Public Health Awareness Campaigns Research Articles

Evaluating the Cost Effectiveness of a Suicide Prevention Campaign Implemented in Ontario, Canada.

Although suicide-prevention campaigns have been implemented in numerous countries, Canada has yet to implement a strategy nationally. This is the first study to examine the cost utility of the implementation of a multidimensional suicide-prevention program that combines several interventions over a 50-year time horizon. We used Markov modeling to capture the dynamic changes to health status and estimate the incremental cost per quality-adjusted life-year gained over a 50-year period for Ontario residents for a suicide-prevention strategy compared to no intervention. The strategy consisted of a package of interventions geared towards preventing suicide including a public health awareness campaign, increased identification of individuals at risk, increased training of primary-care physicians, and increased treatment post-suicide attempt. Four health states were captured by the Markov model: (1) alive and no recent suicide attempt; (2) suicide attempt; (3) death by suicide; (4) death (other than suicide). Analyses were from a societal perspective where all costs, irrespective of payer, were included. We used a probabilistic analysis to test the robustness of the model results to both variation and uncertainty in model parameters. Over the 50-year period, the suicide-prevention campaign had an incremental cost-effectiveness ratio (ICER) of $18,853 (values are in Canadian dollars) per QALY gained. In all one-way sensitivity analyses, the ICER remained under $50,000/QALY. In the probabilistic analysis, there was a probability of 94.8% that the campaign was cost effective at a willingness-to-pay of $50,000/QALY (95% confidence interval of ICER probabilistic distribution: 2650-62,375). Among the current population, the intervention was predicted to result in the prevention of 4454 suicides after 50years (1033 by year 10; 2803 by year 25). A healthcare payer perspective sensitivity analysis showed an ICER of $21,096.14/QALY. These findings demonstrate that a suicide-prevention campaign in Ontario is very likely a cost-effective intervention to reduce the incidence of suicide and suggest suicide-prevention campaigns are likely to be cost effective for some other Canadian provinces and potentially other countries.

Migraine Literacy and Treatment in a University Sample

There are many factors that can lead to underutilization of appropriate medical treatments for migraine, including a poor understanding regarding the diagnostic features of migraine and available treatment options. The purpose of the present study was therefore to assess migraine literacy and factors leading to different treatment decisions. Respondents were 229 university students, both migraineurs and non-migraineurs, who completed online questionnaires which surveyed their knowledge of migraines, and for migraineurs, their experiences of migraine and migraine treatment. While migraineurs had significantly greater migraine literacy than non-migraineurs according to the questions asked, knowledge was incomplete in both groups. The majority of migraineurs who used prescription medication for acute pain relief found such medications to be very effective, and for those who did not use such medications, one in five cited the reason was that they did not know that such medications were available. The imperfect migraine literacy, both in terms of diagnostic features and available treatments, highlights avenues for future public health awareness campaigns.

Morbidity Profile of Pregnant Women Attending Antenatal Clinic in Nanyuki Teaching and Referral Hospital, Kenya - A Cross Sectional Study (P11-015-19)

ObjectivesTo determine the health morbidity profile of pregnant women attending antenatal clinic in Nanyuki Teaching and Referral hospital, Kenya. MethodsA cross-sectional study was conducted among pregnant women where data on maternal morbidity profile was collected. A total of 254 pregnant women attending antenatal clinic were recruited. ResultsMore than half (57.5%) of the women recruited in this study reported to be unwell in the immediate two weeks preceding the day of the interviews. The common diseases/disorders reported were heartburn (42.9%), anemia (16.9%) anorexia (15.4%), vomiting (14.2%) and constipation (11.4%) with most of them having a duration of more than 7 days. Other morbidities such as fever, abdominal pain, upper respiratory infection, diarhoea and headache were also reported. Further, out of all those who reported being sick, only 40.4% who sought medical attention. ConclusionsMorbidity among the pregnant women was notably high. Public health awareness campaigns among pregnant women on prevention, early identification and timely treatment of diseases/disorders during pregnancy should be up-scaled. Funding SourcesNone.

