Hospital Health Center Research Articles

Malaria prevalence and patients’ knowledge, attitude, and preventive practices toward the disease in the Jawi District, Awi Zone, Northwest Ethiopia

BackgroundMalaria is the most important parasitic illness causing morbidity and mortality with high prevalence in tropical regions.ObjectiveThis study was aimed at evaluating the 7-year malaria trend and community awareness at Jawi Health Center and primary Hospital in Northwest Ethiopia.MethodsA retrospective and cross-sectional or prospective design were used for the study. The data was analyzed using SPSS version 22 software. The findings were considered significant at P < 0.05.ResultsAmong 62,624 blood films between 2015 and 2021 at Jawi Health Center, 40.9% were positive. Plasmodium falciparum accounted for 85.8%. Women had more mixed infections (P. falciparum and P. vivax) (X2 = 8.9, df = 2, P = 0.011) than men. A greater proportion (20.6%) of malaria cases was observed within the under 5 years age group and the number of malaria cases was higher in September, October, and June. The overall prevalence of malaria was found to be 25.2% and June had the highest proportion (75.6%). In total, 335 (80.9%) respondents recognized mosquito bites as the cause and fever (50%) as a clinical symptom of malaria. More than half of the respondents (60.1%) never sleep under mosquito nets.ConclusionThus, these findings have substantial implications for the trend of malaria prevalence and patient awareness of the disease which support the existing malaria control efforts.

Relationship between anxiety and poor sleep quality in family caregivers of psychiatric patients based on history of sharp object injuries: a case-control study in Bitlis, Turkey

ObjectivesThis study aims to investigate the relationship between anxiety levels and poor sleep quality among family caregivers of psychiatric patients, based on the history of sharp object injuries (SOI) inflicted...

Drug resistance of tuberculosis patients at the makassar city community lung health center hospital: Case Study

Introduction: Drug-resistant tuberculosis (TB-RO) is still a health problem because of its rapid transmission with an increasing number of cases. Objective: This study aims to discover in-depth patient knowledge about tuberculosis and the family's role in treating drug-resistant tuberculosis patients. Methods: This research uses a qualitative case study approach with nine informants. The selection of informants was determined using a purposive sampling technique. Data collection was obtained through interviews and observations. Data analysis was carried out qualitatively. Result: The research shows that informants' knowledge about drug-resistant tuberculosis depends on their educational history. In contrast, informants with low educational backgrounds only know the term tuberculosis but do not know the causes and dangers of drug-resistant tuberculosis. Another thing that was found was that the family also played a role in the patient's treatment by providing support and encouragement for the informant during the treatment period. Conclusion: This research concludes that the informant's knowledge about tuberculosis plays an essential role in the occurrence of drug-resistant tuberculosis. The role of the family does not contribute to the occurrence of drug-resistant tuberculosis in the informant. It can be concluded that the earlier the age of menarche increases the risk of uterine myoma later in life. In contrast, slower menarche may be associated with a reduced risk of myomas. Other factors such as genetic, environmental, and lifestyle factors also influence the incidence of uterine myomas, but menarche age is one of the significant hormonal indicators of risk.

Prevalence of postpartum depression and its association with diabetes mellitus among mothers in public health facilities in Mbarara, Southwestern Uganda

