scholarly journals Injections and infections: understanding syringe service program utilization in a rural state

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kinna Thakarar ◽  
Nitysari Sankar ◽  
Kimberly Murray ◽  
Frances L. Lucas ◽  
Debra Burris ◽  
...  

Abstract Background Increasing rates of injection drug use (IDU) associated-infections suggest significant syringe service program (SSP) underutilization. Our study objective was to assess practices of safe injection techniques and to determine predictors of SSP utilization in a rural state. Patients and methods This was a fifteen-month cross-sectional study of participants hospitalized with IDU-associated infections in Maine. Data were collected through Audio Computer-Assisted Self-Interview survey and medical record review. Descriptive analyses were performed to characterize demographics, health characteristics, and injection practices. The primary outcome was SSP utilization, and the main independent variable was self-reported distance to SSP. Logistic regression analyses were performed to identify factors associated SSP utilization, controlling for gender, homelessness, history of overdose, having a primary care physician and distance to SSP. Results Of the 101 study participants, 65 participants (64%) reported past 3 month SSP utilization, though only 33% used SSPs frequently. Many participants (57%) lived more than 10 miles from an SSP. Participants who lived less than 10 miles of an SSP were more likely to use an SSP (adjusted odds ratio 5.4; 95% CI 1.9–15.7). Conclusions Our study highlights unsafe injection practices and lack of frequent SSP utilization among people admitted with IDU-associated infections in a rural state. Especially given increasing stimulant use, these results also highlight the need for SSP access. Particularly in rural areas where patients may live more than 10 miles from an SSP, expansion of harm reduction services, including mobile units, should be a priority.

2021 ◽  
Author(s):  
Kinna Thakarar ◽  
Nitysari Sankar ◽  
Kimberly Murray ◽  
Frances Lee Lucas ◽  
Deb Burris ◽  
...  

Abstract Background: Increasing rates of injection drug use (IDU) associated-infections suggest significant syringe service program (SSP) underutilization. Our study objective was to assess patient knowledge, attitudes, and practices of safe injection techniques and to determine predictors of SSP utilization in a rural state. Patients and Methods: This was a fifteen-month cross-sectional study of participants hospitalized with IDU-associated infections in Maine. Data were collected through Audio Computer-Assisted Self-Interview survey and medical record review. Descriptive analyses were performed to characterize injection knowledge, attitudes and practices. The primary outcome was SSP utilization, and the main independent variable was self-reported distance to SSP. Logistic regression analyses were performed to identify factors associated SSP utilization, controlling for gender, homelessness, history of overdose, having primary care physician and distance to SSP. Results: Of the 101 study participants, 65 participants (64%) reported past 3 month SSP utilization, though only 33% used SSPs frequently. Many participants (57%) lived more than 10 miles from an SSP. Participants who lived less than 10 miles of an SSP were more likely to use an SSP (adjusted odds ratio 5.39; 95% CI 1.9-15.7). Conclusions Our study highlights unsafe injection practices and lack of frequent SSP utilization among people admitted with IDU-associated infections in a rural state. Especially given increasing stimulant use, these results also highlight the need for SSP access even among individuals prescribed medication for opioid use disorder. Particularly in rural areas where patients may live more than 10 miles from an SSP, expansion of harm reduction services, including mobile units, should be a priority.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S715-S716
Author(s):  
Kinna Thakarar ◽  
Kim Murray ◽  
Nityasri Sankar ◽  
Jenny Carwile ◽  
F L Lucas ◽  
...  

Abstract Background Increasing rates of injection drug use (IDU) associated-infections suggest significant syringe service program (SSP) underutilization. Our study objective is to assess patient knowledge, attitudes, and practices of safe injection techniques and to determine predictors of SSP utilization in a rural state. Methods This is a fifteen-month cross-sectional study of participants hospitalized with IDU-associated infections at four hospitals in Maine. Data were collected through Audio Computer-Assisted Self-Interview survey and medical record review. Descriptive analyses were performed to characterize injection knowledge, attitudes and practices. The primary outcome was past 3-month SSP utilization, and the main independent variable was self-reported distance to SSP. Secondary outcomes were uptake of clean drug equipment, naloxone, and treatment with medication for opioid use disorder. Logistic regression analyses were performed to identify factors associated with the primary outcome, controlling for gender, homelessness, history of overdose, having primary care physician and distance to SSP. Results Of the 101 study participants, 62 participants (65%) reported past 3 month SSP utilization, though only 33% used SSPs frequently. Few participants (10%) reported clean needle/syringe use or clean drug equipment use (5%). Forty-eight percent of participants reported naloxone uptake, and 66% of participants were prescribed medication for opioid use disorder prior to admission. Many participants (59%) lived more than 10 miles from an SSP with 18% of participants living in rural areas. Fifty-four percent reported difficulty accessing an SSP. Participants who lived less than 10 miles of an SSP were more likely to use it (adjusted odds ratio 5.47; 95% CI 2.1- 14.3). Conclusion Our study highlights unsafe injection practices and lack of frequent SSP utilization among people admitted with IDU-associated infections in Maine. Especially given increasing stimulant use in our state and nationally, these results also highlight the need to promote harm reduction even among individuals prescribed medication for opioid use disorder. Particularly in rural areas where patients may live more than 10 miles from an SSP, expansion of harm reduction services should be a priority. Disclosures All Authors: No reported disclosures


