scholarly journals Strengthening routine immunization in Papua New Guinea: implications for post-polio renewal from a cross-sectional provincial assessment of front-line services

2019 ◽  
Author(s):  
Christopher Morgan ◽  
Olga PM Saweri ◽  
Nicholas Larme ◽  
Elizabeth Peach ◽  
Pele Melepia ◽  
...  
Keyword(s):  
Health Services ◽  
Papua New Guinea ◽  
New Guinea ◽  
Population Characteristics ◽  
Routine Immunization ◽  
World Health ◽  
National Strategy ◽  
Cross Sectional ◽  
Immunization Service ◽  
World Health Organization Quality

Abstract Background Routine immunization programs face challenges in settings such as Papua New Guinea: dispersed rural populations, rugged geography, and limited resources for transport and health. Low routine coverage contributes to outbreaks such as measles and the polio that re-appeared in 2018. Diversion of resources to the necessary emergency response can risk further weakening of the routine system. We report on an in-depth local assessment that documented immunization service provision so as to review new national strategy, and consider how emergency polio responses could simultaneously strengthen routine immunization. Methods In East New Britain Province, over 2016 and 17, we carried out a cross-sectional assessment of 12 rural health facilities, staff and clients. The study was timed to follow implementation of a new national strategy for strengthening routine immunization. We used interview, structured observation, and records review, informed by theory-based evaluation, a World Health Organization quality checklist, and other health services research tools. Results We documented strengths and weaknesses across six categories of program performance relevant to national immunization strategy and global standards. We found a functional immunization service with an operational level of staff, equipment and procedures in place; but one that could reach only half to two thirds of its target population. Stronger routine services require improvement in: understanding of population catchments, tracking the unvaccinated, reach and efficiency of outreach visits, staff knowledge of vaccination at birth and beyond the first year of life, handling of multi-dose vials, and engagement of community members. Many local suggestions to enhance national plans, including more reliable on-demand services, integration of other family health services and increased involvement of men. Conclusions The national strategy addresses most local gaps, but implementation and resourcing was insufficient. Emergency polio campaigns could support a stronger routine program by building local planning capacity, identifying new outreach sites, sharing intelligence on local population characteristics, integrating high-demand services and other vaccines, distributing educational materials, and modelling better involvement of trained lay health workers. Long-term strengthening requires a major increase in centrally-allocated resources, however there are immediate locally feasible steps within current resources that could boost coverage and quality of routine immunization.

scholarly journals Strengthening routine immunization in Papua New Guinea: a cross-sectional provincial assessment of front-line services.

2019 ◽  
Author(s):  
Christopher Morgan ◽  
Olga PM Saweri ◽  
Nicholas Larme ◽  
Elizabeth Peach ◽  
Pele Melepia ◽  
...  
Keyword(s):  
Health Services ◽  
Papua New Guinea ◽  
New Guinea ◽  
Routine Immunization ◽  
World Health ◽  
National Strategy ◽  
Services Research ◽  
Cross Sectional ◽  
Immunization Service ◽  
World Health Organization Quality

Abstract Background Routine immunization programs face many challenges in settings such as Papua New Guinea with dispersed rural populations, rugged geography and limited resources for transport and health. Low routine coverage contributes to disease outbreaks such as measles and the polio that re-appeared in 2018. We report on an in-depth local assessment that aimed to document immunization service provision so as to review a new national strategy, and consider how routine immunization could be better strengthened.Methods In East New Britain Province, over 2016 and 17, we carried out a cross-sectional assessment of 12 rural health facilities, staff and clients. The study was timed to follow implementation of a new national strategy for strengthening routine immunization. We used interview, structured observation, and records review, informed by theory-based evaluation, a World Health Organization quality checklist, and other health services research tools.Results We documented strengths and weaknesses across six categories of program performance relevant to national immunization strategy and global standards. We found an immunization service with an operational level of staff, equipment and procedures in place; but one that could reach only half to two thirds of its target population. Stronger routine services require improvement in: understanding of population catchments, tracking the unvaccinated, reach and efficiency of outreach visits, staff knowledge of vaccination at birth and beyond the first year of life, handling of multi-dose vials, and engagement of community members. Many local suggestions to enhance national plans, including more reliable on-demand services, integration of other family health services and increased involvement of men.Conclusions The national strategy addresses most local gaps, but implementation and resourcing requires greater commitment. Long-term strengthening requires a major increase in centrally-allocated resources, however there are immediate locally feasible steps within current resources that could boost coverage and quality of routine immunization especially through better population-based local planning, and stronger community engagement. Our results also suggest areas where vaccination campaigns in PNG can contribute to routine immunization services.

