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An integrated community-based hypertension improvement program improves hypertension awareness in Ghana 一项以社区为基础的综合高血压改善计划提高了加纳人对高血压的认识
Pub Date : 2021-01-01 DOI: 10.35500/jghs.2021.3.e16
A. Laar, A. Adler, D. Prieto-Merino, Reina Der, Debbie Mangortey, Rebecca Dirks, P. Perel, P. Lamptey
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引用次数: 1
The challenge of dearth of information in Tanzania’s COVID-19 response 坦桑尼亚COVID-19应对工作中信息匮乏的挑战
Pub Date : 2021-01-01 DOI: 10.35500/jghs.2021.3.e20
Allan Kangwerema, Hipolite Thomas, Simfukwe Knovicks, Jackson Safari, Mutale Diluxe, Shekiba Madadi, Y. A. M. Elhadi, Attaullah Ahmadi, Y. Adebisi, D. Lucero‐Prisno
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引用次数: 2
COVID-19 started again COVID-19再次爆发
Pub Date : 2021-01-01 DOI: 10.35500/jghs.2021.3.e14
So Yoon Kim
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引用次数: 0
Caries status and risk factors among urban and rural primary students in Thua Thien Hue Province, Vietnam 越南顺化省城乡小学生龋齿状况及危险因素分析
Pub Date : 2020-07-16 DOI: 10.35500/jghs.2020.2.e27
T. Tran, T. Hoang, Dinh Tuyen Hoang, Ngoc Hoat Luu
Background: Dental caries is an essential public health problem in most developing countries including Vietnam. This study's aims were to discover the dental caries prevalence in selected areas of Thua Thien Hue province, Vietnam, and to detect the association of sweet food consumption and oral hygiene practices with caries among Vietnamese primary school students. Methods: A cross-sectional study was conducted in Hue City and in Nam Dong District as one urban and one rural areas of Thua Thien Hue province, Vietnam that identifies the dental caries prevalence and to find participants for the matched case-control study. Each child in the dental caries group was matched to a student in the non-caries group using multivariate matched sampling methods that incorporated the propensity score. Practices related to dental hygiene and sweet food consumption were obtained using an intervieweradministered questionnaire for the matched case-control study. Results: Prevalence of dental caries in Hue City was 77.9% and in Nam Dong District was 77.3%, giving no statistically significant difference between two areas. Brushing teeth and replacing toothbrush frequently were related to the presence of dental caries in both urban and rural areas. Children who brushed teeth at least twice a day were less likely to have dental caries compared to those who did not (adjusted odds ratio [aOR], 0.42; 95% CI, 0.29–0.62; P < 0.001). The odds of having dental caries were significantly higher among children who replaced their toothbrush after at least each nine months than among those who replaced toothbrushes less than every three months (aOR, 2.66; 95% CI, 1.77–4.01; P < 0.001). Conclusion: The prevalence of dental caries was equally high among primary students in Hue City and Nam Dong District. Using toothbrush correctly more than twice per day and replacing the toothbrush every three months can reduce dental caries among primary school students.
