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Journal Cover   Journal of Epidemiology and Global Health
  [SJR: 0.142]   [H-I: 2]   [9 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2210-6006
   Published by Elsevier Homepage  [2588 journals]
  • Analyzing seasonality of tuberculosis across Indian states and union
           territories
    • Abstract: Publication date: Available online 18 March 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Pankaj Narula , Praveer Sihota , Sarita Azad , Pietro Lio
      A significant seasonal variation in tuberculosis (TB) is observed in north India during 2006–2011, particularly in states like Himachal Pradesh, Haryana and Rajasthan. To quantify the seasonal variation, we measure average amplitude (peak to trough distance) across seasons in smear positive cases of TB and observe that it is maximum for Himachal Pradesh (40.01%) and minimum for Maharashtra (3.87%). In north India, smear positive cases peak in second quarter (April–June) and reach a trough in fourth quarter (October–December), however low seasonal variation is observed in southern region of the country. The significant correlations as 0.64 (p-value<0.001), 0.54 (p-value<0.01) and 0.42 (p-value<0.05) are observed between minimum temperature and seasonality of TB at lag-1 in north, central and northeast India respectively. However, in south India, this correlation is not significant.


      PubDate: 2015-03-18T17:52:25Z
       
  • Hypertension in the Lebanese adults: Impact on health related quality of
           life
    • Abstract: Publication date: Available online 12 March 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Malak Khalife , Pascale Salameh , Amal Al Hajje , Sanaa Awada , Samar Rachidi , Wafa Bawab
      Cardiovascular disease is a major cause of morbidity and mortality worldwide, hypertension being one of their most prevalent risk factors. Information on health related quality of life (QOL) of hypertensive individuals in Lebanon is lacking. Our objectives were to evaluate QOL of hypertensive patients compared with non-hypertensive subjects and to suggest possible predictors of QOL in Lebanon. We conducted a case control study among individuals visiting outpatient clinics. Quality of life was assessed using the eight item (SF-8) questionnaire administered face to face to the study population, applied to hypertensive (N =224) and non-hypertensive control (N =448) groups. Hypertensive patients presented lower QOL scores in all domains, particularly in case of high administration frequency and occurrence of drug related side effects. Among hypertensive patients, QOL was significantly decreased with the presence of comorbidities (β =−13.865, p =0.054), daily frequency of antihypertensive medications (β =−8.196, p <0.001), presence of drug side-effects (β =−19.262, p =0.031), older age (β =−0.548, p <0.001), female gender (β =−21.363, p =0.05), lower education (β =−22.949, p =0.006), and cigarettes smoked daily (β =−0.726, p <0.001); regular sport activity (β =23.15, p <0.001) significantly increased quality of life. These findings indicate the necessity for health professionals to take these factors into account when treating hypertensive patients, and to tackle special subgroups with attention to their deteriorated QOL.


      PubDate: 2015-03-14T17:34:56Z
       
  • Association between worldwide dietary and lifestyle patterns with total
           cholesterol concentrations and DALYs for infectious andw cardiovascular
           diseases: An ecological analysis
    • Abstract: Publication date: Available online 5 March 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): C. Oggioni , H. Cena , J.C.K. Wells , J. Lara , C. Celis-Morales , M. Siervo
      Global dietary and lifestyle trends are primary risk factors for communicable and non-communicable diseases. An ecological analysis was conducted to examine the association of global dietary and lifestyle patterns with total cholesterol concentrations. This study also investigated whether total cholesterol modified the association between dietary and lifestyle habits with disability-adjusted-life-years-lost (DALYs) for infectious and cardiovascular diseases (CVDs). Country-specific mean total cholesterol concentrations and DALYs for infectious and CVDs were obtained. Data were then matched to country-specific food and energy availability for consumption and information on obesity, physical inactivity, urbanization, gross domestic product (GDP), life expectancy and smoking. Stepwise multiple regression models were developed to identify significant predictors of total cholesterol concentrations and DALYs for infectious and CVDs. Life expectancy and egg and meat consumption were significantly associated with cholesterol concentrations. DALYs for infectious diseases were associated with smoking, life expectancy and per capita GDP. Smoking was the only predictor of DALYs for CVDs. The improvement of socio-demographic conditions and economic growth is likely to reduce the burden of communicable diseases in developing countries. A concurring increase in non-communicable diseases is expected, and these results have, yet again, identified smoking as a primary risk factor for CVDs.


      PubDate: 2015-03-09T16:10:41Z
       
  • Leveraging “big data” to enhance the effectiveness of
           “one health” in an era of health informatics
    • Abstract: Publication date: Available online 5 March 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): G.V. Asokan , Vanitha Asokan
      Zoonoses constitute 61% of all known infectious diseases. The major obstacles to control zoonoses include insensitive systems and unreliable data. Intelligent handling of the cost effective big data can accomplish the goals of one health to detect disease trends, outbreaks, pathogens and causes of emergence in human and animals.


      PubDate: 2015-03-09T16:10:41Z
       
  • Fall-related injuries in a low-income setting: Results from a pilot injury
           surveillance system in Rawalpindi, Pakistan
    • Abstract: Publication date: Available online 25 February 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Junaid A. Bhatti , Umar Farooq , Mudassir Majeed , Jahangir S. Khan , Junaid A. Razzak , Muhammad M. Khan
      This study assessed the characteristics and emergency care outcomes of fall-related injuries in Pakistan. This study included all fall-related injury cases presenting to emergency departments (EDs) of the three teaching hospitals in Rawalpindi city from July 2007 to June 2008. Out of 62,530 injury cases, 43.4% (N =27,109) were due to falls. Children (0–15years) accounted for about two out of five of all fall-related injuries. Compared with women aged 16–45years, more men of the same age group presented with fall-related injuries (50% vs. 42%); however, compared with men aged 45years or more, about twice as many women of the same age group presented with fall-related injuries (16% vs. 9%, P <0.001). For each reported death due to falls (n =57), 43 more were admitted (n =2443, 9%), and another 423 were discharged from the EDs (n =24,142, 91%). Factors associated with death or inpatient admission were: aged 0–15years (adjusted odds ratio [aOR]=1.35), aged 45years or more (aOR=1.94), male gender (aOR=1.15), falls occurring at home (aOR=3.38), in markets (aOR=1.43), on work sites (aOR=4.80), and during playing activities (aOR=1.68). This ED-based surveillance study indicated that fall prevention interventions in Pakistan should target children, older adult women, homes, and work sites.


      PubDate: 2015-02-28T15:15:40Z
       
  • Prospective study of predictors of poor self-rated health in a 23-year
           cohort of earthquake survivors in Armenia
    • Abstract: Publication date: Available online 13 February 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Anahit Demirchyan , Varduhi Petrosyan , Haroutune K. Armenian , Vahe Khachadourian
      Long-term prospective studies exploring general health outcomes among disaster survivors are rare. Self-rated health (SRH) – a proven correlate of morbidity and mortality prognosis – was used to investigate predictors of perceived health status among a 23-year cohort of survivors of 1988 Spitak earthquake in Armenia. A geographically-stratified subsample of 725 adults from a larger initial cohort was followed during the period of 1990–2012. A logistic regression model identified predictors of SRH. Adjusted relative risks for the long-term predictors of SRH were calculated. The rate of poor SRH among the survivors was 18.8%, fair 56.5%, and good/excellent 24.7%. In the fitted model, long-term risk factors of poor SRH included baseline body mass index, baseline multi-morbidity, number of experienced stressful life events, and perceived poor living standards during the post-earthquake decade, while participation in sports in the early 1990s was a protective factor. Short-term protective factors included socio-economic status score, social support, employment and dignity, while current household size was a risk factor for poor SRH. No association was found between earthquake exposure severity and SRH after 23years. However, the identified predictors included a number of modifiable lifestyle, material and psychological factors. Thus, interventions targeting these factors could have a long-lasting impact on disaster victims’ health status.


