Regional and income disparities in treatment and drug adherence of patients with dyslipidemia: a retrospective cohort study in South Korea, 2003–2015

Abstract Backgrounds Health disparities represent a major public health problem that needs to be addressed, and a variety of factors, including geographical location and income, can contribute to these disparities. Although previous studies have suggested that health differs by region and income, evidence on the difference in treatment rate is relatively insufficient. To identify differences in prescription rates by region and income in patients with dyslipidemia. Methods Using data from the National Health Insurance Service senior cohort, we included older adults who were diagnosed with dyslipidemia in Korea from 2003 to 2015. Overall prescription rate was determined for patients with dyslipidemia. In addition, medication possession ratio and a defined daily dose were analyzed in patients who were prescribed statins. A generalized estimating equation Poisson model was used to assess differences in prescription rates. Results Patients living in rural areas (Chungcheong-do, Jeolla-do, and Gyeongsang-do) had a significantly higher prescription rate than those in metropolitan cities. Unlike the prescription rate, the drug adherence was significantly higher in Seoul, Gyeonggi-do, and Gangwon-do but lower in Jeolla-do and Gyeongsang-do than in metropolitan cities. Patients with low income had lower prescription rates than those with high income, but this difference was not statistically significant. Conclusion Our findings demonstrate differences in the treatment rates of patients with dyslipidemia by region and income. Appropriate interventions are needed in vulnerable regions and groups to increase the treatment rate for patients with dyslipidemia.

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Dynamic Oral Texture Properties of Selected Indigenous Complementary Porridges Used in African Communities

Foods ◽

10.3390/foods8060221 ◽

2019 ◽

Vol 8 (6) ◽

pp. 221 ◽

Cited By ~ 3

Author(s):

James Makame ◽

Tanita Cronje ◽

Naushad M. Emmambux ◽

Henriette De Kock

Keyword(s):

Young Children ◽

Low Income ◽

Nutrient Intake ◽

Control Method ◽

Protein Energy Malnutrition ◽

Public Health Problem ◽

Major Public Health Problem ◽

Texture Properties ◽

Protein Energy ◽

Infants And Young Children

Child malnutrition remains a major public health problem in low-income African communities, caused by factors including the low nutritional value of indigenous/local complementary porridges (CP) fed to infants and young children. Most African children subsist on locally available starchy foods, whose oral texture is not well-characterized in relation to their sensorimotor readiness. The sensory quality of CP affects oral processing (OP) abilities in infants and young children. Unsuitable oral texture limits nutrient intake, leading to protein-energy malnutrition. The perception of the oral texture of selected African CPs (n = 13, Maize, Sorghum, Cassava, Orange-fleshed sweet potato (OFSP), Cowpea, and Bambara) was investigated by a trained temporal-check-all-that-apply (TCATA) panel (n = 10), alongside selected commercial porridges (n = 19). A simulated OP method (Up-Down mouth movements- munching) and a control method (lateral mouth movements- normal adult-like chewing) were used. TCATA results showed that Maize, Cassava, and Sorghum porridges were initially too thick, sticky, slimy, and pasty, and also at the end not easy to swallow even at low solids content—especially by the Up-Down method. These attributes make CPs difficult to ingest for infants given their limited OP abilities, thus, leading to limited nutrient intake, and this can contribute to malnutrition. Methods to improve the texture properties of indigenous CPs are needed to optimize infant nutrient intake.

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Antiparasitic phytotherapy perspectives, scope and current development

Infectio ◽

10.22354/in.v23i2.777 ◽

2019 ◽

Vol 23 (2) ◽

pp. 189 ◽

Cited By ~ 3

Author(s):

Jhon Carlos Castaño Osorio ◽

Alejandra María Giraldo García

Keyword(s):

Low Income ◽

Public Health Problem ◽

Cost Effective ◽

Prolonged Treatment ◽

Major Public Health Problem ◽

Middle Income ◽

Middle Income Countries ◽

Commercial Markets ◽

Health And Economic Development ◽

New Treatments

Tropical protozoan diseases are currently a major public health problem throughout the world and are strongly linked with poverty, this combined with a lack of commercial markets for potential drugs has created a large burden on the health and economic development of low-income and middle-income countries in Africa, Asia, and the Americas. Due to the low research interest and the high increase of resistance against the existing treatments, as well as increasing inefficiency, toxicity, prolonged treatment schedules and costs, there is an urgent need for cost-effective, safe and easy-to-administer, new effective compounds with novel mechanisms of action. Several studies of crude plant extracts have already identified potential compounds to treat Chagas’ disease, Leishmaniasis, Toxoplasmosis, Giardiasis, and Malaria among other protozoan parasites. Natural compounds of medicinal plants have shown lower toxicity together with higher specificity, creating an optimistic view of new treatments for diseases. Out of 1010 new active substances approved as drugs for medical conditions by regulatory agencies during the past 25 years, 490(48.5%) were from a natural origin.

