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   ISSN (Print) 2210-6006
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  • HIV-infected presumptive tuberculosis patients without tuberculosis: How
           many are eligible for antiretroviral therapy in Karnataka, India'

    • Authors: Ajay M.V. Kumar; Anil Singarajipura; Balaji Naik; Deepak K. Guddemane; Yogesh Patel; Suresh Shastri; Sunil Kumar; Rajesh Deshmukh; B.B. Rewari; Anthony David Harries
      Pages: 11 - 19
      Abstract: Publication date: March 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 1
      Author(s): Ajay M.V. Kumar, Anil Singarajipura, Balaji Naik, Deepak K. Guddemane, Yogesh Patel, Suresh Shastri, Sunil Kumar, Rajesh Deshmukh, B.B. Rewari, Anthony David Harries
      For certain subgroups within people living with the human immunodeficiency virus (HIV) [active tuberculosis (TB), pregnant women, children <5years old, and serodiscordant couples], the World Health Organization recommends antiretroviral therapy (ART) irrespective of CD4 count. Another subgroup which has received increased attention is “HIV-infected presumptive TB patients without TB”. In this study, we assess the proportion of HIV-infected presumptive TB patients eligible for ART in Karnataka State (population 60million), India. This was a cross-sectional analysis of data of HIV-infected presumptive TB patients diagnosed in May 2015 abstracted from national TB and HIV program records. Of 42,585 presumptive TB patients, 28,964 (68%) were tested for HIV and 2262 (8%) were HIV positive. Of the latter, 377 (17%) had active TB. Of 1885 “presumptive TB patients without active TB”, 1100 (58%) were already receiving ART. Of the remaining 785 who were not receiving ART, 617 (79%) were assessed for ART eligibility and of those, 548 (89%) were eligible for ART. About 90% of “HIV-infected presumptive TB patients without TB” were eligible for ART. This evidence supports a public health approach of starting all “HIV-infected presumptive TB patients without TB” on ART irrespective of CD4 count in line with global thinking about ‘test and treat’.

      PubDate: 2017-02-02T00:25:33Z
      DOI: 10.1016/j.jegh.2015.12.002
  • Democracy predicts sport and recreation membership: Insights from 52

    • Authors: Shea M. Balish
      Pages: 21 - 28
      Abstract: Publication date: March 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 1
      Author(s): Shea M. Balish
      Although evidence suggests sport and recreation are powerful contributors to worldwide public health, sizable gender differences persist. It is unknown whether country characteristics moderate gender differences across countries. The primary purpose of this study was to examine if countries’ levels of democracy and/or gender inequality moderate gender differences in sport and recreation membership across countries. The secondary purpose was to examine if democracy and/or gender inequality predicts overall rates of sport and recreation membership for both males and females. This study involved a nested cross-sectional design and employed the sixth wave (2013) of the world value survey (n Ss =71,901, n countries =52). Multiple hierarchal nonlinear Bernoulli models tested: (1) if countries’ levels of democracy moderate gender differences in sport and recreation membership; and (2) if democracy is associated with increased sport and recreation membership for both males and females. Countries’ level of democracy fully moderated gender differences in sport and recreation membership across countries. Moreover, democracy was positively associated with both male and female membership, even when controlling for individual and country-level covariates. Democratic political regimes may confer health benefits via increased levels of sport and recreation membership, especially for females. Future research should test mediating mechanisms.

      PubDate: 2017-02-02T00:25:33Z
      DOI: 10.1016/j.jegh.2015.12.003
  • ‘Before reaching the last mile’- Knowledge, attitude, practice and
           perceived barriers related to tuberculosis directly observed therapy among
           ASHA workers in Central India: A mixed method study

    • Authors: Akash Ranjan Singh; Abhijit Pakhare; Arun M. Kokane; Hemant Deepak Shewade; Ashish Chauhan; Abhishek Singh; Arti Gangwar; Prahlad Singh Thakur
      Abstract: Publication date: Available online 14 August 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Akash Ranjan Singh, Abhijit Pakhare, Arun M. Kokane, Hemant Deepak Shewade, Ashish Chauhan, Abhishek Singh, Arti Gangwar, Prahlad Singh Thakur
      Introduction Community-based direct observed treatment (DOT) providers are an important bridge for the national tuberculosis programme in India to reach the unreached. The present study has explored the knowledge, attitude, practice and barriers perceived by the community-based DOT providers. Methods Mixed–methods study design was used among 41 community-based DOT providers (Accredited Social Health Activist (ASHAs)) working in 67 villages from a primary health center in Raisen district of Madhya Pradesh, India. The cross-sectional quantitative component assessed the knowledge and practices and three focus-group discussions explored the attitude and perceived barriers related to DOT provision. Result ‘Adequate knowledge’ and ‘satisfactory practice’ related to DOT provision was seen in 14 (34%) and 13 (32%) ASHAs respectively. Only two (5%) received any amount of honorarium for completion of DOT in last 3years. The focus-group discussions revealed unfavourable attitude; inadequate training and supervision, non-payment of honorarium, issues related to assured services after referral and patient related factors as the barriers to satisfactory practice of DOT. Conclusion Study revealed inadequate knowledge and unsatisfactory practice related to DOT provision among ASHAs. Innovations addressing the perceived barriers to improve practice of DOT provision by ASHAs are urgently required.

