Late Attendance Research Articles

Patient's Satisfaction On Service Quality In Mental Hospital Of Riau Province

Background : The ability of the hospital in fulfilling the needs of patients can be measured by level of patients satisfaction. The satisfaction of starting with an acceptance of the patient from first came, until that patient left the hospital. There are still some indicators services must be increased in order to give maximum satisfaction to customers a mental hospital. Purpose : to known the customer satisfaction and dimension services had to be defended and corrected in a mental hospital . Method : This study using a quantitative approach with cross-sectional design and various variables such as tangibles, reliability, responsiveness, assurance, and emphaty. Analysis of the value of satisfaction using servqual methods (service quality) and mapping diagram cartesius to determine the quadrant of health services. The population is all the customers who did health services in a mental hospital with 100 customers of mental hospital. Results : The results showed that average conformity level between services provided by Tampan Mental Hospital of Riau Province and patient’s expectations was 92,08% with average service of 4,3 and average expectation of 4,4. There are 10 variables that must be maintained, they are room’s cleanliness and tidiness, complete equipment set, registration officer and cashier’s accuracy, pharmacy officer’s skills, nurse’s alertness, doctor’s responsiveness in dealing with patient complaints, nurse’s attention and politeness and equal treatment for patients regardless of social status. While there are 3 variables that must be improved, they are doctor’s late attendance and parking attendant’s responsiveness and other general stuffs. Conclusions : The patients feel very satisfied with services provided by Mental Hospital of Riau Province, although there are several service dimension variables that need to be improved Keywords : Patient satisfaction, Service quality, ServQual, Cartesian diagram

Evaluating transition in Turner syndrome in the West of Scotland

A Turner Syndrome (TS) Transition clinic, Royal Hospital for Children Glasgow (RHCG), with paediatric and adult endocrinology/gynaecology teams was established in 1998 with an aim of improving health outcomes in TS throughout the lifespan. To evaluate the success of our TS transition service, focussing on evaluating established follow-up after transfer to adult services. Girls attending the TS Transition clinic at Royal Hospital for Children Glasgow, 1998-2017, were identified. Attendance data were obtained from patient records and an electronic appointment system. We assessed good and late early attendance in our cohort of TS patients as well as established endocrine follow-up, defined as those still attending adult endocrine services 3 years after transfer. Success of TS transition was determined by the proportion of girls in established endocrine follow-up. Forty-six girls (median age 18.3 yrs) were identified. Thirty-six, 36/46 girls transferred prior to 2015 and 26 of those (72%) were in established follow-up at 3 years, 22/36 girls had met with an Adult specialist prior to transfer and 14/36 had not met with an adult specialist prior to transfer. Twenty-one (80.7%) were good early attenders (p=0.10). In the early attenders' cohort, there was no significant difference between those that had and had not met an adult specialist prior to transfer. A significant proportion of girls with TS are currently lost to endocrine follow-up following transfer to adult clinics. Early attendance at an adult clinic appears topredict established long-term follow-up. Strategies to improve early attendance and long-term endocrine follow-up are needed to ensure lifelong health needs are addressed.

Vague property status and future risk of mangroves: lesson learned from South Sulawesi, Indonesia

Mangrove forest management in South Sulawesi is challenging due to jurisdictional boundaries to biophysical processes, resource characteristics, and community development dynamics. The research aims to study the future risk of mangrove forest management growing on accretion land due to its vague status. Data and information were collected through in-depth interviews involving 17 key-informants selected by using the snowball method. Mangrove forest in the research site grows on accretion land, and it was classified as state property with Common Pool Resources (CPR) characteristics. Late attendance of the Indonesian government has instigated the “de jure” status of accretion land becomes illegitimate as the local community does not recognize it as state property. The situation leads to the ambiguity of mangrove forest property status, resulting in multilayer property formulation for several products/services/benefits generated. Several strategies to prevent its transformation into other usages are proposed, i.e., (a) improve the community understanding of the economic value of mangrove resource and risk if vanished; (b) strengthening and intensive socialization of regulations both at the local and higher-level; and (c) providing legal access for the community to manage mangrove forest through the development of Social Forestry Program in the area.

