Advances in Preventive Medicine最新文献

Background: Promotion of health is vital for the optimal growth and development of every infant. Globally, many infants died due to common problems such as diarrhoea and respiratory infection; most of these problems are related to inadequate breast feeding, improper complimentary feeding, lack of immunization, and home accident. Infant and child health status depends upon mothers' knowledge and practice regarding health promotional measures. This study aimed to determine practice and its determinants regarding health promotional measures of infant with 6-12 months age amongst the mothers attending Pediatrics Outpatient Department of Universal College of Medical Science and Teaching Hospital, Bhairahawa, Rupandehi, Nepal.

Methods: Hospital-based cross-sectional study was conducted in Universal College of Medical Science, Bhairahawa, Rupandehi, Nepal, among 414 mothers attending pediatrics outpatient department from September 2019-March 2020. Purposive sampling technique was used to select mothers of infants aged 6-12 months. Bivariate analysis was used primarily to assess the association between dependent and independent variables. Variables which were associated in bivariate analysis with p < 0.05 were entered into a multivariable logistic regression model to identify associated factors of health promotional measures. The goodness of fit of multivariate logistic regression was checked by Nagelkerke R square and variation inflation factor.

Results: The mean age and family size was 25.89 ± 4.81 years and 5.94 ± 2.48, respectively. A total of 71.5% mothers have good practice of health promotional measures. Mothers from Dalit caste (adjusted odds ratio = 0.04, confidence interval: 0.005-0.30), mothers with below school leaving certificate education (AOR = 0.08, CI: 0.02-0.27), fathers engaged in nonagricultural work (AOR = 7.21, CI: 2.59-20.11), birth space of index child greater than 2 years (AOR = 12.88, CI: 3.49-47.58), and family monthly income greater than 20000 Nepalese rupees (AOR = 3.29, CI: 1.16-13.32 were significantly associated with good practice of health promotional measures.

Conclusions: More than one-fourth of the mothers have poor practice of health promotional measures. Ethnicity, mothers' education, fathers' occupation, birth space of index child, and family monthly income were found to be independent determinants of practice of health promotion measures. Thus, policy makers should provide specific education regarding health promotional measures to both parents.

Background: Hepatitis C virus infection during pregnancy is associated with a high risk of maternal complications and poor birth outcomes. There are variable reports on the prevalence of hepatitis C virus infection among pregnant women in Ethiopia. Therefore, this study aims to estimate the pooled prevalence of hepatitis C virus infection among pregnant women in Ethiopia.

Methods: A comprehensive search of electronic databases including PubMed, Scopus, EMBASE, the Cochrane Library, Web of Sciences, and Google Scholar was conducted from April 03, 2020, to May 03, 2020. The quality of included article was evaluated by the JBI. Heterogeneity between the studies was assessed using Cochrane Q and I ² test. The presence of publication bias was tested by funnel plots and Egger's test. A random-effects meta-analysis was computed to determine the pooled prevalence of HCV infection among pregnant women.

Results: Of 502 studies, 6 studies with a total of 2117 pregnant women were included in the meta-analysis. The overall pooled prevalence of hepatitis C virus infection among pregnant women in Ethiopia was 1.83% (95% CI: 0.61, 3.06). Besides, subgroup analysis revealed that the highest HCV prevalence among pregnant women was observed in Oromia region, 5.10% (95% CI: -0.53, 10.73).

Conclusions: This study shows an intermediate level of HCV infection among pregnant women in Ethiopia. The finding suggests the need of implementing a routine hepatitis C virus screening program for all pregnant women, which enables women to access HCV antiviral treatment to minimize vertical transmission to the newborn infants. Moreover, national and regional health programs should mandate and monitor the screening procedures so as to reduce the risk of hepatitis C virus infection.

