Ministry Of Health Research Articles

Meeting Men Where they are: Motivators and Barriers to Accessing Health Services through a Men's Mobile Wellness Clinic, October 2019 to March 2020, Blantyre, Malawi.

In Malawi approximately, 88.3% people living with HIV are aware of their HIV status. Significant gaps are among men aged 15-34 years; only 72% know their HIV status. To reach men, Jhpiego, in collaboration with the Ministry of Health (MOH), implemented the Men's Mobile Wellness Clinic (MMWC) at workplace settings in Blantyre, Malawi between October 2019 and March 2020. We conducted a descriptive qualitative study to understand motivators and barriers to MMWC service uptake by employees and employers. Primary data was drawn from in-depth telephone interviews from four study populations: employers who accepted or declined to host the MMWC at their worksite, and employees who accessed or did not access the services. We performed a thematic analysis using Nvivo 12 software to identify patterns and themes across the dataset. Main reasons given for using the service among male employees were a desire to know their health status, availability of free health services at the workplace, and good quality services offered by MMWC staff, and support from their supervisor. Men who did not access services stated reasons such as work-clinic scheduling conflicts, lack of adequate promotion of the service, and miscommunication on the criteria about who should attend the MMWC. Employers who accepted to host the MMWC stated convenience and employee's rights to know their health status. Those who declined either stated that employees did not want the services or COVID-19 preventive measures by the MOH between October 2019 and March 2020 restricted participation. This study underscores the potential utility of MMWC services including HIV testing among men. The desire to know their health status, availability of free MMWC services at the workplace, good quality services offered by MMWC staff, and the endorsement of MMWC by supervisors were main motivators to access the MMWC services. Sensitizing supervisors and employees about the benefits of the MMWC services, strengthening demand creation, and clarifying eligibility are important to facilitate MMWC uptake among men in Malawi.

Performance Assessment of Health Visitor and Family Medicine Units in Babylon's Main Health Care Centers

Background: The Ministry of Health (MoH) has developed a standardized package of basic health services for all primary healthcare (PHC) facilities to enhance service quality. This study evaluates service availability and facility needs in the family health units in Babylon. Methods: This cross-sectional study was conducted in three family healthcare sectors (the first Al-Hillah sector, Al-Musayyib sector, and Al-Hashemiyyah sector), which includes 6 out of 23 primary healthcare centers in the Babylon Governorate. The data collection started on March 3, 2022, and ended on August 27, 2022, and was randomly chosen from all sectors. Results: According to this study, the family health unit had a poor mean score of 48.03±17.97. Similarly, the health visitor indicators had an inadequate level of assessment, with a mean score of 46.87±14.09. In conclusion, this revealed a study that the primary health care centers evaluated had poor scores in all the final evaluation indicators for the family health unit and the health visitor unit.

Comparative study on health behaviors among adolescents with chronic allergic disease before and during COVID-19 using data from the Korean Youth Health Panel Surveys

BackgroundThis study aimed to investigate the changes in the health behaviors and subjective health perception of adolescents with chronic allergic disease, including atopic dermatitis, asthma, and allergic rhinitis, amidst the coronavirus disease 2019 (COVID-19) pandemic in South Korea.MethodsThis study used the 15th (2019) and 17th (2021) raw data obtained from the Korea Youth Risk Behavior Web-based Survey (KYRBWS), conducted by the Ministry of Health and Welfare of South Korea. Data were analyzed using multiple logistic regression with complex sampling using weighted values. Odds ratios with 95% confidence intervals for six health behaviors and subjective health perception were used as the major variables.ResultsSix health behaviors (dietary habits, weight gain, smoking, alcohol consumption, sleep time, and physical activity) changed substantially during COVID-19. There was an increase in the duration of sedentary activities, a slight increase in BMI, and improvements in mental health. Concurrently, there was a decrease in alcohol consumption, sleep duration, and the consumption of sweetened beverages. Despite these improvements in big six health behaviors, adolescents with chronic illnesses continue to perceive themselves as unhealthy.ConclusionsThese findings suggest that the follow-up and monitoring of health behaviors and subjective health perception in adolescents with chronic allergic diseases during the COVID-19 pandemic are necessary. Understanding the mechanisms underlying sustained behavioral change can inform the development of interventions to promote healthy behavior after the pandemic has passed.

