Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1899575
Anthony C. Torres, Madan Joshi, W. Chan
Abstract Abstract: Thirty-three-year-old Caucasian male underwent initiation of levetiracetam following witnessed generalized seizure activity at the same time presenting with a right MCA territory ischemic stroke. He then developed elevated CPK and myalgias are highly suspicious for rhabdomyolysis following levetiracetam. Subsequent improvement noted following complete cessation of medication. At follow-up patient reported complete resolution of hemiparesis and myalgias and no new neurological deficits while tolerating valproic acid. This case exemplifies potential rare adverse effect of levetiracetam. Levetiracetam is an antiepileptic medication effective for both generalized and focal types of epilepsy by affecting a broad spectrum of neurotransmitter release via calcium channels GABA receptors and synaptic vessel protein 2A (SV2A). Typical adverse effects include mild dizziness, headache, nausea, somnolence and sometimes hostility. This case provides further evidence of a rare and potentially life-threatening adverse effect of rhabdomyolysis. Further study is needed to possibly detect the exact mechanism resulting in this rare and dangerous adverse effect.
{"title":"Levetiracetam induced rhabdomyolysis","authors":"Anthony C. Torres, Madan Joshi, W. Chan","doi":"10.1080/2331205X.2021.1899575","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1899575","url":null,"abstract":"Abstract Abstract: Thirty-three-year-old Caucasian male underwent initiation of levetiracetam following witnessed generalized seizure activity at the same time presenting with a right MCA territory ischemic stroke. He then developed elevated CPK and myalgias are highly suspicious for rhabdomyolysis following levetiracetam. Subsequent improvement noted following complete cessation of medication. At follow-up patient reported complete resolution of hemiparesis and myalgias and no new neurological deficits while tolerating valproic acid. This case exemplifies potential rare adverse effect of levetiracetam. Levetiracetam is an antiepileptic medication effective for both generalized and focal types of epilepsy by affecting a broad spectrum of neurotransmitter release via calcium channels GABA receptors and synaptic vessel protein 2A (SV2A). Typical adverse effects include mild dizziness, headache, nausea, somnolence and sometimes hostility. This case provides further evidence of a rare and potentially life-threatening adverse effect of rhabdomyolysis. Further study is needed to possibly detect the exact mechanism resulting in this rare and dangerous adverse effect.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"111 3S 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78799369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1939838
Habtamu Alganeh Guadie, Mulugeta Hayelom Kalayou, B. Endehabtu, Fedlu Nurhussien, T. Yilma, Binyam Tilahun
Abstract Abstract: Electronic consultation is a means of communication with clients using different types of electronic devices at distance. However, health professionals’ perception towards the e-consultation is not well addressed. This study aimed to explore health workers’ perception on e-consultation to combat the coronavirus disease 2019 pandemic at the University of Gondar specialized hospital. A qualitative study was undertaken to explore health workers’ perception on e-consultation to tackle COVID-19 pandemic. Eight health-care workers were purposively selected from the University of Gondar specialized hospital. Medical doctors, nurses, medical laboratory professionals and public health officers were selected as key informants for in-depth interview. A thematic analysis was carried out. The analysis was performed with four identified themes, namely e-consultation benefit, technical skill, barriers of e-consultation and facilitators of e-consultation. All the respondents were aware of e-consultation service as a solution in the health-care system to tackle the spread of pandemic. Some had the experience of reminding their clients to take drugs by using their mobile phone. They also expressed their feelings that using e-consultation would have an impact on health professional and client satisfaction by reducing the fear of transmission of the pandemic. Health workers believe that e-consultation solutions can reduce the spread of the pandemic at the point of service delivery. Technical skills, organizational setup and information technology-related factors were major contributing ones. Health professionals’ perception could not be a problem in implementing e-consultation service to tackle the spread of the pandemic.
