scholarly journals Financial burden of HIV and TB among patients in Ethiopia: a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036892
Author(s):  
Lelisa Fekadu Assebe ◽  
Eyerusalem Kebede Negussie ◽  
Abdulrahman Jbaily ◽  
Mieraf Taddesse Taddesse Tolla ◽  
Kjell Arne Johansson
Keyword(s):  
Indirect Cost ◽  
Economic Burden ◽  
Financial Burden ◽  
Household Survey ◽  
Income Quintile ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures ◽  
The Mean ◽  
Substantial Economic Burden

ObjectivesHIV and tuberculosis (TB) are major global health threats and can result in household financial hardships. Here, we aim to estimate the household economic burden and the incidence of catastrophic health expenditures (CHE) incurred by HIV and TB care across income quintiles in Ethiopia.DesignA cross-sectional survey.Setting27 health facilities in Afar and Oromia regions for TB, and nationwide household survey for HIV.ParticipantsA total of 1006 and 787 individuals seeking HIV and TB care were enrolled, respectively.Outcome measuresThe economic burden (ie, direct and indirect cost) of HIV and TB care was estimated. In addition, the CHE incidence and intensity were determined using direct costs exceeding 10% of the household income threshold.ResultsThe mean (SD) age of HIV and TB patient was 40 (10), and 30 (14) years, respectively. The mean (SD) patient cost of HIV was $78 ($170) per year and $115 ($118) per TB episode. Out of the total cost, the direct cost of HIV and TB constituted 69% and 46%, respectively. The mean (SD) indirect cost was $24 ($66) per year for HIV and $63 ($83) per TB episode. The incidence of CHE for HIV was 20%; ranges from 43% in the poorest to 4% in the richest income quintile (p<0.001). Similarly, for TB, the CHE incidence was 40% and ranged between 58% and 20% among the poorest and richest income quintiles, respectively (p<0.001). This figure was higher for drug-resistant TB (62%).ConclusionsHIV and TB are causes of substantial economic burden and CHE, inequitably, affecting those in the poorest income quintile. Broadening the health policies to encompass interventions that reduce the high cost of HIV and TB care, particularly for the poor, is urgently needed.

scholarly journals POS0733 REAL-LIFE PHYSICAL ACTIVITY IN SLE PATIENTS: ASSOCIATIONS WITH FATIGUE AND QUALITY OF SLEEP

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 617.1-617
Author(s):  
H. Wohland ◽  
N. Leuchten ◽  
M. Aringer
Keyword(s):  
Physical Activity ◽  
Sleep Quality ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Real Life ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Fatigue Score ◽  
The Mean

