Killer Disease Research Articles

Prevalence and Factors Associated with Malaria Treatment Among Pregnant Women in Selected Rural and Urban Health Centres in Osun State

Background: Malaria is one of the killer diseases worldwide majorly transmitted by the bite of infected female Anopheles mosquitoes. Malaria during pregnancy remains a major public health concern in many sub-Saharan African countries with Nigeria having the highest prevalence rate (27%). Purpose: This study was therefore designed to assess the prevalence and factors associated with treatment of malaria among pregnant women in selected rural and urban health centres in Osun State, Nigeria. Materials and Methods: Two hundred consenting pregnant women were selected using a multi-stage sampling technique from eight PHCs from Olorunda and Osogbo LGAs. The study was a facility-based, cross-sectional comparative survey using semi-structured interviewer-administered questionnaires Descriptive statistics, Chi-square tests and logistic regression were used to analyze data and the level of statistical significance was set at α ≤ 0.05. Results: Mean age of 28.29±7.23 and 28.37±6.90 for rural and urban PHCs respectively. All the respondents are Yoruba, almost two-thirds and more than half were Muslims and Christian in rural and urban LGAs respectively. The sero-prevalence of malaria was higher among women in urban PHCs (11%) compare to women in rural PHCs (4%) with cumulative sero-prevalence of 7.5% for both LGAs, the health-seeking for women in rural area is better compare to those women in urban area. Conclusion: This study provides a better understanding of malaria in pregnancy in the study areas with a clear contrast on prevalence, health-seeking behaviour and treatment practice between the target groups two LGAs.

KNOWLEDGE REGARDING EMERGENCY MANAGEMENT OF MYOCARDIAL INFARCTION PATIENTS AMONG STAFF NURSES

ABSTRACT MI is a killer disease and required treatment immediately the symptoms have been established. The term "myocardial infarction" focuses on the myocardium (the heart muscle) and the changes that occur in it due to the sudden deprivation of circulating blood, hence limited oxygen supply. The main change is necrosis (death) of myocardial tissue. The patients suffering from AMI usually experience several problems during treatment period, including mental reactions related to the illness. Key Words: Knowledge, Myocardial Infraction, Physical Inactivity, Vulnerable.

Chemical Composition and In Vitro Evaluation of the Mosquito (Anopheles) Repellent Property of Neem (Azadirachta indica) Seed Oil

As one of the killer diseases in the world, malaria contributes to child mortality and global death annually. As a result, many reactive mechanisms have evolved to control and repel mosquitoes. The use of synthetic mosquito repellents with N,N-Diethyl-meta-toluamide (DEET) is one of the popular interventions despite its dermatological limitations such as skin irritations. Ethnobotanical reviews have identified that the adoption of natural repellents promises high repellence on mosquitoes with minimal side effects compared with synthetic ones. However, this has received little attention in modern pharmaceutical literature. This research is focused on the formulation of a natural mosquito repellent from the oil extracted from Azadirachta indica (A. Juss). The oil cream was formulated in concentrations of 10% v/w, 12.5% v/w, 15% v/w, 17.5% v/w, and 20% v/w using an in vitro evaluation approach. Pharmacopoeia characteristics of the cream such as pH, viscosity, spreadability, and organoleptic properties were carried out to verify acidity, permeation, and flow properties of the formulated cream. The spreadability rate was inversely proportional to the concentration of the cream in terms of oil content falling from 1.24 gm/s to 0.84 gm/s from concentrations 10% v/w to 20% v/w correspondingly. Skin irritation tests, however, indicated traces of irritation at 20% v/w. Repellency properties of the cream revealed a lasting effect on the mosquitoes, although this was dependent on concentration levels. Formulations of 17.5% v/w and 20% v/w neem seed oil cream had an equal repellency effect of 87.5%, whereas the synthetic repellent had a repellency of 75% within a justifiable time frame for all the formulations. This work shows that plant-based mosquito repellents promise a healthier approach in controlling mosquito bites, protecting the skin, and preventing malaria.

