Availability of Medications Used for Puberty Induction and Maintenance in Adolescents with Hypogonadism in the Arab Region

AbstractPurposeInducing puberty in hypogonadal patients enables achieving normal final adult height, healthy bone mass accrual and improves fertility potential. Reliable availability and access to medicines remain a challenge around the world, particularly in low income countries. We aim to study the availability/access to medications used for inducing and maintaining puberty in centers within the Arab region.Patients and MethodsA cross-sectional survey was conducted using a link to an online questionnaire which was emailed to paediatric endocrinologists in the Arab region. The questionnaire consisted of three questions related to availability of various forms of sex hormones.Results99 physicians from 16 countries participated in the study. The commonest available form of estrogen was conjugated estrogen (29% of centers) followed by ethinylestradiol in 26%. Depot estradiol was available in 11centers while topical estrogen preparations of gel and patches were available in 6 and 10 centers respectively. Medroxy progesterone was available in 26% of the centers followed by noresthisterone (24%). The combined forms of oral and transdermal patches of estrogen/progestorne were available in 35 and 9% of centers. Intramuscular testosterone (Sustanon) was the most commonly available preparation of testosterone followed by the depot injection (Nebido), oral testosterone and testosterone gel and cream.ConclusionsWe report the first availability data of medications used for puberty induction and maintenance in paediatric hypogonadism in the Arab region. Recommended preparations for this purpose are not widely available. Creating essential list of medications used in paediatric endocrinology disorders might improve availability, access and consequently practice.

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Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-023013 ◽

2018 ◽

Vol 8 (9) ◽

pp. e023013 ◽

Cited By ~ 6

Author(s):

Deogratius Bintabara ◽

Keiko Nakamura ◽

Kaoruko Seino

Keyword(s):

Health Insurance ◽

Low Income ◽

Formal Education ◽

Wealth Index ◽

Population Based ◽

Reproductive Age ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Low Income Country

ObjectiveThis study was performed to explore the factors associated with accumulation of multiple problems in accessing healthcare among women in Tanzania as an example of a low-income country.DesignPopulation-based cross-sectional survey.SettingNationwide representative data for women of reproductive age obtained from the 2015–2016 Tanzania Demographic and Health Survey were analysed.Primary outcome measuresA composite variable, ‘problems in accessing healthcare’, with five (1-5) categories was created based on the number of problems reported: obtaining permission to go to the doctor, obtaining money to pay for advice or treatment, distance to a health facility and not wanting to go alone. Respondents who reported fewer or more problems placed in lower and higher categories, respectively.ResultsA total of 13 266 women aged 15–49 years, with a median age (IQR) of 27 (20–36) years were interviewed and included in the analysis. About two-thirds (65.53%) of the respondents reported at least one of the four major problems in accessing healthcare. Furthermore, after controlling for other variables included in the final model, women without any type of health insurance, those belonging to the poorest class according to the wealth index, those who had not attended any type of formal education, those who were not employed for cash, each year of increasing age and those who were divorced, separated or widowed were associated with greater problems in accessing healthcare.ConclusionThis study indicated the additive effects of barriers to healthcare in low-income countries such as Tanzania. Based on these results, improving uptake of health insurance and addressing social determinants of health are the first steps towards reducing women’s problems associated with accessing healthcare.

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Availability of ENT Surgical Procedures and Medication in Low-Income Nation Hospitals: Cause for Concern in Zambia

BioMed Research International ◽

10.1155/2020/1980123 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Lufunda Lukama ◽

Chester Kalinda ◽

Warren Kuhn ◽

Colleen Aldous

Keyword(s):

Surgical Procedures ◽

Low Income ◽

Care Delivery ◽

National Policy ◽

Low Income Countries ◽

Health Concern ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Essential Drugs ◽

High Prevalence

Background. Ear, nose, and throat (ENT) diseases are an oft overlooked global health concern. Despite their high prevalence and associated morbidity and mortality, ENT diseases have remained neglected in health care delivery. In Zambia and many other low-income countries, ENT services are characterized by poor funding, unavailable surgical procedures, and erratic supply of essential drugs. Objective. To investigate ENT service provision in Zambia with regard to availability of surgical procedures and supply of essential drugs. Methods. A descriptive cross-sectional survey was conducted using a piloted structured questionnaire between 17 January 2017 and 2 January 2018. Included in the study were the 109 hospitals registered with the Ministry of Health (MoH) across the 10 provinces of Zambia. Results. Of the participating hospitals, only 5.9% (n=1) and 40% (n=2) of Second-Level Hospitals (SLH) and Third-Level Hospitals (TLH), respectively, carried out tympanoplasty, myringotomy, and grommet insertion (M+G). Frontal trephination and external ethmoidectomy were offered in 11.7% (n=2) and 40% (n=2) of SLH and TLH, respectively. While tracheostomy (39.3%, n=24), tonsillectomy (27.9%, n=17), and adenoidectomy (27.9%, n=17) were the most widely performed head and neck procedures, laryngectomy was carried out by 1 hospital. Between 14.8% (n=9) and 36.1% (n=22) of hospitals lacked antibiotic and/or antiseptic ear drops. Despite 96.7% (n=59) of the respondents acknowledging ENT as an important branch of clinical practice, only 15.3% (n=4) of the hospitals had a budget for ENT. Also, 6.6% (n=4) of the respondents thought the discipline of ENT had received enough attention. Conclusion. ENT service delivery in Zambia is limited with regard to performed surgical procedures and availability of essential drugs, necessitating urgent intervention. The findings from this study may be used to direct national policy on the improvement of provision of ENT services in Zambia.

