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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

Treatment Adherence among Tuberculosis and Human Immuno Deficiency Virus Coinfected Patients in Ginnir Referral Hospital

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


American Journal of Public Health Research. 2014, 2(6), 239-243
DOI: 10.12691/ajphr-2-6-4
Copyright © 2014 Science and Education Publishing

Cite this paper:
Ahmed Yasin Mohammed, Muhammedawel Kaso Adem. Treatment Adherence among Tuberculosis and Human Immuno Deficiency Virus Coinfected Patients in Ginnir Referral Hospital. American Journal of Public Health Research. 2014; 2(6):239-243. doi: 10.12691/ajphr-2-6-4.

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

Abstract

Tuberculosis is a major public health problem in Ethiopia, and a high number of TB patients are co-infected with HIV. There is a need for more knowledge about factors influencing treatment adherence in co-infected patients on concomitant treatment. The objective of this study is to assess treatment adherence among TB/HIV co infected patients in Ginnir referral hospital from March - April 2013. Institution based cross sectional study design was used to collect, analyze and summarize data from TB/HIV co-infected patients. The data was sorted manually and scientific calculator was used to compile and express in table and graphs. Descriptive statistics like frequencies, mean and median were used to analyze the data. Prior to data collection, permission request was obtained from Madawalabu University, Goba campus and it was submitted to Ginnir referral hospital’s medical director. Respondents were told about the objective of this study, reassured for confidentiality and asked for consent. The results shown among the 53 TB/HIV co- infected patients, 11(20.7%) had missed taking both ARV and anti TB drugs at least once. Of these, 4 (36.4%) had missed the ARV treatment while remaining 7(63.6%) of them missed the anti TB medication. The result showed that, the main reason for missing the drugs was forgetting taking medication 6(54.6%). It can be concluded that the level of non adherence is relatively high and the main reason behind was forgetting distance from health institution and income related problems. Intervention s to reduce it need to be instituted such as adherence educations should have to be given for the patients to take the treatment by the recommended schedule and also family members and supporters should have to be told to remind and follow them carefully. On the other hand bringing the health service nearby might alleviate the problem of distance. In order to deal with the income related problems, Ginnir referral hospital should have to work in collaboration with NGOs and other fund raising institutions.

Keywords

References

[1]  Swaminath S, Padmapaiyadarsini C and Narendran G (2011). HIV-Associated Tuberculosis. J Manag Care Pharm, 17(3), 213-23.
 
[2]  World Health Organization (2007). Global Tuberculosis Control: Surveillance, Planning, Financing. WHO report.
 
[3]  Afework K, Mengistu G, Ayele B (2007).Co-infection and clinical manifestation of TB in HIV infected and uninfected adults at teaching hospital. J Microbial Immunol Infect. 25, 135-143.
 
[4]  Demissie M, Lindtjon B, Tegbaru B (2000).Human Immunodeficiency virus (HIV) infection in tuberculosis patients. J Health Dev, 60, 564-674.
 
[5]  Anthony Harries Stephen Graham Dermot Maher (2004). Department of child and adolescent health and development, World Health Organization,2nd edition.
 
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[6]  Shargie EB, Lindtjørn B (2007). Determinants of treatment adherence among smear-positive pulmonary tuberculosis patients. Journal pmed, 4(2), e37.
 
[7]  Chesney MA, Morin M, Sherr L (2000). Adherence to HIV combination therapy. Soc Sci Med, 50, 1599-1605.
 
[8]  Farmer P (1997). Social scientists and the new tuberculosis. Soc Sci Med. 44, 347-358.
 
[9]  Wares DF, Singh S et al (2003). Non-adherence to tuberculosis treatment, Soc Sci Med, 7, 327-335.
 
[10]  Amare D, Markos T, Yohannis H (2009). TB and HIV co infection its impact on quality of life. Soc Sci Med, 8, 212-230.
 
[11]  Munro SA, Lewin SA, Smith H, Engel ME, Fretheim A, et al (2007). Patient adherence to tuberculosis treatment: A systematic review of qualitative research. PLoS Med, 4(7), e238.
 
[12]  Mekdes K, Gunnar A, Jane F (2010). Barriers and facilitators of adherence to TB treatment in patients on concomitant TB and HIV treatment PLoS Med, 1471-2458.
 
[13]  Mkopi A, Range N, Lwilla F, Egwaga S, Schulze A, et al (2012). Adherence to Tuberculosis Therapy among Patients Receiving Home-Based Directly Observed Treatment: Evidence from the United Republic of Tanzania. PLoS ONE, 7(12), e51828.
 
[14]  Nackers F, Huerga H, Espie´ E, Aloo AO, Bastard M, et al (2012). Adherence to Self-Administered Tuberculosis Treatment in a High HIV-Prevalence Setting: A Cross-Sectional Survey in Homa Bay, Kenya. PLoS ONE, 7(3), e32140.
 
[15]  Estifanos Biru, Bernt Lindtjorn (2007). Determinants of treatment adherence among smear-positive pulmonary TB patients in South Ethiopia, 122-130.
 
[16]  Wondimeneh Y, Muluye D, Belyhun Y (2012). Prevalence of PTB and immunological profile of HIV-co infected patient in North west Ethiopia, 456-460.
 
[17]  Monica G, Paul K, Freddy E (2009). Non-adherence to anti-TB drugs among TB/HIV co-infected patients in Mbarara Hospital Uganda. African Health Sciences, 9 (1), 326-371.
 
[18]  Adams SA, Soumeraj BS, Jonathan L, Doss-Degan D (1999). Evidence of self report bias in assessing adherence to guidelines. International Journal for Quality in Health Care, 187-192.
 
[19]  Kebede A and Wube K (2012). Medication adherence and its determinants among patients on concomitant tuberculosis and anti retroviral therapy. North American journal of medical science, 4(2), 60-69.
 
[20]  Jaiswal A, Singh V, Ogden J.A et al (2003). Adherence to tuberculosis treatment: lessons from the urban setting of Delhi, India. Tropical medicine and international health, 8(7), 625-633.
 
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Article

Effects of Sexual Dysfunction on Female Teachers Performance

1Department of Biology, Faculty of Mathematics and Sciences, University of Lampung, Indonesia

2Department of Biomedical Sciences, Faculty of Medicine, University of Lampung, Indonesia


American Journal of Public Health Research. 2014, 2(6), 244-247
DOI: 10.12691/ajphr-2-6-5
Copyright © 2014 Science and Education Publishing

Cite this paper:
M. Kanedi, Sutyarso. Effects of Sexual Dysfunction on Female Teachers Performance. American Journal of Public Health Research. 2014; 2(6):244-247. doi: 10.12691/ajphr-2-6-5.

Correspondence to: M.  Kanedi, Department of Biology, Faculty of Mathematics and Sciences, University of Lampung, Indonesia. Email: wegayendi@yahoo.com

Abstract

This research is aimed to find out whether sexual dysfunction affects female teachers performance in fulfilling pedagogical tasks. Eighty-four female teachers who work at 12 elementary schools in the city of Bandar Lampung, Lampung Province, Indonesia became the participants in this study. To assess the teacher’s sexual quality, we used the Female Sexual Function Index (FSFI), a brief questionnaire designed to measure sexual functioning in women with focus on sexual desire, sexual arousal, lubrication, orgasm, satisfaction, and pain. To measure the quality of a teacher, two pupils were asked to become respondents and fill out a Likert Scale questionnaire containing both positive and negative quality indicators of the teacher. The positive indicators consist of punctual, prepared, approachable, respectful and professional, while the negative ones include bad tempered, rude, insulting, arrogant and domineering. Mann-Whitney comparison test and Spearman Rank Correlation were performed in data analysis. The results showed that 39 (46%) of the participant categorized as teachers without sexual disorder (total FSFI score of 29.1±1.33) and the other 45 (54%) categorized as teachers with sexual disorders (total FSFI score of 21.48 ± 2.84). Compared with the teacher without sexual dysfunction, teachers with sexual disorders tend to be less diligent (P <0.05), less prepared for class (P <0.001), less friendly (P <0.001) and less appreciative students (P <0.01). In addition, teachers with sexual problems tend to be more hothead (P< 0.001), rude (P<0.001) and domineering (P<0.01). As the conclusion, sexual dysfunction potentially affects teaching performance of the female teachers.

Keywords

References

[1]  Meston C.M. and Bradford, A,”Sexual Dysfunction in Women,” Annu. Rev. Clin. Psychol., 3:233-56. 2007.
 
[2]  van Klaveren, M., Tijde, K., Hughie-Williams, M. and Martin, N.R, “An overview of women’s work and employment in Indonesia,” in Working Paper 10-91. May 2010. Amsterdam Institute for Advanced Labour Studies University of Amsterdam. CrossRef
 
[3]  UNESCO. World education report 1998: Teachers and teaching in a changing world. Unesco Publishing, 1998, 178p.
 
[4]  United Nation, “The World's Women 2010: Trends and Statistics,” United Nation Publication Sales No. E.10.XVII.11. 2010.
 
[5]  Hausmann, R., Tyson, L.D., Zahidi, S, The Global Gender Gap Report 2012. World Economic Forum collaborated with Faculty at Harvard University and the University of California. Berkeley.
 
Show More References
[6]  Thakur, K.S. and Kumar, S., “Mental Health as a Predictor of Emotional Competence of Prospective Teachers of Science in Himachal Pradesh,” MIER Journal of Educational Studies. Trends & Practice. Vol. 3. No. 1 pp. 84-94. May 2013.
 
[7]  Holeyannavar, P.G. and Itagi, S.K.,”Stress and Emotional Competence of Primary School Teachers,” J Psychology, 3(1): 29-38. 2012.
 
[8]  Laumann, E.O., Nicolosi, A., Glasser, D.B., Paik, A., Gingell, C., Moreira, E. and Wang, T., “Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors,” International Journal of Impotence Research, 17. 39-57. 2005.
 
[9]  Stronge. J., Qualities of effective teachers, Alexandria. VA: Association for Supervision and Curriculum Development, 2002.
 
[10]  Gorham, J. and Christophel, D.M., “Students' Perceptio of Teacher Behaviors As Motivating and Demotivating Factors in College Classes,” Communication Quarterly. Vol. 40. No. 3. 239-252. Summer 1992.
 
