Global Journal of Medicine & Public Health

Assessing childhood malnutrition in Haiti: Meeting the United Nations Millennium Development Goal #4

2024-06-30T16:02:30+00:00

Background

The United Nations (UN) Millennium Developmental Goal #4 addresses needed

reductions in childhood mortality. A major cause of death in Haitian children is

malnutrition and starvation.

Objectives

Our primary objective was to identify population characteristics of children

living in rural Haiti that may place them at higher risk of malnutrition than

others. Armed with this knowledge, community health workers can recognize

and attribute resources to those most in need. We will also examine the overall

nutrition status in the population of interest and compare to the UN

Millennium Goal statistics.

Study design

The study cohort consisted of 103 children under the age of 5 years, who were

consecutively seen in a rural medical clinic from 4 communities in the

Thomazeau region of Haiti over a 7-day time period. Families were asked the

following five questions: (1) How many children do you have? (2) What is the

birth order of this child (1st, 2nd, etc.)? (3) What is the distance between your

house and clean water? (4) Do you obtain water for your family? (5) What was the highest grade you finished

in school? The medical team recorded each child’s gender, age, height, weight, household size, when the last

meal was eaten, and last time protein was ingested. Nutritional status was assessed using World Health

Organization growth standards. The data was then analyzed to determine each child’s level of malnutrition as

measured by weight-for-height Z-score (number of standard deviations [SD] below reference value),

percentage of malnutrition for all children surveyed, and whether correlations existed between malnutrition

level and number of siblings, household size, or location. Trends were defined as associations significant at

p<0.10.

Socio-economic inequity in use of antennal care and child immunization services in Goa

2024-06-30T16:16:02+00:00

The antenatal care and child immunization are important strategies for

reducing maternal and infant mortality rate. The present study aims to

measure the economic and educational inequity in the use of antenatal care

and child immunization for the state of Goa. The data for the present study was

collected using a cross sectional study design based on two stage stratified

random sampling method in North Goa District. The sample size consisted of

250 mothers delivered during last two years for measuring antenatal care, and

250 mothers of children in the age group 12-24 months. The data was analyzed

using chi-square test, logistic regression, Lorenz’s curve and Gini coefficient.

The analysis of the data revealed that the use of antenatal care was 78.2% and

the use of child immunization was 89.2 %. There was significant disparity in the

use of antenatal care and use of child health care according to education of

mother, religion and socio-economic status of mother. The Gini coefficient for

the utilization antenatal care was 0.07 and 0.11 for educational and economic inequity respectively, whereas

the Gini coefficient for child immunization was 0.04 and 0.03 for educational and economic inequity

respectively. The inequity was more in use of antenatal care compared to child immunization, which

highlights the needs for health administrators to reduce the gap in the antenatal care services provided to the

pregnant women.

Unsafe abortion among young people in Katete, Zambia

2024-06-30T16:21:24+00:00

The current research took place at Saint Francis Hospital. It is a hospital based

health survey using semi-structured questionnaire. A total number of 39

youths participated in the study, including 28 adolescents (71.8%) and 11 older

youths (28.2%). The majority were single and school going girls. 37% of

adolescent had their first sex intercourse on the year following menarche. The

average ages at menarche and first sex were 13 years and 15 years respectively

for both groups. Most girls (61.5%) did not know their HIV status while 38.5%

were HIV negative. All pregnancies were unplanned and unwanted, resulting in

induced abortions. The majority of abortions were unsafe and unsanitary,

conducted in the bush, in homes/villages, at school, and sometimes in drug

shops. They were either self induced or conducted by lay providers. Only 28.6%

of adolescent had used contraceptives in the past, mostly condoms; as

compared to 54.5% of older youths. 67.9% of adolescents and 81.8% of older

youths were involved in risky, unstable relationships (multiple and/or concurrent sexual partners). The

common complications of abortions were: retained product of conception, sepsis, haemorrhage, shock, pelvic

infection, and lacerations of the cervix. Projects and programmes aiming at addressing unsafe sex and

reproductive health needs among young people are urgently needed.