Background:Fatigue is among the top complaints of patients with systemic lupus erythematosus (SLE), but only in part associated with SLE disease activity. Physical activity can help to reduce fatigue and should therefore be recommended to SLE patients. Vice versa, fatigue may arguably lead to reduced physical activity.Objectives:To investigate the extent of physical activity and the perception of fatigue and sleep quality in patients with SLE.Methods:Starting in February 2019, SLE patients were invited to participate in a cross-sectional survey study of fatigue and physical exercise during their routine outpatient clinic visits. Participants filled out a ten-page paper questionnaire focused on physical activity. To evaluate fatigue, we primarily used a 10 cm visual analogue scale (0-100 mm, with 100 meaning most fatigued), but also the FACIT fatigue score (range 0-52). Sleep quality was estimated using grades from 1 (excellent) to 6 (extremely poor).Results:93 SLE patients took part in the study. All patients fulfilled the European League Against Rheumatism/ American College of Rheumatology (EULAR/ACR) 2019 classification criteria for SLE. 91% of the patients were female. Their mean (SD) age was 45.5 (14.3) years and their mean disease duration 12.1 (9.4) years. The mean BMI was 25.2 (5.6). Of all patients, 7.5% had a diagnosis of (secondary) fibromyalgia. The mean fatigue VAS was 32 (27) mm and the mean FACIT fatigue score 35.7 (10.3). As expected, fatigue by VAS and FACIT was correlated (Spearman r=-0.61, p<0.0001). The mean SLEDAI was 1 (1) with a range of 0 to 6. Median glucocorticoid doses were 2 mg prednisolone equivalent, with a range from 0 to 10 mg.Out of 66 patients in payed jobs, 64 (97%) reported details on their working space. One person (2%) worked in a predominanty standing position, 37 (58%) worked in essentially sedentary jobs and 26 (40%) were in positions where they were mildly physically active in part. The mean fatigue VAS was 31 (24) mm for patients with partly active jobs and 27 (30) mm for those in sedentary jobs. Sleep was graded 2.9 (0.9) by those with active and 3.1 (1.3) by those with sedentary jobs.Half of the patients (51%) reported more than one physical recreational activity. 44 (47%) were walking and for five persons (5%) this was the only form of activity. Cycling was reported by 19 patients (20%), 18 of whom also practiced other activities. For transport, 52 (56%) in part chose active modes, such as walking and cycling. Patients who reported any of the above activities showed a mean fatigue VAS of 28 (25) mm, compared to 36 (28) mm in the patient group without a reported activity. Sleep quality was very similar: 3.1 (1.2) and 3.2 (1.1) for more active and more passive patients, respectively.65 (70%) patients regularly practiced sports. Of these, 39 (60%) practiced one kind of sport, 15 (23%) two, 7 (11%) three, and 2 (3%) each four and five kinds of sports. Fatigue VAS of patients practicing sports was 27 (25) mm versus 43 (28) in those who did not (p=0.0075). Sleep quality was 2.9 (1.1) in the sports cohort and 3.5 (1.1) in the no-sports cohort (p=0.0244).Conclusion:A majority of SLE patients in remission or low to moderate disease activity regularly practiced sports, and those doing so reported lesser fatigue and better sleep quality. The absolute values on the fatigue VAS were in a moderate range that made fatigue as the main cause of not performing sports rather unlikely for most patients.Disclosure of Interests:Helena Wohland: None declared, Nicolai Leuchten Speakers bureau: AbbVie, Janssen, Novartis, Roche, UCB, Consultant of: AbbVie, Janssen, Novartis, Roche, Martin Aringer Speakers bureau: AbbVie, Astra Zeneca, BMS, Boehringer Ingelheim, Chugai, Gilead, GSK, HEXAL, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, UCB, Consultant of: AbbVie, Astra Zeneca, BMS, Boehringer Ingelheim, GSK, Lilly, MSD, Roche, Sanofi, UCB

scholarly journals Dietary acrylamide intake by potato crisps consumers: A case of Nairobi County

2020 ◽  
Vol 5 (1) ◽  
pp. 871-878
Author(s):  
George Ooko Abong ◽  
Jackline Akinyi Ogolla ◽  
Michael Wandayi Okoth ◽  
Bruno De Meulenaer ◽  
Jackson Ntongai Kabira ◽  
...  
Keyword(s):  
Probabilistic Approach ◽  
Mean Value ◽  
Mitigation Measures ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Potato Crisps ◽  
Flame Ionization ◽  
Consumption Data ◽  
Dietary Acrylamide ◽  
The Mean

AbstractThe levels of acrylamide intake because of potato crisps consumption remains unknown in Kenyan context. This study assessed the exposure to acrylamide because of consumption of potato crisps in Nairobi, Kenya. A cross-sectional survey was carried out among 315 crisps consumers in Nairobi, and consumption patterns were collected using a pre-tested structured 7-day recall questionnaire. A total of 43 branded and 15 unbranded potato crisps samples were purchased in triplicates of 100 g and acrylamide was quantified using a gas chromatograph with a flame ionization detector. Consumption data were combined with the data on acrylamide contents from which dietary acrylamide intake was calculated using a probabilistic approach based on @Risk TopRank 6 risk analysis software for excel. The mean estimated acrylamide intake was 1.57 µg/kg body weight (BW) per day while the 95th (P95) percentile was 5.1 µg/kg BW per day, with margins of exposures (MOE) being 197 and 61, respectively. The intake of acrylamide was significantly (P < 0.05) higher in unbranded crisps with a mean value of 2.26 and 95th percentile of 6.54 µg/kg BW per day, MOE being 137 and 47, respectively. There were extremely lower MOE indicating higher exposure to acrylamide by the consumers mainly because of the higher acrylamide contents in potato crisps, and hence the need for mitigation measures.

