Effective Health Programs Research Articles

War-related trauma and posttraumatic stress disorder in refugees, displaced, and nondisplaced people during armed conflict in Sudan: a cross-sectional study

BackgroundThe ongoing armed conflict in Sudan has caused mass displacement, affecting mental health. This study aimed to assess the prevalence of posttraumatic stress disorder (PTSD) and trauma among refugees, internally displaced, and nondisplaced people, while also examining the link between displacement type, PTSD severity, and associated factors.MethodsThis cross-sectional study used the Posttraumatic Stress Disorder Checklist for DSM-5 to assess PTSD symptoms and the General Health Questionnaire-28 to evaluate depression. Data were collected from 642 participants, targeting general social media groups for those within Sudan and specific groups for refugees outside the country. Sociodemographic and trauma event data were also gathered. Data analysis was conducted using SPSS, applying one-way ANOVA and independent t-tests to compare PTSD and depression. Binary logistic regression identified associations between sociodemographic factors and PTSD symptoms.ResultsAmong the 642 participants, 46.3% were internally displaced people (IDP), 42.1% were refugees, and 11.7% were non-displaced individuals. Clinically significant PTSD symptoms were identified in 36.6% of the participants. Refugees had a significantly greater percentage of traumatic events (M = 4.31, SD = 2.605, p < .01). Depression symptoms were found to be strongly associated with clinically significant PTSD (p < .001). Factors significantly linked to depression symptoms included female gender (p = 0.015), being single (p = 0.048), younger age (p = 0.036), dissatisfaction with living conditions (p < 0.001), and unemployment (p = 0.021). Dissatisfaction with living conditions also significantly influenced the likelihood of developing PTSD (p < .001).ConclusionThe study found that 36.6% of participants experienced PTSD, with refugees having a 1.4 times greater risk of developing PTSD compared to IDP and non-displaced individuals. Traumatic events were moderately correlated with PTSD symptoms, though non-displaced individuals had higher exposure to such events. These findings highlight the need for targeted mental health interventions, particularly for refugees and those affected by traumatic events. Further research using probability sampling is necessary to confirm these results and inform more effective mental health policies and programs for displaced populations.

Optimizing Colorectal Screening in Portugal with Process Mining

Abstract Background Efficient healthcare screening programs management influences patient outcomes. Process mining has emerged as a powerful tool to enhance these programs by refining complex workflows and pinpointing operational deviations. Objectives This study utilizes process mining techniques to analyze the colorectal cancer screening program in Northern Portugal, focusing on detecting deviations and performance bottlenecks in process models. Methods This screening program started in March 2018, but process mining was only used on data posterior to 2020. Over 1 million case observations from administrative data were included in the process model analysis, involving more than six key process activities and numerous resources. We used new software and statistical tools for process mining to rapidly compute observations and filter for different operational needs and monitor interventions. Results The discovery analysis identified deviations, such as unexpected performance issues and irregular activity sequences. Although over 100 traces were identified, fewer than five traces accounted for more than 90% of all case paths, indicating the most common traces that have a true impact in participation rates, referral rates, and treatment rates. Notable differences in resource performance during specific periods, such as COVID-19 or seasonal events, were also observed. These findings provided insights for adjusting resource allocation and improving coordination, with impact in minimizing seasonal phenomena or peak production periods. Lessons Process mining offers actionable insights for effective health program coordination, enabling the monitoring and timely response to process deviations. With key areas for action identified in a more timely and precise manner, we can enhance efficiency, and expand population coverage and treatment referral. Future initiatives will focus on further process optimization and national coverage expansion using these management tools. Key messages • Process mining revolutionizes healthcare by enabling the strategic management of complex oncological screening program workflows. • Comprehensive data analysis across the patient pathway enhances program efficiency and expands treatment access.

Implementing Effective School-Based Mental Health Services: A Guide for School Counselors

Across the United States, the number of children with mental health conditions has continued to rise. However, access and utilization of mental health services vary greatly. School-based mental health complements comprehensive school counseling and provides an opportunity for K–12 students to receive needed treatment they may not otherwise have access to. School counselors are well positioned to support the development, implementation, and sustainability of effective school-based mental health programming. We provide an overview of implementation science and case examples that detail the school counselor’s role in this work.

