Public Health

  • Public Health aspects of Cesarean section including overuse and underuse of the procedure

    Caesarean section (CS) is lifesaving medical procedure that is able to avert both maternal and neonatal mortality. However, across the globe an estimated 3.2 million necessary CSs do not happen in low income countries and an estimate of 6.2 million unnecessary CSs happen in middle and high income countries. The overuse and underuse of this procedure driven by both the supply-side (such as resources within the health system, healthcare policy and strategies, health financing systems and perceptions of the healthcare professional) and demand-side (such as socio-economic status, population preference and perceptions and trust in health system) determinants. There are stark inequities in CS rates between and within regions and countries. Many regions across the globe (Eastern Asia, Northern Europe, Central America, Southern America, Northern America and Oceania) have over double recommended optimal rates, whereas several African regions (Eastern, Middle and Western) have dangerously low rates. Both of these have detrimental impacts on maternal and neonatal outcomes. There is a need now for health policy and decision makers at both national and facility level to try and optimize the CS rates through facilitating strategies that promote positive human relations and encourage standardized evidence based care.

  • Should We Build Our School Here? Children’s Level of Fitness, School Site-Typology and the Built Environment

    Background: No prior studies have assessed the relationship of school-sites with children’s fitness, nor evaluated how it is influenced by types of built environments surrounding school-sites. Purpose: To create a typology of school-sites and assess their associations, with school-level cardiorespiratory fitness (PACER score), as well as 34 environmental measures, reflecting food retailers and parks. Methods: PACER scores (#laps) were obtained on 20,900 children, 5-18 years-old, attending 103 rural and urban public schools in Wisconsin 2009-2010. Scores were aggregated at the school-level (mean 25.2±10.5). School-site typology reflects walkability context and parcel size. Schools were classified as: Neighborhood-School, Neighborhood-Campus, Neighborhood-Suburban, or Campus-School. Geospatial and linear regression were performed , overall and by sex and age strata, using a 1600-meter circular buffer around each school. Associations with school-level-PACER score were assessed for school types; density of unhealthy and healthier food retailers; and types of parks. Results: Campus-Schools predict a school average-PACER 7 laps significantly higher than Neighborhood-schools. ‘Neighborhood-Campus’ showed the lowest PACER for males and 11-13 years-old (10 and 12 laps lower). Negatively correlated with average-PACER were, unhealthy convenience stores for both sex, large parks for females. More fast-casual restaurants predict higher average-PACER. Schools with more students predict higher average-PACER for males and 6-10 years-old. Conclusion: Among Wisconsin schools, school-site and its context are associated with children’s physical fitness, suggesting that school-siting should include a health benefit analyses in the process. This study demonstrates the utility of school-level PACER scores and suggests further study of the mechanisms by which children’s fitness is influenced by food retailers around school zones.

  • Assessment The Role Of Motivation On Technicians And Teaching Assistants Performance In College Of Medical Technology In Derna City, Libya

    Background: Motivation is crucial for organizations to function; without motivation the organization would be less efficient. Objective: To assess the role of motivation on technicians and teaching assistants performance in College of Medical Technology in Derna, city. Methodology: A cross- sectional design was used to conduct the study. The target population of the study was technicians and teaching assistants working in College of Medical Technology. Data was collected using a questionnaire and analyzed by percentage, mean, range, rank, frequency and standard deviation. Results: Among 39 study sample 11 were male and 28 were female. Most of them were within age group of 21- 30 years (87.18%). The study reveals that, “training” was ranked first as the most important motivational factor, followed by second rank was shared between “salary and job security”. Few of the study sample received incentives in form of financial incentive, clothing allowance, phone and petrol cards. And said the incentive has a positive impact on job performance. All participants said would do better job if they were motivated. Conclusion: The findings of this study indicate that motivational factors such as “training, salary, and job security” are major motivational factors, which can lead to better services delivery in the college as it brings positive results on the technicians and teaching assistant’s performance. The study also revealed that incentives available to technicians and teaching assistants in the college are inadequate.

  • A quasi experiment to implementing standard multimodal strategy to improve hand hygiene behavior in a healthcare facility in central Saudi Arabia

    Hand hygiene (HH) compliance of healthcare workers (HCWs) remains suboptimal despite standard multimodal promotion, and evidence for the effectiveness of novel interventions is urgently needed. Aim: Improve HCWs’ HH compliance toward minimizing healthcare associated infection (HCAI) risk in Wadi Al Dawasir Hospital (WDH), central Kingdom of Saudi Arabia (KSA). Methodology: A quasi experimental approach was adopted to achieve study aim. The HCWs’ behavior of HH during the duration between 2015 and 2016 was evaluated before and after a HH educational plan based on the World Health Organization (WHO) “Multimodal HH Improvement Strategy” (MMHHIS). The HCWs’ compliance in response to HH indications represented by the WHO’s “My 5-Moments for HH” and the type of HH action taken, whether hand washing (HW) or hand-rubbing (HR) were analyzed. Results: The number of opportunities observed of HH performance accounted 230 in 2015 (pre-education), and 237 in 2016 (post-education). The HCWs’ HH compliance rate in the pre-education phase did not vary by the 5-moment indications [χ2(df 4) = 0.01, p=0.98]. Conversely, the compliance rate after HH education was higher than non-compliance across all 5-moment indication opportunities (ranged between 57.0% up –to 88.9%) [χ2(df 1) =18.25, p

