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Journal Cover Journal of Epidemiology and Global Health
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2210-6006
   Published by Elsevier Homepage  [3089 journals]
  • Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An
           overview

    • Authors: Abdulellah Alotaibi; Lin Perry; Leila Gholizadeh; Ali Al-Ganmi
      Pages: 211 - 218
      Abstract: Publication date: December 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 4
      Author(s): Abdulellah Alotaibi, Lin Perry, Leila Gholizadeh, Ali Al-Ganmi
      Objective This study aimed to report on the trends in incidence and prevalence rates of diabetes mellitus in Saudi Arabia over the last 25 years (1990–2015). Design A descriptive review. Methods A systematic search was conducted for English-language, peer reviewed publications of any research design via Medline, EBSCO, PubMed and Scopus from 1990 to 2015. Of 106 articles retrieved, after removal of duplicates and quality appraisal, 8 studies were included in the review and synthesised based on study characteristics, design and findings. Findings Studies originated from Saudi Arabia and applied a variety of research designs and tools to diagnosis diabetes. Of the 8 included studies; three reported type 1 diabetes and five on type 2 diabetes. Overall, findings indicated that the incidence and prevalence rate of diabetes is rising particularly among females, older children/adolescent and in urban areas. Conclusion Further development are required to assess the health intervention, polices, guidelines, self-management programs in Saudi Arabia.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.10.001
       
  • Low pre-diagnosis attrition but high pre-treatment attrition among
           patients with MDR-TB: An operational research from Chennai, India

    • Authors: Hemant Deepak Shewade; Dina Nair; Joel S. Klinton; Malik Parmar; J. Lavanya; Lakshmi Murali; Vivek Gupta; Jaya Prasad Tripathy; Soumya Swaminathan; Ajay M.V. Kumar
      Pages: 227 - 233
      Abstract: Publication date: December 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 4
      Author(s): Hemant Deepak Shewade, Dina Nair, Joel S. Klinton, Malik Parmar, J. Lavanya, Lakshmi Murali, Vivek Gupta, Jaya Prasad Tripathy, Soumya Swaminathan, Ajay M.V. Kumar
      Background Worldwide, there’s concern over high pre-diagnosis and pre-treatment attritions or delays in Multidrug resistant tuberculosis (MDR-TB) diagnosis and treatment pathway (DTP). We conducted this operational research among patients with presumptive MDR-TB in north and central Chennai, India to determine attrition and turnaround times (TAT) at various steps of DTP and factors associated with attrition. Methods Study was conducted in Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all patients with presumptive MDR-TB (eligible for DST) in 2014. Results Of 628 eligible for DST, 557 (88%) underwent DST and 74 (13%) patients were diagnosed as having MDR-TB. Pre-diagnosis and pre-treatment attrition was 11% (71/628) and 38% (28/74) respectively. TAT [median (IQR)] to test from eligibility for DST and initiate DR-TB treatment from diagnosis were 14 (9,27) and 18 (13,36) days respectively. Patients with smear negative TB and detected in first quarter of 2014 were less likely to undergo DST. Patients in first quarter of 2014 had significantly lower risk of pre-treatment attrition. Conclusion There was high uptake of DST. However, urgent attention is required to reduce pre-treatment attrition, improve TAT to test from eligibility for DST and improve DST among patients with smear-negative TB.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.07.001
       
  • Establishing a cohort in a developing country: Experiences of the
           diabetes-tuberculosis treatment outcome cohort study

    • Authors: Fatima Mukhtar; Zahid A. Butt
      Pages: 249 - 254
      Abstract: Publication date: December 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 4
      Author(s): Fatima Mukhtar, Zahid A. Butt
      Background Prospective cohort studies are instrumental in generating valid scientific evidence based on identifying temporal associations between cause and effect. Researchers in a developing country like Pakistan seldom undertake cohort studies hence little is known about the challenges encountered while conducting them. We describe the retention rates among tuberculosis patients with and without diabetes, look at factors associated with loss to follow up among the cohort and assess operational factors that contributed to retention of cohort. Methods A prospective cohort study was initiated in October 2013 at the Gulab Devi Chest Hospital, Lahore, Pakistan. We recruited 614 new adult cases of pulmonary tuberculosis, whose diabetic status was ascertained by conducting random and fasting blood glucose tests. The cohort was followed up at the 2nd, 5th and 6th month while on anti-tuberculosis therapy (ATT) and 6months after ATT completion to determine treatment outcomes among the two groups i.e. patients with diabetes and patients without diabetes. Results The overall retention rate was 81.9% (n=503), with 82.3% (93/113) among patients with diabetes and 81.8% (410/501) among patients without diabetes (p=0.91). Age (p=0.001), area of residence (p=0.029), marital status (p=0.001), educational qualification (p=<0.001) and smoking (p=0.026) were significantly associated with loss to follow up. Respondents were lost to follow up due to inability of research team to contact them as either contact numbers provided were incorrect or switched off (44/111, 39.6%). Conclusion We were able to retain 81.9% of PTB patients in the diabetes tuberculosis treatment outcome (DITTO) study for 12months. Retention rates among people with and without diabetes were similar. Older age, rural residence, illiteracy and smoking were associated with loss to follow up. The study employed gender matched data collectors, had a 24-h helpline for patients and sent follow up reminders through telephone calls rather than short messaging service, which might have contributed to retention of cohort.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.08.003
       
  • Effect of exclusive cigarette smoking and in combination with waterpipe
           smoking on lipoproteins

