Eastern Region
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2021 ◽  
Mohamed Ali DAW ◽  
Abdallah Hussean El-Bouzedi ◽  
Mohamed Omar Ahmed

Abstract The interrelationships between HIV/AIDS and armed conflict are a complex phenomenon and studies are rarely devoted to this area of research. Libya is the second-largest country in Africa that has been evoked with war since NATO intervention in 2011. The country has also experienced one of the largest HIV outbreaks associated with the Bulgarian Nurses saga. The effect of the armed conflict on the dynamic spread of HIV is not well known. The objectives of this study were to determine the impact of armed conflict on the epidemiological situation of HIV infection in Libya and analyze the transmission dynamics of HIV strains during the conflict. We investigated the movement of HIV-infected people during the Libyan armed conflict and analyzed the HIV subtypes reported from 2011 to 2020 and followed up the infected cases all over the country. The patterns of HIV spread within the Libyan regions were traced and risk factors were determined during the conflict period. A total of 4539 HIV/AIDS patients were studied from the four regions during the Libyan conflict. Our data analysis indicated that Benghazi the biggest city in the Eastern region was the significant exporter of the virus to the rest of the country. Viral dissemination changes were observed within the country particularly after 2015. A major virus- flow from the Eastern region during the armed conflict associated with internally displaced people. This resulted in a dissemination of new HIV strains and accumulations of HIV cases in Western and Meddle regions. Although, there were no significant changes in the national prevalence of HIV/AIDS. Our data highlights the factors that complicated the spread and dissemination of HIV during the armed conflict which provides a better understanding of the interaction between them. This could be used to plan for effective preventive measures in tackling the spread of HIV in conflict and post-conflict settings.

2021 ◽  
Quraish Sserwanja ◽  
Lilian Nuwabaine ◽  
Kassim Kamara ◽  
Milton W Musaba

Abstract Background Globally, about 289,000 maternal deaths are registered annually. Timely access to quality maternal health services is an effective intervention to reduce maternal deaths. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone. Methods We used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 7,326 women aged 15 to 49 years. We conducted multivariable logistic regression to determine the factors associated with PNC utilisation, using SPSS version 25. Results Out of 7,326 women, 3,329 (45.5%, 95% CI: 44.6–46.8) had their babies have at least a PNC contact, 6,646 (90.7%, 95% CI: 90.2–91.5) had a postnatal check after childbirth and 3,133 (42.8%, 95% CI: 41.9–44.1) had PNC for both their babies and themselves. Delivery by caesarean section (aOR 1.79, 95% CI: 1.20–2.67), having a visit by a health field worker (aOR 1.77, 95% CI: 1.47–2.13), having had eight or more ANC contacts (aOR 1.79, 95% CI: 1.45–2.22), initiating ANC after first trimester (aOR 1.18, 95% CI: 1.04–1.35), being a Muslim (aOR 1.34, 95% CI: 1.11–1.61), belonging to richer wealth quintile (aOR 1.69, 95% CI: 1.22–2.35), being of low parity (2–4) (aOR 1.20, 95% CI: 1.04–1.39), having no big problems seeking permission to access healthcare (aOR 1.52, 95% CI: 1.27–1.83) and having had delivery at home (aOR 1.75, 95% CI: 1.32–2.32) were associated with more PNC utilisation odds. On the other hand, being resident in the Eastern region (aOR 0.31, 95% CI: 0.21–0.46) and urban areas (aOR 0.71, 95% CI: 0.52–0.98) were associated with lower odds of utilising PNC. Conclusion Although maternal PNC utilisation is high, utilisation of PNC by neonates alone and by both the mother and neonatal is low. More focus is needed to mothers and their neonates from the Eastern region, urban areas, Christians, less empowered in terms of healthcare seeking decision making and those who are more parous, utilise less ANC contacts and utilise health facilities for delivery.

Ritesh Kumar ◽  
Md. Monobrullah ◽  
Deepak Ranjan Kishor ◽  
Anil Kumar ◽  
Parnav Kumar

The present study was conducted at Research Farm of ICAR- Research Complex for Eastern Region, Patna, Bihar during rabi 2020-21. Eight insecticides were evaluated against aphid, Brevicoryne brassicae in cauliflower and found that all insecticidal treatments were significantly superior over untreated control, in reducing the population of aphid however; significant differences existed among the various treatments. Flubendiamide20% WG @ 0.4gm/l was found most effective followed by lufenuron 5.4% EC @ 1ml/l and others showed intermediated effects in reduction of aphid population. The least effective treatments were neem oil and diafenthiuron in reducing the population of B. brassicae.

