Health Education Research Articles

16. KNOWLEDGE AND PRACTICE OF ANTIBIOTICS USE AND SOME RELATED FACTORS AMONG PEOPLE IN MINH LANG COMMUNE, VU THU DISTRICT, THAI BINH PROVINCE IN 2023

Objectives: To describe the knowledge and practice of people on antibiotics use and analyze some related factors to knowledge and practice of people on antibiotics use in Minh Lang commune, Vu Thu district, Thai Binh province in 2023 Methodology: The study employed a cross-sectional study design with the study sample size of 366 people. Results: Results indicated moderate knowledge prevalence (48.9%) and predominantly high-level antibiotic usage practices (67.5%). Factors influencing knowledge and practices included familial ties to healthcare, exposure to health education campaigns, and proximity to healthcare facilities. Targeted educational interventions are crucial for enhancing understanding and promoting responsible antibiotic usage practices, particularly in rural communities vulnerable to antibiotic resistance.

Sexual and reproductive health awareness and practices among adolescents and adults in a rural farming community in Baja California, Mexico: a quantitative and qualitative cross-sectional study

Rural, indigenous populations in Mexico face barriers to accessing sexual and reproductive health (SRH) resources and services. Given the lack of information to inform educational materials tailored to the needs of these indigenous communities, we aimed to: (a) quantitatively characterise the SRH awareness and practices among adolescents and adults in a rural, mostly indigenous community in northern Mexico and (b) qualitatively assess community perspectives on an educational pamphlet with SRH information (e.g., contraceptive options). Quantitative data collection occurred in November 2018 and April 2019 using convenience sampling in a community clinic and random sampling for community households. Qualitative data collection occurred in November 2019 via individual interviews and focus group discussions to assess community perspectives about an SRH educational pamphlet developed from quantitative data. Participants in the quantitative phase of our study (n = 217) were a median age of 30 years, 71% were female, and those with children reported having a median of three (range = 1-11). SRH knowledge was low, as were self-reported efforts to obtain contraceptives or testing for HIV/STIs. Most believed that children should learn about SRH by age 10-15 years, and 94% felt that parents should deliver such education. Participants had low knowledge about SRH but high motivation to educate children and adolescents on these topics, indicating potential for SRH campaigns in this community. Health education materials were well-received in the qualitative phase of our study (n = 17 from individual interviews; n = 22 from focus group discussions), and raised interest among community members in learning more about these topics.

Conocimiento del manejo de las lesiones precancerosas de cérvix de los profesionales de salud, en una empresa social del estado de baja complejidad del departamento del Valle del Cauca, Colombia

Introduction: Cervical cancer, according to estimates from the Global Cancer Observatory (GLOBOCAN), was the third cause of cancer and the fourth cause of mortality associated with cancer in Colombia during 2020. Despite multiple screening and detection interventions in the country, The expected results have not been obtained in terms of a decrease in cases of cervical cancer and an increase in the early diagnosis of premalignant lesions. Objective: To determine the knowledge of health personnel about precancerous lesions of the cervix, according to the Colombian clinical practice guide, in a low-complexity State Social Enterprise in the department of Valle del Cauca, Colombia. Materials and methods: Descriptive cross-sectional study in 42 health professionals, made up of doctors, professional nurses and nursing assistants from a low-complexity hospital entity in the department of Valle del Cauca, through a self-administered virtual survey. With the results obtained, univariate analyzes of the included variables were carried out, and using frequency tables, bar graphs and cakes, the behavior of the analysis variables was described. Results: 42 participants were included, with an average age of 34 years; 57% were nursing assistants and professional nurses. The average work experience in years was 9. 54.8% of participants had received training to perform cervical cancer screening. Knowledge of risk factors is significantly affected by the occupation of health personnel. When evaluating the screening and diagnosis of precancerous lesions of the cervix, it was found that most respondents know that screening is related to their detection. In relation to treatment, between 79 and 100% of pro- fessionals know the therapeutic alternatives. Regarding the behavior of health personnel regarding the results of the screening and the subsequent management approach, the doctors had a higher percentage of overall correctness. Conclusion: The study shows that there were misconceptions and inadequate approaches among the health professionals surveyed. It is necessary for low-complexity health entities to develop and disseminate cervical cancer prevention guidelines and health education materials to ensure standardization of the quality of services provided by health workers.

