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Journal Cover Journal of Epidemiology and Global Health
  [SJR: 0.471]   [H-I: 7]   [8 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 2210-6006
   Published by Elsevier Homepage  [3030 journals]
  • 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
  • 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
  • Bradford Hill’s criteria, emerging zoonoses, and One Health

    • Authors: G.V. Asokan; Vanitha Asokan
      Pages: 125 - 129
      Abstract: Publication date: September 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 3
      Author(s): G.V. Asokan, Vanitha Asokan
      Zoonoses constitute more than 60% of infectious diseases and 75% of emerging infectious diseases. Inappropriate overemphasis of specialization of disciplines has ignored public health. Identifying the causes of disease and determining how exposures are related to outcomes in “emerging zoonoses” affecting multiple species are considered to be the hallmarks of public health research and practice that compels the adoption of “One Health”. The interactions within and among populations of vertebrates in the causation and transmissions of emerging zoonotic diseases are inherently dynamic, interdependent, and systems based. Disease causality theories have moved from one or several agents causing disease in a single species, to one infectious agent causing disease in multiple species-emerging zoonoses. Identification of the causative pathogen components or structures, elucidating the mechanisms of species specificity, and understanding the natural conditions of emergence would facilitate better derivation of the causal mechanism. Good quality evidence on causation in emerging zoonoses affecting multiple species makes a strong recommendation under the One Health approach for disease prevention and control from diagnostic tests, treatment, antimicrobial resistance, preventive vaccines, and evidence informed health policies. In the tenets of One Health, alliances work best when the legitimate interests of the different partners combine to prevent and control emerging zoonoses.

      PubDate: 2016-08-03T19:30:48Z
      DOI: 10.1016/j.jegh.2015.10.002
  • Household wealth, residential status and the incidence of diarrhoea among
           children under-five years in Ghana

    • Authors: Akwasi Kumi-Kyereme; Joshua Amo-Adjei
      Pages: 131 - 140
      Abstract: Publication date: September 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 3
      Author(s): Akwasi Kumi-Kyereme, Joshua Amo-Adjei
      This study examines the impact that the joint effect of household wealth quintile and urban–rural residence has on the incidence of diarrhoea among Ghanaian children. Data for this paper were drawn from the Ghana Multiple Indicator Cluster Survey (MICS) of 2006. Descriptive and logistic regression was applied to analyse data on 3466 children. Rural residents are less likely, albeit insignificant, to report diarrhoea compared with those in urban areas. Significant wealth gradients are manifested in childhood experiences of diarrhoea. However, an interaction of wealth with residence does not show significant disparities. Controlling for other important covariates of childhood, the odds of diarrhoea incidence were significantly higher among: the rural poorer (OR=4.869; 95% CI=0.792, 29.94), the rural middle (OR=7.477; 95% CI=1.300, 42.99), the rural richer (OR=6.162; 95% CI=0.932, 40.74) and the rural richest (OR=6.152; 95% CI=0.458, 82.54). Apart from residential status and wealth quintile, female children (OR=0.441; 95% CI=0.304, 0.640), older children (OR=0.968; 95% CI=0.943, 0.993), having a mother with secondary and higher education (OR=0.313; 95% CI) had lesser odds of experiencing diarrhoea. The findings show that there is a need to apportion interventions intended to improve child health outcomes even beyond residential status and household wealth position.

      PubDate: 2016-08-03T19:30:48Z
      DOI: 10.1016/j.jegh.2015.05.001
  • Predictive factors for percutaneous and mucocutaneous exposure among
           healthcare workers in a developing country

    • Authors: Zeynep Türe; Ayşegül Ulu Kiliç; Fatma Cevahir; Dilek Altun; Esra Özhan; Emine Alp
      Pages: 141 - 146
      Abstract: Publication date: September 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 3
      Author(s): Zeynep Türe, Ayşegül Ulu Kiliç, Fatma Cevahir, Dilek Altun, Esra Özhan, Emine Alp
      The aim of this study is to determine the risk factors for percutaneous and mucocutaneous exposures in healthcare workers (HCW) in one of the largest centers of a middle income country, Turkey. This study has a retrospective design. HCWs who presented between August 2011 and June 2013, with Occupational Exposures (OEs) (cases) and those without (controls) were included. Demographic information was collected from infection control committee documents. A questionnaire was used to ask the HCWs about their awareness of preventive measures. HCWs who work with intensive work loads such as those found in emergency departments or intensive care units have a higher risk of OEs. Having heavy workloads and hours increases the risk of percutaneous and mucocutaneous exposures. For that reason the most common occupation groups are nurses and cleaning staff who are at risk of OEs. Increasing work experience has reduced the frequency of OEs.

      PubDate: 2016-08-03T19:30:48Z
      DOI: 10.1016/j.jegh.2015.06.003
  • Pilot use of a novel smartphone application to track traveller health
           behaviour and collect infectious disease data during a mass gathering:
           Hajj pilgrimage 2014

    • Authors: Amani S. Alqahtani; Nasser F. BinDhim; Mohamed Tashani; Harold W. Willaby; Kerrie E. Wiley; Anita E. Heywood; Robert Booy; Harunor Rashid
      Pages: 147 - 155
      Abstract: Publication date: September 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 3
      Author(s): Amani S. Alqahtani, Nasser F. BinDhim, Mohamed Tashani, Harold W. Willaby, Kerrie E. Wiley, Anita E. Heywood, Robert Booy, Harunor Rashid
      This study examines the feasibility of using a smartphone application (app) to conduct surveys among travellers during the Hajj pilgrimage, where the use of apps has not been evaluated for infectious disease surveillance. A longitudinal study was conducted among pilgrims at the Hajj 2014 using an iPhone app with separate questionnaires for three study phases covering before, during, and after Hajj. Forty-eight pilgrims from 13 countries downloaded the app. Respondents were aged between 21 and 61 (median 36) years and 58.5% (24/41) were male. Of these, 85% (41/48) completed the first phase, 52% (25/41) completed both the second and third phases, and 25 of these reported meningococcal vaccination, with 36% (9/25) receiving other vaccines. All (25) reported hand hygiene use and 64% (16/25) wore a facemask at some point during the pilgrimage. Four (6%) reported close contact with camels. Respiratory symptoms commenced from the 4th day of Hajj, with sore throat (20%) and cough (12%) being the most common. Three participants (12%) reported respiratory symptoms after returning home. Conducting a prospective survey using a smartphone app to collect data on travel-associated infections and traveller compliance to prevention is feasible at mass gatherings and can provide useful data associated with health-related behaviour.