背景:龋齿是包括越南在内的大多数发展中国家的重要公共卫生问题。本研究的目的是发现越南化天顺化省选定地区的龋齿患病率,并检测越南小学生中甜食消费和口腔卫生习惯与龋齿的关系。方法:在顺化市和越南顺化省南东区作为一个城市和一个农村地区进行了一项横断面研究,以确定龋齿患病率,并为匹配的病例对照研究寻找参与者。每个龋齿组的孩子与非龋齿组的学生使用多元匹配抽样方法进行匹配,并结合倾向评分。在匹配的病例对照研究中,通过访谈问卷获得与牙齿卫生和甜食消费相关的实践。结果:顺化市龋患病率为77.9%,南东区龋患病率为77.3%,两区差异无统计学意义。在城市和农村地区,频繁刷牙和更换牙刷与龋齿的发生有关。与不刷牙的儿童相比,每天至少刷牙两次的儿童患龋齿的可能性更小(调整优势比[aOR], 0.42;95% ci, 0.29-0.62;P < 0.001)。至少每9个月更换一次牙刷的儿童患龋齿的几率明显高于每3个月更换一次牙刷的儿童(aOR, 2.66;95% ci, 1.77-4.01;P < 0.001)。结论:顺化市与南东区小学生龋病患病率相当。每天正确使用牙刷两次以上,以及每三个月更换一次牙刷,可减少小学生蛀牙。
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引用次数: 0
Reproductive, maternal and child health services in the wake of COVID-19: insights from India 2019冠状病毒病后的生殖、孕产妇和儿童保健服务:来自印度的见解
Pub Date : 2020-07-16 DOI: 10.35500/jghs.2020.2.e28
Chandan Kumar, Chhavi Sodhi, Abdul Jaleel CP
The United Nations Development Programme has designated severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), or coronavirus disease 2019 (COVID-19) pandemic as a ‘systematic human development crisis’.1 In the span of a few short months, this pandemic has upended and overrun healthcare systems in countries across the world.2,3 The worst afflicted have been lowand middle-income countries,4-6 which had already been straining hard to meet their population's health needs and achieve the targets outlined under the Sustainable Development Goals (SDGs) by 2030.
联合国开发计划署已将严重急性呼吸系统综合征-冠状病毒2 (SARS-CoV-2)或冠状病毒病2019 (COVID-19)大流行指定为“系统性人类发展危机”在短短几个月的时间里,这场大流行颠覆了世界各国的卫生保健系统,使其不堪重负。2,3受影响最严重的是低收入和中等收入国家,4-6这些国家已经在努力满足其人口的健康需求,并在2030年前实现可持续发展目标所概述的具体目标。
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引用次数: 5
Perceived preparedness to respond to the COVID-19 pandemic: A study with healthcare workers in Ghana 感知准备应对COVID-19大流行:对加纳卫生保健工作者的研究
Pub Date : 2020-07-11 DOI: 10.1101/2020.07.10.20151142
P. Afulani, Akua O. Gyamerah, R. Aborigo, J. J. Nutor, H. Malechi, A. Laar, Mona Sterling, J. Awoonor-Williams
Introduction: Healthcare workers' (HCWs) preparedness to respond to pandemics is critical to containing disease spread. Low-resource countries, however, experience barriers to preparedness due to limited resources. In Ghana, a country with a constrained healthcare system and high COVID-19 cases, we examined HCWs' perceived preparedness to respond to COVID-19 and associated factors. Methods: 472 HCWs completed questions in a cross-sectional self-administered online survey. Perceived preparedness was assessed using a 15-question scale (Cronbach alpha=0.91) and summative scores were created (range=0-45). Higher scores meant greater perceived preparedness. We used linear regression with robust standard errors to examine associations between perceived preparedness and potential predictors. Results: The average preparedness score was 24 (SD=8.9); 27.8% of HCWs felt prepared. In multivariate analysis, factors associated with higher perceived preparedness were: training ({beta}=3.35, 95%CI: 2.01 to 4.69); having adequate PPE ({beta}=2.27, 95%CI: 0.26 to 4.29), an isolation ward ({beta}=2.74, 95%CI: 1.15 to 4.33), and protocols for screening ({beta}=2.76, 95%CI: 0.95 to 4.58); and good perceived communication from management ({beta}=5.37, 95%CI: 4.03 to 7.90). When added to the model, perceived knowledge decreased the effect of training by 28.0%, although training remained significant, suggesting a partial mediating role. Perceived knowledge was associated with a 6-point increase in perceived preparedness score ({beta}=6.04, 95%CI: 4.19 to 7.90). Conclusion: HCWs reported low perceived preparedness to respond to COVID-19. Training, clear protocols, PPE availability, isolation wards, and communication play an important role in increasing preparedness. Government stakeholders must institute necessary interventions to increase HCWs' preparedness to respond to the ongoing pandemic and prepare for future pandemics.
