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Journal Cover   Journal of Epidemiology and Global Health
  [SJR: 0.142]   [H-I: 2]   [7 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2210-6006
   Published by Elsevier Homepage  [2812 journals]
  • Evaluation of tuberculosis public health surveillance, Al-Madinah
           province, Kingdom of Saudi Arabia, 2012
    • Abstract: Publication date: Available online 18 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Mohammed J. Alkhalawi , Scott J.N. McNabb , Abdullah M. Assiri , Ziad A. Memish
      The objective of the study is to evaluate the quality of the data, the sensitivity of the surveillance, and the completeness of identification and investigation of tuberculosis (TB) patient’s contacts. The study covered the TB surveillance program in Al-Madinah province in 2011. First, we reviewed all the notifications, treatment cards, and register books, as well as monthly and quarterly reports, for completeness and accuracy of data. Then, we searched for the missed cases that were not reported. Finally, we reviewed all the patients’ household contacts’ reports to assess the degree of completion of identification and investigation. There were 444 cases detected during the study period; only 200 cases were reported. The sensitivity of the TB surveillance system was 45%. Among the 200 reported cases, the results revealed high completeness rates for demographic and disease data and low completeness rates for the test result fields. The contact identification and investigation showed that 34.4% of smear-positive cases’ contacts were not identified. Only 67% of identified contacts were investigated. The review of hospital records and lab registers showed that 244 cases were not reported. In conclusion, the TB surveillance system has several areas that need improvement.

      PubDate: 2015-05-21T14:52:21Z
  • An assessment of the occupational and environmental health needs in seven
           Southeastern European and West-Central Asian countries
    • Abstract: Publication date: Available online 8 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Alexandru Coman , Răzvan M. Cherecheş , Marius I. Ungureanu , Emanuela O. Marton Vasarhelyi , Marissa A. Valentine , Tara Sabo-Attwood , Gregory C. Gray
      Eastern European and Central Asian countries are undergoing rapid socioeconomic and political reforms. Many old industrial facilities are either abandoned, or use outdated technologies that severely impact the environment. Emerging industries have less regulation than in developed countries and environmental and occupational problems seem to be increasing. Under a US National Institutes of Health pilot grant, we developed an interdisciplinary One Health research network in Southeastern Europe and West-Central Asia to identify environmental and occupational problems. From 2012 to 2014, this GEOHealth Hub engaged 11 academic centers and 16 public health institutions in eight different countries: Albania, Armenia, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Romania, and the United States with a goal of strengthening environmental and occupational research and training capacities. Employing face-to-face interviews and large group meetings, we conducted an evidenced-based needs and opportunities assessment focused on aquatic health, food safety, and zoonotic diseases. Comprehensive reviews of the published literature yielded priority research areas for each of the seven GeoHealth Hub countries including heavy metal and pesticide contamination, tick-borne diseases, rabies, brucellosis, and inadequate public health surveillance.

      PubDate: 2015-05-12T13:22:58Z
  • First and second line drug resistance among treatment naïve cases
           pulmonary tuberculosis patients in a district under Revised National
           Tuberculosis Control Programme (RNTCP) in New Delhi
    • Abstract: Publication date: Available online 2 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Vithal Prasad Myneedu , Ritu Singhal , Khalid Umer Khayyam , Prem Prakash Sharma , Manpreet Bhalla , Digamber Behera , Rohit Sarin
      There is limited information of level of drug resistance to first-line and second line anti-tuberculosis agents in treatment naïve pulmonary tuberculosis (PTB) patients from the Indian region. Therefore, the present prospective study was conducted to determine the antimicrobial susceptibility to first-line and second line anti-TB drug resistance in such patients. Sputum samples from consecutive treatment naïve PTB cases registered in Lala Ram Sarup (LRS) district, under RNTCP containing 12 Directly Observed Treatment Centre’s (DOTS), were enrolled using cluster sampling technology. A total of 453 samples were received from July 2011 to June 2012. All samples were cultured on solid medium followed by drug susceptibility to first and second line anti-tubercular drugs as per RNTCP guidelines. Primary multi-drug resistance (MDR) was found to be 18/453; (4.0%). Extensively drug resistance (XDR) was found in one strain (0.2%), which was found to be resistant to other antibiotics. Data of drug resistant tuberculosis among treatment naïve TB patients are lacking in India. The presence of XDR-TB and high MDR-TB in small population studied, calls for conducting systematic multi-centric surveillance across the country.

