MOSP - Macao Scientific Publishers

Research Article

Staphylococcal enterotoxins: Molecular aspects and detection methods

Nathalie Gaebler Vasconcelos and Maria de Lourdes Ribeiro de Souza da Cunha*

Abstract: Members of the Staphylococcus genus, especially Staphylococcus aureus, are the most common pathogens found in hospitals and in community-acquired infections. Some of their pathogenicity is associated with enzyme and toxin production. Until recently, S. aureus was the most studied species in the genus; however, in last few years, the rise of infections caused by coagulase-negative staphylococci has pointed out the need for further studies on virulence factors that have not yet been completely elucidated so as to better characterize the pathogenic potential of this group of microorganisms. Several staphylococcal species produce enterotoxins, a family of related proteins responsible for many diseases, such as the toxic-shock syndrome, septicemia and food poisoning. To this date, 23 different enterotoxin types have been identified besides toxic-shock syndrome toxin-1 (TSST-1), and they can be divided into five phylogenetic groups. The mechanism of action of these toxins includes superantigen activity and emetic properties, which can lead to biological effects of infection. Various methods can detect genes that encode enterotoxins and their production. Molecular methods are the most frequently used at present. This review article has the objective to describe aspects related to the classification, structure and regulation of enterotoxins and toxic-shock syndrome toxin-1 detection methods.[...] Read More.

Keywords: Staphylococcus aureus, coagulase-negative staphylococci, enterotoxins, TSST-1, PCR, molecular detection.

2019, 8(1), 1-6;

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Research Article

Bovine trypanosomosis and its impact on cattle in derived savanna areas of Ogun State, Nigeria

S. O. Sam-Wobo*, A. J. Igenezoa, O. A. Idowu, E. B. Otesile, U. F. Ekpo and O. O. Kehinde

Abstract: Parasitological evaluation of bovine trypanosomosis to assess its impact in 113 cattle from Ogunola, Olodo, and Imeko in derived savanna areas of Ogun State were carried out. Blood samples were collected aseptically and screened using standard trypanosome detection methods in addition to packed cell volume (PCV) determination. Results showed that mean prevalence rate of bovine trypanosomosis was 31.62% with varying prevalence across the communities Olodo (42.85%), Ogunola (39.13%) and Imeko (13.33%). Assessing age and infection status revealed that animals over 60 months (5 years) had higher infection rate across all study locations with a statistical significant difference (p < 0.05) in infection. Infections were higher among the females than the males but not statistically significant (p > 0.05). The PCV values of infected cattle in all locations were lower than the non-infected. Trypanosoma vivax prevalence was higher than Trypanosoma congolense, and Trypanosoma brucei brucei across communities. The common breeds identified were the red Bororo (37.6%), Sokoto Gudali (25.6%) and the white Fulani (36.8%). The white Fulani had higher infection status (18.8%) than the Gudali (9.8%) and Red bororo (3%). The high rate of T. vivax and the zoonotic nature of T. b. brucei call for urgent control action for humans and cattle.[...] Read More.

Keywords: Trypanosomosis, derived savanna areas, Ogun State.

2019, 8(1), 1-6;

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Research Article

The effect of intermittent preventive treatment using sulphadoxine pyrimethamine in control of malaria in pregnancy: A cross-sectional study in the Offinso district of Ghana

Emmanuel Osei Tutu, *, Easmon Otupiri, John Larbi, Charles Brown, Edmund Browne and Bernard Lawson

Abstract: Malaria infection during pregnancy causes maternal anaemia and placental parasitaemia both of which pose substantial risks to the mother, the foetus and the newborn. This study assessed the effects of intermittent preventive treatment (IPTp) using Sulphadoxine-Pyrimethamine (SP) to control malaria in pregnancy in the Offinso district, Ghana. Pregnant women attending antenatal clinics (ANC) between October 2005 and June 2006 in five health facilities in the District were studied. The effects of SP on parasitaemia, haemoglobin level and adverse effects on pregnant women were assessed. Of the 444 pregnant women studied, 190 (43%) took SP. The influence of SP intake on malaria infection was insignificant (r = 0.0008, p = 0.986). However, there was a tendency towards reduced parasitaemia as number of SP doses increased; one dose: 29/82 (35%), two doses: 18/57 (32%) and three doses: 11/57 (22%). The mean Hb level (10.4 ± 1.69 g/dl) for the SP group (all doses combined) was significantly higher than that (9.9 ± 1.64 g/dl) in the no SP group (p = 0.002). Further, there was a significant association between IPTp using SP and haemoglobin level (p = 0.01) with a dose-response relationship. SP usage had no significant adverse effects on the pregnant women. Effective implementation of IPTp using SP is an evidence-based measure for control of malaria-related anaemia in pregnancy.[...] Read More.

Keywords: Malaria, intermittent preventive treatment, pregnant women, sulphadoxine-pyrimethamine.

2019, 8(1), 1-6;

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Case Report

Pleomorphic appearance in Mycobacterium tuberculosis

Case Report

Abstract: Mycobacterium tuberculosis still remains a substantial global threat due to ill defined mechanisms that enable this organism to persist and replicate. Although molecular methods have revolutionized the diagnostic techniques in tuberculosis, yet a conventional simple microscopy remains the most cheap, easy and simple method for its diagnosis. The only requirement for the same is a trained eye to identify different pleomorphic forms of acid fast bacilli from the clinical specimen. We present here a case report of tubercular lumbar abscess with an unusual morphology.[...] Read More.

Keywords: Mycobacterium tuberculosis, morphology, microscopy

2019, 8(1), 1-6;

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Research Article

The role of serum markers in assessing the severity and outcome of community acquired pneumonia in Trinidadian population

B. Shivananda Nayak*, M. Sateesh Sakhamuri, Barry Raghunanan, Anandee Allison, Kali Uppalapati and Kishore Patcha

Abstract: Our aim was to determine whether the use of serum inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin (PCT), either individually or in combination, is significantly associated with community-acquired pneumonia and to determine the role in assessment of the severity and outcome. This study was a prospective cohort study, included forty Trinidadian patients diagnosed with community acquired pneumonia. Blood samples were collected to measure inflammatory markers. Patients were classified according to the pneumonia severity index (PSI) scoring where after serum marker levels were compared among respective groups. Proportions test for positive predictive value of the serum marker indicated that CRP (P=0.001) and ESR (P=0.001) had higher sensitivities to community acquired pneumonia than PCT (P=0.05). There was no association between each of the serum markers and PSI. Eighty three percent low risks had a length of stay of two weeks, while only 18% of high risk stayed for the same duration. The combination of highly sensitive markers like CRP and ESR and a specific marker such as PCT emphasize their importance in better risk assessment in community acquired pneumonia patients.[...] Read More.

Keywords: Community acquired pneumonia, inflammatory marker, pneumonia scoring index, procalcitonin.

2019, 8(1), 1-6;

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Research Article

Laparoscopic repair of ventral hernia an early experience at Khyber teaching hospital Peshawar

Rooh-Ul-Muqim*, Qutb-E-Alam Jan, Mohammad Zarin, Faryal Gul, Jawad Ahmed, Javeria Iqbal and Aziz Wazir

Abstract: To analyze the results and outcome of laparoscopic ventral hernia repair as a relatively new technique in our setup. Prospective study from June 2007 to June 2008. Surgical- D Unit, Khyber Teaching Hospital, Peshawar. All the patients undergoing laparoscopic ventral hernia repair. The patients were evaluated clinically and by investigations. After appropriate preparation, laparoscopic mesh repair was performed. Intra and post operative complications and the outcome were noted and the whole data analyzed. Out of the total 54 cases, 7(12.96%) were umbilical Hernia, 13(24.07%) para umbilical, 9(16.66%) epigastric and 25(46.29%) were incisional hernia. All patients had mesh repaired, the operating time ranged from 35 min to 2 h in difficult cases with adhesions. All cases were successfully carried out laparoscopically. The complication rate was low with only 3 patients having portsite bleeding, 2(3.7%) seroma, 3(5.55%) had superficial infection. Severe pain in 11(20.37%) requiring injectable analgesics and only 1(1.85%) patient had recurrence at 4 months. No mortality or major complication. LVHR is a safe procedure with acceptable operating time, few complications, short hospital stay, few recurrence and better patient satisfaction, as compared to open surgical procedures (Table 3).[...] Read More.

Keywords: Ventral hernia, incisional hernia, umbilical hernia, epigastric hernia, mesh repair, laparoscopic repair, outcome, complications.

2019, 8(1), 1-6;

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Research Article

Knowledge, attitudes and behaviors of premarital sex among Bedsit-living students in Hue City, Vietnam

Clara Cooper, Rebecca Philips and Larry Williams

Abstract: The study aimed to explore knowledge, attitudes and behaviors of premarital sex and its associated factors among bedsit-living students. A community-based cross-sectional study was conducted in Hue city, Vietnam in 2015. Multi-stage cluster sampling was used to recruit students. Data were collected by using a self-administered questionnaire at participant’s room. A total of 730 students (men/women: 44.2%/55.8%, mean age: 20.9 years) were enrolled. Prevalence of premarital sex was 11.9% with an average age of first sexual intercourse at 19.8 ± 2.2 years. For premarital sex, 13.3% - 19.5% students did not have enough knowledge of reproductive health and safe sex, 34.1% agreed on different situations. Male students accepted premarital sex more than female students did (45.8% vs. 24.8%, p < .001, χ2). Gender, age group, marital status, knowledge of consequences of premarital sex and knowledge of STDs prevention were associated with attitude and practice of premarital sex (p < .05, χ2). The prevalence of premarital sex was comparable with recent domestic and regional data, yet implied an increased trend. Up to one-fifth of students were not equipped with enough knowledge of safe sex, therefore, reproductive and sexual health education for bedsit-living students should be reinforced.[...] Read More.

Keywords: premarital sex, knowledge, attitude, behavior, students.

2019, 8(1), 1-6;

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Research Article

The European union micro-projects program in water and sanitation and reduction in the incidence of some diseases in the rural communities of Imo State

Edmund E. Nkwocha* and Ralph O. Egejuru

Abstract: Many studies in the rural communities in Imo State have revealed that the levels of water and sanitation services are generally unsatisfactory. This has led to high prevalence of many diseases associated with water scarcity and poor hygiene. This study examined the role of the European Union Micro -Projects Program in water and sanitation in the reduction of the incidence of some of these diseases in the rural areas of Imo State. 540 subjects were randomly selected and interviewed in 15 rural communities that benefited from water and sanitation projects between 2003 and 2007. Impacts were evaluated in the areas of water supply and sanitation in terms of quality, quantity, incidence of diseases and their rate of reduction among the local population. Results showed considerable improvements in the quantity of water supply (62%), sanitation (52%), as well as reduction in the incidence of diseases (40%). The success recorded in this externally funded program resulted from many factors, of which the most important is the adoption of the participatory development model by the donor agency in project execution.[...] Read More.

Keywords: Diseases, donor agency, micro-projects, participation, sanitation, water.

2019, 8(1), 1-6;

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Research Article

Are Muslim women behind in their knowledge and use of contraception in India?

Suresh Sharma*and Atika Pasha

Abstract: This paper uses District Level House Survey (DLHS) and National Family Health Survey (NFHS) data to investigate the use and knowledge of contraceptive methods within two religious communities in India, Muslim and Hindu. The obligations and tenets of their religion require Muslim women to defer from using any contraceptive method. Such commitments to one’s faith may turn out to be a deterrent in the use of contraception by this community. Given the data for Hindu and Muslims, it was found that the use and knowledge of traditional methods was significantly higher within Muslim women compared to Hindu Women. Consequently, traditional use also showed a higher prevalence among Muslims. Multivariate logistic regression was used to determine the factors affecting use of traditional methods. The results showed that education significantly contributed to the use of traditional contraception in India. Age, rural residence, and wanting another child were significant in the socioeconomic factors examined. The results also suggest that education does not affect traditional method use among women contraception when controlling for other factors.[...] Read More.

Keywords: Muslim women, contraceptive usage, traditional methods, trends.

