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Journal Cover Journal of Epidemiology and Global Health
   [9 followers]  Follow    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 2210-6006
     Published by Elsevier Homepage  [2575 journals]   [SJR: 0.105]   [H-I: 2]
  • Investigation of an outbreak of bloody diarrhea complicated with hemolytic
           uremic syndrome
    • Abstract: Publication date: December 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 4
      Author(s): Otar Chokoshvili , Khatuna Lomashvili , Naile Malakmadze , Marika Geleishvil , Jonas Brant , Paata Imnadze , Nazibrola Chitadze , Lia Tevzadze , Gvantsa Chanturia , Tea Tevdoradze , Tengiz Tsertsvadze , Deborah Talkington , Rajal K Mody , Nancy Strockbine , Russell A Gerber , Edmond Maes , Thomas Rush
      In July–August 2009, eight patients with bloody diarrhea complicated by hemolytic uremic syndrome (HUS) were admitted to hospitals in Tbilisi, Georgia. We started active surveillance in two regions for bloody diarrhea and post-diarrheal HUS. Of 25 case-patients who developed HUS, including the initial 8 cases, half were ⩾15years old, 67% were female and seven (28%) died. No common exposures were identified. Among 20 HUS case-patients tested, Shiga toxin was detected in the stools of 2 patients (one with elevated serum IgG titers to several Escherichia coli serogroups, including O111 and O104). Among 56 persons with only bloody diarrhea, we isolated Shiga toxin-producing E. coli (STEC) O104:H4 from 2 and Shigella from 10; 2 had serologic evidence of E. coli O26 infection. These cases may indicate a previously unrecognized burden of HUS in Georgia. We recommend national reporting of HUS and improving STEC detection capacity.


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


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


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


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


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


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


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


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


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



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



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


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


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



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


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



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



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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


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


      PubDate: 2014-12-14T12:53:55Z
       
  • MicroResearch: Finding sustainable local health solutions in East Africa
           through small local research studies
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): N.E. MacDonald , R. Bortolussi , J. Kabakyenga , S. Pemba , B. Estambale , K.H.M. Kollmann , R. Odoi Adome , M. Appleton
      Background Sub-Saharan African countries have urged grassroots input to improve research capacity. In East Africa, MicroResearch is fostering local ability to find sustainable solutions for community health problems. At 5years, the following reports its progress. Methods The MicroResearch program had three integrated components: (1) 2-week training workshops; (2) small proposal development with international peer review followed by project funding, implementation, knowledge translation; (3) coaching from experienced researchers. Evaluation included standardized questions after completion of the workshops, 2013 online survey of recent workshop participants and discussions at two East Africa MicroResearch Forums in 2013. Results Between 2008 and 2013, 15 workshops were conducted at 5 East Africa sites with 391 participants. Of the 29 projects funded by MicroResearch, 7 have been completed; of which 6 led to changes in local health policy/practice. MicroResearch training stimulated 13 other funded research projects; of which 8 were external to MicroResearch. Over 90% of participants rated the workshops as excellent with 20% spontaneously noting that MicroResearch changed how they worked. The survey highlighted three local research needs: mentors, skills and funding – each addressed by MicroResearch. On-line MicroResearch and alumni networks, two knowledge translation partnerships and an East Africa Leaders Consortium arose from the MicroResearch Forums. Conclusion MicroResearch helped build local capacity for community-directed interdisciplinary health research.


      PubDate: 2014-12-14T12:53:55Z
       
  • Trend of application of World Health Organization control strategy of
           tuberculosis in Egypt
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Amal Saad-Hussein , Asmaa M. Mohammed
      World Health Organization (WHO) control policy for tuberculosis (TB) includes Bacillus Calmette-Guérin (BCG) vaccine at birth, case detection, and treatment of cases with directly observed therapy short-course (DOTS). This policy has been applied through the Ministry of Health and Population in Egypt for more than 30years. The controversies about the efficacy of the BCG vaccination against TB in adults initiate some suggestions for its discontinuation from compulsory vaccinations in countries with low incidence of TB. The present work aimed to study the trend of applying the WHO control policy for TB in Egypt among the Egyptian population throughout the last 20years (1992–2011). The documented database of the country, bibliographic review on MEDLINE, published studies and reports, WHO and EMRO databases that covered the period from 1992 to 2011 were used in this study. The incidence rate of all forms of TB (pulmonary and extrapulmonary) dropped by 50% from 34 cases to 17 cases per 100,000 population, as well as the prevalence rate declined by 60.6% from 71 cases per 100,000 population throughout the last 20years. Case detection and treatment success rates have increased throughout the studied period while it flat-lined over the past 6years which may need attention. The results of this study introduce an evidence-based recommendation for continuation of the WHO TB control policy in Egypt towards elimination of the disease.


