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  Subjects -> HEALTH AND SAFETY (Total: 1292 journals)
    - CIVIL DEFENSE (18 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (521 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (379 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (101 journals)
    - WOMEN'S HEALTH (81 journals)

HEALTH AND SAFETY (521 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 25)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 179)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 8)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 7)
Global Journal of Public Health     Open Access   (Followers: 9)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 14)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 46)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 11)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 10)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 32)
Health Policy and Technology     Hybrid Journal  
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 20)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 47)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 10)
Health, Risk & Society     Hybrid Journal   (Followers: 9)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 1)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Research     Open Access   (Followers: 4)
International Journal of Health Sciences Education     Open Access   (Followers: 2)

        1 2 3 | Last

Journal Cover African Health Sciences
  [SJR: 0.441]   [H-I: 25]   [2 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1680-6905
   Published by African Journals Online Homepage  [266 journals]
  • Editorial: Grappling with mother, newborn and child health (MNCH) issues
           in a continentbeset by non-communicable and infecious diseases

    • Authors: J.K. Tumwine
      Abstract: No
      PubDate: 2017-06-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Proportion and factors associated with low fifth minute Apgar score among
           singleton newborn babies in Gondar University referral hospital; North
           West Ethiopia

    • Authors: Temesgen Worku Gudayu
      Abstract: Background: New born babies with low Apgar scores are at an increased risk of perinatal morbidity and mortality.Objective: To assess proportion and factors associated with low 5th minute Apgar Apgar score among singleton newborn babies in Gondar University referral hospital; North West Ethiopia.Methods: A cross-sectional study was conducted on singleton 261 live births from March - May, 2013. Data was collected from mother/newborn index using a structured and pre-tested questionnaire. It was then cleaned, coded and entered using EPI INFO version 3.4.3, then analyzed with IBM SPSS statistics versions 20.0. Logistic regression was used to identify significant variables with low 5th minute Apgar score.Result: The proportion of low 5th minute Apgar score in this study was 13.8%. Factors that were significantly associated with low 5th minute Apgar score were: non-vertex fetal presentation, prolonged labor, presence of meconium stained liquor, induced/ augmented labor and low birth weight.Conclusion: Mainly obstetric factors contribute to low Apgar score. Improving labor management through implementing regular use of partograph, 1:1 midwife-client ratio and advanced electronic fetal monitoring technology is recommended.Keywords: Apgar score, Gondar University referral hospital
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Delivery practices, hygiene, birth attendance and neonatal infections in
           Karamoja, Uganda: a community-based study

    • Authors: Leah J. Hopp
      Abstract: Background: Drawing attention to home birth conditions and subsequent neonatal infections is a key starting point to reducing neonatal morbidity which are a main cause of mortality in sub-Saharan Africa.Objectives: To determine the proportion of respiratory, ophthalmic, and diarrhoeal infections in neonates; the proportion of mothers of neonates, following clean delivery practices; and to explore existing community practices during delivery and the neonatal period.Methods: A descriptive, cross-sectional, exploratory study, including 10 questionnaires and five Key-Informant interviews, in rural Karamoja, Uganda.Results: Post-delivery razor blade and string use was 90%, but clean delivery surface use only 30%, while 90% obtained bathing water for neonates from boreholes. No mothers washed hands after latrine-related activities compared with 83% for food-related activities. None delivered in health centres or with skilled birth attendants. Respiratory infections occurred in eight neonates, compared to two ophthalmic infections, and no diarrhoea.Conclusion: Use of clean delivery surfaces needs to be improved as well as washing after latrine-related activities. Diarrhoea was far less common than expected. Since rural Mother-Infant pairs spend the majority of their post-delivery time around the homestead, hygiene impacts neonatal infections to a large degree, possibly even more so than delivery practices.Keywords: Neonatal, birth, delivery, clean delivery kit (CDK), clean delivery practices, infection, diarrhoea, ophthalmic, respiratory, hygiene, traditional birth attendant (TBA), home, rural, community, Nakaale, Nakapiripirit, Karamoja, Uganda
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • How weight during pregnancy influences the association between
           pre-pregnancy body mass index and types of delivery and birth: a
           comparison of urban and rural areas

    • Authors: Manoochehr Babanezhad
      Abstract: Background: Women in study areas suffered from the problems of caesarean delivery (CD), low birth weight (LBW), and macrosomia.Objective: To investigate how gestational weight gain (GWG) influences the effect of the pre-pregnancy body mass index (BMI) on the risks of CD, LBW, and macrosomia in urban and rural areas in a city of Iran.Methods: We used 767 and 612 eligible subjects from the public health care centers in urban and rural areas respectively.Results: The risk of CD increased from 74% to 2.62-fold in urban and from 62% to 2.15-fold in rural areas, and the risk of macrosomia increased from 58% to 2.35-fold in urban and from 47% to 96% in rural areas, among obese women compared to normal weight women who gained above median GWG. The risk of LBW increased from 38% to 92% in urban and from 49% to 97% in rural areas among lean women compared to normal weight women who gained below median GWG.Conclusion: These findings strongly support the need to reform adequate pre-pregnancy weight and GWG against the risks of CD and macrosomia among overweight and obese women, and against the risk of LBW among lean women in both areas.Keywords: Body mass index, gestational weight gain, caesarean delivery, low birth weight, macrosomia
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Geophagy as risk behaviour for gastrointestinal nematode infections among
           pregnant women attending antenatal clinics in a humid tropical zone of
           Nigeria

    • Authors: Njoku Ivoke, Nnenna Ikpor, Obinna Ivoke, Felicia Ekeh, Ngozi Ezenwaji, Gregory Odo, Florence Iyaji, Uwakwe Onoja, Joseph Eyo
      Abstract: Background: Geophagy is wide spread among pregnant women in Ebonyi State, Nigeria.Objective: The aim of this study was to assess intestinal nematode infections among geophagous pregnant women in Southern Ebonyi State, Nigeria.Methods: Pregnant women were aged 17-45 years at gestational ages of ≥ 14 to 24 weeks on hospital enrolment were sampled. Data on geophagy was collected using structured questionnaire. Gastrointestinal nematode status of the participants was determined by stool analyses. Soil types ingested were examined for intestinal nematode ova / larvae.Results: The prevalence of geophagy (46.4%) was associated with socio-demographic characteristics. Ascaris lumbricoides and hookworm were associated with geophagy while Trichuris trichiura and Strongyloides stercoralis had no association. Prevalence of A. lumbricoides, T. trichiura and S. stercoralis differed significantly (p<0.05) between geophagous and non-geophagous women. The soil types consumed had eggs / larvae of A. lumbricoides and T. trichiura. Geophagy is a risk behaviour directly associated with A. lumbricoides, hookworm, T. trichiura, and to a lesser extent S. stercoralis infection among pregnant women.Conclusion: Sensitization and mass education of pregnant women on the dangers of geophagy is needed. Furthermore, deworming of pregnant women should be integrated into the healthcare delivery system of the State.Keywords: Geophagy, gastrointestinal nematode, pregnant women, humid tropics
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Sexual risk behavior among HIV-positive persons in Jamaica

