National Prevention Strategy Research Articles

Epidemiological surveillance of HIV in Ecuador

Introduction: The human immunodeficiency virus (HIV) is an infectious disease that affects public health worldwide, including the country of Ecuador. The approach to confronting HIV involves providing comprehensive care that addresses the prevention, diagnosis and treatment of general way. Objective: Determine the effectiveness of the National Epidemiological Surveillance, Prevention and Control strategies in HIV-AIDS patients, in Ecuador. Materials and methods: study with a systematic literature review design, with respect to the databases: Scielo, Elsevier, PubMed, Web of Science and the SADI clinical guide of Argentina, from November 2023 to February 2024. Studies were included where Issues related to the effectiveness of the epidemiological strategy, prevention and control in patients with HIV/AIDS are focused on. Results: HIV is a big problem in Ecuador, according to the Ministry of Public Health and the support of UNAIDS, estimates were made that indicate that by the end of 2020 there will be 45,056 people with HIV, in an age group between 15-49 years, greater case in men. The average estimate of adults and children living with HIV was 48,000. The highest prevalence of HIV infection was in the province of Guayas during the periods 2017-2019 (31.7%, 27.99%, 30.42%, respectively). Conclusion: This study concludes that the surveillance systems on HIV/AIDS prevention and control strategies in Ecuador were slightly effective during the periods 2017 to 2019.

Identifying potential predictors of surgical site infection risk following cardiac surgery: a scoping review.

This scoping review was undertaken to identify risk predictions models and preoperative predictors of surgical site infection (SSI) in adult cardiac surgery. A particular focus was on the identification of novel predictors that could underpin the future development of a risk prediction model to identify individuals at high-risk of SSI, and therefore guide a national SSI prevention strategy. A scoping review to systematically identify and map out existing research evidence on preoperative predictors of SSI was conducted in two stages. Stage 1 reviewed prediction modelling studies of SSI in cardiac surgery. Stage 2 identified primary studies and systematic reviews of novel cardiac SSI predictors. The search identified 7887 unique records; 7154 studies were excluded at abstract screening and 733 studies selected for full-text assessment. Twenty-nine were included for Stage 1 and reported the development (n = 14), validation (n = 13), or both the development and validation (n = 2) of 52 SSI risk prediction models including 67 different preoperative predictors. The remaining 703 studies were re-assessed for Stage 2; 49 studies met the inclusion criteria, and 56 novel preoperative predictors not yet assessed in models were identified. This review identified 123 preoperative predictors of SSI risk following cardiac surgery, 56 of which have not been previously included in the development of cardiac SSI prediction models. These candidate predictors will be a valuable resource in the future development of risk prediction scores and may be relevant to SSI risk prediction in other surgical specialities.

Unintentional drowning fatalities in Sweden between 2002 and 2021

BackgroundDespite declining over the past three decades, unintentional drownings still account for an estimated 236 000 annual deaths worldwide. Susceptibility persists amongst demographic groups and is influenced by sex, age, and socio-economic status, emphasizing the need for targeted interventions. Due to rapidly evolving population dynamics, particularly within Europe, there is a further responsibility to understand the impact of ethnicity on the risks of drowning to guide prevention.MethodsWe conducted a national population-based retrospective study using data from the Swedish National Board of Forensic Medicine and Statistics Sweden for the years 2002 to 2021. The analysis includes variables such as age, sex, presence of alcohol and narcotics as well as activity undertaken at the time of drowning and type of water body. Furthermore, we considered ethnicity to identify subpopulations at greater risks.ResultsResults revealed a plateau in unintentional drowning rates in Sweden since 2012, despite an overall decrease from 2002 to 2021. Findings confirm the trend that males are overrepresented within drowning statistics across all age groups, and that individuals aged > 50 constitute over half of all unintentional drownings. Men aged between 40-69 years boating, and individuals of non-Swedish origin, particularly those < 20 years of age, face a notably greater risk of drowning, underscoring the need for subpopulation-targeted prevention strategies.ConclusionThe ten-year plateau in unintentional drowning signals the need for an official national prevention strategy with annual evaluations. Suggestions also include improved parental supervision of children, further avoidance of alcohol while swimming and boating, as well as targeted swimming lessons and water competency training for individuals of non-Swedish origin.