[11]  Fisher, D., Waldrip, B. and Brok, P.J, “Students' perceptions of primary teachers' interpersonal behaviour and of cultural dimensions in the classroom environment,” International Journal of Educational Research, 43(1/2). 25-38. 2005.
 
[12]  Khine, M.S. and Atputhasamy, L., “Self-perceived and students’ perceptio of teacher interaction in the classrooms,” A paper presented at the Conference on Redesigning Pedagogy; Research. Policy. Practice. Singapore. 30 May to 1 June 2005.
 
[13]  Keeley, J., Smith, D., & Buskist, W., “The teacher behaviors checklist: Factor analysis of its utility for evaluating teaching,” Teaching of Psychology, 33(2), 84-91. 2006.
 
[14]  Rosen, R., Brown, C., Heiman, J., Leiblum, S., Ferguson, D. and D’agostino, R., “The Female Sexual Function Index (FSFI): A Multidimensional Self-Report Itrument for the Assessment of Female Sexual Function,” Journal of Sex & Marital Therapy. 26: 191-208. 2000.
 
[15]  Wiegel, M., Meston, C., and Rosen, R., The Female Sexual Function Index (FSFI): Cross-Validation and Development of Clinical Cutoff Scores. Journal of Sex & Marital Therapy, 31: 1-20, 2005.
 
[16]  Palacios,S., Castaño, R. and Graziottin, A., ”Epidemiology of female sexual dysfunction,” Maturitas 63(2). 2009. Special issue on "Female sexual dysfunctions in the office: tools to meet the challenge", p. 119-123.
 
[17]  Cayan, S., Akbay, E., Bozlu, M., Canpolat, B., Acar, D. and Ulusoy, E., “The prevalence of female sexual dysfunction and potential risk factors that may impair sexual function in Turkish women,” Urol Int. 2004.72(1):52-7.
 
[18]  Thompson, R. J., Mata, J., Jaeggi, S. M., Buschkuehl, M., Jonides, J., & Gotlib, I. H. (2012, June “The Everyday Emotional Experience of Adults With Major Depressive Disorder:Examining Emotional Instability, Inertia, and Reactivity”. Journal of Abnormal Psychology.
 
[19]  Kunnskapssenteret, “Psychological, social and sexual consequences of female genital mutilation/cutting (FGM/C): a systematic review of quantitative studies,” Report from Kunnskapssenteret (Norwegian Knowledge Centre for the Health Services) No.13-2010.Systematic review. pp.77.
 
[20]  Marwick, C, “Survey Says Patients Expect Little Physician Help on Sex,” JAMA, 28.23: 2173-4. 1999.
 
[21]  Blumberg, E.S, “The Lives and voices of highly sexual women,” The Journal of Sex Research, 40.2: 146-157. 2003.
 
[22]  Mah, K. and Binik, Y.M, “Female orgasmic disorders: A Clinical approach,” Urodinamica, 14:99-104. 2004.
 
[23]  Fons, C.E, “Impact of sexual dysfunction on quality of life among anxiety disorder patients (2008)”. Masters Theses and Doctoral Dissertations. (2008) Paper 189.
 
[24]  Davison, S.L., Bell R.J., La China, M., Holden, S.L. and Davis, S.R, “The relationship between self-reported sexual satisfaction and general well-being in women,” J Sex Med., 6(10):2690-7. Oct.2009.
 
[25]  Dogan, T., Tugut, N. and Golbasi, Z, “The Relationship Between Sexual Quality of Life,Happiness, and Satisfaction with Life in Married Turkish Women,”.
 
[26]  Edalati, A. and Redzuan, M, “A Review: Dominance, Marital Satisfaction and Female Aggression,” Journal of Social Sciences, 6 (2): 162-166. 2010.
 
[27]  Gupta, V, “Importance of Being Happy at Work,” International Journal of Research and Development - A Management Review (IJRDMR), 1(1). 2012. 9-14.
 
Show Less References

Article

Parasitic Infection and Associated Factors among the Primary School Children in Motta Town, Western Amhara, Ethiopia

1School of Public Health, College of Medicine and Health Sciences, Bahir Dar University Ethiopia


American Journal of Public Health Research. 2014, 2(6), 248-254
DOI: 10.12691/ajphr-2-6-6
Copyright © 2014 Science and Education Publishing

Cite this paper:
Mulusew Andualem Asemahagn. Parasitic Infection and Associated Factors among the Primary School Children in Motta Town, Western Amhara, Ethiopia. American Journal of Public Health Research. 2014; 2(6):248-254. doi: 10.12691/ajphr-2-6-6.

Correspondence to: Mulusew  Andualem Asemahagn, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University Ethiopia. Email: muler.hi@gmail.com

Abstract

Background: Globally, about 3.5 billion and 45 million people, particularly children are affected and ill with parasitic infection respectively. Intestinal parasitic infection constitutes one of the ten top major public health problems in resource-limited countries. Methods: An institutional based cross sectional study was conducted among 364 randomly selected students from the Motta primary School, November 2014. A pretested structured questionnaire was used to collect data on socio-demographic and associated risk factors. The stool specimens were examined using a direct wet mount and formal-ether concentration techniques. Epi-Info version 3.5.4 and SPSS version16 were used to enter and analyze data respectively. Descriptive statistics and regression analysis were used to describe study objectives and indentify associated factors respectively. The strength of association between the study and outcome variables was described using Odds ratio at a 95% CI. Results: The majority (98.3%) of the students gave sample in the study. About 245 (68.4%) of the respondents were infected with one or more species of intestinal parasites. Six types of intestinal parasites were identified and the most prevalent parasite was Hookworm 81(33.1%) followed by Entamoeba histolytica 42(17.1%), Ascaris lumbricoides 38 (15.5%), and Giardia lamblia 29 (11.8%). Double parasitic infection was found among 45(18.4%) students. Residence, health education access, family education, shoe wearing habits, hand washing practices, toilet availability and use, family income, availability of safe water, and open defecation practices were significant factors (p < 0.05) for intestinal parasitic infection. Conclusion: Intestinal parasitic infection is an important major health problem among Motta primary school students. Improving environmental/personal hygiene, availing water supply, providing health education to students and families, and availing toilet services are some of the important interventions to solve the problem.

Keywords

References

[1]  Hotez PJ., et.al. Helminth infections: the great neglected tropical diseases. J Clin Invest. 2008; 118: 1311-1321.
 
[2]  WHO. Intestinal parasite: Burden and trends, 2013. Available at https://apps.who.int/ctd/intpara/burdens.htm
 
[3]  W HO. Prevention and control of schistosomiasis and soil-transmitted helminthiasis. WHO technical report series 912. WHO, Geneva, Switzerland, 2002.
 
[4]  Auta T., Oricha EK., Audu K. Studies on the Intestinal Helminths Infestation among Primary School Children in Gwagwada, Kaduna, North Western Nigeria. Journal of Biology, Agriculture, and Healthcare. 2013; 3: 7, Available at www.iiste.org
 
[5]  Haque R. Human intestinal parasites. Journal of Health, Population, and Nutrition. 2007; 25, 387-391.
 
Show More References
[6]  Albonico M., Crompton DW., Savioli L. Control strategies for human intestinal nematode infections. Adv Parasitol. 1999; 42: 277-341.
 
[7]  Matthys B., et al. Prevalence and risk factors of helminths and intestinal protozoa infections among children from primary schools in western Tajikistan. Parasites and Vectors. 2011; 4: 195. http://www.parasitesandvectors.com/content/4/1/195
 
[8]  Golia S., Sangeetha K.T., Vasudha C.L. Prevalence of parasitic infections among primary school children in Bangalore. International Journal of Basic and Applied Medical Sciences. 2014; Vol. 4: 1, 2277-2103. Available at http://www.cibtech.org/jms.htm
 
[9]  Emmy-EGBE, I.O., et.al. Prevalence of Intestinal helminthes in students of Ihiala local government area of Anambra state, 2012; Journal of Applied Technology in Environmental Sanitation, 2 (1): 23-30.
 
[10]  Auta T., Kogi E., Audu OK. Studies on the Intestinal Helminths Infestation among Primary School Children in Gwagwada, Kaduna, North Western Nigeria. Journal of Biology, Agriculture, and Healthcare. 2013; Vol. 3: 7, 2224-3208.
 
[11]  Federal Democratic Republic of Ethiopia, Ministry of Health HSDP-IV, 2010/11 2014/15.
 
[12]  Debalke S., Worku A., Jahur N., Mekonnen Z. Soil transmitted helminths and associated factors among school children in government and private primary school in Jimma town, Southwest Ethiopia. Soil Transmitted Helminths. November 2013; 23: 3.
 
[13]  Belyhun Y, Medhin G, Amberbir A. Prevalence and risk factors for soil-transmitted helminth infection in mothers and their infants in Butajira, Ethiopia: a population based study. BMC Public Health. 2010; 10: 21.
 
[14]  Legesse, M. and Erko, B. Prevalence of intestinal parasites among school children in a rural area close to the southeast of Lake Langano, Ethiopia. The Ethiopian Journal of Health Development. 2004; 18, 116-120.
 
[15]  Nyantekyi, L.A., Legesse, M., Belay, M., Tadesse, K., Manaye, K., Macias, C. and Erko, B. Intestinal parasitic infections among under-five children and maternal awareness about the infections in Shesha Kekele, Wondo Genet, Southern Ethiopia. The Ethiopian Journal of Health Development. 2010; 24, 185-190.
 
[16]  Alemu, A.et.al. Soil transmitted helminths and Schistosoma mansoni infections among school children in Zarima town, northwest Ethiopia. BMC Infectious Diseases. 2011; 11: 189. Available at http://dx.doi.org/10.1186/1471-2334-11-189
 
[17]  Tadesse G. The prevalence of intestinal helminthic infections and associated risk factors among school children in Babile town, Eastern Ethiopia. Ethiop. J. Health Dev. 2005; 19 (2): 140-147.
 
[18]  Debalke S., Worku A., Jahur N., Mekonnen Z. Soil transmitted helminths and associated factors among school children in Jimma Town, South west Ethiopia. Ethiop J Health Sci. 2013; Vol. 23: 3.
 
[19]  Prevalence and risk factor of intestinal parasites among Delgi School children, North Gondar, Ethiopia. Journal of Parasitology and Vector Biology. 2011; Vol. 3 (5), 75-81.
 