      PubDate: 2016-08-03T19:30:48Z
      DOI: 10.1016/j.jegh.2015.07.005
  • Evaluation of medication adherence in Lebanese hypertensive patients

    • Authors: Mohammad Yassine; Amal Al-Hajje; Sanaa Awada; Samar Rachidi; Salam Zein; Wafa Bawab; Mayssam Bou Zeid; Maya El Hajj; Pascale Salameh
      Pages: 157 - 167
      Abstract: Publication date: September 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 3
      Author(s): Mohammad Yassine, Amal Al-Hajje, Sanaa Awada, Samar Rachidi, Salam Zein, Wafa Bawab, Mayssam Bou Zeid, Maya El Hajj, Pascale Salameh
      Controlling hypertension is essential in cardiovascular diseases. Poor medication adherence is associated with poor disease outcomes, waste of healthcare resources, and contributes to reduced blood pressure control. This study evaluates treatment adherence to antihypertensive therapy in Lebanese hypertensive patients by estimating the proportion of adherent hypertensive patients using a validated tool and investigates what factors predict this behavior. A questionnaire-based cross-sectional study was conducted on a random sample of 210 hypertensive outpatients selected from clinics located in tertiary-care hospitals and from private cardiology clinics located in Beirut. Adherence level was measured using a validated 8-item Modified Morisky Medication Adherence Scale (MMMAS). Among 210 patients, 50.5% showed high adherence, 27.1% medium adherence, and 22.4% low adherence to medication. Mean MMMAS score was 6.59±2.0. In bivariate analyses, having controlled blood pressure (p =0.003) and taking a combination drug (p =0.023) were predictors of high adherence. Forgetfulness (p <0.01), complicated drug regimen (p =0.001), and side effects (p =0.006) were predictors of low adherence after multiple liner regression. Logistic regression results showed that calcium channel blockers (p =0.030) were associated with increased adherence levels. In conclusion, developing multidisciplinary intervention programs to address the factors identified, in addition to educational strategies targeting healthcare providers, are necessary to enhance patient adherence.

      PubDate: 2016-08-03T19:30:48Z
      DOI: 10.1016/j.jegh.2015.07.002
  • Prevalence of Lebanese stroke survivors: A comparative pilot study

    • Authors: Nathalie Lahoud; Pascale Salameh; Nadine Saleh; Hassan Hosseini
      Pages: 169 - 176
      Abstract: Publication date: September 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 3
      Author(s): Nathalie Lahoud, Pascale Salameh, Nadine Saleh, Hassan Hosseini
      Stroke is a leading cause of morbidity and mortality worldwide and its late burden has mainly been attributable to developing countries. Lebanon is one of these countries where epidemiological studies on stroke burden are scarce but necessary. Thus, the present study was conducted to assess the prevalence of stroke survivors among Lebanese inhabitants. A cross-sectional survey was carried out using randomly selected landline phone numbers on all governorates to retrieve data on stroke survivors and their sociodemographic characteristics. Results were then standardized over the Lebanese and the World Health Organization (WHO) world populations. A total of 6963 Lebanese inhabitants were included in the study; among these were 56 stroke survivors. This led to an adjusted stroke prevalence of 0.50% [95% confidence interval (CI)=0.33–0.66%] and a world-standardized prevalence of 0.60% (95% CI=0.42–0.78%). A significantly higher stroke prevalence was found among older age groups and more socioeconomically privileged areas. Overall, the study showed a relatively higher prevalence of stroke in this sample of Lebanese inhabitants when compared to other developing countries. However, larger community-based studies with a clinical assessment of stroke cases are needed to confirm our findings.

      PubDate: 2016-08-03T19:30:48Z
      DOI: 10.1016/j.jegh.2015.10.001
  • Extracurricular activities associated with stress and burnout in
           preclinical medical students

    • Authors: Jawad Fares; Zein Saadeddin; Hayat Al Tabosh; Hussam Aridi; Christopher El Mouhayyar; Mohamad Karim Koleilat; Monique Chaaya; Khalil El Asmar
      Pages: 177 - 185
      Abstract: Publication date: September 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 3
      Author(s): Jawad Fares, Zein Saadeddin, Hayat Al Tabosh, Hussam Aridi, Christopher El Mouhayyar, Mohamad Karim Koleilat, Monique Chaaya, Khalil El Asmar
      This study aims to assess the prevalence of stress and burnout among preclinical medical students in a private university in Beirut, Lebanon, and evaluate the association between extracurricular involvement and stress and burnout relief in preclinical medical students. A cross-sectional survey was conducted on a random sample of 165 preclinical medical students. Distress level was measured using the 12-item General Health Questionnaire (GHQ-12) while that of burnout was measured through the Maslach Burnout Inventory-Student Survey (MBI-SS). The MBI-SS assesses three interrelated dimensions: emotional exhaustion, cynicism, and academic efficacy. Extracurricular activities were divided into four categories: physical exercise, music, reading, and social activities. All selected participants responded. A substantial proportion of preclinical medical students suffered from stress (62%) and burnout (75%). Bivariate and multivariate regression analyses revealed that being a female or a 1st year medical student correlated with higher stress and burnout. Music-related activities were correlated with lower burnout. Social activities or living with parents were associated with lower academic efficacy. The high stress and burnout levels call for action. Addressing the studying conditions and attending to the psychological wellbeing of preclinical medical students are recommendations made in the study.

      PubDate: 2016-08-03T19:30:48Z
      DOI: 10.1016/j.jegh.2015.10.003
  • A cohort study of chronic diseases for Mongolian people: Outline with
           baseline data of the Moncohort study

    • Authors: Tsogzolbaatar Enkh-Oyun; Dambadarjaa Davaalkham; Kazuhiko Kotani; Yasuko Aoyama; Satoshi Tsuboi; Ryusuke Ae; Gombojav Davaa; Dayan Angarmurun; Nanjid Khuderchuluun; Yosikazu Nakamura
      Pages: 187 - 196
      Abstract: Publication date: Available online 29 January 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Tsogzolbaatar Enkh-Oyun, Dambadarjaa Davaalkham, Kazuhiko Kotani, Yasuko Aoyama, Satoshi Tsuboi, Ryusuke Ae, Gombojav Davaa, Dayan Angarmurun, Nanjid Khuderchuluun, Yosikazu Nakamura
      Many Mongolian people suffer from non-communicable chronic diseases. In order to plan preventive strategies against such diseases, we designed a community-based prospective cohort study of chronic diseases, called the Moncohort study, in Mongolia. This is the first nationwide large-scale cohort study of chronic diseases. This paper describes the study’s rationale, design and methods with baseline data. Mongolian residents aged ⩾40years were selected nationwide from many geographic regions in 2009. Data were collected on demographics, socioeconomic status, lifestyle, and anthropometric and biochemical measurements. In total, 2280 Mongolian residents were registered in the survey. Socioeconomic, lifestyle, anthropometric and biochemical characteristics were differentiated by gender and geographical area in descriptive data. Aging, low social class, physical inactivity and infrequent fruits intake were positively associated with histories of chronic disease in men, while aging was positively associated with histories of chronic disease in women. Factors associated with chronic diseases reveal gender-oriented strategies might be needed for their prevention. Detailed prospective analyses will illustrate the impact of risk factors on chronic diseases and lead to evidence for designing programs aimed at preventing chronic diseases and related disorders in Mongolia.