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The application of the attitudes towards suicide questionnaire (ATTS) in Tunisian elderly

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1787 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s884-s884

Author(s):

W. Abbes ◽

M. Manel ◽

H. Kaouthar ◽

C. Nada ◽

Z. Nasreddine ◽

...

Keyword(s):

Low Income ◽

Public Health Problem ◽

Religious Practice ◽

Cross Sectional Study ◽

Automatic Thoughts ◽

High Educational Level ◽

Major Public Health Problem ◽

Cross Sectional ◽

Attitudes Towards Suicide ◽

The Veil

IntroductionAccording to WHO, suicide is a major public health problem and the most affected age group by suicide in Tunisia is that of over 70 years.AimsTo study the perception of the Tunisian elderly of suicide.MethodsA cross-sectional study was conducted during a 3-month period from October to December 2015. Fifty persons aged at least 65 years participated to the study. We used an anonymous questionnaire with a specific scale: “Attitudes Towards Suicide Questionnaire” (ATTS).ResultsThe mean age of our patients was 67.5 years. Sex ratio was 1.27. Most of the participants were married (82%), unemployed (63.2%), with a secondary or high educational level (62%), and low income (73.5%). All participants were believers. As for religious practice, 74.5% of the recruited elderly made the fast and 73.5% were prayers. Among women, 70.8% wore the veil. Concerning the perception of suicide, it was on the dimension of “permissiveness” (M = 1.88) that our participants agreed less. Those who made prayers had lower scores of “permissiveness” (P = 0.032). Women who wore the veil had higher scores on the field of “incomprehensibility” than the unveiled ones (P = 0.047). Furthermore, 68% of our participants believed that suicide is stigmatizing.ConclusionsIt might be time to try to lift the taboo and stigma through information and sensitizing campaigns on suicide. In this direction, studies of perception help to identify, somehow, “automatic thoughts” regarding representations of suicide and to try to develop an “alternative thinking” in the general population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Awareness On Cervical Cancer and Utilization of Pap-Smear (Papanicolaou) Test Among Adult Women-A Hospital Based Study

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.05.01.01 ◽

2021 ◽

Vol 5 (1) ◽

Keyword(s):

Cervical Cancer ◽

Low Income ◽

Hpv Vaccine ◽

Pap Smear ◽

Public Health Problem ◽

Major Public Health Problem ◽

Adult Women ◽

Pap Smear Test ◽

Smear Test ◽

Significant Difference

Background: Cervical cancer, a major public health problem and stood in the 2nd position among other cancers in women and accounts more than 84% new cases worldwide and more than 85% death from middle and low income countries. It ranks as the 1st most frequent cancer among women of age 15 to 44 years in Nepal. Purpose: To assess the awareness of cervical cancer and screening test and its practice among women in Nepal. Method: A cross sectional study was conducted from June 2017 to August 2017 among 409 women at the Gynecology Out Patient Department (OPD) of Helping Hands Community Hospital, Kathmandu. Prior to data collection, necessary ethical approvals were taken from concern authorities and informed consents were taken from the participants. Data were collected using a semi-structured questionnaire with a face-to-face interview. Data were analyzed and presented in the tabular form with the frequency and percentage. To see the significant differences between variables chi square test was used and p value of <0.05 was set as the level of significance. Knowledge related factors were obtained using a Likert scale. Results: The mean (standard deviation) age of the women was 33.52 (9.98) years. Among total respondents, 32.8% heard about cervical cancer and among them, only 13.4 % of them had knowledge of the causative agent the HPV and about 21.1% of them had an idea about the vaccine. Women who had heard about cervical cancer, only 13% had knowledge on the Pap smear test. Among the women who have heard about cervical cancer, only 23.9% of them had experienced on the Pap smear test. Among the women who had knowledge of cervical cancer (134), only 9.7% (13) of them had heard about the HPV vaccine. This study showed that heard about cervical cancer, knowledge on Pap smear test and knowledge of the HPV vaccine are significant difference with the education level of the respondents (p <0.01). Conclusion: Enrollment of women in academic education and adequate information through different media targeting eligible women is needed to raise awareness to change their behaviors to utilize the screening facility.

