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Impact of Institutionalisation of Births on Health Policies and Birth Registration in India. 出生制度化对印度卫生政策和出生登记的影响。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4474
Sheetal Verma, Laxmi Kant Dwivedi, Ritul Kamal

Background: The Registration of Births and Deaths Act (RBD) of 1969 in India mandates continuous recording of vital events; however, after more than 50 years of its enactment, universality remains elusive. Birth registration, a fundamental right, is essential for demographic analysis and effective policy planning. Birth registration is closely linked to child development, access to healthcare, and other societal factors. Analysing its trends helps in designing targeted interventions and monitoring progress toward the Sustainable Development Goals (SDGs). Objectives: This paper aims to analyse the changes in birth registration across Indian states. This paper also examines the impact of institutionalization of births on registration and underscores its significance in policymaking. Methods: The study utilises data from the latest two rounds of National Family Health Survey (NFHS-4 & NFHS-5) to analyse birth registration trends in India. Multivariable logistic regression analysis was employed to examine the impact of place of delivery on birth registration. Findings: The comparison of NFHS-4 and NFHS-5 data demonstrates varying birth registration rates across Indian states, with notable progress in some regions and persistent challenges in others. Multivariable logistic regression analysis highlights the significant influence of place of delivery on registration likelihood. The interaction between wealth and place of delivery suggests a mitigating effect, indicating that increasing institutional births has a positive impact on birth registration, with this effect being more pronounced at different levels of household wealth. It highlights that wealthier households were more likely to register births due to the higher rate of institutional deliveries. Conclusion: India's journey towards universal birth registration under the SDGs presents progress and challenges. NFHS data shows improvements in birth registration, but disparities still persist. Socio-economic status, place of delivery, and maternal education have strong influences on birth registration. Institutional deliveries significantly increase registration likelihood, facilitated by programs like Janani Suraksha Yojana. Integrating birth registration with health services enhances health data accuracy and service delivery. By prioritising targeted interventions, addressing social barriers, and leveraging existing programs, India can ensure that every child's birth is registered, advancing towards a healthier, more equitable future.

背景:印度 1969 年颁布的《出生和死亡登记法》(RBD)规定必须持续记录人口动态事件;然而,该法颁布 50 多年后,普遍性仍未实现。出生登记是一项基本权利,对于人口分析和有效的政策规划至关重要。出生登记与儿童发展、医疗保健和其他社会因素密切相关。分析出生登记的趋势有助于设计有针对性的干预措施和监测可持续发展目标 (SDG) 的进展情况。目标:本文旨在分析印度各邦出生登记的变化。本文还探讨了出生登记制度化的影响,并强调了其在政策制定中的重要性。研究方法:本研究利用最新两轮全国家庭健康调查(NFHS-4 和 NFHS-5)的数据分析印度的出生登记趋势。研究采用了多变量逻辑回归分析来检验分娩地点对出生登记的影响。研究结果对 NFHS-4 和 NFHS-5 数据的比较表明,印度各邦的出生登记率各不相同,一些地区取得了显著进步,而另一些地区则面临持续挑战。多变量逻辑回归分析凸显了分娩地点对登记可能性的重要影响。财富与分娩地点之间的交互作用显示出一种缓解效应,表明增加住院分娩对出生登记有积极影响,这种效应在不同的家庭财富水平下更为明显。这突出表明,由于住院分娩率较高,较富裕的家庭更有可能进行出生登记。结论印度在根据可持续发展目标普及出生登记方面取得了进展,也面临着挑战。全国家庭健康调查数据显示出生登记有所改善,但差距依然存在。社会经济地位、分娩地点和产妇教育对出生登记有很大影响。在 Janani Suraksha Yojana 等计划的推动下,住院分娩大大提高了登记的可能性。将出生登记与医疗服务相结合可提高医疗数据的准确性和服务的提供。通过优先采取有针对性的干预措施、消除社会障碍和利用现有计划,印度可以确保每个孩子都能进行出生登记,从而迈向更健康、更公平的未来。
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引用次数: 0
Malnutrition among Children under Age Five in Panama: Results of the ENSPA 2019. 巴拿马五岁以下儿童营养不良:2019 年 ENSPA 的结果。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-08 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4409
Alicia Sosa Pedreschi, Flavia Fontes, Reina Roa, Hedley Quintana, Roger Montenegro Mendoza