The Risk of Catastrophic Health Expenditures Due to Direct Non-Medical Costs in Patients: A Study of the Outpatients in Qazvin, Iran

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Saeed Asefzadeh ◽  
Bahman Ahadi Nezhad ◽  
Saeed Norouzi
Keyword(s):  
Health Expenditures ◽  
Medical Costs ◽  
Healthcare Services ◽  
Disease Diagnosis ◽  
Cross Sectional Survey ◽  
Diagnostic Laboratory ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
Catastrophic Expenditures

Background: Out-of-pocket payment encompasses the costs that patients pay for healthcare services, which is an inefficient approach to healthcare financing as it may lead to poverty. Objectives: The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran. Methods: This cross-sectional survey was conducted on 341 outpatients referring to the internists of Velayat Hospital and Bu-Ali Sina Hospital in Qazvin. The required data were collected using a researcher-made questionnaire and the prescriptions of the patients. Out-of-pocket payments were defined as the direct medical and non-medical costs within one month. Results: The mean out-of-pocket payments of the patients in one month was 49.97 dollars, 75.8% of which covered direct medical cost (disease diagnosis and treatment), and 24.2% covered direct non-medical costs to receive health services. The highest out-of-pocket payments were for diagnostic/laboratory tests (50.3%), medications (21.5%), and transportation (18.2%). In addition, the exposure rate to catastrophic expenditures was estimated at 31%, and the patients with lower income had less exposure compared to those without incomes. Conclusions: According to the results, direct non-medical costs were associated with the increased out-of-pocket payments of the patients, which in turn led to the higher rates of catastrophic expenditures.

Prevalence of Depression, Anxiety and Stress in Medical Students, interns and residents in Pakistan

2021 ◽  
Vol 15 (9) ◽  
pp. 2333-2336
Author(s):  
Anum Arif ◽  
Minahil Iram ◽  
Sabih Nofal ◽  
Aima Sohail ◽  
Bismah Riaz ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Severe Depression ◽  
Poor Mental Health ◽  
Military Hospital ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Interns And Residents ◽  
The Mean

Aim: To assess prevalence of Depression, Anxiety, Stress in medical students, interns, and residents in Pakistan Study design: Cross-sectional Survey (Questionnaire) based study. Place and duration of study: This study was conducted at Combined Military Hospital Lahore Medical College from March 2020 to May 2020. Results: 104 participants were included in the study. There was female predominance 58(55.8%), and the mean age was 23.55±1.42. The overall mean score of depression and anxiety was 21.2±12.67 and 15.7±10.67 respectively and most prevalent in third and fourth-year residents. The mean stress score was 13.7, 10. 27. Twenty-eight (26.9%) of the overall participants had extremely severe depression, 36 (34.6 %) had extremely severe anxiety and 13(12.5%) had severe stress. Doctors studying and practicing in the private sector have a higher DASS21 score (p = < 0.006) Conclusion: Multiple factors have been found to contribute to the poor mental health of health care workers, including financial trouble, sleep deprivation, abuse from colleagues, high expectations, female gender, broken relationships, and substance misuse. Keywords: Anxiety Disorders, Depression, Medical, Mental Health Problem Solving, Psychological Distress,

scholarly journals Influence on attitudes and lifestyle due to lockdown amidst COVID-19 pandemic: a perception-based analysis among Bangladeshi residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Md. Saiful Islam ◽  
Md. Asad Ullah ◽  
Ummay Soumayia Islam ◽  
Sahadat Hossain ◽  
Yusha Araf ◽  
...  
Keyword(s):  
Associated Factors ◽  
Formal Education ◽  
Rural Residence ◽  
Regression Analyses ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Positive Attitudes ◽  
The Mean ◽  
Structured Questionnaire