    • Authors: Souheil Hallit; Marouan Zoghbi; Rabih Hallit; Lara Youssef; Rachelle Costantine; Nelly Kheir; Pascale Salameh
      Pages: 269 - 275
      Abstract: Publication date: December 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 4
      Author(s): Souheil Hallit, Marouan Zoghbi, Rabih Hallit, Lara Youssef, Rachelle Costantine, Nelly Kheir, Pascale Salameh
      Objective A significant increase in total cholesterol and LDL-C is well shown in tobacco users, as compared to non-tobacco users. The additive effects of waterpipe and cigarette smoking on LDL levels have not been studied. The study’s objective was to assess the correlation between cigarette smoking and LDL levels in Lebanese cigarette smokers and to check the interaction effect of waterpipe and cigarette smoking on LDL levels. Methods This cross-sectional study was conducted between October 2016 and February 2017 in 4 different laboratories, enrolling 308 patients (188 non-smokers, 105 cigarette smokers, 15 previous smokers). Results Current cigarette smoking (Beta=25.57; p<0.0001) was significantly associated with higher LDL levels and higher total cholesterol levels (Beta=53.29; p<0.0001) in exclusive cigarette smokers. Among current cigarette smokers who were current waterpipe smokers, a significant increase in LDL level was observed relative to current cigarette smokers who were not waterpipe smokers (Beta=66.64 vs Beta=37.37; p<0.0001). Conclusion Among Lebanese current cigarette smokers, LDL levels increased relative to nonsmokers, consistent with findings in other populations. In addition, among Lebanese current cigarette smokers, current waterpipe smoking might increase adverse lipid profiles associated with adverse coronary effects more than cigarette smoking alone. The direct cause responsible for these observed variations in our study remains unidentified, with the hope that future research will reveal it.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.08.006
       
  • Prevalence of zoonotic tuberculosis and associated risk factors in Central
           Indian populations

    • Authors: Prachi R. Bapat; Renuka S. Dodkey; Seema D. Shekhawat; Aliabbas A. Husain; Amit R. Nayak; Anuja P. Kawle; Hatim F. Daginawala; Lokendra K. Singh; Rajpal S. Kashyap
      Pages: 277 - 283
      Abstract: Publication date: December 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 4
      Author(s): Prachi R. Bapat, Renuka S. Dodkey, Seema D. Shekhawat, Aliabbas A. Husain, Amit R. Nayak, Anuja P. Kawle, Hatim F. Daginawala, Lokendra K. Singh, Rajpal S. Kashyap
      In the present study, we aimed to estimate the occurrence of bovine tuberculosis (TB) and examine the determinants of distribution of the disease in three high-risk populations of Central India. A prospective cohort study was conducted in Central India between March 2014 and June 2015. Based on the requisite inclusion criteria, we recruited a total of 301 participants whose blood samples were subjected to polymerase chain reaction-based detection and differentiation of Mycobacterium bovis and Mycobacterium tuberculosis. M. bovis was detected in 11.4%, 8.9%, and 12.6% of the recruited participants belonging to three distinct population groups (Groups A, B, and C, respectively). The highest proportion of cases infected with M. bovis was observed in Group C, who lived in the high TB endemic region. Previous contact with active TB cases (odds ratio=3.7; 95% confidence interval, 0.9612–14.4533) and raw milk consumption (odds ratio=5.3472; 95% confidence interval, 1.9590–14.5956) were found to be important determinants of bovine TB in this population. The high incidence rates of bovine TB in the Central Indian populations indicate the substantial consequences of this disease for some population groups and settings. However, more research is necessary to identify the main transmission drivers in these areas.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.08.007
       
  • Evidence of ongoing brucellosis in livestock animals in North West Libya

    • Authors: Huda H. Al-Griw; Elfurgani Salem Kraim; Milad E. Farhat; Lorraine L. Perrett; Adrian M. Whatmore
      Pages: 285 - 288
      Abstract: Publication date: December 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 4
      Author(s): Huda H. Al-Griw, Elfurgani Salem Kraim, Milad E. Farhat, Lorraine L. Perrett, Adrian M. Whatmore
      Animal brucellosis is thought to be present in small ruminants, cattle, and camels in Libya, particularly in the west coastal strip. Before the system collapsed due to political unrest in 2011, prevalence of the disease did not exceed 0.2% in cattle, 0.1% in camels, 8.3% in sheep, and 14.8% in goats. The aim of this study was to highlight outbreaks of disease that took place during the 18-month period from November 2014 to April 2016. A total of 1612 serum samples, collected opportunistically from 29 herds in 12 different localities in the northwest region of Libya, were investigated for brucellosis. The samples were screened for Brucella antibodies using the Rose Bengal test, and confirmed with either indirect enzyme linked immunosorbent assay in the case of sheep, and/or a serum agglutination test, followed with a complement fixation test, in the case of cattle and camels. Our results showed the highest rates of brucellosis seropositivity in goats (33.4%) and sheep (9.2%). The overall percentage of brucellosis seropositivity was 21%. The high level of brucellosis identified by this study, particularly in small ruminants, strongly suggests re-emergence of the disease in the region. Re-evaluation of intervention measures applied to the control of brucellosis is highly recommended.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.09.001
       
  • Venous thromboembolism risks and prophylaxis in King Fahad Hospital,
           Madinah, Saudi Arabia

    • Authors: Ayman Kharaba; Mohammad Al Aboud; Madinah Reham Kharabah; Khaled Alyami; Amal Al Beihany
      Pages: 295 - 298
      Abstract: Publication date: December 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 4
      Author(s): Ayman Kharaba, Mohammad Al Aboud, Madinah Reham Kharabah, Khaled Alyami, Amal Al Beihany
      Objective To evaluate the risk factors, physician's compliance, and implementation of the American College of Chest Physicians (ACCP) guidelines for venous thromboembolism (VTE) prophylaxis at our hospital. Methods A retrospective cohort study was conducted in King Fahad Hospital, Madinah, Saudi Arabia, from July 2015 to September 2015. We used the ACCP 2012 guidelines to assess the VTE risk and to determine whether patients had received the recommended prophylaxis. All hospital inpatients aged 14years or older were assessed for risk of VTE by reviewing the hospital chart. The primary endpoint was the rate of appropriate thromboprophylaxis. Results A total of 414 patients were studied. Their mean age was 47.74±20.4years, and 208 (50.2%) were female. There were 292 (70.5%) patients at high risk and 73 (17.6%) at moderate risk. As per the ACCP criteria, 375 (90.5%) patients were at risk for VTE and qualified for prophylaxis. Although 227 (60.5%) received some form of prophylaxis, only 144 (38.4%) of them received ACCP-recommended VTE prophylaxis. Conclusion In our hospital, most of the patients are at high risk for developing VTE. The VTE prophylaxis guideline is not properly implemented and is underutilized. Strategies should be developed and implemented to ensure patient safety.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.09.003
       
