scholarly journals Lung ultrasound patterns in pediatric pneumonia in Mozambique and Pakistan

2020 ◽  
pp. 00518-2020
Author(s):  
Amy Sarah Ginsburg ◽  
Pio Vitorino ◽  
Zunera Qasim ◽  
Jennifer L. Lenahan ◽  
Jun Hwang ◽  
...  

ObjectiveImproved pneumonia diagnostics are needed, particularly in resource-constrained settings. Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing pneumonia. The objective was to explore LUS patterns associated with pediatric pneumonia.MethodsWe conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at two district hospitals in Mozambique and Pakistan. We assessed LUS and chest radiograph (CXR) examinations, and viral and bacterial nasopharyngeal carriage, and performed a secondary analysis of LUS patterns.ResultsLUS demonstrated a range of distinctive patterns that differed between children with and without pneumonia and between children in Mozambique versus Pakistan. The presence of LUS consolidation or interstitial patterns was more common in children with chest-indrawing pneumonia than in those without pneumonia. Consolidations were also more common among those with only bacterial but no viral carriage detected (50.0%) than among those with both (13.0%) and those with only virus detected (8.3%;p-value 0.03). LUS showed high interrater reliability among expert LUS interpreters for overall determination of pneumonia (κ=0.915), consolidation (κ=0.915), and interstitial patterns (κ=0.901), but interrater reliability between LUS and CXR for detecting consolidations was poor (κ=0.159, Pakistan) to fair (κ=0.453, Mozambique).DiscussionPattern recognition was discordant between LUS and CXR imaging modalities. Further research is needed to define and standardise LUS patterns associated with pediatric pneumonia and to evaluate the potential value of LUS as a reference standard.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amy Sarah Ginsburg ◽  
Imran Nisar ◽  
Lola Madrid ◽  
Jennifer L. Lenahan ◽  
Benazir Balouch ◽  
...  

AbstractLung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing and managing pneumonia. We sought to explore serial LUS examinations in children with chest-indrawing pneumonia in resource-constrained settings and compare their clinical and LUS imaging courses longitudinally. We conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at 2 district hospitals in Mozambique and Pakistan. We assessed serial LUS at enrollment, 2, 6, and 14 days, and performed a secondary analysis of enrolled children’s longitudinal clinical and imaging courses. By Day 14, the majority of children with chest-indrawing pneumonia and consolidation on enrollment LUS showed improvement on follow-up LUS (100% in Mozambique, 85.4% in Pakistan) and were clinically cured (100% in Mozambique, 78.0% in Pakistan). In our cohort of children with chest-indrawing pneumonia, LUS imaging often reflected the clinical course; however, it is unclear how serial LUS would inform the routine management of non-severe chest-indrawing pneumonia.


2018 ◽  
Vol 5 (1) ◽  
pp. e000340 ◽  
Author(s):  
Jennifer L Lenahan ◽  
Giovanni Volpicelli ◽  
Alessandro Lamorte ◽  
Fyezah Jehan ◽  
Quique Bassat ◽  
...  

IntroductionPneumonia is the leading infectious cause of death among children under 5 years of age worldwide. However, pneumonia is challenging to diagnose. Lung ultrasound (LUS) is a promising diagnostic technology. Further evidence is needed to better understand the role of LUS as a tool for the diagnosis of childhood pneumonia in low-resource settings.Methods and analysisThis study aims to pilot LUS in Mozambique and Pakistan and to generate evidence regarding the use of LUS as a diagnostic tool for childhood pneumonia. Children with cough <14 days with chest indrawing (n=230) and without chest indrawing (n=40) are enrolled. World Health Organization Integrated Management of Childhood Illness assessment is performed at enrolment, along with a chest radiograph and LUS examination. Respiratory and blood specimens are collected for viral and bacterial testing and biomarker assessment. Enrolled children are followed for 14 days (in person) and 30 days (phone call) post-enrolment with LUS examinations performed on Days 2, 6 and 14. Qualitative and quantitative data are also collected to assess feasibility, usability and acceptability of LUS among healthcare providers and caregivers. The primary outcome is LUS findings at enrolment with secondary outcomes including patient outcomes, repeat LUS findings, viral and bacterial test results, and patient status after 14 and 30 days of follow-up.Ethics and disseminationThis trial was approved by the Western Institutional Review Board as well as local ethics review committees at each site. We plan to disseminate study results in peer-reviewed journals and international conferences.Trial registration numberNCT03187067.


