scholarly journals Cross-sectional study to evaluate Trichomonas vaginalis positivity in women tested for Neisseria gonorrhoeae and Chlamydia trachomatis, attending genitourinary medicine and primary care clinics in Bristol, South West England

2017 ◽  
Vol 94 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Jane E Nicholls ◽  
Katy M E Turner ◽  
Paul North ◽  
Ralph Ferguson ◽  
Margaret T May ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Trichomonas Vaginalis ◽  
Older Age ◽  
Nucleic Acid Amplification ◽  
Cross Sectional ◽  
South West ◽  
Genitourinary Medicine ◽  
Asymptomatic Women ◽  
South West England

BackgroundHighly sensitive, commercial nucleic acid amplification tests (NAAT) for Trichomonas vaginalis have only recently been recommended for use in the UK. While testing for T. vaginalis is routine in symptomatic women attending genitourinary medicine (GUM) clinics, it is rare in asymptomatic women or those attending primary care. The aim of this study was to evaluate the positivity of T. vaginalis using a commercial NAAT, in symptomatic and asymptomatic women undergoing testing for chlamydia and gonorrhoea in GUM and primary care settings.MethodsSamples from 9186 women undergoing chlamydia and gonorrhoea testing in South West England between May 2013 and Jan 2015 were also tested for T. vaginalis by NAAT alongside existing tests.ResultsT. vaginalis positivity using NAAT was as follows: in GUM 4.5% (24/530, symptomatic) and 1.7% (27/1584, asymptomatic); in primary care 2.7% (94/3499, symptomatic) and 1.2% (41/3573, asymptomatic). Multivariable regression found that in GUM older age, black ethnicity and deprivation were independent risk factors for T. vaginalis infection. Older age and deprivation were also risk factors in primary care. Testing women presenting with symptoms in GUM and primary care using TV NAATs is estimated to cost £260 per positive case diagnosed compared with £716 using current microbiological tests.ConclusionsAptima TV outperforms existing testing methods used to identify T. vaginalis infection in this population. An NAAT should be used when testing for T. vaginalis in women who present for testing with symptoms in primary care and GUM, based on test performance and cost.

Prevalence of Mycoplasma genitalium in men with urethritis and in high risk asymptomatic males in Tel Aviv: a prospective study

2016 ◽  
Vol 28 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Tamar Gottesman ◽  
Orit Yossepowitch ◽  
Zmira Samra ◽  
Shoshana Rosenberg ◽  
Michael Dan
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Trichomonas Vaginalis ◽  
Poor Response ◽  
Mycoplasma Genitalium ◽  
Dual Infection ◽  
Nucleic Acid Amplification ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Tel Aviv

We sought to investigate the prevalence of Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in men presenting to a sexually transmitted infection (STI) clinic, with special attention to M. genitalium, its occurrence in Israeli patients, coinfections, and risk factors. In a cross-sectional study, 259 men were successively enrolled in the Tel Aviv Levinsky Clinic for STIs between November 2008 and November 2010. There were 118 men with urethritis and 141 high-risk men without symptoms. M. genitalium, C. trachomatis, N. gonorrhoeae, and T. vaginalis were detected using nucleic acid amplification tests. Demographic characteristics and risk factors were documented. The overall prevalence of infection with M. genitalium, C. trachomatis, N. gonorrhoeae, and T. vaginalis, were 6.6%, 12.7%, 23.1%, and 0%, respectively. Prevalences in men with urethritis were 11.9%, 22%, and 49%, for M. genitalium, C. trachomatis, and N. gonorrhoeae, respectively. Prevalences in men without symptoms were 2.1%, 5.0%, and 1.4%, for M. genitalium, C. trachomatis, and N. gonorrhoeae, respectively. Co-infections were found only in symptomatic individuals, in whom 5.9% were infected concomitantly with C. trachomatis and N. gonorrhoeae, and 2.5% had dual infection with M. genitalium and N. gonorrhoeae. N. gonorrhoeae, C. trachomatis, and M. genitalium were significantly more prevalent in patients with urethritis. M. genitalium was significantly more prevalent in the heterosexual population than in homosexual males. To conclude, we have found that M. genitalium infection is associated with urethritis in Israeli men, and more so in the heterosexual population. Testing men for M. genitalium as a cause of non-gonococcal urethritis is warranted, particularly because of its poor response to doxycycline and possible failure of azithromycin.

scholarly journals A cross-sectional study to describe and explore factors associated with measles immunisation and recording among cases linked to an outbreak, South West England, 2016

2019 ◽  
Vol 20 (3) ◽  
pp. 150-153 ◽  
Author(s):  
Joanna C McLaughlin ◽  
Neville Q Verlander ◽  
Julie Yates ◽  
Charles R Beck
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Socioeconomic Deprivation ◽  
Health Protection ◽  
Sectional Study ◽  
Cross Sectional ◽  
South West ◽  
Primary Care Record ◽  
Immunisation Status ◽  
South West England