  • Exposure to toxics during pregnancy and childhood and asthma in children:
           A pilot study

    • Authors: Souheil Hallit; Pascale Salameh
      Pages: 147 - 154
      Abstract: Publication date: September 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 3
      Author(s): Souheil Hallit, Pascale Salameh
      Environmental factors, pesticides, alcohol and smoking are linked to asthma in children. The association of toxic substances exposure with asthma has not been evaluated. Our objective is to assess such associations among children aged less than 16years old. This is a cross-sectional study, conducted between January and May 2015, using a sample of Lebanese students from private schools in Beirut and Mount Lebanon. Out of 700 distributed questionnaires, 527 (75.2%) were returned to us. Verbal informed consent was also obtained from all parents prior to participating in the study. A significant association was found between waterpipe smoking and diagnosed asthma (p=0.003; ORa =13.25; 95% CI 2.472–71.026). Alcohol during pregnancy, waterpipe smoking during pregnancy and parents respiratory problems significantly increased the risk of respiratory problems by approximately 5 times, 6 times and 2 times respectively (p=0.016; ORa =4.889; 95% CI 1.339–17.844, p=0.021; ORa =6.083; 95% CI 1.314–28.172, p=0.004; ORa =1.748; 95% CI 1.197–2.554 respectively). Waterpipe smoking, alcohol during pregnancy, recurrent otitis and humidity at home seem to be significantly correlated with asthma in children. Spreading awareness by health care professionals is needed to permit a reduction of the prevalence of these allergic diseases, especially asthma, in children.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.04.004
       
  • Frequency of multi-drug resistance and mutations in Mycobacterium
           tuberculosis isolates from Punjab state of India

    • Authors: Ritu Singhal; Jyoti Arora; Grish C. Sah; Manpreet Bhalla; Rohit Sarin; Vithal Prasad Myneedu
      Pages: 175 - 180
      Abstract: Publication date: September 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 3
      Author(s): Ritu Singhal, Jyoti Arora, Grish C. Sah, Manpreet Bhalla, Rohit Sarin, Vithal Prasad Myneedu
      Data regarding prevalence of multi-drug resistant tuberculosis (MDR-TB) and associated common mutations is scarce from Punjab region. The study was designed to determine rate of MDR-TB among presumptive MDR-TB from Punjab and mutation patterns using GenoType MTBDRplus assay. Total of 812 consecutive sputum samples were received from January 2012 to July 2013, from 14 districts of Punjab at the National Reference Laboratory at New Delhi for diagnosis of MDR-TB as hand holding activity. Presumptive MDR-TB patients were identified on basis of criterion B defined by the programme. Smear positive and negatives patients were found to be 636/798 (79.7%) and 162/ 798 (20.3%) respectively. Total of 606 GenoType MTBDRplus tests were conducted and mutations in rpoB, kat G and inhA genes analyzed. Total of 94/606 (15.5%), 43/606 (7.1%) and 40/606 (6.6%) were found to be RIF and INH resistant, mono-RIF resistant and 40/606 (6.6%) mono-INH resistant respectively. Commonest known mutation for RIF in rpoB gene and INH in kat G gene was S531L (80/ 137; 58.4%) and S315T1 (119/134; 88.8%) respectively. Mutations in inhA were found in 21/134 (15.7%) strains. Average turn-around time (TAT) for dispatch of result toPunjab was 4.6days. Prevalence of RIF resistance in Punjab was found to be 22.6%. Common mutations for RIF and INH were similar to that in other regions of country. GenoType MTBDRplus was found to be useful assay for rapid detection of MDR-TB, responsible for determining better management of MDR-TB patients under the programme.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.05.002
       
  • Ground water as the source of an outbreak of Salmonella Enteritidis

    • Authors: Ana Kovačić; Željko Huljev; Edita Sušić
      Pages: 181 - 184
      Abstract: Publication date: September 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 3
      Author(s): Ana Kovačić, Željko Huljev, Edita Sušić
      In September 2014, an outbreak of gastroenteritis was reported to the Public Health Institute of Šibenik and Knin County in Croatia. The outbreak occurred in the County center of Šibenik, a town with 50,000 inhabitants, and it lasted for 12days. An epidemiological investigation suggested a nearby water spring as the source of the outbreak. Due to the temporary closure of the public water supply system, the inhabitants started to use untreated water from a nearby spring. Microbiological analysis revealed that the outbreak was caused by Salmonella enterica subsp. enterica serovar Enteritidis that was isolated from stool samples of the patients and ground water. The isolates were further analysed with pulsed-field gel electrophoresis using XbaI, which revealed an identical macrorestriction profile. Although 68 cases were reported, it was estimated that the actual number of affected persons was more than several hundred. In order to prevent further spread of disease, public advice was released immediately after the first epidemiological indication and a warning sign was placed at the incriminated water source, after microbiological confirmation. It is necessary to regularly monitor microbiological quality of ground water especially in urban areas and provide adequate education and awareness to the inhabitants regarding the risk of using untreated ground water.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.05.001
       
  • Predictors of past quit attempts and duration of abstinence among
           cigarette smokers

    • Authors: N. Layoun; S. Hallit; M. Waked; Z. Aoun Bacha; I. Godin; A. Leveque; M. Dramaix; P. Salameh
      Pages: 199 - 206
      Abstract: Publication date: September 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 3
      Author(s): N. Layoun, S. Hallit, M. Waked, Z. Aoun Bacha, I. Godin, A. Leveque, M. Dramaix, P. Salameh
      Objective Despite the widespread awareness of the harms of smoking, millions continue to smoke around the world partly due to the difficulty it takes to quit smoking. Identifying the factors associated with making quit attempts is an essential pillar to reach successful quitting. The purpose of this study is to assess the factors associated with the past quit attempts and their past length of abstinence in a Lebanese sample of cigarette smokers. Methods This study was conducted between March 2014 and March 2015, involving 382 patients randomly chosen from 5 outpatient clinics in 5 hospitals in Lebanon. A standardized questionnaire was completed including socio-demographic characteristics, smoking behavior, chronic respiratory symptoms, Fagerstrom scale, Mondor scale, packaging perception, quitting behavior and readiness to quit ladder. Results Smokers who have chronic allergies (ORa=2.45, p=0.03), those who have ever stopped smoking for at least one month due to the warnings implemented on the packages (ORa=4.6, p<0.0001) and smokers with an intention to quit in 2months (ORa=2.49, p<0.0001) had significantly more past quit attempts. Furthermore, longer quit attempts duration (more than 1month) were significantly associated with low-nicotine dependent smokers (ORa=0.56, p=0.02), higher-motivated smokers (ORa=1.85, p=0.01), people with chronic allergies (ORa=2.07, p=0.02), smokers who have ever stopped smoking for at least one month due to the warnings (ORa=3.72, p<0.0001) and those with an intention to quit in 2months (ORa=1.98, p=0.05). Conclusion The promoters of smoking cessation services should consider these factors when designing comprehensive tobacco control initiatives and in service planning.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.06.003
       