Cureus ◽  
2021 ◽  
Abdulrhman Alabdulgader ◽  
Ali O Mobarki ◽  
Ahmed AlDuwayrij ◽  
Abdullah Albadran ◽  
Mohammed I Almulhim ◽  

2021 ◽  
Paterne Safari Mudekereza ◽  
Jules Balagizi Mudekereza ◽  
Gauthier Murhula Bahizire ◽  
Hervé Monka Lekuya ◽  
Edouard Amani Mudekereza ◽  

2021 ◽  
Xianzhao Liu ◽  
Xu Yang

Abstract Facing the growing problem of carbon emission pollution, the scientific and reasonable division of environmental management power between governments is the premise and institutional foundation for realizing China's carbon emission reduction target in 2030. Although existing studies have focused on the relationship between Chinese decentralization and carbon emissions, most of them are based on fiscal decentralization indicators to depict China's environmental decentralization, lacking of systematic analysis and empirical test of institutional factors affecting carbon emissions from the perspective of environmental management. In this paper, we directly assess the environmental decentralization degree according to the allocation of environmental management personnel among different levels of government. By incorporating fiscal decentralization indicators, the provincial panel data and dynamic spatial econometric model are used to empirically test the impact of environmental decentralization on carbon emissions from spatial perspective. The study found that: (1) China's provincial carbon emissions have a significant positive spatial autocorrelation, showing a clear trend of high-high, low-low aggregation, and the carbon emissions of the previous period and the current have an obvious positive relationship. (2) At the national level, environmental decentralization, environmental administrative decentralization and environmental monitoring decentralization significantly reduce China's carbon emissions, while environmental supervision decentralization and fiscal decentralization significantly aggravate carbon emissions, which means that China's current environmental decentralization systems are generally conducive to carbon emission governance. The interaction between fiscal decentralization and environmental decentralization with its decomposition indicators significantly promotes carbon emissions, and its impact is related to the category of environmental decentralization, indicating that when local governments have greater environmental management power and fiscal autonomy, the combination of the two will push up carbon emissions. (3) The carbon emission effects of environmental decentralization in different regions are spatially heterogeneous. In the central region, environmental decentralization, environmental administrative decentralization and environmental supervision decentralization can promote carbon emissions apart from environmental monitoring decentralization. In the western region, the carbon emission suppression effect of environmental decentralization, environmental administrative decentralization and environmental monitoring decentralization is stronger than the eastern region, but the inhibitory effect of fiscal decentralization and environmental decentralization with its decomposition index interaction on carbon emissions in the eastern region is significantly better than the central and western regions. The above results provide policy ideas and theoretical support for the construction of the environmental management system with long-term carbon emission control in China in terms of regional differences and categories of environmental management power.

2021 ◽  
Vol 9 ◽  
Changhao Zhang ◽  
Yan Kong ◽  
Kunling Shen

Background: Asthma can be exacerbated by many triggers, and the heterogeneity of asthma triggers is clear among children with asthma. This study describes asthma triggers using a large-scale electronic dataset from the smartphone-based Chinese Children's Asthma Action Plan (CCAAP) app and aims to examine the difference in asthma triggers among different subgroups of children with asthma.Methods: Data from the smartphone-based CCAAP app between February 22, 2017, and November 23, 2020, were reviewed, and children with asthma who reported their asthma triggers were enrolled. Eight common asthma triggers were listed in the software: upper respiratory infection (URI), allergen sensitization, exercise, emotional disturbances, pungent odors, air pollution/smog, weather change, and tobacco smoke. We compared the incidence of asthma triggers among different subgroups (<6 years vs. 6–17 years; boy vs. girl; eastern region vs. central region vs. western region).Results: We enrolled 6,835 patients with self-reported asthma triggers. When compared by sex, boys had a higher proportion of exercise-triggered asthma than girls (boys vs. girls, 22.5 vs. 19.7%, p < 0.05). The proportion of patients <6 years of age with URI-triggered asthma was higher than that of patients 6–17 years of age (<6 vs. 6–17 years, 80.9 vs. 74.9%, p < 0.001). Patients 6–17 years of age were more likely than patients <6 years of age to report five of the asthma triggers: allergen sensitization (<6 vs. 6–17 years, 26.6 vs. 35.8%, p < 0.001), exercise (<6 vs. 6–17 years, 19.3 vs. 23.7%, p < 0.001), pungent odors (<6 vs. 6–17 years, 8.8 vs. 12.7%, p < 0.001), air pollution/smog (<6 vs. 6–17 years, 9.4 vs. 16.2%, p < 0.001), and tobacco smoke (<6 vs. 6–17 years, 3.5 vs. 5.3%, p < 0.001). In subgroups based on geographical distribution, asthma triggering of allergen sensitization was reported to be the most common in patients from the eastern region (eastern region vs. central region vs. western region, 35.0 vs. 24.6 vs. 28.0%, p < 0.001). Exercise-triggered asthma was found to be the most prevalent among patients from the central region (eastern region vs. central region vs. western region, 21.6 vs. 24.8 vs. 20.4%, p < 0.05). However, the proportion of patients with air pollution/smog as an asthma trigger was the lowest among those from the western region (eastern region vs. central region vs. western region, 14.1 vs. 14.1 vs. 10.8%, p < 0.05).Conclusion: Children with asthma present different types of asthma triggers, both allergenic and nonallergenic. Age, sex, and geographical distribution affect specific asthma triggers. Preventive measures can be implemented based on a patient's specific asthma trigger.