{"title":"eConsultation perception among health professionals in response to the COVID-19 pandemic in University of Gondar referral hospital, Ethiopia","authors":"Habtamu Alganeh Guadie, Mulugeta Hayelom Kalayou, B. Endehabtu, Fedlu Nurhussien, T. Yilma, Binyam Tilahun","doi":"10.1080/2331205X.2021.1939838","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1939838","url":null,"abstract":"Abstract Abstract: Electronic consultation is a means of communication with clients using different types of electronic devices at distance. However, health professionals’ perception towards the e-consultation is not well addressed. This study aimed to explore health workers’ perception on e-consultation to combat the coronavirus disease 2019 pandemic at the University of Gondar specialized hospital. A qualitative study was undertaken to explore health workers’ perception on e-consultation to tackle COVID-19 pandemic. Eight health-care workers were purposively selected from the University of Gondar specialized hospital. Medical doctors, nurses, medical laboratory professionals and public health officers were selected as key informants for in-depth interview. A thematic analysis was carried out. The analysis was performed with four identified themes, namely e-consultation benefit, technical skill, barriers of e-consultation and facilitators of e-consultation. All the respondents were aware of e-consultation service as a solution in the health-care system to tackle the spread of pandemic. Some had the experience of reminding their clients to take drugs by using their mobile phone. They also expressed their feelings that using e-consultation would have an impact on health professional and client satisfaction by reducing the fear of transmission of the pandemic. Health workers believe that e-consultation solutions can reduce the spread of the pandemic at the point of service delivery. Technical skills, organizational setup and information technology-related factors were major contributing ones. Health professionals’ perception could not be a problem in implementing e-consultation service to tackle the spread of the pandemic.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"646 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77541939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1964184
S. Adedini, Hassan Ogunwemimo, L. Bisiriyu
Abstract There has been a divergence in the pace of fertility decline between the Muslim-dominated countries of Maghreb and those of Middle/West Africa (despite having similar religious beliefs, which studies have implicated as a major determinant of fertility behaviours). While the Maghreb countries have total fertility rate ranging between 2 and 3, it ranges between 6 and 7 in Muslim-majority countries of Middle/West Africa. Factors other than religion seem to be responsible for this divergent pattern. Evidence is sparse on this. This paper provides empirical evidence on factors influencing divergent pattern in fertility levels of selected Muslim-dominated countries of Maghreb and Middle/West Africa. Based on availability of recent data, this paper drew on Demographic and Health Survey data of three Middle/West Africa countries—Mali (2013–14), Niger (2012) and Northern Nigeria (2013); and two North African countries—Egypt (2014) and Morocco (2003–04). Relationships were explored using Poisson regression models that adjusted for religion and women characteristics. Findings showed that age at first marriage, age at first birth, contraceptive use, child mortality, plurality of marriage and women education are the major drivers of divergence in fertility patterns of the selected countries in both sub-regions. Differences in proximate determinants of fertility played significant roles in shaping the divergent pattern in fertility levels between both sub-regions. Rather than focusing on religion, this study suggests the need for transition in the proximate determinants of fertility in Middle/West African countries, if the sub-region would achieve the desired fertility decline.
{"title":"Divergence in fertility levels and patterns of muslim-majority countries of maghreb and middle/West Africa","authors":"S. Adedini, Hassan Ogunwemimo, L. Bisiriyu","doi":"10.1080/2331205X.2021.1964184","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1964184","url":null,"abstract":"Abstract There has been a divergence in the pace of fertility decline between the Muslim-dominated countries of Maghreb and those of Middle/West Africa (despite having similar religious beliefs, which studies have implicated as a major determinant of fertility behaviours). While the Maghreb countries have total fertility rate ranging between 2 and 3, it ranges between 6 and 7 in Muslim-majority countries of Middle/West Africa. Factors other than religion seem to be responsible for this divergent pattern. Evidence is sparse on this. This paper provides empirical evidence on factors influencing divergent pattern in fertility levels of selected Muslim-dominated countries of Maghreb and Middle/West Africa. Based on availability of recent data, this paper drew on Demographic and Health Survey data of three Middle/West Africa countries—Mali (2013–14), Niger (2012) and Northern Nigeria (2013); and two North African countries—Egypt (2014) and Morocco (2003–04). Relationships were explored using Poisson regression models that adjusted for religion and women characteristics. Findings showed that age at first marriage, age at first birth, contraceptive use, child mortality, plurality of marriage and women education are the major drivers of divergence in fertility patterns of the selected countries in both sub-regions. Differences in proximate determinants of fertility played significant roles in shaping the divergent pattern in fertility levels between both sub-regions. Rather than focusing on religion, this study suggests the need for transition in the proximate determinants of fertility in Middle/West African countries, if the sub-region would achieve the desired fertility decline.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73770823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1965709
