scholarly journals Malnutrition Precipitated Measles Outbreak in Gewane District, Afar Regional State, Northeastern Ethiopia, 2016

2020 ◽  
Author(s):  
Wolde Melese Ayele

Abstract Background: Measles is a contagious viral and vaccine-preventable disease that is continuing a public health problem. It is occurring as an outbreak not only in developing but also in developed countries.Methods: A 1:2 ratios, unmatched case-control study was conducted from September 19/2016- October 08/2016 in Undufo Kebele, Gewane district, Northeastern Ethiopia. Both confirmed by laboratory and epidemiologically linked measles cases were involved. Controls were those who had no clinical signs of measles during the data collection period and residents of the same community where cases were identified. An interviewer-administered questionnaire was used to collect data. Nutritional status was measured using MUAC and the result decided based on the world health organization's nutritional categorization of children by MUAC. Data were entered into Epi-info 7 and analyzed using SPSS-21. Binary logistic regression was done to identify risk factors for measles infection with 95% confident level of Odds ratio.Result: Fifty cases and 100 controls have participated in this investigation. Four out of five samples collected were positive for measles IgM antibody. There were three deaths reported. There was no vaccination history of cases and controls. The majority of cases were female and between 6–15 years of age. In multivariable analysis, malnutrition (AOR = 3.21; 95%CI 1.871,6.334), and contact history (AOR = 12.24; 95%CI 6.992,28.121) increased the risk of contracting measles infection.Conclusion: children under 15-year age were more affected groups. The absence of vaccination in the area precipitated by a high rate of malnutrition was the main cause that aggravates the number of new infections. Contact history and malnutrition were the identified risk factors for measles infection. Therefore, increasing immunization coverage of more than 80%, and securing food security decrease the susceptibility of outbreak occurrence.

Author(s):  
Steffi Veientlena ◽  
Prabu P

Objective: Hypertension is a global public health problem that estimates about 4.5% of overall disease burden. It is a general health challenge in economically developing and developed countries. High blood pressure prevalence is increased from 11.2% to 28% (p<0.001) and 23–42.2% in rural and urban area according to the study done in Delhi for about 20 years. It is one of the important risk factors of cardiovascular disease, which is associated with morbidity and mortality. The aim was to identify the significant correlates of hypertension in a rural village in south India. Methods: Data were collected through a door-to-door survey among the residents of the village. Data collected was related to demographics and anthropometric measures. Blood pressure was measured with the help of the medical supervisor. Data were analyzed using Chi-square test for comparison between attributes. The potential hazard factor of hypertension was found by performing binary logistic regression model.Result: Of 299 participants considered for the study, 50 were hypertensive contributing to the overall prevalence of 16.72% with 95% confidence interval of 0.1292–0.2137, in which females have the prevalence rate of 17.8% and males with the prevalence rate of 15.5%. The study outcome identified education level, occupation, and family history of hypertension is the predicted risk factors.Conclusion: The high blood pressure prevalence is low and comparable with the studies conducted in other rural regions of India. More studies are, however, required to decide the appropriation and determinants of hypertension in different parts of this region.


Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1293
Author(s):  
Shujuan Li ◽  
Yacong Bo ◽  
Hongyan Ren ◽  
Chen Zhou ◽  
Xiangqian Lao ◽  
...  

Infantile anaemia has been a severe public health problem in China for decades. However, it is unclear whether there are regional differences in the prevalence of anaemia. In this study, we used data from the China Nutrition and Health Surveillance (CNHS) to assess the prevalence of anaemia and the risk factors associated with its prevalence in different regions. We included 9596 infants aged 0–23 months from the CNHS 2013 database. An infant was diagnosed with anaemia if he/she had a haemoglobin concentration of <110 g/L. We used multivariate logistic regression to investigate the potential risk factors associated with the development of anaemia. We found that anaemia was present in 2126 (22.15%) of the infants assessed. Approximately 95% of these cases were classified as mild anaemia. Based on the guidelines laid out by the World Health Organization, 5.5% and 43.6% of the surveillance sites were categorized as having severe and moderate epidemic levels of anaemia, respectively. The prevalence of infantile anaemia in Eastern, Central and Western China was 16.67%, 22.25% and 27.44%, respectively. Premature birth, low birth weight, breastfeeding and residence in Western China were significantly associated with higher odds of developing anaemia. Female sex and having mothers with high levels of education and maternal birth age >25 years were associated with lower odds of developing anaemia. In conclusion, we observed significant regional disparities in the prevalence of infantile anaemia in China. Western China had the highest prevalence of infantile anaemia, and rural regions showed a higher prevalence of anaemia than urban regions.