Intestinal parasites amongst primary school children attending Ta’al Model Primary School in Lafia Local Government Area of Nasarawa State, Nigeria

Intestinal parasites are a major health challenge in the tropical and sub-tropical regions. The high prevalence of intestinal parasites has been attributed to poverty leading to poor hygiene, inadequate health services and contaminated food and water. A survey of intestinal parasitic infectation was conducted among 200 primary school children of Ta’al Modern Primary School, Bukan-Sidi in Lafia Local Government Area of Nasarawa State, Nigeria. Stool specimens were collected and examined using direct smear method and formol-ether concentration technique. The prevalence of intestinal parasite recorded was 95(47.5%) in the study-area. A total of six intestinal parasites species were identified: Entomoeba histolytica 15(15.8%), Giardia lamblia 14(14.7%) Ascairis lumbicoides 23(24.2%), Hookworm 28(29.5%), Trichuris trichiura 8 (8.4%) and Fasciola hepatica 7(7.4%). Amongst the six intestinal parasites, Hookworm recorded the highest prevalence 28(29.5%). Generally females 54(56.8%) were found to be more infected than males 41(43.1%). It was observed that prevalence of infection decreased with increase in age group of the pupils. The age-group 7-9 years recorded the highest 27(28.4%) prevalence and least 22(23.2%) in age group 13-15. The highest prevalence 23(24.2%) was found amongst primary one pupils and the least 8(8.4%) was in primary six. Statistical analysis using chi-square (x2) showed no significant difference (p>0.05) in the prevalence of infection between sex, age-group and class of pupils. Intestinal parasitic infection can be reduced through public health awareness campaign to improved personal hygiene and environmental sanitation including good water supply.Keywords: Intestinal parasite; infection; primary school children; Nasarawa State

South African Marine Envenomations and Poisonings as Managed Telephonically by the Tygerberg Poisons Information Centre: A 20-Year Retrospective Review

South Africa has an abundance of marine life, and the potential for hazardous exposure to marine life is high. To our knowledge, this is the first epidemiological review regarding marine toxicity that has ever been conducted in sub-Saharan Africa. The aim of this review was to investigate marine toxicology data as managed telephonically by the Tygerberg Poisons Information Centre. Marine toxicology cases were retrospectively analyzed for a 20-y period (January 1, 1995 to December 31, 2014). Data were extracted from archived consultation forms. Descriptive statistics are presented, and post hoc analyses compared age, sex, province, and caller's background with severity and type of toxicology. A total of 311 calls involved 392 cases. Most calls involved adults (n=317, 81%) and males (n=214, 55%) and presented with no or minor symptoms (n=242, 62%). Poisoning from ingestion (n=239; 61%) was more commonly encountered than was marine envenomation (n=153; 39%), with paralytic shellfish poisoning (n=118; 30%), scombroid poisoning (n=93; 24%), and envenomation from stingrays (n=36; 9%) and bluebottles (n=33; 8%) occurring often. Healthcare professionals were more likely to consult for severe cases (odds ratio 3.3; 95% CI 1.9-5.9) and poisoning-related cases (odds ratio 1.8; 95% CI 1.1-2.9). The proportion of marine-related toxicology cases was low. Telephonic consultations by healthcare professionals relating to poisoning were generally of a serious nature. The data can be used to drive public health awareness campaigns.

Microbial Quality of Drinking Water and Prevalence of Water-Related Diseases in Marigat Urban Centre, Kenya.

