scholarly journals Mapping of yaws endemicity in Ghana; Lessons to strengthen the planning and implementation of yaws eradication

2020 ◽  
Author(s):  
Laud Anthony Wihibeturo Basing ◽  
Moses Djan ◽  
Shirley Victoria Simpson ◽  
Yaw Adu-Sarkodie
Keyword(s):  
Treatment Plan ◽  
Demographic Data ◽  
Treponema Pallidum ◽  
World Health Organisation ◽  
Haemophilus Ducreyi ◽  
Community Treatment ◽  
World Health ◽  
Significant Difference ◽  
Ulcerative Lesions ◽  
Study Sites

AbstractIntroductionYaws caused by Treponema pallidum subsp pertenue is a disease of poverty and affects communities where basic socio-economic amenities are lacking. With results showing that single dose azithromycin is effective in the treatment of yaws, the World Health Organisation introduced the Morges strategy with the intent to eradicate yaws by 2020. Ghana is one of the countries with the most yaws cases globally, and the National Yaws Eradication Program in Ghana intends to conduct Mass Drug Administration (MDA) of endemic communities in line with the Total Community Treatment plan of the Morges strategy. It is therefore important to map out endemic communities to ensure that MDA is both effective and financially efficient.MethodsChildren with suspected yaws lesions were actively selected from the recruitment sites (schools and communities). A full medical history, study site information including GPS coordinates, demographic data including communities of residence and clinical assessment were taken. Each of the clinically diagnosed children were screened using the DPP® Syphilis Screen & Confirm Assay (DPP). Samples for PCR were collected by swabbing ulcerative lesions of participants and tested for Treponema pallidum subsp pertenue and Haemophilus ducreyi DNAResultsIn all, 625 children with a median age of 10 years were recruited into the study. While 401(64.2%) were DPP positive, only 141 of them had Treponema pallidum subsp pertenue DNA (TPE_DNA) accounting for 22.6% of those who were clinically diagnosed. Based on the DPP results, yaws was endemic in all the 4 study sites with participants from 88 communities in 13 districts in 4 regions in Ghana. There was no statistically significant difference between the various districts in terms of DPP results (x2=0.9364, p= 0.817) and 154 (24.6%) of those clinically diagnosed as yaws were positive for Haemophilus ducreyi i DNA.ConclusionOur study shows that communities endemic for yaws are also endemic for Haemophilus ducreyi i. Most yaws endemic communities were found at the border of other districts and regions. It is recommended that MDA should not only target endemic communities, it should target entire endemic districts as well as neighbouring districts in order to be effective.

scholarly journals Socioeconomic influences on breastfeeding and weaning practices in a Mediterranean setting

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Justine Parnis ◽  
Neville Calleja ◽  
Petra Jones
Keyword(s):  
Demographic Data ◽  
World Health Organisation ◽  
Cross Sectional Study ◽  
World Health ◽  
Complementary Foods ◽  
Cross Sectional ◽  
Professional Advice ◽  
Level Of Education ◽  
High Level ◽  
Duration Of Breastfeeding

AbstractThe World Health Organisation (2016) recommends exclusive breastfeeding up to 6 months of age and the introduction of complementary foods at around 6 months. International literature suggests that although knowledge of the guidelines is high, only a minority of parents wait until 6 months to wean and sub-optimal weaning practices are common. The aim of this study was to assess breastfeeding and weaning practices and to evaluate the effect of socio-economic determinants on such behaviours in a Mediterranean setting.A cross-sectional study design was used. One-time short interviews with 250 consenting mothers having 8 month old infants were conducted using a structured questionnaire. Mothers attending all the well baby clinics in the primary health care centres of the Maltese Islands for a period of two months were included in the study. The questionnaire included socio-economic and demographic data, details on the initiation and duration of breastfeeding, weaning practices and a short assessment of the infant's usual diet at 8 months.Mothers between 25–34 years old (26%) and mothers with a high level of education (25%) were more likely to breastfeed only during the first 8 months of life without using any other type of milk, compared to younger (6.5%) or older (21%) mothers, and to mothers with a lower level of education (16%). The level of education was also positively associated with the continuation of breastfeeding, with the mean duration of breastfeeding for higher educated mothers being 4 months compared to 2.6 months in less educated mothers. Mothers with a lower level of education and mothers who are house-wives are more likely to give their infants only ready-made foods however associations were in this case borderline significant. On the other hand, appropriateness of weaning age was not associated with any socio-economic factors.The length of breastfeeding and the introduction of complementary foods varied widely between mothers. Compliance with infant feeding guidelines was poor. The mother's age, level of education and employment status all have an impact on breastfeeding and weaning practices. The provision of professional advice and a supportive environment for mothers, together with interventions for increasing awareness may promote maternal adherence to WHO guideline.