Higher educational status, staying in joint family and early treatment initiation improves quality of life in leprosy: Experiences from and observational study at a tertiary centre in Eastern India

2024-07-02T15:48:34+00:00

Introduction

Leprosy is a chronic infectious disease with various risks of permanent and

progressive disabilities as well as deformities. This can lead to social stigma and

discrimination.

Methodology

A cross sectional institution based study was conducted among the patient of a

leprosy clinic in a tertiary care center. WHOQOL-BREF questionnaire was used

after taking consent from each study individual.

Results

Majority (69.8%) of the patients was male and 41.3% of the study population

belonged to below poverty line. Majority (85.7%) of the study population were

suffering from multi-bacillary type of leprosy. Though Majority (96.8%) of the

patients was receiving MDT (multi drug therapy) regularly but still 33.33% of

them were leading a poor quality of life. It has been seen that literacy, family

type and time gap between starting of symptoms and initiation of treatment

were significantly associated with quality of life.

Discussion

Different previous studies showed QOL (quality of life) was associated with factors like SES (socio economic

status), literacy and male gender, the present study revealed higher literacy, staying in the joint family and

early treatment initiation helped to improve the QOL.

Conclusion

Better QOL was associated with higher educational status, good family support and early initiation of

treatment among the leprosy patients.

Rapidly changing treatment options adding burden to the management of typhoid fever

2024-07-02T15:55:06+00:00

Typhoid fever continues to be a global public health problem. It is caused by the

facultative intracellular organisms Salmonella enteric serotype Typhi and

Salmonella paratyphi. Antimicrobial therapy is the mainstay for treatment of

typhoid fever. Chloramphenicol, ampicillin, and cotrimoxazole had been in use

for decades for treating enteric fever. But the emergence and rapid spread of

drug resistance has resulted in rapid shift of treatment options from

chloramphenicol to fluoroquinolones to third generation cephalosporins to

azithromycin with tigecycline and carbapenems in line, thus adding burden to

the health-care sector in developing countries. Rational and judicious

antibiotic prescribing practices by health professionals are necessary to prevent

further development of drug resistance and help in re-emergence of sensitive

strains.

Scaling up success to improve health: Towards a rapid assessment guide for decision makers

2024-07-02T15:58:45+00:00

Introduction

Evidence-based health interventions exist and are effectively implemented

throughout resource-limited settings. The literature regarding scale-up strategies

and frameworks is growing. The purpose of this paper is to identify and

systematically document the variation in scale-up strategies to develop a rapid

assessment tool for decision-makers looking to identify the most appropriate

strategy for their organizational and environmental contexts.

Methods

A list of scale-up strategies and frameworks were identified through an in-depth

literature review and conversations with scale-up and quality improvement

leaders. The literature search included a broad range of terms that might be used

interchangeably with scale-up of best practices. Terms included: implementation research, knowledge

translation, translational research, quality improvement research, health systems improvement, scale-up,

best practices, improvement collaborative, and community based research. Based on this research, 18

strategies and frameworks were identified, and nine met our inclusion criteria for scale-up of health-related

strategies. We interviewed the key contact for four of the nine strategies to obtain additional information

regarding the strategy’s scale-up components, targets, underlying theories, evaluation efforts, facilitating

factors, and barriers. A comparative analysis of common elements and strategy characteristics was completed

by two of the authors on the nine selected strategies. Key strategy characteristics and common factors that

facilitate or hinder the strategy’s success in scaling up health-related interventions were identified.

Results

Common features of scale-up strategies include: 1) the development of context-specific evidence; 2)

collaborative partnerships; 3) iterative processes; and 4) shared decision-making. Facilitating factors include

strong leadership, community engagement, communication, government collaboration, and a focus on

human rights. The analysis informed the development of a two-step rapid assessment tool that can be used

to guide decision-makers in identifying the most appropriate scale-up strategy given their political

environment, leadership styles, and program characteristics.