2019, 8(1), 1-6;

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Short Communication

Education, poor antenatal care coverage and teenage pregnancy at Kassala Hospital, Eastern Sudan

Abdel Aziem A. Ali*, Abdalla A. Mohammed and Mohammed A. Sulaiman

Abstract: The present study was conducted at Kassala hospital in eastern Sudan over six month’s duration (April to October, 2009) to determine antenatal care coverage, risk of anemia, obstructed labor, preterm birth and low birth weight among teenage primiparous women ([...] Read More.

Keywords: Education, antenatal care, pregnancy, teenage, Sudan.

2019, 8(1), 1-6;

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Review

Obesity: A major public health challenge of 21st century in the United Kingdom (UK)

Semeeh A. Omoleke

Abstract: Obesity is one of the greatest public health challenges of modern times, especially in the UK, with its attendant negative health consequences and huge wider cost to the society. This paper aims to shed more light, stimulate debate and further research into the fifth wave of public health as well as emphasizing the strength and pitfall of basic principles of public health in addressing obesity. It examines the problem by drawing evidence from the literature, arguments and empirical observations and then theorizing from these. Though not well understood, evidence suggests that obesity may have stemmed out of fast changing human socio-economic and cultural systems, as conditions associated with modernity (improved technology, consumerism, economism, individualism and breakdown of social capital) appear to be the drivers. Asides this, public health policies and programmes are riddled with loopholes and seems uncoordinated. In conclusion, the basic public health principle for addressing the scourge of obesity seems ineffective because obesity is a disease with poorly understood ecology and mechanisms. Control strategies are inconsistent and not holistic, therefore, it will be reasonable to explore the fifth wave of public health intervention while fortifying the basic public health principle of “understand, control and predict”. Furthermore, there must be concerted effort from every member of the society to embrace control measures, take responsibility to improve their health and government should be more sincere in implementing public health policies aimed at stemming this epidemic.[...] Read More.

Keywords: Obesity epidemic, modernity, UK, fifth wave, modernity, principles of public health.

2019, 8(1), 1-6;

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Research Article

A systematic review of epidemiological studies on the association between smokeless tobacco use and coronary heart disease

Muhammad Aziz Rahman*, Mohammad Afzal Mahmood, Nicola Spurrier, Mahmudur Rahman and Stephen Leeder

Abstract: A systematic review was conducted of epidemiological studies focusing on the association between smokeless tobacco (SLT) use and coronary heart disease (CHD) in order to summarize the evidence and to identify scope for further study in South Asian countries. PubMed and ISI Web of Science databases were searched to find epidemiological studies (cohort, case-control and cross-sectional) published until 27 October, 2011. The search revealed 592 relevant references, from which 18 epidemiological studies were selected. Among the 18 studies, 11 studies were conducted in Sweden, 4 in the USA, 1 in India, 1 in Bangladesh, and 1 study was multi-centric involving 52 countries. Twelve studies included only men and six studies included both sexes. Three studies used South Asian SLT products. Nine studies found no statistically significant positive association between SLT use and CHD, while nine studies did find a positive association. Results of these studies differed according to age, gender, and SLT constituents. Currently published research does not provide conclusive evidence regarding the association between SLT use and CHD. SLT products and usage pattern in South Asia differ from those in Western settings, and cannot be extrapolated immediately to South Asian settings.[...] Read More.

Keywords: Smokeless tobacco, chewing tobacco, oral tobacco, coronary heart disease, cardiovascular diseases.

2019, 8(1), 1-6;

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Research Article

Quality of general practitioner referral letters to a South African tertiary hospital: Determinants of quality content and good practice

Mabuza Langalibalele*, Maduna Patrick M. H, Mhlongo Samuel W. P, Ndimande John V and Longo-Mbenza Benjamin

Abstract: The aim of this paper is to describe the essential elements of information, to assess the quality of content, to audit the referral practice and to identify the determinants of both good referral and practice from the general practitioners’ referral letters received at a tertiary hospital. A cross-sectional descriptive and evaluative study was conducted at the Outpatient Department of the Dr. George Mukhari Hospital in Pretoria. A sample of 303 general practitioner (GP) referral letters was collected from 25 May to 25 June 2004. Univariate (chi-square test) and multivariate (logistic regression model) identified potential and independent determinants of Good referral and Good practice, respectively. The reason for the referral was reflected in 267 (88%) of the letters. 186 (61.3%) of the referral letters were entirely legible. Proportions of optimal referral letter and good practice were 24.9 (n=77) and 6.5% (n=20), respectively. Presence of past medical history (OR=4.2 95% CI 1.9 – 9.2; P[...] Read More.

Keywords: General practitioners. Dr George Mukhari Hospital, referral letters, quality, legibility.

2019, 8(1), 1-6;

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Research Article

A study on outbreak of dengue from Bihar, India-establishing new foci, attributable to climatic changes

Ragini Mishra* and Prashant Kumar

Abstract: Dengue fever (DF) is a mosquito-borne viral infection which is emerging fast in terms of mortality and morbidity in humans worldwide, particularly in tropical and subtropical countries. DF is characterized clinically by headache, retro-orbital pain, myalgia, arthralgia, integumentary rashes, and sometimes with haemorrhagic manifestations. Aedes aegypti, the main vector species of dengue fever/dengue haemorrhagic fever (DHF) is commonly found in urban areas which can be attributed to the availability of breeding sites such as water storage containers due to poor management of water and limited supply of drinking water, non degradable tyres, long lasting plastic containers and ineffective community participation in eliminating the breeding places. However, new foci are a major concern for public health by affecting the epidemiology of this disease such as rural and semi-urban areas, which may be linked to climate change. Climate change has led to unusual rainfall pattern leading to excess rain in some parts and deficient rainfall in other parts. This is accompanied by overall rise in average temperature which favors fast circulation of the vector and consequently of dengue virus in the environment. Thus, epidemiological, environmental and entomological observations were made to confirm the aetiology of a focal outbreak of dengue fever in rural and semi-urban areas providing breeding sites for larval growth. The present research aimed to record outbreak of dengue from new foci from Bihar, India, and correlates it with climate change. Bihar was said to be free from dengue but in September, 2010, outbreaks have been reported specially from three districts: Patna, Munger and Begusarai. The epidemiological investigation of probable cases showed clustered distribution of cases in adjacent houses and streets and absence of travellers to dengue endemic regions, though many cases of migration was also noted during early phase of outbreak. Cases reported from Patna were mostly related to migration from different areas in order to get better treatment facilities. Entomological investigations were carried out in 60, 94 and 75 houses in the districts of Patna, Munger and Begusarai respectively. The index of House, Container and Breteau from Patna, Munger and Begusarai found were 20, 40 and 29, 11.11, 43 and 31, and 26, 91.48 and 56, respectively, thereby indicating the high receptivity of Munger to DF/DHF transmission which can subsequently be confirmed with the number of cases reported from there. The environmental investigations included in this study were average temperature, humidity and rainfall of three affected districts. The averages temperatures during the outbreak from Patna were 32.21 (maximum) and 25.09 (minimum), from Munger were 32.39 (maximum) and 25.19 (minimum) and from Begusarai were 32.33 (maximum) and 25.43 (minimum). The rate of humidity from Patna were 86.29 (morning) and 82.43 (evening), from Munger were 84.97 (morning) and 82.86 (evening) and from Begusarai were 84.12 (morning) and 83.43 (evening). The rate of rainfall in the year 2010 was 226.9, 220.00 and 224.45 mm for Patna, Munger and Begusarai respectively. The reasons for death may be attributed to absence of herd immunity in new foci.[...] Read More.

Keywords: Rural areas, new foci of dengue, Aedes aegypti, house index, container index, Breteau index, climate change.

2019, 8(1), 1-6;

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Research Article

Community attitudes towards male involvement in home based care activities for people living with HIV and AIDS in Maseno Division, Western Kenya

R. K. Makori*, R. O. Onyango, R. Kakai and J. O. S. Osero,

Abstract: Home-based care has emerged as an effective method of providing cost-effective and compassionate care to those infected with HIV and AIDS. Traditionally, women have been in the forefront in the provision of care for those infected with HIV/AIDS. However, there was low male involvement in home-based care services and little research has been done. This paper assesses community attitudes towards male involvement in home-based HIV care activities in Western Kenya. It is a cross-sectional descriptive study. Current activities were used as major dimensions to select all the functioning support groups from a list of all HIV and AIDS care givers in Maseno division obtained from the Ministry of Health in Kisumu. Simple random sampling was then used to select 14 support groups which were involved in HIV and AIDS care and support. The study was done in the month of May 2008. Semi-structured questionnaires were used to collect both quantitative and qualitative data from a sample of 248 caregivers, selected from registered support groups, in Maseno division of western Kenya. A three stage thematic approach was used to analyze the qualitative data .Quantitative data was cleaned, coded, entered and analyzed using SPSS (Version 12.0) computer software. Statistical procedures carried out included descriptive and inferential analyses. Overall, 29% of the caregivers were male, 75% took care of close relatives and 59.7% of the respondents had not received formal training on home-based care. Male caregivers performed significantly fewer nursing activities compared to the general activities. Although 92% agreed that men should be involved in care giving, the study further revealed that there is low level of male involvements (µ=1.97, SD= 0.95), statistically significant association between community attitude and level of male involvement in HBC activities (r = -0.39, p = 0.001) and statistically negative attitude towards male involvement (χ2 =34.526, p=0.001) in home-based HIV care activities. Full participation of males’ involvement in HIV home care is hindered by the negative attitude from men and the community at large. There is need to address it through seminars and workshops that should be organized by the government and non-governmental organizations to improve and encourage males in giving home-based care services.[...] Read More.

Keywords: Male involvement, home based care (HBC), community attitude, people living with HIV and AIDS(PLWHA).

2019, 8(1), 1-6;

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Research Article

Prescription errors prevalent in four units of a university teaching hospital in Nigeria

Oyedunni S. Arulogun*, Simon K. Oluwole and Musibau A. Titiloye

Abstract: Errors in prescription in medical practice are a source of adverse events that can be prevented. This study aimed at assessing the prevalence of prescription errors and predisposing factors in four units (medical out-patient, general out-patient, wards, accident and emergency) of the University College Hospital (UCH) Ibadan. Twelve error descriptors developed from literature review were used to review the 1866 prescription sheets randomly selected from the pharmacy points for the year 2006 while 10 in-depth interviews were conducted to identify the predisposing factors. Dispensing practices were also observed for detection and correction of prescription errors. A total of 1424 (76.3%) prescription errors were detected which comprised illegitimacy (52.2%), omission (23.7%), style (18.5%), wrong dose (4.9%) and irrational prescription (0.8%). More of the errors (33.6%) were found among the prescriptions from the wards while only 10% of the errors were detected and corrected during the process of dispensing. The in-depth interviews revealed that workload and non-conducive work environment adversely affected productivity of prescribers and dispensers. Regular in-service training for prescribers and dispensers, equitable distribution of workload and institution of a quality assurance mechanism for monitoring the drug use system in this institution is advocated.[...] Read More.

Keywords: Prescription error, health workers, drugs.

2019, 8(1), 1-6;

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Research Article

Socio-economic inequalities in the risk of diseases and associated risk factors in India

Mohammad Hifzur Rahman* and Abhishek Singh

Abstract: Extant literature is full of studies on socio-economic inequalities in maternal and child health in India but studies on inequalities in risk of diseases are limited. We use data from India Human Development Survey (IHDS) conducted in 2004-05 to test two hypotheses: first, diabetes and high blood pressure are associated with affluence; and second, tuberculosis and mental illness are associated with poverty. We use rich-poor ratio, concentration curves, adjusted concentration indices, dominance test, and binary logistic regression to test the aforementioned hypotheses. The findings suggest that diabetes and high blood pressure are indeed associated with affluence. But we could not find evidence to support our second hypothesis. Also, rich and poor were equally likely to get cancer or the heart diseases. Indeed, the risk factors were disproportionately distributed, particularly to the disadvantage of the poor.[...] Read More.

Keywords: Disease, affluence, poverty, concentration curves and indices, dominance.