Background: Malnutrition has important short- and long-term consequences in children under age five. Malnutrition encompasses undernutrition, overnutrition, and the coexistence of both of them, known as the double burden of malnutrition (DBM). Objective: The aim of this study was to estimate the prevalence of undernutrition, overnutrition, and the DBM among these children at the national level and by living area in Panama. Methods: Data from the National Health Survey of Panama (ENSPA, Spanish acronym), a population-based, cross-sectional study carried out in 2019 were used. Stunting, wasting, overweight, and obesity were defined according to the cut-off points of the World Health Organization Growth Standards. Undernutrition was defined as being stunted only, wasted only or both; overnutrition was defined as being overweight only or obese only; and the DBM was defined as the co-occurence of stunting and overweight/obesity in the same child. Prevalence and general characteristics at the national level and by living area were weighted. Findings: The prevalence of undernutrition was 15.3% (95% confidence interval (CI) 13.4-17.3) at the national level and 36.6% (CI: 30.1-43.5) in indigenous areas. The prevalence of overnutrition was 10.2% (8.2-12.6) at the national level and 11.9% (CI: 8.5-16.3), 8.4% (CI: 6.5-10.7) and 8.7% (CI: 5.2-14.3) in urban, rural and indigenous areas, respectively. The DBM prevalence was 1.4% (CI: 1.0-2.1) at the national level and 2.7% (CI: 1.4-5.1) in indigenous areas. Conclusions: Undernutrition is still the most prevalent malnutrition condition in our country. Panama has the highest prevalence of overnutrition in Central America. The highest prevalence of undernutrition and DBM was found among children living in indigenous areas.

背景:营养不良对五岁以下儿童具有重要的短期和长期影响。营养不良包括营养不足、营养过剩和两者并存,被称为营养不良的双重负担(DBM)。研究目的本研究旨在估算巴拿马全国和各生活区营养不良、营养过剩和双重营养不良儿童的患病率。研究方法研究使用了巴拿马全国健康调查(ENSPA,西班牙语缩写)的数据,这是一项基于人口的横断面研究,于 2019 年开展。发育迟缓、消瘦、超重和肥胖是根据世界卫生组织生长标准的临界点定义的。营养不良被定义为仅发育迟缓、仅消瘦或两者皆有;营养过剩被定义为仅超重或仅肥胖;DBM被定义为同一儿童同时出现发育迟缓和超重/肥胖。全国和生活地区的患病率和一般特征均已加权。研究结果全国营养不良率为 15.3%(95% 置信区间为 13.4-17.3),土著地区为 36.6%(CI:30.1-43.5)。全国营养过剩率为 10.2% (8.2-12.6),城市、农村和土著地区分别为 11.9% (CI:8.5-16.3)、8.4% (CI:6.5-10.7) 和 8.7% (CI:5.2-14.3)。全国 DBM 患病率为 1.4%(CI:1.0-2.1),土著地区为 2.7%(CI:1.4-5.1)。结论营养不足仍然是我国最普遍的营养不良状况。巴拿马是中美洲营养过剩发生率最高的国家。生活在土著地区的儿童营养不良和DBM发病率最高。
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引用次数: 0
An Epidemiological Assessment of SARS-CoV-2 in the Sewage System of a Higher Education Institution. 一所高等院校污水系统中 SARS-CoV-2 的流行病学评估。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-07 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4413
Carmem Cícera Maria da Silva, Carolina Rangel de Lima Santos, Eliomar Pivante Céleri, David Salles, Julia Miranda Fardin, Kamily Fagundes Pussi, Daniel Claudio de Oliveira Gomes, Vinicius de Oliveira Ribeiro, Leila Cristina Konrad-Moraes, Herintha Coeto Neitzke-Abreu, Valdemar Lacerda Júnior

Background: The World Health Organization declared the end of the COVID-19 pandemic in May 2023, three years after the adoption of global emergency measures. Monitoring of SARS-CoV-2 in sewage underscores its importance due to its effectiveness and cost-effectiveness, highlighting the need to prioritize research on water resources and sanitation. Objectives: The aim of this study was to conduct an epidemiological assessment of SARS-CoV-2 in the sewage system of a higher education institution located in Vitória Espírito Santo State, Maruípe campus. Methods: Over a period of 66 days, from February 6 to April 12, 2023, 15 samples were collected. Each sample consisted of 1 L, collected in 1 hour, with 250 mL collected every 15 minutes. The samples were characterized by assessing their appearance, and pH was measured using a Horiba U-50 multiparameter probe. The extracted RNA was subjected to RT-qPCR using the Allplex™ 2019-nCovAssay Seegene kit. Results: The samples exhibited a cloudy appearance with impurities, and the pH ranged from 6.35 to 8.17. Among the evaluated samples, SARS-CoV-2 RNA was detected in two, and, by comparing this with the epidemiological bulletin issued by the State Health Department, an increase in cases in the state was observed during the collection period of these samples. Conclusions: Sewage monitoring proved to be an important tool in this post-pandemic period, serving as an alert and prevention mechanism for the population in relation to new outbreaks. Furthermore, it represents a low-cost mapping strategy and extensive testing of a population, aligning with the studies presented at the beginning of the pandemic. We recommend specific adjustments considering distinct populations.

