Central European journal of public health最新文献

Objective: The aim of the study was the assessment of adherence to antiretroviral (ARV) treatment in a population of people living with HIV (PWH), improving the awareness of PWH, drawing attention to the risk of developing HIV drug resistance and subsequent treatment failure.

Methods: The basic cohort consisted of PWH followed up long-term at the HIV centre of the University Hospital Pilsen. Adherence to treatment was assessed by ARV levels. Nucleoside analogs were determined in urine by high pressure liquid chromatography (HPLC), in relation to clinical data, viral load (HIV RNA), and absolute CD4 and CD8 T cell counts. To assess mental and physical state of the patients, a modified SF-36 questionnaire was used to measure social relationships, education and ability to relax.

Results: From a group of 131 PWH, 18 (13.7%) with zero levels and 113 (86.3%) with any detectable ARV levels were followed for 6-12 months. A statistically significant lower viral load was demonstrated in patients who adhered to the treatment at the time of the test as indicated by ARV levels in the urine. CD4 T lymphocyte values in adherent patients were, as expected, statistically significantly higher. A significant difference for CD8 T lymphocyte was not demonstrated. A survey assessed subjective factors influencing the degree of adherence. PWH consider important: quality care enabling trust, low risk of developing opportunistic infections, self-sufficiency, quality of sleep, managing leisure activities, and good family relationships. Quality of life evaluation and satisfaction in the monitored areas were similar in both groups of PWH.

Conclusions: Non-adherence leads to deterioration of CD4 and viral load levels and may be the cause of the development of HIV drug resistance and treatment failure on the part of the patient. PWH with zero or low urinary nucleoside levels were repeatedly instructed about the need for regular and sustained medication use. Regular checks with a laboratory examination service are needed to detect early emergence of resistance and side effects of the treatment, which are initially only detectable in the laboratory.

Objectives: The aim of the study was to identify potential areas for improvement in the prevention of oral diseases in pregnant women by assessing their oral care habits and awareness regarding oral health.

Methods: An original, anonymous, web-based survey was conducted among women at any stage of pregnancy. The survey consisted of 23 questions regarding oral care habits, knowledge about oral health of mother and child, general and oral health changes, and attendance of oral healthcare services during pregnancy. The data analysis was performed using IBM SPSS 27.0 version software. Descriptive statistics, Chi-square and Wilcoxon signed-rank tests were used to analyse the data. The level of statistical significance was set at p < 0.05.

Results: A total of 714 pregnant women participated in the study, with a mean (SD) age of 30.2 (4.4) years. Majority of the respondents demonstrated acceptable oral health-related knowledge and habits. A lack of interdental care among pregnant women was discovered. Nearly a third (27.6%) of the respondents reported a decline in their oral health during pregnancy. The most commonly reported general and oral health issues during pregnancy were increased stomach acid levels (71.3%) and gum bleeding (43.3%). Pregnant women were most frequently informed about the importance of oral care by an obstetrician-gynaecologist (25.4%).

Conclusions: The study revealed the need for targeted interventions to enhance oral health awareness and practices among pregnant women in Lithuania. While overall oral hygiene habits were acceptable, deficiencies in interdental care and knowledge regarding oral health during pregnancy were evident. Higher level of education and urban residency were associated with superior oral care practices of pregnant women. In order to improve oral health of mother and child, interdisciplinary collaboration and dissemination of accessible, evidence-based information are essential.

Objectives: The global situation concerning the incidence of infectious diseases emphasises the need for increased health literacy, particularly after the COVID-19 pandemic. A large part of this need relates to the area of education. The aim of this study was to analyse health literacy in relation to the cognitive dimension in the field of knowledge about the COVID-19 disease in the post-pandemic period among future teachers.

