Health Morbidity Research Articles

Rapid, sensitive and specific electrochemical detection of E. coli using graphitized mesoporous carbon modified electrodes

Escherichia coli (E. coli) is a highly pathogenic bacterium causing infections to the human body primarily from a variety of sources including food intake. As per the World Health Organization (WHO), the mortality and morbidity rate due to E. coli is significantly high, approximately 8%. Therefore, a real-time, rapid, user-friendly and interference-free E. coli detection system offers great clinical importance. In this work, a highly sensitive, specific, and simple method of electrochemical detection of E. coli has been demonstrated. The electrochemical system employs the conventional three-electrode configuration, wherein glassy carbon (GC), chemically modified with graphitized mesoporous carbon (GMC), has been employed as the working electrode. While using platinum and Ag/AgCl as counter and reference electrodes respectively, voltametric techniques were applied to obtain the interference mitigated response of E. coli detection. The GCE/GMC electrode showed excellent sensitivity and selective response towards E. coliin a linear detection range of 2.52 × 103 CFU/mL to 25.2 × 104 CFU/mL and 252CFU/mL to 2268CFU/mL respectively with a limit of detection (LOD) of 50.40CFU/mL. Further, the developed system was tested for interference with other bacteria and real samples, such as pond water, tap water, and deionized water. Appreciable recovery values and negligible interference were observed. The prepared electrode demonstrated promising results towards efficient, real-time, and rapid E. coli detection.

Health Conditions and Morbidities Among Older Adults in the States of India

The present contribution forms the thirteenth installment of our on-going series, Social Change Indicators. In this installment, we have deliberated on the health conditions of older adults in India which have exacerbated because of the COVID-19 pandemic. Over the past five issues, we looked specifically at the social and economic challenges brought on by the pandemic . The topics covered included vulnerable household across social classes, poverty and migration, living conditions for social distancing, social protection networks and the displacement of rural labour. In this part, we examine health conditions among older adults, aged 60 and above, in different states of India. We present the state’s ranking according to self-rated health status as well as the morbidity prevalence for the 60 plus population. We also look at the prevalence of chronic health conditions, such as hypertension, cardiovascular disease, diabetes mellitus, asthma and lung disease, among older adults in different states of India.

Shifting landscapes of global child mental health: Imperatives for transdisciplinary approaches.

There are a multitude of stakeholders involved in the protection, education, mental health and psychosocial care of children for children in LMIC countries. The article presents how the current medical and public health models for child mental healthcare, do not adequately address the complexities of child protection and mental health. It argues for mental health professionals to: (a) recognise the role of Adverse Childhood Experiences (ACEs) in mental health morbidity; (b) adopt an alternative approach, namely that of transdisciplinarity, to enable more effective solutions to children's psychosocial and mental health issues, through systemic reform and transformation.

The Sports Participation Trend among Malaysians by Gender, Ethnic and Age Group

The national Health Morbidity survey by the Malaysian Health Ministry since 2006 showed the percentage of physically inactive Malaysians is still high. Sedentary lifestyles among Malaysians can contribute to an increase in the prevalence of obesity and have been identified as a key risk factor for cardiovascular diseases. The aim of this survey is to identify the trend of participation in physical activity by gender, ethnic and age group from the year 2018 until 2020. The current choice of activities among Malaysians is also considered in this study. The proportionate random stratified sampling method employed to select the Malaysian population aged 13 years and above with an inclusion criteria “participated at least once a month with minimum duration of 60 minutes in any kind of sports, physical exercise and recreational activities”. The Malaysian Sports Culture Index (MSCI’2018), an instrument which was designed by Institute for Youth Research Malaysia (IYRES), used to collect the data. Descriptive analysis showed there were significant differences among gender for all the three years. Male populations’ activeness higher than females. The ethnic factor also influences the participation in physical activities especially during Movement Control Order due to pandemic COVID-19. Participation by age group also showed significant differences from 2018 to 2020. The One way ANOVA test showed significant differences between age group and ethnic for all the three years with p=0.000. Further analysis on choice of activities revealed that activities such as Badminton, Futsal, Jogging, Walking, Cycling and Hiking have become the preference of the Malaysian Population since the year 2018 until now. As a conclusion, physically active and the prevention measures of sedentary lifestyle are major pillars in reducing the risk of morbidity and mortality among our nations. Creating awareness and making sports a culture in daily life will be a better solution for the current health phenomenon.

