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American Journal of Public Health Research

ISSN (Print): 2327-669X

ISSN (Online): 2327-6703

Website: http://www.sciepub.com/journal/AJPHR

Article

Stress, a Major Determinant of Nutritional and Health Status

1Institute of Agricultural Research and Training, Apata, Ibadan, Nigeria. University of Ibadan, Nigeria


American Journal of Public Health Research. 2015, 3(1), 15-20
DOI: 10.12691/ajphr-3-1-3
Copyright © 2015 Science and Education Publishing

Cite this paper:
Paulina Oludoyin ADENIYI. Stress, a Major Determinant of Nutritional and Health Status. American Journal of Public Health Research. 2015; 3(1):15-20. doi: 10.12691/ajphr-3-1-3.

Correspondence to: Paulina  Oludoyin ADENIYI, Institute of Agricultural Research and Training, Apata, Ibadan, Nigeria. University of Ibadan, Nigeria. Email: doyinadeniyi@yahoo.com

Abstract

The continual desire to thrive against all odds even with the current global economic and other livelihood challenges coupled with various natural and man-made disasters has subjected humanity incessantly to physical, physiological and psychological stress traceable to different etiologic stressors. This has consequently resulted into increasing prevalence in stress and stress-related diseases worldwide. Hence, this paper reviews stress as it relates to appetite, digestion, nutrient metabolism, immunity and other diseases with a view of creating public awareness on this concept and the possible stress management techniques. The search engines used are HINARI, PubMED and Google Scholar. Stress can have both orexigenic and anorexigenic effect thus influencing appetite and food intake via the metabolic activities of glucocorticiods and Neuropeptide Y commonly produced during a fight-or-flight response to stress. Vagus nerve activation which occurs during stress directly and profoundly influences metabolic responses to food via altered digestion, absorption and metabolism of nutrients thus pre-disposing the body to malnutrition. Glucocorticoids may adversely affect immune system by suppressing the helper T-cells and over-expressing the T suppressor cells thus inhibiting the body’s defence mechanism against both infectious and non-infectious diseases. More still, glucocorticoids have been implicated in the pathogenesis of diabetes via increased hepatic blood glucose by increased gluconeogenesis and may exacerbate or inhibit tumorigenicity in cancer progression. Regular exercise, healthy diet, deep breath exercise, adequate sleep and limiting exposure to stressors if possible are generally effective in coping with stress and managing stress.

Keywords

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Article

Socio-Demographic Factors Influencing Maternal and Child Health Service Utilization in Mwingi; A Rural Semi-Arid District in Kenya

1Department of Environmental Health, University of Kabianga, Kericho, Kenya

2Department of Public Health, Maseno University, Kisumu , Kenya

3Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya


American Journal of Public Health Research. 2015, 3(1), 21-30
DOI: 10.12691/ajphr-3-1-4
Copyright © 2015 Science and Education Publishing

Cite this paper:
Japheth M. Nzioki, Rosebella O. Onyango, James H. Ombaka. Socio-Demographic Factors Influencing Maternal and Child Health Service Utilization in Mwingi; A Rural Semi-Arid District in Kenya. American Journal of Public Health Research. 2015; 3(1):21-30. doi: 10.12691/ajphr-3-1-4.

Correspondence to: James  H. Ombaka, Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya. Email: nziokimativo@gmail.com