Evaluation of the diagnostic techniques in the detection of hookworm infestation among school children in Ethiopia: Cross-sectional study design

BackgroundHookworm infestation is an important public health concern especially in regions with poor sanitation and limited resources. In healthcare institutions in Ethiopia, wet mount microscopy with low performance has been used as the sole diagnostic technique. Sensitive diagnostic methods are essential for the proper identification of hookworm infection in national strategies for hookworm prevention and management. Thus, the objective of the article was to evaluate the performance of diagnostic techniques in the detection of hookworm infestation among school children in the Gozamin district, Northwest Ethiopia. MethodsA cross-sectional study with 530 school children was conducted from February to April 2022 in Ethiopia. The study participants were selected by using systematic random sampling technique. Direct wet mount (DWM), Richie’s, Kato-Katz (KK), and spontaneous tube sedimentation (STS) diagnostic techniques were utilized to process the stool samples. The data were entered into the Epi-data version 4.2 and the data was analyzed using SPSS version 25.0. The sensitivity, specificity, predictive values and test efficiency of the test were calculated with respect to the Composite Reference Standard (CRS) as the reference method. The degree of agreement with the methods of diagnosis was assessed by the Kappa value. ResultsThe overall prevalence of hookworm was 34.9 %. The detection rate of STS, Richie’s, KK and DWM techniques in hookworm detection was 30.2 %, 27.0 %, 22.3 % and 15.1 %, respectively. The sensitivity and test efficiency of STS to detect hookworm were 86.5 % and 95.3 %, for Richie’s 77.3 % and 92.1 %, for KK 63.8 % and 87.4 %, for DWM method 43.2 % and 80.2 %, respectively. The agreement of STS, Richie’s, KK and DWM techniques with CRS were perfect (κ = 0.893), perfect (κ = 0.816), substantial (κ = 0.696) and moderate (κ = 0.498), respectively in detecting hookworm parasites. ConclusionThe prevalence of hookworm among school children was high. The STS method is superior to other methods for detecting hookworm infections. The Richie’s technique was more successful in detecting the hookworm parasite than the KK and DWM techniques. It is important to implement the STS technique in routine diagnostic methods and in endemic areas of hookworm infection because it cheaper, easy to perform, and identifies a wide range of parasitic species.

ISLAMIC EDUCATIONAL APPROACHES TO STUNTING PREVENTION AND CHILD PROTECTION

Stunting, characterized by impaired growth and development in children under five years old, represents a significant global nutritional issue, particularly in Indonesia. This study aims to explore stunting prevention and child protection from the perspective of Islamic education. Employing a qualitative methodology with a phenomenological approach, the research seeks to understand and interpret specific events and social situations related to stunting and child protection within the Indonesian context. Data were collected through in-depth interviews and documentation, specifically involving lecturers at UIN Ar-Raniry Banda Aceh. The findings reveal that the incidence of stunting in Indonesia remains alarmingly high compared to other middle-income countries, leading to decreased cognitive abilities, heightened health risks, and diminished future productivity. The research concludes that stunting prevention and child protection are critical national programs that require synergistic implementation to secure a better future for children and ensure their right to quality education. From the perspective of Islamic education, these efforts are intrinsically linked, as Islamic teachings emphasize the importance of proper care, provision of halal and nutritious food, which positively influence both the physical and mental well-being of children. The study highlights the need for integrating Islamic educational principles in national stunting prevention strategies to foster holistic child development.

