Local Public Health Center Research Articles

Cumulative incidence of vancomycin-resistant Enterococcus faecium detection by patient characteristics or possible exposures: prioritization of patients for active screening culture

The target population for active surveillance culture (ASC) of vancomycin-resistant Enterococcus species (VRE) by stool or rectal swabs has not been fully determined during VRE outbreaks in healthcare settings in non-VRE endemic situation. We evaluated cumulative incidences of VRE detection during a vancomycin-resistant Enterococcus faecium outbreak to determine reasonable target populations for ASC. Cases included inpatients whose first VRE-positive sample was obtained at Shizuoka General Hospital between February 2022 and January 2023, during which we conducted admission screening for possible high-risk patients, biweekly screening of all inpatients, admission and discharge screening in the high-care unit, and screening of contacts in each ward by using stool or rectal samples. We calculated cumulative incidences of VRE detection for those screened by patient characteristics or possible exposure. Among 60 cases identified, 55 (92%) were by ASC. Cumulative incidence was higher for contacts (6.4%, 15/234) than for those identified by other screening methods (0.5%, 40/8565). Among the patients identified through admission screening, those previously hospitalized in areas of reported VRE outbreaks had the highest cumulative incidence (6.6%, 5/78) followed by patients requiring toilet assistance (3.7%, 6/161). A bundle approach including ASC and prompt contact precautions by the hospital infection control team, local public health centre, and local and national infection control experts helped terminate the outbreak in seven months. Patients with contacts, prior hospitalization in areas with known VRE outbreaks, and who need toilet assistance appear to be high-risk populations for VRE detection and are candidates for ASC.

Assessment of demographic factors and mental health status: initiating a healthy campus program

Mental health issues have been essential in formulating global health policies for 30 years. The campus community is inseparable from the problem of mental health disorders, which can affect the work either students, lecturers, or staff. This research aimed to describe mental health conditions among the campus community based on demographic factors as an opportunity to initiate a healthy campus program. This study used a quantitative method with a cross-sectional design. The population was an academic community at a private campus in Yogyakarta, Indonesia. There are 347 samples taken by accidental sampling. The mental health instrument used the self-reporting questionnaire. There, 60.81% of respondents experienced psychological disorders, and 73.49% of respondents needed to be referred to a mental health professional regarding addiction, psychotic disorders, and post-traumatic stress disorder (PTSD). There was a significant relationship between demographic factors consisting of gender, age, type of work, employment status, education level, faculty, and emotional disorders with a p-value of <0.005. Moreover, age, gender, education level, type of work, and employment status related to mental disorders due to addiction, psychosis, and PTSD with a p-value<0.005. It is concluded that a large proportion of responders need a referral to a mental health expert. To promote a healthy campus, university officials should follow up with health promotion initiatives such as partnering with the local health office and public health center for additional treatment and improving policy support.

Characteristics and courses of COVID-19 in patients from the first through fifth waves of the disease: Focused on a single public health center in Tokyo, Japan

Objective Coronavirus disease 2019 (COVID-19) became a global public health threat, and local public health centers in Japan implemented an infectious disease response to support patients. The response was subsequently modified to meet the needs for each of the five waves of infection. The study aim was to analyze the characteristics and courses of the disease in patients with COVID-19 at a single public health center. The study period included the first through fifth waves of the disease.Methods We utilized a descriptive epidemiological design in this study and data of patients with COVID-19 from one administrative district in Tokyo, Japan. We analyzed age, gender, nationality, symptoms at diagnosis, the route of infection, the recovery environment, and associated morbidity intervals, including case fatality rate, days from symptom onset to diagnosis, days from diagnosis to hospitalization, and recovery time for each of the first through fifth waves.Results From February 2020 to November 2021, 11,252 patients were diagnosed with COVID-19. Specifically, in the first wave, 151 patients were diagnosed, followed by 803 in the second wave, 2,406 in the third wave, 1,480 in the fourth wave, and 6,412 in the fifth wave. Hospitalization was the primary recovery environment during the first wave, while home recovery became the primary approach from the third wave onward. The case fatality rate was highest during the first wave, likely because of limited testing and treatment options for severe cases. The median time from onset to diagnosis was seven days in the first wave, significantly longer than for the other waves. The median time from diagnosis to hospitalization was one day in the first through fourth waves but three days in the fifth wave. The extension of this interval suggests that hospitalization was delayed in this wave as the number of severe patients increased rapidly, likely because of the novel COVID-19 variant.Conclusion This study of patients testing positive for COVID-19 provides valuable insights into the characteristics and courses of the pandemic within this district. These findings can inform regarding the development of effective strategies to manage the ongoing COVID-19 pandemic and other future emerging infectious diseases.