[20]  Workneh T, Esmael A, Ayichiluhm M. Prevalence of Intestinal Parasitic Infections and Associated Factors among Debre Elias Primary School Children, East Gojjam Zone, Amhara Region, North West Ethiopia. J Bacteriol Parasitol. 2014 5: 181.
 
[21]  Alamir M., Awoke W., Feleke A. Intestinal parasites infection and associated factors among Dagi Primary School, Amhara National Regional State, Ethiopia. 2013; 5: 10, 1697-1701.
 
[22]  Abate A., et. al. Cross-Sectional Study on the Prevalence of Intestinal Parasites and Associated Risk Factors in Teda Health Centre, Northwest Ethiopia. ISRN Parasitology, 2013. Available at http://dx.doi.org/10.5402/2013/757451.
 
[23]  Mathewos B., et. al. The current status of soil transmitted helminths and S. mansoni infection among children in two primary schools in North Gondar, Northwest Ethiopia. BMC Research Notes. 2014; 7: 88. Available at http://www.biomedcentral.com
 
[24]  Romano, N., Saidon, I., Chow, S., Roehl M.,Yvonne A. Prevalence and risk factors intestinal parasitism in rural and remote west Malaysia. Plos Neglected Tropical Disease. 2011; 5: 74.
 
[25]  Abossie A., Seid M. Assessment of the prevalence of intestinal parasitosis and associated risk factors among primary school children in Chencha town, Southern Ethiopia. BMC Public Health. 2014; 14: 166.
 
Show Less References

Article

Sero-prevalence of Hepatitis B Surface Antigen (HBsAg) amongst Pregnant Women Attending Antenatal Clinic at the Federal Medical Centre Umuahia, Abia State, Nigeria

1Department of Microbiology, College of Natural Sciences, Michael Okpara University of Agriculture Umudike, Abia State, Nigeria

2Department of Accident & Emergency, Federal Medical Centre, Umuahia, Abia State, Nigeria


American Journal of Public Health Research. 2014, 2(6), 255-259
DOI: 10.12691/ajphr-2-6-7
Copyright © 2014 Science and Education Publishing

Cite this paper:
Onwuakor C.E, Eze V.C, Nwankwo I.U, Iwu J.O. Sero-prevalence of Hepatitis B Surface Antigen (HBsAg) amongst Pregnant Women Attending Antenatal Clinic at the Federal Medical Centre Umuahia, Abia State, Nigeria. American Journal of Public Health Research. 2014; 2(6):255-259. doi: 10.12691/ajphr-2-6-7.

Correspondence to: Onwuakor  C.E, Department of Microbiology, College of Natural Sciences, Michael Okpara University of Agriculture Umudike, Abia State, Nigeria. Email: chijiokeonwuakor@gmail.com

Abstract

Despite the existence of a safe and effective vaccine, Nigeria has remained a hyper-endemic area for hepatitis B virus infection, with estimated 12% of the total population being chronic carriers. Neonates who contact hepatitis B virus infection will have an almost 90% risk of developing chronic hepatitis B surface antigen (HBsAg) carrier state and chronic liver disease. The objectives of this study were to determine the sero-prevalence of hepatitis B surface antigen among pregnant women and identifying potential risk factors associated with the infection. This study involved a total of 350 pregnant women who attended antenatal at the Federal medical Centre, Umuahia, Abia State, Nigeria. Blood samples from all consenting pregnant women were collected. A structured pro forma designed for this purpose was used to obtain socio-demographic information and the presence of risk factors. Data collated was analyzed using GraphPad Prism statistical software with P<0.05 at 95% confidence interval. The results showed that HBsAg sero-prevalence rate of 7.1% was observed in all the pregnant women tested. Sero-prevalence of HBsAg amongst parturients were more in patients within their first trimesters (11.1%), Primigravida pregnant women (8.0%), women with history of dental or surgical procedures (34.0%) and multiple sexual partners (25.0%) and in women with no formal education (37.5%). An intermediate prevalence of HBsAg was identified which justifies the need for routine screening in pregnancy in order to identify and treat the infection, thus reducing the risk of transmission of the virus. Contraceptive options aimed at prevention of pregnancy and sexually transmitted infection (STI) should be encouraged.

Keywords

References

[1]  Goldstein, S,T., Zhou, F., Hadler, S.C., Bell, B.P., Mast, E.E and Margolis, H.S, “A mathematical model to estimate global hepatitis B disease burden and vaccination impact”, Int. J. Epidemol. 2005, 34(6): 1329-1339.
 
[2]  Burnett, R., Francois, G and Kew, G, “Hepatitis B virus and human immunodeficiency virus co-infection in sub-Saharan Africa: a call for further action”. Liver Int. 2005, 25: 201-213.
 
[3]  Lavanchy, D, “Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures”. J. Viral Hep. 2004, 11: 97-107.
 
[4]  Maddrey, W.C, ‘Hepatitis B: an important public health issue”. J. Med. Virol. 2000, 61: 362-366.
 
[5]  Kao, J.H, “Diagnosis of hepatitis B virus infection through serological and viral markers”. Expert Rev. Gastroenterol. Hepatol. 2008, 2(4): 504-62.
 
Show More References
[6]  Eke, A.C., Eke, U.A., Okafor, C.I., Ezebialu, I.U and Ogbuagu, C, “Prevalence, correlates and pattern of Hepatitis B surface antigen in a low resource setting”. Virol. J. 2011, 8: 12.
 
[7]  El-Magrahe, H., Furarah, A.R., El-Figih, K., El-Urshfany, S, and Ghenghesh, K.S, “Maternal and neonatal seroprevalence of Hepatitis B surface antigen (HBsAg) in Tripoli, Libya”. J. Infect. Dis. Dev. Ctries, 2010, 4: 168-170.
 
[8]  Mbaawuaga, E.M., Enenebeaka, M.N.O., Okopi, J.A and Damen, J.G, “Hepatitis B virus infection (HBV) among pregnant women in Makurdi, Nigeria”. Afr. J. Biol. Res. 2008, 11:155-159.
 
[9]  Ugwuja, E.I., “Seroprevalence of Hepatitis B surface antigen and liver function tests among adolescents in Abakaliki, Southern Nigeria”. Int. J. Trop. Med. 2010, 6(2):1-6.
 
[10]  Obi, C.L., Nnatu, S.N., Anyiwo, C.E., Agbonlahor, D.E., Esuneh, F.I and Karpos, A, “A comparison of HIV seropositivity and Hepatitis B surface antigenaemia (HBsAg) among the same group of apparently healthy pregnant women in Lagos, Nigeria: a preliminary report”. Viral Immunol. 1993, 6(1): 43-47.
 
[11]  Ezegbudo, C.N., Agbonlahor, D.E., Nwobu, G.O., Igwe, C.U., Agba, M.I and Okpala, H.O, “The seroprevalence of Hepatitis B surface antigen and Human immunodeficiency virus (HIV) among pregnant women in Anambra State”. Shiraz E-medical J. 2004, 5(2): 1-8.
 
[12]  Baba, M.M., Onwuka, I.S and Baba, S.S, “Hepatitis B and C infections among pregnant women in Maiduguri, Nigeria”. Central Eur. J. Pub. Health. 1999, 7(2): 60-62.
 
[13]  Chen, C and Chang, M, “Hepatitis B and pregnancy; The scientific basis for perinatal prevention”. Cambridge J. Online, 2010, 21: 89-113.
 
[14]  Pennap, G.R., Osanga, E.T and Ubam, A, “Seroprevalence of hepatitis B surface antigen among pregnant women attending antenatal clinic in Federal Medical Center, Keffi, Nigeria’. Res. J. Med. Sci. 2011, 51(2):80-82.
 
[15]  Akani, C.I., Ojule, A.C., Opurum, H.C and Ejilemele, A.A “Seroprevalence of HbsAg in pregnant women in Port Harcourt, Nigeria”. Postgrad Med. J. 2005, 12 (4): 266-270.
 
[16]  Ojo, O.O and Anibijuwon, I.I, “Determination of antibodies to hepatitis B virus in pregnant women in Akure, Ondo state, Nigeria”. Cont. J. Microbiol. 2009, 3: 6-10.
 
[17]  Jatau, E.D and Yabaya, A, “Seroprevalence of hepatitis B virus in pregnant women attending a clinic in Zaria, Nigeria”. Sci. World J. 2009, 7-9.
 
[18]  Ndams, I.S., Joshua, I.A., Luka, S.A and Sadiq, H.O, “Epidemiology of hepatitis B infection among pregnant women in Minna, Nigeria”. Sci. World J. 2008, 3(3): 5-8.
 
[19]  Duncan, M.E., Tibaus, G and Pelger, A, “Prevalence and significance of sexually transmitted diseases among women attending clinics in Addis Ababa”. Ethiop. J. Health Dev. 1995, 12: 31-40.
 
[20]  Candotti, D., Danso, K and Allain, J, “Maternal transmission of hepatitis B virus genotype E in Ghana, West Africa”. J. Gen. Virol. 2007, 88: 2686-2695.
 
[21]  WHO/EPI, “Protocol for assessing prevalence of hepatitis B infection in antenatal patients’. 1990, WHO/EPI/GEN/90.6.
 
[22]  Awole, M and Gebre-selassie, S, “Seroprevalence of hepatitis B surface antigen and its risk factors among pregnant women in Jimma, South-west Ethiopia”. Ethiop. J. Health Dev. 2005, 19(1): 45-50.
 
[23]  Ahmedin, J., Taylor, m and Ram, C.T, “A new section in cancer offering timely and targeted information”. Can. J. Clin. 2004, 54: 23-25
 
[24]  Chakravati, A., Rawat, D and Jarin, M, “A study of the perinatal trans-mission of the hepatitis B virus”. Ind. J. Med. Microbiol. 2005, 23: 128-130.
 
[25]  Wiseman, E., Fraser, M.A., Holden, S., Glass, A., Bronwynne, L.K., Leon, G.H., Michael, W.M., Ayres, A and Locarnini, S.A, “Perinatal transmission of hepatitis B virus: an Australian experience”. Med. J. Aust. 2009, 190(9): 489-492.
 