    • Authors: Butho Ncube, Jessica Ansong, Kewanna Daniels, Dianne Campbell-Stennett, Pauline E. Jolly
      Abstract: Background: HIV/AIDS remains a global public health challenge, especially in sub-Saharan Africa and the Caribbean. Sexual risk behaviors among HIV-positive persons place their partners at risk for HIV transmission and other sexually transmitted infections. Stopping transmission acts among HIV-positive people is crucial in reversing HIV incidence.Objective: This study aimed to assess the prevalence and predictors of sexual risk behaviors among HIV-positive individuals in clinical care in Northwestern Jamaica.Methods: A cross-sectional survey of 118 (33 males and 85 females) HIV-positive individuals was used to assess demographic and health characteristics, HIV/AIDS knowledge, attitudes, and beliefs and sexual risk behaviors.Results: About 12% of the study population stated that they had unprotected anal or vaginal sex without disclosing their HIV status. Participants who agreed that condoms reduce the risk of HIV transmission were 13.1 times more likely to use condoms during their last sexual encounters(95% CI: 2.1-79.0) than those who disagreed. About 75% of participants reported using a condom every time they had sexual intercourse in the past year, while 25% used condoms irregularly. Participants who had unprotected anal or vaginal sex without disclosing their status were less likely to have used condoms during the last sexual encounter (OR=0.1; 95% CI: 0.02-0.5).Conclusion: The prevalence of unsafe sex remains high among sexually active people living with HIV/AIDS in Jamaica. Study participants who engaged in unprotected sex without disclosing their HIV-positive status potentially place their partners at risk for HIV transmission and other sexually transmitted infections. The study findings highlight the need to promote safe sexual behaviors and a positive social environment for people living with HIV/AIDS in Jamaica.Keywords: HIV-seropositivity, sexual behavior, Jamaica, anti-retroviral therapy, condom use
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Diversities in timing of sexual debut among Nigerian youths aged 15-24
           years: parametric and non-parametric survival analysis approach

    • Authors: Adeniyi Francis Fagbamigbe, Erhabor Idemudia
      Abstract: Objective: This study examined gender, generational, cultural and social diversities in timing of sexual debut among Nigerian youths and determined factors influencing the timings.Methods: We extracted data of respondents aged 15-24 years from 2012 Nigeria nationally representative data. The outcome of interest was time at sexual debut while predictors included residence, marital status, zones, education, religion, age at first marriage. Data was censored, cox proportional hazard and generalized gamma models were used to model age at sexual debut with p=0.05.Results: The median survival time of sexual debut was 19 years, female youths were twice as likely to begin sexual activities than their male counterparts, HR=1.99, 1.87-2.11 while uneducated youths were more than twice likely to have earlier sexual debut than those with higher education, HR=2.19, 1.95-2.25. Likelihood of having had sexual debut was about 30% higher among those aged 20-24 years than those aged 15-19 years, HR=1.27, 1.19-1.36.Conclusion: Females from poor households mostly in rural areas with no education and who married early in life were more likely to have earlier sexual debut. Both teenagers and young adults are on different trajectories of sexual debut but both urgently need sexual and reproductive health education to delay sexual debut.Keywords: Sexual debut, survival analysis, Nigeria, generalised gamma, wealth
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Developmental screening: predictors of follow-up adherence in primary
           health care

    • Authors: Joanné Christine Schoeman, De Wet Swanepoel, Jeannie van der Linde
      Abstract: Background: The importance of early identification for infants and young children with developmental delays is well established. Poor follow-up on referrals, however, undermines the effectiveness of early intervention programmes.Objectives: To identify factors, including text message reminders, that influence follow-up adherence for early intervention after developmental screening in primary health care. A secondary objective surveyed reasons for follow-up default.Methods: The PEDS tools were used to screen 247 high-risk children. A risk assessment questionnaire was completed with caregivers whose children were referred for speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental correlational study was employed to identify risk factors for defaulting on appointments. A thematic analysis of telephonic interviews was also employed to determine reasons for follow-up defaults.Results: Follow-up adherence was 17%. Participants who were never married, divorced or widowed were 2.88 times more likely to attend a follow-up appointment than those who were married or living together (95%, CI 0.97-8.63). Text message reminders did not improve follow-up. More than half (58%) of participants who defaulted on appontments could be reached for telephonic interviews. Interviews showed that 87% of participants were unconcerned about their child’s development. Other reasons for defaulting were employment, logistical issues, other responsibilities and forgetfulness.Conclusion: Follow-up adherence for early intervention services following a positive primary health care screen was poor. Increased awareness and education regarding the importance of development for educational success is needed.Keywords: Developmental screening, follow-up return rate, occupational therapy, PEDS tools, primary health care, speech-language therapy, text message reminders
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Contextual determinants of adolescent mortality in South Africa

    • Authors: Nicole De Wet, Clifford Odimegwu
      Abstract: Objectives: South Africa has a large adolescent population (approximately 20% of the total population). The survival and development of these individuals are a priority among parents and the government. In an effort to better understand the factors contributing to adolescent mortality in South Africa, this study examined the effect of household and community factors on adolescent death.Methods: The study used data from Census 2001. Multilevel modelling was used to study the impact of community and household factors on adolescent mortality. A multivariate binary logistic 2- level model was developed. Odds ratios were produced and, statistically significant values (p<0.05) were discussed. There were 41,261 reported adolescent deaths from census data.Results: This study found that having a few household assets, six or more people living in a residence, and high racial diversity is associated with increased odds of adolescent mortality in South Africa in 2001.Conclusions: Socio-economic status of the household and racial diversity within communities is likely to increase adolescent mortality in South Africa. However, there is need to examine the role of other community characteristics, such as number of schools, health facilities and employment opportunities in order to create a holistic profile of the contextual determinants of adolescent mortality in the country.Keywords: Adolescent mortality, South Africa
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Distribution of symptoms of post-stroke depression in relation to some
           characteristics of the vulnerable patients in socio-cultural context

    • Authors: Sam. C. Ibeneme, Akachukwu O. Nwosu Nwosu, Georgian C. Ibeneme, Muideen O. Bakare, Gerhard Fortwengel, Dnyanesh Limaye
      Abstract: Objective: To determine the distribution of symptoms of post-stroke depression (PSD) in relation to some predisposing factors in an African population.Relevance: Environment is a key determinant of behavior, and varied socio-cultural contexts must have implications for modifiable characteristics (age, duration of the stroke, marital status, type of employment, gender, the location of cerebral lesion and complications) of individuals vulnerable to PSD, which may be targeted to enhance recovery.Method: This was a cross-sectional observational study of 50 (22 females and 28 males) stroke survivors (mean age=54.76±8.79 years), at the physiotherapy department, the University of Nigeria teaching hospital, Enugu, selected using convenience sampling technique. Data were collected using Becks Depression Inventory and analyzed using Z-score, Chi-square test and univariate logistic regression, at p<0.05.Results: PSD was more prevalent in females (45.45%); young(100%); middle-age(60%) adults(27-36/47-56 years respectively); living with spouse (45%); left cerebral lesions (40.74%); complications(45%); cold case >3 years(47.05%); self-employed and unemployed (66.67%), respectively. Age was significantly associated with depression (χ2 =4.92,df=1,p=0.03), and was related to the risk of PSD (3.7[1.1-12.0], p=0.03, φ = +0.31, φ2=0.1).Conclusion: Age could be a risk factor for PSD, which was more prevalent in the elderly than young/middle-age adults, female gender, left cerebral lesion, complications, cold case; those living with a spouse, self-employed and unemployed.Keywords: Symptoms of post-stroke depression, modifiable characteristics of the vulnerable patients, African socio-cultural context
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Utilization of physiotherapy in the continuum of stroke care at a tertiary
           hospital in Ibadan, Nigeria