Following an outbreak of measles across South West England in 2016, the multi-agency outbreak control team suggested that immunisation history records collected for the health protection response may not be reliable. We undertook a cross-sectional study to compare measles immunisation records collected from outbreak cases on the case management system HPZone by the Health Protection Team with the full primary care record. A total of 122 cases were reported. We identified 86.9% cases were not fully immunised and 5.7% had an unknown immunisation status. There were 14 cases whose primary care records did not match HPZone and 18 cases where primary care records were available and immunisation status was not documented in HPZone. Complex, non-linear associations were found between age and socioeconomic deprivation status of each case and having an incorrect HPZone record. Cases who resided in postcode areas of greater socioeconomic deprivation had statistically significantly higher odds of having been fully immunised. Only 13.3% of partially or unimmunised cases received an MMR immunisation following their onset of measles infection. Collecting immunisation status from the full primary care record during acute management of measles cases may support improvements in control and prevention of further cases.

scholarly journals Policies and strategies to retain and support the return of experienced GPs in direct patient care: the ReGROUP mixed-methods study

2019 ◽  
Vol 7 (14) ◽  
pp. 1-288 ◽  
Author(s):  
John L Campbell ◽  
Emily Fletcher ◽  
Gary Abel ◽  
Rob Anderson ◽  
Rupatharshini Chilvers ◽  
...  
Keyword(s):  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Mixed Methods ◽  
Patient Care ◽  
Mixed Methods Study ◽  
Direct Patient Care ◽  
South West ◽  
Career Break ◽  
South West England

BackgroundUK general practice faces a workforce crisis, with general practitioner (GP) shortages, organisational change, substantial pressures across the whole health-care system and an ageing population with increasingly complex health needs. GPs require lengthy training, so retaining the existing workforce is urgent and important.Objectives(1) To identify the key policies and strategies that might (i) facilitate the retention of experienced GPs in direct patient care or (ii) support the return of GPs following a career break. (2) To consider the feasibility of potentially implementing those policies and strategies.DesignThis was a comprehensive, mixed-methods study.SettingThis study took place in primary care in England.ParticipantsGeneral practitioners registered in south-west England were surveyed. Interviews were with purposively selected GPs and primary care stakeholders. A RAND/UCLA Appropriateness Method (RAM) panel comprised GP partners and GPs working in national stakeholder organisations. Stakeholder consultations included representatives from regional and national groups.Main outcome measuresSystematic review – factors affecting GPs’ decisions to quit and to take career breaks. Survey – proportion of GPs likely to quit, to take career breaks or to reduce hours spent in patient care within 5 years of being surveyed. Interviews – themes relating to GPs’ decision-making. RAM – a set of policies and strategies to support retention, assessed as ‘appropriate’ and ‘feasible’. Predictive risk modelling – predictive model to identify practices in south-west England at risk of workforce undersupply within 5 years. Stakeholder consultation – comments and key actions regarding implementing emergent policies and strategies from the research.ResultsPast research identified four job-related ‘push’ factors associated with leaving general practice: (1) workload, (2) job dissatisfaction, (3) work-related stress and (4) work–life balance. The survey, returned by 2248 out of 3370 GPs (67%) in the south-west of England, identified a high likelihood of quitting (37%), taking a career break (36%) or reducing hours (57%) within 5 years. Interviews highlighted three drivers of leaving general practice: (1) professional identity and value of the GP role, (2) fear and risk associated with service delivery and (3) career choices. The RAM panel deemed 24 out of 54 retention policies and strategies to be ‘appropriate’, with most also considered ‘feasible’, including identification of and targeted support for practices ‘at risk’ of workforce undersupply and the provision of formal career options for GPs wishing to undertake portfolio roles. Practices at highest risk of workforce undersupply within 5 years are those that have larger patient list sizes, employ more nurses, serve more deprived and younger populations, or have poor patient experience ratings. Actions for national organisations with an interest in workforce planning were identified. These included collection of data on the current scope of GPs’ portfolio roles, and the need for formal career pathways for key primary care professionals, such as practice managers.LimitationsThe survey, qualitative research and modelling were conducted in one UK region. The research took place within a rapidly changing policy environment, providing a challenge in informing emergent policy and practice.ConclusionsThis research identifies the basis for current concerns regarding UK GP workforce capacity, drawing on experiences in south-west England. Policies and strategies identified by expert stakeholders after considering these findings are likely to be of relevance in addressing GP retention in the UK. Collaborative, multidisciplinary research partnerships should investigate the effects of rolling out some of the policies and strategies described in this report.Study registrationThis study is registered as PROSPERO CRD42016033876 and UKCRN ID number 20700.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Diabetes and Hypertension among Patients Receiving Antiretroviral Treatment Since 1998 in Senegal: Prevalence and Associated Factors

