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Residence-based inequalities in overweight/obesity in sub-Saharan Africa: a multivariate non-linear decomposition analysis 撒哈拉以南非洲地区基于居住地的超重/肥胖不平等现象:多变量非线性分解分析
IF 4.5 Q1 Medicine Pub Date : 2024-04-07 DOI: 10.1186/s41182-024-00593-5
Priscilla Atsu, Aliu Mohammed, C. Adu, R. Aboagye, B. Ahinkorah, A. Seidu
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引用次数: 0
Immune response to hepatitis B vaccine among children under 5 years in Africa: a meta-analysis. 非洲 5 岁以下儿童对乙型肝炎疫苗的免疫反应:一项荟萃分析。
IF 4.5 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1186/s41182-024-00594-4
Babayemi O Olakunde, Ijeoma M Ifeorah, Daniel A Adeyinka, Olubunmi A Olakunde, Temitayo Ogundipe, John O Olawepo, Echezona E Ezeanolue

Background: Hepatitis B virus (HBV) infection in Africa is mostly acquired before the age of 5 years through vertical or horizontal routes. While all the countries in the World Health Organization African region have introduced HBV vaccination into their national immunization programs, the rate of protective immune response to HBV vaccine among children in Africa has not been systematically synthesized. In this study, we estimated the HBV vaccine seroprotection rate (defined as anti-HBs titer ≥ 10 IU/L) and the associated factors among under-five children who completed a primary series of HBV vaccination in Africa.

Methods: We systematically searched PubMed, Web Science, and Scopus databases from inception to May 2022 for potentially eligible studies. The pooled seroprotection rate was estimated using a random-effects model with Freeman-Tukey double arcsine transformation and the associated factors were examined using odds ratio estimated by the DerSimonian and Laird method.

Results: From the 1063 records identified, 29 studies with a total sample size of 9167 under-five children were included in the meta-analysis. The pooled seroprotection rate was 89.23% (95% CI   85.68-92.33%, I2 = 95.96%, p < 0.001). In the subgroup analyses, there was a significant difference in the rate by the assay method, vaccine dose, and vaccine combination. HIV-positive children had lower odds of achieving seroprotection when compared with HIV-negative children (OR = 0.22, 95%CI   0.12-0.40).

Conclusions: The majority of under-five children in Africa achieved seroprotection after completing three or four doses of HBV vaccine. However, the rate was lower among children living with HIV. This calls for interventions to timely identify and address nonresponse to HBV vaccine, particularly among immunosuppressed children.

背景:在非洲,乙型肝炎病毒(HBV)感染大多是在 5 岁前通过垂直或水平途径获得的。虽然世界卫生组织非洲地区的所有国家都已将 HBV 疫苗接种纳入其国家免疫计划,但非洲儿童对 HBV 疫苗的保护性免疫反应率尚未得到系统的总结。在本研究中,我们估算了非洲完成初级系列 HBV 疫苗接种的五岁以下儿童的 HBV 疫苗血清保护率(定义为抗 HBs 滴度≥ 10 IU/L)及相关因素:我们系统检索了 PubMed、Web Science 和 Scopus 数据库中从开始到 2022 年 5 月可能符合条件的研究。使用弗里曼-图基双弧线变换随机效应模型估算了汇总的血清保护率,并使用德西蒙和莱尔德方法估算的几率比对相关因素进行了研究:从已确定的 1063 份记录中,29 项研究被纳入荟萃分析,样本量共计 9167 名五岁以下儿童。汇总后的血清保护率为 89.23%(95% CI 85.68-92.33%,I2 = 95.96%,P 结论:五岁以下儿童中的大多数人都有血清保护意识:非洲大多数五岁以下儿童在接种了三或四剂 HBV 疫苗后实现了血清保护。然而,感染艾滋病毒的儿童中这一比例较低。这就需要采取干预措施,及时发现并解决对 HBV 疫苗无反应的问题,尤其是免疫抑制儿童。
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引用次数: 0
Multi-country case study on school health policy and its implementation in relation to COVID-19 control in Micronesia Small Islands Developing States. 密克罗尼西亚小岛屿发展中国家学校卫生政策及其实施与 COVID-19 控制相关的多国案例研究。
IF 4.5 Q1 Medicine Pub Date : 2024-03-29 DOI: 10.1186/s41182-024-00590-8
Fumiko Shibuya, Margaret Hattori-Uchima, Paul Dacanay, Florence Peter, Tarmau Terry Ngirmang, Rudelyn Dacanay, Rie Takeuchi, Calvin de Los Reyes, Jun Kobayashi

Introduction: The COVID-19 pandemic caused school closures and rises in mental illness and non-communicable disease among school children worldwide. The Pacific Small Islands Developing States (SIDS) were also affected, but school health activities, which can effectively reduce negative effects of COVID-19, were not widely implemented compared to other Asia-Pacific countries. This study examined current school health implementation and related policies at national, local, and school levels in the Micronesia SIDS according to phases of COVID-19 control.

