Burden Of Communicable Diseases Research Articles

Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening

A well-established antimicrobial resistance (AMR) laboratory-based surveillance (LBS) is of utmost importance in a country like Zambia which bears a significant proportion of the world's communicable disease burden. This study assessed the capacity of laboratories in selected hospitals to conduct AMR surveillance in Zambia. This cross-sectional exploratory study was conducted among eight purposively selected hospitals in Zambia between August 2023 and December 2023. Data were collected using the self-scoring Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC) tool. Of the assessed facilities, none had full capacity to conduct AMR surveillance with varying capacities ranging from moderate (63% (5/8)) to low (38% (3/8)). Some of the barriers of AMR-LBS were the lack of an electronic laboratory information system (63% (5/8)) and the lack of locally generated antibiograms (75% (6/8)). Quality control for antimicrobial susceptibility testing (AST), pathogen identification and media preparation had the lowest overall score among all of the facilities with a score of 14%, 20% and 44%, respectively. The highest overall scores were in specimen processing (79%), data management (78%), specimen collection, transport and management (71%), and safety (70%). Most facilities had standard operating procedures in place but lacked specimen-specific standard operating procedures. The absence of laboratories with full capacity to conduct AMR surveillance hinders efforts to combat AMR and further complicates the treatment outcomes of infectious diseases. Establishing and strengthening LBS systems are essential in quantifying the burden of AMR and supporting the development of local antibiograms and treatment guidelines.

Epidemiology of Reportable Bacterial Infectious Diseases in Saudi Arabia.

Bacterial infections have a significant impact on human health; they can cause severe morbidity and mortality, particularly in susceptible populations. Epidemiological surveillance is a critical tool for monitoring the population's health and facilitate the prevention and control of infectious disease outbreaks. Knowing the burden of bacterial communicable diseases is an initial core step toward public health goals. Saudi epidemiology surveillance data were utilized to depict the changing epidemiology of bacterial infectious diseases in Saudi Arabia from 2018 to 2021. The cumulative numbers of cases, demographics, and incidence rates were analyzed and visualized. Parametric tests were used to compare the difference in the mean values between categorical variables. Regression analysis was employed to estimate trends in disease rates over time. Statistical significance was set at pvalue ≤ 0.05. The results revealed that brucellosis, tuberculosis, and salmonellosis were the most frequently reported bacterial infectious diseases in Saudi Arabia. Males were more significantly affected by brucellosis and tuberculosis infections than females. Salmonellosis infections were more significant among Saudi citizens, while pulmonary tuberculosis was more significant in non-Saudis. Interestingly, there was a decline in the incidence rates of numerous bacterial infectious diseases during the Coronavirus Disease 2019 (COVID-19) pandemic and COVID-19 restrictions. Some bacterial infectious diseases were rarely reported in Saudi Arabia, including syphilis and diphtheria. The future perspective of this research is to enhance disease surveillance reporting by including different variables, such as the source of infection, travel history, hospitalization, and mortality rates. The aim is to improve the sensitivity and specificity of surveillance data and focus on the mortality associated with bacterial pathogens to identify the most significant threats and set a public health priority.

Feasibility of Community Needs Assessment Tools as an Alternative For Health Survey in Describing Health Profile of A Community - A Mixed Method Study In Muddungere, Karnataka, India

Introduction: In India, even with planned health services, it is difficult to reach the health goals without community participation. While Community needs assessment approach (CNAA) tools like Focussed group Discussion (FGD), Village mapping and matrix ranking have been effective in quickly gathering information, surveys have been conventionally preferred. Aim & Objective: The present study compares qualitative and quantitative methods to understand feasibility of using CNAA tools in place of survey as an alternative tool Methodology: Mixed Method research employing Survey and CNAA methods of FGD, Village Mapping, transect walk and Matrix ranking score was carried out as a part of academic activity of National Service Scheme(NSS). Data was represented in form of percentages and frequency tables. Association was measured using Chi Square using Epi Info TM version 7.2.1software. Results: Using quantitative survey, we found that 71% used piped supply and 93.1% of the households used toilets. But 6.9% of them still preferred open fields for defecation. Amongst the participants of FGD, it was found that 90% participants preferred going to government hospitals. Comparable data found for variables like Maternal and child health indicators, Sanitation practices and burden of Non communicable diseases. Partially comparable results were found for burden of communicable diseases. Conclusion: CNAA research tools demonstrated comparability with survey in most areas of health concern and reduced the time required for conducting research without compromising the quality of results