Interactive dental health education on the knowledge level of little doctors students of Muhammadiyah 4 Elementary School

Background: Dental and oral health education is conducted with the aim of changing the habits of a person, group of people, or society so they can gain knowledge, attitudes, and habits to behave in a healthy way in the field of dental and oral health. Elementary school age is the right time for teachers to introduce and instill healthy living habits. A dental and oral health education for Little Doctor students is assumed to help improve the dental and oral health of other students, teachers, and other staff of the school, as well as the people around the student outside of school. Purpose: To describe the effect of interactive dental health education on knowledge improvement. Methods: This study’s sample size was 31 Little Doctor students in the third through sixth grades. The activity in general adopted two-way communication; interactive speaking was performed to stimulate the students attentiveness to the topics, allowing students to engage with the speakers. To assess the students’ knowledge level of oral and dental health, a pre-test questionnaire was filled out prior to starting, and the same questionnaire was filled out as a post-test after completing all the agenda. Results: There were significant differences between pre-test and post-test results (P-value < 0.05), with the mean rank of the post-test group (45.56%) being significantly higher than the pre-test group (17.44%). Conclusion: The interactive education method in elementary school was found to be efficacious and more preferable as it matches the level of growth and development in school-age children.

Survey of Public Needs on The Design of an Integrated Information System Model for Adolescent, Mother, and Child Health

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Indonesia are still high, with MMR reaching 305/100,000 live births and IMR at 22.23 per 1,000 live births. Although the government has launched various programs for adolescent, maternal, and child health, there has been no effort to integrate these programs into a comprehensive reproductive health cycle. This study aims to analyze the needs of the community in designing an integrated information system model for adolescent, maternal, and child health. This study used a survey design conducted in Dau, Malang Regency, Indonesia. The population consisted of all women of childbearing age (15-49 years) totaling 945 people, with a sample size of 311 respondents obtained using the Slovin formula. The sampling technique used cluster sampling from 4 RW in Petungsewu Village, and 279 respondents could be processed. The research instrument used a questionnaire, and the data were analyzed quantitatively in the form of frequency distribution. The results of the data analysis showed that the design of the integrated model of adolescent, maternal, and child health has significant potential as the basis for developing an integrated website system. This system not only facilitates comprehensive health education but also strengthens real-time health recording and reporting mechanisms. This study shows that the integration of health education is essential to meet the different information needs of adolescents, mothers, and children. The model successfully identified and categorized these needs, so that the developed website could provide relevant and specific content for each user group.

Effect of electroacupuncture on the characteristic signal of electroencephalogram in the patients with chronic insomnia： a randomized controlled trial

To observe the effect of electroacupuncture (EA) on sleep quality and electroencephalogram (EEG) signal in the patients with chronic insomnia and to explore its mechanism. Sixty patients with chronic insomnia were randomized into an EA group (30 cases, 3 cases dropped out) and a health learning group (30 cases, 3 cases dropped out). In the health learning group, the sleep health education was provided. In the EA group, besides the health education as the health learning group, EA was delivered at Baihui (GV20), Yintang (GV24+), bilateral Shenmen (HT7), bilateral Sanyinjiao (SP6), with continuous wave, 2 Hz in frequency, once every other day, and 3 interventions a week. EA was given for 4 weeks successi-vely, composed of 12 treatments. The score of Pittsburgh sleep quality index (PSQI), Hamilton anxiety scale (HAMA), and patient health questionnaire-9 (PHQ-9) before and after treatment were compared between the two groups. The EEG signals were collected and the relative power and entropy of EEG before and after treatment were compared between the two groups. After treatment, the scores of PSQI, HAMA and PHQ-9, the relevant power of β wave in F8 and T3 channels, and that of α wave in T4 channel, and the entropy in T3 channel under the eyes-open (EO) resting state, as well as the relevant power and the entropy of γ wave in F8 channel under the eyes-closed (EC) resting state in the EA group were lower (P<0.05) than those before the treatment. All of the above results were lower than those of the health learning group at the same time points (P<0.05). Under the EO resting state, the relevant power of the θ and δ waves of T3 channel and θ wave of T4, O2 and Pz channels of patients in the EA group after the treatment were increased (P<0.05) than those before the treatment, and higher (P<0.05) than those of the health learning group at the same time points. Acupuncture is effective on chronic insomnia, which may be related to the regulation EEG signals.