Resilience and Family Socialization Processes in Ethnic Minority Youth: Illuminating the Achievement-Health Paradox.

Youth in marginalized communities who “strive” to rise above adversity, including systemic racism and poverty, are considered “resilient.” African-American, Latinx, and Asian-American youth often achieve admirable academic success despite limited social capital and high early life stress by adopting a “striving persistent behavioral style” (SPBS). SPBS may be supported by family socialization processes that facilitate reliance on self-regulation processes. Unfortunately, a young person’s resilience in one domain (i.e., academic) can come at a cost in other domains, including physical and mental health morbidities that are under-identified and under-treated. Indeed, research suggests a link between SPBS in the face of adversity and later health morbidities among ethnic minority youth. Herein, we describe SPBS as an adaptation to minority stress that not only promotes social mobility but may also stoke physical and mental health disparities. We review how family processes related to academic, emotional, and ethnic-racial socialization can facilitate the striving persistent behavioral style. We emphasize the double bind that ethnic minority families are caught in and discuss directions for future research and clinical implications for individual and family-level interventions. While needed, we argue that individual and family-level interventions represent a near-term work around. Solutions and factors that shape the need for SPBS and its cost must be addressed structurally.

Facilitators for use of oral healthcare services among people with substance use disorders: a qualitative study in Norway

Objective Opioid maintenance treatment (OMT) patients in Norway are eligible for free oral healthcare services; however, oral health morbidity remains high and the uptake of services among this patient group is low. As knowledge of the reasons for the low uptake of services among OMT patients is insufficient, this study adopted a qualitative approach to explore this from the perspectives of patients and dental healthcare workers (DHWs). Material and methods Through focus group and individual interviews, data were collected from 63 participants: 30 patients receiving OMT and 33 DHWs. Key themes were identified through a thematic analysis. Results Teeth were a significant factor in OMT patients’ quality of life and recovery. Accompaniment to scheduled dentist appointments was identified as a facilitator by both the patients and the DHWs. The dentist-patient relationship was also seen as an important facilitator of dental treatment; DHWs with previous experience of treating OMT patients were valued by patients because of their high verbal and non-verbal communication. Conclusions Helping OMT patients attend dental appointments, improving the dentist-patient relationship, and expanding stakeholders’ knowledge of OMT patients’ right to oral healthcare services may increase the uptake and benefits of dental healthcare services among OMT patients. The current support framework within the OMT system has the potential to increase the communication and efficiency of dental healthcare services available to patients undergoing OMT.

Pharmacological Management of Heroin Withdrawal Syndrome: A Century of Expert Opinions in Cecil Textbook of Medicine.

Opioid use disorder continues to have a significant impact on public health morbidity and mortality throughout the United States and elsewhere. Managing opioid withdrawal is a critical treatment goal in individuals entering treatment with an active opioid use. What are the milestones of the changes in the expert approach to the pharmacological management of heroin withdrawal syndrome in the past century? To determine the changes in the expert approach to the management of heroin withdrawal syndrome, as presented in a widely used textbook in the United States. The chapters on opioid dependence in the 26 editions of Cecil Textbook of Medicine published from 1927 through 2020. Opioid replacement taper with morphine (1927-1947), codeine (1931-1943), and methadone (1951-present) administered for 3-10 days has remained the main intervention. The anticholinergic drugs, scopolamine and atropine, were recommended from 1927 to 1943, but their use has never been backed by scientific evidence. Newer approaches relied on clonidine, an alpha-2 receptor agonist used since 1982, and buprenorphine, an opioid agonist/antagonist endorsed for the treatment of heroin withdrawal in 2000. The pharmacological management of heroin withdrawal syndrome in the past century has progressed from the introduction of methadone to the utilization of clonidine and buprenorphine. More recent advances in treating opioid use disorder have changed the goals of opioid withdrawal management to achievement of abstinence from all opioids to facilitation of long-term treatment with medications for opioid use disorder.