Abstract

By the end of this year (2015), Kenya is expected to meet the targets of Millennium Development Goals number 4 and 5 among others. Available evidence suggests that utilization of Maternal and Child Health services is critical in realization of these goals. The aim of this study was to explore the socio-demographic factors influencing Maternal and Child Health service utilization in Mwingi district. This was a descriptive cross-sectional study. Data was collected from a sample of 416 women. Variables of interest were; socio-demographic variables and selected MCH service utilization indicators. Binary logistic regression model was used to assess the influence of socio demographic characteristics on MCH service utilization. Results indicated that Women who sought WHO recommended Antenatal Care services (at least 4 visits) were 38.9%, 47% delivered assisted by Skilled Birth Attendants , 46.2% sought postpartum care within 2 days after delivery, 88.7% ensured their children completed routine immunizations in time and 35.6% used modern family planning within 6 weeks after postpartum. Women with secondary education and above, women in households earning more than 1 US Dollar in a day and women in employment or operating a business were more likely to utilize MCH services. Women over 26 years of age and these with 3 children and above were less likely to utilize MCH services with exception of utilization of Family Planning services in which Women with 3 children and above were more likely to utilize Family Planning services compared to these with 2 children and below. Increasing the number of women with secondary level of education and above, creating initiatives to economically empower people especially these living in rural semi-arid regions, and developing and implementing age specific health education programs may improve utilization of MCH services in Mwingi district and other semi- arid regions in Kenya.

Keywords

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Article

The Practice of Medical Referral: Ethical Concerns

1Department of Family Medicine, Delta State University Teaching Hospital, Oghara, Oghara, Nigeria

2Department of Obstetrics and Gynaecology, Delta State University Teaching Hospital, Oghara, Oghara, Nigeria


American Journal of Public Health Research. 2015, 3(1), 31-35
DOI: 10.12691/ajphr-3-1-5
Copyright © 2015 Science and Education Publishing

Cite this paper:
Anyanwu E. B., Abedi Harrison O., Onohwakpor Efe A.. The Practice of Medical Referral: Ethical Concerns. American Journal of Public Health Research. 2015; 3(1):31-35. doi: 10.12691/ajphr-3-1-5.

Correspondence to: Anyanwu  E. B., Department of Family Medicine, Delta State University Teaching Hospital, Oghara, Oghara, Nigeria. Email: ebirian@yahoo.com

Abstract

Medical referral is the act of sending a patient by one professional care giver to another, who may be a specialist and therefore be more knowledgeable in the diagnosing and further management of the patient. Most cases of referral of patients is therefore for proper diagnosis, adequate investigations and their proper treatment by the receiving specialists. It is mostly assumed and believed that patients depend on the medical information available to their health care providers. Therefore, the need for a referral, its appropriatness, timing and to whom the referral is made to mostly depends on the attending physician. This should be done after due consultation with the patients family and appropriate consent obtained. It is believed that a health practitioner should make a referral when he thinks that it will be of benefit to the patient and not when he wants to avoid the challenges of unraveling the patients’ complex problems. Also, referral should not be made to avoid possible death of the patient in a hospital so as not to worsen its statistics. Unfortunately, the seemingly good intention of referring of patients may cause a conflict of interests when physicians because of inherent financial gains refer patients to facilities that they own or have investment interest in. Such referral challenges as self-referral, and fee-splitting whereby a fee is paid to one physician by another for a referral is unethical, and are known to occur. Several “Anti-referral Laws” have subsequently been set up to prevent such actions and protect patients against abuse by health workers.

Keywords

References

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Article

Perceived Sexual and Reproductive Health Needs and Service Utilization among Higher Secondary School Students in Urban Nepal

1James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh

2Department of Public Health and Informatics, Bangabandhu Sheikh, Mujib Medical University, Shahbag, Dhaka, Bangladesh

3Pokhara University Research Center (PURC), Pokhara University, Nepal

4Fulbright Student Researcher

5BRAC Institute of Global Health, BRAC University Mohakali, Dhaka, Bangladesh

6Institute of Medicine, Maharajgunj Medical Campus, Tribhuwan University, Kathmandu, Nepal


American Journal of Public Health Research. 2015, 3(2), 36-45
DOI: 10.12691/ajphr-3-2-1
Copyright © 2015 Science and Education Publishing

Cite this paper:
Kiran Bam, Fariha Haseen, Rajendra Kumar BC, M. Sophia Newman, Asiful Haider Chaudhary, Rajshree Thapa, Ismat Bhuyia. Perceived Sexual and Reproductive Health Needs and Service Utilization among Higher Secondary School Students in Urban Nepal. American Journal of Public Health Research. 2015; 3(2):36-45. doi: 10.12691/ajphr-3-2-1.