ABSTRACT Postpartum Depression (PPD) is a major health challenge with potentially devastating maternal and physical health outcomes. Development of diabetes mellitus has been hypothesized as one of the potential adverse effects of PPD among mothers in the postpartum period, but this association has not been adequately studied especially in low resource settings. This study aimed at determining prevalence of postpartum depression and its association with diabetes mellitus among mothers in Mbarara District, southwestern Uganda. We conducted a facility based cross-sectional study of 309 mothers between 6th week to 6th month after childbirth. Using proportionate stratified consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health center IV. PPD was diagnosed using the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diabetes mellitus was diagnosed by measuring Hemoglobin A1c (HbA1c). Logistic regression was used to determine the association of PPD and diabetes mellitus among mothers. The study established that PPD prevalence of PPD among mothers of 6th weeks to 6th months postpartum period in Mbarara was 40.5% (95% CI: 35.1–45.1%) and it was statistically significantly associated with diabetes mellitus in mothers between 6 weeks and 6 months postpartum. The prevalence of diabetes mellitus among mothers with PPD was 28% compared to 13.6% among mothers without PPD. Mothers with PPD had 3 times higher odds of being newly diagnosed with diabetes as compared to those without PPD (aOR = 3.0, 95% CI: 1.62–5.74, p = 0.001). Mothers with PPD between 6 weeks and 6 months postpartum are more likely to have diabetes mellitus as compared to those without PPD. Well-designed prospective analytical studies are needed to conclude on the risk of diabetes mellitus in relation to PPD. Early screening of PPD may be considered in postpartum mothers.

Assessment of patient knowledge and perceptions towards orthodontic treatment in the Aljouf Region, Saudi Arabia: a cross-sectional study.

In orthodontic treatment, it is most important to assess the patient's perspective of malocclusion because these perceptions are fundamental to determining the patient's demands and level of treatment satisfaction. This study was done to assess the knowledge and perception of residents of the Aljouf Region of Saudi Arabia seeking orthodontic treatment. Furthermore, we determined the factors associated with the patients' knowledge and perception of orthodontic treatment. This cross-sectional study was conducted using a pre-tested and validated questionnaire among patients seeking orthodontic treatment who were registered at King Abdulaziz Hospital, Sakaka, and primary health centers. We identified the associated factors using binomial logistic regression analysis. Finally, we applied Spearman's correlation test to identify the correlation between knowledge and perception. A total of 282 individuals participated in the current study, of which 53.3% were female and 46.1% were male. About one-third (36.9%) of patients had a low level of knowledge, 35.5% had a medium level of knowledge, and 27.7% had a high level of knowledge regarding orthodontic treatment. A total of 20.6% had low perceptions, 42.9% had medium perceptions, and 36.5% had high perceptions of orthodontic care. A significant correlation was found between age and gender, knowledge (p = 0.001), and perception (p = 0.040). Moreover, we observed a positive correlation between knowledge and perception (Spearman's rho = 0.297, p = 0.001). People in Aljouf have poor knowledge and medium perception regarding orthodontic treatment. We recommend that the concerned authorities make a health educational plan for the patients seeking orthodontic treatment.

Factors influencing antenatal care attendance in the eight contact era policy: a case of selected maternal health service facilities in Blantyre, Malawi

BackgroundMaternal mortality in sub-Saharan Africa and Malawi remains high. Effective antenatal care (ANC) services can reduce maternal morbidity and mortality. However, attendance to ANC clinics and the quality of services provided remain a challenge. Malawi adopted the 2016 WHO antenatal care model and there is a need to assess factors that influence antenatal care attendance. The main objective of this study was to assess factors influencing attendance in the era of the eight ANC contact policy in Blantyre.MethodsThis was an exploratory qualitative design in which 28 respondents participated using in-depth interviews and focus group discussions for the data collection process. The study sites included two healthcare facilities, namely Queen Elizabeth Central Hospital and Bangwe Health Centre, and a rural community (William Village Bangwe Rural) in Blantyre district. The 28 study participants included 11 ANC attendees, which comprised seven women in their final trimester and four postpartum women who attended ANC during their pregnancy, five midwives running the ANC clinics, and 12 non-users of ANC. The recordings were transcribed verbatim. The data were organized using Microsoft Excel and Microsoft word and analyzed using inductive content analysis.ResultsThe factors promoting ANC attendance in the context of the eight ANC contact policy include; motivation from health workers, family, and spouses and the women’s perceptions of ANC particularly the role it plays in preventing, detecting, and treating illness, but also preventing adverse pregnancy outcomes. On the other hand, the hindering factors to ANC attendance included lack of knowledge of the new ANC visit guidelines, financial constraints, quality of health services provided, attitude of healthcare workers, inadequate availability and training of healthcare workers, perceived poor quality of ANC services and personal beliefs.ConclusionIt is essential to provide comprehensive training to healthcare workers in the antenatal department regarding the new WHO ANC recommendations. This will help improve the quality of services at the antenatal clinics, including ensuring the availability of all necessary resources to encourage attendance. Additionally, promoting comprehensive spousal support, encouraging participation in activities, and adequately planning scheduled visits can help overcome financial barriers and further support antenatal attendance.