2021 ◽  
Vol 12 ◽  
Author(s):  
Marcia M. L. Kho ◽  
Stefan Roest ◽  
Dominique M. Bovée ◽  
Herold J. Metselaar ◽  
Rogier A. S. Hoek ◽  
...  

BackgroundStudies on herpes zoster (HZ) incidence in solid organ transplant (SOT) recipients report widely varying numbers. We investigated HZ incidence, severity, and risk factors in recipients of four different SOTs, with a follow-up time of 6–14 years.MethodsRecords of 1,033 transplant recipients after first heart (HTx: n = 211), lung (LuTx: n = 121), liver (LiTx: n = 258) and kidney (KTx: n = 443) transplantation between 2000 and 2014 were analyzed for VZV-PCR, clinical signs of HZ, and complications.ResultsHZ was diagnosed in 108 of 1,033 patients (10.5%): 36 HTx, 17 LuTx, 15 LiTx, and 40 KTx recipients. Overall HZ incidence rate after HTx (30.7 cases/1,000 person–years (PY)), LuTx (38.8 cases/1,000 PY), LiTx (22.7 cases/1,000 PY) and KTx (14.5 cases/1,000 PY) was significantly higher than in the general 50–70 year population. Multivariable analysis demonstrated age ≥50 years at transplantation (p = 0.038, RR 1.536), type of organ transplant (overall p = 0.002; LuTx p = 0.393; RR 1.314; LiTx p = 0.011, RR 0.444; KTx p = 0.034, RR 0.575), CMV prophylaxis (p = 0.043, RR 0.631) and type of anti-rejection therapy (overall p = 0.020; methylprednisolone p = 0.008, RR 0.475; r-ATG p = 0.64, RR1.194) as significant risk factors. Complications occurred in 33 of 108 (31%) patients (39% of HTx, 47% of LuTx, 20% of LiTx, 20% of KTx): post-herpetic neuralgia, disseminated disease, and cranial nerve involvement.ConclusionHZ incidence and severity in SOT recipients are most pronounced after heart and lung transplantation, in older patients, and when CMV prophylaxis is lacking.


2018 ◽  
Vol 08 (01) ◽  
pp. 003-010 ◽  
Author(s):  
Flávia Machado ◽  
Daniela de Souza

AbstractSepsis, or dysregulated host response to infection, is considered a worldwide public health problem. It is a major childhood disease both in terms of frequency and severity, and severe sepsis is still considered the main cause of death from infection in childhood. This review provides an overview of the epidemiology of pediatric septic shock. The prevalence of severe sepsis and septic shock among hospitalized children ranges from 1 to 26%. Mortality is high, ranging from 5% in developed countries to up to 35% in developing countries. However, 10 years after the publication of pediatric sepsis definitions, a global perspective on the burden of this disease in childhood is still missing. Major obstacles to a better knowledge of sepsis epidemiology in children are the absence of an adequate disease definition and not having sepsis as a cause of death in the World Health Organization Global Burden of Disease Report, which is one of the most important sources of information for health policies decision-making in the world. Several studies performed in both developed and developing countries have shown that mortality from septic shock is high and is associated with delayed diagnosis, late treatment, and nonadherence to the treatment guidelines. Reducing mortality from sepsis in childhood is a worldwide challenge, especially in developing countries, where the highest number of cases and deaths are recorded and where financial resources are scarce. Many specialists consider that prevention, education, and organization are key to achieve a reduction in the burden of sepsis.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036048
Author(s):  
Nur Azzalia Kamaruzaman ◽  
Yin-Hui Leong ◽  
Mohd Hafiidz Jaafar ◽  
Halilol Rahman Mohamed Khan ◽  
Noor Afiza Abdul Rani ◽  
...  