The Effectiveness of Health Education to Increasing Hemoglobin Levels in Pregnant Women as Stunting Prevention Effort

Stunting is a nutritional health problem that is the center of attention worldwide with cases reaching 150.8 million people (22.2%). Stunting causes failure of growth and development of toddlers which has an impact on increasing mortality, morbidity, physical and cognitive disorders in adolescence and adulthood. Mothers who are malnourished during pregnancy are prone to anemia. Mothers with anemia can give birth to children who are at risk of stunting. This study aims to see the effectiveness of health education on increasing hemoglobin in pregnant women to prevent stunting. This research method was quasi-experimental with one group pre-post test. Sampling was done by purposive sampling method. The number of samples in this study was 60 samples. The data were analyzed using a normality test, and then a different test was performed using Wilcoxon. This study was conducted from August-September 2020. The results showed the effectiveness of health education during pregnancy in increasing the Hb value in pregnant women as indicated by the difference in the average Hb concentration before the intervention and after the intervention with a value of sig. (0.00) &lt; (0.05). It was expected that health workers in primary health care facilities and hospitals provide continuous education to pregnant women in fulfilling balanced nutrition and consuming at least 90 iron tablets during pregnancy to prevent stunting.Keywords: Health education, hemoglobin, pregnant women, stunting.

Developing and validating a knowledge, attitude, and practice questionnaire regarding dengue among secondary schoolchildren in Malaysia

IntroductionDengue is a viral disease borne by mosquitoes that infects humans that is a significant public health concern and socio-economic burden globally, especially in countries in the tropics and subtropics. Health education and community participation are the most powerful prevention strategies. Assessing local community knowledge, attitude, and practice (KAP) on dengue is essential for targeted interventions, as enhancing KAP helps communities recognize risks, adopt preventive attitudes, and implement effective measures to reduce dengue transmission. This study developed and validated a questionnaire on dengue KAP among secondary schoolchildren. Questionnaires serve as essential tools in research, allowing for standardized measurement of knowledge, attitudes, and practices, which supports accurate data collection and meaningful analysis.MethodsThe development and evaluation process (structure and content) involved consultations with eight experts including public health medicine specialists, medical officers, behavioural insights officer, academician, and entomologist, to ensure the relevance and comprehensiveness of the questionnaires. A QDengue-KAP questionnaire was administered to 30 secondary schoolchildren in Kuala Lumpur, Malaysia. The online questionnaire was self-administered, closed-ended, distributed anonymously, and participation was voluntary.ResultsThe final questionnaire comprised four sections and 50 items after the initial version had undergone a rigorous evaluation to ensure its reliability and validity. The content validity index (CVI) and content validity ratio (CVR) values exceeded the minimum requirement and indicated that all items met the minimum standards for content validity. Compared to the initial version, the final version of the questionnaire had improved Cronbach alpha values for each dengue KAP domain: knowledge [Cronbach’s alpha: 0.765 (items: 15)], attitude [0.894 (15)], practice Part A [0.735 (15)], and practice Part B [0.876 (5)]. Thus, each statement in the Knowledge (K), Attitude (A), and Practice (P) domains was deemed valid through validity and reliability evaluation, ensuring their relevance and accuracy in assessing dengue-related factors.ConclusionThe validation process demonstrated that each statement in the KAP domains was relevant, accurate, and aligned with the study's objectives, supported by expert validation and representation of the target population. This rigorous approach strengthens the validity and reliability of the questionnaire, making it a valid tool for assessing and improving dengue-related behaviours within the target population.

