How useful is routine pre-endoscopy viral screening?

2019 ◽  
Vol 15 (3) ◽  
Author(s):  
Abiodun Christopher Jemilohun ◽  
Charlse John Elikwu ◽  
Daniel Ekhaeyouno Ezuduemoih

Pre-procedural screening for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are routinely done in several endoscopy centres in Nigeria. These tests constitute an additional layer of financial burden to the patients since most of them settle their medical bills out of pocket. At the same time, the burden of these viral infections on the society demands that all measures are taken to prevent their iatrogenic transmission. The aim of this study was to evaluate the prevalence of HBV, HCV and HIV among patients referred for gastrointestinal endoscopy so as to determine the relevance of routine screening before procedures. The study was a retrospective cross-sectional survey of patients referred to the Digestive Endoscopy Unit of the Babcock University Teaching Hospital, Ilisan-Remo, for endoscopy from January 2015 to December 2018. A total of 432 patients were included in the study. The mean age was 48.15 (±15.89) while the age range was 12-86 years. Of these, 240 (54.7%) were females while 199 (45.3%) were males. The results of the viral screening available in the record book varied: HBV (n = 419), HCV (n = 238) and HIV (n = 417). The prevalence of HBV, HCV and HIV was 4.3% (95% CI = 2.4% - 6.2%), 2.1% (95% CI = 0.4% - 4.2%) and 1.0% (95% CI = 0.2% - 1.9%) respectively. Fourteen (3.3%), 5 (2.2%) and 14 (3.4%) patients who were initially negative, were rescreened for HBV, HCV and HIV respectively for repeat endoscopy. None of these patients tested positive for the viruses. We found no evidence of viral transmission from endoscope to patients in our centre. Viral pre-screening for endoscopy in settings with low to moderate prevalence rates of HBV, HCV and HIV infections may not be necessary.

2011 ◽  
Vol 18 (04) ◽  
pp. 697-702
Author(s):  
MUHAMMAD NAFEES ◽  
ISHTIAQ AHMED ◽  
GHAZALA JAFFERI

Objective: The infections with hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are common among prisoners but such data are sparse from Pakistan; hence in this study, we evaluated the sero-prevalence of these three infections among Jail inmates. Design: Cross-sectional survey. Setting: Central Jail, Lahore. Period: May to November 2009. Methodology: Investigate the seroprevalence of HBV, HCV and HIV infections among the random population of sentenced inmates of Central Jail, Lahore. We examined 3062 jail inmates, 396 of them were females and 2666 males. Majority of the inmates were Pakistani national (97.06 %). All collected blood samples were tested for HIV antibodies, HBsAg, and anti-HCV antibodies with one step chromatographic immunoassay. Results: Seroprevalence rate of HCV, HBV and HIV infections was 15.31%, 3.46 % and 1.79 % respectively. Overall prevalence of these infections in the jail inmates was 20.57 % and 18.77 % of them were positive for markers of viral hepatitis B/C. Conclusions: We evaluated that jail inmates in Pakistan had a high incidence of HCV, HBV and HIV infections. Regular testing is required to identify infected prisoners and refer them for appropriate treatment. In addition, general disease prevention efforts are needed to minimize transmission of these viral infections in this subpopulation, before and after release.


2021 ◽  
Vol 11 (8) ◽  
pp. 105
Author(s):  
Kranthi Swaroop Koonisetty ◽  
Ubydul Haque ◽  
Rajesh Nandy ◽  
Nasrin Aghamohammadi ◽  
Tamanna Urmi ◽  
...  

Dengue fever is one of the most important viral infections transmitted by Aedes mosquitoes and a major cause of morbidity and mortality globally. Accurate identification of cases and treatment of dengue patients at the early stages can reduce medical complications and dengue mortality rate. This survey aims to determine the knowledge, attitude, and practices (KAP) among physicians in dengue diagnosis and treatment. This study was conducted among physicians in Turkey as one nonendemic country and Bangladesh, India, and Malaysia as three dengue-endemic countries. The dosing frequencies, maximum doses, and contraindications in dengue fever were examined. The results found that physicians from Bangladesh, India, and Malaysia have higher KAP scores in dengue diagnosis and treatment compared to physicians in Turkey. This may be due to a lack of physician’s exposure to a dengue patient as Turkey is considered a nonendemic country. This assessment may help establish a guideline for intervention strategies among physicians to have successful treatment outcomes and reduce dengue mortality.


Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1120
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Damien Urban

Honest communication between oncologists and patients is important in alleviating the financial burden of cancer care. This study explored patient–relative–oncologist communication regarding the affordability of out-of-pocket (OOP) medication and the extent to which this communication addresses itself to the families’ financial burden. A cross-sectional survey was conducted among primary caregivers of deceased cancer patients. About 43% of relatives said that they and/or the patients had paid out of pocket for medications during the last six months of the patient’s life. Most (73%) oncologists suggested an OOP medication without asking about financial ability, 43% hardly explained the advantages of an OOP medication, and 52% hardly explained any treatment alternatives. Older age and female gender were related to less communication about an OOP medication, and better education, greater affluence, and having private health insurance were related to more communication. About 56% of relatives said that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. Physicians’ interest in financial ability and giving explanation lightened the burden. Given the difficulty of explaining the complex interactions of cost and clinical outcomes, oncologists need to be better educated in skills that would enable them to communicate costs more openly and should consider the cost of a treatment when prescribing it.


