigated in a large metropolis associations between prevalence rates of depression per borough (n = 67 boroughs) in all age groups (excluding the age group of 0–17 years) using health claims data (year 2011) and the variables “social deprivation” and “number of family members”, which were obtained from a previously conducted principal component analysis, and by using multivariate regression model. Additionally, the proportion of borough area affected by noise > 65 db(A) and physician density used as a surrogate parameter for health access were considered as potentially associated factors for depression. The results demonstrated that depression might be associated with increasing social borough deprivation. Additionally, the number of family members used as a proxy measure for positive family support showed decreasing prevalence rates the more family members were present. Furthermore, proportions of borough areas affected by noise > 65 db(A) was positively associated with depression. Our ecological study design has the advantage that a large number of large-scale, population-based aggregated data could easily be obtained and analysed and first potential associations could be found and discussed. To improve our findings, future studies will use data from a survey and data from the Hamburg City Health Study, a local follow-up health study, to better elucidate the individual risk factors together with environmental living and working conditions.
Jul 2017 DOI 10.14302/issn.2575-1212.jvhc-17-1586
Caroline ROSOLEM MayaraCorresponding author
Students of the Postgraduate Program in Veterinary Medicine, Universidade Estadual Paulista “Júlio de Mesquita Filho” (Unesp) Faculdade de Ciências Agrárias e Veterinárias (FCAV), Campus de Jaboticabal, São Paulo, Brasil.
The mammary tumor is one of the most common cancer in female dogs and, at the present days, there is a big focus on the study of the relation between this kind of tumor in animals and the cells that stay around them, like the inflammatory cells. The objective of this study was to evaluate and show where the inflammatory cells stay in simple mammary carcinomas in female dogs by immunohistochemistry. Samples of simple mammary carcinomas (tumor group; n=26) and mammary gland samples without tumor (control group; n=18) were submitted to immunohistochemical analysis for the detection of T lymphocytes, macrophages, plasma cells and the MHC-II molecule. The mast cells were evaluated by the histochemical technique (toluidine blue). Lymphocytes, macrophages and mast cells were observed distributed in the tumor stroma. MHC-II was detected in tumor cells and in the inflammatory infiltrate. Plasma cells predominated in the peritumoral stroma. Macrophages differed significantly between the two groups and predominated in the tumor group. In the comparison between histological types of mammary carcinomas, mast cells differed significantly between solid tumors of the tubular / papillary types. The cytoplasmic immunodetection of MHC-II was suggested an inefficient antigen presentation. Some of the leukocytes present in the tumor infiltrate, appear to be exerting a pro-tumor effect and allowing the progression of tubular and papillary carcinomas. But in solid carcinomas (may be poorly immunogenic), as they had the lowest proportion of leukocytes present in the tumor site. More studies are necessary to confirm these results, such as the determination of the cytokine profile and the predominant leukocyte subpopulations in the tumor microenvironment.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-17-1578
Wilson DaisyCorresponding author
Institute of Ageing and Inflammation, University of Birmingham, Edgbaston, Birmingham, UK, B15 2GW
Frailty describes a medical syndrome that confers increased vulnerability to disproportionate changes in health status following minor stressors. With loss of homeostatic reserve in multiple physiological systems, frailty conveys an increased risk of adverse health outcomes. Despite the lack of a clear universal definition, the utilisation of two landmark operational models has allowed a rapid expansion in frailty-centred research. The pathophysiology of frailty is yet to be elucidated in the literature, but a critical role for a heightened inflammatory state is hypothesised. Raised levels of pro-inflammatory cytokines are associated with frailty, with emerging evidence relating their biochemical action with development of the frailty phenotype. Dysregulation of both the innate and adaptive immune system are key components of the frailty syndrome. Remodelling of the T cell compartment and upregulated inflammatory pathways are theorised to propagate the heightened inflammatory state critical in the frailty syndrome. Increased neutrophil counts, in conjunction with ineffective neutrophil migration associated with age, is theorised to produce tissue damage and secondary inflammation conducive of the inflammatory picture in frailty. Beyond the gold standard of the comprehensive geriatric assessment, management of frailty is a fast-evolving area of research. Exercise interventions have shown promising results, improving functional ability and showing beneficial immunomodulation. Vitamin D supplementation, with proposed anti-inflammatory effects, nutritional support and pharmacological treatments all provide promising areas for future therapeutic intervention.