2020 ◽  
Vol 1 (1) ◽  
pp. 8
Author(s):  
Fera Riswidautami Herwandar ◽  
Russiska Russiska ◽  
Intan Maharani Fakhrudin

Permasalahan kesehatan pada remaja yang menduduki persentasi terbesar dibanding yang lainnya adalah gangguan menstruasi. Gangguan pada siklus menstruasi (durasi perdarahan yang lebih lama dan ketidakteraturan siklus) disebabkan oleh beberapa faktor, salah satunya ialah stres. Stres diketahui sebagai faktor-faktor penyebab (etiologi) terjadinya gangguan siklus menstruasi. Stres akan memicu pelepasan hormon kortisol dimana hormon kortisol ini dijadikan tolak ukur untuk melihat derajat stres seseorang. Hormon kortisol diatur oleh hipotalamus otak dan kelenjar pituitari, dengan dimulainya aktivitas hipotalamus, hipofisis mengeluarkan FSH dan proses stimulus ovarium akan menghasilkan estrogen. Penelitian yang dilakukan oleh Pelayanan Kesehatan Peduli Remaja (PKPR) dibawah naungan World Health Organization (WHO) menyebutkan bahwa permasalahan remaja di Indonesia adalah seputar permasalahan yang mengenai gangguan menstruasi. Tujuan penelitian ini adalah untuk mengetahui hubungan tingkat stres dengan siklus menstruasi pada mahasiswa kebidanan tingkat I di STIKES Kuningan tahun 2019. Penelitian ini menggunakan desain penelitian kuantitatif dengan pendekatan Cross Sectional. Populasi dalam penelitian ini adalah mahasiswa kebidanan tingkat I di STIKES Kuningan tahun 2019 sebanyak 41 responden. Analisis yang digunakan analisis univariat dan bivariat dengan menggunakan uji Rank Spearman. Hasil penelitian menunjukkan adanya hubungan tingkat stres dengan siklus menstruasi pada mahasiswa kebidanan tingkat I di STIKES Kuningan, dari 41 responden terdapat 18 (44%) responden yang mengalami stres sedang, pada siklus menstruasi yang tidak teratur terdapat 25 (61%) responden. Hasil uji rank spearman,  yakni p value = 0,01 (<0,05) yang ada hubungan antara tingkat stres dengan siklus menstruasi. Berdasarkan hasil penelitian penulis dapat menyimpulkan bahwa terdapat hubungan yang signifikan antara tingkat stres dengan siklus menstruasi pada mahasiswa kebidanan tingkat I di STIKES Kuningan tahun 2019. Bagi institusi Pendidikan khususnya Program Studi Diploma III Kebidanan diharapkan dapat membuat sebuah program edukasi mengenai manajemen stres pada remaja yang bisa dilakukan secara rutin di luar jadwal perkuliahan.  