      PubDate: 2017-08-19T08:31:12Z
      DOI: 10.1016/j.jegh.2017.07.002
  • Pulmonary tuberculosis in Patna, India: Durations, delays, and health care
           seeking behaviour among patients identified through household surveys

    • Authors: Nerges Mistry; Eunice Lobo; Shimoni Shah; Sheela Rangan; Yatin Dholakia
      Abstract: Publication date: Available online 10 August 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Nerges Mistry, Eunice Lobo, Shimoni Shah, Sheela Rangan, Yatin Dholakia

      PubDate: 2017-08-19T08:31:12Z
      DOI: 10.1016/j.jegh.2017.08.001
  • Assessment of metabolic syndrome in Kashmiri population with type 2
           diabetes employing the standard criteria’s given by WHO, NCEPATP III and

    • Authors: Shafat Lone; Kouser Lone; Saika Khan; Rafiq Ahmed Pampori
      Abstract: Publication date: Available online 9 August 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Shafat Lone, Kouser Lone, Saika Khan, Rafiq Ahmed Pampori
      Background Around 20–25 percent of the world’s adult populations have the metabolic syndrome and they are twice as likely to die from heart attack or stroke compared with people without the syndrome. The World Health Organization proposed a definition for the metabolic syndrome in 1998 and later on NCEP ATPIII and IDF provided new definitions of this syndrome in 2001 and 2003 respectively. Very few studies have compared the different definitions to diagnose the metabolic syndrome in type two diabetics in India while as for Kashmir valley no such documented study has been carried out till date. Objective To study the prevalence of metabolic syndrome in type 2 Kashmir diabetics and to find out the degree of agreement between three different criteria given by WHO, NCEPATPIII and IDF for diagnosis of metabolic syndrome. Materials and Method A cross sectional study was conducted in one of the two tertiary care hospitals of Kashmir, India. About 1000 patients were selected and their demographic, clinical and biochemical parameters were studied after obtaining informed consent from each patient. Results Prevalance of metabolic syndrome was found to be highest(84.5%) while using WHO definition.Kappa statistic between WHO, ATP III and WHO, IDF definitions was 0.697 (95% CI 0.637-0.754) and 0.775 (95%CI 0.72–0.82) respectively while the degree of agreement between IDF and ATP III definitions was highest with kappa of 0.851 (95%CI 0.810–0.889). Conclusion Our study warrants for interventions to prevent the progression towards this syndrome among type 2 diabetics as early as the diagnosis of diabetes is made.

      PubDate: 2017-08-19T08:31:12Z
      DOI: 10.1016/j.jegh.2017.07.004
  • Diarrheagenic Escherichia coli infections among the children of Andaman
           Islands with special reference to pathotype distribution and clinical

    • Authors: .P Ramya Raghavan; Subarna Roy; Ramanathan Thamizhmani; Attayur Purushothaman Sugunan
      Abstract: Publication date: Available online 31 July 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): .P Ramya Raghavan, Subarna Roy, Ramanathan Thamizhmani, Attayur Purushothaman Sugunan
      Diarrhoeagenic E. coli (DEC) is one of the most common causes of diarrhoeal death in children less than five years globally. It is responsible for 30%–40% of all diarrhoeal episodes in developing countries. It is estimated that 0.12million children died of diarrhoea caused by DEC in 2011 globally. There is no baseline data on the occurrence of DEC diarrhoea in Andaman Islands, the remote islands of India. The study is particularly important as these strains are the emerging enteric pathogen in both developed and developing countries. DEC was screened from E. coli isolates obtained from diarrhoeal stool samples by multiplex PCR with specific primers using stasndard protocols. During the study period, among the 1394 stool samples collected, 95 (6.82%) patients were found infected with DEC. Of the 97 isolates from 95 patients, 68 (70.1%) were EAEC, 19 (19.6%) were EPEC and 10 (10.3%) were ETEC. Of the 19 EPEC isolates, 63.2% were atypical EPEC which is the emerging enteric pathogen among the children in developing as well as developed countries. More than 80% of the patients had watery diarrhoea and 6% of them had invasive diarrhoea. Persistent diarrhoea was also found in three infected children. This study documents the occurrence and type of DEC diarrhoea in Andaman Islands first time and highlights the significant proportions of E. coli diarrhoea being caused by EAEC and atypical EPEC strains.

