National Public Health Programs Research Articles

The prevalence of anterior open bite in Portuguese children during deciduous and mixed dentition – Correlations for a prevention strategy

Anterior open bite (AOB) is a vertical malocclusion that requires thorough diagnosis to ensure long-term stability. The aim of this study was to determine the prevalence of AOB in Portuguese children during deciduous and mixed dentition in order to assess the need for orthodontic treatment and to determine its relation to other associated features. A group of 1264 children aged between 3 and 12 from Porto in Portugal were observed. The statistical methodology included the independent Chi(2) test, Fisher's exact test and binary logistic regression. The prevalence of AOB was 16.9% with 95% CI (11.9%, 24.5%) for primary dentition and 11.3% with 95% CI (8.4%, 15.1%) for mixed dentition. Pacifier sucking, thumb sucking, tongue thrust and oral breathing are major risk factors for AOB in primary dentition, ranked in descending order. In mixed dentition, the factors are ranked as follows: pacifier sucking, lip sucking, tongue thrust and oral breathing. Due to the close connection between the prevalence of AOB and dysfunctional problems, prevention strategies should be integrated into a national public health program. The habits mentioned above should be eliminated early by using the appropriate protocols in order to reduce the risk factors of malocclusion.

A need for a health IT portal to disseminate information about national health programmes in India

The objective of our study is to evaluate information about the national health programmes in India, available over the internet and to study the challenges faced while acquiring this information. To achieve our objective, we used the key words national health programmes OR public health programmes OR health programs AND India in Google from January 1-January 10 2012, to find information about the existing health programmes. We chose first 20 web links across all the three search terms to yield 60 websites, which were then reviewed for their relevance. Only 16 websites were found to be relevant that met the inclusion criteria. The study showed that there was inadequate information about the existing national health programmes in India. This suggests a need to develop a national public health IT portal that can disseminate information about the various health programmes in a more structured manner and which is tailored to the needs of diverse group of stakeholders.

Exposición infantil al plomo en sitios contaminados

To assess the exposure to lead in children living in various types of contaminated sites. The study was conducted from June 2008 to December 2009 at four sites in Mexico: Avalos metallurgical, Chihuahua; Morales metallurgical, San Luis Potosí (SLP); Trinidad pottery area, Tlaxcala and Cedral mine site, SLP. These sites contain different sources of lead. The metal levels were quantified in outdoor dust and in peripheral blood of children. Lead dust concentrations exceed the National Guidelines for residential soils (400 mg/kg) in a range of values for the four sites from 62 to 5 187 mg/kg. Regarding biological monitoring, the studied children showed maximum lead blood levels of 22 µg/dL in Cedral, 31 µg/dL in Morales, 32 µg/dL in Avalos, and 52 µg/dL in Trinidad. It is important to mention that in all the studied sites, a significative positive correlation was found between blood lead levels and the lead concentrations in dust. These sites are an example of the health risks related to lead exposure in Mexico; therefore, there is an urgent need for a national public health program aimed at reducing lead exposure in vulnerable populations.

Piloting the Affordable Medicines Facility-malaria: what will success look like?

The Affordable Medicines Facility-malaria is an innovative financing mechanism, managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria. This initiative aims to increase the use of artemisinin-based combination therapies for treating malaria. A pilot is underway in eight countries to determine whether the mechanism reduces the consumer price of these drugs and increases their availability in public and private outlets, their market share and their use. To evaluate the pilot, an analysis was done to estimate predetermined "benchmarks" of success at 1 and 2 years. The analysis used a mixed-methods approach, triangulating data from a literature review with information from 33 interviews with experts. A sensitivity analysis and other methods were used to verify the results. Benchmarks used to determine success include an increase in availability of artemisinin-based combination therapies of 40 percentage points from baseline, and an increase in their use of 10-15 percentage points from baseline at year 2. These benchmarks were based on evidence that national public health programmes aimed at increasing the use of a specific health commodity in developing countries have generally achieved only modest changes in use within a 2-year time frame. Evaluation should also take individual country contexts into account.

Perspectives in the Effective Use of Fluoride in Asia

Dental caries is the most prevalent chronic disease affecting human populations worldwide. The diverse disease patterns across and within countries are related to socio-behavioral determinants, demographic factors, environmental conditions, and the availability and accessibility of oral health services, in particular, exposure to disease prevention programs (Petersen, 2003, 2008a). Benefits of fluoride for caries prevention have been substantiated in many countries (Petersen and Lennon, 2004; Jones et al., 2005). In the second half of the 20th century, this focus shifted to the development and evaluation of fluoride toothpastes and rinses and, to a lesser extent, to alternatives to water fluoridation, such as salt and milk fluoridation. Most recently, efforts have been made to summarize this extensive database through systematic reviews of fluoride administration (McDonagh et al., 2000; Marinho et al., 2003; Australian Government, 2007). The Asian workshop held in Phan-Nga, Thailand, during March 22-24, 2011, aimed to discuss current information on fluoride and dental caries, as well as to try identifying barriers and opportunities that countries of Asia may have for implementing such programs. In addition, the intention was to give recommendations for including fluoride schemes within national public health programs.