Azalech Ayza, E. Tadesse, Yoseph Halala Handiso
Abstract Abstract: Overweight and obesity has become a major global health challenge that affects virtually all ages. The aim of this study is to assess the prevalence of overweight/obesity and associated factors among adults of Sodo Town, Southern Ethiopia. Community based cross sectional study was conducted from January to February 2016. A total of 370 households were selected from 14,551 household using a simple random sampling technique., Lottery method was used to select an adult individual with age of ≥25 years. Anthropometric measurements (height and weight) was assessed using the World Health Organization) recommended techniques. Data were analyzed using SPSS windows version 20 Software. Both bivariate and multivariable logistic regression analyses were done. Prevalence of overweight was 32.4% and obesity 16.2%. The combined prevalence of overweight/obesity was 48.6%. Factors associated with overweight/obesity were being female (AOR = 4.0; 95% of CI: 1.7−9.4), Age group between 35–44, 45–54 and age >55 were more likely to be overweight/obesity than age group 25–34 (AOR = 28; 95% CI:1.51–5.15), AOR = 2.44; 95%CI:1.12–5.32), AOR = 5; 95%CI:1.94–12-92) respectively. Similarly, having chronic illness (AOR = 2.9;95%CI:1.1–7.2), using Bajaj/car for transportation (AOR = 1.9; 95% of CI:1.1–3.3), spent 3–5 hours in sitting or reclining (AOR = 3.7;95% CI:1.6–8.5), taking one bottle of soft drink per day (AOR = 2.0;95% CI: 1.1–3.7) and those who consumed vegetable ≥3 times per day (AOR = 5.7; 95% of CI1.6–19.7). Prevalence of overweight/obesity among adult population in Sodo Town is high. Therefore, prioritizing counseling dietary modification about the risk of overweight /obesity in community level, provision of early care and treatment of chronic illness, regular physical exercise by avoiding sedentary life style are recommended.
{"title":"Prevalence of overweight/obesity and associated factors among adults in Wolaita Sodo Town, Southern Ethiopia","authors":"Azalech Ayza, E. Tadesse, Yoseph Halala Handiso","doi":"10.1080/2331205X.2021.1965709","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1965709","url":null,"abstract":"Abstract Abstract: Overweight and obesity has become a major global health challenge that affects virtually all ages. The aim of this study is to assess the prevalence of overweight/obesity and associated factors among adults of Sodo Town, Southern Ethiopia. Community based cross sectional study was conducted from January to February 2016. A total of 370 households were selected from 14,551 household using a simple random sampling technique., Lottery method was used to select an adult individual with age of ≥25 years. Anthropometric measurements (height and weight) was assessed using the World Health Organization) recommended techniques. Data were analyzed using SPSS windows version 20 Software. Both bivariate and multivariable logistic regression analyses were done. Prevalence of overweight was 32.4% and obesity 16.2%. The combined prevalence of overweight/obesity was 48.6%. Factors associated with overweight/obesity were being female (AOR = 4.0; 95% of CI: 1.7−9.4), Age group between 35–44, 45–54 and age >55 were more likely to be overweight/obesity than age group 25–34 (AOR = 28; 95% CI:1.51–5.15), AOR = 2.44; 95%CI:1.12–5.32), AOR = 5; 95%CI:1.94–12-92) respectively. Similarly, having chronic illness (AOR = 2.9;95%CI:1.1–7.2), using Bajaj/car for transportation (AOR = 1.9; 95% of CI:1.1–3.3), spent 3–5 hours in sitting or reclining (AOR = 3.7;95% CI:1.6–8.5), taking one bottle of soft drink per day (AOR = 2.0;95% CI: 1.1–3.7) and those who consumed vegetable ≥3 times per day (AOR = 5.7; 95% of CI1.6–19.7). Prevalence of overweight/obesity among adult population in Sodo Town is high. Therefore, prioritizing counseling dietary modification about the risk of overweight /obesity in community level, provision of early care and treatment of chronic illness, regular physical exercise by avoiding sedentary life style are recommended.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84116527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1876321
M. Gaetz
Abstract Abstract: Media reports of difficulties with post-career functioning and death in ex-professional hockey enforcers have led to concerns within the ice hockey community. The purpose of the study was to interview 10 ex-professional ice hockey enforcers and integrate their lived experiences into the narrative on post-retirement problems experienced by these athletes. Based on the existing literature, it was hypothesised that ex-professional hockey enforcers would be at high risk for development of symptomology consistent with Chronic Traumatic Encephalopathy (CTE). A mixed methods analytical approach informed by Pragmatic and Indigenous methodologies was employed. Participants had a significant history of fighting in their sport (range 100–250; mean = 218.5). All had significant concussion histories related to their careers in hockey. One participant reported problems post-career associated with concussions sustained while playing hockey. Five participants reported issues with chronic pain that mildly impacted their sleep and/or daily functioning. The majority reported relatively good post-career functioning. In summary, the hypothesis that ex-professional hockey enforcers are at high risk for developing symptomology consistent with CTE was not supported. The pattern of results is in opposition to the commonly held perspective that fighting in hockey leads to a cascade of events that results in poor post-career outcome.