Methods: The research sample comprised 286 female students in the first year of Bachelor's teacher training courses at the Faculty of Education in the Czech Republic. The research study was conducted during the academic year 2022/2023. To explore the level of health literacy, the present research used the standardized HLS-EU-Q86 questionnaire designed by the World Health Organization. For the purposes of this study, the original 'structured interview' method was changed to an online questionnaire. An additional online questionnaire was attached to explore participants' knowledge related to the COVID-19 disease.

Results: The average score for general health literacy was 34.1, placing it within the 'sufficient' category. A total of 14.0% of the students showed an excellent level and 38.1% a sufficient level of general health literacy. Relatively the most favourable results were observed in the dimension of health promotion literacy. The threshold for successful completion of each knowledge test related to the COVID-19 was set at 80% of correct answers. Only 14.0% of the future teachers met the criteria for inclusion in the overall excellent level of the knowledge test.

Conclusions: The level of knowledge of future teachers associated with COVID-19 is inadequate. Therefore, it is desirable to strengthen education in the field of prevention of infectious diseases. The results indicate the need for some action, e.g., expanding the portfolio of compulsory courses in all branches of teacher training in order to increase the level of health literacy among future teachers.

Objective: Our research was focused to find a relation between the occurrence of spondylodiscitis and occurrence of chronic diseases. We were trying to discover some new risk factors and relations between chronic disorders in our research group. This analysis was also focused to detect factors that prolong the hospitalization of patients and worsen their prognosis.

Methods: A study was carried out involving patients with spondylodiscitis treated between 2013 and 2022. A statistical analysis expressed by several coefficients was calculated in software IBM SPSS 21.

Results: The study group comprised 32 (53.3%) females and 28 (46.7%) males. During the period the overall incidence of spondylodiscitis was increasing (except the year 2020 where only 2 patients were treated) with a peak in 2019. The average age of patients was 69.3 (±12.3) years, and the highest incidence was in the age group 60-69 years (n = 19, 31.7%). The most impacted vertebral region was lumbar (n = 29, 48.3%). The most prevalent associated comorbidity was some cardiovascular disorder (n = 39, 65%) followed by diabetes mellitus (DM) (n = 23, 38.3%). Genitourinary system was the most common source of primary infection (n = 22, 36.7%). Average length of stay was 34.3 (±14.5) days and surgery prolonged hospitalization period. Mortality rate was 1.7%.

Conclusion: The results of our study are confirmed by the data of other European and non-European studies. We confirmed diabetes mellitus and hypertension as the most common non-infectious risk factors of spondylodiscitis and the presence of pathogens in genitourinary system as the most frequent source of primary infection.

Objective: Childhood overweight and obesity has been a major global problem for a long time, with a steadily increasing prevalence of obesity and a growing number of cases of serious health complications associated with childhood obesity. The main objective of the study is to assess the prevalence of overweight and obesity in boys and girls before the COVID-19 pandemic in the Czech Republic.

Methods: Body height, weight, BMI, and body composition (fat free mass, skeletal muscle mass, body fat, visceral fat area) were assessed in a cohort of 4,475 subjects (2,180 boys and 2,295 girls) aged 6-15 years. Somatic status was assessed by standardized anthropometry and body composition was determined by bioelectrical impedance. The subjects were classified according to BMI in percentile bands (up to 3rd percentile, P3-10, P25-75, P75-90, P90-97, above 97th percentile). Statistical analysis was performed using the software TIBCO Statistica 14.0.015.

Results: During growth, statistical differences in the proportion of fat-free mass and fat fractions were found between boys and girls. In boys, there is an increase in muscle mass, in girls, there is an increase in the proportion of fat fraction. Sexual differentiation is pronounced during pubertal growth. By their BMI, 10.32% of the boys and 7.36% of the girls were categorized as overweight, and 8.12% of the boys and 7.71% of the girls were categorized as obese. Using bioelectrical impedance analysis and the percentage of fat fraction, 21.61% of the boys and 21.87% of the girls were categorized as obese; 5.96% of the boys and 8.19% of the girls were found to have visceral adipose tissue posing a health risk (more than 100 cm²). From 2002 to 2019, there was a significant increase of 3.72% in the overweight category for boys and 1.36% for girls, while the obesity category showed an increase of 3.62% for boys and 4.91% for girls.