    • Authors: Olubukola Adebisi Olaleye, Zainab Iyabo Lawal
      Abstract: Objectives: To investigate the pattern of referral for and utilisation of physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria.Methods: Referral notes and medical records of patients admitted in the University College Hospital, Ibadan with a clinical diagnosis of stroke between January, 2009 and December, 2013 were retrospectively reviewed. Information on age, sex, type of stroke, length of hospital stay, referral for physiotherapy and utilisation of physiotherapy were retrieved. Data were summarised using descriptive statistics and analysed using Chi-square test.Results: A total of 783 patients with stroke were admitted in the hospital during the period under study. The in-patient mortality rate was 37.2%. The mean Length of Hospital Stay (LoHS) was 16.17±12.34 days. Referral rate for physiotherapy was high (75.8%) and the mean time from admission to referral for physiotherapy was three days. Majority of patients referred utilised physiotherapy (63.4%) and mean number of physiotherapy sessions received during in-patient care was 8.69±6.45. There was a significant association between LoHS and utilisation of in patient physiotherapy (p=0.02).Conclusion: The referral rate of stroke patients for physiotherapy was relatively high. Utilisation of in-patient physiotherapy reduced length of hospital stay among patients with stroke. Utilisation of out-patient physiotherapy was low. Strategies to enhance out-patient utilisation should be explored.Keywords: Stroke, utilisation, physiotherapy
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • A cross-sectional analysis of the association between age and gender and
           prescribed minimum benefit chronic disease list conditions among South
           Africans with concomitant hypertension, diabetes and dyslipidaemia

    • Authors: Johanita Burger, Martie Lubbe, Jan Serfontein, Suria Ellis
      Abstract: Background: Prescribed Minimum Benefit Chronic Disease List (PMB CDL) conditions are a regulated list of conditions most common to South Africa.Objectives: To investigate the prevalence and association between PMB CDL conditions and age and gender among patients with concomitant hypertension, diabetes and dyslipidaemia.Methods: The study population consisted of patients (n = 17 866) with a prescription containing at least one co-prescribed antilipemics, antihypertensive and antidiabetic (identified using the MIMS Desk Reference). ICD-10 codes on claims for PMB CDL conditions were counted.Results: 39.5% of patients had a PMB CDL condition. Women had higher odds for hypothyroidism (OR 6.30, 95% CI; 5.52, 7.19, p < 0.001) and lower odds for coronary artery disease (CAD) (OR 0.63, 95% CI; 0.55, 0.72, p < 0.001) than men. In combination with hypothyroidism the odds for CAD were reversed and strongly increased; 3.54 (95% CI; 2.38, 5.25, p < 0.001). The odds for females having cardiac failure (CF) was insignificant and low (OR 0.87, 95% CI; 0.75, 1.01, p = 0.063); however combined with hypothyroidism, the odds increased to 5.35 (95% CI; 3.52, 8.13, p < 0.001).Conclusion: Hypothyroidism was an important discriminating factor for co-morbidity in women with concomitant hypertension, diabetes and dyslipidaemia, in particular with cardiovascular disease.Keywords: Concomitant hypertension, diabetes and dyslipidaemia, South Africa, prescribed minimum benefit chronic disease list (PMB CDL) conditions
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Role of plasma adiponectin /C-reactive protein ratio in obesity and type 2
           diabetes among African Americans

    • Authors: Preetha Anna Abraham, Selasi Attipoe, Josh B. Kazman, Stacey Anne Zeno, Merrily Poth, Patricia Anne Deuster
      Abstract: Background: Obesity is a modifiable risk factor for hypertension and T2D.Objective(s): We examined relations between fasting plasma adiponectin (ADIP), C-reactive protein (CRP) concentrations and markers of T2D in African Americans (AA).Methods: Fasting plasma ADIP, CRP, Insulin (IN), HOMA-IR, lipid profiles, body fat percent (%BF), waist circumference (WC), body mass index (BMI) and blood pressure measures were determined in AA women (W: n=77) and men (M: n=34). Participants were classified into: 1) Normal fasting glucose (FG) and Normal %BF; 2) Normal FG and High %BF; and 3) High FG.Results: Compared to men, women had significantly higher mean ADIP (W: 31.4±2.9 vs. M: 18.0±4.4 ng/L), CRP (W: 3.2±0.3 vs. M: 2.0±0.5 mg/L), %BF (W: 41.2±0.9 vs. M: 27.2±1.3), and BMI (W: 32.3±0.7 vs. M: 29.2±1.1 kg/m2). Women with normal FG and %BF had significantly higher ADIP (64.0±6.0) and lower CRP (1.3±0.6) concentrations than normal FG/ high %BF (ADIP: 37.0±5.0 and CRP: 3.1 0.5) and high FG (ADIP: 15.1±4.1 and CRP: 4.0 0.5) groups. Women with high ADIP to CRP ratio had favorable metabolic and anthropometric profiles.Conclusion: Low ADIP and high CRP are associated with excessive %BF and FG in AA women. ADIP/CRP, may be useful for detecting metabolic dysregulation.Keywords: Obesity, type 2 diabetes, inflammation
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Association between ALDH2 Glu504Lys polymorphism and colorectal cancer
           risk: a meta-analysis

    • Authors: Jiang Xinhua, Zhao Yanfei
      Abstract: Background: The findings from studies on the relationship between aldehyde dehydrogenases(ALDH) gene Glu504Lys polymorphism and colorectal cancer(CRC) were inconsistent.Objectives: The aim of this meta-analysis was to assess ALDH gene Glu504Lys polymorphism and CRC risk.Methods: All of the relevant studies were identified from PubMed and Embase database. Statistical analyses were conducted with STATA 12.0 software.Odds ratio (OR) with 95% confidence interval (CI) values were applied to evaluate the strength of the association. Nine studies with 2779 cases and 4533 controls were included.Results: No significant variation in CRC risk was detected in any of the genetic models overall. To explore the sources of heterogeneity,we performed further sub-group analyses by ethnicity and quality assessment of these studies.In the sub-group analysis by race,significant associations between ALDH gene Glu504Lys polymorphism and CRC risk were found in China(Glu/Lys vs Glu/Glu: OR = 0.70, 95%CI = 0.57–0.85; the dominant model: OR =0.69, 95%CI =0.48–0.98) and Japan(Lys/Lys vs Glu/Glu:OR =0.72, 95%CI =0.55–0.95).Conclusion: This meta-analysis suggests that the ALDH2 Glu504Lys polymorphism may be associated with susceptibility to CRC. Furthermore, large and well-designed studies are needed to confirm these conclusions.Keywords: Aldehyde dehydrogenases, colorectal cancer, polymorphism, susceptibility
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Clinical and cranial computed tomography scan findings in adults following
           road traffic accidents in Kampala, Uganda

