scholarly journals Does cotrimoxazole prophylaxis in HIV patients increase the drug resistance of pneumococci? A comparative cross-sectional study in southern Ethiopia

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243054
Author(s):  
Mohammed Seid ◽  
Getnet Beyene ◽  
Yared Alemu ◽  
Bereket Workalemahu ◽  
Mulugeta Delbo ◽  
...  

Background Infections caused by antibiotic-resistant bacteria results in high rates of morbidity and mortality. Although the prolonged cotrimoxazole (CTX) prophylaxis is arguably associated with the risk of increasing drug resistance in the common pathogens, information regarding its impact on Streptococci pneumoniae / pneumococcus is very limited. Objective This study was conducted to investigate the effect of cotrimoxazole prophylaxis on nasopharyngeal colonization rate and antimicrobial resistance using Streptococci pneumoniae (pneumococcus) as an indicator organism among HIV patients in Arba Minch, Ethiopia. Materials and methods A comparative cross-sectional study was designed and conducted among HIV patients attending the Anti-Retroviral Treatment (ART) clinic of Arba Minch General Hospital (AMGH) from April 01 to August 31, 2018. A total of 252 participants were systematically selected and clustered into two study groups based on their CTX prophylaxis status, one taking CTX prophylaxis, and the second one, the control group (without prophylaxis). A structured questionnaire was used to collect socio-demographic and clinical data from patients. A nasopharyngeal swab was collected and cultured for pneumococcal isolation and identification in accordance with standard microbiological techniques. An antibiotics sensitivity test was performed according to the CLSI guidelines. Data were analyzed using the Statistical package for social science (SPSS) version 20. The primary outcome was determined using logistic regression analysis. Results Of the 252 enrolled HIV patients (mean age (37.38± 9.03 years), 144 (57.14%) were males. The overall, nasopharyngeal colonization rate of S. pneumoniae was 13.5% (95% CI: 8.4–15.6). Asymptomatic pneumococcal carriage rates among patients on CTX prophylaxis and the control group were 16.3%, and 10.3% respectively (p-value = 0.03). Regarding the risk factors analyzed, CTX prophylaxis (AOR: 2.2; 95% CI: 1.05–4.9) and gender (AOR: 2.5; 95% CI: 1.09–5.93) were significantly associated with pneumococcal colonization, showing a male preponderance. Cotrimoxazole-resistant pneumococci were 85.7% vs. 47.4% in the prophylaxis group and the control group respectively and it was statistically significant (AOR: 6.7; 95% CI: 1.3–36). Percentages of multi-drug resistant isolates in these two groups were 38.09 and 15.38 respectively (p-value = 0.04). Among the CTX resistant pneumococci isolates, 85% were also found to be co-resistant towards penicillin and was statistically significant. Conclusion The percentage prevalence of nasopharyngeal pneumococci colonization was higher in patients taking CTX prophylaxis. It was noted that CTX prophylaxis eventually results in the selection of cotrimoxazole resistance and multi-drug resistance in pneumococci. There is evidence of existing cross-resistance between cotrimoxazole and penicillin antibiotics. Therefore, CTX prophylaxis must be administered judiciously. Surveillance for antimicrobial susceptibility is warranted where the prophylaxis is common.

2021 ◽  
Author(s):  
Fatemeh Lavaee ◽  
Zahra Ranjbar ◽  
Mina Jalalian ◽  
Mohammad Amin Amiri