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Article

Anxiety Sensitivity in Patients with Alcohol Dependence: A Cross-Sectional Case-Control Study

1Department of Experimental and Clinical Medicine, University of Florence, Italy

2Miller Institute for Behavioural and Cognitive Psychotherapy, Genoa, Italy

3Department of Mental Health, Florence, Italy

4Department of Health Sciences, University of Florence, Italy


American Journal of Public Health Research. 2014, 2(6), 260-265
DOI: 10.12691/ajphr-2-6-8
Copyright © 2014 Science and Education Publishing

Cite this paper:
Andrea Pozza, Davide Berardi, Sandro Domenichetti, Davide Dèttore. Anxiety Sensitivity in Patients with Alcohol Dependence: A Cross-Sectional Case-Control Study. American Journal of Public Health Research. 2014; 2(6):260-265. doi: 10.12691/ajphr-2-6-8.

Correspondence to: Andrea  Pozza, Department of Experimental and Clinical Medicine, University of Florence, Italy. Email: andrea.pozza@unifi.it

Abstract

Anxiety Sensitivity (AS) is a cognitive risk and maintenance factor for anxiety disorders, and it consists of three dimensions: Physical concerns, Cognitive concerns, and Social concerns. No study has investigated the role of AS in individuals with Alcohol-Dependence (A-D), comparing a group of patients with Alcohol-Dependence (A-D) to patients with Anxiety Disorders (AD) and healthy individuals on AS dimensions. Specific dimensions of AS might play a role as cognitive vulnerability and maintenance factors also for A-D-related problems. Examination of AS in patients with A-D might inform clinical practice and public health policy suggesting the integration of treatments specifically targeting AS in A-D patients. The current study aimed to explore the relationship between AS dimensions and A-D. One hundred twenty-five participants, including patients with a diagnosis of A-D (n= 35), patients with a diagnosis of any Anxiety Disorder (AD) (n= 40) and healthy individuals as a control group (CG) (n= 50) completed the ASI-3, STAI-Y and BDI-II. After controlling for anxious traits, A-D patients had stronger Social concerns. Physical and Cognitive concerns appeared, however, significantly more severe among the AD group than the other two groups. Given the strong association between Social concerns and A-D, treatments for A-D patients should also target Social concerns. Study limitations, implications for mental health policy and intervention programs are addressed.

Keywords

References

[1]  REISS, S. & McNaLLY, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107-121). San Diego, CA: Academic Press.
 
[2]  DEACON, B. & ABRAMOWITZ, J.S. (2006). Anxiety sensitivity and its dimensions across the anxiety disorders. Journal of Anxiety Disorders, 20, 837-857.
 
[3]  OLATUNJI, B.O. & WOLITZKY-TAYLOR, K.B. (2009). Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis. Psychological Bulletin, 135, 974-999.
 
[4]  SCHMIDT, N.B., ZVOLENSKY, M.J. & MANER, J.K. (2006). Anxiety sensitivity: Prospective prediction of panic attacks and Axis I pathology. Journal of Psychiatric Research, 40 (8), 691-699.
 
[5]  TAYLOR, S. (1999). Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety. Mahwah, NJ: Erlbaum.
 
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[6]  TAYLOR, S., ZVOLENSKY, M.J., COX, B., DEACON, B., HEIMBERG, R., LEDLEY, D.R. et al. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety sensitivity Index-3 (ASI-3). Psychological Assessment, 19 (2), 176-188.
 
[7]  WHEATON, M.G., DEACON, B. J., McGRATH, P.B., BERMAN, N.C. & ABRAMOWITZ, J.S. (2012). Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. Journal of Anxiety Disorders, 26, 401-408.
 
[8]  REISS, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141-153.
 
[9]  STEWART, S.H., PETERSON, J.B. & PIHL, R.O. (1995). Anxiety sensitivity and self-reported alcohol consumption rates in university women. Journal of Anxiety Disorders, 9 (4), 283-292.
 
[10]  DeMARTINI, K.S. & CAREY, K.B. (2011). The role of anxiety sensitivity and drinking motives in predicting alcohol use: A critical review. Clinical Psychology Review, 31, 169-177.
 
[11]  CONROD, P.J., PIHL, R.O. & VASSILEVA, J. (1998). Differential sensitivity to alcohol reinforcement in groups of men at risk for distinct alcoholism subtypes. Alcoholism: Clinical and Experimental Research, 22 (3), 585-597.
 
[12]  LAWYER, S.R., KARG, R.S., MURPHY, J.G. & MCGLYNN, F.D. (2002). Heavy drinking among college students is influenced by anxiety sensitivity, gender, and contexts for alcohol use. Journal of Anxiety Disorders, 16, 165-173.
 
[13]  NOVAK, A., BURGESS, E.S., CLARK, M., ZVOLENSKY, M.J. & BROWN, R.A. (2003). Anxiety sensitivity, self-reported motives for alcohol and nicotine use, and level of consumption. Journal of Anxiety Disorders, 17, 165-180.
 
[14]  HOWELL, A.N., LEYRO, T.M., HOGAN, J., BUCKNER, J.D. & ZVOLENSKY, M.J. (2010). Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use problems among young adult drinkers. Addictive Behaviors, 35, 1144-1147.
 
[15]  DEHAAS, R.A.B., CALAMARI, J.E. & BAIR, J.P. (2002). Anxiety sensitivity and the situational antecedents to drug and alcohol use: An evaluation of anxiety patients with substance use disorders. Cognitive Therapy and Research, 26 (3), 335-353.
 
[16]  DEHAAS, R.A., CALAMARI, J.E., BAIR, J.P. & MARTIN, E.D. (2001). Anxiety sensitivity and drug or alcohol use in individuals with anxiety and substance use disorder. Addictive Behaviors, 26, 787-801.
 
[17]  SCHMIDT, N.B., BUCKNER, J.D. & KEOUGH, M.E. (2007). Anxiety sensitivity as a prospective predictor if alcohol use disorders. Behavior Modification, 31 (2), 202-219.
 
[18]  WATT, M.C., STEWART, S.H., BIRCH, C. & BERNIER, D. (2006). Brief CBT for high anxiety sensitivity decreases drinking problems, relief alcohol outcome expectancies, and conformity drinking motives: Evidence from a randomized controlled trial. Journal of Mental Health, 15 (6), 683-695.
 
[19]  SPIELBERGER, C.D., GORSUCH, R.K., LUCHENE, R., VAGG., P.R. & JACOBS, G.A. (1983). Manual for the state-trait anxiety inventory (Form Y). Palo Alto, CA: Consulting Psychologist Press.
 
[20]  BECK, A.T., STEER, R.A., & BROWN, G.K. (1996). Beck Depression Inventory Second Edition Manual. San Antonio (TX): The Psychological Corporation Harcourt Brace & Company.
 
[21]  AMERICAN PSYCHIATRIC ASSOCIATION (2000). Diagnostic and Statistical Manual of mental Disorders, 4th edn, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
 
[22]  AMERICAN PSYCHOLOGICAL ASSOCIATION (1992). Ethical Principles of Psychologist and code of conduct. Washington, DC: American Psychological Association.
 
[23]  OLEJNIK, S. & ALGINA, J. (2003). Generalized eta and omega squared statistics: measures of effect size for some common research designs. Psychological Methods, 8 (4), 434.
 
[24]  NARAGON-GAINEY, K. (2010). Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychological Bulletin, 136, 128-150.
 
[25]  ALLAN, N.P., CAPRON, D.W., RAINES, A.M. & SCHMIDT, N.B. (2014). Unique relations among anxiety sensitivity factors and anxiety, depression, and suicidal ideation. Journal of Anxiety Disorders, 28, 266-275.
 
[26]  OLTHUIS, J.V., WATT, M.C. & STEWART, S.H. (2014). Anxiety Sensitivity Index (ASI-3) subscales predict unique variance in anxiety and depressive symptoms. Journal of Anxiety Disorders, 28, 115-124.
 
[27]  SMITH, J.P., & BOOK, S. W. (2010). Comorbidity of generalized anxiety disorder and alcohol use disorders among individuals seeking outpatient substance abuse treatment. Addictive Behaviors, 35, 42-45.
 
[28]  CLARK, D.M. A cognitive approach to panic. Behaviour Research and Therapy, 24 (4), 461-470.
 
[29]  KEMPER, C.J., LUTZ, J., BÄHR, T., RÜDDEL, H. & HOCK, M. (2012). Construct validity of the Anxiety Sensitivity Index-3 in Clinical Samples. Assessment, 19 (1), 89-100.
 
[30]  WILSON, K.A. & HAYWARD, C. (2006). Unique contributions of anxiety sensitivity to avoidance: A prospective study in adolescents. Behaviour Research and Therapy, 44, 601-609.
 
[31]  NORTON, P.J. & PRICE, E.C. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. The Journal of Nervous and Mental Disease, 195 (6), 521-531.
 
[32]  HEIMBERG, R.G. (2002). Cognitive-behavioral therapy for social anxiety disorder: current status and future directions. Biological psychiatry, 51 (1), 101-108.
 
[33]  SMITS, J.A.J., BERRY, A.C., TART, C.D. & POWERS, M.B. (2008). The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: A meta-analytic review. Behaviour Research and Therapy, 46, 1047-1054.
 
[34]  ZVOLENSKY, M.J., YARTZ, A.R., GREGOR, K., GONZALES, A. & BERNSTEIN A. (2008). Interoceptive exposure-based cessation intervention for smokers high in anxiety sensitivity: A case series. Journal of Cognitive Psychotherapy, 22 (4), 346-365.
 
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Article

Study of the Effects of Snack-Centered Dietary Education on First-Grade Elementary Students and Duration of These Effects

1Department of Food and Nutrition, Faculty of Agriculture, Kinki University, Nara, Japan


American Journal of Public Health Research. 2015, 3(1), 1-7
DOI: 10.12691/ajphr-3-1-1
Copyright © 2015 Science and Education Publishing

Cite this paper:
Toshiyuki Kohri, Naoko Kaba. Study of the Effects of Snack-Centered Dietary Education on First-Grade Elementary Students and Duration of These Effects. American Journal of Public Health Research. 2015; 3(1):1-7. doi: 10.12691/ajphr-3-1-1.

