Clinic Attendance Research Articles

Bone-anchored hearing aids: Percutaneous versus transcutaneous attachments – a health economics comparison in paediatric patients

IntroductionBone anchored hearing aids (BAHA) are a useful support when conventional hearing aids are not suitable. The two types of attachment of the aid are onto a percutaneous abutment or a transcutaneous magnet. Anecdotally, the abutment requires more care, revision procedures and causes more infections than magnet-based devices. MethodsA multicentre, retrospective review was conducted of all patients that underwent a BAHA since our programme began, identified through a prospectively maintained database of patients. Patients’ charts were audited for outpatient clinic visits, skin complications and revision surgeries. Developmental delay was also recorded. Patients were censored if the hearing aid was removed, replaced or the patient reached 16 years old. Bilateral or reimplanted patients were recorded as separate implants. Statistical analysis was performed using SAS version 9.4. Results150 implants were assessed over 126 patients: 115 transcutaneous and 35 percutaneous. Percutaneous patients had significantly more outpatient clinic attendances (Least square mean 4.19 vs. 1.39 p = 0.00), skin complications (mean 4.82 v 0.11 p = 0.00) and theatre visits (mean 2.8 vs. 1.03 p = 0.00) compared to transcutaneous patients. 77 implants were in patients that had developmental delay; having same made no significant difference to above outcomes. ConclusionThere is a significant difference in healthcare burden between percutaneous and transcutaneous systems in a paediatric population. The increased cost of the percutaneous implant to the healthcare system and inconvenience to the patient is cause to consider a transcutaneous system in the first instance.

Gaps and Opportunities for Strengthening In-School Support for Youth Living With HIV.

With optimized antiretroviral treatment youth living with HIV (YLH) now spend most of their time in schools, making schools an important venue to optimize outcomes. We evaluated school support for YLH. We conducted surveys with public secondary/high schools in 3 Kenyan counties (Nairobi, Homa Bay, and Kajiado) to determine policies and training related to HIV. Chi-squared tests and Poisson regression were used to compare policy availability and staff training by county HIV prevalence and school type. Of 512 schools in the 3 counties, we surveyed 100. The majority (60%) of schools surveyed had boarding facilities. The median student population was 406 (IQR: 200, 775). Only half (49%) of schools had medication use policies; more in boarding than day schools (65% vs 30%, p = .003). While most schools (82%) had clinic attendance policies; policy availability was higher in higher HIV prevalence counties (Homa Bay [100%], Nairobi [82%], Kajiado [56%], p < .05). Overall, 64% had confidentiality policies with higher policy availability in higher HIV prevalence regions (p < .05). Few schools had staff trained in HIV-related topics: HIV prevention (37%), HIV treatment (18%), HIV stigma reduction (36%). Few were trained in confidentiality (41%), psychosocial support (40%), or mental health (26%). Compared to day schools, boarding school were more likely to have staff trained in HIV prevention (prevalence ratio: 2.1 [95% confidence interval 1.0, 4.0], p = .037). In this survey of Kenyan schools, there were notable gaps in HIV care policy availability and training, despite high HIV burden. Development and implementation of national school HIV policies and staff training as well as strengthening clinic and family support may improve outcomes for YLH.

Knowledge and Practice of Prevention of Anaemia in Pregnancy Among Women Attending Antenatal Clinic at Olabisi Onabanjo University Teaching Hospital, Ogun State