背景:世界卫生组织在采取全球紧急措施三年后,于 2023 年 5 月宣布 COVID-19 大流行结束。监测污水中的 SARS-CoV-2 因其有效性和成本效益而显得尤为重要,这也凸显了优先开展水资源和卫生研究的必要性。目标:本研究旨在对位于圣埃斯皮里图州维托里亚市 Maruípe 校区的一所高等教育机构的污水系统中的 SARS-CoV-2 进行流行病学评估。评估方法在 2023 年 2 月 6 日至 4 月 12 日的 66 天内,采集了 15 个样本。每个样本 1 升,1 小时采集一次,每 15 分钟采集 250 毫升。通过评估样本的外观来确定样本的特征,并使用 Horiba U-50 多参数探头测量 pH 值。使用 Allplex™ 2019-nCovAssay Seegene 试剂盒对提取的 RNA 进行 RT-qPCR 分析。结果:样品外观浑浊,含有杂质,pH 值在 6.35 至 8.17 之间。在评估的样本中,有两份样本检测到了 SARS-CoV-2 RNA,通过与州卫生局发布的流行病学公告进行比较,发现在这些样本采集期间,该州的病例有所增加。结论事实证明,污水监测是疫情后时期的一项重要工具,可作为新疫情爆发时的预警和预防机制。此外,它还代表了一种低成本的绘图策略和对人群的广泛测试,与大流行初期的研究结果一致。考虑到不同的人群,我们建议做出具体调整。
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引用次数: 0
An Implementation Science Study of a Heat-Producing Wrap to Complement KMC in Rwanda. 在卢旺达开展的 "发热裹布辅助 KMC 的实施科学研究"。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4430
Florent Rutagarama, Cyiza Francois Regis, Christian Umuhoza, Lisine Tuyisenge, Cynthia Grace Mfuranziza, Pacifique Hagenimana, Micaela Matteo Smith, Henry A Feldman, Anne R Hansen

Background: Neonatal hypothermia is a major cause of preventable morbidity and mortality, especially among the world's poorest newborns. A heat-producing wrap is necessary when kangaroo mother care (KMC) is insufficient or unavailable, yet there is little published research on such wraps. The Dream Warmer is a wrap designed to complement KMC and has been extensively studied in formal research settings but not in real-world conditions. Objectives: We used implementation science methodology to understand the safety, effectiveness, and functionality of the Dream Warmer (hereafter, "Warmer"); its effect on clinical workflows; its interaction with other aspects of care such as KMC; and the Warmer's reception by healthcare providers (HCPs) and parents. Methods: We conducted a prospective, interventional, one-arm, open-label, mixed-methods study in 6 district hospitals and 84 associated health centers in rural Rwanda. Our intervention was the provision of the Warmer and an educational curriculum on thermoregulation. We compared pre and post intervention data using medical records, audits, and surveys. Findings: The Warmer raised no safety concerns. It was used correctly in the vast majority of cases. The mean admission temperature rose from slightly hypothermic (36.41 °C) pre, to euthermic (36.53 °C) post intervention (p = 0.002). Patients achieved a temperature ≥36.5 °C in 86% of uses. In 1% of audits, patients were hyperthermic (37.6-37.9 °C). Both HCPs and parents reported a generally positive experience with the Warmer. HCPs were challenged to prepare it in advance of need. Conclusions: The Warmer functions similarly well in research and real-world conditions. Ongoing education directed toward both HCPs and parents is critical to ensuring the provision of a continuous heat chain. Engaging families in thermoregulation could ease the burden of overtaxed HCPs and improve the skill set of parents. Hypothermia is a preventable condition that must be addressed to optimize neonatal survival and outcome.