      PubDate: 2017-08-08T19:51:55Z
      DOI: 10.1016/j.jegh.2017.07.003
  • Occupational stress, anxiety and depression among Egyptian teachers

    • Authors: Dalia Desouky; Heba Allam
      Abstract: Publication date: Available online 18 July 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Dalia Desouky, Heba Allam
      Occupational stress (OS) among teachers predispose to depression and anxiety. No study was done to assess these problems among Egyptian teachers. This study aimed to assess the prevalence of OS, depression and anxiety among Egyptian teachers. A cross sectional study was done on 568 Egyptian teachers. The respondents filled a questionnaire on personal data, and the Arabic version of the Occupational Stress Index (OSI), the Arabic validated versions of Taylor manifest anxiety scale and the Beck Depression Inventory (BDI) were used to assess OS, anxiety and depression respectively. The prevalence of OS, anxiety and depression among teachers was (100%, 67.5% and 23.2%) respectively. OS, anxiety and depression scores were significantly higher among teachers with an age more than 40years, female teachers, primary school teachers, those with inadequate salary, higher teaching experience, higher qualifications and higher workload. A significant weak positive correlation was found between OS scores and anxiety and depression scores. This study indicated the need for future researches to address risk factors of OS and mental disorders among Egyptian teachers, and the need of periodical medical evaluation of teachers and medical and psychological support for the identified cases.

      PubDate: 2017-07-23T17:41:24Z
      DOI: 10.1016/j.jegh.2017.06.002
  • Low pre-diagnosis attrition but high pre-treatment attrition among
           patients with MDR-TB: An operational research from Chennai, India

    • Authors: Hemant Deepak Shewade; Dina Nair; Joel S. Klinton; Malik Parmar; J. Lavanya; Lakshmi Murali; Vivek Gupta; Jaya Prasad Tripathy; Soumya Swaminathan; Ajay M.V. Kumar
      Abstract: Publication date: Available online 6 July 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Hemant Deepak Shewade, Dina Nair, Joel S. Klinton, Malik Parmar, J. Lavanya, Lakshmi Murali, Vivek Gupta, Jaya Prasad Tripathy, Soumya Swaminathan, Ajay M.V. Kumar
      Background Worldwide, there’s concern over high pre-diagnosis and pre-treatment attritions or delays in Multidrug resistant tuberculosis (MDR-TB) diagnosis and treatment pathway (DTP). We conducted this operational research among patients with presumptive MDR-TB in north and central Chennai, India to determine attrition and turnaround times (TAT) at various steps of DTP and factors associated with attrition. Methods Study was conducted in Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all patients with presumptive MDR-TB (eligible for DST) in 2014. Results Of 628 eligible for DST, 557 (88%) underwent DST and 74 (13%) patients were diagnosed as having MDR-TB. Pre-diagnosis and pre-treatment attrition was 11% (71/628) and 38% (28/74) respectively. TAT [median (IQR)] to test from eligibility for DST and initiate DR-TB treatment from diagnosis were 14 (9,27) and 18 (13,36) days respectively. Patients with smear negative TB and detected in first quarter of 2014 were less likely to undergo DST. Patients in first quarter of 2014 had significantly lower risk of pre-treatment attrition. Conclusion There was high uptake of DST. However, urgent attention is required to reduce pre-treatment attrition, improve TAT to test from eligibility for DST and improve DST among patients with smear-negative TB.

      PubDate: 2017-07-12T16:42:05Z
      DOI: 10.1016/j.jegh.2017.07.001
  • Predictors of past quit attempts and duration of abstinence among
           cigarette smokers

    • Authors: N. Layoun; S. Hallit; M. Waked; Z. Aoun Bacha; I. Godin; A. Leveque; M. Dramaix; P. Salameh
      Abstract: Publication date: Available online 4 July 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): N. Layoun, S. Hallit, M. Waked, Z. Aoun Bacha, I. Godin, A. Leveque, M. Dramaix, P. Salameh
      Objective Despite the widespread awareness of the harms of smoking, millions continue to smoke around the world partly due to the difficulty it takes to quit smoking. Identifying the factors associated with making quit attempts is an essential pillar to reach successful quitting. The purpose of this study is to assess the factors associated with the past quit attempts and their past length of abstinence in a Lebanese sample of cigarette smokers. Methods This study was conducted between March 2014 and March 2015, involving 382 patients randomly chosen from 5 outpatient clinics in 5 hospitals in Lebanon. A standardized questionnaire was completed including socio-demographic characteristics, smoking behavior, chronic respiratory symptoms, Fagerstrom scale, Mondor scale, packaging perception, quitting behavior and readiness to quit ladder. Results Smokers who have chronic allergies (ORa=2.45, p=0.03), those who have ever stopped smoking for at least one month due to the warnings implemented on the packages (ORa=4.6, p<0.0001) and smokers with an intention to quit in 2months (ORa=2.49, p<0.0001) had significantly more past quit attempts. Furthermore, longer quit attempts duration (more than 1month) were significantly associated with low-nicotine dependent smokers (ORa=0.56, p=0.02), higher-motivated smokers (ORa=1.85, p=0.01), people with chronic allergies (ORa=2.07, p=0.02), smokers who have ever stopped smoking for at least one month due to the warnings (ORa=3.72, p<0.0001) and those with an intention to quit in 2months (ORa=1.98, p=0.05). Conclusion The promoters of smoking cessation services should consider these factors when designing comprehensive tobacco control initiatives and in service planning.

