Care Seeking Research Articles

Transrectal ultrasound-guided intraprostatic injection therapy for treatment of chronic prostatitis in a Ugandan population

Abstract Background Globally, the clinical understanding of prostatitis has been obscured mainly due non-specificity of clinical features, no uniform diagnostic criteria and its protracted treatment course. Conventional treatment of chronic prostatitis by oral or parenteral routes of drug administration remains a challenge basically because of the poor ability of drugs to penetrate prostate epithelium; the alternative of direct prostate injection has not been thoroughly studied in an African population. The aim of this retrospective study was to determine the effect of transrectal ultrasound (TRUS)-guided intraprostatic injection of a cocktail of antibiotics, antifungal and long-acting steroids on alleviating symptoms attributed to chronic prostatitis in Ugandan patients. Methods We conducted a retrospective review of records among patients who were referred with symptoms attributed to chronic prostatitis at the Radiology Department of Ernest Cook Ultrasound Research and Education Institute (ECUREI). Patients were treated using TRUS-guided intraprostatic injection of a cocktail of antibiotics, antifungal agents and long-acting steroids. Results At baseline, we found that out of the 131 patients, 90 had pain or burning during urination in the last week to seeking care and 89 had symptoms, which had kept them away from doing the kinds of things they would usually do. Additionally, 85 of the total number of patients felt terrible about their symptoms. Post intervention, after 1 year following completion of intraprostatic injection therapy (IPIT), we found that most patients had mild residual symptoms which were largely; mild pain and burning at urination. None of the patients had symptoms, which kept them away from doing the kind of things they would usually do. Furthermore, 62 patients felt delighted about their quality of life, whereas prior to treatment, none was delighted. Eighty-five patients had felt terrible about their quality of life prior to the IPIT, but post therapy, no patient felt terrible. Conclusion Transrectal ultrasound-guided intraprostatic injection therapy of a drug cocktail composed of antibiotics, antifungal agents, long-acting steroids and lidocaine for treatment of patients presenting with symptoms attributed to chronic prostatitis and refractory to conventional oral therapy has shown a good response in this study.

Exploring the Health Care Seeking Behavior of Rohingya Community during COVID-19 Pandemic

Introduction: COVID-19 was declared a 'pandemic,' and it was the most horrific diseases the world. Objective: The study aimed to explore the healthcare-seeking behavior of Rohingya people during the COVID-19. Materials and methods: It was conducted as a cross-sectional study involving a sample size of 200 participants. Respondents were chosen through convenience sampling methods. The study population was the Rohingya population residing in Cox’s Bazar. A well-designed and pretested set of structured questionnaires was used to collect the information. The total study duration was for 3 months. Informed consent was taken from the participants, and Ethical clearance was taken from the IRB of AIUB. Data were analyzed using IBM STATA 16. Place and period of study: The study was conducted at Cox’s Bazar Rohingya Camp in Bangladesh. Results Majority (40%) of the respondents was aged between 30 to 49 years and 51% of them were female. A significant majority, 88%, expressed a preference for treatment at a Refugee health camp, while 9% opted for a Pharmacy and 3% chose a Traditional healer. Overall, 88% of respondents demonstrated positive behavior, in contrast to 12% who exhibited negative behavior. The results of a multivariate logistic regression analysis indicated that factors such as low educational attainment, fear of visiting health facilities, and a lack of awareness regarding COVID-19 prevention were significantly associated with negative health-seeking behavior. Conclusion: The healthcare-seeking behavior exhibited by the Rohingya community in Bangladesh during the COVID-19 pandemic has been observed to be commendable.

Culture, community, and cancer: understandings of breast cancer from a non-lived experience among women living in Soweto