Methods: Multi-country case study targeted the Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), and Republic of Palau (ROP). These studies focused on school health implementation periods according to the PPR (Prevention, Preparedness, and Response) concept: Phase #1: prevention/preparedness, #2: early phase response, and #3: chronic phase response/recovery phase. Data were collected through policy document reviews that identified school health policies related to COVID-19 controls in the three phases and key informant interviews (KIIs) with 44 key informants (FSM, n = 14; RMI, n = 18; ROP, n = 12) whose work related to school health. The collected data were analyzed using content analysis methods according to the conceptual framework in this study.

Results: This study identified three factors of school health implementation related to COVID-19 controls: promotion of decentralized education (FSM), implementation of COVID-19 controls in the school community (RMI), and disaster management for the protection of students including response to infectious disease (ROP). In Phase #1, no country had established a school health policy. In Phase #2, three enablers were identified in FSM and ROP, as reflected in COVID-19 controls by the education and health sectors. In Phase #3, RMI implemented COVID-19 controls in the school community. Documents on youth policy and disaster management in ROP were updated to reflect the chronic phase response and response to future public health crises.

Conclusions: A decentralized education was instrumental in immediately implementing COVID-19 control measures in schools at national and local levels for coordination between education and health sectors. Despite each county's multi-sectoral approach to engage COVID-19 controls in schools, local government organization requires strengthening and implementation of the formulated school health policy. In preparation for the next public health crisis, school health should be promoted that is integrated into both infection control and disaster management.

导言:COVID-19 大流行导致学校关闭,世界各地学童的精神疾病和非传染性疾病增加。太平洋小岛屿发展中国家(SIDS)也受到了影响,但与其他亚太国家相比,能有效减少 COVID-19 负面影响的学校卫生活动并未得到广泛开展。本研究根据 COVID-19 的控制阶段,考察了密克罗尼西亚小岛屿发展中国家目前在国家、地方和学校层面实施的学校卫生活动和相关政策:多国案例研究以密克罗尼西亚联邦(FSM)、马绍尔群岛共和国(RMI)和帕劳共和国(ROP)为对象。这些研究的重点是根据 PPR(预防、准备和响应)概念确定的学校卫生实施阶段:第一阶段:预防/准备阶段,第二阶段:早期响应阶段,第三阶段:长期响应/恢复阶段。收集数据的方式包括:查阅政策文件,确定与 COVID-19 三个阶段控制措施相关的学校卫生政策;与 44 位从事学校卫生相关工作的关键信息提供者(密歇根州,n = 14;罗得岛州,n = 18;罗得岛州,n = 12)进行关键信息提供者访谈(KII)。根据本研究的概念框架,采用内容分析法对收集到的数据进行了分析:本研究确定了与 COVID-19 控制有关的学校卫生实施的三个因素:促进分散教育(密克罗尼西亚)、在学校社区实施 COVID-19 控制(马绍尔群岛)以及保护学生的灾害管理,包括应对传染病(马绍尔群岛)。在第一阶段,没有一个国家制定了学校卫生政策。在第二阶段,在密克罗尼西亚联邦和路易港确定了三个促进因素,反映在教育和卫生部门的 COVID-19 控制措施中。在第三阶段,马绍尔群岛共和国在学校社区实施了 COVID-19 控制措施。更新了太平洋区域办事处的青年政策和灾害管理文件,以反映长期阶段的应对措施和未来公共卫生危机的应对措施:分散式教育有助于在国家和地方层面立即在学校实施 COVID-19 控制措施,以协调教育和卫生部门。尽管每个县都采取了多部门方法在学校进行 COVID-19 控制,但地方政府组织仍需加强,并落实已制定的学校卫生政策。为应对下一次公共卫生危机,应促进学校卫生与感染控制和灾害管理相结合。
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引用次数: 0
A descriptive study of stroke types, risk factors, clinical features, and outcomes in a tertiary hospital in Myanmar. 缅甸一家三级医院对中风类型、风险因素、临床特征和预后的描述性研究。
IF 4.5 Q1 Medicine Pub Date : 2024-03-18 DOI: 10.1186/s41182-024-00592-6
Thant Zin Tun, Su Myat Han, Kazuhiko Moji, Mitsuaki Matsui

Background: Stroke is a leading cause of death in the world, and the burden of stroke is higher in low- and middle-income countries. Understanding the risk factors, complications, and outcomes of stroke are useful for healthcare planning and resource allocation. Little information on stroke is available for many low- and middle-income Asian countries; including Myanmar, which is the focus of this study.