      PubDate: 2017-07-04T15:49:21Z
      DOI: 10.1016/j.jegh.2017.06.003
  • Is Google Trends a reliable tool for digital epidemiology? Insights from
           different clinical settings

    • Authors: Gianfranco Cervellin; Ivan Comelli; Giuseppe Lippi
      Abstract: Publication date: Available online 9 June 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Gianfranco Cervellin, Ivan Comelli, Giuseppe Lippi
      Internet-derived information has been recently recognized as a valuable tool for epidemiological investigation. Google Trends, a Google Inc. portal, generates data on geographical and temporal patterns according to specified keywords. The aim of this study was to compare the reliability of Google Trends in different clinical settings, both for both common diseases with lower media coverage, and for less common diseases attracting major media coverage. We carried out a search in Google Trends using the keywords “renal colic”, “epistaxis”, and “mushroom poisoning”, selected on the basis of available and reliable epidemiological data. Besides this search, we carried out a second search for three clinical conditions (i.e., “meningitis”, “Legionella Pneumophila pneumonia”, and “Ebola fever”), which recently received major focus by the Italian media. In our analysis, no correlation was found between data captured from Google Trends and epidemiology of renal colics, epistaxis and mushroom poisoning. Only when searching for the term “mushroom” alone the Google Trends search generated a seasonal pattern which almost overlaps with the epidemiological profile, but this was probably mostly due to searches for harvesting and cooking rather than to for poisoning. The Google Trends data also failed to reflect the geographical and temporary patterns of disease for meningitis, Legionella Pneumophila pneumonia and Ebola fever. The results of our study confirm that Google Trends has modest reliability for defining the epidemiology of relatively common diseases with minor media coverage, or relatively rare diseases with higher audience. Overall, Google Trends seems to be more influenced by the media clamor than by true epidemiological burden.

      PubDate: 2017-06-13T14:09:48Z
      DOI: 10.1016/j.jegh.2017.06.001
  • Frequency of multi-drug resistance and mutations in Mycobacterium
           tuberculosis isolates from Punjab state of India

    • Authors: Ritu Singhal; Jyoti Arora; Grish C. Sah; Manpreet Bhalla; Rohit Sarin; Vithal Prasad Myneedu
      Abstract: Publication date: Available online 24 May 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Ritu Singhal, Jyoti Arora, Grish C. Sah, Manpreet Bhalla, Rohit Sarin, Vithal Prasad Myneedu
      Data regarding prevalence of multi-drug resistant tuberculosis (MDR-TB) and associated common mutations is scarce from Punjab region. The study was designed to determine rate of MDR-TB among presumptive MDR-TB from Punjab and mutation patterns using GenoType MTBDRplus assay. Total of 812 consecutive sputum samples were received from January 2012 to July 2013, from 14 districts of Punjab at the National Reference Laboratory at New Delhi for diagnosis of MDR-TB as hand holding activity. Presumptive MDR-TB patients were identified on basis of criterion B defined by the programme. Smear positive and negatives patients were found to be 636/798 (79.7%) and 162/ 798 (20.3%) respectively. Total of 606 GenoType MTBDRplus tests were conducted and mutations in rpoB, kat G and inhA genes analyzed. Total of 94/606 (15.5%), 43/606 (7.1%) and 40/606 (6.6%) were found to be RIF and INH resistant, mono-RIF resistant and 40/606 (6.6%) mono-INH resistant respectively. Commonest known mutation for RIF in rpoB gene and INH in kat G gene was S531L (80/ 137; 58.4%) and S315T1 (119/134; 88.8%) respectively. Mutations in inhA were found in 21/134 (15.7%) strains. Average turn-around time (TAT) for dispatch of result toPunjab was 4.6days. Prevalence of RIF resistance in Punjab was found to be 22.6%. Common mutations for RIF and INH were similar to that in other regions of country. GenoType MTBDRplus was found to be useful assay for rapid detection of MDR-TB, responsible for determining better management of MDR-TB patients under the programme.

      PubDate: 2017-05-29T12:35:50Z
      DOI: 10.1016/j.jegh.2017.05.002
  • Frequency and implications of ofloxacin resistance among previously
           treated tuberculosis patients

    • Authors: Jyoti Arora; Gavish Kumar; Ajoy Kumar Verma; Manpreet Bhalla; Ritu Singhal; Rohit Sarin; Vithal Prasad Myneedu
      Abstract: Publication date: Available online 24 May 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Jyoti Arora, Gavish Kumar, Ajoy Kumar Verma, Manpreet Bhalla, Ritu Singhal, Rohit Sarin, Vithal Prasad Myneedu

      PubDate: 2017-05-29T12:35:50Z
      DOI: 10.1016/j.jegh.2017.05.003
  • Ground water as the source of an outbreak of Salmonella Enteritidis