Screening for Anxiety, Depression and Panic in older adults in a Family Medicine Unit in Sinaloa, Mexico

Introduction: The most prevalent mental disorders in Primary Care are Anxiety, Depression and Panic. These are one of the main causes of health demand in hospital stay services. Objective: to determine the frequency of mental disorders in older adults at the Family Medicine Unit No. 35, Culiacán, Sinaloa, México in the period from March to November 2024. Methods: Descriptive cross-sectional study. Older adults aged 60 to 75 years without a diagnosis of any mental disorder or syndrome were included. Sample of 379 participants. Simple random probabilistic sampling. A socio-demographic data sheet and the PHQ-4 + PHQ-TP scale were used. Descriptive and inferential statistics (Chi square) p ≤0,05 were used, it adhered to ethical and legal criteria. Results: The average age was 65,59 years. 53,3 % were men, 52 % were married, 50,7 % were currently working, 35,1 % had primary education and 76 % lived in urban areas. 34 % had anxiety, 28,2 % depression and 30,6 % panic. A significant relationship was found between anxiety and marital status (χ²=5,814, p=0,05) and schooling (χ²=12,845, p=0,00). Depression was related to schooling (χ²=18,479, p=0,00) and current job (χ²=8,528, p=0,003). Panic was related to sex (χ²=17,688, p=0,00), marital status (χ²=10,935, p=0,004), current job (χ²=6,273, p=0,001) and education (χ²=13,092, p=0,004). Conclusions: Anxiety was the most common mental disorder among older adults, highlighting the need to promote accessible and effective mental health programs that address the particular needs of this age group.

Pengukuran Komposisi Tubuh dalam Upaya Deteksi Obesitas pada Laki-laki dan Perempuan Usia Produktif di SMA Kalam Kudus II, Kelurahan Duri Kosambi, Jakarta

This community service evaluated body composition in men and women of productive age at Kalam Kudus II Senior High School, Duri Kosambi, Jakarta. This community service study included 68 respondents. Measurements were carried out using a body composition scae to assess percentage of total fat, visceral fat, subcutaneous fat and total muscle. The results showed that the 51-64 year age group had the highest percentage of total and visceral fat, while the 18-35 year age group had the highest percentage of total muscle. These findings emphasize the importance of routine body composition monitoring for early detection and appropriate intervention to prevent obesity and metabolic disease. Recommended interventions include a balanced diet, increased physical activity, and health education focused on weight management and healthy body composition. The use of body composition analysis technology can provide more accurate data to support effective and measurable health programs among the productive age group.

Retrospective evaluation of the causes and distribution of lameness in beef and dairy cattle evaluated by ambulatory and in-house clinical services at a North American veterinary teaching hospital

Since lameness occurs so commonly and has such significant effects on cattle productivity and farm profitability, manage­ment and prevention of lameness is essential to the design of effective health and husbandry programs. Unfortunately, the causes and distribution of lameness lesions between beef and dairy cattle, as well as the different management groups within a specific production class, can differ dramatically. A recent report analyzing data from 17 dairies found infectious condi­tions, specifically digital dermatitis and foot rot, were the most common cause of lameness in first-lactation cattle. In contrast, non-infectious lesions, namely white line disease and sole and toe ulcers, were the most common cause of lameness in cows in their second or greater lactation. A report evaluating the inci­dence of specific causes of lameness in cattle on 6 commercial beef feedlots found that the most frequently identified causes of lameness were upper limb issues and deep digital sepsis. How­ever, when characterizing different causes of lameness in beef cattle outside of feedlots, there exists a dearth of published data. Therefore, the objective of this study was to describe the different causes and distribution of lameness in beef and dairy cattle presenting to either a primary care ambulatory service or in house referral services at a veterinary teaching hospital in the southeastern United States.