      PubDate: 2015-05-02T21:47:09Z
  • Occlusal characteristics and prevalence of associated dental anomalies in
           the primary dentition
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Seema Lochib , K.R. Indushekar , Bhavna Gupta Saraf , Neha Sheoran , Divesh Sardana
      Introduction Morphological variations in primary dentition are of great concern to a pediatric dentist as it may pose clinical problems like dental caries, delayed exfoliation and also anomalies in the permanent dentition, such as impaction of successors, supernumerary teeth, permanent double teeth or aplasia of teeth. The present study was conducted to investigate the presence of dental anomalies in the primary dentition of 1000 schoolchildren in the 3–5year-old age group in Faridabad. Materials and methods One-thousand schoolchildren were examined using Type III examination (WHO, 1997) for primary molar relationship, occlusal characteristics, primate spaces, physiological spaces and other anomalies of teeth, including number and morphology. Results and conclusions The prevalence of physiological spaces in maxillary and mandibular arches was 50.9% and 46.7%, respectively, whereas primate spaces were found in 61.7% of the children in the maxillary arch and 27.9% in the mandibular arch. The prevalence of unilateral anterior and posterior cross-bite was 0.1% and 0.8%, respectively, in the present study. The prevalence of hypodontia in the primary dentition was found to be 0.4% and the prevalence of fusion and gemination in the present study was 0.5%. Double teeth (fusion and gemination) and hypodontia were the most common dental anomalies found in the primary dentition in the present study.

      PubDate: 2015-05-02T21:47:09Z
  • Tuberculosis screening among Bolivian sex workers and their children
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Silvia S. Chiang , Jessica K. Paulus , Chi-Cheng Huang , P.K. Newby , Dora Castellón Quiroga , Renée Boynton-Jarrett , Lara Antkowiak
      Bolivian sex workers were more likely than other employed women to report tuberculosis screening only if they reported HIV screening. Of all women with household tuberculosis exposure, <40% reported screening for themselves or their children. Coupling tuberculosis screening with sex workers’ mandatory HIV screenings may be a cost-efficient disease-control strategy.

      PubDate: 2015-05-02T21:47:09Z
  • Terrorism-related trauma in Africa, an increasing problem
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Maryam Alfa-Wali , Kaji Sritharan , Mira Mehes , Fizan Abdullah , Shahnawaz Rasheed
      Global terrorist activities have increased significantly over the past decade. The impact of terrorism-related trauma on the health of individuals in low- and middle-income countries is under-reported. Trauma management in African countries in particular is uncoordinated, with little or no infrastructure to cater for emergency surgical needs. This article highlights the need for education, training and research to mitigate the problems related to terrorism and surgical public health.

      PubDate: 2015-05-02T21:47:09Z
  • Prevalence of pulmonary tuberculosis in Wardha district of Maharashtra,
           Central India
    • Abstract: Publication date: Available online 30 April 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Pratibha Narang , Deepak K. Mendiratta , Naresh K. Tyagi , Ullhas N. Jajoo , Atul T. Tayade , Pratapsingh H. Parihar , Rahul Narang , Pranav S. Mishra , Sharda M. Anjinappa , Vineet K. Chadha
      A house based survey was conducted during 2007–2009 in a representative sample of population in Wardha district implementing Directly Observed Treatment Short Course strategy for tuberculosis (TB) control since 2001. The objective was to estimate prevalence of bacillary pulmonary TB (PTB) in individuals aged 15years or above, and to estimate trends in prevalence when compared to a previous survey carried out in mid 1980’s. Two sputum samples (one spot, one early morning) collected from individuals having symptoms suggestive of PTB, history of previous anti-TB treatment (ATT) or abnormal pulmonary shadow on Mass Miniature Radiography (MMR) consistent with possibly or probably active tuberculosis were subjected to Ziehl–Neelsen microscopy and culture on Lowenstein–Jensen medium. Of 55,096 individuals registered into the survey, 50,332 (91.4%) were screened by interview for symptoms and history of ATT and/or by MMR. Of them, 4805 were eligible for sputum collection; both specimens were collected in 4285 (89.2%) and only one specimen in 27 (0.6%). A total of 86 bacillary cases were detected during the survey. Prevalence of bacillary PTB was estimated at 188.7 (140.3–236.9) per 100,000 populations. There was a decline of 61% in the prevalence of PTB over a period of 22years.

