scholarly journals Tuberculosis Skin Test Screening in the National Tuberculosis Program of Trinidad and Tobago

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 236
Author(s):  
Vijay Kumar Chattu ◽  
Sateesh Sakhamuri ◽  
Shastri Motilal ◽  
Liam J. Pounder ◽  
Vasishma Kanita Persad ◽  
...  
Keyword(s):  
Trinidad And Tobago ◽  
Skin Test ◽  
Vaccination Status ◽  
World Health ◽  
Categorical Variables ◽  
Cross Sectional ◽  
Bcg Vaccination ◽  
National Tuberculosis Program ◽  
National Tuberculosis ◽  
Contact Screening

Globally, a quarter of the population is infected with tuberculosis (TB), caused by Mycobacterium tuberculosis. About 5–10% of latent TB infections (LTBI) progress to active disease during the lifetime. Prevention of TB and treating LTBI is a critical component of the World Health Organization’s (WHO) End TB Strategy. This study aims to examine the screening practices for prevention and treatment employed by the National Tuberculosis Program of Trinidad and Tobago in comparison to the WHO’s standard guidelines. A cross-sectional retrospective study was conducted from the TB registers (2018–2019) for persons aged 18 years and above with recorded tuberculin skin test reactions (TST). Bivariate comparisons for categorical variables were made using Chi-square or Fisher’s exact test. Binary logistic regression was used for exploring predictors of TST positivity with adjustment for demographic confounders in multivariable models. Of the total 1972 eligible entries studied, 384 (19.4%) individuals were tested positive with TST. TB contact screening (aOR 2.49; 95% CI 1.65, 3.75) and Bacillus Calmette–Guerin (BCG) vaccination status (aOR 1.66; 95% CI, 1.24 to 2.22) were associated with a positive TST reaction, whereas, preplacement screening failed to show such association when compared to those screened as suspect cases. The findings suggest that TB contact screening and positive BCG vaccination status are associated with TST positivity independent of age and gender.

Vaccination Coverage: Vaccine-Related Determinants & Anthropometric Measures in Children Resident in a Rural Community in Nigeria

2021 ◽  
Vol 16 ◽  
Author(s):  
Iribhogbe Osede Ignis ◽  
Sonila Tomini
Keyword(s):  
Rural Community ◽  
Vaccination Coverage ◽  
Sampling Technique ◽  
Vaccination Status ◽  
Childhood Vaccination ◽  
Vaccine Hesitancy ◽  
Categorical Variables ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Susceptible Population

Background: Vaccination of children has played a significant role in reducing early childhood morbidity and mortality from vaccine-preventable diseases; however, some factors act as deterrents in achieving adequate coverage in this susceptible population. Aims & Objectives: The study, therefore, aimed to identify vaccine-related determinants of childhood vaccination as well as determine the relationship between childhood vaccination status and body weight, height, and a child’s body mass index (BMI). Methods: The study was conducted using a cross-sectional design in which 608 caregiver-child pair was recruited sequentially by using a two-stage sampling technique. Structured questionnaires based on the SAGE vaccine hesitancy model were used to interview the participants. Elicited data was analyzed and categorical variables were presented in tables and charts as frequencies, while a chi-square test was used to test the association between the independent and dependent variables. Pearson’s correlation analysis was also done to determine the correlation between vaccination status and weight, height, and BMI of children. Result: The study showed that vaccination coverage was suboptimal (70.56%) in children and was below the expected target of 80%. Although a few (183, 30.10%) of the respondents claimed they would prevent the vaccination of their children due to the fear of needles, the majority (87.50%) will be willing to accept more vaccine doses for their children if there were no pain. While factors such as the experience of adverse reaction (X2 = 13.22, df = 2, p<0.001), crying from pain (X2 = 11.33, df = 2, p<0.001) and the scientific evidence of safety (X2 = 34.63, df = 2, p<0.001) were significantly associated with a complete vaccination status, vaccination status was positively correlated with the weight (r=0.160, p<0.001), height (r=0.081, p=0.023) and BMI (r=0.214, p<0.001) of children in the rural community. Conclusion: Vaccination uptake and coverage can be significantly improved in children by designing and implementing interventional programs that target pharmaceutical and vaccine-specific factors acting as barriers in these rural communities.

scholarly journals Prevalence and Mortality of Cryptococcal Disease in Adults with Advanced HIV in an Urban Tertiary Hospital in Sierra Leone: A Prospective Study

2019 ◽  
Author(s):  
Sulaiman Lakoh ◽  
Hannah Rickman ◽  
Momodu Sesay ◽  
Sartie Kenneh ◽  
Rachael M. Burke ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Sub Saharan Africa ◽  
World Health ◽  
Categorical Variables ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Cryptococcal Disease