Effect of COVID-19 lockdowns on maxillofacial fractures in New Zealand: a retrospective study

Introduction: The New Zealand Accidents Compensation Corporation received 28,901 new claims for maxillofacial fractures between January 2018 and December 2021, at an annual cost of NZ$70–80 million. We have previously reported interpersonal violence as the most common cause of maxillofacial fractures disproportionately affecting young Māori males. This study provides an update on the incidence and cause of maxillofacial fractures with a specific review of the impact of COVID-19 lockdowns. Methods: Patients referred to the Wellington Regional Plastic, Maxillofacial and Burns Unit from 1 January 2018 to 31 December 2021 were identified from our maxillofacial fracture database. Age, ethnicity, gender, cause of injury, risk factors, and fracture pattern and management were analysed. Results: Out of 1281 patients identified, 75.2 per cent were male, most commonly (38.7%) aged 16–30 years. Interpersonal violence, falls and sports accounted for 37.6 per cent, 24.9 per cent, and 24.0 per cent of all maxillofacial fractures, respectively. Māori (22.0%) and New Zealand Europeans (55.7%) were the two largest groups, most commonly affected by interpersonal violence and falls, respectively. There was a relative increase in referral rates for females and for those older than 60 years (1.78 per 10 person-days versus 0.014 per 10 person-days and 4.2 per 10 person-days versus 1.8 per 10 person-days, respectively) and a decrease in the rates of interpersonal violence and sports related referrals (1.2 per 10 person-days versus 3.4 per 10 person-days and 0.41 per 10 person-days versus 2.19 per 10 person-days, respectively) during COVID-19 lockdowns, compared with outside lockdown. Conclusions: Interpersonal violence remains the main cause of maxillofacial fractures. There is a need for a national prevention strategy to reduce this. During COVID-19 lockdowns, there was a relative increase in the referral rates of females aged 60 years and over. Both sports and interpersonal violence showed significantly reduced referral rates during lockdowns, while falls, road traffic accidents and other were referred at a similar rate as out of lockdown.

Cholera and diarrheal diseases in Cuamba District, Niassa Province, Mozambique: Systematic healthcare facility-based surveillance strengthening, characteristics of suspected cholera and diarrheal patients, and incidence of diarrheal diseases.

Mozambique is one of the countries in Africa that is continuously at risk of cholera outbreaks due to poor sanitation, hygiene, and limited access to potable water in some districts. The Mozambique Cholera Prevention and Surveillance (MOCA) project was implemented in Cuamba District, Niassa Province to prevent and control cholera outbreaks through a preemptive cholera vaccination, strengthened surveillance system for cholera and diarrheal diseases, and better understanding of cholera-related healthcare seeking behavior of local populations, which may further guide the national cholera control and prevention strategies. This article presents the surveillance component of the MOCA project. A prospective healthcare facility (HCF)-based surveillance of cholera and diarrheal disease was conducted in six HCFs in the District of Cuamba from March 2019 to December 2020. A systematic surveillance procedure has been put in place with capacity building in selected sentinel HCFs and a basic microbiology laboratory established on-site. Patients presenting with suspected cholera or other diarrheal symptoms were eligible for enrollment. Clinical data and rectal swab samples were collected for laboratory confirmation of Vibrio Cholerae and other pathogens. A total of 419 eligible patients from six HCFs were enrolled. The median age was 19.8 years with a similar age distribution between sentinel sites. The majority were patients who exhibited diarrhea symptoms not suspected of cholera (88.8%; n = 410). Among those, 59.2% (210/397) were female and 59.9% (235/392) were 15 years and above. There were 2 cholera cases, coming outside of the catchment area. The incidence of diarrheal diseases ranged from 40-103 per 100,000 population. No Vibrio cholerae was isolated among surveillance catchment population and Escherichia coli spp. (82/277; 29.6%) was the most common pathogen isolated. Efforts were made to strengthen the systematic surveillance of suspected cholera with standardised patient screening, enrolment, and diagnostics. The first basic microbiology laboratory in Niassa Province established in Cuamba District under the MOCA project needs to be integrated into the national network of laboratories for sustainability. No reports of laboratory confirmed cholera cases from the surveillance catchment area may be highly related to the pre-emptive oral cholera vaccine (OCV) mass vaccination campaign conducted in 2018 and the use of drugs by local populations prior to visiting the sentinel HCFs. Continued systematic cholera surveillance is needed to closely monitor the cholera endemicity and epidemics, and further evaluate the long-term impact of this vaccination. High incidence of diarrheal illnesses needs to be addressed with improved water, sanitation, and hygiene (WaSH) conditions in Cuamba District. Efforts integrated with the prioritization of prevention measures are fundamental for the control of cholera in the country.