Abstract Background Countrywide lockdown or stay-at-home order has been implemented to slow down the transmission of emergent coronavirus. However, the influence on attitudes and lifestyle due to lockdown amidst the coronavirus disease 2019 (COVID-19) pandemic has been poorly understood. The present study aimed to investigate the influence on attitudes and lifestyle due to lockdown amidst the COVID-19 pandemic among Bangladeshi residents. Methods A cross-sectional survey carried out involving 1635 community dwellers across eight divisions in Bangladesh conducted from April 15, 2020 to May 10, 2020. A structured questionnaire incorporating socio-demographic, attitudes towards lockdown and adverse lifestyle amidst lockdown measures was employed to collect data using the Google Forms. Multiple regression analyses were executed to determine the associated factors of positive attitudes towards lockdown and adverse lifestyle. Results The mean scores of attitudes towards lockdown were 67.9 (SD = 8.4) out of 85 with an overall correct rate (positive attitudes) of 79.9%; whereas the mean scores of adverse lifestyle amidst lockdown were 16.1 (SD = 4.8) out of 34 with an overall rate of 47.4%. The factors associated with more positive attitudes towards lockdown included being female, divorced, higher educated, and students. Conversely, being male, having no formal education, and rural residence were associated factors of adverse lifestyle amidst the COVID-19 pandemic. Conclusions The findings reflect how the COVID-19 lockdown has preciously impacted the attitudes, and lifestyle of Bangladeshi citizens, which will contribute to promoting appropriate measures during a subsequent zonal or complete lockdown.

scholarly journals Program Quality and Developmental Outcomes Related to Youth Volleyball in Ethiopia: Assessing Relationships and Variations

2021 ◽  
Vol 11 (4) ◽  
pp. 1388-1405
Author(s):  
Abdulaziz Mussema ◽  
Tefera Tadesse ◽  
Zelalem Melkamu
Keyword(s):  
Developmental Outcomes ◽  
Central Zone ◽  
Youth Sport ◽  
Program Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Practical Applications ◽  
The Mean ◽  
Project Site

This study aims to assess program quality and developmental outcomes of a youth volleyball project in one of the regional states in Ethiopia, and further examine variations between groups across gender and project site zones. We applied a cross-sectional survey design, collecting quantitative data from youth volleyball players (n = 215) with a mean age of 16.18 years (SD = 0.69) through a self-reported questionnaire. The results indicated that young players’ perceptions did not vary significantly across gender, except for the mean score of the perceived experience variable for girls (M = 2.68, SD = 0.318) was significantly higher than the mean score of boys (M = 2.58, SD = 0.258). One-way (project site zone) analyses of variance (ANOVAs) identified that youth volleyball projects in the central zone were consistently rated higher than those in the western zone, except for the current practice rating. Moreover, correlation analysis results indicated the presence of a significant relationship, both within and between program quality and developmental outcome variables. Furthermore, the results of regression analysis indicated that the program quality variables together predicted each of the developmental outcomes, accounting for 18.9% to 31.7% of the variances. It is concluded that the quality of the youth volleyball program in Ethiopia varies considerably across the project site zones and the program quality variables significantly relate to the developmental outcomes measured with differential effects. The data from this study reveals several practical applications for Ethiopia and beyond in terms of guiding youth volleyball projects. Moreover, the findings of the study showed that youth sport and the manner in which it is structured and delivered to youth players influences the attainment of positive developmental outcomes. These results suggest that contextual differences really do have an effect on the quality of youth sport program processes and developmental outcomes.

scholarly journals The Status and Associated Factors  of Early Childhood Caries among 3- to 5-year-old Children in Guangdong, Southern  China: A Provincial Cross-sectional Survey

2020 ◽  
Author(s):  
Jianbo Li ◽  
Weihua Fan ◽  
Yueshan Zhou ◽  
Linmei Wu ◽  
Wei Liu ◽  
...  
Keyword(s):  
Preschool Children ◽  
Oral Health ◽  
Associated Factors ◽  
Early Childhood Caries ◽  
Southern China ◽  
Guangdong Province ◽  
Deciduous Teeth ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Mean

