Impact of the COVID-19 pandemic on neonatal admissions in a tertiary children’s hospital in southwest China: An interrupted time-series study

Background The unprecedented coronavirus disease 2019 (COVID-19) pandemic has caused millions of infections worldwide and represents a significant challenge facing modern health care systems. This study was conducted to investigate the impact of lockdown measures in a tertiary Children’s Hospital in southwest China, which might be used to predict long-term effects related to health-seeking behavior of parents/caregivers. Methods This study included newborns enrolled over a span of 86 weeks between January 4, 2019, and August 27, 2020. We designated two time periods for analysis purposes: a stable pre-COVID period(55 weeks between January 4, 2019, and January 23, 2020) and a COVID-impacted period (31 weeks between January 24, 2020, and August 27, 2020). An interrupted time-series analysis was employed to compare changes and trends in hospital admissions and disease spectra before and after the period of nonpharmaceutical interventions (NPIs). Furthermore, this study was conducted to evaluate whether the health-seeking behavior of parents/caregivers was influenced by pandemic factors. Results Overall, 16,640 infants were admitted to the neonatology department during the pre-COVID period (n = 12,082) and the COVID-impacted period (n = 4,558). The per week neonatal admissions consistently decreased following the first days of NPIs (January 24, 2020). The average weekly admission rates of 220/week pre-COVID period and 147/week COVID-impacted period. There was an evident decrease in the volume of admissions for all disease spectra after the intervention, whereas the decrease of patients complaining about pathological jaundice-related conditions was statistically significant (p<0.05). In the COVID-impacted period, the percentage of patients who suffered from respiratory system diseases, neonatal encephalopathy, and infectious diseases decreased, while the percentage of pathological jaundice-related conditions and gastrointestinal system diseases increased. The neonatal mortality rates (NMRs) increased by 8.7% during the COVID-impacted period compared with the pre-COVID period. Conclusions In summary, there was a significant decline in neonatal admissions in a tertiary care hospital during the COVID-19 Pandemic and the associated NPIs. Additionally, this situation had a remarkable impact on disease spectra and health-seeking behavior of parents/caregivers. We, therefore, advise continuing follow-ups and monitoring the main health indicators in vulnerable populations affected by this Pandemic over time.

Assessment of Health Seeking Behavior of Gestational Diabetes in Pregnancy among Elderly Primi Mother

Introduction: Gestational diabetes mellitus (GDM) is diagnosed by elevated blood glucose in pregnancy though the definition has changed repeatedly since its first description in the 1960’s. The most frequently reported perinatal consequence of GDM is macrosomia (usually defined as a neonate weighing over 4 kg) which can increase the risk of caesarean section and shoulder dystocia. For the mother, there are also potential longer-term consequences including an increased risk of type 2 diabetes post-pregnancy and/or in later life. The investigators of a large international Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study aimed to identify a cut-point in the continuum to decide the blood glucose level (BGL) thresholds that should be used to define GDM. Objective: To assess the incidence rate of gestational diabetes in pregnancy among the elderly primi mother. To assess the health seeking behavior of gestational diabetes in elderlyprimimothers. To associate the demographic variables of gestational diabetes in elderly primi mothers. Materials and Methods: A Descriptive research study was to assess the incidence and Health seeking behavior of gestational diabetes in pregnancy among the elderly primi mother. The target population for the study includes all antenatal women (12-36 weeks of gestation) who attend the antenatal clinics of AVBRH Out Patient Department. Sample consists of sub set of units that compose accessible population. In this study sample size was 100 elderly primi mother of selected area of community of Wardha. A tool is an instrument or equipment used for collection of data. A blue print was prepared prior to the construction of knowledge questionnaire based on which items were developed. Results: A finding shows that (41%) were having good, (40%) were having very good, (17%) were having average and (2%) were having excellent knowledge score. The minimum score was 05 and maximum score was 14, the mean score for the test was 8.93 ± 2.23 and mean percentage of knowledge was 59.54%. There was no significant association in relation to age, education, occupation, No.of gravida, income etc.

A study on the morbidity profile of children under 5 years of age and knowledge of parents regarding their health seeking behavior