      PubDate: 2015-02-23T14:34:38Z
       
  • Study of drug resistance in pulmonary tuberculosis cases in south coastal
           Karnataka
    • Abstract: Publication date: Available online 14 February 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Parashuram Rao , Kiran Chawla , Vishnu Prasad Shenoy , Chiranjay Mukhopadhyay , Vishwanath Brahmavar , Asha Kamath , Aswini Kumar Mohapatra
      The present cross-sectional study was conducted the first time from the Udupi district of coastal Karnataka to know the prevalence of drug resistance and comparative analysis of MDR and non-MDR cases of pulmonary tuberculosis. Details of 862 smear positive cases of pulmonary tuberculosis with age ⩾15years from 12 designated microscopy centres of the Udupi district were studied. Initially 2 sputum samples trailed by one follow-up sample were collected from each patient and processed for culture and drug sensitivity on the Lowenstein–Jensen medium. A total resistance of 33.4% was observed that includes the mono-resistance of 22.5%, multidrug resistance (MDR) of 6.3% and extensive drug resistance (XDR) of 0.3%. Significant odds ratio (OR) was observed in category 2 cases (OR 3.9) for the development of MDR tuberculosis. A significant statistical association was observed using Fisher’s exact test while comparing mortality rate (19.3% vs. 1.8%), treatment failure (8.8% vs. 3.8%) and cure rate (68.4% vs. 85.4%) between MDR and non-MDR cases (p <0.001). Category 2 patients are important risk factors for the development of MDR in pulmonary tuberculosis. Due to the high mortality and low cure rate in MDR cases it is imperative to know the drug sensitivity report before institution of anti-tubercular treatment.


      PubDate: 2015-02-23T14:34:38Z
       
  • Barriers related to non-adherence in a mammography breast-screening
           program during the implementation period in the interior of São Paulo
           State, Brazil
    • Abstract: Publication date: Available online 7 February 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): René Aloisio da Costa Vieira , Tânia Silveira Lourenço , Edmundo Carvalho Mauad , Valter Gonçalves Moreira Filho , Stela Verzinhasse Peres , Thiago Buosi Silva , Maria do Rosário Dias de Oliveira Lattore
      Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40–69years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn’t done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.


      PubDate: 2015-02-23T14:34:38Z
       
  • Foot ailments during Hajj: A short report
    • Abstract: Publication date: Available online 7 February 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Shruti Sridhar , Samir Benkouiten , Khadidja Belhouchat , Tassadit Drali , Ziad A. Memish , Philippe Parola , Philippe Brouqui , Philippe Gautret
      A study of ailments of the feet in pilgrims of Hajj revealed that 31% of them suffered from blisters, and the prevalence was five times higher in females. The presence of comorbidity (diabetes, obesity and advanced age) warrants immediate attention to them to avoid serious complications.


      PubDate: 2015-02-23T14:34:38Z
       
  • Prevalence and correlates of tobacco use among school-going adolescents in
           Madagascar
    • Abstract: Publication date: Available online 30 January 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Sreenivas P. Veeranki , Hadii M. Mamudu , Rijo M. John , Ahmed E.O. Ouma
      Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents’ tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13–15years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors. Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females’ tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents’ tobacco use.


      PubDate: 2015-02-05T04:03:43Z
       
  • Global tuberculosis control requires greater ambition and resources
    • Abstract: Publication date: Available online 2 February 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Madhukar Pai , Ziad A. Memish



      PubDate: 2015-02-05T04:03:43Z
       
  • Smoking motivators are different among cigarette and waterpipe smokers:
           The results of ITUPP
    • Abstract: Publication date: Available online 30 January 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Hamidreza Roohafza , Kamal Heidari , Tahereh Alinia , Razieh Omidi , Masoumeh Sadeghi , Elham Andalib , Ali Ajami , Nizal Sarrafzadegan
      The present study explores different drivers of cigarette and water pipe smoking among middle and high school students in Isfahan province. A questionnaire-based cross-sectional study was conducted. Trained staff collected questionnaires and saliva samples for response accuracy evaluation. Prevalence by demographic, parental and educational factors was calculated. Logistic regression was applied to compare behavior drivers of those who purely smoked cigarettes or a waterpipe. Waterpipe smokers were considered as the reference category. This study reported ORs along 95% confidence intervals; 5408 questionnaires were returned. The sample age was 15.37±01.70 on average. The self-reported prevalence of cigarette and waterpipe experimentation was 11.60% (n =624) and 20.70% (n =1,109), respectively; and 5.08% (n =311), 11.06% (n =619) for smokers, and 13.30% (n =711) for the whole sample. Psychological factors were the most important driver for cigarette smoking; bad event happening with odds of 2.38 (95% CI: 1.29–4.39); angriness 2.58 times (95% CI: 1.51–4.43); and distress by 2.49 times (95% CI: 1.42–4.40). Habitual situations were strong predictors of cigarette smoking, but not a predictor of waterpipe smoking, such as smoking after a meal (OR =3.11, 95% CI: 1.67–5.77); and smoking after waking up (OR =2.56, 95% CI: 1.42–4.40). Comprehensive and multifaceted preventive programs must tailor identified factors and increase family’s awareness.


      PubDate: 2015-02-05T04:03:43Z
       
  • Volunteering to improve health worldwide. Current trends in Out of
           Programme Experience/Training in the UK 2014
    • Abstract: Publication date: Available online 27 January 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): T. Bharucha , A. Traianou , M. Keniger , G. Chisholm , G. Lewis , J. Roland , M. Stark , C.S. Brown



      PubDate: 2015-01-29T15:17:24Z
       
  • Symptom clusters on primary care medical service trips in five regions in
           Latin America
    • Abstract: Publication date: Available online 29 January 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Christopher Dainton , Charlene Chu
      Short-term primary care medical service trips organized by the North American non-governmental organizations (NGOs) serve many communities in Latin America that are poorly served by the national health system. This descriptive study contributes to the understanding of the epidemiology of patients seen on such low-resource trips. An analysis was conducted on epidemiologic data collected from anonymized electronic medical records on patients seen during 34 short-term medical service trips in five regions in Ecuador, Guatemala, and the Dominican Republic between April 2013 and April 2014. A total of 22,977 patients were assessed by North American clinicians (physicians, nurse practitioners, physician assistants) on primary care, low-resource medical service trips. The majority of patients were female (67.1%), and their average age was 36. The most common presenting symptoms in all regions were general pain, upper respiratory tract symptoms, skin disorders, eye irritation, dyspepsia, and nonspecific abdominal complaints; 71–78% of primary care complaints were easily aggregated into well-defined symptom clusters. The results suggest that guideline development for clinicians involved in these types of medical service trips should focus on management of the high-yield symptom clusters described by these data.