Abstract Background:In this study, we aimed to evaluate the sex hormonal serum level in patients with recurrent aphthous stomatitis and compare them with healthy participants.Methods:This cross-sectional study was done on patients with recurrent aphthous stomatitis who had referred to Shiraz Dental Faculty, Oral and Maxillofacial Medicine Department during 2018-2019. The non -menopause women with recurrence of at least 3 lesions per year were enrolled in this study.The mean serum level of FSH, LH, PRL (prolactin), testosterone, DHT (Dihydrotestosterone), DHEA-S (Dehydroepiandrosterone sulfate), estradiol and progesterone of 30 participants in each group of case and control were measured and compared. The data were analyzed by SPSS version 18 and independent T-test, Mann-Whitney U test, Spearman’s correlation coefficient test, Chi-square test and Fisher’s test.Results: The mean serum level of DHEA-S in patients with recurrent aphthous stomatitis (RAS) was significantly lower than the control group (p value=0.002). In addition to DHEA-S, the mean serum level of testosterone was lower in the evaluation group although this difference was not significant (p value=0.057).Considering the effect of age on the mean serum level of sex hormones, our results revealed that only DHEA-S mean serum level was decreased by increasing the age of participants in patients with RAS (p value=0.018).The number of participants with abnormal range of testosterone (p value<0.0001) and progesterone (p value=0.037) serum level was significantly more in patients with RAS. The frequency of RAS in a year did not show a significant relationship with the serum level of the evaluated hormones.Conclusion: The patients with RAS had a lower serum level of DHEA-S. The mean serum level of testosterone and progesterone was significantly abnormal in RAS patients.


2011 ◽  
Vol 18 (04) ◽  
pp. 663-666
Author(s):  
KAMAL ELDIN AHMED ABDELSALAM ◽  
MANAHIL ALI SHARWANI ◽  
SHAZA SALIH TAHA

Objective: determine serum lipid profile in diabetic and obese non-diabetic patients. Materials: 300 subjects comprising three groups, the first group included 100 diabetic patients (non-obese) with duration of diabetes over 5 years, the second group (obese) included 100 obese subjects (non-diabetic) with duration of obesity over 5 years, and the third group (control) included 100 healthy subjects. Methods: Lipid profile on the serum was performed with an auto analyzer using standard methods. Study design and period: Prospective Analytical Cross Sectional Study conducted in period from September 2006 to January 2008. Results: A significant (p value<0.05) increase in lipid profile results of diabetic and obese patients comparing to control while HDL-C showed significant decreasing. The cholesterol is significantly increased in females than males in diabetic patients, while the triglycerides are significantly decreased in diabetic females. The parameters showed insignificant variations between males and females in obese patients. Conclusions: In comparison to control group, DM & obese groups showed significantly increase in TG, TC, and LDL-C, but significantly decrease in HDL-C. Females showed significant increasing in TC and significant decreasing in DM group, while in obese group females showed insignificant decreasing in TG and TC. 


Author(s):  
Tanisha Negi ◽  
Syed Yunus Zama ◽  
Dushyanth P.

Background: HIV today is one of the worst pandemic diseases. Unlike terminal illnesses, HIV patients have to live for decades with the disease, which now shifts the interest to the quality of their life. The present study was planned, considering a necessity to inquire about the quality of life of patients taking Antiretroviral therapy in Mysore, various coping strategies prevalent among them and correlation between the two.Methods: This cross sectional study was done on 150 adults coming for anti retroviral therapy (ART), diagnosed with HIV at least 6 months back. ART centre was approached with required permissions. After explaining the study purpose, data was collected on paper with due consent from patients. Standard WHO QOL BREF and COPE carver Bref were used as questionnaire instruments. Analysis was done using SPSS software and Pearson’s correlation was used.Results: Analysis revealed that the most affected domain in quality of life was social domain with mean=11.75±2.12 (4-20 scale) and least affected was environmental with mean14.49±0.849. Self distraction was coping strategy of the highest prevalence (mean=4.98) having no correlation with QOL. Active coping showed positive correlation under all domains while behavioural disengagement and substance abuse had significant negative correlation overall (p value<0.001).Conclusions: Our study underlined a gap in Social domain of selected HIV affected population. Self distraction was the most preferred style of coping and humour was found to be least adopted method. Active coping had linear relationship all the 4 domains whereas behavioural disengagement showed significant lowering in QOL as a whole. 