Anaemia in pregnancy is a significant public health concern and is common among pregnant women and children. The study examined the knowledge of anaemia in pregnancy and preventive practices among pregnant women attending antenatal clinic at Olabisi Onabanjo University Teaching Hospital Sagamu. This study adopted descriptive survey design and 150, sample size was calculated. The same number of questionnaire was distributed following an informed consent. The data for the study were analyzed using descriptive statistics such as frequency/percentages and inferential statistics such as correlation analysis. The findings revealed that there is a significant relationship between the level of knowledge and practice of prevention of anaemia in pregnancy by the pregnant women at p-value of 0.000 which is significant at 5%. Also, the study revealed that there is a significant relationship between the perceived causes of anaemia in pregnancy and its preventive practices among the pregnant women attending antenatal clinic at Olabisi Onabanjo University Teaching Hospital Sagamu at p-value of 0.000 which is significant at 5% level. The implication of this is that the level of knowledge and practice of prevention of anaemia in pregnancy by pregnant women has influence on pregnant women attending antenatal clinic at Olabisi Onabanjo University Teaching Hospital Sagamu especially those affected by the menace. In conclusion, it was clear that anaemia in pregnancy is prevalent in Nigeria contemporary society whose quick prevention should be taken into prompt consideration. It is however recommended that the government should employ more public health nurses in order to ensure at least a visit to help increase the knowledge of pregnant women on anaemia in pregnancy and lay more emphasis on the preventive practices.

Increasing rates of clinic no-shows during and following the COVID-19 pandemic at an academic orthopaedic multispecialty group

Background: Clinic no-shows are common throughout all medical specialties and can be used as a potential surrogate marker for access to care and have a significant impact on patients and providers. While anecdotally, orthopaedic surgeons have noticed unprecedented changes in the delivery of care as a result of the COVID-19 pandemic, the effect on no-show rates has not been quantified. Methods: An analysis of the rates of outpatient clinic no-shows within a multispecialty, academic orthopaedic surgery practice was completed. Encounters were sub-classified into designated periods based on a “pre-COVID-19” period, a “COVID-19” period, and a “post-COVID-19” period. A univariate analysis was performed to comment on differences amongst insurance payer status. A multivariate regression was completed to assess which variables contributed to no-show rates among this orthopaedic practice. Results: The overall no-show rate over the course of the study was 8.5%. These rates differed significantly between insurance groups, with the lowest no-show rate among Workers’ Compensation/Liability Insurance (WC/LI; 6.4%) and the highest among uninsured patients (21.4%). Additionally, no-show rates differed significantly by COVID period (pre-COVID=7.3%, COVID=8.6%, P&lt;.0001). These rates further increased in the post-COVID period (9.6%, P&lt;.0001) In response to the COVID-19 pandemic, medical practice habits have altered out of necessity. Conclusions: Despite a relaxation of social distancing guidelines, no-show rates have continued to increase at our institution. Our results suggest a disproportionate effect on those of lower socioeconomic status. The specific needs of the patient population should be considered when implementing strategies to improve clinic attendance.

Predictors of Clinic Attendance After Community-Based Vision Screening.

The purpose of this study was to analyze appointment attendance rates and patient characteristics associated with follow-up adherence after referral from a community vision screening event. A retrospective chart review of patients who attended a 2021 or 2022 community vision screening event and were referred to the university clinic for further care. Appointments were offered without charge and scheduled at the event. Associations between patients' clinical and demographic characteristics and appointment attendance were assessed by binary logistical regression. A total of 935 patients attended the annual community vision screening events held in 2021 and 2022. Of these patients, 117 (13%) were referred to the clinic for follow-up, of whom 56 (48%) attended their scheduled follow-up appointment. The most common reasons for clinic referral included cataract (12, 10%), diabetic retinopathy (11, 9%), glaucoma (9, 8%), and challenging refractive error (9, 8%). Health insurance and male gender were predictors of follow-up (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 1.19-7.99, P = 0.021 and OR = 2.72, 95% CI = 1.10-6.61, P = 0.035, respectively). Half of the referred patients followed up after vision screening. Providing appointment scheduling at the point of care and offering follow-up care at no cost may help to promote clinic follow-up, but further assessment of barriers to regular eye care is warranted. Health insurance most strongly predicted successful clinic attendance. This study emphasizes the enduring impact of health insurance status as a barrier to accessing comprehensive vision care.