      PubDate: 2016-02-09T15:34:02Z
      DOI: 10.1016/j.jegh.2015.12.001
  • Verification of measles elimination in Australia: Application of World
           Health Organization regional guidelines

    • Authors: H.F. Gidding; N.V. Martin; V. Stambos; T. Tran; A. Dey; G.K. Dowse; H.A. Kelly; D.N. Durrheim; S.B. Lambert
      Pages: 197 - 209
      Abstract: Publication date: Available online 27 January 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): H.F. Gidding, N.V. Martin, V. Stambos, T. Tran, A. Dey, G.K. Dowse, H.A. Kelly, D.N. Durrheim, S.B. Lambert
      Background The World Health Organization (WHO) Western Pacific Region (WPR) Guidelines on verification of measles elimination were established in 2012. This article outlines Australia’s approach to addressing the guideline’s five lines of evidence, which led to formal verification of elimination by the WHO Regional Verification Commission (RVC) in March 2014. Methods The criteria were addressed using national measles notifications, data from selected laboratories, the national childhood immunization register, and three national serosurveys (1998/1999, 2002, 2007). Results Australia met or exceeded all indicator targets with either national or sentinel data. Laboratory and epidemiological surveillance were of high quality, with 85% of cases documented as imported/import-related (target 80%); coverage with the first dose of measles vaccine was close to 94% in 2008–2012 and second dose coverage increased to 91% in 2012 (target >95%). There is ongoing commitment by the Australian Government to increase immunization coverage, and the absence of sustained transmission of any single measles genotype was demonstrated. Conclusions This is the first documentation of the successful application of the WPR RVC guidelines. The indicators afford some flexibility but appear to provide appropriate rigor to judge achievement of measles elimination. Our experience could assist other countries seeking to verify their elimination status.

      PubDate: 2016-01-29T15:15:49Z
      DOI: 10.1016/j.jegh.2015.12.004
  • Presence of blaPER-1 and blaVEB-1 beta-lactamase genes among isolates of
           Pseudomonas aeruginosa from South West of Iran

    • Authors: Elham Davodian; Nourkhoda Sadeghifard; Abdolmajid Ghasemian; Samileh Noorbakhsh
      Pages: 211 - 213
      Abstract: Publication date: Available online 2 March 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Elham Davodian, Nourkhoda Sadeghifard, Abdolmajid Ghasemian, Samileh Noorbakhsh
      Pseudomonas aeruginosa isolates have acquired resistance to antibiotics such as novel beta-lactams. The aim of this study was to investigate the bla PER-1, bla VEB-1, and bla PSE-1 genes among isolates of P. aeruginosa among intensive care unit (ICU) patients. Sixty-five isolates were collected. The antibiotic susceptibility testing and combined disk tests were performed to detect the isolates producing ESBLs among ceftazidime-resistant isolates. Polymerase chain reaction (PCR) amplification of bla PER-1, bla VEB-1, and bla PSE-1 genes was conducted. Ten (15.3%) isolates were ESBL-positive, of which 40% (n =4) belonged to males and 60% (n =6) were collected from females. Moreover, two and one isolates harbored bla PER-1 and bla VEB-1 genes, respectively.

      PubDate: 2016-03-05T19:06:10Z
      DOI: 10.1016/j.jegh.2016.02.002
  • Antimicrobial resistance and the growing threat of drug-resistant

    • Authors: Madhukar Pai; Ziad A. Memish
      Pages: 45 - 47
      Abstract: Publication date: Available online 16 February 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Madhukar Pai, Ziad A. Memish

      PubDate: 2016-02-18T16:39:03Z
      DOI: 10.1016/j.jegh.2016.02.001
  • The psychology of health and well-being in mass gatherings: A review and a
           research agenda

    • Authors: Nick Hopkins; Stephen Reicher
      Pages: 49 - 57
      Abstract: Publication date: June 2016
      Source:Journal of Epidemiology and Global Health, Volume 6, Issue 2
      Author(s): Nick Hopkins, Stephen Reicher
      Mass gatherings bring large numbers of people into physical proximity. Typically, this physical proximity has been assumed to contribute to ill health (e.g., through being stressful, facilitating infection transmission, etc.). In this paper, we add a new dimension to the emerging field of mass gatherings medicine. Drawing on psychological research concerning group processes, we consider the psychological transformations that occur when people become part of a crowd. We then consider how these transformations may have various consequences for health and well-being. Some of these consequences may be positive. For example, a sense of shared identity amongst participants may encourage participants to view others as a source of social support which in turn contributes to a sense of health and well-being. However, some consequences may be negative. Thus, this same sense of shared identity may result in a loss of disgust at the prospect of sharing resources (e.g., drinking utensils) which could, in turn, facilitate infection transmission. These, and related issues, are illustrated with research conducted at the Magh Mela (North India). We conclude with an agenda for future research concerning health practices at mass gatherings.

      PubDate: 2016-05-12T07:30:40Z
      DOI: 10.1016/j.jegh.2015.06.001
  • Declining trends in injuries and ambulance calls for road traffic crashes
           in Bahrain post new traffic laws of 2015

    • Authors: Muyssar Sabri Awadhalla; Govindaraj Vaithinathan Asokan; Amina Matooq; Richard Kirubakaran
      Pages: 59 - 65
      Abstract: Publication date: Available online 16 March 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Muyssar Sabri Awadalla, G.V. Asokan, Amina Matooq, Richard Kirubakaran
      Road traffic crashes (RTC) are of serious global health concern. To identify whether the number of ambulance calls, injuries, and deaths has declined after the implementation of the new traffic law (NTL) 2015 in Bahrain, de-identified administrative RTC data obtained from the tertiary care center, and the General Directorate of Traffic (GDT) of Bahrain were used. A quasi-experimental design was employed to trend the impact of the NTL on RTC and associated healthcare events. Bahrainis and non-Bahrainis who met with RTC, either in a vehicle or as a pedestrian, between February 8 and May 8 in 2013, 2014 (pre NTL), and 2015 (post NTL) were included in the study. Our results show a reduction in the number of ambulance calls from vehicular and pedestrian RTC victims. The ambulance calls from pedestrian RTC victims were <10% compared to the number of ambulance calls from vehicular RTC victims. There was a significant reduction in minor injuries post 2015, whereas no obvious difference was seen for serious injuries and deaths. A longer follow-up study to confirm the sustained decline in RTC, enforcing a zero tolerance policy toward traffic transgressions, and raising public awareness on the “critical four minutes” and “golden hour” is recommended.