Background:Accessibility to potable water is a fundamental right for dignity and well-being. Despite this observation, more than 1.1 billion people lack access to safe drinking water. This is particularly true in the Sub-Saharan Africa and South East Asia regions.Objective:The main aim of this study was to assess microbial quality of drinking water and prevalence of water-related diseases in Marigat town, Baringo County, Kenya.Methods:Samples of drinking water were collected from water sources (boreholes, rivers, and wells) and at the point of use (households) and analyzed for Escherichia coli and total coliform (TC) bacteria using the most probable number method. In situ measurements of pH and temperature were performed using a Wagtech International portable meter. Clinical health records from the local health centers were also reviewed to assess the prevalence rates of some of the water-related diseases.Results:There were significant differences among water sources during dry season for E coli (F2,21 = 3.629, P < .05) and TC (F2,21 = 4.041, P < .05). Similar observations were made during wet season for E coli (F2,21 = 4.090, P < .05) and TC (F2,21 = 1.893, P < .05). Furthermore, there were significant interactions between the water sources and season for E coli (F2,42 = 7.66, P < .01) and TC (F2,42 = 5.494, P < .05). Drinking water in large plastic storage containers (herein referred to as sky-plast) had the highest E coli and TC concentrations. Typhoid was the most prevalent water-related disease during the dry season (10%), whereas diarrhea (3%) was the most prevalent during the wet season.Conclusions and recommendations:All drinking water at abstraction and point of use for Marigat residents are microbiologically contaminated and therefore pose serious health risks to consumers of such water. Thus, there is need for public health awareness campaigns on household water management to curb incidences of water-related diseases. Public health practitioners at county and national levels need to ensure that households have adequate access to potable water and improved sanitation.

Impact of Weekly Climatic Variables on Weekly Malaria Incidence throughout Thailand: A Country-Based Six-Year Retrospective Study.

Purpose. This study aimed to evaluate climatic data, including mean temperature, relative humidity, and rainfall, and their association with malaria incidence throughout Thailand from 2012 to 2017. The correlation of climatic parameters including temperature, relative humidity, and rainfall in each province and the weekly malaria incidence was analyzed using Spearman's rank correlation. The results showed that the mean temperature correlated with malaria incidence (p value < 0.05) in 44 provinces in Thailand. These correlations were frequently found in the western and southern parts of Thailand. Relative humidity correlated with malaria incidence (p value < 0.05) in 35 provinces. These correlations were frequently found in the northern and northeastern parts of Thailand. Rainfall correlated with malaria incidence (p value < 0.05) in 38 provinces. These correlations were frequently found in the northern parts and some western parts of Thailand. The impacts of the mean temperature, relative humidity, and rainfall were observed frequently in specific provinces, including Chiang Mai, Chiang Rai, Trat, Kanchanaburi, Ubonratchathani, and Si Sa Ket. This is the first study to report areas where climatic data are associated with malaria incidence throughout Thailand from 2012 to 2017. These results can map out the climatic change process over time and across the country, which is the foundation for effective early warning systems for malaria, public health awareness campaigns, and the adoption of proper adaption measures that will help in malaria detection, diagnosis, and treatment.

Tailoring Therapies: Improving the Outcome of Breast Cancer in a Comprehensive Cancer Center in West Africa—The University of Nigeria Teaching Hospital Experience

Background and context: Early detection and improved treatments are associated with a reduction in breast cancer mortality and morbidity. UNTH is a leading comprehensive cancer center in Nigeria with referrals from the entire southeast and south south regions. Our goal is to offer high quality comprehensive cancer care services across the cancer care continuum from public health awareness campaigns and provision of screening services all the way to palliative care and survivorship. This is the first attempt by any institution in the country to standardize and harmonize available treatment options for breast cancer. Aim: To optimize, standardize and harmonize treatment options and management strategies for breast cancer using a multidisciplinary approach by developing guidelines adapted to our peculiar infrastructure and health system. Strategy/Tactics: The practice guideline was specifically developed for UNTH using a multidisciplinary approach and taking into consideration circumstances peculiar to UNTH, including the following: UNTH's specific patient population; UNTH's services and structure; and UNTH's clinical information. Program/Policy process: The process used recognized methods that are robust, objective, scientifically valid, consistent and adaptable to UNTH and engaged all identified multisectoral and multidisciplinary stakeholders involved in the care of patients with breast cancer. Outcomes: We reviewed substantial evidence on documented and proven strategies for community screening and prevention, less expensive and only marginally less effective diagnostic tools, locoregional and systemic therapies for the management of breast cancer. The team also recommended all patients receive psycho-oncology support through a dedicated team and through the breast cancer support group. It was agreed that palliative care be incorporated within the first 8 weeks of commencing treatment in line with the current ASCO guidelines and receive consultation from the exercise immunology unit. What was learned: Institutionalized care offers better management strategies and standardized treatment in line with best global practices of care for patients with breast cancer across the cancer care continuum which will ultimately translate to better treatment outcomes.

