Dialogues in health最新文献

COVID-19 has caused unprecedented disruption to everyday life. Unsurprisingly, this has resulted in increased prevalence of poor mental wellbeing. While previous mental health issues have been consistently flagged as a risk factor, the absence of these may also leave individuals vulnerable due to a lack of psychological coping strategies. This study explored the change in symptoms of anxiety, depression, and trauma in 167 females who provided data at four timepoints over the course of the first year of the pandemic. There was a significant effect of time on the extent of the change in depression but, for all wellbeing measures, those with current or previous mental health issues experienced a similar magnitude of change as those with no previous issues. This suggests that low-risk individuals may be faring worse, relatively. Ensuring that this group is not overlooked will be imperative in protecting and re-building the wellbeing of the nation.

Background

Family Life and HIV Education (FLHE) program is a national school-based sexual education intervention program to prevent the spread of HIV among young people in Nigeria. The FLHE curriculum was first implemented nationwide in 2003. However, there have been challenges mitigating the implementation of this intervention. An important challenge is the low capacity of teachers to adequately deliver the contents of the developed curriculum. Considering the significant roles teachers play in the implementation of this important prevention program, it is important that they have the capacity to deliver it. Literature review has shown that there are no documented studies in Nigeria that have considered the use of mobile technology to improve the capacity of teachers to teach FLHE. Therefore, in this paper we have documented the methodology of a study that tested the feasibility of enhancing the self-reported capacity of teachers to deliver the FLHE curriculum through mobile technology.

Methods

This study was a multiphase study. In this paper, we present an overview of the methods employed in the mobile-FLHE (m-FLHE) program for teachers. We describe study design, participant eligibility and recruitment, assessments, intervention procedures, and measures in the assessments. We also present treatment fidelity assessment, procedures utilized to enhance retention of study participants, and data analysis plans.

Discussion

Although, the role of teachers and instructors in ensuring the fidelity of CSE has been shown to be critical to its success, very few programs have sought to improve the capacity of teachers to teach FLHE. This study presents the methods of an innovative and sustainable way to improve the capacity of teachers to increase the comprehensive knowledge of HIV among adolescents.

Introduction

The upscale of surgical service delivery in low to middle income countries will increase health sector greenhouse gas emissions globally. Understanding surgical greenhouse gas emissions from surgical suite activities can direct decarbonization strategies and achieve local, and global climate change objectives.

Material and methods

A prospective surgical suite carbon foot print study was conducted at the Alotau Provincial Hospital from the 28^th March 2022 to the 28^th of May 2022.

Results

The total carbon emission for the surgical suite in APH over the study period was 2,665.8 kgCO₂e. The average carbon emission per surgical case within the boundary of the surgical suite was 8.4 kgCO₂e. Scope one emissions (anaesthetic gases) accounted for 44.7% (1171.3 kgCO₂e) of all carbon emissions.

Conclusion

If no action is taken, carbon emissions in the western pacific region will continue to increase from surgical suites. Therefore, proactive efforts to reduce greenhouse gas emissions must be prioritized.

Background

Hypertension is highly prevalent in India; however, little is known about the dietary intakes of those living with hypertension, particularly in rural areas. The primary aim was to assess the dietary intakes of individuals living in rural India with self-reported history of hypertension. As secondary analyses, we explored the dietary impact of a salt substitute in this population group.

Materials and methods

This study used data from a large randomised controlled trial conducted in seven villages across rural India. Participants received either regular salt (100% sodium chloride) or the salt substitute (70% sodium chloride/30% potassium chloride) to replace all home salt use. Dietary intake at baseline and end-of-trial was assessed using 24-h dietary recalls. A range of dietary outcomes were assessed including energy intake, macronutrient intake and overall diet quality according to the Alternate Healthy Eating Index (AHEI).

Results

A total of 454 participants were included in the analysis. At baseline, mean (SE) energy intakes in regular salt group and salt substitute group were similar at 5240 (110) kJ/day and 5120 (106) kJ/day, respectively. This was largely attributable to intakes of carbohydrates (74.4% of total energy intakes for regular salt group vs 75.4% for the salt substitute group) followed by total fat (15.8% vs 15.4%) and protein (10.4% vs 10.3%). Both groups also had similar AHEI scores at baseline, with mean (SE) total scores equating to 33.0 (0.4) (out of a total 90) for the regular salt group and 32.7 (0.4) for the salt substitute group. Both groups received lowest AHEI scores across the following components: vegetables, fruit and wholegrains. At baseline, the mean (SE) intakes of sodium across the regular salt and salt substitute groups were similar at 2349 (67) mg/day and 2396 (64) mg/day, respectively. In the salt substitute group, there was a significant reduction in total sodium intakes over time (−264 mg/day, 95% CI, −442 to −85), driven by the use of the salt substitute.

Conclusion

This study found individuals with hypertension living in rural India had poor dietary intakes, including low intakes of fruits, vegetables and wholegrains, and high intakes of sodium. Salt substitutes may be an effective strategy for reducing sodium intake in this population group.