Correspondence to: Toshiyuki  Kohri, Department of Food and Nutrition, Faculty of Agriculture, Kinki University, Nara, Japan. Email: tkohri@nara.kindai.ac.jp

Abstract

Irregular diets and nutrient imbalances that result from a lack of interest in food have become more common among not only adults but also children. Snacks are a category of food that most children like and can select for themselves. This study validated the effects of snack-centered dietary education for children on the ability of snack selection and duration of these effects. Twenty-three types of snacks, including drinks, were lined up on a table and presented to 103 Japanese first grade elementary students (intervention group) in a snack selection test in which children were allowed to freely select the snacks they would eat in one day. The ability of children to select the proper quality and quantity of snacks was evaluated on the basis of the energy and nutrient content of the selected snacks. Subsequently, snack-centered dietary education intervention lessons were provided to the children, and the same test conducted at baseline was immediately reconducted after the intervention and seven months after the end of the intervention. The control group comprised 118 children who were in the first grade during the subsequent school year. In the intervention group, the snacks selected in the baseline test had excessive energy content; post-intervention, the energy content approached a more appropriate level and the nutrient density of vitamins, iron, and dietary fiber increased. Moreover, these improvements were observed even seven months after the intervention ended. However, in the control group, there were no significant changes. These findings suggested that snack-centered dietary education for first grade elementary students contributed to improving the quality and quantity of snack selection, and these effects persisted for more than half a year.

Keywords

References

[1]  Ogden, C.L., Carroll, M.D., Kit, B.K. and Flegal, K.M., “Prevalence of childhood and adult obesity in the United States, 2011-2012,” JAMA, 311 (8). 806-814. Feb. 2014.
 
[2]  Lazzeri, G., Rossi, S., Kelly, C., Vereecken, C., Ahluwalia, N. and Giacchi, M.V., “Trends in thinness prevalence among adolescents in ten European countries and the USA (1998-2006): a cross-sectional survey,” Public Health Nutr, 24. 1-9. Sep. 2013.
 
[3]  Inokuchi, M., Matsuo, N., Takayama, J.I. and Hasegawa, T., “Trends in thin body stature among Japanese male adolescents, 2003-2012,” Ann Hum Biol, 41 (3). 277-281. May. 2014.
 
[4]  Lien, N., Lytle, L.A. and Klepp, K.I., “Stability in consumption of fruit, vegetables, and sugary foods in a cohort from age 14 to age 21,” Prev Med, 33 (3). 217-226. Sep. 2001.
 
[5]  Skinner, J.D., Carruth, B.R., Wendy, B. and Ziegler, P.J., “Children’s food preferences: a longitudinal analysis,” J Am Diet Assoc, 102 (11). 1638-1647. Nov. 2002.
 
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[6]  Larson, N., Fulkerson, J., Story, M. and Neumark-Sztainer, D., “Shared meals among young adults are associated with better diet quality and predicted by family meal patterns during adolescence,” Public Health Nutr, 16 (5). 883-893. May. 2013.
 
[7]  Jones, S.C. and Kervin, L., “An experimental study on the effects of exposure to magazine advertising on children's food choices,” Public Health Nutr, 14 (8). 1337-1344. Aug. 2011.
 
[8]  Takeichi, H., Taniguchi, H., Fukinbara, M., Tanaka, N., Shikanai, S., Sarukura, N., Hsu, T.F., Wong, Y. and Yamamoto, S., “Sugar intakes from snacks and beverages in Japanese children,” J Nutr Sci Vitaminol, 58 (2). 113-117. 2012.
 
[9]  Johnson, G.H. and Anderson, G.H., “Snacking definitions: impact on interpretation of the literature and dietary recommendations,” Crit Rev Food Sci Nutr, 50 (9). 848-871. Oct. 2010.
 
[10]  Mercille, G., Receveur, O. and Macaulay, A.C., “Are snacking patterns associated with risk of overweight among Kahnawake schoolchildren?,” Public Health Nutr, 13 (2). 163-171. Feb. 2010.
 
[11]  Melnik, T.A., Rhoades, S.J., Wales, K.R., Cowell, C. and Wolfe, W.S., “Food consumption patterns of elementary schoolchildren in New York City,” J Am Diet Assoc, 98 (2). 159-164. Feb. 1998.
 
[12]  Cullen, K.W., Eagan, J., Baranowski, T., Owens, E. and de Moor, C., “Effect of a la carte and snack bar foods at school on children's lunchtime intake of fruits and vegetables,” J Am Diet Assoc, 100 (12). 1482-1486. Dec. 2000.
 
[13]  Baxter, S.D., Thompson, W.O., Litaker, M.S., Frye, F.H. and Guinn, C.H., “Low accuracy and low consistency of fourth-graders' school breakfast and school lunch recalls,” J Am Diet Assoc, 102 (3). 386-395. Mar. 2002.
 
[14]  Warren, J.M., Henry, C.J., Livingstone, M.B., Lightowler, H.J., Bradshaw, S.M. and Perwaiz, S., “How well do children aged 5-7 years recall food eaten at school lunch?,” Public Health Nutr, 6 (1). 41-47. Feb. 2003.
 
[15]  Matvienko, O., “Impact of a nutrition education curriculum on snack choices of children ages six and seven years,” J Nutr Educ Behav, 39 (5). 281-285. Sep. 2007.
 
[16]  Hammond, J., Nelson, M., Chinn, S. and Rona, R.J., “Validation of a food frequency questionnaire for assessing dietary intake in a study of coronary heart disease risk factors in children,” Eur J Clin Nutr, 47 (4). 242-250. Apr. 1993.
 
[17]  Yoshiike, N., Hayashi, F., Takemi, Y., Mizoguchi, K. and Seino, F., “A new food guide in Japan: the Japanese food guide Spinning Top,” Nutr Rev, 65 (4). 149-154. Apr. 2007.
 
[18]  The Committee for Science and Technology Council Subcommittee Resources Survey of the Ministry of Education, Culture, Sports, Science and Technology in Japan. Standard Tables of Food Composition in Japan, 5th ed., Ishiyaku Publishers, Tokyo, 2001, 1-508.
 
[19]  Burchett, H., “Increasing fruit and vegetable consumption among British primary schoolchildren: a review,” Health Educ, 103 (2). 99-109. 2003.
 
[20]  Blanchette, L. and Brug, J., “Determinants of fruit and vegetable consumption among 6-12-year-old children and effective interventions to increase consumption,” J Hum Nutr Diet, 18 (6). 431-443. Dec. 2005.
 
[21]  Reynolds, K.D., Yaroch, A.L., Franklin, F.A. and Maloy, J., “Testing mediating variables in a school-based nutrition intervention program,” Health Psychol, 21 (1). 51-60. Jan. 2002.
 
[22]  Kelly, B., Smith, B., King, L., Flood, V. and Bauman, A., “Television food advertising to children: the extent and nature of exposure,” Public Health Nutr, 10 (11). 1234-1240. Nov. 2007.
 
[23]  Salvy, S.J., Kluczynski, M.A., Nitecki, L.A. and O'Connor, B.C., “Peer influence on youth's snack purchases: a laboratory analog of convenience store shopping,” Eat Behav, 13 (3). 233-239. Aug. 2012.
 
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Article

HIV/AIDS Knowledge and Attitude among Military Recruits at Depot Nigeria Army, Zaria, Nigeria

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

2Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria

3Department of Community Medicine, Kaduna State University, Kaduna, Nigeria


American Journal of Public Health Research. 2015, 3(1), 8-14
DOI: 10.12691/ajphr-3-1-2
Copyright © 2015 Science and Education Publishing

Cite this paper:
Chinedu John-Camillus IGBOANUSI, Tukur DAHIRU, Istifanus Anekoson JOSHUA. HIV/AIDS Knowledge and Attitude among Military Recruits at Depot Nigeria Army, Zaria, Nigeria. American Journal of Public Health Research. 2015; 3(1):8-14. doi: 10.12691/ajphr-3-1-2.

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

Abstract

Military personnel have higher HIV/AIDS prevalence than the general population. They tend to be young, single, sexually active and highly mobile and may stay away from their home. This study assessed HIV/AIDS knowledge and attitude among recruits at Nigerian Army Depot in Zaria Nigeria. It was a cross sectional descriptive study carried out February 2011 using 300 structured, self-administered questionnaires. Majority of the respondents (80.3%) were within the age bracket of 20- 24 years with mean age of 21.8 ± 2.0 years, 93% single and 53.3% secondary school graduate. Majority of the respondents (91.0%) have heard of HIV/AIDS, while a lot of them (72.6%) knew those that are victims of the disease. Majority of the respondents (74.3%) also knew that HIV/AIDS was caused by virus. On the overall, only 48.7% of the respondents had good knowledge of the disease. About 80.7% of the respondents would offer assistance to HIV infected people, 62.3% agreed that HIV positive women should not be having babies, while 66.0% believed that HIV/AIDS patients should not be stigmatized against among others. The study revealed amongst others that the recruits had very good knowledge of HIV/AIDS and also good attitudes to it. The recommendations include- aggressive regular HIV/AIDS awareness campaigns, development of attitudinal and behavioural change communication strategies for the recruits in particular, health education by faith based organisations. There is also the need to develop a good practical tool and quality control programs for monitoring and evaluation of the various HIV/AIDS awareness programs in the barracks for enhanced effectiveness and efficiency.

Keywords

References

[1]  AIDS and the Military. UNAIDS point of view, May, 1998.
 
[2]  Inungu Joseph and Sarah Karl. Understanding the scourge of HIV/AIDS in sub-Saharan Africa. Medscape General Medicine 2006; 8 (4):30.
 
[3]  Ekong E. HIV/AIDS and the military. http://www.hsph.harvard.edu/apin/chapter24.pdf. (Accessed on 22 February, 2009).
 
[4]  Classic Encyclopedia. http://www.1911encyclopedia.org/Zaria. (Accessed on 14 December, 2008).
 
[5]  Zaria climate and weather. http://www.world66.com/africa/nigeria/zaria/lib/climate. (Accessed on 20 January, 2009).
 
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[6]  UNAIDS. 2008 country profile: Nigeria. http:/www.unaids.org/en/countryresponses/countries/Nigeria.asp. (Accessed on 20 January, 2009).
 
[7]  Ugboga AN. and Ajuwon AJ. Knowledge of AIDS and HIV risk-related sexual behaviour among Nigerian naval personnel. Bio Med Central Public Health 2004, 4:24.
 
