scholarly journals Study of the Déterminants of Stillbirths in the Reference Health Centers of Sélingué and Yorosso (Sikasso Region) From January 1, 2015, to December 31, 2017

2021 ◽  
Vol 6 (1) ◽  
Keyword(s):  
Multivariate Analysis ◽  
Antenatal Care ◽  
Protective Factor ◽  
Significant Risk ◽  
Public Health Problem ◽  
Routine Data ◽  
Significant Risk Factor ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Major Public Health Problem

Background: Stillbirths remain a major public health problem in sub-Saharan Africa and Mali. According to routine data collected from 2008 to 2016 in Sikasso, the health district of Sélingué had the highest stillbirth rate in the region (51.7 (‰) births) and that of Yorosso had the lowest (13.7 (‰) births). This led us to initiate this study to study the determinants of stillbirths in the Reference Health Centers of the two districts from January 1, 2015, to December 31, 2017. Methods: It was a case-control study of 440 cases including 110 cases and 330 controls in each of the Health Centers. The statistical analysis was done on SPSS version 20 and the writing was done on Word. The value of p<0.05 was found to be statistically significant. Result: The prevalence’s of stillbirths were 28, 6 ‰ in Sélingué and 140 ‰ in Yorosso. The Multivariate Analysis Yielded the Following Results: 1. Women who have not had an antenatal care have a 3 to 4 times higher risk of stillbirths than those who have had antenatal care (OR=3.87; CI: [1.86-8.04]; p=0.000); ambulance transport is a protective factor compared to other means of transport (OR: 0.27; CI: [0.09; 0.77];p=0.015); The following reasons for evacuation were risk factors for stillbirths: painful uterine contractions (OR: 4.23; CI: [1.55-11.55]; p=0.005) and stationary dilatation (OR: 6.04; CI: [1.11; 32.85], p=0.037). 2. In Yorosso, the multivariate analysis selected antenatal care as the only statistically significant risk factor for stillbirths. Women who did not have antenatal care were 4 times more likely to give birth to stillbirths than those who did (OR=4.27; CI: [1.08-16.88]; p=0.038). Conclusion: In light of these results, we believe that emphasis should be placed on the importance of prevention by strengthening antenatal care and improving evacuation conditions.

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 Risk for Severe Pulmonary Tuberculosis among Alcoholics and Diabetics

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Balachandran J ◽  
Sreekumar B
Keyword(s):  
Diabetes Mellitus ◽  
Pulmonary Tuberculosis ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Public Health Problem ◽  
Significant Risk Factor ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Minimal Disease

Tuberculosis is a major public health problem. Some patients present with minimal lesions where as others present with advanced lesions. Patients with advanced or severe disease have high morbidity and mortality. Their infectiousness is also high. This is a Case control study to identify the strength of associations between two important factors, namely alcoholism and diabetes mellitus, and severity of disease. There were 80 cases and 80 controls. Cases were patients with severe disease and controls were patients with minimal disease. Severity of tuberculosis was assessed by chest radiographic criteria as per American Thoracic Society recommendation. The study was done over a period of 18 months. Both inclusion and exclusion criteria were applied in the selection of cases and controls. 46.25% of cases and 23.75% of controls were alcoholic. 15% of cases were suffering from diabetes mellitus whereas only 5% of controls were diabetic. Univariate analysis showed that both alcoholism and diabetes mellitus were significant risk factors. When the confounding effect of age was also taken into account, diabetes mellitus was not found to be a significant risk factor in causing severe pulmonary tuberculosis. Therefore preventive measures may be targeted to alcoholics for the early identification of severe pulmonary tuberculosis.

scholarly journals Risk for Severe Pulmonary Tuberculosis among Alcoholics and Diabetics

2013 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
Balachandran J ◽  
Sreekumar B
Keyword(s):  
Diabetes Mellitus ◽  
Pulmonary Tuberculosis ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Public Health Problem ◽  
Significant Risk Factor ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Minimal Disease

Tuberculosis is a major public health problem. Some patients present with minimal lesions where as others present with advanced lesions. Patients with advanced or severe disease have high morbidity and mortality. Their infectiousness is also high. This is a Case control study to identify the strength of associations between two important factors, namely alcoholism and diabetes mellitus, and severity of disease. There were 80 cases and 80 controls. Cases were patients with severe disease and controls were patients with minimal disease. Severity of tuberculosis was assessed by chest radiographic criteria as per American Thoracic Society recommendation. The study was done over a period of 18 months. Both inclusion and exclusion criteria were applied in the selection of cases and controls. 46.25% of cases and 23.75% of controls were alcoholic. 15% of cases were suffering from diabetes mellitus whereas only 5% of controls were diabetic. Univariate analysis showed that both alcoholism and diabetes mellitus were significant risk factors. When the confounding effect of age was also taken into account, diabetes mellitus was not found to be a significant risk factor in causing severe pulmonary tuberculosis. Therefore preventive measures may be targeted to alcoholics for the early identification of severe pulmonary tuberculosis.

