scholarly journals Free hospitalization for acute respiratory infections in children: what effect and how much does it cost for Armenia?

2019 ◽  
Vol 13 (05.1) ◽  
pp. 051S-056S
Author(s):  
Sergey Sargsyan ◽  
Diana Andreasyan ◽  
Samvel Kharazyan ◽  
Olga Denisiuk ◽  
Karapet Davtyan ◽  
...  

Introduction: The “Child Certificate” program, launched in Armenia in 2011, made hospitalization for children less than seven years free in order to improve access to hospitalization, reduce out-of-pocket expenses and ensure Universal Health Coverage. We aimed to estimate trends in the number of outpatient and hospitalized acute respiratory infection (ARI) cases and related under-five mortality. Methodology: Cross-sectional study using data from national databases before (2008-2011) and after (2012-2017) Program implementation. The diagnosis of ARI was based on the International Classification of Disease (ICD-10). Results: The average hospitalization per 1000 children under 14 and infants increased by 85% and 75% respectively, compared with the period before the introduction of the Program, while the frequency of outpatient visits remained unchanged. The ARI-related mortality in children less than five years and in infants decreased by 11% and 19%, respectively. Financial allocations for ARI-associated hospitalizations amounted to 2.1 billion Armenian drams in 2011 and increased to 3.3 billion drams in 2016 (an increase of 57%). For pneumonia, this increase was 108% (from 0.35 to 0.72 billion). Conclusions: The introduction of free hospitalization for ARI led to an increase in the hospitalization rates. There was a favorable decline in under-five mortality and an exponential increase in financial allocations. The reasons for hospitalization should be investigated to ensure rational hospitalization with parallel improvement of primary care to reduce delayed presentations. It is necessary to find ways addressing the growing financial allocations for ARI-associated hospitalization.

2016 ◽  
Vol 9 (2) ◽  
pp. 413
Author(s):  
Débora Aparecida da Silva Santos ◽  
Pedro Vieira de Azevedo ◽  
Ricardo De Olinda ◽  
Amaury De Souza ◽  
Jullianna Vitorio Vieira de Azevedo ◽  
...  

As infecções respiratórias agudas constituem o principal motivo de consulta e hospitalização de crianças menores de cinco anos, sendo a pneumonia uma das principais causas de morte. O objetivo desta pesquisa foi analisar a influência das variáveis climáticas na hospitalização por pneumonia em crianças menores de cinco anos em Rondonópolis-MT, no período de 1999 a 2014. Estudo do tipo transversal com abordagem quantitativa e descritiva, com dados do banco de dados meteorológicos para ensino e pesquisa e do departamento de informática do sistema único de saúde. Na análise estatística dos dados, foi ajustado o modelo binomial negativo pertencente à classe dos modelos lineares generalizados, adotando-se um nível de significância de 5%, com base na plataforma estatística R. Estimou-se que o número médio de casos destas hospitalização diminui em aproximadamente 11,34% a cada grau centígrado de aumento acima da média da temperatura do ar e diminua cerca de 1,52% a cada 1% de aumento acima da média da umidade relativa do ar. A precipitação pluviométrica não apresentou relação com a hospitalização. As atividades de promoção de saúde e de prevenção da pneumonia devem incluir ações que relacionem questões ambientais climáticas, voltadas para a diminuição dos casos de hospitalização de crianças.    A B S T R A C T Acute respiratory infections are the main cause of consultation and hospitalization of children under five years, and the pneumonia one of the leading causes of death. The objective of this research was to analyze the influence of climate variables in hospitalization for pneumonia in children under five years in Rondonópolis-MT, from 1999 to 2014 cross-sectional study with quantitative and descriptive approach, with meteorological data from the database for teaching and research and information department of the unified health system. Statistical analysis of the data, the negative binomial model belonging to the class of generalized linear models, adopting a significance level of 5% has been adjusted, based on the statistical platform R. It has been estimated that the average number of cases these decreases hospitalization approximately 11.34% per degree centigrade increase above the air temperature and lower average about 1.52% every 1% increase above average relative humidity. Rainfall was not associated with hospitalization. The health promotion activities and prevention of pneumonia should include actions that relate climate environmental issues, aimed at reducing cases of hospitalization of children. Keywords: Climate; pneumonia; child; hospitalization.  