Experience of Intimate Partner Violence and Associated Psychiatric, Neurobehavioral, and Functional Burden in Male and Female Veterans: Implications for Treatment

ABSTRACT Intimate partner violence (IPV) is prevalent among Veterans. Injuries to head, neck, and face are frequent and elevate risk for traumatic brain injury (TBI). IPV also increases risk for mental health morbidity. A better understanding of IPV’s impact on health and functioning is needed among Veterans to inform assessment and intervention. This study identified lifetime IPV in post-9/11 Veterans and examined the associations between lifetime IPV and health and functioning. A sample of 813 post-9/11 Veterans completed a comprehensive assessment of psychiatric, neurobehavioral and functional outcomes. Thirty-eight percent of female and 22% of male Veterans experienced IPV during their lifetime. Veterans with IPV experience had higher prevalence of TBI, pain, and psychiatric conditions (posttraumatic stress disorder [PTSD], mood, anxiety, substance use). Lifetime IPV experience, PTSD, mood disorder, and pain were significantly associated with functional disability in men and women (β’s = .12–.44; ps < .05); the effect was larger for women. Given the clinical complexity of Veterans with a history of IPV, we propose the need for novel, transdiagnostic treatments. The STEP-Home workshop is a skills-based intervention with preliminary effectiveness in treating combat-related TBI and commonly co-occurring psychiatric disorders in post-9/11 Veterans that could expand evidence-based treatments for IPV.

Epidemiology of Hospital Admissions for Craniosynostosis in Australia: A Population-Based Study.

To describe trends, age, and sex-specific patterns of population hospital admissions with a diagnosis of craniosynostosis (CS) in Australia. Population data for hospital separations (in-patient) from public and private hospitals (July 1996-June 2018) were obtained from the publicly available Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database. The outcome variables were hospital separation rates (HSR) (number of hospital separations divided by the estimated resident population [ERP] per year) and average length of stay (aLOS) (patient days divided by the number of hospital separations) with a diagnosis of CS. Trends in HSR and aLOS adjusted for age, sex, and type of CS were investigated by negative binomial regression presented as annual percent change (APC). In 8057 admissions identified, we observed no significant change in the annual trend for HSR for the 22-year period. However, a marginal annual decrease of 1.6% (95% CI: -0.7, -2.4) in the aLOS was identified for the same time period. HSR were higher for males, infants, and single suture synostosis. aLOS was 3.8 days (95% CI: 3.8, 3.9) per visit, longer for syndromic conditions. There was a minor reduction in the average length of hospital stay for CS over the 22-year period potentially indicative of improved care. Population-level information on hospitalisations for rare craniofacial conditions can inform research, clinical, and surgical practice.

Measures of Personality Pathology, Levels of Functioning, and Physical Health in an Urban Primary Care Sample.

Integrative approaches in the primary care setting have grown in favor over the past few decades, with many interesting findings about the influence of personality disorders on physical health and functioning; however, less is known about how specific pathological personality traits impact patient-provider assessments of physical and mental health. Using the DSM-5 Levels of Personality Functioning Questionnaire-Short Form (DLOPFQ-SF) and Personality Inventory for DSM-5-Brief Form, these relationships were evaluated in a sample of 50 inner-city, low-income patients in a primary care clinic. Point-biserial correlations revealed significant correlations between physical and mental health morbidities, as well as personality pathology and patient response to treatment. Our findings lend further support to describing the relationships between personality pathology, medical comorbidities, and patient response to treatment.

Duration of untreated psychosis and pathways to care in Suriname: a qualitative study among patients, relatives and general practitioners

PurposePsychosis is a severe mental health problem and is responsible for poor health outcomes, premature mortality and morbidity, especially in low- and middle-income countries. The duration of untreated psychosis (DUP),...