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Key bottlenecks to the provision of safe obstetric anaesthesia in low- income countries; a cross-sectional survey of 64 hospitals in Uganda

BMC Pregnancy and Childbirth ◽

10.1186/s12884-017-1566-3 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 8

Author(s):

Isabella Epiu ◽

Agnes Wabule ◽

Andrew Kambugu ◽

Harriet Mayanja-Kizza ◽

Jossy Verel Bahe Tindimwebwa ◽

...

Keyword(s):

Low Income ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Obstetric Anaesthesia

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Physical and Social Demographic Factors Affecting Utilization of Pit Latrine in Tigania East, Meru County, Kenya

Journal of Scientific Research and Reports ◽

10.9734/jsrr/2020/v26i830302 ◽

2020 ◽

pp. 122-132

Author(s):

Sylvia M. Nkatha ◽

Eric M. Muchiri ◽

Patrick Kubai ◽

Jane Rutto

Keyword(s):

Low Income ◽

Protective Factor ◽

Demographic Factors ◽

Water Sources ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Open Defecation ◽

Cross Sectional ◽

Pit Latrine ◽

Social Demographic

Introduction: Globally, poor sanitation is the cause of childhood diseases. Annually, more than 19,500 people die from diarrhea of which 17,100 are children. Diarrhea, which accounts for 16% of deaths among the children below 5 years, is highly linked to open defecation (OD). Poor excreta disposal remains a major challenge to improved sanitation and hygiene in many communities of Kenya and therefore they continue to practice open defecation. Construction and utilization of a latrine at home is a protective factor for communicable diseases. About 52% of the population practice proper utilization of latrine in low-income countries. Improper utilization of latrines leads to the contamination of the water sources. Availability of a pit latrine does not guarantee utilization because other factors like functionality and distance influence its use. Furthermore, the availability and use of the latrine depends on maintenance practices of the latrines and cleanliness as well as the quality of housing and household compound. Aims: To analyze the physical and social demographic factors influencing the utilization of pit latrines in Tigania East Sub-County, Meru County, Kenya. Study Design: The study was a descriptive cross-sectional survey. Place and Duration of Study: The study was carried out in Tigania East Sub-County, Meru County, Kenya shown in Fig. 3. Household survey was carried out between June 2018 and December 2019. Methodology: This was a descriptive cross-sectional survey involving 369 respondents selected by systematic random sampling from different households across the sub-county was utilized. Data collection was done using a structured questionnaire administered in English and a spot observation checklist. All data generated was entered, validated and analyzed using SPSS using SPSS Software Version 23. Descriptive analysis was done during the calculation of measures of central tendency and proportions. Regression analysis was used in the determination of any association between the socio-demographic factors and the utilization of latrines. Results: Ownership, location and functionality of the pit latrine were positively associated with utilization (OR=2.127, OR=1.53, OR=4.36, P=.00). Households that owned pit latrines were 2 times likely to utilize the pit latrines than those without a pit latrine. Moreover, household size, gender, and employment were positively related to utilization (R=0.502, P=.00). High construction costs challenges were 7 times linked to open defecation practices. Households with less than 6 members were 2.35 times more likely to utilize the pit latrine compared to those with 7-12 members (OR=2.35, X²=13.573, P=.00). Conclusion: Interventions should target households with more than 7 members. A call for partnerships between government and donors to improve household income, water sources, and sanitation practices in Tigania East Sub-County is necessary. A call for funding projects related to pour-flush pit latrines and wet technologies to enhance utilization.

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Tobacco Use and Associated Risk Factors in Burkina Faso: Results from a Population-Based Cross-Sectional Survey.

10.21203/rs.2.12694/v5 ◽

2019 ◽

Author(s):

Bruno Bonnechère ◽

Cissé Kadari ◽

Millogo Tiéba ◽

Ouédraogo H. Gautier ◽

Garanet Franck ◽

...