Perceptions of lecturers and students regarding discriminatory experiences and sexual harassment in academic medicine – results from a faculty-wide quantitative study

BackgroundDiscrimination and sexual harassment are prevalent in higher education institutions and can affect students, faculty members and employees. Herein the aim was to assess the extent of discriminatory experiences and sexual harassment of students and lecturers at one of the largest teaching hospitals in Europe. We analyze whether there are differences between lecturers and students, different study programs as well as sex/gender differences.MethodsIn an interdisciplinary, iterative process, a semi-standardized questionnaire was developed and sent to N = 7095 students (S) of all study programs and N = 2528 lecturers (L) at Charité—Universitätsmedizin Berlin, Germany. The study was conducted from November 2018 to February 2019. Besides a broad range of questions on sociodemographic background allowing for diversity sensitive data analysis, they were asked if they had witnessed and/or experienced any form of discrimination or sexual harassment at the medical faculty, if yes, how often, the perceived reasons, situational factors and perpetrators.ResultsThe response rate was 14% (n = 964) for students and 11% (n = 275) for lecturers. A proportion of 49.6% of students (L: 31%) reported that they have witnessed and/or experienced discriminatory behavior. Sexual harassment was witnessed and/or experienced by 23.6% of students (L: 19.2%). Lecturers (85.9%) were identified as the main source of discriminatory behavior by students. Directors/supervisors (47.4%) were stated as the main source of discriminatory behavior by lecturers. As the most frequent perceived reason for discriminatory experiences sex/gender (S: 71%; L: 60.3%) was reported. Women and dental students experienced more discriminatory behavior and sexual harassment.ConclusionsDiscriminatory behavior is experienced by a significant number of students and lecturers, with power structures having a relevant impact. Dental students and women appear to be particularly exposed. Specific institutional measures, such as training programs for lecturers and students are necessary to raise awareness and provide resources. Furthermore, national preventive strategies should be thoroughly implemented to fight discrimination and harassment at the workplace.

Prevalence of cardiometabolic risk factors according to urbanization level, gender and age, in apparently healthy adults living in Gabon, Central Africa.

The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28-50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.

Actes auto-agressifs avec substance chez les moins de 18 ans : étude prospective des cas régulés par le centre antipoison et de toxicovigilance de Marseille

