RECOGNITION AND PREVENTION OF MEDICATION ERRORS IN PEDIATRIC INPATIENTS: THE ROLE OF CLINICAL PHARMACISTS

Introduction: Medication errors (MEs) are considered preventable errors that may occur frequently during the treatment process with or without patient harm in addition to their economic consequence. MEs occur during prescribing, dose calculation, dispensing, or administration of medicine which could be made by any healthcare professional as a physician, pharmacist or nurse, or by the patient himself. Objective: To detect and report MEs in pediatric inpatients’ medical records and potentially preventing these MEs by making recommendations/suggestions for healthcare professionals about the proper action needed to be taken. Methods: This was a prospective observational study, in which the medical records of admitted pediatric patients to Ibn Al-Atheer Teaching Hospital, Nineveh were reviewed to detect, report, and prevent MEs between the 1st of January and the 30th of June 2019. Results: Out of 6964 medical records reviewed by clinical pharmacists during the study period, 119 MEs were reported to healthcare professionals and prevented. 83% of detected MEs were dosing errors. The results of the Chi-square analysis showed that the highest percentage of dosing errors were associated with antibiotics (p=0.0493). Furthermore, the results of Chi-square analysis showed that the highest percentage of dosing errors were seen in infants and toddlers (p=0.011). Conclusion: This study highlighted the role of clinical pharmacists in recognizing, reporting and preventing MEs which are still occurring in every medical setting. Dosing errors were the most commonly occurring errors and antibiotics were the most frequent group of medicines involved in MEs.

DEVELOPMENT AND CONSTRUCT VALIDATION OF QUESTIONNAIRE ASSESSING THE ADULT IMMUNISATION PERCEPTIONS AMONG MALAYSIAN POPULATION

Introduction: Immunisations are one of the most effective public health interventions, reducing or eliminating the burden of many infectious diseases. This study aims to establish the construct validity of a newly developed adult immunisation perceptions questionnaire among Malaysians. Methods: The Adult Immunisation Perceptions-Questionnaire (AIP-Q) was created following literature reviews on The Health Belief Model. Primarily, 64 questions were pooled, followed by face validity by experts, pretested via 20 healthcare personnel and later translate into the Malay language. A total of 305 respondents were selected for the construct validation process. Varimax rotation method used in the analysis for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) done using AMOS software. Results: Ten constructs were produced as predicted in EFA: health believes, experience, knowledge, attitude, perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and 2 cues for action. Thirteen items with low factor loading and unrelated to the recovered domains were removed from being included in CFA. In path analysis, the scale fitted ?2/df=1.943 (n=305) =p<0.001, CFI=0.908, IFI=0.909, TLI=0.901 and RMSEA=0.056. Strong factor loading was found across the final items, ranged from 0.53 to 0.94 with a good reliability test (Cronbach Alpha, AVE and CR values) for all constructs. Conclusion: The final AIP-Q consists of 10 domains with 45 items that give a promising psychometric property. This questionnaire can measure the perceptions of adult immunisation among the Malaysian population and can be utilized for the nationwide study.

STATISTICS & MEDICINE: THE EXACT LINK

STATISTICS & MEDICINE: THE EXACT LINK

ACUTE DIARRHOEA AMONG UNDER FIVE YEARS OLD CHILDREN OF UNDERPRIVILEGED COMMUNITY IN KOTA KINABALU, SABAH

The severity of childhood diarrhoea is linked with poor socioeconomic status, unhygienic living environment, and caregiver’s behaviour. This study is to determine the risk factors and economic burden associated with diarrhoea in children under 5 years of age. A case-control study using convenience sampling method with 105 cases and 105 controls was performed in Menggatal health clinic, Kota Kinabalu, Sabah between March-June 2017. Younger caregivers, without formal education, poor knowledge, practice handwashing with water only and stopped breastfeeding were associated with diarrhoea. Household with poor economic status, a family of five and more, crowded, with a pet, unsafe drinking water, no sanitary toilet, unsanitary garbage disposal and consuming street vendor food also associated with diarrhoea. The mean of total direct costs, total indirect costs and total incurred costs were (Ringgit Malaysia) RM 9.70, RM 59.40, and RM 14.30, respectively. As a conclusion, the risk factors for diarrhoea under 5 years of age still presents in Sabah. Environmental factors and hygienic practice are needed to control under 5 diarrhoea.