Abstract Background: Dental caries of deciduous teeth (Early Childhood Caries, ECC) has become a crucial oral health problem over the decades in China. The aim of this study was to examine the prevalence and severity of ECC among preschool children from Guangdong Province, Southern China. In addition, to assess the association of ECC with reported oral health-related behaviors.Methods: A cross-sectional survey was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method. According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of ECC was determined by the dmft (decayed-missing-filled tooth) index using a CPI (Community Periodontal Index) probe. A questionnaire about caries-related factors was completed by each of the participants’ parents or grandparents through a face-to-face and one-on-one interview. Then, t-test, Chi2 tests, One-Way ANOVA served for statistical analysis, and logistic regression analysis as well as covariance analysis were executed to identify potential associated factors for ECC.Results: There were 2592 3- to 5-year-old preschool children. The prevalence (% dmft >0) of ECC was 68.3 (95% CI: 66.5-70.1), the mean dmft was 4.36 (95% CI: 4.17-4.55), and the filled rate was 1.2%. In multivariable modeling, associated factors for both prevalence and mean dmft were older age, rural areas, consumption of sweets before sleep, dental visit history, low household income, and low parental education level. Initiating toothbrushing after 3 years of age and being exclusively/ predominantly breastfed indicated only the prevalence; being female and frequently consuming sweetened milk/powdered milk indicated only the mean dmft.Conclusions: The preschool children in Guangdong Province experienced a significant amount of ECC. More attention should be given to children’s dental health for deciduous teeth. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors.

scholarly journals A Reformulation of business education curriculum for the development of career opportunities among undergraduates of South Nigerian Universities

2020 ◽  
Vol 10 (1) ◽  
pp. 10-22
Author(s):  
Chika Madu Ile ◽  
James Edomwonyi Edokpolor
Keyword(s):  
Lifelong Learning ◽  
Business Education ◽  
Survey Design ◽  
Education Curriculum ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Lifelong Learners ◽  
Social Burden ◽  
Career Opportunities ◽  
The Mean

Concerning on the rates social burden among the graduates of business education in Nigeria has provided an opportunity for the authors to extant the study to examine the current state of business education curriculum and the reformulation of business education curriculum equips the undergraduates with skills to start a business and engaging towards lifelong learning. A cross-sectional survey design was applied to achieve the objectives of the study. The design of the research is a quantitative method. Structured questionnaires were given to a sample of 289 participants (43 lecturers and 246 students) which were randomly selected across three universities in Nigeria. The data obtained are analyzed by the Statistical Package for Social Sciences (SPSS) version 23.0 and the mean statistic is used to answer the research questions and standard deviations are used to assess the degree to which participants’ scores are clustered around the mean. The results show that the business education curriculum is theoretical in nature, as such does not have the capability of preparing students to become entrepreneurs and lifelong learners. Hence, the data shows that most of the respondents vote for business education curriculum prepares student to work for the entrepreneurs with mean 3.49 for lecturers and 3.67 for students. Moreover, the result shows that a change in business education curriculum could help to equip students with skills to engage in becoming an entrepreneur. Therefore, the managers of business education should endeavor collaborations with major stakeholders to capable of integrating the 21st-century skills and apprenticeship models into the business education curriculum. It will help to equip undergraduates with the skills needed to pursue entrepreneurial and lifelong learning careers upon graduation.

scholarly journals Out-of-Pocket Spending for Cancer Medication, Financial Burden, and Cost Communication with Oncologists in the Last Six Months of Life in Israel

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1120
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Damien Urban
Keyword(s):  
Private Health Insurance ◽  
Financial Burden ◽  
Female Gender ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Complex Interactions ◽  
The Cost ◽  
Treatment Alternatives ◽  
Financial Burden Of Cancer ◽  
Heavy Financial Burden

Honest communication between oncologists and patients is important in alleviating the financial burden of cancer care. This study explored patient–relative–oncologist communication regarding the affordability of out-of-pocket (OOP) medication and the extent to which this communication addresses itself to the families’ financial burden. A cross-sectional survey was conducted among primary caregivers of deceased cancer patients. About 43% of relatives said that they and/or the patients had paid out of pocket for medications during the last six months of the patient’s life. Most (73%) oncologists suggested an OOP medication without asking about financial ability, 43% hardly explained the advantages of an OOP medication, and 52% hardly explained any treatment alternatives. Older age and female gender were related to less communication about an OOP medication, and better education, greater affluence, and having private health insurance were related to more communication. About 56% of relatives said that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. Physicians’ interest in financial ability and giving explanation lightened the burden. Given the difficulty of explaining the complex interactions of cost and clinical outcomes, oncologists need to be better educated in skills that would enable them to communicate costs more openly and should consider the cost of a treatment when prescribing it.

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