To study the morbidity profile of children under 5 years of age and knowledge of parents regarding their health seeking behavior. The study was a community based cross-sectional study. The study was conducted in the Field practice area of Rural Health Training Centre (RHTC) of Hind Institute of Medical Sciences, Barabanki. Families with at least one under five-year child, all family willing to participate and consenting and families residing in the study site for the minimum last 1 year were included in the study. A total of 400 subjects were included in the study. Door to door visit was done for data collection. Morbidity was almost nil in 0-2 months preceding the interview. Diarrhoea was most common morbidity during 2 months – 5 years preceding the interview. Government hospital for treatment was preferred by 53.5% of the respondents. Treatment at government hospital was taken by 55% of the respondents. Secondary level of care was available in 50.2% of the respondents. Only 2.2% of the respondents reported any problem with the treatment. Hospital was visited by 65% of the respondents for the treatment. Child’s last illness was 3-6 months in 52.8% of the respondents and Diarrhoea was the most common type of illness. 62.8% of the respondents visited government hospital for the treatment of child. More than one third of respondents visited health facility by bicycle (42.8%) and 24.5% approached by walking. Time taken to reach health facility was 15-30 minutes in 51% of the respondents. The main reason to choose particular health facility was Trust over the provider of the facility (41.5%). This study demonstrates the importance of maternal perception of illness severity in determining facility based care seeking for childhood illness in rural area.

Patients’ Perceptions of Hospital Care in a Covid-19 Pandemic Population

Background: COVID-19 pandemic was associated with pandemonium and misinformation, affecting patients' health-seeking behavior. This study was designed to explore patients' perceptions of hospital care during this period and to provide evidence-based and appropriate public health planning strategies. Materials and Method: A cross-sectional survey was conducted among 155 patients using 22 items structured and self-completion questionnaires to determine (A) Socio-demographic variables, (B) Knowledge and perception of the disease, and (C) The participants’ behaviors towards COVID-19. A Hardcopy version of the questionnaire was administered to the respondents by direct issuance. Results: 103(66.45%) of the respondents knew the cause of COVID-19, while 104 (67.09%) agreed that people can be infected with COVID-19 in the hospital. 84 (54.19%) were afraid of a hospital visit and 66 (42.58%) are unwilling to self-report if they have minor symptoms. A large number 43(27.74%) perceived a clean environment as the impetus to make them comfortable in the hospital. Conclusion: Our study illuminates gaps in the patients’ perceptions of hospital care during the COVID-19 pandemic, which impacted negatively on the patient population as they avoided hospitalization for fear of contracting COVID-19 in the hospital. Furthermore, appropriate public health strategies can improve patients’ perceptions and health-seeking behavior in a pandemic period.

Utilization of Insecticide Treated Nets and Health Seeking Behavior for fever among Children under Five in Southwest Nigeria

BackgroundMalaria remains a burden globally with the WHO African region accounting for 94% of the overall disease burden and deaths in 2019. Nigeria alone accounted for 27% of total malarial cases and 23% of deaths. Insecticide-treated nets (ITN) use and receiving early care for fever represent the most cost-effective means of malaria prevention and control. In this study, we assessed the utilization of ITNs in households with under-five children in Southwest Nigeria, the health-seeking behavior of their caregivers for fever, and associated factors.MethodsThis was a secondary data analysis of the 2018 Nigeria Demographic and Health Survey. Analysis was restricted to under-five children residing in Southwest Nigeria. Multivariate analysis using logistic regression was conducted to determine factors associated with utilization of ITNs and care-seeking for fever in under-five children. Complex samples command of SPSS (Version 23) was used to account for survey sampling design.ResultsOf 2,281 under-five children in households with at least one ITN, 67.6% (1542) slept under an ITN the night before the survey. Predictors of ITN use were the age of child (<12 months), wealth index (poorest), number of nets in a household (2 or more), and number of household members (1-3). Of the 4,153 under-five children, 8.7% (360) had fever, and advice or treatment was sought for 72.4% (261). Predictors of good health-seeking behavior were the age of a child <12 months (AOR=2.81, 95% CI = 1.08-7.31), mothers’ education, and state of residence. Mothers who had secondary education were less likely to report care-seeking than those with higher education (AOR = 0.43, 95% CI = 0.19-0.98). Mothers from Osun, Ekiti, and Lagos state were less likely to seek care than those from Ogun state.ConclusionWe found that the utilization of insecticide-treated nets and seeking of care for fever in under five years of age in Southwest Nigeria were below the National Malaria Strategic Plan goal of 80% and 100% respectively. The state governments of Osun, Ekiti, and Lagos should develop strategies to improve ITN use and early seeking of care for fever in under-five children.