The Impact of Public Health Awareness Campaigns on the Awareness and Quality of Palliative Care.

The right to health includes a right of access to good quality palliative care, but inequalities persist. Raising awareness is a key plank of the public health approach to palliative care, but involves consideration of subjects most of us prefer not to address. This review addresses the question: "do public health awareness campaigns effectively improve the awareness and quality of palliative care"? The evidence shows that public awareness campaigns can improve awareness of palliative care and probably improve quality of care, but there is a lack of evidence about the latter. Rapid review and synthesis. A comprehensive public awareness campaign about palliative care (including advance care planning and end-of-life decision making) should be based on clear and shared terminology, use well piloted materials, and the full range of mass media to suit different ages, cultures, and religious/spiritual perspectives. Arts and humanities have a role to play in allowing individuals and communities to express experiences of illness, death, and grief and encourage conversation and thoughtful reflection. There is evidence about key factors for success: targeting, networking, and use of specific, measurable, achievable, realistic time-bound objectives; continuous evaluation; and complementarity to national and international policy. Campaigns should be located within the framework of public health promotion and the synergy between short national mass media campaigns and longer term local community action initiatives carefully considered. National and local projects to raise awareness should identify and address any barriers at the level of individuals, communities, and systems of care, for example, literacy skills and unequal access to resources.

A Public Health Response to the Poor Outcomes in Out-of-Hospital Cardiac Arrests in Australia

The high incidence and poor outcomes for those who suffered out-of-hospital cardiac arrests, plus the knowledge that early bystander treatment improves outcomes, called for a public health response to this issue. The ‘Shock Verdict’ National CPR Campaign sought to improve the rates of bystander compression-only cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, through a social media public health awareness campaign. An 8-week social media campaign centred around an educational video based on a popular Australian comedy drama ‘Rake’ was designed and developed through a partnership between the Tasmanian Branch of the Australian Resuscitation Council and the University of Tasmania. To date, there have been over 1 million views on the various social media platforms. The campaign focuses on how untrained bystanders can perform compression-only CPR and use an AED in out-of-hospital cardiac arrest, to increase chances of survival. Baseline data collected from an online survey found approximately 50% of respondents rated their CPR knowledge and their confidence to perform CPR as good or fair. Participants were more likely to report a willingness to start hands-only CPR on strangers and unkempt individuals than standard CPR. The campaign provides an example of using social media to communicate a health message, and demonstrates the practicalities of planning such a campaign, including the design of content, and building partnerships. It highlights the importance of collaboration between academic research, health and marketing, and of applying a public health approach to improving clinical outcomes.

Exploratory study into the awareness of heart diseases among Emirati women (UAE) and their health seeking behaviour- a qualitative study

Background: Cardiovascular diseases were the leading cause of death in women in the United Arab Emirates (UAE) in 2010. The UAE is expected to experience a tripling of heart diseases in the next two decades as risk factors for heart diseases increase. Research shows that first year survival rates of younger women suffering from a heart attack are lower than in men. Women present with a wider range of symptoms for heart diseases than men; non-recognition of atypical symptoms may explain the delay in seeking treatment and poor prognosis following heart diseases in women. No known study on awareness of heart diseases among women has been carried out in the Middle Eastern region. Methods: Social constructionist and interpretivist epistemological approaches have been considered in this qualitative study to explore the awareness of heart diseases and the health seeking behavior of Emirati women. Convenience sampling was used to recruit 41 Emirati women. Three focus groups and six in-depth semi-structured interviews were conducted to obtain data. Thematic content analysis was applied to the data following transcription and translation of recordings. Results: Emirati women had limited knowledge on heart diseases. Women were generally unaware of the atypical symptoms, commonly experienced by women however they identified most risk factors associated with heart diseases. Lack of awareness of disease severity and symptoms, sociocultural influences and distrust in the healthcare system were considered the main barriers to seeking prompt treatment. Conclusions: This study clearly identified gaps and inaccuracies in knowledge of heart diseases, which could contribute to delayed health seeking action and possibly poorer prognosis among Emirati women. Absence of initiatives to educate women on cardiovascular diseases in UAE has erroneously deemed it a less serious concern among Emirati women. The findings from this study provide clear indications of the need to increase accountability of the healthcare system and to develop culturally relevant, gender specific, age focused, heart diseases related public health awareness campaigns in UAE.