Dump Sites Location and its Health Implications within the Polytechnic, Ibadan using Geographical Information System Approach

This study examines the distribution of dump sites within The Polytechnic, Ibadan, Nigeria. IKONOS Satellite imagery was acquired and processed for proper identification of the existing dump sites. Field data were acquired using Global Positioning System (Garmin GPS 72csx). Image and data processing as well as database creation was done using ArcGIS 10.5 (Arcmap 10.5). Legal and illegal dump sites were identified and mapped out and as well as the proximity of the dump sites to roads, residential areas and waterways in the study area were determined. Composite map and spatial analysis map queries were produced. From the result, it shows that eleven (11) legal dump sites and twenty four (24) illegal dump sites were within the study area. World standards on dump sites conformity were considered. From the result in the study area, it shows that there are more illegal dump sites than legal dump sites. Based on proximity of the dump sites to the roads, waterways and built up areas, many of the dump site were very close to buildings where they only not destroy the aesthetic value of the areas but also constitute breeding grounds for vectors like flies, rodents, mosquitoes, which transmit diseases like typhoid fever, malaria, cholera and laser fever which are part of the killer diseases in Nigeria and most of the African countries. Therefore, the study recommends that more legal dump sites should be created and monitored in the study area, most especially in the Northern parts the study area since the population there is high. Also, students as well as staff should be well educated on the risk associated with indiscriminate refuse disposal. Keywords: Dump, Satellite imagery, World standards, Spatial analysis, Conformity, Vectors.

Penyuluhan, Cek Kesehatan Dan Pengobatan Gratis Di Klinik Kartika Husada

Diabetes Mellitus is a silent killer disease that can cause both macro and microvascular complications. The prevalence of DM in Indonesia is 1.5% of interviews diagnosed with doctors, and in DIY 12.2% of DM patients are not treated and show taking medication or using insulin from all ages in the Yogyakarta area 89.94%. Prolanis is a health service system and a proactive approach that is implemented in an integrated manner that involves participants, health facilities, and BPJS Kesehatan in the framework of health care for BPJS Kesehatan participants who suffer from chronic diseases to achieve optimal quality of life with cost-effective and efficient health services. Community service is carried out at the Kartika Husada Clinic in DM prolanic patients with counseling methods about DM disease and its prognosis and appropriate pharmacological and non-pharmacological therapies. Followed by supporting health tests as a basis for drug administration. The administration of drugs to prolanis patients is carried out by the interactive Information and Education Communication (IEC) method for both the patient and accompanying family. A series of community services carried out to support the BPJS prolanis program which aims to improve the quality of life of patients by controlling blood sugar and regulating lifestyle.

Improving Neural Network Performance with Feature Selection Using Pearson Correlation Method for Diabetes Disease Detection

Diabetic or silent killer diseases are an alarming scourge for the world and are classed as serious diseases. In Indonesia, the increase in diabetics occurred by 2% in vulnerable times between 2013 to 2018. This affects all sectors, both medical services and the financial sector. The Neural Network method as a data mining algorithm is present to overcome the burden that arises as an early detection analysis of the onset of disease. However, Neural Network has slow training capabilities and can identify important attributes in the data resulting in a decrease in performance. Pearson correlation is good at handling data with mixed-type attributes and is good at measuring information between attributes and attributes with labels. With this, the purpose of this study will be to use the Pearson correlation method as a selection of features to improve neural network performance in diabetes detection and measure the extent of accuracy obtained from the method. The dataset used is diabetes data 130-US hospital UCI with a record number of 101767 and the number of attributes as many as 50 attributes. The results of this study found that Pearson correlation can improve neural network accuracy performance from 94.93% to 96.00%. As for the evaluation results on the AUC value increased from 0.8077 to 0.8246. Thus Pearson's Correlation algorithm can work well for feature selection on neural network methods and can provide solutions to improved diabetes detection accuracy.

Limited utility of the HScore in detecting secondary haemophagocytic lymphohistiocytosis in COVID‐19

Limited utility of the HScore in detecting secondary haemophagocytic lymphohistiocytosis in COVID‐19

The Suitability of the Health Belief Model as an Assessment Framework for Women With Breast Ill-Health

Objectives: Globally, breast cancer is the commonest cancer in women. Empirical literature indicate that it is the second cause of cancer-related mortality in high-resource regions, while it is the most common cause of cancer-related deaths among women in poor-resource regions. This study presents the suitability of the health belief model (HBM) as a framework for carrying out a comprehensive assessment of women with late-stage breast cancer in Nigeria. Materials and Methods: This qualitative study employed interpretive description as its methodological approach, while the HBM was the conceptual framework. Two institutional review boards granted approval to conduct the study. Thirty women with advanced breast cancer were recruited for the study using purposeful sampling techniques. Components of the original HBM were identified to carry out the investigation. Data analysis was inductive. Results: Findings indicated that the participants viewed breast cancer as a definite threat- both as a spiritual attack – an arrow shot by the enemy, and as a killer disease. Many of their perceptions appeared to be culturally based, while others were based on their individual experiences. They perceived some benefits to both traditional and medical treatment options. Conclusions: Interventions that address people’s cultural and individual perceptions enables a comprehensive assessment of the patients with breast cancer, which can improve the treatment outcomes and survival rates of disease.