Abstract Background The global annual estimate for cryptococcal disease related deaths exceeds 180,000, with three fourth occurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg) screening in all HIV patients with CD4 count <100/µl. As there is no previous published study on the burden and impact of cryptococcal disease in Sierra Leone, research is needed to inform public health policies. We aimed to establish the seroprevalence and mortality of cryptococcal disease in adults with advanced HIV attending an urban tertiary hospital in Sierra Leone. MethodsA cross-sectional study design was used to screen consecutive adult (18 years or older) HIV patients at Connaught Hospital in Freetown, Sierra Leone with CD4 count below 100 cells/mm3 from January to April, 2018. Participants received a blood CrAg lateral flow assay (IMMY, Oklahoma, USA). All participants with a positive serum CrAg had lumbar puncture and cerebrospinal fluid (CSF) CrAg assay, and those with cryptococcal diseases had fluconazole monotherapy with eight weeks followed up. Data were entered into Excel and analysed in Stata version 13.0. Proportions, median and interquartile ranges were used to summarise the data. Fisher’s exact test was used to compare categorical variables. Results A total of 170 patients, with median age of 36 (IQR 30-43) and median CD4 count of 45 cells/mm3 (IQR 23-63) were screened. At the time of enrolment, 54% were inpatients, 51% were newly diagnosed with HIV, and 56% were either ART-naïve or newly initiated (≤ 30 days). Eight participants had a positive blood CrAg, giving a prevalence of 4.7% (95% CI: 2.4-9.2%). Of those with a positive CrAg, CSF CrAg was positive in five (62.5%). Five (62.5%) CrAg-positive participants died within the first month, while the remaining three were alive and established on ART at eight weeks. ConclusionA substantial prevalence of cryptococcal antigenaemia and poor outcome of cryptococcal disease were demonstrated in our study. The high mortality suggests a need for the HIV programme to formulate and implement policies on screening and pre-emptive fluconazole therapy for all adults with advanced HIV in Sierra Leone, and advocate for affordable access to effective antifungal therapies.

scholarly journals Association between Intimate Partner Violence with Quality of Life

2021 ◽  
Author(s):  
NV Roopesh Gopal ◽  
SV Sathish Kumar ◽  
Kiran S Bhat
Keyword(s):  
Quality Of Life ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Intimate Partner ◽  
World Health ◽  
Categorical Variables ◽  
Early Interventions ◽  
Continuous Variables ◽  
Cross Sectional

Introduction: An intimate relationship is an interpersonal relationship that involves physical or emotional intimacy. Those who are in such a relationship may experience violence from partners which may affect their day-to-day quality of life and thus cause a burden on the family. Aim: To assess the relationship between Intimate Partner Violence (IPV) with Quality of life and to provide early interventions. Materials and Methods: Hospital-based, cross-sectional study was conducted at the Department of Psychiatry, Kodagu Institute of Medical Sciences (KoIMS) teaching hospital Madikeri, Karnataka. The subjects were recruited by purposive sampling method. A total of 5810 consecutive subjects who visited the psychiatry OPD from March 2017 to June 2019 were assessed and among them, 82 subjects both men and women in the age group of 18 to 60 years were recruited. All of them reported IPV on the Hurt, Insulted, Threatened, and Screamed (HITS) scale and were further assessed for Quality of life using the World Health Organisation Quality of Life BREF (WHOQOL-BREF) scale. Descriptive statistics were used for continuous variables. A Nonparametric Chi-square test was applied for categorical variables and Mann-Whitney U scores were used for quality of life variables. The correlation was done using Pearson’s correlation. Results: Mean age was 36.04 in years (SD±11.28) having a mean of 7.5 years of schooling (SD±4.5). The majority belonged to the rural background and lower socioeconomic status. Out of 82 subjects, 21 subjects reported IPV score less than 10 (25.60%) and among the rest of the 61 (74.39%) subjects, 80.32% were females and 19.67% were males who had IPV scores of more than 10. The study subjects reported poor and very poor scores in their overall quality of life and very dissatisfied and dissatisfied in their health domain. IPV also correlated with reduced quality of life, which was statistically significant. Conclusion: People that experience IPV has an overall reduced quality of life. Routine clinical assessment needs to be done to provide early interventions.

scholarly journals Changes in obesity, sedentary behavior and physical inactivity, between 2010 and 2017, in adolescents

1989 ◽  
Vol 32 ◽  
Author(s):  
Marcelo Barros Vasconcellos ◽  
◽  
Isabela Matta ◽  
Danilo Dias Santana ◽  
Gloria Valeria da Veija ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sedentary Behavior ◽  
Body Mass ◽  
Video Game ◽  
Physical Inactivity ◽  
World Health ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Prevalence Of Obesity