      PubDate: 2016-03-20T16:55:36Z
      DOI: 10.1016/j.jegh.2016.02.004
  • Knowledge, attitudes, and practices regarding travel health among Muscat
           International Airport travelers in Oman: Identifying the gaps and
           addressing the challenges

    • Authors: Seif S. Al-Abri; Doaa M. Abdel-Hady; Idris S. Al-Abaidani
      Pages: 67 - 75
      Abstract: Publication date: Available online 3 March 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Seif S. Al-Abri, Doaa M. Abdel-Hady, Idris S. Al-Abaidani
      Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers’ knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice.

      PubDate: 2016-03-05T19:06:10Z
      DOI: 10.1016/j.jegh.2016.02.003
  • Ecological correlations of dietary food intake and mental health disorders

    • Authors: Jordan Hoerr; Joshua Fogel; Benjamin Van Voorhees
      Abstract: Publication date: Available online 18 December 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Jordan Hoerr, Joshua Fogel, Benjamin Van Voorhees
      This paper examines the ecological association of dietary food intake with mental health outcomes on the group level across countries. Published data from the World Mental Health Survey were used to compare lifetime prevalence of four categories of mental health disorders (anxiety disorders, mood disorders, impulse control disorders, and substance use disorders) with a country’s fish/seafood and sugar/sweetener supply quantity using the Spearman rank correlation. Data were compared for 17 countries across the world. Sugar and sweetener supply quantity was significantly and positively associated with anxiety disorders (rho=0.75, p =0.001), mood disorders (rho=0.75, p =0.001), impulse control disorders (rho=0.78, p =0.001), and substance use disorders (rho=0.68, p =0.007). Fish and seafood supply quantity had no significant association with any mental health disorders. Mental health disorders represent a significant health problem around the world. Public health measures aimed at improving the quality and availability of a nation’s food supply could have a significant positive impact on mental health. Further randomized studies are needed to further validate the study findings.

      PubDate: 2016-12-25T16:46:11Z
      DOI: 10.1016/j.jegh.2016.12.001
  • Population-attributable fraction of hypertension associated with obesity
           and abdominal obesity, and the joint effect of both in the Central
           Provinces of Iran

    • Authors: Masoud Mohammadi; Masoud Mirzaei
      Abstract: Publication date: Available online 7 December 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Masoud Mohammadi, Masoud Mirzaei
      The prevalence of obesity has been increasing in Iran over the past decade. This study aimed to determine the population-attributable fraction (PAF) of hypertension associated with obesity and abdominal obesity, and the joint effect of both in the central provinces of Iran. Prevalence of hypertension was extracted from the Iranian Ministry of Health Non-Communicable Disease Risk Factor InfoBase 2009. Measure of association between obesity and hypertension was extracted from Tehran Lipid and Glucose Study, for men and women, in order to calculate the PAF of hypertension associated with obesity. Age standardization of the reported prevalence of obesity was done using a World Health Organization method. The PAF of hypertension associated with the joint effect of obesity and abdominal obesity in females was highest in Semnan Province: 22.7 [95% confidence interval (CI): 4.2–35.6], followed by Qom 21.09 (95% CI: 3.7–33.1), and Yazd 20.3 (95% CI: 3.5–32.1). In males, the highest PAF was observed in Qom Province 31.07 (95% CI: 16.7–41.1), followed by Semnan 29.6 (95% CI: 15.9–39.3), Qazvin 25.9 (95% CI: 13.7–34.5), Tehran 24.2 (95% CI: 12.7–32.3), and Isfahan 20.4 (95% CI: 3.5–27.4). Prevalence of hypertension is higher in more developed provinces. PAFs suggest that a sizable share of hypertension in these provinces is associated with obesity. It is recommended that health promotion programs focus on obesity in the provinces with a higher share of hypertension due to obesity.

      PubDate: 2016-12-10T11:56:04Z
      DOI: 10.1016/j.jegh.2016.11.002
  • Are we facing a noncommunicable disease pandemic?

    • Authors: Luke Allen
      Abstract: Publication date: Available online 22 November 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Luke Allen
      The global boom in premature mortality and morbidity from noncommunicable diseases (NCDs) shares many similarities with pandemics of infectious diseases, yet public health professionals have resisted the adoption of this label. It is increasingly apparent that NCDs are actually communicable conditions, and although the vectors of disease are nontraditional, the pandemic label is apt. Arguing for a change in terminology extends beyond pedantry as the move carries serious implications for the public health community and the general public. Additional resources are unlocked once a disease reaches pandemic proportions and, as a long-neglected and underfunded group of conditions, NCDs desperately require a renewed sense of focus and political attention. This paper provides objections, definitions, and advantages to approaching the leading cause of global death through an alternative lens. A novel framework for managing NCDs is presented with reference to the traditional influenza pandemic response.

      PubDate: 2016-11-25T15:06:28Z
      DOI: 10.1016/j.jegh.2016.11.001
  • A clinical study of cutaneous changes in pregnancy

    • Authors: Vinitha V. Panicker; Najeeba Riyaz; P.K. Balachandran
      Abstract: Publication date: Available online 19 November 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Vinitha V. Panicker, Najeeba Riyaz, P.K. Balachandran
      Background/objective Pregnant women experience a myriad of physiological and metabolic changes that affect different organ systems in the body. Cutaneous and appendageal alterations that manifest during pregnancy are largely modulated by hormonal, immunologic, and metabolic factors. Detailed reports encompassing physiological changes and specific dermatoses of pregnancy and effects of various dermatoses on pregnant women are scanty in literature. This study was conducted to examine in detail both physiological changes and specific dermatoses. The cutaneous changes are divided into physiological changes, skin diseases aggravated by pregnancy, and specific dermatoses of pregnancy. The objectives were to study the various cutaneous changes of pregnancy and to know the proportion of these cutaneous manifestations in pregnant women. Methods This study included 600 pregnant women attending the Obstetrics and Gynecology Department of a tertiary teaching hospital in Northern Kerala, India. Detailed history elicitation and complete physical and dermatological examination were performed. Skin biopsy was performed in relevant cases. Results Cutaneous changes were seen in a majority of patients, of which physiological changes were the most common (99%). The most common cutaneous manifestation was hyperpigmentation (526; 87.6%), followed by striae gravidarum (72.8%). Other changes were vascular, including pedal edema (10%), pregnancy gingivitis (1.8%), and varicose veins (1%). Infections were the common dermatological problem in this study group. The most common infections were vulvovaginal candidiasis (21%), Tinea versicolor (6%), scabies (2.8%), dermatophytosis (1.5%), and sexually transmitted infection (0.5%). Specific dermatoses were seen in 12 cases (2%), with the most common being pruritic urticarial papules and plaques of pregnancy (1.3%). Conclusion Pregnant women are prone to suffer from a wide range of dermatological problems apart from specific dermatoses of pregnancy. The study emphasizes the need for a detailed and meticulous examination of these patients to detect these various disorders.