Public health research systems in the European union.

BackgroundStrengthening health research is an important objective for international health organisations, but there has been less attention to support for health research in Europe. We describe the public-health (population and organisational level) research systems in the 27 European Union countries.MethodsWe developed a typology for describing health research structures based on funding streams and strategies. We drew data from internet sources and asked country informants to review these for consistency and completeness. The structures were described as organograms and narratives in country profiles for each of the 27 EU member states. National public-health research structures included public and independent funding organisations, 'mixed' institutions (which receive funds, and both use and allocate them) and provider institutions.ResultsMost health research is funded through ministries of science or science councils (and sometimes foundations), while parliaments and regions may also contribute. National institutes of public health are usually funded by ministries of health. Many national research organisations both determine research programmes and undertake health research, but there is a move towards public-health sciences within the universities, and a transition from internal grants to competitive funding. Of 27 national research strategies, 17 referred to health and 11 to public health themes. Although all countries had strategies for public health itself, we found little coherence in public-health research programmes. The European Commission has country contact points for both EU research and health programmes, but they do not coordinate with national health-research programmes.ConclusionsPublic-health research is broadly distributed across programmes in EU countries. Better understanding of research structures, programmes and results would improve recognition for public health in Europe, and contribute to practice. EU ministries of health should give greater attention to national public-health research strategies and programmes, and the European Union and the World Health Organisation can provide coordination and support.

Mental health system in China: history, recent service reform and future challenges

This paper summarizes the history of the development of Chinese mental health system; the current situation in the mental health field that China has to face in its effort to reform the system, including mental health burden, workforce and resources, as well as structural issues; the process of national mental health service reform, including how it was included into the national public health program, how it began as a training program and then became a treatment and intervention program, its unique training and capacity building model, and its outcomes and impacts; the barriers and challenges of the reform process; future suggestions for policy; and Chinese experiences as response to the international advocacy for the development of mental health.

P2-419 Physical activity among Dubai population prevalence and some associated factors

ObjectivesStudy the prevalence of physical activities among Dubai population and the effect of some associated factors, assess the knowledge, practice and attitudes.MethodologyA cross sectional survey has been carried out upon...

Controversial issues in colorectal screening in Hungary

In Hungary, mortality rates from colorectal cancer are dramatically high, therefore the reduction by population screening as a public health measure is considered as one of the priorities of National Public Health Program. In the beginning, a human-specific immunological test was applied in the "model programs", as a screening tool, to detect the occult blood in the stool; compliance was 32% in average. However, the objectives of the model programs have not been achieved, because, among other reasons, a debate on the method of choice and the strategy to follow have divided the professional public opinion. In this study the debated issues are critically discussed, being convinced that, at present, population screening seems to be the most promising way to alleviate the burden of colorectal cancer.

Executive SummaryThe Surgeon General's Call to Action to Support Breastfeeding

Executive SummaryThe Surgeon General's Call to Action to Support Breastfeeding

The “gray zone” in fine-needle aspiration cytology of the organized mammography screening. Cytohistological correlation

The National Public Health Program has established the organized mammography screening in Hungary. The aim of this study was to conduct an audit of “gray zone” smears of the organized mammography screening in comparison with histopathological diagnoses. Methods: Cytology results were rated to C3 atypia probably benign and C4 suspicious of malignancy. Results: 1361 women had aspiration cytology performed from a total of 47,718 mammography non-negative lesions. 105 (7.8%) were diagnosed as C3, whereas 78 (5.7) as C4. Of the 105 patients with C3 diagnosis 61 (58%) patients underwent surgical biopsy. Histology proved malignancy in 20 (32.8%) cases, and benign lesion in 41 (67.2%) cases. All (100%) of the 78 patients with C4 diagnosis had open biopsies; 69 (88.4%) cases were histologically malignant and 9 (11.6%) cases were benign lesions. Conclusion: The auditing results of fine needle aspiration cytology of “gray zone” in organized mammography screening meet the proposed threshold values. Authors conclude that the “gray zone” category in breast cytology is useful and of value if used judiciously. Orv. Hetil., 2011, 152, 292–295.