A COMPREHENSIVE REVIEW OF A RACE OF VACCINATION AGAINST COVID - 19 VIRUS: THE RECENT VACCINES DEVELOPED

Vaccines are urgently needed at the present time to protect humanity from COVID-19, which is caused by the Coronavirus 2 that causes severe acute respiratory syndrome. Large quantities of antibodies which have high affinity virus-neutralizing capability were induced by vaccines may optimally prevent infection and avoid unfavourable effects. During the progression of the vaccine, different vaccine models were assessed by disparate groups. This review summarizes the currently approved COVID- 19 vaccines with late-stage clinical results. The currently authorized SARS-CoV-2 vaccines with late stage clinical data are summarized in this review. Thrombosis may be related in some way to the vaccine, but the direct link has not yet been established. It was stressed that the probability of developing strokes is very small and does not compare with the benefit gained from using the vaccine at all.

SYSTEMATIC REVIEW ON IMPACT OF MASS DRUG ADMINISTRATION ON LYMPHATIC FILARIASIS PREVENTION

introduction: Lymphatic filariasis (LF) is a disease caused by filarial parasites transmitted to human by mosquitoes and infecting 120 million people worldwide. Mass drug administration (MDA) involves delivering treatment to every person living in a defined geographical area, is the current practice in place and has shown to be very useful in reducing the global transmission of LF. This review aims to explore into the effectiveness of MDA in interrupting the transmission of LF in terms of the types of MDA, number of cycles, coverage, and percentage of transmission reduction. Methods: A systematic search via Scopus, PubMed, and Cochrane was done for articles published from 2015 to 2019 by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The articles identified from the databases searched and any that appeared to relate to the research questions were included. A total number of 14 articles fulfilled the criteria for review. Results: Overall, the review showed a reduction in LF indices of more than 50% and up to 100% post-MDA in endemic communities with high prevalence. The entomological assessment revealed a reduction in LF transmission post-MDA, which strongly supported the reduction of LF indices. Biannual MDA conducted further showed a marked reduction in LF indices compared to annual MDA. Double therapy of MDA significantly reduced the transmission indices to almost nil compared to single therapy. Conclusion: Review of MDA showed promising effects in which it reduced the prevalence microfilaraemia (mf) and Circulating Filarial Antigen (CFA) from baseline, as well as the clinical prevalence and entomological indices. Combination therapy showed better outcome compared to single therapy. Therefore, complementary vector control is suggested in addition to MDA, as well as education delivery to the endemic communities.

HEALTH CARE PROVIDERS’ VIEWS CONCERNING KNOWLEDGE AND PRACTICES OF TRADITIONAL BIRTH ATTENDANTS IN TAJIKISTAN: A QUALITATIVE STUDY

Introduction: This study seeks to explore health care providers’ perspectives of the traditional birth attendants’ knowledge and practices. Methods: This qualitative study was conducted in 2018 with 16 health care professionals working at various levels of maternal health care system in two purposefully selected research settings, Khorog town and Dushanbe, which have different social, economic and ethnic backgrounds. Semi-structured face-to-face interviews were conducted to gather the data. Duration of interviews ranged from 30-60 min. NVivo software for qualitative research was used to analyse the results. Results: This study has shown that health care workers have extremely negative views of the knowledge and practices of traditional birth attendants. They highlight the lack of adequate knowledge of traditional birth attendants on biomedical aspects of birth, poor skills in infections control and lack of use of clean delivery practices. They also claim that the traditional birth attendants’ practices also lead to different complications while they are woefully unprepared to recognize obstetric complications during birth. Conclusion: The study recommends providing a skilled birth attendant in every area. It also recommends avoiding a homogeneous approach to address maternal health issues in diverse countries of the Global South and reviewing maternal health care policies and programs to provide the most marginalized groups of women with skilled birth services to improve their maternal health and further decrease maternal mortality in Tajikistan.