BackgroundIndividual perceptions, socio-cultural beliefs and health system factors are key determinants of people’s health seeking behavior and are widely cited as the causes of delayed breast cancer diagnosis among women from structurally vulnerable settings. Asking: “how do women with a non-lived experience of cancer understand the disease and, what informs their health seeking behaviors?”, we qualitatively explored, individual, sociocultural and health system elements from a conceptual model derived from the Socioecological, Health Belief and Cancer Stigma Frameworks, to understand perspectives of breast cancer in a South African urban community setting.MethodsUsing a deductive approach and allowing new themes to emerge inductively, we investigated phenomenologically, breast cancer perceptions among 34 women from Soweto, Johannesburg (aged 35–74 years) in 6 Focus Group Discussions. We then conducted 20 follow-up semi-structured in-depth interviews to explore novel themes and suggestions for increasing breast cancer screening.ResultsFindings revealed some awareness of breast and other cancers, but confusion and gaps in understanding of the disease, resulting in socio-culturally influenced misperceptions of risks, causes, and outcomes following treatment of breast cancer. This fueled perceptions of profound fear and stigma against people with breast and other cancers. These findings together with participant perceptions of primary healthcare providers being unwelcoming, under-resourced, and insufficiently trained to deal with breast cancer, resulted in women reporting being reluctant to participating in screening/early detection care seeking behavior. Women only accessed primary care when experiencing extreme pain or ill-health. Participants suggested as solutions for future interventions, the need for sustained community engagement, harnessing existing clinic and community stakeholders and resources to provide clear and understandable breast cancer information and encouragement for screening uptake.ConclusionsHealth literacy gaps surrounding breast cancer fuels socio-culturally influenced misperceptions, fear, stigma, and fatalism among women from Soweto. Women perceive primary care providers of having insufficient knowledge, skills, and resources to provide effective breast cancer screening services. Participants suggested the need for greater community engagement involving primary clinics and existing community stakeholders working collaboratively. Clear, understandable, and consistent information about breast cancer must be regularly disseminated and communities must be regularly encouraged to utilize breast cancer screening services.

User Views on Online Sexual Health Symptom Checker Tool: Qualitative Research.

Delayed diagnosis and treatment of sexually transmitted infections (STIs) contributes to poorer health outcomes and onward transmission to sexual partners. Access to best-practice sexual health care may be limited by barriers such as cost, distance to care providers, sexual stigma, and trust in health care providers. Online assessments of risk offer a novel means of supporting access to evidence-based sexual health information, testing, and treatment by providing more individualized sexual health information based on user inputs. This developmental evaluation aims to find potential users' views and experiences in relation to an online assessment of risk, called iSpySTI (Melbourne Sexual Health Center), including the likely impacts of use. Individuals presenting with urogenital symptoms to a specialist sexual health clinic were given the opportunity to trial a web-based, Bayesian-powered tool that provides a list of 2 to 4 potential causes of their symptoms based on inputs of known STI risk factors and symptoms. Those who tried the tool were invited to participate in a once-off, semistructured research interview. Descriptive, action, and emotion coding informed the comparative analysis of individual cases. Findings from interviews with 14 people who had used the iSpySTI tool support the superiority of the online assessment of STI risk compared to existing sources of sexual health information (eg, internet search engines) in providing trusted and probabilistic information to users. Additionally, potential users reported benefits to their emotional well-being in the intervening period between noticing symptoms and being able to access care. Differences in current and imagined urgency of health care seeking and emotional impacts were found based on clinical diagnosis (eg, non-STI, curable and incurable but treatable STIs) and whether participants were born in Australia or elsewhere. Online assessments of risk provide users experiencing urogenital symptoms with more individualized and evidence-based health information that can improve their health care-seeking and provide reassurance in the period before they can access care.

Factors and Reasons Associated with Hesitating to Seek Care for Migraine: Results of the OVERCOME (US) Study.

Despite a variety of available treatment options for migraine, many people with migraine do not seek medical care, thereby reducing opportunities for diagnosis and effective treatment and potentially leading to missed opportunities to reduce the burden of disease. Understanding why people hesitate to seek care for migraine may help healthcare professionals and advocates address barriers and improve outcomes. The aim of this study, in a large adult population sample in the United States (US), was to identify factors associated with and reasons for hesitating to seek healthcare for migraine. The web-based OVERCOME (US) survey study identified adults with active migraine in a demographically representative US sample who answered questions about hesitating to seek care from a healthcare provider for migraine and reasons for hesitating. Supervised machine learning (random forest, least absolute shrinkage and selection operator) identified factors associated with hesitation; logistic regression models assessed association of factors on hesitation. The study results show that of the 58,403 participants with active migraine who completed the OVERCOME (US) baseline survey and provided responses to the question on hesitating to seek care for migraine, 45.1% (n = 26,330/58,403) with migraine indicated that they had ever hesitated to seek care for migraine. Factors most associated with hesitating to seek care were hiding migraine (odds ratio [OR] = 2.69; 95% confidence interval [CI]: 2.50, 2.89), experiencing migraine-related stigma (OR = 2.13; 95% CI 1.95, 2.33), higher migraine-related disability (OR = 1.30; 95% CI 1.23, 1.38), and higher ictal cutaneous allodynia (OR = 1.26; 95% CI 1.19, 1.35). The most common reasons participants stated for hesitating included (1) 44.2% wanting to try and take care of migraine on their own, (2) 33.8% feeling that their migraine or headache would not be taken seriously, (3) 29.2% thinking that their migraine was not serious/painful enough, and (4) 27.4% not being able to afford it or not wanting to spend the money. The main limitation of the study includes the requirement for respondents to have internet, access which may have reflected cohort bias, and the quota sampling rather than random sampling to create a demographically representative sample. Hesitating to seek migraine care is common and is most strongly associated with hiding the disease and migraine-related stigma. Those experiencing higher migraine-related burden are more hesitant to seek the care that might alleviate the burden. These findings suggest that migraine's social context (e.g., stigma) is a major determinant of hesitance to seek migraine care.