Correspondence to: Kiran  Bam, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh. Email: bam.kiran@gmail.com

Abstract

Introduction: Adolescent sexual and reproductive health (ASRH) is best addressed through the promotion of responsible, healthy behavior and the provision of age-appropriate services. This study aimed to assess Nepali adolescents’ perceived ASRH service needs and factors influencing their utilization of ASRH services. Methodology: This descriptive cross-sectional quantitative study was based on a structured, self-administered questionnaire of adolescents aged 15-19 (n = 338) in three government-run higher secondary schools in Bhaktapur, Nepal. Descriptive data was used to summarize socio demographics, sexual activity, and awareness and usage of SRH services. Chi-square and Fisher’s exact tests and binary logistical regression modeling were used to identify factors influencing ASRH service utilization. Results: ASRH service utilization was 9.2% among all respondents. Service utilization was lower among female (4.3%) than males (12.5%). Fifteen percent of students had ever felt a need to access ASRH services, a larger percentage than those who had accessed ASRH services (9.2%). Almost 37% intend to utilize ASRH services in the future. Students attending secondary schools that included ASRH in the school’s health services were 15 times more likely to utilize ASRH services(Adjusted OR: 14.85). The distance from health facility (Adjusted OR: 12.80) and being sexually active within 12 months (Adjusted OR: 10.31) were found to be associated with ASRH service utilization. Those who perceived barriers to services were more likely to utilize the services (Adjusted OR: 7.05).Lack of confidential services was the biggest barrier (71.4%),while friend and peer group influence (86.7%) was a major motivator to access ASRH services. Conclusion: ASRH service utilization among the adolescents is very low, with a gap between perceived needs and service utilization. Students who have accessed ASRH services are more likely to report that they perceived barriers, demonstrating that logistical difficulties may be considerable. Accessibility should be expanded.

Keywords

References

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Article

Systemic Lupus Erythematosus: some Epidemiological and Clinical Aspects

1Department of Paraclinical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago

2San Fernando General Hospital, San Fernando, Trinidad and Tobago


American Journal of Public Health Research. 2015, 3(2), 46-50
DOI: 10.12691/ajphr-3-2-2
Copyright © 2015 Science and Education Publishing

Cite this paper:
Angel Justiz-Vaillant, Patrick E. Akpaka, Peter Poonking. Systemic Lupus Erythematosus: some Epidemiological and Clinical Aspects. American Journal of Public Health Research. 2015; 3(2):46-50. doi: 10.12691/ajphr-3-2-2.

Correspondence to: Angel  Justiz-Vaillant, Department of Paraclinical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago. Email: Angel.Vaillant@sta.uwi.edu

Abstract

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with a wide array of clinical manifestations including rash, photosensitivity, oral ulcers, arthritis, serositis, glomerulonephritis among others clinical findings. In this paper we globally summarized the most important epidemiological and clinical aspects to bear in mind, when the time comes to make the diagnosis of this rheumatic disorder and its management. Factor that are involved in the SLE pathogenesis and novel treatment options are mentioned.

Keywords

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Article

Sexual History, Behaviour and Practice of HIV/AIDS Prevention among Recruits of Depot Nigeria Army, Zaria-Nigeria

1Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

2Department of Community Medicine, Kaduna State University, Kaduna, Nigeria

3Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria


American Journal of Public Health Research. 2015, 3(2), 51-55
DOI: 10.12691/ajphr-3-2-3
Copyright © 2015 Science and Education Publishing

Cite this paper:
ChineduJohn-Camillus IGBOANUSI, IstifanusAnekoson JOSHUA, Tukur DAHIRU. Sexual History, Behaviour and Practice of HIV/AIDS Prevention among Recruits of Depot Nigeria Army, Zaria-Nigeria. American Journal of Public Health Research. 2015; 3(2):51-55. doi: 10.12691/ajphr-3-2-3.