Associated Factors of Low Birth Weight among Newborns at Hospitals in Kisangani, Democratic Republic of Congo

Background: Low birth weight remains a major public health problem in every country in the world. It is a predictor of early neonatal mortality, morbidity and long-term health. The aim of this study was to determine the prevalence of low birth weight and to identify the associated factors in a hospital setting in Kisangani. Material and Methods: An unmatched case-control study was used including all live and full-term births was conducted from 1 December 2023 to 31 May 2024 in the maternity wards of Makiso-Kisangani General Referral Hospital, Mangobo General Referral Hospital, Tshopo General Referral Hospital and Alwaleed Health Centre. A sample of 646 newborns was selected: 86 cases (newborns weighing less than 2500 grams) and 560 controls (newborns weighing 2500 grams or more). Factors associated with prehypertension were identified using logistic regression. Results: The prevalence of low birth weight was 13.4%. Factors associated with low birth weight were maternal age less than 18 years, intergenital interval less than 2 years, maternal infection during pregnancy, high blood pressure, level of primary education and urban residential environment. Conclusion: This study shows that low birth weight remains a public health problem in Kisangani. In addition to shedding light on the other contributing variables and the connections between them, prospective national research would enable the development of preventative measures.

Modern Family Planning Utilization and Associated Factors among Hiv Women of Reproductive Age Attending at Care and Treatment Clinics (CTC) in Mwanza City,tanzania

Background: In Sub-Saharan Africa HIV/AIDS prevalence remains high and makes it the world’s most severely affected region. The use of family planning helps to prevent unplanned pregnancies among HIV positive women of reproductive age. There is a dearth of evidence on the preferred methods, reasons for use and non-use and discontinuation of the use of family planning among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City. Therefore this study was conducted to determine family planning uptake, methods preferred and the reasons for discontinuation of the use of family planning among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City. Objective: To determine family planning uptake, methods preferred and reasons for discontinuation among HIV positive women of reproductive age appearing at HIV Care and Treatment Clinics (CTCs) in Mwanza City. Methodology: This is a hospital based cross-sectional study involving 440 HIV positive reproductive age women (18 – 49 years) who were attending Bugando Medical Centre, Sekou Toure Regional Referral Hospital and Buzuruga Health Centre HIV Care and Treatment Clinics was carried out. A structured pre tested questionnaire was used to collect data on socio-demographic characteristics, information on current family planning use, health service related factors, family factors, disclosure and ART status, and factors associated with modern family planning use. Data analysis was done using STATA version 13 according to objectives. Results: A total of 440 participants were enrolled in the study and their median age was 36 [IQR 30 – 42] years. Majority, 246(56.2%) of the participants were aged 35 to 49 years. Majority 279 (63.4%) of women attained primary education. Factor associated with family planning discontinuation were not been counseled on FP(AOR 5.5; 95% CI 2.0 – 15.1; p-value 0.001), Partner has desire of children AOR 0.3; 95% CI 0.1 – 0.8;p-value=0.029), Advanced stage of HIV(AOR13.4; 95% CI 5.1 – 35.0; p-value<0.001 ), Divorced women(AOR 3.2; 95% CI 1.1 – 9.7; p-value=0.038) and women’s age ≥35 years(AOR 6.8; 95% CI 2.2-20.9 p-value=0.001). Conclusion: The overall uptake of modern family planning methods was low. Integration of modern family planning services within the CTCs was low too in all the facilities. Furthermore, the proportions of HIV positive women using dual family planning methods were very low. Factor associated with family planning discontinuation were not been counseled on FP, Partner has desire of children, Advanced stage of HIV, Divorced women and women’s age ≥35 years.

