Prevalence of anaemia among pregnant women attending antenatal clinic at St. Francis Referral Hospital Ifakara, Tanzania

Background: Anemia in pregnancy is a worldwide public health problem affecting both developing and developed countries with significant impact on the health of mothers and fetus. Objective: This study aimed to determine the prevalence of anemia among pregnant women attending antenatal clinic at St. Francis Referral Hospital (SFRH), Ifakara, Tanzania. Methodology: This was a descriptive cross-sectional study conducted from January to March 2021. A total of 116 pregnant women were enrolled in this study. Interviews were conducted followed by determination of haemoglobin level. Results: The results revealed the prevalence of anemia among pregnant women attending antenatal clinic at SFRH to be 52.6%. In this study mild anemia was 34.5%, moderate anemia13.8% and severe anemia 4.3%. Conclusion: Anemia in pregnancy is a public health problem in study setting of St. Francis Referral Hospital, Ifakara, Tanzania.

Chronic respiratory disease disparity between American Indian/Alaska Native and white populations, 2011–2018

Background American Indian/Alaska Native (AI/AN) populations have been disproportionately affected by chronic respiratory diseases for reasons incompletely understood. Past research into disease disparity using population-based surveys mostly focused on state-specific factors. The present study investigates the independent contributions of AI/AN racial status and other socioeconomic/demographic variables to chronic respiratory disease disparity in an 11-state region with historically high AI/AN representation. Using data from the Behavioral Risk Factor Surveillance System (BRFSS) spanning years 2011–2018, this work provides an updated assessment of disease disparity and potential determinants of respiratory health in AI/AN populations. Methods This cross-sectional study used data from the BRFSS survey, 2011–2018. The study population included AI/AN and non-Hispanic white individuals resident in 11 states with increased proportion of AI/AN individuals. The yearly number of respondents averaged 75,029 (62878–87,350) which included approximately 5% AI/AN respondents (4.5–6.3%). We compared the yearly adjusted prevalence for chronic respiratory disease, where disease status was defined by self-reported history of having asthma and/or chronic obstructive pulmonary disease (COPD). Multivariable logistic regression was performed to determine if being AI/AN was independently associated with chronic respiratory disease. Covariates included demographic (age, sex), socioeconomic (marital status, education level, annual household income), and behavioral (smoking, weight morbidity) variables. Results The AI/AN population consistently displayed higher adjusted prevalence of chronic respiratory disease compared to the non-Hispanic white population. However, the AI/AN race/ethnicity characteristic was not independently associated with chronic respiratory disease (OR, 0.93; 95% CI, 0.79–1.10 in 2017). In contrast, indicators of low socioeconomic status such as annual household income of <$10,000 (OR, 2.02; 95% CI, 1.64–2.49 in 2017) and having less than high school education (OR, 1.37; 95% CI, 1.16–1.63 in 2017) were positively associated with disease. These trends persisted for all years analyzed. Conclusions This study highlighted that AI/AN socioeconomic burdens are key determinants of chronic respiratory disease, in addition to well-established risk factors such as smoking and weight morbidity. Disease disparity experienced by the AI/AN population is therefore likely a symptom of disproportionate socioeconomic challenges they face. Further promotion of public health and social service efforts may be able to improve AI/AN health and decrease this disease disparity.

Determinants of multiple partner fertility among males in Uganda: a cross-sectional study

Background Multiple-partner fertility is a relatively new area of study, especially in Sub-Saharan Africa. This study focused on identifying determinants of multiple partner fertility among males in Uganda. Method The assessment was carried out using a logistic regression model and secondary data from the 2016 Uganda Demographic and Health Survey. Results Among the males, 42% had children with multiple partners. Older age, being Muslim, and being divorced or separated increased the likelihood of multiple partner fertility whereas residing in the Western region, reporting an age at first sex above 19 years and being married or cohabiting reduced the likelihood. Increase in number of wives or partners and lifetime sex partners resulted into a higher likelihood of multiple partner fertility. Conclusion There is need to come up with policies and programs aimed at increasing the age at first sex so as to reduce the likelihood of multiple partner fertility among males in Uganda. Government and other stakeholders such as cultural and religious institutions should sensitize and educate the masses on the negative outcomes of having children with multiple partners and promote fidelity for those in marriage. There is also need to increase modern contraceptive use and coverage.