Associations between body mass index and physical fitness indicators among Chinese university students: a multicenter cross-sectional study

BackgroundIncreasing body mass index (BMI) has many negative effects on the physical and mental health of university students and has become a common public health problem in all countries. However, there are few studies on the association between BMI and physical fitness indicators among Chinese university students in developing countries, and the findings are inconsistent. The present study aims to analyze the association between BMI and physical fitness indicators among Chinese university students, to assist in university students’ health development and intervention.MethodsIn this study, we conducted a cross-sectional assessment of BMI of 29,371 university students and a cross-sectional assessment of physical fitness indicators of vital capacity, sit and reach, pull-up(boys), sit-up(girls), standing long jump, 50 m dash, 1000 m run(boys ), 800 m run(girls). One-way analysis of variance (ANOVA), Pearson’s correlation analysis, and nonlinear regression modeling were used to analyze the associations that existed between BMI and various physical fitness indicators.ResultsThe percentages of Chinese university students in emaciated, normal, overweight, and obese were 17.8%, 65.3%, 14.9%, and 2.0%, respectively. Comparing between different BMI groups (emaciated, normal, overweight, and obesity), for boys, the effect values ranged from 1.0 to 2.0% for the items of vital capacity, sit and reach, pull-up/situp, standing long jump, 50 m dash, and 1000/800 m-run. For run events, the range of effect sizes ranged from 0.2 to 0.9; the range of effect sizes for girls also ranged from 0.2 to 0.9.ConclusionsThe physical fitness level of emaciated and obese Chinese university students is generally lower than that of normal-weight students, and the relationship between BMI and physical fitness indicators shows a “U-shape” or “inverted U-shape” curve. The effect of BMI on physical fitness is more significant in boys than in university girls. In the future, targeted physical exercise and health education should be provided to emaciated and obese university students to maintain a reasonable body weight and promote the healthy development of physical fitness.

The Role of Health Education: Changing Knowledge and Attitude of Adolescents in Providing Reproductive Health

Adolescence is a transitional phase towards adulthood, marked by sexual maturation and identity exploration. Reproductive health encompasses physical, mental, and social well-being. Sexual education, provided by both parents and schools, is crucial for preventing unwanted pregnancies, abortions, and sexually transmitted infections (STIs). This study examines the impact of sexual education on adolescents' knowledge and attitudes about reproductive health, focusing on high school students in Jakarta, Bekasi, and Pekalongan. Using an experimental method (one group pretest-posttest design) over three months (April-June 2024), the study involved 120 respondents who completed questionnaires. Data analysis included univariate health promotion analysis and bivariate analysis using the Wilcoxon Signed Rank Test. The results showed a significant influence of sexual education on changes in knowledge and attitudes, with a p-value of 0.000 (p &lt; 0.05). These findings suggest that health education interventions effectively enhance students' understanding and attitudes, providing valuable insights for schools in preventing unwanted pregnancies, abortions, and STIs.

Prevalence and risk factors of osteoarthritis in patients at a public hospital in Limpopo province.

Osteoarthritis (OA) is a public health concern affecting millions globally. Osteoarthritis has been ranked as the 12th leading cause of disability among the ageing population globally. In addition, OA can lead to disability, which can affect the quality of life and physical and emotional well-being. A cross-sectional survey was conducted. An interviewer-administered questionnaire was utilised. Logistic regression was used to identify OA-related factors in the univariable and multivariable models. Ap-value less than 0.05 was deemed statistically significant. A total of 210 participants responded to the questionnaire. The overall prevalence of OA at the public hospital was 55.7% in adults over 18 years willing to participate. Among the study participants, females, individuals over the age of 50 years, and obese patients reported a high prevalence of OA. Family history and knee and hip pain were significantly associated with OA (p 0.05). Participants with a family history of OA were 6.9 times more likely to have OA, those with knee pain were 22.8 times more likely and those with hip pain were 5.5 times more likely after adjusting for the other variables. A high proportion of patients reported to have OA. Family history, knee pain and hip pain were strongly associated with OA. Understanding the prevalence and risk factors associated with OA is crucial for developing targeted interventions for prevention and management.Contribution:Targeted health promotion and education interventions are needed for prevention and early management.

Prevalence and intensity of Schistosoma mansoni infection, and contributing factors in Alamata district of Tigray Region, Northern Ethiopia.