背景:新生儿体温过低是可预防的发病率和死亡率的主要原因,尤其是在世界上最贫穷的新生儿当中。当袋鼠妈妈护理(Kangaroo Mother Care,KMC)不足或无法使用时,就需要使用产热裹布,但有关此类裹布的公开研究却很少。Dream Warmer 是一种用于辅助袋鼠式母婴护理的裹包,已在正式的研究环境中进行了广泛的研究,但尚未在实际环境中使用过。目标:我们采用实施科学方法来了解 "梦幻保暖包"(以下简称 "保暖包")的安全性、有效性和功能性;它对临床工作流程的影响;它与 KMC 等其他护理方面的相互作用;以及医疗保健提供者 (HCP) 和家长对保暖包的接受程度。方法:我们在卢旺达农村地区的 6 家地区医院和 84 家相关医疗中心开展了一项前瞻性、干预性、单臂、开放标签、混合方法研究。我们的干预措施是提供保暖器和体温调节教育课程。我们利用医疗记录、审计和调查对干预前后的数据进行了比较。研究结果暖宝宝没有引起任何安全问题。绝大多数情况下都能正确使用。平均入院体温从干预前的轻度低体温(36.41 °C)升至干预后的热体温(36.53 °C)(p = 0.002)。86%的患者体温≥36.5 °C。在 1% 的审核中,患者体温过高(37.6-37.9 °C)。医疗保健人员和家长普遍对使用暖箱的体验表示肯定。高级保健人员面临的挑战是在需要时提前准备。结论:暖宝宝在研究和实际使用条件下的功能相似。针对保健医生和家长的持续教育对于确保提供持续的热链至关重要。让家庭参与体温调节可减轻医护人员的负担,提高家长的技能。低体温是一种可预防的疾病,必须加以解决,以优化新生儿的存活率和预后。
{"title":"An Implementation Science Study of a Heat-Producing Wrap to Complement KMC in Rwanda.","authors":"Florent Rutagarama, Cyiza Francois Regis, Christian Umuhoza, Lisine Tuyisenge, Cynthia Grace Mfuranziza, Pacifique Hagenimana, Micaela Matteo Smith, Henry A Feldman, Anne R Hansen","doi":"10.5334/aogh.4430","DOIUrl":"10.5334/aogh.4430","url":null,"abstract":"<p><p><i>Background:</i> Neonatal hypothermia is a major cause of preventable morbidity and mortality, especially among the world's poorest newborns. A heat-producing wrap is necessary when kangaroo mother care (KMC) is insufficient or unavailable, yet there is little published research on such wraps. The Dream Warmer is a wrap designed to complement KMC and has been extensively studied in formal research settings but not in real-world conditions. <i>Objectives:</i> We used implementation science methodology to understand the safety, effectiveness, and functionality of the Dream Warmer (hereafter, \"Warmer\"); its effect on clinical workflows; its interaction with other aspects of care such as KMC; and the Warmer's reception by healthcare providers (HCPs) and parents. <i>Methods:</i> We conducted a prospective, interventional, one-arm, open-label, mixed-methods study in 6 district hospitals and 84 associated health centers in rural Rwanda. Our intervention was the provision of the Warmer and an educational curriculum on thermoregulation. We compared pre and post intervention data using medical records, audits, and surveys. <i>Findings:</i> The Warmer raised no safety concerns. It was used correctly in the vast majority of cases. The mean admission temperature rose from slightly hypothermic (36.41 °C) pre, to euthermic (36.53 °C) post intervention (<i>p</i> = 0.002). Patients achieved a temperature ≥36.5 °C in 86% of uses. In 1% of audits, patients were hyperthermic (37.6-37.9 °C). Both HCPs and parents reported a generally positive experience with the Warmer. HCPs were challenged to prepare it in advance of need. <i>Conclusions:</i> The Warmer functions similarly well in research and real-world conditions. Ongoing education directed toward both HCPs and parents is critical to ensuring the provision of a continuous heat chain. Engaging families in thermoregulation could ease the burden of overtaxed HCPs and improve the skill set of parents. Hypothermia is a preventable condition that must be addressed to optimize neonatal survival and outcome.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"90 1","pages":"49"},"PeriodicalIF":2.6,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Burden and Risk Factors Associated with Infectious Diseases among Refugees in a Camp for Migrants in Porto Alegre: A Cross-Sectional Survey. 阿雷格里港移民营中难民感染传染病的负担和相关风险因素:一项横断面调查》(The Burden and Risk Factors Associated with Infectious Diseases among Refugees in a Camp for Migrants in Porto Alegre: A Cross-Sectional Survey)。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-26 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4242
Mauricio Da Silva Roxkow Fraga, Filipe Andre Angst, James January, Agnes Madziwa, Laston Gonah, Alexandre Lazzarotto

Refugees usually face a disproportionate burden of infectious diseases. Recently, Brazil has experienced an influx of refugees which demands the need for scaling up public health efforts to address the challenges. The research sought to study the burden and risk factors associated with infectious diseases among refugees received in the city of Porto Alegre. This was a cross-sectional study of 261 newly arrived refugees. The study sample was predominantly composed of Venezuelans (50.6%) and Haitians (44%), male (146: 56.7%), single (30.7%), with an average age of 33.38 (± 7.30) years. The average schooling was 10.42 (± 2.09) years. Diseases with the highest prevalence were influenza, whooping cough, diphtheria, and tuberculosis. There was significant association between the country of origin and presence of symptoms for infectious and contagious diseases, which warrants targeted interventions for reducing the incidence of these diseases among refugees in Brazil.