The awareness of the health implication of Covid-19 pandemic marked an increase consumption of various dietary and herbal supplements (DHS) for the deterrence and/or prophylaxis against the novel emerging and infectious disease. However, there is little indication of the usefulness or otherwise of their use in alleviating symptoms of COVID-19.

Objectives

To investigate the pattern and determinants of DHS use among the Nigerian population for the prevention and treatment of COVID-19.

Design

Cross-sectional questionnaire survey. Setting: Older adolescents and adults residing in Nigeria.

Participants

Participants (n = 645) residing in the Nigeria were recruited from different geo-political zones and various ethnic groups.

Primary and secondary outcomes

Prevalence and determinants for the use of different DHS for the prevention and treatment of COVID-19 in Nigeria, and sources of information for DHS use.

Results

Most participants (425, 65.9%) believed that dietary supplements are necessary during infectious disease outbreak, but a fewer proportion believed that supplements can be used in conjunction with other drugs to treat Covid-19. Vitamin C was the most known (70.0%) and Vitamin A. The least known (0.3%) dietary supplement Approximately half (50.2%) of the study subjects, more than a third (37.8%) and less than a quarter (22.7%) were aware that Folic acid, vitamin D and vitamin E are DS. Herbal dietary supplements mentioned as known by the study participants included Garlic (46.5%), Ginger (44.7%), Tumeric (36.3%), Moringa (40.0%) and Ginseng (26.3%). Citrus fruit as a DS was recognized by fewer (6.5%) study participants and only 1.6% referred to herbal tea as DHS. In all, 571 (88.5%) of the study participants took DHS during the Covid-19 pandemic with males 1.5 times more likely to take DHS than females (χ² = 3.09, P-value = 0.08, OR = 1.54, 95% CI = 0.95, 2.47) during the pandemic. Participants reported lesser consumption of Selenium (27, 4.2%), Iron (20,3.1%), Zinc (61, 9.5%) and calcium (101, 15.7%) to prevent/treat Covid-19. Majority (271, 42.0%) of the study participants mentioned “health worker” as source of information on DHS while 13% mentioned “Social media”. The sociodemographic determinants of DHS practices used to prevent/treat COVID-19 during the pandemic included older age group of 61–70 years, widows, secondary level of education and not employed.

Conclusions

The findings showed widespread use of DHS for the prevention and treatment of COVID-19. The use of DHS in this study was mainly guided by health workers with a marginal role of social media and Mass media. These findings call for a more robust consolidative tactic towards DHS to ensure its proper and safe use.

Background

The attendant long-term mental health consequence of the conflict of various kinds in Nigeria is yet to be thoroughly investigated. The Tiv-Fulani farmer-herdsmen crisis is one such conflict that occurred in 2013/2014 in Guma local government in Benue state.

Aims

This study seeks to find out some years after the crisis, the prevalence difference in posttraumatic stress disorder (PTSD) between a community (Uikpiam) with direct exposure to the conflict and another (Daudu) with indirect exposure, the pattern of distribution of PTSD symptoms and the associate factors of PTSD.

Methods

It is a cross-sectional one that employed a multi-stage cluster sampling method to select 413 participants; 135 from Uikpiam and 278 from Daudu. The study instruments administered included a questionnaire with some socio-demographic variables and an extract from the PTSD module of the Composite International Diagnostic Interview.

Results

The prevalence rate of PTSD was higher in Uikpiam (16.3%) when compared to Daudu (4.3%). A high proportion of sub-threshold symptoms of PTSD was recorded in both communities. An association was found between a lower educational qualification and PTSD (χ2 = 8.373; p = 0.039).

Conclusion

PTSD can be a prolonged mental ill-effect of crisis and proximity to trauma sites increases vulnerability including lower education. This study looked at PTSD only as an outcome of this crisis, but mental health adverse outcomes of the crisis may not be limited to this alone, hence the need for further investigations for relevant stakeholders to act.

Background

Despite the global disease burden associated with the co-occurrence of cardiovascular diseases (CVDs) and depression, depression remains underdiagnosed and undertreated in the CVD population, especially among older adults in India. As such, this study examines (1) the association between single and multiple CVDs and major depressive disorder among older Indians; (2) whether this association is mediated by older adults' self-rated health and functional limitations; and (3) whether these associations vary for older men and women.

Methods

Data come from the 2017–18 wave 1 of the Longitudinal Ageing Study in India. Multivariable logistic regression is used to explore the association between CVDs and major depressive disorder among older men and women. The Karlson–Holm–Breen (KHB) method is used to examine the mediation effects of self-rated health and functional difficulties in the observed associations.