[8]  Adewole DA. and Lawoyin TO. Knowledge, attitude to HIV/AIDS and risk behaviour among unmarried male youths of the University of Ibadan, Nigeria. The XV International Conference on AIDS 2004. http://gateway.nlm.nih.gov/MeetingAbstracts/ma. (Accessed on 20 January, 2009).
 
[9]  Sudha RT, Vijah DT and Lakshmi V. Awareness, attitudes, and beliefs of the general public towards HIV/AIDS in Hyderabad, a capital city from South India. Indian Journal of Medical Sciences 2005; 59 (7): 307-316.
 
[10]  McManus A and Dhar L. Study of knowledge, perception and attitude of adolescent girls towards STIs/HIV, safer sex and sex education: (A cross sectional survey of urban adolescent school girls in South Delhi, India). Bio Med Central Women’s Health 2008; 8: 12.
 
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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

References

[1]  Almon R.R., Dubois D, Jim JY., Jusko W.F. (2005). Temporal profiling of the transcriptional basis for the development of corticosteroid-induced insulin resistance in rat muscle. J. Endocrimol.; 184 (1): 219-232.
 
[2]  Almon RR.,DuBois D.C., and Jusko W.J. (2007). A micro array analysis of the temporal response of liver to methylprednisolone: a comparative analysis of two dosing regimens. Endocrinology; 148 (5): 2209-2225.
 
[3]  Amsten A.M.T. 2009. Stress signaling pathways that impair prefrontal cortex structure and function. Nature; Reviews Neuroscience; 10 (6): 410-422.
 
[4]  Andrews G., Davies M. and Titov N. (2011).Effectiveness of Randomized Controlled Trial of face to face versus internet Cognitive Behavior Therapy for social phobia. Australian and New Zealand Journal of Psychiatry; 45 (3): 337-340.
 
[5]  Bazuline M.,Carlotti F., Tafrechi R.S.J., Hoeben R.C., Maassem J.A. (2004). Mitogen-activated protein kinase (MAPK) phosphatase-1 and -4 attenuate p38 MAPK during dexamethasone-induced insulin resistance in 3T3-L1 adipocyte. Mol. Endocrinol.; 18 (7): 1697-1707.
 
Show More References
[6]  Bennett J.M., Fagundes C.P. and Kiecolt-Glaser J.K. (2013). The chronic stress of care giving accelerates the natural ageing of the immune system. Immunosenescence. Bosch J.A. (eds). Pg 35-46. Springer Suremert Bussiness Media, New York.
 
[7]  Bhatia V and Tandon R.K. (2005). Stress and the gastrointestinal tract. J. Gastroenterol. Hepatol.; 20 (3): 332-9.
 
[8]  Bracke P.E. (2010). Progressive Muscle Relaxation. Corsini Encyclopedia of Psychology (1-2).
 
[9]  Breivik T., Throne P.S.,Murison R and Gjermo P.(2007). Emotional stress effects on immunity, ginvitis and periodontitis. European Journal of Oral Science; 104: 327-334.
 
[10]  Buren J., Lai Y.C., Lundaren M., Eriksson J.W. and Jensen J.(2008). Insulin action and signaling in fat and muscle from dexamethasone-induced rats. Arch. Biochem Biophys.; 474 (1): 91-101.
 
[11]  Chrousos G.P. (2000). The role of stress and the hypothalamic-adrenal-axis in the pathogenesis of the metabolic syndrome, neuro-endocrine and target tissue-related causes. Int J. Obes. Relat. Metab. Disorder; 24: (Suppl 2): S50-5.
 
[12]  Crespo C.S., Cachero P., Jimenez L.P., Barrios V and Ferreiroo E.A (2014). Peptides and food intake. Frontiers in Endocrinology; 5: 58-62.
 
[13]  Dayas C.V., Buller K.M. and Day T.A. (2008). Neuroendocrine responses to an emotional stressor: evidence for involvement in the medial but not the central amygdale. European Journal of Neuroscience; 11 (7): 2312-2322.
 
[14]  Elias C.F., Lee C., Kelly J., Aschkenasi C.,Ahima R.S.,Couceyro P.R., Kuhar M.J., Saper C.B. and Eimquest J.K. (1998). Leptin activates hypothalamic CART neurons projecting to the spinal cord. Neuron; 21 (6): 1375-85.
 
[15]  Fan J.,Cui Y.,Wan M.,Wang W and Li Y. (2014). Lipid accumulation and biosynthesis genes response of the oleaginous Chlorella pyrenoidosa under three nutrition stressors. Biotechnology for Biofuels; 7: 17-30.
 
[16]  Fernandes M., Cukier A and Feltrim M.I.Z. (2011). Efficacy of diaphragmatic breathing in patients with chronic obstructive pulmonary diseases. Chronic Respiratory Disease; 8 (4): 237-244.
 
[17]  Flak J.N., Myers B., Solomon M.B.,McKlveen J.M.,Krause E.G. and Herman J.P. (2014). Role of paraventricular nucleus-projecting norepinephrine neurons in acute and chronic stress. European Journal of Neuroscience; 39 (11): 1903-1911.
 
[18]  Frank G.M., Watkins L.R and Maier S.F. (2013). Stress-induced glucocorticoids as a neuro endocrine alarm signal of danger. Brain Behaviour and Immunity; 30: 1-6.
 
[19]  Granath J., Ingvarsson S., von Thiele U and Lundberg U. (2006). Stress management: A randomized study of cognitive behavioral therapy and yoga, Cognitive Behavior Therapy; 35 (1): 3-10.
 
[20]  Hahn T.M.., Breininger J.F., Baskin D.G and Schwartz M.W. (1998). Co-expression of Agrp and NPY in fasting-activated hypothalamic neurons.Nut. Neurosci.; 1 (4): 271-2.
 
[21]  Hawton K.E.(Ed), Salkovskis P.M.(Ed).,Kirk J.E. (Ed) and Clark D.M. (Ed). (1989). Cognitive Behavior Therapy for psychiatric problems: A practical guide. Oxford University Press, New York, NY, U.S.A.
 
[22]  Janice U (2008). Neuropeptide Y in the amygdale induces long-term resilience to stress-induced reductions in social responses but not hypothalamic-adrenal-pituitary axis activity or hypothalamus. The Journal of Neuroscience; 28 (4): 893-903.
 
[23]  Janssen J.A.M.J.L and Lamberts S.W. (2014). Diabetes associated with glucocorticoid excess in Diabetes Secondary to endocrine and pancreatic disorders. Chigo E and porta M (eds) Front Diabetes Base; Volume 22: 22-23., Karger Publishers.
 
[24]  Jaremka L.M., Glaser R.,Loving T.J.,Malawkey W.B., Stowell J.R and Kietcolt-Glaser J.K. (2013). Attachment anxiety is linked to alterations in cortisol production and cellular immunity. Psychological Science; 24 (3): 272-279.
 
[25]  Jefferson L.L. (2010). Exploring effects of therapeutic massage and patient teaching in the practice of diaphragmatic breathing on blood pressure, stress and anxiety in hypertensive Africa-America women: an intervention study. Europe PubMed Central. www.europepmc.org/med/20857772
 
[26]  Kim B.S., Lee J., Bang M.,Seo B.A., Khalid A., Jung M.W. and Jeon D. (2014). Differential regulation of observational fear and neural oscillations by serotonin and dopamine in the mouse anterior cingulated cortex. Psychopharmacology; 231: 4371-4381.
 
[27]  Kokot F and Ficek R. (1999). Effects of neuropeptide Y on appetite. Mineral Electrolyte Metabolism; 25(4-6): 303-5.
 
[28]  Kriengwatana B.., Wada H., Schmidt K.L., Taves M.D.,Sama K.K. and MacDougall-Shackleton S.A. (2014). Effects of nutritional stress during different developmental periods and the hypothalamic-pituitary-adrenal-axis in zebra flinches. Hormones and Behavior; 65 (3): 285-293.
 
[29]  Krou I., Chrousos G.P and Tsigos C (2006). Stress, visceral obesity and metabolic complications. Ann. New York Acad. Sci.; 1083: 77-110.
 
[30]  Lee E.J., Bhattacharya J., Sohn C and Verres K.(2012). Monochord sounds and progressive muscle relaxation reduce anxiety and improve relaxation during chemotherapy: A pilot EEG study. Complementary Therapies in Medicine; 20 (6): 409-416.
 
[31]  Lin T-K., Man M-Q., Santiago J-L., Scharschmidt T.C., Hupe M., Martin-Ezquerra G., Youm J-K., Zhai Y., Trullas C., Feingold K.R. and Rlias P.M. (2014). Paradoxical benefits of psychosocial stress in inflammatory dermatoses models are glucocorticoid mediated. Journal of Investigative Dermatology; 134: 2890-2897.
 
[32]  Maina G.,Palmas A and Day T.A.(2008). Relationship between self-reported mental stressors at the workplace and salivary cortisol. Int. Arch. Occup. Environ. Health; 81: 391-400
 
[33]  Marsis P.M. and Barcim T.Z. (2012). Sculpting the hippocampus from within stress, spines and CRH. Trends in Neuroscience; 35 (5): 315-324.
 
[34]  Martarelli D., Cocchioni M., Sairi S and Pampei P. (2011). Diaphragmatic breathing reduces exercise-induced oxidative stress; Evidence-Based Complementary and Alternative Medicine; Vol 2011.
 
[35]  McEwen B.S. (2012). Brain on stress: How the social environment gets under the skin. Proceedings of the National Academy of Science; 109 (Suppl 2): 17180-17185.
 
[36]  McEwen B.S. and Morrison J.H. (2013). The brain on stress: Vulverability and plasticity of the prefrontal cortex over the life course. Neuron; 79 (1): 16-29.
 
[37]  Naglatzki R.P., Schiamann M., Gasser T., Lado M.E., Sure U., Forsting M. and Gizewski E.R. (2012). Cerebral somatic pain modulation during autogenic training in IMRI. European Journal of Pain; 16 (9): 1293-1301.
 
[38]  Nakazeto M., Murakami N., Date Y., Kojima M., Matsuo H., Kangawa K. and Matsukura S. (2001). A role for ghrelin in the central regulation of feeding. Nature; 469 (6817): 194-8.
 
[39]  O Connor T.M., O’Hailoran D.J. and Sharaathan F (2000). The stress response and the hypothalamic pituitary adrenal axis: from molecule to melancholia. QJM monthly Journal of the Association of Physicians; 93 (6): 323-333.
 