  • Risk Factors of Pregnancy-Induced Hypertension in Block Hazratbal of District Srinagar, Jammu and Kashmir- a Prospective Longitudinal Study

    INTRODUCTION:The term Pregnancy induced hypertension (PIH) refers to a disorder of blood pressure that arises because of the state of pregnancy. PIH is defined as new onset hypertension with or without significant proteinuria emerging after 20 weeks of gestation, during labour, or in first 48 hours post-partum. Objectives:To find out the risk factors of PIH in block Hazratbal, Srinagar. METHODOLOGY:A Community based longitudinal study was conducted in Block Hazratbal (District Srinagar) for a period of 18 months. All the pregnant females attending the antenatal clinic at the subcenters and PHCs were included in the study and assessed for eligibility. The pregnant women enrolled in the study were examined again around 30 weeks, 37 weeks and once in postnatal period. The information was collected from the study subjects on the basis of pretested semi- structured questionnaire regarding age, educational status, income per capta, occupation, family history of PIH, history of (H/O) hypertension in any family member, H/O addiction, physical activity, gravidity, parity, time since last child birth, H/O PIH in previous pregnancy, height, weight, anemia, edema, gestational age at delivery, fetal gender mode of delivery. RESULTS: Incidence of PIH increased with increasing age and was much higher among those study subjects who had a history of PIH in the previous pregnancy, who had a family H/O PIH, who delivered twins, who had a H/O hypertension in any family member, who had edema at baseline examination and who delivered male babies. DISCUSSION AND CONCLUSION: Risk factors of PIH include increasing age, H/O PIH in past, family H/O PIH, family H/O hypertension, male gender of fetus, twin pregnancy and edema in early pregnancy. PIH is a major cause of perinatal mortality, preterm delivery, IUGR, and maternal morbidity and mortality. Awareness about PIH and its risk factors among females and health care workers must…

  • Community Based Assessment of Bed Bug Infestation Status in Arba Minch Zuria Woreda, Southern Ethiopia

    Introduction: Bedbug infestations have become a serious problem in housing dueto their crawling and blood sucking activities. Objective: This study was aimed to assess the infestation status and public health importance of bed bug infestation in low income communities at household level. Methods: A community based cross-sectional study was conducted between January and February, 2018 on 721 housuholds in Arba Minch zuria Woreda, Southern Ethiopia with random sampling technique. Data collection was undertaken on knowledge and attitude about bed bug and bedbug infestation health impacts and factors for the infestation and control practices used were collected with well prepared questionnaire and standard observational check. Results: From all inspected materials, 97% infestation were on wall and sleeping and mosquito bed nets. The left materials relatively infested less were arm chair (2.76%) and other materials (0.89%) found in the house of the participants. About 31% and 15% participants reported bed bug infestation prohibited from using mosquito nets and cause thyphoid respectively. The left 55 % of participants reported the infestation causes wounds, itching, lossing rest and skin lesion. 98.1% of the participants have a knowledge about bed bug, blood sucking insects and 44% of respondents believed in insecticide nets increases the infestation. 72.5% household are using together hot water (42.28%) and ajjacks with water (30.2%) followed by 18.8% chemicals to control infestation. Omo soap, sun lights and plants were optional mechanisms of infestation controls. Conclusion: Bedbugs resurgences and its related factors are being considered as public health problem in Ethiopia. More researches focusing on bed bug biology and epidemiology are required establish a new prevention, treatment, control options and public health response.

  • Change of pain threshold in patients with muscle disorder subjected to conservative treatment

    Temporomandibular Disorder (TMD) is a clinical syndrome that mainly affects the masticatory muscles and temporomandibular joints (TMJ). The manual palpation is the most used clinical method to evaluate the muscle pain and is considered an important part of the clinical examination. The pressure algometry is used to verify the initial threshold of myofascial pain perception in the temporomandibular disorder. The purpose of this research was to evaluate the pain threshold change in patients with muscle-type TMD before and after the conservative treatment. Twenty seven volunteers were screened according to the Research Diagnostic Criteria (RDC/TMD), and 14 had muscle TMD and 13 with absence of TMD (control group). Measurements were taken with the pressure algometer in every patient in temporal and masseter muscles in order to quantify the response to the patient painful stimulus. After the proposed treatment the patient was scheduled to return in 7,14, 28 and 56 days. Therefore, it resulted in 18 patients for the study. The algometer comparison between the groups treated before and after the care, showed an initial value (in KgF) of 0.827 ± 0.405 and final of 1.416 ± 0.745, p