难民通常面临着不成比例的传染病负担。最近,巴西经历了难民潮,这就要求加大公共卫生工作的力度,以应对挑战。这项研究旨在研究阿雷格里港市接收的难民中与传染病相关的负担和风险因素。这是一项针对 261 名新抵达难民的横断面研究。研究样本主要由委内瑞拉人(50.6%)和海地人(44%)组成,男性(146 人:56.7%),单身(30.7%),平均年龄为 33.38 (± 7.30)岁。平均受教育年限为 10.42 (± 2.09)年。发病率最高的疾病是流感、百日咳、白喉和肺结核。原籍国和感染传染病的症状之间存在着明显的关联,因此需要采取有针对性的干预措施,以减少这些疾病在巴西难民中的发病率。
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引用次数: 0
Maintaining Delivery of Evidence-Based Interventions to Reduce Under-5 Mortality During COVID-19 in Rwanda: Lessons Learned through Implementation Research. 在卢旺达 COVID-19 期间继续提供循证干预措施以降低 5 岁以下儿童死亡率:通过实施研究吸取的经验教训。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-23 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4348
Alemayehu Amberbir, Felix Sayinzoga, Kedest Mathewos, Jovial Thomas Ntawukuriryayo, Amelia VanderZanden, Lisa R Hirschhorn, Agnes Binagwaho

Background: The COVID-19 pandemic resulted in drops in access to and availability of a number of evidence-based interventions (EBIs) known to reduce under-5 mortality (U5M) across a wide range of countries, including Rwanda. We aimed to understand the strategies and contextual factors associated with preventing or mitigating drops nationally and subnationally, and the extent to which previous efforts to reduce U5M supported the maintenance of healthcare delivery. Methods: We used a convergent mixed methods implementation science approach, guided by hybrid implementation research and resiliency frameworks. We triangulated data from three sources: desk review of available documents, existing routine data from the health management information system, and key informant interviews (KIIs). We analyzed quantitative data through scatter plots using interrupted time series analysis to describe changes in EBI access, uptake, and delivery. We used a Poisson regression model to estimate the impact of COVID-19 on health management information system indicators, adjusting for seasonality. We used thematic analysis of coded interviews to identify emerging patterns and themes. Results: We found moderate 4% (IRR = 0.96; 95%CI: 0.93, 1.00) and 5% (IRR = 0.95; 95%CI: 0.92, 0.99) drops in pentavalent and rotavirus 2 doses vaccines administered, respectively. Nationally, there was a 5% drop in facility-based delivery (IRR = 0.95; 95%CI: 0.92, 0.99). Lockdown and movement restrictions and community and health-worker fear of COVID-19 were barriers to service delivery early in the pandemic. Key implementation strategies to prevent or respond to EBI drops included leveraging community-based healthcare delivery, data use for decision-making, mentorship and supervision, and use of digital platform. Conclusions: While Rwanda had drops in some EBIs early in the pandemic, especially during the initial lockdown, this was rapidly identified, and response implemented. The resiliency of the health system was associated with the Rwandan health system's ability to learn and adapt, encouraging a flexible response to fit the situation.

背景:COVID-19 大流行导致包括卢旺达在内的许多国家在获取和提供已知可降低 5 岁以下儿童死亡率(U5M)的循证干预措施(EBIs)方面出现下降。我们的目的是了解在国家和次国家范围内防止或减轻下降的相关策略和背景因素,以及以前为降低 5 岁以下儿童死亡率所做的努力在多大程度上支持了医疗保健服务的维持。方法:在混合实施研究和复原力框架的指导下,我们采用了一种聚合混合方法实施科学方法。我们对三个来源的数据进行了三角测量:对现有文件的案头审查、卫生管理信息系统中的现有常规数据以及关键信息提供者访谈(KIIs)。我们利用间断时间序列分析法,通过散点图对定量数据进行了分析,以描述 EBI 获取、吸收和交付方面的变化。我们使用泊松回归模型来估计 COVID-19 对卫生管理信息系统指标的影响,并对季节性因素进行了调整。我们对编码访谈进行了主题分析,以确定新出现的模式和主题。结果我们发现五联疫苗和轮状病毒 2 剂疫苗接种量分别适度下降了 4% (IRR = 0.96; 95%CI: 0.93, 1.00) 和 5% (IRR = 0.95; 95%CI: 0.92, 0.99)。在全国范围内,设施接种率下降了 5%(IRR = 0.95;95%CI:0.92, 0.99)。封锁和行动限制以及社区和医疗工作者对 COVID-19 的恐惧是大流行早期提供服务的障碍。预防或应对 EBI 下降的关键实施策略包括利用社区医疗保健服务、决策数据使用、指导和监督以及数字平台的使用。结论:虽然卢旺达在大流行初期,特别是在最初的封锁期间,出现了一些 EBI 下降的情况,但这种情况被迅速识别出来,并实施了应对措施。卫生系统的复原力与卢旺达卫生系统的学习和适应能力有关,鼓励根据情况采取灵活的应对措施。
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引用次数: 0
Assessing the Impact of COVID-19 Vaccination Programs on the Reduction of COVID-19 Cases: A Systematic Literature Review. 评估 COVID-19 疫苗接种计划对减少 COVID-19 病例的影响:系统性文献综述。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4484
Brightwell Sibanda, Budi Haryanto