The invisibility of health effects associated with water pollution within disease burden estimates: Analysis from a Colombian Andean watershed

Modernization is marked by an increase in pollution-related health risks due to the rapid economic and technological growth. In the Global South, there is concern regarding the disease burden attributable to chemical contaminants released into the environment, especially in river basins, where populations are exposed through multiple pathways. While significant research exists linking chemical exposure to disease, mostly in occupational settings, less data is available for the open environment. Emerging pollutants have shown ecotoxicological and genotoxic effects at low concentrations in both terrestrial and aquatic ecosystems, with humans at the apex. Despite such evidence, water quality standards focus primarily on communicable diseases risks, and the burden of disease method mainly includes gastrointestinal and respiratory infections. Therefore, the use of DALYs as a prioritization strategy needs to be evaluated to suggest alternatives for integrated analysis. Our aim was to enhance the comprehension of watersheds as socioecological entities that necessitate inclusive indicators to display the intricate and diverse links between water, health, and the resultant inequities. Based on previous research and information collected in a tropical Andean watershed at southwestern Colombia, we characterized drivers of pollution and health hazards. Using standardized methods for calculating DALYs, we estimated the water-related environmental burden of communicable and noncommunicable diseases. Estimates of disease burden were analyzed to find out disparities driven by ethnic, gender and socioeconomic status. Results indicate that significant inequalities persist affecting the most vulnerable populations for preventable communicable diseases. Furthermore, the impact of noncommunicable diseases, which are linked to chemical pollution from individual substances and their cocktail effect, remains largely invisible due to insufficient data and research. The econometric approach of the DALY addition effect needs to be expanded with historical and critical perspectives to expose the profound social and health inequities present in the socioecological systems of the Global South.

Engagement of private health sector in communicable disease and immunization programmes in Pakistan.

In Pakistan, where the burden of communicable diseases remains high, the private sector accounts for 62% of health care provision. To describe the role of the private sector in communicable disease management in Pakistan and inform a more effective engagement towards achieving Universal Health Coverage. We searched the literature and available documents on policies, regulations and experiences in private health sector engagement in Pakistan. We interviewed policy level experts regarding the formulation of national health policies and plans and a sample of private providers using a structured questionnaire to assess their awareness of and engagement in communicable disease programmes. Published reports described initiatives to engage the private sector in improving coverage for a package of care and programme-specific initiatives. Pakistan did not have a national policy for structural engagement, and regulations were limited. Policy level experts interviewed perceived the private sector as market-driven and poorly regulated. Thirty-nine percent of private sector providers interviewed were aware or had been trained in procedures or guidelines, and 23% of them had had their performance monitored by government. We recommend that the Ministry of Health provide overall vision for the operations of the public and private health sectors so that both sectors can complement each other towards the achievement of Universal Health Coverage, including for communicable diseases.

“Hospitals respond to demand. Public health needs to respond to risk”: health system lessons from a case study of northern Queensland’s COVID-19 surveillance and response

BackgroundThe vast region of northern Queensland (NQ) in Australia experiences poorer health outcomes and a disproportionate burden of communicable diseases compared with urban populations in Australia. This study examined the governance of COVID-19 surveillance and response in NQ to identify strengths and opportunities for improvement.MethodsThe manuscript presents an analysis of one case-unit within a broader case study project examining systems for surveillance and response for COVID-19 in NQ. Data were collected between October 2020–December 2021 comprising 47 interviews with clinical and public health staff, document review, and observation in organisational settings. Thematic analysis produced five key themes.ResultsStudy findings highlight key strengths of the COVID-19 response, including rapid implementation of response measures, and the relative autonomy of NQ’s Public Health Units to lead logistical decision-making. However, findings also highlight limitations and fragility of the public health system more generally, including unclear accountabilities, constraints on local community engagement, and workforce and other resourcing shortfalls. These were framed by state-wide regulatory and organisational incentives that prioritise clinical health care rather than disease prevention, health protection, and health promotion. Although NQ mobilised an effective COVID-19 response, findings suggest that NQ public health systems are marked by fragility, calling into question the region’s preparedness for future pandemic events and other public health crises.ConclusionsStudy findings highlight an urgent need to improve governance, resourcing, and political priority of public health in NQ to address unmet needs and ongoing threats.