ObjectivesTo describe poison exposures in case of self-poisoning subjects younger than 18 years old reported to the Marseille Poison Control Center. Patients and methodThis is a descriptive, monocentric and prospective review of self-poisoning patients aged<18years who reported to the Marseille Poison Control Center from 1st October 2021 to 31st January 2022. ResultsThe 308 subjects included were aged 11 to 17years with an average age of 14.9years (±1.5) for girls and 14.6 (±1.7) for boys (P=0.234). The sex ratio was 0.14. Two hundred and forty patients (77.9%) already had prior psychological or psychiatric follow-up. It was a recurrence of suicide attempts in 43.8% of cases (n=135). The use of an emergency department was almost systematic (n=277, 89.9%). Most of these were mono-intoxications (n=193, 62.7%). The poisonings were in most cases drug-induced (n=281, 91.2%). Analgesics-antipyretics were the most used drug class (n=147 patients, 47.7%), followed by anxiolytics (n=62, 20.1%). Paracetamol proved to be the most ingested substance (n=108, 35.1%). One hundred and six patients remained asymptomatic (34.4%). Of the 308 cases included, 78.6% were hospitalized for an average of four days. Two hundred forty-nine cases (80.8%) had one psychiatric evaluation in an emergency department and 200 (64.9%) will have an appointment for a psychiatric consultation on discharge. DiscussionThe demographic characteristics of young suicides and those of intoxication were globally like those found in the literature although our recurrence rate was higher than those in the literature. More than two years after the start of the SARS-CoV-2 pandemic, the malaise of young people remains while the care offer is already saturated. To reverse the trend by 2027 the French Ministry of Health and Prevention has updated its national prevention strategy by various means. A subsequent study could be interesting to see the impact of these measures. ConclusionThis study is limited but seems to complement some indicators, which shows that the pediatric mental health crisis is worsening, especially among the youngest adolescents who have an increased recurrence rate. We must remain vigilant and continue to implement screening actions and means of prevention, particularly of recurrences.

Governance of noncommunicable diseases in Afghanistan.

Noncommunicable diseases (NCDs)arethe main reasons of mortality worldwide. One of every two person is dying due to NCDs in Afghanistan. International policy actors, mainly the World Health Organization (WHO), published several reports and declarations on controlling and preventing NCDs. This study aimed to provide a situation for governance of NCDs in Afghanistan and proper solutions for identified challenges. We conducted qualitative research utilizing interpretive phenomenology. A self-developed questionnaire was developed to conduct the semi-structured interviews with 39 experts fromAfghanistan. The results were analyzed using a deductive framework analysis. Six building block framework of health system developed by theWHO was used as predefined framework for this study. The governance building block of health system consists of five subthemes including policy making, planning, organizing, stewardship, and control. We identified main strengths, weaknesses, opportunities, and challenges for these subthemes. The experts also provided key recommendations to address the challenges. Management of NCDs is a neglected part of the health system in Afghanistan. Strengthening evidence-based policy making with technical and indigenous planning, establishing responsive units with adequate financial and human resources within different ministries to address "health in all policies" concept, passing and implementing national laws and regulations to support national strategies for prevention and control of NCDs, and establishing decentralized monitoring systems to control the implementation of these strategies are the main recommendations of this study. Local government and international policy actors should invest and support the development of a multisectoral coordination system at national level for Afghanistan.

Injury hospitalisations for children and young people: a 20-year review

BackgroundChildhood injuries can have significant lifelong consequences. Quantifying and understanding patterns in injury severity can inform targeted prevention strategies and policies. This study examines the characteristics of child injury hospitalisations...

Cancer Risk in Nepal: An Analysis from Population‐Based Cancer Registry of Urban, Suburban, and Rural Regions

Background. Cancer is one of the leading causes of death globally. The low and middle‐income countries (LMICs) cover a major share of the global cancer burden; however, most of the LMICs including Nepal still lack national cancer control and prevention strategies. Since 1st January 2018, the Nepal Health Research Council (NHRC) started the population‐based cancer registry (PBCR) in urban, suburban, and rural regions to support evidence‐based cancer control intervention in each geographical region. Methods. Data regarding incidence and mortality was collected by the PBCR in Nepal. Indirect and direct methods were used to collect data from health facilities and communities, respectively. Registered cases of incidence and mortality from 1st January 2019 to 31st December 2019 were used. Each case was verified for correctness and duplication followed by residence confirmation via phone call. Guidelines and principles of the International Association of Cancer Registry were followed for the overall registration process including data quality control. Ethical approval was taken from the Ethical Review Board of the NHRC. Result. Age‐adjusted incidence (AAR) and mortality rates in Nepal were found 65.6 and 29 per 100,000 people, respectively. Every 1 in 14 men and 1 in 13 women were at risk of getting, and 1 in 28 men and 1 in 33 women were dying of cancer before age 75 in Nepal. The highest risk was found for lung cancer (1 in 80) followed by stomach and mouth among men, and in women, breast cancer (1 in 76) was the commonest among all followed by lung and cervix. Conclusion. Cancer has been growing as one of the major public health burdens in Nepal. Screening with cost‐effective technology, awareness, and vaccination against HPV should be a government priority including revision of treatment protocols for cancers that have higher mortality to prevent further preventable life loss from malignancies.