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.

scholarly journals Monitoring migrant groups as a post-validation surveillance approach to contain the potential reemergence of lymphatic filariasis in Togo

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Monique Ameyo Dorkenoo ◽  
Martin Kouame Tchankoni ◽  
Degninou Yehadji ◽  
Kossi Yakpa ◽  
Mawèké Tchalim ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Significant Risk ◽  
Public Health Problem ◽  
Test Strip ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Positive Case ◽  
Cross Sectional ◽  
Case Investigation ◽  
Migrant Groups

Abstract Background In March 2017, Togo was declared the first country in sub-Saharan Africa to eliminate lymphatic filariasis as a public health problem, but post-validation surveillance has been lacking. In some areas of the country, migrant groups from neighboring countries that are still endemic for LF pose a risk of reintroduction of LF to Togo. The objective of this study was to identify the risk posed by migrant groups by measuring their prevalence of LF infection and investigating any positive case using Togo’s case investigation algorithm to prevent resurgence of LF and sustain Togo’s elimination success. Method A cross-sectional study was conducted in 2018 in the northernmost region of the country. Three migrant populations were identified: (i) nomadic Peuhls, (ii) Togolese members of local communities who migrate annually to neighboring countries for seasonal labor, and (iii) refugees from Ghana who came to Togo because of a communal conflict in Ghana. A questionnaire was designed to collect data on demographics and history of LF and MDA; all participants were tested for circulating filariasis antigen (CFA) using the filariasis test strip (FTS). Any CFA-positive case was confirmed with nocturnal microfilaremia. Results Refugees, seasonal economic migrants and nomadic Peuhls represented 42.1%, 31.4% and 26.5% of the study participants, respectively. The overall prevalence of CFA was 4.2% (58/1391) with the highest prevalence in the nomadic Peuhl group (11.9%), but only one of them (0.07%) was confirmed positive with nocturnal microfilaremia. Using the case investigation algorithm, no other positive case was identified in the positive case’s surroundings. Conclusion This study demonstrates that nomadic Peuhls, with a CFA prevalence of 11.9%, pose a potential risk for reintroduction of LF into Togo while Ghanaian refugees and seasonal economic migrants do not appear to pose a significant risk. Periodic monitoring of migrants, especially the nomadic Peuhl population, is a potential post-validation surveillance approach that could be used to promptly detect any LF cluster that may arise.

A multi-state spatio-temporal Markov model for categorized incidence of meningitis in sub-Saharan Africa

2012 ◽  
Vol 141 (8) ◽  
pp. 1764-1771 ◽  
Author(s):  
L. AGIER ◽  
M. STANTON ◽  
G. SOGA ◽  
P. J. DIGGLE
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Public Health Problem ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Major Public Health Problem ◽  
Temporal Dependence ◽  
Spatio Temporal ◽  
Sub Saharan ◽  
Annual Scale

SUMMARYMeningococcal meningitis is a major public health problem in the African Belt. Despite the obvious seasonality of epidemics, the factors driving them are still poorly understood. Here, we provide a first attempt to predict epidemics at the spatio-temporal scale required for in-year response, using a purely empirical approach. District-level weekly incidence rates for Niger (1986–2007) were discretized into latent, alert and epidemic states according to pre-specified epidemiological thresholds. We modelled the probabilities of transition between states, accounting for seasonality and spatio-temporal dependence. One-week-ahead predictions for entering the epidemic state were generated with specificity and negative predictive value >99%, sensitivity and positive predictive value >72%. On the annual scale, we predict the first entry of a district into the epidemic state with sensitivity 65·0%, positive predictive value 49·0%, and an average time gained of 4·6 weeks. These results could inform decisions on preparatory actions.