Geriatrics ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 61 ◽  
Author(s):  
Lai San Kong ◽  
Farida Islahudin ◽  
Leelavathi Muthupalaniappen ◽  
Wei Wen Chong

Antibiotics are commonly prescribed among older adults, and inappropriate use of antibiotics has been noted. However, there is limited information about their knowledge and expectations for antibiotics. This study aimed to assess older adults’ knowledge of antibiotic use and resistance, their expectations for antibiotics and the relationship between knowledge, expectation and inappropriate practices related to antibiotic use. A cross-sectional survey involving respondents aged 60 years and above was conducted, using a validated questionnaire. A lack of knowledge about the role of antibiotics was observed, whereby more than half of the respondents incorrectly believed that antibiotics can treat viral infections (53.5%) and colds and coughs (53.7%). Also, 67.9% of respondents incorrectly believed that antibiotic resistance occurs when the body becomes resistant to antibiotics. Almost half of the respondents would expect antibiotics for symptoms of self-limiting viral infections. Respondents who answered correctly for the role of antibiotics in viral infections were more likely not to expect antibiotics for cold, flu and cough (p < 0.001). Respondents who answered correctly regarding the need to adhere to antibiotics were more likely to have completed their antibiotic course (p < 0.001). Future educational initiatives should provide key information on the role of antibiotics and the importance of complying with antibiotics in this population.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Trang Nguyen ◽  
Thach Tran ◽  
Sally Green ◽  
Arthur Hsueh ◽  
Tuan Tran ◽  
...  

Abstract Background People with severe mental illness (SMI) living in low and middle-income countries can experience extended delays to diagnosis, which hinder access to medical treatment. The aims of this study were to describe the interval to diagnosis among these people in rural Vietnam and its associated factors. Methods A population-based cross-sectional study was conducted among people with SMI in two provinces in Vietnam. The delay to diagnosis was defined as the time between the first abnormal behaviour being observed by family members and the formal diagnosis of psychosis. A multilevel linear regression was used to examine the factors associated with the delay to diagnosis. Results Among 404 people with SMI from 370 households, the median delay to diagnosis was 11.5 months (IQR 0–168.0). Overall, 53.7% had a delay to diagnosis of less than one year (95% CI: 48.81–58.54). The financial burden of these people on their families was nearly USD 470/year. After adjusting for other factors at individual and household levels, living in a Northern province; older age, and having psychotic diagnosis before the implementation of the National Community Mental Health program (2003) were associated with a delay of more than twelve months to diagnosis. Conclusions These data indicate that the implementation of a national policy for community-based care has been effective in reducing the delay to diagnosis in rural Vietnam. Therefore, there is a need for strengthening the program and mental health policies, focusing on public communication to improve mental health literacy and reduce stigma against SMI.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036892
Author(s):  
Lelisa Fekadu Assebe ◽  
Eyerusalem Kebede Negussie ◽  
Abdulrahman Jbaily ◽  
Mieraf Taddesse Taddesse Tolla ◽  
Kjell Arne Johansson

ObjectivesHIV and tuberculosis (TB) are major global health threats and can result in household financial hardships. Here, we aim to estimate the household economic burden and the incidence of catastrophic health expenditures (CHE) incurred by HIV and TB care across income quintiles in Ethiopia.DesignA cross-sectional survey.Setting27 health facilities in Afar and Oromia regions for TB, and nationwide household survey for HIV.ParticipantsA total of 1006 and 787 individuals seeking HIV and TB care were enrolled, respectively.Outcome measuresThe economic burden (ie, direct and indirect cost) of HIV and TB care was estimated. In addition, the CHE incidence and intensity were determined using direct costs exceeding 10% of the household income threshold.ResultsThe mean (SD) age of HIV and TB patient was 40 (10), and 30 (14) years, respectively. The mean (SD) patient cost of HIV was $78 ($170) per year and $115 ($118) per TB episode. Out of the total cost, the direct cost of HIV and TB constituted 69% and 46%, respectively. The mean (SD) indirect cost was $24 ($66) per year for HIV and $63 ($83) per TB episode. The incidence of CHE for HIV was 20%; ranges from 43% in the poorest to 4% in the richest income quintile (p<0.001). Similarly, for TB, the CHE incidence was 40% and ranged between 58% and 20% among the poorest and richest income quintiles, respectively (p<0.001). This figure was higher for drug-resistant TB (62%).ConclusionsHIV and TB are causes of substantial economic burden and CHE, inequitably, affecting those in the poorest income quintile. Broadening the health policies to encompass interventions that reduce the high cost of HIV and TB care, particularly for the poor, is urgently needed.