scholarly journals The Importance Of A Consultation Liaison Psychiatry Service In General Hospitals: A Brazilian 6-Years Experience

2021 ◽  
Author(s):  
Yoichi Takaki Konno ◽  
Fernanda Menezes de Faria ◽  
Gisele Zocoller Seno ◽  
Vinicius dos Santos Sguerri ◽  
Ana Carolina Gonçalves Olmos ◽  
...  
Keyword(s):  
Medical Records ◽  
Treatment Plan ◽  
Demographic Data ◽  
Liaison Psychiatry ◽  
Chi Square ◽  
General Hospitals ◽  
Significant Difference ◽  
Chi Square Test ◽  
Consultation Liaison Psychiatry ◽  
Level Of Significance

Abstract Background: The importance of consultation-liaison psychiatry (CLP) services have been progressively growing in all general hospitals.Methods: Data were collected from medical records of patients treated by the CLP service, from 2014 to 2020, including clinical-demographic data, characteristics of hospitalization, reason for request, treatment plan, and clinical outcome. For these analyses, the chi-square test, z-test, and Kruskal-Wallis test were used. The level of significance was set at 5%.Results: A total of 2,742 consultation requests were evaluated by the psychiatry team. The number of requests made grew by 109.64% over the years. In 58.21% of cases, the patient was in the ward, and 33% were requested by Internal Medicine. There was a statistically significant difference (p <0.001) in the distribution of reasons for request according to patients' characterization variables.Conclusions: This study sought to analyze the functioning and growth of CLP in a tertiary Brazilian general hospital. The present findings reinforce the importance of this service and the need to implement and develop CLP in general hospitals.

scholarly journals Multiplex Recombinase Polymerase Amplification Assay for Simultaneous Detection of Treponema pallidum and Haemophilus ducreyi in yaws-like lesions

2020 ◽  
Author(s):  
Michael Frimpong ◽  
Shirley Victoria Simpson ◽  
Hubert Senanu Ahor ◽  
Abigail Agbanyo ◽  
Solomon Gyabaah ◽  
...  
Keyword(s):  
Simultaneous Detection ◽  
Treponema Pallidum ◽  
Recombinase Polymerase Amplification ◽  
Nucleic Acid Amplification ◽  
Haemophilus Ducreyi ◽  
World Health ◽  
Clinical Samples ◽  
Successful Implementation ◽  
Effective Diagnosis

Yaws is a skin debilitating disease caused by Treponema pallidum subspecies pertenue with most cases reported in children. World Health Organization (WHO) aims at total eradication of this disease through mass treatment of suspected cases followed by an intensive follow-up program. However, effective diagnosis is pivotal in the successful implementation of this control program. Recombinase polymerase amplification (RPA), an isothermal nucleic acid amplification technique offers a wider range of differentiation of pathogens including those isolated from chronic skin ulcers with similar characteristics such as Haemophilus ducreyi (H. ducreyi). We have developed a duplex RPA assay for the simultaneous detection of Treponema pallidum (T. pallidum) and H. ducreyi (TPHD-RPA). TPHD-RPA assay demonstrated no cross-reaction with other pathogens and enable detection of T. pallidum and H. ducreyi within 15 minutes at 42 oC. The duplex RPA assay was validated with 49 clinical samples from individuals confirmed to have yaws by serological tests. Compared with commercial multiplex real-time PCR, the TPHD-RPA assay demonstrated 94-95% sensitivity for T. pallidum and H. ducreyi confirmed samples, respectively and 100% specificity. This simple novel TPHD-RPA assay enables the rapid detection of both T. pallidum and H. ducreyi in yaws-like lesions. This test could support the yaws eradication programs by ensuring effective diagnosis as well as enable monitoring of eradication efforts success or failure and planning of follow-up interventions at the community level.