Levels of Regional Inequality of Health Infrastructure and Morbidity Pattern in West Bengal

This article examines the differences in health infrastructural availability in West Bengal. Furthermore, the study looks at the pattern of communicable and non-communicable diseases in the six different regions of the state. It measures and analyses the disparities through the lens of demand and supply gaps in healthcare. The trends, patterns and distribution of various diseases were captured through the NSS unit-level data from 60th and 71st rounds. The study shows that inter-regional and inter-district differences in health infrastructure are striking in West Bengal. The state’s health infrastructure lags behind the national average. The average population served per rural health facility in North Bengal as well as West Bengal is quite high compared to national figures. Similarly, the population served per hospital bed in North Bengal is also substantially higher in comparison to other regions. The inadequacy of hospital beds is one of the major obstacles in reducing the burden of disease in the region. The results for the distribution of diseases of inpatient cases show that the burden of communicable diseases in North Bengal is relatively higher than the other regions in both rounds of NSS. The inpatient cases of water- and food-borne infectious diseases like gastrointestinal diseases are considerably high in North Bengal.

Current major public health challenges

After COVID-19 pandemic, there are still many public health challenges in the world. The double burden of communicable and non-communicable diseases is still heavy in many countries. Mental health and injury are crucial public health problems which are often neglected. Environmental health and food and drug safety are closely related to human health, to which further management and intervention are needed. These problems have different impacts on people at different life stages, resulting in health problems throughout the life course. The current status of public health is far from the requirements set by the Sustainable Development Goals of United Nations or the initiative of "Healthy China 2030". It is necessary for governments and related departments of all countries to consider public health in all policy development to tackle the major challenge to public health.

An Insight into the Role of Biodegradable Controlled-release Polymers and Nanoformulations for Enhanced Brain Drug Delivery

Abstract: Neurological or brain disorders are increasingly recognized as major causes of death and disability worldwide, eventually leading to the burden of non-communicable and communicable diseases in the world. Biodegradable functions of polymers provide promising solutions to meet the therapeutic needs of neurological disorders owing to advantages such as the usage of biodegradable polymers in drug delivery approaches, which has become noticeable due to their biocompatibility and degradability properties. Due to such properties, they are degraded inside the body to produce natural/ nontoxic byproducts such as water and carbon dioxide and hence eliminated easily. Sustained drug delivery by biodegradable polymer devices can increase the therapeutic efficacy of drugs by producing high local tissue concentrations over extended periods of time. This review discusses recent progress in the research and development of biodegradable polymers, including their nanoformulation approaches.

Mortality Associated with Priority Diseases in Flood-Affected Areas Using District Health Information System (DHIS2) During September-December 2022: Pakistan Experience.

To quantify the burden of communicable diseases and characterize the most reported infections during public health emergency of floods in Pakistan. The study's design is a descriptive trend analysis. The study utilized the disease data reported to District Health Information System (DHIS2) for the 12 most frequently reported priority diseases under the Integrated Disease Surveillance and Response (IDSR) system in Pakistan. In total, there were 1,532,963 suspected cases during August to December 2022 in flood-affected districts (n = 75) across Pakistan; Sindh Province reported the highest number of cases (n = 692,673) from 23 districts, followed by Khyber Pakhtunkhwa (KP) (n = 568,682) from 17 districts, Balochistan (n = 167,215) from 32 districts, and Punjab (n = 104,393) from 3 districts. High positivity was reported for malaria (79,622/201,901; 39.4%), followed by acute diarrhea (non-cholera) (23/62; 37.1%), hepatitis A and E (47/252; 18.7%), and dengue (603/3245; 18.6%). The crude mortality rate was 11.9 per 10 000 population (1824/1,532,963 [deaths/cases]). The study identified acute respiratory infection, acute diarrhea, malaria, and skin diseases as the most prevalent diseases. This suggests that preparedness efforts and interventions targeting these diseases should be prioritized in future flood response plans. The study highlights the importance of strengthening the IDSR as a Disease Early Warning System through the implementation of the DHIS2.