    • Authors: Ana Kovačić; Željko Huljev; Edita Sušić
      Abstract: Publication date: Available online 22 May 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Ana Kovačić, Željko Huljev, Edita Sušić
      In September 2014, an outbreak of gastroenteritis was reported to the Public Health Institute of Šibenik and Knin County in Croatia. The outbreak occurred in the County center of Šibenik, a town with 50,000 inhabitants, and it lasted for 12days. An epidemiological investigation suggested a nearby water spring as the source of the outbreak. Due to the temporary closure of the public water supply system, the inhabitants started to use untreated water from a nearby spring. Microbiological analysis revealed that the outbreak was caused by Salmonella enterica subsp. enterica serovar Enteritidis that was isolated from stool samples of the patients and ground water. The isolates were further analysed with pulsed-field gel electrophoresis using XbaI, which revealed an identical macrorestriction profile. Although 68 cases were reported, it was estimated that the actual number of affected persons was more than several hundred. In order to prevent further spread of disease, public advice was released immediately after the first epidemiological indication and a warning sign was placed at the incriminated water source, after microbiological confirmation. It is necessary to regularly monitor microbiological quality of ground water especially in urban areas and provide adequate education and awareness to the inhabitants regarding the risk of using untreated ground water.

      PubDate: 2017-05-24T11:59:22Z
      DOI: 10.1016/j.jegh.2017.05.001
  • The prevalence and association of stress with sleep quality among medical

    • Authors: Abdullah I. Almojali; Sami A. Almalki; Ali S. Alothman; Emad M. Masuadi; Meshal K. Alaqeel
      Abstract: Publication date: Available online 5 May 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Abdullah I. Almojali, Sami A. Almalki, Ali S. Alothman, Emad M. Masuadi, Meshal K. Alaqeel
      Introduction Medical students tend to reduce their sleep, in an effort to adjust and cope with their workload and stressful environment. This study estimated the prevalence of and the relationship between poor sleep quality and stress among medical students. Methods This cross-sectional study was conducted using a stratified random sample of male and female medical students in King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A self-administered questionnaire was distributed to assess sleep quality using the Pittsburgh Sleep Quality Index, and the stress level by using the Kessler Psychological Distress Scale. Results A high prevalence of poor sleep quality (76%) and stress (53%) were found, with a statistically significant association (p<0.001). Logistic regression indicated that students who are not suffering from stress are less likely to have poor sleep quality (OR=0.28, p<0.001), and the risk of having poor sleep quality is almost four times higher in students whose cumulative grade point average (GPA) is less than 4.25 (OR=3.83, p=0.01). Conclusion The study documents a statistically significant association between stress and poor sleep quality. A recommendation for the management of medical college is to establish academic counseling centers focusing in promoting good sleep hygiene and strengthening students’ study skills and coping with their stressful environment.

      PubDate: 2017-05-09T20:52:37Z
      DOI: 10.1016/j.jegh.2017.04.005
  • Exposure to toxics during pregnancy and childhood and asthma in children:
           A pilot study

    • Authors: Souheil Hallit; Pascale Salameh
      Abstract: Publication date: Available online 4 May 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Souheil Hallit, Pascale Salameh
      Environmental factors, pesticides, alcohol and smoking are linked to asthma in children. The association of toxic substances exposure with asthma has not been evaluated. Our objective is to assess such associations among children aged less than 16years old. This is a cross-sectional study, conducted between January and May 2015, using a sample of Lebanese students from private schools in Beirut and Mount Lebanon. Out of 700 distributed questionnaires, 527 (75.2%) were returned to us. Verbal informed consent was also obtained from all parents prior to participating in the study. A significant association was found between waterpipe smoking and diagnosed asthma (p=0.003; ORa =13.25; 95% CI 2.472–71.026). Alcohol during pregnancy, waterpipe smoking during pregnancy and parents respiratory problems significantly increased the risk of respiratory problems by approximately 5 times, 6 times and 2 times respectively (p=0.016; ORa =4.889; 95% CI 1.339–17.844, p=0.021; ORa =6.083; 95% CI 1.314–28.172, p=0.004; ORa =1.748; 95% CI 1.197–2.554 respectively). Waterpipe smoking, alcohol during pregnancy, recurrent otitis and humidity at home seem to be significantly correlated with asthma in children. Spreading awareness by health care professionals is needed to permit a reduction of the prevalence of these allergic diseases, especially asthma, in children.

      PubDate: 2017-05-04T20:18:00Z
      DOI: 10.1016/j.jegh.2017.04.004
  • Trends in lung cancer incidence in Lebanon by gender and histological type
           over the period 2005–2008

    • Authors: Sally Temraz; Maya Charafeddine; Deborah Mukherji; Ali Shamseddine
      Abstract: Publication date: Available online 29 April 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Sally Temraz, Maya Charafeddine, Deborah Mukherji, Ali Shamseddine
      Introduction Lung cancer incidence rates, overall and by histologic subtypes, vary substantially by gender and smoking. This study’s aim was to review data regarding trends in the number of cases of different lung-cancer histologies and relate these to smoking habits by gender in Lebanon. Materials and methods Lung cancer data using ICD-O, 3rd edition, from the Lebanese National Cancer Registry from 2005 to 2008 were stratified by gender for histology type for patients aged over 18years. Results Lung cancer cases among males were 2.5 times higher than those in females. The most common lung cancer histology type for males and females was adenocarcinoma for all observed years. The proportion of squamous cell carcinoma in incident cases was significantly higher in males than in females for the total period from 2005 to 2008, P=0.032, but not in individual years. The ratio of adenocarcinoma to squamous cell carcinoma in incident cases between 2005 and 2008 was 2:45 for males and 3:15 for females. Conclusion Lung cancer histology in Lebanon is following a pattern similar to that found in most countries of North America and in Europe, where adenocarcinoma is the most prevalent subtype among both males and females.