Background: Vaccination is the most effective way to prevent serious illness and death from COVID-19 among the various preventive interventions available. Objective: This review aimed to assess the actual effectiveness of COVID-19 vaccines in curbing the transmission and incidence of COVID-19 cases, to examine the role of different vaccine types in controlling the COVID-19 pandemic, as well as to identify the key factors influencing the efficacy of COVID-19 vaccines in containing the spread of the virus. Methods: The suggestions made by the PRISMA Framework were adhered to. To find the publications for the 2020-2023 timeframe, searches were performed through the PubMed databases, EMBASE, Scopus, and ProQuest. For the review, 17 reports satisfied the inclusion requirements. Ad26.CoV2.S or ChAdOx1-S, Gam-COVID-Vac(GAM), Sinovac Life Sciences Co., Oxford-AstraZeneca, Pfizer-BioNTech, and viral vector vaccines are among the vaccines that act on various variations. They dealt with the Delta, B.1.1.519, Omicron, and Alpha variations. Findings: Vaccinations against various Variants resulted in fewer COVID-19 infections, fewer deaths, and fewer hospitalizations. The emergency of the Delta variant, persons over 60, and vaccine hesitancy were the main issues affecting the effectiveness of COVID-19 vaccinations in containing the virus's spread. Conclusion: The collective evidence strongly supports the conclusion that COVID-19 vaccination plays a crucial role in mitigating the spread of the virus and reducing the severity of illness among those who contract the virus.

背景:在现有的各种预防干预措施中,接种疫苗是预防 COVID-19 引起的严重疾病和死亡的最有效方法。目的:本综述旨在评估 COVID-19 疫苗在遏制 COVID-19 传播方面的实际效果:本综述旨在评估 COVID-19 疫苗在遏制 COVID-19 病例传播和发病率方面的实际效果,研究不同类型疫苗在控制 COVID-19 大流行方面的作用,并确定影响 COVID-19 疫苗遏制病毒传播效果的关键因素。研究方法遵循 PRISMA 框架的建议。为了找到 2020-2023 年期间的出版物,我们通过 PubMed 数据库、EMBASE、Scopus 和 ProQuest 进行了检索。共有 17 篇报告符合纳入要求。Ad26.CoV2.S或ChAdOx1-S、Gam-COVID-Vac(GAM)、Sinovac Life Sciences Co.、Oxford-AstraZeneca、Pfizer-BioNTech和病毒载体疫苗是作用于各种变异的疫苗。他们处理了 Delta、B.1.1.519、Omicron 和 Alpha 变体。研究结果接种各种变异体疫苗后,COVID-19 感染人数减少,死亡人数减少,住院人数减少。德尔塔变异体、60 岁以上人群和疫苗接种犹豫不决是影响 COVID-19 疫苗有效遏制病毒传播的主要问题。结论综合证据有力地支持了这一结论,即 COVID-19 疫苗接种在减少病毒传播和降低病毒感染者疾病严重程度方面发挥了至关重要的作用。
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引用次数: 0
Knowledge, Attitudes, and Practices toward Antimicrobial Resistance among Young Italian Nurses and Students: A Multicenter, Cross-Sectional Study. 意大利年轻护士和学生对抗菌药耐药性的认识、态度和做法:一项多中心横断面研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4488
Elda De Vita, Francesco Vladimiro Segala, Luisa Frallonardo, Giovanni Civile, Denise De Scisciolo, Roberta Novara, Andrea De Vito, Maria Giacobba De Girolamo, Angela Amendolara, Luigi Piccolomo, Giordano Madeddu, Antonio Terranova, Davide Mariani, Salvatore Altavilla, Nicola Veronese, Mario Barbagallo, Giancarlo Cicolini, Francesco Di Gennaro, Annalisa Saracino

Background: Nurses play a pivotal role in combating antimicrobial resistance (AMR). However, the success of local and national AMR containment efforts hinges on the knowledge, attitude, and practice (KAP) of nursing staff and undergraduate students. Objectives: This study aims to explore the determinants of nurses' KAP regarding AMR, offering insights to control the emergence and spread of drug-resistant pathogens. Methods: This cross-sectional, multicenter survey involving Italian nurses, nursing students, and healthcare professionals was conducted administering an anonymous online questionnaire focusing on AMR. The median score of 12 was taken as the cutoff for "good KAP." The association between study variables and good KAP was assessed using chi-square or t-tests, followed by multivariable logistic regression analysis for statistically significant (p < 0.05) variables. Findings: Among 848 participants, 61.9% (n = 525) were students, and 39.6% (n = 336) scored as having "low KAP." High KAP was associated with being female and studying AMR independently. Conversely, living in southern Italy and receiving AMR training from pharmaceutical companies were associated with low KAP. Conclusions: Among Italian nurses, AMR awareness relies on those who have studied AMR as self-taught and is affected by gender and region. Italian universities lack in lectures on AMR management, and much needs to be done to improve awareness of antimicrobial stewardship among nonmedical health workers.