Severity of Fall-Related Injuries and Older Persons' Hospital Admission in Kuwait: A Cross-Sectional Study.

Falls among the older population have attracted global attention, with a specific emphasis on the regional contexts of falls. This study reports the incidence and characteristics of falls in the State of Kuwait, where there is currently no national fall prevention strategy. A prospective, cross-sectional study reported on 420 individuals aged 55 years and above admitted to Alrazi Orthopaedic Hospital in Kuwait City due to falls between March 2022 and February 2023. ICD-10 codes were used to classify the fall causes. The National Database of Nursing Quality Indicators injury severity classification was used to classify the fall-related injuries. Structured interviews were used to identify 10 main fall risk factors. Annual fall-rate was calculated and fall-related injuries were reported in frequencies and percentages. Chi-square tests and multinomial logistic regression models were used to examine the cross-sectional associations between fall severity and risk factors to determine the factors that could predict more severe fall-related injuries. Fall-related injuries comprised 24.1% of the total hospital admissions, with 4% mortality rate. Around 31.6% of the falls led to temporary impairment injuries, 23.5% resulted in long-term impairment injuries, and 44.8% created potentially fatal injuries. The results of this study show that being between 55 and 74 years of age, having no history of falls, suffering from at least one illness, with no polypharmacy effect, and possessing fair vision are significantly associated with the severity of fall injuries. Being male (odds ratio [OR] = 3.38), being over 65 years of age (OR = 3.46), having a history of falls (OR = 2.49), and limitations in visual acuity predict more severe fall injuries among older individuals. The severity of fall injuries is significantly associated with more capable older people. Government officials should immediately design and implement culture-specific fall-prevention strategies tailored to the targeted population.

An overview of Climate Change Impacts on the Health Sector for the Research Program of the National Adaptation Plan Support Project in Senegal

Senegal, a coastal country in the semi-arid Sahel region, faces significant risks associated with climate variability and climate change. Climate change is already affecting vulnerable people’s wellbeing and it’s expected to contribute to the (re)emergence of vector-borne, some water-borne and heat-related diseases, which will have disastrous consequences on the country’s fragile health system and socio-economically vulnerable population. Our contribution to the National Adaptation Plan support Project - Global Environment Fund (NAP-GEF) aims to support community- based epidemiological surveillance and the design/maintenance of health information systems in order to improve planning, decision-making, and public health response. Our methodological approach aims to build a detailed climate and health database to describe the spatio-temporal characteristics of the climate-health relationships at national scale. Considering various indices of targeted diseases, we assess the degree of transmission of those diseases in Senegal for different historical period (1950-2014 and projections (2015-2100) based on a combination of the Shared Socio-Economic Pathways (SSPs) produced within the Coupled Model Intercomparison Project, phase 6 (CMIP6). Selected diseases include malaria, meningitis, dengue and Chronic – non communicable to heat waves. The project will strengthen institutional capacity to mainstream climate related risks within the Ministry of Health’s strategies and governance model, enabling a public health system framework to support long-term and sustainable adaptation funding and programs. The project is being implemented jointly with the Ministry of Environment and Sustainable Development (MEDD) and the Ministry of Health and Social Action (MSAS). The findings in the project will guide and operationalize community-based early-warning systems and adaptation strategies specific to local climate-sensitive diseases in targeted regions in Senegal, which will feed into the national health prevention, response, and care strategies adapted to the needs of local communities. Development of scientific evidence and a knowledge management system get started in this study about the links between climate change and health through the launch of studies in collaboration with research institutions. However, barriers or limitations to integrating climate change data and information into health policies have also been identified