Decreased anxiety after Dawood fasting in the pre-elderly and elderly

2018 ◽  
Vol 16 (1) ◽  
Author(s):  
Ika Fidianingsih ◽  
Nur Aisyah Jamil ◽  
Russy Novita Andriani ◽  
Wira Muhammad Rindra
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Ketone Bodies ◽  
The Elderly ◽  
World Health Organisation ◽  
World Health ◽  
Control Group ◽  
Control Group Design ◽  
Significant Difference

Abstract Background A high prevalence of anxiety in the elderly often leads to decreased quality of life (QOL). A restrictive diet can increase the production of ketone bodies that encourage mood enhancement, neural protection and pain reduction. This study aimed to identify whether Dawood fasting could increase the QOL of the elderly by reducing anxiety. Methods This research was a quasi-experimental study involving a pretest–post-test control group design. The subjects were pre-elderly and elderly or healthy people aged more than 50, and a consecutive sampling method was employed. The fasting group observed the fast of Dawood, in which they abstained from eating, drinking, or having sexual intercourse from the break of dawn to dusk with the expressed intent to fast every other day. The fast was observed for 22 days (11 fasting days). Anxiety was examined using the Hamilton Rating Scale for Anxiety (HRS-A), while QOL was identified using the Indonesian version of the World Health Organisation Quality of Life (WHOQOL). Results A total of 48 respondents participated in this study with 24 respondents observing the fast of Dawood and 24 others not fasting. Results showed that the 22 days of Dawood fast reduced respondents’ complaints about anxiety by 4.37% and was significantly different from the non-fasting group (p=0.001). There was an increase in the QOL of the fasting group (p=0.019), although no significant difference was found when compared to the non-fasting group. Conclusions The fast of Dawood reduced anxiety in the pre-elderly and elderly.

A Comparison of Australian Men with Psychotic Disorders Remanded for Criminal Offences and a Community Group of Psychotic Men who have not Offended

2006 ◽  
Vol 40 (3) ◽  
pp. 260-265 ◽  
Author(s):  
Paul White ◽  
David Chant ◽  
Harvey Whiteford
Keyword(s):  
Mental Disorder ◽  
Psychotic Disorders ◽  
World Health Organisation ◽  
Diagnostic Interview ◽  
Community Treatment ◽  
World Health ◽  
Pathways To Care ◽  
Severe Mental Disorder ◽  
Community Group ◽  
Prison Studies

Background: People remanded into custody by the courts have a substantially higher rate of severe mental disorder than other prisoners and the general population. Knowledge of their prevalence, needs and characteristics and an analysis of pathways to care may be necessary to provide mental health care effectively and efficiently. Previous prison studies focusing on psychotic offenders have suffered from the use of instruments not validated in a forensic setting and lack of a relevant comparison group. Method: The Diagnostic Interview for Psychosis (DP) is a composite semi-structured standardized interview schedule. It combines social and demographic descriptors with measures of functioning adapted from the World Health Organisation Disability Assessment Schedule (DAS). The remand centre surveyed had 466 cells and is the main remand and reception centre for males for the southern region of the state of Queensland, Australia. Of the 621 men screened, 65 answered yes to at least one question in the DP and were interviewed. Results: Six hundred and twenty-one remandees were screened and of these 61 were interviewed as screened positive for psychotic disorder. Thirty-five per cent had been homeless for an average of 32 weeks during the previous year. Most had had little contact with families or close friends. Eighty-one per cent were receiving no treatment at the time of offence. Seventy-eight per cent were unemployed and in receipt of a pension. Eighty per cent were dependent on alcohol, cannabis or amphetamines. Statistical issues of power are detailed in the text. Conclusions: The simplistic ‘prison, hospital or community treatment’ debate is misleading. Instead, the development of flexible preventative, management and accommodation services for people with severe mental disorder who have committed offences is a priority.

scholarly journals Assessment of heavy metals concentration in the intestine, kidney and muscle of Oreochromis niloticus in Federal University of Agriculture Abeokuta reservoir

2020 ◽  
Vol 40 (1) ◽  
pp. 191-196
Author(s):  
F. I. Adeosun ◽  
A. A. Akinyemi ◽  
W. O. Abdul ◽  
A. O. Agbon ◽  
O. C. Odebiyi
Keyword(s):  
Heavy Metals ◽  
Oreochromis Niloticus ◽  
Heavy Metal Concentration ◽  
World Health Organisation ◽  
World Health ◽  
Human Consumption ◽  
Fish Tissues ◽  
Reservoir Water ◽  
Significant Difference ◽  
Safe Limits

Different sizes of Oreochromis niloticus (Tilapia) were caught using cast net in FUNAAB reservoir. Water samples were also collected and analyzed for five metals: Lead, Chromium, Cadmium, Zinc, and Copper by Atomic Absorption Spectroscopy (AAS). During the experiment, three tissues were compared with the level of metal in water, Intestine, Kidney and Muscles. Generally, lower concentrations of metals were recorded in water than in fish tissues; lower concentration in the tissue of O niloticus except were found in the water which is less than the recommendation for human consumption by World Health Organisation. Lead was found to be the dominant in the intestine of Oreochromis niloticus while Chromium was recorded the least of all the metals. There is a significant difference (P<0.05) in heavy metal concentration in the tissue of O niloticus except for Chromium. Though, the heavy metals of interest were present in a measurable quantities, they are still within safe limits for consumption.