Pengaruh Keselamatan dan Kesehatan Kerja (K3) serta Standar Operasional Prosedur (SOP) Terhadap Kinerja Karyawan di PT. PLN (Persero) ULP Paniki

This research aim is to analyze the influence of occupational health and safety variables and standard operating procedures (SOP) on employee performance at PT. PLN (Persero) ULP Paniki. Occupational health and safety and SOP implementation are considered to have significant roles in creating a comfortable and effective work environment that supports optimal employee performance. The research employs a quantitative approach and a survey method involving 50 respondents from workers at PT. PLN (Persero) ULP Paniki. The research results show that there is a positive and significant relationship between occupational health and safety variables and employee performance. This finding indicates that the implementation of effective occupational health and safety programs contributes to the increase in employee performance. Furthermore, the analysis results also state that standard operating procedures (SOP) have a strong positive influence on employee performance. Based on these research findings, the recommendations proposed emphasize the need for increased investment in occupational health and safety programs, as well as a more efficient approach in delivering and explaining SOP within the PT. PLN (Persero) ULP Paniki area. Thus, the industry can create a more comfortable and effective work environment that fosters the achievement of optimal employee performance.

Utilization of routine health data and its determinants among healthcare workers in public health facilities of harari region, eastern Ethiopia

BackgroundRoutine health information is the pillar of the planning and management of health services and plays a vital role in effective and efficient health service delivery, decision making, and program improvement. Little is known about evidence-based actions to successively advance the use of information for decision making. Therefore, this study aimed to assess the level and determinants of routine health data utilization among health workers in public health facilities in the Harari region, Ethiopia.MethodsAn institutional-based cross-sectional study design was used from June 1 to July 31, 2020. A total of 410 health care providers from two hospitals and five health centers were selected using a simple random sampling technique. Data were collected through a structured questionnaire complemented by an observational checklist. The collected data were thoroughly checked, coding, and entered into Epi-data version 4.6 before being transferred to Stata version 14 for analysis. Frequency and cross-tabulations were performed. To measure factors associated with routine use of health data, bivariate and multivariate logistic regression analyzes were performed. The odds ratio with a 95% CI was calculated, and then a p-value of less than 0.05 was considered significant.ResultThe general utilization of routine health data was 65.6%. The use of routine health data was significantly associated with healthcare workers who had a positive attitude towards data [AOR = 4 (2.3–6.9)], received training [AOR = 2.1 (1.3–3.6)], had supportive supervision [AOR = 3.6 (2.1–6.2)], received regular feedback [AOR = 2.9 (1.7–5.0)] and perceived a culture of information use [AOR = 2.5 (1.3–4.6)].ConclusionsSixty percent of health professionals had used routine health data utilization. Training, supervision, feedback, and the perceived culture of information were independently associated with the use of routine health data utilization. Therefore, it is critical to focus on improving data utilization practices by addressing factors that influence the use of routine health data.

Global Trends and Correlations in Mental Health Disorders: A Comprehensive Analysis from 1990 to 2019

This original paper aims to provide a comprehensive analysis of the prevalence and trends in mental health disorders (n=6,420) from 1990 to 2019. Utilizing a sourced dataset, statistical methods are used to explore the increasing rates of mental health disorders, with a focus on healthcare workers, gender disparities, and geographical variations. The study reveals a significant increase in the prevalence of mental health disorders over the past three decades. Healthcare workers were found to be at a particularly higher risk for adverse mental health outcomes. Additionally, the data showed notable geographical variations, indicating the need for region-specific healthcare policies. Gender disparities were also evident, emphasizing the importance of gender-specific mental health interventions. Policymakers and healthcare providers should consider these findings to implement effective mental health programs, especially for at-risk groups like healthcare workers. The study also highlights the need for future research to provide a more comprehensive understanding of mental health trends globally.