Assessing knowledge, awareness, and attitudes between rural and urban communities in Indonesia regarding cleft lip and palate care

Background: Insufficient understanding and consciousness regarding cleft lip and palate (CLP) deformity could increase unfavorable perceptions and perspectives. This study aims to determine the differences between urban and rural communities regarding knowledge, awareness, and attitudes regarding CLP care. Methods: This research was a cross-sectional descriptive study with the aid of an administered questionnaire conducted among 69 participants as patient's parent attending Universitas Airlangga Dental Hospital, urban Communities, and community health center Nusa Tenggara, rural communities; it was carried out in the 2022-2023 period in social service activities. Data were analyzed using SPSS version 24.0 for Windows. Results: The data were analyzed using the Chi-Square statistical test to measure whether there were significant differences among knowledge, awareness, and attitudes variables. There were statistically significant differences between rural and urban communities for knowledge (p=0.012), awareness (p=0.000), and attitudes (p=0.012). Conclusion: There was a significant differences in the level of knowledge, awareness, and attitude between rural and urban communities in Indonesia.

Incremental Value of Radiomics Features of Epicardial Adipose Tissue for Detecting the Severity of COVID-19 Infection.

Epicardial adipose tissue (EAT) is known for its pro-inflammatory properties and association with Coronavirus Disease 2019 (COVID-19) severity. However, existing detection methods for COVID-19 severity assessment often lack consideration of organs and tissues other than the lungs, which limits the accuracy and reliability of these predictive models. The retrospective study included data from 515 COVID-19 patients (Cohort 1, n=415; Cohort 2, n=100) from two centers (Shanghai Public Health Center and Brazil Niteroi Hospital) between January 2020 and July 2020. Firstly, a three-stage EAT segmentation method was proposed by combining object detection and segmentation networks. Lung and EAT radiomics features were then extracted, and feature selection was performed. Finally, a hybrid model, based on seven machine learning models, was built for detecting COVID-19 severity. The hybrid model's performance and uncertainty were evaluated in both internal and external validation cohorts. For EAT extraction, the Dice similarity coefficients (DSC) of the two centers were 0.972 (±0.011) and 0.968 (±0.005), respectively. For severity detection, the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) of the hybrid model increased by 0.09 (p<0.001), 19.3 % (p<0.05), and 18.0 % (p<0.05) in the internal validation cohort, and by 0.06 (p<0.001), 18.0 % (p<0.05) and 18.0 % (p<0.05) in the external validation cohort, respectively. Uncertainty and radiomics features analysis confirmed the interpretability of increased certainty in case prediction after inclusion of EAT features. This study proposed a novel three-stage EAT extraction method. We demonstrated that adding EAT radiomics features to a COVID-19 severity detection model results in increased accuracy and reduced uncertainty. The value of these features was also confirmed through feature importance ranking and visualization.

Acupuncture and Escitalopram for Treating Major Depression Clinical Study (AE-TMDCS): protocol for a factorial randomised controlled trial

IntroductionMajor depressive disorder (MDD), the second leading cause of disability globally, is considered to be associated with a consequent deterioration in the quality of life and can lead to a...

Environmental Impact of Heavy Metals on Health in Soils Polluted with Medical Waste in Baiji City