背景:护士在抗击抗菌药物耐药性(AMR)方面发挥着举足轻重的作用。然而,地方和国家遏制 AMR 的努力能否取得成功,取决于护理人员和本科生的知识、态度和实践 (KAP)。研究目的本研究旨在探讨护士对 AMR 的 KAP 的决定因素,为控制耐药病原体的出现和传播提供见解。研究方法:这项横断面多中心调查涉及意大利护士、护理专业学生和医疗保健专业人员,采用匿名在线问卷调查的方式,重点关注 AMR。中位数 12 分被视为 "良好 KAP "的分界线。采用卡方检验或 t 检验评估研究变量与良好 KAP 之间的关联,然后对具有统计学意义(p < 0.05)的变量进行多变量逻辑回归分析。研究结果在 848 名参与者中,61.9%(n = 525)为学生,39.6%(n = 336)为 "低 KAP"。高 KAP 与女性和独立学习 AMR 相关。相反,居住在意大利南部和接受制药公司提供的 AMR 培训则与低 KAP 有关。结论:在意大利护士中,AMR 意识取决于那些自学 AMR 的人,并受性别和地区的影响。意大利大学缺乏有关 AMR 管理的讲座,要提高非医疗卫生工作者对抗菌药物管理的认识还有很多工作要做。
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引用次数: 0
Infant Feeding Practices, Prevalence of Adolescent Motherhood and Malnutrition among Infants in Mangu Local Government Area, Plateau State, Nigeria. 尼日利亚高原州曼古地方政府辖区的婴儿喂养方式、未成年母亲比例和婴儿营养不良情况。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-19 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4229
Aloysius N Maduforo, Clementina E Okoro, Justina N Chikwendu, Chika Ndiokwelu, Gift Asogwa, Miracle C Aloysius-Maduforo, Chinyere C Okwara, Josephine Nwanneoma Okorie

Background: Adolescent motherhood and malnutrition among children are significant challenges in Africa, but there is limited data on the impact of adolescent motherhood on their children's health and nutrition. This study assessed infant feeding practices, prevalence of adolescent motherhood, and malnutrition among infants in Mangu local government area (LGA). Methodology: A cross-sectional survey using multistage sampling was conducted. Validated questionnaires were used to collect socio-demographic data, and appropriate tools were used for anthropometric measurements. Data were compared with established standards. Descriptive statistical tools, chi square, Pearson correlation, and independent sample t-test were used for data analysis, with significance set at p < 0.05. Results: A total of 200 mothers completed the study. The majority of the infants (78.5%) were less than 6 months old, and 21.5% were 6-12 months old. Breastfeeding initiation within 1 hour was reported by 39% of mothers, while 38% practiced prelacteal feeding. Only 28.5% practiced exclusive breastfeeding, and all mothers breastfed their babies. The prevalence of adolescent motherhood was 37.5%. The prevalence of stunting, wasting, and underweight among infants were 29.5%, 12%, and 8.5%, respectively. Children of adolescent mothers had higher rates of severe stunting compared to children of mothers above 19 years of age. There were significant differences (p = 0.017 and p = 0.029) in stunting rates and weight-for-age indices between children of adolescent mothers and mothers above 19 years of age. Conclusion: Adolescent motherhood contributes to chronic malnutrition in children, and there is a high prevalence of malnutrition among infants in Mangu LGA, Plateau State.