Correspondence to: ChineduJohn-Camillus  IGBOANUSI, Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Email: chinedujc@yahoo.com

Abstract

Background: Among Nigerian Military Personnel (NMP), HIV prevalence has been reported to be higher than in the general population due to several factors. Data on HIV among the military are difficult to obtain and comprehensive program for the military in Sub-Saharan Africa were not well coordinated. This study assessed sexual history, behavior and practice of HIV/AIDS prevention among military recruits at Depot Nigeria Army in Zaria Nigeria. Materials and Methods: It was a cross sectional descriptive study carried out on February, 2011 with a sample of 300 army recruits selected by a stratified random sampling technique. Information on socio-demographic characteristics, sexual history, behavior and practice of HIV/AIDS prevention were collected using structured, self–administered questionnaire, and blood samples collected were screened using Determine® and and Uni-gold® test kits for HIV antibodies. Stat pak® test kit was used as a tie-breaker. The data collected were cleaned and entered into SPSS version 15.0 and results presented in tables and statistical significance was set at p <0.05. Results: The age range of the respondents was 17 – 29 years, with mean age of 29 ±1.9 years and male: female ratio of 2.8:1. Majority (93.0%) were single with mean age at sexual debut of 15 years and 40.0% had coitus a month prior to the time of the study. About 21.0% satisfied their sexual urge by having sex with their partners. Two-thirds had used male condom before out of which 29.7% had problems such as reduced sexual urge (16.7%), burst condom (11.3%) among others. The results of the HIV screening for all the respondents were negative for both HIV-1 and HIV-2. Conclusion: The sexual history, behavior and HIV/AIDS prevention among the military recruits showed mixed picture and the HIV screening results were negative for HIV 1 and HIV 2. There is need to have a well-coordinated HIV/AIDS prevention program that is multi-disciplinary and innovative among others to ensure the recruits remain negative for HIV.

Keywords

References

[1]  United Nations AIDS: UNAIDS 2005 Report on the global AIDS epidemic. http://www.unaids.org, (Accessed on January 20, 2015)
 
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[15]  Zaria census figures. Nigerian National population commission. 2006 National Census.
 
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Article

Maxillofacial Fractures in Makka City in Saudi Arabia; an 8-year Review of Practice

1Umm Alqura University, Oral Maxillofacial Surgery Department, Saudi Arabia / Consultant at Alnoor Specialist Hospital

2Oral Maxillofacial Surgery Department, Alnoor Specialist Hospital


American Journal of Public Health Research. 2015, 3(2), 56-59
DOI: 10.12691/ajphr-3-2-4
Copyright © 2015 Science and Education Publishing

Cite this paper:
Mazen Almasri, Dina Amin, Anas F AboOla, Jamil Shargawi. Maxillofacial Fractures in Makka City in Saudi Arabia; an 8-year Review of Practice. American Journal of Public Health Research. 2015; 3(2):56-59. doi: 10.12691/ajphr-3-2-4.

Correspondence to: Mazen  Almasri, Umm Alqura University, Oral Maxillofacial Surgery Department, Saudi Arabia / Consultant at Alnoor Specialist Hospital. Email: mazen_ajm@yahoo.com

Abstract

Objective: to review the practice of maxillofacial trauma surgery in Makka city, Saudi Arabia, as road traffic accidents is considered a major cause of morbidity and mortality in the kingdom. Materials and methods: a chart review of all the maxillofacial trauma cases that visited the major hospital in the city, Alnoor specialist hospital (NSH), from October 2005 to October 2013 was collected. A total of 1132 patients’ records were retrieved. Amongst, 965 maxillofacial injuries were included in the study as completed information was found. Charts of incomplete records, soft tissue injuries only, or solitary dental injury were excluded. Then, pertinent information such as age, gender, residence status, and fracture pattern were extracted, tabulated, and correlated. Results: it was presented that males were affected four times more than females (ratio of 4.4:1), of an age ranged from 3 years old to 97 with a mean of 51 years old, and patients of 1 to 16 years old counting 135 cases (11.9%), while the age between 17 – 45 years counting 856 (75.7%), and the age 46 – 97 counting 139 (12.3%). The majority of injuries was involving the lower facial third (mandible) by 523 cases (54.19%), then the middle third that include Zygomatic maxillary complex (ZMC) by 399 cases (41.3%; p=0.006), orbital floor by 25 cases (2.5%), and upper third (nasal, ethmoid, orbital, and frontal bar) fractures of 18 cases (1.8%). The ratio of Saudi patients to non Saudi was found to be 1.89:1. Conclusion: The maxillofacial injuries in Makka city are mainly affecting male patients aged between 17-45 years old with the mandible and middle face fractures being most commonly injured respectively.