Due to the environmental concerns of improper medical waste management inside and outside hospitals and health institutions, this issue is one of the most important environmental studies topics. Four places in Baiji City in Iraq were selected as study areas: Al-Hajjaj Health Center, Al-Boutama Health Center, Al-Zuwai Health Center, and Baiji General Hospital. This study investigates the environmental health risks of incineration treating hospital waste and health centers. According to the data obtained from practical and laboratory studies, Baiji General Hospital had the highest concentrations of the five toxic heavy metals tested, i.e., lead, cadmium, chromium, zinc, and nickel. These values peaked at 98.36, 59.54, 58.74, 79.52, and 13.32 mg/l for Pb+2, Cd+2, Cr+3, Ni+2, and Zn+2, respectively. Exceeding the measured values of toxic metal elements within internationally permissible limits increases the concentration of these toxic metals, posing greater health risks to the population. This process appears clearly and significantly if medical waste is burned in random locations, producing toxic fumes and gases that can cause diseases dangerous to health when inhaled; therefore, there must be mechanisms and scientific management to control the combustion process in private health incinerators. The survey results showed that the indiscriminate burning of medical waste in surveyed areas leads to diseases and can pose a tangible and immediate threat to human life, such as high blood pressure, eye irritations, suffocation of patients with difficulty and shortness of breath, and asthma, especially the elderly and newborns. Original overshooting of the measured values of toxic metal elements within the internationally permissible limits can increase the concentration of these toxic metals, posing more significant health risks to the population.

THE EFFECT OF PRE-MEDICATION WITH ORAL STEROIDS ON INTRA-OPERATIVE BLEEDING IN PATIENTS WITH CHRONIC RHINOSINUSITIS UNDERGOING FUNCTIONAL ENDOSCOPIC SINUS SURGERY.

An inflammation of the nasal and paranasal sinus mucosa that lasts longer than three months is known as chronic rhinosinusitis. When corticosteroids and other medicinal treatments fail to relieve a patient's symptoms, then functional endoscopic sinus surgery (FESS) is a commonly performed procedure to alleviate the symptoms. The aim of the study was to evaluate the impact of oral steroids given prior to surgery on intraoperative bleeding in patients having functional endoscopic sinus surgery for chronic rhinosinusitis. The study was conducted in ENT Department of Shifa Foundation Community Health Centre (SFCHC) and Shifa International Hospital (SIH) Islamabad, in a period of three years from June 2019 to June 2021. A total of 72 patients consisting of 36 patients in study group and 36 in control group, fulfilling the inclusion criteria were included in the study. Per-operative bleeding was assessed by measuring the amount of blood collected in suction bottle at the end of the procedure (the amount of saline used during the procedure was subtracted) and the number of surgical gauzes stained with blood (1 partially stained gauze = 5 ml and 1 completely stained gauze = 10 ml). The surgeon performing the surgery was unaware of the study group of the patient. All the collected data was entered and analyzed with SPSS v. 25. The mean age of group A (35.39±13.86 vs. 29.83±15.86, p-value > 0.05) was similar to group B. There was male dominance in both group (69.4% vs. 72%) males in group A and group B. Nasal obstruction and nasal discharge was observed in all patients of both groups. Post nasal drip (88.9% vs. 88.9%), headache (97.2% vs. 91.7%) and facial pain (97.2% vs. 94.4%) was present in majority patients of both groups without any significant (p-value >0.05) difference. Both the groups were compared on the basis of amount of blood loss per-operatively and it was seen that the mean blood loss in group A was (164.03±42.99 ml) significantly (p-value <0.05) lower as compared to (215.83±39.397 ml) in group B. This study showed that individuals with nasal polyps receiving preoperative steroids could successfully lower their perioperative morbidity, specifically intraoperative haemorrhage, after undergoing functional endoscopic sinus surgery.