PENGARUH BRISK WALKING EXERCISE TERHADAP PENURUNAN KADAR GULA DARAH PADA PASIEN DM TIPE II DI RUMAH SAKIT GRANDMED LUBUK PAKAM

The silent killer disease that often occurs in humans was Diabetes Mellitus (DM). DM sufferers were generally unaware of this disease condition and when complications were known to have occurred. Control of basic sugar levels was the right way to reduce complications that occur in sufferers. The research objective was to determine the effect of walking exercise on changes in blood glucose levels in patients with type 2 diabetes mellitus. The Methode that used at this research was a pre-experimental design with a one group pretest-posttest design approach. There were 30 people of population of this study with diabetes mellitus taken using a simple random sampling technique which was 21 respondents. The Data analysis using Paired Samples T-test. The results showed that before doing all respondents exeperienced, blood glucose levels before walking exercise 21 people (100 %). After walking exercise decreased by 21 people (66,3%). Paired Sample T- test results obtained a probability value (p = 0.00) <(α = 0.05) which means H1 is accepted. Physical exercise which is carried out 3 times 30 minutes per week can reduce the risk for type 2 DM sufferers to have uncontrolled blood glucose level. Physical exercise is highly recommended for people with type 2 diabetes. To maintain body functions to work properly, the stability of blood sugar levels needs to be maintained.

LITERATURE REVIEW: LOW SALT DIET IN PATIENT WITH HYPERTENSION

ABSTRACTHypertension is still the most highest causes of death in Indonesia . Patient with hypertension not knowing that they have hypertension and in the end they have complications of hypertension, so it is often called the silent killer disease. Things that can be do so hypertension does not get worse is do a low salt diet. This study aims to determine the application of a low salt diet in patients with hypertension. The research method uses a traditional literature review, articles used by Portal Garuda and Google Scholar with a range of 2016-2020. The keywords used in the article search were low salt diet, hypertension. The results of the search for articles obtained on the Portal Garuda are 12 articles on Google Scholar are 4,030 articles, of which are only 15 articles that match the topic. Patients with hypertension mostly adhere to a low salt diet but there are still many who do not adhere to a low salt diet. Knowledge, attitude, family support and self awareness are factors that affects hypertension. The conclusion in this study, the application of a low-salt diet in hypertensive patients can be carried out well, hypertensive patients have knowledge, attitude and good family support for the implementation of a low salt diet and hypertensive patients who have the awareness to control their blood pressure. Suggestions for health workers can provide counseling regarding a low salt diet, for people with hypertension to apply a low salt diet properly so that blood pressure can be controlled.

A REVIEW ON AMALTAAS (CASSIA FISTULA LINN.) AS AN EKAL DRAVYA CHIKITSA IN BRIHATRAYEE

Cassia fistula, also known as golden shower, is a plant with many medicinal uses being used for various therapeutic purposes. It is also known by name Aaragvadha, which means “disease killer”. Its leaves, fruits and flowers are known to have medicinal relevance in Ayurveda. The fruit pulp is known to have laxative properties. It has many health benefits due to its constituents of variety of biologically active compounds those have various medicinal properties in its different part. Amaltaas is a potential medicine when used in Ekal form as well as in compound formulations. Since ancient times, it has been used in different traditional system of medicines for various ailments. This article aims to provide a comprehensive review on the use of Amaltaas as an Ekal Dravya for treating many ailments like diabetes, hematemesis, leucoderma, pruritis, intestinal disorders, as an antipyretic, analgesic and laxative. Amaltaas is being used as a one of the best prescribed remedy for many of the common ailments in day today’s life by large number of physicians. Using Amaltaas as a single dravya with various anupaan may results in optimum health benefit. Ekal dravya concept of using single substances has been mentioned in our ancient Ayurvedic literature. Use of amaltaas as a single drug therapy has been evidenced at various instances in Brihatrayee which is being reviewed in this article. Using Amaltaas as an ekal dravya and with other medicinal substances as an anupaan is also been considered and taken for the review.