      PubDate: 2016-11-25T15:06:28Z
      DOI: 10.1016/j.jegh.2016.10.002
  • Risk factors and quality of life of dyslipidemic patients in Lebanon: A
           cross-sectional study

    • Authors: Akram Farhat; Amal Al-Hajje; Samar Rachidi; Salam Zein; Mayssam Bou Zeid; Pascale Salameh; Wafaa Bawab; Sanaa Awada
      Abstract: Publication date: Available online 11 November 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Akram Farhat, Amal Al-Hajje, Samar Rachidi, Salam Zein, Mayssam Bou Zeid, Pascale Salameh, Wafaa Bawab, Sanaa Awada
      The main objective of this study was to identify the risk factors of dyslipidemia and measure its impact on patients’ quality of life (QOL). Secondary objectives were to determine the percentage of dyslipidemia and assess the predictive factors affecting patients’ QOL. A cross-sectional study was conducted in a sample of Lebanese population. A standardized questionnaire was developed to assess the QOL using the SF-36 score. A total of 452 individuals were interviewed, of which 59.5% were females. The mean age was 43.3±15.6years, and 24.8% had dyslipidemia. The results show a lower overall QOL score among dyslipidemic patients compared with controls (57.9% and 76.5%, respectively; p <0.001). Waterpipe smoking [adjusted odds ratio (ORa)=4.113, 95% confidence interval (CI): 1.696–9.971, p =0.002], hypertension (ORa =3.597, 95% CI: 1.818–7.116, p <0.001), diabetes (ORa =3.441, 95% CI: 1.587–7.462, p =0.002), cigarette smoking (ORa =2.966, 95% CI: 1.516–5.804, p =0.001), and passive smoking (ORa =2.716, 95% CI: 1.376–5.358, p =0.004) were significantly associated with dyslipidemia in individuals older than 30years. A higher overall QOL score (p =0.013) was observed in patients treated with statins in comparison with other lipid-lowering medications. In addition to clinical and economical consequences, dyslipidemia may have a significant impact on patients’ QOL. Further research is needed to confirm the impact of treatment on dyslipidemic patients’ QOL in order to maximize the overall benefits of therapy.

      PubDate: 2016-11-18T14:28:05Z
      DOI: 10.1016/j.jegh.2016.10.001
  • Assessment of vitamin D levels, awareness among Lebanese pharmacy
           students, and impact of pharmacist counseling

    • Authors: Diana Malaeb; Souheil Hallit; Pascale Salameh
      Abstract: Publication date: Available online 4 October 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Diana Malaeb, Souheil Hallit, Pascale Salameh
      Vitamin D inadequacy, frequently underdiagnosed, affects people of all age groups worldwide. This prospective study aims at determining the percentage of inadequate vitamin D levels among students and evaluating the impact of pharmacist counseling on raising the awareness of the importance of sun exposure and adequate vitamin D intake. A total of 160 university students were recruited. Blood samples were taken to check the vitamin D, calcium, and phosphorous levels. Vitamin D levels ⩽30ng/mL were defined as inadequate. Scores were given to the questions and aimed at gathering patient knowledge about vitamin D before and after pharmacist counseling. A total of 115 (71.87%) patients had vitamin D levels <30ng/mL, with a mean vitamin D serum level of 16.80±5.85ng/mL. The mean level of calcium was 9.51±1.23mg/dL and, of phosphorus 3.62±0.95mg/dL. The mean difference in the knowledge score of the recommended daily amount of vitamin D before and after pharmacist counseling was 2.81 versus 5.88 (p <0.001). Concerning patient education for diseases and drugs that affect vitamin D levels, pharmacist counseling was effective in raising the awareness (p <0.001). Given that vitamin D inadequacy is linked to many disease progressions, it is important that health professionals provide interventional strategies and education measures to correct inadequate levels in patients of all age groups.

      PubDate: 2016-10-08T04:51:26Z
      DOI: 10.1016/j.jegh.2016.09.001
  • Measuring a hidden population: A novel technique to estimate the
           population size of women with sexual violence-related pregnancies in South
           Kivu Province, Democratic Republic of Congo

    • Authors: Lisa G. Johnston; Katherine R. McLaughlin; Shada A. Rouhani; Susan A. Bartels
      Abstract: Publication date: Available online 20 September 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Lisa G. Johnston, Katherine R. McLaughlin, Shada A. Rouhani, Susan A. Bartels
      Successive sampling (SS)–population size estimation (PSE) is a technique used to estimate the sizes of hidden populations using data collected in respondent-driven sampling (RDS) surveys. We here assess past estimations and use new data from an RDS survey to calculate a new PSE. In 2012, 852 adult women in South Kivu Province, Democratic Republic of Congo, who self-identified as survivors of sexual violence, resulting in a pregnancy, since the start of the war (in 1996) were sampled using RDS. We used imputed visibility, enrollment order, and prior estimates for PSE using SS-PSE in RDS Analyst. Prior estimates varied between Congolese local experts and researchers. We calculated the PSE of women with a sexual violence-related pregnancy in South Kivu using researchers’ priors to be approximately 17,400. SS–PSE is an effective method for estimating the population sizes of hidden populations, useful for providing evidence for services and resource allocation. SS–PSE is beneficial because population sizes can be calculated after conducting the survey and do not rely on separate studies or additional data (as in network scale-up, multiplier, and capture-recapture methods).

      PubDate: 2016-09-25T02:51:50Z
      DOI: 10.1016/j.jegh.2016.08.003
  • Careseeking for childhood diarrhoea at the primary level of care in
           communities in Cross River State, Nigeria

    • Authors: Oluranti Ekpo
      Abstract: Publication date: Available online 14 September 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Oluranti Ekpo
      Risk factors for care-seeking choices for childhood diarrhea in Nigeria are poorly understood. They are essential to the control of childhood illnesses because diarrhea is an important cause of childhood mortality. This study explored the contributors to care-seeking choices in Cross River State, Nigeria. Caregivers of children aged 0–59months in 1240 randomly selected households in Cross River State were involved in this cross-sectional study. Questionnaires were used to collect information on demographics, knowledge of illness, and care-seeking patterns, and observed associations were explored using logistic regression. Care was given at home (50.4%, n =142; as recommended), at the health center (27%, n =76), and at the local drug store (19.1%, n =54). Main reasons for care sought were health education (31.9%, n =94), treatment cost (18%, n =53), and experiences (16.6%, n =49). Caregivers living in the mainly urban area of Calabar Municipality [AOR=2.81 (1.26–6.26)] and the mainly rural area of Obanliku [AOR=3.59 (1.94–6.64)], were more likely to give home treatment. Choice of treatment was only associated with area of residence. Influencers of care-seeking behavior, especially for childhood diarrhea, are complex and need to be better understood to encourage enhanced care for young children with diarrhea.