The study investigated changes in the prevalence of obesity, sedentary behavior (SB) and physical inactivity (PI) in adolescents. Two cross-sectional studies were analyzed, 2010 and 2017, with probabilistic samples from students (328 and 366, respectively) in 12 municipal schools in Niterói, RJ. Obesity was classified based on body mass index (BMI = weight / height2) Z score values ≥ +2, according to the World Health Organization criteria. The weight classification was made with body mass index (BMI = weight/height2), the SB for those with some screen behavior (television, video game) for ≥ 2 hours/day and IF those who performed <300 min / week moderate to intense physical activity. The comparison between the studies was based on the chi-square test (categorical variables) and Student's t test (continuous variables). The prevalence of obesity increased in boys (6.2% to 15.6% p <0.001) and decreased in girls (8.4% to 6.9% p = 0.035). The frequency of SB decreased from (90.7% to 67.7% p <0.001) in boys and from (90.3 to 52.8% p <0.001) in girls and the PI did not change in boys and increased in girls (84.6% to 89.9% p <0.001). The changes observed were sex-dependent, with boys more vulnerable to increased obesity, girls more PI and both sexes less SB in the investigated period.

scholarly journals Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya

2021 ◽  
Vol 15 (07) ◽  
pp. 897-903
Author(s):  
Enock Oburi Marita ◽  
Richard Gichuki ◽  
Elda Watulo ◽  
Sylla Thiam ◽  
Sarah Karanja
Keyword(s):  
Community Health ◽  
World Health ◽  
Categorical Variables ◽  
Quality Of Services ◽  
Community Case Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Community Health Volunteers ◽  
Better Than

Introduction: Kenya adopted the World Health Organization’s recommendation of community case management of malaria (CCMM) in 2012. Trained community health volunteers (CHVs) provide CCMM but information on quality of services is limited. This study aimed to establish determinants of quality of service of CCMM conducted by CHVs. Methodology: A cross-sectional survey was conducted in November 2016 in Bungoma County, Kenya. Data were collected through observing CHVs perform routine CCMM and through interviews of CHVs using structured questionnaires. A ≥ 75% score was considered as quality provision. Descriptive statistics were performed to describe basic characteristics of the study, followed by Chi-Square test and binary logistic regression to examine the differences and associations between the categorical variables. Results: A total of 147 CHVs participated; 62% of CHVs offered quality services. There was a direct association between quality of services and stock-outs of artemether-lumefantrine (AL), stock-outs of malaria rapid diagnostic tests (RDT) and support supervision. CHVs who were supervised during the year preceding the assessment were four times more likely to perform better than those not supervised (uOR 4.2, 95% CI: 1.38-12.85). CHVs with reliable supplies of AL and RDT kits performed three times better than those who experienced stock outs (uOR = 3.2, 95% CI: 1.03-10.03 and 3.3, 95% CI: 1.63-6.59 respectively). Biosafety and documentation were the most poorly performed. Conclusions: The majority of CHVs offered quality CCMM services despite safety gaps. Safety, continuous supplies of RDT, AL and supervision are essential for quality performance by CHV in delivering CCMM.

scholarly journals Factors Influencing Adherence to the New Intermittent Preventive Treatment of Malaria in Pregnancy Policy in Keta District of the Volta Region, Ghana

2019 ◽  
Author(s):  
Alren O. Vandy ◽  
Nana Yaw Peprah ◽  
Joseph Yaw Jerela ◽  
Perfect Titiati ◽  
Abubakar Manu ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
World Health ◽  
Categorical Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Volta Region ◽  
In Pregnancy

Abstract Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.

Comparative Studies on Hormonal Changes and Metabolic Syndrome in Perimenopausal and Premenopausal Igbo Women in Enugu Metropolis Nigeria: A Cross-sectional Study

2019 ◽  
Vol 15 (4) ◽  
pp. 284-294
Author(s):  
Chinwe Ifeoma Ikegwuonu ◽  
Uchendu Kingsley Ikenna ◽  
Okonkwo Innocent Nwabueze ◽  
Mba Chika Betina ◽  
Maduka Ignatius Chukwudi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
International Diabetes Federation ◽  
Premenopausal Women ◽  
World Health ◽  
Categorical Variables ◽  
Hormonal Changes ◽  
Cross Sectional ◽  
Perimenopausal Women

