Global Journal of Medicine & Public Health

Patterns of deliveries in rural area of Nandyal district, Andhra Pradesh, India

Tue, 01 Oct 2024 00:00:00 +0000

Introduction

This study was conducted to study the pattern of deliveries in rural areas of Nandyala & to observe the association

of delivery pattern with socio-cultural and economic factors.

Methodology

A community based cross-sectional retrospective study was carried out during 2016 for a period of one year, in a

Rural area Nandivargam of Nandyala district having 5400 populations of which Sample size of 455 were taken.

The study subjects selected were the mothers who delivered within last 6 years. The data was analysed and

interpreted using SPSS.

Results

Majority of the women belonged to 23 years, 70% were Hindus, and 11% women delivered babies at their

residence. 60% of home delivery respondents belonged to lower middle class. There was an equal proportion of

respondents from the category of home delivery were from nuclear joint and extended families, 52% of the

women were illiterates which is statistically significant. Majority of home deliveries were conducted by 40% of

their relatives. 81% of the home delivery respondents were initiated breast feeding within 0-1 hour after birth,

42% from all respondents were initiated weaning after 6 months which was a correct method. 89% of population

that used health facility for delivery was attended by skilled birth attendants which was still low when compared

to the national target of 100%, though there was some improvement when compared to the past national

average.

Conclusion

For delivery in health facility increased with increase in education level, being from high income group. Majority

were initiated breast feeding within one hour.

Trends of chicken pox in children: an ode to the robust network of surveillance system with laboratory support

Nileena Suresh, .Shantala G B,, Kusuma G R — Tue, 01 Oct 2024 00:00:00 +0000

BACKGROUND

Chicken pox (varicella) is the primary infection caused by Varicella Zoster Virus (VZV) and it predominantly affects

children, with highest incidence in the 1-9 years old age group.VZV transmission mainly occurs from direct contact,

inhalation of aerosols from vesicular fluid of skin lesions of varicella or zoster, and possibly through infected

respiratory secretions and its aerosols. Varicella outbreaks are frequently reported from various regions of India. In

India about 74 outbreaks of chicken pox was reported in 2022. The objective of this research to describe the

distribution and characteristics of Chicken pox outbreaks in Karnataka region during 2022 & 2023 in 7 districts, an

observational study.

METHODS

Total of 213 suspected cases from February 2022 to February 2023 were included in the study. Samples from various

districts of Karnataka were received in reference laboratory BMCRI under IDSP. Laboratory confirmation was

performed in the State level viral research and diagnostic laboratory, BMCRI on representative samples sent from

each district for VZV. IgM antibodies against VZV were detected by ELISA (NovaLisa).

RESULTS

A total of 213 suspected cases were observed from February 2022 to February 2023. Towards the end of the year in

2022, 58 cases were reported in Kolar.8 representative samples were sent and all were positive for VZV IgM ELISA. A

total of 47 cases were reported from Tumkur throughout the year.47 samples were sent in total of which 43 tested

positive for VZV. 48 cases were reported in Mandya,10 representative samples were positive.12 cases in Koppal.29

cases from Hassan and all 7 representative samples were positive for IgM. 8 cases were reported from Davanagere

and confirmed positive for IgM VZV through ELISA.

CONCLUSION

Karnataka has an ideal setting for the spread of VZV. The ambient temperature in the winter, early spring & closely

placed population aids in the spread of infection. The number of chickenpox cases were higher amongst the children

compared to the adults. This may be due to the fact that adult population already developed natural acquired

immunity against chickenpox.Timely identification by surveillance and referral of samples by the district public health

laboratories helped in early detection and treatment of the cases.The Chicken pox Vaccination has not been

incorporated into the National immunization schedule as of now. A programme of varicella vaccination can

potentially change the epidemiology of varicella and limit its burden childhood as well as its social and financial cost.

Health problems of anganwadi workers in an urban area-a pilot study

Jayalekshmi CS, Geetanjali Joshi, Ravindra Gurav, , Dinesh Samel, — Tue, 01 Oct 2024 00:00:00 +0000

BACKGROUND

Anganwadi Workers have been the frontline workers providing a package of services to the children below 6 years of

age, pregnant and lactating mothers as well as females in the reproductive age group, under the Integrated Child

Development Services (ICDS) Programme. Promoting the health and socio-demographic status of this frontline force

is critical to improve the delivery of services. Ultimately, this will improve the outcomes of the ICDS scheme.