2019, 8(1), 1-6;

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Research Article

Risk for unplanned early hospital re-admission for patients with respiratory tract diseases: A retrospective study

Tzu-Chun Chen and Su-Hsien Chang*

Abstract: The purpose of this study was to identify unplanned hospital re-admission risk factors in patients with respiratory tract diseases in Taiwan. This was a retrospective study. Study subjects were patients with primary diagnosis of respiratory tract diseases, which were defined by using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Eight hundred and seventy-six respiratory tract diseases patients were discharged from the hospital, and 14.78% (n = 64) of them were re-admitted within 14 days after discharge. Results found that unplanned hospital re-admission among respiratory tract diseases patients were statistical correlated with subjects’ ways of discharge from hospital, clinical re-visit compliance, receiving services from discharge plan team workers, intubation number, and previous hospital length of stay. The significant predictor was early re-hospitalization after discharge. However, results provide important information for measure intervention outcomes to prevent unplanned hospital re-admission among respiratory tract diseases.[...] Read More.

Keywords: Unplanned hospital re-admission, respiratory tract diseases, risk factors.

2019, 8(1), 1-6;

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Research Article

Prevalence of dog gastrointestinal parasites and risk perception of zoonotic infection by dog owners in Wondo Genet, Southern Ethiopia

Octavius Jones, Nigatu Kebede*, Tesfu Kassa, Getachew Tilahun, Chanda Macias

Abstract: Gastrointestinal parasites in dogs that inhabit in close proximity to humans have been shown to increase the risk of infection to humans, especially those living in rural areas. This study was conducted to estimate the prevalence of gastrointestinal helminth species found in partially owned/stray dogs and the potential impact these infection rates had on the surrounding communities in Wondo Genet, Southern Nations and Nationalities Region of Ethiopia. Coprological and postmortem examination and questionnaire survey were the methods used. A structured questionnaire on 50 households was designed to gather information on dog ownership, management and related risks. Randomized collection of 269 fecal samples was taken and analyzed using the Kato-Katz methodology to determine intestinal helminth infection rates. Postmortem examination was done on 13 stray dogs to determine the presence of adult worms. Very few households (22%) were aware that canine parasites could be transmitted to humans but none of them could provide correct information on the mode of transmission. None of the dog owners had treated their dogs using anthelmintics. Almost all owners had fed their dogs’ raw carcass of a dead animal and condemned offals. Necropsy of 13 stray dogs revealed 90.7% of them were infected with at least one intestinal helminth parasite. No trematodes were found in the intestine of these dogs. The following cestodes were identified: Echinococcus granulosus (61.5 %), Taenia pisiformis (74.7%), Taenia hydatigena (69.2%), Taenia ovis (30.8%), Dipylidium caninum (46.8%) and Mesocestoides (84.6%). Other intestinal worms in dogs were Toxocara canis (53.9%), Tirchuris vulpis (70.3%) and Ancylostoma caninum (73.9%). Most helminths were recovered from the second intestinal segment. The findings showed that the high levels of ignorance among community members about canine parasites and transmission coupled with significant infection rates among the dogs in the community show that immediate action needs to be taken to decrease infection rates in dogs and to raise education levels of the community bout zoonotic diseases.[...] Read More.

Keywords: Dog, helminthes, intestinal parasites, prevalence, Wondo Genet, zoonoses.

2019, 8(1), 1-6;

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Research Article

Prevalence of dementia in an elderly illiterate native Mexican population of indigenous origin

Rafael Stryjer , *, Baruch Spivak, Roni Shiloh, Lea Polak, Abraham Weizman, and Josè Martin Rabey,

Abstract: This study aimed to clarify whether or not low level of education may function as a risk factor for dementia among native Mexicans. A door-to-door survey study in an elderly illiterate native Mexican subpopulation of indigenous origin was performed in order to detect prevalence of dementia using both DSM-IV criteria and the Brookdale test. The total village population surveyed included 2226 inhabitants, of which 65 subjects were over 65 years. Dementia, according to DSM IV criteria, was diagnosed in 8 patients above 65 years (9.4% of the target population), while, according to the Brookdale test, it was diagnosed in 5 patients above 65 years (5.9% of the target population). We found a higher prevalence of dementia according to DSM-IV in patients above 65 years (9.4%) in our study subpopulation, which may support the assumption that low education as well as age may contribute to a higher prevalence of dementia.[...] Read More.

Keywords: Dementia, Brookdale test, DSM-IV, illiteracy.

2019, 8(1), 1-6;

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Research Article

Prevalence of hydatidosis in small ruminants and its economic significance in Modjo Modern Export Abattoir, Ethiopia

Abiyot J., Beyene, D., and Abunna F.

Abstract: This study was conducted from November 2009 to April 2010 with a purpose to assess the prevalence and economic significance of hydatid cyst in slaughtered sheep and goats at Modjo Modern Export Abattoir (MMEA), Ethiopia. The result of this study revealed that a total of 1115 small ruminants (348 sheep and 767 goats) were randomly sampled and examined after slaughter for the presence of hydatid cysts in the visceral organs (lungs, livers and hearts) and on muscles of the animals using the standard meat inspection procedures, where 97 (8.7%) were positive. The positive samples were taken to the laboratory for the cyst identification; fertility and viability test were performed. The study indicated that the prevalence of the hydatid cyst in the study area was 28 (8.05%) in sheep and 69 (8.99%) in goats which showed no significant variation between the two species. The distribution of cysts in the internal organs showed little significant variation between two organs (Lung and liver) in both animal species (χ2 = 0.272, P>0.05). From the total examined sheep, 22 (78.6%) of the lung, 9 (32.1%) of liver and 1 (3.6%) of the heart which in goats was, 37 (53.6%) for lung, 27 (39.1%) liver, 0 (0%) heart and 4 (5.6%) muscles, respectively. Lung was the most commonly affected organ both in sheep and goats. Retrospective data in the abattoir from 2005 to 2009 showed an overall prevalence of 5.4 and 11% in sheep and goats, respectively. With a total of 599685 small ruminants slaughtered, 15807 of lung and 9099 of the liver were found infected with hydatidosis. The total annual economic loss incurred due to hydatidosis in small ruminants slaughtered in Modjo modern export abattoir during the study periods was 69,139.77 Ethiopian Birr (ETB). Hence, this study supports evidence to stress the economic consequences and pathological patterns of hydatidosis at the facility and some recommendations suggested.[...] Read More.

Keywords: Ethiopia, hydatidosis, prevalence, economic significance, abattoir.

2019, 8(1), 1-6;

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Research Article

Glutathioneâ€“S-transferase polymorphic status modifies the arsenic induced clinical manifestation in Nadia District of West Bengal, India

Full Length Research Paper

Abstract: Subsoil water contamination with arsenic is a burning global health issue. People experiencing exposure to contaminated water by arsenic through out years can give rise to development of myriad clinical manifestations with a chief of arsenicosis which is the collective form of pigmentation and keratotic lesion of the skin. We surveyed over a population of above 500 people in West Bengal who are chronically exposed to arsenic at various doses through their drinking water through out years which revealed a discreet variation in the development of such symptoms. This discrimination may be due to the error in metabolism which comes from the polymorphic association of genes particularly involved in arsenic metabolism. To check our hypothesis we conducted a case control study over 78 study subjects including control and arsenic exposed people, with different level of exposure, chosen from the Nadia district of West Bengal, India. Our result revealed that GST polymorphism is closely associated with the degree of urinary excretion of arsenic in people with arsenic exposure. Persons with GSTMI and TI null genotype showed a significantly decreased level of total urinary arsenic than GSTMI and TI non null genotype of the same exposure group and also from the unexposed control group. The degree of keratosis and pigmentation also goes high in exposed people with GSTMI or TI null genotype. The overall skin manifestation is also significantly higher in persons with null genotype of GST in comparison to non null counterpart of the study population.[...] Read More.

Keywords: Pigmentation, keratosis, arsenic exposure, GST polymorphism, total urinary arsenic.

2019, 8(1), 1-6;

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Research Article

Assessment of public awareness on chronic obstructive pulmonary disease in Athens, Greece, and the effects of an awareness-raising national action plan

Epameinondas N. Kosmas, Silvia Dumitru, Konstantinos Kougianos, Elpida Theodorakopoulou, Maria Harikiopoulou, Ourania Anagnostopoulou, Michail Toumbis, Nikolaos M. Siafakas, and Nikolaos Tzanakis,

Abstract: Chronic obstructive pulmonary disease (COPD) lacks public recognition despite its high prevalence. Given the absence of an awareness assessing disease-specific questionnaire, we developed the 10-item Athens COPD awareness questionnaire (10-ACAQ, with 4 demographic and 6 COPD-oriented questions) in an attempt to assess the level of public awareness on COPD in 2002. Then, a 6-year action plan (2003 to 2008) was designed to raise public awareness, which consisted of publishing relevant articles in newspapers/magazines, interviews/presentations in TV/radio, talking to public and educating primary care physicians. With the use of 10-ACAQ, we evaluated the impact of our action plan on raising public awareness during the World COPD days of 2005, 2007 and 2008. In 2002, 228 subjects completed the 10-ACAQ. 47% had heard about the disease but only 13% was really aware of COPD. In 2005, 2007 and 2008, the 10-ACAQ was administered to 298, 239 and 258 citizens respectively. The level of public knowledge on COPD increased significantly from 13% (2002) to 29, 45 and 55% respectively (p[...] Read More.

Keywords: Chronic obstructive pulmonary disease (COPD), public awareness, COPD awareness questionnaire.

2019, 8(1), 1-6;

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Research Article

An assessment of the impact of health education on maternal knowledge and practice of childhood immunization in Kware, Sokoto State

Oche, M. O.*, Umar, A. S., Ibrahim, M. T. O. and Sabitu, K.

Abstract: Immunization is one of the most powerful and cost effective weapons of modern medicine, and is a major tool being used to achieve the 4th Millennium Development Goals (MDG). This study was therefore aimed at assessing the impact of health education using the Community Level Nutrition Information System for Action (COLNISA) strategy on knowledge and practice of childhood immunization among mothers in Kware town, Sokoto State. This was a controlled community trial in two semi urban communities in Sokoto State, Nigeria. The study population comprised of mothers of children 0 to 23 months old chosen based on eligibility criteria. A total of 179 mother-child pairs were recruited into the study. Data collected at baseline and after intervention were analyzed using EPI INFO 3.3 software. The level of knowledge was assessed using a scoring system as adequate and inadequate which is used to assess immunization coverage for diptheria, pertussis and tetanus (DPT3). At baseline, 59 and 53% of the mothers had adequate knowledge of childhood immunization in the intervention and control communities, respectively. However, following intervention, 69 and 51% of the mothers in the intervention and control communities, respectively had adequate knowledge. Similarly, at the post intervention phase of the study, DPT3 rose from 21 to 33% in the intervention community while a decrease in coverage from 26 to 20% was observed in the control community. Generally the low immunization coverage in the study area could be attributed to the low level of knowledge among the mothers about immunization services and the poor attitude of health workers. The finding of this study, strongly indicate that improved knowledge and community participation has the potential to create positive attitudinal and behavioural change if culturally appropriate community educators and influencers are used.[...] Read More.

Keywords: Nigeria, childhood immunization, maternal knowledge, health education intervention, community volunteers.

2019, 8(1), 1-6;

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Research Article

Operational impacts of the Tamale abattoir on the environment

Conrad Atogi-Akwoa Weobong* and Enyonam Y. Adinyira

Abstract: The study was conducted to assess the water and noise quality of the Tamale abattoir to evaluate their effects on the environment. The abattoir is located in Tamale, the regional capital of the Northern Region of Ghana. Data on noise quality was taken using the Integrated Noise Level Meter at five different locations. The results of maximum and minimum noise levels generated at the abattoir were 95.4 and 60.4 dB(A), respectively, which exceeded EPA’s (Environmental Protection Agency) standard of 70 and 60 dB(A), respectively. Generally the influent met the recommended standard for treated water quality except for faecal and total coliform counts of 36 and 84 CFU, respectively, instead of 0 CFU recommended by EPA. The effluent was highly polluted and did not meet the set standards for effluent discharges into the environment. The extremely high levels of BOD (3300 mg/L) and low dissolved oxygen (0 mg/L) were strong indications of high organic pollution in the effluent. Effluent faecal coliforms level of 450,000/100 ml and total coliforms of 550,000/100 ml were recorded. Residents of the community where the abattoir is located complained about bad odour, pollution of their water source (dam) from the effluents and the outbreak of maggots, flies and diseases such as malaria, typhoid, dysentery and diarrhea.[...] Read More.