导言:卫生保健工作者应对大流行的准备工作对控制疾病传播至关重要。然而,由于资源有限,资源匮乏的国家在防备方面遇到障碍。加纳是一个医疗保健系统受限且COVID-19病例高的国家,我们调查了卫生保健机构应对COVID-19的准备情况及其相关因素。方法:对472名卫生保健工作者进行横断面自我管理的在线调查。感知准备使用15题量表(Cronbach alpha=0.91)进行评估,并创建总结性得分(范围=0-45)。分数越高意味着准备得越充分。我们使用具有稳健标准误差的线性回归来检验感知准备和潜在预测因子之间的关联。结果:心理准备平均得分为24分(SD=8.9);27.8%的医护人员感到准备充分。在多变量分析中,与感知准备程度较高相关的因素有:训练({beta}=3.35, 95%CI: 2.01 ~ 4.69);拥有足够的个人防护装备({beta}=2.27, 95%CI: 0.26至4.29)、隔离病房({beta}=2.74, 95%CI: 1.15至4.33)和筛查方案({beta}=2.76, 95%CI: 0.95至4.58);管理层良好的感知沟通({beta}=5.37, 95%CI: 4.03 ~ 7.90)。当添加到模型中时,感知知识降低了28.0%的训练效果,尽管训练仍然显著,表明部分中介作用。感知知识与感知准备得分增加6分相关({beta}=6.04, 95%CI: 4.19至7.90)。结论:卫生保健工作者对应对COVID-19的准备程度较低。培训、明确的规程、个人防护装备的可用性、隔离病房和沟通在加强防范方面发挥着重要作用。政府利益攸关方必须采取必要的干预措施,加强卫生保健中心的准备工作,以应对当前的大流行病,并为未来的大流行病做好准备。
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引用次数: 5
Equal risk, unequal burden? Gender differentials in COVID-19 mortality in India 风险相等,负担不相等?印度COVID-19死亡率的性别差异
Pub Date : 2020-05-14 DOI: 10.35500/jghs.2020.2.e17
W. Joe, Abhishek Kumar, S. Rajpal, U. Mishra, S. Subramanian
Background: Early reports on coronavirus disease 2019 (COVID-19) case fatalities in India suggests that males are at a greater disadvantage than females, but it is unclear whether males experience a higher risk of mortality throughout the age-spectrum or there are sexdifferentials in survival risk. We adopt a gender lens and present a disaggregated view of agesex specific COVID-19 infection and mortality risk in India. Methods: We use crowdsourced data (https://www.covid19india.org/) to provide preliminary estimates for age-sex specific COVID-19 case fatality rate (CFR) for India. We analyse the burden of the cases and deaths for age-sex categories. CFR is estimated as the ratio of confirmed deaths in total confirmed cases. We report binomial confidence interval for the CFR estimates. Also, an adjusted-CFR is developed to capture the potential mortality among the currently active infections. Results: As of May 20, 2020, males share a higher burden (66%) of COVID-19 infections than females (34%) but the infection is more or less evenly distributed in under-five as well as elderly age groups. The CFR among males and females is 2.9% and 3.3%, respectively. The age-specific COVID-19 CFR assumes ‘Nike-swoosh’ pattern with elevated risks among the elderly. The World Health Organization world standard population structure standardized CFR for India is 3.34%. The adjusted-CFR is estimated to be 4.8%. Conclusion: Early evidence indicates that males have higher overall burden, but females have a higher relative-risk of COVID-19 mortality in India. Elderly males and females both display high mortality risk and require special care when infected. Greater focus on data collection and sharing of age-sex specific COVID-19 cases and mortality data is necessary to develop robust estimates of COVID-19 case fatality to support policy decisions.