ObjectivePesticide poisoning is a global health problem, and its progressive deterioration is a major cause of concern. The objective of this study is to assess epidemiological characteristics and identify risk factors of pesticide poisoning in Malaysia.SettingPesticide poisoning database of Malaysia National Poison Centre (NPC) from 2006 to 2015.ParticipantsTelephone enquiries regarding pesticide poisoning were made by healthcare professionals. Information received by the NPC was entered into a retrievable database of standardised Poison Case Report Form, as adapted from the World Health Organization (WHO).OutcomesThe outcome of the study is to provide an overview of national epidemiological profile of pesticide poisoning. High-risk groups of people and their circumstances were also identified to ensure that appropriate measures are strategised.ResultsWithin the study period, a total of 11 087 pesticide poisoning cases were recorded. Sixty per cent of these cases were intentional in nature and most were found among male individuals (57%) of the Indian race (36.4%) aged between 20 and 29 years (25.5%), which occurred at home (90%) through the route of ingestion (94%). The highest number of poisoning was due to herbicides (44%) followed by agricultural insecticides (34%), rodenticides (9.9%), household insecticides (9.5%) and fungicides (0.5%). In addition, 93.6% of intentional pesticide poisoning cases were caused by suicide attempts. The results of this study show that there was an increasing trend in pesticide poisoning incidents over the 10-year duration. This indicates that pesticide poisoning is a prevalent public health problem in Malaysia, resulting in an average incidence rate of 3.8 per 100 000 population.ConclusionsDeliberate pesticide ingestion as a method of suicide has become a disturbing trend among Malaysians. Therefore, regulation of highly hazardous pesticides must be enforced to ensure controlled and limited access to these chemicals by the public.


Author(s):  
Sunil Kumar Kasundriya ◽  
Mamta Dhaneria ◽  
Aditya Mathur ◽  
Ashish Pathak

Childhood pneumonia is a major public health problem. The aim of this prospective hospital-based study is to determine the incidence and risk factors for community-acquired severe pneumonia in children in Ujjain, India. The study includes 270 children, 161 (60%) boys and 109 (40%) girls, aged between 2 months and 5 years with World Health Organization defined and radiologically confirmed severe pneumonia. Considering the 270 children, 64% (95% confidence interval (CI) 57.9–69.4) have severe pneumonia. The following are identified as risk factors for severe pneumonia from the generalized logistic regression model: Born premature (adjusted odds ratio (AOR) 7.50; 95% CI 2.22–25.31; p = 0.001); history of measles (AOR 6.35; 95% CI 1.73–23.30; p = 0.005); incomplete vaccination (AOR 2.66; 95% CI 1.09–6.48; p = 0.031); acyanotic congenital heart disease (AOR 9.21; 95% CI 2.29–36.99; p = 0.002); home treatment tried (AOR 3.84; 95% CI 1.42–10.39; p = 0.008); living in a kuchha house (AOR 3.89; 95% CI 1.51–10.01; p = 0.027); overcrowding (AOR 4.50; 95% CI 1.75–11.51; p = 0.002);poor ventilation in living area (AOR 16.37; 95% CI 4.67–57.38; p < 0.001); and practicing open defecation (AOR 16.92; 95% CI 4.95–57.85; p < 0.001). Awareness of these risk factors can reduce mortality due to severe pneumonia.


2019 ◽  
Vol 54 (1) ◽  
pp. 1802256 ◽  
Author(s):  
Phuong T.K. Nguyen ◽  
Hoang T. Tran ◽  
Dominic A. Fitzgerald ◽  
Thach S. Tran ◽  
Stephen M. Graham ◽  
...  

Pneumonia is the most common reason for paediatric hospital admission in Vietnam. The potential value of using the World Health Organization (WHO) case management approach in Vietnam has not been documented.We performed a prospective descriptive study of all children (2–59 months) admitted with “pneumonia” (as assessed by the admitting clinician) to the Da Nang Hospital for Women and Children to characterise their disease profiles and assess risk factors for an adverse outcome. The disease profile was classified using WHO pneumonia criteria, with tachypnoea or chest indrawing as defining clinical signs. Adverse outcome was defined as death, intensive care unit admission, tertiary care transfer or hospital stay >10 days.Of 4206 admissions, 1758 (41.8%) were classified as “no pneumonia” using WHO criteria and only 252 (6.0%) met revised criteria for “severe pneumonia”. The inpatient death rate was low (0.4% of admissions) with most deaths (11 out of 16; 68.8%) occurring in the “severe pneumonia” group. An adverse outcome was recorded in 18.7% of all admissions and 60.7% of the “severe pneumonia” group. Children were hospitalised for a median of 7 days at an average cost of 253 USD per admission. Risk factors for adverse outcome included WHO-classified “severe pneumonia”, age <1 year, low birth weight, previous recent admission with an acute respiratory infection and recent tuberculosis exposure. Breastfeeding, day-care attendance and pre-admission antibiotic use were associated with reduced risk.Few hospital admissions met WHO criteria for “severe pneumonia”, suggesting potential unnecessary hospitalisation and use of intravenous antibiotics. Better characterisation of the underlying diagnosis requires careful consideration.


2020 ◽  
Author(s):  
Samina Bakhtawar ◽  
Sana Sheikh ◽  
Rahat Qureshi ◽  
Zahra Hoodbhoy ◽  
Beth Payne ◽  
...  