May 2017 DOI 10.14302/issn.2474-7785.jarh-16-1350
S. Kao Hsueh-FenCorresponding author
School of Nursing, The University of Texas at El Paso, EI Paso, TX
The prevalence of type-2 diabetes (T2DM) among Mexican-American older adults along the U.S.-Mexico border region is at epidemic proportions. Healthcare reform is trending toward long-term home-based management of chronic conditions. Under the Mexican cultural norm of familism, daily care for elders is also often provided by family caregivers whose competence levels may vary. Adherence to the prescribed medication regimen is critical to attainment of optimal glucose control. However, there is a startling lack of literature that addresses the link between family medication administration and care recipients’ health outcome. This paper explores the role of culture in medication administration by family caregivers of elders with T2DM from the perspective of caregiver capabilities and caregiving demands. A critical review of the literature offers suggestions to guide future studies.
Apr 2017 DOI 10.14302/issn.2474-3585.jpmc-17-1449
L. James WesleyCorresponding author
University of Memphis
Using proprietary data of patient records from four medical clinics in the Mississippi Delta, this research utilizes a natural experiment design to explore if the patient centered medical home (PCMH) has a positive effect on chronic disease maintenance for low SES, majority African-American patients in a rural and medically underserved region. The patients are divided into two cohorts, those attending PCMH clinics (level 2) and those attending non-PCMH clinics. Each cohort is comprised of similar demographic, socioeconomic, and health (large proportion of diabetics) characteristics. HbA1c scores of the cohorts are compared at two time periods, baseline and six-month follow-up. PCMH patients report more uncontrolled diabetes at baseline but the trend reverses at follow-up, providing evidence that the PCMH model of primary care produces positive health outcomes for patients with diabetes in the sample area.
Mar 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1468
Gibb JeanCorresponding author
University of California, Los Angeles Medical Center
Successful viral load programs rely on the presence of data systems and high quality of patient data. Using a cohort of 49 patients at Partners in Hope, a large, urban HIV clinic in Malawi, we performed a quality improvement assessment of a new viral load program with a focus on accuracy of data collected from patients as well as adherence to Malawi HIV Guidelines in regard to response to elevated viral loads (≥1,000 copies/mL). Data were obtained from three parallel medical record systems to investigate the proportion of patients with a repeat viral load and whether the three data systems agreed in regard to sociodemographic and clinical data. Fewer than 30% of patients had a repeat viral load within six months, as recommended in the Malawi HIV Guidelines. There were significant problems with data agreement across the three parallel databases used for care. Date of birth was consistent for 55.1% (N=27) of patients, while a different date of birth was noted in all three sources for 10.2% of patients (N=5). Viral load data from all three sources agreed for only 2.0% of patients (N=1). For 65.3% (N=32), the viral load from the laboratory did not match the recorded viral load in the electronic or paper record. Scale-up of viral load monitoring must be accompanied by the development of data systems that support workflow from sample collection to lab and back to provider. Education of providers and strategies for data collection with minimal errors can facilitate scale-up of high quality programs.
Mar 2017 DOI 10.14302/issn.2474-7785.jarh-17-1420
Vivanti AngelaCorresponding author
Centre for Dietetics Research, School of Human Movement and Nutrition Studies, University of Queensland, St Lucia, Queensland, Australia 4072.
Dehydration in acute care is associated with increased morbidity and mortality. However, no standard approach to hydration assessment exists in clinical settings. The pilot study aimed to explore total body water content as means for immediately assessing hydration status in clinical settings. People aged 60 years or more, voluntarily admitted to a tertiary teaching hospital’s Geriatric and Rehabilitation Unit were eligible for participation. Total body water assessment by tracer dilution was compared with standard clinical assessment of hydration status. The study participants (78.6±8.5 years, 6/14, 43% male) clinically assessed with poor hydration (3/14) had a higher percentage of body weight as water (59.0±2.3 vs 50.6±6.4%), and lower mean weight (54.1±12.9 vs 77.5±24.1 kg) and lower body mass index (20.0±3.7 vs 30.2±6.5 kg/m2) than the well-hydrated (11/14). Weight (n=14) and body mass index (n=11) explained a substantial proportion of variation in total litres of body weight as water (r=0.92, R2=0.85; r=0.80, R2= 0.64) and percentage of body weight at water (r=0.6, R2= 0.36; r=0.72, R2= 0.52) respectively. This pilot study revealed higher percentages of body weight as water amongst those clinically assessed with poorer hydration. Future regression analysis of total body water and hydration needs to adjust for the potential confounding effect of weight and body mass index. Implications for practice from this preliminary study indicate that findings did not support single point measurements of either total body water or percentage of body weight as water as potentially simple methods for clinically assessing hydration status amongst older hospitalised people.