    • Authors: Geoffrey Erem, Samuel Bugeza, Elsie Kiguli Malwadde
      Abstract: Background: Globally, road traffic accidents are a major cause of death and disability. The developing countries bear a disproportionately large share of the RTAs which account for about 85% of the deaths. Most of these RTAs result in head injury, which globally, most scholars and medical practitioners consider a significant economic, social and medical problem. In Mulago National referral hospital, RTA is the leading cause of surgical admission.Objective: To describe the cranial computed tomography (CT) scan findings in adults following RTA in Mulago hospital.Methods: Using CT, detailed analysis of 178 adult patients with head injury following RTA was performed. Data was analyzed using SPSS version 16 and presented in tables and graphs. Data recorded included socio-demographic characteristics, clinical and CT variables.Results: Seventy seven percent of the respondents were between 18- 39 years. 52.6% of patients had open head injury. Headache was the most common clinical variable followed by dizziness and aphasia. The most common CT characteristic was extra cerebral haemorrhage followed by brain oedema and raised Intra-cranial pressure (ICP). Intra-cerebral haemorrhage was commonest in the frontal lobe followed by parietal lobe.Conclusion: Public health interventions like advocacy and education of the population on safe and responsible road usage should be emphasized to reduce on RTAs.Keywords: Computed tomography scan, road traffic accidents, head injury, Uganda
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • A randomized controlled trial to assess the effect of a ketamine infusion
           on tourniquet hypertension during general anaesthesia in patients
           undergoing upper and lower limb surgery

    • Authors: Joyce Ongaya, Vitalis Mung’ayi, Thikra Sharif, Jimmie Kabugi
      Abstract: Background: Tourniquet hypertension arising from tourniquet inflation remains a primary concern to the anaesthetist. One drug commonly used to manage tourniquet hypertension is ketamine. No studies have examined the effect of ketamine on tourniquet hypertension for a period of more than one hour or an infusion of the same.Objective: To compare the effect of an intravenous infusion of ketamine versus placebo on tourniquet induced hypertension in patients undergoing upper and lower limb surgery under general anaesthesia.Methods: Forty six adult patients scheduled for upper and lower limb surgery under general anaesthesia were randomized into two equal groups. The ketamine group received an intravenous bolus of 0.1mg/kg of ketamine followed by an infusion of 2ug/kg/min. The saline group received an intravenous bolus of physiological saline followed by an infusion of saline. All the patients were reviewed post-operatively. Data of the baseline characteristics, haemodynamic changes, post-tourniquet pain and side effects were collected. If post-tourniquet pain was present post-operatively, a visual analogue scale (VAS) was used to assess its severity.Results: 46 patients successfully completed the trial. There were no significant differences between the groups for baseline patient demographics. The incidence of tourniquet hypertension was higher in the saline group (26.1%) compared with ketamine group (4.6%) with a 95% confidence interval. The difference was shown to be statistically significant (‘P’<0.05). There was an increase in systolic blood pressure after 60 minutes of tourniquet inflation in the saline group but the difference was not statistically significant(‘P’>0.866). There were no significant differences between the groups as regards diastolic blood pressure and heart rate. VAS scores did not differ between the two groups. Statistically, there was no difference found between the two groups. Side effects were minimal in the ketamine group whilst in the saline group, nausea and vomiting were predominant but were also not statistically significant.Conclusion: Based on the results of this study,there was a difference in the proportion of tourniquet hypertension between the ketamine and saline groups for patients undergoing upper and lower limb orthopaedic surgery under general anaesthesia.Keywords: Randomized controlled trial, effect of a ketamine infusion, tourniquet hypertension, general anaesthesia, upper and lower limb surgery
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Effect of posture on swallowing

    • Authors: Ahmad H. Alghadir, Hamayun Zafar, Einas S. Al-Eisa, Zaheen A. Iqbal
      Abstract: Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while swallowing.Objectives: To observe the effect of different body postures on the self-perceived difficulty while swallowing in normal healthy subjects.Methods: Participants were asked to swallow 25 ml of water in one go while sitting upright, sitting with head/neck flexed, head/ neck extended and lying supine. Following this, they had to rate their self-perceived difficulty while swallowing on a scale of 0-10, 0 being most easy and 10 being most difficult.Results: 186 subjects with mean age 32.7 SD 9.04 participated in this study. It was found to be least difficult to swallow when subjects were asked to swallow in upright sitting position. Statistically significant differences were found between sitting upright, sitting with head/neck flexed, head/neck extended and lying supine.Conclusion: Postural modification may help in rehabilitation of patients with dysphagia by affecting bolus flow to improve speed and safety of swallowing by closure of airways to prevent aspiration.Keywords: Swallowing, posture, dysphagia
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • The effect of a preanaesthesia clinic consultation on adult patient
           anxiety at a tertiary hospital in Kenya: a cohort study

    • Authors: Anthony Kamau, Vitalis Mung’ayi, Gerald Yonga
      Abstract: Background: Preoperative anxiety is a common perioperative complication seen in approximately 11-80% of adults undergoing surgery. One of the goals of the preanaesthesia clinic is to allay anxiety. A preanaesthesia clinic evaluation has been shown to reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction.Objective: To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward.Methods: Fifty one adult patients with 28 patients in anaesthesia clinic (AC) group and 23 in the ward (W) group were sequentially recruited from both the surgical, gynaecology and antenatal outpatient clinics and the wards. The patient’s State Trait Anxiety Index (STAI) was taken once the patient was booked for theatre. The patients then had a preanaesthesia evaluation either in the preanaesthesia outpatient clinic (PAC) or in the wards. Another STAI score was taken in the preoperative area in theatre on the day of surgery. The difference in the change of STAI scores in both groups was then analysed.Results: Fifty one adult patients were recruited with 28 in the AC group and 23 in the W group. The majority of patients were female (n=38). Statistically significant difference was seen in the reduction of the anxiety scores between the clinic group 2.143 (C.I=1.384-2.902) and ward group 0.74(C.I=0.17-1.31) with a p value=0.0051.There was also significant difference in reduction in anxiety scores within ward group in the patients with no prior anaesthetic experience having a greater reduction than those with prior anaesthetic experience. There were no other significant differences between the two groups.Conclusion: Patients evaluated in the anaesthesia clinic had a greater reduction in their anxiety but it was not as much as hypothesised which may be due to the multi-factorial nature of preoperative anxiety. A larger multicenter study is recommended to increase generalizability to the population.Keywords: Preanaesthesia clinic, consultation on adult patient anxiety, cohort study , Kenya
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Cytotoxicity testing of aqueous extract of bitter leaf (Vernonia
           amygdalina Del) and sniper 1000EC (2,3 dichlorovinyl dimethyl phosphate)
           using the Alium cepa test