Health problems and health-seeking behavior of Muslim women in southern India.

The health of women and girls is of particular concern because, in many societies, they are disadvantaged by discrimination rooted in sociocultural factors that prevent them from benefiting from quality health services and attaining the best possible level of health. Muslim women face a number of unique health challenges, including discrimination, poverty, and lack of access to healthcare. These challenges can lead to a number of health problems, including mental health issues, chronic diseases, and infectious diseases. A descriptive research was conducted among the Muslim women in Dakshina Kannada among n = 675 participants drawn using two-stage stratified random sampling through interview method using semistructured questionnaire. The majority of the participants reported musculoskeletal and noncommunicable diseases. A majority of them resorted to modern medicine and there was a statistically significant association found with respect to spending on health problems (χ2 = 29.933, P < 0.001). The study reveals that women had a high incidence of musculoskeletal problems, and noncommunicable diseases such as cardiovascular disease, carcinoma, kidney, diabetes, and liver problems. They preferred allopathic medicine and sought treatment from local public health centers and private clinics since the majority of them were homemakers.

The epidemiology of male lower urinary tract symptoms associated with benign prostatic hyperplasia: Results of 20 years of Korean community care and surveys.

To investigate the prevalence of lower urinary tract symptoms/benign prostatic hyperplasia in a Korean population. The Korean Prostate &amp; Voiding Health Association provided free prostate-related community health care and conducted surveys in all regions of Korea from 2001 to 2022 with the cooperation of local government public health centers. A total of 72,068 males older than 50 were surveyed and analyzed. History taking, International Prostate Symptom Score (IPSS), transrectal ultrasonography, prostate-specific antigen (PSA) testing, uroflowmetry, and urine volume testing were performed. The mean prostate volumes in males in their 50s, 60s, 70s, and 80s or above were 24.7 g, 27.7 g, 31 g, and 33.7 g, respectively. The proportion of males with high PSA greater than 3 ng/mL was 3.8% among males in their 50s, 7.7% among males in their 60s, 13.1% among males in their 70s, and 17.9% among males 80 years of age or older. The mean IPSS total scores in males in their 50s, 60s, 70s, and 80s or above were 10.7, 12.7, 14.5, and 16, respectively. Severe symptoms were reported by 27.3% of males, whereas 51.7% reported moderate symptoms. The mean Qmax in males in their 50s, 60s, 70s, and 80s or above were 20 mL/s, 17.4 mL/s, 15.4 mL/s, and 13.8 mL/s, respectively. In this population-based study, mean prostate volume, IPSS, PSA, and Qmax were 30.6±15.1 g, 14.8±8.2, 1.9±4.7 ng/mL, and 15.6±6.5 mL/s, respectively. Aging was significantly associated with increased prostate volume, PSA levels, and IPSS scores, and with decreased Qmax and urine volume.

Principal’s Strategy in Improving Educational Quality

The purpose of this research is to discover (1) the principal’s plan for improving educational quality; and (2) the challenges and solutions for executing the principal’s strategy at Bukit Asam Tanjung Enim Muara Enim High School in South Sumatra. A descriptive qualitative technique was used in this investigation. The school principal is the focus of this study. Data were gathered through interviews, observation, and documentation. Data triangulation is used to determine the validity of the data. Milles and Huberman’s interactive analysis was employed as the analytical model. According to the research, the principal’s plan at SMA Bukit Asam Tanjung Enim Muara Enim South Sumatra has a reference, especially by looking at the 8 National Education standards. Attempts to increase the quality of education for school principals via collaboration in the health sector (PMI and local public health center); public universities; tutoring; state apparatus (civil and military resort command); and the surrounding community. Teachers who did not support and limited communication were hurdles. Teacher training and online communication are the necessary solutions.