      PubDate: 2016-09-20T02:13:25Z
      DOI: 10.1016/j.jegh.2016.08.002
  • The authors’ reply to the commentary of Dr. Josué Lily Vidal Paper:
           Prevalence of Lebanese stroke survivors: A comparative pilot study

    • Authors: Lahoud Nathalie; Salameh Pascale Saleh Nadine Hosseini Hassan
      Abstract: Publication date: Available online 22 August 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Lahoud Nathalie, Salameh Pascale, Saleh Nadine, Hosseini Hassan

      PubDate: 2016-08-23T22:10:51Z
  • Hospital admissions among immigrants from low-income and foreign citizens
           from high-income countries in Spain in 2000–2012

    • Authors: José M. Ramos; Héctor Pinargote; Eva M. Navarrete-Muñoz; Alejando Salinas; Jaume Sastre
      Abstract: Publication date: Available online 18 August 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): José M. Ramos, Héctor Pinargote, Eva M. Navarrete-Muñoz, Alejando Salinas, Jaume Santre
      Over the last decade, the number of foreign nationals in Spain has increased. Our aim was to report the trends in hospital admissions, differentiating between foreign nationals from high-income countries (HICs) and from low- and middle-income countries (LMICs) in a public hospital. A retrospective analysis of hospital admissions in patients aged ⩾15years between 2000 and 2012 was performed by means of hospital information systems at a public hospital in the city of Alicante, Spain. During the period of the study, 387,862 patients were admitted: 32,020 (8.3%) were foreign, 22,446 (5.8%) were from LMICs, and 9574 (2.5%) were from HICs. The number of foreign nationals, foreign nationals from LMICs, and foreign nationals from HICs admitted increased from 1019, 530, and 489 in 2000 to 2925, 2097, and 828, respectively in 2012. A total of 27.5% of patients were admitted for pregnancy, childbirth, and puerperium, especially foreign nationals from LMICs (34.3%), and 14.1% of foreign nationals were admitted for cardiovascular diseases (14.1%), which were more common in those from HICs (26.3%). The number of admissions among foreign nationals from LMICs increased significantly in all the diagnoses, but in pregnancy, childbirth, and puerperium, the increase was higher. In conclusion, nearly one out of 10 adult patients admitted to our hospital was foreign, mainly from LMICs, and the main reason for admission was diagnoses related to pregnancy, childbirth, and puerperium.

      PubDate: 2016-08-18T21:47:58Z
      DOI: 10.1016/j.jegh.2016.07.002
  • Epidemiology and risk factors of uninvestigated dyspepsia, irritable bowel
           syndrome, and gastroesophageal reflux disease among students of Damascus
           University, Syria

    • Authors: Tareq Al Saadi; Amr Idris; Tarek Turk; Mahmoud Alkhatib
      Abstract: Publication date: Available online 5 August 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Tareq Al Saadi, Amr Idris, Tarek Turk, Mahmoud Alkhatib
      Uninvestigated dyspepsia (UD), irritable bowel syndrome (IBS), and gastroesophageal reflux disease (GERD) are common disorders universally. Many studies have assessed their epidemiological characteristics around the world. However, such information is not known for Syria. We aim to estimate the epidemiologic characteristics and possible risk factors for UD, IBS, and GERD among students at Damascus University, Damascus, Syria. A cross-sectional study was conducted in July–September 2015 at a campus of Damascus University. A total of 320 students were randomly asked to complete the survey. We used ROME III criteria to define UD and IBS, and Montreal definition for GERD. In total, 302 valid participants were included in the analysis. Prevalence for UD, IBS, and GERD was 25%, 17%, and 16%, respectively. Symptom overlap was present in 46 students (15%), with UD+IBS in 28 (9.3%), UD+GERD in 26 (8.6%), and IBS+GERD in 14 (4.6%) students. Eleven (3.6%) students had symptoms of UD+IBS+GERD. Each of these overlaps occurred more frequently than expected by chance. Significant risk factors included cigarettes, waterpipe consumption, and body mass index <18.5kg/m2 for UD; female gender and three cups of coffee/d for IBS; and two cups of tea and one to five cigarettes/d for GERD. Risk factors for these disorders remain poorly characterized and need further investigations.

      PubDate: 2016-08-08T20:30:35Z
      DOI: 10.1016/j.jegh.2016.07.001
  • A commentary of the article “Prevalence of Lebanese stroke survivors: A
           comparative pilot study” by N. Lahoud, P. Salameh, N. Saleh and H.
           Hosseini, published in the Journal of Epidemiology and Global Health on
           October 24th 2015

    • Authors: Josué A. Lily Vidal
      Abstract: Publication date: Available online 19 July 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Josué A. Lily Vidal

      PubDate: 2016-07-23T17:52:45Z
      DOI: 10.1016/j.jegh.2016.06.004
  • Peritoneal dialysis related peritonitis due to Mycobacterium spp.: A case
           report and review of literature

    • Authors: Anusha Rohit; Georgi Abraham
      Abstract: Publication date: Available online 18 July 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Anusha Rohit, Georgi Abraham

      PubDate: 2016-07-18T16:43:32Z
      DOI: 10.1016/j.jegh.2016.06.005
  • Predictors of Ramadan fasting during pregnancy

    • Authors: Lily A. van Bilsen; Ary I. Savitri; Dwirani Amelia; Mohammad Baharuddin; Diederick E. Grobbee; Cuno S.P.M. Uiterwaal
      Abstract: Publication date: Available online 30 June 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Lily A. van Bilsen, Ary I. Savitri, Dwirani Amelia, Mohammad Baharuddin, Diederick E. Grobbee, Cuno S.P.M. Uiterwaal

      PubDate: 2016-07-03T15:13:14Z
      DOI: 10.1016/j.jegh.2016.06.002
  • Community-engaged strategies to promote hepatitis B testing and linkage to
           care in immigrants of Florida

    • Authors: Jevetta Stanford; Alma Biba; Jagdish Khubchandani; Fern Webb; Mobeen H. Rathore
      Abstract: Publication date: Available online 30 June 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Jevetta Stanford, Alma Biba, Jagdish Khubchandani, Fern Webb, Mobeen H. Rathore
      To improve early identification and linkage to treatment and preventive services for hepatitis B virus (HBV) in persons born in countries with intermediate or high (>2%) HBV prevalence, the University of Florida Center for HIV/AIDS Research, Education, and Services (UF CARES) employed community-engaged strategies to implement the Hepatitis B Awareness and Service Linkage (HBASL) program. In this brief report, we present a summary of program components, challenges, and successes. Faith and community-based networks were established to improve HBV testing and screening and to increase foreign born nationals (FBNs) access to HBV care. A total of 1516 FBNs were tested and screened for hepatitis B. The majority were females (50.4%), Asians (62.8%), non-Hispanic (87.2%), and they also received post-test counseling (54.8%). Noted program advantages included the development of community networks and outreach to a large population of FBNs. The major challenges were institutional delays, pressures related to meeting program deliverables, and diversity within FBNs populations. Community health workers in the United States can replicate this program in their respective communities and ensure success by maintaining a strong community presence, establishing partnerships and linkage processes, developing a sustainability plan, and ensuring the presence of dedicated program staff.

