scholarly journals Global community perception of ‘surgical care’ as a public health issue: a cross sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nurhayati Lubis ◽  
Meena Nathan Cherian ◽  
Chinmayee Venkatraman ◽  
Fiemu E. Nwariaku

Abstract Background In the last decade surgical care has been propelled into the public health domain with the establishment of a World Health Organisation (WHO) designated programme and key publications. The passing of the historic World Health Assembly Resolution (WHA) acknowledged surgical care as a vital component towards achieving Universal Health Coverage (UHC). We conducted the first worldwide survey to explore the perception of surgical care as a public health issue. Method The anonymous, cross sectional survey targeted worldwide participants across a range of professional backgrounds, including non-medical using virtual snowball sampling method (in English) using Google Forms (Google Inc., Mountain View, CA, USA) from 20th February 2019 to 25th June 2019. The survey questions were designed to gauge awareness on Sustainable Development Goals (SDGs), UHC, WHO programmes and key publications on surgical care as well as perception of surgical care as a priority topic in public health. Results The survey was completed by 1954 respondents from 118 countries. Respondents were least aware of surgical care as a teaching topic in public health courses (27%; n = 526) and as a WHO programme (20%; n = 384). 82% of respondents were aware of UHC (n = 1599) and of this 72% (n = 1152) agreed that surgical care fits within UHC. While 77% (n = 1495) of respondents were aware of SDGs, only 19% (n = 370) agreed that surgery was a priority to meet SDGs. 48% (n = 941) rated surgical care as a cost-effective component of Primary Health Care. 88% (n = 1712) respondents had not read the WHA Resolution on ‘Strengthening emergency and essential surgical care and anaesthesia as a component of UHC’. Conclusion There is still a widespread gap in awareness on the importance of surgical care as a public health issue amongst our respondents. Surgical care was not seen as a priority to reach the SDGs, less visible as a WHO programme and not perceived as an important topic for public health courses.

Author(s):  
Jakob Tarp ◽  
Juel Jarani ◽  
Florian Muca ◽  
Andi Spahi ◽  
Anders Grøntved

Abstract Background The extent of the obesity epidemic among youth is an important public health statistic which provides an indication of the future burden of non-communicable diseases. Many developing countries, including Albania, do not have systematic and repeated monitoring systems in operation. Methods The Balkan Survey of Inactivity in Children study is a population-based cross-sectional survey including Albanian children living in the four Balkan nation-states of Albania, Kosovo, FYR Macedonia and Montenegro. In total, 19,850 children from 49 schools were approached. The LMS method was used to provide body mass index (BMI), height, weight and waist circumference reference centiles for boys and girls. The World Health Organisation (WHO) and International Obesity Task Force (IOTF) age- and sex-specific BMI cut-points were applied to evaluate adiposity levels. Results A sample of 18,460 participants aged 6–16 years old was available for creation of the BMI for age and sex reference centiles. The prevalence of overweight (including obesity) in the full sample was 21% (95% CI: 20%–21%) according to IOTF cut-off points and 28% (95% CI: 28%–29%) at WHO cut-off points. Overweight/obesity levels where higher in boys than in girls irrespective of the cut-off points applied (p<0.001). Noticeable between-country differences were observed with a prevalence of overweight/obesity of 40% (95% CI: 38%–42%) in Montenegro but only 20% (95% CI: 19%–21%) in Kosovo (WHO cut-off points). Conclusions Overweight/obesity is highly prevalent in Albanian children and adolescents. The apparent sex and country differences may inform public health actions.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Malcata ◽  
G Saldanha ◽  
M Henriques

Abstract Background Measles is one of world's most contagious diseases and a growing population mobility has promoted its spreading. Outbreaks have been recorded around the world, despite public health efforts. Measles spreads faster among clusters of unvaccinated people. In 2018, World Health Organization reported 328629 cases worldwide, of which 82596 in Europe and 171 in Portugal- 93% of the latter were imported. Portugal had one of the highest proportions of childhood immunization coverage for Measles-Mumps-Rubella (MMR): 98% for first dose, and 96-98% for second. The main goal of this study was to describe the contribution of the Oporto International Vaccination Centre (OIVC), one of the largest in Portugal, to measles elimination. Methods Cross-sectional study, with analysis of vaccination records from travelers vaccinated for MMR at OIVC between January 2017 and December 2018. Results OIVC held 5426 pre-travel consultations in 2017, and 6192 in 2018. 535 travelers got the MMR vaccine (57.2% males). Mean age was 44.3±10.9 [1;76] years. Among travelers aged 12 months-18 years (n = 10), 50% were inoculated with the first dose and 50% with the second. Regarding adult travelers (n = 525), 71.6% received the first dose; 24.2% the second; 2.9% the third dose; and 1.3% received both first and second (within &gt; 4 weeks). Conclusions The substantial number of inoculated vaccines in OIVC resulted from checking traveler's vaccination immunity status in all pre-travel consultations; this routine practice aimed at reducing the risk of importing/exporting measles. The second dose of MMR was justified by the diversity of travelers who came to OIVC, and to whom such inoculation was indicated: health professionals, humanitarian travelers, and workers in airlines and cruises. The third dose was given due to loss of measles serologic immunity. These measures are important to implement the recommendations of the Measles National Elimination Program, while contributing to global public health. Key messages This is an original study on the contribution of international vaccination centers to reduce the number of imported/exported cases and to eliminate measles - which is a global public health issue. At a global level, measles has a large disease burden. Therefore, it is essential to take every opportunity, including pre-travel consultations, to vaccinate people.