METHODOLOGY

The present descriptive cross-sectional study was conducted in an urban area among 31 Anganwadi Workers. The

convenience sampling technique was used to conduct the study. Socio-demographic profile and health status of the

Anganwadi workers was recorded in pre-designed and pre-tested proforma by interviewing them. The data was then

analysed and interpreted using suitable statistical methods.

RESULTS

31 Anganwadi workers were included in the study. 28(90.32%) subjects were in the age group of >40-58 years.

29(93.55%) subjects were having health problems at the time of study (p<0.05). Of the 29(93.55%) symptomatic

subjects, 22(75.86%) were suffering from non-communicable diseases and 07(24.14%) were suffering from

communicable diseases (p<0.05). 11(35.48%) subjects gave history of major illnesses in the past.

CONCLUSION

Previous studies done on Anganwadi Workers have focused primarily on the efficiency of service delivery. It is now

imperative to delve into the socio-demographic and health issues affecting them, in order to identify effective

measures for overcoming these challenges and enhancing the overall efficacy of the ICDS program.

Risk Factors and Clinical Profile of Nutritional Anemia in Children at a Tertiary Care Center of Western Uttar Pradesh, India

ShwetaGupta, Rufaida Mazahir, Shahzad Alam — Tue, 01 Oct 2024 00:00:00 +0000

Background

Little is known about the burden and clinical characteristics of children with nutritional anemia in the population of

westernUttar Pradesh. This research was conducted to assess the risk factors and clinical profile of nutritional anemia

in children admitted at a tertiary care center in western Uttar Pradesh, India.

Materials and methods

This hospital based cross-sectional study involved 220 subjects aged 6 months to 12 year presenting with anemia

(nutritional) as per WHO definition at our center. Structured questionnaires were used to collect socioeconomic and

demographic characteristics of the family and child. Blood samples were collected for estimation of hemoglobin,

serum iron, B12 and folate levels. Univariate and Multiple logistic regression was used to calculate adjusted odds ratios

and the corresponding 95% confidence intervals.

Results

In our study, the majority of subjects were having moderate anemia (53.64%) followed by severe form (25.46%). Iron

deficiency was found in 67.27% of the subjects. Pallor was found to be the commonest sign (71.36%) followed by

tachycardia (27.27%). Majority of subjects reported microcytic hypochromic anemia (74.54%) followed by macrocytic

anemia. On multiple regression: younger age, higher birth order, lower SES, poor nutritional status and lower serum

iron, B12 and folate concentration were significantly associated with moderate to severe nutritional anemia.

Conclusion:

In northern India, nutritional anemia still poses a significant problem not only among younger children but also among

older ones. Iron deficiency continues to be the primary cause of this condition, however, B12 and folate deficiencies

also have substantial contributions.

A Clinical Audit to Assess the Adherence of Doctors Regarding Hypertension Management Guidelines in Bhopal (M.P.)

Aanchal Bijlwan, Lopamudra Ghosh,, Saurav Kumar,, Pulkit Pandey — Tue, 01 Oct 2024 00:00:00 +0000

High blood pressure (BP) is a common condition. Globally, it is projected that there are over one billion hypertensive

individuals, with the number expected to rise to 1.56 billion by 2025, representing a 60 percent increase since 2000. 1

In recent years, HTN has been identified as a factor in roughly half of all deaths caused by stroke and heart disease.

Hypertension (HTN) is a serious public health issue across the world, with high rates of morbidity and mortality.2

Because the vast majority of cases are asymptomatic, they go unnoticed and untreated, increasing the risk of

coronary artery disease, heart failure, renal failure, cerebrovascular disease, and retinopathy. According to evidence,

the number of deaths and disabilities caused by coronary heart disease and cerebrovascular illness is quickly growing

in emerging nations, and they are predicted to rank first and fourth, respectively, as the leading causes of global

disease burden by 2020.3

In India, hypertension (HTN) has a significant public health impact on cardiovascular health and healthcare systems.4

In India, hypertension is directly responsible for 57% of all stroke fatalities and 24% of all coronary heart disease (CHD)

death. 5 HTN is one of the leading causes of mortality in the globe, according to the WHO.6

Histopathological Spectrum of Ovarian Tumours in a Tertiary Care Centre of Garhwal Region

Srijan Srivastav,, 1.Shubhani Singh, Deepa Hatwal, ; 3.Swati Pundir, — Tue, 01 Oct 2024 00:00:00 +0000

Background

Globally ovarian tumour is one of the leading causes of cancer death among women. The ovarian tumor has varied

histogenesis, clinical behavior, and malignant potential.The aims and objectives of the present study is to study the

histopathological pattern and age distribution of ovarian neoplasms.