Methods: A review was conducted of medical records for stroke admissions during 2017 in a tertiary hospital in Myanmar. The final diagnoses, risk factors, clinical features, complications, and outcomes were systematically collected from computer- and paper-based medical records.

Results: Of 908 cases analysed, haemorrhagic stroke was the most common type (49%), followed by ischaemic stroke (43%). Unimproved cases were 32%. Identified risk factors of unimproved cases were 'haemorrhagic stroke' [adjusted odds ratio (aOR): 1.73], 'having fever during hospitalization' [aOR: 2.49], 'Glasgow Coma Scale (GCS) at the admission between 9 and 14' [aOR: 4.33], and GCS less than 9 [aOR: 42.86].

Conclusion: This study is based on hospital medical records to assess stroke types, risk factors, clinical features, and outcomes in a tertiary hospital, in Nay Pyi Daw, Myanmar. The findings indicated that early case admission, improved hospital care management, and increased awareness of the modifiable risk factors within populations are crucial for preventing stroke incidents.

背景:中风是世界上主要的死亡原因,中低收入国家的中风负担较重。了解中风的风险因素、并发症和预后对医疗规划和资源分配很有帮助。许多中低收入亚洲国家(包括本研究的重点国家缅甸)有关中风的信息很少:方法:对缅甸一家三级医院 2017 年收治的脑卒中患者的医疗记录进行了审查。从计算机和纸质病历中系统收集了最终诊断、风险因素、临床特征、并发症和结果:在分析的908个病例中,出血性中风是最常见的类型(49%),其次是缺血性中风(43%)。未好转病例占 32%。未好转病例的风险因素为 "出血性中风"[调整后的几率比(aOR):1.73]、"住院期间发烧"[aOR:2.49]、"入院时格拉斯哥昏迷量表(GCS)在 9 至 14 之间"[aOR:4.33]以及 GCS 小于 9 [aOR:42.86]:本研究以医院病历为基础,评估了缅甸内比都一家三级医院的卒中类型、风险因素、临床特征和预后。研究结果表明,尽早收治病例、改善医院护理管理、提高对人群中可改变风险因素的认识,对于预防中风事件至关重要。
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引用次数: 0
Knowledge, attitudes, and practices related to dengue among public school teachers in a Central Luzon Province in the Philippines: an analytic cross-sectional study. 菲律宾中部吕宋省公立学校教师对登革热的认识、态度和做法:横断面分析研究。
IF 4.5 Q1 Medicine Pub Date : 2024-03-15 DOI: 10.1186/s41182-024-00591-7
Ernesto R Gregorio, Rie Takeuchi, Paul Michael R Hernandez, John Robert Medina, Shin-Ya Kawamura, Mikaela B Salanguit, Marian Danille C Santillan, Kimberly Mae S Ramos, Gideon John Tuliao, Lyndon Morales, Maylin Palatino, Fumiko Shibuya, Jun Kobayashi

Background: Dengue has become a major health issue in tropical regions as the numbers of reported cases and estimated infections continuously increase. In the Philippines, many challenges remain in preventing and controlling the disease amidst all the mitigation efforts of the government. This study sought to measure the health literacy of Filipino teachers and determine the associations among teachers' knowledge, attitudes, and selected practices (KAP) against dengue.

Methods: Elementary and secondary school teachers from the consistently declared dengue hotspots in the City of San Fernando, Pampanga, Philippines, from the years 2017 to 2019 were selected as target participants in this cross-sectional study. A self-administered online survey tool was used in this study for both screening of participants and the KAP survey proper. STATA, descriptive statistics, and multiple logistic regression were used for the data analysis. Odds Ratios (ORs) and 95% confidence intervals (CIs) were reported.

Results: The study comprised 604 participants whose mean age was 38.4 years. Television was determined as the top media source of information, and various health staff were the most trusted and common source of information. Good knowledge on dengue treatment (OR = 1.81; 95% CI 1.18-2.78) and dengue prevention (OR = 1.85; 95% CI 1.26-2.71) were positively associated with having good practices on protection against mosquito bites. Good knowledge on dengue signs and symptoms (OR = 1.56; 95% CI 1.02-2.37) and dengue prevention (OR = 2.38; 95% CI 1.59-3.58) were positively associated with having good practices on preventing breeding sites. Those with positive perceived susceptibility to dengue had lower odds of having good practices on protection against mosquito bites (OR = 0.64; 95% CI 0.41-0.99) and of having good practices on preventing breeding sites (OR = 0.46; 95% CI 0.26-0.81).