  • Assessing the quality of the Acute Flaccid Paralysis surveillance system in Edo state, Nigeria 2017

    This paper accesses the quality of the Acute Flaccid Paralysis (AFP) surveillance system in Edo state using the May/June 2017 Rapid Surveillance Assessment tool for reviewing existing surveillance systems. This was a descriptive cross-sectional study involving the Disease surveillance and notification officers (DSNOs), and their assistants (ADSNOs) in all 18 Local Government Areas (LGAs). All the surveillance officers were 100% knowledgeable on the AFP case definition. About, 94% of the ADSNOs knew how the AFP stool specimens were transported. Only 75% and 50% of the DSNOs and ADSNOs respectively could mention all seven AFP differential diagnosis stated in the AFP surveillance guidelines. Active surveillance was conducted by 89% of the DSNOs in their respective LGAs within the last six months prior to this study. Only 22% of the ADSNOs were actively involved in surveillance activities. Records of documentation of AFP surveillance activities dating as far back as three years were readily available at the offices of 90% of the DSNOs and with the state epidemiologist. Edo state has shown attributes of a quality surveillance system in terms of knowledge, AFP surveillance and documentation. We however encourage a surveillance system that is more inclusive with active participation from the ADSNOs.

  • Food/Drinking Water Contaminants/Adulterants in Bangladesh

    Food adulteration and contamination is nothing new in this age. It is the consequence of modern civilization, people moving from places with altered social value and ethics, industrialization and rapid progression of economic activities. It is highly prominent in urban areas of many developed or underdeveloped countries and so is with in Dhaka city. Commercialism and business mind drive people toward such unethical activities knowingly or unknowingly. Most of the cases it is done by uneducated or illiterate people, having least idea about what evil they are doing to mankind. People who are health conscious mostly avoid these but many of them have to go with this because of busy life schedule or carelessness. By definition, safe food or drink means pollutants or adulterants presence within the limit of standard such as pathogenic micro-organisms, natural toxins and potentially harmful chemicals that may cause health hazards beyond certain limit, either deliberately added or naturally present in them. Again, the economic development of the country doesn’t reveal basic literacy and awareness of general people. Necessary steps should be taken by the authority and mass people should change their mind set up and have to avoid those who creates harm. Purpose of the study: Brief review of chemical induced food and drinking contamination, their consequences and control. Healthcare providers/Policy makers have a major role play to concerned field. Findings: Both general people and the old system, are responsible for this unlivable condition of Bangladesh. Population is not the sole for this instance. A sense of poor rules and regulation is always found everywhere. Negligence is becoming a wide spread disease contaminating illiterate to well educated, all kind of people.Research limitations: Many articles and documents found in concerned area of research, but the scope of this research is on its focus point chemical induced…

  • Enigmatic Domination of Chemical Contaminants and Pollutants in the Measurable Life of Dhaka City

    Background Environmental pollution and food contamination are as old as the civilization itself. It is the result of the improvement of civilization, over usage of nature, industrialization and in certainty a cost for the advancement. It is exceedingly conspicuous in Dhaka city. Air pollution is chiefly because of the vehicle emanation, modern release and consuming of non-renewable energy source. The water asset of Dhaka turns into a noteworthy wellbeing danger because of arsenic contamination, insufficient family unit/modern/restorative waste transfer and mechanical emanating the executives. Food contamination originated from the commercialism of specialists who are doing this purposely to augment benefit. Fundamental advances are to be taken to secure nature for our own reality. This paper uncovers compound pollution and contamination issues of Dhaka city, the capital of Bangladesh. Purpose of the Study: Brief review of chemical induced pollution and contamination, their consequences and control. Healthcare providers/Policy makers have a major role play to the concerned field. Materials and Methods: Comprehensive literature search followed by consulting healthcare professionals about environmental pollution and food contamination. Hospital, clinic and company personnel, newspaper journalists, NGO workers given their valuable suggestions and asked help for necessary books, journal, newsletters. A few western magazine and newspapers also observed to get the necessary concern. Projections were based on public life pattern, their food habits, pollution and contamination sources, waste disposal features of urban life as well as industry and hospital waste disposals.Results and Discussion: Pollution and adulteration are the most notorious enemy of mankind. Civilization has its own drawback that even causing destruction of itself. Very few people raised voice on this but crippled by the facts of commercialism. The scope of this article is limited to chemical pollution of air and water, medical or household waste products and food contaminants and adulterants. A few discussions based…