Ministry Of Health Research Articles

Estimation and determinants of direct hospitalisation cost for coronary heart disease in a low-middle-income country: evidence from a nationwide study in Iranian hospitals

BackgroundCoronary heart disease (CHD) is the most prevalent type of cardiovascular disease in Iran. This study aims to investigate the estimation and determinants of direct hospitalisation cost for patients with...

Impact of a community-based participatory research project with underserved communities at risk for hepatitis C virus in Ho Chi Minh City, Vietnam: an evaluation study

BackgroundParticipatory approaches have become a widely applied research approach. Despite their popularity, there are many challenges associated with the evaluation of participatory projects. Here we describe an evaluation of a community-based participatory research study of underserved communities in Ho Chi Minh City (HCMC), Vietnam at risk for hepatitis C virus. The goals of our evaluation were to explore the main benefits and challenges of implementing and participating in a participatory study and to describe study impacts.MethodsWe conducted two meetings with leaders and members of the participating groups followed by in-depth interviews with 10 participants. We then held a dissemination meeting with over 70 participants, including the representatives of each group, researchers from non-governmental organizations (community-based, national and international), and govenrment officials from the Vietnam Ministry of Health and the Department of Health of HCMC.ResultsResults include four categories where we describe first the participatory impacts, followed by the collaborative impacts. Then we describe the benefits and challenges of creating and belonging to one of the groups, from members’ and leaders’ points of view. Finally, we describe the key suggestions that participants provided for future research.ConclusionIn conclusion, the evaluation approach led to both a research reflection on the ‘success’ of the project and enabled participants themselves to reflect on the outcomes and benefits of the study from their point of view.

Halving of the meniscectomy rate and their costs in Italy: A15-years period analysis.

The purpose of this study was to determine the incidence and hospitalization trends of meniscectomy in Italy from 2001 to 2016. A secondary aim was to investigate the economic burden of the disease on the national healthcare system. Data were extracted from the Italian Ministry of Health's National Hospital Discharge Reports. Diagnoses are coded according to the ICD-9-CM. Meniscectomy was defined by the following main procedure codes: 806, 8026 and 8145. By dividing the number of annual cases by the size of the adult population reported annually by ISTAT, incidence rates were computed. Overall, 1,454,891 meniscectomies were performed in the study period between 2001 and2016. The incidence was 178 procedures for every 100,000 Italian inhabitants. The incidence declined from 202 in 2001 to 106 in 2016. Males were the largest portion of patients undergoing surgery (68.2%). The average age of patients was 46.59 ± 15.07. A decreasing trend inlength of hospital stay was observed over the study period. The annual average cost per 100,000 inhabitants was EUR 491.219 ± 122.148 with a range from EUR 291,500 ± 79.500 in 2016 to EUR 610,500 ± 166.500 in 2004. In Italy, the number of meniscectomies performed in the adult population has almost halved over the study period. Results of the present study in the Italian population seem to reflect how the clinical evidence basis affects surgical technique selection. The economic burden of meniscectomy is relevant in Italy with an estimated expenditure from EUR 181.861.375 to 318.257.406 between 2001 and 2016. Level III.

Patient safety reporting and learning system of Catalonia (SNiSP Cat): a health policy initiative to enhance culture, leadership and professional engagement

Patient safety reporting and learning systems (PSRLS) are tools to promote patient safety culture in healthcare organisations (HCO). Many PRSLS are locally developed. WHO Global Action Plan on Patient Safety...

Measles resurgence in armenia: unmasking health system vulnerabilities and crafting comprehensive eradication strategies – a review