Conclusion: Even with the existing dengue policies, programs, and strategies, and the high disease literacy rate of Filipinos, dengue remains a struggle with an increasing case rate. Therefore, specific concepts should be emphasized, and interventions should be fine-tuned to better reach and influence the target population to attain a dengue-free Philippines.

背景:随着报告病例和估计感染人数的不断增加,登革热已成为热带地区的一个主要健康问题。在菲律宾,尽管政府采取了各种缓解措施,但在预防和控制登革热方面仍然存在许多挑战。本研究旨在衡量菲律宾教师的健康素养,并确定教师对登革热的知识、态度和选定做法(KAP)之间的关联:本横断面研究选取了菲律宾邦板牙省圣费尔南多市 2017 年至 2019 年持续公布的登革热热点地区的中小学教师作为研究对象。本研究采用自填式在线调查工具,用于筛选参与者和进行适当的 KAP 调查。数据分析使用了 STATA、描述性统计和多元逻辑回归。结果显示,604 名参与者的平均年龄为 24.5 岁,平均年龄为 24.6 岁:这项研究共有 604 名参与者,他们的平均年龄为 38.4 岁。电视被认为是最主要的媒体信息来源,而各类医务人员则是最值得信赖和最常见的信息来源。登革热治疗知识(OR = 1.81;95% CI 1.18-2.78)和登革热预防知识(OR = 1.85;95% CI 1.26-2.71)与预防蚊虫叮咬的良好习惯呈正相关。对登革热症状和体征的了解(OR = 1.56;95% CI 1.02-2.37)和登革热预防(OR = 2.38;95% CI 1.59-3.58)与预防登革热滋生地的良好做法呈正相关。那些对登革热有积极易感性的人在防止蚊虫叮咬(OR = 0.64;95% CI 0.41-0.99)和防止滋生地(OR = 0.46;95% CI 0.26-0.81)方面有良好做法的几率较低:即使菲律宾制定了现有的登革热政策、计划和策略,而且菲律宾人的疾病知识普及率也很高,但登革热仍然是一个棘手的问题,病例率仍在不断上升。因此,应强调特定的概念,并对干预措施进行微调,以更好地覆盖和影响目标人群,从而实现菲律宾无登革热的目标。
{"title":"Knowledge, attitudes, and practices related to dengue among public school teachers in a Central Luzon Province in the Philippines: an analytic cross-sectional study.","authors":"Ernesto R Gregorio, Rie Takeuchi, Paul Michael R Hernandez, John Robert Medina, Shin-Ya Kawamura, Mikaela B Salanguit, Marian Danille C Santillan, Kimberly Mae S Ramos, Gideon John Tuliao, Lyndon Morales, Maylin Palatino, Fumiko Shibuya, Jun Kobayashi","doi":"10.1186/s41182-024-00591-7","DOIUrl":"10.1186/s41182-024-00591-7","url":null,"abstract":"<p><strong>Background: </strong>Dengue has become a major health issue in tropical regions as the numbers of reported cases and estimated infections continuously increase. In the Philippines, many challenges remain in preventing and controlling the disease amidst all the mitigation efforts of the government. This study sought to measure the health literacy of Filipino teachers and determine the associations among teachers' knowledge, attitudes, and selected practices (KAP) against dengue.</p><p><strong>Methods: </strong>Elementary and secondary school teachers from the consistently declared dengue hotspots in the City of San Fernando, Pampanga, Philippines, from the years 2017 to 2019 were selected as target participants in this cross-sectional study. A self-administered online survey tool was used in this study for both screening of participants and the KAP survey proper. STATA, descriptive statistics, and multiple logistic regression were used for the data analysis. Odds Ratios (ORs) and 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>The study comprised 604 participants whose mean age was 38.4 years. Television was determined as the top media source of information, and various health staff were the most trusted and common source of information. Good knowledge on dengue treatment (OR = 1.81; 95% CI 1.18-2.78) and dengue prevention (OR = 1.85; 95% CI 1.26-2.71) were positively associated with having good practices on protection against mosquito bites. Good knowledge on dengue signs and symptoms (OR = 1.56; 95% CI 1.02-2.37) and dengue prevention (OR = 2.38; 95% CI 1.59-3.58) were positively associated with having good practices on preventing breeding sites. Those with positive perceived susceptibility to dengue had lower odds of having good practices on protection against mosquito bites (OR = 0.64; 95% CI 0.41-0.99) and of having good practices on preventing breeding sites (OR = 0.46; 95% CI 0.26-0.81).</p><p><strong>Conclusion: </strong>Even with the existing dengue policies, programs, and strategies, and the high disease literacy rate of Filipinos, dengue remains a struggle with an increasing case rate. Therefore, specific concepts should be emphasized, and interventions should be fine-tuned to better reach and influence the target population to attain a dengue-free Philippines.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":4.5,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of COVID-19 on ophthalmic surgical procedures in sub-Saharan Africa: a multicentre study. COVID-19 对撒哈拉以南非洲眼科手术的影响:一项多中心研究。
IF 4.5 Q1 Medicine Pub Date : 2024-03-15 DOI: 10.1186/s41182-024-00589-1
Naseer Ally, Sarah Ismail, Natasha Naidu, Ismail Makda, Ismail Mayet, Michael E Gyasi, Peter Makafui, Arlette Nomo, Chantal Nanfack, Anesu T Madikane, Walda D Pohl, Bayanda N Mbambisa, Jonathan T Oettle, Feyi Adepoju, Toibat B Tota-Bolarinwa, Amelia Buque, Sidonia J N Khalau, Douglas Zirima, Brian Takayidza, Ugochukwu A Eze, Akinyemi Adedeji, Frank Sandi, Jacinta Feksi, Ogugua Okonkwo, Adekunle Hassan, Nagib du Toit, Shahlaa Petersen, Caroline Tsimi, Viola Dovoma, Mustapha Bature, Mohammed Adamu, Suhanyah Okeke, Ifeoma N Asimadu, Nkiru N Kizor-Akaraiwe, Chinyelu N Ezisi, Henry E Nkumbe, Tchoyou T M Olivier, Hassan D Alli