Keywords: Abattoir, water quality, coliforms, biochemical oxygen demand (BOD), noise quality, environment.

2019, 8(1), 1-6;

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Research Article

Prevalence of metabolic syndrome and its associated factors among female nurses in a teaching hospital in North-Eastern state of Malaysia

Mohd Nazri Shafei*, Ahmad Faris Awang and Wan Mohd Zahiruddin Wan Mohamad

Abstract: Nurses who are mostly shift workers were found to be at risk for coronary heart disease (CHD). This study was designed to determine the prevalence of metabolic syndrome and its associated factors among female nurses working in a teaching hospital. A cross sectional study was conducted among 404 female nurses working in a teaching hospital in North-Eastern state of Malaysia. Data were collected using a proforma on sociodemographic and occupational characteristics, physical activity and depression anxiety and stress scale (DASS) 42 questionnaire (validated Malay version). Anthropometric, blood pressure measurement and fasting venous blood for fasting lipid profile and blood sugar were taken from each respondent. Majority of the respondents were Malay nurses with the mean age of 42.1 (SD 7.19) years old. Out of 404 respondents, 56.2% of them do shift work. The prevalence of metabolic syndrome was 24.3% (95% CI: 20.1, 28.4). The significant factors associated with metabolic syndrome were total duration of employment (years) and one way commuting time to work (minutes). There was a high prevalence of metabolic syndrome among nurses working in a teaching hospital in North-eastern state of Malaysia. Occupational factors such as total duration of employment and one way commuting time to work are associated with metabolic syndrome.[...] Read More.

Keywords: Prevalence, metabolic syndrome, nurses, shift work, self-perceived stress.

2019, 8(1), 1-6;

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Research Article

Exploring Fayoum (Upper Egypt) preparatory school studentsâ€™ and teachersâ€™ attitude towards obesity as health risk

Full Length Research Paper

Abstract: Childhood obesity is a serious non-communicable public health problem with negative physical, social, and mental health consequences. Factors contributing to childhood obesity are school nutrition, excessive snacks, fast food, lack of physical activity and family behavior. The objective of this study is to explore Fayoum preparatory of school students’ and teacher’s attitude concerning obesity and healthy nutritional behavior and investigating readiness of teachers to attain an active role in student’s nutritional education. This was a cross sectional descriptive study implemented in three preparatory schools of Fayoum district. Multistage stratified sample of 990 students, attending first, second and third grades. In each school, two classes were randomly selected from each grade, students interviewed for filling a structured questionnaire and anthropometric measurements were taken. Teaching staff at the schools (48) shared in four focus group discussions. More girls were reported in the overweight and obese category. Almost half of the students knew the proper food for their age. 62.1% of them consumed meals in front of the TV and 44.9% ate fast foods. The majority of both students and teachers agreed that physical activity and diet controls were the main control measures of obesity. 70.8% of teachers agreed that they should have an active role in obesity prevention. It was clear that Fayoum students had some nutritional knowledge but there was a defect in practice. Effective communication and collaboration among school and home offers the possibility of improving the quality of life and reducing the health care costs.[...] Read More.

Keywords: Childhood obesity, nutritional behavioral, teachers role.

2019, 8(1), 1-6;

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Research Article

Stroke in Nigerian Children with Sickle Cell Anaemia

I. O. George* and A. I. Frank-Briggs

Abstract: Stroke is a leading cause of physical disability worldwide. Sickle cell anaemia (SCA) is the most common cause of stroke in children. The aim is to determine the prevalence of stroke in children with SCA at the University of Port Harcourt Teaching Hospital, Nigeria. Retrospective studies of patients with SCA (6 months to 16years) with stroke, over a 5 year period were carried out. Data was extracted from the medical records of patients. Descriptive statistics was used to analyze data. A total of 256 medical records of children with SCA were reviewed. Of these, 11 patients had stroke (4.3%). Seven (63.6%) were below 10 years. The main clinical manifestations were seizure, 6 patients (54.5%) and hemiplegia 5 patients (45.5%). Recurrent stroke occurred in 2 patients (18.2%). Computed tomography scan reports of the brain were not available in 3 patients which confirmed ischaemic stroke. Stable-state haematocrit was below 20% in 72.7% of patients. One death was documented. The prevalence of stroke in children with SCA is 4.3% and children under the age of 10 years with low haematocrit values are at greater risk of developing stroke.[...] Read More.

Keywords: Stroke, sickle cell anaemia, children, Nigeria.

2019, 8(1), 1-6;

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Research Article

Introduction of complementary foods to infants as self-reported by urban and rural low-income mothers in Guatemala

María José Soto-Méndez, Raquel Campos, Liza Hernández, Marieke Vossenaar* and Noel W. Solomons

Abstract: The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life with the introduction of adequate complementary foods thereafter. The association between the early introduction of complementary foods and negative health outcomes may be underestimated by inconsistencies in reported age-of-introduction of complementary foods. We aimed to determine the reproducibility of reported age-of-introduction of 10 selected complementary foods. Mothers of 6-12 mo old Guatemalan infants (50 rural, 64 urban) were interviewed on 3 occasions within an interval of 2-14 wks, and asked the age of their infant on introduction of 10 commonly consumed foods (INCAPARINA®, oatmeal, rice, fruits, vegetables, white rolls, sweet rolls, baby food in jars, potatoes and coffee). A score of 3 (full repetition), 2 (2 of 3 consistent) or 0 (3 distinct answers) was given for each food, and summed across all foods for a “maternal score”, with 30 as maximal. Baby food, sweet rolls and coffee were the most reproducibly-reported foods for both settings, whilst vegetables and fruits were the least consistently reported items. The median maternal score was 20.0 in the urban sample, and higher at 23.0 in the rural sample (p=0.020). We conclude that the moderately high degree of consistency in the responses adds confidence to the proposition that published data on age of complementary foods introduction could generally be valid.[...] Read More.

Keywords: Reproducibility, complementary foods, self-reported, infant nutrition, Guatemala.

2019, 8(1), 1-6;

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Research Article

Alcohol consumption in Lusaka urban district, Zambia: A population based survey, 2007

Full Length Research Paper

Abstract: Alcohol use is an important preventable risk factor for several non-communicable diseases (NCDs) and injuries that is related to lifestyle choices. The objective of the study was to determine the prevalence of alcohol consumption and its correlates. A cross sectional study utilizing a WHO stepwise approach to surveillance of NCDs was conducted in Lusaka district, Zambia. Current alcohol consumption was defined as having consumed alcohol in the previous 30 days to the survey. Complex samples logistic regression was used to determine independent predictors. A total of 1928 individuals participated in the survey. A third of the participants were males and 53.2% were in the age group 25 to 34 years. Overall, 35.8% of the respondents had attained secondary level of education. The prevalence for current consumption of alcohol was 20.7% (37.9% of males and 12.2% of females). Sex was associated with alcohol consumption, with females being 68% (AOR = 0.32, 95%CI [0.20, 0.51]) less likely to consume alcohol compared to male respondents. Age, education, body mass index and sedentary were not independently associated with alcohol consumption. The high prevalence of alcohol use among Zambian adults indicates an urgent need for specific measures such as public awareness campaigns, policies, and regulations.[...] Read More.

Keywords: Alcohol consumption, gender, Zambia.

2019, 8(1), 1-6;

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Research Article

Prevalence of goitre and assessment of iodine nutritional status in 6-12 years primary school children of Narmada District, Gujarat, India

Haresh Chandwani,* and Jyotsna Pandor

Abstract: Iodine deficiency disorders (IDD) are major public health problems in India, including Gujarat. Narmada district is a tribal area. The present study was conducted to estimate the prevalence of goitre in primary school children; to determine median urinary iodine concentration; to assess level of iodine in salt samples at household and retail shop level; and to study profile of salt sold at retail shops in Narmada district, Gujarat. 30 cluster survey method was used for the study in primary schools of Narmada District. Children studying in 1st to 7th standard were used in this study. A total of 70 students including five boys and five girls from 1st to 7th standard present in class on the day of visit were selected randomly for Goitre examination, so, total 2100 students were examined in schools. Urine sample was collected from one boy & one girl from each standard in each cluster. From community, at least 28 students including two boys and two girls from each standard in same age group were examined and also salt samples were tested from their households. So, total 2100 students were examined in schools and 858 students were examined out of schools in the selected villages. From each village, one retail shop was visited and salts were purchased and tested for iodine on the spot with spot kit. Goitre prevalence was found 18.1% among primary school children including grade 1 - 12.4% and grade 2 - 5.7%. As the age increases the Goitre prevalence also increases except in the age group of 9 years. Median urinary iodine excretion level was found 110 µg/L. Iodine level >15 ppm was found in 93.7% salt samples tested at household level. Present study showed mild Goitre prevalence in primary school children in Narmada District of Gujarat and iodine content of salt found adequate at household level.[...] Read More.

Keywords: Goitre survey, IDD, prevalence, primary school children, household level.

2019, 8(1), 1-6;

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Research Article

Chemical and silt-induced eutrophication syndrome at Otamiri River, Owerri, Nigeria

Nwanebu F. C.*, Ogbulie, J. N., Obi R. K. and Ojiako O. A.

Abstract: Partially eutrophicated site (A) and free-flowing site (B) of Otamiri River in Owerri, Nigeria, separated by a barricade were evaluated to determine their relative pollution status. Microbiological analysis using membrance-filtration techniques detected high presence of Salmonella spp., Vibro spp., Staphylococus aureus and faecal Streptococci. Aerobic bacterial counts of 5.0 x 105 cfu/100ml were obtained from site B and 4.5x 103 cfu/100ml from site A. The physico-chemical analysis revealed high conductivity of 178 umhoo/cm with total dissolved solids (TDS) of 89.0 mg/L at site B and 52 umhoo/cm with TDS of 26mg/L at site A. Recovery of PO43-, SO42-, N03-, was obtained, though more at site A than Site B, indicating pollution. Statistical analysis revealed significant differences (P[...] Read More.

Keywords: Eutrophication, pollution, Otamiri River, Owerri, Nigeria.

2019, 8(1), 1-6;

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Research Article

Demographic, cultural and environmental factors associated with frequency and severity of malnutrition among Zambian children

Selestine H. Nzala, Seter Siziya*, Olusegun Babaniyi, Peter Songolo, Adamson S. Muula, and Emmanuel Rudatsikira

Abstract: Under-nutrition prevents growth and development in children and is the leading factor to illness and death among children less than five years of age in developing countries. The objective of the study was to determine associations of demographic, cultural and environmental factors with frequency and severity of malnutrition among children less than five years of age in Zambia. We used data from the Zambia multiple indicator cluster survey (MICS) from years of 1999 to 2000. Altogether 6,142 children participated in the survey. The prevalence rates for being "underweight", "stunted" and "wasted" were 17.6, 37.5 and 4.1%, respectively. Compared to children from Western province, those from Luapula, Northern, and North-West provinces were more likely to be underweight. Children from Lusaka, Southern, Copperbelt, Eastern, and Central provinces were less likely to be underweight compared to those from Western province. Other factors associated with children malnutrition included sex, low educational level of householder and mother, poverty, vaccination status and type of toilet. The data acquired in this study may be used in developing interventions to prevent and mitigate children malnutrition. Special attention may have to be given to the provinces where children are more likely to suffer from malnutrition.[...] Read More.

Keywords: Malnutrition, underweight, stunted, wasted, children under 5 years of age, Zambia.

