scholarly journals Factors associated with the referral of children with severe illnesses at primary care level in Ethiopia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047640
Author(s):  
Habtamu Beyene ◽  
Dejene Hailu Kassa ◽  
Henok Dangiso Tadele ◽  
Lars Persson ◽  
Atkure Defar ◽  
...  
Keyword(s):  
Primary Care ◽  
Severe Disease ◽  
Health Centre ◽  
Severe Illness ◽  
Health Post ◽  
Health Extension Workers ◽  
Cross Sectional ◽  
Factors Associated ◽  
Young Infants ◽  
Sick Children

Context and objectiveEthiopia’s primary care has a weak referral system for sick children. We aimed to identify health post and child factors associated with referrals of sick children 0–59 months of age and evaluate the healthcare providers’ adherence to referral guidelines.DesignA cross-sectional facility-based survey.SettingThis study included data from 165 health posts in 52 districts in four Ethiopian regions collected from December 2018 to February 2019. The data included interviews with health extension workers, assessment of health post preparedness, recording of global positioning system (GPS)-coordinates of the health post and the referral health centre, and reviewing registers of sick children treated during the last 3 months at the health posts. We analysed the association between the sick child’s characteristics, health post preparedness and distance to the health centre with referral of sick children by multivariable logistic regressions.Outcome measureReferral to the nearest health centre of sick young infants aged 0–59 days and sick children 2–59 months.ResultsThe health extension workers referred 39/229 (17%) of the sick young infants and 78/1123 (7%) of the older children to the next level of care. Only 18 (37%) sick young infants and 22 (50%) 2–59 months children that deserved urgent referral according to guidelines were referred. The leading causes of referral were possible serious bacterial infection and pneumonia. Those being classified as a severe disease were referred more frequently. The availability of basic amenities (adjusted OR, AOR=0.38, 95% CI 0.15 to 0.96), amoxicillin (AOR=0.41, 95% CI 0.19 to 0.88) and rapid diagnostic test (AOR=0.18, 95% CI 0.07 to 0.46) were associated with less referral in the older age group.ConclusionFew children with severe illness were referred from health posts to health centres. Improving the health posts’ medicine and diagnostic supplies may enhance adherence to referral guidelines and ultimately reduce child mortality.

Demographic Factors Associated with Congenital Malformations Among Young Infants in Fallujah Maternity and Children Hospital, Fallujah City, Iraq

2020 ◽  
pp. 1-5
Author(s):  
Samira T.Abdulghani ◽  
Samira T.Abdulghani
Keyword(s):  
Developing Countries ◽  
Congenital Anomalies ◽  
Prevalence Rate ◽  
Gestational Hypertension ◽  
Heart Defects ◽  
Demographic Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Young Infants ◽  
History Of

Background: Congenital anomalies are a major cause of infant morbidity and mortality in developing countries including our country. Registries and data on these anomalies are still primitive and poorly collated. In this study we aimed to assess the important demographic factors associated with the development of congenital anomalies. Methods: This was a cross-sectional hospital-based study involving 880 infants in the 1st year of life registered in the birth defect unit in Fallujah Maternity and Children Hospital in the period between 1st of January 2017 to the 31st of December 2019. The prevalence rate, the pattern of anomalies and the factors associated with their occurrence were determined. Results: The prevalence rate of the group enrolled in this study was 31/1000 total births, congenital heart defects was the commonest followed by central nervous system anomalies, 58% of the infants were males, 65% had ≥ 2.5 kg birth weight & 95% were singletons. Family history of congenital anomalies was found in 31.25% of cases. The largest group of mothers (55.7%) were 21-30 years old & 92.5% of fathers were less than 45 years old. Parental consanguinity reported in 64.3% of the total cases. Only 4.5% of mothers reported history of fever during pregnancy, and none of them had history of exposure to x-ray or teratogenic drug use. Gestational hypertension was reported in 10% of the total (880) mothers, hypertension and diabetes mellitus in 0.3%, while hepatitis C, hepatitis B, toxoplasmosis and epilepsy, each was reported in only one mother (0.1% of the total). Regarding the outcome of pregnancy, 66.6% were live births, 24.2% were abortions and 9.2% were stillbirths. History of previous abortions was reported in 22% of cases. Urban residents accounted for 63% of the families of congenitally abnormal infants while 37% were rural. Conclusion: Congenital anomalies are still a major cause for concern and tension in Fallujah society, there is serious need to establish a surveillance and good statistical system for congenital anomalies and efforts should be made to raise awareness of their occurrence and the associated risk factors in Iraq and other developing countries.