Significance of the “Coordination Headquarters for Healthcare and Medical Support” in Japan; comparison with Emergency Medical Team Coordination Cell (EMTCC)

Introduction:The Japan Disaster Medical Assistance Team (DMAT) was established in 2005. Although it had become possible to gather medical teams at an early stage in the fields of health and welfare, there had still been a lack of personnel. In 2017, the Japanese government decided to establish the Health and Medical Coordination Headquarters when we had major disasters. Not only the medical team, but also the public health nurse and the welfare team gathered at this headquarter, and activities that integrated health, medical care, and welfare started from an early stage. On the other hand, WHO indicates to establish EMTCC within the Ministry of Health, in order to manage and coordinate EMT activities and aggregate data.Method:The Japanese Headquarters and the EMTCC were compared in terms of their functions and issues.Results:In Japanese headquarters, the director of the local public health center will be the director, and the secretariat for the headquarters will be run by supporters. Participants in the headquarter meeting include leaders of public institutions involved in health risk management. Furthermore, leaders of unions such as medical, dentist, pharmacists and nurses on the side of supporters, leaders of medical, healthcare, and welfare will participate. To establish EMTCC, WHO dispatches a coordinator, information manager, and data analyst.EMTCC collects medical information by using Minimum Data Set (MDS), which is similar to Japanese Surveillance in post extreme emergencies and disasters (J-SPEED). The most significant difference is that EMTCC does not deal with health and welfare issues.Conclusion:Regarding medical care, information is summarized in a similar way at headquarters. These facts indicate the Japanese headquarters management experience is applicable to EMTCC.

When a Doctor Falls from the Sky: The Impact of Easing Doctor Supply Constraints on Mortality

This paper describes the results of a policy experiment conducted in coordination with the Nigerian government. In this experiment, some communities were randomly selected to receive a new doctor. These doctors were posted to the local public health center. Prior to their arrival, health care was provided by midlevel health-care providers (MLP). To separate the effect of (ostensibly higher) quality from that of quantity, another group of communities was provided with an additional midlevel provider. A third group of communities received no additional workers. No other inputs were provided. I find a measurable decrease in mortality in communities assigned a doctor but not in communities assigned an MLP, suggesting that quality in the health-care sector is a significant constraint. (JEL I11, I12, O15, O18)

Challenges and Achievements in Fighting Infectious Diseases to Promote Sustainable Maternal and Child Health in Kenya - Multiplex Immunodiagnosis Solution for HIV, HBV, Syphilis among Fertile Women in Kenya -

In Kenya, the ‘Linda Mama Program’, a free care program for pregnant women, is being implemented, but as of 2017, maternal deaths per 100,000 live births reached 342, and the infection rate such as AIDS, hepatitis B, and syphilis is high. Diagnosis is being made centering on a quick simple test (rapid diagnosis), but the reliability is low, so an accurate and quick diagnosis method is needed. Through the Innovative Technology Program (CTS) of Korea International Cooperation Agency (KOICA), we developed a multi-immune diagnostic device and multi-diagnostic kit that can diagnose AIDS, hepatitis B, and syphilis, which can be tested with minimal education at schools and local public health centers in addition to hospitals. The sensitivity and specificity of the diagnostic kit were each 90% or more, which was improved by more than 20% compared to the rapid diagnostic kits. The supply of cost-competitive diagnostic devices and test kits will enable continuous monitoring of AIDS, hepatitis B, and syphilis infections among women of childbearing age between the ages of 15 and 49, thereby contributing to the improvement of maternal and child health.

Model Of The Influence Of Diarrhea In Purbalingga District Central Of Java

One of the causes of diarrhea is the behavior of the community and as an indicator of Clean and Healthy Living Behavior in household arrangements. In fact, all of this cannot be separated from the participation and commitment of the local Public Health Center's staff. This study aims to determine the effect of organizational commitment on community culture, sanitation hygiene and the incidence of diarrhea in the community. The sample used in this study is the people who live in the working area of five Public Health Centers in Purbalingga district. The research data were obtained from the results of distributing questionnaires which were then analyzed using Partial Least Square analysis techniques. Based on the results of the analysis in this study, it was concluded that: 1) the organizational commitment of the puskesmas officers had an effect on the creation of a good community culture, 2) the organizational commitment of the Public Health Centers officers had an effect on the sanitation hygiene formed in the community around the Public Health Centers, 3) the organizational commitment of the Public Health Centers officers. also affects the incidence of diarrhea in the community, 4) good community culture will support the creation of good sanitation hygiene, 5) good community culture can support the low incidence of diarrhea in the community and 6) sanitation hygiene affects the incidence of community .