Efficient detection of data entry errors in large-scale public health surveys: an unsupervised machine learning approach

Data entry errors in large-scale public health surveys can undermine the effectiveness of data-driven interventions. Therefore, identifying these data entry errors is crucial for public health experts. In large-scale public health surveys, manually verifying the accuracy of every data point by domain experts is nearly impossible. This study evaluates unsupervised machine learning algorithms for detecting these errors, focusing on the 'weight' parameter in the Annual Health Survey (AHS) dataset. The AHS, conducted by the Ministry of Health and Family Welfare, Government of India, in collaboration with the Registrar General of India, is a large-scale, stratified, household-level survey targeting maternal and child health across nine states in India. The dataset is freely available on the Open Government Data (OGD) Platform of India for public health research. In this study, five algorithms—DBSCAN, K-Means, Gaussian Mixture Model (GMM), Isolation Forest (IF), and One-Class SVM (1C-SVM) were applied to detect erroneous data entries. The evaluation process involved comprehensive preprocessing and feature engineering to optimize detection capabilities. Performance metrics such as precision, recall, accuracy, false anomaly, and missed anomaly rates were used to assess each algorithm. Among these, DBSCAN demonstrated superior performance, achieving a recall of 94.7% and a precision of 81.9%, making it highly effective for this task. The findings underscore the potential of unsupervised machine learning in automating the detection of data entry errors, thereby improving the integrity of public health data. This research contributes to the advancement of precision public health, supporting more accurate and reliable evidence-based decision-making and policy formulation.

The state of the hypothalamic-pituitary-adrenal system in workers exposed to electric and magnetic fields of industrial frequenc

Introduction. Electric and magnetic fields of industrial frequency are an integral part of production processes, and their effect on the human body is of increasing interest both among scientists and among specialists in the field of medicine and occupational safety. In recent decades, there has been growing concern about the potential impact of these areas on the health of workers, especially those who are exposed to prolonged exposure in the course of their professional activities. In this context, we pay special attention to the neuroendocrine system, which plays a key role in regulating many physiological processes, including metabolism, stress reactions and maintaining homeostasis. The study of the fundamentals of the neuroendocrine system and the mechanisms of the effect of electromagnetic fields on the body not only contributes to the deepening of scientific knowledge in the field of biomedical research, but also has practical significance in ensuring occupational safety and improving working conditions in industrial enterprises, allowing to identify possible health consequences and develop effective measures to protect workers from negative bioeffects. The study aims to research the effects of electric and magnetic fields of industrial frequency on the functional state of the hypothalamic-pituitary-adrenal system of employees of electric grid facilities. Materials and methods. Specialists examined 144 employees of the main group engaged in the repair and operation of electric grid facilities and 40 employees of the control group who were not exposed to electromagnetic fields of industrial frequency. We determined the concentration of adrenocorticotropic hormone, cortisol and dehydroepiandrosterone sulfate in blood serum samples and calculated the ratio of dehydroepiandrosterone sulfate to cortisol. Results. Workers exposed to the combined effects of electric and magnetic fields of industrial frequency had a lower (p<0.05) level of adrenocorticotropic hormone (1.9 [0.5; 3.9] pg/ml) and dehydroepiandrosterone sulfate (5.8 [3.7; 8.4] mmol/l) in the blood compared with the group of workers exposed to magnetic fields industrial frequency fields (4.4 [2.1; 12.9] pg/ml; 9.8 [6.3; 14.5] mmol/l) and to the control group (6.4 [4.0; 19.8] pg/ml; 7.8 [4.7; 13.3] mmol/l), respectively. The scientists also revealed in the group of workers exposed to combined exposure in the field, the association of a low ratio of dehydroepiandrosterone sulfate and cortisol with the development of cardiovascular diseases and feedback from work experience (p<0.05). Limitations. The study is limited by the number of people surveyed (144 employees). Conclusion. The results of the study indicate the hypoactivity of the hypothalamic-pituitary-adrenal system induced by exposure to electric and magnetic fields of industrial frequency, manifested by a decrease in the level of adrenocorticotropic hormone, dehydroepiandrosterone sulfate and its relationship to cortisol in workers exposed to combined effects of electric and magnetic fields of industrial frequency. Ethics. The work complies with ethical standards developed in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting Scientific medical research with human participation" as amended in 2000 and the "Rules of Clinical Practice in the Russian Federation" approved by Order of the Ministry of Health of the Russian Federation dated 04/01/2016 No. 200n. We received informed consent from each examined person to participate in the study, approved in accordance with the established procedure by the local Ethics Committee of Izmerov Research Institute of Occupational Health (minutes of the meeting of the Ethics Committee No. 17 dated 12/16/2015).