      PubDate: 2017-05-04T20:18:00Z
      DOI: 10.1016/j.jegh.2017.04.003
  • Determination of carbapenem resistance mechanism in clinical isolates of
           Pseudomonas aeruginosa isolated from burn patients, in Tehran, Iran

    • Authors: Akbar Mirsalehian; Davood Kalantar-Neyestanaki; Morovat Taherikalani; Fereshteh Jabalameli; Mohammad Emaneini
      Abstract: Publication date: Available online 29 April 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Akbar Mirsalehian, Davood Kalantar-Neyestanaki, Morovat Taherikalani, Fereshteh Jabalameli, Mohammad Emaneini
      Carbapenems are the most important therapeutic options that effect against serious infections caused by multidrug resistant Pseudomonas aeruginosa (MDR-PA) isolates. Carbapenems resistant isolates of P. aeruginosa are increasing worldwide. The aim of this study was to determine the carbapenem resistance mechanisms in clinical P. aeruginosa isolates from burn patients, in Tehran, Iran. A total of 53 non-duplicated isolates of carbapenem-resistant P. aeruginosa were collected from burn patients. The presence of carbapenemase genes were determined by PCR. AmpC overproducer isolates were detected by phenotypic method. The mutation and transcription level of oprD were determined by PCR-sequencing and quantitative Real-time PCR (RT-PCR), respectively. Twenty-seven (50.9%) isolates were positive for carbapenemase (bla VIM =25 and bla IMP =2) and showed high-level resistance to imipenem and meropenem. Twenty-eight isolates were AmpC overproducers. All isolates had a mutation in the oprD gene and down-regulation of oprD was found in 56.6% of MDR-PA isolates. Although the presence of carbapenemase is the common mechanism of resistant to carbapenem, but carbapenem resistance was found by oprD mutation-driven and the AmpC overproducing isolates in Tehran, Iran.

      PubDate: 2017-05-04T20:18:00Z
      DOI: 10.1016/j.jegh.2017.04.002
  • Investigation of OMNIgene·SPUTUM performance in delayed tuberculosis
           testing by smear, culture, and Xpert Mycobacterium tuberculosis/RIF assays
           in Uganda

    • Authors: Cassandra Kelly-Cirino; P.S. Curry
      Abstract: Publication date: Available online 13 April 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Cassandra D. Kelly-Cirino, P.S. Curry
      OMNIgene·SPUTUM (OM-S) is a sample transport reagent designed to work with all tuberculosis diagnostics while eliminating the need for cold chain. OM-S-treated sputum samples were assayed in several tests after multiday holds. Raw sputa from 100 patients underwent direct smear microscopy, were manually split and assigned to the OM-S group [OM-S added at collection (no other processing required) and tested after 0- to 5-day holds at room temperature] or standard-of-care (SOC) group (NaOH/N-acetyl l-cysteine decontamination, all tested on day of collection). Concentrated smear microscopy, Lowenstein Jensen (LJ) culture, and mycobacteria growth indicator tube (MGIT) culture were performed. For patients with negative direct smear, a second sample was split, with SOC (raw sputum) and OM-S portions (sediment) tested in the Xpert Mycobacterium tuberculosis/RIF (Xpert) assay. OM-S group and SOC group results were strongly concordant on all four tests [range, 89% (MGIT)–97% (Xpert)]. OM-S MGIT, LJ, and Xpert tests were in statistical agreement with SOC MGIT as reference. OM-S specimens had lower culture contamination rates (3% vs. 10% LJ; 2% vs. 5% MGIT) but required, on average, 5.6 additional days to become MGIT-positive. The findings suggest that samples held/transported in OM-S are compatible with smear microscopy, LJ or MGIT culture, and Xpert, and perform comparably to fresh sputum samples. Larger feasibility studies are warranted.

      PubDate: 2017-04-14T09:13:15Z
  • Magnitude and determinants of adverse treatment outcomes among
           tuberculosis patients registered under Revised National Tuberculosis
           Control Program in a Tuberculosis Unit, Wardha, Central India: A
           record-based cohort study