Anti-Hepatitis C (HCV) test positivity and new HCV diagnoses among women tested in antenatal services in England between 2015-2019

ObjectiveTo determine associations with hepatitis C virus (HCV) positivity, new HCV diagnoses and subsequent linkage to HCV treatment services among pregnant women in England. MethodA retrospective cohort using routine laboratory tests for HCV-specific antibody (anti-HCV) and HCV-RNA undertaken during antenatal attendances England. All women receiving at least one anti-HCV test during an antenatal clinic attendance between 2015 and 2019 were included. Multivariable logistic regression was used to investigate sociodemographic associations with anti-HCV test positivity among pregnant women who did (PWIDs) and did not (non-PWIDs) inject drugs, as well as to identify sociodemographic factors associated with being newly diagnosed during pregnancy. Linkage to antiviral treatment services and treatment outcomes were determined for those women who tested HCV-RNA positive. Results32,088 women (median age 32 years, 19,664 (61 %) UK-born, 337 (1.1 %) PWID) received an anti-HCV test among whom 814 (2.5 %) had a positive anti-HCV test (95 % confidence interval [2.4–2.7 %]). Anti-HCV test positivity was 2.1 % [2.0–2.3 %] among non-PWIDs and 40 % [35–46 %] among PWIDs. In multivariable analyses among non-PWIDs, anti-HCV test positivity was associated with older age, living in more deprived areas, and varied by ethnicity and country of birth. Among PWIDs, anti-HCV test positivity was associated with older age only. Three hundred and twenty (39 %) of the women testing anti-HCV positive were new diagnoses; those who were newly diagnosed were younger and lived in less deprived than those with a prior diagnosis whereas PWIDs were less likely to be newly diagnosed. HCV-RNA positivity was 52 % (n = 330/640, 95 %CI[47.6–55.5 %]) among those with an HCV-RNA test within 30 days, and 75 % (n = 220/293, 95 %CI[69.7–79.9 %]) of those eligible for treatment had engaged in HCV treatment services after antenatal testing. ConclusionsAntenatal testing for HCV provides an opportunity for new case findings and engagement with treatment services where needed. Therefore, universal opt-out testing for HCV antenatally should be reconsidered.

Characterization of sperm cells in infertile male subjects in southwest Nigeria

Sperm characteristics are used as proxy to estimate or gain insight into the underlying causes of male infertility. The aim of the study was to characterize sperm cells in infertile males in South-West Nigeria. This is a cross-sectional study involving 92 male subjects, grouped as 35 fertile males (control) and 57 infertile males (test subjects). The subjects, who volunteered, were attendees of Fertility Clinics in Lagos Metropolis, Lagos, Nigeria. Semen specimens were collected and analyzed with computer-assisted sperm analyzer (CASA) in conjunction with WHO guidelines for semen preparation and examination. Raw data obtained from the measurements, were subjected to statistical analysis using GraphPad Prism Version 5.03 (San Diego, California, USA). Results were expressed as percentage. The results revealed sperm cells in the infertile subjects as following: (a) based on sperm counts; the sperm cells were oligospermia and azoospermia with prevalence of 54 (79%) and 12 (21%) respectively. (b) Based on sperm cell morphology: the sperm cells were 14 (25%) oligoasthenoteratospermia, 12 (21%) teratospermia, 9 (16%) oligoasthenospermia; 9 (16%) oligoteratospermia, 5 (8%) asthenospermia, 4 (7%) asthenoteratospermia and 4 (7%). Cryptospermia. (c) Based on ejaculatory volume; 14 (24.5%) hypovolaemia, 2 (3.5%) hypervolaemic, and 41 (72%) normovolaemia, (d) Based on viscosity: 53 (93 %) Normoviscosity, and 4 (7%) hyperviscocity. In conclusion, Infertility in the studied population was caused by high percentage of spermatozoa with abnormal morphology.

Seroprevalence and Risk Factors of Toxoplasmosis Among Pregnant Women Attending Antenatal Clinic in Uyo Nigeria

Seroprevalence and Risk Factors of Toxoplasmosis Among Pregnant Women Attending Antenatal Clinic in Uyo Nigeria

A Longitudinal Assessment of Interruptions in HIV Clinic Visits and Virologic Failure among Pregnant and Postpartum Women in the Kabeho Study