Methods

A total of 68 cases were studied for a period of 3 years in a tertiary care center of Garhwal region. They were reviewed

and analyzed for age, histopathological findings, and clinical presentations. The classification was done according to

the WHO histologic classification of ovarian tumors,2020.

Results

Of the 68 ovarian tumors studied, 80.80% were benign, 7.35% cases were borderline, and 11.76% cases were

malignant. Among the WHO 2020 morphological classification, surface epithelial tumors comprised 60.30%, followed

by germ cell tumors (27.94%). Serous cystadenoma (23.52%) was the most typical benign neoplasm, followed by

mature cystic teratoma (19.11%). Mucinous cyst adenocarcinoma (2.90%) was the most common malignant

neoplasm. Tumors were seen over an age range of 18-78 years, and a maximum number of cases presented in the 2nd

to 3rd decade of life. The younger age group primarily presented with benign tumors, whereas malignant tumors were

common in the elderly age group.

Conclusions

Surface epithelial tumors were the most common ovarian tumors. Maximum numbers of ovarian tumors were in the

age range of 20-39 years.

Taboos related to Dog bite in Urban Bengaluru — A Cross-sectional study

Arun kumar V, Ranganath T S, Hamsa L, Jayaraj P, — Tue, 01 Oct 2024 00:00:00 +0000

Introduction

India is known for its different social and artistic backgrounds with a wide range of myths and misconceptions

related to conditions. One similar belief is about certain food taboos and diet restrictions following a dog bite,

which is extensively prevalent. Dogs are the main source of rabies, contributing up to 99% of all rabies

transmissions to humans.

Materials and Methods

A community-based cross-sectional study was carried out in the urban field practice area of Bangalore Medical

College & Research Institute (BMC&RI), Bengaluru, Karnataka, among 200 adults. A pre-tested, semi

structured questionnaire containing details on socio-demographic variables and taboos related to dog bites

was obtained from the participants following their consent.

Results

84(42%) of the study subjects were told that certain kinds of limitations should be followed after a dog bite.

57.8% of people who got bit followed a certain form of food constraint and 66(78.6%) of them told that non

veg food can be eluded after the bite incident. Nearly 82(41%) of them got such information from their family

members/ relatives.72(46.75%) were aware of the first aid of washing wounds with soap and water following

the bite 166(83%) and said that anti-rabies vaccination should be given after the dog bite.

Conclusion

The public still believes in traditional and alternative medicine therapists, which leads to an interruption in

receiving the much-wanted lifesaving vaccination. More exploration is required all over the nation to uncover

the actual problem and make strategies accordingly.

The rise and spread of Dengue and its vectors in India: A Review

R.S.Sharma,, Himmat Singh,, SM Kadri,, 4. Harshdeep Joshi, — Tue, 01 Oct 2024 00:00:00 +0000

The dengue as an illness has been recognized for more than 200 years and the role of Aedes aegypti as the

vector of this arbovirus has been known for the last 90 years. About half of the world's population is now

infected with an estimated 100–400 million new infections occurring each year. Dengue is found in tropical and

sub-tropical climates worldwide, mostly in urban, semi-urban and rural regions. The first reference of dengue

was mentioned in Mumbai, Pune and Kolkata in 1871 and after that reported from Ganges valley as far as

Ludhiana , Kerala coast and from Calicut to Quilon. The dengue vector Aedes aegypti was also distributed all

over India in 1934s in a faunistic survey done by Barraud. . The vector species was even reported from all over

India and even from Lahaul and Spiti in Himachal Pradesh. The species was also confirmed by the following

surveys. In India dengue was first reported and documented in 1956 from Vellore. Thereafter, there was an

outbreak in Kolkata during 1960s. During this period, reports of Chikungunya spread was also seen in different

parts of the country, potentially because both viruses were circulating in the same place at the same time.

Following that, an epidemic of haemorrhagic fever was reported in Kolkata in 1963 and febrile illness in Nagpur

city in Maharashtra during 1965. 50% of the infected population were affected by severe joint and body pain.