{"title":"Understanding Post-Career adjustment in Ex-Professional Ice Hockey Enforcers: Concussion history and chronic pain","authors":"M. Gaetz","doi":"10.1080/2331205X.2021.1876321","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1876321","url":null,"abstract":"Abstract Abstract: Media reports of difficulties with post-career functioning and death in ex-professional hockey enforcers have led to concerns within the ice hockey community. The purpose of the study was to interview 10 ex-professional ice hockey enforcers and integrate their lived experiences into the narrative on post-retirement problems experienced by these athletes. Based on the existing literature, it was hypothesised that ex-professional hockey enforcers would be at high risk for development of symptomology consistent with Chronic Traumatic Encephalopathy (CTE). A mixed methods analytical approach informed by Pragmatic and Indigenous methodologies was employed. Participants had a significant history of fighting in their sport (range 100–250; mean = 218.5). All had significant concussion histories related to their careers in hockey. One participant reported problems post-career associated with concussions sustained while playing hockey. Five participants reported issues with chronic pain that mildly impacted their sleep and/or daily functioning. The majority reported relatively good post-career functioning. In summary, the hypothesis that ex-professional hockey enforcers are at high risk for developing symptomology consistent with CTE was not supported. The pattern of results is in opposition to the commonly held perspective that fighting in hockey leads to a cascade of events that results in poor post-career outcome.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84717171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1892289
P. Mhagama, Patrick Makono, Chimwemwe Tsitsi
Abstract Abstract: Voluntary Medical Male Circumcision (VMMC) has been promoted as an effective biomedical intervention in the reduction of the risk of new HIV and STI infections. The government of Malawi and its stakeholders including the World Health Organization have committed a lot of resources to VMMC programming. However, research shows that its uptake among men is still low in Malawi. This study, therefore, investigated the communication-related factors that influence decision-making in the uptake of VMMC among men in Lilongwe, Malawi. To achieve this aim, twenty-five men, aged between 18 and 35 years old were interviewed on what influenced them to undergo VMMC. The study found that the respondents were influenced to uptake VMMC mostly by peer pressure and the need for conformity; partner/girlfriend demand and considerations; and advice from health personnel. The paper concludes that although the final decision was theirs to make, the men in the study underwent circumcision under duress and/or coercion. It cannot be said to be voluntary. The medical necessity of VMMC can be said to be voluntary if it is negotiated and consented to without duress. Although the respondents mentioned the HIV and STI infection risk reduction properties, hygienic advantages, and cervical cancer reduction properties of VMMC as benefits of VMMC, these had very little influence on their decision. It is recommended that current intervention messages be reviewed and modified to incorporate new ideas that can address the shortcomings that the current crop of messages has with the aim of increasing the uptake of VMMC programmes or other health focused behaviour change programmes.