ANALYSIS OF STUNTING INCIDENTS IN TODDLER CHILDREN

Children who experience malnutrition, repeated infections, and inadequate psychosocial stimulation can result in impaired growth and development or stunting. There are still findings of cases of stunting in children under five, followed by the presence of malnourished children under five, where in 2023 there will be 243 stunting. There are many factors that cause stunting in the Puskesmas work area which causes problems in children, both health and growth and development. This research aims to determine the factors which is related to the incidence of stunting in children under five at the Megang Sakti Community Health Center, Musi Rawas Regency in 2024. The design of this research is quantitative research with a cross-sectional approach. The population in this study is the target group of children under five in 2023, totaling 32,561 respondents. The sample in this study consisted of 100 respondents. The sampling method uses purposive sampling technique, using the Slovin formula. Inclusion criteria are willingness to become a respondent by filling out a consent form. This research was carried out on March 10 - April 30 2024 at the Megang Hospital Health Center. Collecting primary data by interviews using questionnaires. Bivariate data analysis used the Chi-Square test and multivariate logistic regression. The results of the study showed that there was a relationship between maternal age (p value 0.02) and birth weight (p value 0.002) with the incidence of stunting in children under five at the Megang Sakti Community Health Center, Musi Rawas Regency. in 2024. The conclusion is that there is a relationship between age and birth weight with the incidence of stunting in children under five at the Megang Sakti Community Health Center, Musi Rawas Regency in 2024. The community health center should carry out continuous screening of children under five who are at risk of stunting and provide education on efforts to prevent stunting children, such as risk factors for stunting.

Prevalence, Awareness, and Factors Associated with Hypertension Among People Living with HIV in Eastern Uganda. A Multicentre Cross-Sectional Study.

Despite advancements in Antiretroviral Therapy (ART), people living with HIV (PLHIV) face increasing risks of HTN, leading to significant morbidity and premature mortality, undermining the hard-earned gains of fighting HIV. The prevalence of hypertension among HIV patients and associated risk factors has not been extensively studied in the rural parts of Uganda. We assessed the prevalence, awareness, and factors associated with hypertension among PLHIV at two health facilities in Eastern Uganda. A cross-sectional study was conducted at Mbale Regional Referral Hospital and Bugobero Health Center IV HIV clinics from May to July 2023. We recruited patients with HIV above the age of 18 years and willing to consent. Participants were interviewed using a structured questionnaire adapted from the WHO STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) and the AIDS Clinical Trials Group. Anthropometric measurements and blood pressure were taken. Bivariate and multivariable logistic regression were performed. A P value <0.2 in the bivariate analysis was transferred to the multivariable logistic regression model. A P value < 0.05 was statistically significant. The study surveyed 400 PLHIV with a mean age of 46.5 (SD: 12.4) years; most were female (n=261, 65.3%). Hypertension prevalence was at 37.5%, with 20.5% in stage 2 and 68% ((n=102) of hypertensive participants were unaware. Hypertension was associated with age ≥50 years (aOR: 2.11, 95% CI: 1.33-3.37, p = 0.002), a suppressed viral load (aOR: 3.71, 95% CI: 1.02-5.13, p = 0.046) and BMI ≥25 Kg/m2 (aOR: 1.64, 95% CI: 1.01-2.66, p = 0.044). Hypertension is a significant burden among PLHIV in Eastern Uganda, influenced by HIV and lifestyle-related risk factors. Improved screening and diagnosis are needed with close monitoring for patients with viral load suppression due to the possible negative effects of ART on blood pressure.

Kajian Perilaku Kepatuhan Medikasi Pasien Tuberculosis Paru di Kabupaten Ngawi: Sebuah Model Matematis

Background: Tuberculosis (TB) is currently still a health issue in Indonesia. Indonesia is the country that contributes the second largest number of tuberculosis cases after India. Ngawi is one of the cities in East Java Province with a large number of tuberculosis cases. In 2022, tuberculosis cases in Ngawi Regency will double from the previous year with the death rate also increasing from the previous year. This shows that tuberculosis control in Ngawi Regency has not been effective. Efforts are needed to increase medication compliance in tuberculosis sufferers so that therapeutic success can be achieved so that the death rate and tuberculosis transmission rate can be reduced.Methods: This research is an analytical observational study with a cross sectional research design which aims to create a mathematical model of medication adherence in pulmonary TB sufferers in Ngawi Regency. This research involved 102 pulmonary TB sufferers at Dr. Soeroto Hospital, Widodo Hospital and Ngawi Regency Health Center. Pulmonary TB sufferers were selected using a purposive sampling technique. Data were analyzed using multiple logistic regression tests.Result: Based on interviews conducted with 102 respondents, the results obtained were that the variables age, length of treatment, motivation to recover, self-perception, knowledge, access to health facilities, medication assistance, family support, drug side effects and health facility administration were candidates for bivariate testing.Conclusion : The variables of self-perception, knowledge, family support and health facility administration are the dominant factors influencing medication compliance in pulmonary TB sufferers in Ngawi Regency in 2023.