Background: Antiretroviral therapy (ART) for women with HIV is recommended for life, yet most studies measure retention in HIV care and treatment as a binary outcome rather than patterns of intermittent clinic attendance. Pregnancy and the post-partum period are critical times to study interruptions in care, as retention among these women is particularly challenging and can affect the outcomes of both the mother and her child. Methods: The Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) study was an observational prospective cohort of 608 pregnant and postpartum women with HIV followed for 2 years. Clinic visit attendance was used to construct an interruption variable defined as a missed visit followed by a return to care. In multivariate analyses, we examined interruption patterns as predictors of virologic failure and detectable viral load. Results: During the study period, 48% of women had multiple visit interruptions and 29% had an interruption that lasted more than one month. Adjusting for age, ART regimen, time on ART, and CD4 count, the odds of virologic failure among women with multiple interruptions were almost 3 times higher than for women with one or no interruptions (aOR=2.72, 95%CI: 1.09, 6.77). The odds of virologic failure were nearly 3.5 times higher among women with an interruption lasting more than one month compared with women with shorter or no interruptions (aOR=3.47, 95%CI: 1.59, 7.66). Conclusions: Interruptions in HIV care visits are common with significant increases in virologic failure among women with multiple and long-term interruptions. Measuring patterns of interruption, rather than a single binary measure captures the fluid nature of lifetime and health-seeking behavior.

Assessment of Obstetric Characteristics Associate with Anemia Disease among Pregnant Women Attending Antenatal Clinics at Garowe General Hospital, Somalia

Introduction: Existence of anaemia pregnancy women is when it comes to this hematologic abnormality. Hemoglobin deficiency during pregnancy has serious effect on maternal and fetus development, which could prompt high maternal mortality rates.&#x0D; Purpose of the Study: The purpose of the study was to assess obstetric characteristics associate with anemia disease among pregnant women attending antenatal clinics at Garowe general hospital. &#x0D; Methods: A hospital based cross-sectional study design was conducted. Systematic random sampling method was used to select 266 pregnant women. Mothers who attended Antenatal Clinic during the study period and who met the inclusion criteria were interviewed and a capillary blood sample was taken. Hemoglobin level was determined by using HemoCue photometer. A structured questionnaire as well as focus group discussions were held in collecting data. Qualitative data was analyzed using a content technique and quantitative data was analyzed using descriptive and inferential statistics.&#x0D; Results: The inferential statistics entailed a bivariate chi-square analysis and odds ratio (OR) with corresponding 95% confidence intervals (CI) computed to find association between independent and dependent variables. The study found that 46% of the pregnant women in the study were anemic. Obstetric characteristics such as the interval or space between births and the abortion history of the mother was significantly associated with anemia disease.&#x0D; Recommendation: The study recommends that stakeholders including governments, Non-Governmental Oganization and the private sector in Somalia should seek to increase access to iron and folic acid supplements, should increase education on nutrition. In addition, the study recommends that sanitation and access to clean water should also be enhanced. Finally, the study recommends that the underlying socio-economic factors such as poverty, lack of education, unemployment and poor housing that lead to anemia should be addressed.

Willingness for Medical Screening in a Dental Setting-A Pilot Questionnaire Study.

An important way to manage noncommunicable diseases (NCDs) is to focus on prevention, early detection, and reducing associated risk factors. Risk factors can be detected with simple general health checks, which can also be performed in dental clinics. The purpose of this study was to investigate participants' willingness to participate in general health checks at the dentist, in particular the difference in opinion between medical patients and random healthy dental attendees. A total of 100 medical patients from an outpatient internal medicine clinic and 100 dental clinic attendees were included (total of 200 participants). The participants were asked for their opinion using six closed-ended questions. Overall, 91.0% of participants were receptive to information about the risk of diabetes mellitus (DM) and cardiovascular diseases (CVD). The majority (80-90%) was receptive to screening for DM and CVD risk, such as weight and height measurements, blood pressure measurement, saliva testing for CVD and to measure glucose and cholesterol via finger stick. No significant differences were found in the frequencies of the responses between the different groups based on health status, age, sex, or cultural background. This study shows that most participants are willing to undergo medical screening at the dentist for early detection and/or prevention of common NCDs.

Seroprevalence of Human T-Cell Lymphotropic Virus-1 in a Jamaican Antenatal Population and Assessment of Pooled Testing as a Cost Reduction Strategy for Implementation of Routine Antenatal Screening.