Primary care seeking among adults with chronic neck and low back pain in Norway: A prospective study from the HUNT study linked to Norwegian primary healthcare registry.

To describe the frequency of primary care seeking for neck or back-related conditions among people with chronic neck and low back pain and to develop prediction models of primary care seeking and frequent visits. We included participants of the Trøndelag Health Study (HUNT4, 2017-19) in Norway who self-reported chronic neck and/or low back pain in the preceding year, and extracted data of primary care visits from the Norwegian primary healthcare registry. We investigated a total of 23 potential predictors and used multivariable logistic regression models to predict primary care seeking for neck or back-related conditions and frequent visits by healthcare provider (i.e., the highest quartile of number of visits). Among the 15,352 HUNT4 participants with chronic neck and/or low back pain, 6231 participants (40.6%) sought primary care for neck or back-related conditions (median = 5 visits, IQR 2-15) within 2 years after the study. Participants who consulted physical therapists sought care the most frequently (median = 10 visits, IQR 3-26). Discrimination of the best-fit prediction model of primary care seeking and frequent visits by healthcare provider, assessed by C-statistic, ranged from 0.66-0.76. Participants who made frequent primary care visits in the preceding year were highly likely to continue frequent care seeking in the following 2 years. Around 40% of people seek primary care for chronic neck and low back pain, and frequent care seeking may continue for years. Future studies should investigate strategies to reduce recurrent primary care visits, especially seeking physical therapist care, and promote self-management of chronic pain. People with chronic neck and low back pain who seek physical therapist care had the highest frequency of care seeking, underscoring the significant burden on healthcare systems. The high frequency of visits and associated healthcare expenditures highlight the critical need for effective and valuable primary care for chronic pain management. To mitigate recurrent visits and reduce costs, it is essential to provide patients with evidence-based treatments and self-management interventions.

Impact of Gender and Marital Status on Door-to-Treatment (DTT) Time and Acute Stroke Outcome.

Delays in acute stroke treatment lead to poor outcomes. Women can present with atypical stroke symptoms, are older at the time of stroke, and tend to be living alone, causing delays in pre-hospital diagnosis and seeking care. It is unclear if gender disparities in ED arrival and stroke assessment are compounded by gender differences after ED arrival. Therefore, we sought to identify if gender and marital status were associated with faster door-to-treatment (DTT) time. Our single-center stroke database was queried for adults presenting to ED with acute stroke between January 1, 2018 and January 30, 2023 treated with IV thrombolytics (IVT)+/- endovascular thrombectomy (EVT) and a known DTT time. The primary outcome was DTT (door-to-needle+door-to-puncture) time. Data collected includes the National Institutes of Health Stroke Scale (NIHSS) at presentation and discharge, gender, marital status, age, and intervention (IVT alone or IVT+/- EVT). Among 674 patients identified, 35 patients were excluded due to missing data. Of 639 patients (median age 66y), 25%/18% of patients were married men/women, respectively, and 22%/35% were single men/women. Median DTN time, DTP time, and discharge NIHSS score were 36, 79, and 4mins, respectively. On multivariable analysis, neither DTT time nor NIHSS score at discharge improved among married men relative to any other combination of gender and marital status. Gender differences in the knowledge of stroke warning signs and gender disparities in ED assessment did not translate into faster DTT time. More work is needed to find ways to accelerate stroke care after ED arrival.