{"title":"Communication-related factors influencing the uptake of voluntary medical male circumcision among men in Lilongwe Urban, Malawi","authors":"P. Mhagama, Patrick Makono, Chimwemwe Tsitsi","doi":"10.1080/2331205X.2021.1892289","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1892289","url":null,"abstract":"Abstract Abstract: Voluntary Medical Male Circumcision (VMMC) has been promoted as an effective biomedical intervention in the reduction of the risk of new HIV and STI infections. The government of Malawi and its stakeholders including the World Health Organization have committed a lot of resources to VMMC programming. However, research shows that its uptake among men is still low in Malawi. This study, therefore, investigated the communication-related factors that influence decision-making in the uptake of VMMC among men in Lilongwe, Malawi. To achieve this aim, twenty-five men, aged between 18 and 35 years old were interviewed on what influenced them to undergo VMMC. The study found that the respondents were influenced to uptake VMMC mostly by peer pressure and the need for conformity; partner/girlfriend demand and considerations; and advice from health personnel. The paper concludes that although the final decision was theirs to make, the men in the study underwent circumcision under duress and/or coercion. It cannot be said to be voluntary. The medical necessity of VMMC can be said to be voluntary if it is negotiated and consented to without duress. Although the respondents mentioned the HIV and STI infection risk reduction properties, hygienic advantages, and cervical cancer reduction properties of VMMC as benefits of VMMC, these had very little influence on their decision. It is recommended that current intervention messages be reviewed and modified to incorporate new ideas that can address the shortcomings that the current crop of messages has with the aim of increasing the uptake of VMMC programmes or other health focused behaviour change programmes.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82790662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1874090
Bsrat Tesfay, T. Getinet, E. A. Derso
Abstract Abstract: Breast cancer is the major public health problem throughout the world and it results in serious physical damages and death. This work proposes the use of joint model to study breast cancer in patients of Ayder Hospital. The primary motivation is to contribute to the understanding of the tumor cell progression of breast cancer, within Ayder Hospital, using a joint model that takes into account a possible existence of a serial correlation structure within a same subject observations from September 2015 till December 2018. The general aim of this study was to investigate the risk of longitudinal change in tumor cell level on time to death due to breast cancer among breast cancer patients. Hospital-based retrospective cohort study was conducted among breast cancer patients. A joint model of longitudinal and time to death model was used to determine the risk of longitudinal change in tumor cell level on time to death due to breast cancer patients. These were used by using JM package in R version. Results from joint models, showed that the longitudinal Tumor cell progression was signicantly associated with the survival probability of these patients(estimated association parameter(ɑ) in the joint model is 0.84 with corresponding (95% CI: 2.28,2.37). A comparison between parameter estimates obtained in this joint model and independent survival and longitudinal analysis lead us to conclude that independent analysis brings up bias parameter estimates. There is a strong association between the progression change in log(TCL) and risk of mortality due to breast cancer.
{"title":"Joint modeling of longitudinal change in tumor cell level and time to death of breast cancer patients: In case of Ayder comprehensive specialized Hospital Tigray, Ethiopia","authors":"Bsrat Tesfay, T. Getinet, E. A. Derso","doi":"10.1080/2331205X.2021.1874090","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1874090","url":null,"abstract":"Abstract Abstract: Breast cancer is the major public health problem throughout the world and it results in serious physical damages and death. This work proposes the use of joint model to study breast cancer in patients of Ayder Hospital. The primary motivation is to contribute to the understanding of the tumor cell progression of breast cancer, within Ayder Hospital, using a joint model that takes into account a possible existence of a serial correlation structure within a same subject observations from September 2015 till December 2018. The general aim of this study was to investigate the risk of longitudinal change in tumor cell level on time to death due to breast cancer among breast cancer patients. Hospital-based retrospective cohort study was conducted among breast cancer patients. A joint model of longitudinal and time to death model was used to determine the risk of longitudinal change in tumor cell level on time to death due to breast cancer patients. These were used by using JM package in R version. Results from joint models, showed that the longitudinal Tumor cell progression was signicantly associated with the survival probability of these patients(estimated association parameter(ɑ) in the joint model is 0.84 with corresponding (95% CI: 2.28,2.37). A comparison between parameter estimates obtained in this joint model and independent survival and longitudinal analysis lead us to conclude that independent analysis brings up bias parameter estimates. There is a strong association between the progression change in log(TCL) and risk of mortality due to breast cancer.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"234 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83456907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205x.2021.1944477
Tsehay Haile, Kasim Mohammed, Endeshaw Assefa
Abstract Abstract: Tuberculosis (TB) is still a public health problem and amongst the top 10 leading causes of death. The objective of this study is to analyze the survival time of TB patients and identify the risk factors that influence their survival in Pawe Hospital during the treatment period. The data for this study are obtained from TB patients registered books from September 2009 to January 2010 under Directly Observed Treatment, Short-course (DOTS) at the health centers in Pawe Hospital. The analytical methodologies used were the Kaplan–Meier to estimate the survival time and Cox’s regression model to identify the covariates that have a statistically significant effect on the survival longevity of TB patients. The estimation of the model parameters was done by partial maximum likelihood procedures. The multivariate analysis of the Cox regression model gives that age, category (patient category), initial weight and HIV status have statistically significant effects on the survival longevity of TB patients. On the other hand, sex, marital status, and history of previous treatment have no impact on the survival experience of TB patients. The study shows that 84.5% of the patients were still alive at the end of 8 months of anti-TB treatment. Based on the result of the study, different factors are identified for the death of TB. Patients recommended that TB co-infected people should have awareness about the hazard of the risk factors identified in this study, and health workers should be cautious when a patient has lower Initial weight and HIV-positive status.