Keywords

References

[1]  Mazen Almasri. Severity and Causality of Maxillofacial Injuries in the Southern region of Saudi Arabia, The Saudi Dental Journal. 2013; 25: 107-110.
 
[2]  Walid Abdulla, Khalid Almutairi, Yasir AlAli, Abdulla Alsughair, Abdulla Ashnwani. Patterns and etiology of maxillofacial fractures in Riyadh city, Saudi Arabia, Saudi Dental J. 2013; 25: 33-38.
 
[3]  Rabi A.G., Khateery S.M. Maxillofacial trauma in al madina region of Saudi Arabia: a 5-year retrospective study. Asian J. Oral Maxillofac. Surg. 2002; 14(1), 10-14.
 
[4]  Motamedi, M.H. An assessment of maxillofacial fractures: a 5- year study of 237 patients. J. Oral Maxillofac. Surg. 2003; 61(1), 61-64.
 
[5]  Heckle W, Hausberger K, Sailer R, Ulmer H, Gassner R. Prevelance of cervical spine injuriesin patients with facial trauma, Oral surg oral med oral path oral radio endodon. 2001; 92(4): 370-376.
 
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[7]  Gusztav, Klenk, Adam, Kovacs. Etiology and patterns of facial fractures in the United Arab Emirates. J. Craniofac. Surg. 2003; 14(1), 78-84.
 
[8]  Ozkaya O., Turgut G., Kayali M.U., Ug ̆ urlu K., Kuran I., Babs L. A retrospective study on the epidemiology and treatment of maxillofacial fractures. Ulus Travma Acil Cerrahi Derg. 2009; 15(3), 262-266.
 
[9]  Maliska M.C.S., Lima ju ́nior S.M., Gil J.N. Analysis of 185 maxillofacial fractures in the state of Santa Catarina, Brazil. Oral Res. 2009; 23(3), 268-274.
 
[10]  Metcalfe D, Boumara O, Parsons NR, Aletari MO, Lecky FE, Costa ML. Effect of regional truma centralization on volume, injury severity and outcomesof injured patientsadmitted to trauma centers, British J of surgery. 2014; 101(8): 959-64.
 
[11]  Gassner R., Tuli T., Ha ̈ chl O., Rudisch A, Ulmer H. Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J. Craniomaxillofac. Surg. 2003;31(1), 51-61.
 
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Article

Assessment of Factors Affecting Art Adherence among People Living with Human Immune Virus in Bale Robe Hospital, South East Ethiopia

1Department of Public Health, College of Medicine and Health Science, Madawalabu University, Bale Goba, Ethiopia


American Journal of Public Health Research. 2015, 3(2), 60-67
DOI: 10.12691/ajphr-3-2-5
Copyright © 2015 Science and Education Publishing

Cite this paper:
Ahmed Yasin Mohammed, Muktar Beshir Ahmed, Tomas Benti Tefera. Assessment of Factors Affecting Art Adherence among People Living with Human Immune Virus in Bale Robe Hospital, South East Ethiopia. American Journal of Public Health Research. 2015; 3(2):60-67. doi: 10.12691/ajphr-3-2-5.