2017 ◽  
Vol 6 (2) ◽  
pp. 129
Author(s):  
Entia Nopa ◽  
Ranissa Dwi Imansari ◽  
Irwandi Rachman

Faktor Risiko Kejadian Penyakit Kulit Pada Pekerja Pengangkut Sampah Di Kota Jambi 1Entianopa, 2Ranissa Dwi Imansari, 3Irwandi Rachman       123Program Studi Kesehatan Masyarakat STIKES Harapan Ibu, Jambi   Abstrak Latar Belakang: Kulit merupakan organ terbesar pada tubuh manusia yang membungkus otot-otot dan organ-organ dalam serta merupakan jalinan jaringan pembuluh darah, saraf, dan kelenjar yang tidak berujung, semuanya memiliki potensi untuk terserang penyakit yang salah satunya adalah penyakit kulit. Penyakit kulit merupakan salah satu gangguan kesehatan yang sering dialami oleh pekerja pengangkut sampah. Berdasarkan komposisi sampah yang diangkut serta waktu paparan kerja. Tujuan penelitian ini untuk mengetahui hubungan antara masa kerja, pemakaian Alat Pelindung Diri (APD), dan personal hygiene dengan kejadian penyakit kulit pada pekerja pengangkut sampah di Kota Jambi. Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain penelitian cross sectional study. Sampel penelitian yaitu sebanyak 62 pekerja pengangkut sampah yang berada di Kantor Pekerjaan Umum dan Penata Ruang, yang mana seluruh populasi dijadikan sampel. Data dikumpulkan berdasarkan pemeriksaan kesehatan oleh dokter dan dengan kuesioner, kemudian dianalisa menggunakan uji statistik chi-square. Hasil: Hasil menunjukan bahwa pekerja yang mengalami penyakit kulit sebanyak 35 pekerja (56,5%). Berdasarkan hasil analisis chi-square didapatkan bahwa ada hubungan yang bermakna antara masa kerja dengan kejadian penyakit kulit pada pekerja pengangkut sampah dimana nilai (p-value= 0,006), Pemakaian Alat Pelindung Diri (APD) nilai (p-value= 0,008), personal hygiene nilai (p-value= 0,008). Kesimpulan: Untuk meminimalisir risiko terjadinya penyakit kulit pada pekerja pengangkut sampah disarankan perlunya disusun standar operasional prosedur yang aman, penyediaan sarana sanitasi agar dapat mengurangi resiko terkena penyakit kulit. Pentingnya pemakaian APD dan perilaku hidup bersih dan sehat selama bekerja, serta diharapkan pekerja menggunakan APD pada saat bekerja dan lebih memperhatikan personal hygiene.   Kata kunci      : Masa Kerja, APD, Personal Hygiene


Author(s):  
Dina Dewi Anggraini

ABSTRACT   The study aims todetermine the relationship between parenting style and the level of independence of Personal Hygiene Hand Wasting and Tooth Brush in Preschoolers in Kindergarten Negeri Pembina Blora in 2019. The study is a quantitative study, based on the research location including the type of field reseaerch, based on the ansence of the treatment of subjects including survey research, based on time is a cross sectional study, and based on objectives includin correlation analytics. The population in this study were all parents in Kindergarten Negeri Pembina Blora as many as 85 respondents. Based on the sample calculation, the sample obtained in this study that most parent in Kindergarten Negeri Pembina Blora amounted to 70 respondents. Srearmen’s rho test analysis results parenting parents with the level of independence of personal hygiene hand wasting result obtained p value = 0,000 < α (0,05), and parenting patters with the independence of personal hygiene tooth brush obtained results p value = 0,000 < α (0,05). So it can be concluded that were is a significant relationship between parenting parents with the level of independence of personal hygiene washing hands and brushing their tooth at preschoolers in Kindergarten Negeri Pembina Blora in 2019. Keywords: parenting; personal hygiene, preschool ABSTRAK   Penelitian ini bertujuan untuk mengetahui Hubungan Pola Asuh Orangtua Terhadap Tingkat Kemandirian Personal Hygiene Cuci Tangan dan Gogok Gigi pada Anak Prasekolah di TK Negeri Pembina Blora Tahun 2019. Penelitian ini adalah penelitian kuantitatif, berdasarkan tempat penelitian termasuk jenis penelitian lapangan, berdasarkan tidak adanya perlakuan terhadap subjek termasuk penelitian survey, berdasarkan waktu merupakan penelitian cross sectional, dan berdasarkan tujuan termasuk analitik korelasi. Populasi dalam penelitian ini adalah seluruh orangtua di TK Negeri Pembina Blora sebanyak 85 responden. Berdasarkan perhitungan sampel  maka diperoleh sampel pada penelitian ini adalah sebagian orangtua di TK Negeri Pembina Blora sebanyak 70 responden. Hasil analisis uji spearmen’s rho pola asuh orangtua dengan tingkat kemandirian personal hygiene cuci tangan didapatkan hasil p value = 0,000 < α (0,05), dan pola asuh orangtua dengan kemandirian personal hygiene gosok gigi didapatkan hasil p value = 0,000 < α (0,05). Sehingga dapat disimpulkan bahwa ada hubungan yang signifikan antara pola asuh orang tua dengan tingkat kemandirian personal hygiene cuci tangan dan gosok gigi pada anak prasekolah di TK Negeri Pembina Blora Tahun 2019. Kata kunci: pola asuh; personal hygiene; prasekolah