      PubDate: 2015-01-29T15:17:24Z
       
  • Counselling services in prevention of mother-to-child transmission (PMTCT)
           in Delhi, India: An assessment through a modified version of UNICEF-PPTCT
           tool
    • Abstract: Publication date: Available online 16 January 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Arvind Kumar , Bir Singh , Yadlapalli S. Kusuma
      The study aims to assess the counselling services provided to prevent mother to child transmission of HIV (PMTCT) under the Indian programme of prevention of parent-to-child transmission of HIV (PPTCT). Five hospitals in Delhi providing PMTCT services were randomly selected. A total of 201 post-test counselled women were interviewed using a modified version of the UNICEF-PPTCT evaluation tool. Knowledge about HIV transmission from mother-to-child was low. Post-test counselling mainly helped in increasing the knowledge of HIV transmission; yet 20%–30% of the clients missed this opportunity. Discussion on window period, other sexually transmitted diseases and danger signs of pregnancy were grossly neglected. The PMTCT services during the antenatal period are feasible and agreeable to be provided; however, certain aspects, like lack of privacy, confidentiality of HIV status of the client, counsellor’s ‘hurried’ attitude, communication skills and discriminant behaviour towards HIV-positive clients, and disinterest of clients in the counselling, remain as gaps. These issues may be addressed through refresher training to counsellors with an emphasis on social and behaviour change communication strategies. Addressing attitudinal aspects of the counsellors towards HIV positives is crucial to improve the quality of the services to prevent mother-to-child transmission of HIV.


      PubDate: 2015-01-21T14:05:48Z
       
  • Estimating the potential impact fraction of hypertension as the main risk
           factor of stroke: Application of the distribution shift method
    • Abstract: Publication date: Available online 20 January 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Azam Biderafsh , Manoochehr Karami , Javad Faradmal , Jalal Poorolajal
      Few published studies have assessed the impact of quantitative risk factors such as high blood pressure on stroke. The aim of this study was to quantify the potential impact fraction (PIF) of hypertension on stroke in Hamadan Province, western Iran. Avoidable burden of stroke associated with high blood pressure was calculated using distribution shift at different scenarios. Data on the prevalence of high blood pressure among residents of Hamadan province older than 19years were extracted from non-communicable diseases risk factors surveillance system in 2009. Five mmHg hypothetical reduction in systolic blood pressure above 140mmHg, leads to 3.5% (PIF=0.035) reduction in the total burden to stroke. This value may reach 7%, if systolic blood pressure decreases 10mmHg. In addition, 5mmHg hypothetical reduction in diastolic blood pressure above 82mmHg, leads to 4.87% reduction in the total burden to stroke. PIF more than 10mmHg modification on distribution of diastolic blood pressure was estimated as 9.38%. According to these findings, policy makers are advised to implement interventions on hypertension based on the distribution shift method rather than the proportion shift one.


      PubDate: 2015-01-21T14:05:48Z
       
  • Spatial and non-spatial determinants of successful tuberculosis treatment
           outcomes: An implication of Geographical Information Systems in health
           policy-making in a developing country
    • Abstract: Publication date: Available online 12 January 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Goodarz Kolifarhood , Davoud Khorasani-Zavareh , Shaker Salarilak , Alireza Shoghli , Nasim Khosravi
      This retrospective study aimed to address whether or to what extent spatial and non-spatial factors with a focus on a healthcare delivery system would influence successful tuberculosis (TB) treatment outcomes in Urmia, Iran. In this cross-sectional study, data of 452 new TB cases were extracted from Urmia TB Management Center during a 5-year period. Using the Geographical Information System (GIS), health centers and study subjects’ locations were geocoded on digital maps. To identify the statistically significant geographical clusters, Average Nearest Neighbor (ANN) index was used. Logistic regression analysis was employed to determine the association of spatial and non-spatial variables on the occurrence of adverse treatment outcomes. The spatial clusters of TB cases were concentrated in older, impoverished and outskirts areas. Although there was a tendency toward higher odds of adverse treatment outcomes among urban TB cases, this finding after adjusting for distance from a given TB healthcare center did not reach statistically significant. This article highlights effects of spatial and non-spatial determinants on the TB adverse treatment outcomes, particularly in what way the policies of healthcare services are made. Accordingly, non-spatial determinants in terms of low socio-economic factors need more attention by public health policy makers, and then more focus should be placed on the health delivery system, in particular men’s health.


      PubDate: 2015-01-16T13:48:52Z
       
  • Investigation of an outbreak of bloody diarrhea complicated with hemolytic
           uremic syndrome
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Otar Chokoshvili , Khatuna Lomashvili , Naile Malakmadze , Marika Geleishvil , Jonas Brant , Paata Imnadze , Nazibrola Chitadze , Lia Tevzadze , Gvantsa Chanturia , Tea Tevdoradze , Tengiz Tsertsvadze , Deborah Talkington , Rajal K Mody , Nancy Strockbine , Russell A Gerber , Edmond Maes , Thomas Rush
      In July–August 2009, eight patients with bloody diarrhea complicated by hemolytic uremic syndrome (HUS) were admitted to hospitals in Tbilisi, Georgia. We started active surveillance in two regions for bloody diarrhea and post-diarrheal HUS. Of 25 case-patients who developed HUS, including the initial 8 cases, half were ⩾15years old, 67% were female and seven (28%) died. No common exposures were identified. Among 20 HUS case-patients tested, Shiga toxin was detected in the stools of 2 patients (one with elevated serum IgG titers to several Escherichia coli serogroups, including O111 and O104). Among 56 persons with only bloody diarrhea, we isolated Shiga toxin-producing E. coli (STEC) O104:H4 from 2 and Shigella from 10; 2 had serologic evidence of E. coli O26 infection. These cases may indicate a previously unrecognized burden of HUS in Georgia. We recommend national reporting of HUS and improving STEC detection capacity.


      PubDate: 2014-12-14T12:53:55Z
       
  • Evaluation of physical fitness and weight status among fisherwomen in
           relation to their occupational workload
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Pallav Sengupta , Elzbieta Krajewska-Kulak
      Background Fisherwomen contribute significantly to the coastal economy of Eastern India; however, data about their physical fitness and weight status are scant. Objectives The present cross-sectional study was designed to investigate cardiorespiratory fitness and weight status of fisherwomen, which may be influenced by their occupational workload, using morphometric and anthropometric measures. Methods The study was conducted among young fisherwomen (mean age 23.7years) randomly selected from Araku, Visakhapatnam, Andhra Pradesh, and among young women who are not engaged in the fishing industry but are residents of Araku, who served as controls (mean age 21.3years). Measurements of body composition included several anthropometric variables, while physical efficiency parameters included a physical fitness index (PFI), VO2max, total energy expenditure, and anaerobic capacity. Results A significant difference (p <0.05) in body mass index (BMI), body surface area (BSA), body fat percentage, diastolic blood pressure, fitness index, total energy expenditure, and anaerobic power was found in fisherwomen compared with controls. Analysis of collected data showed that the majority of the fisherwomen studied have a normal range of BMI (42%), but 6% of them were found to be mildly overweight. They also showed lower fat mass (13.5 [±3.87]kg) and lower waist-to-hip ratio (WHR) and conicity index. Additionally, they were found to have a moderate level of physical fitness (64.3 [±1.97]%) and a higher total energy expenditure (4.92 [±0.52]k.cal.min−2). Conclusion This study implies that physical fitness and weight status of young fisherwomen in Eastern India are influenced by their occupational workload.