Experiences of family caregivers of children living with thalassaemia-major in Karachi: a phenomenological study

IntroductionThalassaemiamajor, a global health burden, presents a growing challenge in Pakistan’s strained healthcare system. This study explores how caregivers of children with beta-thalassaemia major navigate healthcare services, aiming to identify facilitators and barriers to accessing optimal care.MethodsA qualitative interpretative phenomenological approach was employed. In-depth interviews with 18 purposively sampled caregivers from Karachi thalassaemia centres were conducted. Thematic analysis using a combined inductive-deductive approach identified themes within the interview data.ResultThe study revealed significant challenges for caregivers at individual, interpersonal and organisational levels. Lack of awareness about carrier states, limited disease knowledge, financial constraints and concerns about the child’s future emerged as primary hurdles. Parents felt helpless due to the absence of emotional and social support for their children’s treatment. Obstacles such as complicated registration processes at thalassaemia-care centres, high costs of chelating agents and blood unavailability were major barriers to seeking care and caregiving. Additionally, the study highlighted the absence of guidelines for thalassaemia-carrier detection among mothers during antenatal care.ConclusionThe study emphasised the importance of implementing premarital screening programmes due to the lack of knowledge about the disease and carrier state. To prevent the disease, it is crucial to include thalassaemia-carrier detection for mothers in antenatal guidelines and provide counselling at the primary level. Additionally, caregivers encountered treatment accessibility issues, prompting the establishment of a satellite thalassaemia centre linked to a top-tier tertiary care hospital in the public sector. This initiative addressed treatment challenges and improved overall care for patients with thalassaemia and their caregivers.

Parental Ability to Detect Visual or Ocular Anomalies in Their Children

INTRODUCTION: Children typically depend on their parents to seek eyecare. Visual and ocular disorders can be challenging for parents to identify with the absence of apparent symptoms. This may hinder timely clinical diagnosis for children who need treatment. Parental awareness regarding common paediatric eye and vision anomalies along with eye care seeking behaviour has been reported, but there is a lack of studies that demonstrate parental ability to identify a presenting eye or vision disorder in their own children. AIM: This study aimed to determine parental ability to recognise a significant eye problem in their children. METHODS: The study population consisted of beneficiaries of Jaber Al Ahmad Armed Forces Hospital in Kuwait. Structured history and symptoms were taken from parents and comprehensive eye examinations were conducted for their children. Parental responses were compared to the eye test results to attain the study purpose. RESULTS: A total of 188 parental interviews and 188 eye test results data were collected from 137 parents and their children. Only a few parents (18.1%) were able to detect significant visual or ocular anomalies in their children. One-third of the parents (33%) were under the assumption that the visual or ocular status of their children was within the norm, while the eye test results showed that the children had clinically significant issues. Overall, 41.5% of the entire group of parents were wrong in their assumption about the children’s visual or ocular status. CONCLUSION: The findings suggest that a large proportion of parents may not be able to identify a presenting eye disorder in their children. This emphasises the significance of routine eye examinations at an early age.

Healthcare Seeking Behaviour and Associated Factor Among Community Based Health Insurance Members and Non-Members in Addis Ababa, Ethiopia, 2023

Background: Community based health insurance (CBHI) is voluntary, non-profit health insurance. It helps to mobilize additional resource to the health sector. Community Based Health Insurance uses principles of insurance, members pay fees to the insurance scheme and in return their health service cost is covered by the scheme. This way risks can be shared among individuals and financial inputs pooled between individuals who need health service but are not able because they cannot afford it and those who are well but pay premium. Objective: To assess health Care seeking behavior and Community based health insurance among members and non-members in Addis Ababa, Ethiopia 2023. Methodology: A community based comparative cross-sectional study was conducted. A total of 580 households included in this study. Data was collected by data collectors using a standardized questionnaire through interviews. Associated factors for healthcare seeking behavior is identified by binary and multivariate logistic regression analysis and expressed by adjusted odds ratio (AOR). Multivariate analysis also used to control the effect of confounders. Result: Healthcare-Seeking Behavior of the Study Participants Factors Associated with Healthcare-Seeking Behavior participants the study indicated that the decision-making to visit a health facility for illnesses, disease severity, and CBHI membership had a statistically significant association with HSB. Conclusion: The overall household Health Seeking Behavior was 56.3% for Community Based Health Insurance members and 43.7% for non-Community Based Health Insurance members. Membership status has significant positive effect on healthcare seeking behavior. Decision- making process to visit a health facility for illnesses, disease severity was positively associated with membership status.