House-wall modification after indoor residual spraying in Shashogo district, southern Ethiopia

BackgroundIndoor residual spraying has been a key national malaria prevention and control strategy in Ethiopia. However, there is a gap in monitoring and evaluation of house-wall modification after indoor residual spraying before the end of residual lifespan. This study has determined the prevalence of house-wall modification after indoor residual spraying and identified the associated factors in Shashogo district, southern Ethiopia.MethodsA community-based cross-sectional study was conducted from April to May 2022. Data were collected from 640 randomly selected households using a pre-tested questionnaire and an observational checklist. The binary logistic regression models were used to identify factors associated with house-wall modification after indoor residual spraying before the end of the potency period.ResultsThe prevalence of house-wall modification after indoor residual spraying was found to be 30.4% (95% CI 27.4–34.2%). Educational status of could not read and write [AOR = 1.76, 95% CI (1.16, 2.68)], monthly income of more than birr 3000 [AOR = 3.27, 95% CI (1.78, 6.01)], low level of knowledge about indoor residual spraying [AOR = 3.81, 95% CI (2.39, 6.06)], lack of information within two weeks before spraying [AOR = 2.23, 95% CI (1.44, 3.46)], absence of supervision after spraying [AOR = 1.79, 95% CI (1.14, 2.81)], absence of stagnant water near house [AOR = 3.36, 95% CI (2.13, 5.39)], and thatched roof [AOR = 1.82, 95% CI (1.04, 3.16)] were factors significantly associated with house-wall modification after indoor residual spraying.ConclusionThis study has revealed that the prevalence of house-wall modification after indoor residual spraying before the end of the residual lifespan in the study area was higher compared to other studies in developing countries. Therefore, special emphasis should be given to providing community education about indoor residual spraying, conducting regular supervision before and after residual spraying, enforcing some legislative strategies for modifying the house-wall before six months after spraying, and improving environmental and housing conditions.

No national plans. Tackling radicalisation and discrimination with the effort of civil society in Greece and Romania

ABSTRACT This paper looks at the two case studies of Greece and Romania where national policies and strategies for Prevention and Countering of Violent Extremism (P/CVE) are non-existent or suffer from a deficiency in implementation. The analysis begins with a diagnosis of each country’s history and reaction to different types of violent extremism and attempts to highlight the ways in which each of them has dealt with this phenomenon. Both in Greece and Romania, the task has fallen into the hands of civil society to lead and develop local, regional, and national P/CVE programs. This is examined in this article, followed by an in-depth analysis of local action against radicalisation and VE in two cities in Greece and Romania. The paper also takes the perspective of education and social cohesion in analysing the issues at hand. The results of the analysis showcase that both countries lag in realising effective P/CVE strategies, with Greece having the institutional infrastructure – relevant agencies and local actors – albeit remaining inactive, and Romania still struggling to recognise the potential threat of radicalisation and violent extremism in the country – exemplified by the lack of open conversation at the level of government and public information.