      PubDate: 2015-05-02T21:47:09Z
  • Drinking water studies: A review on heavy metal, application of biomarker
           and health risk assessment (a special focus in Malaysia)
    • Abstract: Publication date: Available online 2 May 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Nurul Hafiza Ab Razak , Sarva Mangala Praveena , Ahmad Zaharin Aris , Zailina Hashim
      Malaysia has abundant sources of drinking water from river and groundwater. However, rapid developments have deteriorated quality of drinking water sources in Malaysia. Heavy metal studies in terms of drinking water, applications of health risk assessment and bio-monitoring in Malaysia were reviewed from 2003 to 2013. Studies on heavy metal in drinking water showed the levels are under the permissible limits as suggested by World Health Organization and Malaysian Ministry of Health. Future studies on the applications of health risk assessment are crucial in order to understand the risk of heavy metal exposure through drinking water to Malaysian population. Among the biomarkers that have been reviewed, toenail is the most useful tool to evaluate body burden of heavy metal. Toenails are easy to collect, store, transport and analysed. This review will give a clear guidance for future studies of Malaysian drinking water. In this way, it will help risk managers to minimize the exposure at optimum level as well as the government to formulate policies in safe guarding the population.

      PubDate: 2015-05-02T21:47:09Z
  • Point prevalence survey of antimicrobial utilization in a Canadian
           tertiary-care teaching hospital
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Colin Lee , Sandra A.N. Walker , Nick Daneman , Marion Elligsen , Lesley Palmay , Bryan Coburn , Andrew Simor
      Objectives Inappropriate antimicrobial use can promote antimicrobial resistance, which is associated with increased patient morbidity and mortality. Identifying the pattern of antimicrobial use can provide data from which targeted antimicrobial stewardship interventions can be made. The primary objective was to identify the prevalence of antimicrobial use at a tertiary care teaching hospital with both acute and long-term care patients. Methods A point prevalence study was conducted on July 19th, 2012. Data on antimicrobial utilization, indication for prescribing, duration of therapy, and frequency of infectious disease or antimicrobial stewardship consultations were collected using a customized integrated stewardship database (SPIRIT) and prospective chart review. Results One or more antimicrobial agents were ordered in 31% and 4% of acute care and long-term care patients, respectively. Respiratory and urinary tract infections were the most common indication for antimicrobial therapy in both acute and long-term care. About 25% of surgical prophylaxis orders were prescribed for greater than 24h. Conclusion This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.

      PubDate: 2015-05-02T21:47:09Z
  • A cross-sectional study of pediatric eye care perceptions in Ghana,
           Honduras, and India
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Daryl Ramai , Ryan Elliott , Shoshanna Goldin , Tejas Pulisetty
      Of the more than 1.4 million blind children worldwide, 75% live in developing countries. To reduce the prevalence of childhood blindness and associated diseases, attention is given to understanding the perceptions and level of awareness held by caregivers. This understanding can enable tailored health programs to reduce the global prevalence of blindness with increased efficiency. This study, which took place in Ghana, Honduras, and India, found that 95% of caregivers believed in the importance of eye exams for children, yet 66% of caregivers said that none of their children had ever received an eye exam. Participants’ major reasons for not bringing their children included the belief that their child had no eye problems along with similar and unique socio-economic barriers. Further information was gained through the use of a five-question test on basic child eye care symptoms, which showed that out of the three country locations, the studied population in India had the least understanding about pediatric eye symptoms. Further analysis revealed significant gaps in understanding of general eye health while detected knowledge barriers provide evidence that fundamental misconceptions appear to be inhibiting caregivers’ competence in facilitating their children’s eye health.

      PubDate: 2015-05-02T21:47:09Z
  • Adherence to medications and associated factors: A cross-sectional study
           among Palestinian hypertensive patients
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Rowa’ Al-Ramahi
      Objective To assess adherence of Palestinian hypertensive patients to therapy and to investigate the effect of a range of demographic and psychosocial variables on medication adherence. Methods A questionnaire-based, cross-sectional descriptive study was undertaken at a group of outpatient clinics of the Ministry of Health, in addition to a group of private clinics and pharmacies in the West Bank. Social and demographic variables and self-reported drug adherence (Morisky scale) were determined for each patient. Results Low adherence with medications was present in 244 (54.2%) of the patients. The multivariate logistic regression showed that younger age (<45years), living in a village compared with a city, evaluating health status as very good, good or poor compared with excellent, forgetfulness, fear of getting used to medication, adverse effect, and dissatisfaction with treatment had a statistically significant association with lower levels of medication adherence (P <0.05). Conclusions Poor adherence to medications was very common. The findings of this study may be used to identify the subset of population at risk of poor adherence who should be targeted for interventions to achieve better blood pressure control and hence prevent complications. This study should encourage the health policy makers in Palestine to implement strategies to reduce non-compliance, and thus contribute toward reducing national health care expenditures. Better patient education and communication with healthcare professionals could improve some factors that decrease adherence such as forgetfulness and dissatisfaction with treatment.