Author(s):  
Kelley Lee

This chapter examines the politics that has shifted tobacco control policy over the past three decades, from a long-neglected public health issue to a flagship global health issue supported by collective action by state and non-state actors. These efforts were spurred by the expansion of leading transnational tobacco companies (TTCs) into emerging markets, beginning in the 1960s, amid growing regulation and declining sales in traditional markets. By the 1990s tobacco use was steadily rising in the wake of the global expansion of the tobacco industry. The negotiation of the World Health Organization Framework Convention on Tobacco Control (FCTC) became the focus of intense political contestation between a powerful industry seeking to protect its commercial interests and an alarmed public health community. Since adoption of the FCTC in 2004, this political battle has shifted to its effective implementation in signatory states. This has included the eventual negotiation of the FCTC Protocol to Eliminate the Illicit Trade in Tobacco Products and continued efforts by the tobacco industry to sustain sales through a variety of political strategies.


2019 ◽  
Vol 19 (1) ◽  
pp. 197-205
Author(s):  
José Rogério de Jesus Linhares de Souza ◽  
Tatyana Santana de Azevedo Silva ◽  
Eduardo Durans Figueredo

Abstract Objectives: to measure the prevalence of hypovitaminosis D in healthy pregnant women and to analyze the association among some variables and the levels of vitamin D. Methods: an analytical cross-sectional study. 174 healthy pregnant women were selected from four basic health units in São Luís, Brazil, from January to February 2017. The participants answered a questionnaire about sociodemographic and obstetric data. A blood sample was collected to evaluate the plasmatic level of vitamin D. The association between independent variables and the outcome was evaluated by using the Student’s t-test and Chisquare test. Results: the mean of vitamin D concentration was 24.9±6.6ng/ml. Forty women (23.0%) presented vitamin D sufficiency, 93 (53.4%) insufficient, and 41 (23.6%) with deficiency. There was a difference in the vitamin D concentration between evangelical (23.1 ng/ml) and non-evangelical (25.5 ng/ml) (p=0.02) and between primigravida (23.8 ng/ml) and non-primigravida (25.7 ng/ml) (p=0.03). There was a difference in the hypovitaminosis D between adolescents (89.7%) and non-adolescents (72.6%) (p=0.02) and between primigravida (85.0%) and non-primigravida (69.2%) (p=0.01). Low monthly income per capita was associated with a higher frequency of vitamin D sufficiency. Conclusions: Due to the impact of inadequate levels of vitamin D in pregnant women and their babies’ health, even in an equatorial city, hypovitaminosis D in pregnant women is an important public health issue.


2020 ◽  
Author(s):  
Keith Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baluku ◽  
...  

Abstract BackgroundThe incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. A recent national TB prevalence survey revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). The objective of this study was to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda.MethodsA facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation using STATA 14.ResultsTwo hundred forty seven presumptive TB patients were recruited into this study exiting at antiretroviral therapy (ART) clinics (n=132) or general outpatient clinics (n=115) at public health facilities. Majority of participants were females (161/247, 65.2%) and the mean +SD age was 35.1 + 11.5 years. Sputum and/or CXR were not requested from 138 (55.9%) patients with symptoms suggestive of TB disease. Patients who did not inform health workers about TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio: 1.68, 95%CI; 1.36-2.08, P<0.001). Conclusion; A large proportion of patients with symptoms suggestive of TB did not have sputum and/ or CXR requested for investigation. Patients who did not inform health workers about their TB related symptoms were more likely to miss having sputum and/ or CXR requested. We recommend studies to explore barriers and facilitators of disclosure of TB symptoms to enable formulation of effective interventions to empower people to improve likelihood of disclosing TB related symptoms.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keith Twirire Kakame ◽  
Noel Namuhani ◽  
Andrew Kazibwe ◽  
Felix Bongomin ◽  
Joseph Baruch Baluku ◽  
...  