      PubDate: 2016-07-03T15:13:14Z
      DOI: 10.1016/j.jegh.2016.06.003
  • The prevalence of allergic rhinitis and atopic markers in obstructive
           sleep apnea

    • Authors: Ghadah Gadi; Siraj Wali; Emad Koshak; Mohammad Albar; Abdulkareem Fida; Muntasir Abdelaziz; Khaled Alnoury; Nabil Alama
      Abstract: Publication date: Available online 27 June 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Ghadah Gadi, Siraj Wali, Emad Koshak, Mohammad Albar, Abdulkareem Fida, Muntasir Abdelaziz, Khaled Alnoury, Nabil Alama
      Allergic rhinitis (AR) related inflammation might worsen the severity of obstructive sleep apnea (OSA), however, the relationship between the two disorders remains controversial. Our aim was to determine the prevalence of AR and atopic markers in OSA. This cross-sectional study recruited participants with sleep-related complaints referred to a sleep center from February 2013 to June 2014. The diagnosis of OSA was based on the Berlin questionnaire (BQ) followed by confirmatory polysomnography (PSG). The diagnosis of AR was made via focused history and clinical examination and was confirmed by measuring atopic markers. OSA was diagnosed in 97 out of 157 adults attending the sleep clinic (61.8%). There was a high prevalence of AR (52.6%) among OSA individuals. This was not significantly different from the frequency in the non-OSA individuals (p =0.5). Elevated total immunoglobulin E (IgE; >100K/μL), eosinophil count, and positive Phadiatop tests were found in individuals with OSA to be 37.1%, 11.3%, and 41.2%, respectively. Individuals without OSA have shown similar percentages. In our cohort, there was no significant difference in frequency of AR and atopy among participants with OSA compared to those without OSA.

      PubDate: 2016-07-03T15:13:14Z
      DOI: 10.1016/j.jegh.2016.06.001
  • Middle East respiratory syndrome coronavirus in Medinah City, Saudi
           Arabia: Demographic, clinical and survival data

    • Authors: Nahid Sherbini; Ayman Iskandrani; Ayman Kharaba; Ghalilah Khalid; Mohammed Abduljawad; Hamdan AL-Jahdali
      Abstract: Publication date: Available online 11 June 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Nahid Sherbini, Ayman Iskandrani, Ayman Kharaba, Ghalilah Khalid, Mohammed Abduljawad, Hamdan AL-Jahdali
      Background Middle East respiratory syndrome coronavirus (MERS-CoV), is an emerging virus respiratory infection. It has a high mortality rate and a wide spectrum of clinical features. This study describes the clinical characteristics and outcome of MERS infected patients. Methods A retrospective study was conducted of all confirmed MERS-CoV infections from March 2014 to May 2014 at two tertiary care hospitals in Medinah region (Saudi Arabia). We gathered data about demographic, clinical presentation, and factors associated with severity and mortality. Results A total of 29 cases were identified; 20 males (69%) and nine females (31%), age 45±12years. The death rate was higher for men (52%) than for women (23%). Initial presentation was fever in 22 (75%) cases, cough in 20 (69%) cases, and shortness of breath in 20 (69%) cases. Associated comorbidities were diabetes mellitus in nine (31%) patients and chronic kidney disease (CKD) in eight (27%) patients. Duration of symptoms before hospitalization ranged from 2.9days to 5days. Elevated liver enzymes were present in 14 (50%) patients and impaired renal profile present in eight (27%) patients. We also describe in this study radiological patterns and factors associated with mortality Conclusion MERS-CoV infection transmission continues to occur as clusters in healthcare facilities. The frequency of cases and deaths is higher among men than women and among patients with comorbidities.

      PubDate: 2016-06-14T06:52:56Z
      DOI: 10.1016/j.jegh.2016.05.002
  • Enhancing the role of pharmacists in the cascade of tuberculosis care

    • Authors: Amrita Daftary; Nita Jha; Madhukar Pai
      Abstract: Publication date: Available online 31 May 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Amrita Daftary, Nita Jha, Madhukar Pai

      PubDate: 2016-06-02T09:25:53Z
      DOI: 10.1016/j.jegh.2016.05.001
  • Protecting health workers from nosocomial Hepatitis B infections: A review
           of strategies and challenges for implementation of Hepatitis B vaccination
           among health workers in Sub-Saharan Africa

    • Authors: Bridget Malewezi; Saad B. Omer; Beatrice Mwagomba; Trish Araru
      Abstract: Publication date: Available online 4 May 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Bridget Malewezi, Saad B. Omer, Beatrice Mwagomba, Trish Araru
      The Sub-Saharan region has the highest Hepatitis B virus (HBV) rates, and health workers are at an increased risk of contracting nosocomial HBV infection. Vaccination of health workers plays a critical role in protecting them from sequelae of HBV; however, health-worker vaccination remains a challenge for many countries. This study was conducted to review practices/measures and challenges in the Sub-Saharan region relating to vaccination of health workers against HBV. We performed a literature review of articles addressing any aspect of HBV vaccination of health workers in the Sub-Saharan region sourced from PubMed, Embase, and Web of Science, including a case study of Malawi policies and strategies in training institutions and facilities. Our findings indicated that HBV awareness and vaccination were relatively high, but vaccination rates were lower, with 4.6–64.4% of those “ever vaccinated” completing the vaccination regimen. There was also great variation in the proportion of health workers exhibiting natural immunity from previous exposure (positive for anti-Hepatitis B core antibodies; 41–92%). Commonly cited reasons for non-uptake of vaccine included cost, lack of awareness of vaccine availability, and inadequate information concerning the vaccine. Countries in this region will require locally relevant data to develop cost-effective strategies that maximize the benefit to their health workers due to the great diversity of HBV epidemiology in the region.