背景:印度关于2019年冠状病毒病(COVID-19)病例死亡的早期报告表明,男性比女性处于更大的劣势,但目前尚不清楚男性在整个年龄范围内的死亡风险是否更高,还是在生存风险方面存在性别差异。我们采用性别视角,对印度特定年龄段的COVID-19感染和死亡风险进行了分类分析。方法:我们使用众包数据(https://www.covid19india.org/)对印度特定年龄性别的COVID-19病例病死率(CFR)提供初步估计。我们按年龄和性别分类分析病例和死亡的负担。病死率估计为确诊死亡人数占确诊病例总数的比例。我们报告了CFR估计的二项置信区间。此外,还开发了一种调整后的病死率,以捕获当前活动性感染的潜在死亡率。结果:截至2020年5月20日,男性感染COVID-19的负担(66%)高于女性(34%),但感染在5岁以下和老年人群体中大致均匀分布。男性和女性的CFR分别为2.9%和3.3%。特定年龄的COVID-19 CFR呈“耐克旋风”模式,老年人的风险较高。世界卫生组织世界标准人口结构标准化CFR为3.34%。经调整后的cfr估计为4.8%。结论:早期证据表明,在印度,男性的总体负担更高,但女性的COVID-19死亡率相对风险更高。老年男性和女性都有很高的死亡风险,感染后需要特别护理。有必要更加注重数据收集和共享特定年龄性别的COVID-19病例和死亡率数据,以制定可靠的COVID-19病死率估计数,以支持政策决策。
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引用次数: 57
Where do women birth during a pandemic? Changing perspectives on Safe Motherhood during the COVID-19 pandemic 大流行期间妇女在哪里分娩?在COVID-19大流行期间对安全孕产的看法不断变化
Pub Date : 2020-05-14 DOI: 10.35500/jghs.2020.2.e4
Lucia Rocca-Ihenacho, C. Alonso
During the coronavirus disease 2019 (COVID-19) pandemic, health systems all over the world are either stressed to their maximum capacity or anticipating becoming overwhelmed. The population is advised not to attend hospital unless strictly necessary, yet this advice seems to apply to all but healthy women during childbirth. Specialized hospital care during childbirth can be lifesaving in case of obstetric complications or for COVID-19 symptomatic women, while strong evidence suggests the appropriateness of midwifery units that are integrated into the healthcare system for eligible women. We must ask ourselves whether obstetric units are the appropriate birthing facilities for healthy women during the pandemic. We have learned from previous crises that the needs of women and children are often badly served during disasters. The COVID-19 pandemic raises concerns over escalation of mistreatment and abuse media are already reporting on restrictions to the rights of birthing women in Europe and the US. In addition, concerns have emerged over increased risk of infection to COVID-19 among birthing women and familied by concentrating all women in obstetric units and lack of optimal care due to pressure on staff and resources. Women's rights in childbirth are being threatened by lack of care during labor, restrictions on accompaniment, unnecessary interventions including inductions, separation of mother and baby and prohibition on breastfeeding. An effective response to the crisis depends on strong and coordinated health care systems where mothers can birth safely, and the needs of the newborn babies are met. The interpretation of what constitute safe care is a stimulus for a strong debate between those who argue for strengthening community and primary care services and those who recommend for centralization of all births in hospitals. This debate is particularly salient during this pandemic and in preparation of future pandemics. We propose a strategic response in the face of the pandemic by expanding the use of midwifery units both alongside the obstetric unit and freestanding (in the community). Where midwifery units are absent pop-up units can be created quickly following the example of the Netherlands. This strategy in high income countries is evidence-based and also serves as a response to the surge in requests of safe childbirths pathways away from