scholarly journals The Charcot Foot: An Emerging Public Health Problem for African Diabetes Patients

Author(s):  
Zulfiqarali G. Abbas ◽  
J. K. Lutale ◽  
C. Formosa ◽  
A. Gatt ◽  
N. Chockalingam

Background: Although the awareness, diagnosis, management of the complications associated with diabetes have improved in African countries over the past decade, surveillance activities in Tanzania and anecdotal reports from other African countries have suggested an increased prevalence of Charcot Neuroarthropathy (CN) over the past few years. Aim: To characterize the epidemiology and the clinical burden of CN in a large diabetes population in Tanzania, and to evaluate outcomes of persons with the condition. Methods: This was a prospective analytic cohort study conducted between January 2013 through December 2015. Following informed consent, patients were followed at the outpatient clinic. Detailed clinical assessments and documented presence of diabetic peripheral neuropathy (DPN), macrovascular disease and microvascular disease were recorded. Education and counseling were part of the follow-up program. Results: 3271 ulcerations were presented at the clinic during the 3-year study period. 571 (18%) met the case definition for CN; all patients had Type 2 diabetes. The prevalence for each of the years 2013, 2014, and 2015 was 19/1192 (1.6%), 209/1044 (20%), and 343/1035 (34%), respectively; the increases in the slope of the trendline was statistically significant ( P < .001). Conclusion: The prevalence of CN is increasing in the Tanzanian diabetes patient population, and is strongly associated with neuropathy. CN can lead to severe deformity, disability, and amputation. Due to the risk of limb amputation, patients with diabetes must seek immediate care if signs or symptoms appear and avoid delay in seeking medical attention. Early diagnosis of CN by caregivers is extremely important for successful outcomes.

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Rafaella Fortini Queiroz Grenfell ◽  
Vanessa Silva-Moraes ◽  
Diana Taboada ◽  
Ana Carolina Alves de Mattos ◽  
Ana Karine Sarvel de Castro ◽  
...  

WorldwideSchistosomiasis mansonicontinues to be a serious public health problem. Over the past decades, control programmes have made remarkable progress in reducingS. mansoniinfections to a relatively low level in Brazil and African countries. Endemic regions are currently circumscribed in certain core areas where reinfection and repeated chemotherapy are frequent and, consequently, are related to residents with low parasite load. At present, diagnosis is predominately a key step for final disease control although low endemicity area residents are hardly detected by most of the available assays. In this paper, we review the current status and efforts made aiming at the improvement of diagnostic tools forS. mansoniin low endemicity infections. The establishment of diagnostic assays—simple, affordable, sensitive, and specific for field diagnosis ofS. mansoni—is essential and should be given high priority.


2021 ◽  

Distracted driving is defined in the Oxford English Dictionary as “the practice of driving a motor vehicle while engaged in another activity, typically one that involves the use of a mobile phone or other electronic device.” However, other distractions not involving the use of a cell phone or texting are important as well, contributing to this burgeoning public health problem in the United States. Examples include talking to other passengers, adjusting the radio or other controls in the car, and daydreaming. Distracted driving has been linked to increased risk of motor vehicle crashes (MVCs) in the United States, representing one of the most preventable leading causes of death for youth ages 16 to 24 years. Undoubtedly, the proliferation of cell phone, global positioning system (GPS), and other in-vehicle and personal electronic device use while driving has led to this rise in distracted driving prevalence. This behavior has impacted society—including individual and commercial drivers, passengers, pedestrians—in countless numbers of ways, ranging from increased MVCs and deaths to the enactment of new driving laws. In 2016, for example, 20 percent of all US pediatric deaths (nearly 4,000 children and adolescents) were due to fatal MVCs. It has been estimated that at any given time, more than 650,000 drivers are using cell phones or manipulating electronic devices while driving. In the United States, efforts are underway to reduce this driving behavior. In the past two decades, state and federal laws have specifically targeted cell phone use and texting while driving as priority areas for legal intervention. Distracted driving laws have become “strategies of choice” for tackling this public health problem, though their enforcement has emerged as a major challenge and varies by jurisdiction and location. Multimodal interventions using models such as the “three Es” framework—Enactment of a law, Education of the public about the law and safety practices, and Enforcement of the law—have become accepted practice or viewed as necessary steps to successfully change this behavior caused by distractions while driving. This Oxford Bibliographies review introduces these and other aspects (including psychological influences and road conditions) of distracted driving through a presentation of annotated resources from peer- and non-peer-reviewed literature. This selective review aims to provide policymakers, program implementers, and researchers with a reliable source of information on the past and current state of American laws, policies, and priorities for distracted driving.


