scholarly journals Behavior and major barriers faced by non-injectable drug users with HBV/HCV seeking treatment for hepatitis and drug addiction in Rio de Janeiro, Brazil

2011 ◽  
Vol 16 (12) ◽  
pp. 4777-4786 ◽  
Author(s):  
Monica Malta ◽  
Sabine Cavalcanti ◽  
Louis Gliksman ◽  
Edward Adlaf ◽  
Mariana de Andrea Vilas-Boas Hacker ◽  
...  
Keyword(s):  
Health Services ◽  
Rio De Janeiro ◽  
Drug Users ◽  
Addiction Treatment ◽  
Educational Background ◽  
Treatment Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Hepatitis Treatment

Drug users (DU) are a marginalized group and at risk for viral hepatitis, who seldom access health services. A cross-sectional survey was conducted with 111 DU with chronic HBV/HCV and 15 in-depth interviews with health professionals/policymakers in Rio de Janeiro, Brazil. Most interviewees were male, non-white, with a low educational background, unemployed and/or living on less than $245 a month (minimun wage). In the last 6 months, 61.8% of interviewees snorted cocaine, 64.7% at least once a week. Half of the interviewees had a stable partner and 38.3% of those with occasional partners never/almost never using condoms. Addiction treatment seeking was found to be associated with: being white (OR:5.5), high-school degree (OR:8.7), and employment (OR:5.7). Hepatitis treatment seeking was high (80.9%), and access to low-threshold, user-friendly health services was key for treatment seeking behaviors (OR:3.6). Missed opportunities for hepatitis treatment seem to be associated with structural (uneven political/financial support to hepatitis programs) and patient-related barriers (severe addiction and non-adherence). Those most in need were less likely to access treatment, calling for renewed strategies, in order to curb hepatitis among impoverished drug users and their sexual partners.

scholarly journals Trends and determinants of HIV transmission among men who inject drugs in the Pokhara Valley, Nepal

2020 ◽  
Author(s):  
Sam Hogan ◽  
Andrew Page ◽  
Felix Ogbo ◽  
Sameer Dixit ◽  
Rajesh Man Rajbhandari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injection Drug Users ◽  
Drug Users ◽  
Addiction Treatment ◽  
Public Health Issue ◽  
Hiv Education ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge Based ◽  
Pokhara Valley

Abstract Background HIV is a major public health issue around the world, especially in developing countries. Although the overall prevalence of HIV in Nepal is relatively low and the country itself is considered low risk, there are specific sub-populations where the prevalence is far higher than the national average. One of these sub-groups is male injection drug users (IDUs). In order to understand the reasons for the differences in prevalence, a series of socio-demographic, behavioural and knowledge-based risk factors need to be assessed.Methods The study used a series of 7 cross-sectional survey datasets, collected between 2003 and 2017 (N=2,235) to investigate trends in HIV prevalence among male IDUs by key socio-demographic and behavioural and knowledge-based risk factors. A series of logistic regression models were conducted to investigate the association between study factors and HIV in the Pokhara valley, Nepal.Results A lower risk of HIV was associated with younger age (≤24 years compared to >24 years, OR = 0.17, 95% CI = 0.10, 0.31), not being married (OR = 0.51, 95% CI = 0.33, 0.80) and shorter duration of drug use (≤4 years compared to >4 years, OR = 0.16, 95% CI = 0.09, 0.29). A higher risk of HIV was associated with low (compared to secondary or higher) education level (OR = 2.76, 95% CI = 1.75, 4.36), a lack of addiction treatment (OR = 2.59, 95% CI = 1.64, 4.08), and recent use of unsterilized injection equipment (OR = 2.22, 95% CI = 1.20, 4.11).Conclusion Although knowledge of HIV is high among male IDUs, the prevalence of individuals who possess comprehensive knowledge and the number of individuals who have received treatment for drug addiction has decreased. This may indicate that addiction treatment and HIV education programs need to be strengthened.

scholarly journals Pre-Exposure Prophylaxis Training among Medical Schools in the United States

2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Robert L. Cooper ◽  
Mohammad Tabatabai ◽  
Paul D. Juarez ◽  
Aramandla Ramesh ◽  
Matthew C. Morris ◽  
...  
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Injection Drug Users ◽  
Drug Users ◽  
Healthcare Providers ◽  
Medical Schools ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

scholarly journals Utilization of key preventive measures for pregnancy complications and malaria among women in Jimma Zone, Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mariame Ouedraogo ◽  
Jaameeta Kurji ◽  
Lakew Abebe ◽  
Ronald Labonté ◽  
Sudhakar Morankar ◽  
...  
Keyword(s):  
Health Services ◽  
Pregnant Women ◽  
Malaria Infection ◽  
Preventive Measures ◽  
Health Sector ◽  
Maternal Health Services ◽  
Cross Sectional Survey ◽  
Wealth Status ◽  
Cross Sectional ◽  
Jimma Zone