{"title":"Determinanet of the survival pattern of tuberculosis patients treated under directly observed treatment short course at Pawe Hospital, Ethiopia","authors":"Tsehay Haile, Kasim Mohammed, Endeshaw Assefa","doi":"10.1080/2331205x.2021.1944477","DOIUrl":"https://doi.org/10.1080/2331205x.2021.1944477","url":null,"abstract":"Abstract Abstract: Tuberculosis (TB) is still a public health problem and amongst the top 10 leading causes of death. The objective of this study is to analyze the survival time of TB patients and identify the risk factors that influence their survival in Pawe Hospital during the treatment period. The data for this study are obtained from TB patients registered books from September 2009 to January 2010 under Directly Observed Treatment, Short-course (DOTS) at the health centers in Pawe Hospital. The analytical methodologies used were the Kaplan–Meier to estimate the survival time and Cox’s regression model to identify the covariates that have a statistically significant effect on the survival longevity of TB patients. The estimation of the model parameters was done by partial maximum likelihood procedures. The multivariate analysis of the Cox regression model gives that age, category (patient category), initial weight and HIV status have statistically significant effects on the survival longevity of TB patients. On the other hand, sex, marital status, and history of previous treatment have no impact on the survival experience of TB patients. The study shows that 84.5% of the patients were still alive at the end of 8 months of anti-TB treatment. Based on the result of the study, different factors are identified for the death of TB. Patients recommended that TB co-infected people should have awareness about the hazard of the risk factors identified in this study, and health workers should be cautious when a patient has lower Initial weight and HIV-positive status.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80799605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2020.1870069
P. Tabong, P. Akweongo, P. Adongo
Abstract Globally, the agenda is to end tuberculosis (TB) by 2030. The emic (local) perspective about causes, signs and symptoms, and management of the disease has implications in service utilization and health-seeking. This research paper examines the local beliefs about TB and how this affects case detection and treatment. The analysis triangulates data from eight focus group discussions (N = 72), 15 in-depth interviews (IDIs) with patients with TB, and four traditional healers. TB described locally as Kɔrongkpong, kɔrongpilah (in Dagaare), and Kusibine (in Sissalla) is believed to be caused by curses, bewitchment, breaking local taboos, and a sin against the gods. The ethnosemantics depict TB as a condition of the lungs which presents with severe cough, caused by spiritual factors with fatal health outcome. In that regard, traditional medicine to exorcise the spirit is required before modern medicine can be effective. Initial symptoms such as cough and fever of TB are often self-managed and later traditional remedies sought. Furthermore, some of the signs are misconstrued for conditions such as asthma and whooping cough. The worldview of the community also dictates that these conditions have spiritual aetiologic factors and should be managed as such. This health-seeking pattern results in delays in receiving appropriate treatment. As an infectious disease, the delays in health-seeking will hinder progress towards achieving the end TB global agenda. Incorporating local beliefs into the design of interventions and social and behavioural change communication strategies can help improve case detection and treatment.