  • 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
      Pages: 111 - 118
      Abstract: Publication date: June 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 2
      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 was collected from the records available at the District Tuberculosis Office. Results Data of 510 patients was 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: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.02.002
       
  • 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
      Pages: 131 - 134
      Abstract: Publication date: June 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 2
      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: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2016.12.002
       
  • A survey of hypertension prevalence, awareness, treatment, and control in
           health screening camps of rural central Punjab, Pakistan

    • Authors: Salman T. Shafi; Tahir Shafi
      Pages: 135 - 140
      Abstract: Publication date: June 2017
      Source:Journal of Epidemiology and Global Health, Volume 7, Issue 2
      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: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.01.001
       
  • 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: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2015.12.002
       
  • The predictive value of personality traits for psychological problems
           (stress, anxiety and depression): Results from a large population based
           study

    • Authors: Zeinab Alizadeh; Awat Feizi; Mehri Rejali; Hamid Afshar; Ammar Hassanzadeh Keshteli; Peyman Adibi
      Abstract: Publication date: Available online 26 November 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Zeinab Alizadeh, Awat Feizi, Mehri Rejali, Hamid Afshar, Ammar Hassanzadeh Keshteli, Peyman Adibi
      The current study aimed to determine the prognostic values of personality traits for common psychological problems in a large sample of Iranian adult. In a large sample of healthy people (n = 4763) who lived in Isfahan province; the NEO-FFI was used to assess the personality traits; depression and anxiety were assessed using the “Hospital Anxiety and Depression Scale (HADS)” also stress was measured through Persian validated version of General Health Questionnaire (GHQ-12). Receiver Operating Characteristics Curve (ROC) analysis was used as main statistical method for data analysis. ROC analysis showed neuroticism was the best predictor for all psychological problems with highest area under the curve (AUC) (95% confidence interval) for stress, 0.837 (0.837–0.851), anxiety 0.861 (0.847–0.876) and depression 0.833 (0.820–0.846) (p < .001) and the corresponding cut-off points (sensitivity, specificity), were 21.5 (77%, 66%), 22.5 (81%, 77%) and 20.5 (77%, 74%), respectively .Other personality traits were significant protective factors for being affected with psychological problems (p < .001). Similar findings were observed separately in women and men. The present study showed that the neuroticism is significant risk factor for being affected with three psychological problems while other traits are significant protective factors. Personality traits are useful indices for screening psychological problems and an effective pathway toward prevention in general population.

      PubDate: 2017-12-09T09:31:11Z
      DOI: 10.1016/j.jegh.2017.11.003
       
  • Global health diplomacy: Between global society and neo-colonialism: The
           role and meaning of “ethical lens” in performing the six leadership
           priorities

    • Authors: Michele Rubbini
      Abstract: Publication date: Available online 16 November 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Michele Rubbini
      Establishing indicators oriented towards the creation of a global society to the detriment of new forms of neo-colonialism. In the relations between Developed and Emerging Countries as part of the Global Health Diplomacy, there is a risk that the former can adopt behaviors induced by the financial needs of overcoming their crisis. The most relevant Documents by International Organizations and Articles published in the past regarding actions in this area and the forecast of economic growth in various areas of the World are considered and the hypothesis of dual scenarios that may arise from these are postulated. There are two hypothetical scenarios arising from the “six leadership priorities”: the search for a Global Society or initiating forms of neo-colonialism on the part of developed countries towards emerging ones. If the “economic lens” is to prevail then the developed Countries, would seek to charge their crisis to emerging Ones where a forthcoming significant growth has expected; if the “ethical lens” is to prevail, it will be most likely be the hypothesis of a Global Society where there is a respect of Human Rights in order to drive growth and harmonization of relations between Governments.

      PubDate: 2017-12-09T09:31:11Z
      DOI: 10.1016/j.jegh.2017.11.002
       
  • Device-associated nosocomial infection in general hospitals, Kingdom of
           Saudi Arabia, 2013–2016

    • Authors: Eiman Gaid; Abdullah Assiri; Scott McNabb; Weam Banjar
      Abstract: Publication date: Available online 28 October 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Eiman Gaid, Abdullah Assiri, Scott McNabb, Weam Banjar
      Healthcare-associated infections (HAIs) including device-associated HAI (DA-HAI) are a serious patient safety issue in hospitals worldwide, affecting 5–10% of hospitalized patients and deadly for patients in intensive care units (ICUs). (Vincent, 2003; Al-Tawfiq et al., 2013; Hu et al., 2013). DA-HAIs account for up to 23% of HAIs in ICUs and about 40% of all hospital infections (i.e. central line-associated blood stream infections [CLABSI], ventilator-associated pneumonia [VAP], and catheter-associated urinary tract infections [CAUTI]). This study aims to identify DA-HAI rates among a group of selected hospitals in the Kingdom of Saudi Arabia (KSA), 2013–2016. Secondary data was analyzed from 12 medical/surgical intensive care units (M/SICUs) and two cardiac care units (CCUs) from 12 Ministry of Health (MoH) hospitals from different regions in KSA. These data were reported by infection control practitioners to the MoH via electronic International Nosocomial Infection Control Consortium (INICC) systems in each hospital. Among 6178 ICU patients with 13,492 DA-HAIs during 2013–2016, the average length of stay (LOS) was 10.7 days (range 0–379 days). VAP was the most common DA-HAI (57.4%), followed by CAUTI (28.4%), and CLABSI (14.2%). In CCUs there were no CLABSI cases; CAUTI was reported from 1 to 2.6 per 1000 device-days; and VAP did not occur in Hospital B but occurred 8.1 times per 1000 device-days in the CCU in Hospital A. In M/SICUs, variations occurred among time periods, hospitals, and KSA provinces. CLABSI varied between hospitals from 2.2 to 10.5 per 1000 device-days. CAUTI occurred from 2.3 to 4.4 per 1000 device-days, while VAP had the highest rates, from 8.9 to 39.6 per 1000 device-days. Most hospitals had high device-utilization ratios (DURs) (from the 75th to 90th percentile of National Healthcare Safety Network (NHSN)’s standard and the 50th to 75th percentile of INICC’s). This study showed higher device-associated infection rates and higher device-utilization ratios in the study’s CCUs and M/SICUs than NHSN benchmarks. To reduce the rates of infection, ongoing monitoring of infection control practices and comprehensive education are required. Furthermore, a sensitive and specific national healthcare safety network is needed in KSA.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.10.008
       