2019 ◽  
Vol 13 (05.1) ◽  
pp. 075S-080S ◽  
Author(s):  
Hrachuhi Ghazaryan ◽  
Ara Babloyan ◽  
Ashot Sarkissian ◽  
Karapet Davtyan ◽  
Christoph Berger

Introduction: Acute respiratory infections (ARIs) are major causes of morbidity in early childhood. They are mainly caused by viruses, including influenza (INF) and respiratory syncytial viruses (RSV). We aimed to investigate the role of RSV and INF in children hospitalized for ARIs and to show the impact of RSV/INF rapid testing on management of patients. Methodology: Cross-sectional study using data of inpatient care of children younger than five years hospitalized in Arabkir Medical Center due to ARI from November 1, 2013 to April 1, 2014. Nasopharyngeal swabs were tested for RSV and INF types A and B by direct antigen detection tests. Results: A total of 915 patients, 583 (63.7%) boys and 332 (36.3%) girls were included in the study with the mean age of 18.8 ± 16.3 months. Among them, 390 (42.6%) were tested positive, 3 (0.3%) subjects tested positive both for RSV and INF: 269 (29.4%) for RSV and 124 (13.6%) for INF (A – 121, B – 3). Out of 915 children, 209 (23%) were pretreated with antibiotics, most often with oral amoxicillin/clavulanic acid (n = 54, 25.8%), sulfamethoxazole/trimethoprim (n = 46, 22%), and amoxicillin (n = 38, 18.2%), followed by intramuscular ceftriaxone (n = 37, 17.7%). Conclusions: The usage of antigen tests for detection of respiratory viruses allowed to document high rates of RSV and INF in children admitted to the hospital. In settings where polymerase chain reaction method is not readily available, implementation of rapid tests for detection of respiratory viruses is important in the management of pediatric patients including cohorting and more targeted use of antibiotics.


1970 ◽  
Vol 7 (2) ◽  
pp. 95-99
Author(s):  
Nadia Jabeen ◽  
Shahzad Ali Khan ◽  
Zubia Qureshi

Background: Acute Respiratory Infection (ARI) is an important cause of mortality and morbidity in children, especially in under-fives, it is necessary to explore its risk factors for better health of children. Methods: This study was a cross sectional study, conducted in the Federal Government Polyclinic Dispensary of G- 7/3-4, Islamabad on 104 under five children, from April 2016 to June 2016. All the children from 0-59 years of age, irrespective of sex visiting dispensary were included in the study. Structured questionnaire used to collect the data. Frequencies and proportions were calculated as descriptive part of the analysis while Qui/Fisher Exact test was done as inferential analysis by using SPSS. Results: Out of 104 under five children ARI was found in 34 (32.7%). It was more in male children 23 (37.1) compared to female 11 (26.2%). A significant association was found between ARI and child's birthplace, their history of low birth weight, breast-feeding history, vaccination status, mothers education, mother's occupation, number of family members, smoking in fathers, ventilation condition of home, kitchen type, and knowledge of mothers regarding ARI signs and symptoms. Conclusion: The present study found that ARI is prevalent in under five children of the studied area. Results suggested that there is need to enhance the knowledge of mothers regarding ARI risk factors, its signs and symptoms, prevention and treatment.


Author(s):  
Shaliet Rose Sebastian

Background: More than 2 million children die from pneumonia each year, accounting for almost 18 percent of under five deaths worldwide. Childhood ARI is a significant public health problem in India, although robust epidemiological data are not available on its incidence. In recent years, the burden posed by ARI in underdeveloped and developing countries has stimulated global concern. The objective of the study was to study the occurrence of acute respiratory infections (ARI) in children under the age of five years in Nellanad Panchayat, Trivandrum district and to study the factors associated with ARI in children under five years of age.Methods: A community based cross-sectional study was conducted among 375 children below the age of five years.Results: Occurrence of ARI was found to be 52%. A significant association was found between ARI and under-nutrition, low birth weight, poor breast feeding practices, poor parental education, exposure to passive smoking and inadequate indoor ventilation.Conclusions: The study points towards the importance of basic health promotional measures like good antenatal care, proper breast feeding practices, proper nutrition of the child and socio-economic improvement in prevention and control of ARI.