PEDIATRICS ◽  
1952 ◽  
Vol 10 (2) ◽  
pp. 150-161
Author(s):  
FRED H. HOWARD ◽  
WILLIAM A. MERIWETHER

Forty-eight cases of fatty liver disease in infancy coming to autopsy over the past 10 years at Gorgas Hospital are reported. The diagnosis of this condition is extremely difficult clinically; liver biopsy is the only certain way of making the premortem diagnosis. In Panama, vomiting, diarrhea and fever are the most frequent presenting complaints. Physical findings of help are the stunted growth, fever, and possibly enlarged liver. Other findings seen commonly in the African cases, such as edema, glossitis and dermatosis, are usually not, seen. The essential pathologic finding is a markedly fatty liver. Pancreatic changes consisting of acinar atrophy were seen in some cases. The cause of the deficiency state appears to be an inadequate protein intake, and will not be simple to deal with, as poverty and ignorance, rather than neglect, would seem to be responsible for this disease. The prognosis is extremely poor, only 11 of the 48 patients surviving for more than 24 hours after medical attention was sought. It is probable that fatty liver disease in infants is relatively common in Panama but almost completely overlooked clinically.


2021 ◽  
Author(s):  
Amanuel Mulugeta ◽  
Atsede Assefa ◽  
Atsede Eshetie ◽  
Birhanie Asmare ◽  
Meseret Birhanie ◽  
...  

Abstract Background: Malaria is disease caused by plasmodium species and transmitted by the bite of female anopheles mosquito. Globally, it is still the major public health problem that causes morbidity and mortality especially in tropical and sub-tropical African countries including Ethiopia. The objective of this study was to assess the Six year trend of malaria at University of Gondar Specialized Referral Hospital, northwest Ethiopia, from 2014-2019Method: A retrospective study was conducted by reviewing the laboratory registration logbook at University of Gondar Specialized Referral Hospital by using data extraction tool. The data was analysized by SPSS version 20. Descriptive statistics was used to summarize the socio-demographic characteristics of study participants and presented by graphs, tables and texts. The binary logistic regression was also used test the association of trend of malaria and different factors like sex, age, year, and season. Result: From a total 17,500 malaria suspected patients, 1341 (7.7%) were confirmed for malaria and (47.2%), (45.6%) and (7.2%) were P.vivax, P. falciparum and mixed infection, respectively. P.vivax was the predominant species in the first three years and P. falciparum became the predominant species in the last three years. The trend prevalence was showed a fluctuated significantly decrement. It decreased by 68%, 60% and 69% in the year of 2017, 2018 and 2019 compare to 2014, respectively. The positivity rate were significantly higher in the males (1.41 times higher) than females. It was also significantly higher in lower age groups compare to the older age groups (> 54 years old). It was 1.60, 1.64, 2.45 and 1.82 times higher in the age group of < 5, 5-14, 15-24 and 25-54 years old, respectively.Conclusion: There has been a significant declining trend of malaria in the study area. However, it is still a major health problem and requires extra efforts for further reduction. Even, autumn was the season when the highest peak of malaria cases in was observed, there was high fluctuation from year to year. Therefore, control activities should be continued and strengthened manner in the study area considering these variability.


Author(s):  
Fernando Coelho Dias ◽  
Mateus Menezes Ribeiro ◽  
Camilla Oleiro Da Costa ◽  
Zayanna Christine Lopes Lindôso