The Impact of Leadership and Management on the Implementation of Electronic Health Record Systems in the Primary Healthcare Centers.

In the last three decades, Electronic Health Records Systems (EHRSs) have become one of the top priorities of policymakers globally. Nowadays, EHRS reform is fast becoming a priority in developed countries. The introduction of EHRSs in Saudi healthcare organizations is considered one of the highest priorities of policymakers. Saudi Arabian e-health strategy pays reasonable attention to the EHRS implementation project. According to Saudi Vision 2030, the e-health transformation will be on top of IT projects in the country. However, an estimated 50% of EHRS implementations have failed. Project leadership and type of project management have been found to be crucial components of effective EHRS implementation. To evaluate the role of centralized project management (CPM) in the implementation of large-scale EHRSs in Primary Healthcare Centers (PHCs) in Saudi Arabia (SA). A sequential explanatory mixed-methods approach involving a survey and semi-structured qualitative interview methods were utilized. A total of 39 (75%) out of 53 policymakers at the Saudi Ministry of Health completed the survey, and 14 project team members were interviewed. Findings from both illustrated that adopting centralized project management approaches to implementation was beneficial in facilitating large-scale EHRS implementation and helped to overcome barriers that may have otherwise led to the failure of the project. EHRS interoperability and software selection were the factors that CPM influenced most positively.

Beta-Blocker Interruption or Continuation after Myocardial Infarction

BackgroundThe appropriate duration of treatment with beta-blocker drugs after a myocardial infarction is unknown. Data are needed on the safety and efficacy of the interruption of long-term beta-blocker treatment to reduce side effects and improve quality of life in patients with a history of uncomplicated myocardial infarction.MethodsIn a multicenter, open label, randomized, noninferiority trial conducted at 49 sites in France, we randomly assigned patients with a history of myocardial infarction, in a 1:1 ratio, to interruption or continuation of beta-blocker treatment. All the patients had a left ventricular ejection fraction of at least 40% while receiving long-term beta-blocker treatment and had no history of a cardiovascular event in the previous 6 months. The primary end point was a composite of death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for cardiovascular reasons at the longest follow-up (minimum, 1 year), according to an analysis of noninferiority (defined as a between-group difference of <3 percentage points for the upper boundary of the two-sided 95% confidence interval). The main secondary end point was the change in quality of life as measured by the European Quality of Life–5 Dimensions questionnaire.ResultsA total of 3698 patients underwent randomization: 1846 to the interruption group and 1852 to the continuation group. The median time between the last myocardial infarction and randomization was 2.9 years (interquartile range, 1.2 to 6.4), and the median follow-up was 3.0 years (interquartile range, 2.0 to 4.0). A primary-outcome event occurred in 432 of 1812 patients (23.8%) in the interruption group and in 384 of 1821 patients (21.1%) in the continuation group (risk difference, 2.8 percentage points; 95% confidence interval [CI], <0.1 to 5.5), for a hazard ratio of 1.16 (95% CI, 1.01 to 1.33; P=0.44 for noninferiority). Beta-blocker interruption did not seem to improve the patients’ quality of life.ConclusionsIn patients with a history of myocardial infarction, interruption of long-term beta-blocker treatment was not found to be noninferior to a strategy of beta-blocker continuation. (Funded by the French Ministry of Health and ACTION Study Group; ABYSS ClinicalTrials.gov number, NCT03498066; EudraCT number, 2017-003903-23.)