Correspondence to: Ahmed  Yasin Mohammed, Department of Public Health, College of Medicine and Health Science, Madawalabu University, Bale Goba, Ethiopia. Email: ahmedyassinmoha@yahoo.com

Abstract

Human Immune Virus now a day is one of the devastating illnesses witnessed worldwide. It becomes a prevalent disease and presents a global public health concern without a cure. Among East Africa countries, Ethiopia is one of which Human Immune Virus becomes major public health emergency. Antiretroviral Treatment (ART) services are important and effective in prevention and palliative treatment of the virus. Non adherence is the risk for the development of drug resistance and failurity of therapy. The objective of this study is to assess factors affecting ART adherence among People Living With Human immune virus. A facility based cross sectional study was conducted on 245 subjects on ART follow up at Bale Robe Hospital selected using systematic random sampling from March 18 to April 13/2013. A structured and pre- tested interviewer administered questionnaires were used for data collection. The item consists of socio demographic variables, psychosocial, Clinical, Behavioral factors and items measure level of ART adherence. Data were analyzed using SPSS version 20. Frequency and percentages were calculated. The x2 (chi – square) test and P values determined and associations were assessed. P < 0.05 considered statistically significant association with ART adherence status. The rate ART dose adherence of the study subjects were 83.1%. The finding emphasize that important multiple psychosocial factors: patients disclosure status, types of social support, stigma, depression, social isolation and active substance use were significantly associated (P < 0.05) with adherence level. Additionally other barriers like being too busy and attitude towards the drug has been significantly associated (P < 0.05) with adherence. The adherence rate found in this study seems to be encouraging. However, focusing on strengthening psychosocial aspects affecting ART adherence behavior and appropriate monitoring of patients could potentially help them to maintain adherence and therefore improve the outcome.

Keywords

References

[1]  Anthony’s. Hauser, Dennis L. Kasper et al, Allianf Human immune Deficiency Virus Diseases. In. Harrison’s Principles of Internal medicine, 2012, 2695.
 
[2]  EDHS, (2005), Ethiopia Demographic and Health Survey reports.
 
[3]  Ministry of Health Ethiopia and Federal HIV/AIDS prevention and control office single point HIV prevalence estimate. Addis Ababa, Ethiopia, 2007.
 
[4]  Chesney MA, Factors affecting adherence to ART. Clin Infec Dec 2000, 30; 5171-5176.
 
[5]  Wright MT, The old problem of adherence research on treatment adherence and its relevance for HIV/AIDS: AIDS care, 12 (6), 2000, 703-710.
 
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[6]  Carter M, Adherence. Information service for HIV positive people, 2005.
 
[7]  Bale Robe Hospital second quarter report, 2013.
 
[8]  Gordillo V, del Amo J, Soriano V, Gonzalez-Lahoz J. (1999). Socio demographic and psychological variables influencing adherence to antiretroviral therapy. PMED AIDS; 13 (13): 1763-9.
 
[9]  Carballo E, Suarez CC, Carrera I, et al. (2004).Assessing relationships between health-related quality of life and adherence to antiretroviral therapy. Qual Life Research Apr; 13 (3): 587-99.
 
[10]  Bonolo, Palmira de Fae, Casar, Cibele Cb, Acurio, Fransisco A ac, et al. (2006). Non-adherence among patients initiating antiretroviral therapy: a challenge for health professionals in Brazil. JAIDS; 19 Sppl 4: S5-S13.
 
[11]  Nachega Jean B, Michael Hislop, Dowdy David W, et al., (2006). Adherence to Highly Active Antiretroviral Therapy Assessed by Pharmacy Claims Predicts Survival in HIV Infected South African Adults. J Acquir Immune Defic Syndr; 43 (1): 1-7.
 
[12]  Tadios Y & Davey G. (2006): Antiretroviral treatment adherence and its correlates among people living with HIV/AIDS on highly active antiretroviral therapy in Addis Ababa, Ethiopia. EMJ; 44 (2): 237-244.
 
[13]  Mengesha A & Worku A. (2005), Assessment of antiretroviral treatment among HIV infected persons in the Ministry of Defense Hospitals. AAU.
 