Intracranial aneurysms: The era of endovascular intervention in Australia

Intracranial aneurysms (ICAs) can be treated by surgical or endovascular techniques. Endovascular procedures have become common in many specialties, including neurosurgery. In this paper we aim to examine the overall numbers and trends in treatment of IA in Australia. This study was a ten-year retrospective analysis of the Medicare Benefits Schedule (MBS) and Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity databases. These databases were searched for codes corresponding to clipping of ICAs and endovascular coiling of ICAs from the financial years 2008–2009 to 2018–2019.The total number of procedures increased from 2.25 to 3.37 per 100,000 from 2008 to 2009 to 2018–2019 financial years in the MBS database and 7.90 to 10.35 per 100,000 people in the AIHW database for the same financial years. The rate of change of MBS was 0.12 (0.08– 0.16, p < 0.0001) and for AIHW 0.23 (0.19– 0.28, p < 0.0001).Endovascular coiling reached parity with surgical clipping in the 2010–2011 financial year. Women were over twice as likely as men to be treated. The frequency of treatment per 100,000 people peaked in the 55–64 year-old age group. Tasmania performed the most number of treatments per capita compared to other Australian states and territories, according to the MBS database. These figures from Australian databases are in line with other countries from studies around the world that examine preferences of intervention and demographics.

Prevalent Multimorbidity Combinations Among Middle-Aged and Older Adults Seen in Community Health Centers.

Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs). To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period. A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic characteristics of patient panels by prevalent patterns. The study included data from 838,642 patients aged ≥ 45years who were seen in 337 CHCs across 22 states between 2014 and 2019. Prevalent multimorbidity patterns of somatic, mental health, and mental-somatic combinations of 22 chronic diseases based on the U.S. Department of Health and Human Services Multiple Chronic Conditions framework: anxiety, arthritis, asthma, autism, cancer, cardiac arrhythmia, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), congestive heart failure, coronary artery disease, dementia, depression, diabetes, hepatitis, human immunodeficiency virus (HIV), hyperlipidemia, hypertension, osteoporosis, post-traumatic stress disorder (PTSD), schizophrenia, substance use disorder, and stroke. Multimorbidity is common among middle-aged and older patients seen in CHCs: 40% have somatic, 6% have mental health, and 24% have mental-somatic multimorbidity patterns. The most frequently occurring pattern across all years is hyperlipidemia-hypertension. The three most frequent patterns are various iterations of hyperlipidemia, hypertension, and diabetes and are consistent in rank of occurrence across all years. CKD-hyperlipidemia-hypertension and anxiety-depression are both more frequent in later study years. CHCs are increasingly seeing more complex multimorbidity patterns over time; these most often involve mental health morbidity and advanced cardiometabolic-renal morbidity.

Patterns of Suicide Ideation Across Eight Countries in Four Continents During the COVID-19 Pandemic Era: Repeated Cross-sectional Study.