Macrophage hyperfunction as a cellular trigger for fibroplastic changes in internal organs in pneumoconiosis among miners

Introduction. The significant prevalence of anthracosilicosis and silicosis, characterized by the rapid development of pneumofibrosis in coal mine workers, is a serious socially significant problem worldwide. A key component of the pathogenesis of pneumoconiosis is the macrophage reaction to fibrogenic dust, which is a complex immunological response, with prolonged and intense exposure leading to chronic inflammation in various organs and systems, fibrosis and a progressive decrease in their functions. A deep understanding and evaluation of the macrophage reaction as a potential biomarker for the diagnosis of lung damage in miners will allow us to develop more effective strategies to combat dust damage to organs and systems. The study aims to consider macrophage hyperfunction as a trigger mechanism for fibroplastic changes in internal organs in pneumoconiosis in miners. Materials and methods. Using light microscopy, specialists conducted extended cytological, histological and immunohistochemical studies of bronchial smears and autopsy material (fragments of bronchi, lungs, heart, liver and kidneys) of 50 miners of Kuzbass coal enterprises who died simultaneously as a result of a man-made disaster. Morphometric analysis of histological structures with measurement of linear dimensions was used for a comprehensive assessment of pathomorphological changes. Results. There was a sharp increase in the number and size of actively phagocytic alveolar macrophages loaded with dust particles in the lungs of miners. Pathological changes in internal organs were characterized by pronounced fibrosis in the peribronchial and perivascular zones, stroma with deposition of dust particles and a pronounced macrophage reaction. In a group of miners with more than 15 years of experience in the central and distal parts of the lungs, in the intermuscular zones of the myocardium, the portal tracts of the liver, and the central segments of the kidneys, there was a constant increase in the expression of immunohistochemical markers CD14, CD34, actin and vimentin, which can be used as diagnostic markers for the identification of macrophage inflammation and fibrosis, will allow to assess the degree of severity of the pathological process. A characteristic feature of the miners' long experience of dust exposure was the presence of progressive pronounced perivascular sclerosis extending beyond the vascular histione. Experts found fibroblastic cells with positive expression of CD14, CD31 and CD34 in the sclerotic zones. Limitation. The absence of cytogenetic and electron microscopic examination, which is expected in the future in conjunction with the expansion of the range of immunohistochemical research methods. Conclusion. The results of extended pathomorphological and cytological studies emphasize the importance of an integrated approach to the diagnosis of occupational diseases in the coal industry. The use of a combination of these methods will allow timely detection of macrophage inflammation and fibrous process in dust pathology, specific changes at the cellular and tissue levels, as well as to assess the severity of the pathological process. Ethics. The study of autopsy material was based on a secondary examination of blocks and ready-made histological micro-preparations (glasses) of the material of the Bureau of Forensic Medical examination of Novokuznetsk, Osinniki, Prokopyevsk. The studies of pathomorphological material were carried out strictly on the basis of Federal Law No. 323-FZ dated 11/21/2011 "On the Basics of Protecting the Health of Citizens in the Russian Federation", in particular Article 67 "Conducting pathological anatomical autopsies", Federal Law No. 8-FZ dated 12.01.1996 "On Burial and Funeral Business" (Article 5, pp. 1, 2), as well as in accordance with the Order of the Ministry of Health of the Russian Federation dated 06.06.2013 No. 354n "On the procedure for conducting pathological anatomical autopsies", Order of the Ministry of Health of the Russian Federation dated 03/24/2016 No. 179n "On the Rules for conducting pathological anatomical studies".

Atherosclerotic vascular lesion in the coal industry workers of average and high fatal risk groups