ISRN AIDS ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Assane Diouf ◽  
Amandine Cournil ◽  
Khadidiatou Ba-Fall ◽  
Ndèye Fatou Ngom-Guèye ◽  
Sabrina Eymard-Duvernay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Antiretroviral Treatment ◽  
Cross Sectional Study ◽  
Older Age ◽  
World Health ◽  
Resource Constrained ◽  
Hiv Patients ◽  
Cross Sectional

Cardiovascular risk factors in people on antiretroviral treatment (ART) are poorly documented in resource-constrained settings. A cross-sectional study was conducted in 2009 to assess prevalence of diabetes and hypertension in a sample of 242 HIV-infected patients who had initiated ART between 1998 and 2002 in Dakar, Senegal (ANRS 1215 observational cohort). World Health Organization (WHO) criteria were applied to diagnose diabetes and hypertension. Multiple logistic regressions were used to identify factors associated with diabetes and hypertension. Patients had a median age of 46 years and had received ART for a median duration of about 9 years. 14.5% had diabetes and 28.1% had hypertension. Long duration of ART (≥119 months), older age, higher body mass index (BMI), and higher levels of total cholesterol were associated with higher risks of diabetes. Older age, higher BMI at ART initiation, and higher levels of triglycerides were associated with higher risk of hypertension. This study shows that diabetes and hypertension were frequent in these Senegalese HIV patients on ART. It confirms the association between duration of ART and diabetes and highlights the need to implement programs for prevention of cardiovascular risk factors in HIV patients from resource-constrained settings.

scholarly journals Predictors of Urinary Tract Infections in Children and Antibiotic Susceptibility Pattern in the Buea Health District, South West Region, Cameroon

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Che Pantalius Nji ◽  
Jules Clément Nguedia Assob ◽  
Jane-Francis Tatah Kihla Akoachere
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Trichomonas Vaginalis ◽  
Pediatric Population ◽  
Health Facilities ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Tract Infections

Urinary tract infections (UTI) are among the most common pediatric infections and if not promptly diagnosed and treated, it could cause long term complications. Worldwide and in Cameroon, little attention has been paid to this growing problem in the pediatric population. Identification of risk factors will contribute significantly to prevention. A cross-sectional case-control study was carried out in children ≤ 15 years to identify the risk factors of UTI, etiologic agents, and their antibiotic susceptibility. Samples (urine) were collected from in and outpatients with symptoms of UTI attending two health facilities in Buea. Controls were age- and sex-matched children in the community and those visiting these health facilities for unrelated reasons. Samples were analyzed by microscopy, culture, and antibiotic susceptibility of bacteria isolates tested by the disc diffusion technique. Questionnaires were administered to collect sociodemographic, clinical characteristics and data on risk factors. Odds ratios and bivariate and multivariate analyses were used to assess the relationship between predictors (symptoms and risk factors) and UTI. P < 0.05 was considered significant. A total of 405 participants (200 cases and 205 controls) were investigated. UTI prevalence was 12% in cases. From the UTI cases, bacteria was the major cause of infection, with E. coli (39.4%) predominating. Parasitic organisms, Trichomonas vaginalis (0.5%) and Schistosoma spp (0.5%), and yeast (6%) were also detected. Urinary urgency ( F = 4.98 , P = 0.027 ) and back pain ( F = 12.37 , P = 0.001 ) were associated to UTI following bivariate analysis. These parameters could be used to predict UTI in the pediatric population in the study area. Third generation cephalosporins: ceftriaxone (90.1%) and cefadroxil (85.4%) were the most effective and thus recommended for treatment.

scholarly journals Malnutrition and related risk factors in older adults from different health-care settings: an enable study

2019 ◽  
Vol 23 (3) ◽  
pp. 446-456 ◽  
Author(s):  
Eva Kiesswetter ◽  
Miriam G Colombo ◽  
Christa Meisinger ◽  
Annette Peters ◽  
Barbara Thorand ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Older Age ◽  
Dietary Behaviour ◽  
Individual Risk ◽  
Mobility Limitations ◽  
Cross Sectional ◽  
Living Situation ◽  
Poor Appetite ◽  
Individual Risk Factors

AbstractObjective:The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition.Design:Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m2 and/or weight loss of >3 kg in the previous 3–6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression.Setting:Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH).Participants:CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years.Results:Malnutrition prevalence was lower in CD (11 %) than in the other settings (16–19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors.Conclusions:The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.

Risk factors for foot ulcers—A cross sectional survey from a primary care setting in Brazil

2014 ◽  
Vol 8 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Maira Sayuri Sakay Bortoletto ◽  
Selma Maffei de Andrade ◽  
Tiemi Matsuo ◽  
Maria do Carmo Lourenço Haddad ◽  
Alberto Durán González ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Foot Ulcers ◽  
Cross Sectional Survey ◽  
Cross Sectional
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