The burden of diseases and risk factors in Bangladesh, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Bangladesh has made substantial progress in improving socioeconomic and health indicators over the past 50 years, but data on national disease burden are scarce. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to estimate the burden of diseases and risk factors in Bangladesh from 1990 to 2019. For this systematic analysis, we analysed data from vital registration systems, surveys, and censuses using multistage modelling processes to estimate life expectancy at birth, mortality rate, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). Additionally, we compared the health status of Bangladesh with that of the other countries in the GBD south Asia region-Bhutan, India, Nepal, and Pakistan. Life expectancy at birth in Bangladesh increased from 58·2 years (95% uncertainty interval 57·1-59·2) in 1990 to 74·6 years (72·4-76·7) in 2019. Between 1990 and 2019, the age-standardised mortality rate decreased from 1509·3 (1428·6-1592·1) to 714·4 (604·9-838·2) deaths per 100 000 population. In 2019, non-communicable diseases represented 14 of the top 20 causes of death; the leading three causes were stroke, ischaemic heart disease, and chronic obstructive pulmonary disease. High blood pressure, high fasting plasma glucose, and smoking were the top three risk factors. From 1990 to 2019, the rate of all-cause DALYs decreased by 54·9% (48·8-60·4). In 2019, the leading causes of DALYs and YLLs were neonatal disorders, stroke, and ischaemic heart disease, whereas musculoskeletal disorders, depressive disorders, and low back pain were the leading causes of YLDs. Bangladesh has the lowest age-standardised rates of mortality, YLDs, and YLLs and the highest life expectancy at birth in south Asia. Over the past 30 years, mortality rates have reduced by more than half in Bangladesh. Bangladesh must now address the double burden of communicable and non-communicable diseases. Cost-effective, multisectoral efforts are needed to prevent and control non-communicable diseases, promote healthy lifestyles, and prevent premature mortality and disabilities. Bill & Melinda Gates Foundation. For the Bangla translation of the abstract see Supplementary Materials section.

Developing a prehospital care service in a low-resource setting: Barriers and solutions.

Prehospital care (PHC) is critical to the comprehensive and effective functioning of a healthcare system. Given the disproportionate burden of both communicable and non-communicable diseases in low-income nations, its significance cannot be understated. In spite of this, many of these nations lack a comprehensive PHC system. Setting up a cost-effective PHC system in this environment can be difficult and necessitate a variety of stakeholders at various healthcare delivery system levels. Therefore, it is necessary to consider these anticipated barriers and identify feasible solutions for its execution. This will assist in creating a PHC system that is suited to the local needs and achieve sustainable and global health goals. This paper describes the challenges and solutions to establishing a prehospital care service in a low-resource setting.

The Magnitude of Hypertension and Its Contributing Factors Among Patients Receiving Antiretroviral Therapy in Public Hospitals in Harar City, Eastern Ethiopia: A Cross-Sectional Study.

Although people living with HIV (PLHIV) are surviving longer due to the development of highly active antiretroviral therapy (HAART), hypertension continues to be a significant obstacle for human immunodeficiency virus (HIV) positive patients. This study aims to determine the prevalence of hypertension and its contributing factors among patients receiving HAART in public hospitals in Harar City, Eastern Ethiopia. A hospital-based cross-sectional study was conducted among adult PLHIV who receive HAART in public hospitals in Harar City, Eastern Ethiopia, from 20 March to 14 April 2023. A simple random sampling technique was employed to select a total of 406 clients (382 participated in the study). Data were collected through patient interview and chart review using a questionnaire. The binary logistic regression was used for data analysis. The association was declared statistically significant at a p-value less than 0.05. The magnitude/prevalence of hypertension was 23% (95% CI: 19.1, 27.5) in study settings from a total of 382 adults who participated in this study. Factors significantly associated with hypertension in a multivariable binary logistic regression model include residence (rural residence, AOR = 1.95, 95% CI: 1.04, 3.65); body mass index (obese, AOR = 4.35, 95% CI: 1.08, 16.77); cigarette smoking (past cigarette smoking, AOR = 4.7, 95% CI: 1.10, 21.8); and HAART regimen change (AOR = 0.44, 95% CI: 0.20, 0.97). The prevalence of hypertension observed among adult PLHIV in the study settings was high. Adults from rural areas, with a history of past smoking cigarette, and obesity need close attention during their clinic visits for more health education to reduce risk factors. The changed HAART regimen was associated with a reduced risk of hypertension. Generally, hypertensive PLHIV need consideration for their double burden of communicable and non-communicable diseases during disease management and hospital guideline development.