Introduction. Experts do not take into account the presence of subclinical atherosclerosis when stratifying risk on the SCORE scale, however, it is the main substrate for the occurrence of cardiovascular disasters. Most primary cardiovascular events occur in low cardiovascular risk groups, which requires timely detection of atherosclerosis and preventive measures to preserve the working population's ability to work and reduce the economic burden of treatment of cardiovascular diseases. The study aims to research the incidence of atherosclerosis in workers of the main professions of the coal industry in the South of Kuzbass in groups of medium and high risk of fatal events on the SCORE scale. Materials and methods. We divided the subjects into two groups using the SCORE scale: high-risk (main) — from 5 to 9%, which included 60 people, and moderate-risk group — from 2 to 4% (comparison) — 70 employees. The average age of the first was 50.98±0.43 years, the comparison group was 49.96±0.35 years (p=0.070). The scientists examined the indicators of blood pressure, lipid, carbohydrate and purine metabolism, and performed an ultrasound examination of the main arteries. Results. The incidence of atherosclerotic plaques in at least one vascular basin was 80.0% in the main group and 78.6% in the comparison group, p=0.845. The frequency of carotid artery atheromas in the high-risk group on the SCORE scale (52.7%) did not significantly differ from the comparison group (54.3%), p=0.862; a similar pattern in the arteries of the lower extremities: 80.0% vs. 70.0%, respectively, p=0.203. The frequency of carotid artery atheromas in the high-risk group on the SCORE scale (52.7%) did not significantly differ from the comparison group (54.3%), p=0.862; a similar pattern in the arteries of the lower extremities: 80.0% vs. 70.0%, respectively, p=0.203. The combination of thickening of the intima of vessels and the presence of atheromas tended to be more frequent in the main group — 83.6% compared with those in the comparison group — 70.1%, p=0.076 Limitations. The study is limited by the number of examined patients who underwent periodic medical examination at the Scientific Research Institute of Complex Problems of Hygiene and Occupational Diseases. Conclusion. The incidence of atherosclerosis among employees of coal enterprises turned out to be very high and did not statistically differ in the groups of medium and high fatal risk stratified on the SCORE scale, which requires more thorough screening and measures of enhanced angioprotective prevention, even in people with a low risk of fatal cardiovascular disasters. Ethics. All the subjects signed an informed consent to participate in the study, the Protocol of which corresponded to the requirements of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, executed in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting medical research with human participation as a subject" as amended in 2013 and the "Rules of Good Clinical Practice" approved by the order Ministry of Health of the Russian Federation No. 200n dated April 1, 2016.

Prevalence and factors contributing to mental health challenges among school-going adolescents: a case of a climate-vulnerable Manafwa Watershed in Uganda

BackgroundGlobally, mental health challenges are common among school-going adolescents, with a prevalence of 50.2% and 43.6% for depression and anxiety disorders, respectively. In Northeastern Uganda, a prevalence of 26.6% and 8.6% for anxiety and depressive disorders respectively were reported among children. School-going adolescents are at higher risk of developing these mental health challenges and this could be worsened by natural disasters like landslides. We aimed to determine the prevalence and factors contributing to mental health challenges (having at least one of following; depression, anxiety, anger, disruptive behaviour and social concept) among school adolescents in the Manafwa Watershed area.MethodsThis was a cross-sectional study in 3 districts of the Manafwa watershed area (Bududa, Manafwa, and Butaleja). We selected school-going adolescents aged 13-18 years because of the nature of study tools. Mental health challenges (anxiety, depression, anger, disruptive behaviour and self-concept) were assessed using the Beck Youth Inventory-II. Descriptive statistics and inferential analysis were performed to determine factors associated with mental health challenges.ResultsA total of 762 adolescents participated, with a median age of 17 years (interquartile range =16–17 years). More than half of the students were females. The prevalence of mental health challenges was 65% with a (confidence interval) = 54.0% — 75.0%; the majority 44% of the participants had anxiety, and 31% had disruptive behaviour. Families with more than five children [adjusted odds ratio = 1.18, 95% confidence interval= 1.08—1.29, p value = <0.001] and substance abuse [adjusted odds ratio = 1.20, 95% confidence interval= 1.15—1.24, p value <0.001] were significantly associated with mental health challenges.ConclusionThe prevalence of mental health challenges among students was high with majority having anxiety and disruptive behaviour. Adolescents from families with more than five children and those with substance abuse were more likely to have mental health challenges. We therefore recommend that various stakeholders such as the Ministry of Health, and the Ministry of Education, design a curriculum that caters to the mental health needs of children. Family planning awareness, awareness on Government laws prohibiting alcohol and substance use, and parenting skills should be raised by the local leaders.

Implementation Models and Examples of Health Policy in Indonesia

Indonesia's health policy continues to develop in line with changes in community needs and the global situation (Ministry of Health, 2020). However, the implementation of health policies often faces various challenges. Therefore, this research was conducted with the aim of analyzing examples of health policy implementation in Indonesia, including the problems. The research method used in this research is a qualitative descriptive method, namely collecting data from various secondary sources including journals, government reports and other official articles. The terms used in the literature review as a source for writing this journal are implementation, policy, and health. The results of this research show that the implementation of health policy in Indonesia faces various challenges, suchas limited resources, lack of coordination between stakeholders, and cultural barriers, as well as achieving optimal results varies. This also shows that improvements are needed in certain aspects.