The Association Between Changes in Body Mass Index and the Risk of Depression.

In recent years, the risk of depression has increased among young people, and changes in body mass index (BMI) during childhood may be important factors in their development. However, the relationship between changes in BMI during childhood and the risk of depression needs further research and exploration. The annual health examination data were collected from Physical Examination Center of Wuhan Mental Health Center Hospital, including 1226 students. The height and weight of students at the age of 11, 14, and 17 were recorded in sequence, and at 18 years old, these students were followed up according to the Hamilton Depression Scale (HAMD) to evaluate the depression. The relationship between BMI trends and depression was analyzed through Logistic regression analysis. The growth trend of BMI was divided into normal growth, slow growth, and excessive growth. The odds ratio (OR) value for depression in the slow growth was 1.218 (95% CI, 0.995-1.493) compared to the normal growth, which was no significant difference (P = .056). The OR value for depression in the excessive growth was 1.982 (95% CI, 1.243-3.177) compared to the normal growth, which was significant difference (P = .003). The rapid growth of BMI is correlated with the occurrence of depression in young individuals and may be a contributing factor to the development of depression in this demographic.

Exploring coagulation parameters as predictive biomarkers of Plasmodium infection: A comprehensive analysis of coagulation parameters.

Malaria affects the intravascular environment, leading to abnormal coagulation activation, prolonged prothrombin time, and activated partial thromboplastin time. Despite the high prevalence of malaria in the study area, there has been little published research on the effects of Plasmodium infection on coagulation parameters. The aim was to assess the effect of malaria on basic coagulation parameters among patients attending Dembia Primary Hospital and Makisegnit Health Center. A cross-sectional study was carried out from January to March 2020. The study involved 120 participants. Blood specimens were collected, which were analyzed using a Huma Clot Due Plus analyzer. The collected data were entered into EpiData and exported to SPSS version 21 for analysis. Non-parametric statistical methods were employed to analyze the data. The results were considered statistically significant if the p-value was less than 0.05. Individuals infected with Plasmodium exhibit coagulation disorders with elevated levels of PT (Prothrombin Time), APTT (Activated Partial Thromboplastin Time), and INR (International Normalization Ratio) in comparison to healthy controls. The median PT, APTT, and INR values for infected cases were measured at 20.5 [8.6], 39.5 [17.9], and 1.8 [0.9], respectively, while healthy controls had measurements of 15.1 [2.5], 28.8 [8.3], and 1.3 [0.2] (p ≤ 0.001). The severity of coagulation disorders increased with an increase in parasitemia levels. The type of Plasmodium species present had a significant impact on PT and INR values (p ≤ 0.001), whereas APTT did not show any significant impact across the Plasmodium species (p > 0.05). The results of this study found that malaria has a substantial impact on various blood clotting parameters, including PT, APTT, and INR. Parasitemia severity is significantly associated with extended PT and INR, implying that the higher the parasitemia, the longer it takes for blood to clot. Furthermore, the study discovered that the PT and INR levels differed based on the type of Plasmodium species responsible for the infection.