scholarly journals Strengthening routine immunization in Papua New Guinea: a cross-sectional provincial assessment of front-line services

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christopher J. Morgan ◽  
Olga P. M. Saweri ◽  
Nicholas Larme ◽  
Elizabeth Peach ◽  
Pele Melepia ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
New Guinea ◽  
Routine Immunization ◽  
Front Line ◽  
Cross Sectional

Glittre ADL test in eutrophic, overweight and obese elderly

2020 ◽  
Vol 21 (1) ◽  
pp. 49
Author(s):  
Augusto Baumhardt Guidoti ◽  
Ângelo Pereira Cattani ◽  
Cintia Laura De Araujo ◽  
Fernanda Beatriz Costa Delacoste ◽  
Guilherme Scotta Hentschke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Elderly Women ◽  
Handgrip Strength ◽  
Exercise Intolerance ◽  
World Health ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
World Health Organization Quality

The Glittre ADL-test (TGlittre) has been designed and validated to measure functional capacity during daily living activities in patients with chronic obstructive pulmonary disease (COPD) but is now used in several other situations. The aim of this study was to evaluate the applicability of TGlittre in a sample of overweight and obese eutrophic elderly. This was an experimental and cross-sectional study, which included 21 elderly women, allocated by BMI, in eutrophic (n = 8), overweight (n = 6) and obese (n = 7) groups. They were assessed for functional capacity (TGlittre and 6MWT), quality of life (QOL) with the questionnaire World Health Organization Quality of Life for Older People (WHOQOL-OLD) and handgrip strength (HGS). TGlittre correlated with age (p = 0.0040) and with 6MWT (p = 0.0086), but no statistical difference was found in TGlittre's performance time and the distance covered in 6MWT between groups. TGlittre did not correlate with HGS (p = 0.1493) and WHOQOL-Old (p = 0.0905). The data obtained in the present study corroborate that TGlittre is used as a functional measurement variable in the elderly population.Keywords: aged, obesity, exercise intolerance.­­­

scholarly journals Comparison of Quality and Lifestyle in Women with and Without Uterine Leiomyoma Referred to Gynecology Clinics of Shiraz University of Medical Sciences in 2018

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mahnaz Zarshenas ◽  
Mozhgan Sorkhenezhad ◽  
Marzieh Akbarzadeh
Keyword(s):  
Quality Of Life ◽  
Uterine Leiomyoma ◽  
Healthy Lifestyle ◽  
World Health ◽  
Medical Sciences ◽  
Cross Sectional ◽  
World Health Organization Quality ◽  
Significant Difference ◽  
The Mean

Background: Uterine leiomyomas are considered as a major source of complications and the most common cause of hysterectomy. Objectives: The aim of this study was to compare the quality of life in women with and without uterine leiomyoma referred to gynecology clinics of Shiraz University of Medical Sciences in 2018. Methods: In this cross-sectional study, a total of 126 patients who referred to the clinics of Shiraz University of Medical Sciences were selected and divided into equal groups according to uterine leiomyoma, 1 - 7 cm uterine leiomyoma group and non-uterine leiomyoma group by convenience sampling. The World Health Organization Quality of Life and Healthy Lifestyle questionnaires were used for data collection. Independent t-test was used to analyze the data. Results: The mean quality of life of women with uterine leiomyoma was 47.20 ± 12.41 and women without uterine leiomyoma had a significant difference (51.11 ± 11.23, t = 3.93, P = 0.041). The mean lifestyle of women with uterine leiomyoma was 114.18 ± 25.48 and women without uterine leiomyoma had 149.11 ± 23.81 (t = 4.01, P = 0.029). Conclusions: The mean score of quality of life and lifestyle were significantly different in women with and without uterine leiomyoma. Therefore, it is necessary to improve the quality of life of women by improving their lifestyle and providing psychological counseling.

scholarly journals Increase in the proportion of Plasmodium falciparum with kelch13 C580Y mutation and decline in pfcrt and pfmdr1 mutant alleles in Papua New Guinea