Introdução: Atualmente, a obesidade é considerada um grave problema de saúde pública, pois além de ser uma doença, é um fator de risco para progressão e desenvolvimento de outras doenças crônicas não transmissíveis. Objetivo: Compreender a percepção de indivíduos com obesidade quanto à participação em papeis ocupacionais, grau de importância atribuído a cada papel e padrão de desempenho de papeis ocupacionais ao longo da vida. Método: Configura-se como um estudo transversal do tipo exploratório de caráter descritivo, com análise quantitativa dos dados. Como instrumento, utilizou-se a Lista de Identificação de Papéis Ocupacionais. Resultados: A amostra foi composta por 65 indivíduos com obesidade, 87,7% (n=57) era do sexo feminino e 12,3% (n=8) do sexo masculino, tendo como média de idade 42 anos e 9 meses. Constatou-se que o papel mais comum no passado foi o de estudante e com relação ao presente e futuro, os papeis mais citados foram os de serviço doméstico e membro da família. Quanto ao grau de importância, identificou-se que os indivíduos valorizam os papeis ocupacionais, atribuindo maior valorização aos papeis de membro da família e trabalho, e menor proporção de valor ao papel de participação em organizações. Conclusão: A condição de obesidade pode interferir no modo como o indivíduo se envolve e desempenha suas ocupações, evidenciando a terapia ocupacional como uma estratégia importante no enfrentamento da obesidade. AbstractIntroduction: Currently, obesity is considered a serious public health problem, since it is also a disease, it is a risk factor for progression and development of other chronic non-communicable diseases. Objective: To understand the perception of individuals with obesity regarding the participation in occupational roles throughout life, about the degree of importance attributed to each role, and in a complementary way to identify the performance pattern of occupational roles in Long life. Method: It is configured as a cross-sectional exploratory study of descriptive character, with quantitative analysis of the data, as an instrument used the identification list of occupational roles. Results: The sample consisted of 65 obese individuals. Of these, 87.7% (n = 57) were females and 12.3% (n = 8) were males, with a mean age of 42 years 9 months. It was found that the most common role in the past was that of student and in relation to the present and future the most cited roles were those of domestic service and family member. As to the degree of importance, it was identified that the individuals value the occupational roles, attributing greater value to the roles of family members and work, and less appreciation of the role of participation in organizations. Conclusion: The condition of obesity can interfere in the way the individual engages and performs his occupations, thus placing the occupational therapy professional as an important member in coping with obesity.Key words: Obesity, Activities of Daily Living, Occupations, Occupational Therapy.ResumenIntroducción: Actualmente, la obesidad se considera un grave problema de salud pública, ya que es también una enfermedad, es un factor de riesgo para la progresión y el desarrollo de otras enfermedades crónicas no transmisibles. Objetivo: comprender la percepción de los individuos con obesidad con respecto a la participación en los roles ocupacionales a lo largo de la vida, sobre el grado de importancia atribuido a cada función, y de manera complementaria para identificar el patrón de desempeño de los roles ocupacionales en Larga vida. Método: se configura como un estudio exploratorio transversal de carácter descriptivo, con análisis cuantitativo de los datos, como instrumento utilizó la lista de identificación de roles ocupacionales. Resultados: la muestra consistió en 65 individuos obesos. De ellos, 87,7% (n = 57) fueron hembras y 12,3% (n = 8) fueron varones, con una edad media de 42 años 9 meses. Se descubrió que el papel más común en el pasado era el de los estudiantes y en relación con el presente y el futuro, los papeles más citados eran los del servicio doméstico y el miembro de la familia. En cuanto al grado de importancia se identificó que los individuos valoran los papeles ocupacionales, atribuyendo mayor valoración a los papeles de miembro de la familia y trabajo, y menor valorización al papel de participación en organizaciones. Conclusión: la condición de la obesidad puede interferir en la forma en que el individuo se involucra y realiza sus ocupaciones, colocando así al profesional de la terapia ocupacional como un miembro importante para hacer frente a la obesidad.Palabras clave: Obesidad, Actividades Cotidianas, Ocupaciones, Terapia Ocupacional.  


2020 ◽  
Vol 15 (3) ◽  
pp. 209-217
Author(s):  
Vincent PK Titanji

The ongoing SARS CoV-2 pandemic also known as COVID-19 is a highly infectious and deadly disease that has disrupted socio- economic activities  and killed over 500 000 people worldwide during the past six months since it first erupted in Wuhan China in December 2019.While intensive efforts  are under way in the developed countries to find a vaccine and cure for the disease, Cameroon and other African countries should not fold their hands and wait , but join the search for new remedies including from cures from traditional herbs while rigorously applying barrier and social  distancing measures that have proven effective in in curbing the spread of the disease. Herein we enumerate a short list of research priorities that are feasible in our milieu and that could improve on diagnostics, treatment and prevention of the disease in the short and medium terms. Key Words: SARS CoV-2, COVID-19, research, diagnostics, medicinal plants, traditional medicine, pandemic, Cameroon.


2019 ◽  
Vol 8 (1) ◽  
pp. 30
Author(s):  
Johanna Chandra ◽  
Laksmiari Setyowati ◽  
Setyabudi Setyabudi

Background: Cigarette smoking is a public health problem that may influence physical properties of dental composites. Surface roughness is one of the physical properties of restorative materials that can influence their success. The use of nanofilled and nanohybrid composites in dentistry has substantially increased over the past few years. Purpose: The purpose of this study was to evaluate the surface roughness of nanofilled and nanohybrid composite resins exposed to kretek cigarette smoke. Methods: Twelve cylindrical specimens were prepared of each material and divided into two groups (n=6). For the control groups, the specimens were immersed in distilled water for 24 hours at 37oC and the water was renewed daily. For the experimental groups, the specimens were exposed daily to kretek cigarette smoke, then washed and stored in distilled water at 37oC. After 21 days, specimens were measured using a Surface Roughness Tester and the data was statistically analyzed. Result: Independent-T Test revealed that there were statistically significant differences in the surface roughness between control and experimental groups both nanofilled and nanohybrid, and between experimental groups nanofilled and nanohybrid. Conclusion: The exposure to kretek cigarette smoke can significantly increase the surface roughness of nanohybrid composites more than nanofilled composites.