    • Authors: Anuj Mundra; Pradeep R. Deshmukh; Ajay Dawale
      Abstract: Publication date: Available online 18 March 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Anuj Mundra, Pradeep R. Deshmukh, Ajay Dawale
      Introduction Deaths, defaults, relapses, and treatment failures have made the control of TB difficult across the globe. Methodology This study is a record-based follow-up of a cohort of patients registered under Revised National Tuberculosis Control Program in the year 2014 in Wardha Tuberculosis Unit, India. Data were collected from the records available at the District Tuberculosis Office. Results Data of 510 patients were analyzed. The sputum conversion rate was 88%. The overall treatment success rate was 81.9%, and rates of any adverse outcome, deaths, defaults, failure, and shift to Category IV regimen were 32.60/100 person years at risk (PYAR), 16.88/100 PYAR, 11.12/100 PYAR, 3.45/100 PYAR, and 1.15/100 PYAR, respectively. The median times for the above outcomes were 81days, 110days, 66days, 118days, and 237days, respectively. The cumulative probability of occurrence at 6months of any adverse outcome, deaths, default, failure, and shift to Category IV regimen was 0.145, 0.056, 0.088, 0.002, and 0.004, respectively. On multivariate analysis, the determinant of any adverse outcome was age >45years, whereas extrapulmonary disease was protective. The hazard of defaulting was also significantly higher in male patients and those aged >45years. Conclusion Appropriate interventions and program implementation to reduce the adverse treatment outcomes and interruptions will help in improving program performance.

      PubDate: 2017-03-24T06:33:44Z
      DOI: 10.1016/j.jegh.2017.02.002
  • Sickle cell disease in Saudi Arabia: A challenge or not

    • Authors: Maha Mohammed Alotaibi
      Abstract: Publication date: Available online 28 February 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Maha Mohammed Alotaibi

      PubDate: 2017-03-06T04:54:24Z
      DOI: 10.1016/j.jegh.2016.12.006
  • Predictors of hepatitis C testing intention among African American Baby

    • Authors: Mohamed Rashrash; Mary Maneno; Anthony Wutoh; Earl Ettienne; Monika Daftary
      Abstract: Publication date: Available online 16 February 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Mohamed Rashrash, Mary Maneno, Anthony Wutoh, Earl Ettienne, Monika Daftary
      Baby Boomers (BBs) are responsible for three-quarters of hepatitis C (HCV) infections in the United States; however, HCV testing is distinctly underused by them. A cross-sectional study was conducted to assess the prevalence of HCV testing and to evaluate predictors of HCV testing intention among African–American BBs. The study was guided by the Health Belief Model and theory of reasoned action frameworks. Of the 137 participants included in the study, 44.8% had at least a college education; 13.9% received prior to 1992 blood transfusion. Findings related to HCV testing showed that 32.1% of the participants intended to test for HCV within 6months and 43.8% had received a previous HCV test. Significant predictors of HCV testing intention within 6months included having a blood transfusion prior to 1992 [odds ratio (OR)=8.25, 95% confidence interval (CI): 2.02–33.61], perceptions of benefits (OR=1.57, 95% CI: 1.13–2.18), severity (OR=1.39, 95% CI: 1.17–1.65), and subjective norms (OR=1.42, 95% CI: 1.12–1.79). These predictors of HCV testing intention can be used to develop future HCV testing initiatives for African–American BBs.

      PubDate: 2017-02-20T03:15:35Z
      DOI: 10.1016/j.jegh.2016.12.005
  • New tuberculosis estimates must motivate countries to act

    • Authors: Madhukar Pai; Ziad A. Memish
      Abstract: Publication date: Available online 14 February 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Madhukar Pai, Ziad A. Memish

      PubDate: 2017-02-20T03:15:35Z
      DOI: 10.1016/j.jegh.2017.02.001
  • Incidence and economic burden of acute otitis media in children aged up to
           5years in three Middle Eastern countries and Pakistan: A multinational,
           retrospective, observational study

    • Authors: Ghulam Mustafa; Amal Y. Al Aidaroos; Idris S. Al Abaidani; Kinga Meszaros; Kusuma Gopala; Mehmet Ceyhan; Mohamad Al-Tannir; Rodrigo DeAntonio; Shyam Bawikar; Johannes E. Schmidt
      Abstract: Publication date: Available online 8 February 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Ghulam Mustafa, Amal Y. Al Aidaroos, Idris S. Al Abaidani, Kinga Meszaros, Kusuma Gopala, Mehmet Ceyhan, Mohamad Al-Tannir, Rodrigo DeAntonio, Shyam Bawikar, Johannes E. Schmidt
      Epidemiological data on acute otitis media (AOM), an infectious disease frequently affecting children, are lacking in some countries. This study was undertaken to assess the incidence of AOM in children ≤5years in Saudi Arabia, Oman, Pakistan, and Turkey, as well as the economic burden from a parent/caregiver perspective. Medical records of 4043 children (Saudi Arabia=1023, Oman=998, Pakistan=1022, Turkey=1000) were retrospectively reviewed and the incidence of AOM episodes calculated from suspected and confirmed cases. Using a standardized Health Economics Questionnaire, parents recorded resource use and expenses incurred per AOM episode [in local currency and converted to US dollars (USD)]. The overall incidence of AOM episodes per 1000 person–years was: Saudi Arabia, 207 [95% confidence interval (CI): 178–238]; Oman, 105 (95% CI: 85–127); Pakistan, 138 (95% CI: 116–163); and Turkey, 99 (95% CI: 79–123). The mean total out-of-pocket healthcare expense incurred by parents/caregivers per episode was: Saudi Arabia USD67.1 [standard deviation (SD)=93.0], Oman USD16.1 (SD=16.4), Pakistan USD22.1 (SD=20.5), and Turkey USD33.6 (SD=44.9). The incidence of AOM episodes varied across all four countries, probably due to different diagnostic and management practices. Nevertheless, our results confirm that AOM causes a substantial burden to public health, reinforcing the need for cost-effective prevention strategies.