Results

Overall, 5.08% of the older adults had multiple CVDs. Older women (9.71%) had a higher prevalence of major depressive disorder compared to men (7.50%). Multiple CVDs were associated with greater odds of major depressive disorder after adjusting the potential covariates (adjusted odds ratio [AOR]: 1.49; 95% confidence interval [CI]: 1.10–2.00). Older men with multiple CVDs had a greater risk of major depressive disorder (AOR: 1.64; 95% CI: 1.05–2.57) relative to women with CVDs (AOR: 1.39; 95% CI: 0.93–2.08). The association between multiple CVDs and depression was mediated by self-rated health (34.03% for men vs. 34.55% for women), ADL difficulty (22.25% vs. 15.42%), and IADL difficulty (22.90% vs. 19.10%).

Conclusions

One in five older Indians with multiple CVDs reports major depressive disorder, which is three times more common than the prevalence of depressive disorder in older adults without CVDs. This association is attenuated by self-rated health and functional limitations. Moreover, these associations are more pronounced in older men relative to older women. These findings depart from prior inferences that men with CVDs are less psychologically distressed than their female counterparts. Moreover, the findings underscore the importance of gender-specific approaches to interventions and therapeutics for CVD-related mental health.

Background

Despite growing scientific knowledge of Zika virus (ZIKV) infection, questions remain regarding ZIKV infection in pregnancy and congenital ZIKV syndrome (CZS).

Methods

The ZIKAction Paediatric Registry is an international registry of children with documented ZIKV exposure in utero and/or with confirmed or suspected CZS. Its aim is to characterize these children (i.e., clinical, radiological, neurodevelopmental features) and describe outcomes, longer-term sequelae and management through retrospective case note review. This analysis described the maternal and perinatal characteristics of children in the Registry’s Bahia arm, assessed their neuroimaging, ophthalmic, hearing and electroencephalography abnormalities by microcephaly classification and reported on hospitalisations. Children born in 2015-2018 and enrolled 2020-2021 in three public health facilities in Salvador were included.

Results

Of 129 (57% female) children, 15 (11·6%) had laboratory-confirmed congenital ZIKV infection and 114 (88·4%) suspected CZS. At delivery, 15 (11·6%) were normocephalic, 30 (23·3%) moderately microcephalic, and 84 (65·1%) severely microcephalic. Median birth head circumference z-score was -3·51 [IQR, -4·69,-2·73]. During follow-up, all children had abnormal neuroimaging, 80·3% (94/117) abnormal electroencephalogram, 62·2% (77/120) ophthalmic abnormalities, and 27·4% (34/124) hearing impairment. Microcephaly classification was significantly associated with gestational age, and ophthalmological and electroencephalography abnormalities. Of 125 children with hospitalisation data, 52 (41·6%) had been hospitalised by most recent follow-up, at median age of 15·8 [4·0, 34·4] months; infections were the leading cause.

Conclusion

Congenital ZIKV infection is an emerging disease with a varied and incompletely understood spectrum. Continued long-term follow-up is essential to understand longer-term prognosis and to inform future health and educational needs.

Introduction

Injuries during adolescence cause lifelong harm and death. Our study used a nationally representative sample to examine the prevalence and risk factors associated with serious injuries among in-school adolescents in Panama.

Methods

We analysed Panama’s 2018 Global School-Based Student Health Survey data using SPSS. Percentages were used to summarise the results of the prevalence of serious injuries. Binomial logistic regression analysis was performed to examine the risk factors of serious injuries. The results were presented as an adjusted odds ratio (AOR) at a 95% confidence interval (CI).

Results

The prevalence of serious injury among in-school adolescents in Panama is 45%. Furthermore, the study found that males (AOR= 1.495, CI=1.272--1.756), truancy (AOR=1.493, CI=1.249--1.785), overweight (AOR= 1.246, 95% CI=11.057--1.469), drinking alcohol (AOR= 1.397, CI=1.151--1.695), experiencing physical attack (AOR= 2.100, CI=11.646--2.681), engaging in a physical fight (AOR=1.586, CI=1.289--1.952) and bullied outside school (AOR=1.276, CI=1.005--1.621) significantly predict serious injuries among adolescents in Panama.

Conclusion

Multidisciplinary approaches targeting the correlates observed will help reduce the high prevalence of serious injuries among in-school adolescents in Panama.

With over 6.5 million deaths due to COVID-19, it has become an issue of global health concern. Early findings have identified several social determinants of deaths from COVID-19. However, very few studies have been done on the relationship between internet access and COVID-19 mortality in the context of developing countries. Using geospatial methods, this study examines the relationship between internet access and COVID-19 mortality disparity in Nigeria. In contrast to the widely reported relationship in the literature that internet access lowers the risk of COVID-19 mortality, the current study finds that geographical locations with the highest internet access are the hotspots of COVID-19 mortality in Nigeria, especially some parts of southwest Nigeria. In addition, findings show that population density and unemployment are risk factors of COVID-19 mortality. The study recommends educating the population on the use of online health information and the need to adhere strictly to non-pharmaceutical and vaccination interventions to reduce the number of deaths caused by the virus.