scholarly journals Knowledge on tuberculosis and utilization of DOTS service by tuberculosis patients in Lalitpur District, Nepal

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245686
Author(s):  
Nirmal Gautam ◽  
Rewati Raj Karki ◽  
Rasheda Khanam
Keyword(s):  
Rural Areas ◽  
Age Groups ◽  
Directly Observed Therapy ◽  
Middle Income ◽  
Public Health Burden ◽  
The Public ◽  
Middle Income Countries ◽  
Adequate Knowledge ◽  
Short Course ◽  
Younger Age

Background Tuberculosis is one of the major infectious diseases and is both complex and serious. It is spread from person to person through the air, causing a public health burden, especially in low- and middle-income countries. This study aims to assess the knowledge on tuberculosis and the utilization of Directly-Observed Therapy, Short Course (DOTS) service from the public DOTS centers in Lalitpur district of Nepal. Method A structured questionnaire was used to collect data from 23 DOTS centers in Lalitpur district. Univariate and multivariate logistic regression was applied to assess the knowledge on tuberculosis and utilization of DOTS among people living with tuberculosis. Results Among 390 respondents, 80% of patients had knowledge of tuberculosis and 76.92% utilized the DOTS service from the DOTS center. People of higher age (50–60 years) [aOR; 13.96, 95% CI 4.79,40.68], [aOR; 10.84,95% CI 4.09,28.76] had significantly more knowledge on TB and utilization of the DOTS service compared to the younger group. Additionally, those who completed twelfth class [aOR; 2.25, 95% CI 0.46,11.07] and [aOR;2.47, 95% CI 0.51,11.28] had greater knowledge of Tuberculosis and utilization of DOTS compared to those who had not completed twelfth class. Likewise, compared to urban residents, respondents in rural areas (aOR; 0.51, 95% CI 0.27,0.97) had less knowledge of tuberculosis, (aOR; 0.57, 95% CI 0.32,1) and less chance of utilization of the DOTS service from the DOTS center. Conclusion Approximately one quarter of patients did not have adequate knowledge of tuberculosis and were not utilizing the DOTS service, particularly in younger age groups, people living in a combined family, with no education, poor economic position, and from rural areas. Findings of this study revealed that some specific programs are needed for enhancing the knowledge and utilization of DOTS, particularly for those patients whose economic situations extended from low to mid range.

scholarly journals Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

2015 ◽  
Vol 19 (7) ◽  
pp. 1260-1269 ◽  
Author(s):  
Anahit Demirchyan ◽  
Varduhi Petrosyan ◽  
Viktoria Sargsyan ◽  
Kim Hekimian
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Regression Models ◽  
Severe Anaemia ◽  
Linear Regression Models ◽  
Middle Income ◽  
Middle Income Countries ◽  
Daily Diet ◽  
Younger Age ◽  
Low Middle Income Countries

AbstractObjectiveDespite the trend of increasing prevalence of childhood anaemia in Armenia, no studies exploring its risk factors have been conducted in the country. The present study aimed to investigate the prevalence and determinants of childhood anaemia in rural Armenia.DesignBlood Hb level was measured among a representative sample of children using the HemoCue Hb201+ analyser. The revealed cases with anaemia were compared with randomly selected non-anaemic controls. Mothers of cases and controls were interviewed. Logistic and linear regression models were fitted to identify the risk factors of anaemia and low Hb level, respectively.SettingTalin communities, Aragatsotn Province, Armenia.SubjectsChildren under 5 years of age in Talin region.ResultsOf the 729 studied children, 32·4 % were anaemic with 14·7 % having moderate/severe anaemia. Infants were the most affected group with 51·1 % being anaemic before 6 months and 67·9 % at 6–12 months of age. Fitted regression models identified the following predictors of anaemia: younger age, male gender, shorter birth length, anaemia during pregnancy, lower meal frequency per day, lack of meat in the diet, using dung cakes for heating and living in a community that received an incomplete set of nutrition interventions.ConclusionsThe study identified several modifiable risk factors that could be targeted to reduce childhood anaemia in rural Armenia and, possibly, in rural areas in other low-/middle-income countries. The suggested interventions include prevention and treatment of anaemia during pregnancy, provision of adequate complementary feeding to children with inclusion of meat in their daily diet and reduction of their exposure to biomass fuel smoke.