scholarly journals Clinical diagnosis in paediatric patients at urban primary health care facilities in southern Malawi: a longitudinal observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mtisunge Joshua Gondwe ◽  
Marc Y. R. Henrion ◽  
Thomasena O’Byrne ◽  
Clemens Masesa ◽  
Norman Lufesi ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Health Workers ◽  
Health Centre ◽  
Treatment Algorithm ◽  
Secondary Level ◽  
Support Staff ◽  
Health Care Facilities ◽  
Severe Illness ◽  
Primary Health ◽  
Sick Children

Abstract Background Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included long waiting times, high numbers of patients and erratic consultation systems which lead to mis-diagnosis and delayed referrals. Proper case management at this level of care is critical to prevent severe disease and deaths in children. We aimed to adopt Emergency, Triage, Assessment and Treatment algorithm (ETAT) to improve ability to identify severe illness in children at primary health centre (PHC) through comparison with secondary level diagnoses. Methods We implemented ETAT mobile Health (mHealth) at eight urban PHCs in Blantyre, Malawi between April 2017 and September 2018. Health workers and support staff were trained in mHealth ETAT. Stabilisation rooms were established and equipped with emergency equipment. All PHCs used an electronic tracking system to triage and track sick children on referral to secondary care, facilitated by a unique barcode. Support staff at PHC triaged sick children using ETAT Emergency (E), Priority (P) and Queue (Q) symptoms and clinician gave clinical diagnosis. The secondary level diagnosis was considered as a gold standard. We used statistical computing software R (v3.5.1) and used exact 95% binomial confidence intervals when estimating diagnosis agreement proportions. Results Eight-five percentage of all cases where assigned to E (9.0%) and P (75.5%) groups. Pneumonia was the most common PHC level diagnosis across all three triage groups (E, P, Q). The PHC level diagnosis of trauma was the most commonly confirmed diagnosis at secondary level facility (85.0%), while a PHC diagnosis of pneumonia was least likely to be confirmed at secondary level (39.6%). The secondary level diagnosis least likely to have been identified at PHC level was bronchiolitis 3 (5.2%). The majority of bronchiolitis cases (n = 50; (86.2%) were classified as pneumonia at the PHC level facility. Conclusions Implementing a sustainable and consistent ETAT approach with stabilisation and treatment capacity at PHC level reinforce staff capacity to diagnose and has the potential to reduce other health system costs through fewer, timely and appropriate referrals.

scholarly journals Data-Driven Decision Making and Proactive Citizen–Scientist Communication: A Cross-Sectional Study on COVID-19 Vaccination Adherence

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1384
Author(s):  
Emil Syundyukov ◽  
Martins Mednis ◽  
Linda Zaharenko ◽  
Eva Pildegovica ◽  
Ieva Danovska ◽  
...  
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Exploratory Study ◽  
Large Scale ◽  
Severe Disease ◽  
Data Driven ◽  
Personal Factors ◽  
Cross Sectional ◽  
Digital Platform ◽  
Factors Associated

Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between scientists and the general population, and to use it for an exploratory study on factors associated with vaccination readiness. The digital platform was developed in Latvia and was equipped with dynamic consent management. During a period of six weeks 467 participants were enrolled in the population-based cross-sectional exploratory study using this platform. We assessed demographics, COVID-19-related behavioral and personal factors, and reasons for vaccination. Logistic regression models adjusted for the level of education, anxiety, factors affecting the motivation to vaccinate, and risk of infection/severe disease were built to investigate their association with vaccination readiness. In the fully adjusted multiple logistic regression model, factors associated with vaccination readiness were anxiety (odds ratio, OR = 3.09 [95% confidence interval 1.88; 5.09]), feelings of social responsibility (OR = 1.61 [1.16; 2.22]), and trust in pharmaceutical companies (OR = 1.53 [1.03; 2.27]). The assessment of a large number of participants in a six-week period show the potential of a digital platform to create a data-driven dialogue on vaccination readiness.

scholarly journals Time Trends and Factors Associated with Antibiotic Prescribing in Swiss Primary Care (2008 to 2020)

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 837
Author(s):  
Nahara Anani Martínez-González ◽  
Stefania Di Gangi ◽  
Giuseppe Pichierri ◽  
Stefan Neuner-Jehle ◽  
Oliver Senn ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Trends ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
Antibiotic Prescribing ◽  
Employment Level ◽  
Cross Sectional ◽  
Factors Associated ◽  
Swiss Primary Care

