Global Journal of Medicine & Public Health

The association between mHealth wearables and hypertension selfmanagement in African-born immigrants from medically underserved areas in the United States: a causal-comparative study

Nelson Bryant — Sun, 13 Apr 2025 00:00:00 +0000

Background

Hypertension remains a major global health concern, increasing the risk of heart disease and stroke. It affects over

1.3 billion adults globally and nearly half the US adult population (47.3%), or 116 million individuals. African-born

immigrants (40.2%) are disproportionately affected compared to 30% for other ethnic groups. A significant portion

of Americans (67 million) have uncontrolled hypertension. Using mHealth interventions, especially

wearable devices, has shown some potential in improving hypertension control and treatment compliance in ethnic

minorities.

Methods

This causal-comparative study conducted in 2024 aimed to determine if there is an association between using

mHealth wearable devices and improving hypertension control in African-born immigrant groups. The inclusion and

exclusion criteria consisted of having a hypertension diagnosis, being 45-75 years old, reading at a third-grade level,

and living in a medically underserved primary care area (MUA). A t-test was used to compare the mean arterial

pressure data in two groups.

Results

All 100 participants from nine MUAs were randomly divided into two equal groups. Group 1 used a smart watch (the

mHealth group) to measure their blood pressure, whereas Group 2 (the usual care group) used an automated blood

pressure monitor. The study yielded two statistically significant results, including 1) the mean arterial pressure at

the end of six weeks was lower in the mHealth group than in the usual care group (p < 0.001) with a -4 mmHg

difference. The mHealth group participants achieved a better mean arterial pressure with a -3 mmHg reduction in

mean arterial pressure (p = 0.005).

Conclusions

The study suggested that African-born immigrants can benefit from using mHealth wearable devices to improve

hypertension management. It contributed to the understanding of factors associated with the higher prevalence of

hypertension among African-born immigrants. It aligns with ongoing efforts to uncover novel approaches for

assisting minority populations in low-resource settings to control hypertension using mHealth wearable devices.

Prevalence of Anemia and Its Association with Dietary Restrictions Among Pregnant Women in Eastern Gujarat's Tribal Communities

Sun, 13 Apr 2025 00:00:00 +0000

Context

Anaemia is a very common health problem seen in developing countries. It leads to poor outcomes in pregnancy

and complicates the life of the newborn in certain cases. In multiple surveys conducted over the years it is noted

that the diet plays an important role in development of Anaemia, varying in the micronutrient intake, geographical

location and season.

Objectives

To assess the prevalence of Anaemia tribal women
To assess the association of food restriction with Anaemia.

Method

A descriptive cross-sectional study was conducted in a tribal district of Eastern Gujarat. This study was conducted

at Anganwadi centre.The sampling type was purposive sampling, all those women who were pregnant and were in

15–49-year-old age groups, who were willing to take part in the study were included.Their hemoglobin levels were

evaluated for anaemia and they were evaluated for food related deficiencies through a self-administered

questionnaire. 80 women were included in the study and descriptive analyses was conducted to calculate

frequencies with percentages and proportions of categorical variables in the total study sample. Chi-square tests

were used to assess association of various food restrictions and anemia

Results

The mean hemoglobin of the study was 9.6+1.9 g/dl, prevalence of anemia was 76.25 %, out of which 85% of the

population had mild anemia. A significant association was noted between food restriction/avoidance and Anaemia

with a p value of 0.019.

Conclusion

Food restriction during pregnancy is associated with Anaemia in Pregnancy.

Mannose binding lectin as a marker for coronary artery disease in hypertension

M Dilagamari, V.Amuthavalli — Sun, 13 Apr 2025 00:00:00 +0000

Background

According to The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases hypertension is an

independent risk factor for cardiovascular disease (1). Inflammation plays a major role in atherosclerosis. Markers

of innate immunity have been shown to predict the development of coronary artery disease. MBL (Mannose binding

lectin) being a component of innate immunity can be used as a marker of cardiovascular risk in hypertension.

Aim & Objectives:

The study was conducted to evaluate the risk of coronary artery disease in recently diagnosed hypertensive patients

by estimating serum mannose binding lectin levels

Materials & Methods:

This cross sectional case control study was conducted among 180 subjects who were divided into three groups as

follows

Group A : 60 recently diagnosed hypertensive patients ( < 6 months duration )

Group B : 60 hypertensive patients who had myocardial infarction recently (< 7 days)

Group C : 60 age & sex matched healthy controls

Serum levels of MBL was evaluated in the three groups using ELISA technique. Collected data were analysed

statistically.