      PubDate: 2014-12-14T12:53:55Z
       
  • Knowledge about tobacco smoking among medical students in Saudi Arabia:
           Findings from three medical schools
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Hoda Jradi , Ali Al-Shehri
      Introduction Tobacco smoking is the leading cause of preventable death worldwide. Educating and training medical students about tobacco dependence prevention and treatment will prepare them for the task of helping smokers quit. In Saudi Arabia, little is known about medical students’ knowledge on this topic. Methods This study was conducted among 237 medical students (89% response rate) from three medical schools in Saudi Arabia. Students were asked to complete a 55-item questionnaire about the knowledge of smoking epidemiology, smoking cessation practice and benefits, and treatment of tobacco dependence. Results The majority of the students (91.4%) do not have adequate knowledge about the epidemiology of smoking. Students demonstrated a low knowledge of the health risks associated with tobacco use (average score 53%; SD=11.6), a fair understanding of the benefits of smoking cessation, and insufficient information about treatment of tobacco dependence. Respondents thought they were adequately prepared to counsel their patients to quit smoking. Conclusions Medical students in Saudi Arabia are not well informed and trained in tobacco dependence and treatment. It is necessary to address this deficit by prioritizing these topics in medical education curricula.


      PubDate: 2014-12-14T12:53:55Z
       
  • Change in the structures, dynamics and disease-related mortality rates of
           the population of Qatari nationals: 2007–2011
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Mohamed H. Al-Thani , Eman Sadoun , Al-Anoud Al-Thani , Shamseldin A. Khalifa , Suzan Sayegh , Alaa Badawi
      Background Developing effective public health policies and strategies for interventions necessitates an assessment of the structure, dynamics, disease rates and causes of death in a population. Lately, Qatar has undertaken development resurgence in health and economy that resulted in improving the standard of health services and health status of the entire Qatari population (i.e., Qatari nationals and non-Qatari residents). No study has attempted to evaluate the population structure/dynamics and recent changes in disease-related mortality rates among Qatari nationals. Objective The present study examines the population structure/dynamics and the related changes in the cause-specific mortality rates and disease prevalence in the Qatari nationals. Methods This is a retrospective, analytic descriptive analysis covering a period of 5years (2007–2011) and utilizes a range of data sources from the State of Qatar including the population structure, disease-related mortality rates, and the prevalence of a range of chronic and infectious diseases. Factors reflecting population dynamics such as crude death (CDR), crude birth (CBR), total fertility (TFR) and infant mortality (IMR) rates were also calculated. Results The Qatari nationals is an expansive population with an annual growth rate of ∼4% and a stable male:female ratio. The CDR declined by 15% within the study period, whereas the CBR was almost stable. The total disease-specific death rate, however, was decreased among the Qatari nationals by 23% due to the decline in mortality rates attributed to diseases of the blood and immune system (43%), nervous system (44%) and cardiovascular system (41%). There was a high prevalence of a range of chronic diseases, whereas very low frequencies of the infectious diseases within the study population. Conclusion Public health strategies, approaches and programs developed to reduce disease burden and the related death, should be tailored to target the population of Qatari nationals which exhibits characteristics that vary from the entire Qatari population.


      PubDate: 2014-12-14T12:53:55Z
       
  • Prevalence and determinants of electrocardiographic abnormalities in
           African Americans with type 2 diabetes
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Matthew B. Sellers , Jasmin Divers , Lingyi Lu , Jianzhao Xu , S. Carrie Smith , Donald W. Bowden , David Herrington , Barry I. Freedman , Elsayed Z. Soliman
      Background Electrocardiographic (ECG) abnormalities are independently associated with poor outcomes in the general population. Their prevalence and determinants were assessed in the understudied African American population with type 2 diabetes. Methods Standard 12-lead ECGs were digitally recorded in 635 unrelated African American-Diabetes Heart Study (AA-DHS) participants, automatically processed at a central lab, read, and coded using standard Minnesota ECG Classification. Age- and sex-specific prevalence rates of ECG abnormalities were calculated and logistic regression models were fitted to examine cross-sectional associations between participant characteristics and ECG abnormalities. Results Participants were 56% women with a mean age of 56years; 60% had at least one minor or major ECG abnormality [23% ⩾1 major (or major plus minor), and 37% ⩾1 minor (with no major)]. Men had a higher prevalence of ⩾1 minor or major ECG abnormality (66.1% men vs. 55.6% women, p =0.0089). In univariate analysis, age, past history of cardiovascular disease, diabetes duration, systolic blood pressure, sex and statin use were associated with the presence of any (major or minor) ECG abnormalities. In a multivariate model including variables, female sex (OR [95% CI] 0.79 [0.67, 0.93]), statin use (0.79 [0.67, 0.93]) and diabetes duration (1.03 [1.0, 1.05]) remained statistically significant. Conclusions Nearly three out of five African Americans with diabetes had at least one ECG abnormality. Female sex and statin use were significantly associated with lower odds of any ECG abnormality and diabetes duration was significantly associated with higher odds of any ECG abnormality in the multivariable model.


      PubDate: 2014-12-14T12:53:55Z
       
  • Validation of the Arabic version of the Epworth Sleepiness Scale
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Anwar E. Ahmed , Abdulhamid Fatani , Abdullah Al-Harbi , Abdullah Al-Shimemeri , Yosra Z. Ali , Salim Baharoon , Hamdan Al-Jahdali
      Background The Epworth Sleepiness Scale (ESS) is a questionnaire widely used in developed countries to measure daytime sleepiness and diagnose sleep disorders. Objective This study aimed to develop an ESS questionnaire for the Arabic population (ArESS), to determine ArESS internal consistency, and to measure ArESS test–retest reproducibility. It also investigated whether the normal range of ESS scores of healthy people in different cultures are similar. Methods The original ESS questionnaire was translated from English to Arabic and back-translated to English. In both the English and Arabic translations of the survey, ESS consists of eight different situations. The subject was asked to rate the chance of dozing in each situation on a scale of 0–3 with total scores ranging between 0 (normal sleep) and 24 (very sleepy). An Arabic translation of the ESS questionnaire was administered to 90 healthy subjects. Results Item analysis revealed high internal consistency within ArESS questionnaire (Cronbach’s alpha=0.86 in the initial test, and 0.89 in the retest). The test–retest intra-class correlation coefficient (ICC) shows that the test–retest reliability was substantially high: ICC=0.86 (95% confidence interval: 0.789–0.909, p-value<0.001). The difference in ArESS scores between the initial test and retest was not significantly different from zero (average difference=−0.19, t =−0.51, df=89, p-value=0.611). In this study, the averages of the ESS scores (6.3±4.7, range 0–20 in the initial test and 6.5±5.3, range 0–20 in the retest) are considered high in Western cultures. Conclusions The study shows that the ArESS is a valid and reliable tool that can be used in Arabic-speaking populations to measure daytime sleepiness. The current study has shown that the average ESS score of healthy Arabian subjects is significantly higher than in Western cultures.


      PubDate: 2014-12-14T12:53:55Z
       
  • Awareness of pro-tobacco advertising and promotion and beliefs about
           tobacco use: Findings from the Tobacco Control Policy (TCP) India Pilot
           Survey
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Maansi Bansal-Travers , Geoffrey T. Fong , Anne C.K. Quah , Genevieve Sansone , Mangesh S. Pednekar , Prakash C. Gupta , Dhirendra N. Sinha
      Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n =562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (p <0.01). The findings from this study reiterate the need for stronger legislation and strict enforcement of bans on direct and indirect advertising and promotion of tobacco products in India.