Antibiotic resistance (ABR) is a major threat to public health, and the majority of antibiotics are prescribed in the outpatient setting, especially in primary care. Monitoring antibiotic consumption is one key measure in containing ABR, but Swiss national surveillance data are limited. We conducted a retrospective cross-sectional study to characterise the patterns of antibiotic prescriptions, assess the time trends, and identify the factors associated with antibiotic prescribing in Swiss primary care. Using electronic medical records data, we analysed 206,599 antibiotic prescriptions from 112,378 patients. Based on 27,829 patient records, respiratory (52.1%), urinary (27.9%), and skin (4.8%) infections were the commonest clinical indications for antibiotic prescribing. The most frequently prescribed antibiotics were broad-spectrum penicillins (BSP) (36.5%), fluoroquinolones (16.4%), and macrolides/lincosamides (13.8%). Based on the WHO AWaRe classification, antibiotics were 57.9% Core-Access and 41.7% Watch, 69% of which were fluoroquinolones and macrolides. Between 2008 and 2020, fluoroquinolones and macrolides/lincosamides prescriptions significantly declined by 53% and 51%; BSP prescriptions significantly increased by 54%. Increasing patients’ age, volume, and employment level were significantly associated with antibiotic prescribing. Our results may inform future antibiotic stewardship interventions to improve antibiotic prescribing.

Factors associated with workability in Spanish health centre workers

2020 ◽  
Author(s):  
I Mateo-Rodríguez ◽  
E Knox ◽  
A Daponte-Codina ◽  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Centre ◽  
Cross Sectional Study ◽  
Work And Family ◽  
Physical And Mental Health ◽  
Related Factors ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Spanish Health

Abstract Background The concept of workability provides a conceptual framework and proposes measures for the evaluation of relevant actions focused on a healthy workforce. In Spain, one of the countries with the highest life expectancy, there are practically no scientific studies on workability and its associated factors. Aims The objective of this study is to examine the associations between workability and variables related to health and work in a sample of workers from Spanish health centres. Methods Cross-sectional study including 1184 health centre workers who completed a questionnaire at baseline, comprising measures of workability, health and other work-related factors. Workability has been analysed as a one-factor construct, and as a two-factor construct. Multinomial logistic regression models were used to analyse factors associated with workability. Results As a one-dimensional construct, workability is associated with physical and mental health, number of hours of worked, insomnia, work and family life balance, adequate training, never having had an accident and type of contract. When the two-factor measure was used, sensitivity of findings increased, and it was identified that those participants who were older, lived alone and have more years of service in their profession also show worse workability. Conclusions The present study identified factors associated with the workability of health centre workers. The two-factor workability index (WAI) has better psychometric properties and used in combination with the global measure of WAI, identifies important additional aspects, specifically, age and years of professional experience as additional considerations for the intervention.

Individual-level characteristics associated with oral HIV test acceptability among Peruvian men who have sex with men and transgender women: a cross-sectional study

2018 ◽  
Vol 94 (7) ◽  
pp. 528-533 ◽  
Author(s):  
Juan A Flores ◽  
Brandon Brown ◽  
Segundo R León ◽  
Hugo Sánchez ◽  
Jerome T Galea
Keyword(s):  
Health Centre ◽  
Secondary Analysis ◽  
Prevalence Ratio ◽  
Transgender Women ◽  
Cross Sectional ◽  
Individual Level ◽  
Factors Associated ◽  
Hiv Test ◽  
Sex With Men ◽  
The Individual

ObjectivesPeruvian men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to HIV infection (HIV), but stigma, access issues and fear of venipuncture hamper testing. The oral HIV test—which uses oral fluids and provides results in 20 minutes—could reduce these barriers. The objective of this study was to determine the acceptability of the oral HIV test and the individual-level factors associated with its acceptability among MSM and TGW.MethodsWe conducted a cross-sectional secondary analysis among Peruvian MSM and TGW attending a community-based health centre between February 2012 and February 2013 to determine the individual-level factors associated with oral HIV test acceptability.ResultsOf 334 participants, 88% were MSM and 12% TGW. Overall, 85% of participants indicated their acceptability of the oral HIV test. Acceptability was higher in MSM than TGW (85.7% vs 80.0%) but this difference was not significant. Factors associated with acceptability in MSM were: tertiary or higher education (prevalence ratio (PR)=1.18, 95% CI 1.06 to 1.32 and PR=1.16, 95% CI 1.03 to 1.30, respectively); sex with drug use (PR=1.19, 95% CI 1.05 to 1.36); believing that HIV is transmitted by saliva (PR=1.20, 95% CI 1.08 to 1.33); and potential use of the oral test at home (PR=1.56, 95% CI 1.32 to 1.85). The only factor associated with lower acceptability was having had first anal intercourse between 14 and 19 years of age (PR=0.89, 95% CI 0.80 to 0.98).ConclusionsWe identified the individual factors associated with oral HIV test acceptability among Peruvian MSM and TGW. Expanded use of the oral HIV test to increase testing rates among Peruvian MSM and TGW is recommended.Trial registration numberNCT01387412, post-results.