The Role of Public Engagement in Priority-Setting

2019 ◽  
pp. 283-298
Author(s):  
Matthew S. McCoy ◽  
Harald Schmidt ◽  
Jennifer Prah Ruger ◽  
Marion Danis
Keyword(s):  
Public Engagement ◽  
Priority Setting ◽  
Directly Observed Therapy ◽  
Structural Barriers ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Low And Middle Income

Recent years have seen growing enthusiasm for public engagement in priority-setting. But despite this widespread support, there remains uncertainty both about the precise benefits of public engagement in priority-setting and about how public engagement activities should be structured in order to realize those benefits. The authors aim to move beyond generalizations about the value of public engagement by presenting several distinct rationales for engaging the public in priority-setting. The authors illustrate how these rationales can be achieved in practice using the case study of directly observed therapy for tuberculosis. They then highlight a number of practical challenges involved in implementing engagement activities and offer advice for addressing them. The chapter pays particular attention to challenges that arise in low- and middle-income countries, where efforts to engage the public face unique structural barriers.

scholarly journals Direct and indirect effects of COVID-19 on perinatal outcomes in low- and middle-income countries

2021 ◽  
Vol 4 ◽  
pp. 108
Author(s):  
Felisita Tupou Ratu ◽  
Kathleen Ryan ◽  
Netsanet Workneh Gidi ◽  
Ilisapeci Vereti ◽  
Tsinuel Girma ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Indirect Effects ◽  
Vaccine Development ◽  
Age Groups ◽  
Perinatal Outcomes ◽  
Direct And Indirect Effects ◽  
Middle Income ◽  
Middle Income Countries ◽  
Younger Age ◽  
Low And Middle Income

Similar to previous outbreaks, the coronavirus disease 2019 (COVID-19) pandemic will have both direct and indirect effects on perinatal outcomes, especially in low- and middle-income countries. Limited data on the direct impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy shows women who are Black, obese and with co-morbidities are at higher risk of hospitalisation due to COVID-19. Younger age groups in Africa and South Asia have shown increased COVID-19 mortality. Indigenous pregnant women in Pacific Island countries are likely to be high risk for severe outcomes from COVID-19 due to high rates of diabetes and obesity. It is important to involve pregnant women in research, especially with regards to vaccine development and therapeutics.

scholarly journals Access and rational use of psychotropic medications in low- and middle-income countries

2015 ◽  
Vol 25 (1) ◽  
pp. 4-8 ◽  
Author(s):  
P. Padmanathan ◽  
D. Rai
Keyword(s):  
Mental Illness ◽  
Psychotropic Medications ◽  
Middle Income ◽  
Policy Makers ◽  
Rational Use ◽  
Public Health Burden ◽  
The Public ◽  
Middle Income Countries ◽  
Management Cycle ◽  
Low And Middle Income

Improving access and rational use of psychotropic medications in low- and middle-income countries is an important factor in reducing the public health burden resulting from mental illness. This paper considers each component of the medications management cycle to identify current barriers to improvement. Selection is hindered by a lack of up to date local essential drugs lists, while procurement and distribution can be affected by the type of system used: centralised or decentralised, government-run or independent, push or pull. Rational use involves patients, prescribers and policy-makers and requires consideration of who is able to prescribe, how prescribing decisions are made and how to ensure patient-centred care. We include a number of recommendations based on these issues, while emphasising the importance of ensuring the broader context of mental illness and its management is not overlooked when improving access to psychotropic medications.

scholarly journals Direct and indirect effects of COVID-19 on perinatal outcomes in low- and middle-income countries

2020 ◽  
Vol 4 ◽  
pp. 108 ◽  
Author(s):  
Felisita Tupou Ratu ◽  
Kathleen Ryan ◽  
Netsanet Workneh Gidi ◽  
Ilisapeci Vereti ◽  
Tsinuel Girma ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Indirect Effects ◽  
Vaccine Development ◽  
Age Groups ◽  
Perinatal Outcomes ◽  
Direct And Indirect Effects ◽  
Middle Income ◽  
Middle Income Countries ◽  
Younger Age ◽  
Low And Middle Income

Similar to previous outbreaks, the coronavirus disease 2019 (COVID-19) pandemic will have both direct and indirect effects on perinatal outcomes, especially in low- and middle-income countries. Limited data on the direct impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy shows women who are Black, obese and with co-morbidities are at higher risk of hospitalisation due to COVID-19. Younger age groups in Africa and South Asia have shown increased COVID-19 mortality. Indigenous pregnant women in Pacific Island countries are likely to be high risk for severe outcomes from COVID-19 due to high rates of diabetes and obesity. It is important to involve pregnant women in research, especially with regards to vaccine development and therapeutics.

scholarly journals Status of drowning in Nepal: A study of central police data

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 576
Author(s):  
Bhagabati Sedain ◽  
Puspa Raj Pant
Keyword(s):  
Descriptive Analysis ◽  
Epidemiological Studies ◽  
Water Bodies ◽  
Limited Data ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Police Data ◽  
The Status ◽  
Data Source