BackgroundThe COVID-19 pandemic and countries’ response measures have had a globally significant mental health impact. This mental health burden has also been fueled by an infodemic: an information overload that includes misinformation and disinformation. Suicide, the worst mental health outcome, is a serious public health problem that can be prevented with timely, evidence-based, and often low-cost interventions. Suicide ideation, one important risk factor for suicide, is thus important to measure and monitor, as are the factors that may impact on it.ObjectiveThis investigation had 2 primary aims: (1) to estimate and compare country-specific prevalence of suicide ideation at 2 different time points, overall and by gender and age groups, and (2) to investigate the influence of sociodemographic and infodemic variables on suicide ideation.MethodsA repeated, online, 8-country (Canada, the United States, England, Switzerland, Belgium, Hong Kong, Philippines, and New Zealand), cross-sectional study was undertaken with adults aged ≥18 years, with measurement wave 1 conducted from May 29, 2020 to June 12, 2020 and measurement wave 2 conducted November 6-18, 2021. Self-reported suicide ideation was derived from item 9 of the Patient Health Questionnaire-9 (PHQ-9). Age-standardized suicide ideation rates were reported, a binomial regression model was used to estimate suicide ideation indication rates for each country and measurement wave, and logistic regression models were then employed to relate sociodemographic, pandemic, and infodemic variables to suicide ideation.ResultsThe final sample totaled 17,833 adults: 8806 (49.4%) from measurement wave 1 and 9027 (50.6%) from wave 2. Overall, 24.2% (2131/8806) and 27.5% (2486/9027) of participants reported suicide ideation at measurement waves 1 and 2, respectively, a difference that was significant (P<.001). Considerable variability was observed in suicide ideation age-standardized rates between countries, ranging from 15.6% in Belgium (wave 1) to 42.9% in Hong Kong (wave 2). Frequent social media usage was associated with increased suicide ideation at wave 2 (adjusted odds ratio [AOR] 1.47, 95% CI 1.25-1.72; P<.001) but not wave 1 (AOR 1.11, 95% CI 0.96-1.23; P=.16). However, having a weaker sense of coherence (SOC; AOR 3.80, 95% CI 3.18-4.55 at wave 1 and AOR 4.39, 95% CI 3.66-5.27 at wave 2; both P<.001) had the largest overall effect size.ConclusionsSuicide ideation is prevalent and significantly increasing over time in this COVID-19 pandemic era, with considerable variability between countries. Younger adults and those residing in Hong Kong carried disproportionately higher rates. Social media appears to have an increasingly detrimental association with suicide ideation, although having a stronger SOC had a larger protective effect. Policies and promotion of SOC, together with disseminating health information that explicitly tackles the infodemic’s misinformation and disinformation, may importantly reduce the rising mental health morbidity and mortality triggered by this pandemic.

A Smartphone App to Improve Oral Anticoagulation Adherence in Patients With Atrial Fibrillation: Prospective Observational Study.

BackgroundPoor adherence to oral anticoagulation in elderly patients with atrial fibrillation (AF) has been shown to negatively impact health care costs, morbidity, and mortality. Although various methods such as automated reminders, counseling, telephone support, and patient education have been effective in improving medication adherence, the burden on health care providers has been considerable. Recently, an attempt has been made to improve medication adherence without burdening health care providers by using smartphone apps; however, the use of the app for elderly patients with AF is still limited.ObjectiveThe purpose of this study was to determine whether the newly developed smartphone app for patients with AF (the Smart AF), which integrates education, automatic reminder, and patient engagement strategies with a simple user interface, can improve medication adherence in elderly patients with AF.MethodsPatient enrollment was carried out by obtaining informed consent from patients with AF attending Kyoto Prefectural University of Medicine hospital between May 2019 and September 2020. Follow-up was planned at 1, 3, and 6 months after enrollment, and questionnaire reminders were automatically sent to patient apps at designated follow-up time points. A questionnaire-based survey of medication adherence was performed electronically using the self-reported 8-item Morisky Medication Adherence Scale (MMAS-8) as the survey tool.ResultsA total of 136 patients with AF were enrolled in this study. During the follow-up period, 112 (82%) patients underwent follow-up at 1 month, 107 (79%) at 3 months, and 96 (71%) at 6 months. The mean age of the enrolled patients was 64.3 years (SD 9.6), and male participants accounted for 79.4% (108/136) of the study population. The mean CHADS2 (congestive heart failure, hypertension, age, diabetes, previous stroke, or transient ischemic attack) score was 1.2, with hypertension being the most common comorbidity. At the time of enrollment, 126 (93%) and 10 (7%) patients were taking direct oral anticoagulants and warfarin, respectively. For medication adherence as measured according to the MMAS-8, MMAS scores at 1 month, 3 months, and 6 months were significantly improved compared with baseline MMAS scores (all P values less than .01). The overall improvement in medication adherence achieved by the 6-month intervention was as follows: 77.8% (14/18) of the patients in the high adherence group (score=8) at baseline remained in the same state, 45.3% (24/53) of the patients in the medium adherence group (score=6 to <8) at baseline moved to the high adherence group, and 72% (18/25) of the patients in the low adherence group (score <6) moved to either the medium or high adherence group.ConclusionsThe Smart AF app improved medication adherence among elderly patients with AF. In the realm of medication management, an approach using a mobile health technology that emphasizes education, automatic reminder, and patient engagement may be helpful.