Why women choose at-home abortion via teleconsultation in France: drivers of telemedicine abortion during and beyond the COVID-19 pandemic

ObjectivesIn an attempt to understand the demand and main drivers of telemedicine abortion, we analysed the requests that Women on Web (WoW), an online telemedicine abortion service operating worldwide, received from France throughout 2020.MethodsWe conducted a parallel, convergent, mixed-methods study among 809 consultations received from France at WoW between 1 January and 31 December 2020. We performed a cross-sectional study of data obtained from the WoW consultation survey and a manifest content analysis of anonymised email correspondence of 140 women consulting with the WoW helpdesk from France.FindingsWe found that women encounter macro-level, individual-level and provider-level constraints while trying to access abortion in France. The preferences and needs over secrecy (n=356, 46.2%), privacy (n=295, 38.3%) and comfort (n=269, 34.9%) are among the most frequent reasons for women from France to choose telemedicine abortion through WoW. The COVID-19 pandemic seems to be an important driver for resorting to telemedicine (n=236, 30.6%). The lockdowns had a significant impact on the number of consultations received at WoW from France, increasing from 60 in March to 128 in April during the first lockdown and from 54 in October to 80 in November during the second lockdown.ConclusionsThe demand for at-home medical abortion via teleconsultation increased in France during the lockdowns. However, drivers of telemedicine abortion are multidimensional and go beyond the conditions unique to the pandemic.

Black fungus or mucormycosis: a cross-sectional knowledge assessment among the Bangladeshi health care workers during COVID-19 pandemic

‘Black fungus’ or ‘Mucormycosis’ is an emerging public health concern during the COVID-19 pandemic. The rise of black fungus cases here in Bangladesh among the COVID-19 infected persons has been raised reasonable alarming conditions among health care workers along with the general people. Therefore, this study aimed to investigate black fungus knowledge of Bangladeshi health care workers aiming the issue could be managed readily by the health care systems. A cross-sectional study was carried out among the Bangladeshi health care workers from May 25, 2021, to June 5, 2021. As COVID-19 restriction existed countrywide, data were collected via a semi-structured online questionnaire by following convenient and snowball sampling methods. The main outcome variable of this study was the black fungus knowledge score; was measured by a six items’ questionnaire. The other studied variables included socio-demographic, workplace, COVID-19, and health-related information of the respondents. The t-test and one-way ANOVA test were performed to investigate the association between the black fungus knowledge score and the studied variables. This study found 422 responses from the health care workers of Bangladesh. Among the respondents, nearly half of them (45.26%) were doctors (n= 191); where the nurses (n=161) were 38.15%, and other health care workers (n=70) were 16.59%. This study found that the black fungus knowledge mean scores of health care workers were significantly associated with seniority (p=0.001), gender (p-value = 0.012), profession (p &lt;0.001), death of friends and family members due to COVID-19 (p=0.049), and, etc. Moreover, the gender, income, job type, and marital status of the respondents were also found to be significantly associated with the mean scores of several items of the black fungus knowledge questionnaire. Proper knowledge of health care workers regarding any emerging public health issues is considered as a sine qua non-indicator of implementing the health care system readily. This study emphasized the black fungus knowledge of the health care workers along with other associated factors. The study's findings could help the policymakers to mitigate the mucormycosis and other infectious diseases emergencies in the post-COVID-19 situation, where the wave of the pandemic was surging continuously.

