MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaccine Coverage ◽  
Significant Risk ◽  
Public Health Problem ◽  
Maculopapular Rash ◽  
Healthcare Facility ◽  
Control Measures ◽  
Major Public Health Problem ◽  
District Health ◽  
Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

Prevalence and Risk Factors Associated with First-Line Anti-Tuberculosis Induced Hepatotoxicity in Suratthani Hospital, Thailand

2021 ◽  
Vol 104 (2) ◽  
pp. 233-239
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Clinical Symptoms ◽  
Significant Risk ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
First Line ◽  
Drug Induced ◽  
Factors Associated ◽  
Drug Risk

ackground: Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand. Objective: To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients. Materials and Methods: The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms. Results: Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age>60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009). Conclusion: Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity. Keywords: Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand

Environmental Vector Control Practices among Households of Patients with Dengue Fever during the Epidemic of 2018 in Kerala, India

2021 ◽  
Vol 8 (02) ◽  
pp. 48-52
Author(s):  
Chintha Sujatha ◽  
Reshma Rajan Sudha ◽  
Sreejith Lalitha Krishnankutty ◽  
Prajitha Kannamkottapilly Chandrasekharan
Keyword(s):  
Vector Control ◽  
Dengue Fever ◽  
Protective Factor ◽  
Significant Risk ◽  
Public Health Problem ◽  
Community Level ◽  
Control Measures ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Breeding Habitats

BACKGROUND Dengue fever is a major public health problem in Kerala. Vector control measures practiced at household level is the most cost-effective way of controlling dengue. This study aims to assess environmental measures of vector control practised among households of suspected or confirmed dengue patients in Thiruvananthapuram district of Kerala. METHODS A cross sectional study was done among households of patients diagnosed with dengue fever and reported in Integrated Disease Surveillance Programme (IDSP) in Thiruvananthapuram district from June to December 2018. Investigators interviewed the household members and made direct observations to collect data on vector control practices using a structured questionnaire. RESULTS A total of 108 houses were surveyed. Potential breeding habitats were found in 58 (53.7 %) houses. Aedes larva was found in containers from four (3.7 %) houses. Dry day observance was not regular with only 5 (4.6 %) houses practicing it weekly. Waste management practiced was proper in 47 (43.5 %) houses. Community level pre monsoon preparedness for epidemics was done in the vicinity of 53 (49.1 %) houses and it was found to be a protective factor against presence of breeding habitats in and around houses (p = 0.013). Low education (p = 0.012) and low occupational status (p = 0.017) were found to be significant risk factors. CONCLUSIONS Even during an epidemic, with occurrence of infections in the family, only half of the households are practising adequate vector control methods. Community level interventions and targeted information education campaign will help improve practice of environmental methods of vector control in dengue. KEYWORDS Dengue, Vector Control, Aedes Control, Environmental Methods, Community Interventions

scholarly journals The Isle of Wight Suicide Study: a case study of suicide in a limited geographic area

2014 ◽  
Vol 31 (2) ◽  
pp. 133-141
Author(s):  
H. Shahpesandy ◽  
M. Oakes ◽  
Ad van Heeswijck
Keyword(s):  
Risk Factors ◽  
Mental Disorders ◽  
Significant Risk ◽  
Public Health Problem ◽  
Geographic Area ◽  
Major Public Health Problem ◽  
Service Users ◽  
Female Ratio ◽  
Isle Of Wight ◽  
Axis I