Base of thumb osteoarthritis in UK interface services-a cohort and survey-based study to assess current practice.

ObjectiveBase of thumb OA (BTOA) is a common age-related disease that has a significant negative impact on quality of life, while little is known about the structure and pathways of interface services. Our aim was to assess disease burden, referral pathways, service structure and management pathways in UK interface services.MethodsA structured questionnaire was carried out with a participating clinician at each centre to detail the local guidelines and management of BTOA. Five patients referred with BTOA were prospectively identified in each of 32 UK interface centres.ResultsMost centres (72%) had a local guideline and a standardized treatment regime consisting of education (100%), joint protection (100%), range of motion exercises (84%), strengthening exercises (88%), splintage (100%) and use of assistive devices (78%). No centre routinely offered a steroid injection at the first appointment and no centre had a specific threshold for offering an injection. Injection delivery was variable. Most patients had not been referred previously (82%). Most patients used analgesia (72%), but a minority of patients had been treated with a splint (46%), therapy (43%) and steroid injection (27%) prior to their latest attendance.ConclusionMost BTOA patients newly referred to interface services have been treated with analgesics and have not received comprehensive multimodal intervention. The management of BTOA at interface services is standardized in terms of education, splintage and therapy. However, there is a lack of standardization in terms of both the threshold for, timing of and mode of delivery of injection therapy.

The impact of HIV status on the distance traveled to health facilities and adherence to care. A record-linkage study from rural South Africa.

BackgroundFor people living with HIV (PLWH), the burden of travelling to a clinic outside of one’s home community in order to reduce the level of stigma experienced, may impact adherence to treatment and accelerate disease progression.MethodsThis study is set in the Agincourt Health and Demographic Surveillance System (HDSS) in South Africa. Probabilistic and interactive methods were used to individually link HDSS data with medical records. A regression analysis was used to assess whether travel distance was correlated with the condition for which individuals were seeking care (primarily HIV, diabetes or hypertension). For PLWH, a Cox proportional hazard regression model was used to test for an association between the distance travelled to the clinic and late attendance at follow-up visits.ResultsThe adjusted relative risk (RR) of travelling to a clinic more than 5 km from that nearest to their home for HIV patients compared to those being treated for other conditions was 2.78 (95% confidence interval (CI) = 2.23-3.48). The adjusted Cox regression model showed no evidence for an association between the distance travelled to a clinic and the rate of late visits. (RR = 1.00, 95% CI = 0.99-1.00).ConclusionsThe findings were consistent with the hypothesis that people living with HIV/AIDS would be willing to accept the burden of increased clinic travel distances in order to maintain anonymity and so limit their exposure to stigma from fellow community members. For those seeking HIV care the lack of an association between increased travel distances and late visit attendance suggests this may not impact treatment outcomes.

Patterns and Predictors of Insufficient Antenatal Care Utilization in Nigeria over a Decade: A Pooled Data Analysis Using Demographic and Health Surveys.

This study investigated the patterns of antenatal care (ANC) utilization and insufficient use of ANC as well as its association with some proximate socio-demographic factors. This was a cross-sectional study using pooled data Nigeria Demographic and Health Surveys from years 2008, 2013 and 2018. Participants were 52,654 women of reproductive age who reported at least one birth in the five years preceding the surveys. The outcome variables were late attendance, first contact after first trimester and less than four antenatal visits using multivariable logistic regression analysis. The overall prevalence of late timing was 74.8% and that of insufficient ANC visits was 46.7%. In the multivariable regression analysis; type of residency, geo-political region, educational level, household size, use of contraceptives, distance to health service, exposure to the media and total number of children were found to be significantly associated with both late and insufficient ANC attendance. About half of the pregnant women failed to meet the recommendation of four ANC visits. Investing on programs to improve women’s socio-economic status, addressing the inequities between urban and rural areas of Nigeria in regard to service utilization, and controlling higher fertility rates may facilitate the promotion of ANC service utilization in Nigeria.