    • Authors: Jane Ogoamaka Okwuzu, Peter Odeiga, Olubunmi Adetoro Otubanjo, Oliver Chukwujekwu Ezechi
      Abstract: Background: The unrefined nature of the herbal preparations from Vernonia amygdalina (VA) and toxicity potentials of Sniper may both have severe consequences on the biochemical and genetic systems.Objectives: To assess the microscopic and macroscopic effects of these substances.Methods: VA leafs and Sniper were prepared and dissolved in distilled water to give different concentrations. Series of baseline tests were carried out to establish concentration range for root growth. Series of twelve onion bulbs of three per series was prepared, with a series of three onion bulbs serving as control. Chromosomal aberrations were statistically analysed using chisquared test. Root bundle mean length was obtained after 96 hours and EC50 values at 95% confidence interval was determined from a plot of root length against sample concentrations using Microsoft Excel software.Results: Total cytotoxic effect was induced by 2% sniper and 70% VA. EC50 for VA and sniper were 33.07 and 0.346 respectively. The two substances induced chromosomal aberrations and the effect was concentration dependent.Conclusion: There are risks of these widely used substances for therapeutic and environmental purposes.Keywords: Chromosomal aberrations, Sniper 1000EC, Vernonia amygdalina, toxicity
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Oxidative stress and histopathological changes induced by
           methylthiophanate, a systemic fungicide, in blood, liver and kidney of
           adult rats

    • Authors: Ben Amara Ibtissem, Ben Saad Hajer, Hakim Ahmed, Elwej Awatef, Kallel Choumous, Boudawara Ons, Zeghal Khaled Mounir, Zeghal Najiba
      Abstract: Background: Methyl-thiophanate (MT), a fungicide largely used in agriculture throughout the world including Tunisia, protects many vegetables, fruits and field crops against a wide spectrum of fungal diseases. Oxidative stress has been proposed as a possible mechanism involved in MT toxicity on non-target organism.Methods: In the present study, the effect of MT injected intraperitoneally to adult rats at 300 or 500 mg/kg of body weight was studied on blood, liver and kidney.Results: Our results showed 3 days after MT injection, a significant decrease in hemoglobin and hematocrit values. A disruption in total white blood cells and platelets also occurred. Accordingly, an increased in malondialdehyde, H2O2 and advanced oxidation protein levels in liver and kidney were noted with the two doses. A significant change in plasma biomarkers and organ enzymatic and non-enzymatic activities were observed after MT treatment. The modifications in biochemical parameters were substantiated by histopathological data.Conclusion: These data confirmed the pro-oxidant effects of this fungicide. Accordingly, care must be taken to avoid mammalian and human exposure to MT.Keywords: Methyl-thiophanate, white blood cells, red blood cells, liver, kidney
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Renal histoarchitectural changes in nevirapine therapy: possible role of
           kolaviron and vitamin C in an experimental animal model

    • Authors: Ugochukwu Offor, Sunday Adelaja Ajayi, Isaac Ayoola Jegede, Salem Kharwa, Edwin Coleridge Naidu, Onyemaechi Okpara Azu
      Abstract: Background: There is paucity of literature regarding the nephrotoxicity of antiretroviral drugs and its interaction with plantbased adjuvants. This study investigates the attenuating effect of kolaviron in nevirapine- therapy on the histological structure of the kidneys of adult male Sprague-Dawley rats.Objective: To determine the attenuating influence of anti-oxidant status of kolaviron on the kidneys of experimental animals following nevirapine administration.Methods: Forty eight pathogen-free adult male Sprague-Dawley rats were used for this study. The animals were divided into 8 groups (A-H) with 6 animals in each group. Group A was given normal saline as the control; group B was given nevirapine; group C was given kolaviron; group D was given vitamin C; group E was given nevirapine and kolaviron; group F was given nevirapine and vitamin C; Group G was given nevirapine and kolaviron (kolaviron withdrawn after day 28) and group H was given corn oil. The experiment lasted 56 days after which the animals were sacrificed, blood samples were collected through cardiac puncture for serum analysis and the kidneys were harvested and prepared for H& E histological examination.Results: Nevirapine caused histoarchitectural damage in the glomerular apparatus with resultant increase in kidney/body weight ratio (p<0.001). Adjuvant treatment with kolaviron attenuated these nephrotoxic effects. Serum anti-oxidant enzyme (SOD and CAT) activities were significantly reduced in kolaviron and vitamin C treated animals, whereas in the nevirapine group these parameters were significantly elevated (P<0.05). However, co-administration of nevirapine and vitamin C did not improve the histoarchitecture of the kidney.Conclusion: Adjuvant treatment with kolaviron (an anti-oxidant) for 56 days appears to attenuate the nephrotoxicity of nevirapine in this model.Keywords: Kidney, histoarchitecture, kolaviron, antiretroviral drugs
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Prevalence of khat chewing and its effect on academic performance in
           Sidama zone, Southern Ethiopia

    • Authors: Andargachew Kassa, Eskindir Loha, Atkilt Esaiyas
      Abstract: Background: Khat use is a well-established public health problem in Yemen, Arabian Peninsula, and Ethiopia. Along with its large scale production, the magnitude of khat use is increasing among students.Objective: This study was intended to assess the prevalence, determinants, and effect of khat use on academic performance of high school students in Sidama Ethiopia.Methodology: A cross-sectional study was conducted from April to June 2015. We used a stratified sampling technique to draw a total of 1,577students. The data was collected using self-administered questionnaires and analyzed using SPSS version 20. Descriptive statistics and logistic regression models were used to determine the prevalence, effects, and predictors of khat use.Result: The life time and current prevalence of khat use were 14.6% and 13%, respectively. Smoking cigarette (AOR=5.1, 95% C.I: 2.3-14.3), drinking alcohol (AOR=3.0, 95% C.I: 1.4-6.3), having a family growing khat (AOR=2.0, 95% C.I: 1.1-2.5), having friend chewing khat (AOR=3. 95% C.I: 2.0-4.6), were some of factors that increased the odds of students’ khat use. Student’s khat use increased the odds of student’s poor academic performance (AOR=2.1, 95% C.I: 1.1-3.9).Conclusion: The prevalence of khat use in high khat producing districts of Sidama and its contribution to poor academic performance demand prompt intervention.Keywords: Khat, high school student, academic performance, Ethiopia
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Evaluation of the mobile phone electromagnetic radiation on serum iron
           parameters in rats