협력 관점에서 ‘서울시 건강생태계 조성사업’ 돌아보기

Objectives: This qualitative study describes how the multi-year public health program in Seoul for participatory community health was launched and implemented. Methods: Data were collected through program documentation reviews and interviews with people involved in program development and implementation. Twenty individuals representing different sectors (e.g., city office, local public health center, community-based organizations) and roles (e.g., planner, advisor, and implementer) in the program were interviewed between September and November 2021. Pattern-finding and pattern-matching were used to analyze the data. Results: The pattern-finding analysis identified nine issues, which were: the background and context of the program; the program’s unique role, structure, operation, and evaluation; different views on partner roles and program outcomes; and issues with program sustainability. The community participation program was further analyzed as a collaboration project using pattern-matching, which recommended paying attention to the specific roles anticipated and opportunities available for the community leaders trained in the program. Additionally, it emphasized the importance of shared goals among the program participants in different sectors and roles. Conclusion: Approaching public health projects for community participation from the perspective of collaboration and building case studies of such approaches will enhance both research and practice of community health promotion.

The Effect of the Commander Application (Gender Equality-Based Adolescent Reproductive Health Education) on Knowledge, Attitudes, and Self-efficacy of High School Students in Yogyakarta City

BACKGROUND: Teenage dating behavior can lead to unsafe dating behavior. There has been an increase in the incidence of sexual violence, involving adolescent girls as victims of abuse. It is imperative to provide more proactive protection and violence prevention by gender equality-based reproductive health education through application media. AIM: The aim of the study was to determine the effect of the Commander application (gender equality-based adolescent reproductive health education) on knowledge, attitudes, and self-efficacy of high school students in Yogyakarta, Indonesia. METHODS: This quasi-experimental study was conducted with a non-equivalent design (pretest and posttest) and a control group. The intervention group received gender-based adolescent reproductive health education with the media application that was made by the research team, while the control group received routine reproductive health education with lectures organized by the local public health center (Puskesmas). The research population was all high school students in the Yogyakarta City, and the schools were selected based on those in the target area of the Puskesmas that had adolescent health services. School selection based on school characteristic type of school and number of students. Two schools were selected as the intervention and control groups with a minimum sample of 30 male and 30 female students from each school. The total sample was 170 people. The questionnaire used to measure attitude, knowledge, and self-efficacy was previously tested for validity and reliability and declared valid and reliable. Comparative analysis has been carried out in two paired groups using a dependent t-test, while for two unpaired groups using an independent t-test. RESULTS: The mean values of knowledge in the intervention and control groups were 0.628 versus −0.183 and the difference between the two groups was not significant (p = 0.108). The average attitude values of the intervention and control groups were 0.557 versus −2.283 and the difference between the two groups was significantly different (p = 0.000). The average self-efficacy values of the intervention and control groups were 3.785 versus −3.350 and the difference between the two groups was significantly different (p = 0.012). CONCLUSIONS: Gender-based adolescent reproductive health education interventions with application media can improve adolescent attitudes and self-efficacy.

지역보건의료기관 분포가 서울시 고령자의 안녕감에 미치는 영향

This study analyzes the effect of the distribution of local health institutions on the elderly's wellbeing in Seoul dividing into private and public centers. This study analyzes the direct effect of the distribution and the moderating effect of personal economic status using a multi-level model. Data from the 2018 Seoul Elderly Survey and Seoul Statistics 2018 were used. Not only distribution of public health centers but local clinics increased, elderly's wellbeing increased significantly. However, the influence of the distribution of clinics was different according to the economic status. The local effect of clinics and hospitals appears to decrease as the economic status increases. In other words, the influence of the hospitals and clinics generates more psychological utility with low economic status. Therefore, the distribution effect of private hospitals can partially contribute to narrowing the well-being gap due to economic status. However, the distribution of public centers did not differ. It is challenging for the preconceived notion that local public health centers are useful only to economically vulnerable people. This study revealed that, regardless of the type, a considerable number of health institutions is positive to the elderly, and it can be more beneficial to the economically vulnerable. Also, many public centers are positive to the wealthy, too. This study makes pay attention to the role of public medical institutions for the elderly in metropolitan cities.&#x0D;