BackgroundSuicide is a major public health problem, with mental disorders being one of its major risk factors. The high incidence of suicide on the Isle of Wight has motivated this study, the first of its kind on suicide in this small geographic area.AimThe aim of the study was to identify socio-demographic and clinical risk factors for suicide in the population of service users and non-service users, and gender-related characteristics of suicidal behaviour in a limited geographic region.MethodData were collected on 68 cases of suicide (ICD-10×60-X84) from residents of the Isle of Wight District between January 2006 and December 2009. All data were statistically analysed using Pearson’s χ2 test and Yates’ correction for continuity.ResultsThe mean annual suicide rates over the period were 5.65 per 100 000 for women and 19.28 for men. Significantly (p=0.0006), more men than women (male/female ratio 3:1) died as a result of suicide. Relatively (p=0.07) more women (56.2%) than men (32.7%), and significantly more (p=0.05) service users (45.3%) than non-service users (13.3%) were unemployed. Significantly, more (p=0.0006) service users (64%) than non-service users (20%) had a history of suicide attempts and relatively (p=0.06) more (50.9%) service users than non-service users (20%) had attended the accident and emergency department before their death; 69% had an adverse life event within a year before their suicide. Depression as the most common Axis-I illness was diagnosed in 36% of all; but significantly (p=0.008) more in women (66.6%) than men (17.3%). Relatively (p=0.07) more women (56.2%) than men (32.7%) have contacted services before their death. Suicide by hanging was the most common cause, accounting for the death of 71% of men and 50% of women.ConclusionsThe study found that 80% of all suicides occurred in people suffering from mental disorder. Men are at a significant risk of suicide. Depressive disorders in women and stress-related disorders in men were the most common mental disorders. Treating mental disorders and co-morbid conditions seems to be one of the key elements in suicide prevention strategies.

scholarly journals Risk Factors of Dengue Fever Outbreak in Karo District, North Sumatera, Indonesia

2019 ◽  
Vol 5 (1) ◽  
pp. 16-22
Author(s):  
Frans Yosep Sitepu
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Significant Risk ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Control Measures ◽  
Breeding Sites ◽  
Mosquito Breeding

Dengue fever (DF) infection continues to present a seriuos public health problem in North Sumatera, Indonesia. A DF outbreak was reported in Merek Sub-district, Karo District which is one tourist destination in North Sumatera during April-May 2017. An epidemiological investigation was conducted to identify the risk factors and recommend control measures. An observational study with a matched case control design was conducted. A case was defined as any resident of Merek sub-district who had suffer major clinical symptoms of DF such as fever, severe headache, pain behind eyes, muscle and joint pains, and rash from April – May, 2017. A control was defined as neighbors of cases who did not have clinical signs and symptoms of DF and were matched for age and sex. We interviewed 37 cases and 37 controls. Age cases ranged from 2 year to 37 years (median= 12 years). The multivariate analyses showed that presence of mosquito breeding sites (OR=4.87, 95%CI=1.33-17.85) and habit of hanging worn clothes (OR=5.12, 95%CI=1.25-21.03) were significant risk factors. It is recommended to eliminate mosquito breeding sites routinely, avoid habit of hanging worn clothes, and conduct strict surveillance of DF continously.

scholarly journals Prevalence and Risk Factors for Hypertension in Adults Living in Central Development Region of Nepal

2012 ◽  
Vol 9 (1) ◽  
pp. 13-18 ◽  
Author(s):  
J Chataut ◽  
R K Adhikari ◽  
N P Sinha
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Alcohol Consumption ◽  
Significant Risk ◽  
Public Health Problem ◽  
Anthropometric Measurement ◽  
Bivariate Analysis ◽  
Major Public Health Problem ◽  
Cross Sectional

Background Hypertension is the commonest cardiovascular disorder and now regarded as major public health problem. It is a precursor to major diseases like myocardial infarction, stroke, renal failure etc. There are very limited community based data on hypertension in Nepal, so, information on the prevalence of hypertension in the population is desirable. Objectives To estimate the prevalence of hypertension and to explore the risk factors associated with hypertension. Methods In a cross sectional study , a total of 527 subjects (males n=214 and females n=313) participated in our study (age ?18 years). The participants underwent anthropometric measurement and blood pressure and answered a pretested questionnaire. Hypertension was defined as per JNC VII criteria. Results Overall prevalence of hypertension was 22.4% (males: 32.7% and female: 15.3%). Age specific prevalence of hypertension showed significant progressive increase in blood pressure ranging from 8% to 35%. Almost 40% of hypertensives did not know about their status. Bivariate analysis showed significant relationship of hypertension with gender, age, literacy, physical inactivity, body mass index (BMI), smoking and alcohol consumption. Multivariate analysis excluded literacy but all other risk factors continued to show positive association with hypertension. Conclusion Being elderly, less physical activity, obese/overweight, smoking and alcohol consumption are significant risk factors of hypertension. Therefore, intervention measures are warranted emphasizing on modifiable risk factors such as smoking, alcohol consumption, physical activity and obesity to prevent hypertension.http://dx.doi.org/10.3126/kumj.v9i1.6255 Kathmandu Univ Med J 2011;9(1):13-18