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Prevalence and associated factors of diarrhea among under-five children in Debre Berhan Town, Ethiopia 2018: A cross sectional study

10.21203/rs.2.13141/v4 ◽

2020 ◽

Author(s):

Sisay Shine ◽

Sindew Muhamud ◽

Solomon Adnew ◽

Alebachew Demelash ◽

Makda Abate

Keyword(s):

Low Income ◽

Public Health Problem ◽

Cross Sectional Study ◽

Low Income Countries ◽

Major Public Health Problem ◽

Sectional Study ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

Debre Berhan

Abstract Background: Diarrhea is responsible for 525,000 children under-five deaths and 1.7 billion cases globally and is the second leading cause of death among children under-five every year. It is a major public health problem in low income countries like Ethiopia. The main aim of this study was to assess the prevalence of diarrhea and associated risk factors among children under-five in Debre Berhan Town, Ethiopia. Methods: A community-based cross-sectional study was conducted in 420 parent or caretaker/children pairs in Debre Berhan town between 13–18 April 2018. A multi-stage sampling strategy was used to select the study participants. Data were collected using pre-tested and structured questionnaires. Data were entered in Epi-info computer software version 3.5.1 and exported to SPSS Window Version-16 for analysis. Adjusted odds ratios with 95% confidence intervals were used to assess the level of significance. Results: The two week prevalence of diarrhea among children under-five was 16.4% (69/351). Children aged 7-11 months (adjusted odds ratio (AOR): 4.2, 95% confidence interval (CI): 1.2 - 15.3), being the second-born child (AOR: 3.9, 95%CI: 1.8 - 8.5), not vaccinated against rotavirus (AOR: 10.3, 95%CI: 3.2 - 91.3) and feeding children by hand (AOR: 2.5, 95%CI: 1.1 - 6.1) were significant predictors of diarrhea. Conclusions: This study revealed that the two weeks period prevalence of diarrhea among children under-five years was 16.4%. Education programs on the importance of vaccination against rotavirus, increasing breast feeding frequency with complementary food after six months and the critical points of hand washing are recommended.

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A school-based soil-transmitted helminths survey in the Guadalcanal Province, the Solomon Islands

Tropical Doctor ◽

10.1177/0049475520970055 ◽

2020 ◽

pp. 004947552097005

Author(s):

June-Der Lee ◽

Chuan-Min Yen ◽

Jiun-Jye Wang ◽

Rong-Jyh Lin ◽

Li-Yu Chung

Keyword(s):

Low Income ◽

Solomon Islands ◽

Gastrointestinal Symptoms ◽

Public Health Problem ◽

Strongyloides Stercoralis ◽

Low Income Countries ◽

Major Public Health Problem ◽

Formaldehyde Concentration ◽

Soil Transmitted Helminths ◽

School Based

Infections by soil-transmitted helminths are a major public health problem worldwide, especially among schoolchildren in low-income countries. Little information is described about their prevalence in the Solomon Islands. From 2017 to 2018, a school-based soil-transmitted helminths survey in the Guadalcanal Province was conducted. A total of 454 schoolchildren were selected; the Merthiolate–iodine–formaldehyde concentration and stain was used. The prevalence was 17% of one or more parasites, including hookworm (8.8%), Strongyloides stercoralis (5.7%), Ascaris lumbricoides (4.2%) and Trichuris trichiura (3.5%). STH infection was significantly correlated with parents' occupations, hand washing, shoe wearing as well as gastrointestinal symptoms. To prevent STH transmission for schoolchildren in the Solomon Islands completely, combined preventive strategies seem necessary.

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Hyperglycaemia lowering activity and hypoglycaemic risk assessment of Sarenta, an Ivorian traditional herbal remedy

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20194103 ◽

2019 ◽

Vol 8 (9) ◽

pp. 1939

Author(s):

Geneviève A. N’guessan Irié ◽

Ange A. Tako ◽

Etienne K. Effo ◽

Landry S. Kouakou ◽

Gisèle N. Siransy Kouakou

Keyword(s):

Traditional Medicine ◽

Low Income ◽

Herbal Remedy ◽

Public Health Problem ◽

Physiological Saline ◽

Major Public Health Problem ◽

Traditional Use ◽

Physiological Saline Solution ◽

Pre Treatment ◽

Lowering Activity

Background: Diabetes remains a major public health problem for which traditional medicine is a better therapeutic alternative for low-income populations, including African populations. The aim of this work was to evaluate the effect of Sarenta, an herbal preparation used in Ivorian traditional medicine as anti-diabetic, on hyperglycaemia and on basic glycaemia.Methods: Hyperglycaemia lowering activity was led in rats receiving glucose at 5 g/kg body weight by gavage after oral pre-treatment with either Sarenta at 125, 206 or 209.5 mg/kg b. wt., either glibenclamide at 10 mg/kg b. wt., or physiological saline solution. Hypoglycaemic risk was assessed by administering the same doses of Sarenta to native i.e. NaCl-treated rats. For both tests, blood glucose was measured before any substance was administered and then every hour for 4 hours.Results: After 4 hours, Sarenta at 206 mg/kg b. wt. and 209.5 mg/kg b. wt. significantly reduced the induced hyperglycaemia in rats by 33.87% and 37.39%, respectively. The degree of the hyperglycaemia lowering effect of the remedy at these two doses was not significantly different from that of glibenclamide. In addition, Sarenta at 209.5 mg/kg b. wt. resulted in a significant reduction of basic blood sugar to 29.78% four hours after administration.Conclusions: The remedy Sarenta has a hyperglycaemia lowering activity that could partially justify its traditional use in the treatment of diabetes. However, considering its hypoglycemic effect, precautions should be taken when using this traditional medicine.