Background: The COVID-19 pandemic had a profound impact on healthcare and ophthalmology services globally. Numerous studies amongst various medical and surgical specialties showed a reduction in patient attendance and surgical procedures performed. Prior published ophthalmic literature focused on specific types of procedures and were usually single centre. The current study attempts to quantify the impact on a larger scale, namely that of sub-Saharan Africa, and to include all ophthalmic subspecialties.

Methods: This is a retrospective analysis of the surgical records from 17 ophthalmology centres in seven countries located in East, Central, West and Southern Africa. The date of declaration of the first lockdown was used as the beginning of the pandemic and the pivot point to compare theatre records one year prior to the pandemic and the first year of the pandemic. We examined the total number of surgical procedures over the two year period and categorized them according to ophthalmic subspecialty and type of procedure performed. We then compared the pre-pandemic and pandemic surgical numbers over the two year period.

Results: There were 26,357 ophthalmic surgical procedures performed with a significant decrease in the first year of the pandemic (n = 8942) compared to the year prior to the pandemic (n = 17,415). The number of surgical procedures performed was lower in the first year of the pandemic compared to the year prior to the pandemic by 49% [Incidence rate ratio (IRR) 0.51, 95% CI 0.41-0.64), 27% (0.73, 0.55-0.99), 46% (0.54, 0.30-0.99), 40% (0.60, 0.39-0.92) and 59% (0.41, 0.29-0.57) in sub-Saharan Africa (4 regions combined), West, Central, East and Southern Africa, respectively]. The number of surgical procedures in the different sub-specialty categories in sub-Saharan Africa (4 regions combined) was significantly lower in the first year of the pandemic compared to the year prior to the pandemic, except for glaucoma (IRR 0.72, 95% CI 0.52-1.01), oncology (0.71, 0.48-1.05), trauma (0.90, 0.63-1.28) and vitreoretinal (0.67, 0.42-1.08) categories.

Conclusion: This study provides insight into the impact of the COVID-19 pandemic in multiple regions and countries on the African continent. The identification of which surgical subspecialty was most affected by the COVID-19 pandemic in each region allows for better planning and resource allocation to address these backlogs.