Knowledge Regarding Osteoporosis among Young Adult Women of a Selected Community of Pokhara, Kaski

Background: Osteoporosis is a silent killer disease that is highly prevalent among females. Even though thesymptoms of osteoporosis can be identified in later stages of life, it can be prevented with a healthy lifestyleadaptation at an early stage of life.Objectives: The present study aims to assess the knowledge level of osteoporosis among young adultfemales and examine the association between knowledge level and selected socio-demographic variables.Methodology: A quantitative descriptive cross-sectional study design was used. A non-probability purposivesampling technique was used to select 153 samples. The data were collected for 6 weeks using a semistructuredinterview schedule. Osteoporosis Knowledge assessment tool (OKAT) was used to collect thedata. Descriptive statistics (frequency, percentage, mean, standard deviation) was used for quantitative dataanalysis and inferential statistics (chi-square) were used to find out the association between knowledge leveland selected socio-demographic characteristics of the respondents.Results: The study concluded that 51 percent of the young adult women had an average level of knowledgeand 49 percent had a poor level of knowledge regarding osteoporosis. However, none of them had a goodlevel of knowledge regarding osteoporosis. A significant association was found between the knowledge leveland educational status of the respondents (p=0.002).

Global COVID-19 Pandemic: Prevention and Protection Techniques

The COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). It has been identified as the causative agent of the viral pneumonia outbreak in Wuhan, China, at the end of 2019. It has a high human to human transmission capability and primarily targets the human respiratory system. Healthcare providers to common people are in high risks of the contamination of this fatal disease. It spreads person to person through respiratory droplets that produced during talking, coughing and sneezing. It is associated with severe and fatal respiratory disease in humans. At present it becomes great global public health concern. On 11 March 2020, the WHO declared the global COVID-19 outbreak as a pandemic. The COVID-19 pandemic has entered in a very dangerous phase in April and May 2020, and the severity is increasing day by day. On 26 July 2020, about 216 countries and territories are infected worldwide; total global infections become more than 16.3 million and total recovered about 9.9 million with total deaths 648,477. The disease have not abolished even in the 2021. On 09 February 2021, the disease spread up to 223 countries and territories globally; total confirmed deaths become 2,337,368, total confirmed cases 107,037,441, with total recovery 78,913,746. The paper discusses the social, economic, and health impacts in the world’s poorest countries due to COVID-19 pandemic outbreak. The study also presents the current economic situation of the world and analyses the potential consequences on global economy. An attempt has been taken here to create consciousness among the common people to reduce the fatality of this killer disease. From the beginning of 2021, COVID-19 vaccines are distributed worldwide and all nations are united to abolish the virus completely.

Turning threats into opportunities: how to implement and advance quality TB services for people with HIV during the COVID-19 pandemic and beyond.

IntroductionUntil COVID‐19, tuberculosis (TB) was the leading infectious disease killer globally, disproportionally affecting people with HIV. The COVID‐19 pandemic is threatening the gains made in the fight against both diseases.DiscussionAlthough crucial guidance has been released on how to maintain TB and HIV services during the pandemic, it is acknowledged that what was considered normal service pre‐pandemic needs to improve to ensure that we rebuild person‐centred, inclusive and quality healthcare services. The threat that the pandemic may reverse gains in the response to TB and HIV may be turned into an opportunity by pivoting to using proven differentiated service delivery approaches and innovative technologies that can be used to maintain care during the pandemic and accelerate improved service delivery in the long term. Models of care should be convenient, supportive and sufficiently differentiated to avoid burdensome clinic visits for medication pick‐ups or directly observed treatments. Additionally, the pandemic has highlighted the chronic and short‐sighted lack of investment in health systems and the need to prioritize research and development to close the gaps in TB diagnosis, treatment and prevention, especially for children and people with HIV. Most importantly, TB‐affected communities and civil society must be supported to lead the planning, implementation and monitoring of TB and HIV services, especially in the time of COVID‐19 where services have been disrupted, and to report on legal, policy and gender‐related barriers to access experienced by affected people. This will help to ensure that TB services are held accountable by affected communities for delivering equitable access to quality, affordable and non‐discriminatory services during and beyond the pandemic.ConclusionsSuccessfully reaching the related targets of ending TB and AIDS as public health threats by 2030 requires rebuilding of stronger, more inclusive health systems by advancing equitable access to quality TB services, including for people with HIV, both during and after the COVID‐19 pandemic. Moreover, services must be rights‐based, community‐led and community‐based, to ensure that no one is left behind.