Abstract Background The incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. The population-based survey on the prevalence of TB in Uganda revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). This study aimed to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda. Methods A facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to the World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB diagnosis were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation. Results Two hundred forty-seven (247) patients with presumptive TB exiting at antiretroviral therapy (ART) clinics (n = 132) or general outpatient clinics (n = 115) at public health facilities were recruited into this study. Majority of participants were female (161/247, 65.2%) with a mean + SD age of 35.1 + 11.5 years. Overall, 138 (55.9%) patients with symptoms suggestive of TB disease did not have sputum and/or CXR examinations. Patients who did not inform health workers about their TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio (aPR): 1.68, 95%CI; 1.36–2.08, P < 0.001). However, patients who reported duration of cough of 2 weeks or more were less likely to be missed for TB screening (aPR; 0.69, 95%CI; 0.56–0.86, p < 0.001). Conclusion There are substantial missed opportunities for TB diagnosis in Wakiso District. While it is important that patients should be empowered to report symptoms, health workers need to proactively implement the WHO TB symptom screen tool and complete the subsequent steps in the TB diagnostic cascade.


2013 ◽  
Vol 17 (7) ◽  
pp. 1538-1546 ◽  
Author(s):  
Mimi Bhattacharyya ◽  
Louise Marston ◽  
Kate Walters ◽  
Gladstone D'Costa ◽  
Michael King ◽  
...  

AbstractObjectivePsychological distress, defined as symptoms of depression and anxiety, is an increasingly important public health issue in developing countries. Little is known about the extent to which adverse dietary factors are associated with psychological distress in South Asians. Our aim was to compare the associations of diet and psychological distress in men and women in Goa, India.DesignCross-sectional study of consecutive attendees in nine urban and rural general practices in Goa, India in 2004–2005. All participants completed an FFQ on their dietary intake in a typical week. Psychological distress was measured using the Kessler Psychological Distress Scale (K10), a WHO-validated screening instrument.ResultsConsecutive attendees (n 1512; 601 men and 911 women) aged 30 to 75 years participated. Moderate and high scores of psychological distress were detected in significantly more women than men (eighty-eight men v. 264 women, unadjusted OR = 0·39; 95 % CI 0·29, 0·52). Those who ate one or more portions of fish weekly had nearly half the prevalence of distress in both sexes (women, OR = 0·52; 95 % CI 0·29, 0·91; men, OR = 0·50; 95 % CI 0·25, 0·99) and this was independent of age, marital status, education, income, religion and living alone.ConclusionsPsychological distress is significantly lower with fish intake in both sexes. Further longitudinal work is needed to establish temporal relationships. Addressing psychological distress is becoming an increasingly significant public health priority in both high- and low-income countries.


Author(s):  
Nyeil Ali ◽  
Subrina Alli ◽  
Ashley Ali ◽  
Aleema Ali ◽  
Chelsi Ali ◽  
...  

Objectives: Antibiotic resistance (ABR) is a growing public health issue globally. This study aimed to ascertain the public’s knowledge of antibiotic resistance and to determine any associated demographic factors. Method: A cross-sectional survey was undertaken in Trinidad using a modified version of a World Health Organization questionnaire. Five hundred and fifty participants aged 16 years and older were interviewed. Data were analysed using SPSS Version-22. Results: The response rate was 91% (502/550). Most responders (53%) reported having taken antibiotics during the 6-month period prior to the survey. Almost 60% of responders believed that sore throat and colds/flu can be treated with antibiotics. Sixty-seven percent of responders believed that they had no individual role in combating the issue. Responders with a primary level education or older respondents were more likely than responders with a higher level of education or younger to agree that antibiotic resistance only affects those who use antibiotics frequently (p= 0.002 and p=0.017 respectively). Income level was also significantly associated with knowledge levels, the higher the income the more knowledgeable the responder. Conclusion: Our study found that public knowledge of antibiotic resistance is low. Age, income and educational levels were significantly associated with certain knowledge parameters. Much work needs to be done to change the attitudes of responders who believe they have no role to play in the fight against this national and global threat. These findings may be useful to health education professionals and government antimicrobial resistance programmes.


2015 ◽  
Vol 25 (3) ◽  
pp. 377 ◽  
Author(s):  
Simone Grilo Diniz ◽  
Heloisa De Oliveira Salgado ◽  
Halana Faria de Aguiar Andrezzo ◽  
Paula Galdino Cardin de Carvalho ◽  
Priscila Cavalcanti Albuquerque Carvalho ◽  
...  

Disrespect and abuse (in Brazil called obstetric violence), described by different terms, is increasingly used in social activism, in academic research and public policy formulation, and was recently recognized as a public health issue by the World Health Organization. As an innovative theme, it requires a mapping its origins, definitions, typology, impacts on maternal health and proposals for its preventing and remedy. We presente a critical-narrative review about this issue, including academic literature, productions of social movements and institutional documents, in Brazil and internationally. After a short historical overview, we map the definitions and types of violence. The complex causation of these forms of violence is discussed, including the role of professional training, the organization of health services, and the implications for maternal morbidity and mortality. Finally we present interventions in public health that have been used or proposed to prevent and mitigate obstetric violence, and an agenda for innovation and research in this area.


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