背景:COVID-19 大流行对全球医疗保健和眼科服务产生了深远影响。各内科和外科专科进行的大量研究表明,患者就诊人数和所实施的手术程序均有所减少。之前发表的眼科文献主要集中在特定类型的手术上,而且通常都是单中心进行的。本研究试图在更大范围内(即撒哈拉以南非洲地区)量化这一影响,并将所有眼科亚专科纳入研究范围:本研究对东非、中非、西非和南部非洲 7 个国家 17 个眼科中心的手术记录进行了回顾性分析。我们将宣布首次封锁的日期作为大流行的开始时间,并以此为支点比较大流行前一年和大流行第一年的手术记录。我们检查了两年内的手术总数,并根据眼科亚专科和手术类型进行了分类。然后,我们比较了大流行前和大流行后两年内的手术数量:共进行了 26,357 例眼科手术,与大流行前一年(n = 17,415)相比,大流行第一年的手术例数(n = 8942)明显减少。与大流行前一年相比,大流行第一年进行的手术数量减少了 49% [发病率比 (IRR) 0.51,95% CI 0.41-0.撒哈拉以南非洲(4 个地区合计)、西非、中非、东非和南部非洲的发病率分别为 27%(0.73,0.55-0.99)、46%(0.54,0.30-0.99)、40%(0.60,0.39-0.92)和 59%(0.41,0.29-0.57)]。与疫情发生前一年相比,撒哈拉以南非洲地区(4 个地区总和)不同亚专科类别的手术数量在疫情发生第一年显著减少,但青光眼(IRR 0.72,95% CI 0.52-1.01)、肿瘤(0.71,0.48-1.05)、创伤(0.90,0.63-1.28)和玻璃体视网膜(0.67,0.42-1.08)类别除外:本研究有助于深入了解 COVID-19 大流行对非洲大陆多个地区和国家的影响。确定每个地区哪个外科亚专科受 COVID-19 大流行的影响最大,有助于更好地规划和分配资源,解决这些积压问题。
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引用次数: 0
Knowledge, attitude and practice towards intestinal schistosomiasis among school-aged children and adults in Amhara Regional State, northwest Ethiopia. A cross-sectional study. 埃塞俄比亚西北部阿姆哈拉地区州学龄儿童和成人对肠道血吸虫病的认识、态度和做法。横断面研究。
IF 4.5 Q1 Medicine Pub Date : 2024-03-11 DOI: 10.1186/s41182-024-00584-6
Getaneh Alemu, Endalkachew Nibret, Arancha Amor, Abaineh Munshea, Melaku Anegagrie

Background: Schistosoma mansoni causes intestinal schistosomiasis (SCH) in all regions of Ethiopia. Despite many years of mass treatment, the prevalence has not dropped significantly. The reduction of SCH transmission demands the integration of deworming with safe water, sanitation, and hygiene (WASH) activities. Adequate knowledge and a positive attitude towards SCH are critical to practicing those interventions. However, data on the knowledge, attitude, and practice (KAP) level in school and community settings is limited in Ethiopia.

Methods: School and community-based cross-sectional studies were conducted from February to June 2023 among 634 school-aged children (SAC) and 558 adults. A pre-tested questionnaire was used to collect socio-demographic and KAP data. Records were entered and analyzed using SPSS software version 21. Correct responses for each of the KAP questions were scored as one, while incorrect or 'I don't know' responses were scored as zero. Good knowledge, a positive attitude and good practice were declared if percentage scores were ≥ 80%, ≥ 90% and ≥ 75%, respectively.

Results: Only 229 (19.2%) respondents, comprising 91 (14.4%) SAC and 138 (24.7%) adults, had ever heard of SCH. Adults, males, and urban residents had higher awareness level compared to their respective counterparts (p < 0.05). Only 28.4% of aware respondents knew that swimming or bathing in freshwater is a risk factor for schistosoma infection; 10.9% knew the etiologic agent; and 14.4% mentioned at least one sign and symptom associated with SCH. The majority (97.8%) of the respondents were willing to take therapeutic drugs, but only 37.6% believed that SCH is a serious disease. Regarding risky practices, 89.5% practiced swimming or bathing in freshwater, and 25.3% had no access to piped water. Among the aware respondents, only 18 (7.9%) had good knowledge, while 30 (13.1%) had a positive attitude towards SCH. Ninety-nine (43.2%) respondents had good Schistosoma infection prevention practices.

Conclusions: The knowledge, attitude, and preventive practice level towards schistosomiasis are low in the study area. Therefore, strengthening school and community-based health education, along with mass drug administration (MDA), WASH, and a vector control program, is recommended for preventing SCH.