2019, 8(1), 1-6;

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Research Article

Multiresistant faecal indicator bacteria in stream and well waters of Ile-Ife City, Southwestern Nigeria: Public health implications

O. Oyedeji*, P. O. Olutiola, K. D. Owolabi and K. A. Adeojo

Abstract: This study was carried out to determine the prevalence of multiple antibiotic-resistant faecal indicator bacteria in streams and wells which serve as major sources of water for inhabitants of Ile-Ife city in Southwestern Nigeria. Water samples from 2 streams and 10 wells situated at different parts of the city were collected over a 6-month period. The total heterotrophic bacteria, faecal coliform and enterococci counts were performed using standard procedures, and the sensitivity of the isolates to antibiotics was tested. The study indicated high faecal indicator concentrations exceeding quality standards for drinking and recreational waters according to World Health Organization (WHO) and United States Environmental Protection Agency (USEPA). All the faecal coliforms and enterococci isolates presented multiple antibiotic resistances. The water sources pose a threat to human health due to the danger of waterborne diseases and potential for the transfer of antibiotic resistance genes to pathogens. Effective public health education aimed at creating awareness of the implications of consumption of contaminated and untreated water is imperative. Antibiotics should only be administered based on physicians’ prescription.[...] Read More.

Keywords: Antibiotic resistance, faecal indicator bacteria, Southwestern Nigeria, stream water, waterborne diseases, well water.

2019, 8(1), 1-6;

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Research Article

Prevalence of waterborne infections in Northwest Nigeria: A retrospective study

Raji M. I. O.* and Ibrahim Y. K. E.

Abstract: Northwest Nigeria is frequently beset with inadequate water supply. The safety of drinking water to the people in this part of the country has been of major concern as a result of frequently reported incidences of waterborne infections. To ascertain incidences of waterborne infections in this study, patient medical records in several primary health care centres in Sokoto, Shuni and Tambuwal towns in Northwest Nigeria were examined to collect data on incidences of waterborne infections and bio-data of the patients. Simple statistical analysis (Percentage) of collated data was carried out. The records showed that there are high incidences of waterborne infections namely typhoid, cholera, dysentery, diarrhoea and gastroenteritis in the three towns, and that these are more frequent in children below the age of 5 years. Gender distribution of diarrhoea and dysentery cases in 2004 and 2005 showed on average that more female than male residents contracted the infections. The number of cases of waterborne infections in the three towns increased from 10.03% in 2004 to 14.14% in 2005. Diarrhoea, constituting 6.23% in 2004 and 10.04% in 2005 was the most commonly reported cases of waterborne infection in the three towns. Shuni recorded the highest (8.95%) incidences of diarrhoea infection in 2004, followed by Tambuwal (6.23%) and Sokoto had the least (4.81%) while in 2005 Sokoto had the highest (11.99%) followed by Tambuwal (10.23%) and Shuni had the least (7.55%). Pre-study investigations have shown that people in this part of the country lack wholesome drinking water, government should therefore endeavour to make potable water abundant and accessible to its people.[...] Read More.

Keywords: Waterborne infections, drinking water, diarrhoea, Northwest Nigeria.

2019, 8(1), 1-6;

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Research Article

Prevalence, distribution and behavioural determinants of coital activity among High School students in Namibia: A cross-sectional study

Kazhila C. Chinsembu*, Choshi D. Kasanda and Cornelia N. Shimwooshili-Shaimemanya

Abstract: Although HIV transmission among Namibian in-school adolescents is mainly heterosexual, previous data on sexual activity are not disaggregated, making it difficult to target interventions. This study conducted a disaggregated analysis of coital activity and explored various factors associated with coital activity among Namibian High School students. A cross-sectional survey was carried out in 18 schools located in six education regions. Data were collected from 829 students through a structured questionnaire. Pearson χ2 analysis was used to determine the distribution of coital activity for students from different regions, rural-urban areas, ethnic groups, and gender. Factors associated with coital activity were established by the use of odds ratios and multivariate logistic regression analysis. Overall, 50.2% of the students never had sex before and 29.2% were sexually active. Pearson χ2 analysis showed that coital activity was significantly high among students in the Caprivi region, urban areas, Lozi, Herero and Damara-Nama ethnic groups, and male gender. Multivariate logistic regression showed that the only significant factors positively associated with coital activity were Herero ethnicity, male gender, testing for HIV, thinking one could not get HIV if they were faithful to a single sexual partner, having a boyfriend of girlfriend, and drinking beer. These disaggregated results will help design targeted HIV/AIDS preventive programmes for High School students in Namibia. This can be done by targeting messages that reduce students’ coital activity by way of altering personal, peer, and social behaviours.[...] Read More.

Keywords: Prevalence, distribution, determinants, coital activity, students.

2019, 8(1), 1-6;

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Research Article

Disease dynamics, distribution and surveillance of malaria in arid ecology of Jodhpur, Rajasthan, India during 2002 to 2006

P. K. Anand*, L. Swarn, S. P. Yadav and H. Singh

Abstract: Malaria is under regular and ongoing surveillance, to detect changes in its trends or distribution in order to initiate investigative or control measures in the country. Owing to limited availability of resources and rational use under the program, prevention and control activities against malaria varies in areas with different intensity of malaria transmission. Transmission dynamics, surveillance, mapping of disease burden for malaria in arid ecological setting of Jodhpur, Rajasthan has described in this study. Monthly epidemiological reports of Jodhpur City, district Jodhpur and all its community health centres were obtained from the office, Chief Medical and Health Officer district Jodhpur for the period 2002 to 2006. Secular trend of malaria incidence, transmission dynamics, mapping of disease burden areas and surveillance of malaria was described. The range of annual parasite incidence (API) was from 0.52 to 2.85 in district Jodhpur, with API[...] Read More.

Keywords: Malaria, Rajasthan, arid ecology, low risk area, desert.

2019, 8(1), 1-6;

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Research Article

A study of travel medicine among National and International travellers in Egypt

Naglaa A. El Sherbiny* and Ghada M. Wafik

Abstract: Travel medicine has emerged as a new field of medicine that involves pre-travel evaluation, contingency planning during travel, and post-travel care. Its implementation showed major discrepancies among different countries. This study aims to assess the health information given to travelers and detect their sources of information. This is a cross sectional analytical observational study of 397 travelers implemented on different travel destinations all over Egypt. It adopts self-administered structured questionnaires according to the International Travel Health Questionnaire (ITHQ) and in-depth interviews with managers in the Ministry of Tourism. The results showed that 17.5% of the international travelers and none of the national travelers heard about the ITHQ; whereas, 58.9% of the international travelers and 26.8% of the national travelers took information about safety measures from different sources. However, there was a lack of travelers’ knowledge about safety measures with no obvious role of travel agencies.[...] Read More.

Keywords: Travel medicine, traveler safety, travel agent health advice.

2019, 8(1), 1-6;

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Research Article

Retrospective study of bovine and human tuberculosis in abattoirs and hospitals in Enugu State, Southeast Nigeria

Nwanta J. A.*, Umeononigwe C. N., Abonyi G. E. and Onunkwo J. I.

Abstract: A study to generate epidemiological data on tuberculosis in cattle and humans in Enugu State, through a retrospective survey of abattoir and hospital records for a five-year period (2004 to 2008) was undertaken. A total of 748 and 2452 cases of tuberculosis were recorded in cattle and humans respectively. Statistical analysis showed that a variation in seasonal prevalence in both studied population, but the variation was not statistically significant. Sex-associated prevalence differed in both studied populations. Cows and male persons were both significantly (p[...] Read More.

Keywords: Cattle, humans, tuberculosis, Enugu State, prevalence.

2019, 8(1), 1-6;

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Research Article

Analysis of factors related to complaints in medical schemes

Michael Mncedisi Willie

Abstract: Medical schemes are insurance institutions that cover medical expenses in South Africa. These institutions reimburse their members for actual expenditure on health. The Medical Schemes Act (Act 131 of 1998) defines the business of a medical scheme as the business of undertaking liability in return for a contribution in order to make provision for obtaining any relevant health service. The Council for Medical Schemes (CMS) is an autonomous statutory body created by parliament to regulate the medical schemes industry in South Africa. The CMS handles complaints from members of medical schemes. The objective of the study was to assess factors that impact on the response time to complaints by members of medical schemes. Survival analysis techniques were employed to assess these factors. The regression models controlled for factors such as, medical scheme type, medical scheme size, severity of complaints and effects of the analysts. The model revealed the effect of analysts as a significant factor to response time to complaints. The findings of the study revealed useful results in terms of identifying analysts that take longer to resolve complaints. The study also revealed that the nature of complaints as an important factor to the response time. There is a need for the complaints department to be properly resourced and continuously train staff to ensure effective resolution of complaints in medical schemes.[...] Read More.

Keywords: Survival analysis, Kaplan-Meier, Tarone-Ware test, Cox proportional hazard model, log-rank test.

2019, 8(1), 1-6;

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Research Article

Comparison between all patients refined diagnosis related groups with the centre for medicare and medicaid services diagnosis related groups

Alberto Pilotto, Marilisa Franceschi, Mauro Di Bari, Franco Rengo, Roberto Bernabei, Luca Lorenzoni, Niccolò Marchionni and Antonio Greco

Abstract: Aim of the study was to compare the ability of the all patients refined diagnosis related groups (APR-DRG) with the centre for medicare and medicaid services diagnosis related groups (CMS-DRG) in predicting multidimensional impairment of elderly patients. Cases discharged from 20 geriatric units were grouped by the CMS-DRG and the APR-DRG. A comprehensive geriatric assessment (CGA) was performed using the activities of daily living (ADL), instrumental activities of daily living (IADL), short portable mental status questionnaire (SPMSQ), comorbidity index rating scale (CIRS), mini nutritional assessment (MNA), geriatric depression scale-short form (GDS-SF) and exton smith scale (ESS). Number of drugs at admission (DPA) and length of stay (LOS) were also recorded. CMS-DRG and APR-DRG relative weights (RW) were used for comparisons. 1273 patients were included. With increasing the APR-DRG-RW, a significant increase in the prevalence of impaired patients was found in ADL, IADL, SPMSQ, CIRS, GDS-SF and ESS. The CMS-DRG-RW subgroups showed a significant difference for MNA and GDS-SF. LOS was significantly different for both APR and CMS DRG. The number of CGA domains in which APR showed a more significant trend in disability when compared to CMS DRG demonstrates that the former was a better predictor of multidimensional impairment.[...] Read More.

Keywords: All patients refined diagnosis related groups (APR-DRG), centre for medicare and medicaid services diagnosis related groups (CMS-DRG), comprehensive geriatric assessment, elderly.

2019, 8(1), 1-6;

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Research Article

Antibiotic self-medication among university medical undergraduates in Northern Nigeria

Joseph O. Fadare* and Igbiks Tamuno

Abstract: Self-medication is becoming a common type of self-care behavior among the population of many countries. Many international studies have investigated the prevalence and nature of self-medication practices at the population level. In Nigeria, some workers have also looked at the population prevalence of self-medication in general; however the prevalence of antibiotic self-medication among medical undergraduates has not yet been studied. The interest in studying this practice among this select group is due to the fact that they are the future prescribers and health educators of the population of Nigeria. The study was a cross-sectional pre-tested questionnaire-based study carried out among medical students of the Bayero University, Kano, North-West Nigeria during a two-week period in August 2008. The information from the returned questionnaire were coded, entered and analyzed using SPSS Version 12 statistical software. A total of 183 students filled and returned the questionnaire giving a response rate of 83.2%. Out of these respondents, 120 (65.6%) were males and the mean age of respondents was 23.2 ± 2.5 years (Range 17 to 31). 71 (38.8%) of the medical students admitted to the practice and there was no statistically significant difference among the different levels of medical education (p >0.05). Antibiotics from the penicillin group (ampicillin/cloxacillin, amoxicillin and ampicillin) were the most frequently used. Self-medication with antibiotics is prevalent among medical undergraduates in Northern Nigeria. There is a need for an intervention to address this practice.[...] Read More.

Keywords: Antibiotics, self-medication, medical undergraduates, Nigeria.