Author(s):  
Shiren Ali Al Hamzawi

Estimates of Trichomonas vaginalis prevalence in pregnant women are variable with few studies in Iraq.T. vaginalis is a worldwide prevalent sexually transmitted infection,but fortunately,it is very treatable. Researchers believed that pregnancy is one of the effective factors for T. vaginalis infection in women.A cross-sectional study performed in Obstetrics and Gynecology Department at Maternity and Children Teaching Hospital in Al-Diwaniya city on two hundred female pregnant patients between the ages of 16-45 years. These females had no intercourse for 2–3 days,not using drugs (antibiotics,antiprotozoal or steroids) for the last 15 days. Vaginal discharges of any type with or without itching,burning sensation or both were their main complaints. Vaginal swabs were taken from all participating patients for direct wet mount microscopy and culture for the detection of Trichomonas vaginalis infection. The study showed that twelve out of two hundred examined pregnant women (6%) presented with T. vaginalis infection. The infection was more in those with mothers’ age (26-35) years,housewives,low education,higher parity,and of rural residents. Other maternal variables were not significantly associated with T. vaginalis infection. The study showed a prevalence of (6%) of T. vaginalis infection in pregnant female attendees. Infection was more in those with mothers ’age (26-35) years,housewives,low educational level,higher parity,and living in rural areas.


Author(s):  
Kate Emond ◽  
Melanie Bish ◽  
Michael Savic ◽  
Dan I. Lubman ◽  
Terence McCann ◽  
...  

Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.


2021 ◽  
Vol 13 (9) ◽  
pp. 4953
Author(s):  
Alfredo Guzmán Rincón ◽  
Sandra Barragán ◽  
Favio Cala Vitery

As part of the 2030 Agenda, higher education has been conceptualised as one of the ways to overcome the social disparities experienced in rural areas in Colombia. Thus, in concordance with the benefits of this level of education, the state has been designing public policies during the last few years, in order to facilitate access to undergraduate programmes to these populations, focusing mainly on the implementation of the virtual modality. In this context, it is recognised that access itself is not enough, but that continuance and timely graduation are required to materialise the benefits obtained along with a higher education degree; hence, dropout is a subject of interest for study, especially due to the high rates existing in the rural student population. Therefore, the event of dropout becomes an obstacle to social change and transformation in rural areas. Thus, this article aimed to identify which individual, institutional, academic and socio-economic characteristics influence rural student dropout in virtual undergraduate programmes in Colombia. For this purpose, an exploratory, quantitative and cross-sectional study was proposed, with a sample of 291 students to whom a student characterisation instrument and a classroom evaluation instrument were applied. With these data, it was proceeded to establish which of them had deserted, constituting the extraction of the sample of the study, which were 168. With the information, an exploratory factor analysis, hierarchical cluster analysis and descriptive statistics were used to establish which explanatory variables are involved in the dropout of this type of student. The results showed that the academic variables analysed do not have an impact on the event, while marital status (associated with family obligations), age, social stratum, work obligations, parents’ level of education and type of work, income and type of employment relationship of the student, and, finally, the number of people who depend on the family’s income do.


2021 ◽  
Vol 6 (1) ◽  
pp. 29
Author(s):  
Cruz S. Sebastião ◽  
Joana Morais ◽  
Miguel Brito

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.


Author(s):  
Sabuj Kanti Mistry ◽  
Armm Mehrab Ali ◽  
Md. Ashfikur Rahman ◽  
Uday Narayan Yadav ◽  
Bhawna Gupta ◽  
...  

The present study explored the changes in tobacco use patterns during the COVID-19 pandemic and their correlates among older adults in Bangladesh. This cross-sectional study was conducted among 1032 older adults aged ≥60 years in Bangladesh through telephone interviews in October 2020. Participants’ characteristics and COVID-19-related information were gathered using a pretested semi-structured questionnaire. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic (6 months prior to the survey). Nearly half of the participants (45.6%) were current tobacco users, of whom 15.9% reported increased tobacco use during the COVID-19 pandemic and all others had no change in their tobacco use patterns. Tobacco use was significantly increased among the participants from rural areas, who had reduced communications during COVID-19 compared to pre-pandemic (OR = 2.76, 95%CI:1.51–5.03). Participants who were aged ≥70 years (OR = 0.33, 95% CI: 0.14–0.77), widowed (OR = 0.36, 95% CI: 0.13–1.00), had pre-existing, non-communicable, and/or chronic conditions (OR = 0.44, 95% CI: 0.25–0.78), and felt themselves at the highest risk of COVID-19 (OR = 0.31, 95% CI: 0.15–0.62), had significantly lower odds of increased tobacco use. Policy makers and practitioners need to focus on strengthening awareness and raising initiatives to avoid tobacco use during such a crisis period.