An Ayurvedic Medication (Chyawanprash) as a Prophylaxis for Non-Communicable Disease and Communicable Disease: A Protocol for Systematic Review and Meta-Analysis.

Globally, non-communicable diseases (NCDs) and communicable diseases (CDs) are on the rise, posing a significant public health threat. A holistic ayurvedic preparation called chyawanprash (CP) has shown positive outcomes in NCDs and CDs. Hence, we aimed to report the outcomes in a systematic manner. To determine the safety, efficacy, healthcare utilization, and quality of life of CP as an optional therapy for NCD and CD management. This systematic review will adhere to PRISMA-P and Cochrane guidelines for methodological considerations. It will evaluate CP efficacy in diverse populations, considering Ayurvedic and non-Ayurvedic comparators. The study design will encompass randomized controlled trials (RCTs) published from 2010 to 2023 in healthcare settings, controlled environments, and communities. We will also analyze primary outcomes related to immunity biomarkers, vital signs, and secondary outcomes such as quality of life. Data sources and search strategy will involve systematic searches in databases such as Cochrane, PubMed, Google Scholar, Web of Science, and Scopus using MeSH terms and Boolean operators. Screening and data extraction will follow a standardized form with four independent reviewers. Quality assessment will use the Cochrane risk of bias tool. The systematic review will provide an exhaustive summary of the effectiveness and safety of CP to address the growing burden of NCDs and CDs. Registration: CRD42023418994.

Analysis of the burden and trends of communicable diseases in Pacific Island countries from 1990 to 2019

BackgroundCommunicable diseases contribute substantially to morbidity and death rates worldwide, particularly in low-and middle-income countries. Pacific Island countries face unique challenges in addressing these diseases due to their remote locations and limited resources. Understanding the burden and trends of these diseases in this region is crucial for developing effective public health interventions.ObjectiveThis study aimed to analyze the burden and trends of communicable diseases in Pacific Island countries from 1990 to 2019.MethodsWe utilized data from the 2019 Global Burden of Disease (GBD) study to analyze indicators including incidence, death, and disability-adjusted life years (DALYs). Excel 2016, R 4.2.1, and GraphPad Prism 9 were used to analyze and visualize the data. Joinpoint regression models were used for trend analysis, and the average annual percent change (AAPC) was calculated.ResultsFrom 1990 to 2019, the standardized incidence rate of communicable diseases in Pacific Island countries showed an upward trend (AAPC = 0.198%, 95% CI = 0.0174 ~ 0.221), while the standardized death rate (AAPC = -1.098%, 95% CI = –1.34 ~ 0.86) and standardized DALY rate (AAPC = -1.008%, 95% CI = -1.187 ~ -0.828) showed downward trends. In 2019, the standardized incidence, death, and DALY rates of communicable diseases were higher among males than among females, but the standardized death and DALY rates among males decreased faster than those among females from 1990 to 2019. There were significant differences in the disease burden among different Pacific Island countries. The Solomon Islands had the highest standardized death rate (363.73/100,000), and Guam had the lowest (50.42/100,000). Papua New Guinea had the highest standardized DALY rate (16,041.14/100,000), and the Cook Islands had the lowest (2,740.13/100,000). In 2019, the main attributable risk factors for communicable disease deaths in Pacific Island countries were child and maternal malnutrition (28.32%), followed by unsafe water, sanitation, and handwashing (27.14%), air pollution (16.11%), and unsafe sex (14.96%). There were considerable geographical variations in risk factors.ConclusionThe burden of communicable diseases in Pacific Island countries remains high, despite improvements in mortality and disability-adjusted life-year rates over the past few decades. This study provides valuable insights into the burden and trends of communicable diseases in Pacific Island countries from 1990 to 2019. The findings reveal several important insights and highlight the need for targeted public health interventions in the region.