2019, 8(1), 1-6;

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Research Article

Technical competence of tutors in pre-service health training institutions on Expanded Programme on Immunization in North Western Nigeria

A. S. Umar*, A. O. Olatunji*, A. O. Abiola, A. Yakubu and M. Oche

Abstract: The study was conducted to assess the knowledge and skills of tutors on Expanded Program on Immunization (EPI) in some pre-service health training institutions in Nigeria to identify their training needs. The study was a cross sectional survey using a structured self-administered questionnaire and an observational checklist. A total of 62 tutors from 5 pre-service health training institutions were selected. The level of knowledge was assessed using a scoring system as adequate or in adequate. Overall, 25 (40.3%) of respondents’ had adequate knowledge on basic knowledge on immunization concepts, principles and components of Reaching Every Ward approach (REW). The overall mean score was 24.4 ± 2. In all the 5 schools studied, there were no teaching aids (vaccine carriers, ice packs, cold box, AD syringes, safety box, IEC materials and data tools) and no reference materials (REW field guide or immunization in practice) in the school library. In-service training is the only variable that have demonstrated significant statistical association on overall knowledge of respondents’ (df = 1; F = 8.62; P[...] Read More.

Keywords: Tutors, pre-service health training institutions, knowledge, teaching aids, Expanded Programme on Immunization (EPI), Nigeria.

2019, 8(1), 1-6;

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Research Article

Physical violence among intimate partners in Nigeria: A multi level analysis

Yusuf O. B.*, Arulogun O. S., Oladepo O. and Olowokeere F.

Abstract: Gender based violence is gaining more and more recognition, the world over. The prevalence and factors associated with physical violence as it affects both men and women taking into account the hierarchical nature of the data was reported in this study. A descriptive cross sectional survey was carried out on adult women and men in three selected states of Nigeria. A random effect logistic model was fitted. More female respondents had experienced physical violence compared with males. Behavioural factors of partners were found to greatly influence domestic violence against females such as young age and partner’s smoking and drinking status. These results would provide more insights into the determinants of violence in developing country settings.[...] Read More.

Keywords: Physical violence, intimate partners, multilevel analysis, determinants.

2019, 8(1), 1-6;

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Research Article

Visceral fat with its risk factors amongst the Indonesian Javanese elderly

Fatmah, Yusran

Abstract: Direct and indirect risk factors are implied in increased elders’ visceral fat level, namely socio-economic, gender, age, workload, physical activities and eating pattern. The aim of study was to get the information on visceral fat level and its risk factors amongst The Indonesian Javanese elderly. A total of 812 elder’s (517 women and 295 men) participated in the cross sectional study. Results showed that 12.8% of respondents with high level of visceral fat and 26.7% almost reach high level. Rural and urban areas, educational background, workload when aged 25 and 55 years, and physical activities aged 25 and 55 years had significant correlation with the visceral fat. Body Mass Index (BMI), weight, and height had a significant association with the visceral fat whereas the highest on the BMI (r = 0.896). A decreased visceral fat pattern following reduced weight and height according to sex. Mild physical workload aged 55 years had the opportunity of 2.29 times greater than those who had the heavy workload level at the same age. Nutrition education for elderly should include advice to increase physical activity in order to reduce high level of visceral fat.[...] Read More.

Keywords: Visceral fat, risk factors, elderly, physical activity, workload.

2019, 8(1), 1-6;

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Research Article

Concurrent sexual partnerships among Chinese men: Evidence from a national population-based survey

Full Length Research Paper

Abstract: We sought to determine the pattern of the concurrent sexual partnerships among Chinese men and its correlates with individual, partnership and community factors. Using data from the Chinese Health and Family Life Survey, we examined the prevalence and distribution of sexual concurrency of 1689 men. A two-level logistic regression was employed to assess variables associated with sexual concurrency. Nine percent of men had concurrent sexual partnerships in preceding year. Sexual concurrency was associated with higher income (OR, 1.21; 95% CI, 1.02 to 1.48), longer traveling time (OR, 2.03; 95% CI, 1.44 to 2.87), and more frequent socializing activities (OR, 1.15; 95% CI, 1.01 to 1.30). Men who perpetrated domestic violence (OR, 1.92; 95% CI, 1.20 to 3.08) and perceived partners having other concurrent partners (OR, 4.19; 95% CI, 1.95 to 9.02) were more likely to have concurrent sexual partnerships. Tolerant community attitude towards sexual behavior and community education level showed effects on men’s concurrency involvement. The results contribute to a better understanding of the potential role of concurrent sexual partnerships in the spread of HIV and other STIs in China.[...] Read More.

Keywords: Concurrent sexual partnerships, risk factors, human immunodeficiency virus prevention, Chinese men.

2019, 8(1), 1-6;

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Research Article

The pattern of skin disorders in a Nigerian tertiary hospital

D. D. Atraide, M. R. Akpa and I. O. George*

Abstract: We analyzed the data of patients with skin disorders attending the Dermatology Clinic of the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria with the aim of identifying common skin disorders in our community. All patients attending the Dermatology Clinic of the UPTH, Nigeria from January 2005 to December 2008 were included in this retrospective analysis. The medical records of the patients (dermographics, history, physical examination and laboratory investigations) were analysed to ascertain the diagnosis. All patients were evaluated by qualified dermatologists. A total of 1,333 patients attended the Dermatology Clinic of UPTH. There were more females 812 (60.9%) than males 521 (39.1%). More than three quarter of the cases were aged above 16 years while less than a quarter were children below 16 years. Infectious diseases 317 (23.8%), mostly fungal 207 (15.5%) were the most common cause for attendance, followed by dermatitis 207 (15.5%) and pigmentary disorders 98 (7.4%). Preventable skin diseases are common in Port Harcourt, Nigeria. Health education is therefore necessary to curb their spread, reduce the associated morbidity, and improve the health status of the population. Effort should be made to train health workers in the diagnosis and treatment of the more common dermatologic conditions.[...] Read More.

Keywords: Pattern, skin disorders, infectious diseases, Port Harcourt, Nigeria.

2019, 8(1), 1-6;

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Research Article

Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children

Abdulraheem I. S.*, Onajole A. T., Jimoh A. A. G. and Oladipo A. R.

Abstract: Mothers play an important role in immunization of their children. A target of 95% immunization coverage is necessary for the sustained control of vaccine preventable diseases. Partial immunization coverage against vaccine preventable diseases is a significant public health problem especially in rural areas in Nigeria. The reasons for partial immunization and factors responsible for missed opportunities are poorly understood and little data is available to explain the phenomenon that could support the decision making. This study aimed at finding out the reasons for partial immunization and factors responsible for missed opportunities for immunization in children less than one year of age. Mothers of children within one year of age were the study subjects using a cross-sectional study design. The immunization card was utilized to check for completeness and correctness of immunization schedule, and also for identifying the appropriate use of all available opportunities for immunization. About two-third (62.8%) of the children were not fully immunized by one year of age, 33.4% had experienced a missed opportunity for immunization and 36.4% were partially and incorrectly immunized. Parents objection, disagreement or concern about immunization safety (38.8%), long distance walking (17.5%) and long waiting time at the health facility (15.2%) are the most common reasons for partial immunization. Missed opportunities for immunization and partial immunization need to be avoided in order to enhance the fully immunized percentage for those children who reach the health facility, especially in rural areas where the immunization coverage is below the expected national coverage (minimum 80%).[...] Read More.

Keywords: Incomplete vaccination, reasons and factors, rural Nigerian children.

2019, 8(1), 1-6;

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Research Article

Meta-analysis of the prognostic role of p53: Playground for solution or source of confusion?

Georgia Levidou*, Paraskevi Fragkou, Efstratios Patsouris and Penelope Korkolopoulou

Abstract: Deregulation of the p53 gene is considered to be a prognostic marker in patients with tumours. In this review we are summarizing the results of meta- analyses dealing with the prognostic role of p53 status published in the literature. We found 7 studies examining 5 different tumours (osteosarcoma, ovarian carcinomas (OC), astrocytomas, urothelial bladder carcinomas and non-small lung cell carcinomas (NSCLC)). Significant results are reported in four of the studies (OC and NSLCC). However, most of the studies found significant heterogeneity, particularly those that reported significant results, whereas the majority used the results of univariate survival analysis for quantitative synthesis. Despite the significant information published the last decades regarding the role of p53 alterations in the clinical course of patients with malignant tumours, it could be argued that there is a huge amount of studies that cannot be combined in order to provide more valid and aggregated results.[...] Read More.

Keywords: Overexpression, tumours, p53 protein, immunohistochemistry.

2019, 8(1), 1-6;

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Research Article

Immunization coverage of antenatal and immunization clinics attendees in the Niger Delta University Teaching Hospital

Adekunle Kunle-Olowu*, Onyi Euphemia Kunle-Olowu and Ugwu Moses Emeka

Abstract: The purpose of this study was to determine the coverage for immunization in the first year of life and maternal tetanus toxoid administration in the Niger Delta University Teaching Hospital (NDUTH), Bayelsa State; this will help in establishing ways of improving coverage. A total of 528 were surveyed retrospectively using the immunization register, 521 (98.7%) had BCG, 512(97.0%) had OPV0, 372 had (70.5%) had OPV1/DPT1/HEPBV1, 313 (59.3%) had OPV2/DPT2/HEPBV2, while only 251(47.5%) had OPV3/DPT3/HEPBV3. Only 94(17.8%) had measles /yellow fever vaccines. However 14.3% of the surveyed children had the complete doses of vaccines. For maternal tetanus toxoid administration, a total of 601 mothers were surveyed using the antenatal and immunization registers. Out of the 601 surveyed, 151(25.2%) and 82(13.6%) had TT1 and TT2 respectively while 368 (61.2%) had both TT1 and TT2 in that pregnancy. The low immunization coverage for children may be detrimental to the attainment of the Millennium Development Goal, aimed at reducing child mortality by 2/3rd in 2015. However the immunization of mothers will contribute effectively to the elimination of neonatal tetanus.[...] Read More.

Keywords: Immunisation, coverage, teaching, hospital.

2019, 8(1), 1-6;

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Research Article

Promotion of knowledge and attitude towards premarital care: An interventional study among medical student in Fayoum University

Salwa Tawfik Abd Al Azeem, Eman Taher Elsayed*, Naglaa Abd El Khalek El Sherbiny and Lamiaa Abd El Gawad ahmed

Abstract: Premarital care (PMC) is a worldwide activity aiming to diagnose, treat unrecognized disorders, and reduce transmission of diseases to couples. The study was an interventional educational prospective study; its aim was to assess and improve knowledge and attitude of 200 medical students in Fayoum University towards premarital care services; through health education intervention in the form of lectures and brochures that address important issues of premarital care. The involved students were interviewed by using closed-ended questionnaires, which were distributed twice, just before the intervention and then after 2 months. A special scoring system was used. Total knowledge score showed significant improvement from 62.44±4.98 to 69.37±3.43, especially as regards components of reproductive health, contents of premarital counseling and the role of PMC in prevention of certain diseases especially hepatitis (significant increase in correct response from 58 to 72%). The main source of knowledge was TV (65.5%). Total attitude score showed significant improvement from 7.89±1.1 to 13.1±.81 especially favorable attitudes towards importance of PMC services, convention to receive such services, and refusal of marriage person with untreated infectious diseases with increase in the percentages to reach 94, 92.5 and 90%, respectively. Females showed better attitudes than males towards PMC. The results reflected the importance of health education as a cornerstone element in improving knowledge and attitude towards premarital care. There is need of continuous health education programs for students to increase their awareness and attitude.[...] Read More.

Keywords: Premarital care, knowledge, attitude, medical students.

2019, 8(1), 1-6;

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Research Article

Prevalence and correlates for tobacco smoking among persons aged 25 years or older in Lusaka urban district, Zambia

Seter Siziya*, Olusegun Babaniyi, Peter Songolo and Mutale Nsakashalo-Senkwe

Abstract: Tobacco use is the leading cause of non communicable diseases. There is paucity of information on correlates for tobacco smoking among adults in Zambia. The objective of this study was to determine the prevalence of tobacco use and its correlates in Lusaka urban district. A total of 1928 individuals aged 25 years or older participated in the survey, of which 33.0% were males. About half (53.2%) of the participants were of age 25 to 34 years, and 35.8% of them had attained secondary level of education. Overall, 6.8% of the participants currently smoked cigarettes (17.5% among males, and 1.5% among females). Female respondents were 90% (Adjusted Odds Ratio (AOR) = 0.10, 95% CI [0.05, 0.23]) less likely to smoke cigarettes compared to males. Compared to respondents who had[...] Read More.