Study of Knowledge, Awareness and Practices of Hepatitis A and B Vaccination among the Medical Students of Chittagong Medical College, Bangladesh

Background and aim: To find the degree of knowledge and awareness about hepatitis A virus (HAV) and hepatitis B virus (HBV). We alsoevaluated practices of vaccination among the medical students of Chittagong Medical College, Chittagong, Bangladesh.Materials and methods: A total of 125 students of Chittagong Medical College, 25 each from first year to 5th year were selected by stratifiedand simple random sampling. Information about knowledge, awareness and practices of hepatitis A and B vaccination was collected by selfadministeredquestionnaire along with direct observation of the respondents.Results: About 6.4% and 87% of the students were aware for vaccination against hepatitis A and hepatitis B respectively. None of thestudents had taken vaccine against hepatitis A whereas two-thirds of the students had been vaccinated for hepatitis B.Discussion and conclusion: Almost all students were unaware of vaccine against hepatitis A. In contrast, most of the students were awareabout vaccine against hepatitis B. Despite the fact that vaccination program being priority National Public Health Program, vaccinationprocedures had not been implemented well in reality. Awareness of hepatitis A on preventive activities, such as increased utilization of safewater and handwashing practices should be strengthened.Abbreviations: HAV�Hepatitis A virus; HBV�Hepatitits B virus; HCW�Health care worker; EPI�Extended program on immunization.

Quality assurance of fine-needle aspiration cytology of the organized mammography screening

The National Public Health Program has established the organized mammography screening in Hungary. The aim of our study was to determine the quality assurance of breast aspiration cytology. Cytology results were rated to 5 categories (C1, C2, C3, C4 and C5). All cytology reports were compared with the final histology diagnosis. 1361 women had aspiration cytology diagnosis performed from a total of 47718 mammography non-negative lesions. There were 805 (59.1%) benign and 187 (13.7%) malignant alterations. Sensitivity was 91%, specificity 88%, positive predictive value 96.6% and negative predictive value turned to be 71% (p<0.001). The auditing values of fine needle aspiration cytology in our laboratory meet, or in certain aspects exceed the proposed minimum threshold values.

Caries Control for infants based on Health Plan 2010 in Korea

We examined progress in oral health of Korean 5 year olds children and dental public health infrastructure since the National Health Promotion Plan 2010 Oral Health Objectives were issued. We summarize trends in the prevalence of dental caries and trends in national public oral health program activities and budget. The Oral Health Objectives were achieved in 2006. Oral health in Korean preschool children improved considerably by improving of lifestyle and consumption of fluoride containing toothpaste. Although the number of public oral health center and the budget of oral health education were increased, the impact of public oral health program for preschool children was not influential. New oral health program for infants such as fluoride varnish application and strengthening of existing public oral health program should be performed for continuing improvement of oral health in Korea.

Buruli ulcer

Buruli ulcer is an indolent necrotizing disease of the skin, subcutaneous tissue, and bone that is caused by Mycobacterium ulcerans. Buruli ulcer is presently the third most common mycobacterial disease of humans, after tuberculosis and leprosy, and the least understood of the three. The disease remained largely ignored by many national public health programs, but more recently, it has been recognized as an emerging health problem, primarily due to its frequent disabling and stigmatizing complications. The contribution discusses various aspects of Buruli ulcer, including its geographic distribution, incidence, and prevalence; mode of transmission, pathogenesis, and immunity; clinical manifestations; laboratory diagnosis; differential clinical diagnosis; and treatment.

Core Indicators of Children’s Health and Well-Being at the Municipal Level in Greenland

The aim of this study was to expose the background for proposing core indicators for children’s health and well-being at the municipal level in Greenland; to define criteria for relevant and scientifically sound indicators; to propose a set of such indicators; to give data on their distribution, and compare the outcomes between different types of municipalities. The indicators were drawn from actual knowledge of children’s health and experiences reported in international studies. They were based on goals from the National Public Health strategy and the UN Convention on the Rights of the Child. A set of 24 indicators were identified in 4 domains (demographic and socio-economic conditions; health status and well-being; determinants of health, risk, and protective factors; and health systems and health policy). Additional indicators were proposed for later implementation, most of these lack available data. Data revealed large differences between municipalities. In general, remote communities have the most unfavourable socio-demographic and health conditions. At the same time, larger communities’ access to health care services is more favourable. A consequence is that the health care system unintentionally contributes to the increasing health gap between privileged and less privileged children. A comprehensive strategy is need to guarantee equitable health standards for all Greenlandic children and that reaches far beyond the aims stated in the present national public health programme.