Conclusion

The rapid assessment proposed in this paper can be used to help bridge the gap in bringing evidence-based

health interventions to communities that need them the most. The purpose of the assessment tool is to

decrease the time required to scale effective interventions by identifying and applying a strategy appropriate

to the innovation, organizational capacity, and social and political environment.

Ebola – Are you at risk?

2024-07-02T16:15:15+00:00

The lethal Ebola virus had remained contained in one

area in Africa before it began to move on a vector

course to western Africa and possibly beyond. What

can account for this migration of a relatively

geographically static disease? People and animals

such as monkeys carry this disease and both migrate

for various reasons. Monkeys have market value and

may be captured in one area and transported to

another for transshipment to other countries carrying

diseases with them. People have become more

mobile than ever and disease can migrate at the

speed of air travel. What is especially problematic is

when a disease is initially asymptomatic and the

carrier is relocating with the disease and does not

know it.

Re-emphasizing food as basic medicine of public health to reclaim hunger in health discourse

2024-07-02T16:19:25+00:00

Food is crucial to ensuring human well being. However, prevalence of

widespread hunger and malnutrition in the world, especially in times when

mankind has the capability to feed all the people in the world to enable them to

have healthy and productive lives, obliges us to reiterate the public health

importance of adequate food for ensuring human well-being.

Health is perhaps the best marker of human well-being, and improved health

inter-alia is reflected in longevity of human life – put simply, the ability of man

to live. Talking of human health, the spectacular technological achievements of

modern medical science tend to dwarf every other determinant of health in

popular perception. This has tended to undermine the primary importance of

food strategies in ensuring human well being. Beginning with McKewon’s thesis

on the modern rise of population in England and Whales, we rely on other

evidence available in literature to establish the primacy of food, over and above

medical technologies, in ensuring health and thereby well being of human race.

In order to further highlight the importance of ‘hunger’ in public debate, the

paper examines the shift from ‘Hunger’ to more scientified terminology of

‘Nutrition’ as a strategy by the vested interests to invisibalise the larger

question of ‘Hunger.’ Conclusions are accordingly drawn at the end.

Changing disease profile and preventive health care in India: Issues of economy, equity and effectiveness

2024-07-02T16:24:00+00:00

The importance of preventive health care practices has increasingly been

recognized in the wake of changing disease profile in India. The disease burden has

been shifting from communicable to non-communicable diseases as a result of

greater focus on achieving competitiveness in a fast globalizing economy. The rapid

pace of social and technological changes has led to adverse life style choices

resulting in higher incidence of heart diseases, diabetes, obesity, cancer, and

deteriorating inter-personal relations and psychological well-being among

individuals. Most of these health risks can considerably be reduced through

disseminating science-based information on health promotion and disease

prevention including exercise, nutrition, smoking and tobacco cessation,

immunization, counseling, fostering good habits of health and hygiene, disease

screening and preventive medicine. Prior evidences indicate that preventive health

interventions can improve health outcomes in a great deal. In a regressive health

delivery system of India where major health expenses on curative health is met by out-of-pocket money,

preventive health services hold promise to be cost efficient, clinically effective and equity promoting. This

article, therefore, examines in depth the issues and prospects of preventive and promotive health care

services in realizing optimum health care needs of the people.

Cutaneous leishmaniasis: Literature review and report of two cases from communities devastated by insurgency in North-East Nigeria

2024-07-02T16:27:22+00:00

Leishmaniasis is a parasitic disease most often as

result of bite by infected female phelobotomine

sandflies. Various species of sand flies are potential

vectors and some 100 species of wild and domestic

animals including humans could serve as reservoir

hosts. 1 The causative agents are blood and tissue

dwelling intracellular protozoan parasite species

belonging to the genus Leishmania. Infection with

leishmania specie could result in disease condition

ranging from chronic but often self-healing skin

lesions, cutaneous leishmaniasis (CL), to erosive

mucosal membrane destruction of the nasopharynx

known as mucocutaneous leishmaniasis, and a life

threatening systemic infection with hepato

spleenomegly in visceral leishmaniasis. The nature

and extent of the disease is determined by complex

interactions between the infecting species of

Leishmania and the immunological status of the

host. 1, 2