Keyword(s):

Risk Factors ◽

Alcohol Consumption ◽

Burkina Faso ◽

Tobacco Use ◽

Low Income ◽

Associated Factors ◽

World Health ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional

Abstract Tobacco is a leading preventable cause of non-communicable diseases (NCDs). Studies characterizing the prevalence of tobacco use in low-income countries are lacking. This study describes the prevalence of tobacco use in Burkina Faso and its associated factors. Methods : Data from the 2013 Burkina Faso World Health Organization (WHO) Stepwise approach to Surveillance (STEPS) were analyzed. The prevalence of any tobacco product use, cigarette smoking, and other tobacco use was calculated. Logistic regression analyses identified factors associated with tobacco use. Overall, 4,691 people were included in this analysis. Results: The prevalence of any tobacco use was 19.8% (95% CI: 18.4–21.2). Tobacco use was higher for men (29.2% [27.0–31.5]) than women (11.8% [10.3–13.4]). The prevalence of smoked tobacco was 11.3% (10.3–12.4), with a significantly higher prevalence among men (24.5% [22.1–27.0]) than women (0.1% [0.01–0.3]). The overall prevalence of other tobacco use was 8.9% (7.4–10.7), with lower values for men (5.6% [4.1–7.2]) compared to women (11.7% [9.4–14.1]). Tobacco smoking among men was significantly associated with an increased age and alcohol consumption. The analysis of risk factors for other tobacco use stratified by gender showed that age, education, residence, and alcohol consumption were significantly associated with consumption for women, and age and alcohol consumption for men. Conclusion: Tobacco use is common in Burkina Faso. To effectively reduce tobacco use in Burkina Faso, a comprehensive tobacco control program should consider associated factors, such as gender, age, and alcohol consumption.

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Tobacco use and associated risk factors in Burkina Faso: results from a population-based cross-sectional survey

BMC Public Health ◽

10.1186/s12889-019-7826-6 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Bruno Bonnechère ◽

Kadari Cissé ◽

Tiéba Millogo ◽

Gautier H. Ouédraogo ◽

Franck Garanet ◽

...

Keyword(s):

Risk Factors ◽

Alcohol Consumption ◽

Burkina Faso ◽

Tobacco Use ◽

Low Income ◽

Associated Factors ◽

World Health ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional

Abstract Background Tobacco is a leading preventable cause of non-communicable diseases (NCDs). Studies characterizing the prevalence of tobacco use in low-income countries are lacking. This study describes the prevalence of tobacco use in Burkina Faso and its associated factors. Methods Data from the 2013 Burkina Faso World Health Organization (WHO) Stepwise approach to Surveillance (STEPS) were analyzed. The prevalence of any tobacco product use, cigarette smoking, and other tobacco use was calculated. Logistic regression analyses identified factors associated with tobacco use. Overall, 4691 people were included in this analysis. Results The prevalence of any tobacco use was 19.8% (95% CI: 18.4–21.2). Tobacco use was higher for men (29.2% [27.0–31.5]) than women (11.8% [10.3–13.4]). The prevalence of smoked tobacco was 11.3% (10.3–12.4), with a significantly higher prevalence among men (24.5% [22.1–27.0]) than women (0.1% [0.01–0.3]). The overall prevalence of other tobacco use was 8.9% (7.4–10.7), with lower values for men (5.6% [4.1–7.2]) compared to women (11.7% [9.4–14.1]). Tobacco smoking among men was significantly associated with an increased age and alcohol consumption. The analysis of risk factors for other tobacco use stratified by gender showed that age, education, residence, and alcohol consumption were significantly associated with consumption for women, and age and alcohol consumption for men. Conclusion Tobacco use is common in Burkina Faso. To effectively reduce tobacco use in Burkina Faso, a comprehensive tobacco control program should consider associated factors, such as gender, age, and alcohol consumption.

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Parents’ Decision-making for Childhood Immunization and Prevention of Childhood Diseases – A Cross-Sectional Survey

10.21203/rs.3.rs-1047244/v1 ◽

2021 ◽

Author(s):

Jonas KEMEUGNI NGANDJON ◽

Alfred Laengler ◽

Thomas Ostermann ◽

Virgile Kenmoue

Keyword(s):

Decision Making ◽

Low Income ◽

Childhood Vaccination ◽

World Health ◽

Low Income Countries ◽

Health Seeking ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccination Programs ◽