[14]  Byakika-JusiimeJ, et al. (2003). Ability to purchase& secure stable therapy are significant predictors of nonadherence to antiretroviral therapy in Kampala Uganda (abstract). 10th conference on Retroviruses and Opportunistic Infection, Boston, February
 
[15]  Lawent, et al. (2003). Long-term follow up of a cohort of patients on HAART in Senegal (abstract). 10th Conference on Retroviruses & Opportunistic Infections, Boston, February
 
[16]  Day J, Godoka N, Nyamafeni P, Chigwanda M et al. (2002). Adherence to ART in clinical trial settings in Zimbabwe and Uganda: lessons learned; Int. Conf. AIDS Jul 11-16; 15 Bangkok Thailand.
 
[17]  Adriana A, Paola TM, Rita M et al. (2002), Correlates and predictors of adherence to Highly Active Antiretroviral Therapy. JAIDS; 31 supplement 3: s123-s127.
 
[18]  Olisah, VO Baiyewu O & Sheikh TL, (2010). Adherence to highly active antiretroviral therapy in depressed patients with HIV/AIDS attending a Nigerian university teaching hospital clinic. Afr J Psychiatry; 13: 275-279.
 
[19]  Endrias Markos, Alemayehu Worku & Gail Davey. (2008). Adherence to ART in PLWHA at Yirgalem Hospital, South Ethiopia Ethiop.J.Health Dev; 22 (2).
 
[20]  Alemayehu Amberbir, Kifle Woldemichael, Sofonias Getachew, et al. (2008). Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in Southwest Ethiopia. BMC Public Health; 8: 265.
 
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Article

Triple Infection in Chickenpox Outbreak in Unvaccinated Population of Gopalpur Block, Palampur of Himanchal, India

1District AIDS Program Officer, Department of Health and Family Welfare, Government of Himachal Pradesh, office of Chief Medical Officer, Kangra at Dharamshala cum Epidemiologist- in-charge, Chamba District, Himachal Pradesh_India

2Freelance researcher in Epidemiology, Kangra, Himachal Pradesh_India

3Free lance researcher in food technology and infectious diseases, Kangra, Himachal Pradesh_India


American Journal of Public Health Research. 2015, 3(2), 68-73
DOI: 10.12691/ajphr-3-2-6
Copyright © 2015 Science and Education Publishing

Cite this paper:
S. Nikhil Gupta, Naveen Gupta, Shivani Gupta. Triple Infection in Chickenpox Outbreak in Unvaccinated Population of Gopalpur Block, Palampur of Himanchal, India. American Journal of Public Health Research. 2015; 3(2):68-73. doi: 10.12691/ajphr-3-2-6.

Correspondence to: S.  Nikhil Gupta, District AIDS Program Officer, Department of Health and Family Welfare, Government of Himachal Pradesh, office of Chief Medical Officer, Kangra at Dharamshala cum Epidemiologist- in-charge, Chamba District, Himachal Pradesh_India. Email: drsurendernikhil@yahoo.com

Abstract

Background: In an outbreak setting, in co-educational school, we investigated suspected triple outbreak in April, 2009: varicella first and then, with chance detection of measles and german measles to confirm diagnosis and recommend remedial measures to prevent further outbreaks. Methods: We defined a case of varicella with maculopapulovesicular rash without other apparent cause in students/staff of the school and residents of neighbouring nutritionally poor villages of Khalet and Roady since 23rd March to 14th October, 2009. We line listed case patients to collect information on age, sex, residence, date of onset, symptoms, signs, traveling, treatment history and vaccination status. The outbreak was described by time, place and person characteristics. Diagnosis was confirmed epidemiologically and serologically; first to chickenpox, measles and german measles viruses. Results: We identified 505 case patients from mixed outbreaks of varicella, measles and german measles (30/505 clinically, 467/505 epidemiologically linked and 8/505 laboratory confirmed case patients from a study population of 3280. We investigated the suspected outbreak with case definition of chickenpox but measles 20/3280 (0.60%) and german measles 34/3280 (1.03%) cases were also observed. The overall all attack rate (AR) was 15% while in school, it was 22% but highest (56%) in Nursery upto 4th standard with index case in first standard. Sex specific AR was (23%) more in boys. Triple concurrent infection caused 05% complications but no death reported. Severity of the symptoms was more in 5th standard onwards with 49-249 lesions and severer in poor villages Roady and Khalet (p< 0.05). Only 4% were immunized against varicella/german measles privately. 17% of the cases went for traditional treatment Vs modern medicine (p <0.001). 5/10 samples for IgM antibodies for chickenpox and 2/10 samples were positive for rubella. Conclusions: Triple infection of varicella, measles and rubella was confirmed epidemiologically and serologically. We recommended local authorities for MMRV in the school and near villages with aggressive information, education and communication (IEC) activities in affected areas.