Neck circumference as a marker of obesity and a predictor of cardiometabolic risk among Saudi subjects.

Objectives:To determine the optimal cutoff value for neck circumference (NC) that define overweight/obesity and assess its predictive potential for cardiometabolic risks (CMR) among Saudi subjects.Methods:A cross sectional study of 785 adults recruited from a public health awareness campaign in Medina, Saudi Arabia during June 2015. Waist circumference (WC), NC, body mass index (BMI), blood pressure (BP), and random blood glucose (RBG) were assessed, and the presence of CMR were collected by a questionnaire. Pearson’s correlation coefficients were used to evaluate the associations of NC with other anthropometric indices and CMR. The optimal cutoff value for NC to identify overweight/obesity was determined by receiver operating characteristic (ROC) curves.Results:There were significant correlations between NC and BMI, weight, WC, age, RBG, and BP. The area under the curve for NC and WC in the ROC analysis was 0.86 for men and 0.77 for women, and NC ≥39.25 cm for men and ≥34.75 cm for women were the best cutoff levels for identifying subjects with central obesity with an 89% sensitivity and a 71% specificity for men and an 80% sensitivity and a 65% specificity for women. These cutoff levels for NC were associated with a significantly increased risk for diabetes, dyslipidemia, and hypertension.Conclusion:Neck circumference is positively correlated with BMI and WC, and can be used to identify overweight/obesity and predict CMR in Saudi individuals.

Human – monkey interaction on a University campus in Nigeria: An avenue for zoonotic disease transmission at the human wildlife interface?

Monkeys are potential sources of infectious diseases to humans. Mona monkeys frequently gain access to human dwellings within the University of Lagos campus. This study was conducted to assess the level of human-monkey interaction with a view to determining if such interaction will create an avenue for zoonotic disease transmission from monkeys to humans resident in this human-wildlife interface. Information on frequency and closeness of human – monkey interaction was gathered from 395 respondents using a semi-structured questionnaire and in-depth interviews. These were used to determine respondents’ attitude towards the monkeys as well as their knowledge on monkey related zoonoses. Responses from the questionnaire were entered into and analysed using EPI INFO TM version 7.2.0.1 statistical software. Categorical data were summarised as tables and bar chart. Chi Square, Fisher exact tests and binary logistic regression were used to test for significance and deduce relationships among variables. Statistical significance was determined at 95% Confidence interval. Most of the respondents (63.5%) were undergraduates; while 70.1% of all respondents were residents on campus. Only 19.8% and 6.6% of the respondents had close and risky contacts respectively, while 11.1% and 8.3% had negligible and minimal contacts respectively. Majority of the respondents (69.1%) had inadequate knowledge about monkey related zoonoses Only 39% were aware that monkeys could transmit disease to humans and 2% believed that monkeys could not transmit diseases to humans. Campus residents have significantly closer contacts with monkeys than visitors (p<0.05, OR=0.32). Residents were three times more likely to have had any form of contact with monkeys than non-residents. There was no significant difference between the frequency of risky human-monkey contacts among visitors and residents. The low level of awareness about zoonotic disease among the respondents could be ameliorated through public health awareness campaigns by health workers and conservationists. Keywords: Conservation, Human–wildlife interface, Mona monkeys, Public health, Zoonosis