Comparative assessment of the epidemic state of tuberculosis before and during the war in Ukraine

BACKGROUND. The war has a negative impact on patient care and the efficiency of the health care system; access to medical care is limited, coverage of preventive examinations and detection of tuberculosis (TB) are deteriorating. There is a threat of exacerbation of the epidemic situation with TB in Ukraine. OBJECTIVE. To assess the epidemic situation with TB during the war in Ukraine. MATERIALS AND METHODS. Comparison of data from the Ministry of health on TB (epidemiological indicators and indicators on detection, diagnosis and prevention) in the pre-war (2018-2021) and war (2022-2023) periods. RESULTS. The following were revealed: 1) a positive trend towards a decrease in epidemiological indicators of TB in 2018-2020, which slowed down in 2021 due to the COVID-19 pandemic, and a negative trend towards an increase in almost all indicators of TB incidence, separate indicators of mortality from TB and its prevalence in 2022-2023; 2) significant increase in the incidence of TB among contacts and children; 3) increase by ⅓-. of mortality from TB in certain regions; 4) correlation between regional rates of morbidity, mortality and prevalence of TB. In 2018-2023, the following decreased: fluorography examination, tuberculin diagnostics, detection of TB during preventive examinations (by 2-4 times), preventive vaccinations for children of the first year of life, detection of newly diagnosed and recurrent TB by smear, preventive treatment in contacts. CONCLUSIONS. Incidence is a marker of response to negative external factors and the main criterion for assessing the epidemic state of TB during the war. Fluorography examination, tuberculin diagnostics, detection of TB during professional examinations, preventive vaccinations for children of the first year of life, detection of newly diagnosed and recurrent TB by smear, preventive treatment of contacts are the main criteria for evaluating the activity of the anti-TB service during the wartime, since they are the first to significantly respond to the challenges of war.

A Policy Proposal to Strengthen the Income Redistribution Function of the National Pension Scheme in South Korea: An Analysis of South Korea’s 5th National Pension Comprehensive Plan (Draft)

In this study, we elucidate the income redistribution effects of the proposal to incorporate the Bend Points mechanism of the U.S. OASDI into the Korean National Pension Scheme (BP-KNPS Proposal) through a micro-simulation analysis using individual data from the Korean Labor and Income Panel Study (KLIPS). In addition to examining the effects of introducing the BP-KNPS Proposal into the current National Pension Scheme (NPS), we also consider the impact of this scheme being combined with the 5th National Pension Comprehensive Plan (Draft), announced by Korea’s Ministry of Health and Welfare on 30 October 2023. When the BP-KNPS Proposal is introduced into the current NPS, the Mean Log Deviation (MLD) of the net transfer amount (lifetime pension benefits minus lifetime pension contributions) for regular employees decreases from 0.2022863 to 0.1929960. Similarly, the MLD for self-employed and irregular workers decreases from 0.2046127 to 0.1721433, indicating a reduction in income inequality. Furthermore, when the BP-KNPS Proposal is combined with the 5th National Pension Comprehensive Plan (Draft), the effects are mixed. The proposals to increase the pension contribution rate and adjust the rate increase speed via generation lead to a reduction in income inequality compared to the current NPS when combined with the BP-KNPS Proposal. However, the proposals to raise the pensionable age result in increased income inequality, similar to the outcomes under the current system. This finding suggests that the triple burden identified by literature review—the reduction in benefits due to disparities in contribution periods and life expectancy, and the raised pensionable age—has a greater impact on low-income participants than the inequality-reducing effects of the BP-KNPS Proposal.

Hysterectomy across Different Occupational Groups of Women in India: A Cross-sectional Study

Abstract Aims and Objective: The paper aims to examine the prevalence of hysterectomy amongst 451,853 women aged 25–49 years by different occupation groups in India and seek to identify associated factors. It is a cross-sectional study using bivariate and multivariate analyses. Materials and Methods: Data available in the public domain from the fourth round of the National Family Health Survey, conducted pan-India including both rural and urban areas during 2015–2016 by the Ministry of Health and Family Welfare, Government of India, are used. Descriptive statistical analyses were performed to investigate hysterectomy prevalence across various states and union territories and other independent variables in India. Further, two binary logistic regression models were run to examine the determinants of hysterectomy where the dependent variable had undergone hysterectomy and not undergone hysterectomy. Results: The result revealed that about five in every 100 Indian women had undergone hysterectomy. Excessive menstrual bleeding was the most common underlying condition for undergoing hysterectomy amongst all occupation groups. The prevalence was found to be the highest amongst agricultural women workers who are 32% (odds ratio = 1.320; confidence interval: 1.209–1.440) significantly more likely to undergo hysterectomy compared to other occupation groups. Conclusion: These results raise questions about poor access to quality healthcare services particularly for sexual and reproductive health amongst women working in the agricultural sector.