Efforts to Improve Discipline of Sidoarjo Regency Environmental and Hygiene Service Employees

Work discipline is highly emphasized to civil servants for the success of an organization or government agency, which is more broadly a common goal that has been designed together. The purpose of this study is to analyze and describe the level of performance and factors that affect the performance of employees at the Department of Environment and Hygiene, Sidoarjo Regency. The method used is a qualitative method with a descriptive approach. This study focuses on one performance indicator, namely discipline. Data collection techniques in the form of observation, documentation, and interviews with sampling technique. The data analysis technique is by collecting data, presenting data, reducing data, and drawing conclusions. The results of this study indicate that employees at the Environmental and Hygiene Service of Sidoarjo Regency still have employees who are late and neglect finger print attendance. In addition, there is a lack of motivation from leaders to their subordinates not to be late.

Influence of Family Income Level on Obstetric and Perinatal Outcomes in Spain

For pregnant women, having a low family income status is associated with late prenatal attendance and an increased risk of adverse outcomes during pregnancy, delivery, and immediately after delivery. However, the influence of the socioeconomic level on maternal and child health may be minimal as long as the health system model is able to neutralise health inequity. For this reason, the objective of this study is to determine the relationship between the socioeconomic level assessed through monthly household income and obstetric and perinatal outcomes in the Spanish Health System, where midwives play a relevant role. To meet this objective, a cross-sectional observational study aimed at women who have been mothers between 2013 and 2018 in Spain was developed. The final study population was 5942 women. No statistically significant differences with linear trend were found between income level and obstetric and perinatal outcomes after the adjustment by confounding factors (pregnancy composite morbidity, p = 0.447; delivery composite morbidity, p = 0.590; perinatal composite morbidity, p = 0.082; postpartum composite morbidity, p = 0.407). The main conclusion is that, in the current Spanish health system, household income as an indicator of socioeconomic status is not related to perinatal outcomes after the adjustment by confounding factors. These results are likely due to the public model of our health system that serves all citizens on equal footing, although other social and individual factors may have influenced these results

FACTORS ASSOCIATED WITH TIMING OF ANTENATAL CLINIC ATTENDANCE AT MEDINA HOSPITAL, SOMALIA

Background: Antenatal care (ANC) ensures the best health conditions for both the mother and baby during pregnancy. Globally during the period 2007-2014 only 64% of pregnant women attended WHO recommended minimum of the four contacts for ANC. Somalia lacks local data on utilization of the ANC services yet this is important in maternal and newborn healthcare planning. The aim of this study was to determine the prevalence of early versus late attendance at antenatal clinic and describe the factors associated with the specified attendance at Medina Hospital, Somalia. 
 Methodology: This is a comparative cross-sectional study conducted among early versus late antenatal attendees at Medina Hospital, Somalia between December 2018 to February 2019. 247 women who meet the inclusion criteria were seen at the clinic. Data was analyzed using IBM statistic SPSS version 23. Structured questionnaire was used to collect data. Statistical significance of association between variables was tested by the use of chi square or fisher’s exact test, with the T-test used to determine whether continuous data were significantly associated with late attendance. 
 Results: Out of the 247 women, 149(60%) attended ANC early i.e.<12 weeks and 98(40%) attended late (≥12weeks). The average age was 28.4 (SD±7.17) years. Maternal age ≥ 26 years (OR 0.39, 95% CI 0.23 – 0.69, p<0.001), higher number of residents in the household (OR 3.11, 95% CI 1.75-5.52, p<0.001), distance >5km from the nearest health facility (OR 2.85, 95% CI 1.17-6.99, p=0.022) and lack of easy access to antenatal care service (OR 4.76; 95% CI 2.17-10.5; p =0.003). were associated with late attendance. 
 On the contrary, urban residence (OR 3.26, 95%CI 1.33 – 0.82, p <0.001) and higher educational attainment (OR 0.40, 95% CI 0.23-0.67, p<0.001) were associated with early attendance. Although more than half of the participants were unemployed and had a monthly household income <200USD, these did not significantly influence the timing of antenatal attendance. 
 Conclusion: Sociodemographic and reproductive factors influence the timing of seeking antenatal care. Three key strategies that can improve uptake of early antenatal care are: health education strategies to improve health-seeking behavior, increase the number of clinics in order to enhance access and provide free maternity care. 
 Recommendation: Creating awareness and increasing sensitization of the importance of early attendance will help in early detection of complications and hence reduce the maternal morbidity and mortality.

Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis

BackgroundWhen started early in pregnancy and continued up till childbirth, antenatal care (ANC) can be effective in reducing adverse pregnancy outcomes. While the proportion of women who attend ANC at least once in low income countries is high, most pregnant women attend their first ANC late. In Tanzania, while over 51% of pregnant women complete ≥4 visits, only 24% start within the first trimester. This study aimed to understand the factors that lead to delay in seeking ANC services among pregnant women in Tanzania.MethodsThis qualitative descriptive case study was conducted in two rural districts in Iringa Region in Tanzania. A total of 40 focus group discussions (FGDs) were conducted involving both male and female participants in 20 villages. In addition, 36 semi-structured interviews were carried out with health care workers, members of health facility committees and community health workers. Initial findings were further validated during 10 stakeholders’ meetings held at ward level in which 450 people participated. Data were analysed using thematic approach.ResultsKey individual and social factors for late ANC attendance included lack of knowledge of the importance of early visiting ANC, previous birth with good outcome, traditional gender roles, fear of shame and stigma, and cultural beliefs about pregnancy. Main factors which inhibit early ANC attendance in Kilolo and Mufindi districts include spouse accompany policy, rude language of health personnel and shortage of health care providers.ConclusionsTraditional gender roles and cultural beliefs about pregnancy as well as health system factors continue to influence the timing of ANC attendance. Improving early ANC attendance, therefore, requires integrated interventions that address both community and health systems barriers. Health education on the timing and importance of early antenatal care should also be strengthened in the communities. Additionally, while spouse accompany policy is important, the implementation of this policy should not infringe women’s rights to access ANC services.

Socio-Demographics and Late Antenatal Care Seeking Behavior: A Cross Sectional Study among Pregnant Women at Kyenjojo General Hospital, Western Uganda

Background: Late antenatal care attendance among pregnant women at health facilities remains a significant public health problem. Globally, approximately 830 women die every day due to pregnancy-related complications and 99% of these deaths occur in developing countries whereby 86% of pregnant women access Antenatal Care (ANC) services at least once. Objective: The general objective of the study was to determine factors associated with late antenatal care seeking behavior among pregnant women at Kyenjojo general hospital. Methods: This was a descriptive cross sectional study design that considered quantitative data collection methods among pregnant women attending ANC. The sample size was determined using Kish and Leslie (1969) formula using a proportion of 37% (0.37) of women who sought late ANC. A systematic sampling technique was used to sample pregnant women on daily basis. Results: A total of 283 women participated in the study. Spouse’s occupation was significantly associated with late ANC attendance (p = 0.026). On the other hand, education level of respondent (Fisher’s = 8.363, p = 0.028*), religion (Fisher’s = 5.77, p = 0.048*) and parity (Fisher’s 10.312, p = 0.026*) revealed statistically significant association with late ANC attendance. In multivariate logistic regression, on occupation, women with unemployed spouses were significantly associated with 25% increase in attendance of late ANC compared to those in formal employment (AOR = 0.25, CI: 0.073 - 0.855, p = 0.027*). Conclusion: The Majority of pregnant women sought ANC at 90.1% (n = 255). There’s a need for government to strengthen health promotion targeting women in rural communities.