Determinants of dietary diversity among pregnant women in Laikipia County, Kenya: a cross-sectional study

BackgroundDietary diversity has continued to gain widespread attention among the population since it has evidently been associated with nutrient adequacy. A diverse diet has been shown to reflect nutrient adequacy since no one food can meet the nutritional requirement of a person. Pregnant women have been considered vulnerable to malnutrition due to their increased nutrient requirement and therefore a variety of foods in their diet is considered imperative in ensuring adequate nutrient intake. To promote dietary diversity, it is important to understand the factors associated with it. This paper therefore assessed the determinants of dietary diversity among pregnant women in Laikipia County, Kenya.MethodsThe study was a cross-sectional analytical study consisting of 254 pregnant women attending antenatal clinic at Nanyuki Teaching and Referral Hospital in Laikipia County, Kenya.ResultsThe mean Dietary Diversity Score (DDS) was 6.84 ± 1.46 Standard Deviation (SD), with cereals being the most (99%) commonly consumed food group. Adjusted Logistic Regression (AOR) analyses revealed education level (AOR = 2.78; (95% Confidence Interval (CI) 1.06, 5.32; p < 0.001), employment status (AOR = 2.29; CI 1.18, 4.14; p = 0.003), monthly income (AOR = 2.08; CI 1.32, 3.03; p < 0.001), household assets (AOR = 1.93; CI 0.73, 6.90; p = 0.030), land ownership (AOR = 0.64; CI 0.44, 2.25; p = 0.040), and morbidity (AOR = 0.78; CI 0.36, 2.34; p = 0.010) among the pregnant women as the variables that influenced their dietary diversity.ConclusionSocioeconomic factors (education level, employment status, monthly income, household assets and land ownership) have been shown to influence dietary diversity in this study. New policies and intervention programmes targeting these determinants of dietary diversity should therefore be enacted, while the existing ones should be supported and monitored particularly among the vulnerable populations. Such policies and programmes among pregnant women will ensure improved dietary diversity and adequate nutrient intake. Similarly, since morbidity incidence among pregnant women have been shown to significantly influence dietary diversity, public health awareness campaign on the importance of early detection and timely treatment of diseases among pregnant women should be launched by the relevant stakeholders.

Exploratory study into the awareness of heart diseases among Emirati women (UAE) and their health seeking behaviour- a qualitative study.

BackgroundCardiovascular diseases were the leading cause of death in women in the United Arab Emirates (UAE) in 2010. The UAE is expected to experience a tripling of heart diseases in the next two decades as risk factors for heart diseases increase. Research shows that first year survival rates of younger women suffering from a heart attack are lower than in men. Women present with a wider range of symptoms for heart diseases than men; non-recognition of atypical symptoms may explain the delay in seeking treatment and poor prognosis following heart diseases in women. No known study on awareness of heart diseases among women has been carried out in the Middle Eastern region.MethodsSocial constructionist and interpretivist epistemological approaches have been considered in this qualitative study to explore the awareness of heart diseases and the health seeking behavior of Emirati women. Convenience sampling was used to recruit 41 Emirati women. Three focus groups and six in-depth semi-structured interviews were conducted to obtain data. Thematic content analysis was applied to the data following transcription and translation of recordings.ResultsEmirati women had limited knowledge on heart diseases. Women were generally unaware of the atypical symptoms, commonly experienced by women however they identified most risk factors associated with heart diseases. Lack of awareness of disease severity and symptoms, sociocultural influences and distrust in the healthcare system were considered the main barriers to seeking prompt treatment.ConclusionsThis study clearly identified gaps and inaccuracies in knowledge of heart diseases, which could contribute to delayed health seeking action and possibly poorer prognosis among Emirati women. Absence of initiatives to educate women on cardiovascular diseases in UAE has erroneously deemed it a less serious concern among Emirati women. The findings from this study provide clear indications of the need to increase accountability of the healthcare system and to develop culturally relevant, gender specific, age focused, heart diseases related public health awareness campaigns in UAE.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0350-2) contains supplementary material, which is available to authorized users.