2017 ◽  
Vol 5 (1) ◽  
pp. 32-39
Author(s):  
Dedeh Husnaniyah

Tuberkulosis Paru merupakan penyakit menular yang disebabkan oleh Mycobacterium tuberculosis. Dampak TB Paru adalah penurunan daya tahan tubuh, kelemahan fisik, merugikan secara ekonomis dan dapat mengakibatkan isolasi sosial. Keadaan tersebut dapat mempengaruhi harga diri penderita TB Paru. Perubahan harga diri pada penderita TB Paru dapat mempengaruhi keberhasilan pengobatan, sehingga dibutuhkan adanya dukungan keluarga. Tujuan Penelitian ini adalah untuk mengidentifikasi pengaruh dukungan keluarga terhadap harga diri penderita TB Paru di Wilayah Puskesmas Eks Kawedanan Indramayu tahun 2015. Jenis penelitian ini adalah deskriptif analitik dengan rancangan penelitian cross sectional study. Pengambilan sampel dilakukan dengan tekhnik total sampling sebayak 45 responden. Hasil penelitian menunjukkan bahwa penderita TB Paru yang memiliki harga diri tinggi sebanyak 23 responden (51,1%) dan yang memiliki harga diri rendah sebanyak 22 responden (48,9%), penderita TB Paru yang mendapatkan dukungan keluarga sebanyak 26 responden (57,8 %) dan yang tidak mendapatkandukungan keluarga sebanyak 19 (42,2 %). Responden yang mendapatkan dukungan keluarga lebih banyak yang memiliki harga diri tinggi dibandingkan dengan responden yang tidak mendapatkan dukungan keluarga yaitu 69,6% dengan nilai p value = 0,047 (< 0,05). Simpulan dari penelitian ini adalah terdapat hubungandukungan keluarga denganharga diri penderita TB Paru. Hasil penelitian ini diharapkan dapat menjadi masukan bagi pemegang program TB untuk memberikan konseling terkait pentingnya dukungan keluarga bagi penderita TB Paru.


Author(s):  
Quratul-Ain Zafar

Objective: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on frontline healthcare workers in Pakistan in terms of psychological factors emotional distress, insomnia, and burnout. Study Design: Observational cross-sectional study. Place and Duration of Study: This study was conducted at different hospitals across Pakistan and data collection was carried out from 15th June 2020 till 15th August 2020. Material and Methods: This was a questionnaire-based study aiming to compare the levels of burnout and emotional distress between frontline COVID-19 and non-COVID-19 healthcare workers. Any physician, nurse, and other healthcare workers were recruited from emergency care units and Covid-19 care units (target group), and non-COVID-19 care units (control group). Participation was voluntary and participants had to complete self-reported questionnaires and scales. A mixed-mode data collection was carried out, either in paper or web-based form to ensure maximum participation. Results: The independent t-test showed a statistically significant difference between the two groups regarding depression, stress, and insomnia. The study group showed higher scores for these factors than the control group. Chi-square test of association revealed significant scores of burnout and professional fulfillment in both groups. There was a higher prevalence of burnout in the study group than in the control group. Conclusion: This study concludes that there was a significant psychosocial impact of the Covid-19 pandemic in the frontline healthcare workers measured in terms of emotional distress, insomnia, and burnout.