Development of a «people-centred approach» to realising healthcare by facilitating, patient participation in health attainment in South Africa and Ukraine

Object of this research is South Africa's healthcare system. South Africa's healthcare system faces numerous challenges that contribute to inadequate access to quality healthcare for its citizens. These challenges include a scarcity of healthcare workers, insufficient funding and resource allocation, a high burden of communicable and non-communicable diseases, as well as disparities in healthcare access and outcomes driven by socioeconomic status and geographic location. Consequently, many South Africans endure unfavourable health outcomes, limited availability of essential health services, and a prevailing sense of mistrust towards the healthcare system. Concurrently, Ukraine has encountered its own set of healthcare obstacles, including similar shortages of healthcare professionals, funding deficiencies, and disparities in healthcare access exacerbated by armed conflict. This study provides insights into the patient experience, utilizing Kolb's experiential learning theory. It employs qualitative and quantitative methods, including a questionnaire administered to conveniently sampled participants at Chris Hani Baragwanath hospital's HIV/AIDS unit. Data analysis using Excel and SPSS reveals a communication gap between healthcare workers and patients, highlighting the need for Department of Health training on communication and diversity. Finally, the implementation of consistent patient feedback mechanisms is essential for healthcare institutions to comprehend evolving patient needs, fostering the adoption of a «people-centred» approach to delivering high-quality healthcare services. By incorporating insights from Ukraine's challenges, this study not only addresses the specific healthcare obstacles faced by South Africa but also provides a broader perspective on healthcare issues across diverse contexts. These insights enable policymakers and healthcare professionals to identify potential solutions and work towards improving healthcare access and outcomes for all citizens, ensuring the overall health and well-being of the population of South Africa and other countries with similar challenges.

Review on the recent infectious diseases in the State of God’s own country

The burden of communicable and non-communicable diseases is increasing in Kerala. Despite the State’s past success in keeping a variety of communicable diseases under control, the recent research of Dengue, Malaria, Leptospirosis, Hepatitis, Chikungunya and H5N1 has resulted in a marked rise in morbidity and mortality. Infectious diseases continue to be the main causes of morbidity and mortality in humans and animals with enormous healthcare costs in India. Over the past few years, Kerala, a state in the nation of India, has conflicted with nature. The nation’s diverse terrains, extreme geoclimatic variations, and unequal population distribution exhibit distinctive patterns of viral illness dispersion. The state of Kerala has faced a significant public health issue over the past decade due to the resurgence of infectious illnesses, resulting in elevated rates of both mortality and morbidity. Methodology: This review article aims to investigate and discuss epidemics that are known to have happened during the 21st century. For this purpose, the investigator has done a literature review through Google Scholar and PubMed. All articles pertaining to reported infections in the state of Kerala and factors contributing to the outbreak of an infection were chosen for inclusion in the review. Results: From a number of sources, we culled a selection of articles covering the topic of viral infections. We found that many people in the Kerala state have fallen victim to and suffered many deaths from bacterial infectious diseases like chikungunya fever, scrub typhus fever, rotavirus diarrhea, the break bone fever, Nipah virus, Kyasanur Forest Disease (KFDV), leptospirosis, COVID-19 and monkeypox in the past decade. The people of Kerala are fortunate to have access to excellent medical care, and the government has recently begun to prioritize illness prevention and control. Conclusion: This report emphasizes the Kerala’s infectious disease management strategy and the necessity for other Indian states to emulate it. States can prevent disease spread and protect residents by taking comparable steps.