      PubDate: 2016-05-12T07:30:40Z
      DOI: 10.1016/j.jegh.2016.04.003
  • Four cases of nontravel-related leptospirosis in Oman: A call for action

    • Authors: Idris Al Abaidani; Salem Al Kathery; Satish L Ghugey; Mohhamad Baqi; Khalid Al-Mashikhi; Seif Al-Abri
      Abstract: Publication date: Available online 4 May 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Idris Saleh Al-Abaidani

      PubDate: 2016-05-12T07:30:40Z
      DOI: 10.1016/j.jegh.2016.04.004
  • A novel sputum transport solution eliminates cold chain and supports
           routine tuberculosis testing in Nepal

    • Authors: Bhagwan Maharjan; Bhabana Shrestha; Alexandra Weirich; Andrew Stewart; Cassandra D. Kelly-Cirino
      Abstract: Publication date: Available online 27 April 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Bhagwan Maharjan, Bhabana Shrestha, Alexandra Weirich, Andrew Stewart, Cassandra D. Kelly-Cirino
      This preliminary study evaluated the transport reagent OMNIgene SPUTUM (OMS) in a real-world, resource-limited setting: a zonal hospital and national tuberculosis (TB) reference laboratory, Nepal. The objectives were to: (1) assess the performance of OMS for transporting sputum from peripheral sites without cold chain stabilization; and (2) compare with Nepal’s standard of care (SOC) for Mycobacterium tuberculosis smear and culture diagnostics. Sixty sputa were manually split into a SOC sample (airline-couriered to the laboratory, conventional processing) and an OMS sample (OMS added at collection, no cold chain transport or processing). Smear microscopy and solid culture were performed. Transport was 0–8days. Forty-one samples (68%) were smear-positive using both methods. Of the OMS cultures, 37 (62%) were positive, 22 (36%) were negative, and one (2%) was contaminated. Corresponding SOC results were 32 (53%), 21 (35%), and seven (12%). OMS “rescued” six (i.e., missed using SOC) compared with one rescue using SOC. Of smear-positives, six SOC samples produced contaminated cultures whereas only one OMS sample was contaminated. OMS reduced culture contamination from 12% to 2%, and improved TB detection by 9%. The results suggest that OMS could perform well as a no cold chain, long-term transport solution for smear and culture testing. The findings provide a basis for larger feasibility studies.

      PubDate: 2016-05-12T07:30:40Z
      DOI: 10.1016/j.jegh.2016.04.002
  • Burden of chronic kidney disease and its risk factors in Malaysia

    • Authors: Rubina Begum; Tahir Mehmood Khan; Long Chiau Ming
      Abstract: Publication date: Available online 16 April 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Rubina Begum, Tahir Mehmood Khan, Long Chiau Ming

      PubDate: 2016-05-12T07:30:40Z
      DOI: 10.1016/j.jegh.2016.03.004
  • Institutional Research Evaluation Model (IREM): A framework for measuring
           organizational research trends and impact and its application in medical
           academia in Saudi Arabia

    • Authors: Mazen Hassanain; Shirin Anil; Ayman Abdo
      Abstract: Publication date: Available online 16 April 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Mazen Hassanain, Shirin Anil, Ayman Abdo
      Increased financial and human resource constraints for research and development (R&D) imply rigorous research evaluation to guide the research policy for wise allocation of resources. In this study, we developed a conceptual framework called the “Institutional Research Evaluation Model” (IREM) to evaluate the quality of research and its determinants. The IREM was then applied to a medical institution to study its applicability in Saudi Arabia. The IREM consists of five levels: duration decision; choice of research quality indicators [impact factor (IF), article influence scores (AIS), citations per paper (CPP), and publication in indexed journal]; trend indicators (numbers of publications, study design, subject); data extraction; and statistical techniques to determine the factors affecting impact of research. Application of the IREM to the College of Medicine, King Saud University (CMKSU) for research evaluation from 2003 to 2013 revealed that during this duration, 1722 studies were published, the highest in 2013 (n =314) and 85.5% (n =1472) in indexed journals (p <0.001). The mean IF was 2.6, mean AIS 1.16, and mean CPP 10.06. IF was positively associated with duration, indexation, CPP, and subject being human genetics at multivariable linear regression. The IREM is an applicable basic tool for institutional research evaluation which can guide the research policy.

      PubDate: 2016-05-12T07:30:40Z
      DOI: 10.1016/j.jegh.2016.03.002
  • Factors associated with the farmer suicide crisis in India

    • Authors: Dominic Merriott
      Abstract: Publication date: Available online 11 April 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): Dominic Merriott
      Background In India, it is estimated that ∼16,000 farmers die by suicide each year, and at rates far above those of the general population. This paper reviews much of the literature concerning the factors associated with this crisis. Methods A literature search was undertaken from multiple databases on Ovid, as well as more elementary searches of Google, Google Scholar, and PubMed. This paper presents a review of the key results. Results Socioeconomic factors, rather than mental health problems, are associated with farmer suicides, with increased indebtedness playing the predominant role. Available research suggests this has arisen to a greater extent recently, due to an agrarian crisis affecting the most vulnerable farmers. This has multiple manifestations, including a lack of agricultural investment and irrigation improvement, use of cash crops, the increased use of noninstitutional credit sources, and the reduction of trade barriers. Bt cotton is unlikely to be an important factor and no studies reported a significant burden of mental health problems. Conclusion Indebtedness and numerous factors relating to this are clearly identified as the most important risk factors. Further large-scale assessments are required to further understand the situation.

      PubDate: 2016-05-12T07:30:40Z
      DOI: 10.1016/j.jegh.2016.03.003
  • Disaster response under One Health in the aftermath of Nepal earthquake,

    • Authors: G.V. Asokan; A. Vanitha
      Abstract: Publication date: Available online 5 April 2016
      Source:Journal of Epidemiology and Global Health
      Author(s): G.V. Asokan, A. Vanitha
      Until now, an estimate quotes that 1100 healthcare facilities were damaged and over 100,000 livestock lost in the two earthquakes that occurred in April and May of 2015 in Nepal. Threats of infectious diseases, mostly zoonoses, could affect Nepal’s economy, trade, and tourism, and reaching the targets of the United Nations Millennium Development Goals. Historically, outbreaks of infectious diseases, including zoonoses, were largely associated with the aftereffects of the earthquakes. It has been documented that zoonoses constitute 61% of all known infectious diseases. Therefore, the purpose of this communication was to examine the infectious disease outbreaks after earthquakes around the world and explore the risk assessment of the zoonoses threats reported in Nepal and highlight adopting One Health. Our summaries on reported zoonoses in Nepal have shown that parasitic zoonoses were predominant, but other infectious disease outbreaks can occur. The fragile public health infrastructure and inadequately trained public health personnel can accelerate the transmission of infections, mostly zoonoses, in the post impact phase of the earthquake in Nepal. Therefore, we believe that with the support of aid agencies, veterinarians and health professionals can team up to resolve the crisis under One Health.

      PubDate: 2016-04-07T19:35:53Z
      DOI: 10.1016/j.jegh.2016.03.001
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