Mother to child transmission (MTCT) of human T-cell lymphotropic virus (HTLV)-1 is associated with increased risk of adult T-cell leukemia and can be unrecognized without routine antenatal screening. We assessed the seroprevalence of HTLV-1/2 among pregnant women attending The University Hospital of the West Indies Antenatal Clinic, 2019, and validated a cost-effective strategy to screen antenatal clinic attendees for HTLV-1/2. Residual antenatal samples from 370 women were tested for HTLV-1/2 by chemiluminescence microparticle immunoassay (CMIA). Six samples were confirmed HTLV-1 positive by Western blot (none for HTLV-2) for a prevalence of 1.62%. Four mother-child pairs were able to be recruited for HTLV testing of children, with two children testing HTLV-1/2 positive. Medical records of HTLV-1-infected women revealed that all women breastfed, indicating an unrecognized risk for HTLV MTCT. To assess whether pooling of samples as a cost-reduction strategy could be introduced, we pooled all antenatal samples received between November and December 2021 into 12 pools of eight samples/pool. Two pools were CMIA positive, and de-pooling of samples identified two CMIA-positive samples (one per pool), both confirmed as HTLV-1 by Western blot. These results indicate that HTLV-1 remains prevalent in pregnant Jamaican women and that sample pooling can be a cost-effective strategy to limit MTCT in Jamaica.

Incidence, Management, and Hospital Costs of Orthopaedic Injuries of E-Scooter Riders in Western Australia.

The use of electric scooters (e-scooters) is increasing in Australia and internationally. The increasing availability of e-scooters has led to a rise in the number of injuries, with most patients sustaining orthopaedic injuries. This retrospective case series describes the incidence, management, and hospital costs of the orthopaedic injuries, which presented to the emergency department (ED) of the major trauma center in Western Australia. Data on demographics, ED dispatch destination, management, follow-up clinics, and hospital costs were collected between 2017 and 2022. Since June 2020, there have been 61 e-scooter crashes, which resulted in orthopaedic injuries, with more than half of the crashes occurring after the introduction of regional e-scooter sharing schemes. Thirty-two patients (52%) were admitted to the hospital. The most common orthopaedic fracture was to the upper limb (44%), followed by the lower limb (41%) and the axial skeleton (15%). Fourteen (23%) patients sustained more than one fracture. Twenty-two patients (36%) required operative management. The median number of outpatient clinic attendances per patient was 3 (interquartile range (IQR): 1-5), with inpatients requiring twice the number of clinics as compared to those discharged from the ED. The median cost per presentation was AU$5880.60 (IQR: AU$1283.10-AU$21,150.90) with inpatient costs exceeding those discharged from the ED. The range of the total costs was AU$413.80 to AU$100,239.80. The rise in the accessibility of e-scooters in Western Australia has led to a rise in ED presentations with orthopaedic injuries. Considering the recent implementation of e-scooter sharing schemes in metropolitan areas, ongoing surveillance of e-scooter injuries by clinicians and policy makers is warranted to inform harm minimization strategies.

Work Patterns and Intensity of Chinese Surgical Residents- A Multicenter Time-and-Motion Study

This study aimed to record and analyze surgical resident trainee time allocation among junior doctors in China in order to understand the training environment and optimize realistic training and patient care objectives. Multicenter observational time and motion study. Multicenter, carried out in 5 tier 3 public hospitals in 5 provinces across China. Surgical resident trainees at various stages of training were eligible to enter the study, total n = 44. Registered nurses were eligible to be observers, n = 4 from each hospital. An expert team comprising 4 chief surgeons and 10 surgical residents participated in establishing the clinical activity list. Participants were observed during working hours (08.00-17.00) for 10 consecutive working days and time spent on different activities were recorded. Work patterns between hospitals were often dissimilar. Most time was spent on direct patient care (34.1%; 95% CI, 28.0%-40.1%) followed by indirect patient care (24.4%; 95% CI, 15.5%-33.2%), scholarly activity (21.1%; 95% CI, 13.7%-28.5%) and other (20.4%; 95% CI, 14.1%-26.8%). Subcategory analysis showed that the amount of time spent each day performing certain tasks was 137 minutes for operating theatre tasks, 103 minutes for medical record-keeping, 25 minutes for direct patient contact, 20 minutes being taught, 12 minutes teaching others, 12 minutes hand-over time, and 0 minutes of outpatient clinic attendance. Inter-observer reliability of 96.5% was obtained prior to recordings. Chinese surgical resident work patterns fall within the range found in other international studies albeit with some exceptions. The training environment appears broadly suitable for competence-based surgical training in China. Inadequate outpatient activity has led to changes in trainee work rosters and trainer requirements. Both strengths and deficiencies were confirmed and addressed. Further audit is required.