Perception and Aspiration on Primary Healthcare Service Quality in Puskesmas in Pati Regency Government, Central Java Province, Indonesia

The research of the quality of primary public health services in the Government of Kabupaten Pati is measured using the quality of medical services that are being held by all of its local public health centers, Puskesmas. The number of respondents in this research is 640 respondents. The research is being done in 64 different places that are distributed equally so that it can gather good quality data. The result of this research shows that the quality of primary public health services in the Government of Kabupaten Pati is perceived as good by its citizens. The improvement on the quality of medical services of Puskesmas can be done by improving its facility, human resource, and its medicine quality.

Relationship of Nutritional Concerning Families with the Nutritional Status of Children In the Working Area of Local Public health center

The status of malnutrition and malnutrition is caused by various interrelated factors, including family behavior factors in providing food, breastfeeding and complementary feeding, and nutrition service efforts. This study aims to analyze the relationship between nutritionally conscious families (Kadarzi) and the nutritional status of children under five in the Work Area of the Puskesmas Pelambuan, Banjarmasin. This study used an analytic method with a cross sectional approach. The sampling technique used was proportional random sampling with a sample size of 82 parents of children under five. The measuring instrument used was a questionnaire and observation with weighing tools, the data analysis used the Spearman rank test. The location of this research was conducted in the Working Area of the Pelambuan Health Center, Banjarmasin City. Based on the results of the study, families who were aware of nutrition tended to have normal nutritional status totaling 27 (79.4%) and more than 7 (20.6%). Meanwhile, families who were not aware of nutrition tended to have malnutrition status, amounting to 31 people (64.6%) and malnutrition status 17 (35.4%). The spearman rank statistical test obtained p value 0.000 smaller than α = 0.05. There is a relationship between nutritionally conscious families (adarzi) with the nutritional status of children under five in the working area of Puskesmas Pelambuan, Banjarmasin City.&#x0D; &#x0D; Keywords : Nutritional awareness family, nutritional status, children

Epidemiology of SARS-CoV-2 infection in nursing facilities and the impact of their clusters in a Japanese core city

IntroductionNursing facilities are vulnerable to coronavirus disease 2019 (COVID-19) due to the congregate nature of their housing, the older age of the residents, and the variety of their geriatric chronic conditions. Little is known about the impact of nursing facility COVID-19 on the local health system. MethodsWe collected data of COVID-19 cases in Nagasaki city from April 15, 2020 to June 30, 2021. We performed universal screening of the healthcare workers (HCWs) and the users of nursing facilities, once the first case of COVID-19 was detected within that facility. The community-dwelling people received testing if they had symptoms or if they were suspected of having close contact with the positive cases. The epidemiological survey for each COVID-19 case was performed by the public health officers of the local public health center. ResultsOut of 111,773 community-dwelling older adults (age ≥ 65 years) and 20,668 nursing facility users in Nagasaki city, we identified 358 and 71 COVID-19 cases, and 33 and 12 COVID-19 deaths, respectively, during the study period. The incidence rate ratios (IRRs) for COVID-19 and its deaths among the nursing facility users were 1.07 (95% confidence interval (CI), 0.82–1.39) and 1.97 (95%CI, 0.92–3.91) compared with the community-dwelling older adults. Four clusters, which had more than 10 COVID-19 cases, accounted for 60% (65/109) of the overall cases by the HCWs and the users. ConclusionsThe prevention of COVID-19 clusters is important to reduce the number of COVID-19 cases and deaths among the nursing facility population.