Incidence of high blood pressure among Kenyan adults living with HIV: a longitudinal cohort analysis from 2004-2023.

People with HIV (PWH) face a heightened risk of cardiovascular diseases, partly due to increased high blood pressure risk. This study assessed high blood pressure burden (i.e., incidence, prevalence) among PWH in Kenya over time. Longitudinal, open cohort study. We estimated the incidence and prevalence of high blood pressure in a large sample of Kenyans with HIV from the Coptic Hope Center using electronic medical records from 2004-2023. We defined incident high blood pressure as first visit after baseline at which each patient had a systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg. Our sample included 38,709 PWH seeking care at Coptic Hope Center clinics in Kenya (2004-2023). Nearly 40% of patients had high blood pressure at first visit. Among the 60% of patients initially normotensive, almost 40% developed high blood pressure within 20 years. The yearly prevalence of high blood pressure ranged from 8-58%. Average SBP was higher among patients who had their first visit from 2019-2023 compared to those visiting in the early 2000 s and 2010 s. Our findings reveal a high and rising burden of high blood pressure among PWH in a large, faith-based health system in Kenya. This underscores the need for stronger integration of care for individuals with concurrent HIV, high blood pressure, and other non-communicable diseases. Current systems are insufficient for achieving blood pressure control among PWH. Further research and funding for efforts to address HIV and NCD care in Kenya are warranted.

Implementing a pilot primary care program: Armenia’s steps toward universal health coverage

Abstract Problem Armenia has struggled to transform its ineffective primary healthcare (PHC) system into one that can address the non-communicable disease burden, which causes 93% of mortality. To address this issue, Armenia aims to establish universal health coverage and invest in high-quality primary care. Description In 2023, the Armenian Ministry of Health signed a multisectoral policy to implement a pilot primary care program to trial a multitude of reforms related to diabetes (DM) and hypertension (HTN). Pilot interventions include pathways for screening/diagnosis, provider training, free medications and diagnostics, and new provider financial incentives. The key question to be answered is if these pilot interventions cause DM and HTN health outcomes to improve. Beginning in 2024, the program is being piloted in a primary care clinic in Dsegh. Results As a result of the 2023 Ministerial policy, multisectoral stakeholders designed and implemented this pilot program. Baseline focus groups found that the pilot addresses the financial barriers that community members noted lead to delays in seeking care and that providers perceive the pilot to be beneficial to their patients. Although final results are not yet available, the pilot has already positively changed features in the national EMR and brought together stakeholders in a way never done before. Lessons The pilot’s innovation comes from it being the first time that hypertension and cholesterol medications are provided by the government for free, provider bonuses are based on outcome indicators, indicator targets are set this high, a point-of-care A1c machine is utilized, and a robust monitoring and evaluation (M&E) plan is implemented, all of which are currently shaping discussions on national policy. For countries similarly working on strengthening primary care, it is recommended to pilot specific reforms and establish mechanisms through M&E systems that allow pilots to inform evidence-based decision making. Key messages • To move towards universal health coverage, pilot programs designed with multi-sectoral stakeholders are needed to trial suggested healthcare reforms. • It is essential to invest in monitoring and evaluations systems to generate the data necessary to develop evidence-based policies.

Maternal near-miss and mortality associated with being referred: a case control study in Luanda