Nov 2016 DOI 10.14302/issn.2644-0105.jbfb-16-1257
Aumeistere LivaCorresponding author
Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
Background: Breast milk is the ideal food source that contains all components an infant needs. Infants are at risk of receiving possible pollutants and high levels of trans fatty acids through breast milk that may affect their cardiovascular health and cognitive development. Statistics indicate that the proportion of children who are breastfed up to one year of age shows an annual increase in Latvia. Objectives: 1. To review studies conducted among the Latvian population regarding breast milk composition. 2. To evaluate the necessary future studies emphasizing the importance of the trans fatty acid content in a mother’s diet and correspondingly in breast milk and taking into consideration the new changes in Latvian legislation setting the maximum trans fat content in foodstuffs. Conclusions: There is very little research done about the human milk composition in Latvia that could be referable to a general population. It is known that the exposure of breast milk to persistent organic pollutants in Latvia corresponds to the lowest levels detected in the European countries and is not a cause of health disorders. Taking into consideration the adverse effect trans fatty acids have on human’s health regardless of the age, consumption should be as low as possible. Latvia has become the latest European Union country to set the maximum amount of trans fats in foodstuffs, yet there is no information about trans fatty acids content in human milk among women in Latvia. This problem needs to be addressed and set in motion. Therefore, it would be a novel idea to study if the TFA content also declines in milk among Latvian women after the introduction of the new legislation.
Oct 2016 DOI 10.14302/issn.2329-9487.jhc-16-1301
Sung KiwolCorresponding author
College of Nursing, Catholic University of Daegu, Daegu, South Korea.
Purpose: The purpose of this study was to examine the mediation of depressive symptoms in the relationship between cardiovascular risk and the health conservation of community-dwelling vulnerable diabetic elderly in order to provide a basis for planning nursing interventions to improve the health conservation of vulnerable diabetic elderly. Methods: The participants were 99 vulnerable diabetic elderly who registered at the community health centers in D city. Data were collected using self-report questionnaires and analyzed with the SPSS-WIN 19.0 program. The instruments were Sung’s Health Conservation Scale, the Arizona Heart Institute Cardiovascular Risk Factor Questionnaire, and the Geriatric Depression Scale Short Form-Korea version (GDSSF-K). Results: The mean score for health conservation was 100.52. Overall depressive symptoms were 11.84, cardiovascular risk was 20.35. There were significant correlations among the three variables: health conservation, depressive symptoms, and cardiovascular risk. Also, depressive symptoms had a proportional mediating effect in the relationship between cardiovascular risk and health conservation. Conclusion: Based on the findings of this study, health management programs focusing on cardiovascular risk management and depressive symptom improvement are highly recommended to promote health conservation in the vulnerable diabetic elderly
Aug 2016 DOI 10.14302/issn.2474-7785.jarh-16-1157
Arlappa NimmathotaCorresponding author
Division of Community Studies, National Institute of Nutrition (NIN), Hyderabad, Telangana, India.
Objectives: World has witnessed a considerable increase in the proportion of elderly population.Aging is associated with decreased physical activity and metabolism and thereby the changes in the nutritional requirements of older adults.The objective of this communication was to assess the nutritional status of rural elderly population in India. Methodology: A community based cross-sectional study; adopting multistage stratified random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB), during 2005-06 among the rural population of nine major states of India. A total of 3871 older adults were covered for anthropometry and of them, a total of 2138 older adults were covered for dietary assessment. Key Results: In general, the consumption of all the foods was below recommended daily intakes (RDI), and the in-adequacy (<70% of RDI) of intake was high with respect to leafy vegetables, milk & milk products, fats & oils and sugar & jaggery. Similarly, the in-adequacy of intakes of micronutrients such as vitamin A, iron, riboflavin and free folic acid was high among both genders. The poor intake of diet was reflected in high prevalence of chronic energy deficiency (CED) among the rural elderly in India. Conclusions: In general,the rural elderly were subsisting on inadequate diets in terms of both quantity and quality. Similarly, the prevalence of CED among elderly is a ‘‘very high’’ public health nutrition problem in India. Therefore, the Government of India should initiate appropriate nutrition intervention measures to improve the overall nutritional status and special nutrition policies to address the health and nutritional problems of the aging population.