[40]  Ortega V.A., Lovepy D.A and Bernier N.J. (2013). Appetite suppressing effects and interactions of centrally administered corticotrophin-releasing factor, urotensin I and serotonin in rainbow trout (Oncorhynchus mykiss). Frontiers in Neuroscience; 7: 196.
 
[41]  Padgett D.A and Glaser R (2003). How stress influences the immune response. Trends in Immunology; 24 (8): 444-448.
 
[42]  Parkinson JR., Ohillo W.S.,Small C.J., Chavdlin O.B., Bewick G.A., Pritchard I.,Moore S., Ghate M.A., and Bloom S.R., (2008). PYY 3-36 injection in mice produces an acute anorexigenic effect followed by a delayed orexigenic effect not observed with other anorexigenic gut hormones. Am J. Physiol. Endocrinol. Metab. 294 (4): 698-708.
 
[43]  Pascuan C.G., Rubistein M.R., Palumbo M.L. and Genaro A.M. (2014). Prenatal stress induces up regulation of glucocorticoid receptors in lymphoid cells modifying the T cell response after acute stress exposure in the adult life. Physiology and Behaviuor; 126 (10): 141-147.
 
[44]  Potthoff K., Schmidt M.E., Wiskemam J., Hof H., Klassen O., Habermann N., Beckhove P., Debris J., Ulrich C.M and Steindorf K (2013). Randomized controlled trial to evaluate the effects of progressive risitance training compared to progressive muscle relaxation in breast cancer patients undergoing adjuvant radiotherapy: the BEST study. BMC Cancer; 13: 162.
 
[45]  Puglisi-Allegra S. and Andolina D. (2015). Serotonin and stress coping. Behavioral Brain Research; 277: 58-67.
 
[46]  Raspopow K., Abizaid A., Matheson K and Anisman H. (2014). Anticipation of a psychosocial stressor differentially influences ghrelin, cortisol and food intake among emotional and non-emotional eaters. Appetite: 74: 35-43.
 
[47]  Reiche E.M.V., Numes S.O.V. and Morimoto H.K. (2004). Stress, depression, the immune system and cancer. THE LANCET Oncology; 5 (10): 617-625.
 
[48]  Rider C.V., Boekelheide K., Catlin N., Cardon C.J.,Morata T, Selgrade M.K., Sexton K. and Simmons J.E. (2014). Cummulative Risk: Toxicity and Interactions of physical and chemical stressors; Toxicology Science; 137:3-11.
 
[49]  Roozendaal B., McEwen M.S. and Charttarji S. (2009). Stress, memory and the amygdale. Nature Reviews Heuroscience; 10 (6): 423-433.
 
[50]  Rossman M.L (2010). ED Kramer HT. Guided imagery for self healing. New World Library, California, U.S.A.
 
[51]  Saad M.J., Folli F., Kahn J.A. and Kahn C.R. (1993). Modulation of insulin receptor, insulin receptor substrate-1 and phosphatidylinositol 3 kinase in liver and muscle of dexamethasone-treated rats. J. Clin. Invest.; 92 (4): 2083-2072.
 
[52]  Sam A.H.., Troke R.C.., Tan T.M., and Bowok G.A. (2012). The role of the gut/brain axis in modulating food intake. Neuropharmacology; 63 (1): 46-56.
 
[53]  Segerstrom S.C. and Miller G.E. (2004). Psychological stress and the human immune system: a meta- analytic study of 30 years of inquiry. Psychological Bulletin; 130 (4): 601-630.
 
[54]  Shinozaki M., Kanazawa M., Kano M., Endo Y., Nakaya N., Bongo M and Fukudo S. (2010). Effect of autogenic training on general improvement in patients with irritable bowel syndrome : a randomized controlled trial. Applied Psychophysiol. And Biofeedback; 39: 180-198.
 
[55]  Siopen N.,Duettetra L.M., Williams D.R., Mujahid M.S., Lewis T.T., Bennett C.G., Ryff C.D. and Albert M.A. (2012). Psychosocial stressors and cigarette smoking among African American adults in midlife. Nicotine and Tobacco Research; 14 (10): 1161-1169.
 
[56]  Sklor L.S. and Anisman H. (1981) Stress and Cancer. Psychological Bulletin; 78 (3); 389-406.
 
[57]  Torres S.T. and Nowson C.A. (2007). Relationship between stress, eating behavior and obesity. Nutrition; 23 (11-12): 887-94.
 
[58]  Tsigel C and Chrousous G.P. (2002). Hypothalamic-pituitary-adrenal-axis, neuro endocrine factors and stress. J. Psychosom. Res.; 53 (4): 865-71.
 
[59]  Upton K.R and Roley L.G. (2013). Acute stress inhibits food intake and alters ghrelin signaling in the brain of tilapia (Oreochromis mossambicus). Domestic Animal Endocrinology; 44(3): 157-164.
 
[60]  Vancampfort D., Correl C.U., Scheewe T.W., Probst M., De Herdt A., Krapen J and DeHert M. (2013). Progressive muscle relaxation in persons with schizophrenia: a systematic review of randomized control trials. Clinica; Rehabilitation; 27 (4): 291-298.
 
[61]  Vancampfort D., DeHert M., Knapen J., Maurissen K.,., Roaepsaet J., Deckx S., Remans S and Probst M(2011). Effects of progressive muscle relaxation on state anxiety and subjective well-being in people with schizophrenia: a randomized controlled trial. Clinical Rehabilitation; 25 (6): 567-575.
 
[62]  Veal D., Anson M., Miles M., Costa A and Ellison N. (2014). Efficacy of cognitive behavior therapy versus anxiety management for body dysmorphic disorders: a randomized controlled trial. Psychotherapy and Psychosomatics; 83 (6): 341-353.
 
[63]  Verkark R., Busch M., Koenerman T.,van der Berg R., Spreeuwenberg P. and Francke A.L. (2014). Guided imagery in people with fibromyalgia: A randomized controlled trial of effects on pain, functional status and self efficacy. Journal of Health Psychology; 19 (5): 678-688.
 
[64]  Walsh K., Elliot J.C., Shmulewitz D., Aharonovich E., Strous R., Frisch A., Wereman A., Spivak B., Grout B.F and Hasin D (2014). Trauma exposure, post trauma stress disorder and risk for alcohol, nicotine and marijuana dependence in Israel. Comprehensive Psychiatry; 55 (3): 621-630.
 
[65]  Young J.B., Flatt J.P. and Ravussin E. (1996). Effects of glucocorticoids on energy metabolism and food intake in humans. Am. J. Physiol.; 27 (2): E317-25.
 
Show Less References

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

References

[1]  Ministry of Public Health and Sanitation & Ministry of Medical Services, National Reproductive Health Strategy 2009-2015, Division of Reproductive Health, Nairobi, 2009.
 
[2]  Ministry of Public Health and Sanitation, National Malaria Strategy 2009-2017, Division of malaria control, Nairobi, 2009.
 
[3]  A. Guguyu, O., Ochieng’, O. Zilper, Budget 2013 / 14: The Onset of the Devolved Government and the Hurdles Ahead, Instute of economic affairs, Nairobi, 2014. [e-book] Available: http://www.ieakenya.or.ke/publications/doc.../277-budget-guide-2013-14
 
[4]  B. N. Bourbonnais, Implementing Free Maternal Health Care in Kenya, Kenya National Commission on Human Rights, Nairobi, November, 2013. [E-book] Available: http://www.knchr.org/Portals/0/EcosocReports/Implementing%20Free%20Maternal%20Health%20Care%20 in%20Kenya.pdf
 
[5]  Kenya National Bureau of Statistics (KNBS) and ICF Micro, Kenya Demographic and Health Survey 2008-09., KNBS and ICF Macro., Calverton, Maryland, 2010.
 
Show More References
[6]  World Health Organization, Provision of effective Antenatal Care; integrated management of pregnancy and Child Birth, Department of making pregnancy safer, Geneva, 2014. [E-book] Available: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/effective_antenatal_care.pdf
 
[7]  O. Emelumadu, A. Ukegbu, N. Ezeama, O. Kanu, C. Ifeadike, and U. Onyeonoro, “Socio-demographic determinants of maternal health-care service utilization among rural women in anambra state, South East Nigeria.,” Ann. Med. Health Sci. Res., vol. 4, no. 3, pp. 374-82, May 2014.
 
[8]  S. Dhakal, E. van Teijlingen, E. A. Raja, and K. B. Dhakal, “Skilled care at birth among rural women in Nepal: practice and challenges.,” J. Health. Popul. Nutr., vol. 29, no. 4, pp. 371-8, Aug. 2011.
 
[9]  B. E. Sines, U. Syed, S. Wall, and H. Worley, Postnatal Care: A Critical Opportunity to save mothers and newborns, Population Reference Bureau, Washington DC, 2007. [E-book] Available: http://www.prb.org/pdf07/snl_pncbrieffinal.pdf
 
[10]  World Health Organization, Postnatal care of the mother and newborn. World Health Organization , Geneva:, 2014. [E-book] Available: http://apps.who.int/iris/bitstream/10665/97603/1/9789241506649_eng.pdf
 
[11]  A. J. Pollard, “Childhood immunisation: what is the future?,” Arch. Dis. Child., vol. 92, no. 5, pp. 426-33, May 2007.
 
[12]  S. Ahmed, Q. Li, L. Liu, and A. O. Tsui, “Maternal deaths averted by contraceptive use: an analysis of 172 countries.,” Lancet, vol. 380, no. 9837, pp. 111-25, Jul. 2012.
 
[13]  A. Srivastava, S. Mahmood, P. Mishra, and V. Shrotriya, “Correlates of maternal health care utilization in rohilkhand region, India.,” Ann. Med. Health Sci. Res., vol. 4, no. 3, pp. 417-25, May 2014.
 
[14]  Kenya National Bureau of Statistics (KNBS), The 2009 Kenya Population and Housing Census: Population Distribution by Age, Sex and Administrative Units, KNBS, Nairobi, 2010. [E-Book] Available: http://statistics.knbs.or.ke/nada/index.php/catalog/55
 
[15]  T. J. W. Fisher A.A, Laing J.E, Stoeckel J.E., Handbook for Family Planning Operations Research, Second Edi. Population Council, New York, 1998.
 