Abstract Background Understanding of determinants of severe maternal morbidity is crucial for reducing Maternal Near Misses (MNM) and Maternal Deaths (MD). We aimed to assess whether being referred from lower level to tertiary-level hospitals is a determinant of MNM and MD in Luanda, capital of Angola. Methods A facility-based case control study was conducted (June-September 2022) at 2 referral hospitals in Luanda. Consecutive sampling for the cases (women admitted with life-threatening conditions) and systematic sampling for the controls (women admitted for vaginal delivery) was used. Cases were classified by the outcome at discharge: MD or MNM. Multivariate multinomial regression was conducted to assess whether being referred is associated with MNM and MD (controls as reference). Sociodemographic, clinical and obstetric factors and circumstances at admission related with MNM or MM (p-value <0.05) were included in the models. Reduced models (forward technic) were fitted for obtaining adjusted odds ratio (AOR) and respective 95% confidence interval (95%CI). Results Data from 331 cases (245 MNM and 86 MD) and 662 controls were analyzed and bivariate analysis revealed large differences between groups in regards to the sociodemographic, clinical and obstetric characteristics and circumstances of admission. The proportion of being transferred from another facility was 7.9%, 51.0% and 65.1% among controls, MNM and MD, respectively. After adjusting for pre-existing diseases during pregnancy, previous cesarean section and delay in seeking care, being referred from another facility increased the odds of MNM (AOR=10.97; 95%CI: 7.19-16.75) and MD (AOR=18.89; 95%CI: 10.50-33.89). Conclusions According to our findings, being referred from lower level facilities is a strong determinant of MNM and MD. Strategies for improving lower level of healthcare services and the referral system for pregnant women could have a positive impact on prevention of MNM and MD in our setting. Key messages • Awareness should be given to the conditions of maternal transfer from lower level to tertiary level hospitals in Angola. • Public health strategies should address the quality of maternal care at primary and secondary level hospitals, before maternal transfer, as well as, the maternal referral system in this setting.

How have respiratory tract infections changed in the post-covid era for children under 5 years?

Abstract Background Social distancing measures introduced in response to the covid-19 pandemic reduced transmission of all respiratory pathogens. Exposure to respiratory pathogens in early life affects future lung health. We aimed to describe changes in the incidence of respiratory tract infections (RTIs) in children <5 years in England in the post-pandemic era. Methods Population-based retrospective cohort study using electronic health records. We included all children aged <5 years registered with a primary care practice from April 2016 to March 2023. We compared monthly GP consultation rates for RTIs in the two post-pandemic years (April 2021 - March 2022 and April 2022 - March 2023) with corresponding months during pre-pandemic years (April 2016 - February 2020). Results There were 3 045 701 respiratory tract infections among 2 894 539 children <5 years registered with a GP practice during the study period. Pre-pandemic, monthly RTI rates varied from lows of 29.1 per 100 child-years in August to highs of 108.8 per 100 child-years in November. In 2021/22, monthly RTI rates were bimodal peaking in June and October, although the winter peak was lower than pre-pandemic years and mean monthly RTI rates were ∼15% lower overall. In 2022/23 mean monthly RTI rates remained ∼15% lower than pre-pandemic years, but there was a single peak in December 2022 of 117.6 RTIs per 100 child-years, exceeding the pre-pandemic winter peaks by 8.1%. Conclusions Overall, monthly RTIs in post-pandemic years were 15% lower than pre-pandemic years. However, there was a concerning peak in December 2022 that exceeded the winter peaks from previous years. Comparisons with national surveillance data suggest this peak reflects changes in RTI incidence, particularly among group A streptococcal infections, but this peak may also reflect changes in access to care or healthcare seeking behaviour. Continued monitoring of post-pandemic seasonal patterns will assist in planning for health service use. Key messages • Respiratory tract infections in children <5 years in post-pandemic years were 15% lower than pre-pandemic years, but winter peaks in incidence may be of greater magnitude in the post pandemic era. • Ongoing monitoring of patterns of respiratory tract infections in young children is important for future health service planning and delivery.

The use of digital technologies to promote sexual health in young adults: a narrative review

Abstract Background New technologies have the potential to play an important role in promoting sexual health, especially among young people, who are the biggest users and those at greatest risk of contracting Sexually Transmitted Infections (STI). The risk behavior assumed by young people today highlights this vulnerability in several contexts, such as individual, social, economic, and family. In this sense, it becomes relevant to approach sex education in schools using digital technologies. Objectives To identify the evidence in the literature on the use of digital technologies to promote the sexual health of young adults. Methods Narrative literature review. Three independent reviewers extracted, analyzed and synthesized the articles and results. Results Through the selection process, four studies were included. The articles show that the use of digital technologies (mobile phones/applications) leads to increased knowledge, improved attitudes and sexual behavior among young adults. The interventions studied in the studies were based on Short Message Service, electronic mail interventions and the MyPEEPS mobile application, with the following main focuses: Increased knowledge, attitudes, and behaviors of young adults. Considering the results of the studies, all interventions proved to be effective as facilitators of sexual health promotion. Conclusions The use of digital technologies allowed an increase in the promotion of the sexual health of the participants, since there was an increase in the level of knowledge with the use of digital technologies such as SMS, emails and mobile applications when comparing the experimental and control groups. The use of these digital technologies also allowed for a change in attitudes and behaviors, such as a significant increase in serological testing for STIs and an increase in health care seeking. Key messages • The use of digital technology promotes the sexual health of young adults, so these strategies should be implemented by health professionals. • The dissemination of these digital strategies will have an impact on Public Health, specifically regarding the sexual health of young adults.