2021 ◽  
Quarban Aliyar ◽  
Santosh Dhungana ◽  
Sangam Shrestha

Abstract The civil war, harsh climate, tough topography and lack of accurate meteorological stations has limited observed data across Afghanistan. In order to fulfill the gap, this study analyzed the trend in precipitation and its extremes using Asian Precipitation Highly Resolved Observational Data Integration Towards Evaluation (APHRODITE) daily dataset between 1951 to 2010 at the spatial resolution of 0.25˚˟0.25˚. Non-parametric modified Mann-Kendall test and Sen’s slope estimator were employed to detect trend and quantify it at the significance level of 5%. Significant decreasing trends were observed only in small clusters of southwestern regions ranging between 0 to -1.5mm/year and northeastern region between -1.5 to -6 mm/year for the annual time series. Similar trend pattern was observed in spring season decreasing at the rate of -0.15 to 0.54 mm/year in northeastern and 0 to -0.15 mm/year southwestern region. Decrease in spring precipitation is expected to affect crop production especially in northeastern region which host 22 % of the arable area. Increasing trend in eastern region at maximum of 0.16 mm/year was observed which could intensify the flooding events. Trend analysis of extreme precipitation indices indicated similar spatial distribution to the mean precipitation, concentrated around southwestern, northeastern, and eastern regions. Increasing frequency of consecutive dry days in western region and very heavy precipitation (R10mm) and extremely heavy precipitation (R20mm) in eastern region are fueling the occurrence of droughts and floods respectively. Taking these findings of erratic nature of rainfall and extreme events into consideration for sustainable management of water resources would be fruitful.

2021 ◽  
Hui Zi Gong ◽  
Kui Ru Hu ◽  
Jun Li ◽  
Xia Wan ◽  
He Yi Zheng

Abstract Background Few studies investigating the direct medical cost of syphilis was conducted in developing countries, including China. Methods The main tasks of our study were to estimate the direct medical costs of syphilis in China at subnational level, and to characterize the distribution of the direct medical cost of syphilis in 31 Chinese provincial districts in relation to GDP. Data on medical expenses for syphilis patients diagnosed at Peking Union Medical College Hospital (PUMCH) was used to estimate direct medical cost per case, which was then multiplied by the number of newly reported cases of syphilis in China to yield the absolute medical cost for syphilis. Relative costs, defined as the absolute costs in per million of gross domestic product (GDP), was also calculated. Comparisons of direct medical cost represented as absolute cost and relative cost respectively, in different years and different provincial districts were conducted. Gini index was used to characterize the distribution of syphilis cases and direct medical cost of syphilis at provincial level. Results Average cost of patients with follow-up more than 36 month was regarded as the most reasonable estimate of direct medical cost per case, and was obtained as US $ 134.43 in primary syphilis, US $ 119.24 in secondary syphilis, US $ 503.76 in tertiary syphilis and US $ 97.59 in latent syphilis. Absolute medical cost of syphilis in China increased from US $ 11.15 million to US $46.89 million from 2004 to 2016. Relative cost in China increased from 2.85 to 5.26 per million of GDP from 2004 to 2010, and decreased from 5.26 to 3.99 per million of GDP from 2010 to 2016. The largest relative cost was always observed in western region. Between 2009 and 2016, a large relative medical cost was observed in 7 to 9 provinces in western region, 3 to 5 provinces in eastern region, 1 to 4 provinces in central region, 1 to 2 provinces in northeastern region. The level of inequality decreased from 2010 to 2016, and kept a continuously moderate equality from 2012 to 2016. Conclusion This study provided a rough estimate of the direct medical costs of syphilis in China and its distribution pattern in 31 Chinese provincial districts. The results highlight that syphilis caused a huge economic burden in China, which distributed disproportionally within provinces. Western region bore a huge and increasing economic burden, while the economic burden in eastern region had once been huge, but tending to decline. Thus, more active and effective control are needed, and strategies on the prevention and control of syphilis be managed according to local conditions.

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 771
Lin-Yi Huang ◽  
Wan-Ju Chen ◽  
Yung-Ning Yang ◽  
Chien-Yi Wu ◽  
Pei-Ling Wu ◽  

Sudden infant death syndrome (SIDS) has always been a regrettable issue for families. After sleeping in the supine position was proposed, the incidence of SIDS declined dramatically worldwide. However, SIDS still accounts for the top 10 causes of infant deaths in Taiwan. Recognizing the risk factors and attempting to minimize these cases are imperative. We obtained information on cases with SIDS from the National Health Insurance Research Database in Taiwan and interconnected it with the Taiwan Maternal and Child Health Database to acquire infant–maternal basal characteristics between 2004 and 2017. The SIDS subjects were matched 1:10 considering gestational age to normal infants. After case selection, a total of 953 SIDS cases were included. Compared with healthy infants, SIDS infants had younger parents, lower birth weight, and lower Apgar scores. After adjusting for potential confounders, infants with mothers aged <20 years had 2.81 times higher risk of SIDS. Moreover, infants in the non-eastern region had a significantly lower risk of SIDS than those in the eastern region. We concluded that infants of young mothers (especially maternal age <20 years) and infants in the eastern region of Taiwan had a higher risk of SIDS than their counterparts.

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