Analysis of algorithm support vector machine learning and k-nearest neighbor in data accuracy

K-Nearest Neighbor is a method of lazy learning method which is a group of instances-based learning. K-NN searches by searching for groups of objects in the training data that are closest to the object on new data or testing data. Support Vector Machine is a learning machine method that works with the aim of finding the best hyperplane that separates two classes in input space. School Achievement is an achievement obtained by serious learning and discipline. The category of outstanding students is to get a good average score and not have an attendance list, especially Absent (A) and a list of late attendance at school can be classified to obtain information on the accuracy of the data being tested. In the testing process both methods obtained good accuracy results between the two methods, namely K-NN obtained an accuracy of 88.52% while SVM is 91.07%.

Factors for late initiation of antenatal care in Dar es Salaam, Tanzania: A qualitative study

BackgroundAntenatal care (ANC) provided by a trained health care provider is important for monitoring pregnancy thereby reducing potential risks for the mother and child during pregnancy and delivery. The World Health Organization (WHO) recommends at least four ANC visits to all pregnant women. While the proportion of women who attend at least one ANC in low-income countries is high, most pregnant women start their first ANC attendance very late. In Tanzania only 24% of pregnant women start their first ANC attendance before the fourth month of pregnancy. While factors for the utilization of antenatal care in general have been widely studied, there is paucity of studies on the factors affecting timing of the first ANC attendance. This study aimed to understand individual, community, and health system factors that lead to the delay in seeking ANC services among pregnant women in Ilala Municipal in Dar es Salaam region, Tanzania.MethodsA qualitative exploratory study, using in-depth interviews with 20 pregnant women and five health care workers was conducted in three different health facilities in Dar es Salaam Tanzania. Thematic analysis approach was used to analyse the data.ResultsIndividual perceptions of antenatal care, past experience with pregnancy, fear of pregnancy disclosure, and socio-cultural beliefs were the key individual and social factors for late ANC attendance. Shortage of trained health care workers, lack of spouse’s escort and health providers’ disrespect to pregnant women were the main health system barriers to early ANC attendance.ConclusionsThis study concludes that community members should be sensitized about the importance of early ANC attendance. Additionally, while spouse’s escort policy is important for promoting PMTCT, the interpretation of the policy should not solely be left to the health providers. District and regional health officials should provide correct interpretation of this policy.

The associations between social factors and suboptimal use of paediatric dental services (Tiny Teeth): a mixed method study

BackgroundDental decay is the leading reason for hospital admission of children aged 5–9 years. Prevalence of dental decay is strongly associated with deprivation, decreased maternal education, and ethnicity. This study aimed to investigate social and parental factors that prevent timely and regular use of dental services in Haringey and Enfield (London, UK), and to address the suitability of the emergency department (ED) as a site of opportunistic oral health education, using a dental intervention (DI). MethodsThe study was undertaken at the North Middlesex University Hospital's paediatric ED in North London, UK. It was a mixed method study with cross-sectional surveys, a brief DI, and qualitative interviews. Parents of children aged 10 years and younger in the ED were invited to participate in the study. Informed written consent was obtained from 101 participants. Data collection was from Jan 31, 2019, to March 13, 2019. Questionnaires collected background social and medical data, and assessed each caregiver's oral health literacy. The Big Bites and Pearly Whites DI provided parents with up-to-date information about teeth cleaning practices, dentistry, and diet. A post-intervention questionnaire assessed changes in parental knowledge. Adjusted logistic regressions explored associations between social factors and child dental registration. Seven semistructured interviews were conducted, collecting data on barriers faced to the use of paediatric dental services. FindingsBlack British, Caribbean, and African children had an odds ratio of 0·158 (95% CI 0·037–0·679) for dental registration compared with their white counterparts, after adjusting for age of child and sibling number. The DI led to a significant difference between pre and post intervention median knowledge scores (Wilcoxon signed rank test; p=0·009) with a small effect size (r=0·2). Qualitative interviews exposed that current oral health advice, from dentists alone, is inconsistent and not universally delivered, resulting in late, suboptimal, and problem-based attendance. InterpretationTo maximise and reinforce early and universal parental receipt of oral health messages, collaboration and coordination is needed between educational, dental, and general health providers. Disparities in health-seeking behaviour due to ethnicity and knowledge should be accounted for when planning service engagement programmes. The study supports the ED as a site to opportunistically make every contact count by reinforcing preventive oral health messages. The major limitations of the study are its size and cross-sectional design. FundingNone.