Jun 2016
V. Seeman MaryCorresponding author
Professor Emerita, Department of Psychiatry, University of Toronto, 260 Heath St. W., Suite 605, Toronto, Ontario, M5P 3L6, Canada.
Background: There is a growing scientific interest in the phenomenon of earworms, which are melodies that are heard and re-heard despite the absence of an external stimulus. Aim: The aim of this paper is to determine whether understanding earworms can shed light on mechanisms underlying auditory hallucinations in psychosis. Method: Using recent data sources, this report briefly reviews what is most relevant about musical hallucinations and earworms. Results: Musical hallucinations, like hallucinated voices, are more prevalent in women. In the elderly, they are often associated with hearing impairment. They are most distressing when they first begin, with the degree of distress inversely proportional to the extent to which they can be controlled. Earworms can be provoked both by the memory of past events and by the anticipation of future events. Strong emotion can trigger earworms, but so can boredom. Limitations: The neurobiology potentially involved in the phenomenon of earworms is not explored in this paper. The pertinence of the literature about earworms and musical hallucinations, while interesting, is of unproven relevance to pathological voices in psychotic illness. Conclusions: The clinical relevance, while unproven, is that addressing recurring memories, as well as managing strong emotions and avoiding occupations that lead to boredom are all strategies worth trying when treating pathologicalauditory hallucinations
Apr 2016 DOI 10.14302/issn.2470-5020.jnrt-16-980
Stein MarcoCorresponding author
Department of Neurosurgery, Justus Liebig University Giessen, Germany
Spontaneous intracerebral hemorrhage (ICH) is one of the leading causes of death worldwide. In randomized trials on surgical therapy inclusion of the very old was limited by the recruitment process. This study was performed to evaluate the age limits in published surgical trials on ICH, and to determine how upper age limits effect the inclusion of men and women in these and future trials on the basis of a large cohort of ICH patients in central Europe. The Hessian stroke registry, a state-wide prospective stroke databank, was used to analyze upper age limits and sex differences for patients with the diagnosis of ICH (ICD-10: I61.0 to I61.9) who were admitted between January 2010 and December 2012. Sex differences were calculated at different age cutoffs, and the proportions of potentially excluded sex-specific patients from surgical trials on ICH were calculated. Overall, 5184 patients with the diagnosis of spontaneous ICH were identified. A total of 2457 (47.4%) patients were female and 2727 (52.6%) patients were male. Mean age was 72.3 ± 13.6 years. Female patients were significantly older compared to male patients (74.9 ± 13.5 years vs. 69.9 ± 13.2 years; p<0.001). With an upper age limit of 70, 75, and 80 years, 3437 patients (66.3%), 2664 patients (51.4%), and 1765 patients (34.0%) were excluded, respectively. Upper age limits in surgical trials on ICH could lead to the exclusion of a significant portion of patients from studies. This should be noted when transferring conclusions from these trials into clinical practice.
Apr 2016 DOI 10.14302/issn.2474-7785.jarh-15-699
Coronado-Vázquez ValleCorresponding author
Healthcare Director, Hospital of Riotinto, Mines of Riotinto, Huelva
Purpose Hospital readmission of patients with pluripathologies is frequent and costly. This study describes the impact of patients’ pluripathologies, functional capacity and social complexity on readmissions during a 12-month period following hospital discharge. Methods A prospective cohort study. Monthly monitoring of 111 patients over 12 months in Hospital of Riotinto. The primary endpoint was readmission rate. Predictive variables: age, gender, hospitalizations the year before, illnesses that define the pluripathology, medication prescribed on discharge, social situation (Gijón Scale), functional state (Barthel) and cognitive impairment (Pfeiffer). Results Readmissions accounted for 21.6% of the patients surveyed. Of those readmitted, the mean age was lower than those who did not return to hospital (75.4 vs.79.6) (p=0.031), the average amount of medication prescribed greater (10.5 vs.8.7) (p=0.014), the Barthel score higher (52.5 vs.50.6) and the Gijón value lower (13.8 vs.14.6), but no results was significant. The mean survival time (without readmission) was 310.9 days (95% CI, 289.4-332.5). Category B (chronic renal disease and vasculitis) and F (diabetes with microangiopathy and artery disease) had a lower average survival time (X2=7.02; p=0.008) (X2=7.07; p=0.008). The readmission risk was hazard ratio (HR) = 3.13 (95% CI, 1.37-7.14) for category B, and HR = 3.38 (95% CI, 1.37-8.36) for category F. Conclusions There is a high proportion of readmissions among patients with pluripathologies in the year following discharge from hospital. The greater risk occurs in patients with chronic renal insufficiency and diabetes with microvascular complications. Factors that can be modified are polymedication and the proper control of patients’ diabetes.