Measles is an acute febrile illness associated with rashes, fever and life-threatening complications. It is a vaccine-preventable disease with the Measles Mumps Rubella(MMR) vaccine but a recent global trend unveils a resurgence of measles in various parts of the world including Armenia. Measles was declared eliminated from Armenia in 2021 before reports of local outbreaks surfaced in 2023. The World Health Organization(WHO) identified discrepancies in the vaccination coverage during COVID-19. Measles also poses a great financial burden as a public health issue worldwide. Sociocultural factors impacting measles transmission are Maternal Education,Healthcare access, migration, vaccine hesitancy and socioeconomic status (Table 3). Efforts to control and eradicate measles from Armenia are run by a collaborative approach of national and international health bodies such as United Nations Children’s Fund(UNICEF), WHO,Global Vaccine Alliance (GAVI) and the Ministry of Health. Thus, the resurgence of measles can be managed through widespread patient education, innovative approaches, strengthening the healthcare system and addressing vaccine hesitancy, sociocultural barriers and humanitarian emergencies (Figure 2). This review investigates the complicated dynamics of measles inside Armenia’s health system in depth. A thorough examination of measles incidence and immunization patterns highlights the shift from few cases and high vaccination rates to a comeback caused by imported viruses. The causes of its recurrence have been thoroughly investigated, including reduced immunization programs and vaccine hesitancy. The research delves further into the “One Health” idea, assessing the possibility of interspecies transmission among nonhuman primates and examining the environmental factors that influence measles transmission. Among the challenges are weaknesses within Armenia’s health system as well as the possibility of interruptions from the COVID-19 outbreak. In measles vaccination status, the combination of maternal education, postnatal care, and socioeconomic variables exposes the larger drivers at work. The study concludes with a comprehensive set of public health policy recommendations covering vaccination promotion, surveillance, healthcare provider education, public awareness, international collaboration, data analysis, law enforcement, emergency preparedness, research, and coordination. The research sheds light on the tangled web of measles dynamics, health system resilience, and contextual subtleties via this multifaceted approach, inviting readers to investigate the multiple strategies required for eliminating measles in Armenia.

Lipocalin-2 as a marker of inflammation, bone density, and triglyceride-glucose index for new-onset arthritis patients in Mosul, Iraq.

Lipocalin-2 is an acute phase-associated adipokine that can serve as an inflammatory and biomarker indicator of cartilage deterioration in osteoarthritis. However, its role in the musculoskeletal system remains not fully understood. Hence, this study aimed to evaluate lipocalin-2 and its relationship with markers of inflammation (Interferon-gamma, ESR, and CRP), bone density (vitamin D3 and calcium), and the triglyceride-glucose index in new-onset arthritis patients in Mosul, Iraq. This study included 125 participants aged 20 to 65, divided into two groups. The Arthritis Patient Group comprised 70 participants (37 females and 33 males) attending the Bone Diseases Consultation Unit at the Ibn Sina Teaching Hospital in Mosul, Iraq. The Control Group comprised 31 females and 24 males. Ethical approval was obtained from the Iraqi Ministry of Health - Nineveh Health (No. 2022095). Commercial ELISA kits were used to measure serum lipocalin-2, Interferon-gamma, ESR, and CRP as inflammation markers, vitamin D3, and calcium as bone density markers. Moreover, the Triglyceride Glucose (TYG) Index was evaluated. The findings revealed a significant increase in lipocalin-2 levels in males compared to females, with LCN-2 increasing with age. Arthritis patients showed a significant increase (72%) in lipocalin-2 levels. Inflammatory indicators (erythrocyte sedimentation rate, C-reactive protein, interferon-gamma) displayed significant increases (46%, 1200%, and 581%, respectively). Glucose (23%), triglycerides (71%), and TYG index (21%) also exhibited significant increases. Meanwhile, bone density indicators (vitamin D3 and calcium) found a significant decrease (53% and 20%, respectively) in arthritis patients. Linear correlation coefficient (R) analysis revealed a significant positive relationship between lipocalin-2 and indicators of inflammation, glucose, TG, and TYG index. This study's findings suggest that LCN-2 serum levels were higher in patients with new-onset arthritis than in controls in Mosul, and LCN-2 serum increased in males compared with females and getting older serum LCN-2 increased for the patients and control groups. Furthermore, a significant correlation was found between the Triglyceride Glucose Index, which measures metabolic disorders, and serum LCN-2 levels and inflammatory indicators in new-onset arthritis patients in Mosul, Iraq.

Routine Data Analysis of HIV Pre-Exposure Prophylaxis Use and Rates of Sexually Transmitted Infections Since Coverage of HIV Pre-Exposure Prophylaxis by the Statutory Health Insurance in Germany.