Associations Among Daily Fish Intake, Monocyte/HDL-C Ratio, and Lifestyle in Japanese Males Aged >50: Risk Stratification of Atherosclerotic Cardiovascular Disease

Background: The monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR) may be a novel inflammatory marker of the developing atherosclerotic cardiovascular disease (ASCVD). We investigated the relationship between the average number of days of fish intake per week and the MHR and lifestyle behaviors and to explore the validity of stratifying the risk of ASCVD using the combination of MHR and the serum HDL-C level.Methods: This cross-sectional study was conducted in a population of 2485 males aged over 50 years at the Health Planning Center of Nihon University Hospital between April 2018 and March 2019.Results: The average frequency of fish intake was 2.32 ± 1.31 per week. Multiple stepwise regression analysis identified increased weekly fish frequency intake as an independent determinant of a decreased MHR (β = -0.072, p < 0.0001). Healthier lifestyle behaviors were also significantly associated with decreased MHR. As the fish intake frequency increased, the proportion of subjects with the cigarette smoking habit decreased (p = 0.014), that of subjects with aerobic exercise habit increased (p < 0.0001), and that of subjects with alcohol drinking habit increased (p < 0.0001). A risk stratification or ASCVD by combining the HDL-C level and fish intake frequency with the MHR could be developed, indicating that even with similar HDL-C levels, higher HMR and fish frequency are associated with higher risk ASCVD. Conclusion: A high fish intake frequency may be associated with healthier lifestyle behaviors as well as a lower MHR, and may thus represent a component of a healthy lifestyle associated with a lower risk of ASCVD in Japanese males aged over 50 years. These associations may be related to being the preventive effect of fish intake on ASCVD.Clinical Trial Registration: UMIN (http://www.umin.ac.jp/) Study ID: UMIN 000041368 registered 10/08/2020

Ultrasonographic and resistance index evaluation of nails in psoriatic arthritis, psoriasis, and control groups: a cross-sectional study

Background Nail psoriasis occurs frequently in patients with psoriatic disease, it can lead to functional impairment, pain, discomfort, decreased quality of life and can also be a predictor for the development of arthritis. Early recognition of this condition can provide early and effective treatment and prevent structural impairment. This study aims to identify nail ultrasonographic characteristics in three groups: psoriasis (PsO), psoriatic arthritis (PsA) and controls patients, to determine if the ultrasonography (US) can identify early signs of nail psoriatic impairment or local inflammation. We conducted nail US to determine nail matrix resistance index (NMRI), nail bed resistance index (NBRI), and power Doppler (PD) and grayscale (GS) parameters in these 3 groups. Methods Single-center, cross-sectional study. GS, PD, and spectral doppler images of bilateral 2nd and 3rd fingernails were acquired from 35 PsO, 31 PsA, and 35 controls patients. An US equipment with an 18 MHz linear transducer for GS and 8.0 MHz for PD was used. PD, NMRI, NBRI, nail plate thickness (NPT), nail bed thickness (NBT), nail matrix thickness (NMT), and morphostructural characteristics of the trilaminar structure (TS) were evaluated in saved images, blind. Results Mean NMRI and NBRI did not differ between groups. Linear regression analysis detected no relationships between PsO or PsA and NMRI or NBRI. Nail PD grade did not differ between groups. Type I and IV TS changes were more frequent in PsO; types II and III changes were more frequent in PsA (p < 0.001). NPT was greater in PsA and PsO groups than controls: PsA 0.73 ± 0.14 mm, PsO 0.72 ± 0.15 mm, Controls 0.67 ± 0.10 mm (p = 0.001). Conclusion Echographic TS characteristics of the nail plate and NPT evaluated by GS are useful and can distinguish PsO and PsA nails from controls. NMRI, NBRI, and US nail microcirculation parameters could not distinguish psoriatic nails. Trial registration 72762317.4.0000.5327 (Certificate of Presentation of Ethical Appreciation – CAAE - Plataforma Brasil) Avaiable in https://plataformabrasil.saude.gov.br/login.jsf.