      PubDate: 2014-12-14T12:53:55Z
       
  • Chikungunya outbreak in Al-Hudaydah, Yemen, 2011: Epidemiological
           characterization and key lessons learned for early detection and control
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Mamunur Rahman Malik , Abraham Mnzava , Emad Mohareb , Alia Zayed , Abdulhakeem Al Kohlani , Ahmed A.K. Thabet , Hassan El Bushra
      Little is known about the occurrence of chikungunya fever in the Eastern Mediterranean Region of the World Health Organization (WHO). In January 2011, the Ministry of Public Health and Population (MoPH&P) of Yemen reported to WHO an increasing number of “dengue-like” acute febrile illnesses of unknown origin from one of its coastal governorates. An epidemiological investigation was conducted in Al-Hudaydah governorate between 23 and 26 January 2011 by a joint team of WHO, the MoPH&P of Yemen and the U.S. Naval Medical Research Unit (NAMRU-3) in Cairo, Egypt. The investigation led to the detection of an outbreak of chikungunya in Yemen which was the first time ever from any of the 22 countries in the Eastern Mediterranean Region of WHO. Appropriate public health control measures were strengthened following the investigation, and the outbreak was contained. This paper provides a short description of the outbreak and its epidemiological characteristics and highlights the important lessons that were learned for early detection and control of chikungunya in countries where competent vectors for transmission of the virus exist.


      PubDate: 2014-12-14T12:53:55Z
       
  • Neonatal mortality in Nepal: A multilevel analysis of a nationally
           representative
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Subas Neupane , David Teye Doku
      Objectives This study investigated individual, community and district level factors associated with neonatal mortality among a national sample of Nepalese women. Methods Data were drawn from the 2006 Nepalese Demographic and Health Survey on women aged 15–49 who delivered within three years prior to the survey (N =4136). Multilevel logistic regression models with three levels were fitted to assess the influences of measured individual, community and district level variables on neonatal mortality. Results The total neonatal mortality in three years preceding the survey was 4.5 deaths per 100 live births (N =190), with neonatal mortality rate (NMR)=46 per 1000 live births. Having a partner with no formal education, being in the middle on the wealth index and residing in less developed district were associated with neonatal death in bivariate analysis. Women who were assisted by skilled personnel during delivery were less likely to have neonatal death (adjusted OR for no assistance = 2.26, 95% CI=1.19–4.26). Having prenatal care with skilled attendant was associated with less likelihood of neonatal death (adjusted OR for no care = 1.75, 95% CI=1.17–2.62). Older women, mother’s education, parity and wealth index were associated with neonatal mortality. Considerable variations in neonatal mortality at community and district levels were found. Conclusions These findings emphasize the need for interventions at the individual level with regard to access and utilization of healthcare in order to reduce the neonatal mortality in Nepal.


      PubDate: 2014-12-14T12:53:55Z
       
  • Mammography use among women with and without diabetes: Results from the
           Southern Community Cohort Study
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Maureen Sanderson , Loren Lipworth , Xijing Han , Alicia Beeghly-Fadiel , David Shen-Miller , Kushal Patel , William J. Blot , Margaret K. Hargreaves
      Studies have shown an increased risk of breast cancer associated with diabetes which may be due to differences in mammography use among women who have diabetes compared with women who do not have diabetes. Baseline data was used from the Southern Community Cohort Study – a prospective cohort study conducted primarily among low-income persons in the southeastern United States – to examine the association between diabetes and mammography use. In-person interviews collected information on diabetes and mammography use from 14,665 white and 30,846 black women aged 40–79years between 2002 and 2009. After adjustment for potential confounding, white women with diabetes were no more likely (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.85–1.06) to undergo mammography within the past 12months than white women without diabetes. Nor was there an association between diabetes and mammography use among black women (OR 1.00, 95% CI 0.93–1.07). An increase in mammography use was seen within one year following diabetes diagnosis, more so among white than black women, but this was offset by decreases thereafter. Although there was some evidence of an increase in mammography use within one year of diabetes diagnosis, these results suggest that mammography use is not related to diabetes.