Background:  Drowning is a serious and mostly preventable injury-related cause of death. Low-and-middle income countries represent 90% of total drowning deaths worldwide. There is lack of epidemiological studies of drowning in Nepal. The aim of this paper is to describe the status of drowning in Nepal. Methods: Cases of drowning, occurring between January 2013 and December 2015 were extracted from the Daily Incident Recording System of Nepal Police. Variables on age, sex of the deceased, types of water bodies, places, season when drowning occurred and activities of deceased were extracted and descriptive analysis was done. Results: A total of 1,507 drowning cases were recorded over a 3 year period. The rate of drowning was 1.9 per 100,000 (2.95 for males and 0.92 for females). Majority of drowning occurred among males (76%) and more than half were (53%) under 20 years of age. Mostly drowning occurred in rivers (natural water bodies). The findings provide strong indication that drowning occurs throughout the year in Nepal. Children were highly vulnerable to drowning. The magnitude of drowning was found to be lower than estimated by global burden of disease (GBD) study. Conclusion: The burden of drowning in Nepal is considerable, but mostly unknown to the public. Despite only having access to a limited data source, this study provides useful evidence that comprehensive research in Nepal is needed urgently.

scholarly journals Identification of Bacillus Anthracis, Brucella Spp., and Coxiella Burnetii DNA Signatures From Bushmeat

2021 ◽  
Author(s):  
Robab Katani ◽  
Megan Schilling ◽  
Beatus Lyimo ◽  
Ernest Eblate ◽  
Andimile Martin ◽  
...  
Keyword(s):  
Bacillus Anthracis ◽  
Coxiella Burnetii ◽  
Wildlife Diseases ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Close Proximity ◽  
Disease Risks ◽  
Potential Risks ◽  
Dry Seasons

Abstract Meat from wildlife species (bushmeat) represents a major source of dietary protein in low- and middle-income countries where humans and wildlife live in close proximity. Despite the occurrence of zoonotic pathogens in wildlife, their prevalence in bushmeat remains unknown. To assess the risk of exposure to major pathogens in bushmeat, a total of 3,784 samples were collected from three major regions in Tanzania during both rainy and dry seasons, both fresh and processed and screened by real-time PCR for the presence of DNA signatures of Bacillus anthracis, Brucella spp and Coxiella burnetii (Coxiella). The analysis identified DNA signatures of B. anthracis (0.48%), Brucella (0.9%), and Coxiella (0.66%) in a total of 77 samples. Highest prevalence rates of B. anthracis, Brucella, and Coxiella were observed in wildebeest, dik-dik, and impala, respectively. Fresh samples, those collected during the rainy season, and samples from Selous or the Serengeti had a greater relative risk of being positive. Microbiome characterization identified Firmicutes and Proteobacteria as the most abundant phyla. The results highlight and define potential risks of exposure to endemic wildlife diseases from bushmeat and the need for future investigations to address the public health and emerging infectious disease risks associated with bushmeat harvesting, trade, and consumption.

scholarly journals Co-morbid anaemia and stunting among children of pre-school age in low- and middle-income countries: a syndemic

2018 ◽  
Vol 22 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Thach Duc Tran ◽  
Beverley-Ann Biggs ◽  
Sara Holton ◽  
Hau Thi Minh Nguyen ◽  
Sarah Hanieh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Secondary Analysis ◽  
Logistic Models ◽  
Demographic And Health Surveys ◽  
Healthy Children ◽  
Middle Income ◽  
Disadvantaged Children ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
Low And Middle Income

AbstractObjectiveTo determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries.DesignSecondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the sample (children who were not stunted and not anaemic) using multiple logistic models.SettingLow- and middle-income countries.SubjectsChildren aged 6–59 months.ResultsData from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 %; 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3; 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries.ConclusionsCo-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.

Could massive open online courses improve health and medical education?

2018 ◽  
Vol 26 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Stefanie Schütte ◽  
Sophie-Hélène Goulet-Ebongue ◽  
Khamsa Habouchi
Keyword(s):  
Medical Education ◽  
Health Care Professionals ◽  
Online Courses ◽  
Massive Open Online Courses ◽  
Special Focus ◽  
Massive Open Online ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Technological Advances

Abstract Technological advances during the last decade have provided novel opportunities for development of health and medical education. Education of health care professionals by massive open online courses (MOOCs) has been suggested in order to improve care and treatment of patients and the health literacy of the public. This article discusses the strengths, weaknesses, opportunities and threats of MOOCs in health and medical education by taking a special focus on low and middle-income countries.

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