Abstract Background In Ethiopia, malaria infections and other complications during pregnancy contribute to the high burden of maternal morbidity and mortality. Preventive measures are available, however little is known about the factors influencing the uptake of maternal health services and interventions by pregnant women in Ethiopia. Methods We analyzed data from a community-based cross-sectional survey conducted in 2016 in three rural districts of Jimma Zone, Ethiopia, with 3784 women who had a pregnancy outcome in the year preceding the survey. We used multivariable logistic regression models accounting for clustering to identify the determinants of antenatal care (ANC) attendance and insecticide-treated net (ITN) ownership and use, and the prevalence and predictors of malaria infection among pregnant women. Results Eighty-four percent of interviewed women reported receiving at least one ANC visit during their last pregnancy, while 47% reported attending four or more ANC visits. Common reasons for not attending ANC included women’s lack of awareness of its importance (48%), distance to health facility (23%) and unavailability of transportation (14%). Important determinants of ANC attendance included higher education level and wealth status, woman’s ability to make healthcare decisions, and pregnancy intendedness. An estimated 48% of women reported owning an ITN during their last pregnancy. Of these, 55% reported to have always slept under it during their last pregnancy. Analysis revealed that the odds of owning and using ITNs were respectively 2.07 (95% CI: 1.62–2.63) and 1.73 (95% CI: 1.32–2.27) times higher among women who attended at least one ANC visit. The self-reported prevalence of malaria infection during pregnancy was low (1.4%) across the three districts. We found that young, uneducated, and unemployed women presented higher odds of malaria infection during their last pregnancy. Conclusion ANC and ITN uptake during pregnancy in Jimma Zone fall below the respective targets of 95 and 90% set in the Ethiopian Health Sector Transformation Plan for 2020, suggesting that more intensive programmatic efforts still need to be directed towards improving access to these health services. Reaching ANC non-users and ITN ownership and use as part of ANC services could be emphasized to address these gaps.

scholarly journals Physician’s use of sickness certification guidelines: a nationwide survey of 13 750 physicians in different types of clinics in Sweden

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051555
Author(s):  
Veronica Svärd ◽  
Kristina Alexanderson
Keyword(s):  
Occupational Health ◽  
Health Services ◽  
Sick Leave ◽  
Primary Healthcare ◽  
Work Capacity ◽  
Occupational Health Services ◽  
Sickness Certification ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Different Types

ObjectivesTo explore physicians’ experiences of using the national sickness certification guidelines introduced in 2007 and the types of information they used, in general and in different types of clinics.DesignCross-sectional survey.SettingMost physicians working in Sweden in 2017.ParticipantsA questionnaire was sent to 34 718 physicians; 54% responded. Analyses were based on answers from the 13 750 physicians who had sick leave cases.Outcome measuresTo what extent the guidelines were used and what type of information from them that was used.ResultsTen years after the sickness certification guidelines were introduced in Sweden, half of the physicians used them at least once a month. About 40% of physicians in primary healthcare and occupational health services used the guidelines every week. The type of information used varied; 53% used recommendations about duration and 29% about degree of sick leave. Using information about function and activity/work capacity, respectively, was more common within primary healthcare (37% and 38%), psychiatry (42% and 42%), and occupational health services (35% and 41%), and less common in surgery and orthopaedic clinics (12% and 12%) who more often used information about duration (48% and 53%). Moreover, 10% stated that the guidelines were very, and 24% fairly problematic to apply. Half (47%) stated that the guidelines facilitated their contacts with patients and 29% that they improved quality in their management of sick leave cases. More non-specialists, compared with specialists, found that the guidelines facilitated contacts with patients (OR 3.28, 95% CI 3.04 to 3.55).ConclusionsThe majority of the physicians used the sickness certification guidelines, although this varied with type of clinic. Half stated that the guidelines facilitated patient contacts. Yet, some found it problematic to apply the guidelines. Further development of the guidelines is warranted as well as more knowledge about them among physicians.