Feb 2016 DOI 10.14302/issn.2379-7835.ijn-16-924
Arlappa NimmathotaCorresponding author
Division of Community Studies, National Institute of Nutrition (NIN), Hyderabad, Telangana, India.
Objectives: Vitamin A deficiency (VAD) among the rural pre-school children in India is continues to be a major nutritional problem of public health significance, even after the implementation of national vitamin A prophylaxis programme for more than four decades. The aim of the study was to assess the prevalence of vitamin A deficiency among rural pre-school children of South India. Methodology: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB) among rural pre-school children of four South Indian states viz. Kerala, Tamil Nadu, Andhra Pradesh and Karnataka during 2003-05. A total of 35,480 (Boys: 18,216; Girls: 17,264) rural children of 1-5 year age group was covered for this study. Key Results: The prevalence of Bitot’s spot, an objective ocular sign of VAD among the rural pre-school children of South Indian was 0.6% (95%CI:0.5-0.7). Similarly, the proportion of children with sub-clinical VAD was 59.3%, suggestive of a severe public health problem. In general, the prevalence of VAD was significantly higher (p<0.001) among the children of socio-economically marginalized sections of the communities, labourers, illiterate mothers and those residing in the households with no sanitary latrine. Conclusion: The prevalence of clinical and sub-clinical VAD among the rural pre-school children of south India is suggestive of a public health concern. Therefore, rural communities are encouraged to consume diets rich in pre-formed and pro-vitamin A and administer periodic massive dose vitamin A solution to the children of under five for the prevention and control of VAD.
Dec 2015 DOI 10.14302/issn.2379-8572.joa-15-807
Simoncini DanielaCorresponding author
Department of Clinical and Experimental Medicine, University of Insubria c/o Ospedale Filippo del Ponte, Varese, Italy
Upper and lower airway disease is a common condition. Its prevalence is increasing in different areas of the world, but, at present, non-allergic rhinitis is underestimated. The aim of this study was to investigate FeNO (fractional exhaled nitric oxide) and nasal cytology in allergic and non-allergic patients, in order to reach a correct diagnosis. This study was performed on 120 children with rhinitis and/or asthma, evaluated by an allergist and an otolaryngologist. Skin prick-test and nasal cytology were tested in all patients; FeNO only in the asthmatic ones. The proportion of positive results in nasal cytology was higher in non-allergic than in allergic children: 22 out of 23 patients, vs 91 out of 97 patients. A significant correlation was found between FeNO levels and increase in nasal eosinophil counts. There is compelling evidence of a close relationship between upper and lower airway in asthma and rhinitis. The presence of rhinitis should always be investigated in children with asthma; therefore, FeNO and nasal cytology have clinical benefit both in allergic and non-allergic children. Our finding also supports the use of nasal cytology to evaluate non-allergic rhinitis (NAR).
Dec 2015 DOI 10.14302/issn.2379-7835.ijn-15-675
Antoniazzi Gomes de Gouveia LuizaCorresponding author
Heart Institute (InCor), University Of São Paulo, Medical School, Brazil.
The objective is to evaluate the scientific evolution of articles about vegetarian nutrition. We analyzed the publication of articles of vegetarian nutrition, using the key term ‘vegetarian’ in the National Institutes of Health MEDLINE bibliographic database between 1907 and 2013. We quantified the number of articles in vegetarian nutrition by 5–y time periods, and we classified the kind of journals, the affiliation of the first author, the origin of the study population and the type of articles. The number of articles found in MEDLINE is 3256. The publication rate of vegetarian articles increased steadily, except in periods of 2006-2010 and 2011-2013, and this was explained because the application of “embargo period” for the some publishers. Non-nutrition journals have published more articles on vegetarian nutrition for all periods. It is observed that after 1960 the articles on vegetarian nutrition are proportionately greater than the total published, except in the years 2007, 2008, 2011, 2012 and 2013. The majority of authors were located in Europe (41.7%), followed by North America (26.8%), Asia (16.1%) and Latin America (1.4%). The origin of the study population presented a similar trend being highest in Europe and lowest in Latin America. Original research and review articles represent 52.5% and 20.2% of all publications respectively. We noticed a marked increase in the publication of articles of vegetarian nutrition over the years in absolute and relative terms meaning a growing interest by publication type.