Intestinal schistosomiasis caused by Schistosoma mansoni continues to be a significant public health problem in Ethiopia. This study investigated the prevalence and intensity of S.mansoni infection, and contributing factors in Alamata district of Tigray Region, Northern Ethiopia. A community-based cross-sectional study was conducted and 1762 participants were enrolled from five clusters in Alamata district. A questionnaire was used to collect socio-demographic data and risk factors. Stool samples were examined using Kato-katz technique to determine the prevalence and intensity of infection. The data were analyzed using SPSS version 25. Median, inter quartile range (IQR), mean, frequency, and percentage were used to descriptively summarize data. The Wilcoxon Mann-Whitney and Kruskal-Wallis tests were used to compare the differences in mean rank of egg load between different groups. Bivariate and multivariable logistic regression models were used to investigate the association between the odds of being infected with S.mansoni and the different socio-demographic and other factors. The strength of these associations was reported using odds ratio with corresponding 95% confidence intervals, and a P-value below 5% was used to report statistical significance. Out of 1762 residents included in the study 941 (53.4%) were females. The age varied from 5-80 years, with a median age of 25 years (IQR = 27), the overall prevalence of S.mansoni was 21.5% with males accounting for 26% (204/821) of the infections. The proportion of infection was higher among the age groups of 15-19 and 20-29 years at 32.7% and 33.1%, respectively. The mean egg count among the infected study participants was 146.82 eggs per gram of feces (epg) ± (243.17 SD). Factors significantly associated with increased odds of infection were living in Waja cluster (AOR:8.9; 95% CI, 3.5-23.2; P< 0.001); being in the age groups 10-14 (AOR:6.0, 95% CI: 3.1-11.7, P<0.001), 15-19 (AOR:5.8, 95% CI:2.8-12.2, P<0.001), and 20-29 (AOR:3.5, 95% CI:1.8-6.8; P<0.001) years; having direct contact with water while crossing river (AOR: 2.4, 95% CI: 1.5-3.8, P<0.001); and swimming (AOR: 1.4, 95% CI: 1.01-2.0, P = 0.035). The study indicates a notable S.mansoni burden in the area, driven by various risk factors. To effectively address this, enhancing diagnostics, implementing targeted mass drug administration, and conducting comprehensive health education campaigns on disease transmission routes are imperative.

Study on the Influencing Factors and Coping Strategies of College Students' Mental Health based on Social Media Environment

With the popularity of social media, college students' mental health is deeply affected by it. This paper aims to explore the dual impact of social media on college students' mental health, analyze its main positive and negative factors, and explore the influencing mechanism. The study found that social media plays a positive role in providing information access convenience, emotional support and learning resources, which helps to improve college students' cognitive ability and meet their emotional needs. However, problems such as information overload, social comparison and cyberbullying may trigger negative emotions such as anxiety and depression, which seriously affect mental health. This paper further analyzes the psychological and behavioral mechanisms of social media on college students' mental health, and proposes coping strategies such as improving psychological resilience, strengthening mental health education, and optimizing platform design. The study believes that the combined efforts of individuals, schools and society can effectively alleviate the negative impact of social media and promote the positive development of college students' mental health.

“ANXISCAPE”: An Adventure in Conquering Anxiety Via Game-Based Learning For Students

This study discusses the development and evaluation of a Game-Based Learning (GBL) application designed to educate students about anxiety disorders. The study addresses the challenge of engaging students in mental health education by creating an interactive game called “AnxiScape” using the Game Development Life Cycle (GDLC) methodology. The game aims to enhance students’ understanding of anxiety through an enjoyable and immersive experience. Evaluation results, based on the E-Game Flow Model and Heuristic Evaluation, indicate high levels of user enjoyment (90%) and usability (85.4%), demonstrating the game’s effectiveness in capturing attention, providing feedback, and improving knowledge. Integrating educational content with interactive elements can significantly enhance learning outcomes. The study suggests future improvements to optimize the game’s performance and balance educational depth with user engagement.