Results & Conclusion:

The serum MBL levels were significantly elevated in hypertensive patients (mean = 823.45 ng/mL; Range – 772 to

875 ng/mL) and in hypertensive with myocardial infarction (mean = 1163.39 ng/mL; Range – 945 to 1381 ng/mL) as

compared with control population (mean = 607.15 ng/mL; Range – 513 to 701 ng/mL) with p value of 0.001. From

the ROC curve, it has been determined that MBL has sensitivity of 93% & specificity of 96%) with a positive

predictive value of 96% & negative predictive value of 84.65%.

Our findings suggested the determination of MBL status may serve as a potential marker for early identification of

patients at risk of cardiovascular complications, pending further validation studies.

Determinants of communication dynamics on doctor-patient interactions: a descriptive cross-sectional investigation

Sun, 13 Apr 2025 00:00:00 +0000

Introduction: Communication dynamics in doctor-patient relationships are vital for improving patient outcomes,

with effective communication fostering clear understanding, information gathering, and compassionate

relationships. Studies highlight that physician communication skills lead to earlier problem detection, better

outcomes, higher satisfaction, and improved adherence to treatment plans. While factors like patient

demographics, doctor characteristics, and environmental influences affect doctor-patient communication,

research is limited, especially in the context of rising violence against doctors and legal challenges.

Objectives: Our study aimed to evaluate patients’ perceptions and identify the determinants associated with

negative perceptions of communication dynamics in doctor-patient interactions.

Methods: The community-based cross-sectional study included 230 participants (?18 years) selected via simple

random sampling and was conducted in Angadipuram panchayat, North Kerala, India. A pre-tested validated

questionnaire collected socio-demographic data, DPC effectiveness, and influencing factors. Data were analyzed

using SPSS 26, with chi-square tests for bivariate analysis (p ? 0.05).

Results: Our study found that 61.3% (n=141) of participants reported positive doctor-patient interactions, with

75.3% (n=55) aged 31-45 years reporting good communication and 86.9% (n=106) of females expressing higher

satisfaction levels (p=0.001). Attentive listening and involvement in decision-making (p=0.001) positively influenced

DPC, while factors like religious/cultural influences (p=0.001), high fees (p=0.0001), and rude staff behaviour

(p=0.0001) were linked to poorer communication experiences.

Conclusion: Our study emphasized that doctor-patient communication was shaped by various demographic and

contextual factors. While many participants reported positive interactions, challenges such as religious/cultural

influences, high fees, and staff rudeness pose significant barriers, emphasizing the need for patient-centered

communication strategies to improve healthcare quality and satisfaction

Prevalence and risk factors of type 2 diabetes mellitus in a rural and an urban Nigerian community: Are the demographics changing?

Ubani BC, Nkpozi MO, Ekrikpo UE, Ekuma I, Young EE, Unachukwu CN — Sun, 13 Apr 2025 00:00:00 +0000

Background

The prevalence of Diabetes Mellitus (DM) is increasing at an alarming rate globally and in sub-Saharan Africa,

Nigeria inclusive. Previous community-based studies in Nigeria, including studies in Abia State have demonstrated

a high prevalence of DM, with no significant difference between the rural and urban areas in the previous study

done in Abia State.

Objective

To evaluate the prevalence and risk factors of DM in urban and rural communities of Abia State, South-Eastern

Nigeria.

Method

A cross-sectional comparative study of 2800 adults, comprising equal numbers of rural and urban residents of Abia

State was conducted. Data was obtained using interviewer administered semi-structured questionnaires (Appendix

1). Blood pressure, anthropometric indices and fasting blood glucose were obtained for each of the participants.

Data analysis was done using SPSS version 20.

Results

The mean age of the respondents was 48.54 ± 13.24 years, with the rural residents being significantly older than the

urban, (54.23 ± 14.26 and 42.85 ± 13.24 years, respectively p<0:001). Male to female ratio was 1:2.5, (p<0.001).

Diabetes mellitus was observed in 8% of the respondents (urban = 8.9% and rural = 7.2%, p=0.110). Independent

predictors of DM in this study included age, family history of DM, daily intake of fruits in processed forms and

hypertension in the urban area, while in the rural area are age and family history of DM.