Now dengue is endemic in the country and reported in 36 states/UTs . The cases of dengue increased from

101,192 in 2018 to ,233,251 in 2022. Similarly dengue deaths also increased from 172 (2018) to 303 (2022).

Prevalence and Predictors of malnutrition among elderly in an urban area in Visakhapatnam

Tue, 01 Oct 2024 00:00:00 +0000

Introduction

Malnutrition in the elderly is a significant public health problem and often underreported. It has serious implications

on the overall health and quality of life of elderly population.

Objective

To assess the prevalence of malnutrition and its associated factors among elderly.

Methodology

A community based cross sectional study was done for a period of two months during September 2022 to October

2022 in urban field practice area of a medical college. Total 186 elderly (?60 years) were included in the study by

simple random sampling method. An interview schedule was used to record the socio-demographic and relevant

details of the study participants. Nutritional status assessment was done by using 18 items (30 points) Mini nutritional

assessment (MNA) scale. Data was analyzed using SPSS version 25. Chi- square test and Fisher's exact test was

applied based on the nature of the distribution of data. P<0.05 taken as statistically significant.

Results

Majority of the participants (84.95%) were in the age group of 60-70 years. About 61.83%were females and 38.17 %

were males. The prevalence of malnutrition was 18.28 %. Those who are at risk of malnutrition were 51.61 %. There

was no significant association between socio-demographic profile and malnutrition among elderly.

Conclusion

The present study showed that the majority of the elderly were at risk of malnutrition. There is a need for early

diagnosis and management of malnutrition among elderly which will improve their quality of life.

Keywords Elderly, Malnutrition, Prevalence, Urban.

Prevalence of non-alcoholic fatty liver disease and its correlation with coronary risk factors in patients with type 2 diabetes mellitus

Nisha S. Lalwani,, P.R.Jha, — Tue, 01 Oct 2024 00:00:00 +0000

Introduction

Non alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, type 2 diabetes, dyslipidemia, and

insulin resistance. Presence of NAFLD along with diabetes may also be linked to increased coronary artery disease

(CAD) risk1 . We conducted this study to estimate the prevalence of NAFLD in type 2 diabetes mellitus patients and to

assess association of NAFLD with CAD and its risk factors in type 2 diabetes mellitus patients.

Methodology

A Hospital based prospective cross-sectional study was done in 100 consecutive type 2 diabetic patients fulfilling the

eligibility criteria, in the Department of Medicine, Sir Takhtsinhji General Hospital, Bhavnagar. NAFLD was diagnosed

on the basis of ultrasound assessment of the liver. History, physical examination and results of relevant laboratory

investigations were recorded. Patients were grouped in two groups –NAFLD and Non-NAFLD and various parameters

were compared. A p value of < 0.5 was considered significant.

Results

The prevalence of NAFLD was 59% in type 2 diabetic patients. CAD was more prevalent in the NAFLD subgroup

(49.15%) compared to non-NAFLD subgroups (26.82%). The NAFLD subgroup had significantly higher prevalence

of coronary risk factors like family history of diabetes, low HDL, high triglyceride, microalbuminuria and metabolic

syndrome. The proportion of patients using insulin, antihypertensive drugs, antiplatelet drugs and lipid lowering

agents was higher among patients with NAFLD.

Conclusion

NAFLD is commonly associated with type 2 diabetics. Ultrasonographically detected NAFLD alerts us for metabolic

syndrome and increased risk of coronary artery disease. Thus understanding its pathogenesis, biochemical

parameters and its management, are vital issues today in clinical practice to identify type 2 diabetics who are at

highest risk.

A comparative study of N/L ratio in patients of metabolic vs non-metabolic syndrome attending a tertiary care hospital.

M.Sai Varun, Mudipalli Deepthi, — Tue, 01 Oct 2024 00:00:00 +0000

Background

Numerous studies have shown an association of metabolic syndrome (MS) and insulin resistance with inflammation.

The prevalence of MS as defined by the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP,

ATP), and other criteria indicates ranges from 11% to 41% in India. Neutrophil-lymphocyte ratio, which is calculated

from a routine complete blood count with a widely used marker of inflammation.

Aims and objectives

The aim of the present study was to evaluate the neutrophil-lymphocyte ratio in patients with MS and to correlate

the same with the severity of MS based on the categories of MS.

Materials and Methodology

In this cross-sectional study, 210 patients with and without MS were included after detailed history and examination.