Patient’s experiences of diabetes care at a tertiary health facility in Lilongwe, Malawi

BackgroundLittle is known about experiences of rural people with diabetes care at a tertiary health facility in low-income settings. Understanding their experiences is essential for developing effective diabetes care interventions.MethodsThe study employed a qualitative narrative inquiry. Participants were identified at a diabetes clinic at a tertiary-level healthcare facility. Ten participants from the rural areas attending the diabetes clinic were purposively selected. Data were collected through in-depth interviews in the privacy of the homes of the study participants and analysis was done using the Riessman approach to thematic narrative analysis.ResultsIn this study, the following four themes emerged: (1) the long pathway to a diagnosis of diabetes; (2) Poverty-related hardships and diabetic clinic attendance; (3) The impact of health worker attitudes and behavior on diabetes care; and (4) Low resources and their impact on self-management.ConclusionsRural-based patients living with diabetes encounter enormous challenges as they access diabetes care. One of the challenges is delayed diagnosis of diabetes. There is a need to introduce point-of-care (POC) testing to improve diabetes diagnosis. In addition, there is a need to strengthen awareness campaigns among the population so that people are well informed about the signs and symptoms of diabetes to promote early diagnosis. Diabetes care must be decentralized from tertiary hospitals to primary health centers. This will improve access to diabetes care and reduce the burden associated with traveling a long distance to access diabetes care in Malawi.

Awareness of Childhood Immunization among Well Baby Clinic Attendees in Al Ahsa, Saudi Arabia: A Cross-Sectional Study

Awareness of Childhood Immunization among Well Baby Clinic Attendees in Al Ahsa, Saudi Arabia: A Cross-Sectional Study

Cancer center-based follow-up among pediatric and adolescent/young adult cancer survivors: the role of a community-based organization and the social determinants of health.

Adherence to survivorship care is suboptimal among pediatric and adolescent/young adult (AYA) cancer survivors. We evaluated predictors of cancer center-based follow-up among pediatric/AYA cancer survivors, with an emphasis on social determinants of health (SDOH). This retrospective cohort study used electronic health record data at an academic medical center to identify patients aged 0-29years at last cancer treatment who completed treatment 2010-2019. Cancer center-based follow-up was defined by oncology or survivorship clinic visits through 12/31/2022. Multivariate logistic regression models (overall, ages 0-19 [pediatric], 20-29 [YA]) evaluated the association of demographics, clinical/treatment characteristics, and SDOH (insurance type, distance to cancer center, area deprivation index) with clinic attendance. Further modeling accounted for the service area of a community-based organization (CBO) that supports families of children with cancer. A total of 2210 survivors were included (56% pediatric, 44% YA; 66% non-White). Cancer center-based follow-up decreased from 94% 1-year post-treatment to 35% at > 5-7years. In adjusted analysis, AYAs had the lowest follow-up (5-7years post-treatment: OR 0.25 [0.15-0.41] for age 25-29; OR 0.25 [0.16-0.41] for age 20-24; OR 0.32 [0.20-0.52] for age 15-19). Survivors residing within the CBO service area were twice as likely to follow-up (OR 2.10 [1.34-3.29]). Among a diverse population, AYA survivors were vulnerable to loss to follow-up. Other SDOH were not consistently associated with follow-up. Support from a CBO may partly explain these findings. CBOs may strengthen survivorship follow-up within medically underserved communities. More research is needed to understand community support in survivorship.