    • Authors: Murat Çetkin, Can Demirel, Neşe Kızılkan, Nur Aksoy, Hülya Erbağcı
      Abstract: Background: Electromagnetic fields (EMF) created by mobile phones during communication have harmful effects on different organs.Objectives: It was aimed to investigate the effects of an EMF created by a mobile phone on serum iron level, ferritin, unsaturated iron binding capacity and total iron binding capacity within a rat experiment model.Methods: A total of 32 male Wistar albino rats were randomly divided into the control, sham, mobile phone speech (2h/day) and stand by (12 h/day) groups. The speech and stand by groups were subjected to the EMF for a total of 10 weeks.Results: No statistically significant difference was observed between the serum iron and ferritin values of the rats in the speech and stand by groups than the control and sham groups (p>0.05). The unsaturated iron binding capacity and total iron capacity values of the rats in the speech and stand by groups were significantly lower in comparison to the control group (p<0.01).Conclusion: It was found that exposure to EMF created by mobile phones affected unsaturated iron binding capacity and total iron binding capacity negatively.Keywords: cellular phone, electromagnetic fields, ferritin, serum iron
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • In vitro investigation of clofazimine analogues for antiplasmodial,
           cytotoxic and pro-oxidative activities

    • Authors: E.M. Makgatho, E.F. Mbajiorgu
      Abstract: Background: Tetramethyl-piperidine-substituted, B4119 and B4158 have been shown to exhibit antiplasmodial activity.Objectives: The in vitro antiplasmodial, cytotoxic and oxidative activities of clofazimine and its analogues, all TMP (tetramethylpiperidyl)- substituted phenazines except B669, were evaluated in this study.Methods: The antiplasmodial activity of the compounds against RB-1 and pfUP10 laboratory strains of Plasmodium falciparum was investigated by flow cytometry. The cytotoxic activity against HeLa cells and oxidative activity were studied employing colorimetric and cytochrome C reduction assays respectively.Results: The riminophenazine agents exhibited antiplasmodial action of varying degrees: B669, B4100 and B4103 showed the best activity while B4121 and B4169 exhibited significant activity at 2μg/ml. Clofazimine had no antiplasmodial activity. The compounds B4100, B4103, B4121 and B4169 exhibited significant cytotoxic activity against HeLa cells at concentrations of 0.5μg/ml and above while B669 was active at 2μg/ml. Clofazimine and B669 tested at a concentration of 0.5μg/ml caused enhancement (p ≤ 0.05) of neutrophil superoxide production when compared to the FMLP control while all the other TMP-derivatives had no effect (p ≥ 0.05).Conclusion: Tetramethylpiperidyl-subsituted phenazines may potentially be useful antimalarial/antitumor agents with no pro-oxidative properties. In vivo studies on the agents relative to these properties are recommended.Keywords: Riminophenazines, malaria, cytotoxicity and superoxide anions
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Quorum sensing inhibitory activity of sub-inhibitory concentrations of
           β-lactams

    • Authors: Somaia A. El-Mowafy, Khaled H. Abd El Galil, El-Sayed E. Habib, Mona I. Shaaban
      Abstract: Introduction: The virulence factors of Pseudomonas aeruginosa are under the control of quorum sensing (QS) signals. Hence, interference with QS prevents its pathogenesis.Objective: The aim of the present research is to assess the influence of some β-lactam antibiotics on cell communication and the release of different virulence factors.Methods: The minimal inhibitory concentrations of ceftazidime, cefepime and imipenem were evaluated by microbroth dilution method. The effect of sub-inhibitory concentration of the tested antibiotics on QS signals was investigated using reporter strain assay. In addition, different virulence factors (elastase, protease, pyocyanin and hemolysin) were estimated in the presence of their sub-inhibitory concentrations.Results: Low concentrations of ceftazidime, cefepime and imipenem caused significant elimination of the QS signals 3OHC12- HSL and C4-HSL up to 1/20 MIC. Furthermore, low concentrations of the tested antimicrobials suppressed virulence factors elastase and hemolysin. Moreover, 1/20 of their MICs reduced elastase, protease, pyocyanin and hemolysin.Conclusion: Utilization of β-lactam antibiotics at low concentrations could be an effective approach for prevention and treatment of P. aeruginosa infection.Keywords: Quorum sensing inhibition, β-lactams, Pseudomonas aeruginosa
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Tuberculosis among HIV-infected population: incidence and risk factors in
           rural Tanzania

    • Authors: K Said, S Verver, A Kalingonji, F Lwilla, A Mkopi, S Charalambous, K Reither
      Abstract: Background: The incidence of tuberculosis among HIV-infected populations with high CD4 count in high burden countries has not been well studied.Objective: To assess the TB incidence in HIV-infected adults and its associated risk factors.Method: A cohort study with retrospective review of medical records and prospective follow-up of HIV-infected adult participants attending CTC who were 18-55 years old, had CD4 count more than 250 cells/mm3 in the period of 2008-2010 and were not on ART at enrolment. Cox proportional hazard regression was used to explore the predictors of incident TB.Results: Overall 777 (24%) of 3,279 CTC enrolled HIV-infected adults fulfilled the inclusion criteria of the study. The incidence of TB in the study population ranged from 0.8/100 per person years (PY) at risk (95% CI 0.5-1.3) in the main analysis to 1.7/100 PY at risk (95% CI 1.0-2.6) in sensitivity analyses. Only prior history of TB disease was found to have a significant association with an increased risk of TB, hazard ratio 5.7 (95% CI 2.0-16.4, p value 0.001).Conclusion: Tuberculosis incidence among HIV-infected adults with medium/high CD4 count in Bagamoyo is lower than in other high TB burden countries. Previously TB treated patients have a much higher risk of getting TB again than those who never had TB before.Keywords: Tuberculosis, HIV, Care and Treatment Center, CD4 cell count
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Willingness by people living with HIV/AIDS to utilize HIV services
           provided by Village Health team workers in Kalungu district, central
           Uganda

    • Authors: Mutaawe Lubogo, Ronald Anguzu, Humphrey Wanzira, Irene Namugwanya, Oliver Namuddu, Denis Ssali, Sylivia Nanyonga, Josephine Ssentongo, Janet Seeley
      Abstract: Background: Less than one quarter of people in need have access to HIV services in Uganda. This study assessed willingness of people living with HIV/AIDS (PLWHAs) to utilize HIV services provided by Village Health Teams (VHTs) in Kalungu district, central Uganda.Methods: A cross-sectional study conducted in two health facilities providing anti-retroviral therapy enrolled 312 PLWHAs. Pre-tested semi-structured questionnaires were administered to participants at household level. A forward fitting logistic regression model computed the predictors of willingness of PLWHAs to utilize services provided by VHTs.Results: Overall, 49% were willing to utilize HIV services provided by VHTs increasing to 75.6% if the VHT member was HIV positive. PLWHAs who resided in urban areas were more likely to utilize HIV services provided by VHTs (AOR 0.24, 95%CI 0.06-0.87). Barriers to utilizing HIV services provided by VHTs were: income level > 40 USD (AOR 6.43 95%CI 1.19-34.68), being a business person (AOR 8.71 95%CI 1.23-61.72), peasant (AOR 7.95 95%CI 1.37-46.19), lack of encouragement from: peers (AOR 6.33 95%CI 1.43-28.09), spouses (AOR 4.93 95%CI 1.23-19.82) and community leader (AOR 9.67 95%CI 3.35-27.92).Conclusion: Social support could improve willingness by PLWHAs to utilize HIV services provided by VHTs for increased access to HIV services by PLWHA.Keywords: Willingness by people living with HIV/AIDS to utilize HIV services provided by Village Health Team workers in Kalungu district, central Uganda
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Role of contact tracing in containing the 2014 Ebola outbreak: a review