[16]  M. Tavakol and R. Dennick, “Making sense of Cronbach’s alpha,” Int. J. Med. Educ., vol. 2, pp. 53-55, Jun. 2011.
 
[17]  World Health Oorganization, Monitoring maternal, newborn and child health:. WHO Press, Geneva, 2011, p. 5.
 
[18]  S. M. Tarekegn, L. S. Lieberman, and V. Giedraitis, “Determinants of maternal health service utilization in Ethiopia : analysis of the 2011 Ethiopian Demographic and Health Survey,” BMC Pregnancy Childbirth, vol. 14, no. 1, pp. 1-13, 2014.
 
[19]  F. Yego, C. D’Este, J. Byles, J. S. Williams, and P. Nyongesa, “Risk factors for maternal mortality in a Tertiary Hospital in Kenya: a case control study.,” BMC Pregnancy Childbirth, vol. 14, p. 38, Jan. 2014.
 
[20]  E. Illah, G. , Mbaruku, H. , Masanja, and K. Kahn, “Causes and Risk Factors for Maternal Mortality in Rural Tanzania-Case of Rufiji Health and Demographic Surveillance Site (HDSS),” Afr. J. Reprod. Health, vol. 17, no. September, pp. 119-130, 2013.
 
[21]  E. Sonneveldt, W. DeCormier Plosky, and J. Stover, “Linking high parity and maternal and child mortality: what is the impact of lower health services coverage among higher order births?,” BMC Public Health, vol. 13 Suppl 3, p. 7, Jan. 2013.
 
[22]  C. Joshi, S. Torvaldsen, R. Hodgson, and A. Hayen, “Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data,” BMC Pregnancy Childbirth, vol. 14, no. 1, pp. 1-11, 2014.
 
[23]  Y. Agus and S. Horiuchi, “Factors influencing the use of antenatal care in rural West Sumatra, Indonesia.,” BMC Pregnancy Childbirth, vol. 12, p. 9, Jan. 2012.
 
[24]  T. R. Feyissa and G. A. Genemo, “Determinants of institutional delivery among childbearing age women in Western Ethiopia, 2013: unmatched case control study.,” PLoS One, vol. 9, no. 5, p. e97194, Jan. 2014.
 
[25]  M. Atiqul Hoque Chowdhury, M. Mehedi Hasan, S. Ahmed, C. Darwin, M. Sazzad Hasan, and M. Rabiul Haque, “Socio-demographic Factors Associated with Home Delivery Assisted by Untrained Traditional Birth Attendant in Rural Bangladesh,” Am. J. Public Heal. Res., vol. 1, no. 8, pp. 226-230, Dec. 2013.
 
[26]  A. Amano, A. Gebeyehu, and Z. Birhanu, “Institutional delivery service utilization in Munisa Woreda, South East Ethiopia: a community based cross-sectional study.,” BMC Pregnancy Childbirth, vol. 12, no. 1, p. 105, Jan. 2012.
 
[27]  S. Das, U. Bapat, N. S. More, L. Chordhekar, W. Joshi, and D. Osrin, “Prospective study of determinants and costs of home births in Mumbai slums.,” BMC Pregnancy Childbirth, vol. 10, p. 38, Jan. 2010.
 
[28]  J. N. DiBari, S. M. Yu, S. M. Chao, and M. C. Lu, “Use of postpartum care: predictors and barriers.,” J. Pregnancy, vol. 2014, p. 530769, Jan. 2014.
 
[29]  V. Khanal, M. Adhikari, R. Karkee, and T. Gavidia, “Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal demographic and health survey 2011.,” BMC Womens. Health, vol. 14, no. 1, p. 19, Jan. 2014.
 
[30]  P. K. Singh, R. K. Rai, M. Alagarajan, and L. Singh, “Determinants of maternity care services utilization among married adolescents in rural India.,” PLoS One, vol. 7, no. 2, p. e31666, Jan. 2012.
 
[31]  S. Gidado, P. Nguku, O. Biya, N. E. Waziri, A. Mohammed, P. Nsubuga, H. Akpan, A. Oyemakinde, A. Nasidi, I. Suleman, E. Abanida, Y. Musa, and K. Sabitu, “Determinants of routine immunization coverage in Bungudu, Zamfara State, Northern Nigeria, May 2010.,” Pan Afr. Med. J., vol. 18 Suppl 1, p. 9, Jan. 2014.
 
[32]  J. V Jani, C. De Schacht, I. V Jani, and G. Bjune, “Risk factors for incomplete vaccination and missed opportunity for immunization in rural Mozambique.,” BMC Public Health, vol. 8, p. 161, Jan. 2008.
 
[33]  V. Nankabirwa, T. Tylleskär, J. K. Tumwine, and H. Sommerfelt, “Maternal education is associated with vaccination status of infants less than 6 months in Eastern Uganda: a cohort study.,” BMC Pediatr., vol. 10, no. 1, p. 92, Jan. 2010.
 
[34]  D. Antai, “Inequitable childhood immunization uptake in Nigeria: a multilevel analysis of individual and contextual determinants.,” BMC Infect. Dis., vol. 9, p. 181, Jan. 2009.
 
[35]  M. K. Mutua, E. Kimani-Murage, and R. R. Ettarh, “Childhood vaccination in informal urban settlements in Nairobi, Kenya: who gets vaccinated?,” BMC Public Health, vol. 11, no. 1, p. 6, Jan. 2011.
 
[36]  S. Eliason, J. K. Awoonor-Williams, C. Eliason, J. Novignon, J. Nonvignon, and M. Aikins, “Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study.,” Reprod. Health, vol. 11, no. 1, p. 65, Jan. 2014.
 
[37]  V. Sharma, U. Mohan, V. Das, and S. Awasthi, “Socio demographic determinants and knowledge, attitude, practice: survey of family planning.,” J. Fam. Med. Prim. care, vol. 1, no. 1, pp. 43-7, Jan. 2012.
 
[38]  H. I. Awadalla, “Contraception Use among Egyptian Women : Results from Egypt Demographic and Health Survey in 2005,” J Reprod Infertil. vol. 13, no. 4, pp. 167-173, 2012.
 
[39]  F. Najafi-Sharjabad, S. Zainiyah Syed Yahya, H. Abdul Rahman, M. Hanafiah Juni, and R. Abdul Manaf, “Barriers of modern contraceptive practices among Asian women: a mini literature review.,” Glob. J. Health Sci., vol. 5, no. 5, pp. 181-92, Sep. 2013.
 
[40]  P. K. Malalu, “Determinants of Use of Modern Family Planning Methods: A Case of Baringo North District, Kenya,” Sci. J. Public Heal., vol. 2, no. 5, p. 424, 2014.
 
Show Less References

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

[1]  Referral (Medicine). Wikipedia, the free encyclopedia. Accessed 16/10/2013.
 
[2]  Nunez, 0., Cart-al, W., Hopkins, M., and Southall, D. Ethical Systems within Hospitals. In: International Child Health Care. A Practical Manual for Hospital Worldwide. Child Advocacy International. Eds: Southall, D., Coulter, B., Ronald, C., Nicholson, S., and Park, S. BMJ. 2002 pp. 12-15.
 
[3]  Opinion 8.132 - Referral of patients: Disclosure of Limitations. AMA (American Medical Association) Code of Ethics. http://www. ama.assn .org//ama/pub/physician-resources/medical ethics/code-medical-ethics/opinion8 1 32.pdf Accessed 16/10/2013.
 
[4]  Benjamin R. Physician’s Self-Referral. Report of the Council on Ethical and Judicial Affairs (Resolution 17, A - 07) CEJA Report 1-1-08. www.ama.assn.org/resources/doc/code-medical-ethics/8032/a.pdf Accessed 16/10/2013.
 
[5]  Huang, C. The Ethox Centre. Ethical Issues arising in individual Patient referrals http://www.ethox.org.uk.ethox-blog/ethical-issues-arising-in-individual patient-referrals Accessed 16/10/2013.
 
Show More References
[6]  Sledge, S. K,, and Pierson, H. A. (1992). The Law provides patients with a little more protection. Silicon Valley Business Journal http://www.bizjournals.com/sanjose/stories/1998/02/02/ focus2html? pages all Accessed 16/10/2013.
 
[7]  Harris, S. M. (2008). Pay for referrals may be illegal as well as unethical. American Medical News http://www.amednews.com/article/20081117/business/3 11179998/5/. Accessed 16/10/2013.
 
[8]  Harper, B., and Reuter, S. (2009) Paying Fees to referring physicians Ethical or Not Ethical? Monitor (2009) pg 29-34. Clinicalperformancepartners.com/wp-content/uploads/2012/07 physicians-referral-fee-final-ACRP-monitor 2009.pdf Accessed 16/10/2013.
 
[9]  Sanadi, E. N. (2011) Physician referral: Laws, Rules and Ethics. The Florida Bar www.floridarbar.org/.../110920%2ODr%2OEI%20sanadi’s%2ophysician%20 referral%20presentation.pdf Accessed 25/10/2013.
 
[10]  Kickback and Physician Self-referral Fraud/Office of Inspector General http://oig.hhs.gov/fraud/enforcement/cmp/kickback. asp.
 
[11]  Chetcuti, K., Farrugia, R. and Cassar, K. (2009) GP referral letters: time for a template? Malta Medical Journal Vol. 21 Issue 02, June 2009 pg 26-29
 
[12]  General Guidelines for Referring Dental Patients (2007) American Dental Association Council on Dental Practice www.ada.org/sections/.../pdfs/referring_guidlines.pdf Accessed 25/10/2013.
 
[13]  Slater, D. Y., (2011) The American Occupational Therapy Association Advisory Opinion for the Ethics Commission. Ethical Considerations in Private Practice www.aota.org/.../ethics/.../April%202013%20for%20posting% 20reformatted%20%2. Accessed 25/10/2013.
 
[14]  Goodell, M. A., and Casalino, L. P., (2008) Physician self-referral and physician-owned specialty facilities. Robert Wood Johnson Foundation. The Synthesis Project Policy Brief No. 15 (2008) www.rwjf.org/content/dam/farm/Reports/issue_briefs/2008 /rwjf28861 Accessed 25/10/2013.
 
[15]  The Surprising Secrets behind Doctor Referrals. Market watch http://www.marketwatch.com/story/the-surprising-secrets-behind-doctor referrals- 1334332558571. Accessed 25/10/2013.
 
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