Background and Objective: Few studies have focused on the epidemiology of perimenopausal syndrome, and its prevalence in African women is concerningly high. This study investigated selected biochemical parameters, hormonal changes, and possible metabolic syndrome (MetS) in perimenopausal and premenopausal women among Igbo women in Enugu, Southeast of Nigeria. Methods: This study was conducted between March 2018 and November 2018. A total of 200 apparently healthy women, comprising 120 perimenopausal women (mean age 50 years) and 80 premenopausal women (mean age 35 years), living in Enugu, were randomly recruited for this study. Anthropometric indices (blood pressure, waist circumference, weight, and height) of these women were measured. Fasting blood samples were collected and used for measurement of luteinizing hormone (LH), estradiol (E2), follicle stimulating hormone (FSH), fasting plasma glucose (FPG), and lipid profile using standard methods. MetS in the perimenopausal and premenopausal women was observed using three different criteria: the National Cholesterol Education Program- Adult Treatment Panel 111 (NCEP-ATP 111), the World Health Organization (WHO), and International Diabetes Federation (IDF). Student’s t-test and Chi-square were used to compare continuous and categorical variables. Results: There were significantly (p<0.05) higher values of blood pressure (systolic and diastolic), FPG, waist circumference, LH, FSH, total cholesterol, and LDL-C, but significantly (p<0.05) lower values of estradiol in perimenopausal women as compared to premenopausal women. The incidence of MetS was higher in perimenopausal women as compared to premenopausal women in all the three criteria studied. Interpretation and Conclusion: Perimenopausal women have a higher risk for the development of metabolic syndrome-associated diseases than premenopausal women.

scholarly journals Prevalence and Mortality of Cryptococcal Disease in Adults with Advanced HIV in an Urban Tertiary Hospital in Sierra Leone: A Cross Sectional Study

2019 ◽  
Author(s):  
Sulaiman Lakoh ◽  
Hannah Rickman ◽  
Momodu Sesay ◽  
Sartie Kenneh ◽  
Rachael M. Burke ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
World Health ◽  
Categorical Variables ◽  
Sectional Study ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Cryptococcal Disease

Abstract Background The global annual estimate for cryptococcal disease related deaths exceeds 180,000, with three fourth occurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg) screening in all HIV patients with CD4 count <100/µl. As there is no previous published study on the burden and impact of cryptococcal disease in Sierra Leone, research is needed to inform public health policies. We aimed to establish the seroprevalence and mortality of cryptococcal disease in adults with advanced HIV attending an urban tertiary hospital in Sierra Leone. Methods: A cross-sectional study design was used to screen consecutive adult (18 years or older) HIV patients at Connaught Hospital in Freetown, Sierra Leone with CD4 count below 100 cells/mm3 from January to April, 2018. Participants received a blood CrAg lateral flow assay (IMMY, Oklahoma, USA). All participants with a positive serum CrAg had lumbar puncture and cerebrospinal fluid (CSF) CrAg assay, and those with cryptococcal diseases had fluconazole monotherapy with eight weeks followed up. Data were entered into Excel and analysed in Stata version 13.0. Proportions, median and interquartile ranges were used to summarise the data. Fisher’s exact test was used to compare categorical variables. Results A total of 170 patients, with median age of 36 (IQR 30-43) and median CD4 count of 45 cells/mm3 (IQR 23-63) were screened. At the time of enrolment, 54% were inpatients, 51% were newly diagnosed with HIV, and 56% were either ART-naïve or newly initiated (≤ 30 days). Eight participants had a positive blood CrAg, giving a prevalence of 4.7% (95% CI: 2.4-9.2%). Of those with a positive CrAg, CSF CrAg was positive in five (62.5%). Five (62.5%) CrAg-positive participants died within the first month, while the remaining three were alive and established on ART at eight weeks. Conclusion: A substantial prevalence of cryptococcal antigenaemia and poor outcome of cryptococcal diseases were demonstrated in our study. The high mortality suggests a need for the HIV programme to formulate and implement policies on screening and pre-emptive fluconazole therapy for all adults with advanced HIV in Sierra Leone, and advocate for affordable access to effective antifungal therapies.

scholarly journals Prescription Patterns of Antituberculosis Drugs in Treatment of Tuberculosis at a Tertiary Care Hospital in Andgra Pradesh, a Cross-Sectional Study

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Krishnakanth K ◽  
Chakrapani Cheekavolu ◽  
Poojala Kumar ◽  
Ravi Shankar K ◽  
Jagadeesh A
Keyword(s):  
Tertiary Care ◽  
Control Program ◽  
Tertiary Hospital ◽  
Tuberculosis Treatment ◽  
World Health ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescription Pattern ◽  
Prescription Patterns ◽  
National Tuberculosis

The success of tuberculosis treatment is based upon the prescription pattern following Revised National Tuberculosis Control Program/National Tuberculosis Elimination Program/World Health Organization guidelines, reflecting the burden of the disease which is increasing yearly. This implicates the variations in prescriptions advised in the treatment of tuberculosis. The present study was aimed to evaluate the prescription patterns of tuberculosis treatment in a tertiary hospital at Andhra Pradesh, India. Ninety-two patients were included in the study after obtaining ethical approval and informed consent. The prescription patterns were evaluated and compared to the standard guidelines. The mean age of the patients was 38.72 and showed male preponderance. Six regimens were used during the treatment. The patients showed good recovery which concludes that following the standard prescription pattern provides a good success rate in the treatment of tuberculosis.

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