Human immunodeficiency virus pre-exposure prophylaxis (PrEP) is considered as an effective protection against a human immunodeficiency virus (HIV) infection. However, it is still unclear, how PrEP use is associated with the incidence of sexually transmitted infections (STI) other than HIV. PrEP became reimbursable in Germany from September 1, 2019 for persons with statutory health insurance (SHI). With the EvE-PrEP study, the Federal Ministry of Health commissioned the evaluation of the effects of the new reimbursement situation in Germany. In the presented module of the EvE-PrEP study, routine data from three large German SHI funds were analyzed in anonymized form for the period January 1, 2019 to March 31, 2020. Data were analyzed regarding: Characteristics and adherence of PrEP users, treatment success of PrEP, and changes in STI incidence rates before and since PrEP use. The cooperating SHI funds collectively covered about 52% of the overall population in Germany in 2019. A total of 7102 persons with PrEP use were included into the analysis. These were predominantly male (99%), on average 37.4years old and a high proportion of persons lived in large cities. The average quotient of PrEP daily defined doses and assumed days on PrEP was 87%. The average STI rates normalized per 100 person-years at individual level pre PrEP did not statistically significant differ compared to since PrEP (chlamydia: 17.5 vs. 17.6, gonococcal infection: 29.1 vs. 30.7, and syphilis: 14.6 vs.13.6). A large data set was used to evaluate the introduction of PrEP as a SHI benefit in Germany. A potentially suspected increase in bacterial STI incidence rates was not found. A rather high average adherence rate was observed. The very high proportion of men and people from the largest German cities among PrEP users is striking. These results could indicate barriers to PrEP access for people at risk of HIV, especially if they are women or people living in less urban areas.

A Model for Estimating the Burden of Disease of Transfusion-Transmitted Infection

ObjectivesBlood transfusion is an important mode of infectious disease transmission in low- and middle-income countries (LMICs). This study describes a model to determine the prevalence of transfusion-transmitted infections (TTIs) and the associated burden of disease.MethodsA five-step model was developed to determine the TTI-related burden of disease measured by disability-adjusted life years (DALYs). Uganda was selected as the study country.ResultsApproximately 298,266 units of blood were transfused in Uganda in 2019, yielding an estimated TTI incidence of 6,858 new TTIs (2.3% of transfused units) and prevalence of 19,141 TTIs (6.4% of transfused units). The total burden of disease is 2,903 DALYs, consisting of approximately 2,590 years of life lost (YLLs), and 313 years lived with disability (YLDs).ConclusionThe incidence and prevalence of TTIs and the associated burden of disease can be calculated on a local and national level. The model can be applied by health ministries to estimate the impact of TTIs in order to develop blood safety strategies to reduce the burden of disease.

E-Governments in Africa

Multiple authors have come to view Africa as a victim of the fourth industrial revolution (4IR), a continent which has not been able to take part as one of the driving forces of this technological advancement. This is more so true when considering the state of the African continent during the first, second and third industrial revolutions where Africa's role had been of a more minimal nature. This assumption is however not true when considering how multiple countries in Africa have embraced and entrenched technology into the daily operations of their government institutions during the 4IR. Furthermore, it can be identified that the introduction of the 4IR has only led to an increase in the efficiency and effectiveness of African governments and their institutions in the act of service delivery. This illustrates that not only is the African continent ready for this revolution but that it has also been able to take advantage of it. This paper aims to illustrate the growing potential of digitalisation and e-government in African states. It will do this by providing an observation of the development that technology has fostered better service delivery using five African states as case studies, namely South Africa, Mauritius, Nigeria, Rwanda and Tunisia. It aims to analyse the transformations that have taken place from the periods of 2000 to 2022 whether they be an increase in the overall quality of the services provided, or a reduction in time required for the execution of those said services. The paper uses secondary sources as a mechanism to analyse the impact that the introduction of technology has had on government systems in the five African countries. The main focus will be on the ministries of home affairs, finance, education, transport and health and how the incorporation of technology into these departments and departments that are of similar interests in the other countries has assisted in the improvement of the effectiveness of service delivery of these departments.