Conclusion: The results confirm the increasing negative trend of overweight and obesity in the BMI and the relative body fat categories in children aged 6-15 years. Greater attention and monitoring of the effectiveness of preventive measures is needed to slow and stop the obesity epidemic which has health, social and economic impacts on the entire society.

Objectives: Urinary incontinence is an extremely stressful and often debilitating disease, increasing morbidity in society. The aim of the work is to point out the problems of the management of incontinent patients - seniors in the context of their quality of life as well as treatment costs to find ways to make the widest possible public awareness of the fact that in most cases incontinence is solvable in terms of improving the quality of life.

Methods: The group consisted of 100 patients with urinary incontinence who were treated with conservative medical procedures at the urological outpatient clinic of the Railway Hospital in Košice. The research was conducted in the period from September 2018 to February 2019. The extended standardized Urinary Incontinence Quality of Life Measure (I-QOL) questionnaire was used to evaluate the quality of life. The SPSS program - version 16.0 was used for statistical analysis of the file and hypotheses, and the chi-square test and the McNemar test for analysis of non-parametric data distribution.

Results: The average value of the total social I-QOL score was 14.15 ± 5.03, which means that this area contributes significantly to the reduction of the quality of life. The average value of the total I-QOL score of the group studied was 63.86 ± 19.29, which indicates that urinary incontinence has a significant impact on the quality of life of seniors. Respondents considered the frequent urge to urinate and the absence of a toilet in a reachable place to be a negative factor. Feeling of the state of a certain form of inferiority and obsession was the most serious. Patients expressed approximately equal concerns about feeling out of control of their bladder and concerns about urinating as well as concerns about worsening incontinence due to aging.

Conclusion: Based on the presented results, participants achieved the highest average score in the psychological domain of quality of life (27.81 ± 7.54) and the lowest in the social domain (14.15 ± 5.03). Social support programmes aimed at reducing stigma and enhancing social engagement for individuals dealing with incontinence could help improve the social quality of life. Physical health interventions, such as pelvic floor exercises could support physical well-being.

Objective: This study aims to describe the outcomes of COVID-19 patients treated with molnupiravir and to explore the associations with various risk factors.

Methods: We conducted a single-centre, descriptive, retrospective study without a comparison group.

Results: Out of 141 patients, 70 (49.7%) required follow-up outpatient care. In the subgroup of 66 (46.8%) hospitalized patients, 28 (19.9%) developed interstitial viral pneumonia, with 6 (4.3%) deaths. Unvaccinated patients had a higher incidence of pneumonia (p = 0.020), and obesity was a significant risk factor for both pneumonia (p = 0.001) and mortality (p = 0.011). Patients over 60 years (p = 0.040) and those with cardiovascular diseases (p = 0.026) also had increased pneumonia risk. Male sex was associated with a higher risk of death (p = 0.020).

Conclusion: Molnupiravir treatment was linked to reduced risks of hospitalization and death, particularly in high-risk patients. Vaccination provided additional protection, and obesity obstructive pulmonary disease and autoimmune diseases were significant risk factors for severe outcomes.

Objectives: The aim of this study was the evaluation of a group of patients treated at the Department of Orthopaedics and Traumatology of Locomotory Apparatus at Luis Pasteur University Hospital in Košice for septic arthritis in relation to risk factors and chronic diseases and its microbial aetiologic profile.

Methods: We conducted a retrospective study of patients including all episodes of septic arthritis from March 2013 to August 2022. The occurrence of chronic diseases, risk factors and its microbiological profile were investigated.