  • Impact of mobile teams on tuberculosis treatment outcomes, Riyadh Region,
           Kingdom of Saudi Arabia, 2013–2015

    • Authors: Sami Alqahtani; Abdulhameed Kashkary; Abdullah Asiri; Heba Kamal; Jose Binongo; Kenneth Castro; Scott McNabb
      Abstract: Publication date: Available online 28 September 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Sami Alqahtani, Abdulhameed Kashkary, Abdullah Asiri, Heba Kamal, Jose Binongo, Kenneth Castro, Scott McNabb
      The objective of this study was to evaluate the impact of the tuberculosis (TB) mobile teams on treatment outcomes in Riyadh Region by comparing patients who received treatment under mobile teams and those who did not, from 2013 to 2015. This was a retrospective descriptive study using National TB Control and Prevention Program data from 2013 to 2015 from Riyadh, Kingdom of Saudi Arabia. Descriptive analyses were used to summarize characteristics of TB case-patients served by mobile teams and those who were not served. The χ2 test measured the significant differences between mobile-served and non-mobile-served case-patients. Exposure was whether or not the TB case-patient was under the care of the mobile team; the outcome of interest was whether or not treatment was successful, defined as treatment completed and cured. We found that the ratio of treatment success among mobile team case-patients was 1.28 greater than among those not served by mobile teams. The χ2 test showed a statistically significant finding (probability ratio=1.28; 95% confidence interval=1.21–1.35, p <0.01). Mobile teams increased the treatment success rate to 92%, compared to 71.77% among those not served by mobile teams. This study shows that community mobilization of mobile teams is an effective strategy to enhance TB treatment, reduced mortality and loss to follow-up and improve TB treatment outcomes.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.09.005
       
  • An overview of mortality & predictors of small-cell and non-small cell
           lung cancer among Saudi patients

    • Authors: Hatim I. Alghamdi; Ali F. Alshehri; Ghada N. Farhat
      Abstract: Publication date: Available online 28 September 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Hatim I. Alghamdi, Ali F. Alshehri, Ghada N. Farhat
      Lung cancer ranks as the top cancer worldwide in terms of incidence and constitutes a major health problem. About 90% of lung cancer cases are diagnosed at advance stage where treatment is not available. Despite evidence that lung cancer screening improves survival, guidelines for lung cancer screening are still a subject for debate. In Saudi Arabia, only 14% of lung cancers are diagnosed at early stage and researches on survival and its predictors are lacking. This overview analysis was conducted on predictors of lung cancer mortality according to the two major cancer types, small-cell lung cancers (SCLCs) and non-small cell lung cancers (NSCLCs) in Saudi Arabia. A secondary data analysis was performed on small-cell lung cancers (SCLCs) and Non-small cell lung cancers (NSCLCs) registered in the Saudi Cancer Registry (SCR) for the period 2009–2013 to estimate predictors of mortality for both lung cancer types. A total of 404 cases (197 SCLC and 207 NSCLC) were included in the analysis, all Saudi nationals. A total of 213 (52.75%) deaths occurred among lung cancer patients, 108 (54.82%) among SCLCs and 105 (50.72%) among NCSLCs. Three quarter of patients are diagnosis with advance stage for both SCLC & NSCLC. Univariate analysis revealed higher mean age at diagnosis in dead patients compared to alive patients for SCLCs (p=0.04); but not NSCLCs, a lower mortality for NSCLCs diagnosed in 2013 (p=0.025) and a significant difference in stage of tumor (p=0.006) and (p=0.035) for both SCLC and NSCLC respectively. In multiple logistic regression, stage of tumor was a strong predictor of mortality, where distant metastasis increased morality by 6-fold (OR=5.87, 95% CI: 2.01 – 17.19) in SCLC and by 3-fold (OR=3.29, 95% CI: 1.22 – 8.85) in NSCLC, compared to localized tumors. Those with NSCLC who were diagnosed in 2013 were less likely to die by 64% compared to NSCLC diagnosed in 2009 (OR=0.36, 95% CI: 0.14 – 0.93). Age, sex, topography and laterality were not associated with mortality for both types of lung cancer. We observed that the stage of the tumor is the strongest predictor of mortality for both SCLCs and NSCLs. This confirms the impact of diagnostic stage on survival. However, establishing Saudi-specific lung cancer screening guidelines will require further research on the benefits and harms of screening modalities in the Saudi population.