scholarly journals P-EGS20 Safe emergency laparoscopic cholecystectomy in the first 12 months of the Covid-19 pandemic

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Martin Michel ◽  
Helen Fifer ◽  
Emily Moran ◽  
Felix Hammett ◽  
Madara Kronberga ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Patient Flow ◽  
Demographic Data ◽  
Treatment Options ◽  
World Health Organisation ◽  
Time Frame ◽  
World Health ◽  
First Year ◽  
Healthcare Crisis

Abstract Background The World Health Organisation declared a global pandemic on the 11th March 2020 regarding the COVID-19 infection. This has had a dramatic impact on both acute and elective hospital services that will take a considerable time to recover from. Initial emergency intercollegiate surgical guidance released in March 2020 raised concern regarding laparoscopic surgery and advised to pursue alternative non-surgical or radiological treatment options for the safety of patients and theatre teams. The aim of this study was to assess the safety of emergency laparoscopic cholecystectomy (ELC) for patients presenting to our centre with acute gallstone pathology during the pandemic. Methods Retrospective analysis of all cholecystectomies undertaken in the department during the first year of the pandemic from 11th March 2020 to 11th March 2021. This period encapsulated two recognised peaks of the pandemic in the United Kingdom. Demographic data, elective/emergency, operative time, postop ITU admissions due to COVID and COVID related mortality was collected. Operative numbers and times were compared with historical data (HD) from the previous five years over the same time frame. Results 399 laparoscopic cholecystectomies were performed during the first year of the pandemic which was less than the previous five-year average of 570 cholecystectomies per annum (30% reduction). 247 (61.9%) were performed as an emergency on patients presenting with acute gallstone pathology compared to 35% (HD) performed acutely on average historically. Average age was 56 yrs (16-88 range). Average operative time for ELC during the pandemic was 69 minutes compared to 78 minutes HD (NS). No patients were admitted to ITU with post-operative Covid infections and there were no 30 day post-operative deaths.       Conclusions We performed more ELC’s in the first year of the pandemic compared to the previous five-year average as we were conscious of the inevitable long waiting lists, we would certainly be faced with in the coming months. The Covid-19 pandemic was a global healthcare crisis and one the NHS had never encountered before. At the time there was no high-quality evidence on the safety of laparoscopy on patients presenting acutely. This study adds to the growing body of evidence that with consistent preoperative testing, PPE and appropriate patient flow pathways that emergency laparoscopic cholecystectomies are safe to perform in the current climate.

A secondary exploratory analysis of Physical Activity in COPD Patients Comparing Conventional and Web Based Pulmonary Rehabilitation: Is the Level of Supervision Important? (Preprint)

2021 ◽  
Author(s):  
Emma Chaplin
Keyword(s):  
Physical Activity ◽  
Pulmonary Rehabilitation ◽  
World Health Organisation ◽  
World Health ◽  
Moderate Intensity ◽  
Moderate Activity ◽  
Post Intervention ◽  
Web Based ◽  
Significant Difference ◽  
The Web

BACKGROUND Pulmonary Rehabilitation (PR) increases exercise capacity, with less clear evidence for Physical Activity (PA).The World Health Organisation (WHO) recommends at least 150-300 minutes of moderate intensity or 75-150 of vigorous intensity aerobic physical activity per week to reduce the risks of chronic disease. OBJECTIVE The objective of this study was to assess the effectiveness of conventional PR versus web-based PR with respect to changes in PA. METHODS Patients with COPD were randomised to either conventional PR classes (n=51) or a web-based PR programme (n=52) for 7 weeks in a feasibility study. Accelerometers (Sensewear®) were worn pre and post intervention, PA was measured as steps/day and mean bouts of moderate activity for ≥2, ≥5, ≥10 and ≥20 mins. Measures were derived for patients with ≥8 hrs of data/day for ≥4 days using R language statistical software. Variables were explored to examine relationships with bouts of activity. RESULTS Baseline characteristics did not differ significantly between groups. Complete PA data was available for web (n=20) and conventional (n=34) groups. The web group demonstrated a non-significant increase in steps/24hr which comprised mainly of short bouts of MVPA when compared with conventional PR (P=.2). The conventional group increased 20 min bouts of PA by 49.1% although this was not statistically significant (P=.07). At baseline, age (r =-0.21, P=.043), BMI (r=-0.311, P=.004) and FEV1% predicted (r=-0.248, P=.048) were significantly correlated with 10 min bouts of PA, however post intervention this was not observed. CONCLUSIONS The analysis detected a non-statistically significant difference in the pattern of PA between conventional and web-based PR groups, conventional PR being associated with an increase in 20 min bouts whilst the web group demonstrated an increase in steps/24hr. There appears to be a differing response emerging between the two interventions. CLINICALTRIAL ISRCTN03142263