Author(s):  
Dini Kesumah Dini Kesumah

ABSTRACT According to World Health Organization Health Organization (WHO) in 2005 showed 49% of deaths occur in children under five in developing countries. Nutritional problems can not be done with the medical and health care approach alone. Causes related to malnutrition that maternal education, socioeconomic families, poor environmental sanitation, and lack of food supplies. This study aims to determine the relationship between education and socioeconomic status of families with nutrition survey using a cross sectional analytic approach, with a population of all mothers of children under five who visited the health center in Palembang Keramasan Accidental sampling Sampling the number of samples obtained 35 respondents. Variables include the study independent and dependent variables and univariate analysis using Chi-Square test statistic with a significance level α = 0.05. The results from 35 respondents indicate that highly educated mothers earned as many as 16 people (45.7%), and middle and upper income families as many as 12 people (34.3%) and bivariate test results show that highly educated respondents toddler nutritional status good for 81.3% (13 people) is larger than the less educated respondents balitanya good nutritional status 26.3% (5 persons) as well as respondents who have middle and upper socioeconomic families with good nutritional status of children at 91.7% ( 11 people) is larger when compared to respondents who have family socioeconomic medium with good nutritional status of children at 30.4% (7 people). Statistical tests show that education has a significant relationship with nutritional status of children P value = 0.004 and socioeconomic families have a meaningful relationship with nutritional status of children P value = 0.002. Based on the results of the study suggested the health professionals in the health center should further improve the education, information about the importance of nutrition to the development of the child in the mothers through the selection and processing of good food and a good diet through health centers and integrated health.   ABSTRAK  Menurut badan kesehatan World Health Organization (WHO) tahun 2005 menunjukkan 49% kematian yang terjadi pada anak dibawah umur lima tahun di negara berkembang. Masalah gizi ini tidak dapat dilakukan dengan pendekatan medis dan pelayanan kesehatan saja. Penyebab yang berhubungan dengan kurang gizi yaitu pendidikan ibu, sosial ekonomi keluarga, sanitasi lingkungan yang kurang baik,dan kurangnya persediaan pangan. Penelitian ini bertujuan untuk mengetahui hubungan antara pendidikan dan sosial ekonomi keluarga dengan status gizi balita dengan menggunakan metode survei analitik pendekatan secara Cross Sectional, dengan populasi semua ibu yang memiliki anak balita yang berkunjung ke Puskesmas Keramasan Palembang dengan pengambilan sampel secara Accidental Sampling diperoleh jumlah sampel 35 responden. Variabel penelitian meliputi variabel independen dan dependen serta analisis univariat menggunakan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian ini menunjukkan dari 35 responden didapatkan ibu yang berpendidikan tinggi sebanyak 16 orang  (45,7%), dan keluarga yang berpenghasilan menengah keatas sebanyak 12 orang (34,3%) dan hasil uji bivariat menunjukkan bahwa responden yang berpendidikan tinggi status gizi balitanya baik sebesar 81,3% (13 orang) lebih besar bila dibanding responden yang berpendidikan rendah status gizi balitanya baik 26,3% (5 orang) serta responden yang mempunyai sosial ekonomi keluarga menengah keatas dengan status gizi balita baik sebesar 91,7% (11 orang) lebih besar bila dibanding responden yang mempunyai sosial ekonomi keluarga menengah kebawah dengan status gizi balita baik sebesar 30,4% (7 orang). Uji statistik menunjukkan bahwa pendidikan mempunyai hubungan yang bermakna dengan status gizi balita P value = 0,004 dan sosial ekonomi keluarga mempunyai hubungan yang bermakna dengan status gizi balita P value = 0,002. Berdasarkan hasil penelitian disarankan pada petugas kesehatan di Puskesmas hendaknya lebih meningkatkan penyuluhan-penyuluhan tentang pentingnya gizi terhadap tumbuh kembang anak pada ibu-ibu melalui cara pemilihan dan pengolahan bahan makanan yang baik serta pola makanan yang baik melalui kegiatan Puskesmas dan Posyandu.


Author(s):  
Leny Leny

ABSTRACT Prenatal care is health care by health personnel to care the pregnant according to standards. Worlrd Health Organization (WHO) estimates more than 500.000 women die during pregnancy or childbirth. Maternal mortality in Indonesia is 307 per 100,000 live births. The quantity of pregnant women’s visit in Kabupaten Banyuasin in 2009 of 89.1%. The purpose of this study to determine the relationship between education and occupation with prenatal care at Puskesmas Mariana  Kecamatan Banyuasin I Kabupaten Banyuasin in 2011. This study uses analytic approach survey by Cross Sectional methods, the population are 1.946 pregnant women and the samples as many as 332 people. The results of univariate analysis study of pregnant women who are higher education as much as 45.2%, and  low maternal education as much as 54.8%. In pregnant women who work of 43.4%, and pregnant women who do not work for 56.6%. From the results of bivariate analysis and Chi-Square statistical tests found a significant association between education of pregnant women with prenatal care with P Value = 0.000, and there was a significant association between occupation of pregnant women with prenatal care with P Value = 0.000. Can be concluded that there is a relationship between education and occupation of pregnant women with prenatal care. Expected to health workers to provide counseling on the importance of prenatal care in pregnant women and expected future studies may explore again the factors associated with prenatal care with the different variables.   ABSTRAK Pemeriksaan kehamilan adalah pelayanan kesehatan oleh tenaga kesehatan untuk memeriksakan ibu hamil sesuai standar. World Health Organization (WHO) memperkirakan lebih dari 500.000 ibu pertahunnya meninggal saat hamil atau bersalin. AKI di Indonesia 307 per 100.000 kelahiran hidup. Jumlah kunjungan ibu hamil di Kabupaten Banyuasin tahun 2009 sebesar 89,1%. Tujuan penelitian ini untuk mengetahui hubungan antara pendidikan dan pekerjaan dengan pemeriksaan kehamilan di Puskesmas Mariana Kecamatan Banyuasin I Kabupaten Banyuasin tahun  2011. Penelitian ini menggunakan metode survey analitik dengan pendekatan Cross Sectional, populasi ibu hamil dengan jumlah 1.946 orang dan jumlah sampel sebanyak 332 orang. Hasil penelitian Analisa Univariat adalah ibu hamil yang pendidikan tinggi sebanyak 45,2%, dan pendidikan rendah ibu hamil sebanyak 54,8%. Pada variabel pekerjaan ibu hamil yang bekerja sebesar 43,4%, dan ibu hamil yang tidak bekerja sebesar 56,6%. Dari hasil analisa bivariat dan uji statistik Chi-Square  didapatkan hubungan yang bermakna antara pendidikan ibu hamil dengan pemeriksaan kehamilan dengan  P Value = 0,000, dan ada hubungan yang bermakna antara pekerjaan ibu hamil dengan pemeriksaan kehamilan dengan P Value = 0,000. Dapat disimpulkan bahwa ada hubungan antara pendidikan dan pekerjaan ibu hamil dengan pemeriksaan kehamilan. Diharapkan kepada petugas kesehatan agar dapat memberikan penyuluhan tentang pentingnya pemeriksaan pada ibu hamil dan diharapkan penelitian yang akan datang dapat menggali lagi faktor-faktor yang berhubungan dengan pemeriksaan kehamilan dengan variabel yang berbeda.