Knowledge, attitude and practices regarding implants among women of childbearing age

2021 ◽  
pp. 1-9
Author(s):  
Irshad Begum Shaikh ◽  
Syed Imtiaz Ahmed Jafry ◽  
Syed Muhammad Zulfiqar Hyder Naqvi ◽  
Syeda Nadia Firdous ◽  
Admin
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Contraceptive Method ◽  
Women Of Childbearing Age ◽  
Reproductive Health Services ◽  
Childbearing Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Child Bearing

Abstract A cross-sectional survey was conducted from February 2016 to September 2016 to assess knowledge, attitude and practices regarding implants among women of childbearing age visiting Reproductive Health Services Center, Civil Hospital,Karachi. A total of 396 adult non-pregnant married females of child bearing age, from 18 to 49 years old, were interviewed using a structured questionnaire.Only153 (38.6%) of therespondentshad knowledge about implants whereas out of them 122 (79.7%) acquired it from family planning clinics. Almost two third of them (n=267, 67.4%) were in favor of using implants as a contraceptive method. Moreover, 244 (61.6%) of them were of the opinion that if given the choice, they will use implanon though out of total 316 (79.8%) respondents who ever used contraceptives, only 3 (0.9%) used implants.Despiteafavorable attitude, limited knowledge and poor practices of the respondents highlighted the study findings. Keywords: Knowledge, Attitude, Contraception, Progestins, Continuous...

scholarly journals Distance to health services and treatment-seeking for depressive symptoms in rural India: a repeated cross-sectional study

2020 ◽  
Vol 29 ◽  
Author(s):  
T. Roberts ◽  
S. Shiode ◽  
C. Grundy ◽  
V. Patel ◽  
R. Shidhaye ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Public Mental Health ◽  
Travel Distance ◽  
Rural India ◽  
Treatment Seeking ◽  
Depression Treatment ◽  
Treatment Provider ◽  
Cross Sectional

Abstract Aims Research from high-income countries has implicated travel distance to mental health services as an important factor influencing treatment-seeking for mental disorders. This study aimed to test the extent to which travel distance to the nearest depression treatment provider is associated with treatment-seeking for depression in rural India. Methods We used data from a population-based survey of adults with probable depression (n = 568), and calculated travel distance from households to the nearest public depression treatment provider with network analysis using Geographic Information Systems (GIS). We tested the association between travel distance to the nearest public depression treatment provider and 12 month self-reported use of services for depression. Results We found no association between travel distance and the probability of seeking treatment for depression (OR 1.00, 95% CI 0.98–1.02, p = 0.78). Those living in the immediate vicinity of public depression treatment providers were just as unlikely to seek treatment as those living 20 km or more away by road. There was evidence of interaction effects by caste, employment status and perceived need for health care, but these effect sizes were generally small. Conclusions Geographic accessibility – as measured by travel distance – is not the primary barrier to seeking treatment for depression in rural India. Reducing travel distance to public mental health services will not of itself reduce the depression treatment gap for depression, at least in this setting, and decisions about the best platform to deliver mental health services should not be made on this basis.

scholarly journals Knowledge and practices towards malaria amongst residents of Bushbuckridge, Mpumalanga, South Africa

2011 ◽  
Vol 3 (1) ◽  
Author(s):  
Khumbulani W. Hlongwana ◽  
Alpheus Zitha ◽  
Aaron M. Mabuza ◽  
Rajendra Maharaj
Keyword(s):  
Health Facility ◽  
Indoor Residual Spraying ◽  
Signs And Symptoms ◽  
Control Programme ◽  
Sub Saharan Africa ◽  
Treatment Seeking ◽  
Malaria Control Programme ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Household Heads

Background: Malaria remains one of the greatest public health challenges worldwide and it is amongst the top killers in sub-Saharan Africa. There is however, a general scepticism about the accuracy of Health Management Information Systems (HMIS) in recording all the episodes of malaria in Africa. Given the importance of community knowledge of malaria, its signs and symptoms, as well as prompt treatment-seeking behaviour, the study assessing adult residents’ knowledge and practices in Bushbuckridge provided much needed insights into the Malaria Control Programme (MCP). Objectives: The objectives of this study were to determine the adult residents’ knowledge and practices towards malaria in Bushbuckridge, Mpumalanga Province, South Africa.Method: The study was undertaken as a descriptive cross-sectional survey in Bushbuckridge in August 2008. Six hundred and two (602) household heads or their proxies from the randomly selected households in 20 localities were interviewed (one household member per household), using a structured field-piloted questionnaire.Results: Approximately 93% of the respondents had heard about malaria, 84.6% of whom correctly associated it with mosquito bites. The health facility (29.1%) and radio (19.8%) were the main sources of malaria information. Knowledge of signs and symptoms was low, whilst treatment-seeking intention at the health facility was high (99%) with 82% of which would be carried out promptly. Survey data showed an indoor residual spraying (IRS) coverage of approximately 70% and a good understanding of the reasons for spraying. Walls were replastered infrequently and no evidence was established linking it to the removal of insecticide marks on the wall.Conclusion: The study revealed not only that householders possessed an adequate knowledge of malaria, but also that they had positive malaria treatment-seeking intentions. Their knowledge of malaria signs and symptoms was inadequate and required attention. Whilst IRS coverage needed some improvements, the reasons for IRS were well known.

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