背景:曼氏血吸虫(Schistosoma mansoni)是埃塞俄比亚所有地区的肠血吸虫病(SCH)病因。尽管进行了多年的大规模治疗,但发病率并未显著下降。要减少血吸虫病的传播,就必须将驱虫与安全饮水、环境卫生和个人卫生(WASH)活动结合起来。对 SCH 有足够的了解和积极的态度是实施这些干预措施的关键。然而,在埃塞俄比亚,有关学校和社区环境中的知识、态度和实践(KAP)水平的数据非常有限:2023 年 2 月至 6 月,对 634 名学龄儿童(SAC)和 558 名成人进行了学校和社区横断面研究。采用预先测试的调查问卷收集社会人口学和 KAP 数据。记录使用 SPSS 软件 21 版进行输入和分析。对每个 KAP 问题的正确回答记 1 分,错误或 "我不知道 "的回答记 0 分。如果百分比得分分别≥80%、≥90%和≥75%,则宣布为 "良好知识"、"积极态度 "和 "良好实践":只有 229 名(19.2%)受访者听说过 SCH,其中 91 名(14.4%)为 SAC,138 名(24.7%)为成人。成人、男性和城市居民的知晓率高于其他人群(P研究地区对血吸虫病的认识、态度和预防实践水平较低。因此,建议加强以学校和社区为基础的健康教育,同时开展大规模药物管理 (MDA)、讲卫生运动和病媒控制计划,以预防血吸虫病。
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引用次数: 0
Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study. 缅甸农村地区孕妇亚临床疟疾、其他合并感染和贫血患病率的异质性:一项基于社区的纵向研究。
IF 4.5 Q1 Medicine Pub Date : 2024-03-08 DOI: 10.1186/s41182-024-00577-5
Poe Poe Aung, Kay Thwe Han, Wim Groot, Regien Biesma, Zaw Win Thein, Thura Htay, Zaw Lin, Kyin Hla Aye, Matthew Adams, Milena Pavlova

Background: Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection.

Methods: A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis.

Results: The prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman's age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy.

Conclusions: A comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.

背景:由于缅甸孕妇中临床疑似疟疾的发病率较低,人们对疟疾对母亲和新生儿的影响知之甚少。螺旋体和人类免疫缺陷病毒(HIV)合并感染会导致孕妇贫血。这项研究评估了亚临床疟疾和合并感染在孕妇中的流行情况,以及感染与妊娠不良后果之间的关系:方法:2013 年至 2015 年期间,在缅甸两个乡镇的 12 个村庄开展了一项前瞻性纵向研究。共登记了 752 名孕妇,平均年龄为 27 岁,每月随访一次,直至产后六周。在多变量分析中计算了患病率:结果:通过巢式 PCR 测定的亚临床疟疾流行率为:恶性疟原虫或间日疟原虫 5.7%,恶性疟原虫 2.7%,间日疟原虫 2.8%。17%的妇女患有螺旋体感染,在我们的研究中还发现了一名感染艾滋病毒的妇女。贫血的发病率很高,感染或未感染螺旋体的总发病率为 37%,42% 的妇女为疟疾阳性,43% 的妇女有双重感染(疟疾和螺旋体)。仅发现了 11 例异常妊娠结果(7 例死胎、2 例早产、2 例双胞胎)。泊松回归显示,与怀孕三个月的妇女相比,怀孕头三个月的妇女亚临床疟疾感染率高出 2.9 倍(PR:2.9, 95%CI 1.19, 7.31, p = 0.019),在雨季入学的妇女感染疟疾的几率是雨季妇女的 2.5 倍(PR:2.9, 95%CI 1.19, 7.31, p = 0.019)。疟疾阳性率是旱季妇女的 2.5 倍(PR:2.5, 95%CI 1.27, 4.88, p = 0.008),妇女年龄每增加一岁,疟疾阳性率降低 5%(PR:0.95, 95%CI 0.91, 0.99, p = 0.02)。在多变量回归中,受访者的年龄是与孕期亚临床疟疾相关的唯一重要因素:结论:缅甸农村地区的孕妇在接受产前保健服务时应采取综合措施,对疟疾、贫血和蠕虫病进行干预。
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引用次数: 0
Why avoid naming diseases after animals? The case of "Molluscum contagiosum". 为什么要避免以动物命名疾病?传染性软疣 "的案例。
IF 4.5 Q1 Medicine Pub Date : 2024-03-06 DOI: 10.1186/s41182-024-00586-4
Fabrizio M Machado, Rodrigo B Salvador

For over 200 years, the name molluscum contagiosum-a dermatological disease-has unfairly associated molluscs (the second largest group of animals on the planet) with this highly contagious infectious disease. Herein, arguments are presented demonstrating the serious problem of continuing to use this name, including animal welfare concerns. Thus, to minimize any unnecessary impacts on the biodiversity and conservation of molluscs, we follow WHO best practices in naming diseases to suggest the use of the new term 'wpox' or 'water warts' as a synonym for molluscum contagiosum.