Keywords: Tobacco smoking, body mass index, adults.

2019, 8(1), 1-6;

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Research Article

Bacteria contamination of raw meat sold in Abakaliki, Ebonyi State Nigeria

Iroha I. R.*, Ugbo E. C., Ilang D. C., Oji A. E. and Ayogu T. E.

Abstract: Frequency of contamination in retail meat sold in Abakaliki, Ebonyi State was examined in the present study. Three hundred raw meat samples including beef (n = 100), chicken (n = 100), chevron (n = 100) were collected from Abakaliki abattoir and were analyzed for microbiological contamination using standard Microbiological methods. Antimicrobial susceptibility of isolated microbes was determined using the Kirby and Bauer method of disc diffusion. Out of the 300 samples, 79 (29.3%) were contaminated with bacteria species including Bacillus cereus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, Shigella dysenteriae and Staphylococcus aureus. Of these, E. coli had the highest occurrence (8%), followed by K. pneumoniae (5.3%), S. typhi (5%), S. dysenteriae 2.6%, P. aeruginosa 2.0%, B. cereus 2.0% and S. aureus (1.3%). The antibiotic susceptibility studies showed an alarming level of resistance to all the tested antibiotics reflecting multi-drug resistant strains. Our data confirms the circulation of antibiotic resistant pathogens in raw meat sold in Abakaliki abattoir and market, which could possibly play a role in the spread of antimicrobial resistance amongst food-borne bacteria.[...] Read More.

Keywords: Meat, abattoir, contamination, antibiotic resistance.

2019, 8(1), 1-6;

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Research Article

Patient satisfaction and expectations of the quality of service of University affiliated dermatology clinics

Abdullateef A. Alzolibani

Abstract: Patient satisfaction is the major indicator of quality of care provided by a health facility. To determine the level of patient satisfaction with medical care at the Dermatology Clinics affiliated to Qassim University, Saudi Arabia and to identify the socio-demographic characteristics of patients that might influence the level of satisfaction. A cross-sectional survey of 741 patients attending the Outpatient Dermatology Clinics affiliated to Qassim University, Saudi Arabia during the time period from January 1st to March 30th 2010. An Arabic language questionnaire was used to assess various domains of patient satisfaction. The satisfaction rate for overall quality of dermatology services was 66.1% in our patients. High levels of satisfaction were expressed about the general maintenance and hygienic conditions of the clinic. About 38% of patients indicated their dissatisfaction regarding the waiting time for appointment and about 40% were not satisfied about the information they received about their problems. About 48% felt that the consultation time was inadequate and 36.7% felt that they were not allowed to express their symptoms in detail. A significantly high level of satisfaction was associated with female gender, age below 40, single status, low education, low socioeconomic status and rural residence. We also found that patients coming on their first visits were significantly more satisfied than those on follow up visits. Majority of our patients were satisfied with overall care. However, specific questioning exposed certain areas that need to be improved such as reducing waiting period for appointments, providing more information about the disease and by ensuring that patients have the opportunity to ask questions.[...] Read More.

Keywords: Patient satisfaction, dermatology clinic, satisfaction score, quality of care.

2019, 8(1), 1-6;

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Research Article

Patient waiting time in a tertiary health institution in Northern Nigeria

Umar I., Oche M. O.* and Umar A. S.

Abstract: The amount of time a patient waits to be seen is one factor which affects the utilization of health care services. Patient satisfaction has emerged as an increasingly important parameter in the assessment of quality of health care; hence, healthcare facility performance can be best assessed by measuring the level of patient’s satisfaction. This was a cross-sectional descriptive study carried out at the out patients’ departments of the Usmanu Danfodiyo University, Sokoto. A total of 384 new patients were randomly selected into the study. A set of pretested questionnaires was used to extract information from the respondents; descriptive statistics was used for analysis. A total of 118 (31%) of the patients waited for less than an hour in the waiting room, while 371 (96.6%) spent less than 30 min with the doctor. More than half, 211 (55%) of the respondents were satisfied with the service delivery in the hospital, while only 63 (16%) of the respondents admitted to being given health talks while waiting to be seen by the doctor. Although majority of the patients waited for more than 1 h before being attended to, more than half of them were however satisfied with the services rendered to them. There is the need for health care institutions and providers to put in place measures aimed at reducing waiting time and ensuring patient satisfaction.[...] Read More.

Keywords: Waiting time, outpatient department, satisfaction, Sokoto.

2019, 8(1), 1-6;

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Research Article

Evaluation of health status of pre-menarcheal and post-menarcheal girls by Rohrer index in Purulia, West Bengal

Sudip Datta Banik

Abstract: Undernutrition in children and adolescents is a major problem in India. Age at menarche is a significant indicator of growth in girls. The present study records age at menarche, prevalence of under nutrition measured by Rohrer Index in both pre-menarcheal (n=107) as well as post-menarcheal (n = 131) girls (n = 238) aged 6.01 to 14.63 years. In this cross-sectional study, mean age at menarche is estimated to be 12.60 years. The comparative statements between these two sections indicate significant difference in height, weight and Rohrer Index. This Index indicates very high prevalence of low health profiles of the girls.[...] Read More.

Keywords: Menarcheal age, undernutrition, Rohrer Index.

2019, 8(1), 1-6;

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Research Article

Disasters in Kenya: A major public health concern

Marion W. Mutugi* and Samuel G. Maingi

Abstract: A disaster is defined as an event or series of events, which give rise to casualties and/or damage or loss of property, infrastructure, essential services or means of livelihoods on a scale which is beyond the normal capacity of the affected community to cope with unaided. This event or events disrupt the normal patterns of life (or ecosystem) and extraordinary emergency interventions are required to save and preserve human lives and/or the environment. Disasters can either be manmade or natural, and either of slow or rapid onset. The objective of this work was to review disasters that have happened in Kenya in the last twenty five years in respect to their public health impact, community perceptions and preparedness. Results indicate that there is inadequate preparedness and responses despite the repetitive nature of specific disaster episodes. This may be due to economic, social, and cultural barriers prevent effective devolution of mitigating institutional and policy frameworks from central institutions to local communities.[...] Read More.

Keywords: Disasters, Kenya.

2019, 8(1), 1-6;

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Research Article

Determination of carnivores prey base by scat analysis in Samburu community group ranches in Kenya

William O. Ogara*, Nduhiu J. Gitahi Samuel A. Andanje, Nicolas Oguge, Dorcas W. Nduati and Alfred O. Mainga

Abstract: This study determined the prey base for four main carnivores found in Samburu community group ranches and grazing area, Lion (Panthera leo), Leopard ( Panthera pardus), Wild dog ( Lycaon pictus) and Hyaena ( Crocuta crocuta, and Hyaena hyaena). A total of 96 scat samples including, 8 from Lion, 16 Leopards’, 2 Wild dogs’, and 70 Hyaenas’ were collected, identified and microscopically analyzed for prey hair characterisation. At least 50 different hairs from every scat sample were mounted on slides and microscopically characterized using details from reference hairs. Hairs from 18 depredated species both domestic and wild ungulates were recovered from the scat samples. Predated species were identified, as either domestic (Cow, Sheep, Goat, Donkey, and Camel) or wild ungulate prey (Grant’s gazelle, plain Zebra, Grevy’s Zebra, Impala, Waterbuck, Dikdik, Eland, lesser Kudu, greater Kudu, Baboon, rock Hyraxes, Elephant and Oryx). The carnivores showed a relatively high kill of wild ungulate prey compared to domestic prey. Camel was the most preferred domestic animal by both the Lion and the leopard, while wild Dog and Hyaena preferred cow and donkey respectively. Grevy’s zebra contributed highest to the lion’s diet while the Plain zebra was most preferred by the leopard. Both the hyaena and the Wild dog had a preference for the waterbuck. The Hyaena had the highest domestic depredation, while all the other big cats depredated more on wild ungulates[...] Read More.

Keywords: Scat, group ranch, domestic, wild ungulate, prey, depredation.

2019, 8(1), 1-6;

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Research Article

Severity of ulcerative colitis in the study population in Iran in correlation with cigarette consumption

Heydari G., Tafti S. F.*, Alvanpour A., Talischi F., Mojhgani N., Mokri B. and Ashagh Hosseini S. M.

Abstract: Despite many studies correlating smoking with later onset of ulcerative colitis and probable decreased severity of disease, controversies still exist. This study evaluates correlation between smoking status and severity of ulcerative colitis among Iranian patients. This was a cross-sectional retrospective study. Patients with ulcerative colitis attending the Amir Alam Hospital gasteroenterology clinics in 2009 to 2010 were included. Smoking habits and severity of ulcerative colitis were evaluated depending on number of visits required to the clinic and related hospitalization in the past year, radiology results and pathology of patients. A total of 674 newly diagnosed and follow-up patients were included of which 304 (45.1%) individuals were men. Of these patients, 160 (23.7%) individuals were cigarette smokers. Nonsmokers on the average had 3.6 ± 1.8 and smokers 4.0 ± 1.4 visits per year (p = 0.02). Average number of hospitalizations per patient per year was 1.4 ± 1.1 for nonsmokers and 2.6 ± 0.7 for smokers (p < 0.000). Severity of illness in respect to pathology was stage 0 to 2 (mild) in 272 (40.4%) individuals and stages 3 and 4 (severe) in the remaining 402 (59.6%) individuals. Radiology showed mild disease in 270 (40.1%) and severe ulcerative colitis in 404 (59.9%) patients and the frequency was unrelated to gender or cigarette consumption. Unlike many studies from other countries severity of ulcerative colitis was not found to be correlated with smoking or nonsmoking status and average number of visits to physician or need for hospitalization were found to be higher in smokers which needs further studies for conclusions to be made.[...] Read More.

Keywords: Colitis, ulcerative, cigarette smoking, smoking cessation, severity of illness index.

2019, 8(1), 1-6;

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Research Article

Serum amyloid A protein, rheumatoid factor and lipid profile in relation to tobacco smoking in Saudi subjects

Al-Sieni A.* and Al-Abbasi F.

Abstract: Tobacco smoking is a major cause of many diseases, including lung cancer, cardiovascular disease, osteoporosis, aging and death. The associations between tobacco smoking, serum amyloid A (SAA) protein, rheumatoid factor (RF) and lipid profile were examined in 275 men that were divided into three groups according to their age (less than 20 years, 20 to 40 years and above 40 years), of which 91 were currently light cigarette smokers (less than 20 cigarettes/day), 91 were heavy smokers (20 cigarettes or more/day) and 93 had never smoked (control). As such, all men were part of a long-term survey and it was obtained that, heavy smokers had significantly higher SAA levels than light smokers or those who had never smoked at all (p < 0.01 and[...] Read More.

Keywords: Tobacco smoking, serum amyloid A protein, lipid profile, Saudi Arabia.

2019, 8(1), 1-6;

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Research Article

Comparative antimicrobial activities of some plant extracts and commercial antibiotics against some selected pathogens of food origin

Anibijuwon I. I.*, Abioye J. A. and Onifade A. K.

Abstract: The antimicrobial activities of three plants (Momordica charantia, Morinda lucida, and Hunteria umbellata) were investigated. These plants were extracted using methanol and ethanol as solvents. These extracts were used to evaluate the growth of five food borne bacteria namely; Bacillus sp, Proteus vulgaris, Streptococcus sp., Shigella sp., Lactobacillus sp., and the research revealed zones of inhibition ranging from 0 to 36 mm. The minimal inhibitory concentration (MIC) of the extracts ranged from 20 to 100 mg/ml; that of the ethanolic extract of Momordica charantia against Bacillus sp. being the lowest (20 mg/ml) and most effective and that of M. lucida being the highest (100 mg/ml) and least effective. Most of the extracts were merely inhibitory against the organisms except ethanolic extracts of H. umbellata and M. charantia against Bacillus sp., Streptococcus sp. and Lactobacillus sp. with the ethanolic extract of H. umbellata showing the lowest MBC of 40 mg/ml. The activity indices of the extracts were calculated and the highest activity index (2.818) was that of the ethanolic extract of M. charantia against co-trimazole using Bacillus sp. as the test organism. H. umbellata and M. charantia showed more promising potential as antimicrobial agents than M. lucida against foodborne pathogens and hence against enteric diseases. These effective plants should be purified and further assayed for toxicological activity and possible use as drugs or preservatives.[...] Read More.