      PubDate: 2017-02-14T02:43:12Z
      DOI: 10.1016/j.jegh.2016.12.004
  • A survey of hypertension prevalence, awareness, treatment, and control in
           health screening camps of rural central Punjab, Pakistan

    • Authors: Salman T. Shafi; Tahir Shafi
      Abstract: Publication date: Available online 8 February 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Salman T. Shafi, Tahir Shafi
      Hypertension is a global public health problem with increasing prevalence. There is limited updated information on the prevalence of hypertension in the Pakistani population. This is a cross-sectional study based on data collected during multiple health screening camps held at multiple locations in rural central Punjab, Pakistan in the period between 2008 and 2015. A total of 13,722 patients were included in this study. Crude prevalence of hypertension was 35.1% and age-standardized prevalence was 34.4%. Among patients with hypertension, 62.3% were aware of having high blood pressure; among these patients, 75.3% were already on treatment for hypertension. Blood pressure was controlled in 22.3% of all patients with hypertension. Among those on treatment for hypertension, blood pressure was controlled in 32.3%. Nearly one-third of patients in health screening camps of rural central Punjab had hypertension. Blood pressure control rate was poor among these patients.

      PubDate: 2017-02-14T02:43:12Z
      DOI: 10.1016/j.jegh.2017.01.001
  • Drug resistance detection and mutation patterns of multidrug resistant
           tuberculosis strains from children in Delhi

    • Authors: Jyoti Arora; Ritu Singhal; Manpreet Bhalla; Ajoy Verma; Niti Singh; Digamber Behera; Rohit Sarin; Vithal Prasad Myneedu
      Abstract: Publication date: Available online 7 February 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Jyoti Arora, Ritu Singhal, Manpreet Bhalla, Ajoy Verma, Niti Singh, Digamber Behera, Rohit Sarin, Vithal Prasad Myneedu
      A total of 312 sputum samples from pediatric patients presumptive of multidrug resistant tuberculosis were tested for the detection of drug resistance using the GenoTypeMTBDRplus assay. A total of 193 (61.8%) patients were smear positive and 119 (38.1%) were smear negative by Ziehl–Neelsen staining. A line probe assay was performed for 208 samples/cultures (193 smear positive samples and 15 cultures from smear negative samples). Valid results were obtained from 198 tests. Some 125/198 (63.1%) were sensitive to both rifampicin (RIF) and isoniazid (INH), while 73/198 (36.9%) were resistant to at least INH/RIF, out of which 49 (24.7%) were resistant to both INH and RIF (multidrug resistant). Children with tuberculosis are often infected by someone close to them, so strengthening of contact tracing in the program may help in early diagnosis to identify additional cases within the household. There is a need to evaluate newer diagnostic assays which have a high sensitivity in the case of smear negative samples, a need for additional samples other than sputum among young children not able to expectorate, and a need to fill the gap between estimated and reported cases under the program.

      PubDate: 2017-02-08T02:23:17Z
      DOI: 10.1016/j.jegh.2016.12.003
  • Suicide rate in relation to the Human Development Index and other health
           related factors: A global ecological study from 91 countries

    • Authors: Salman Khazaei; Vajihe Armanmehr; Shahrzad Nematollahi; Shahab Rezaeian; Somayeh Khazaei
      Abstract: Publication date: Available online 7 February 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Salman Khazaei, Vajihe Armanmehr, Shahrzad Nematollahi, Shahab Rezaeian, Somayeh Khazaei
      There has been no worldwide ecological study on suicide as a global major public health problem. This study aimed to identify the variations in suicide specific rates using the Human Development Index (HDI) and some health related variables among countries around the world. In this ecological study, we obtained the data from the World Bank Report 2013. The analysis was restricted to 91 countries for which both the epidemiologic data from the suicide rates and HDI were available. Overall, the global prevalence of suicide rate was 10.5 (95% confidence intervals: 8.8, 12.2) per 100,000 individuals, which significantly varied according to gender (16.3 in males vs. 4.6 in females, p <0.001) and different levels of human development (11.64/100,000 individuals in very high development countries, 7.93/100,000 individuals in medium development countries, and 13.94/100,000 individuals in high development countries, p =0.004). In conclusion, the suicide rate varies greatly between countries with different development levels. Our findings also suggest that male gender and HDI components are associated with an increased risk of suicide behaviors. Hence, detecting population subgroups with a high suicide risk and reducing the inequality of socioeconomic determinants are necessary to prevent this disorder around the world.

      PubDate: 2017-02-08T02:23:17Z
      DOI: 10.1016/j.jegh.2016.12.002
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