Effectiveness of feeding supplementation in preterm infants: an overview of systematic reviews

BackgroundPreterm infants have higher nutrition needs than term infants. The effectiveness of various feeding supplementation was assessed by the improvement of health outcomes in single specific systematic reviews (SRs). The aim of this review was to comprehensively describe the effectiveness of feeding supplementation in promoting health outcomes of preterm infants.MethodsA literature search was conducted in the PUBMED, EMBASE, Science Direct, Cochrane library, Web of Science, and Wiley online library. SRs selection followed clear inclusion and exclusion criteria. Pairs of reviewers independently applied the criteria to both titles/abstracts and full texts. Screening and data extraction were performed by using the advanced tables. The methodological quality of SRs and the quality of the evidence were carried out according to the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool and the Grades of Recommendation, Assessment, Development, and Evaluation guidelines (GRADE) respectively. A qualitative synthesis of evidence is presented.ResultsSeventeen SRs were included in the review. Fifteen kinds of feeding supplementation were reported in the SRs. In preterm infants, the effectiveness of feeding supplementation in addition to regular breast-feeding was mainly shown in six aspects: physical health, neurodevelopment, biochemical outcomes, other health outcomes, morbidity and all-cause mortality. And the effectiveness of the interventions on health outcomes in preterm infants was found by most systematic reviews. The methodological quality of all the included SRs was high, and most of the evidences was of low or very low quality.ConclusionsOur results will allow a better understanding of the feeding supplementation in preterm infants. Although the feeling supplements may improve the health outcomes of in preterm infants, the existing evidence is uncertain. Therefore, the clinical use of these supplements should be considered cautiously and more well-designed RCTs are still needed to further address the unsolved problems of the included SRs.

ПОКАЗАТЕЛИ ТРАВМАТИЗМА ВОЕННОСЛУЖАЩИХ ПО ПРИЗЫВУ ВООРУЖЕННЫХ СИЛ РЕСПУБЛИКИ БЕЛАРУСЬ (2003-2019 гг.)

Research objective. Calculate the injury rates among conscripts during 2003-2019 years using an integral assessment to improve medical support and ensure the security of military service. Materials and methods. We studied annual medical reports about health status and morbidity of conscripts in the Armed Forces of the Republic of Belarus (form №3/med) for 2003-2019. Results. Average annual injury rate among conscripts in 2003-2019 was 20.64±2.03%, proportion in the structure of primary morbidity for all chapters of ICD-10 was 1.3±0.1%, hospitalizations - 14.74±0.98% and 1.6±0.2%, days away from work - 325.2±17.3% and 3.9±0.3%, dismission rates - 0.56±0.05% and 3.5±0.3%, mortality - 25.20±4,42per 100 000 conscripts and 75.1±5.7%, respectively. With different in significance coefficients of determination polynomial trends of the listed medical and statistical indicators demonstrate a data decrease. In the structure of the constructed integral assessment 83.8% accounted for the sum of the proportions of injuries of the shoulder girdle and upper limbs (group 8-10), pelvis and lower limbs (group 5-7), head injuries (group 1), injuries affecting several areas of the body (group 11), consequences of trauma, poisoning and other influences of external causes (group 22). Conclusion. Analysis of the data on injuries of conscripts using an integral assessment will improve medical support in order to maintain health, conduct targeted and high-quality prevention of injuries while ensuring the safety of military service.

Effect of physical health, dietary behaviour and personal hygiene on body mass index of school-going adolescents near Patna, Bihar: A cross-sectional study.