2015 ◽  
Vol 9 (06) ◽  
pp. 635-641 ◽  
Author(s):  
José Paulo Langa ◽  
Cynthia Sema ◽  
Nilsa De Deus ◽  
Mauro Maria Colombo ◽  
Elisa Taviani

Introduction: Africa is increasingly affected by cholera. In Mozambique, cholera appeared in the early 1970s when the seventh pandemic entered Africa from the Indian subcontinent. In the following decades, several epidemics were registered in the country, the 1997–1999 epidemic being the most extended. Since then, Mozambique has been considered an endemic area for cholera, characterized by yearly outbreaks occurring with a seasonal pattern.. At least three pandemic variants are thought to have originated in the Indian subcontinent and spread worldwide at different times. To understand the epidemiology of cholera in Mozambique, whether the disease re-emerges periodically or is imported by different routes of transmission, we investigated clinical V. cholerae O1 isolated during 1997–1999 and 2012–2014 epidemics. Methodology: By detecting and characterizing seven genetic elements, the mobilome profile of each isolate was obtained. By comparing it to known seventh pandemic reference strains, it was possible to discern among different V. cholerae O1 variants active in the country. Results: During 1997–1999, epidemic strains showed two different genetic profiles, both related to a pandemic clone that originated from India and was reported in other African countries in the 1990s. Isolates from 2012–2014 outbreaks showed a genetic background related to the pandemic strains currently active as the prevalent causative agent of cholera worldwide. Conclusions: Despite cholera being endemic in Mozambique, the epidemiology of the disease in the past 20 years has been strongly influenced by the cholera seventh pandemic waves that originated in the Indian subcontinent.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021845 ◽  
Author(s):  
Yang Gao ◽  
Weicong Cai ◽  
Lijie Gao ◽  
Jingjing Wang ◽  
Jiehui Liang ◽  
...  

ObjectivesThis study aimed to investigate the epidemiological characteristics and preliminarily explore possible risk factors of physical activity-related injury (PARI) occurrences among Chinese university students via a multicentre mixed survey.DesignCross-sectional study.ParticipantsA total of 4758 undergraduates graded 1–3 in nine universities in three Chinese cities were enrolled via cluster random sampling and completed the self-administered online questionnaires during March and April 2017.Main outcome measuresPARI in the past 12 months.ResultsOf the 4758 participants, 1081 sustained PARI in the past 12 months, with an overall PARI incidence rate of 22.7% (27.3% (367/1343) in males and 20.9%(714/3415) in females). Around one-quarter of the injured (26.4%) suffered from PARI over at least three episodes. More than half of the injured subjects experienced physical activity (PA) absenteeism and sought medical attention. All PA indicators were significantly and positively associated with PARI, with a frequency of sports and leisure-time vigorous-intensity PA (VPA) participation being the strongest (adjusted OR: 1.079, 95% CI: 1.018 to 1.144). Moreover, males (OR=1.199), Shantou students (OR=4.239), year 1 students (OR=1.287), university and other sports team members (OR=1.717–2.360) and those with insufficient sleep time (OR=1.262–1.333) were also at a higher risk of PARI.ConclusionsPARI is prevalent among university students in China. The frequency of sports and leisure-time VPA participation was most strongly associated with PARI among all PA indicators. These data can inform future programmes for injury intervention among university students. Safety issues should also be emphasised when promoting PA among the public to reduce PARI.


Author(s):  
Laura A. Meek

This research article critically interrogates the implications and unintended consequences of the World Health Organization’s purported elimination of leprosy as a public health problem. I explore how leprosy has been portrayed (for nearly a century) as something from the past, recalcitrantly lingering on into the present, but surely about to be gone—a temporal framing I call the ‘grammar of leprosy’. I recount the experiences of Daniel, my interlocutor in Tanzania, whose existence became a problem for his doctors. This problem they ultimately resolved by fabricating negative test results in order to record what they already knew: leprosy had been eliminated. I also analyse how researchers working for Novartis (the supplier of leprosy’s cure) continue to push for an always imminent ‘elimination’, while field researchers repeatedly caution about the potential problems of this approach. Finally, I reveal how the grammar of leprosy operates through a complex set of temporal politics, pulling into its orbit and being enabled by multiple interwoven temporalities. I conclude that—due to this grammar, the impossible subjects it produces, and the temporal politics through which it operates—leprosy elimination campaigns may have dire consequences for the lives of people with leprosy today, impeding rather than enabling treatment.


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