Risk factors identification and prediction of anemia among women in Bangladesh using machine learning techniques

2021 ◽  
Vol 17 ◽  
Author(s):  
Md. Merajul Islam ◽  
Md. Jahanur Rahman ◽  
Dulal Chandra Roy ◽  
Md. Moidul Islam ◽  
Most. Tawabunnahar ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Feature Selection ◽  
Discriminant Analysis ◽  
Predictive Models ◽  
Classification Accuracy ◽  
Significant Risk ◽  
Public Health Problem ◽  
Support Vector ◽  
Major Public Health Problem

Background: Anemia is a major public health problem with raising its prevalence worldwide including Bangladesh. Objectives: To identify the risk factors of anemia among women in Bangladesh and its prediction using machine learning (ML) based techniques. Methods: The anemia dataset, comprising of 3,020 respondents, was extracted from the Bangladesh demographic and health survey (BDHS). Two feature selection techniques as logistic regression (LR) and random forest (RF) have been utilized to determine the risk factors of anemia. Additionally, eight ML-based techniques, namely LR, linear discriminant analysis (LDA), K-nearest neighborhood (KNN), support vector machine (SVM), quadratic discriminant analysis (QDA), neural network (NN), classification and regression tree (CART), and RF have been also utilized to predict anemia disease among women in Bangladesh. Classification accuracy and area under the curve (AUC) are used to evaluate the performances of these classifiers. Results: LR and RF-based feature selection results indicate that out of 15 factors, 13 for LR and 14 factors for RF appear to be significant risk factors for anemia among women. All predictive models provide the highest classification accuracy and AUC from 74.10-81.29% and 0.744-0.819 under RF features. However, the combination of RF-based feature selection along with RF-based classifier gives the highest classification accuracy (81.29%) and AUC (0.819). Conclusion: Out of eight predictive models, the RF-RF based combination model shows the best performance for the prediction of anemia. This study suggests policymakers to make appropriate decisions to control the anemia using these mentioned combinations to save time and reduce the cost for Bangladeshi women.

scholarly journals Prevalence, antimicrobial susceptibility patterns, and associated risk factors of Salmonella and Shigella among food handlers in Adigrat University student’s cafeteria, Northern Ethiopia, 2018

2020 ◽  
Author(s):  
Haftom Legese ◽  
Tsega Kahsay ◽  
Aderajew Gebrewahd ◽  
Birhane Berhe ◽  
Berhane Fiseha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antimicrobial Susceptibility ◽  
Public Health Problem ◽  
Hand Washing ◽  
Control Measures ◽  
Major Public Health Problem ◽  
Northern Ethiopia ◽  
Food Handlers ◽  
Associated Risk Factors ◽  
Susceptibility Patterns

Abstract Background : Food handlers play a significant role in the transmission of foodborne infection. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem of the globe. Thus, this study was aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated risk factors of Salmonella and Shigella among food handlers. Methodology: A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated risk factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 with a corresponding 95% confidence interval was considered statistically significant. Results: A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0 %). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, hand washing after using the bathroom, hand washing after touching dirty materials, hand washing before food handling and fingernails status were significant associated risk factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin. On the other hand, low resistance was found for chloramphenicol , ceftriaxone, and ciprofloxacin. Conclusion: The present study revealed that the prevalence of Salmonella and Shigella among food handlers found to be 22 (7.3%) and 11 (3.7%) respectively. Such infected food handlers can contaminate food, drinks and could serve as a source of infection to consumers via the food chain. This indicates that the need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students’ cafeteria.

Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Substance Abuse ◽  
Suicidal Ideation ◽  
Family Support ◽  
Drug Users ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

Healthcare-Associated Infections: Not Only a Clinical Burden, But a Forensic Point of View

2019 ◽  
Vol 20 (8) ◽  
pp. 658-664 ◽  
Author(s):  
Marco Di Paolo ◽  
Luigi Papi ◽  
Paolo Malacarne ◽  
Federica Gori ◽  
Emanuela Turillazzi
Keyword(s):  
Health Care ◽  
Clinical Medicine ◽  
Methodological Approach ◽  
Care Facility ◽  
Public Health Problem ◽  
Control Measures ◽  
Major Public Health Problem ◽  
Healthcare Associated Infections ◽  
Open Communication ◽  
Healthcare Associated

Background: Healthcare-associated infections (HCAIs) occur when patients receiving treatment in a health care setting develop an infection. They represent a major public health problem, requiring the integration of clinical medicine, pathology, epidemiology, laboratory sciences, and, finally, forensic medicine. Methods: The determination of cause of death is fundamental not only in the cases of presumed malpractice to ascertain the causal link with any negligent behavior both of health facilities and of individual professionals, but also for epidemiological purposes since it may help to know the global burden of HCAIs, that remains undetermined because of the difficulty of gathering reliable diagnostic data. A complete methodological approach, integrating clinical data by means of autopsy and histological and laboratory findings aiming to identify and demonstrate the host response to infectious insult, is mandatory in HCAIs related deaths. Results: Important tasks for forensic specialists in hospitals and health services centers are the promotion of transparency and open communication by health-care workers on the risk of HCAIs, thus facilitating patients’ engagement and the implementation of educational interventions for professionals aimed to improve their knowledge and adherence to prevention and control measures. Conclusion: HCAIs are a major problem for patient safety in every health-care facility and system around the world and their control and prevention represent a challenging priority for healthcare institution and workers committed to making healthcare safer. Clinicians are at the forefront in the war against HCAIs, however, also forensic pathologists have a remarkable role.

Prevalence and risk factors of Strongyloides stercoralis infection among Orang Asli schoolchildren: new insights into the epidemiology, transmission and diagnosis of strongyloidiasis in Malaysia

Parasitology ◽  
2019 ◽  
Vol 146 (12) ◽  
pp. 1602-1614 ◽  
Author(s):  
Hesham M. Al-Mekhlafi ◽  
Nabil A. Nasr ◽  
Yvonne A. L. Lim ◽  
Fatin Nur Elyana ◽  
Hany Sady ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intestinal Parasites ◽  
Agar Plate ◽  
Significant Risk ◽  
Control Programme ◽  
Control Measures ◽  
Parasitic Infections ◽  
Cross Sectional ◽  
Orang Asli ◽  
Direct Smear

AbstractThis cross-sectional study aimed to determine the prevalence and risk factors of S. stercoralis infection among 1142 Orang Asli primary schoolchildren in six different states of Peninsular Malaysia. Fecal samples were examined using direct smear, formalin-ether sedimentation (FES), agar plate culture (APC) and PCR techniques. Overall, 15.8% of the children were found to be infected with S. stercoralis. The prevalence was 0.2, 1.3, 15.2 and 13.7% by direct smear, FES, APC and PCR, respectively. Multivariate analysis showed that an age of >10 years, being male, belonging to a Proto-Malay tribe, belonging to the Senoi tribe, indiscriminate defecation, using an unimproved water source for drinking water and not wearing shoes when outside were the significant risk factors of infection among these children. In conclusion, we provide new evidence on the occurrence of S. stercoralis in Malaysia to show that there is a relatively high prevalence of infection among Orang Asli schoolchildren. Therefore, the use of specific methods for detecting S. stercoralis should be considered when screening these children for intestinal parasites. Moreover, prevention and control measures specific to S. stercoralis should be integrated into the intestinal parasitic infections control programme in Malaysia.

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