2018 ◽  
Vol 2 (2) ◽  
pp. 125-130
Author(s):  
Noviyani Hartuti

Tujuan Penelitian ini adalah diketahuinya hubungan antara riwayat sectio caesarea dan paritas terhadap kejadian plasenta previa di RSUD Haji Makassar tahun 2018. Penelitian ini menggunakan metode penelitian analitik dengan melakukan pendekatan Cross Sectional Study untuk mengetahui hubungan antara riwayat sectio caesarea dan paritas terhadap kejadian plasenta previa di RSUD Haji Makassar. Secara keseluruhan jumlah populasi yang ada sebanyak 177 orang dan didapatkan besar sampel sebanyak 177 orang dengan menggunakan tekhnik Total Sampling. Dari hasil analisis hubungan antara riwayat sectio caesarea terhadap kejadian plasenta previa yang memiliki riwayat sectio caesarea dan mengalami plasenta previa sebanyak 1 orang (0,6%), sedangkan ibu yang tidak mengalami plasenta previa  sebanyak  9 orang (5,1%), dari paritas ibu dengan paritas tinggi yang mengalami plasenta previa sebanyak 9 orang (5,1%) dan yang tidak mengalami plasenta previa sebanyak 53 orang (29,9%). Hasil penelitian menunjukkan bahwa tidak ada hubungan antara riwayat sectio caesarea terhadap kejadian plasenta previa di RSUD Haji Makassar dengan nilai P-value (0,543), dan ada hubungan antara paritas terhadap kejadian plasenta previa di RSUD Haji Makassar dengan nilai P-value (0,010).  Kesimpulan dari dua variabel yaitu riwayat sectio caesarea tidak berhubungan dengan kejadian plasenta previa sedangkan paritas memiliki hubungan dengan kejadian plasenta previa di RSUD Haji Makassar tahun 2018


2020 ◽  
Vol 17 (1) ◽  
pp. 82-93
Author(s):  
Mary-Joe Youssef ◽  
Antoine Aoun ◽  
Aline Issa ◽  
Lana El-Osta ◽  
Nada El-Osta ◽  
...  

Background: The prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide and the related chronic symptoms can be associated with morbidity and poor quality of life. Objective: The objective of this study was to identify foods and beverages consumed by the Lebanese population, dietary habits, socio-demographic and lifestyle factors, health parameters and perceived stress, implicated in increasing GERD symptoms. Methods: This observational cross-sectional study was carried among Lebanese adults in 2016. A convenient sample of 264 participants was equally divided into a GERD group and a control group. Data on socio-demographic characteristics, lifestyle, health status and dietary habits including Lebanese traditional dishes were collected. The perceived stress scale (PSS) was also used to assess the participants’ perception of stress. Logistic regression analyses were conducted with GERD symptoms (presence or absence) being the dependent variable. Results: The GERD symptoms were significantly associated with age (-p-value=0.017), family history of GERD symptoms (-p-value<0.001), smoking (-p-value=0.003) and chronic medical conditions (-p-value<.001). Regarding the dietary factors, participants who ate three meals or less/day, between meals and outside homes were 2.5, 2.9 and 2.4 times at a higher risk of experiencing GERD symptoms than others, respectively. Moreover, the logistic regression model showed that the GERD symptoms were significantly associated with the consumption of coffee (-p-value=0.037), Lebanese sweets (-p-value=0.027), fried foods (-p-value=0.031), ‘Labneh’ with garlic (-p-value<0.001), pomegranate molasses (-p-value=0.011), and tomatoes (-p-value=0.007). Conclusion: Some specific lifestyle factors and components of the Lebanese Mediterranean diet could be associated with GERD symptoms.


2019 ◽  
Vol 19 (6) ◽  
pp. 803-808 ◽  
Author(s):  
Luigi Vimercati ◽  
Luigi De Maria ◽  
Francesca Mansi ◽  
Antonio Caputi ◽  
Giovanni M. Ferri ◽  
...  

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.


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