Patients were considered as cases based on the NCEP, ATP III criteria for MS. Both groups of patients were subjected

to routine investigations which included complete blood counts, total white blood counts, neutrophil and lymphocyte

levels, HbA1c levels, serum glucose levels, fasting lipid profile, and electrocardiography. Logistic regression analysis

was done to look for the association of neutrophil-lymphocyte ratio with MS. P < 0.05 was considered as statistically

significant.

Results

It was seen that the neutrophil-lymphocyte ratio in participants without MS was found to be 1.57 ± 0.728 and the ratio

in participants with MS fulfilling 3 out of the 5 criteria, 4 out of 5 and 5 out of 5 criteria were, respectively, 2.65 ± 1.003,

3.59 ± 1.258, and 4.79 ± 2.143. This association was statistically significant with a P = 0.00.

Conclusion

Participants with MS had increased neutrophil-lymphocyte ratio when compared to participants without MS.

Participants fulfilling higher criteria of MS had higher neutrophil-lymphocyte ratio suggesting increasing

inflammatory state.

The Insight to the Fertility of the Patients Presenting with Malignant Ovarian Germ Cell Neoplasias with Respect to Its Diagnosis & Management - A Study Conducted in a Tertiary Care Hospital

Birupaksha Biswas, Shilpa Basu Roy,, Soutrik Roy — Tue, 01 Oct 2024 00:00:00 +0000

Background

The ovarian germ cell tumours account for 2.6% of all ovarian malignancies and usually occur in the first two decades

of life. Arising from epithelium, the stroma & the follicular component of the ovary, they are gonadoblastoma, mature

teratoma, dysgerminoma, yolk sac tumour, embryonal carcinoma, immature teratoma & chorio-carcinoma.

Method

A retrospective observational study was conducted in IPGMER & SSKM Hospital over a period of three years (2020-

2023) at the Gynaecology & Obstetrics department along with the radiology & pathology department. The study

aimed to elucidate the fertility stature of the patients who presented with these tumours & were subjected to the

treatment involving cross- sectional imaging combined with the histopathological diagnosis & the surgeries

performed thereafter.

Result

In our study, apart from the regular MOGCT (malignant ovarian germ cell tumours), NET (neuroectodermal tumors)

was found in nearly 25% of the study population, along with dysgerminoma (27.5%), immature teratomas (27.5%),

dermoid (15 %) & yolk - sac tumours (5 %) as the rest. Viable pregnancies in these patients were achieved in due

course, thereby proving the fact that proper diagnosis & the subsequent treatment of these entities will yield the

desirable outcome with respect to achieving pregnancy.

Conclusion

Literature substantiates that 18.8- 55.7% of such patients may achieve favorable pregnancies with a combination

of a near accurate diagnosis, staging & surgeries, which are the cornerstone of the treatment. Nevertheless,

surgery should be tailored according to age, interest in preserving fertility, and the stage of the disease.

Examining the factors associated with tobacco use among adolescents in Qatar in 2018

Bukola G. Olutola, Lebogang M Ramalepe, Siwelile S. Ndlangamandla — Tue, 01 Oct 2024 00:00:00 +0000

Background

Tobacco use is a global health concern and the negative impact it has on the health of the individuals that use it is

indisputable. Between 2004 and 2013, Qatar had an overall increase in the prevalence of smoking, a decline in the role

of media in promoting pro-tobacco and anti-tobacco messages, a drop in second hand smoke exposure at home, a

rise in smoking prevalence in enclosed public spaces, and a decrease in smoking cessation. Therefore, study looks at

the factors associated with tobacco use among school going adolescents in Qatar in 2018, five years after the previous

survey.

Methods

Data from the 2018 Global Youth Tobacco survey were used to conduct a cross-sectional study. The data were

collected from school going children using a two-stage sample design to select the respondents. Statistical analysis

was conducted using STATA version 13. Multivariable logistic regression was used to identify the factors.

Results

Of the respondents, 78.1% were between 13 and 15 years and more than half were females (52.2%). The prevalence

of overall current tobacco use was 14.6% (n=254), current Shisha smoking was 4.4%, current E-cigarette use was

10.8%, current smokeless tobacco use was 13.6% and current cigarette smoking was 6.7%. Having tobacco brand logo

on personal belonging was positively associated with current tobacco use. Those whose mothers were the only parent

smoking in the house were more likely to be current tobacco users compared to those with no parent smoking (AOR:

10.75; 95% Con. Int: 0.99-117.20, p=0.051). No difference between adolescents who were refused cigarette purchase

in the past 30 days and those who were not regarding current tobacco use.