      PubDate: 2017-11-17T20:49:09Z
      DOI: 10.1016/j.jegh.2017.09.004
       
  • The effect of a regimen of Antifungal cream use on episodes of acute
           adenolymphangitis (ADL) among lymphedema patients: An application using
           marginal structural models

    • Authors: K.E. Mues; M. Klein; D.G. Kleinbaum; W.D. Flanders; L.M. Fox
      Abstract: Publication date: Available online 10 November 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): K.E. Mues, M. Klein, D.G. Kleinbaum, W.D. Flanders, L.M. Fox
      Episodes of adenolymphangitis (ADL) are a recurrent clinical aspect of lymphatic filariasis (LF) and a risk factor for progression of lymphedema. Inter-digital entry lesions, often found on the web spaces between the toes of those suffering from lymphedema, have been shown to contribute to the occurrence of ADL episodes. Use of antifungal cream on lesions is often promoted as a critical component of lymphedema management. Our objective was to estimate the observed effect of antifungal cream use on ADL episodes according to treatment regimen among a cohort of lymphedema patients enrolled in a morbidity management program. We estimated this effect using marginal structural models for time varying confounding. In this longitudinal study, we estimate that for every one-unit increase in the number of times one was compliant to cream use through 12 months, there was a 23% (RR = 0.77 (0.62, 0.96)) decrease in the number of ADL episodes at 18 months, however the RR’s were not statistically significant at other study time points. Traditionally adjusted models produced a non-significant RR closer to the null at all time points. This is the first study to estimate the effect of a regimen of antifungal cream on the frequency of ADL episodes. This study also highlights the importance of the consideration and proper handling of time-varying confounders in longitudinal observational studies.

      PubDate: 2017-11-10T19:49:03Z
      DOI: 10.1016/j.jegh.2017.10.009
       
  • Overweight risk and food habits in Portuguese pre-school children

    • Authors: A.M. Machado-Rodrigues; R.A. Fernandes; Maria-Raquel Silva; A. Gama; I. Mourão; H. Nogueira; V. Rosado-Marques; C. Padez
      Abstract: Publication date: Available online 6 November 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): A.M. Machado-Rodrigues, R.A. Fernandes, Maria-Raquel Silva, A. Gama, I. Mourão, H. Nogueira, V. Rosado-Marques, C. Padez
      The relationship between dietary intake and overweight-risk was assessed in 4349 children aged 3–5 years. Eating and sedentary behaviours were assessed by questionnaire. Logistic regressions were used. Children who consumed daily soft-drinks were 1.52 times more likely to be obese, and 72% more likely to be classified as overweight children.

      PubDate: 2017-11-10T19:49:03Z
      DOI: 10.1016/j.jegh.2017.10.006
       
  • Distribution and determinants of tuberculosis in the Kingdom of Saudi
           Arabia from 2005 to 2012

    • Authors: Fahad M. Almutairi; Tamara Tayeb; Raffat Alhakeem; Abdulaziz bin Saeed; Abdullah Assiri; Scott J.N. McNabb
      Abstract: Publication date: Available online 2 November 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Fahad M. Almutairi, Tamara Tayeb, Raffat Alhakeem, Abdulaziz bin Saeed, Abdullah Assiri, Scott J.N. McNabb
      Tuberculosis (TB) remains a public health threat in the Kingdom of Saudi Arabia (KSA) with many challenges that limit its prevention and control. To understand how to meet these challenges, this study calculated the TB incidence rates (IRs) in KSA from 2005 to 2012, which were stratified by nationality, sex, and administrative regions. Furthermore, laboratory capabilities were assessed by determining the proportion of laboratory-confirmed TB cases. The overall TB IRs decreased from 15.80/100,000 population in 2005 [95% confidence interval (CI)=15.29–16.31] to 13.16/100,000 population in 2012 (95% CI=12.74–13.58). The IRs were greater for males than for females from 2009 to 2012. The IRs of non-Saudis were approximately two times those of Saudis during the study period. Mecca had greater IR during the study period compared with other regions [25.13/100,000 (95% CI=24.7–25.56)]. Among non-Saudis, those from Indonesia and Yemen had the greatest proportion of TB cases (15.4% and 12.9%, respectively). Individuals <15years of age comprised 14.2% of the TB cases. Employed non-Saudis had the greatest proportion of TB (32%), followed by unemployed Saudis (22.38%). The proportion of laboratory-confirmed cases of reported TB was 57% from 2005 to 2012. For effective prevention and control, TB screening should be implemented for non-Saudi workers at ports of entry and laboratory-screening capacity for TB should be evaluated.

      PubDate: 2017-11-04T17:02:06Z
      DOI: 10.1016/j.jegh.2017.08.002
       
  • An estimation of the burden of sports injuries among African adolescents

    • Authors: Drake G. LeBrun; Julius del Rosario; John D. Kelly; Sherry M. Wren; David A. Spiegel; Nyengo Mkandawire; Richard A. Gosselin; Adam L. Kushner
      Abstract: Publication date: Available online 2 November 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Drake G. LeBrun, Julius del Rosario, John D. Kelly, Sherry M. Wren, David A. Spiegel, Nyengo Mkandawire, Richard A. Gosselin, Adam L. Kushner
      The extent to which sports injuries contribute to the burden of injury among adolescents in low- and middle-income countries (LMICs) is unknown. The goal of this study was to estimate the incidence of sports injuries among adolescents in Africa. Data from the World Health Organization Global School-Based Student Health surveys were used to estimate the annual number of African adolescents sustaining sports injuries. Gender-stratified injury rates were calculated and applied to every African country’s adolescent population to estimate country-specific and continent-wide injury totals. A total of 21,858 males and 24,691 females from 14 countries were included in the analysis. Country-specific annual sports injury rates ranged from 13.5% to 38.1% in males and 5.2% to 20.2% in females. Weighted average sports injury rates for males and females were 23.7% (95% CI 23.1%–24.2%) and 12.5% (95% CI 12.1%–12.9%), respectively. When these rates were extrapolated to the adolescent populations of the African continent, an estimated 15,477,798 (95% CI 15,085,955–15,804,333) males and 7,943,625 (95% CI 7,689,429–8,197,821) females sustained sports injuries. Our findings suggest that over 23 million African adolescents sustained sports injuries annually. Further work will help to more precisely define the burden of sports injuries in LMICs and the role that surgery can play in mitigating this burden.