背景:未成年母亲和儿童营养不良是非洲面临的重大挑战,但有关未成年母亲对其子女健康和营养影响的数据却很有限。本研究评估了曼古地方政府辖区(LGA)的婴儿喂养方式、青春期母亲的发生率以及婴儿营养不良的情况。研究方法采用多阶段抽样法进行横断面调查。使用经过验证的问卷收集社会人口数据,并使用适当的工具进行人体测量。数据与既定标准进行了比较。数据分析采用了描述性统计工具、卡方检验、皮尔逊相关检验和独立样本 t 检验,显著性以 p < 0.05 为标准。结果共有 200 名母亲完成了研究。大多数婴儿(78.5%)不足 6 个月大,21.5% 为 6-12 个月大。39%的母亲在 1 小时内开始母乳喂养,38%的母亲采用乳前喂养。只有 28.5%的母亲采用纯母乳喂养,所有母亲都用母乳喂养婴儿。未成年母亲的比例为 37.5%。婴儿发育迟缓、消瘦和体重不足的发生率分别为 29.5%、12% 和 8.5%。与 19 岁以上母亲的子女相比,青春期母亲的子女严重发育迟缓的比例更高。青春期母亲的子女与 19 岁以上母亲的子女在发育迟缓率和年龄体重指数方面存在明显差异(p = 0.017 和 p = 0.029)。结论在高原州曼古地方行政区,未成年母亲导致儿童长期营养不良,婴儿营养不良的发生率很高。
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引用次数: 0
The Use of a Theory of Change Model to Guide the Implementation of a Comprehensive Surgical Specialty Training Program in Equatorial Guinea. 使用变革理论模型指导赤道几内亚综合外科专科培训计划的实施》(The Use of Theory of Change Model to Guide the Implementation of a Comprehensive Surgical Specialty Training Program in Equatorial Guinea)。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-16 eCollection Date: 2024-01-01 DOI: 10.5334/aogh.4477
Robert Memba, Juan Carlos Puyana, Martha Grayling, Carme Climent, Patrícia Martínez, Eunice Blanco, Jordi Rigueiro, David Suárez, Guillem Viscasillas, Emma Fortea, Olga Roman, Daniel Gracia, Francesc Feliu, Silvano Nve, Rosa Jorba

Background: Equatorial Guinea (EG) is located on the African west coast, with only 0.4 trained physicians per 1,000 resident population. The country has one medical school and there is no specialist training program. From 2000 to 2022, 524 doctors have received their medical degree. However, the number of national surgical specialists in the entire country is currently 42. Objective: Formación Especializada Sanitaria en Guinea Ecuatorial (FES Guinea) is a program specifically aimed at designing and implementing a long-term national surgical specialist training program. Methods: Más Que Salud (+QS), which means "More than Health" in Spanish, is a nonprofit organization leading the FES Guinea program. We used the theory of change (ToC) framework to evaluate the work accomplished and implement subsequent phases. The initial phase (A) included a needs assessment and mapping of available resources. An intermediate phase (B) started with a memorandum of understanding to implement a Train the Trainer program. The consolidation phase (C) consists of educational interventions and future advanced training projects. Findings: The ToC model allowed us an analyses of initial and intermediate phases. The needs assessments and resources mapping were executed while several scientific meetings and workshops were given. Scholarships to support specialist training abroad benefited six physicians in a diverse set of surgical disciplines. A regulatory commission to implement the FES Guinea program and the National Medical Council of EG were created. Working directly with the EG Ministry of Health, +QS codesigned a National Health Development Plan that began implementation in 2021 to continue until 2025. Conclusions: The ToC model allowed us to predict the current and future potential effects of FES Guinea on surgical workforce development in EG. This is a unique surgical training program, which combined effective initiatives spearheaded initially by an NGO that successfully incorporated both local health and academic authorities, ensuring sustainability.

背景:赤道几内亚(EG)位于非洲西海岸,每 1000 名常住人口中仅有 0.4 名经过培训的医生。该国只有一所医学院,没有专科医师培训计划。从 2000 年到 2022 年,共有 524 名医生获得医学学位。然而,目前全国的外科专科医生只有 42 人。目标:厄瓜多尔几内亚卫生专科培训计划(FES Guinea)是一项专门设计和实施全国外科专科医师长期培训计划的项目。方法:Más Que Salud (+QS) 在西班牙语中的意思是 "不仅仅是健康",它是一个领导 FES 几内亚项目的非营利组织。我们采用变革理论(ToC)框架来评估已完成的工作并实施后续阶段。初始阶段(A)包括需求评估和可用资源规划。中间阶段(B)从签署谅解备忘录开始,实施培训培训师计划。巩固阶段(C)包括教育干预和未来的高级培训项目。研究结果:ToC 模式使我们能够对初始阶段和中期阶段进行分析。在举行了几次科学会议和研讨会的同时,还进行了需求评估和资源规划。支持专家出国培训的奖学金惠及了外科各学科的六名医生。成立了一个负责实施 FES 几内亚计划的监管委员会和 EG 国家医学委员会。+QS 与几内亚卫生部直接合作,制定了一项国家卫生发展计划,该计划于 2021 年开始实施,并将持续到 2025 年。结论:ToC 模型使我们能够预测 FES 几内亚项目当前和未来对埃 及几内亚外科人才队伍发展的潜在影响。这是一项独特的外科培训计划,它结合了最初由非政府组织牵头的有效举措,并成功纳入了当地卫生和学术机构,确保了可持续性。
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引用次数: 0
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