Pattern and Outcome of Paediatric Non-Communicable Diseases in a Teaching Hospital in Southern Nigeria

Non-communicable diseases (NCDs) are chronic non-transmissible diseases that are mainly attributable to lifestyle changes. There is a global increase in this category of diseases, which in developing countries constitute an added burden to the already existing burden of communicable diseases. This study aims at determining the prevalence, pattern, length of hospital stay and outcome of children admitted with non-communicable diseases.
 Methods: This is a retrospective cross-sectional study carried out in the paediatric wards of our hospital. Data was extracted from records of children admitted within the study period. The data was analyzed using the Statistical Package for Social Sciences (IBM SPSS) version 23. The student t-test was used to compare the means between two groups, while an ANOVA was used for more than two groups.
 Result: Out of 820 children studied, 32.2% had NCDs with sickle cell disease, neoplasms, and cardiovascular and neurological diseases, constituting the major non-communicable diseases recorded. There was a significantly longer duration of hospital stay and a higher mortality rate in patients admitted with an NCD. There was a significant association between mortality and the category of NCD, with a greater contribution from neoplastic diseases.
 Conclusion: There is a high prevalence of paediatric non-communicable diseases, although communicable diseases are still more prevalent among children in this study. This is associated with poor outcomes and a longer duration of hospital stay.

Abstract P226: Length Of Stay Discrepancies Between Rural And Urban Hospital Settings For Hypertension Admissions

Introduction: Rural populations experience greater barriers to healthcare access compared to urban populations. This can be attributed to fewer public health services, greater uninsured rate, and greater burden of healthcare shortages in urban healthcare settings. Our study aims to quantify the disproportionate allocation in healthcare resources through analysis of Length of Stay (LOS) in-respect to hypertensive urgency and hypertensive urgency. Methods: This cross-sectional study reviewed the LOS estimates for patients with ICD-10 diagnoses for Hypertension Emergency or Hypertension Urgency within the state of New York, categorized by the type of community hospital; rural or urban. This study utilizes the 2020 National Inpatient Sample (NIS), specifically for urban and rural hospitals in New York. ICD-10 codes included I16.1 & I16.9 for Hypertensive Emergency and I16.0 for Hypertensive Urgency. Community hospital setting was categorized as either rural or urban based on the overlying zip code of the admitting inpatient hospital. Results: LOS was unique to the community setting (p<0.01), but not to hypertensive disease (p=0.11). In summary, the LOS was longer in rural-level inpatient hospital systems when compared to their urban counterparts in both Hypertensive Urgency, 4.4 days vs 3.1 days (p=0.01), and Hypertensive Emergency, 5.5 days vs 3.4 days (p<0.01). Conclusion: The LOS of patients admitted for both hypertensive urgency and emergency were significantly higher in rural hospitals. Furthermore, increased disease severity emphasizes the divide in LOS between the community healthcare settings. Redistribution of resources to rural communities can enhance access to preventative healthcare services, specialty healthcare, and potentially decrease overall community disease burden.

Social Protection Supports and Management of Non-Communicable Diseases in Ghana: A Qualitative Cross-Sectional Perspective of Health Stakeholders

Introduction: Africa faces a double burden of communicable and non-communicable diseases (NCDs). Already, health systems in Africa are overwhelmed with a high burden of communicable diseases with perennial outbreaks of highly infectious diseases. The rise in NCDs comprises an already fragile health system challenging its ability to provide comprehensive care to people living with these diseases. Without responsive social support systems, NCDs will draw more people into catastrophic health financing, worsening health outcomes, and poverty. This study explores how vulnerable people negotiate major disease burdens with the social protection supports available in Ghana. Methods: The study applied a cross-sectional design with a qualitative approach involving healthcare professionals and non-healthcare professionals in 4 regions in Ghana with a total of 32 qualitative interviews analyzed thematically. Results: The main social protection support for the health sector in Ghana is the National Health Insurance Scheme. Other social protection supports such as free maternal healthcare, Livelihood Empowerment Against Poverty, and conventional informal social protection mechanisms do not directly target people afflicted with NCDs. Even though national health insurance covers about 90% of diseases, the quality of care is questionable. Again, the exclusion of diagnostic investigations makes national health insurance a setback to NCD disease management. Also, NCD patients still do out-of-pocket expenses though they have valid national health insurance. Informal social protection supports which used to be effective sometime back are dwindling due to the rising cost of living, gradual breakdown of the African system of reciprocity, and infiltration of Western lifestyles. Conclusion: NCD patients have very limited social protection for the management of their condition. Health insurance which is the only option for many has limited applications. A multidisciplinary body is established by the government to outline more effective ways of offering social protection support for health services, especially chronic conditions such as NCDs which affect a greater proportion of the population.