The prevalence of bronchial asthma and chronic bronchitis among adolescents according to the negotiability data depending on the climatic zones in the Republic of Dagestan

The purpose of the study: The purpose of this work was to study the prevalence of bronchial asthma and chronic bronchitis in adolescents, depending on the factors of the ecosystem and climatic zones in the Republic of Dagestan according to the data of the incidence and morbidity. Material and methods of research: We analyzed statistical data on the incidence and incidence of bronchial asthma and chronic bronchitis among adolescents aged 14–18 years for 5 years (2018–2022) in the lowland, mountainous and foothill zones of the Republic of Dagestan according to the Ministry of Health of the Republic of Dagestan. Previously, similar studies have not been conducted in this age group. Results and their discussion: From these data it can be seen that, firstly, in the republic as a whole, the increase in the incidence of bronchial astma in adolescents amounted to 124.4 % (from 0.86 to 1.93 per 1000 population); secondly, a steady increase in the incidence of bronchial astma is observed in rural areas (228 % vs. 53.8 % in cities), thirdly, the incidence has its own characteristics depending on the height of residence above sea level (mountains – more than 1000 m, foothills – 500–1000 m, plain – less than 500 m). A comparative assessment of the data on the prevalence of asthma in cities and rural areas revealed the following patterns: in general, adolescents in villages are almost 2 times less likely to suffer from bronchial asthma than in the city (summary figures for 5 years per 1000 population – in rural areas – 0.96, in urban areas – 1.78). Although the increase in the number of adolescents with bronchial asthma was also noted among urban residents (by 53.8 %), but among rural adolescents the increase in 5 years exceeded 4 times and amounted to 228 % (0.57 in 2018 and 1.86 in 2022). The heterogeneity of the incidence of chronic bronchitis by year was noted in all climatic zones. In the mountainous climatic zone, the incidence in 2018 was 14.7 per 1000, in 2019 there was a slight decrease (10.5), and in subsequent years there was a gradual increase and by 2022 it reached 19.3 per 1000 population. There were no large differences in morbidity in the foothill zone, although in 2022 it decreased to 3.2 compared to other years (6.4 in 2018, 7.2 in 2019, 5.3 in 2020 and 7.0 in 2021). The same situation was observed in the lowland zone, although in general, the incidence rate in this climatic zone increased from 5.5 in 2018 to 7.3 in 2022, with insignificant differences in 2019 (8,6) and 2020 (4,4). Conclusions: Bronchial asthma is a common disease among adolescents in the Republic of Dagestan and there is its close dependence on both climatic zones and ecosystem factors. When comparing the data on the prevalence of bronchial asthma in urban and rural areas, the following patterns were revealed: in general, adolescents in villages are almost 2 times less likely to suffer from bronchial asthma than in the city. Although the increase in the number of adolescents with AD was also noted among urban residents (by 53.8 %), but among rural adolescents the increase in 5 years exceeded 4 times and amounted to 228 %. Regarding chronic bronchitis, heterogeneity of morbidity by year was noted in all climatic zones. In the mountainous and lowland zones, there was an uneven increase in the incidence of chronic bronchitis over the years, and in the foothill zone there was a downward trend. Such differences in morbidity rates can only be explained by the lack of a unified approach to the nomenclature and diagnosis of chronic bronchitis in various medical institutions of the republic.

Impact of changes in recommendation of optimal gestational weight gain in Japan: A retrospective study in a single tertiary center.