The Effectiveness of Breathing Exercises on the Physiological and Psychological Variables of Patients with Pulmonary Tuberculosis

A study to evaluate the effectiveness of breathing exercises on physiological and psychological variables of patientswith pulmonary tuberculosis in selected hospital at Ambala, Haryana.TB is a 7th killer disease in the world and one of the top 10 causes of death. Pulmonary tuberculosis (PTB) is aninfection, which causes widespread pulmonary fibrosis and cavitation, and often leaves the patient with a chronicrespiratory deficit as a result.Aims and Objectives: The aim of the study was to evaluate the effectiveness of breathing exercises on physiologicaland psychological variables of patients with pulmonary tuberculosis.Material and Methods: A quasi experimental design using non-equivalent control group pretest- posttest designwas conducted on 110 pulmonary tuberculosis patients (55 in comparison group and 55 in experimental group) inDOTS center of UPHC RavidasMajriInderpuri colonyAmbala city, UPHC Baldev NagarAmbala city, UPHC DurgaNagar Ambala city and CHC Mullana. The dependent variables were physiological variables (dyspnea, spo2, heartrate, respiratory rate) and psychological variables (anxiety, quality of life). Pretest was taken in UPHC Durga NagarAmbala city and CHC Mullana on day 1 and posttest was taken inUPHC RavidasMajriInderpuri colonyAmbala cityand UPHC Baldev NagarAmbala cityon day 30. In experimental group, breathing exercises were administered by theresearcher two times a week. Each session was of 30 minutes including 4 breathing exercises (pursed lip breathingexercise, diaphragmatic breathing exercise, deep breathing exercise and segmental breathing exercise) and eachexercise was performed for 6-8 times. Other days patients were estimated to perform breathing exercises themselvesat home and on day 30, posttest was taken.Results: Both the groups were homogenous with respect to physiological and psychological variables before theadministration of breathing exercises. On day 30, the mean dyspnea score and anxiety score of experimental groupwas significantly lower than comparison group (p<0.05). The quality of life of patients in experimental group wassignificantly better than comparison group at day 30.Conclusion:Based on the findings of the study, it can be concluded that breathing exercises are effective in reducingthe dyspnea, anxiety, HR and RR. Breathing exercises are effective in improving theO2saturation, blood pressure andquality of life among pulmonary tuberculosis patients.

Clinicopathological features and management of aspergillosis in some poultry farms in Jos metropolis, Nigeria

Aspergillosis is important in poultry production and human health but difficulty in its ante mortem diagnosis in addition to the unsuccessful outcome of most management options has made the disease a lingering nightmare to farmers. This study presents the clinicopathological features and management of aspergillosis in some poultry farms in Jos metropolis, Nigeria. Thirteen cases of aspergillosis from 12 poultry farms were confirmed and managed from April, 2019 to March, 2020 with 7.6% cases in a mixed turkey-broiler farm, 15.4% in broilers and 76.9% in layers. The ages affected ranged from 3 weeks to 21 weeks with 69.2% cases in pullet grower birds of 10 – 21 weeks compared to young chicks, 3 – 9 weeks with 30.8%. The rainy season accounted for 61.8% cases while mortality ranged from 1.0% to 17.4%. The clinical features were consistent and included dyspnoea; inappetence; retarded growth and mortality. While necropsy showed consolidated lungs with caseous nodules; liver with raised grayish or yellowish irregular nodules; peritonitis with the peritoneum and air sacs laced with caseous nodules; diphtheritic membrane and caseous nodules on intestinal mucosa; haemorrhagic bursitis with granulomata; caseous nodules on osseous tissues as well as nodules on the skin and skeletal muscles. Confirmatory diagnoses of aspergillosis were made by culturing nodules on Sabouraud’s Dextrose Agar. Antifungal susceptibility testing showed CuSO4 to be more susceptible which was used at the dosage of 3g/10L of drinking water for at least 7 days in all the cases. Concurrent bacterial infections were seen in some of the cases and were treated concurrently with antibiotics based on susceptibility testing while farmers using moldy feeds were asked to withdraw such feeds. Conclusively, aspergillosis is prevalent in Jos metropolis with severe impact on production and may be a silent killer disease in poultry due to constraints in diagnosis and its management.
 Keywords: Aspergillosis, clinicopathological features, Jos, management, Nigeria, poultry

STUDY OF SERUM VITAMIN-D IN TYPE-2 DIABETES MELLITUS PATIENTS.