A STUDY ON THE PREVALENCE OF PREHYPERTENSION AMONG ADOLESCENTS IN TIRUNELVELI TOWN TAMILNADU

Objective: The prevalence of hypertensive disease among adolescents is increasing trend. This rise in hypertension (HTN) among adolescents is multifactorial. Prehypertension advances to HTN in due course in adult life, becoming one of the major risk factors for cardiovascular diseases later. We aim to determine the prevalence of prehypertension among adolescents in Tirunelveli town. Methods: One thousand high school children aged 14–18 years from Tirunelveli city were chosen. The blood pressures (BPs) (systolic and diastolic) were recorded using the standard technique. Physical biometrics was documented. Results: BP &gt;90th percentile is considered to be abnormal in adolescents. Prevalence of prehypertension is 0.7% (f-0%, m-0.7%), HTN is 4.7% (f-2.5%, m-2.2%), and cumulative abnormal BP is 5.4%. Among the 54 adolescents, only one had body mass index of overweight category surprisingly. Conclusion: Previous studies indicate approximately 3–4% of adolescents develop consistently elevated BP across many countries. The common causes attributed are physical inactivity, consumption of junk food, besides hormonal changes in adolescents. The results of our study indicate 5.4% of students having more than the 90th percentile nearly corresponds to results of many studies. Early detection of prehypertension in adolescents is cost-effective measure that would further avoid impoverishment to the middle-income group as well as improve the quality and expectancy of life. Effective specific school health programs are needed at the time, especially in developing countries like India.

"Nos apoyamos mutuamente": Strategies to supporting community health workers addressing the emergency and chronic needs of Latinx families.

Community health workers (CHWs) have established pathways to implementing effective, sustainable, and cost-effective health programs among underserved populations. Despite the significant role of CHWs, there is limited literature describing the needs of CHWs, specifically in times of health emergencies and crises. Thus, we explored the challenges and sources of support among CHWs providing services to Latinx families. Participants were recruited from a Latinx community-based organization in metro Atlanta, working to strengthen family relationships using evidence-based programming. Fifteen semistructured interviews were conducted among CHWs. Interviews were conducted primarily in Spanish, recorded, transcribed, and translated into English for analysis. Following a thematic analysis, data were double-coded, and codes were described and compared for themes. Participants identified as Latinx (n = 15), were between the ages of 29 and 69 years, and had worked as CHWs between 1 month to 4 years. Two themes and seven subthemes were identified in the data. Theme 1 highlighted barriers and strategies employed by CHWs to address clients' preexisting and emerging needs, and Theme 2 focused on responding to client needs during the COVID-19 pandemic, which introduced new challenges and barriers that provoked adaptive organizational strategies to promote worker resilience. Addressing the needs of vulnerable communities in times of crisis to improve the working conditions for CHWs will require a multifaceted approach that prioritizes the removal of structural barriers. Barriers can be mitigated by prioritizing cultural assets, adopting flexible and equitable work policies, and enacting policies at the federal level that promote health justice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of an intervention to improve sexual and reproductive health on level and predictors of awareness and knowledge of condoms and dual protection amongst adolescents in Nigeria

BackgroundAdolescents need both information about sexual behaviours and potential risks in order to make the right choices. This study compared adolescents’ level of awareness and predictors of knowledge of condoms and dual protection where a multi-component sexual and reproductive health (SRH) intervention was implemented and in communities where the intervention was not implemented, so as to understand the effect of the intervention on awareness and knowledge and also identify predictors of knowledge of contraception methods.MethodsThe study was an intervention study that was undertaken in six local government areas (three rural and three urban LGAs) in Ebonyi state, southeast Nigeria. Data were collected from 855 adolescent boys and girls, using a pre-tested interviewer administered questionnaire. Systematic random sampling technique was used to select eligible households from which adolescents were interviewed Analysis of data was carried out using bivariate and multivariate linear regression analyses. The level of statistical significance was determined by a p value of < 0.05.ResultsThe level of awareness of condoms and dual protection was similar in the intervention and non-intervention communities. However, the predictors of knowledge about condoms and dual protection were different between the intervention and non-intervention groups. The multivariate linear regression showed that the higher the level of education, the higher the level of awareness of contraception methods among adolescents (p < 0.05). Likewise, increasing age by one year and working for pay increased the awareness of condoms and dual protection(p < 0.05).ConclusionThere was no difference in the level of awareness of pregnancy prevention methods, knowledge of condoms and dual protection in both arms of the study. Higher level of education, increasing age, and working for pay are factors associated with awareness of condom and dual protection. These factors should be prioritized for effective Adolescent sexual and reproductive health (ASRH) programming.

Knowledge, attitudes, and practices regarding cardiovascular disease prevention among middle school students in China: a cross-sectional study.