200 多年来,软体动物传染性软疣--一种皮肤病--这个名称不公平地将软体动物(地球上第二大动物群体)与这种传染性极强的传染病联系在一起。本文提出的论据表明,继续使用这一名称存在严重问题,包括动物福利问题。因此,为了尽量减少对软体动物的生物多样性和保护造成不必要的影响,我们遵循世界卫生组织在疾病命名方面的最佳做法,建议使用新术语 "wpox "或 "水疣 "作为传染性软疣的同义词。
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引用次数: 0
Phenotypic characterization of ESBL-producing urinary isolates of E. coli and Klebsiella spp. in a tertiary care children's hospital in Nepal. 尼泊尔一家三级儿童医院中产ESBL的大肠杆菌和克雷伯氏菌尿液分离物的表型特征。
IF 4.5 Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1186/s41182-024-00587-3
Santosh Pantha, Hiramani Parajuli, Charu Arjyal, Shovana Thapa Karki, Dhiraj Shrestha

Background: The production of extended-spectrum beta-lactamases (ESBLs) among uropathogens, particularly E. coli and Klebsiella spp., poses a severe public health concern. This study explored the epidemiology of ESBL-producing E. coli and Klebsiella spp. isolated from urine samples obtained at a tertiary care children's hospital in Nepal.

Methods: A cross-sectional study was conducted from August 2016 to February 2017. A total of 745 clean catch urine samples were obtained from pediatric patients under the age of 13 and subjected to semiquantitative culture. E. coli and Klebsiella spp. were identified using standard laboratory protocols. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method, and ESBL producers were phenotypically identified using the combined disk method.

Results: Among the bacterial isolates, E. coli predominated, accounting for 139 (81.8%) positive cases. Notably, E. coli showed high susceptibility to nitrofurantoin, with 117 (84.2%) isolates being susceptible. Meanwhile, K. pneumoniae showed high susceptibility to gentamicin, with 21 (91.3%) isolates being susceptible. Of the 163 isolates of E. coli and Klebsiella spp., 62 (38.0%) were identified as multidrug-resistant (MDR), with 42 (25.8%) confirmed as phenotypic ESBL producers. Remarkably, all 41 (100%) ESBL-producing E. coli isolates were susceptible to imipenem.

Conclusions: The prevalence of ESBL producers among E. coli and K. pneumoniae isolates from pediatric patients underscores the importance of antimicrobial stewardship. Nitrofurantoin and gentamicin emerge as effective empirical treatment choices against these pathogens in children. However, the high rates of multidrug resistance and ESBL production highlight the necessity for routine surveillance, and early detection strategies to manage such infections effectively.

背景:泌尿道病原体,尤其是大肠杆菌和克雷伯氏菌属,产生广谱β-内酰胺酶(ESBLs)是一个严重的公共卫生问题。本研究探讨了从尼泊尔一家三级儿童医院获得的尿液样本中分离出的产ESBL大肠杆菌和克雷伯氏菌的流行病学:2016年8月至2017年2月进行了一项横断面研究。共从 13 岁以下的儿科患者处采集了 745 份清洁的尿液样本,并进行了半定量培养。采用标准实验室方案对大肠杆菌和克雷伯氏菌进行了鉴定。抗生素敏感性测试采用柯比-鲍尔盘扩散法进行,ESBL生产者的表型鉴定采用组合盘法进行:结果:在细菌分离物中,以大肠杆菌为主,阳性病例有 139 例(81.8%)。值得注意的是,大肠杆菌对硝基呋喃妥因的敏感性很高,有 117 个(84.2%)分离菌株对硝基呋喃妥因敏感。同时,肺炎克氏菌对庆大霉素的敏感性较高,有 21 个(91.3%)分离菌株对庆大霉素敏感。在 163 个大肠杆菌和克雷伯氏菌分离株中,有 62 个(38.0%)被鉴定为多重耐药菌(MDR),其中 42 个(25.8%)被确认为表型 ESBL 生产者。值得注意的是,所有41个(100%)产生ESBL的大肠杆菌分离株都对亚胺培南敏感:结论:儿科患者分离出的大肠杆菌和肺炎双球菌中普遍存在 ESBL 生产者,这凸显了抗菌药物管理的重要性。硝基呋喃妥因和庆大霉素是治疗儿童这些病原体的有效经验选择。然而,耐多药和产生 ESBL 的高发率凸显了常规监测和早期检测策略对有效控制此类感染的必要性。
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引用次数: 0
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Tropical Medicine and Health
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