Results: A total of 141 patients were included: 92 (65%) males and 49 (35%) females, the mean age of patients was 58.1 years. A continued decrease in cases was recorded during the period of COVID-19 pandemic and the post-pandemic years. The largest group of our cohort represented septic arthritis of the knee (87 cases, 61.7%), followed by hip and shoulder arthritis - 17 (12.1%) and 14 (9.9%) cases, respectively. Gram positive aetiologic flora represented 87.5% of all pathogens isolated and antibiotics were administered to 46 (32.6%) patients before microbiological culture samples were obtained. The dominant chronic disease was diabetes mellitus with 42 (29.8%) cases and degenerative joint disease affecting the joint was verified in 86 (61%) patients. Dental foci in 28 (19.9%) cases and skin infections in 17 (12.1%) cases were the most numerous groups of risk factors with predominant distribution for cases without previous intervention in the affected joint leading to infection.

Conclusion: The distribution of joint involvement and microbial agents was similar to other literature without affecting negative culture results by prior administration of antibiotics. Representation of chronic diseases and risk factors was comparable to the work of other authors. Notable was the continued decline in total number of cases in post-pandemic years of COVID-19 pandemic. What was interesting was the number of confirmed cases of distant focal infection distributed mainly in the group of patients without a history of any previous intervention on the joint before the infection. There is a lack of literature on distant silent infection as a risk factor.

Objectives: Higher-than-recommended sugar consumption (< 10% of total energy intake; WHO) leads to negative health impacts and the development of serious diseases. Sugar-sweetened beverages (SSBs) proved to be among the leading sources of free sugar intake, as they contain large amounts of added sugar. Our article aims to propose tax measures that will help change consumer behaviour and reduce SSBs consumption.

Methods: For a comparison of the forms of taxation, the experience of seven countries (Denmark, France, Hungary, Italy, Poland, Catalonia - Spain, and the UK) were analysed. The evolution of sugar consumption, consumption of sweetened drinks and obesity before and after the introduction and/or abolition of the sugar tax were reviewed.

Results: States that implemented a tax on SSBs were able to reduce SSBs consumption in the first year after the tax was introduced when states with a sugar-content-based tax have implemented it more effectively than states with a volume-based tax. Based on this finding, we propose basic design assumptions for the tax that can be used in European countries that have not yet introduced the tax. Progressive taxation divides beverages into 3 bands. The basic assumption is to encourage the desired consumer behaviour, i.e., consumption of SSBs with lower sugar content. The proposed tax design is applied to the conditions of the Czech Republic as a model case study.

Conclusions: The results of our study suggest that SSBs taxation could be an effective policy intervention to improve population health by reducing the health impacts of SSBs among children and adolescents, although further studies are needed to prove the causality of the described associations.

Objectives: This study aims to assess the frequency of smoking cessation and to identify the factors affecting smoking cessation success among individuals seeking assistance at a smoking cessation centre.

Methods: This cross-sectional study included 1,570 individuals who applied to the smoking cessation centre in Izmir, Turkey, between 2009 and 2018, and completed three follow-ups. Data were obtained from the centre's records. Factors affecting smoking cessation success were analysed using logistic regression in multivariate analysis.

Results: The median age to start smoking was 19 (17-22), and the median number of cigarettes consumed per day was 20 (20-30). Among the participants, 59.9% exhibited a high/very high level of nicotine dependence, and 79.6% had attempted to quit smoking previously. The median number of patient follow-ups was 7 (5-10). Of the patients, 34.0% successfully quit smoking for one year. According to the multivariate analysis results, smoking cessation success increased with being married by 2.26 times (95% CI: 1.51-3.38, p < 0.001), the absence of other smokers in the household by 1.38 times (95% CI: 1.01-1.88, p = 0.04), having a low level of nicotine dependence by 1.75 times (95% CI: 1.23-2.48, p = 0.002), and more patient follow-ups by 1.61 times (95% CI: 1.52-1.72, p < 0.001).

Conclusions: Smoking cessation success is increased by the support and follow-up provided by healthcare professionals, the absence of other smokers in the household, and a low level of nicotine dependency.