Body mass index (BMI) is the most frequently used method to determine the nutritional status in adolescents. School-going population in developing countries like India are susceptible to undernutrition due to several socioeconomic, demographic, and nutritional factors. Poor dietary habits, sedentary lifestyles and improper hygiene can have a deleterious effect on their BMI. The aim of the study was to determine any association of BMI with physical health, nutrition, and personal hygiene among the school-going adolescents near Patna, Bihar. Analytical cross-sectional study was conducted among 160 school-going adolescents, chosen by stratified random sampling. They were given Indian Adolescent Health Questionnaire which had close-ended questions about physical activity, nutritional, and hygienic practices. BMI was calculated from self-reported height and weight. Pearson's correlation, independent t test, ANOVA, and Chi-Square test of proportions were done. Significance level was set at P < 0.05. Only 39.4% adolescents had normal BMI, and almost half were underweight. Pearson's correlation of BMI with age showed a weak positive correlation (r = 0.124, P = 0.118). Participants perceiving themselves overweight, did physical exercise to lose weight (P < 0.001), whereas who stated that they rarely consumed cooked vegetables, had the self-perception of being underweight (P = 0.009). This self-perception of their weight, physical activity, handwashing after using toilet/latrine and weekly frequency of brushing teeth significantly predicted the BMI in these adolescents (F = 10.895, df (4,155), P < 0.001, R2 = 21.9%, Adj. R2 = 19.9%). Malnutrition can lead to infection, impaired reproductive health, anaemia and other long-term morbidities into adulthood. Hence there is need of more objective nutritional assessment in adolescence for prevention of disease burden in the community.

Prevalence and Socio-Demographic Determinants of Unintended Pregnancy among Women Attending Antenatal Clinic in Thyolo District, Malawi

Background: Unintended pregnancies remain a public health problem. Unintended pregnancies continue to be a leading predisposing factor to the high total fertility rate, high maternal and child health morbidity and mortality. Unintended pregnancies lead to unsafe abortion and poor health-seeking behavior, especially among young and poor women. Knowledge of associated factors can help to design and implement appropriate interventions. Objectives: This study aimed to determine the prevalence and socio-demographic factors associated with unintended pregnancy among women attending antenatal clinic (ANC) at Thyolo District Hospital in Malawi. Methodology: It was a quantitative cross-sectional study. Data was collected through face-to-face interviews with 396 women using a questionnaire. Systematic random sampling was used to recruit study participants. STATA version 13 package was used for univariate descriptive statistics, and logistic regression for bivariate and multivariate data analysis. Results: Slightly over half (54%) of women attending the antenatal clinic at Thyolo District Hospital had an unintended pregnancy. Unintended pregnancy was more likely to be reported among women of less than 20 years, education below secondary school level, marriage before 20 years, and polygamous relationships. In addition, families relying on farming alone other than employment or business were more likely to have an unintended pregnancy. Primgravidity and having no living child were also significantly associated with unintended pregnancy. Conclusion: Prevalence of unintended pregnancy is a health burden in Thyolo. Strategies to keep the girl child in school and delay marriage could address this challenge. Increasing access to effective contraceptive methods for the youth could mitigate the problem.

Implication of COVID-19 in patients of HIV with hepatitis C

HIV with coexisting Hepatitis C infection has been a global health problem. HIV with Hepatitis C prevalence is significantly higher in people living with HIV. These patients being immunocompromised are at higher risk of contracting COVID-19 infection. Super added COVID-19 infection may prove to be fatal in these patients. We decided to review literature for assessing the clinical manifestations and management of these patients contracting COVID-19 infection and explore the public health measures in practice in the current scenario. Practices of safety norms against COVID-19 shall prevent associated health morbidity and mortality. Moreover, management of these patients needs to be judiciously done by Physicians as COVID-19 infection may worsen their condition. The Public Health Specialist are playing a crucial role in management of COVID-19 pandemic especially by strategy planning for surveillance, health education and preparedness for any future wave of COVID-19 infection.