The prevalence of cardiovascular disease (CVD) is rapidly increasing globally. With a concerning increase among adolescents due to unhealthy habits, obesity, and hypertension, understanding the current status of knowledge, attitudes, and practices (KAP) related to CVD prevention among middle school students is crucial for developing effective school-based health programs to prevent CVD. The analytic cross-sectional survey is used in questionnaires to assess KAP related to CVD prevention among middle school students (N = 17,731) from 50 schools across 16 provinces in China in June-July 2023. The pass rate of KAP scores is categorized as good and poor. Independent predictors of good KAP of CVD prevention are ascertained using a binary logistic regression model. The study surveyed 8,118 (45.78%) junior high school students and 9,613 (54.22%) high school students. The overall mean [standard deviation (SD)] for the knowledge, attitude, and practice scores were 26.88 (8.12), 53.53 (7.22), and 39.80 (5.96), respectively. The knowledge scores had the lowest pass rate at 56.89%. Only 6.83% of the students know "the definition of blood pressure in adolescents." Attitudes toward health were positive, though the attitude regarding "the danger of prolonged sedentary to cardiovascular health" scored lowest at 73.55%. The practice section had a pass rate of 89.30%; 40.27% of students reported that they spend more than an hour a day on screens. Only one-third of the students would go to bed before 12 o'clock. In univariate analysis, junior high school and high school students differed significantly in knowledge and practice (p < 0.001), but attitude did not differ significantly (p = 0.103). The majority of students lack sufficient knowledge about CVD. It is also found that socioeconomic background, family environment, and educational levels have an impact on cardiovascular health behaviors among students. Strengthening health education involving students, parents, teachers, and communities is essential to promote health knowledge and practices among adolescents.

Analisis K3 pada Mesin Milling, Mesin Bubut dan Ruangan Produksi di PT. Z Menggunakan Metode HIRARC

Occupational safety and health play a crucial role in maintaining productivity, sustainability, and the reputation of a company. Unsafe or unhealthy working conditions can lead to workplace accidents, injuries, or even fatalities. Additionally, the costs associated with work-related accidents or illnesses can be significant, including medical expenses, workers' compensation, and lost productivity. Therefore, it is important for companies to have an effective occupational safety and health program to protect their employees. One method used to analyze and manage occupational safety and health risks is HIRARC (Hazard Identification, Risk Assessment, and Risk Control). In this report, we will discuss the background of occupational safety and health and explain the steps of HIRARC in identifying, assessing, and controlling occupational safety and health risks in the workplace. The HIRARC method serves as an effort to prevent or minimize workplace accidents and includes a combination of Hazard Identification, followed by Risk Assessment to evaluate potential hazards in milling machines, lathe machines, and production areas, and finally Risk Control to implement measures that can minimize workplace accidents in the working environment. Keywords: HIRARC (Hazard Identification, Risk Assessment, and Risk Control), Occupational safety and health, Production area

Impact of occupational heat exposure on selected haematological parameters of bakery workers: A comprehensive study in Ilorin, Kwara State.

The Occupational Health and Safety Administration has identified indoor industries at risk of experiencing heat-related illnesses due to the presence of heat-generating appliances; these include bakeries, kitchens, laundries, and furnaces. This study aimed to assess the effects of heat stress on haematological parameters and erythrocyte sedimentation rates (ESR) of bakery workers in Ilorin, Kwara State. It was a cross-sectional study, involving laboratory analysis, which lasted for 3 months. A total of 60 Male and female bakery workers aged between 18 and 65 years with 1 or more years of working experience were recruited for this study. Full blood count estimation was carried out using haematological analyzer (Sysmex-2000) and the ESR was carried out using the Westergren method in the Haematology unit, Kwara State University, Malete. Results were analyzed using SPSS version 20. This study found the bakery workers to have low ESR (2.13 ± 1.28) compared to (10.05 ± 4.95) of the control, the RBC was high (6.708 ± 2.08) compared to (5.46 ± 1.12) of the control group. TWBC was also found to be high (7.425 ± 1.74) compared to (6.95 ± 2.49) of the control population. Findings from this study concluded that working under high temperatures negatively affected the health of bakery workers with reports of heat stress-related symptoms and also affected ESR and haematological parameters. A comprehensive and effective national occupational health and safety program that includes relevant policies, decrees, and proper enforcement is needed to ensure the worker's safety and health both in the formal and the fast-growing informal sectors.