Conclusion

The study shows that smoking by mother and tobacco brand logo on personal belongings play a role in tobacco use

among adolescents in Qatar. However, being sold cigarette or not does not prevent the adolescents from tobacco

use.

A study to assess knowledge, attitude and practice regarding diagnosis and management of tuberculosis among nursing staff in tertiary care hospital, Bhavnagar, Gujarat, India

Shrinesh Agrawal, Vishal Kansara,, Jigna Trivedi, — Tue, 01 Oct 2024 00:00:00 +0000

Background

Numerous studies have previously been conducted on the management of tuberculosis by healthcare

workers. Given that nurses interact with patients frequently in the course of their work, it is also important to

look at their knowledge, attitudes, and practices. Future studies may take into account additional aspects of

tuberculosis patient care, such as knowledge and approaches for managing patients of multidrug-resistant

pathogens including tuberculosis. A report from the WHO has emphasized the importance of educational

strategies to equip healthcare workers with the appropriate knowledge, skills, and attitudes which will lead to

adequate infection control practices and thus reduce the disease burden of TB.

Methods

For this cross-sectional study, offline survey was conducted among 182 nursing staff members of Sir T General

Hospital, Bhavnagar, Gujarat. A validated self-administered questionnaire comprising five sections (socio

demography, work-related information, knowledge, attitude, and practice) was used for data collection.

Result

155 (84%) out of a total of 182 participants had good knowledge, 129 (70%) had a positive attitude and 77

(42%) had good practice around tuberculosis prevention. Study reveals that only 58% of participants had

provided a surgical mask to a patient with cough Approx. 25% of respondents didn’t know the role of private

practitioners in the treatment of tuberculosis. Every nine out of ten participants thought to increase awareness

regarding tuberculosis in the hospital campus.

Conclusion

The findings of the study reveal that nursing staff of the hospital had an overall good knowledge and a positive

attitude regarding Tuberculosis prevention. However, this knowledge does not explain the cause of TB

therefore it leads to disparities between knowledge and practice. To overcome this problem effective

educational programmes should be implemented.

Effect of Educational Attainment on Health-Seeking Behaviour of Urban Slum Dwellers in Nigeria: An Insight from the Lagos State Metropolis in Nigeria

Michael Olusegun Demehin,, Uche C. Isiugo-Abanihe — Tue, 01 Oct 2024 00:00:00 +0000

Background

This research investigates the effect of socioeconomic correlates of educational attainment on the health-seeking

behaviour of slum dwellers of the Lagos State metropolis.

Methods

Research locations were Ajeromi-Ifelodun, Apapa, Shomolu, and Lagos Mainland, which are Local Government Areas

that account for most of the notable slum settlements in Lagos State. Study methods were mixed, and qualitative

and qualitative data were collected, which were used to enrich the study outcomes. A modified Taro Yamane

sampling formula was used to select four hundred members of the slum settlements, and the sampling techniques

were purposeful and accidental due to the non-availability of a probable sampling frame of the study population.

Results

The p-value statistics of 0.0.14 showed a significant relationship between educational attainment and healthcare

services utilization/health-seeking behaviour, while the binary logistic regression showed an inverse relationship, the

higher the educational attainment of residents the less likely they are to utilize healthcare services in the slum areas.

Conclusion

The research, therefore, recommends accessible education policies and improvement of the healthcare facilities in

the slum settlements.

The importance of HPV Vaccination in Men

Elizabeth Duffy — Tue, 01 Oct 2024 00:00:00 +0000

I'm honored to write the editorial for this edition of the Global Journal of Medicine and Public Health. HPV

(Human Papillomavirus) is well-established as the most common sexually transmitted pathogen worldwide 1 .

It is primarily publicized for the potential of various strains (especially HPV16 and HPV18) to cause genital

warts, precancerous neoplasias, and cervical as well as other cancers in women 1 . One will find endless studies,

editorials, articles, news reports and so on, on the topic.