Obstetric outcomes for women with severe mental illness: 10years of experience in a tertiary multidisciplinary antenatal clinic.

This study aims to describe 10years of antenatal care and outcomes for women with a severe mental illness (SMI). A retrospective cohort study of 420 completed pregnancy records over the last 10years (2007-2017). Findings were compared to the Western Australian (WA) pregnancy data. Antenatal attendance, demographic, obstetric, neonatal and psychosocial variables were analysed using t tests, χ2, ANOVA and odds ratio (OR). Overall, women with a SMI had high rates of comorbidity (47%), antenatal complications, and preterm birth at 12.6% compared to WA mothers (p < 0.001). Those with schizophrenia were at highest risk with increased risk of threatened preterm labour OR 8.25 (95% CI 4.64-14.65), gestational diabetes OR 3.59 (95% CI 2.18-5.91) and reduced likelihood of a spontaneous vaginal birth OR 0.46 (95% CI 0.29-0.71). Late presentation and antenatal attendance for women with SMI were significantly associated with maternal substance use, psychiatric admission during pregnancy, and child welfare involvement. Women with schizophrenia had significantly lower attendance rates at scheduled antenatal care (ANC) appointments than those with bipolar disease (87.1% vs 94%, p = 0.003). Obstetric outcomes are poorer for women with SMI compared to the general population. They have higher rates of medical comorbidities, lifestyle and psychosocial risks factors that are known to contribute to poor obstetric outcomes. Effective delivery of regular and appropriate ANC is essential in addressing these multifactorial risks. Targeted strategies addressing comprehensive medical management, preterm birth prevention, lifestyle modifications and increased psychosocial support could improve both short- and long-term outcomes for these women and their children.

Demand-Side Causes and Covariates of Late Antenatal Care Access in Cape Town, South Africa.

Objectives The objective of this study was to investigate the causes and covariates of late antenatal care access in South Africa. Methods A cross-sectional study was conducted, interviewing 221 women at four public-sector labour wards in Cape Town, South Africa in 2014. A definition of late attendance as attending ≥ 5months was used. Data were analysed using univariate, bivariate and multivariate methods. Results Of the women who attended antenatal care at a public-sector clinic (n = 213, 96.4%), more than half (51.2%) attended ≥ 3months and < 5months, and a quarter (26.3%) attended ≥ 5months. For those attending ≥ 5months, 51.8% cited late recognition of pregnancy as the major reason for delayed attendance. Supply-side barriers were not identified as large contributing factors to delayed attendance. Late antenatal care access was predominantly associated with demand-side factors. Women who accessed antenatal care ≥ 5months were more likely to be in the poorest 40% of the wealth-index distribution (p = 0.034) and to not have completed high school (p = 0.006). They were also more likely to report alcohol consumption during pregnancy (p = 0.020) and be multiparous (p = 0.035). Having completed high school was protective of late antenatal care access in stepwise logistic regression analysis (OR 0.403, CI 0.210-0.773, p < 0.01). For women who attended ≥ 3months, late access was associated with unwanted pregnancy (p = 0.030). Conclusionsfor Practice Improved access to pregnancy tests could assist in earlier pregnancy identification. Interventions to increase awareness of the importance of early antenatal care attendance among vulnerable women may help.

Application of the Andersen-Newman model of health care utilization to understand antenatal care use in Kersa District, Eastern Ethiopia.