The Effect Of Leptospirosis Health Intervention Module On Knowledge And Attitudes In Informal Sector Workers In Semarang City (Intervention Study In The Working Area Of Kedungmundu Health Center Semarang)

Leptospirosis is a zoonotic disease caused by the bacterial genus Leptospira, and a worldwide public health problem caused by climatic and environmental conditions. The incidence of lepotopsirosis in Central Java has always increased in the last two years, namely in 2021 there were 285 cases with a death rate of 44 people (CFR: 16.60%) cases, in 2022 there were 503 cases with a death rate of 70 cases (CFR: 13.32 %). The aim of this research is to analyze the differences before and after administering the leptospirosis health intervention module on knowledge, attitudes, beliefs and practices among informal sector workers in Semarang City (intervention study in the Kedungmundu Semarang health center working area). The research design used a control intervention study with a sample of 45 interventions and 45 controls. The intervention and control groups were determined based on the results of leptospirosis cases found in the working area of the Kedungmundu Community Health Center, Semarang City in 2020 - 2023. Data analysis was carried out univariately, bivariately using the Wilcoxon test and the Mann-Withney test. The results showed that knowledge (p&lt;0.001), attitude (p=0.001). The mean differences between the intervention and control groups were 62.11 and 28.89 for knowledge, 63.86 and 27.14 for attitudes. The Leptospirosis Health Intervention Program is an effective health program, an educational tool to increase awareness and preventive behavior among at-risk groups such as informal sector workers, farmers and livestock breeders

Ang Kalusugan at Kayamanan: The Health and Wealth of Hawai'i Filipinos.

Many Filipinos suffer from high rates of chronic diseases, while systemic and cultural barriers make it challenging for them to access care. Culturally relevant programs that integrate community perspectives and values are essential to improve Filipino health. To understand how health may be improved using self-identified community strengths and assets, researchers partnered with Filipino residents of the Kalihi neighborhood in Honolulu, Hawai'i. Researchers conducted a focused ethnographic study in spring 2016 with 52 adult residents of Kalihi to document Filipino perspectives on the overlapping concepts of health and wealth. Specifically, facilitators led culture circles, resulting in semi-structured discussions of community wellness. Participants shared perspectives of Filipino community health and wealth, resulting in 2 categories-self and relationships, 14 thematic codes and 7 definition components. These components informed the development of a new holistic health framework. The proposed framework may inform the development of more effective health programs rooted in extant community assets. This study sought to empower Filipino residents by acknowledging their views on wellness and prosperity that may not be reflected in conventional health care models. Further research is needed to deepen the understanding of the complex cultural relationships between health and wealth in communities of color.

Factors associated with academic burnout and its prevalence among university students: a cross-sectional study

BackgroundThis study aimed to evaluate the current state of academic burnout among Chinese college students and its influencing factors.MethodsA cross-sectional study of 22,983 students was conducted using structured questionnaires and the Maslach Burnout Inventory General Survey on sociodemographic characteristics, educational process, and personal aspects. Multiple variables were statistically evaluated using logistic regression analysis.ResultsThe total score of the students’ academic burnout was 40.73 (± 10.12) points. The scores for the reduced personal accomplishment, emotional exhaustion, and cynicism were 23.63 (± 6.55), 11.20 (± 6.05), and 5.91 (± 5.31), respectively. Students with academic burnout accounted for 59.9% (13,753/22,983). Male students had higher burnout scores than female students, upper-grade students had higher burnout scores than lower-grade students, and students who smoked had higher burnout than non-smokers during the school day.ConclusionsMore than half of students experienced academic burnout. Gender, grade, monthly living expenses, smoking, parents’ education level, study and life pressures, and the current degree of professional knowledge interest significantly impacted academic burnout. An effective wellness program and an annual long-term burnout assessment may sufficiently reduce student burnout.