{"title":"Community beliefs about tuberculosis in Ghana: Implications for the end tuberculosis global agenda","authors":"P. Tabong, P. Akweongo, P. Adongo","doi":"10.1080/2331205X.2020.1870069","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1870069","url":null,"abstract":"Abstract Globally, the agenda is to end tuberculosis (TB) by 2030. The emic (local) perspective about causes, signs and symptoms, and management of the disease has implications in service utilization and health-seeking. This research paper examines the local beliefs about TB and how this affects case detection and treatment. The analysis triangulates data from eight focus group discussions (N = 72), 15 in-depth interviews (IDIs) with patients with TB, and four traditional healers. TB described locally as Kɔrongkpong, kɔrongpilah (in Dagaare), and Kusibine (in Sissalla) is believed to be caused by curses, bewitchment, breaking local taboos, and a sin against the gods. The ethnosemantics depict TB as a condition of the lungs which presents with severe cough, caused by spiritual factors with fatal health outcome. In that regard, traditional medicine to exorcise the spirit is required before modern medicine can be effective. Initial symptoms such as cough and fever of TB are often self-managed and later traditional remedies sought. Furthermore, some of the signs are misconstrued for conditions such as asthma and whooping cough. The worldview of the community also dictates that these conditions have spiritual aetiologic factors and should be managed as such. This health-seeking pattern results in delays in receiving appropriate treatment. As an infectious disease, the delays in health-seeking will hinder progress towards achieving the end TB global agenda. Incorporating local beliefs into the design of interventions and social and behavioural change communication strategies can help improve case detection and treatment.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77758141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/2331205X.2021.1964185
J. Ofori-Amoah, Sheila Ofori Addai, Oppong Ampratwum, Michael Rockson Adjei, G. Asare, Juliana Adu Mensah, Aziz Obeng, Ziblim Natogmah, Justice Thomas Sevugu, Williams Agyemang-Duah, Job Kusi, Francis Gumah, Y. Ampem Amoako
Abstract Abstract: Scabies is a Neglected Tropical Disease, transmitted from person to person contact and indirectly through fomites. Though preventable, the burden and infection rate of scabies remain a menace with inadequate attention given to it in Ghana. This report presents an outcome of active disease surveillance and response measures undertaken by the District Health Management Team on the fight against the spread of scabies through case search, treatment, awareness creation, and advocacy campaigns. Students and teachers from 29 schools within the Sub District and 21,173 people in 8 communities were targeted for screening and treatment. In all, a mass drug administration was carried on 2,575 students and teachers, and 2,467 infected patients representing 11.58% from the 8 communities were treated using ivermectin 15% and 25% benzyl benzoate emulsion and Sulphur ointment. Response to the outbreak was hampered by inadequate resources and personnel resulting in low geographical and treatment coverage. Also, intensifying public education and health staff capacity building on case search and control is needed and therefore, the District Health Management Team calls for support from stakeholders in managing the situation.
{"title":"Scabies outbreak investigation and treatment in the Sekyere East District, Ghana: A call to end the neglect","authors":"J. Ofori-Amoah, Sheila Ofori Addai, Oppong Ampratwum, Michael Rockson Adjei, G. Asare, Juliana Adu Mensah, Aziz Obeng, Ziblim Natogmah, Justice Thomas Sevugu, Williams Agyemang-Duah, Job Kusi, Francis Gumah, Y. Ampem Amoako","doi":"10.1080/2331205X.2021.1964185","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1964185","url":null,"abstract":"Abstract Abstract: Scabies is a Neglected Tropical Disease, transmitted from person to person contact and indirectly through fomites. Though preventable, the burden and infection rate of scabies remain a menace with inadequate attention given to it in Ghana. This report presents an outcome of active disease surveillance and response measures undertaken by the District Health Management Team on the fight against the spread of scabies through case search, treatment, awareness creation, and advocacy campaigns. Students and teachers from 29 schools within the Sub District and 21,173 people in 8 communities were targeted for screening and treatment. In all, a mass drug administration was carried on 2,575 students and teachers, and 2,467 infected patients representing 11.58% from the 8 communities were treated using ivermectin 15% and 25% benzyl benzoate emulsion and Sulphur ointment. Response to the outbreak was hampered by inadequate resources and personnel resulting in low geographical and treatment coverage. Also, intensifying public education and health staff capacity building on case search and control is needed and therefore, the District Health Management Team calls for support from stakeholders in managing the situation.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77829655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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