EFFICACY OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN TREATMENT OF POSTPARTUM DEPRESSION: A SITUATION ANALYSIS

Postpartum depression is a major public health issue worldwide. It varies in prevalence across countries. Pakistan remains highest to have the prevalence of postpartum depression among South Asian countries. A number of complementary and alternative medicines can help in decreasing depressive symptoms in the postpartum period. The purpose of this article is to subject review the use of complementary and alternative medicine as a treatment for postpartum depression. A comprehensive review of the literature was conducted from articles using PubMed, CINAHL, PsycINFO, EMBASE published since the last ten years. The findings of this review suggest that various complementary and alternative therapies may help in the treatment of postpartum depression. This literature review demonstrated the significant effectiveness of complementary and alternative medicine in the treatment of postpartum depression. As conclusion, the prevention and treatment of postpartum depression are essential for maternal as well as new-born health. Complementary and alternative medicine has less side effects than antidepressants which can affect maternal and newborn health adversely.

A META-ANALYSIS ON THE EFFECTIVENESS OF MALARIA COMMUNITY-BASED INTERVENTION

Introduction: The community-based intervention was proven as one of the best approaches in combatting malaria. It is widely used to reduce malaria cases worldwide. A multisectoral approach must be made to ensure the success of the intervention. Therefore, this study is aimed is to determine the effectiveness of community-based intervention for malaria based on recent findings. Methods: A search strategy using Pub Med and Cochrane database platform investigating the effectiveness of malaria community-based intervention. There are selected terms and words predefined to obtain a comprehensive search strategy that included text fields within records and Medical Subject Headings (MeSH terms). Results: Eight articles were selected for this study. This review identified six communitybased interventions for malaria and four outcome measures. Most of the studies included a low risk of bias in each criterion except for random sequence and allocation of concealment. The meta-analysis found that the overall incidence difference of the included studies was significant (0.05 CI 0.02, 0.08), while the subgroup analysis of Permethrin LLIN the I2 was reduced to 75%. However, the overall usage percentage difference in health education and community mobilization to improve intervention usage was not significant (0.28 CI -0.02, 0.58). Conclusion: The community-based intervention approach is practical to fight malaria thus, to reduced mortality due to malaria. An integrated approach and engagement with multiagency will ensure outstanding achievement in fighting malaria.

RETINOPATHY OF PREMATURITY, AN IMPORTANT PUBLIC HEALTH PROBLEM IN PAKISTAN: A REVIEW

Introduction: Retinopathy of Prematurity (ROP) is the significant cause of blindness in children globally. Although the incidence of ROP is greater in premature infants worldwide, statistics show that it is more common in low-middle-income countries. Multiple causes and complications of ROP in low middle-income countries have been reported therefore the purpose of this literature review was to review the findings from literature about the burden, causes, outcomes, and important preventive measures of ROP for low middle-income countries, especially in Pakistan. Methods: A comprehensive review of the literature was conducted from published articles. Research studies were selected that included risk factors of ROP, screening, and diagnosis of ROP, treatment of ROP, and prevention of ROP.Results The cause of the high rate of ROP in Low-middle income countries (LMICs) includes a high rate of preterm babies, lack of awareness regarding ROP, financial instability, and insufficient treatment and screening programs at the newborn units. ROP is found to be the significant cause of preventable blindness in South Asia. There are three different levels of prevention aimed at reducing the burden of ROP in LMICs. Primary prevention aims at reduction in preterm births, secondary prevention aims at early diagnosis of the disease and tertiary prevention aims at reducing deterioration of conditions due to disease. Conclusion: The emphasis on preventive measures especially primary and secondary level prevention can help in decreasing the burden of ROP. This requires a multidisciplinary approach at all levels including at the level of policymaking, program implementation, health care providers, and community level.