How social media are changing pediatricians and pediatrics? – A claim for regulation

BackgroundSocial media has revolutionized the way healthcare professionals communicate with the public, particularly in Pediatrics. With over 5 billion users globally, platforms such as Facebook, Instagram, and TikTok have become increasingly popular even among caregivers in recent years. These channels offer unique opportunities to improve public health education, allowing pediatricians to reach a wide audience with evidence-based content.Main bodyHowever, the risks associated with misinformation pose significant challenges to health professionals and medical organizations. In response, new recommendations for the proper use of social media in pediatric health communication should be proposed, aiming to provide a network where pediatricians can collaborate, share evidence-based information, and develop effective strategies for digital communication. With the growing use of artificial intelligence in healthcare and the rise of parental self-care practices, pediatricians must actively curate and share reliable information.ConclusionThis could serve as a new hub for ensuring that accurate, high-quality evidence-based information is disseminated, balancing the benefits of digital health advancements with the ethical responsibility of safeguarding patient care. By prioritizing professionalism, ethical communication, and technological adaptation, the aim should be to foster a more informed and health-conscious community.

Effectiveness of the community paramedicine at home (CP@home) program for frequent users of emergency medical services in Ontario: a randomized controlled trial

ObjectiveTo evaluate the impact of the Community Paramedicine at Home (CP@home) program, a community paramedicine home-visit intervention, on reducing emergency medical services (EMS) calls among frequent users.DesignA 6-month, open-label, pragmatic, randomized controlled trial with parallel intervention and control arms. An online automated platform (randomizer.org) was used to randomly allocate participants using a 1:1 allocation sequence.SettingIn homes of frequent EMS users in four paramedic services and regions across Ontario, Canada.ParticipantsEligible participants were frequent callers (≥ 3 EMS calls within six months and ≥ 1 EMS call within the previous month), or had ≥ 1 lift assist call within the previous month, or were referred by paramedics.InterventionCommunity paramedics conducted risk assessments, provided health education, referred appropriate resources, and reported to family physicians for up to three home visits. The control arm received usual care.Primary outcome measureEMS calls in 6 months during intervention.ResultsTwo thousand two hundred eighty four eligible participants were randomly allocated to the intervention and control groups, with 265 participants lost to follow-up due to inability to retrieve participant records from EMS databases. There were 1025 intervention participants (52.7% female, mean age 69.65 years [standard deviation (SD) = 19.98]) and 994 control participants (52.0% female, mean age 69.78 years [SD = 19.09]). In the post-intervention intention-to-treat analysis (zero-inflated negative binomial regression), the EMS call rate was not significantly lower in the intervention group compared to the control group (incidence rate ratio [IRR] = 0.88, 95% confidence interval [CI]: 0.76, 1.01). In the subgroup analysis, the intervention had a significant effect in the lift assist caller subgroup (IRR = 0.73, 95% CI: 0.58, 0.92), but no significant effect among the frequent caller subgroup (IRR = 0.97, 95% CI: 0.82, 1.14). The sensitivity analyses found a similar association for the lift assist caller subgroup. There was a significant subgroup effect (p-value for interaction < 0.01).ConclusionsCP@home had a significant impact on reducing EMS calls for those with a lift assist call but not for the overall sample. This program filled a healthcare gap by shifting primary care delivery, which could reduce the disproportionate number of EMS calls, thus reducing healthcare costs.Trial registrationRegistered with ClinicalTrials.gov NCT02835989 on July 14, 2016.

Youth Mental Health First Aid (YMHFA): A Change Initiative in an Underresourced School.

Background: School-aged children with unidentified mental illnesses experience poor health outcomes; managing this issue requires a collaborative community approach. Objectives: The objective was to implement an evidence-based mental health education and sustainment program within an underresourced school setting for staff and parents/guardians supervising children to optimize adult mental health literacy (MHL). Methods: The intervention included Youth Mental Health First Aid (YMHFA) training; measurements of pre- and post-MHL were completed with the Mental Health Literacy Scale (MHLS). Sustainment was achieved by developing a school-centered mental health toolkit and integrating a school champion. Results: There was a significant MHL score change from pretest to posttest. The toolkit bolstered sustainability by increasing the utilization of community resources. Conclusions: This mental health awareness initiative proved effective and can be expanded across similar underresourced schools to fill voids.