Health Authorities

Abstract Background The childhood vaccination program (EPI) is claimed by the World Health Organization (WHO) to be the most cost-effective intervention to reduce child mortality. Therefore, in low-income countries governments and health authorities invest in vaccination programs to reach herd immunity. However, despite the resources allocated to the EPI, epidemics preventable through vaccines are still reported in these countries. In Cameroon, the Foumbot district in the West region has witnessed measles epidemics since 2010 and in 2013 a polio outbreak was reported. Methods The design of this study is a cross-sectional survey. A total of 160 mothers of children between the ages of 12 to 23 months were selected by simple random sampling technique. Pre-tested structured questionnaire was used for data collection. Data was analyzed using SPSS statistical software. Results The outcome of this survey shows that 60% of the children studied were completely vaccinated, 37.75% were partially vaccinated, and 1.25% had not received any vaccine. The logistic regression analysis shows that a poor knowledge of infectious diseases (OR=0.3) was a significant predictor of partial and no vaccination status in children. Conclusion Parents’ decision-making for EPI was based on the information and experiences available in the community. Therefore, parents who are poorly educated on VPDs and living in a community with missing information and misinformation about vaccination will probably not complete the EPI. Public health authorities should invest in health education programs with the goal of developing skills for health- seeking behavior in individuals and communities.

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Tobacco Use and Associated Risk Factors in Burkina Faso: Results from a Population-Based Cross-Sectional Survey.

10.21203/rs.2.12694/v4 ◽

2019 ◽

Author(s):

Bruno Bonnechère ◽

Cissé Kadari ◽

Millogo Tiéba ◽

Ouédraogo H. Gautier ◽

Garanet Franck ◽

...

Keyword(s):

Risk Factors ◽

Alcohol Consumption ◽

Burkina Faso ◽

Tobacco Use ◽

Low Income ◽

Associated Factors ◽

World Health ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional

Abstract Background: Tobacco is a leading preventable cause of non-communicable diseases (NCDs). Studies characterizing the prevalence of tobacco use in low-income countries are lacking. This study describes the prevalence of tobacco use in Burkina Faso and its associated factors. Methods : Data from the 2013 Burkina Faso World Health Organization (WHO) Stepwise approach to Surveillance (STEPS) were analyzed. The prevalence of any tobacco product use, cigarette smoking, and other tobacco use was calculated. Logistic regression analyses identified factors associated with tobacco use. Overall, 4,691 people were included in this analysis. Results: The prevalence of any tobacco use was 19.8% (95% CI: 18.4–21.2). Tobacco use was higher for men (29.2% [27.0–31.5]) than women (11.8% [10.3–13.4]). The prevalence of smoked tobacco was 11.3% (10.3–12.4), with a significantly higher prevalence among men (24.5% [22.1–27.0]) than women (0.1% [0.01–0.3]). The overall prevalence of other tobacco use was 8.9% (7.4–10.7), with lower values for men (5.6% [4.1–7.2]) compared to women (11.7% [9.4–14.1]). Tobacco smoking among men was significantly associated with an increased age and alcohol consumption. The analysis of risk factors for other tobacco use stratified by gender showed that age, education, residence, and alcohol consumption were significantly associated with consumption for women, and age and alcohol consumption for men. Conclusion: Tobacco use is common in Burkina Faso. To effectively reduce tobacco use in Burkina Faso, a comprehensive tobacco control program should consider associated factors, such as gender, age, and alcohol consumption.

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Towards Ending Immunization Inequity

Vaccines ◽

10.3390/vaccines9121378 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1378

Author(s):

Anna Victoria Sangster ◽

Jane M. Barratt

Keyword(s):

Social Determinants ◽

Low Income ◽

Vaccine Safety ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccine Recommendations ◽

Uptake Rates ◽

Study Results ◽

Entry Points

Vaccine-preventable diseases (VPD) are responsible for a significant portion of mortality across the life course in both low-income countries and in medium- and high-income countries. Yet, countries are consistently below the adult influenza vaccination targets, with rates in recent times even falling in some areas. (1) The study Towards Ending Immunization Inequity seeks to understand the various factors that contribute to the accessibility and effectiveness of vaccine-related messages and campaigns including the effects of social determinants, with the knowledge that these opportunities for communication represent a unique policy lever to improving uptake rates of vaccination in the most at-risk communities. (2) To address this knowledge gap, a 3-phase mixed-methods study was conducted including a preliminary scan of existing vaccine schedules and NITAG recommendations, focus groups and a cross-sectional survey. (3) Study results indicated that social determinants play a key role in an individual’s knowledge of vaccine-related information including types of vaccines available, vaccination gateways, vaccine recommendations and vaccine safety. (4) However, knowing that social determinants can influence uptake rates does not readily create opportunities and entry points for governments to implement tangible actions. An accessible entry point to reducing and ending immunization inequity is through changes in public health messaging to reach those who are currently unreachable.

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