Prevalence of Dementia and Alzheimer’s Disease in a Havana Municipality: A Community-Based Study among Elderly Residents

Introduction Approximately 24.2 million persons throughout the world suffer dementia with 4.6 million new cases reported annually. Only 10% of dementia and Alzheimer's disease studies are conducted in developing countries where 66% of sufferers live. Cuba, a developing country, exhibits health indicators similar to those of developed nations. Its population of 11.6 million is aging rapidly: by the year 2020 it is estimated that persons aged ≥65 years will comprise 25% of the population, making Cuban society the oldest in Latin America. Objectives Ascertain and characterize behavior of dementia, its etiologies and risk factors in persons aged ≥65 years in the Havana City municipality of Playa. Methods A two-phase, cross-sectional, door-to-door study was conducted in the municipality targeting all persons aged ≥65 years, achieving a 96.4% response rate (n=18,351). Folstein Mini Mental State Examination (MMSE), Hughes Clinical Dementia Rating (CDR) and a structured interview on risk factors were applied. DSM-IV, NINCDS-ADRDA and NINDS-AIREN criteria were used to determine dementia diagnosis, as well as other criteria for diagnosing Alzheimer's and other specific forms of dementia. Results Dementia prevalence was 8.2% of adults aged ≥65 years, with a slight predominance in males. The most frequent cause of dementia was Alzheimer's disease, followed by mixed dementias. Dementia-associated risk factors were: history of stroke, hypertension, depression, skull-brain trauma, family history of dementia, low educational level and advanced age. Conclusions This study corroborates that dementia and Alzheimer's disease constitute an important and growing health problem for our country due to the accelerated aging of the Cuban population. It also underlines the importance of early diagnosis and proper treatment of hypertension and other vascular risk factors, as well as the need for a national public health program for the prevention and early diagnosis of dementia and Alzheimer's disease, targeting elderly and at-risk populations.

Trends in the prevalence of obesity in employed adults in central-western France: A population-based study, 1995–2005

Objective The overall trend of obesity prevalence has increased during the last decades, even in France which has one of the lowest prevalence in Europe. The aim of this study was to assess, according to socioeconomic status (SES), whether a shift in the obesity prevalence trends could be observed since the French National Nutrition and Public Health Program was implemented in 2001. Methods Standardised cross-sectional repeated population-based data from the French Social Security Health Examination Centers in the central-western region of France ( n = 339,882). We examined regression slopes (95% CI) of overall and abdominal obesity from 1995 to 2005 according to SES. We also compared slopes within each SES between 1995–2001 and 2001–2005. Results After standardisation to the French age distribution, 6.9% of men and 6.4% of women were obese in 1995 and 8.9% and 8.6% in 2005, respectively. Abdominal adiposity concerned 5.6% of men and 8.5% of women in 1995 and 9.5% and 14.3% in 2005. Obesity prevalence regression slopes between 1995 and 2005 increased in all SES categories, except management professionals in both genders and office/service personnel male who were stable. Significant regression slopes before 2001 became non-significant afterward in office/service personnel males for obesity prevalence; and for abdominal obesity in manual workers women and office/service personnel ( p = 0.05, in men). Conclusions Our data confirm the overall epidemic rise in the obesity prevalence trends during the last decade, except in management professionals and office/service personnel men. Obesity prevalence trends in office/service personnel and manual workers women for abdominal obesity were also observed to stabilise since 2001. We could hypothesize that the National Nutrition and Public Health Program may partly be involved in this decreasing trend among office/service personnel mainly. Policymakers should take into account these data to assess the effectiveness of obesity prevention public-health strategies in the future.

Public health works: Blood donation in urban China

Recent shifts in the global health infrastructure warrant consideration of the value and effectiveness of national public health campaigns. These shifts include the globalization of pharmaceutical research, the rise of NGO-funded health interventions, and the rise of biosecurity models of international health. We argue that although these trends have arisen as worthwhile responses to actual health needs, it is important to remember the key role that public health campaigns can play in the promotion of national health, especially in developing nations. Focusing on an example set by China in response to a public health crisis surrounding the national need for a clean and adequate blood supply and the inadvertent spread of HIV by way of blood donation in the early 1990's, we argue that there is an important role for strong national public health programs. We also identify the key factors that enabled China's response to this bourgeoning epidemic to be, in the end, largely successful.

Preventing and Controlling Emerging and Reemerging Transmissible Diseases in the Homeless

Homelessness is an increasing public health problem. Because of poor living conditions and limited access to healthcare systems, homeless persons are exposed to many communicable infections. We summarize the intervention measures reported to be efficient for the control and the prevention of common transmissible infections among homeless populations. Evidence suggests that appropriate street- or shelter-based interventions for targeted populations are the most efficient methods. Depending on the populations targeted, these interventions may include education, free condom distribution, syringe and needle prescription programs, chest radiography screening for tuberculosis, directly observed therapy for tuberculosis treatment, improvement of personal clothing and bedding hygiene, and widespread use of ivermectin for scabies and body louse infestation. Systematic vaccination against hepatitis B virus, hepatitis A virus, influenza, Streptococcus pneumoniae, and diphtheria is strongly recommended. National public health programs specific to homeless populations are required.