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoko Yoshida ◽  
Masato Yamauchi ◽  
Ryosuke Morikawa ◽  
Francis Hombhanje ◽  
Toshihiro Mita
Keyword(s):  
Plasmodium Falciparum ◽  
Papua New Guinea ◽  
New Guinea ◽  
Therapeutic Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
In The Wild ◽  
Nationwide Surveillance ◽  
Greater Mekong Subregion ◽  
C580y Mutation

Abstract Background The C580Y mutation in the Plasmodium falciparum kelch13 gene is the most commonly observed variant in artemisinin-resistant isolates in the Greater Mekong Subregion (GMS). Until 2017, it had not been identified outside the GMS, except for Guyana/Amazonia. In 2017, three parasites carrying the C580Y mutation were identified in Papua New Guinea (PNG). As the C580Y allele rapidly spread in the GMS, there is concern that this mutant is now spreading in PNG. Methods In 2020, a cross-sectional survey was conducted at two clinics in Wewak, PNG. Symptomatic patients infected with P. falciparum were treated with artemether plus lumefantrine following a national treatment policy. Blood samples were obtained before treatment, and polymorphisms in kelch13, pfcrt, and pfmdr1 were determined. Parasite positivity was examined on day 3. The results were compared with those of previous studies conducted in 2002, 2003, and 2016–2018. Results A total of 94 patients were included in this analysis. The proportion of C580Y was significantly increased (2.2% in 2017, 5.7% in 2018, and 6.4% in 2020; p = 4.2 × 10–3). A significant upward trend was observed in the wild-type proportion for pfcrt (1.9% in 2016 to 46.7% in 2020; p = 8.9 × 10–16) and pfmdr1 (59.5% in 2016 to 91.4% in 2020; p = 2.3 × 10–6). Among 27 patients successfully followed on day 3, including three with C580Y infections, none showed positive parasitaemia. Conclusions Under the conditions of significant increases in pfcrt K76 and pfmdr1 N86 alleles in PNG, the increase in kelch13 C580Y mutants may be a warning indicator of the emergence of parasites resistant to the currently used first-line treatment regimen of artemether plus lumefantrine. Therefore, nationwide surveillance of molecular markers for drug resistance and assessment of its therapeutic effects are important.

Rapid assessment of avoidable blindness in Papua New Guinea: a nationwide survey

2018 ◽  
Vol 103 (3) ◽  
pp. 338-342 ◽  
Author(s):  
Ling Lee ◽  
Fabrizio D'Esposito ◽  
Jambi Garap ◽  
Geoffrey Wabulembo ◽  
Samuel Peter Koim ◽  
...  
Keyword(s):  
Papua New Guinea ◽  
Refractive Error ◽  
Rapid Assessment ◽  
New Guinea ◽  
Nationwide Survey ◽  
Population Based ◽  
Vision Impairment ◽  
Cross Sectional ◽  
National Capital ◽  
Uncorrected Refractive Error

ObjectiveTo estimate the prevalence and main causes of blindness and vision impairment in people aged 50 years and older in Papua New Guinea (PNG).DesignNational cross-sectional population-based survey in National Capital District (NCD), Highlands, Coastal and Islands regions.MethodsAdults aged 50 years and above were recruited from 100 randomly selected clusters. Each participant underwent monocular presenting and pinhole visual acuity (VA) assessment and lens examination. Those with pinhole VA<6/12 in either eye had a dilated fundus examination to determine the primary cause of reduced vision. Those with obvious lens opacity were interviewed on barriers to cataract surgery.ResultsA total of 4818 adults were examined. The age-adjusted and sex-adjusted prevalence of blindness (VA <3/60), severe vision impairment (SVI, VA <6/60 but ≥3/60), moderate vision impairment (MVI, VA <6/18 but ≥6/60) and early vision impairment (EVI, VA <6/12 but ≥6/18) was 5.6% (95% CI 4.9% to 6.3%), 2.9% (95% CI 2.5% to 3.4%), 10.9% (95% CI 9.9% to 11.9%) and 7.3% (95% CI 6.6% to 8.0%), respectively. The main cause of blindness, SVI and MVI was cataract, while uncorrected refractive error was the main cause of EVI. A significantly higher prevalence of blindness, SVI and MVI occurred in the Highlands compared with NCD. Across all regions, women had lower cataract surgical coverage and spectacle coverage than men.ConclusionsPNG has one of the highest reported prevalence of blindness globally. Cataract and uncorrected refractive error are the main causes, suggesting a need for increased accessible services with improved resources and advocacy for enhancing eye health literacy.