Conclusion

The prevalence of DM is rising in Abia State, with no significant urban-rural difference as observed in previous

studies in the state.

Health seeking behavior among interstate migrant workers in a northern district of Kerala

Sun, 13 Apr 2025 00:00:00 +0000

Background

Throughout history, people have migrated for better opportunities, impacting political and economic landscapes.

Recently, there’s been more focus on internal migration challenges, especially in India, where states like Kerala

attract many interstates migrant workers. Despite their economic contributions, migrant workers face significant

health challenges and limited access to healthcare. This study aims to evaluate the health-seeking behaviour of

interstate migrant workers in a northern district of Kerala and identify influencing factors.

Methods

In this cross-sectional study, 400 interstate migrant workers who lived in selected municipalities in the Malappuram

district of Kerala were surveyed using a semi-structured interview schedule in the participants native languages with

the assistance of an interpreter, with an emphasis on health-seeking behavior, and sociodemographic information.

Data analysis utilized descriptive statistics and chi-square tests via SPSS software.

Results

The mean age of participants was 31.3 ±7.7 years. Most preferred was private healthcare (39.8%) and 32% utilized

government facilities. 54% are willing to visit a doctor or healthcare facility when ill, 35% use home treatments,46%

practice self-medication when sick. Socio-demographic factors such as age and income significantly influenced

health-seeking behaviors, with a preference for modern medicine (88.3%).

Conclusions

The study on interstate migrant workers in Malappuram district, Kerala, reveals crucial insights into their health

seeking behaviors and socio-economic conditions. The study identifies high incidences of inadequate healthcare

access and frequent reliance on self-medication and home remedies. The study highlights the impact of

sociodemographic determinants on health behaviors and access to care.

A Cost Analysis of Rheumatic Fever Management in Jamaica, 2012 to 2018

Yohance Rodriguez, Camille-Ann Thoms Rodriguez — Sun, 13 Apr 2025 00:00:00 +0000

Background

Introduction: Jamaica’s burden of Acute Rheumatic Fever (ARF) and sequelae like Rheumatic Heart Disease (RHD)

have declined significantly since introduction of the WHO prevention programme in 1984 and has resulted in

reduced expenditure in prevention and control. This research aims to determine direct costs of Rheumatic Fever

(RF) events, compare them to expenditures recorded in the literature, and assess recommendations for investment

and prioritization.

Methods

A national cross-sectional survey was conducted to estimate inpatient, outpatient and prevention costs for each of

four RF groups (ARF, RHD with and without heart Failure, and Carditis). Medical records were accessed for all

patients recorded in the Hospital Active Surveillance Registries (2012 to 2018) from five major regional and

specialist hospitals. Relevant data were abstracted using an internally developed, pretested tool. Categorical costs

were calculated using the average number of units used per sub-category (e.g. registration, room and board,

consumables, tests, medications) and multiplied by National Health Service fees.

Conclusion

From 156 reports of ARF/RHD, 74 patients were identified as suspected or confirmed, of which 44 had demographic

information: 58.1% were male, and onset of ARF and RHD respectively were at 11.5 (SD 6.9) and 20.8 (SD 12.3)

years. The direct country cost of care was US$78,249.88 annually, averaged across all RF/RHD clients. The single

most costly component was inpatient admission, of which RHD, then ARF/Recurrent RF were costliest at US$695.30

and US$605.28 respectively. Secondary prophylaxis costs US$56.42/patient/year (US$36,189.16 nationally/year)

in optimal circumstances, and US$49.12 at the actual 67% compliance rate. At US$4.78/case, the annual cost of

pharyngitis management for at-risk 0-15 years olds was US$159,377.11.

Interpretation

Previous local data suggests that the total cost of care of RF conditions has fallen significantly since prevention

programme initiation. Adjusted for government subsidy, Jamaica’s direct ARF inpatient costs (US$2,421.12) are

comparable to the WHO-CHOICE inpatient estimate (US$2,225.57). These further approximate if local meal costs

are excluded as CHOICE estimates do. We believe the changing epidemiology of RF warrants prioritization for pre

and peri-natal RHD care, compliance boosting activities for prophylaxis, and clinical decision rules with rapid

antigen detection tests for targeted point of care diagnosis, all in keeping with global recommendations.