Jaga Kesehatan Lansia dengan Deteksi Dini Penyakit tidak Menular sebagai Langkah Awal

Non-Communicable Diseases (NCDs) pose a growing threat to public health, especially among elderly populations. This community service program was conducted in RT 001 and RT 01A, 20 Ilir 4 Village, Palembang, focusing on early detection and education to prevent NCDs such as hypertension, diabetes, and high cholesterol. The program utilized a participatory action research approach, incorporating health screenings and interactive health education sessions. Activities included blood pressure, glucose, cholesterol measurements, and lifestyle counseling. The results demonstrated a significant increase in awareness and proactive health behaviors among residents. Over 60% of participants with high-risk conditions were referred for further medical evaluation. Regular exercise initiatives and dietary modifications were adopted by the community. The program also established health cadres trained to sustain these efforts post-intervention. This initiative highlights the effectiveness of early detection and education in reducing NCD risks and fostering long-term community health improvements.

Effectiveness of a community-based intervention package in maternal health service utilization: A cross-sectional quasi-experimental study in rural Ghana.

We examined the effectiveness of a community-based intervention package that targeted pregnant women for increasing utilization of maternal health services. The intervention package was implemented in Suhum Municipality, Ghana, from March 2019 to April 2022. The package consisted of: (i) maternal health education by female and male peers; (ii) training existing health workers on maternal health; and (iii) strengthening the local community health management committees. A cross-sectional household survey was conducted in May 2022. We sampled four groups of women: (i) intervention at baseline; (ii) intervention at follow-up; (iii) control at baseline; and (iv) control at follow-up. Three outcome variables were set, i.e., the proportions of women having utilized: (i) at least four antenatal care (ANC) services; (ii) facility-based delivery (FBD) services; and (iii) post-partum care (PPC) services. To estimate the effectiveness of the intervention package in increasing the service coverages, both crude and adjusted difference-in-differences (DID) estimates were calculated. Significance levels were set at the values of 0.10, 0.05, and 0.01, since the aforementioned service coverages had already been too high to have room for an increase at the significance level of 0.05. The proportion of women completing at least four ANC services displayed significant DID in both crude and adjusted analyses. The proportions of women utilizing facility-based delivery services and post-partum care services did not display significant DID. Of the three outcome variables set, only the proportion of women having utilized at least four ANC services significantly increased in the intervention group, compared with the control group. Ghana has been in the transition process of shifting the minimum number of ANC visits from four to eight. Thus, nationwide scaling up of the intervention package is expected to help the transition be smooth by increasing the number of ANC visits.

Introduction of Chlamydia psittaci into a hospital area by feral pigeons

Pigeons are associated with zoonotic pathogens such as Chlamydia psittaci, the main causative agent of avian chlamydiosis, and related to psittacosis cases in humans worldwide. The aim of the present study was to investigate the occurrence of C. psittaci in feral pigeons (Columba livia) and environmental samples from places frequented by pigeons in a Brazilian hospital area. A cross-sectional study was carried out sampling feral pigeons, their droppings and nest material in a hospital area. Squares in a nearby region with a high density of pigeons were also sampled. Pigeon cloacal swabs (n=123) were collected from each bird, as well as pigeon droppings from the environment (n=77) and material from pigeon's nests (n=28). Chlamydiaceae-PCR targeting the 23S rRNA gene was used as screening. Positive samples were submitted to another PCR targeting the ompA gene of C. psittaci, followed by sequencing and phylogenetic analysis. C. psittaci was detected in 7.5% (17/228) of the samples, 7.3% (12/164) from the hospital area and 7.8% (5/64) from the squares. By sample type, 9.8% (12/123) of the pigeon cloacal swabs, 5.2% of droppings (4/77) and 3.6% of nest material (1/28) were positive for C. psittaci. All sequenced samples corresponded to C. psittaci genotype B. These results demonstrate the occurrence of C. psittaci in urban areas, with emphasis on a hospital area where immunocompromised individuals are present. Adopting a One health approach to prevent the proliferation of the pigeons, health education campaigns and specific recommendations for the hospital administration are essential. Guidance on practices such as not feeding the pigeons, avoiding contact or proximity and removing available areas for roosting and nesting, are measures that will reduce environmental contamination and risk of human exposure to C. psittaci.