Dec 2015 DOI 10.14302/issn.2470-0436.jos-15-818
Arlappa NimmathotaCorresponding author
National Institute of Nutrition (Indian Council of Medical Research), Hyderabad, India.
Purpose: Vitamin A deficiency (VAD) is still a major nutritional problem of public health importance among the rural pre-school children in India, even after the implementation national vitamin A prophylaxis programme for prevention of nutritional blindness and ICDS have been in operation for more than three decades. The purpose of this communication is to assess the prevalence of ocular manifestations of vitamin A deficiency among rural pre-school children of north India. Methods: A community based cross-section study; adopting multi-stage random sampling procedure was carried out by NNMB among rural pre-school children of four north Indian states viz. Maharashtra, Madhya Pradesh, Orissa and West Bengal. A total of 36,111 rural pre-school children of 1-5years (Boys: 18408; Girls: 17703) were covered for this study. Results: The prevalence of conjunctival xerosis (2.5%), the first ocular sign of VAD and Bitot’s spot (0.9%), an objective ocular sign of VAD was higher than the cut-off values suggestive of public health nutritional problem among the rural children. While, the prevalence of night blindness, the first symptom VAD was reported among 0.5% of rural children. Similarly, the proportion of rural pre-school children with sub-clinical VAD was 64%, suggestive of severe public health importance. Conclusion: The prevalence of ocular manifestation and sub-clinical vitamin A deficiency was high among the rural children of north India. Therefore, rural communities are encouraged to consume diets rich in vitamin A and administer massive dose vitamin A solution to the children of under five for the prevention and control of vitamin A deficiency and its adverse impact on child morbidity and mortality.
Jun 2015 DOI 10.14302/issn.2374-9431.jbd-12-164
Lima-Gomez VirgilioCorresponding author
Hospital Juarez de Mexico, Av. IPN 5160 Colonia Magdalena de las Salinas, CP 06770, México City, México.
Objective: To identify the efficacy of focal photocoagulation to maintain or achieve best corrected visual acuity (BCVA) ≥20/40 in eyes with clinically significant macular edema (CSME) that had a focal angiographic pattern. Material and Methods: Non-experimental, retrospective, longitudinal, descriptive study in type 2 diabetic patients of any gender, who had CSME with focal angiographic pattern, who received focal photocoagulation from January to October 2012, with a register of BCVA before and 3 weeks after photocoagulation. 101 eyes from patients aged 35-74 years (mean 60.1±8.15) were assigned to one of two groups: 1, with BCVA before treatment <20/40 (n=60), and 2, with BCVA ≥20/40 (n=41). The proportion of eyes with BCVA≥20/40 after treatment was identified, in the sample and within each group. Results: In group 1 BCVA improved in 34 eyes (56.7%), did not change in 15 (25%), and worsened in 11 (18.3%); in group 2 BCVA improved in 10 eyes (24.4%), did not change in 18 (43.9%) and worsened in 13 (31.7%). Post treatment BCVA was ≥20/40 in 57 eyes (56.4%, 95% confidence intervals 46.8-66.1%), 21 of them from group 1 (36.8%) and 36 from group 2 (63.2%). Conclusion: Treating CSME with focal photocoagulation was efficacious to maintain BCVA ≥20/40 in 87.8% of eyes with that rank of vision preoperatively, and to achieve BCVA ≥20/40 in 35% of eyes without it. Early detection and treatment of CSME is required to increase the proportion of eyes with BVCA that provides visual independence, preferably when visual function is still good.