Epidemiology of leprosy in China, 2021: an update

Objective: To describe the epidemiological characteristics of leprosy in China in 2021 and provide essential information for future national leprosy control and prevention strategies. Methods: We collected epidemiological data of leprosy from 31 provinces, autonomous regions, and municipalities of China (except for Hong Kong, Macao, and Taiwan) provided by the Leprosy Management Information System. We performed a comparative analysis of the epidemiological features of patients with leprosy including age, sex, geographical distribution, and grade of disability. Results: In total, 374 newly detected leprosy cases were reported nationwide in China in 2021, giving an incidence rate of 0.27 per million population, which represented a decrease of 7.9% compared with 2020. Among the population with leprosy in 2021 that comprised 238 males (63.6%) and 136 females (36.4%), 1.9% (7/374) were children younger than 15 years, 92.8% (347/374) had multibacillary leprosy, and 18.2% (68/374) had grade 2 disability. More than half of the new leprosy cases (54.8%, 205/374) were distributed in southwest China. There were 33 relapsed leprosy cases reported in 2021. By the end of 2021, there were 1,897 registered leprosy cases reported nationwide, giving a prevalence rate of 1.35 per million population. Conclusion: The leprosy epidemic in China shows a downward trend in terms of the prevalence and incidence rates. However, the high prevalence of leprosy in southwest China is still a matter of concern.

A Review on Brucellosis in Tanzania: Prevalence in Livestock, Wildlife, and Humans from 1962-2021, Public Awareness and Knowledge on the Disease, and the Way Forward towards Disease Control

Brucellosis is a zoonotic disease which is among the most widespread and neglected diseases in the world. Most affected parts of the world include the Mediterranean countries of Europe, North and East Africa, the Middle East, South and Central Asia as well as Central and South America. This paper reviews the prevalence of brucellosis in Tanzania as well as public awareness and knowledge on the disease in the past six decades, from 1962 to 2021. Literatures were searched using Google Scholar database. The criteria for literature inclusion or exclusion were the type of literature, year of publication and the country where the study was conducted. In livestock, the disease prevalence ranged from 2.16 to 48% in cattle, 0.2 to 13.79% in goats and 0 to 23% in sheep. A prevalence of 0.7% was reported in pigs. In humans, the prevalence ranged from 0 to 48.4%. The prevalence of brucellosis in wildlife was 0% in baboon, 25% in hyena, 30% in impala, 36.8% in lions, 4% in zebra, ranged from 7.9 to 24% in African buffalo and 3.8 to 17% in wildebeest. Generally, the public awareness and knowledge on the disease were low due to the lack of a well- established channel for sharing of research findings which is friendly to all stakeholders. In the past six decades more emphasis was on research which led to generation of data presented in this review. Although education campaigns to raise public awareness and knowledge on the disease transmission, its control, and socio-economic effects were recommended in many reports, no significant work was done during the period under review. In order to control and prevent brucellosis in the country, embarking on education campaigns to raise public awareness and knowledge on the disease is a recommended way forward, followed by implementation of other objectives outlined in the National Strategy for Prevention and Control of Brucellosis in Humans and Animals.&#x0D; Keywords: Brucellosis, Education campaigns, Neglected, Widespread, Zoonotic.

Nutritional Intake Differences in Combinations of Carbohydrate-Rich Foods in Pirapó, Republic of Paraguay

A national strategy for obesity prevention has been promoted in Paraguay, reflecting the situation where half of adults and 23.4% of children (under 5 years old) are overweight. However, the detailed nutritional intake of the population has not yet been studied, especially in rural areas. Therefore, this study aimed to identify obesity-causing factors in Pirapó by analyzing the results from a food frequency questionnaire (FFQ) and one-day weighed food records (WFRs). From June to October 2015, 433 volunteers (200 males and 233 females) completed the FFQ with 36 items and one-day WFRs. Body mass index (BMI) positively correlated with the consumption of sandwiches, hamburgers, and bread and with age and diastolic blood pressure, although pizza and fried bread (pireca) had a negative correlation in males (p < 0.05). BMI positively correlated with systolic blood pressure, whereas it negatively correlated with the consumption of cassava and rice in females (p < 0.05). The FFQ revealed that fried food with wheat flour was consumed once a day. WFRs showed that 40% of meals consisted of two or more carbohydrate-rich dishes, significantly higher in energy, lipids, and sodium than those containing only one carbohydrate-rich dish. These results imply that less oily wheat dish consumption and healthy combinations of dishes should be considered for obesity prevention.