Socio-demographic determinants influencing health seeking behavior by men experiencing intimate partner violence in Kisumu municipality informal settlements, Kenya

<p><strong>Background: </strong>Socio demographic characteristics are key factors in the health seeking by men experiencing intimate partner violence (IPV). A recent study in Kenya showed that 9% of men experience spousal violence with no reports showing their health seeking behavior. This study assessed the socio-demographic determinants on health seeking by men experiencing IPV in Kisumu municipality informal settlements.</p><p><strong>Methods: </strong>From a target population of 81,882 adult males, 438 adult males aged 18 to 54 years were included in the study from Kisumu municipality informal settlements. Questionnaires were administered to the study participants. Frequency tables expressed as counts and corresponding percentages; chi square test and multiple regression analysis were used in the study.</p><p><strong>Results: </strong>With 398 responding to the survey, there was 90.8% response rate.<strong> </strong>Findings showed that 72.4% of the respondents have experienced IPV, out of whom only 19.8% sought health services. Results of socio-demographic characteristics showed that married wage-earning men of ages 18-35 years with secondary and above level of education sought health services when experiencing IPV.</p><p><strong>Conclusions: </strong>The study established that health seeking in men when experiencing IPV is low despite the fact that it could be life-threatening. Interventions are thus required that would help address men’s cases when faced with any form of violence.</p>

Factors Influencing Caregivers’ Health Seeking Behavior for Malaria Treatment of Children Under 5 Years in Busia Municipality, Uganda

Background: Malaria remains a serious cause of under-five mortality and morbidity worldwide and Uganda inclusive. This burden can be minimized by promptly seeking health care. In Uganda, however, studies around malaria health-seeking behaviors for under-five children in the most malaria prevalent areas are very few. This study aimed at determining the factors influencing caregivers’ health-seeking behavior for malaria treatment of children under five years in Busia Municipality, Uganda. Methods: A cross-sectional research design was used with a structured questionnaire to collect data. Data were analyzed using SPSS Version 22 to establish relationships between the variables. Results: The results showed that the current health-seeking behaviors of the caregivers of under-five children in Busia municipality are associated with caregiver education level (p= 0.008), the health worker’s behavior towards the client (p=0.015), the severity of fever (p<0.001), the severity of last malaria episode (p<0.001), waiting time (p=0.001), the quality of health services (p= 0.001) and age of caregiver (p<0.001). Traditional medicine and home remedies are the most utilized means of malaria management in under-five children in Busia Municipality. Conclusions: Caregivers need to be sensitized about the proper health-seeking behaviors for the management of malaria in children under-five years through radio shows, television, community engagement meetings among others to enhance the knowledge and understanding of communities about the recommended malaria treatment-seeking practices. There is a need to continuously train medical workers on client engagement skills to promote a good relationship with patients and encourage their return.

HEALTH SEEKING BEHAVIOR AS A PREDICTOR OF ADOLESCENTS SECURITY CONSCIOUSNESS

Nigeria is witnessing a disturbing rise of violence occasioned by religious, political, economic, cultural, and social motives. The incidence of violent crimes has created an unimaginable insecurity situation in the country, and the trend is increasing daily. Violent insecurity ranges from kidnapping, rape, armed robbery, terrorism, banditry, and assassinations. Meanwhile, the citizens, especially the younger ones, are caught in the center of these violent situations as they are either used to commit crimes or fall victims of violent crimes. Thus, the primary purpose of this study was to examine health-seeking behavior as a factor that could predict security consciousness among adolescents. The study adopted a cross-sectional survey design. Two hundred samples randomly pooled from public tertiary institutions in Kogi State, Nigeria, participated in the study. The participants completed self-report measures of security consciousness questionnaire and health-seeking behavior scale. A simple regression model established a statistically significant association between HSB and security consciousness among adolescents. The study concludes that health-seeking behavior is an essential determinant of security consciousness. The practical implication of the study is discussed.

Psychiatric Health Problems and Health Seeking Behavior of Men Who Have Sex with Men (MSM) in Agra city, Uttar Pradesh

Introduction: Researches had shown that Men who have sex with men (MSM) have higher chances of having psychiatric disorder as compared to heterosexual men. Ongoing homophobia, stigma and discrimination have negative effects on mental health of MSM. Many MSM do not seek care from mental health provider because of fear of discrimination Objectives: This study was carried out to assess psychiatric health problem among MSM and also assess their health seeking behavior. Method: The Snowball sampling technique was used. First participants were recruited through a non-profit peer group. Further participants were subsequently referred by participants from their peer circles. Data obtained from total 52 MSM using pretested questionnaire and General health questionnaire (GHQ-28) was analyzed using MS Excel. Results: Two-fifth (40.38%) of MSM had self-reported psychiatric health problem. While on GHQ, 57.69% of MSM were found to have psychiatric health problem with GHQ score of ≥24. MSM who were completely homosexual and who were victims/doer of violence with sex partners had significantly higher chances of having psychiatric health problem.57.15% MSM sought treatment for their psychiatric problem from an Allopathic doctor. Rest of them either went for a self treatment (28.57%) or not taken any treatment (14.28%). 75% MSM reportedly sought treatment from private health facility. Better facility, cost effectiveness, someone known recommended were most commonly cited reason for preferring a mental health provider. Conclusion: High prevalence of psychiatric health problems was found among MSM who engage in higher-risk sexual behavior. MSM require access to mental health screening services.