Author(s):  
J Devidas ◽  
Jagatabandhu Mohapatra ◽  
Parthsarathi Dehury ◽  
Ranjit Kumar Dehury

Introduction: The health and well-being among children is an important parameter for the measurement of the progress of a nation, which is also most precious asset in the community for socio-economic development in long run. It is not wise to neglect the health rights of the children in the process of nation building. The under-five children are the most vulnerable group in a society in which there is lack of guarantee for adequate nutrition and social protection. The lack of essential health services ultimately leads to childhood diseases like diarrhoea, respiratory infections, and measles in various parts of India. Aim: To understand the socio-demographic and morbidity pattern among the children of under five years in a district of Telangana state, India. Materials and Methods: A cross-sectional study was undertaken by interviewing mothers with the help of a predesigned and pretested questionnaire to understand the morbidity pattern of children under five years in the rural areas of Adilabad district, Telangana, India. The study was conducted in March 2015 in 30 villages. The study assessed various determinates of morbidity by applying scientific principles. The sample size was calculated as 210. The data was analysed by using MS Excel spread sheet and Statistical Package for the Social Sciences (SPSS) software to understand the morbidity pattern. Descriptive statistical tests were done to find out the results. Results: The result confirms that 154 (73.33%) of the children under five years have several forms of morbidities. The most common morbidity was Acute Respiratory Infection (ARI) (25.71%), which is followed by worm infestation (8.09%), diarrhoea (20%), fever (7.61%), scabies (7.61%), asthma (2.3%) and seizure (fits) (1.9%) in last three months from the data collection. All these diseases are prevalent in rural areas of high concern due to the impeding morbidity and mortality. Conclusion: The ARI and diarrhoea were found to be the cause of concern among under-five children, which dominate the morbidity pattern. The factors responsible with such precarious situation were deeply entrenched conditions like illiteracy, poor socio-economic conditions, poor environmental sanitation, and increased birth order among the population.


Author(s):  
Bernard Hope Taderera

The study of healthcare personnel migration in Ireland reports that most medical graduates plan to leave the country’s health system. It may be possible to address this challenge by understanding and addressing the reasons why young doctors plan to leave. Future studies should contribute to the retention of early career doctors in highincome countries such as Ireland. This will help reduce the migration of doctors from low- and middle-income countries in order to address the global health workforce crisis and its impact on the attainment of universal health coverage in all health systems.


2020 ◽  
Author(s):  
Diana Raj ◽  
Norliza Ahmad ◽  
Nor Afiah Mohd. Zulkefli ◽  
Zalilah Mohd Shariff

BACKGROUND Excessive screen time is detrimental to the child’s health. However, screen time situation among Malaysian children is poorly understood. OBJECTIVE This study aims to identify the prevalence and determinants of screen time among children under five years old using the latest WHO guidelines. METHODS A cross sectional design was used to randomly select 489 children from nine government health clinics. Total screen time and factors were assessed using validated self-administered questionnaires and analyzed using multiple logistic regression. RESULTS Results show an overall prevalence of 91.4% with a median of 3.00 hours (IQR: 1.36-5.04). Majority of children watched television (66%), followed by mobile phones (30%) and computers (4%). The determinants of screen time were Malay ethnicity, (AOR 3.56, 95% CI: 1.65-7.68), parental age of 30 years or more (AOR 3.12, 95% CI: 1.58-6.16), parental screen time exceeding 2 hours a day (AOR 2.42, 95% CI: 1.24-4.73), parent’s moderate self-efficacy to influence child’s physical activity (AOR 2.29, 95% CI: 1.01-5.20) and parent’s positive perception on influence of screen time on child’s cognitive well-being (AOR 1.15, 95% CI:1.01-1.32). CONCLUSIONS Parents played an important role in determining their child’s screen time. Future interventions that focus on the parents may ensure age appropriate screen time for their children.