Lemierre’s syndrome: A case report of an infant with Acute Suppurative Otitis Media and Poly-microbial infection with Leuconostic Citreum and Acinatobacter Baumannii

Deepty Nauriyal, Sukhjinder Singh, Rishabh Dubey — Sun, 13 Apr 2025 00:00:00 +0000

Lemierre’s syndrome is quite a rare condition characterized by septic thrombophlebitis of the internal jugular vein

as a complication of head and neck infection, and septic embolization to other organs. The most common

etiological agent is Fusobacterium necrophorum. It is very rarely reported in infants or secondary to Acute

Suppurative Otitis Media (ASOM) or secondary to bacteria other than Fusobactrium Necrophorum. Here, we report

rare findings of a rare disease, in the case of a 6month old female child who developed Lemierre’s syndrome as a

complication of ASOM and her blood culture grew Acinatobacter baumannii and Leuconostic citreum. By the time

of this study, very few cases of invasive infection in humans due to Leuconostic citreum have been reported.

Level of knowledge, attitude, and practice regarding emergency contraception pills among female undergraduate students at KCMUCo in the Moshi Municipality, Kilimanjaro, Tanzania

Angel A Ng’unda, Mariana J Mung’au, Gloria E Foya, Jamida J Mateni, Bernard Njau — Sun, 13 Apr 2025 00:00:00 +0000

Background

Globally, unplanned pregnancies and unsafe abortions are prevalent among young and unmarried women aged 18

years and above. Existing evidence shows widespread use of emergency contraception pills (ECP) may significantly

reduce induced abortion-related morbidity and mortality. This study aimed to determine the level of knowledge,

attitudes, and practice regarding ECP among female undergraduate students aged 15 years and above at a Medical

University in Moshi Municipality in the Kilimanjaro region, Tanzania.

Methods

Using a descriptive cross-sectional study design with multistage random sampling, semi-structured questionnaire

data were collected among 314 female students at Kilimanjaro Christian Medical University College (KCMUCo) from

July 2024 to August 2024.

Results

Three hundred and fourteen (314) participants were enrolled (response rate 100%). The median age was 22 years

(Interquartile range (IQR)= 2 years), the majority, 302 (96.2%) were in the age group of 15-25 years old, 309, (98.4%),

were unmarried, 218, (69.4%)were Christians,169(53.8%) were enrolled in the Doctor of Medicine program, 44%

(n=138/314), had had a sexual experience, and 60% (83/138) had their sexual debut between 14-19 years old. The

majority, 87.9% (276/314), had heard about ECP, and 72% (198/276) mentioned the internet as the main source of

information on ECP. More than half of participants, 58.8 %(n=168/287), had a high level of knowledge of ECP. More

than half of participants, 54.4% (n=156/287), had positive attitudes towards ECP. 62%(85/138), had used ECP in the

past, and predictors associated with ECP practices at multivariate analysis include social acceptability for female

students to use ECP (Adjusted odds ratio (AOR) = 2.10 [95 % Confidence interval (CI) 1.00-4.31; P= 0.05], intention

to use ECP in the future (AOR=3.01[2.30-8.64]; P=0.000), adequate knowledge of ECP (AOR=6.70[2.80-16.0];

P=0.000), fear of side effects as a barrier to ECP use (AOR=0.23[0.11-0.48]; P= 0.05), and the belief that ECP can

prevent STD (AOR = 0.32[0.12-0.85]; P=0.02).

Conclusion

Female graduate students had a high level of knowledge, and a positive attitude towards ECP, with the internet as

the main source of information. Adequate level of knowledge, social acceptability of female students to use ECP,

and intention to use ECP in the future are positively associated with ECP practices. Participants who reported fear

of side effects of ECP, and the belief that ECP can prevent STDs, are less likely to use ECP. Despite a high level of

knowledge and positive attitude towards ECP, reinforcing the respondent’s knowledge of specific details of ECP

such as mechanism, efficacy, and typology may be beneficial for improving ECP practices among female

undergraduate students at KCMUCo in Moshi Municipality.