      PubDate: 2015-05-02T21:47:09Z
  • Energy drink usage among university students in a Caribbean country:
           Patterns of use and adverse effects
    • Abstract: Publication date: June 2015
      Source:Journal of Epidemiology and Global Health, Volume 5, Issue 2
      Author(s): Sandra D. Reid , Jonathan Ramsarran , Rachel Brathwaite , Sarika Lyman , Ariane Baker , D’Andra C. Cornish , Stefan Ganga , Zahrid Mohammed , Avinash T. Sookdeo , Cathrine K. Thapelo
      Objective There has been little inquiry addressing whether or not concerns about adverse effects of energy drink usage are relevant in the Caribbean. This survey investigated energy drink usage and adverse consequences among tertiary level students in Trinidad and Tobago. Methods A cross-sectional survey of 1994 students from eight institutions was conducted using a de novo questionnaire based on findings from a focus group of students. Chi-squared analyses and logistic regression were used to assess relationships between energy drink usage, adverse effects and other factors affecting energy drink use, and to verify predictors of energy drink use. Results Prevalence of use was 86%; 38% were current users. Males were more likely to use, used more frequently and at an earlier age. Energy drinks were used most commonly to increase energy (50%), combat sleepiness (45%) and enhance academic performance (40%), and occurred during sports (23%) and mixed with alcohol (22.2%). The majority (79.6%) consumed one energy drink per sitting; 62.2% experienced adverse effects, most commonly restlessness (22%), jolt and crash (17.1%) and tachycardia (16.6%). Awareness of adverse effects was associated with no use (p =0.004), but adverse effects were not a deterrent to continued use. Conclusion Energy drink usage is prevalent among students. The use is not excessive, but associated with high rates of adverse effects and occurs in potentially dangerous situations like during exercise and with alcohol. There is a need to educate students about the potential adverse effects of energy drinks.

      PubDate: 2015-05-02T21:47:09Z
  • Commentary for Special Issue “Public health is new in Saudi Arabia.
           With this degree, I can go back and help to develop the field
           there.” – Naif Mohammed Alraihan, King Abdullah Fellow,
           Rollins School of Public Health, 2015
    • Abstract: Publication date: Available online 20 April 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Scott J.N. McNabb , Abdullah M. Assiri , Samar Alsaggaf , Ziad A. Memish

      PubDate: 2015-05-02T21:47:09Z
  • Challenges and opportunities in detecting Taenia solium tapeworm carriers
           in Los Angeles County California, 2009–2014
    • Abstract: Publication date: Available online 23 March 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Curtis Croker
      Carriers of the pork tapeworm, Taenia solium, are the sole source of neurocysticercosis, a parasitic tissue infection that can be chronic and severe. Identifying T. solium tapeworm carriers is challenging. Many are asymptomatic and go undetected and unreported. In addition, T. solium is difficult to distinguish from other Taenia species of less concern. From 2009 to 2014, 24 taeniasis cases were reported to the Los Angeles County (LAC) Department of Public. Twenty reports were received solely from our automated electronic laboratory reporting system (ELR), two from health care providers, and two were generated internally from investigation of households with a reported neurocysticercosis case. Further investigation identified one T. solium carrier originally reported by ELR and one identified from a neurocysticercosis case investigation. These results suggest that T. solium tapeworm carriers can be identified from investigation of ELR reports of unspeciated Taenia cases as well as from households of neurocysticercosis cases.

      PubDate: 2015-04-04T19:40:34Z
  • Relationship between oral clinical conditions and daily performances among
           young adults in India – A cross sectional study
    • Abstract: Publication date: Available online 23 March 2015
      Source:Journal of Epidemiology and Global Health
      Author(s): Ramesh Nagarajappa , Mehak Batra , Sudhanshu Sanadhya , Hemasha Daryani , Gayathri Ramesh
      Objective of the present study was to investigate relationship between oral health-related quality of life using Oral Impacts on Daily Performances (OIDP) scale and specific clinical dental measures. A cross sectional descriptive survey was conducted among 800 students. Oral health status and impacts were assessed using WHO guidelines and OIDP index respectively. Chi square test and multiple logistic regressions were employed for statistical analysis. Participants with caries were significantly (p ⩽0.05) more likely to have an impact on cleaning (OR=2.487) and sleeping and relaxing (OR=8.996). Similarly participants with oral mucosal conditions were more likely to have an impact on eating (OR=3.97), cleaning (OR=2.966) and physical activities (OR=11.190). Dental Aesthetic Index (DAI) impacted on cleaning (OR=2.134), emotional stability (OR=3.957) and social contact (OR=3.21). OIDP Index showed acceptable psychometric properties in the context of an oral health survey. Subjects presented a strong and consistent relationship between dental status and perceived impacts.

      PubDate: 2015-04-04T19:40:34Z
  • Analyzing seasonality of tuberculosis across Indian states and union
    • 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
    • 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
    • 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
    • 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
    • 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
  • 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 (

      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
    • 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
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