This is certainly a crucial topic to discuss. However, it detracts from the severe burden of cases of HPV infection

and HPV-linked cancers in men each year. According to the website of the Centre for Disease Control and

Prevention (CDC), although HPV-linked cancers are not common in men, approximately 4 out of every 10 cases

of cancer related to HPV infection occur in males 2 . Further, each year in the U.S., over 15,000 men develop

HPV-linked cancer 2 . According to a 2023 study published in the Lancet, almost one-third of men over the age

of 15 are infected with at least one HPV strain, and one 1 in 5 are infected with one or more of what are known

as high-risk (oncogenic) HPV types 3 . HPV prevalence was particularly high in young adults, with the incidence

peaking in those between 25 and 29, and stabilized beyond this age range 3 .

Included in these cancers are those of the head, neck, penis, anus, and oropharynx (including the base of the

tongue and tonsils) 4 . Other HPV infections may result in recurrent respiratory papillomatosis and anogenital

warts 5, 6. The latter can take the form of warts, lumps, sores, or other unusual growths; and their size, shape,

and clinical course of can vary between individuals 4 .

Several groups of men are at higher risk; including men who have sex with men (MSM), and those who are

immunocompromised due to co-infection with another virus such as HIV or on immunosuppressant medication

2, 7

. For example, in a 2018 study of data from 25 longitudinal studies, the incidence of HPV was twice that in

those living with HIV in comparison to those without, with HPV clearance being approximately half in the

former group relative to the latter group 7 . Further, a 2019 study published in BMC Infectious diseases found

that “anal HPV infections were common among MSM in Cape Town with the highest HPV burden among HIV

co-infected MSM, men who have sex with men only and those that practiced receptive anal intercourse 8 .”

There are currently no diagnostic or screening tests for HPV in males of any age or medical history. With that,

the best course of action is preventing cancer with HPV vaccination in men . As the vaccine does not treat

existing HPV infection and HPV-linked diseases, the vaccine should be administered prior to being exposed to

HPV 2 . Following administration, it has been shown to be highly effective in preventing HPV infection and HPV

linked disease. For example, a 2022 10 year follow up study “ durable effectiveness of the qHPV vaccine was

demonstrated in women 27–45 years of age, and vaccine efficacy was inferred in men 27–45 years of age based

on the serological results 9 .” Many such studies have shown similar results 9-11. Therefore, it is crucial to raise

awareness and knowledge about the importance of HPV vaccination in men to protect our fathers, brothers,

partners and other male loved ones. Thanks for reading

metropolis.

Determining Patient-Related, Health Service-Related, and Socio-Cultural Factors for Non-Adherence to Tuberculosis Treatment in Namibia

Muhammad Hoque,, Doreen Mwangala Mainga, Lindiwe Zungu, — Tue, 01 Oct 2024 00:00:00 +0000

Background

Tuberculosis (TB) is a major public health issue in Namibia, and treatment adherence is crucial for effective disease

management. It is essential to identify the factors that contribute to non-adherence to enhance treatment outcomes

and decrease the transmission of TB. The study aims to identify patient-related, health service-related, and socio

cultural factors contributing to non-adherence to TB treatment among TB patients in Namibia.

Methods

A quantitative cross-sectional study was carried out on a sample of 43 TB patients from different regions of Namibia.

Data were collected through surveys from patients undergoing TB treatment.

Results

The findings indicated that most of the participants (95%) lacked the motivation to adhere to the prescribed

treatment. All individuals admitted to being negligent regarding their treatment schedule, and if they saw positive

effects during the initial stage of treatment, they would discontinue their medication. Participants reported similar

experiences when they had negative emotions following the initial treatment. Most participants (88%) expressed that

the clinic hours were inconvenient, while all participants indicated that there was insufficient time allocated to discuss

concerns of medication adherence. Most respondents (79%) reported that the healthcare professionals were

unfriendly. Regarding cultural aspects, all participants expressed the idea that tuberculosis can be treated with

traditional remedies, while 95% acknowledged the presence of cultural beliefs related to tuberculosis in their society.

All participants held the belief that the sickness is attributed to a curse and poisoning, with 88% of participants

subscribing to the notion that tuberculosis is passed down through familial inheritance. The results show that socio

cultural factors, such as stigma, and patient-related factors, such as forgetfulness, significantly contribute to non

adherence.

Conclusion

This study emphasises the complex and varied factors that contribute to the lack of adherence to TB treatment in

Namibia, including important factors relating to the patients themselves, the healthcare services, and the socio

cultural context. It is crucial to implement focused interventions that specifically target these characteristics to

improve adherence rates. Effective strategies should encompass thorough patient education, enhanced healthcare

service delivery, and community involvement initiatives to diminish stigma and provide assistance to those with TB.