2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Dina Ardyana ◽  
Erma Puspita Sari

Latar belakang: Berdasarkan data World Health Organization (WHO) setiap tahunnya kira-kira 3%(3,6 juta) dari 120 juta bayi baru lahir mengalami asfiksia,hampir 1 juta bayi ini meninggal. Di Amerika diperkirakan 12.000 bayi meninggal atau menderita kelainan akibat asfiksia perinatal.Sebagian kasus Asfiksia Neonatorum pada bayi baru lahir merupakan kelanjutan dari asfiksia intrauterin. Maka dari itu,diagnosa dini pada penderita Asfiksia merupakan arti penting dalam merencanakan resusitasi yang akan dilakukan.Setelah bayi lahir, diagnosa asfiksia dapat dilakukan dengan menetapkan nilai APGAR. Tujuan: diketahuinya hubungan lilitan tali pusat,partus lama dan plasenta previa dengan kejadian Asfiksia neonatorum di Rumah Sakit “P” Palembang Tahun 2018. Metode: Jenis penelitian yang digunakan adalah survey analitik dengan pendekatan cross sectional. Populasi dalam penelitian seluruh ibu bersalin di zal kebidanan di Rumah Sakit “P” Palembang pada tahun 2018 yang berjumlah 820 orang. Hasil: Hasil analisis univariat diketahui yang mengalami asfiksia neonatorum sebanyak 20 responden (22,5%),yang mengalami plasenta previa sebanyak 15 responden(16,9%),yang mengalami partus lama sebanyak 20 responden (22,5%) dan yang mengalami lilitan tali pusat sebanyak 27 responden (30,3%).Sedangkan hasil uji chi square menunjukan ada hubungan plasenta previa dengan kejadian asfiksia neonatorum dengan p value = 0,000,ada hubungan partus lama dengan kejadian asfiksia neonatorum dengan p value = 0,000,dan ada hubungan lilitan tali pusat dengan kejadian asfiksia neonatorum dengan p value = 0,000. Saran: kepada Pimpinan Rumah Sakit untuk meningkatkan mutu pelayanan kesehatan khususnya mengenai bahaya asfiksia neonatorum. Kata kunci : Lilitan Tali Pusat,Partus Lama,Plasenta Previa,Asfiksia Neonatorum


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Pojchanun Kanitthamniyom ◽  
Pei Yun Hon ◽  
Aiwu Zhou ◽  
Mohammad Yazid Abdad ◽  
Zhi Yun Leow ◽  
...  

AbstractCarbapenemase-producing Enterobacteriaceae (CPE) are a group of drug-resistant Gram-negative pathogens that are classified as a critical threat by the World Health Organization (WHO). Conventional methods of detecting antibiotic-resistant pathogens do not assess the resistance mechanism and are often time-consuming and laborious. We have developed a magnetic digital microfluidic (MDM) platform, known as MDM Carba, for the identification of CPE by measuring their ability to hydrolyze carbapenem antibiotics. MDM Carba offers the ability to rapidly test CPE and reduce the amount of reagents used compared with conventional phenotypic testing. On the MDM Carba platform, tests are performed in droplets that function as reaction chambers, and fluidic operations are accomplished by manipulating these droplets with magnetic force. The simple droplet-based magnetic fluidic operation allows easy system automation and simplified hands-on operation. Because of the unique “power-free” operation of MDM technology, the MDM Carba platform can also be operated manually, showing great potential for point-of-care testing in resource-limited settings. We tested 27 bacterial isolates on the MDM Carba platform, and the results showed sensitivity and specificity that were comparable to those of the widely used Carba NP test. MDM Carba may shorten the overall turnaround time for CPE identification, thereby enabling more timely clinical decisions for better clinical outcomes. MDM Carba is a technological platform that can be further developed to improve diagnostics for other types of antibiotic resistance with minor modifications.