Effect of decentralising childhood tuberculosis diagnosis to primary health centre versus district hospital levels on disease detection in children from six high tuberculosis incidence countries: an operational research, pre-post intervention study

Childhood tuberculosis (TB) remains underdiagnosed largely because of limited awareness and poor access to all or any of specimen collection, molecular testing, clinical evaluation, and chest radiography at low levels of care. Decentralising childhood TB diagnostics to district hospitals (DH) and primary health centres (PHC) could improve case detection. We conducted an operational research study using a pre-post intervention cross-sectional study design in 12 DHs and 47PHCs of 12 districts across Cambodia, Cameroon, Côte d'Ivoire, Mozambique, Sierra Leone and Uganda. The intervention included 1) a comprehensive diagnosis package at patient-level with tuberculosis screening for all sick children and young adolescents <15 years, and clinical evaluation, Xpert Ultra-testing on respiratory and stool samples, and chest radiography for children with presumptive TB, and 2) two decentralisation approaches (PHC-focused or DH-focused) to which districts were randomly allocated at country level. We collected aggregated and individual data. We compared the proportion of tuberculosis detection in children and young adolescents <15 years pre-intervention (01 August 2018-30 November 2019) versus during intervention (07 March 2020-30 September 2021), overall and by decentralisation approach. This study is registered with ClinicalTrials.gov, NCT04038632. TB was diagnosed in 217/255,512 (0.08%) children and young adolescent <15 years attending care pre-intervention versus 411/179,581 (0.23%) during intervention, (OR: 3.59 [95% CI 1.99-6.46], p-value<0.0001; p-value=0.055 after correcting for over-dispersion). In DH-focused districts, TB diagnosis was 80/122,570 (0.07%) versus 302/86,186 (0.35%) (OR: 4.07 [1.86-8.90]; p-value=0.0005; p-value=0.12 after correcting for over-dispersion); and 137/132,942 (0.10%) versus 109/93,395 (0.11%) in PHC-focused districts, respectively (OR: 2.92 [1.25-6.81; p-value=0.013; p-value=0.26 after correcting for over-dispersion). Decentralising and strengthening childhood TB diagnosis at lower levels of care increases tuberculosis case detection but the difference was not statistically significant. Unitaid, Grant number 2017-15-UBx-TB-SPEED.

Late Diagnosis and Treatment of Pulmonary Tuberculosis in Ziguinchor, Southern Region of Senegal

Background: Untreated smear-positive pulmonary tuberculosis constitutes the main source of transmission of the disease in the community. Aims: The aim of our study was to determine the diagnosis delays of smear-positive pulmonary tuberculosis in adults and to identify the factors associated with the diagnosis delay in Ziguinchor, Senegal. Methodology: This is a prospective descriptive and analytical study carried out from January 1, 2019 to December 31, 2022, in cases of pulmonary tuberculosis whose diagnosis was confirmed by the identification of AFB in sputum after Ziehl Nielsen staining and/or detection of Mycobacterium tuberculosis by Genexpert. Delay was defined as a diagnosis confirmed after 36 days. Logistic regression was performed to determine factors associated with diagnosis delay. Results: A total of 141 patients were included. They had an average age of 40 years ± 16 years, (16 years - 86 years). The peak age group was 16-30 years (34.04%). The sex ratio (M/F) was 1.8. The main characteristics of the patients were: a low level of education (34.8%), work in the informal sector (70.2%) and smoking (25.5%). More than half of the patients (78.44%) had their home less than 5 km from the anti-tuberculosis dispensing center. The patients’ initial symptoms were dominated by cough (90.0%), fever (78%) and weight loss (59.6%). The traditional healer was the first source of care in 40.4%, followed by the health post (37.7%), the health center (16%) and regional hospitals (5.8%). HIV serology was positive in 13.5% of cases. The average time between the beginning of symptoms and the tuberculosis diagnosis was 36± 9.22 days (15 - 58 days). The median time to treatment initiation was 1.8± 1.6 days (1 - 6 days). A diagnosis delay was noted in 53.19%. In multivariate analysis with linear regression, age &gt; 50 years (p = 0.021), use of herbal medicine (p = 0.036) and monthly income &lt; 58 USD (p = 0.039) were the factors associated with late diagnosis of tuberculosis. Conclusion: The diagnostic delay in smear-positive tuberculosis cases is significant in our context. To shorten this mean delay period, it is necessary to both strengthen the professional abilities and skills of caregivers in the health posts and involve after training the traditional healers in the screening and sensitizing process of the population