      PubDate: 2014-12-14T12:53:55Z
       
  • Changes in hand hygiene compliance after a multimodal intervention among
           health-care workers from intensive care units in Southwestern Saudi Arabia
           
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Ahmed A. Mahfouz , Ibrahim A. Al-Zaydani , Ali O. Abdelaziz , Mohammad N. El-Gamal , Abdullah M. Assiri
      The aim of this study is to measure the degree of compliance with hand hygiene practices among health-care workers (HCWs) in intensive care facilities in Aseer Central Hospital, Abha, Saudi Arabia, before and after a multimodal intervention program based on WHO strategies. Data were collected by direct observation of HCWs while delivering routine care using standardized WHO method: “Five moments for hand hygiene approach”. Observations were conducted before (February–April 2011) and after (February–April 2013) the intervention by well-trained, infection-control practitioners during their routine visits. The study included 1182 opportunities (observations) collected before and 2212 opportunities collected after the intervention. The overall, hand hygiene compliance increased significantly from 60.8% (95% CI: 57.9–63.6%) before the intervention to reach 86.4% (95% CI: 84.9–97.8%) post-intervention (P =0.001). The same trend was observed in different intensive care facilities. In logistic regression analyses, HCWs were significantly more compliant (aOR=3.2, 95% CI: 2.6–3.8) after the intervention. Similarly, being a nurse and events after patient contact were significant determinants of compliance. It is important to provide sustained intensified training programs to help embed efficient and effective hand hygiene into all elements of care delivery. New approaches like accountability, motivation and sanctions are needed.


      PubDate: 2014-12-14T12:53:55Z
       
  • Use of footwear and foot condition among rural Ethiopian school children
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Emi Watanabe , Colleen M. McBride , Abebayehu Tora , Desta A. Ayode , David Farrell , Gail Davey
      Objective To evaluate whether shoe-wearing affords foot protection among school children living in southern Ethiopia. Methods Data collectors conducted a standardized foot assessment with children in an elementary school in southern Ethiopia (N =168). Results 54% reported wearing shoes consistently in the prior three days. Children wearing closed-toed shoes showed less adherent soil and toe nail dystrophy than those wearing open-toed sandals. There were no differences by shoe type with regard to signs of foot trauma or heel fissures. Conclusions Shoe wearing provided limited foot protection. Interventions are needed to build behavioral skills, including foot washing and wearing appropriate shoes that maximize foot protection.


      PubDate: 2014-12-14T12:53:55Z
       
  • Socioeconomic status and obesity: Causality of the association
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Tomoyuki Kawada



      PubDate: 2014-12-14T12:53:55Z
       
  • Corrigendum to “Neonatal mortality in Nepal: A multilevel analysis
           of a nationally representative” [J. Epidemiol. Global Health 4
           (2014) 213–222]
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Subas Neupane , David Teye Doku



      PubDate: 2014-12-14T12:53:55Z
       
  • The Malay version of the brief questionnaire on smoking urge: Translation
           and psychometric properties of the questionnaire
    • Abstract: Publication date: Available online 1 December 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Ali Qais Blebil , Syed Azhar Syed Sulaiman , Mohamed Azmi Hassali , Juman Abdulelah Dujaili , Alfian Mohamed Zin
      This study aimed to evaluate the psychometric properties of Malay translated version of the brief questionnaire of smoking urges (QSU-Brief). The translation procedure was done following the standard guidelines. The reliability and validity of the Malaysian version scale were evaluated based on the data collected from 133 Malaysian smokers. The internal consistency was calculated to assess the reliability. Factor analysis and construct validity were performed to validate psychometric properties of the scale. Total Cronbach’s alpha of the scale was 0.806. The exploratory factor analysis revealed two factors that accounted for 66.15% of the explained total variance. The first component consisted of items 1, 3, 6, 7, and 10, while the second component included the rest. The QSU-Brief total score had a significant positive relationship with exhaled CO level (r =0.24; P =0.005), number of cigarettes smoked per day (r =0.30; P <0.001) and other clinical factors. Items 2 and 5 loaded strongly on factor 2, whereas both items loaded ambivalently on two factors in the previous studies. This discrepancy might be clarified by language differences. The Malaysian QSU-Brief is a good candidate for evaluating urge to smoke in both clinical practice and clinical trials.


      PubDate: 2014-12-14T12:53:55Z
       
  • Evaluation of the certificate in emerging infectious disease research and
           the certificate in one health training programs, University of Florida
    • Abstract: Publication date: Available online 24 November 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Marissa A. Valentine , Christopher L. Perdue , James F. Cummings , Jacqueline C. Smith , Gregory C. Gray
      In developing countries, public health professionals and scientists need targeted training and practical skills to respond to global emerging infectious disease threats. The Certificate in Emerging Infectious Disease Research was developed in 2008 to aid such professionals to respond to complex emerging disease problems. The short-course was modified slightly in 2013 and renamed the Certificate in One Health. To evaluate the immediate impact of the short-course, an online survey of 176 past participants from both the courses was conducted. The survey tool assessed the program’s process, impact, and outcome measures respectively via assessing the courses’ perceived strengths and weaknesses, perceived skills gained, and the participants’ current position, publication status, funding status, and educational attainment; 85 (48.3%) participants completed the survey. Reported program strengths included the curriculum, expertise of lecturers, and diversity of the training cohort. The principal reported weakness was the compressed academic schedule. The most frequently reported benefits included: epidemiological and biostatistical skills, followed by One-Health knowledge, and research skills. Twenty-eight percent of the survey respondents reported publishing one or more manuscripts since completing the course and 21% reported receiving research funding. The course appears to have had a positive, immediate impact on the students’ self-perceived knowledge and capabilities.


      PubDate: 2014-12-14T12:53:55Z
       
  • Global surgery: Integrating an emerging sub-specialty within global health
    • Abstract: Publication date: Available online 17 November 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Rele Ologunde , Isobel Marks



      PubDate: 2014-12-14T12:53:55Z
       
  • Establishing a field epidemiology elective for medical students in Kenya:
           A strategy for increasing public health awareness and workforce capacity
    • Abstract: Publication date: Available online 16 November 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Wences Arvelo , Zeinab Gura , Samuel Amwayi , Petra Wiersma , Jared Omolo , Steven Becknell , Donna Jones , Dismas Ongore , Richard Dicker
      Medical students have limited exposure to field epidemiology, even though will assume public health roles after graduation. We established a 10-week elective in field epidemiology during medical school. Students attended one-week didactic sessions on epidemiology, and nine weeks in field placement sites. We administered pre- and post-tests to evaluate the training. We enrolled 34 students in 2011 and 2012. In 2011, we enrolled five of 24 applicants from a class of 280 medical students. In 2012, we enrolled 18 of 81 applicants from a class of 360 students; plus 11 who participated in the didactic sessions only. Among the 34 students who completed the didactic sessions, 74% were male, and their median age was 24years (range: 22–26). The median pre-test score was 64% (range: 47–88%) and the median post-test score was 82% (range: 72–100%). Successful completion of the field projects was 100%. Six (30%) students were not aware of public health as a career option before this elective, 56% rated the field experience as outstanding, and 100% reported it increased their understanding of epidemiology. Implementing an elective in field epidemiology within the medical training is a highly acceptable strategy to increase awareness for public health among medical students.