    • Authors: Shrivastava Saurabh, Shrivastava Prateek
      Abstract: Background: The 2014 outbreak of Ebola virus disease which emerged in the month of March in the year 2014 in Guinea has been declared as a public health emergency of international concern.Objectives: The objectives of the review article are to assess the role of contact tracing in the Ebola outbreak and to identify the challenges faced by the health workers while performing contact tracing.Methods: An extensive search of all materials related to the Ebola outbreak and contact tracing was carried out in PubMed, Medline, World Health Organization website and Google Scholar search engines. Keywords used in the search included Ebola virus disease, West-Africa, contact tracing, World Health Organization. Overall 60 articles were selected and included in the discussion.Results: Contact tracing is an important strategy in epidemiology and refers to the identification and diagnosis of those individuals who have come in contact with an infected person. It ultimately aims to reduce the time span required to detect and treat a case of an infectious disease and hence significantly minimize the risk of transmission to the subsequent susceptible individuals. In-fact, contact tracing continues to remain an important measure, as it aids the epidemiologist in containing the infection.Conclusion: The strategy of contact tracing has a great potential to significantly reduce the incidence of cases of Ebola virus disease. However, its success is eventually determined by the level of trust between the community and the public health system and the quality of the diagnostic & treatment services.Keywords: Ebola virus disease, West-Africa, contact tracing, World Health Organization
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Where there is no doctor: can volunteer community health workers in rural
           Uganda provide integrated community case management?

    • Authors: Jennifer L. Brenner, Celestine Barigye, Samuel Maling, Jerome Kabakyenga, Alberto Nettel-Aguirre, Denise Buchner, Teddy Kyomuhangi, Carolyn Pim, Kathryn Wotton, Natukwatsa Amon, Nalini Singhal
      Abstract: Introduction: Integrated community case management (iCCM) involves assessment and treatment of common childhood illnesses by community health workers (CHWs). Evaluation of a new Ugandan iCCM program is needed.Objectives: The objectives of this study were to assess if iCCM by lay volunteer CHWs is feasible and if iCCM would increase proportions of children treated for fever, pneumonia, and diarrhoea in rural Uganda.Methods: This pre/post study used a quasi-experimental design and non-intervention comparison community. CHWs were selected, trained, and equipped to assess and treat children under five years with signs of the three illnesses. Evaluation included CHW-patient encounter record review plus analysis of pre/post household surveys.Results: 196 iCCM-trained CHWs reported 6,276 sick child assessments (45% fever, 46% pneumonia, 9% diarrhoea). 93% of cases were managed according to algorithm recommendations. Absolute proportions of children receiving treatment significantly increased post-intervention: antimalarial for fever (+24% intervention versus +4% control) and oral rehydration salts/zinc for diarrhoea (+14% intervention versus +1% control).Conclusion: In our limited-resource, rural Ugandan setting, iCCM involving lay CHWs was feasible and significantly increased the proportion of young children treated for malaria and diarrhoea.Keywords: Uganda; maternal health; child health; community health worker; integrated community case management
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Healthcare spending and health outcomes: evidence from selected East
           African countries

    • Authors: Murad A. Bein, Dogan Unlucan, Gbolahan Olowu, Wagdi Kalifa
      Abstract: Background: Over the last decade, total healthcare expenditures, comprised of both public and private healthcare expenditures, have increased in most East African countries. At the same time, health outcomes such as infant mortality rates, life expectancy at birth and other health outcome indicators have improved.Objectives: This paper examines the association between healthcare expenditures and health outcomes for eight East African countries: Burundi, Eritrea, Ethiopia, Kenya, Rwanda, Sudan, Tanzania, and Uganda. In this study, health outcomes are defined as an improvement in adult life expectancy and a reduction in the number of neonatal, infant, and under-five deaths.Methods: We implemented a panel data regression technique, analyzing both cross-sectional and time series information. This combined method has been used in healthcare studies by several authors. Data obtained from world development indicators for the years 2000-2014 was used for the panel study.Results: First, we documented that there is a strong, positive association between total healthcare expenditures and total life expectancy. While we identified a positive relationship between healthcare expenditures and female and male life expectancy, we found that healthcare had a stronger effect on improving life expectancy in females than in males. Moreover, we found a negative relationship between healthcare expenditures and the number of neonatal, infant, and under-five deaths.Conclusion: The results of this study have important policy and management implications for the eight East African countries. From a policy perspective, it is necessary to understand if a greater allocation of resources to the healthcare sector is worthwhile and to determine whether to encourage private healthcare investment. From the management perspective, investing in more private institutions, such as hospitals and clinics, is essential for health outcomes in the average country. The results of this study can be used by the World Health Organization as well as other non-governmental organizations that provide financial assistance to East African countries.Keywords: Healthcare expenditures, health outcome, life expectancy, infant deaths, under-five deaths, neonatal deaths
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Hydroxyurea therapy in adult Nigerian sickle cell disease: a monocentric
           survey on pattern of use, clinical effects and patient’s compliance

    • Authors: Ademola Samson Adewoyin, Omokiniovo Sunday Oghuvwu, Omolade Augustina Awodu
      Abstract: Background: The clinical prospects of hydroxyurea therapy in the management of sickle cell disease (SCD) require evaluation in the Nigerian setting to develop indigenous guidelines. This survey examines the pattern of hydroxyurea therapy, its clinico-haematologic benefits and safety profile in Nigerian SCD subjects.Methods: A cross sectional pilot survey was carried out among 60 adult SCD subjects over 3 months. Data on clinical phenotypes, relevant haematological parameters and details of hydroxyurea therapy were obtained using a structured questionnaire through an interview process and case file review.Results: The median age was 30 years. Thirty-four (56.7%) of the subjects are aware of hydroxyurea therapy in SCD. Twenty-four (40%) SCD patients had previously used hydroxyurea. Only 4 subjects were fully compliant. Reasons for non-complianceincluded poor knowledge and lack of funds. In particular, hydroxyurea reduced leucocyte count and increased mean red cell volume (MCV) in compliant subjects.Conclusion: Hydroxyurea use is low among Nigerian SCD subjects despite its proven efficacy/clinical prospects in the developed nations. Large scale multicenter studies and clinical trials are needed to form a basis for developing standard local treatment protocol for its use.Keywords: Hydroxyurea therapy, Nigerian sickle cell disease, pattern of use, clinical effects, patient’s compliance
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • The sensitivity of Na+, K+ ATPase as an indicator of blood diseases