Why has canine rabies remained endemic in the Kilosa district of Tanzania? Lessons learnt and the way forward

BackgroundDomestic dogs are the main targets for rabies control as they are the principal reservoir for transmission of the rabies virus to humans and other domestic animals. The purpose of this study was to identify the factors that contribute to the rabies virus infecting the human population in a rural community of Eastern Tanzania.MethodsUsing a cross-sectional study design, field visits were conducted to gather information on villagers’ knowledge on and practices associated with canine rabies control and dog vaccination campaigns.ResultsA total of 248 individuals were interviewed in the Kilosa district, Tanzania. Almost two-thirds (61.3 %) had a primary school education. The majority (91.1 %) of the respondents were aware that rabies is acquired through dog bites and 66.9 % knew about the clinical signs of rabies in an animal. Very few (17.7 %), however, were aware of the clinical signs of rabies in humans. Only 20.4 % of the respondents knew how rabies is controlled in dogs and 71 % were not aware of dog vaccination campaigns. The average number of dogs kept per household was 4 ± 3.3; 70.0 % of the respondents had one to five dogs, 28.3 % had six to dog dogs, and 1.6 % had 16–20 dogs. The dogs were primarily used to guard livestock and property, and to hunt. About 59.7 % of the respondents indicated that rabies was a public health problem. Low vaccination coverage was observed in the study area, with previous mass vaccination campaigns covering only 24.4 % of the dog population. Dogs appeared to have limited value in the studied community. Furthermore, there were no proper waste disposal facilities and oftentimes wild canids and felids visited the villages to scavenge on kitchen leftovers.ConclusionAlthough communities in the Kilosa district had knowledge on rabies in dogs, they were not aware of the public health implication of the disease, which thus led a poor response during mass dog vaccination campaigns. Establishment of a well-coordinated rabies control program, strategic public health awareness campaigns, and active and passive surveillance systems for humans and domestic and wild animals should be considered as strategies to control and eradicate rabies.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-015-0085-6) contains supplementary material, which is available to authorized users.

Barriers to breast self examination practice among Malaysian female students: a cross sectional study.

IntroductionBreast cancer is the most frequent cancer and the second reason of cancer deaths among woman worldwide, including Malaysia. The objective of this paper is to assess the practice of breast self-examination (BSE) and identify the barriers of BSE practice among undergraduate female students in Malaysia.MethodsA cross-sectional study conducted among 810 female undergraduate students in Klang Valley, Malaysia between April–Jun 2012. Data was collected via self-administered questionnaire which was developed and pre-tested for this study. ResultsThe majority of respondents were Malay 709 (95.6 %) and single 719 (96.9 %) with a mean age of 21.7 (1.1). Only hundred eleven (15 %) of the participants had a family history of breast cancer. 70.5 % of the respondents do not practice breast self-examination, 70.5 % do not know how to do it, 64.7 and 61.5 % reported no symptoms of breast cancer and worries to detect breast cancer, respectively. Univariate analysis showed that age, marital status and personal history of breast disease were statistically associated with the practice of breast self-examination.ConclusionIn this study, a high percentage of respondents were aware of breast cancer but do not perform breast self-examination. Knowledge, socio-cultural and environmental factors were identified as barriers; so it is recommended that knowledge among the public about breast cancer and promotion of public breast health awareness campaigns through the media should be carried out.

The prevalence and determinants of use of vitamin D supplements among children in Alberta, Canada: a cross-sectional study.