      PubDate: 2014-12-14T12:53:55Z
       
  • Incidence of acute-onset atrial fibrillation correlates with air
           temperature. Results of a nine-year survey
    • Abstract: Publication date: Available online 13 November 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Ivan Comelli , Gianfranco Cervellin , Jayme Ferro , Denis Comelli , Elisabetta Sartori , Giuseppe Lippi



      PubDate: 2014-12-14T12:53:55Z
       
  • Acute-onset atrial fibrillation and ambient air temperature: A linear or a
           non-linear association'
    • Abstract: Publication date: Available online 12 November 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Tanvir Chowdhury Turin , Yoshikuni Kita , Nahid Rumana



      PubDate: 2014-12-14T12:53:55Z
       
  • The association between development assistance for health and malaria, HIV
           and tuberculosis mortality: A cross-national analysis
    • Abstract: Publication date: Available online 10 November 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Allan J. Hsiao , Connor A. Emdin
      Development assistance for health (DAH) and foreign aid have been criticized for being poorly associated with health and economic outcomes on a national level. This study is an attempt to examine whether DAH targeted specifically to malaria, HIV and tuberculosis (TB) is associated with changes in malaria, HIV and TB mortality, respectively. A dataset of DAH targeted to malaria, HIV and TB and corresponding malaria-, HIV- and TB-specific mortality was compiled for 120 low- and middle-income countries. Regression analysis was performed using country and time-period fixed effects and control variables. While malaria and HIV DAH were associated with reductions in malaria and HIV mortality, respectively, TB DAH was not significantly associated with reductions in TB mortality. Estimates were consistent in various sensitivity analyses, including generalized method of moments estimation, addition of extra controls and analysis of a multiply imputed dataset. In conclusion, targeted DAH is associated with reduction of HIV and malaria mortality on a national level.


      PubDate: 2014-12-14T12:53:55Z
       
  • Metabolic parameters and blood pressures achieved by diabetic patients at
           two health care facilities in south Trinidad
    • Abstract: Publication date: Available online 27 October 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Ganga Bhagirathee , Rohan G. Maharaj
      Background Previous studies have demonstrated poor metabolic and blood pressure control in the diabetic population in Trinidad. The aim of this study is to compare baseline and follow-up metabolic parameters and blood pressures taken within a 16-month period to ascertain if there have been improvements. Method A retrospective chart review was conducted of diabetic patients at the Siparia and Erin health facilities in 2012. To be eligible, charts had to contain two point-of-care values of HbA1c, Total Cholesterol (TC), Triglycerides (TG), Low Density Lipoproteins (LDL), systolic and diastolic blood pressure (BP), and weight measurements taken within a 16-month period with at least an 8-month interval from the initial to the final testing. Comparisons were made with the Caribbean Health Research Council (CHRC) guidelines to determine clinical significance. Results 253 patients from Siparia and 68 from Erin were studied. At Siparia there was a statistically significant change in TG, LDL and diastolic BP, with TG levels actually worsening (p <0.05). At Erin there was a statistically significant change in HbA1c, LDL and diastolic BP. At neither site did these changes achieve clinical significance. There were statistically significant differences between the means of HbA1c and systolic BP by age, but not by gender or ethnicity. On comparing the outcomes between the two health facilities, there were no statistically significant differences between them. When compared with the recommendations by the CHRC, only for the TC was the guideline level achieved. Conclusion Despite heavy investment in primary care centers, there continues to be little success in achieving metabolic and BP control for diabetic patients in Trinidad.


      PubDate: 2014-12-14T12:53:55Z
       
  • The association between disability and cognitive impairment in an elderly
           Tanzanian population
    • Abstract: Publication date: Available online 23 October 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Catherine L. Dotchin , Stella-Maria Paddick , William K. Gray , Aloyce Kisoli , Golda Orega , Anna R. Longdon , Paul Chaote , Felicity Dewhurst , Matthew Dewhurst , Richard W. Walker
      Cognitive impairment is thought to be a major cause of disability worldwide, though data from sub-Saharan Africa (SSA) are sparse. This study aimed to investigate the association between cognitive impairment and disability in a cohort of community-dwelling older adults living in Tanzania. The study cohort of 296 people aged 70years and over was recruited as part of a dementia prevalence study. Subjects were diagnosed as having dementia or mild cognitive impairment according to the DSM-IV criteria. Disability level was assessed according to the WHO Disability Assessment Schedule, version 2.0 (WHODAS). A higher WHODAS score indicates greater disability. The median WHODAS in the background population was 25.0; in those with dementia and in those with mild cognitive impairment, 72 of 78 (92.3%) and 41 of 46 (89.1%), respectively, had a WHODAS score above this level. The presence of dementia, mild cognitive impairment, hearing impairment, being unable to walk without an aid and not having attended school were independent predictors of having a WHODAS score above 25.0, though age and gender were not. In summary, cognitive impairment is a significant predictor of disability in elderly Tanzanians. Screening for early signs of cognitive decline would allow management strategies to be put in place that may reduce the associated disability burden.


      PubDate: 2014-12-14T12:53:55Z
       
  • Factors associated with incident HIV infection versus prevalent infection
           among youth in Rakai, Uganda
    • Abstract: Publication date: Available online 20 October 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Zoe R. Edelstein , John S. Santelli , Stephane Helleringer , Ashley C. Schuyler , Ying Wei , Sanyukta Mathur , Xiaoyu Song , Tom Lutalo , Fred Nalugoda , Ronald H. Gray , Maria J. Wawer , David M. Serwadda
      Factors associated with prevalent and incident HIV infection were compared among sexually experienced Ugandans aged 15–24. Most factors were similar. However, in women, older age and current marriage were associated with prevalent, but not incident, infection. It is important to recognize the limitations of prevalence analyses for identifying at-risk youth.


      PubDate: 2014-12-14T12:53:55Z
       
  • Does emotion and its daily fluctuation correlate with depression' A
           cross-cultural analysis among six developing countries
    • Abstract: Publication date: Available online 11 October 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Derwin K.C. Chan , Xin Zhang , Helene H. Fung , Martin S. Hagger
      Utilizing a World Health Organization (WHO) multi-national dataset, the present study examined the relationships between emotion, affective variability (i.e., the fluctuation of emotional status), and depression across six developing countries, including China (N =15,050); Ghana (N =5,573); India (N =12,198); Mexico (N =5,448); South Africa (N =4,227); and Russia (N =4,947). Using moderated logistic regression and hierarchical multiple regression, the effects of emotion, affective variability, culture, and their interactions on depression and depressive symptoms were examined when statistically controlling for a number of external factors (i.e., age, gender, marital status, education level, income, smoking, alcohol drinking, physical activity, sedentary behavior, and diet). The results revealed that negative emotion was a statistically significant predictor of depressive symptoms, but the strength of association was smaller in countries with a lower incidence of depression (i.e., China and Ghana). The association between negative affective variability and the risk of depression was higher in India and lower in Ghana. Findings suggested that culture not only was associated with the incidence of depression, but it could also moderate the effects of emotion and affective variability on depression or the experience of depressive symptoms.


      PubDate: 2014-12-14T12:53:55Z
       
  • Anaesthesia, surgery, obstetrics, and emergency care in Guyana
    • Abstract: Publication date: Available online 7 October 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): H.J. Vansell , J.J. Schlesinger , A. Harvey , J.P. Rohde , S. Persaud , K.A. McQueen
      The surgical and anaesthesia needs of low-income countries are mostly unknown due to the lack of data on surgical infrastructure and human resources. The goal of this study is to assess the surgical and anaesthesia capacity in Guyana. A survey tool adapted from the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was used to survey nine regional and district hospitals within the Ministry of Health system in Guyana. In nine hospitals across Guyana, there were an average of 0.7 obstetricians/gynaecologists, 3.5 non-OB surgeons, and 1 anaesthesiologist per hospital. District and regional hospitals performed an annual total of 1520 and 10,340 surgical cases, respectively. All but 2 district hospitals reported the ability to perform surgery. An average hospital has two operating rooms; 6 out of 9 hospitals reported routine medication shortages, and 4 out of 9 hospitals reported routine water or electricity shortages. Amongst the three regional hospitals, 16.1% of pregnancies resulted in Caesarean section. Surgical capacity varies by hospital type, with district hospitals having the least surgical capacity and surgical volume. District level hospitals routinely do not perform surgery due to lack of basic infrastructure and human resources.