      PubDate: 2017-11-04T17:02:06Z
      DOI: 10.1016/j.jegh.2017.10.010
       
  • Evaluation of the cell phone microbial contamination in dental and
           engineering schools: Effect of antibacterial spray

    • Authors: Reihaneh Hosseini Fard; Raziyeh Hosseini Fard; Mohammad Moradi; Maryam Alsadat Hashemipour
      Abstract: Publication date: Available online 27 October 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Reihaneh Hosseini Fard, Raziyeh Hosseini Fard, Mohammad Moradi, Maryam Alsadat Hashemipour
      Introduction The aim of this study was to evaluate the microbial contamination of cell phone in dental and engineering schools and also investigating the effect of an antibacterial spray. Method and Materials A questionnaire was completed by participants, including the pattern of using mobile phones and their disinfection. The number of participants was 120 students and professors in each of dental and engineering schools. Swabs from mobile phones of the participants were taken and plated on culture medium. The t-test, Chi-Square with the SPSS 11.5 program were used in data analysis. Results In total, 240 mobile phones were cultured for microorganisms, while 65.8% (n = 158) were culture-positive. One hundred percent of professors, 98% of students' dental school and 72% of professors and 62% of students of engineering, believe that mobile can serve as a source of pathogens. The most commonly cultured organisms were Staphylococcus Aureus, Escherichia coli, Enterococcus Faecalis, and Pseudomonas. The current study showed that none of the mobile phones of the professors and students of the engineering university was infected by Pseudomonas and Candida albicans. Conclusion The results of this study showed that mobile phones may act as an important source of nosocomial pathogens.

      PubDate: 2017-10-27T22:15:31Z
      DOI: 10.1016/j.jegh.2017.10.004
       
  • Prescribing patterns for acute respiratory infections in children in
           primary health care centers, Makkah Al Mukarramah, Saudi Arabia

    • Authors: M.H. Shaheen; M.I. Siddiqui; H.A. Jokhdar; A. Hassan-Hussein; M.A. Garout; S.M. Hafiz; M.M. Alshareef; A.M. Falemban; A.A. Neveen; A.A. Nermeen
      Abstract: Publication date: Available online 27 October 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): M.H. Shaheen, M.I. Siddiqui, H.A. Jokhdar, A. Hassan-Hussein, M.A. Garout, S.M. Hafiz, M.M. Alshareef, A.M. Falemban, A.A. Neveen, A.A. Nermeen
      Acute respiratory infections (ARI) are a major public health problem and one of the commonest reasons for visiting primary health care centers (PHC). In developing countries, seventy-five percent of the cases are treated with antibiotics, although the majority are caused by viral infection. Our aim was to observe the pattern of physician practices with respect to ARI, in comparison to WHO protocols and to provide recommendations for health promotion enhancement. The study was conducted in Makkah PHC centers, for 2 months. A total 14 PHC centers were randomly selected. And 908 prescriptions were obtained randomly from general practitioners (GP) and analyzed. We found that males were 522 and females were and 386. Weights were not recorded in 224 (24.7%) cases. In 87 cases (9.6%) no diagnosis was recorded. In 515 (62.34%) of cases, antibiotics were prescribed; most of these cases were of simple common cold, with antibiotics not recommended. To conclude, many physicians in Makkah are not following the WHO guidelines for Acute Respiratory Infection. Educational health programs should be conducted to sensitize the physicians regarding the appropriate method of diagnosis and rational use of antibiotics.

      PubDate: 2017-10-27T22:15:31Z
      DOI: 10.1016/j.jegh.2017.10.007
       
  • Physical activity promotion in Saudi Arabia: A critical role for
           clinicians and the health care system

    • Authors: Zahra Alahmed; Felipe Lobelo
      Abstract: Publication date: Available online 24 October 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Zahra Alahmed, Felipe Lobelo
      This work aimed to summarize the benefits of physical activity and the importance of counseling by a physician to promote physical activity in a primary health care setting in Saudi Arabia. Despite established evidence that physical activity is effective for reducing the risk of non-communicable diseases, as well as the importance and cost-effectiveness of physical activity counseling in the primary care setting, few studies have been conducted regarding physical activity counseling in Saudi Arabia.

      PubDate: 2017-10-27T22:15:31Z
      DOI: 10.1016/j.jegh.2017.10.005
       
  • Predictors of healthcare seeking delays among children with chronic
           musculoskeletal disorders in Nepal

    • Authors: Drake G. LeBrun; Divya Talwar; Tuyetnhi A. Pham; Bibek Banskota; David A. Spiegel
      Abstract: Publication date: Available online 12 October 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Drake G. LeBrun, Divya Talwar, Tuyetnhi A. Pham, Bibek Banskota, David A. Spiegel
      Background Healthcare seeking behaviors among children with musculoskeletal disorders are poorly understood. We sought to analyze healthcare seeking delays among children with chronic musculoskeletal conditions in Nepal and identify predictors of clinically significant delays. Methods A cross-sectional study was conducted at a large pediatric musculoskeletal rehabilitation center in Nepal. Baseline sociodemographic data and healthcare seeking behaviors were assessed via interviews with 75 randomly selected caregivers. Delays of at least 3 months between disease recognition and presentation to a health worker were considered clinically significant. Predictors of significant delay were assessed via multivariable logistic regression. Results Clubfoot was the most common condition seen in the study sample (N = 33; 37%). Mean and median presentation delays were 33 months and 14 months, respectively. Sixty-seven percent of children were delayed at least 3 months and 40% were delayed at least 2 years. Caregiver occupation in agriculture or unskilled labor was associated with an increased risk of delayed presentation (adjusted OR = 4.05; 95% CI: 1.36–12.09). Conclusions Children with chronic musculoskeletal disorders in Nepal face significant delays in accessing healthcare. This poses a major clinical problem as the delayed diagnosis and treatment of childhood musculoskeletal disorders can complicate management options and decrease long-term quality of life.