      PubDate: 2014-12-14T12:53:55Z
       
  • A prospective, observational, epidemiological evaluation of the aetiology
           and antimicrobial susceptibility of acute otitis media in Saudi children
           younger than 5years of age
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Khalid A. Al-Mazrou , Atef M. Shibl , Walid Kandeil , Jean-Yves Pirçon , Cinzia Marano
      Background Information regarding acute otitis media (AOM) aetiology is important for developing effective vaccines. Here, bacterial aetiology and antimicrobial susceptibility of AOM were determined in young Saudi children. Methods Children aged 3–60months with a new episode of AOM, who had not received antibiotics or had received antibiotics for 48–72h but remained symptomatic, were enrolled in this prospective, observational, epidemiological study in Riyadh. Middle ear fluid (MEF) samples were collected by tympanocentesis or from spontaneous otorrhea, and tested for the presence of Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes and Moraxella catarrhalis. Antimicrobial susceptibility of the identified pathogens was assessed using E-tests. Results Between June 2009 and May 2011, 66 children were enrolled. S. pneumoniae was detected in 6 episodes and non-typeable H. influenzae (NTHi) in 8 episodes. Moreover, Staphylococcus aureus, which is an uncommon cause of AOM, was detected in 17 episodes. Pneumococcal serotypes were 7F (n =2), 23F (n =2), 19F (n =1) and 15F (n =1). Susceptibility to cefotaxime was observed in all pneumococcal and H. influenzae isolates, to cefuroxime in 4/6 pneumococcal and 8/8 H. influenzae isolates, and to penicillin in 5/6 pneumococcal isolates. Conclusions S. pneumoniae and NTHi were major bacterial contributors for AOM in Saudi children.


      PubDate: 2014-12-14T12:53:55Z
       
  • Tracking women and children in a Continuum of Reproductive, Maternal,
           Newborn, and Child Healthcare (RMNCH) in India
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Rajesh Kumar Rai
      The Continuum of Reproductive, Maternal, Newborn, and Child Healthcare (RMNCH) model is suggested to be an effective tool to improve maternal and child health. This short dispatch proposes that if India pursues the continuum of care model, a well-designed follow-up strategy to track prospective mothers and their children is imperative.


      PubDate: 2014-12-14T12:53:55Z
       
  • Objective cardiac markers and cerebrovascular lesions in Indian seniors
    • Abstract: Publication date: September 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 3
      Author(s): Stephanie H. Charles , Amanda C. Tow , Joe Verghese
      Cardiovascular risk factors are implicated in cerebrovascular disease, resulting in cognitive impairment. This study investigated the relationship between objective cardiac markers and cerebral changes in older Indian adults with and without dementia. Dementia patients with major electrocardiographic (EKG) abnormalities were 8.19 times more likely to have evidence of stroke on magnetic resonance imaging (MRI) compared with patients with no EKG abnormalities (p <.05). The relationship between major EKG abnormalities and stroke on MRI was not significant for patients without dementia. Objective cardiac markers may identify MRI cerebrovascular lesions in patients with dementia, and thus guide neuroimaging allocation in resource-poor areas.


      PubDate: 2014-12-14T12:53:55Z
       
  • A cross-sectional study of pediatric eye care perceptions in Ghana,
           Honduras, and India
    • Abstract: Publication date: Available online 12 August 2014
      Source:Journal of Epidemiology and Global Health
      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: 2014-12-14T12:53:55Z
       
  • Point prevalence survey of antimicrobial utilization in a Canadian
           tertiary-care teaching hospital
    • Abstract: Publication date: Available online 8 August 2014
      Source:Journal of Epidemiology and Global Health
      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: 2014-12-14T12:53:55Z
       
  • Occlusal characteristics and prevalence of associated dental anomalies in
           the primary dentition
    • Abstract: Publication date: Available online 7 August 2014
      Source:Journal of Epidemiology and Global Health
      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: 2014-12-14T12:53:55Z
       
  • Tuberculosis screening among Bolivian sex workers and their children
    • Abstract: Publication date: Available online 19 July 2014
      Source:Journal of Epidemiology and Global Health
      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: 2014-12-14T12:53:55Z
       
  • Terrorism-related trauma in Africa, an increasing problem
    • Abstract: Publication date: Available online 15 July 2014
      Source:Journal of Epidemiology and Global Health
      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: 2014-12-14T12:53:55Z
       
  • Adherence to medications and associated factors: A cross-sectional study
           among Palestinian hypertensive patients
    • Abstract: Publication date: Available online 21 June 2014
      Source:Journal of Epidemiology and Global Health
      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: 2014-12-14T12:53:55Z
       
  • Energy drink usage among university students in a Caribbean country:
           Patterns of use and adverse effects
    • Abstract: Publication date: Available online 19 June 2014
      Source:Journal of Epidemiology and Global Health
      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: 2014-12-14T12:53:55Z
       
  • Health conditions for travellers to Saudi Arabia for the Umra and
           pilgrimage to Mecca (Hajj) – 2014
    • Abstract: Publication date: June 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 2
      Author(s): Ziad A. Memish , Abdullah A. Al Rabeeah



      PubDate: 2014-12-14T12:53:55Z
       
  • Improving the quality of tuberculosis care: We need standards and
           strategies to translate them into practice
    • Abstract: Publication date: June 2014
      Source:Journal of Epidemiology and Global Health, Volume 4, Issue 2
      Author(s): Madhukar Pai



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