In March 2021, the Japanese Ministry of Health, Labour and Welfare revised the optimal gestational weight gain standards. In this study, we examined whether this revision affected gestational weight gain and low birth weight rates. We analyzed the records of singleton pregnant women who underwent checkups from their 1st trimester and delivered at our institute after 37 weeks between 2020 and 2021 (before the revision) and between 2022 and 2023 (after the revision). Pregnancy outcomes were assessed in the following four groups stratified by pre-pregnancy body mass index (BMI): underweight (BMI: <18.5 kg/m2), normal-weight (BMI: 18.5-24.9 kg/m2), overweight (BMI: 25-29.9 kg/m2), and obese (BMI: ≥30 kg/m2). Leaflets on the optimal gestational weight gain standards for each group were distributed to all pregnant women at the first prenatal checkup. In each group, gestational weight gain did not change before and after the revision, with the corresponding values of 10.8 kg and 11.1 kg in the underweight (p = 0.94), 10.7 kg and 10.4 kg in the normal weight (p = 0.14), 9.7 kg and 9.2 kg in the overweight (p = 0.32), and 7.4 kg and 6.7 kg in the obese (p = 0.44) groups. Furthermore, the prevalence of low birth weight did not decrease in all groups. No significant differences in gestational weight gain or low birth weight were observed after the revision of the 2021 gestational weight gain recommendations. Merely distributing leaflets to pregnant women may not be sufficient to improve gestational weight gain or reduce low birth weight rates.

Competing in the "war for talent" in nursing homes: A quantitative investigation.

This study explores the characteristics of primary care organizations that are likely to attract and retain highly skilled professionals, meeting their expectations and increasing Person-Organization fit. Both "hard" dimensions (ownership) and organizational/managerial traits under the span of control of management are investigated. The objective is to raise awareness on how to mitigate unpopular features of primary healthcare organizations so to effectively compete in the war for talent. This study has been carried out based on data extrapolated from a broader study conducted by the Italian National Agency for Regional Health Services and commissioned by the Italian Ministry of Health. Data deriving from Italian nursing homes was extrapolated from the broader public dataset and multiple regressions were carried out to detect associations between managerial variables and staff seniority. Several significant associations were detected, suggesting that both physicians and nurses are affected by some investigated variables when deciding where to work and for how long. While some of these are common to the two categories of professionals (e.g., the presence of a nursing director), others are not (e.g., the presence of internal training programs). The implications of this study are related to the need of increasing awareness of managers of nursing homes on those features that are likely to increase their attractiveness and long-lasting appeal to professionals. This is a paramount topic in times in which the war for talent is strong. A lack of attention on this field may lead to the inability to attract and retain staff in primary care settings and, in turn, to implement strategic trends of change healthcare systems are facing in Italy and worldwide.

Changes in Use of Prenatal Dental Care After Brazil's Incentive Policy.

In 2020, the Brazilian federal government launched the "Prevent Brazil" program to incentivize cities to improve their performance across 7 health care indicators, including prenatal dental care. Our study examines the impact of this policy on the use of oral health care among pregnant women in Brazil. We used a series of cross-sectional data from the Brazilian Public Health System from 2018 to 2023. We linked publicly available data from the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics. Our outcome was the proportion of pregnant women receiving prenatal care who had at least 1 dental visit during the past year. Covariates included city-level socioeconomic (income and literacy), demographic (gender, race, and urban areas), and workforce variables (number of dentists working in the public health system per city/year). We estimated the impact of the policy on prenatal dental visits nationwide and stratified by geographic region using interrupted time-series analysis. Our analyses included 99.9% of all Brazilian cities (n = 5,562). The use of oral health care among pregnant women increased from 15% in 2018 to 69% in 2023. Adjusted estimates show that, after initiation of the Prevent Brazil, dental care use among pregnant women increased nationally at a rate of 4.6 percentage points per 4-mo period (95% confidence interval [CI] 4.5; 4.7). The policy's largest impact was in the North and Northeast regions, which have the lowest socioeconomic profiles (adjusted time-series rate 5.7 [95% CI 5.3; 6.1] and 5.2 [5.0; 5.4] percent points, respectively). Our findings support the positive impact of the Prevent Brazil policy on prenatal dental care in Brazil. The policy was associated with a countrywide improvement in prenatal dental care use, with a greater impact in socioeconomically disadvantaged regions.