    • Authors: Abulnaja Kkalid Omar, Kherd Ali Ahmed, Nawal Mohammed Helmi, Kumosani Taha Abdullah, Mohamad H. Qarii, Huwait Etimad Hasan, Albukhari Ashwag, Alaama Mohammed Nabil, AL-Ghamdi Maryam Abdu, Moselhy Said Salama
      Abstract: Background: Blood-related hereditary diseases are widespread in Eastern and SouthWestern regions of Saudi Arabia until recently. In this study, we used Na+, K+ATPase as an enzymatic indicator for the diagnosis of the diseases.Materials and methods: Individuals with different blood diseases (iron deficiency (n=13), anemia (n=14), thalassemia (n=16) and sickle cell anemia (n=12) were studied for Na+, K+-ATPase activity in the plasma membrane of red blood cell and compared with those of the healthy ones (n=20) of the same age and gender living in Jeddah, Saudi Arabia.Results: There was a significant elevation in the specific activity of Na+, K+ATPase in individuals with anemia compared with those of control (0.0094 + 0.001 nmol / mg protein/min versus 0.0061 0.001). On the other hand, there was a significant reduction in enzyme activity in thalassemia (0.0028 0.002 nmol / mg protein/min) and sickle cell anemia cases (0.0042 0.001 nmol / mg protein/min) compared to the control group. The cut off value for Na+, K+ATPase activity is 0.005 μmol Pi/minshowing 94% sensitivity and 93% specificity for the differentiation of blood abnormality.Conclusion: It can be recommended that the activity of Na+, K+-ATPase can be used for the diagnosis of individuals with blood diseases/disorders.Keywords: Na+, K+-ATPase, red blood cell, plasma membrane, iron deficiency anemia, thalassemia, sickle cell anemia, indicator
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Sonographic assessment of petroleum-induced hepatotoxicity in Nigerians:
           does biochemical assessment underestimate liver damage?

    • Authors: Angel-Mary Anakwue, Raphael Anakwue, Mark Okeji, Felicitas Idigo, Kenneth Agwu, Uloma Nwogu
      Abstract: Background: Exposure to petroleum products has been shown to have significant adverse effects on the liver which can manifest either as morphological or physiological changes.Objectives: The aim of the study was to assess the effects of chronic exposure to some petroleum products on the liver of exposed workers using sonography and to determine whether biochemical assessments underestimated hepatotoxicity.Methods: Abdominal ultrasound was performed on 415 exposed workers in order to evaluate liver echogenicity and size. Also, biochemical assessment of the liver was done to evaluate its functionResults: Statistically significant increase in the liver parenchymal echogenicity and the liver size was seen in the exposed workers compared with control (p ≤ 0.05). These increased as the exposure duration increased. It was also noted that out of 16.87% (N=70) exposed workers with abnormal liver echopattern, only 2.65% (N=11) had alanine aminotransferase above the reference range.Conclusion: The study revealed evidence of ultrasound detectable hepatotoxicity among the exposed subjects. Sonography appeared to detect petroleum products-induced hepatic toxicity more than biochemical assays suggesting that biochemical assessment may have underestimated toxicity.Keywords: Petroleum Products, Exposure, Hepatotoxicity, Sonography, Biochemical assessment, Nigeria
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Practicalities of health survey fieldwork research in a resource limited
           setting: challenges and lessons learnt from Uganda

    • Authors: Julie Abimanyi-Ochom
      Abstract: Background: Countless research has been undertaken in sub-Saharan African countries to provide evidence for health policy interventions. However, despite the bulk of health research, very few studies have documented the experiences and practicalities of conducting health survey fieldwork in such settings.Methods: Results were obtained through synthesis of notes on fieldwork experiences documented during a household survey as part of a doctoral research project. Challenges faced and adaptive strategies developed to overcome or reduce the impact on the survey are highlighted.Results: Key challenges included infrastructure and electrical power outages; sampling and access to clients; ethics approval and political stability; and safety and wellbeing of researchers. Adaptive strategies were developed to overcome the different challenges faced.Conclusion: The experiences highlighted and strategies developed to overcome fieldwork challenges give practical advice for future data collection research in similar sub-Saharan African settings.Keywords: Health survey fieldwork, resource limited setting, sub-Saharan Africa, fieldwork challenges, lessons learnt
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Investigation of the relationship between structural empowerment and
           organizational commitment of nurses in Zanjan hospitals

    • Authors: Fereidoun Eskandari, Soheila Rabie Siahkali, Alireza Shoghli, Mehrnoosh Pazargadi, Mansoreh Zaghari Tafreshi
      Abstract: Background: The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care. Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction.Objective: The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses.Methods: 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010. Tools for data collection were Meyer and Allen’s organizational commitment questionnaire and “Conditions for Work Effectiveness Questionnaire-II” (CWEQ-II). Data was analyzed by SPSS16. The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis.Results: According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (15.98±3.29). Nurses believed "opportunity" as the most important element in structural empowerment with the score of 3.18 ±0.79. Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others. There was a significant relationship between structural empowerment and organizational commitment.Conclusion: Generally, structural empowerment (relatively strong) correlates with nurses’ organizational commitment. We concluded that a high structural empowerment increases the organizational commitment of nurses.Keywords: Structural empowerment, organizational commitment, nurses, Zanjan
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
  • Lateral retroperitoneoscopic adrenalectomy for complicated adrenal tumor
           larger than 5 centimeters

    • Authors: Wei Chen, Wei Lin, Deng-Jun Han, Yong Liang
      Abstract: Background: The role of lateral retroperitoneoscopic adrenalectomy (LRA) for complicated tumor with large diameter remains controversial, this study aimed to evaluate the effectiveness of this procedure on the management of tumor larger than 5cm in diameter.Methods: A retrospective comparison was conducted of 67 patients with large complicated adrenal tumor (>5cm). 41 patients received LRA, and 26 received open adrenalectomy (OA) in our hospital between January 2011 and June 2015. Basic characteristics regarding mean age, gender, body mass index (BMI), tumor size, tumor side, previous abdominal surgery, resection method, pathology were preferentially analyzed. Operative indicators regarding operation time, estimated blood loss (EBL), conversion to ICU, complications, post-operative hospitalization, duration of drain, time to first oral intake and ambulation were compared between groups.Results: There were no significant differences between the two groups in the basic characteristics. The mean operation time for LRA was shorter than OA (98.7±32.3 min vs 152.7±72.3 min, P = 0.001). EBL was 31.9±20.0 ml for LRA and 590.0±1181.1 ml for OA (P = 0.03). There was no complication in LRA group and one patient in OA group had complications, but this difference was not significant (P = NS). The post-operative hospitalization in LRA was 7.4±2.8 days, and shorter than 9.8±2.7 days in OA group (P = 0.00). The time to first oral intake and ambulation for LRA was shorter than OA (first oral intake, 1.9±0.8 days vs 3.1±1.3 days, P = 0.00; time to ambulation, 2.6±1.4 days vs 4.2±1.6 days, P = 0.00). While the difference between groups were not significant in terms of ICU conversion (3/41 vs 4/26, P = NS) and duration of drain (3.9±2.2 days vs 4.7±1.9 days, P = NS).Conclusion: Our study shows that LRA can be performed safely and effectively for complicated adrenal tumors larger than 5 cm in diameter, but it remains technically demanding.Keywords: Retroperitoneoscopic adrenalectomy; adrenal tumor; lateral position
      PubDate: 2017-05-23
      Issue No: Vol. 17, No. 1 (2017)
       
 
 
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