Full Genome Characterization of the First Oropouche Virus Isolate Imported in Europe from Cuba.

On 27 May 2024, the Cuban Ministry of Health reported the first outbreak of Oropouche fever on the island. The etiologic agent, Oropouche virus (OROV), is a poorly understood arbovirus that has been known since the 1960s and represents a public health burden in Latin America. We report the whole-genome characterization of the first European OROV isolate from a returning traveler from Cuba with Oropouche fever-like symptoms. The isolate was obtained from the patient's serum; whole-genome sequencing was performed by next-generation sequencing, followed by phylogenetic analysis and genetic variability studies. The analysis showed that the most closely related sequence was from the French Guiana 2020 outbreak. Interestingly, our isolate is a reassortant virus, included in a highly supported monophyletic clade containing recent OROV cases (Brazil 2015-Colombia 2021), separated from the other four previously known genotypes. More deeply, it was found to be included in a distinct branch containing the sequences of the Brazil 2022-2024 outbreak. The reassortment event involved the S and L segments, which have high similarity with sequences belonging to a new cluster (here defined as OROV_SCDC_2024), while the M segment shows high similarity with older sequences. These results likely describe the viral strain responsible for the current outbreak in Cuba, which may also reflect the ongoing outbreak in Latin America. Further studies are needed to understand how OROV evolves towards traits that facilitate its spread and adaptation outside its original basin, and to track its spread and evolution in the European continent.

Potential of Chest Radiography in Primary Diagnosis of Lung Cancer

Objective: to evaluate the effectiveness of diagnostics for non-small cell lung cancer (LC) based on chest radiography/fluorography data for LC screening diagnostics during preventive medical examination and check-ups.Material and methods. The work was organized as a retrospective cohort study. The starting point of the study was chest radiography, the final point was the diagnosis of LC based on the results of low-dose computed tomography (LDCT) and tumor morphological examination. The patient sample was composed using inclusion and exclusion criteria and initially included 800 patients, then narrowed down to 788. Patients were divided into groups according to LC stage and depending on whether radiography during preventive measures made it possible to suspect LC verified within 3 months via LDCT for any reasons not related to the suspicion of a tumor process. The diagnostic coefficient and informative value of radiography were calculated for each stage of the established LC diagnosis.Results. The study showed that chest radiography does not allow establishing stage I LC diagnosis (J=0.00; p&lt;0.05), it is low informative for stage II LC (J=0.25; p&lt;0.05), and medium informative for stage III LC (J=0.80; p&lt;0.05). Chest radiography does not reliably detect LC signs at early stages in 84.3% of cases.Conclusion. The obtained results indicate an insufficient sensitivity of radiography as a screening method, primarily for early LC diagnosis. The introduction of chest LDCT instead of radiography into the procedure for preventive medical examination and check-ups of the adult population approved by the Ministry of Health of the Russian Federation will increase LC detection at early stages by 5.37 times (95% confidence interval 3,77–7,64).

Integration Telemental Health to Reach Out Patients at Community Mental Health Services: A Systematic Review

Low- and middle-income countries (LMICs) need to digitize mental health services to address disparities and improve access to healthcare. This study systematically reviewed the digitalization of integration mental health services that can reach interactions between service providers and recipients with media such as telemental health and mobile health. A literature search was conducted in March 2023. Randomized controlled trial (RCT) data were used from available studies. RCT data sources were obtained from internationally reputable journal articles with the theme of telehealth. The literature used was obtained from the databases Scopus, Web of Science, and PubMed. Integration digitalized mental healthcare system under the auspices of the Ministry of Health that reach-nationally, official psychiatrists and other professional mental healthcare that provides mental healthcare support to areas lacking specialists consisting crisis and emergency, stable conditions, as well as the process of counseling and follow-up therapy with telemental health and mobile health media. Telemental health plays a major role in mental health services and modality therapy that can be accessed effectively and efficiently, especially for mental patients in remote areas who experience barriers to attending in person.