scholarly journals Correlation between quality of life and burden of family caregivers of infants with cleft lip and palate

2019 ◽  
Vol 53 ◽  
Author(s):  
Marli Luiz Beluci ◽  
Cleide Carolina da Silva Demoro Mondini ◽  
Armando dos Santos Trettene ◽  
Rosana Aparecida Spadoti Dantas
Keyword(s):  
Quality Of Life ◽  
Family Caregivers ◽  
Cleft Lip ◽  
Family Income ◽  
Cleft Lip And Palate ◽  
World Health ◽  
Cross Sectional ◽  
World Health Organization Quality ◽  
Environment Domain

ABSTRACT Objective: To evaluate the correlation between measures of quality of life and burden in family caregivers of infants with cleft lip and palate and to analyze possible associations between quality of life and sociodemographic variables. Method: Exploratory, cross-sectional study conducted in hospital specialized in the treatment of craniofacial anomalies, with caregivers who answered the following data collection instruments: sociodemographic characterization form, World Health Organization Quality of Life - BREF questionnaire and the Burden Interview Scale. The statistical analysis was conducted using the Pearson’s Correlation test, the Student’s t-test and the ANOVA test with a level of significance of 0.05. Results: 77 caregivers participated in the study. There was an inverse correlation between quality of life and burden in the Physical Health, Psychological, Social Relationships and Environment domains. There was a positive correlation between quality of life and family income in the Environment domain. Conclusion: The greater the burden on the caregiver, the lower was their perception of quality of life. Caregivers with higher family income and greater level of education presented a better perception quality of life in the Environment domain.

scholarly journals Work addiction and quality of life: a study with physicians

2017 ◽  
Vol 15 (2) ◽  
pp. 130-135 ◽  
Author(s):  
Walter Fernandes de Azevedo ◽  
Lígia Andrade da Silva Telles Mathias
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
World Health Organization Quality ◽  
Work Addiction ◽  
Organization Quality ◽  
Health Organization ◽  
Improve Health

ABSTRACT Objective To evaluate the quality of life of physicians and investigate to what extent it is affected by work addiction. Methods This is an exploratory, descriptive and cross-sectional study, conducted with 1,110 physicians. For data collection, we used a questionnaire with sociodemographic information, the World Health Organization Quality of Life BREF, and the Work Addiction Scale. Results Most physicians presented high quality of life. Female participants presented lower quality of life in the domains psychologic, environment and general (p<0.05). Quality of life was negatively correlated with the number of shifts (p<0.005). The higher the addiction to work, the lower the quality of life. Conclusion The research allowed understanding the implications of work addiction in the quality of life. Further studies are required to support the development of strategies that improve health conditions and quality of life of medical professionals.

scholarly journals Factors influencing quality of life and predictors of low quality of life scores in patients on treatment for pulmonary tuberculosis: a cross sectional study.

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Olufunke O. Adeyeye ◽  
Olayinka O. Ogunleye ◽  
Ayodele Coker ◽  
Yetunde Kuyinu ◽  
Raymond T. Bamisile ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Tuberculosis ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
University Teaching ◽  
World Health ◽  
Cross Sectional ◽  
World Health Organization Quality ◽  
Factors Influencing

There is paucity of information on the quality of life of patients with pulmonary tuberculosis in Nigeria. This study assessed the factors influencing their quality of life and the independent predictors of low quality of life scores. Two hundred and sixty consecutive patients with pulmonary tuberculosis seen at the Lagos University Teaching Hospital were evaluated for health related quality of life using the World Health Organization Quality of life instrument (WHOQoL-BREF). Sociodemographic characteristics of the patients were related to the various domains of quality of life and a multivariate logistic regression analysis was performed to identify the independent predictors of low quality of life scores in the patients. The mean age of the patients was 36.7±12 years. Sex, age and marital status of patients were found to influence quality of life scores. The independent predictors of low quality of life scores were low monthly income, duration of the illness, concomitant illnesses, unemployment, advancing age and male gender. Several socio demographic and economic factors influenced the quality of life of patients with tuberculosis and are predictive of poor scores. It is important to consider these factors when treating patients with tuberculosis to optimise outcome of care.

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