Health-Promoting Schools Project for Palestine Children's Oral Health

ObjectivesThe aim of this work was to assess the oral health outcome of a 2-year comprehensive school oral health programme based on school-health education combined with supervised toothbrushing using 1450-ppm fluoride toothpaste amongst schoolchildren in Palestine. MethodsA quasi-experimental study (2016–2018) recruited 3939 schoolchildren aged 5 to 6 years from 30 intervention schools (n = 2333) and 31 comparison schools (n = 1606). At baseline and postintervention, mothers and schoolteachers completed World Health Organization (WHO) self-administered questionnaires about oral health of children, oral health behaviour, and family factors. Of the initial participants 75.8 per cent took part in the follow up studies. In addition, 25 calibrated dentists examined dental caries of children according to WHO criteria. Trained teachers provided comprehensive oral health education to children in the classrooms and held regular oral health sessions for mothers. Children brushed their teeth with fluoride-containing toothpaste (1450 ppm fluoride). Student t-test and logistic regression were used in the statistical analysis of changes in dental health and related knowledge, behaviours, and attitudes (P < .05). ResultsIn both dentitions, dental caries experience declined over the project. The reduction in Decayed, Missing and Filled permanent Teeth and Decayed, Missing and Filled Surfaces in permanent teeth was 23.3% and 23.2% (P < .001), respectively. The drop in caries experience indices in the Gaza Strip was 8 to 4 times higher than in West Bank, and it reached 47.4% reduction. Mothers and teachers showed improvement in positive knowledge and attitudes towards dental care. Involvement of schoolteachers in oral health in schools and acceptance of dental health education materials significantly enhanced oral health behaviour of children. ConclusionsThe project recommends national implementation of an intervention for the improvement of oral health of schoolchildren and their parents in conflict zones. The project shows the importance of the WHO Health Promoting Schools concept and involving classroom-based health education carried out by schoolteachers. It is suggested to explore the health care system's capacity in hosting effective oral health programme and maintain its efficacy.

Detection of Toxoplasmosis in Association with Autoimmune Thyroid Disease During Pregnancy in Duhok, Iraq

Toxoplasma gondii is a protozoan parasite that is widely distributed in the human population and is responsible for corresponding global morbidity. Specifically, T. gondii causes toxoplasmosis, leading to miscarriage, stillbirth, and neural disorders. This parasite attacks different human organs and glands, such as the thyroid gland, and causes various corresponding health issues. Recently, studies have established a link between T. gondii and autoimmune thyroid diseases (AITD), which contributes to preterm delivery, miscarriage, low birth weight, and death. Therefore, the aim of this study was to detect the prevalence of toxoplasmosis and its association with AITD among pregnant women. A total of 180 blood samples were collected from pregnant women and examined using an enzyme-linked immunosorbent assay (ELISA). The patients were within the age range of 15–50 years old, and lived in Duhok City, Iraq; samples and clinical information was collected from August 2021 to February 2022. The corresponding blood samples were tested for anti-Toxoplasma IgG antibody, Toxoplasma IgG avidity, FT3, FT4, and TSH hormones, and TPO, Tg, and TSHR antibodies. Overall, our results showed that out of 180 pregnant women, 110 (61.1%) were seropositive for anti-Toxoplasma IgG antibody; specifically, 25 (22.7%) and 85 (77.3%) had recent and past infections, respectively. Approximately 54.4% (98) of the pregnant women had thyroid disorders; further, 22 (12.2%), 13 (7.2%), and 8 (4.4%) women had TPO, Tg, and TSHR antibodies, respectively. A total of 43 (23.8%) patients screened positive for AITD. Out of the 110 Toxoplasma IgG–positive women, 35 (31.8%) had AITD. The older women, rural residents, restaurant food consumers, and women with cat contact had relatively high infection rates. Toxoplasma seropositive women had more elevated autoantibodies than seronegative ones. In conclusion, this study demonstrated a high rate of toxoplasmosis and a corresponding association with thyroid hormones changes and AITD in pregnant women in Duhok, Iraq. Further, it is necessary to reduce overall infection rates through effective health and educational programs. Therefore, it is essential to measure Toxoplasma antibodies, screen for thyroid hormones and autoantibodies, and encourage gynecologist visits to reduce the risks to mothers and fetuses.