2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Agune Ashole Alto ◽  
Wanzahun Godana ◽  
Genet Gedamu

Background. Diarrheal diseases are still one of the major causes of morbidity in under-five children in sub-Saharan Africa. In Ethiopia, diarrhea is responsible for 9% of all deaths and is the major cause of under-five mortality. Objective. To assess the impact of community-led total sanitation and hygiene on the prevalence of diarrheal disease and factors associated among under-five children in Gamo Gofa Zone. Methods. Community-based comparative cross-sectional study design was used to compare the impact of community-led total sanitation and hygiene intervention on under-five diarrheal disease. Multistage sampling method was employed. The data were collected by using pretested structured questionnaires. Data quality was ensured by daily supervision completeness and consistency. The data were coded, entered, and cleaned by using Epi Info version 7 and were analyzed by using SPSS version 20. Bivariate and multivariable analyses were carried out by using binary logistic regression. Significance was declared by using p value of <0.05 and AOR with 95% confidence intervals. Results. The response rate of this study was 93.3%. The overall diarrhea prevalence was 27.5% (CI = (24.06, 30.97)) which was 18.9% (CI = (14.94, 23.2)) in implemented and 36.2%. (CI = (30.41, 41.59)) in nonimplemented woredas. Children whose age was between 12 and 23 months (AOR = 1.6) and greater than 24 months (AOR = 5), availability of handwashing facilities (AOR = 4), disposal of waste in open field (AOR = 9.7), unimproved source of drinking water (AOR = 6.5), using only water for handwashing (AOR = 6), children who started complementary feeding less than 6 months (AOR = 5.6) and greater than 6 months (AOR = 5.2), and utensils used to feed children such as bottle (AOR = 3.9) were the factors positively associated with diarrhea. Conclusion. The overall prevalence of under-five diarrhea was 27.5%. The prevalence was low in CLTSH woredas as compared with non-CLTSH woredas. The study showed that handwashing facility, using only water for handwashing, open refuse disposal, and unimproved source of drinking water among under-five had a statistically significant association with diarrhea occurrence in CLTSH nonimplemented areas. Integrated efforts are needed from the Ministry of Health together with the WASH Project in improving drinking water, handwashing facilities, and solid waste disposal practices.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Taylor Landay ◽  
Julie A Clennon ◽  
José A Ferreira ◽  
Lucia A Fraga ◽  
Maria Aparecida F Grossi ◽  
...  

Abstract Background Leprosy in children under 15 years of age, and in particular, the presence of leprosy grade 2 disability (G2D) in children, signifies ongoing transmission and the need for improved surveillance. Our objective was to describe the epidemiology of pediatric leprosy in Minas Gerais, Brazil and to explore associations with access to medical facilities. Methods A cross-sectional study was conducted using data from the Brazilian Notifiable Diseases Surveillance System (SINAN) from 2002–2017. Incident cases were included if they resided in a municipality with both adult and pediatric cases. Municipalities were divided by the number of medical facilities per municipality: &lt; 5, 5–17, and 18 or higher. Analyses compared pediatric cases across two time periods (2002–2009 and 2010–2017) and number of medical facilities / municipality using chi-square, t-tests, and logistic regression. Results A total of 27,725 cases were reported with 1,611 under 15 years of age. Overall incidence declined from 34.8 per 100,000 to 13.6 per 100,000 during the study period with pediatric incidence declining from 2.6 per 100,000 to 0.8 per 100,000. Time period 2 (TP2) showed an increase in the proportion of pediatric G2D (2.58% vs 1.91%, p &lt; 0.0001) when compared to time period 1 (TP1). Mean age of diagnosis in children was younger in TP2 then in TP1 (10.06 vs 10.43, p=0.02). In 2017, the pediatric incidence in municipalities with the fewest medical facilities was 0.95 per 100,000 compared to 0.23 per 100,000 in municipalities with &gt; 5 facilities (p=0.009). There was significantly higher odds of disability at diagnosis (grades 1 and 2) in pediatric cases residing in municipalities with &lt; 5 medical facilities (aOR 1.88; 95% CI 1.37–2.59), adjusted for age and sex. See map (Fig 1). Figure 1. Cases of Pediatric Disability By Number of Municipality Medical Facilities from 2002–2017 (White areas without reported pediatric leprosy) Conclusion The increasing proportion of G2D in children in the second half of the study period despite declining incidence suggest occult infections among children and adults alike in Minas Gerais. Furthermore, the average age of diagnosis in children should increase, not decrease, if M. leprae transmission was truly declining. Lastly, the association between fewer municipality health facilities and increased disability suggest barriers to timely diagnosis and a critical area of focus for research into access to healthcare and leprosy risk. Disclosures All Authors: No reported disclosures


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