BackgroundLimited cutaneous synthesis due to low sun exposure and inadequate dietary intake makes vitamin D supplementation a necessity for many Canadian children. Identification of the factors associated with supplement use is necessary for public health awareness campaigns, but they have not been identified previously. Therefore, the purpose of this study was to assess the prevalence and the determinants of the use of vitamin D supplements among children in the province of Alberta, Canada.MethodsIn 2014, a representative sample of grade five students (10–11 y) in Alberta (n = 2686) was surveyed. Data on dietary intake and use of vitamin D supplements were obtained using a modified Harvard Youth/Adolescent Food Frequency questionnaire. Mixed effect multiple logistic regression was employed to identify the key correlates of supplement use.ResultsUse of vitamin D supplements by children was 29.45 % although only 11.83 % took supplements daily. Children who resided in a metropolitan area (OR = 1.32; 95 % CI:1.06–1.65), were more physically active (2nd tertile: OR = 1.39; 95 % CI:1.09–1.78 and 3rd tertile: OR = 1.70; 95 % CI:1.33–2.16), or whose parents completed college (OR = 1.35; 95 % CI:1.05–1.74) were more likely to take vitamin D supplements. Prevalence of use was highest among those who had a high vitamin D diet and those with under/normal body weight status, although supplement use was not statistically associated with either dietary vitamin D intake or weight status.ConclusionsA considerable proportion of children did not take vitamin D supplements. Region of residence, physical activity level and parental education were determinants of supplement use, independent of child’s gender, household income, weight status and dietary practices. We suggest prioritizing public health efforts to support strategies to make parents aware of the importance of providing the correct dose of vitamin D supplements for their children to meet dietary recommendations.

Oral health knowledge, attitude and behavior among students of age 10–18years old attending Jenadriyah festival Riyadh; a cross-sectional study

Abstract Introduction: Several studies have documented a high prevalence of dental problems among Saudi youth. In order to plan successful public health awareness campaigns it is essential to evaluate three domains related to oral health at the population level, namely knowledge, attitudes and behavior. Objective: To assess the level and aspects of knowledge, attitudes, and behaviors related to oral health among school students who attended a major festival in the City of Riyadh. Methods: This survey followed a cross sectional study design. Study subjects were recruited randomly among Saudi nationals attending the Jenadriyah festival in Riyadh City in the year 2013. Results: The study population was composed of 287 participants of age 10–18 years. Around 67% students reported brushing their teeth daily. We found significant difference in brushing habit between genders ( P = 0.001) with girls showing a better dental practice. Compared to boys, girls were more aware about bleeding gums ( P value ⩽ 0.001), oral health effects general health ( P value = 0.004) and importance of dental check-up ( P value ⩽ 0.001). Compared to boys’ girls were significantly more conscious about tooth color ( P value = 0.05). Other attitudes toward dental health were not significantly different in-between genders. Conclusion: This population-based study among 15–18-year old students found that around two third of Saudi youth brush their teeth proportion which is similar to that reported among similar age groups 10 years ago. Through this study we recommended that evidenced-based effective dental awareness programs are needed in order to improve dental-related practice among that age group. Evaluations of ongoing campaigns in schools are needed to better understand factors that can facilitate translating improved knowledge and attitudes into changing practice.

Peripheral Artery Disease: A Marked Lack of Awareness in Ireland

Patients with symptomatic peripheral artery disease (PAD) have a 30% risk of death within 5 years. However, public awareness of vascular disease has been shown to be low. The aim of this study was to assess awareness regarding risk factors, significance and potential sequelae of PAD in an Irish population. A cross-sectional, anonymous survey of patients and members of the public. An anonymous questionnaire was developed to collect details on basic demographics, presence of and treatment for risk factors for cardiovascular disease, awareness of PAD and its risk factors and sequelae. The local ethics committee granted ethical approval. Two investigators in face-to-face interviews administered the survey with patients and members of the general public, older than 40 years of age, attending a range of outpatient clinics, day care services and in patients. A total of 336 questionnaires were administered. A post-secondary school course had been completed by 32% of respondents. Only 19% of patients reported familiarity with PAD, a figure considerably lower than those reporting familiarity with stroke (94%), coronary artery disease (78%) or diabetes (98%) (Chi Squared p<0.001). The only independent predictor of awareness of PAD was having a post-secondary school course with an odds ratio or 4.2. This study demonstrates a disturbing lack of awareness of PAD and highlight the need for a meaningful targeted public health awareness campaign on PAD in order to close the gap of knowledge in Irish patients, prior to any prevention campaign.