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Postpartum Depression in The Arab Region: A Systematic Literature Review

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017902016010142 ◽

2020 ◽

Vol 16 (1) ◽

pp. 142-155

Author(s):

Khubaib Ayoub ◽

Amira Shaheen ◽

Shakoor Hajat

Keyword(s):

Risk Factors ◽

Literature Review ◽

Postpartum Depression ◽

Systematic Literature Review ◽

Low Income ◽

Stressful Life Events ◽

Unwanted Pregnancy ◽

Public Health Problem ◽

Arab Countries ◽

Major Public Health Problem

Background: Postpartum Depression (PPD) is a major public health problem affecting mothers and their babies. However, few studies have investigated the prevalence and risk factors for postpartum depression among Arab mothers. This systematic literature review aims to determine the prevalence of PPD among mothers in Arab countries and identify the main risk factors. Methods: A review of all peer-reviewed journal published studies on PPD and its risk factors among Arab mothers until February 2016. The following data bases were searched; PubMed, Springlink, Science direct, EBSCOhost, and Arabpsychnet. Results: 25 studies were included in the review. PPD rates were high in general but prevalences were close to the rates observed in other low and lower-middle-income countries. Twelve studies reported PPD prevalences in the region of 15-25%, 7 studies reported prevalences< 15% and 6 studies reported prevalences<25%. The most important risk factors for PPD were: low income and socioeconomic status, obstetric complications during pregnancy, unwanted pregnancy, ill infant, formula feeding, low social and husband support, marital and in-laws conflicts, stressful life events during pregnancy and personal or family history of depression. Conclusion: Prevalence of PPD is high in most Arab countries, with differences due in part to variations in methods of assessment. This review highlights the problem of PPD and advocates for the adoption of necessary changes in the Arab health systems such as routine screening and efficient referral systems in order to detect and treat this potentially debilitating condition.

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Prevalence and associated factors of diarrhea among under-five children in Debre Berhan Town, Ethiopia 2018: A cross sectional study

10.21203/rs.2.13141/v5 ◽

2020 ◽

Author(s):

Sisay Shine ◽

Sindew Muhamud ◽

Solomon Adnew ◽

Alebachew Demelash ◽

Makda Abate

Keyword(s):

Low Income ◽

Public Health Problem ◽

Cross Sectional Study ◽

Low Income Countries ◽

Major Public Health Problem ◽

Sectional Study ◽

Cross Sectional ◽

Children Under Five ◽

Under Five ◽

Debre Berhan

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Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/243801 ◽

2014 ◽

Vol 2014 ◽

pp. 1-17 ◽

Cited By ~ 7

Author(s):

Harald J. Hamre ◽

Anja Glockmann ◽

Reinhard Schwarz ◽

David S. Riley ◽

Erik W. Baars ◽

...

Keyword(s):

Observational Studies ◽

Antibiotic Prescription ◽

Secondary Analysis ◽

Public Health Problem ◽

Antibiotic Use ◽

Major Public Health Problem ◽

Unadjusted Odds Ratio ◽

Prescription Rates ◽

Ear Infections

Children with acute respiratory or ear infections (RTI/OM) are often unnecessarily prescribed antibiotics. Antibiotic resistance is a major public health problem and antibiotic prescription for RTI/OM should be reduced. Anthroposophic treatment of RTI/OM includes anthroposophic medications, nonmedication therapy and if necessary also antibiotics. This secondary analysis from an observational study comprised 529 children <18 years from Europe (AT, DE, NL, and UK) or USA, whose caregivers had chosen to consult physicians offering anthroposophic (A-) or conventional (C-) treatment for RTI/OM. During the 28-day follow-up antibiotics were prescribed to 5.5% of A-patients and 25.6% of C-patients (P<0.001); unadjusted odds ratio for nonprescription in A- versus C-patients 6.58 (95%-CI 3.45–12.56); after adjustment for demographics and morbidity 6.33 (3.17–12.64). Antibiotic prescription rates in recent observational studies with similar patients in similar settings, ranged from 31.0% to 84.1%. Compared to C-patients, A-patients also had much lower use of analgesics, somewhat quicker symptom resolution, and higher caregiver satisfaction. Adverse drug reactions were infrequent (2.3% in both groups) and not serious. Limitation was that results apply to children of caregivers who consult A-physicians. One cannot infer to what extent antibiotics might be avoided in children who usually receive C-treatment, if they were offered A-treatment.

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