Multidisciplinary Effort Leading to Effective Tuberculosis Community Outbreak Containment in Israel

Tuberculosis (TB) is the second-most prevalent cause of mortality resulting from infectious diseases worldwide. It is caused by bacteria belonging to the Mycobacterium tuberculosis complex (MTBC). In Israel, TB incidence is low, acknowledged by the WHO as being in a pre-elimination phase. Most cases occur among immigrants from high TB incidence regions like the Horn of Africa and the former Soviet Union (FSU), with occasional outbreaks. The outbreak described in this report occurred between 2018 and 2024, increasing the incidence rate of TB in the region. Control of this outbreak posed challenges due to factors including a diverse population (including Ethiopian immigrants, Israeli-born citizens, and immigrants from other countries), economic and social barriers, and hesitancy to disclose information. The unique multidisciplinary team formed to address these challenges, involving the local TB clinic, district health ministry, health maintenance organization (HMO) infectious disease consultant, neighborhood clinic, and National Mycobacterium Reference Laboratory (NMRL), achieved effective treatment and containment. Whole genome sequencing (WGS) proved pivotal in unraveling patient connections during the outbreak. It pinpointed those patients overlooked in initial field investigations, established connections between patients across different health departments, and uncovered the existence of two distinct clusters with separate transmission chains within the same neighborhood. This study underscores collaborative efforts across sectors that successfully contained a challenging outbreak.

Zaske: 'Have more trust in the regional processes'

The Ministry of Social Affairs, Health, Integration and Consumer Protection of the State of Brandenburg (MSGIV) has commissioned Wirtschaftsförderung Land Brandenburg GmbH (WFBB) to carry out basic needs analyses for the five care regions in the state of Brandenburg. The IGES Institute was commissioned together with AGENON at the end of September 2023 with the project 'Preparation of care needs analyses for the healthcare regions of Brandenburg as well as initiation, organisation and content-related support of regional dialogue forums and project groups at different hospital locations'. The first study reports are now available. The project partners present them.

Toothbrushing programme in Saudi Arabia ‘TOPS’: a study protocol for a cluster randomised controlled trial in kindergartens, Riyadh

IntroductionDental caries among children is a major global health problem and is a particular public health challenge in Saudi Arabia. Dental caries cause pain, infection and negatively impact quality of...

Factors associated with tuberculosis drug resistance among presumptive multidrug resistance tuberculosis patients identified in a DRTB surveillance study in western Kenya

Multidrug-resistant tuberculosis (MDR-TB) is caused by M. tuberculosis (Mtb) with resistance to the first-line anti-TB medicines isoniazid (INH) and rifampicin (RIF). In Western Kenya, there is reported low prevalence of drug resistant strains among HIV tuberculosis patients, creating a need to determine factors associated with drug resistance patterns among presumptive MDR-TB patients. To determine factors associated with drug resistance patterns among presumptive MDR-TB patients in western Kenya. Three hundred and ninety (390) sputum sample isolates from among presumptive multidrug TB patients, were analyzed for TB drug resistance as per Ministry of Health (MoH) TB program diagnostic algorithm. Frequency and percentages were used to summarize categorical data while median and interquartile range (IQR) were used for continuous data. Multivariable logistic regression was carried out to identify factors associated with TB drug resistance. Out of 390 participants enrolled, 302/390 (77.4 %) were males, with a median age of 34 years. The HIV-infected were 118/390 (30.3 %). Samples included 322 (82.6 %) from presumptive patients, while 68/390 (17.4 %) were either lost to follow-up patients, failures to first-line treatment or newly diagnosed cases. A total of 64/390 (16.4 %) of the isolates had at least some form of drug resistance. Out of 390, 14/390 (3.6 %) had MDR, 12 (3.1 %) were RIF mono-resistance, 34 (8.7 %) had INH, while 4 (1 %) had ethambutol resistance. The category of previously treated patients (those who received or are currently on TB treatment) had a 70 % reduced likelihood of resistance (aOR: 0.30; 95 % CI: 0.13–0.70). In contrast, older age was associated with an increased likelihood of resistance to INH and RIF, with an adjusted odds ratio of 1.04 per year (95 % CI: 1.00–1.08). Prompt MDR-TB diagnosis is essential for appropriate patient care, management, and disease prevention and control. We recommend active surveillance on drug resistant TB in these regions to detect drug resistance patterns for rapid disease management.