The main volatile organic compounds found at gasoline stations are benzene, toluene, ethylbenzene, and xylene isomers (BTEX). They cause several harmful effects on human health. Regulatory Norm 7 (1978) provides that, in Brazil, biological monitoring of toluene and xylene is carried out by measuring the urinary metabolites hippuric acid (HA) and methylhippuric acid (MHA), respectively. The objective of this study was to assess the exposure to toluene and xylene and to identify related signs and symptoms in gasoline station workers. A cross-sectional epidemiological study was conducted with workers occupationally exposed to fuels. These gasoline station workers were divided into two groups: 94 workers exposed mainly by inhalation (convenience store workers (CSWs)) and 181 workers exposed by inhalation and dermal route (filling station attendants (FSAs)). A comparison group was formed by 119 workers not occupationally exposed to fuels (office workers (OWs)). Workers exposed to fuels had higher average levels of these exposure biomarkers (HA and MHA), which were also higher in convenience store workers than in filling station attendants. In addition, individuals exposed to the solvents present in gasoline had altered mood/depression, cramps, dizziness, drowsiness, headaches, irritability/nervousness, weakness, weight loss, and other symptoms more frequently and had higher urinary levels of HA and MHA compared to the comparison group. Gasoline station workers showed high levels of HA and MHA, reflecting high occupational exposure to the solvents toluene and xylene present in gasoline, demonstrating that changes in the current legislation and in the work environment are necessary to ensure better health protection for these workers.

Background: Immunization acts as a key intervention to reduce under-five mortality and morbidity. Despite global progress on vaccination, difficulties in the utilization of this service in developing countries have been observed. According to Nepal Demographic and Health Survey (NDHS) 2016, only 78% of children received a complete dose of vaccine among which the first-dose receiver of DPT is 98%, whereas only 83% received a third dose. This study aims to explore the influencing factors of DPT vaccination dropout in Nepal.

Methods: The explorative study was done through secondary data analysis of NDHS 2016. The KR file was used for the analysis of information for 2883 children. Factors influencing dropout of DPT vaccination were explored against the independent variables such as external environment, predisposing factors, and enabling resources. All the analyses were weighted before the analysis. The descriptive, bivariate, and multivariate analyses were performed. The variables showing collinearity have been removed in the final model.

Results: A higher dropout was reported in Terai (18.9%) and province 2 (22.0%), among uneducated mothers (18.1%) and uneducated fathers (19.4%), less than once a week internet users (22.2%), the nonradio listener (17.4%), who had <4 ANC visits (22.7%), home delivery (19.2%), no advised SBA (19.1%), long distance to health facility (17.9%), no iron supplementation in pregnancy (24.3%), and PNC by TBA/others (21.1%). All these tested relationships were found statistically significant (P value <0.05). The aOR for dropout was found to be 7.94 (4.07-15.51) for mothers with less than 4 or no ANC visit, long distance to health facility 4.68 (1.98-10.67), province 2 3.53 (1.13-11.03), and mother without formal employment 2.33 (1.52-3.55).

Conclusion: Factors related to health services, distance, provinces, and socioeconomic status of the family were influencers for vaccine dropout. Targeted intervention towards disadvantaged regions, counseling the mother during ANC, improving the education status of parents, access to the health facility, and use of mass media for advocacy are hereby recommended.

Arterial vascular calcification (VC) represents formation of calcium phosphate deposits on the interior of arteries, which could restrict blood flow leading to heart health problems, including morbidity and mortality. VC is a complex and tightly regulated process that involves transformation of vascular smooth muscle cells (VSMCs) to bone-like cells and subsequent deposition of calcium as hydroxyapatite. Natural bioactives, including quercetin (Q), curcumin (C), resveratrol (R), and magnesium (Mg), have been reported to inhibit VC. Thus, we conducted an in vitro study using rat vascular smooth muscle cells (rVSMCs) to evaluate the protective effect of natural bioactives found in OptiCel, that is, Mg combined with polyphenols (PPs), Q, C, and R. Calcification was induced by culturing rVSMCs in a high phosphate (HP) medium. The addition of Mg and Q + C + R separately decreased the HP-induced calcium deposition by 37.55% and 42.78%, respectively. In contrast, when Mg was combined with Q, C, and R, the inhibition of calcium deposition was decreased by 92.88%, which is greater than their calculated additive inhibition (80.33%). These results demonstrate that the combination of Mg with selected PPs (Q, C, and R) is more effective than when used separately. The findings also suggest the combination has a synergistic effect in inhibiting VC, which is a risk factor for cardiovascular disease. Thus, regular consumption of these natural bioactives could have a beneficial effect in reducing the development of heart diseases.