Abstract Background: Majority (99%) of maternal deaths occur in low and middle income countries. The three most important causes of maternal deaths in these regions are postpartum hemorrhage, pre-eclampsia and puerperal sepsis. There are several diagnostic criteria used to identify sepsis and one of the commonly used criterion is systematic inflammatory response syndrome (SIRS). However, these criteria require laboratory investigations which may not be feasible in resource constrained settings. Therefore, this study aimed to develop a model based on risk factors and clinical signs and symptoms that can identify sepsis early among postpartum women.Methods: A case control study was nested in an ongoing cohort of 4000 postpartum women who delivered or were admitted in study hospital. According to standard criteria of SIRS, 100 women with sepsis (cases) and 498 women without sepsis (controls) were recruited from January to July 2017. Information related to socio-demographic status, antenatal care and maternal life styles were obtained via interview while pregnancy and delivery related information, comorbid and clinical sign and symptoms were retrieved from ongoing cohort. Multivariable logistic regression was performed and discriminative performance of the model was assessed using area under the curve (AUC) of the receiver operating characteristic (ROC).Results: Multivariable analysis revealed that 1-4 antenatal visits (95% CI 0.01 - 0.62), 3 or more vaginal examinations (95% CI 1.21 - 3.65), home delivery (95% CI 1.72-50.02), preterm delivery, diabetes in pregnancy (95% CI 1.93-20.23), lower abdominal pain (95% CI 1.15 - 3.42)) vaginal discharge (95% CI 2.97-20.21), SpO2 <93% (95% CI 4.80-37.10) and blood glucose were significantly associated with sepsis. AUC was 0.84 (95% C.I 0.80-0.89) which indicated that risk factors and clinical sign and symptoms based model has adequate ability to discriminate women with and without sepsis.Conclusion: This study developed a non-invasive tool which can identify postpartum women with sepsis as accurately as SIRS criteria with good discriminative ability. Once validated, this tool has a potential to be scaled up for community use by frontline health care workers.


Author(s):  
Iin Novita Nurhudayati Mahmuda ◽  
Nanda Nurkusumasari ◽  
Fakhri Nofaldi ◽  
Prihatin Puji Astuti ◽  
Ferika Dian Syafitri ◽  
...  

<p>Coronary heart disease (CHD), is one of the non-communicable diseases that has a tendency to increase every year and have an impact not only on developed countries, but also in developing countries. According to the World Health Organization (WHO), in 2012 there were 56 million deaths worldwide caused by non-communicable disease and heart disease contributed 46.2% or caused 17.5 million deaths. This review article to give brief explanation about CHD from risk factors, diagnosed criteria, management therapy and prognosis. Risk factors for CHD can be distinguished into major risk factors and minor risk factors. Symptoms of CHD are discomfort in the chest ranging from pain crushed during activity and improved with rest to continuous chest pain. The diagnosis of CHD is established based on anamnesis, physical examination, and laboratory examination. The CHD classification consists  of Stable Angina Pectoris (APS) and Acute Coronary Syndrome (ACS). Lifestyle changes accompanied<em> </em>by right medication can reduce complications caused             by CHD.</p>


Author(s):  
Noppon Popruk ◽  
Satakamol Prasongwattana ◽  
Aongart Mahittikorn ◽  
Attakorn Palasuwan ◽  
Supaluk Popruk ◽  
...  

Diabetes mellitus (DM) is a major global public health problem with an increasing prevalence. DM increases the risk of infections caused by bacteria, fungi, viruses, and parasites. We examined the prevalence, subtypes, and risk factors of Blastocystis infection in patients with and without DM in central Thailand. Stool samples and questionnaires were obtained from 130 people in the DM group and 100 people in the non-DM group. Blastocystis infection was identified via a nested polymerase chain reaction and subtyped via sequencing of the partial small-subunit ribosomal RNA (SSU rRNA) gene. Analysis of potential risk factors was conducted via binary logistic regression. The overall prevalence of Blastocystis infection was 10.8%, including rates of 9% and 12.3% in the non-DM and DM groups, respectively. The most prevalent subtype was ST3, followed by ST1, and ST4. Factors that potentially increased the risk of Blastocystis infection include patients being >65 years old, the presence of DM, a DM duration of ≥10 years, a low level of education, and animal ownership. In conclusion, this is the first study of Blastocystis infection in DM, and a high prevalence was found among this population. Therefore, health education promoting sanitation and hygiene is necessary to reduce and prevent infection in the community.


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