scholarly journals Computerization of primary health care: the manager as a change agent

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Tarcísio Laerte Gontijo ◽  
Paola Karol Martins Lima ◽  
Eliete Albano de Azevedo Guimarães ◽  
Valéria Conceição de Oliveira ◽  
Humberto Ferreira de Oliveira Quites ◽  
...  
Keyword(s):  
Primary Care ◽  
Implementation Process ◽  
Cross Sectional Study ◽  
Minas Gerais ◽  
Software Systems ◽  
Cross Sectional ◽  
Technological Infrastructure ◽  
Factors Associated ◽  
Care Systems ◽  
Primary Care Professionals

ABSTRACT Objective: To analyze factors associated with the implementation of software systems of the e-SUS Primary Care strategy in municipalities of Minas Gerais. Methods: This is a cross-sectional study conducted with municipal managers of the e-SUS Primary Care strategy. A sample of cities stratified according to population size was selected. Descriptive, bivariate, and multivariate analyzes were performed to identify factors associated with the implementation of the systems. Results: In 49.1% (95%CI: 39.5-58.8) of the municipalities investigated, some of the e-SUS Primary Care systems were implemented. Time working as a strategy manager (OR: 3.03) and training for Primary Care professionals in the municipality (OR: 2.28) were associated with the implementation of the systems. Conclusion: The presence of a trained manager leading the implementation process impacted the implementation of the e-SUS AB strategy software systems in the municipalities of Minas Gerais. It is also essential to highlight the need to improve the technological infrastructure for the computerization of Primary Care.

scholarly journals ANALISI FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN INSOMNIA PADA WANITA MENOPAUSE DI POSYANDU WILAYAH KERJA PUSKESMAS PUNTI KAYU TAHUN 2021

2021 ◽  
Vol 16 (3) ◽  
pp. 624-631
Author(s):  
Rima Syafaria ◽  
Titin Dewi Sartika ◽  
Turiyani ◽  
H Hazairin Efendi
Keyword(s):  
Postmenopausal Women ◽  
Research Method ◽  
Health Centre ◽  
Sampling Technique ◽  
Total Sample ◽  
P Value ◽  
Cross Sectional ◽  
Factors Associated ◽  
Menopausal Women ◽  
Anxiety Levels

Menopausal women will experience several problems, one of which is sleep disorders (Insomnia). Insomnia is characterized by difficulty in initiating sleep. Various factors are thought to have a significant relationship with the occurrence of insomnia in postmenopausal women, including response to disease, lifestyle and anxiety levels. The purpose of this study was to determine the factors associated with the incidence of insomnia in postmenopausal women at the Posyandu in the Punti Kayu Palembang Health Centre in 2021. The research method used a survey Analytical by using design cross sectional, the sampling of this research used total sampling technique with a total sample of 63 people. Collecting data using a questionnaire sheet. The analysis used is analysis univariate and bivariat eusing testchi-square. The univariate results showed that 37 (58.7%) menopausal women experienced insomnia, 27 (42.9%) menopausal women, 27 (42.9%) postmenopausal women, and 33 (52.4%) menopausal women experienced poor lifestyle. anxiety as many as 30 (47.6%) postmenopausal women. ResultsIt is known that there is a relationship between response to disease and the incidence of insomnia in postmenopausal women with (p value = 0.000), there is a relationship between lifestyle and the incidence of insomnia in menopausal women with (p value = 0.000), there is a relationship between anxiety levels and the incidence of insomnia in menopausal women with (p value = 0.003). The conclusion of this study is that there is a relationship between response to disease, lifestyle, anxiety levels with the incidence of insomnia in postmenopausal women at the Posyandu in the Punti Kayu Health Centre in 2021. This study is expected to encourage postmenopausal women to maintain their health, change lifestyle habits and consume water, and reduce anxiety.

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