the obstetric unit by concerned women at unprecedented rates. We urge policy makers to consider replicating this model in low- and middle-income countries where hospital conditions are more precarious. A strong collaboration between midwives, nurses, obstetricians and neonatologists and the integration of primary care and acute services could ensure safety while maximizing the rational use of resources. Immediate strategic action would ensure that women are able to access appropriate care at the appropriate time, while hospitals continue to respond to the COVID-19 crisis and obstetric unit
在2019年冠状病毒病(COVID-19)大流行期间,世界各地的卫生系统要么承受着最大的压力,要么预计将不堪重负。除非绝对必要,否则建议人们不要去医院,但这一建议似乎适用于除健康妇女外的所有分娩妇女。如果出现产科并发症或有COVID-19症状的妇女,分娩期间的专科医院护理可以挽救生命,而有力的证据表明,将助产单位纳入医疗保健系统对符合条件的妇女是适当的。我们必须问自己,在大流行病期间,产科病房是否是健康妇女的适当分娩设施。我们从以往的危机中了解到,灾害期间妇女和儿童的需求往往得不到很好的满足。新冠肺炎大流行引发了人们对虐待和虐待升级的担忧,媒体已经报道了欧洲和美国对分娩妇女权利的限制。此外,由于所有妇女都集中在产科病房,产妇及其家人感染COVID-19的风险增加,以及由于工作人员和资源的压力而缺乏最佳护理,人们对这些问题感到担忧。妇女在分娩中的权利受到以下因素的威胁:分娩期间缺乏护理、限制陪伴、包括引产在内的不必要干预、母子分离以及禁止母乳喂养。有效应对危机取决于强大和协调的卫生保健系统,使母亲能够安全分娩,并满足新生儿的需求。对什么是安全护理的解释刺激了主张加强社区和初级保健服务的人与建议在医院集中所有分娩的人之间的激烈辩论。在本次大流行期间以及在准备应对未来大流行时,这一辩论尤为突出。面对这一流行病,我们提出一项战略对策,即扩大助产士单位与产科单位和(社区内)独立式单位的使用。在没有助产单位的地方,可以按照荷兰的例子迅速建立弹出式单位。高收入国家的这一战略是基于证据的,也是对有关妇女以前所未有的速度要求安全分娩途径离开产科的激增作出的回应。我们敦促决策者考虑在医院条件更不稳定的低收入和中等收入国家复制这一模式。助产士、护士、产科医生和新生儿科医生之间的强有力合作以及初级保健和急诊服务的整合可以确保安全,同时最大限度地合理利用资源。立即采取战略行动将确保妇女能够在适当的时间获得适当的护理,同时医院继续应对COVID-19危机,并为需要专科护理的妇女保留产科病房。
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引用次数: 46
Comprehensive NTD elimination project in Mayuge district, Uganda to effectively eliminate schistosomiasis and soil-transmitted helminths 在乌干达马伊格县实施全面消除非传染性疾病项目,以有效消除血吸虫病和土壤传播的蠕虫
Pub Date : 2019-11-05 DOI: 10.35500/jghs.2019.1.e35
Eun Seok Kim
Four years ago, I worked in Kirudu Hospital as a visiting physician in Kampala, Uganda. One day, I went to an endoscopy room in Kirudu Hospital, where I met a young man in his early twenties. I was curious why this young man came to the endoscopy room because he was too young to come to endoscopy room as a patient. A Ugandan gastroenterologist in charge of the endoscopy room explained that he had an esophageal varix bleeding a week ago and came back for follow up endoscopy examination. Then again why did he have esophageal varix? When I reviewed some published articles, I soon learned that there were huge diseases burdens of neglected tropical diseases (NTDs) in Uganda. Esophageal varix was one of common chronic complications of schistosomiasis (SCH) which is a representative NTD. During my stay in this country, I have realized that this young man's case is not uncommon in Uganda.
四年前,我在乌干达坎帕拉的基鲁杜医院担任客座医生。有一天,我去了基鲁都医院的内窥镜检查室,在那里我遇到了一个二十出头的年轻人。我很好奇为什么这个年轻人来内窥镜检查室,因为他太年轻了,不能作为病人来内窥镜检查。负责内窥镜检查的乌干达胃肠病学家解释说,他一周前食道静脉曲张出血,并再次进行内窥镜检查。那他为什么会有食管静脉曲张呢?当我回顾一些已发表的文章时,我很快了解到乌干达存在着被忽视的热带病(NTDs)的巨大疾病负担。食管静脉曲张是血吸虫病(SCH)常见的慢性并发症之一,是典型的NTD。在这个国家逗留期间,我意识到这个年轻人的情况在乌干达并不罕见。
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引用次数: 0
Congratulatory comment from Association of Pacific Rim Universities Global Health Program 环太平洋大学协会全球卫生方案表示祝贺
Pub Date : 2019-11-05 DOI: 10.35500/jghs.2019.1.e37
M. Withers
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引用次数: 0
期刊
Journal of global health science
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