      PubDate: 2017-10-14T06:22:03Z
      DOI: 10.1016/j.jegh.2017.10.002
       
  • A 360-degree view of an ancient killer disease

    • Authors: Sarah E. Ahlbrand; Madhukar Pai
      Abstract: Publication date: Available online 7 October 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Sarah E. Ahlbrand, Madhukar Pai


      PubDate: 2017-10-14T06:22:03Z
      DOI: 10.1016/j.jegh.2017.10.003
       
  • Prevalence of rifampicin-resistant Mycobacterium tuberculosis among
           human-immunodeficiency-virus-seropositive patients and their treatment
           outcomes

    • Authors: C.K. Vidyaraj; A. Chitra; S. Smita; M. Muthuraj; S. Govindarajan; B. Usharani; S. Anbazhagi
      Abstract: Publication date: Available online 21 September 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): C.K. Vidyaraj, A. Chitra, S. Smita, M. Muthuraj, S. Govindarajan, B. Usharani, S. Anbazhagi
      Multidrug resistant (MDR) and extensively drug resistant tuberculosis (TB) are a threat to the TB control programs in developing countries, and the situation is worsened by the human immunodeficiency virus (HIV) pandemic. This study was performed to correlate treatment outcome with the resistance patterns in HIV-seropositive patients coinfected with pulmonary TB. Sputum specimens were collected from 1643 HIV-seropositive patients and subjected to microscopy and liquid culture for TB. The smear- and culture-positive Mycobacterium tuberculosis isolates were subjected to Genotype MTBDRplus assay version 2.0. The M. tuberculosis culture-positivity rate was 39.44% (648/1643) among the 1643 HIV-seropositive patients and the overall MDR-TB rate was 5.6% (36/648). There were 421 newly diagnosed and 227 previously treated patients, among whom, MDR-TB was associated with 2.9% and 10.57% cases, respectively. The rate of rifampicin monoresistant TB among the cases of MDR-TB was 2.31% (15/648) and the rate of combined rifampicin and isoniazid resistance was 3.24% (21/648). The cure and death rates among the 20 registered cases were 30% (6/20) and 35% (7/20), respectively. Five cases were on treatment and two cases were defaulters among the 20 registered cases. High death rate (13, 36.1%, 95% confidence interval 20.8–53.8) was observed in this study among the patients who had mutations at the 530–533 codons. The present study emphasized the prerequisite to monitor the trend of drug-resistant TB in various mutant populations in order to timely implement appropriate interventions to curb the threat of MDR-TB.

      PubDate: 2017-09-23T13:24:21Z
      DOI: 10.1016/j.jegh.2017.09.002
       
  • Characterization of SCCmec and spa types of methicillin-resistant
           Staphylococcus aureus isolates from health-care and community-acquired
           infections in Kerman, Iran

    • Authors: Yaser Fasihi; Somayeh Kiaei; Davood Kalantar-Neyestanaki
      Abstract: Publication date: Available online 30 August 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Yaser Fasihi, Somayeh Kiaei, Davood Kalantar-Neyestanaki
      Spread of methicillin-resistant Staphylococcus aureus (MRSA) isolates is a worldwide problem. Molecular typing is a useful tool to understand MRSA epidemiology. Herein, we determined vancomycin-resistant, SCCmec and spa types among MRSA isolates recovered from healthcare and community-acquired infections in Kerman, Iran. A total of 170 S. aureus isolates were collected from different patients who were admitted to affiliated hospitals of Kerman University of Medical science. MRSA and vancomycin-resistant S. aureus (VRSA) isolates were detected by phenotypic methods. Polymerase chain reaction (PCR) technique was used for detection of mecA, vanA and vanB genes. Staphylococcal cassette chromosomemec (SCCmec) and spa typing were used for molecular typing of among MRSA isolates. Overall, 53% of isolates were considered as MRSA. Two MRSA isolates were resistant to vancomycin and vanA was detected in only one of VRSA isolates. SCCmec type III belonged to spa types t030 and t459 which they were the dominant spa types among community-associated MRSA (CA-MRSA) and healthcare-acquired MRSA (HA-MRSA) isolates. Our findings showed that the SCCmec type I and III spread from hospital settings to community, although the SCCmec type IV spread from community to healthcare systems. We have also reported VRSA isolates from hospitalized patients, therefore, appropriate policies should be enforced in order to prevent the spread of antibiotic resistance isolates in hospitals settings.

      PubDate: 2017-09-06T11:10:18Z
      DOI: 10.1016/j.jegh.2017.08.004
       
  • Prenatal care utilization in Zimbabwe: Examining the role of
           community-level factors

    • Authors: Marshall Makate; Clifton Makate
      Abstract: Publication date: Available online 24 August 2017
      Source:Journal of Epidemiology and Global Health
      Author(s): Marshall Makate, Clifton Makate
      This paper assesses the importance of community-level factors on prenatal care utilization in Zimbabwe. The analysis is performed using data from the two most recent rounds of the nationally representative Demographic and Health Survey for Zimbabwe conducted in 2005/06 and 2010/11 linked with other community-level data. We use logistic, generalized linear regressions as well as multilevel mixed models to examine the factors associated with the frequency, timing and quality of prenatal care. Our results suggest that contraceptive prevalence, religious composition, density of nurses, health expenditures per capita and availability of government hospitals in communities are important predictors of prenatal care use in Zimbabwe. These findings have important implications for public health policy in Zimbabwe – a country with unfavorable maternal and child health outcomes.

      PubDate: 2017-08-29T09:46:29Z
      DOI: 10.1016/j.jegh.2017.08.005
       
  • ‘Before reaching the last mile’- Knowledge, attitude, practice and
           perceived barriers related to tuberculosis directly observed therapy among
           ASHA workers in Central India: A mixed method study

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

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

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


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

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

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

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

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

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

      PubDate: 2017-07-23T17:41:24Z
      DOI: 10.1016/j.jegh.2017.06.002
       
  • Is Google Trends a reliable tool for digital epidemiology? Insights from
           different clinical settings

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

      PubDate: 2017-06-13T14:09:48Z
      DOI: 10.1016/j.jegh.2017.06.001
       
  • Frequency and implications of ofloxacin resistance among previously
           treated tuberculosis patients

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


      PubDate: 2017-05-29T12:35:50Z
      DOI: 10.1016/j.jegh.2017.05.003
       
  • The prevalence and association of stress with sleep quality among medical
           students

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

      PubDate: 2017-05-09T20:52:37Z
      DOI: 10.1016/j.jegh.2017.04.005
       
  • Trends in lung cancer incidence in Lebanon by gender and histological type
           over the period 2005–2008

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

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

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

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

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

      PubDate: 2017-04-14T09:13:15Z
       
  • 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
           Boomers

    • 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
       
  • 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
       
 
 
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