2020 ◽  
Vol 30 (1) ◽  
pp. 34764
Author(s):  
Andressa Barros Ibiapina ◽  
Janaína Soares Leal ◽  
Pedro Ricardo Alves de Santana ◽  
Marcelo Ribeiro Mesquita ◽  
Tito Lívio da Cunha Lopes ◽  
...  

AIMS: This research aims to determine the epidemiology and the spatial distribution of intestinal parasitosis in the city of Teresina.METHODS: A cross-sectional study was carried out based on the data of parasitological fecal exams performed in the Laboratory Raul Bacelar between January, 2014 and July, 2017. In addition to the prevalence of intestinal parasitosis and polyparasitism, we verified the association of these diseases with gender, zone and period of the year by means of the chi-squared test, whereas the relation with age was analyzed by the Mann-Kendall tests and multiple comparisons of age classes. The spatial distribution was performed using the QGIS georeferencing software.RESULTS: The prevalence of enteroparasitosis in Teresina is 17,8% with Ascaris lumbricoides being the most common species, due to the precarious sanitary conditions of the city. The prevalence of individuals with polyparasitism is 3,13%, in which an association between the species Entamoeba coli and Entamoeba histolytica/dispar was found. There was no relation between intestinal parasitosis with gender, but we verified that individuals in rural areas are more susceptible to these diseases. The species Ascaris lumbricoides and Entamoeba histolytica/dispar occur more frequently in the first and second semester, respectively. We observed that there is an apparent tendency to increase cases of E. histolytica/dispar and reduction of cases of Giardia sp. according to aging. Mapping intestinal parasitosis showed us that there is a prevalence between one and 20% in most of Teresina's neighborhoods, and Ascariasis embodies at least 40% of cases of enteroparasitosis in these neighborhoods.CONCLUSIONS: Investments in basic sanitation and new epidemiological investigations must be carried out to control intestinal parasitosis in Teresina, emphasizing that children and the elderly should be considered priority groups in these programs.


Author(s):  
Muhammad Akram ◽  
Asim Nasar ◽  
Abid Rehman

Abstract The study investigates the satisfaction of religious minorities in Pakistan subject to government policies and attitudes of the Muslim majority. A cross-sectional study design was used to collect data from 120 respondents living in rural areas in Pakistan. Descriptive statistics and the Pearson correlation coefficient were used to measure the relatedness of essential factors of freedom of expression, opportunity in government services, security of unprotected assembly, prejudice in relationship with Muslims and welcomeness in Muslim neighbourhoods. Yeh’s Index of Satisfaction was used to measure the satisfaction level of religious minorities with government policies and attitudes of the Muslim majority. The study findings revealed that religious minorities are least satisfied with their citizenship rights in Pakistan, which poses various questions to government policies and legislation. Further, they were also least satisfied with the attitudes of the Muslim majority with whom they must interact in their everyday life.


Author(s):  
MR Begum ◽  
M Anaruzzaman ◽  
MSI Khan ◽  
M Yousuf

A cross sectional study was conducted to observe the factors affecting the productive performance of dairy cattle from northern rural areas of Bangladesh during July and September 2013. Data of 105 cows, 85 (80.95%) from local and 20 (19.05%) cows from cross breed, were randomly selected for the study. A binary logistic regression, expressed by odds ratio with 95% confidence interval, was done to determine the association of daily milk production categorized into ? 2 and > 2 liters (L), based on median, with the significant explanatory variables of body weight, age at first calving, lactation period, vitamin use, type of floor and milking person. The result demonstrated that the probability of milk production of >2 L was 6.16, 4.5, 20.65 and 5.7 times higher from the with animal body weight of >140 kg, age at first calving of >36 m, lactation period of >8 m and vitamin use than that of body weight of 140 kg, age at first calving of ?36 m, lactation period of ? 8 m, and not vitamin used respectively. The chance of milk production of > 2 L was 0.25 and 0.22 times lower for mud floor, and owner milking than that of brick floor and gowala (professional milking person) respectively. DOI: http://dx.doi.org/10.3329/ijarit.v4i2.22646 Int. J. Agril. Res. Innov. & Tech. 4 (2): 41-45, December, 2014


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