Jun 2015 DOI 10.14302/issn.2471-2140.jaa-14-616
Milward E.A.Corresponding author
School of Biomedical Sciences and Pharmacy, The University of Newcastle, Australia
Age-related macular degeneration (AMD) is responsible for a substantial proportion of severe visual impairment and blindness in people over 50 years of age. Current treatments for AMD are not effective in all patients and a proportion of patients who respond well to the treatment will still eventually develop central visual impairment. Despite all efforts to develop safe and efficient medications for AMD, as yet pharmacological approaches have failed to provide fully effective treatments for this condition. Various lines of evidence attest to the contributions of oxidative stress in the etiology of AMD. Anti-oxidant nutrients may be valuable preventive or therapeutic agents however complementary therapies can become widely adopted without sufficient knowledge of the real advantages and liabilities. This review considers the interventional potential of some common phytochemicals for treating AMD, primarily focusing on clinical and epidemiological evidence of potential public health relevance.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-211
Gust D.Corresponding author
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
Recruitment of couples is important for study success. The multi-centered HPTN 052 clinical trial was designed to evaluate whether immediate versus delayed use of ART by HIV-infected individuals would reduce transmission of HIV to their HIV-uninfected partners. The objective of this study was to retrospectively compare several approaches for community recruitment at our site in Kisumu, Kenya based on a) feedback from recruitment staff, b) associated cost, and c) number of eligible couples enrolled. A secondary objective was to assess the discordant couples’ acceptability of the community recruitment approaches relative to the a) main recruitment venues, b) educational materials, and c) local language best suited for explaining the trial. 241 couples were screened for eligibility using nine recruitment approaches. We compared the approaches used for the 60 couples found to be eligible to those used for the 56 ineligible couples for whom that information was available. Analyses for association were carried out. In-depth interviews were conducted with 20 staff and 29 discordant couples. Records were kept of the costs associated with each approach. Overall, staff interviews revealed that acceptability of the approaches was high. Challenges were present with all approaches ranging from one member of the couple not wanting to reveal their positive HIV status to their partner (Patient Support Center or PSC approach), to not finding people at home (home based counseling and testing or HBCT approach). The PSC and the HBCT recruitment approaches were the most effective in terms of recruiting eligible participants. There was an overall significant difference between the proportion of eligible and ineligible participants among the 9 approaches (χ2 (8) =33.5; p<0.0001). Analyses for association showed that the PSC approach resulted in attracting a greater proportion of couples who were eligible than ineligible (χ2 (1) =6.6; p=0.016). The cost for the PSC approach was less than one-third that of the HBCT approach. All discordant couples interviewed found the two main recruitment venues (PSC and their home) acceptable. Among couples who saw the educational materials, the majority found them useful (poster 72.7%; pamphlet 90.9%; flyer 88.9%). All couples found the language they were told about the study acceptable. The evaluation of recruitment approaches indicated that working with local partners, specifically the PSC staff and HBCT staff, was the most effective way to recruit eligible discordant couples. A focus on collaborations and partnerships between research and clinical organizations will help study recruitment efforts. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions. Funding for this substudy was provided by the Kenya Medical Research Institute (KEMRI) through a cooperative agreement with the U.S. Centers for Disease Control and Prevention.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-12-157
Aryal NirmalCorresponding author
Division of Applied Health Sciences, Forester Hill Campus, University of Aberdeen, Aberdeen, Scotland, UK
Background: Human Immunodeficiency Virus (HIV) and antiretroviral therapy (ART) are found to be strongly associated with cardiovascular diseases. Data are sparse on the prevalence and distribution of cardiovascular risk factors among people being treated for HIV in South Asia region. Methods: A cross-sectional study of 103 HIV patients (51 women and 52 men) attending routine follow-up consultations at the largest ART centre in Nepal was conducted. Data on several cardiovascular risk factors were collected through interview questionnaires, biophysical measurements and consulting medical records. Results: The most common cardiovascular risk factors observed were central obesity 34.6% 95% Confidence Interval (CI): 25.3% to 43.9%, chronic kidney disease {20.7% (95% CI: 11.6% to 29.7%)} and tachycardia {20.6% (95% CI: 12.7% to 28.5%)}. Females were significantly more likely to have central obesity (male 9.8% vs. female 60%, p=0.016) and chronic kidney disease (male 15.4% vs. female 26.3%, p=0.003) as compared to the males. Participants were fairly active but a large proportion, especially men, had smoked {65% (95% CI: 57%-72.3%)}, used tobacco products {66% (95% CI: 56.4%-74.4%)} or drugs (53.8% of the men) and consumed alcohol {60.2% (95% CI: 50.5%-69.1%)}. Conclusion: A high prevalence of several cardiovascular risk factors was observed among patients being treated for HIV in Nepal. Further larger studies are warranted to better understand the relevance and public health impact of cardiovascular risk factors in this region.