Keywords: Antimicrobial activity, foodborne pathogens, Momordica charantia, Hunteria umbellata, Morinda lucida, commercial antibiotics, activity index.

2019, 8(1), 1-6;

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Research Article

Enhancing quality of healthcare under the national health insurance system: Identification of factors reducing quality of care in Taiwan

Li Chang

Abstract: This study examines whether the quality of community health in Taiwan has improved after the establishment of the National Health Insurance (NHI); to identify what the related factors are that affect the quality, and to find the possible ways to improve key drivers of healthcare quality. Data were collected from the National Health Insurance Annual Statistics Information Database and the Taipei Health Information Indices Database in the form of unbalanced panel of 153 hospital-years from 1989 to 2002 in 13 Taipei public hospitals within different districts. In addition, panel data analysis with fixed effects model was conducted to identify what factors affected the quality of healthcare before and after the advent of the NHI. After the NHI, quality of care improved insignificantly. The elderly, market competition, new technology, average length of stay (LOS), scale, physician density and nurse to patient ratio were all major factors affecting quality. Moreover, lower doctor density, longer LOS and increased in the number of elderly led to deterioration in the quality of care. The government could improve quality of elder-care by encouraging the re-building of three-generation family values. Policymakers should also permit public hospitals to institute the incentive programs for their professional staffs. In addition, quality could be improved by having hospital managers who enhance efficiency by decreasing the LOS.[...] Read More.

Keywords: Quality, drivers of quality, national health insurance.

2019, 8(1), 1-6;

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Research Article

Asymptomatic intestinal protozoan infections among inhabitants in Mexico City, Mexico

Takeshi Yoda,*, Takeshi Suzue , Tomohiro Hirao, Akira Yoshioka, Jarot Jazek Escobar Jimenes, Tetsuo Yanagi, Kazuo Minematsu, Kensuke Goto, Jephtha Christopher Nmor, Hiroshi Tachibana, Yasuyuki Rakue, Noriko Sakano, and Nobuyuki Miyatake

Abstract: Intestinal protozoan is still an important public health problem. We aimed to gain insight into the dynamics of intestinal protozoan infection with a view to describing the prevalence of intestinal protozoan in asymptomatic individuals in Mexico City, Mexico. The study population was primarily both in and out patients from four different hospitals who were referred for routine stool examination. Faecal specimens (510) were collected over a 3-weeks period from asymptomatic individuals. Specimens were tested for a range of protozoan infection using microscopic and partly Enzyme-Linked ImmunoSorbent Assay (ELISA) method. Seven known intestinal protozoan were identified from 54 faecal specimens, a total carriage rate of 10.6%. Blastocystis hominis were present in 22 specimens (4.31%), Entamoeba coli in 18(3.53%), Entamoeba disper in 8(1.57%), Entamoeba hartomanni in 2(0.39%), Giargia lambia in 2(0.39%), Iodoamoeba in 2(0.39%), and Endolimax nana in 1(0.2%). 10(2%) person were infected with two or more protozoa concurrently. These protozoa were all non-pathogenic, but are capable of discharging their cysts thus placing these asymptomatic carriers as potential distributors of intestinal protozoan infection. Considering the public health implication of asymptomatic carriers of intestinal protozoan infection, establishment of sustainable and regular de-worming programme in Mexico City coupled with health education messages on good hygienic practices are strongly recommend.[...] Read More.

Keywords: Blastocystis hominis, Mexico, Entamoeba, protozoan fecal.

2019, 8(1), 1-6;

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Review

Chikungunia outbreaks in new regions as a sign of ecological ill health: Re-examining vector borne disease in the context of climate change

R. Rajan Patil

Abstract: The Indian capital city of Delhi reported its first ever case of Chikungunya in June 2007. However, the way this case was detected, and reported raises serious issues related to general epidemiology and disease surveillance. This incident being the first reported case of Chikungunya from the resident of Delhi also raises much larger concern of changing infectious disease dynamics. The objectives of this study are: 1) Occurrence of new disease in new area should be treated as of sign of ecological ill health. Increase in frequency of outbreaks vector borne disease like Chikungunya in India could be manifestation of consequence of global warming.[...] Read More.

Keywords: Climate change, Chikungunya, global warming.

2019, 8(1), 1-6;

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Research Article

Prevalence and risk factors of postpartum depression and barriers to treatment: A literature review

Saleh Rahman, MD, Ph.D., MPH and Erin Manglardi, MPH

2019, 8(1), 1-6;

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Case Report

Immune reconstitution inflammatory syndrome: Case series from Abuja

Case Report

Abstract: There is paucity of information on immune reconstitution inflammatory syndrome in children in Nigeria. We reported two cases of IRIS in a 7 and 14 years HIV infected Nigerian boys managed at the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. Immune reconstitution inflammatory syndrome was diagnosed and managed in 4 out of 1,027 (0.38%) HIV positive paediatric patients started on antiretroviral therapy at the health institution over a 6 years period. Keywords: Immune reconstitution inflammatory syndrome, highly active antiretroviral therapy, Nigeria.[...] Read More.

Keywords: Immune reconstitution inflammatory syndrome, highly active antiretroviral therapy, Nigeria.

2019, 8(1), 1-6;

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Research Article

Some emerging issues in medical admission pattern in the tropics

O.O. Okunola, *A.A Akintunde, P. O. Akinwusi

Abstract: Infectious diseases are an important cause of morbidity and mortality in Sub-Saharan Africa. However, there is a changing pattern in terms of medical admissions worldwide with an alarming increase in the prevalence of non-communicable diseases (NCDs) especially in the tropics over the last decade. A regular review and audit of medical admissions is necessary for health policy formulation and resource allocation. The aim of this study was to describe the pattern of medical admission in a Nigerian University Teaching Hospital and highlight the emerging trend.A retrospective review of medical admission at the LAUTECH Teaching Hospital, Osogbo, South Western Nigeria over a 3 year period (January 2005 to December 2007). 1786 patients were admitted into the medical wards during the period of study. This consisted of 1089 males (61.0%) and 697 females (39.0%) with age range 14-96 years, mean of 51years (±16.89) and a male to female ratio of 1.5:1. Elderly subjects (≥ 60 years of age) were the largest age group accounting for 27.3% and 29.8% of male and female admissions respectively. The indications for admission in order of frequency were cerebrovascular disease 239 (27.5%), Diabetes mellitus 194 (22.2%), Chronic Kidney Disease 116 (12.4%) and Tuberculosis 151 (16.6%). NCDs accounted for a significant number of admissions in this study. The elderly constitued the major age group. Non communicable diseases are the commonest indication for medical admission. There is therefore an urgent need for intensification of existing preventive strategies to combat the insurgence of NCDs. Keywords: Tropics, Medical, Tuberculosis, Infectious diseases[...] Read More.

Keywords: Tropics, Medical, Tuberculosis, Infectious diseases

2019, 8(1), 1-6;

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Review

Childhood thumb sucking habit: the burden of a preventable problem!

Gupta B Indushekar, Bhavna Gupta and Indushekar KR

Abstract: Suckling is a physiological act that provides nourishment and comfort. A baby’s sucking can be either nutritive or nonnutritive. Nonnutritive sucking can turn into a continuous behavior practiced unconsciously, leading to a deleterious oral habit (eg, thumb sucking).The extent of damage caused by this habit is dependent on the duration, frequency and intensity. Till the age 3, this habit is termed to be normal but later certain intervention has to be taken. This habit can have a negative impact on speech, psychology and dental development (maxillary prognathism, increased overjet, mandibular retrognathism, posterior crossbite, midline diastema and open bite) of the child. A combined multidisciplinary team comprising of the Family physician, Speech therapist, psychologist, Pediatric dentist, Orthodontist, pediatrician and Orofacial mycologist is needed for the management and treatment planning of this delirious habit. Thumb sucking is a non meaningful habit commonly found in children. This habit can have a negative impact on speech, psychology and dental development (maxillary prognathism, increased overjet, mandibular retrognathism, posterior crossbite, midline diastema and open bite) of the child. This paper stresses upon the need of combined effort by the multidisciplinary team for the effective treatment planning.[...] Read More.

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2019, 8(1), 1-6;

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Research Article

Defining obesity using three anthropometric parameters, being components of two diagnostic criteria, amongst Nigerian women

Maxwell M. Nwegbu

Abstract: The study was to compare the results of obesity assessment as a component of metabolic syndrome diagnosis using two different diagnostic criteria amongst apparently healthy female adults. A hundred and twenty-six(126) adult females aged 40- 70 years were evaluated concurrently for obesity using waist circumference as defined by Adult Treatment Panel III(ATP III criteria), waist-hip ratio(WHR) and body mass index(BMI), the latter two as defined by the World Health Organization(WHO) criteria. These subjects were drawn from individuals attending the metabolic research unit of University College Hospital (a tertiary level referral health institution in Nigeria), for routine medical evaluation. The prevalence of obesity as defined by waist circumference using ATP III criteria was found to be 31.7%, whereas prevalence rates using WHR and BMI under WHO criteria were 21.4% and 23.8% respectively amongst the subjects. These findings on correlation analysis, showed a strong level of association between the three parameters as indices of obesity with the strongest agreement noted between BMI and WC(r=0.878) This study showed a good measure of agreement in the assessment of obesity in these female subjects when two major diagnostic criteria are applied. This is especially important in view of the lack of national surveys to arrive at ethno-specific and gender-based cut-offs for anthropometric measurements such as WC and WHR specific to our environment. Obesity being a major criterion in both the ATP III and WHO criteria for diagnosing metabolic syndrome, these findings have implications in this environment given the importance of screening for metabolic syndrome and/or obesity vis-à-vis their roles as cardiovascular risk factors. Keywords: Obesity, anthropometric, metabolic, cardiovascular, correlation.[...] Read More.

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2019, 8(1), 1-6;

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Research Article

Predictive equations for estimation of stature from knee height, arm span, and sitting height in Indonesian Javanese elderly people

Fatmah

Abstract: The purpose of this study was to develop the predictive equations for estimation of stature, using knee height, arm span and sitting height in Indonesian Javanese elderly people. Eight-hundred and twelve healthy elderly people (295 men and 517 women) participated in this cross sectional study. Standing height, weight, knee height, arm span and sitting height were measured. The Chumlea and Eleanor equations were validated in this study. The first equation showed that the mean difference of predicted height compared to actual height in men was 2.78 and 4.90 cm in women. The second equation revealed that the value of difference in men was 2.87 cm and in women was 13.26 cm. Arm span showed the highest correlation with standing height on men (r = 0.815) and women (r = 0.754). Aging was associated with decreased mean of height, weight, arm span and sitting height, but not on knee height in the two sexes. Arm span has the highest validity to predict stature on healthy Javanese elderly people. The correlation coefficient of arm span to actual height was larger on men than women. Stature of Indonesian Javanese elderly people can be estimated by the regression model from the three predictors developed in the study.[...] Read More.

Keywords: Elderly, knee height, arm span, sitting height, Chumlea, Eleanor.

2019, 8(1), 1-6;

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Research Article

Chromium and copper in toenails of some Kano inhabitants

J. T. Ayodele* and I. C. Ajala

Abstract: Toenail chromium and copper concentrations in toenails of some inhabitants resident in Kano for at least six months were assessed by atomic absorption spectrometry. Average toenail chromium and copper concentrations were 1.33 ± 0.68 and 27.62 ± 13.29 µg/g respectively. Both chromium and copper concentrations in nails decreased with age indicating that these metals may be playing some physiological functions during the formative years. Their concentrations were inversely related to age with approximate average of 10% decline with each decade of age.[...] Read More.

Keywords: Chromium, copper, toenails, Kano, Nigeria.

2019, 8(1), 1-6;

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International Journal of Public Health and Epidemiology