Perception et Conservation des Archives à la Direction « Etudes et Planification » du Ministère de la Santé, Hygiène et Prévention, République Démocratique du Congo

The administrative services of the Ministry of Health are not immune to the multifaceted crises affecting the Congolese public administration. As administration is both the foundation and backbone of public management in a country, the Democratic Republic of the Congo is a nation where archival science, in all its nobility, plays a vital role in good governance. If administrations continue to thrive at the beginning of the 20th century, it is due to the importance of archival documents, which every modern and organized nation strives to preserve well, as an essential tool of national memory. Archives are data with an indefinite lifespan and cannot be materials that disappear. The observation within the General Secretariat of Health is that archives are thrown haphazardly into dark rooms where they are exposed to the elements and various kinds of rodents. Under these conditions, the disappearance of historical data is inevitable, which could constitute a significant loss, especially as some documents exist in a single copy and, once destroyed, they cannot be reconstructed.

Evaluating the World Health Organization's HEARTS Model for Hypertension and Diabetes Management: A Pilot Implementation Study in Guatemala.

The World Health Organization HEARTS Technical Package is a widely implemented global initiative to improve the primary care management of cardiovascular disease risk factors. The study's objective is to report outcomes from a pilot implementation trial of integrated hypertension and diabetes management based on the HEARTS model in Guatemala. We conducted a single-arm pilot implementation trial over 6 months from October 2023 to May 2024 in 11 Guatemalan Ministry of Health primary care facilities in two districts. The pilot evaluated a package of five HEARTS-aligned implementation strategies to improve the pharmacological treatment of hypertension and diabetes. The primary outcomes were feasibility and acceptability, measured through 20 structured interviews with Ministry of Health employees and by examining enrollment and retention. Secondary outcomes included a suite of implementation and clinical outcomes, including treatment rate. The study enrolled 964 patients, of whom 58.8% had hypertension only, 30.4% had diabetes only, and 10.8% had both conditions. Surveys on feasibility and acceptability among Ministry of Health staff had a median score of 5.0 (IQR: 5.0 to 5.0) and 5.0 (IQR range: 4.8 to 5.0), respectively, exceeding the prespecified benchmark of ≥3.5. Both districts achieved the prespecified benchmark of enrolling ≥25 hypertension patients and ≥25 diabetes patients. Only 36% of patients attended a follow-up visit within three months, lower than the prespecified benchmark of ≥75%. M treatment rates during the pilot increased by 22.3 (95% CI: 16.2 to 28.4; P<0.001) and 3.5 (95% CI: -1.6 to 8.7; P=0.17) patients per month for hypertension and diabetes, respectively. Implementation of an integrated hypertension and diabetes model based on HEARTS was generally feasible and acceptable in the Ministry of Health in Guatemala. Findings can refine national scale-up in Guatemala and inform HEARTS implementation projects in other settings.

GIS-Enhanced Survey of Potential Aedes aegypti and Aedes albopictus Artificial Oviposition Containers Distributed across Communities in Trinidad, West Indies.

Dengue and other arboviruses remain a global threat, and enhanced efforts to control the mosquitoes that transmit them are urgently needed. A survey of potential manmade Aedes aegypti (L.) and Aedes albopictus (Skuse) oviposition containers was performed in four communities near the end of the typical dry season in 2018 in Trinidad, West Indies. The purpose was to conduct individual premise surveys and use GIS mapping to visualize premises within communities that had Aedes-positive containers, as this information could be used for the prioritization of mosquito control efforts in potential high risk areas as the wet season progressed. Accessible premises were surveyed following standard inspection protocols used by the Insect Vector Control Division (IVCD), Ministry of Health (MOH). The results indicated that two of the four locations would be at high risk for arbovirus transmission going into the wet season. The GIS mapping of premises with Aedes-positive containers facilitated the identification of potential hot spots for arbovirus transmission risk within communities that should be prioritized for enhanced monitoring and vector control efforts, emphasizing the need to increase community participation in standard surveys by IVCD.