      PubDate: 2014-12-14T12:53:55Z
       
  • A cluster-randomised controlled trial to test the efficacy of facemasks in
           preventing respiratory viral infection among Hajj pilgrims
    • Abstract: Publication date: Available online 2 October 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Mandy Wang , Osamah Barasheed , Harunor Rashid , Robert Booy , Haitham El Bashir , Elizabeth Haworth , Iman Ridda , Edward C. Holmes , Dominic E. Dwyer , Jonathan Nguyen-Van-Tam , Ziad A. Memish , Leon Heron
      Background Cost-effective interventions are needed to control the transmission of viral respiratory tract infections (RTIs) in mass gatherings. Facemasks are a promising preventive measure, however, previous studies on the efficacy of facemasks have been inconclusive. This study proposes a large-scale facemask trial during the Hajj pilgrimage in Saudi Arabia and presents this protocol to illustrate its feasibility and to promote both collaboration with other research groups and additional relevant studies. Methods/design A cluster-randomised controlled trial is being conducted to test the efficacy of standard facemasks in preventing symptomatic and proven viral RTIs among pilgrims during the Hajj season in Mina, Mecca, Saudi Arabia. The trial will compare the ‘supervised use of facemasks’ versus ‘standard measures’ among pilgrims over several Hajj seasons. Cluster-randomisation will be done by accommodation tents with a 1:1 ratio. For the intervention tents, free facemasks will be provided to be worn consistently for 7days. Data on flu-like symptoms and mask use will be recorded in diaries. Nasal samples will be collected from symptomatic recruits and tested for nucleic acid of respiratory viruses. Data obtained from questionnaires, diaries and laboratory tests will be analysed to examine whether mask use significantly reduces the frequency of laboratory-confirmed respiratory viral infection and syndromic RTI as primary outcomes. Conclusions This trial will provide valuable evidence on the efficacy of standard facemask use in preventing viral respiratory tract infections at mass gatherings. This study is registered at the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN: ACTRN12613001018707 (http://www.anzctr.org.au).


      PubDate: 2014-12-14T12:53:55Z
       
  • Work productivity among adults with varied Body Mass Index: Results from a
           Canadian population-based survey
    • Abstract: Publication date: Available online 17 September 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Arnaldo Sanchez Bustillos , Kris Gregory Vargas III , Raul Gomero-Cuadra
      Background The relationship between Body Mass Index (BMI) and work productivity, including absenteeism and presenteeism remains unclear. The objective of this study was to examine work productivity among adults with varied BMI using population-based data. Methods Data source was the 2009–2010 Canadian Community Health Survey. The outcomes reflected work absence (absenteeism) and reduced activities at work (presenteeism). The key explanatory variable was BMI in six categories. Logistic regressions were used to measure the association between outcome and explanatory variables adjusting for potential confounders. Results The sample consisted of 56,971 respondents ranging in age from 20 to 69years. Relative to normal BMI, the odds of absenteeism were higher for those in the obesity class III (OR=1.60, 95% CI: 1.39; 1.83). Presenteeism was weakly associated with all obesity categories (OR=1.49, 95% CI: 1.38; 1.61, for obesity class I). Overweight was marginally associated with absenteeism and presenteeism. Underweight was inversely associated with absenteeism. Conclusions This study found that obesity is an independent risk factor for reduced work productivity. Both absenteeism and presenteeism were associated with obesity. However, being overweight was weakly associated with work productivity.


      PubDate: 2014-12-14T12:53:55Z
       
  • Epidemiology, clinical manifestations, and molecular typing of salmonella
           typhi isolated from patients with typhoid fever in Lebanon
    • Abstract: Publication date: Available online 10 September 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Souha S. Kanj , Zeina A. Kanafani , Marwa Shehab , Nisreen Sidani , Tania Baban , Kedak Baltajian , Ghenwa K. Dakdouki , Mohamad Zaatari , George F. Araj , Rima Hanna Wakim , Ghassan Dbaibo , Ghassan M. Matar
      The objective of this study was to examine the epidemiology and the clinical manifestations of typhoid fever as well as the susceptibility and strain relatedness of Salmonella typhi isolates in Lebanon from 2006 to 2007. A total of 120 patients with typhoid fever were initially identified from various areas of the country based on positive culture results for S. typhi from blood, urine, stools, bone marrow and/or positive serology. Clinical, microbiological and molecular analysis was performed on cases with complete data available. These results indicated that drinking water was an unlikely mode of transmission of the infection. Despite increasing reports of antimicrobial resistance among S. typhi isolates, the vast majority of these isolates were susceptible to various antibiotic agents, including ampicillin, cephalosporins, quinolones, and trimethoprim/sulfamethoxazole. Molecular analysis of the isolates revealed a predominance of one single genotype with no variation in distribution across the geographical regions.


      PubDate: 2014-12-14T12:53:55Z
       
  • Lebanese medical students’ intention to deliver smoking cessation
           advice
    • Abstract: Publication date: Available online 6 September 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Hoda Jradi , Mary Ellen Wewers , Phyllis P. Pirie , Philip F. Binkley , Amy K. Ferketich
      Objectives Objectives of this study were to examine the constructs of the Theory of Planned Behavior and determine how they predict Lebanese medical students’ behavioral intention to advise patients to quit smoking. Study design This was a cross-sectional study conducted among 191 medical students from six medical schools in Lebanon. Methods The instrument contained scales that measured attitudes toward the behavior, behavioral beliefs, subjective norms, and perceived behavioral control. Psychometric properties of the scale were examined. Item to total scale score correlations were determined and linear regression was conducted to predict the intention to advise smokers to quit. Results Respondents had a positive, but not very high, intention to deliver smoking cessation advice. Students reported a positive attitude toward advising patients to quit cigarette smoking and a strong belief in the physician’s obligations in smoking cessation advising. The majority reported lack of time to provide smoking cessation advice, insufficient knowledge of pharmacological aids, and the lack of openness of the patient to receive the advice. The attitude scale was the only variable that yielded a significant prediction of the intended behavior. Conclusions The construct of attitude toward the behavior appeared to be the most predictive of the intention to deliver advice to quit smoking among Lebanese medical students. Focusing training efforts on this construct could improve the rate of delivery of brief cessation counseling.


      PubDate: 2014-12-14T12:53:55Z
       
  • Efficacy of prophylactic dexamethasone in prevention of postoperative
           nausea and vomiting
    • Abstract: Publication date: Available online 4 September 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Leila Sekhavat , Robab Davar , Shekoufeh Behdad
      Objective Many trials have been conducted with regard to the relative benefits of prophylactic anti-emetic interventions given alone or in combination, yet the results remain unknown. This study reviewed the efficacy of a single prophylactic dose of dexamethasone on postoperative nausea or vomiting (PONV) after abdominal hysterectomy. Methods In a prospective study of 100 women undergoing total abdominal hysterectomy (TAH) under general anesthesia, the dexamethasone group (n =50) received a single dose (8mg) immediately after the operation, and the saline group (n =50) received a dose of saline as a placebo, in addition to conventional management. The incidence of nausea, vomiting, the need for an anti-emetic and patient satisfaction with the management of PONV were evaluated during the first 24 postoperative hours. Results The overall frequency of nausea during the initial postoperative 24 in the dexamethasone and saline groups were 12% and 18%, respectively, and vomiting was 10% and 16%, respectively (P =0.001). However, there was a lower need for a rescue anti-emetic drugs in the dexamethasone group (18% vs 24%), but it was not statistically significant (P =0.06). Conclusion The results of this study indicate that a single prophylactic dose of dexamethasone after an operation can reduce postoperative nausea and vomiting.