Background: Type-2 diabetes mellitus (T2DM) is a progressive and chronic disease characterized by both β-cell dysfunction and increased insulin resistance. Diabetes mellitus is now considered a giant killer disease of the 21st century with its vicious prongs in the South-East Asian countries, specially India, which is rightly said to be the ''Diabetes Capital'' of the world. Vitamin D has important effects on insulin action, and may impact on a number of pathways which may be of importance in the development of type 2 diabetes mellitus. Materials & Methods: In this study 62 Type-2 diabetic patients, 62 healthy controls were enrolled. Biochemical analytes measured were Serum glucose (Fasting Blood Sugar & Post Prandial Blood Sugar), Glycosylated Haemoglobin, Serum Vitamin-D. Results: The mean Serum Vitamin-D in Type-2 diabetic subjects were (16.3 ±3.0) while in healthy subjects(controls) the values were (39.3±5.2) respectively. These values were found to be statistically highly signicant(p<0.001). Conclusion: Serum Vitamin-D levels were decreased in Type 2 diabetic subjects as compared to the values in healthy subjects(controls).

An Empirical Bayesian Model in Disease Mapping of TB in Regency Bandung

In this paper we proposed an Empirical Bayesian model in estimating the relative risk of people getting a Tuberculosis (TB) diseases in a small area.. Which is one of the top rank diseases causing death in Indonesia. It is considered that the proposed model will alleviate some of the draw back that exist in the Standardized Mortality Ratio (SMR) method in estimating relative risk. It is shown that the proposed EB method produce an estimate of the risk which is a weighting averegae of SMR and EB estimate. To give a complete insight into the paper, we give an illustration concerning the case of Tuberculosis (TB), which is still considered as a killer disease in Indonesia.

CLINICAL EVALUATION OF HARITAKI CHOORNA IN STHOULYA

Sthoulya is one of the most effective disease which affect someone social, physical and mental features. As per modern view it is a precursor to coronary heart disease, high blood pressure, diabetes mellitus and osteoarthritis which have been recognized as the leading killer diseases of the millennium. Sthoulya is a state of increased Vikruta vruddhi of Medodhatu. It is one of the Satarpanottha vikaras. The drug Haritaki are having Laghu and Ruksha Guna which are opposite Guna to that of the Sthaulya. Objectives: Practical evaluation of Sthoulyahara effects of Haritaki. Results – 30 patients had completed the trial; no adverse effect were reported. All patients get significant result.

A structural equation modeling of supply chain strategies for artemisinin-based combination therapies in Uganda.

Introduction:Malaria is a killer disease in the tropical environment; artemisinin-based combination therapies (ACTs) play a central role in treating malaria. Thus, the supply and presence of ACT drugs in hospitals are a key feature in the fight against malaria. Supply chain management literature has focused on the private sector, and less attention has been paid to the public sector, especially hospitals.Aim:This study uses an interdisciplinary lens in investigating how to boost the supply and distribution of ACTs to save lives in low-income countries, specifically in Uganda.Methodology:The study adopted a quantitative research design using a questionnaire as the data collection instrument. Of the 440-population size, 304 of the sample population participated in the study. The model was estimated using structural equation modeling (SEM) to establish the causal relationship among the variables.Results:From the SEM analysis, all the hypotheses were significant at p < 0.05. The availability of ACTs is strongly affected by strategic dimensions (0.612), followed by operation dimensions (0.257); strategic determinants significantly affect operational determinants by a magnitude of 0.599. The indirect influence of the strategic determinants via operational determinants on the availability of ACTs is not significant. Overall, the factors explained 63.9% of the observed variance in the availability of ACTs, and the ACT availability can be predicted as follows: ACT availability = 0.612 × strategic determinants + 0.256 × operation determinants. Top management commitment and organizational responsiveness are among the items that positively affect the availability of ACTs.Conclusion:Strategically, hospital management should invest in cheap technology and software to minimize the unavailability of medicines. Our research suggests that strategic and operational determinants should be integrated into the hospitals’ core business and implemented by the top management. The article contributes to theoretical and policy direction in the public sector medicine supply chain, specifically in public hospitals.