2021 ◽  
Vol 12 ◽  
pp. 215013272110133
Author(s):  
Samar Fares ◽  
Merihan M. Elmnyer ◽  
Shimaa Sabry Mohamed ◽  
Radwa Elsayed

Introduction COVID-19 pandemic has affected the whole world, especially the frontline worriers. To get shielded through this war, the world is racing to reach and manufacture COVID-19 vaccines. Vaccination hesitancy is one of the significant obstacles to global health. Objectives This study aimed to assess the perception and attitude of healthcare workers in Egypt toward COVID-19 vaccines, acknowledge the determinants of their attitude, and the factors that could increase the acceptance of the vaccine. Methods an observational web-based anonymous survey was conducted on 385 Egyptian healthcare workers in different governorates. The questionnaire-based on Vaccine Hesitancy Survey Questions of the World Health Organization was available in Arabic and English languages and was tested for reliability. Results Regarding vaccination decision, 51% of the participants were undecided, 28% refused, and 21% accepted vaccination. Reasons for vaccine acceptance mainly were risks of COVID-19 (93%), safety (57.5%), and effectiveness (56.25%) of the vaccine. Simultaneously, the reasons for vaccine hesitancy were the absence of enough clinical trials (92.4%) and fear of side effects of the vaccine (91.4%). The leading factor that could increase vaccination acceptance among the participants was to get sufficient and accurate information about the available vaccines. The participants revealed a high mean level of concern for COVID-19 vaccines’ safety (3.8 of 5) that differs significantly among the different study groups ( P-value .002). Conclusion Despite the COVID-19 pandemic, only approximately 21% of Egyptian healthcare workers in our study accepted the COVID-19 vaccination. Vaccine hesitancy represents a major barrier to implementing vaccination programs.


2003 ◽  
Vol 182 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Petros Skapinakis ◽  
Glyn Lewis ◽  
Venetsanos Mavreas

BackgroundUnexplained fatigue has been extensively studied but most of the samples used were from Western countries.AimsTo present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care.MethodSecondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview.ResultsThe prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17–4.33) and 15.05 (95% CI 10.85–20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries.ConclusionsIn less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.


2019 ◽  
Vol 2 (1) ◽  
pp. 57
Author(s):  
Jumiati Jumiati

Pendahuluan : Abortus menjadi masalah yang penting dalam kesehatan masyarakat karena berpengaruh terhadap morbiditas dan mortalitas maternal. Berdasarkan data World Health Organization (WHO) tahun 2016, sekitar 830 wanita meninggal akibat komplikasi terkait kehamilan di seluruh dunia setiap hari. Selama 2010–2014, diperkirakan 56 juta abortus terjadi setiap tahun di seluruh dunia. Tujuan : untuk mengetahui faktor-faktor yang berhubungan dengan abortus di RSU Mutia Sari Duri periode 2017. Metode : penelitian ini menggunakan survei analitik dengan pendekatan cross sectional. Populasi penelitian ini adalah seluruh ibu hamil yang mengalami abortus di RSU Mutia Sari Duri periode 2017 yang berjumlah 86 orang. Sampel dalam penelitian ini adalah total sampling  yaitu seluruh populasi. Uji statistik yang digunakan adalah uji statistik Chi-square. Hasil : data yang diperoleh dari hasil uji statistik menunjukkan ada hubungan jarak kehamilan dengan abortus didapat hasil p value 0,04 (p<0,05), tidak ada hubungan usia dengan abortus didapat hasil p value 0,48 (p>0,05), ada hubungan paritas dengan abortus didapat hasil p value 0,03 (p<0,05), dan ada hubungan pekerjaan dengan abortus didapat hasil p value 0,04 (p<0,05).Kesimpulan : penelitian ini adalah ada hubungan jarak kehamilan, paritas dan pekerjaan ibu hamil dengan abortus dan tidak ada hubungan usia ibu hamil dengan abortus di RSU Mutia Sari Duri periode 2017.


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