Real-world effectiveness of the CoronaVac vaccine in a retrospective population-based cohort in four Colombian Cities 2021-2022

The National Vaccination Plan against SARS-CoV-2/COVID-19 was launched by the Ministry of Health and Social Protection, on 14 February 2021. The main objective of the study was to evaluate the effectiveness of the Corona Vac in preventing three clinical outcomes defined as Infection, Hospitalisation or Death, in a real-world scenario. This is a population-based retrospective dynamic cohort study using a multivariate Cox model to calculate Hazard Ratios (HR) for estimate of vaccine effectiveness, starting on 17 Feb 2021 up to 30 June 2022. The data were taken from the surveillance systems for 12 months for each individual. Four cities were selected considering that each one had a reliable data base. Corona Vac effectiveness was estimated in 32% (95% CI 31-33) in preventing infection, 55% (95%CI 54-56) in hospitalisation, and 90% (95%CI 89-90) in death, at the end of the follow-up. These findings were more consistent during the four first months. Comparing with unvaccinated, booster homologous doses did appear to increase effectiveness in preventing hospitalisation, but for booster heterologous increase protection for hospitalisation and death. Booster doses to whom already were vaccinated with CoronaVac did not improve its effectiveness neither when they received heterologous boosters. CoronaVac shows effectiveness in preventing death or hospitalisation during the first year of follow-up, but less in preventing infection, decreasing rapidly after the first four months of follow-up. It was higher in children between 3 and 12 years, as well as in those over 60. Boosters' doses did not improved effectiveness in those CoronaVac already vaccinated.

How Menstrual Hygiene Management Facilities are Supportive to Girl Students in the School Environment in Tanzania

The study aimed at examining how menstrual hygiene facilities are supportive to girl students in the school environment in selected secondary school in Dodoma city. The study adopted exploratory research design. This study employed a qualitative approach with semi-structured interviews and focus group discussion as data collection tools. A total of 29 students from four different private and public schools in Dodoma city were involved. The study found that menstrual hygiene management facilities were not supportive to girl students in the school environment. Most girls faced different challenges when they were at school; this study found out that there was insufficient water, soap, pads, scarce toilets and no private rooms. Most of them waited until the end of the session; they would not leave the class until they were the last to leave and when they leave, would wrap sweaters around their waists. The findings revealed that the selected secondary schools in Dodoma City have no private changing rooms. Female students were use conventional restroom facilities as personal changing areas. The study recommends that the government, through the Ministry of Health, should make available sanitary pads and distribute them to all secondary school girls for free. Further, the government should set aside 1% of all education budget to be used in the production of sanitary pads. The government may exempt tax to all sanitary products produced within and outside the country to reduce the price of the product.

The new hospital discharge form for inpatient rehabilitation in Italy: a step forward to promote the role of rehabilitation in the healthcare system.

In Italy, longstanding limitations in the existing reporting system of the inpatient rehabilitation activities have been reported. The Hospital Discharge form (HDF) primarily uses ICD codes that inadequately capture the functional status and rehabilitation needs of patients, impacting equity of care and service evaluation. Therefore, the Italian Ministry of Health (IMH) launched an initiative aimed at developing a new reporting system to be specifically adopted in the inpatient rehabilitation setting. A working group (WG), lead by representatives of IMH, was established in 2019. It included members of scientific societies and professional associations in rehabilitation, administrators, policy makers, and other experts. Representatives of the Associations of Patients and Families were also consulted. The WG submitted the new version of the HDF to the political decision makers in early 2020. It includes detailed data on patients' functional levels before and after rehabilitation, and the complexity of clinical conditions. In using the ICD codes, priority is given to functional diagnoses. In 2023, after a period of interruption due to the COVID-19 pandemic, a Ministry of Health Decree sanctioned the adoption of the new reporting system nationwide after a one-year trial period, starting on January 2024. The new HDF is expected to improve data collection, reduce local and regional disparities, allow better comparison of the performances of the structures, and ultimately enhance the quality and outcomes of rehabilitation care across the country. The Italian Society of Physical and Rehabilitation Medicine (SIMFER) gave an important contribution in the development of the system.