Background: The study aimed to determine the correlation between different diet quality indices and glycemic status and lipid profile in patients with diabetes.

Methods: This study was carried out on 235 patients with type 2 diabetes referred to Martyr Motahari Diabetes Clinic of Shiraz city so as to investigate the relationship between glycemic status and lipid profile and the diet quality using Healthy Eating Index (HEI-2010), phytochemical index (PI), and Diet Quality Index-International (DQI_I).

Results: A positive correlation was indicated between the serum levels of LDL-C and HEI-2010 scores (p=0.026). Furthermore, there was a positive correlation between the patients' age and scores of PI (p=0.006) and between PI and DQI_I (p < 0.001). There was no significant relationship between the scores for all three indicators and biochemical parameters.

Conclusion: The results of this study indicated that there was a significant correlation between the serum LDL-C levels and the HEI-2010 scores. Moreover, the age of the patients had a direct correlation with the PI scores.

Background: As one of the most important public health problems worldwide, diabetes is closely linked with patients' lifestyles. The optimal approach to treating diabetes is to prevent it. Our aim in this study was to assess the impact of self-care behaviors on quality of life, blood sugar control, and HbA1C level in patients with type 2 diabetes.

Methods: This randomized clinical trial examined 100 diabetic women referred to Ghadir Comprehensive Health Center in Birjand in 2019. A 5 cc fasting blood sample was taken from each participant. The participants were randomly assigned to experimental and control groups. For the experimental group, a 10-session self-care training workshop was held. Baseline and postintervention fasting blood glucose, HbA1C level, and life quality of the two groups were assessed and compared six months after the intervention. Data were analyzed in SPSS (16).

Results: In the experimental group, the mean serum HbA1C level decreased from the baseline 7.5 ± 1.5 to 6.3 ± 1.0 (P < 0.001). Fasting blood sugar in the intervention group decreased from 136.3 ± 43.5 to 127.3 ± 22.9, but the reduction was not significant (P=0.322). The mean scores of the quality of life (P=0.002) and the visual analogue scale (P < 0.001P < 0.001) in the experimental group increased significantly compared to the control group.

Conclusion: Self-care training for diabetic women had positive effects on both life quality and disease control. Therefore, it is recommended that self-care training be delivered and taken more seriously by physicians and health care providers in addition to drug therapy.

Background: Chronic hepatitis B (CHB) virus (HBV) infection remains a severe problem worldwide. An estimated 240-400 million persons are reported to have chronic HBV infection, and the annual mortality from HBV-related complications including cirrhosis and hepatocellular carcinoma was 600,000 persons. In Sub-Saharan Africa, the prevalence of HBV chronic infection is particularly high while in South Sudan, hepatitis B remains a serious problem of public health importance with health care workers being more at greater risk. Vaccination coverage against HBV is low among all age groups, yet vaccination status among health care workers is not even known in South Sudan. This study aimed at assessing viral hepatitis B vaccination uptake among health care workers at Juba Teaching Hospital, Juba City, South Sudan.

Objective: To assess the uptake of viral hepatitis B vaccination among health care workers in Juba Teaching Hospital, Juba City, South Sudan.

Methods: An analytical cross-sectional study design was conducted targeting 154 health workers. A convenient sampling procedure was used to recruit study participants. Questionnaires were used to collect data. SPSS version 20.0 was used for data analysis. Chi-square tests were used to determine the association between the uptake of hepatitis B vaccination and individual and health facility factors. Multivariable analysis was conducted. Adjusted OR was used to interpret the findings.

Results: Uptake of hepatitis B vaccination was found to be low at 44.20%, only 48.8% had received one dose, 29.1% received two doses, and 22.1% had received all three doses. Being married (p ≤ 0.008), knowing that hepatitis B can be prevented by vaccination (p ≤ 0.001), knowing that HBV can be got through unprotected sexual intercourse (p ≤ 0.001), awareness of where to get hepatitis B vaccination from (p ≤ 0.001), availability of vaccines in the health facility (p ≤ 0.027), and availability of guidelines followed by all health workers in this facility (p ≤ 0.006) were the factors independently associated with the uptake of hepatitis B vaccination.