Keywords

References

[1]  Nguyen HQ, Jumaan AO, Seward JF. Decline in mortality due to varicella after implementation of varicella vaccination in the United States. N Engl J Med. 2005; 352: 450-8.
 
[2]  Lopez AS, Guris D, Zimmerman L, Gladden L, Moore T, Haselow DT, Loparev VN, Schmid DS, Jumaan AO, Snow SL; One dose of varicella vaccine does not prevent school outbreaks: is it time for a second dose? 1: Pediatrics. 2006 Jun; 117 (6): e10.
 
[3]  Gupta SN, Gupta Naveen, Neki NS ; A mixed outbreak of rubeola-rubella in District Kangra of Northern India; European Scientific Conference on Applied Infectious Disease Epidemiology, Stockholm, Sweden, between 06 - 08th November 2011.
 
[4]  Guris D, Jumaan AO, Mascola L, et al. Changing varicella epidemiology in active surveillance sites - United States, 1995-2005. J Infect Dis. 2008; 197(Suppl 2): S71-5.
 
[5]  Gupta SN, Gupta Naveen, Neki NS, Chaudhary S; Bansal P, Gupta MK; Epidemiological investigation of mixed outbreaks of measles/ varicella in hilly villages of district Kangra, Himachal Pradesh, India, 2007; European Scientific Conference on Applied Infectious Disease Epidemiology, Stockholm, Sweden, between 06 - 08th November 2011
 
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Article

Child Healthcare in Nepal: Progress and Direction

1New York Medical College, Valhalla, U.S.A


American Journal of Public Health Research. 2015, 3(2), 74-80
DOI: 10.12691/ajphr-3-2-7
Copyright © 2015 Science and Education Publishing

Cite this paper:
Radeeb Akhtar. Child Healthcare in Nepal: Progress and Direction. American Journal of Public Health Research. 2015; 3(2):74-80. doi: 10.12691/ajphr-3-2-7.

Correspondence to: Radeeb  Akhtar, New York Medical College, Valhalla, U.S.A. Email: radeeb.akhtar@gmail.com

Abstract

Health policy changes in Nepal displayed struggles against a poor political, geographical, and economic setting; Millennium Development Goal #4 demanded improved infant and child mortality, as well as adequate measles vaccine coverage by the year 2015. Research in this report presents progress and direction of child health care policy across more than a decade of time in attempts of attaining MDG #4 and general child health care advancements. Subsequent observations and suggestions were delineated and offered. Progress since the 1990’s up to 2012 was analyzed by review of serial national survey and report data. Trends and variations between regions were mostly analyzed amongst various child health care determinants. Results indicated many improved factors; Nepal will likely achieve MDG regarding child under-5 mortality, but may not achieve measles vaccine coverage or infant mortality goals. Furthermore, severe regional disparities were evident within Nepal, particularly in the Mid and Far-Western regions. A call for integrated community-based primary health care (CB-PHC) for infants and children became an ultimate ideal. A comprehensive, multidisciplinary, and community based primary care delivery service would address many of the deficits identified as well as reach rural and remote areas that still suffered. Risk and data-based resource allocation promise improved utilization, but also demands more frequent and better data reporting. Coordinated, multi-sector health policy initiatives have been underway; this demonstrated a strong direction in improving child health care from urban to every village.

Keywords

References

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