COVID-19 infection in gastrointestinal (GI) cancer patients receiving systemic anticancer treatment (SACT) during the outbreak of the pandemic: The Guy's Cancer Centre experience.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 455-455
Author(s):  
Eirini Tsotra ◽  
Charalampos Gousis ◽  
Beth Russell ◽  
Charlotte Moss ◽  
Kieran Palmer ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Biological Treatment ◽  
Demographic Data ◽  
Stage Iv ◽  
Severe Infection ◽  
World Health Organisation ◽  
World Health ◽  
Cancer Centre ◽  
Gi Cancer ◽  
Increased Risk

455 Background: The COVID-19 pandemic has prompted difficult decisions around the use of SACT. These were based on limited early data suggesting cancer patients receiving SACT were at an increased risk of COVID-19 severe infection and death. Our study aim was to identify the COVID-19 infection and mortality rates of GI cancer patients receiving SACT. Methods: All GI patients receiving SACT at Guy’s Cancer Centre between March, and May 31, 2020 were included. Demographic data (age, ethnicity, socio-economic status (SES)) and cancer characteristics (stage, SACT type, intent and treatment-line) were collected. COVID-19 infection was confirmed by PCR and severity defined by the World Health Organisation (WHO) classification. Patients with clinical or radiological diagnosis alone were excluded. Results: Of 417 GI patients receiving SACT during the study period, 345 (82.7%) received chemotherapy (alone or combined with targeted/biological treatment), 68 (16.3%) targeted/biological treatment alone and 4 (1%) immunotherapy. 14 (3.4%) patients were diagnosed with COVID-19, 13 were on chemotherapy and 1 on targeted/biological treatment. Commonest cancers in the COVID-19 positive group were colorectal (57.1%) and hepatobiliary (21.4%), followed by oesophago-gastric (14.3%) and neuroendocrine tumours (7.1%); 57.1% had stage IV disease. 64.3% of the positive patients were male (compared to 57.3% in the COVID-19 negative population), mean age was 57.7 years (63.1 years) and 85.7% had low SES (79.7%). 8 (57.1%) patients had severe infection and there were 3 (21.4%) COVID-19 related deaths. All the patients who died from COVID-19 were male and were receiving palliative chemotherapy. Only one patient was neutropenic (grade 1) when diagnosed with COVID-19. Conclusions: The rate of COVID-19 infection in our population was relatively low (3.4 %). Of the 14 COVID-19 positive patients, 57.1% had severe infection, 21.4% died (compared to 3.7% mortality in the non-infected group) and all but one were on chemotherapy. This prospective data, from a large UK comprehensive Cancer Centre, provides some evidence that continuing SACT through the pandemic is relatively safe. The risk of COVID-19 related infection and death must be off-set against the cancer-related morbidity and mortality associated with treatment delays.

scholarly journals Adrenocortical Carcinoma: Updates of Clinical and Pathological Features after Renewed World Health Organisation Classification and Pathology Staging

Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 175
Author(s):  
Alfred King-yin Lam
Keyword(s):  
Adrenocortical Carcinoma ◽  
Clinical Care ◽  
Demographic Data ◽  
Management Strategies ◽  
World Health Organisation ◽  
World Health ◽  
Biological Behaviour ◽  
Heterogenous Group ◽  
Histological Variants

Adrenocortical carcinoma (ACC) is a heterogenous group of diseases with different clinical behaviour between adult and paediatric patients. In addition, three histological variants, oncocytic, myxoid and sarcomatoid are noted on the recent World Health Organisation (WHO) classification of ACC. A review of recent literature showed that the different types of ACC have distinctive demographic data, clinical presentation, pathology, biological behaviour, genomic and patients’ prognosis. In addition, recent updates of pathology staging for ACC allow refinement of prognostic grouping for planning treatment of the patients with ACC. These advances in genomic, pathology and staging have driven the development of standardisation of pathology reporting. International standardisation of pathological reporting of adrenocortical carcinoma and adaption to local pathology communities provide universal platforms for clinicians and researchers involved in the management of patients with ACC. To conclude, all these advances in the field of pathology will improve development of management strategies including improvement of clinical care, development of prognostic markers and testing of novel therapeutic approaches for patients with adrenocortical carcinoma.

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