Addressing Underutilization of Antenatal Care in Sagar City: A Call to Action

Shefali Jain — Sun, 13 Apr 2025 00:00:00 +0000

A cross-sectional survey was conducted among 400 postnatal mothers who accessed maternal and child health

(MCH) services across different healthcare institutions, including district hospitals, medical colleges, primary health

centers, and Anganwadi centers. Data collection took place from March 2020 to October 2021 using a pre-tested

semi-structured questionnaire. Mothers from institutions were selected through convenient sampling, while simple

random sampling was used for Anganwadi centers. Informed consent was obtained from all participants.Findings

revealed high early registration rates but significant underutilization of ANC services. Although services were

generally well-received, many women did not complete the recommended ANC visits, and iron-folic acid (IFA)

supplementation adherence was inadequate. Key barriers included lack of awareness, affordability issues, and

limited accessibility.

To enhance ANC utilization, targeted interventions should focus on increasing awareness, improving affordability

through financial incentives, strengthening service accessibility, and ensuring high-quality ANC delivery. Aligning

these efforts with the Sustainable Development Goals (SDGs) related to maternal health can help bridge existing

gaps and improve maternal health outcomes in Sagar.

Knowledge of Sexually Transmitted Infections with Focus on HIV/AIDS and Hepatitis B among Secondary School Adolescents in Ekiti State, Nigeria

Sun, 13 Apr 2025 00:00:00 +0000

Sexually transmitted infections (STI) are a serious public health issue among adolescents because they often have

limited knowledge and insufficient access to health services. Good knowledge of STIs, hepatitis B (HB) and the risk

of developing diseases is essential to engage in preventive actions. The aim of this study is to assess the knowledge

of STIs, including HIV/AIDS and HB among adolescents attending secondary school education in Ekiti State.

Methods

A cross-sectional study design was used in selecting 669 participants among secondary school adolescents from

Ekiti State, Nigeria, through a multistage sampling technique. Data was collected using semi-structured, pre

tested, self-administered questionnaires. SPSS version 26 was used for data analysis. The descriptive statistics

involved percentages, sample mean, and frequency tables. Inferential statistics such as Chi-square were used to

test for associations between categorical variables. P-values < 0.05 were considered significant.

Results

The study included a total of 357 females (53.4%) and 312 males (46.6%), with 256 (38.3%) of participants below 14

years old, and 407 (61,7%) older than 14 years old.611 (91.3%) subjects had awareness of HIV/AIDS, and 233 (34.8%)

of participants were aware of the Hb virus. 330 (49.3%) of students had good knowledge of STIs, and the remaining

339 (50.7%) of subjects were poorly informed on this topic. Being a male and age 14 years and above were

significantly associated with good knowledge of STIs.

Conclusions

Awareness of HB infection is very low among adolescents from Ekiti state, Nigeria, and their knowledge of STDs is

poor as well. Being a male and older adolescents are factors associated with having more knowledge of STIs. It is

recommended that comprehensive education concerning STIs and sexually transmitted diseases and associated

diseases should be started much earlier in life and especially for female adolescents.

Utilizing the association between Hepatitis B viral load and Hepatic failure biomarkers for guided antiviral therapy

Sun, 13 Apr 2025 00:00:00 +0000

Background

Hepatitis B virus infection is a global public health problem. Individuals with chronic Hepatitis B are at an

increased risk of developing liver cirrhosis, hepatic failure and hepato cellular carcinoma. This study was

undertaken in a tertiary care hospital with the aim to measure the Hepatitis B viral DNA and its association

with hepatic biochemical markersso as to guide for better clinical management during therapy.

Methods and Material:

Blood samples from 94 Hepatitis B seropositive patients were collected and tested for HBV viral load by real

time PCR.Patients were divided in two categories A & B (A= < 20000 IU/ml and B >20000 IU/ml) as based on

the quantification of viral DNA. Biochemical tests were performed for assessing Serum ALT, AST, Platelet

count, hemoglobin, Albumin, Bilirubin and Prothrombin time.

Results:

Total patients in category A (< = 20000 IU/ml) viral load were 51 (54%) Total patients in category B (>20000

IU/ml) were 43.Category B patients with >20000 IU/ml of HBV viral load had elevated levels of SGOT (AST)

with statistical significance at P value 0.038. Moreover, Serum albumin and Platelet count were significantly

noted on lower side in category B patients at P values 0.03 and 0.02 respectively.

Conclusion:

Viral load of Hepatitis B varies over time, depending on the phase of theinfection. The findings of this study

points at strong correlation between HBV viral load and biochemical markers for hepatic failure.Thus timely

and regular viral load monitoring along with hepatic biomarkers is crucial for the treatment of Hepatitis B.