Conclusion: The uptake of hepatitis B vaccination among health workers at Juba Teaching Hospital was low (22.1%), putting health workers at great risk of HBV infection. Having knowledge about hepatitis B vaccination and unprotected sexual intercourse were individual factors associated with hepatitis B vaccination. Availability of the vaccine and vaccination guidelines were the health-related factors associated with hepatitis B vaccination. The government of South Sudan through the Ministry of Health should first track approval of the viral hepatitis B vaccination policy and ensure that it is adopted and implemented by all hospitals. Health care workers must be prioritized and mandatorily vaccinated against viral hepatitis B.

Objective: The objective of this meta-analysis was to analyze the benefits and harms of treating the population with statins in those having mean low-density lipoprotein cholesterol (LDL-C) in the near-optimal (100 to 129 mg/dl) to borderline high (130 to 159 mg/dl) range and free of cardiovascular disease (CVD).

Methods: We searched PubMed, PubMed Central, Cochrane Library, and Google Scholar databases for randomized controlled trials (RCTs) published between 1994 and July 2020. We included RCTs with greater than 90% of participants free of CVD. Two reviewers independently screened the articles using the Covidence software, assessed the methodological quality using the risk of bias 2 tool, and analyzed the data using the RevMan 5.4 software.

Results: Eleven trials were included. Statin therapy was associated with a decreased risk of myocardial infarction (RR = 0.56, 95% CI: 0.47 to 0.67), major cerebrovascular events (RR = 0.78, 95% CI: 0.63 to 0.96), major coronary events (RR = 0.67, 95% CI: 0.57 to 0.80), composite cardiovascular outcome (RR = 0.71, 95% CI: 0.62 to 0.82), revascularizations (RR = 0.65, 95% CI: 0.57 to 0.74), angina (RR = 0.76, 95% CI: 0.63 to 0.92), and hospitalization for cardiovascular causes (RR = 0.74, 95% CI: 0.64 to 0.86). There was no benefit associated with statin therapy for cardiovascular mortality and coronary heart disease mortality. All-cause mortality benefit with statin therapy was seen in the population with diabetes and increased risk of CVD. Statin therapy was associated with no significant increased risk of myalgia, creatine kinase elevation, rhabdomyolysis, myopathy, incidence of any cancer, incidence of diabetes, withdrawal of the drug due to adverse events, serious adverse events, fatal cancer, and liver enzyme abnormalities.

Conclusion: Statin therapy was associated with a reduced risk of cardiovascular disease and procedures without increased risk of harm in populations with mean LDL-C in the near-optimal to the borderline high range and without prior atherosclerotic cardiovascular disease.

Background: Family planning (FP) is one of the fundamental pillars of safe motherhood and reproductive health rights. In developing countries, women with unmet need for FP constitute a significant proportion of all women of reproductive age and it is an ongoing public health challenge in the Gambia. The study aimed to determine the women's proportion of contraceptive uptake and knowledge of FP methods.

Methods: The study employed a community-based descriptive cross-sectional study conducted for 643 women of reproductive age (15-49 years) from the selected clusters in rural Gambia through a multistage sampling technique. A pretested structured interview questionnaire was used to collect data. Univariate analysis using frequencies and percentages were used to present results in this study. Data entry and analysis were done using IBM SPSS version 24.

Results: The overall contraceptive prevalence rate was 30.4%, while the CPR for married or in the union was 34.2%. About 86% of women reported child spacing as the major benefits of FP, while 49.5% reported amenorrhea as the most common side effect of contraceptives. Injectable (Depo-Provera, Noristerat, and ) and pills (progesterone and combined) were the two most common FP methods used at 58.5% and 44.0%, respectively.

Conclusion: The present study showed a moderately low contraceptive uptake. Thus, there is a need to focus FP services for women in rural areas, emphasizing the quality of services and gender equality. The study further recommends strengthening and mainstreaming of male involvement and religious leaders participation in FP interventions and the initiation of a communication program that explicitly promotes interspousal communication.