      PubDate: 2014-12-14T12:53:55Z
       
  • Cardiovascular risk factors in semi-urban communities in southwest
           Nigeria: Patterns and prevalence
    • Abstract: Publication date: Available online 2 September 2014
      Source:Journal of Epidemiology and Global Health
      Author(s): Rotimi Oluyombo , Michael A. Olamoyegun , Oluwasegun Olaifa , Sandra O. Iwuala , Oluwole A. Babatunde
      Introduction Over 80% of cardiovascular deaths take place in low- and middle-income countries; most of these deaths are due to modifiable risk factors. The study aimed at estimating the prevalence and pattern of major cardiovascular risk factors in both men and women older than 18years. Methods This is a cross-sectional study of cardiovascular risk factors among semi-urban dwellers in Ekiti State, south-western, Nigeria. 750 participants were drawn from 10 communities. The instrument used was the standard WHO STEPS (II) questionnaire, while blood samples were obtained for analysis. Results There were 750 participants with 529 (70.53%) females. The mean age of participants was 61.7±18.50years and participants’ ⩾65years comprised 38.3%. There were 0.8%, 24.9% and 12.4%, who at the time of this study smoked cigarettes, consumed alcohol, and ate a high salt diet, respectively. The prevalence of hypertension, diabetes, generalized and abdominal obesity was 47.2%, 6.8%, 8.5% and 32.0%, respectively, with only 48.9% receiving hypertension treatment. Elevated total cholesterol, LDL-cholesterol, and low HDL was seen in 4.4%, 16.7% and 56.3% respectively. Conclusion High prevalence of cardiovascular risk factors call for an urgent need for more public health attention and reinforcement of primary preventive strategies to curb its menace.


      PubDate: 2014-12-14T12:53:55Z
       
  • Incidence of acute-onset atrial fibrillation correlates with air
           temperature. Results of a nine-year survey
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Ivan Comelli , Jayme Ferro , Giuseppe Lippi , Denis Comelli , Elisabetta Sartori , Gianfranco Cervellin
      Some diseases, such as renal colic, stroke, and myocardial infarction, correlate with seasonality and microclimatic variations. Although evidence is limited and controversial, a correlation between acute-onset atrial fibrillation (AAF) and seasonality has been previously reported. In order to elucidate the possible correlations between weather and incidence of AAF in a country with a temperate climate, the influence of day-by-day climate changes was analyzed based on the number of visits for AAF (defined as onset of symptoms within 48h) in a large urban Emergency Department (ED) of northern Italy. All the episodes of AAF were retrieved from the hospital’s electronic database during a period of 3287days (January 2002 to December 2010). Only the cases whose onset occurred within 48h from the ED visit were selected. The total number of ED visits was 725,812 throughout the observational period. Among these, 3633 AAF cases were observed, 52% of which were males. A slight but significant negative linear correlation was found between the number of AAFs and the daily temperature (R =−0.60; p =0.001). No correlation was found between the number of AAFs and the daily humidity (R =−0.07; p =0.2).


      PubDate: 2014-12-14T12:53:55Z
       
  • Acceptability of, and willingness to pay for, community health insurance
           in rural India
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Ankit Jain , Selva Swetha , Zeena Johar , Ramesh Raghavan
      Objectives To understand the acceptability of, and willingness to pay for, community health insurance coverage among residents of rural India. Methods We conducted a mixed methods study of 33 respondents located in 8 villages in southern India. Interview domains focused on health-seeking behaviors of the family for primary healthcare, household expenditures on primary healthcare, interest in pre-paid health insurance, and willingness to pay for such a product. Results Most respondents reported that they would seek care only when symptoms were manifest; only 6 respondents recognized the importance of preventative services. None reported impoverishment due to health expenditures. Few viewed health insurance as necessary either because they did not wish to be early adopters, because they had alternate sources of financial support, or because of concerns with the design of insurance coverage or the provider. Those who were interested reported being willing to pay Rs. 1500 ($27) as the modal annual insurance premium. Conclusions Penetration of community health insurance programs in rural India will require education of the consumer base, careful attention to premium rate setting, and deeper understanding of social networks that may act as financial substitutes for health insurance.


      PubDate: 2014-12-14T12:53:55Z
       
  • Coverage of vitamin A supplementation and deworming during Malezi Bora in
           Kenya
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Paloma C. Clohossey , Heather I. Katcher , Geoffrey O. Mogonchi , Nancy Nyagoha , Marissa C. Isidro , Evelyn Kikechi , Edgar E.V. Okoth , Jessica L. Blankenship
      Twice-yearly child health weeks are an effective way of reaching children with essential child survival services in developing countries. In Kenya, child health weeks, or Malezi Bora, were restructured in 2007 from an outreach-based delivery structure to a health facility-based delivery structure to reduce delivery costs and increase sustainability of the events. Administrative data from 2007 to 2011 have demonstrated a decrease in coverage of Malezi Bora services to targeted children. A post-event coverage (PEC) survey was conducted after the May 2012 Malezi Bora to validate coverage of vitamin A supplementation (VAS) and deworming and to inform program strategy. Nine hundred caregivers with children aged 6–59months were interviewed using a randomized, 30×30 cluster design. For each cluster, one facility-based health worker and one community-based health worker were also interviewed. Coverage of VAS was 31.0% among children aged 6–59months and coverage of deworming was 19.6% among children aged 12–59months. Coverage of VAS was significantly higher for children aged 6–11months (45.7%, n =116) than for children aged 12–59months (28.8%, n =772) (p <0.01). Eighty-five percent (51/60) of health workers reported that Malezi Bora was implemented in their area while 23.6% of primary caregivers reported that Malezi Bora occurred in their area. The results of this PEC survey indicate that the existing Malezi Bora programmatic structure needs to be reviewed and reformed to meet WHO guidelines of 80% coverage with VAS.


      PubDate: 2014-12-14T12:53:55Z
       
  • HIV status, knowledge of mother-to-child transmission of HIV and antenatal
           care use among Ethiopian women
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Ida Sahlu , Chanelle J. Howe , Melissa A. Clark , Brandon D.L. Marshall
      Objective To determine whether HIV status and knowledge of mother-to-child-transmission (MTCT) of HIV are associated with antenatal care (ANC) use. Methods Data were obtained from the 2011 Ethiopia Demographic and Health Survey among women aged 15–49years who agreed to HIV testing and who reported giving birth in the preceding five years. The two exposures of interest were HIV status and knowledge of MTCT. Unadjusted and adjusted prevalence ratios for ANC use were estimated by fitting modified Poisson regression models. Results Among the 7392 women in the sample, ANC use was lowest among HIV-negative, low MTCT knowledge women (31.6% [95% confidence interval: 28.1–35.1]), and highest among HIV-positive, high knowledge women (81.9% [69.8–94.0%]). ANC use was significantly higher among HIV-positive, high knowledge (adjusted prevalence ratio [APR]=1.60 [1.32–1.94]) and HIV-negative, high knowledge women (1.37 [1.24–1.51]) compared with HIV-negative, low knowledge women. There was no statistically significant difference in ANC use by HIV status among low knowledge women (1.26 [0.71–2.25]). Conclusions HIV-positive women generally had better MTCT knowledge. Among HIV-negative women, the prevalence of ANC use was greater among women with higher knowledge. Increasing MTCT knowledge may facilitate ANC use and in turn may eliminate MTCT.


      PubDate: 2014-12-14T12:53:55Z
       
 
 
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