PENCEGAHAN DAN SIMULASI DETEKSI DINI VERTIGO DI MESJID BAITURRAHMAN LEUWISARI

Vertigo is a sensation of movement from the body like turning without actual rotation. Vertigo is not always caused by a dangerous disease, but in the long term and if not treated immediately vertigo will cause some adverse effects on quality of life to death. This counseling activity aims to introduce the concept of vertigo, signs and symptoms and practice ways to recognize and eliminate the symptoms of vertigo to the Aisyiyah women's group in Leuwisari sub-district. The outreach activities were carried out by way of explanation and discussion on 65 members of Aisyiyah in the Leuwisari sub-district at the Baiturrahman mosque on October 4, 2019. Before and after the counseling, participants were given a questionnaire to evaluate the activities as a measure of the success of the activity. In this health education activitites the participants of the activity gained increased knowledge compared to before the implementation of health education was given. The results of this activity showed that 62% of participants gave a very good assessment and 21% gave a good level of health education activities about vertigo. The author suggests that this activity can be carried out routinely to community groups by the local public health center.

The response of local governments and public health centers to COVID-19: Looking for infectious disease control due to the change of trend and mutations of the virus

The response of local governments and public health centers to COVID-19: Looking for infectious disease control due to the change of trend and mutations of the virus

Changes in the Number of Public Health Nurses Employed in Local Governments in Japan During the Covid-19 Pandemic: A Cross-Sectional Study.

Prefectural public health centers in Japan conducted epidemiological surveys of all COVID-19 patients, which subsequently increased their workload as the infection rate increased. The survey was conducted by public health nurses (PHNs); therefore, an increase in their workload was expected. However, changes in the number of PHNs have not yet been examined. This study focused on recruiting PHNs to local governments in Japan during the COVID-19 pandemic. This cross-sectional study of 150 local government public health centers was conducted from November to December 2021. The survey items included the number of full-time and part-time PHNs, number of PHNs who resigned or retired from the job, and number of PHNs recruitment examinations conducted between 2017 and 2021. For all variables, the mean, standard deviation, and minimum and maximum values for each municipality and year were calculated, and a one-way analysis of variance was performed. The response rate of the questionnaires was 54.0% (81/150). The change in the employment status of PHNs from 2019 to 2020 was not statistically significant in 2020, which was the COVID-19 outbreak year. However, the number of full-time PHNs increased by 2.6, while part-time PHNs almost doubled from 5.2 ± 8.3 to 10.8 ± 9.6 (p = .61) for prefectures, from 13.6 ± 13.1 to 21.5 ± 34.8 (p = .23) for cities, and from 16.8 ± 26.8 to 52.3 ± 132.5 (p = .70) for wards. The survey revealed that since the COVID-19 pandemic, the ratio of part-time to full-time PHNs significantly increased. Current status reports of public health centers will encourage political decisions and research on the factors necessary to balance the supply and demand of full-time PHNs.

Phenotypes of atopic dermatitis up to 36 months of age by latent class analysis and associated factors in Japan.

BackgroundAtopic dermatitis (AD) in early childhood is the first allergic manifestation in the atopic march. Recently, latent class analysis (LCA) has revealed the presence of AD subgroups in childhood.ObjectiveThis study aimed to elucidate different AD phenotypes up to 36 months of age and identify factors associated with a particular AD phenotype in early childhood.MethodsPediatric allergists or dermatologists examined children who visited local public health centers in Chiba or Yokohama city at 4, 18, and 36 months of age for regular health checkups between 2003 and 2005. LCA was used to identify AD subtypes on the basis of the course of skin symptoms and comorbidity of other allergic diseases. After LCA, the association between genetic and environmental factors and AD phenotypes was assessed.ResultsA total of 1,378 children who underwent the 3 checkups were included. Complete data were available for 515 children up to 36 months of age. Of 515 children, 183 were diagnosed with AD at least at one out of the 3 time points. The LCA model of these children with AD separated 4 AD phenotypes: early-persistent (EP), early-transient (ET), late-onset (LO), and variable (V). Antibiotic use by 4 months of age was significantly higher in EP group than in other 3 groups. Mother’s allergy was significantly higher in EP and LO groups than in other 2 groups. Passive smoking at 18 months of age was higher in LO group than in other groups. Furthermore, >80% of V group was born in spring–summer.ConclusionWe identified 4 AD phenotypes using LCA on the basis of the onset/course of AD and comorbidity of other allergic diseases and also identified several factors related to the particular phenotypes, which may be useful markers for the prediction of prognosis of AD in early childhood.