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

scholarly journals RISK AND PROTECTIVE FACTORS FOR ABUSE AND NEGLECT IN DAILY CAREGIVING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S544-S544
Author(s):  
Maria Yefimova ◽  
Carolyn Pickering ◽  
Christopher Maxwell ◽  
Frank Puga ◽  
Tami Sullivan
Keyword(s):  
Protective Factors ◽  
Process Model ◽  
Protective Factor ◽  
Elder Abuse ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Risk And Protective Factors ◽  
Care Recipient ◽  
Daily Routine ◽  
Abuse And Neglect

Abstract The stress-process model suggests a variety of factors related to the stress-experience as important in the formation of outcomes including elder abuse and neglect (EAN). Multi-level modeling with days (n=831) nested within caregivers (N=50) was used to evaluate relationships between theoretically-based risk and protective factors and odds of EAN. Disruptions in the daily routine are a significant risk factor for abuse and neglect. Participating in a meaningful activity at least twice a day with the care recipient is a significant protective factor for neglect (OR=0.19; CI=0.06-0.64; p=0.01), but not abuse. Hypotheses that spending the full day together would increase the risk of EAN, and receipt of instrumental support and caregiver participation in self-care would decrease risk, were not supported. Findings demonstrate that the risk of EAN varies from day-to-day in the presence and absence of contextual factors. Moreover, abuse and neglect may have different etiologic pathways.

scholarly journals P1708EFFECT OF PREGNANCY ON KIDNEY TRANSPLANT RECIPIENTS: A PROPENSITY SCORE-MATCHED STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Toyofumi Abe ◽  
Taniguchi Ayumu ◽  
Kawamura Masataka ◽  
Kato Taigo ◽  
Tomoko Namba-Hamano ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
P Value ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Pregnancy And Delivery

Abstract Background and Aims This study aimed to evaluate whether the experience of pregnancy and delivery would be associated with poor maternal outcome among kidney transplant recipients. Method A total of 401 female transplant recipients from the Osaka University Transplantation Group Database were included in this study. 73 women who underwent renal transplantation between 1970 and 2017 and became pregnant and delivered at Osaka University Kidney Transplant Group Hospitals. Multivariable logistic regression analysis was used to assess the impact of pregnancy and delivery on renal transplant recipient outcome after one-to-one propensity score (PS) matching for 12 variables including serum creatinine at one year post-transplant between the parous group and the nulliparous group. The outcomes were kidney graft survival and patient survival. Results In all patients before PS matching, 75 (18.7%) of the 401 patients died and 137 (34.2%) of the 401 patients lost their kidney grafts during the follow-up period. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.662 [95%CI, 0.265-1.656], p-value 0.378) and for death-censored graft survival (adjusted HR 1.224 [95%CI, 0.683-2.196], p-value 0.497). In the PS matched population, 14 (17.5%) of the 80 patients died and 31 (38.8%) of the 80 patients lost their grafts. In the multivariate analysis, pregnancy and delivery was not a significant risk factor for death (adjusted HR 0.611 [95%CI, 0.180-2.072], p-value 0.430) and for death-censored graft survival (adjusted HR 1.308 [95%CI, 0.501-3.416], p-value 0.584). Conclusion Pregnancy and delivery after kidney transplantation was not associated with poor kidney transplant outcome in recipients with adequate and stable graft function.

Molecular epidemiology and phylogeography of Schistosoma mansoni around Lake Victoria

Parasitology ◽  
2010 ◽  
Vol 137 (13) ◽  
pp. 1937-1949 ◽  
Author(s):  
C. J. STANDLEY ◽  
N. B. KABATEREINE ◽  
C. N. LANGE ◽  
N. J. S. LWAMBO ◽  
J. R. STOTHARD
Keyword(s):  
Population Genetics ◽  
Schistosoma Mansoni ◽  
Molecular Epidemiology ◽  
Lake Victoria ◽  
Public Health Problem ◽  
Human Migration ◽  
Sub Saharan Africa ◽  
Major Public Health Problem ◽  
Sub Saharan ◽  
Coi Sequences

SUMMARYIntestinal schistosomiasis continues to be a major public health problem in sub-Saharan Africa, and is endemic in communities around Lake Victoria. Interest is growing in the molecular evolution and population genetic structure of Schistosoma mansoni and we describe a detailed analysis of the molecular epidemiology and phylogeography of S. mansoni from Lake Victoria. In total, 388 cytochrome oxidase 1 (COI) sequences were obtained from 25 sites along the Ugandan, Tanzanian and Kenyan shorelines of Lake Victoria, and 122 unique barcodes were identified; 9 corresponded to previously discovered barcodes from Lakes Victoria and Albert. A subset of the data, composed of COI sequences from miracidia from 10 individual children, was used for population genetics analyses; these results were corroborated by microsatellite analysis of 4 isolates of lab-passaged adult worms. Overall, 12 barcodes were found to be shared across all 3 countries, whereas the majority occurred singly and were locally restricted. The population genetics analyses were in agreement in revealing high diversity at the level of the human host and negligible population structuring by location. The lack of correlation between genetic distance and geographical distance in these data may be attributed to the confounding influence of high intra-individual diversity as well as human migration between communities.

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