BackgroundIn Ethiopia, the uptake of antenatal care services has been low. Moreover, there is less frequent and late attendance of antenatal care among women who attend. Using the Anderson-Newman model of health care utilization, this study identified factors that either facilitate or impede antenatal care utilization in Kersa district, Eastern Ethiopia.MethodA community-based cross-sectional study was conducted. A total of 1294 eligible women participated in the study. Data were collected using face to face interviews with a pre-tested structured questionnaire administered with a digital survey tool. Data were collected in a house to house survey of eligible women in the community. Bivariate and multivariate logistic regression analyses were used to examine the predisposing, enabling and need factors associated with antenatal care utilization.ResultOut of the 1294 respondents, 53.6% (95% CI: 50.8%, 56.3%) attended antenatal care at least once during their last pregnancy. Only 15.3% attended four or more antenatal care visits and just 32.6% attended prior to the 12th week of gestation. Educational status, previous use of antenatal care and best friend’s use of maternal care were significant predisposing factors associated with at least one antenatal care visit. Type of kebele, wealth index and husband’s attitude towards antenatal care were significant enabling factors associated with at least one antenatal care consultation. Health Extension Workers providing home visits, perceived importance of ANC and awareness of pregnancy complications were significant need factor associated with at least one antenatal care consultation. Husband’s attitude towards ANC, head of the household, awareness of pregnancy complications, and history of abortion were predictors of attending four or more antenatal care visits.ConclusionMore than half of the women attended at least one antenatal care visit. A sizable proportion of women had infrequent and delayed antenatal care. Intervention efforts to improve antenatal care utilization should involve the following: improving women’s educational achievement, peer education programs to mobilize and support women, programs to change husbands’ attitudes, ameliorate the quality of antenatal care, increasing the Health Extension Worker’s home visits program, and increasing the awareness of pregnancy complications.

Chief complaint, treatment need and factors Affect Late Attendance to Dental Clinic in a Sample Collected from Iraqi Patients

This study conducted on (470) subjects attending dental clinic in Baghdad. Information was collected from all patients regarding their age, sex and chief compliant at the time of presentation. This was followed by clinical examination. Chief complaint of the majority of patients was toothache (47.02%) while the rest were come for various reasons. All of the patients examined were in need of some type of treatment. (56.60%) of patients needed conservative treatment, (14.89%) extraction, (5.79%) prosthodontic treatment, (8.64%) periodontal treatment, (2.34%) fixation of bridge, (0.2%) surgical operation and only medication were (5.74%).The factors that affect the delay attendance of dental patients to the clinic were studied after direct question to the patients who gave nearly the same causes mentionened in other previous similar studies which reflect the great need to dental health education and improvement of the dentist-patient interaction

High seroprevalence of syphilis infection among pregnant women in Yiregalem hospital southern Ethiopia

BackgroundDespite availability of effective treatment and the implementation of focused antenatal care (ANC), still the prevalence of syphilis persists in Ethiopia. Yet, data is not found in southern Ethiopia. Therefore, this study was conducted to determine the seroprevalence and associated factors of syphilis among pregnant women in Yiregalem Hospital, Southern Ethiopia.MethodsA cross-sectional study was conducted among pregnant women from October 2015 to August 2016. Data on socio-demography and obstetric conditions of pregnant women were collected using a structured questionnaire. Serum samples were screened for syphilis using rapid plasma regain (RPR) test and those found seropositive were further confirmed by Treponema pallidum haemagglutination assay (TPHA) test following the manufacturer’s instruction. HIV results were reviewed from records. The data were analyzed using SPSS version 20 software.ResultsOf 494 pregnant women, 204(41.3%) were first ANC visit attenders. Of these, 123(60.3%) were after the 12th gestational week. Sero-prevalence of syphilis and HIV was found to be 5.1% (25/494; 95 CI, 3.2-7.1%) and 10.3% (51/494; 95 CI, 7.7-13.2%), respectively. The overall prevalence of syphilis and HIV co-infection was 2.2% (11/494). Women with HIV infection were significantly more likely to be syphilis-seropositive (AOR = 10.3, 95%CI, 4.213-25.185) than HIV negatives.ConclusionsHigh seroprevalence of syphilis particularly among HIV positive women and late first ANC visit attenders in the study area calls for further ramping up of current intervention measures. Like integration of syphilis testing and treatment to the already established HIV prevention program and creating awareness about early ANC visit and follow-up.

Late attendance of maternal health care services: A Nepalese context

Late attendance of maternal health care services: A Nepalese context