Exploring Barriers and Facilitators to Indirect Cascade Screening for Familial Hypercholesteraemia in a Paediatric/Parent Population.

Familial hypercholesteraemia (FH), an inherited disorder of cholesterol metabolism, has a prevalence of 1:250 and an associated 6- to 22-fold increased risk for cardiovascular disease. Despite the prevalence and availability of effective risk-reduction treatments, 90% of at-risk Canadians are undiagnosed. Indirect cascade screening from an index case is useful but the uptake is low (<4%), suggesting that barriers may exist. Using the Theoretical Domains Framework, we sought to determine barriers and facilitators among parents of children diagnosed with FH that may influence the uptake of cascade screening among families. A qualitative description approach was used for virtual interviews with 10 parents of children with FH, recruited from a regional Lipid Clinic in Toronto, Canada. Semistructured interviews were conducted. The data were analysed using a directed content analysis method. Five interconnecting themes were identified that captured both facilitators and barriers of indirect cascade screening: a high level of knowledge about FH after clinic attendance; parents' surprise of their child's diagnosis and ongoing worry; parents' willingness to communicate the need for cholesterol screening; parents' desire for educational materials, dictated by an external vs internal locus of control; and social and societal influences including the lack of awareness about FH in professional and public domains. The themes identified will inform next steps in programme development. An urgent need was identified for strategies to educate the public and primary care providers about FH and blood cholesterol/genetic screening.

Intestinal Parasitosis among Pregnant Women Attending Antenatal Clinic at a Tertiary Care Hospital in Sikkim, a Northeastern State of India.

The research paper explores the burden and associated factors of intestinal parasitic infections among pregnant women in Sikkim, India, categorized as neglected tropical diseases affecting 1.5 billion globally, with higher rates in tropical regions. These infections pose significant health risks, causing anemia, poor maternal-perinatal health, and perpetuating generational undernutrition and recurrent infections. A cross-sectional study of 100 pregnant women in Sikkim aimed to determine the burden of intestinal parasitosis and associated sociodemographic factors. It reported a lower prevalence compared to similar studies, with Giardia Lamblia as the dominant parasite. The study found a significant link between intestinal parasitosis and anemia. In conclusion, the paper recommends routine screening and deworming for pregnant women with low hemoglobin levels, emphasizing health education and awareness about intestinal parasitosis during pregnancy, especially in resource-limited settings. Adherence to India's National Guidelines for Deworming during pregnancy is crucial.

The Update of HIV-1 Prevalence and Incidence and Spatio-Temporal Analyses of HIV Recent Infection Among Four Sub-Groups in Sichuan, China During Surveillance Period Between 2016 and 2022.

Sichuan Province has gradually become a hot-spot for HIV/AIDS. Little is known about the HIV-1 incidence and prevalence among four sub-groups since 2015. Meanwhile, the distributions of hot-spot areas related to recent infection cases that indicate current transmission among the four subgroups are also rare. The main purpose of this study was to assess the HIV-1 prevalence and incidence and to visualize the distributions of hot-spot areas of current transmission among four subgroups (people who inject drugs, male STD clinic attendees, female sex workers and men who had sex with men) during the surveillance period in Sichuan province between 2016 and 2022. Of the 267,617 individuals, 2158 HIV-positive samples were tested with Lag-Avidity EIA, among which 493 samples were identified as recent infections. Among people who inject drugs (PWID), both HIV-1 prevalence (from 1.41% to 0.34%) and incidence (from 0.03% to 0.140%) showed a significant decreasing trend. Among men who had sex with men (MSM), female sex workers (FSWs), and male STD clinic attendees, HIV-1 prevalence indicated significant decreasing trends, whereas HIV-1 incidence showed no significant changes. Spatial analysis demonstrated the formation of hot-spots and clusters of current transmissions sharing regional differences, mainly concentrated in the southeast, and most of these were consecutive hot-spots. The prevention and control were efficacious and persistent. However, among the other three subgroups, there is a need for a regional cooperative in prevention and control approaches and collaborative research in many aspects.