2021 ◽  
Vol 8 ◽  
pp. 204993612110424
Author(s):  
Israel Kiiza Njovu ◽  
Benson Musinguzi ◽  
James Mwesigye ◽  
Kennedy Kassaza ◽  
Joseph Turigurwa ◽  
...  

Background: Pulmonary mycoses are important diseases of the respiratory tract caused by pulmonary fungal pathogens. These pathogens are responsible for significant morbidity and mortality rates worldwide; however, less attention has been paid to them. In this study we determined the prevalence of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara Regional Referral Hospital. Method: This was a hospital based cross sectional survey. Sputum samples were collected from each study participant. For each sample, the following tests were performed: Sabouraud dextrose agar for fungal culture, GeneXpert for Mycobacteria tuberculosis (MTB) and potassium hydroxide for fungal screening. Filamentous fungal growth and yeasts were further examined with lactophenol cotton blue staining and germ tube respectively. Results: Out of 113 study participants, 80 (70.7%) had pulmonary fungal pathogens whilst those with pulmonary tuberculosis numbered five (4.4%). Candida albicans [21 (22.58%)] and Aspergillus species [16 (17.20%)] were the pathogens most identified among others. Two (1.7%) TB GeneXpert positive participants had fungal pathogens isolated from their sputum samples. We established a prevalence of 57 (71.3%) for pulmonary fungal pathogen (PFP) isolates, three (60.0%) for MTB in HIV positive patients and 18 (22.5%) for PFP, and zero (0.0%) for MTB in HIV negative patients. On the other hand, two (100%) HIV positive patients had both PFP isolates and MTB. Conclusion: Our findings highlight the diversity of neglected pulmonary fungal pathogens whose known medical importance in causing pulmonary mycoses cannot be overemphasised. Therefore this presents a need for routine diagnosis for pulmonary mycoses among TB suspects and set-up of antimicrobial profile for pulmonary fungal isolates to support clinical management of these cases.


2020 ◽  
Vol 2 (1) ◽  
pp. 16-23
Author(s):  
Irem Akdemir Kalkan ◽  
Ayşe Nur Usturalı Mut ◽  
Gule Cinar ◽  
Fatih Keskin ◽  
Kemal Osman Memikoglu ◽  
...  

Objective: Influenza is a systemic infectious disease. It is recommended that all pregnant women receive the influenza vaccine because the mortality of the disease is high during pregnancy. However, the rates of influenza vaccination in pregnant women are low. This study aims to estimate the rate at which Turkish gynecologists and obstetricians (GOs) recommend the influenza vaccine to their pregnant patients.. Materials and Methods: This study was designed as a cross-sectional survey. The sample size was calculated to be 364 based on 95% confidence interval and 5% margin of error. The data were collected through a questionnaire consisting of 17 questions, which was distributed through social media. The final study group included in the research consisted of 384 GOs. Results:The mean age of the GOs that participated in the study was 39.7 years (SD = 10.2). 43.5% of the GOs reported that they recommended the influenza vaccine to pregnant women who had consulted with them, while 62.8% reported that at least 50% of the pregnant women they had recommended the vaccine rejected it. According to multivariate logistic regression analysis, three factors increased the rate of GOs’ not to recommend influenza vaccination: the GOs’ age, not receiving influenza vaccination themselves, and not knowing the social insurance reimbursement for the vaccine. Conclusion: Vaccination of pregnant women is necessary because of the increased mortality risk of influenza during pregnancy. Even though GOs are not in charge of vaccinating their patients during their routine pregnancy follow-up, they can contribute to vaccination rates by recommending the vaccine. Physicians’ application of scientific knowledge and transferring it to their patients can contribute to increased adult immunization rates. Conclusion: Influenza, Influenza Vaccine, Pregnancy, Vaccination, Viral Infections


Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 759
Author(s):  
Mikaela Michaelidou ◽  
Spyridon A. Karageorgos ◽  
Constantinos Tsioutis

We aimed to assess the knowledge and understanding of antibiotic use and resistance in the general population of Cyprus, in order to inform future antibiotic awareness campaigns with local evidence. Cross-sectional survey following the methodology of the “Antibiotic resistance: Multi-country public awareness survey” of the World Health Organization, during December 2019–January 2020. A total of 614 respondents participated: 64.3% were female and most were aged 35–44 years (33.2%) or 25–34 years (31.8%). One-third had used antibiotics >1 year ago and 91.6% reported receiving advice on appropriate use from a medical professional. Despite high awareness on correct use of antibiotics, lack of knowledge was noted for specific indications, where approximately one-third believed that viral infections respond to antibiotics and 70.7% lack understanding of how antibiotic resistance develops. Higher education graduates exhibited significantly higher knowledge rates. As high as 72.3% were informed about “antibiotic resistant bacteria” from healthcare professionals or social media. Most agreed on the usefulness of most suggested actions to address antibiotic resistance, with higher proportions acknowledging the role of prescribers. Up to 47% could not identify their role in decreasing antibiotic resistance. Our study provides local evidence to inform future efforts in a country characterized by high antibiotic consumption rates.


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