Jan 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-187
Gust D.A.Corresponding author
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
Retention of sufficient numbers of participants in longitudinal research studies is a serious methodological concern, as retention influences the validity of the research findings. An assessment of participant retention or attending all study visits was made quarterly during a 12 month follow-up of an HIV incident cohort in Kisumu, Kenya. The study objectives were to determine 1) the proportion of participants attending all study visits and 2) demographic and behavioral factors associated with missing ≥ 1 visit. The Kisumu Incidence Cohort Study (KICoS) was initiated in January 2007 (N=831). Detailed contact information was collected from each participant to enhance retention. Bivariate and multivariable analyses were used to determine factors associated with missing ≥ 1 visit. Overall retention was 90%. Of those enrolled, 46.4% were females. The adjusted odds of missing ≥ 1 study visit were greater for participants who were female (AOR=2.85; CI=1.90-4.28) and who had technical training (AOR=2.51; CI=1.20-5.25) or college/university education (AOR=1.89; CI=1.10-3.24) compared to having no or only primary education. Retention was high in this HIV prevention cohort study. However, studies could benefit by tailoring retention strategies for women. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions.
Jun 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-74
Madiba SphiweCorresponding author
School of Public Health, Faculty of Health Sciences, University of Limpopo, Medunsa Campus, South Africa
HIV infected children who started antiretroviral therapy (ART) in public health facilities in South Africa have survived to older age and disclosure has become an essential part of their care. Available data on HIV disclosure to children were collected much earlier in the provision of ART in South Africa. The aim of the study was to (a) determine the characteristics of caregivers of pediatric HIV patients in Gauteng, South Africa, (b) estimate the prevalence and timing of HIV disclosure among these patients, and (c) assess the factors associated with disclosure status. A cross-sectional study was conducted among 286 caregivers of paediatric ART children aged 4–17 in two centres in Gauteng, South Africa. Bivariate and multivariate logistic regression analyses were carried out. The highest proportion of care givers were biological mothers (n=140, 49.3%). The mean age of the children was 8.5 years, (range 4-17 years). More than a third (n=99, 34%) were disclosed their HIV status, and the mean age at disclosure was 9.3 years, (SD = 2.7). Child’s age older than 10 years (OR =1.63; 95% CI: 1.44–1.85), having a nonbiological caregiver (OR=1.75; 95% CI: 1.06-2.89), caregiver educational level (OR =0.64; 95% CI: 0.47–0.87), and caregiver’s age older than 60 years (OR=1.02; 95% CI: 1.01-1.04), were significantly associated with HIV disclosure to infected children. The relatively higher prevalence of disclosure is attributed to increasing access to paediatric ART. Training healthcare providers to support caregivers in disclosure will increase the rate of disclosure to HIV infected children receiving ART in public health facilities.
May 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-137
Kumar AlokCorresponding author
Ladymeade Reference Unit, Ministry of Health, Government of Barbados; School of Clinical Medicine and Research, University of the West Indies and Queen Elizabeth Hospital, Barbados.
Background: HAART has resulted in significant decline in morbidity and mortality from HIV. However, it is unclear if the trends have continued in the current HAART era. An understanding of healthcare utilization patterns is important for optimization of care and resource allocation. We examined the diagnoses for hospitalizations of patients with HIV and their clinical and demographic profile years after the introduction of HAART. Methods: A retrospective audit of the HIV admissions from July 2009 through June 2010. The case notes of all the adult admissions where one of the discharge diagnoses was HIV infection was reviewed. Data including the demographics, date of diagnosis, treatment and the follow up details, admission outcome and the final diagnosis were extracted from the case notes. Results: Over the 12 months period there were 154 admissions where one of the discharge diagnosis was HIV infection, and this accounted for 2.9% of all medical admissions in adults. 103(67%) admissions were in persons who were known to be HIV infected prior to the current admission. HIV infection was diagnosed for the first time during the current admission in 51(33%) cases. Nearly two-thirds of those hospitalized, had a CD 4 cell counts of < 200/µL and 63 (66%) had a viral load greater than 50,000 copies/ml. Over all, opportunistic infection was the commonest (47%) discharge diagnosis, followed by serious bacterial infections and HIV nephropathy. The median duration of hospitalization was 6 days (Range 2 to 71 days). There were 49 (32%) deaths. Conclusions: A significant proportion of patients admitted with HIV infection were still diagnosed on admission and were found to be severely immunosuppressed. An opportunistic infection continues to be the commonest discharge diagnosis in HIV infected patients.