Improving cultural competency of healthcare providers to reduce prehospital delays in care seeking among culturally and linguistically diverse populations.

Improving cultural competency of healthcare providers to reduce prehospital delays in care seeking among culturally and linguistically diverse populations.

Lived experiences of women with uterine rupture who were managed at Nekemte specialized hospital: a qualitative study

BackgroundUterine rupture is a rare but severe obstetric complication that poses significant risks to maternal and fetal health. Understanding the lived experiences of individuals who have undergone uterine rupture is crucial for improving care and support for those affected by this condition. This qualitative phenomenological study aimed to explore the experiences of individuals who have experienced uterine rupture.MethodThe study employed a qualitative phenomenological approach, conducting 12 in-depth interviews and four key informant interviews with individuals who had experienced uterine rupture. Data analysis was conducted thematically using Atlas ti software to identify patterns and themes within the participants’ narratives.ResultsThe analysis of the interviews highlighted six key themes: experience during diagnosis and initial symptoms, perceived predisposing factors of uterine rupture, challenges faced by individuals with uterine rupture, impacts on their lives, and coping and resilience strategies. The findings revealed that women often failed to recognise the initial symptoms of uterine rupture due to a lack of preparation, a preference for home deliveries, husband refusal, and a general lack of awareness. This delay in seeking care resulted in severe consequences, including the loss of their babies, infertility, fistula, psychological trauma, and disruptions to daily life and relationships. To cope, many women resorted to accepting their situation, isolating themselves, and using traditional healing techniques.ConclusionsThis study’s findings provide valuable insights into the complex and multifaceted nature of uterine rupture, shedding light on the experiences of those affected by this condition. To address the challenges, it is essential to enhance awareness and education through community education programs and comprehensive antenatal classes. Additionally, improving access to healthcare by strengthening health infrastructure and deploying mobile health clinics can ensure better prenatal care. Furthermore, encouraging hospital deliveries through incentives and the support of community health workers can reduce risks. Providing psychological counselling and establishing support groups can help affected women cope with the consequences. Moreover, engaging men in maternal health through educational programs and involving them in antenatal care can foster better support. Finally, promoting safe traditional practices by integrating traditional healers and respecting cultural sensitivities can increase acceptance and adherence.

Socioeconomic Determinants of Household Access to HIV/AIDS Healthcare in Kibra Sub-County, Nairobi County, Kenya

This study examined the impact of social and economic factors on the uptake of HIV/AIDS care in Kibra Sub County, Nairobi. The research was grounded in Behavioral theory and focused on how household income, literacy levels, and access to health information influenced the adoption of HIV/AIDS treatment. A descriptive survey design approach was employed, involving a sample of 365 households chosen through simple random and stratified sampling techniques from target population of 61,690 households, as outlined by Krejcie and Morgan's formula. Data collection was carried out using key informant interviews and self-administered questionnaires. Descriptive techniques, such as frequency and median analysis, as well as inferential techniques, such as bivariate correlation analysis, chi-square testing, and binomial logistic regression, were used. The results were displayed using tables, graphs, and percentages. Thematic analysis was also used to examine qualitative data in order to find new topics. The analysis revealed a strong positive relationship between access to health information and the likelihood of seeking treatment. Households with higher income and literacy levels were more likely to pursue HIV/AIDS care. Quantitative results showed that access to HIV-related information increased the likelihood of treatment uptake by 6.666 times. Additionally, increased household income and higher literacy levels were linked to a 7.434-fold and 3.554-fold rise, respectively, in the probability of seeking care. The study concluded that socio-economic factors, particularly income, literacy, and information access, significantly influenced healthcare-seeking behaviors in Kibra. To enhance access to HIV/AIDS treatment, it is recommended that policymakers, NGOs, and other stakeholders implement targeted interventions, including income-generating programs and comprehensive health education, to address the socio-economic barriers that hinder healthcare uptake.

PROFILE OF PATIENTS WITH SLEEP COMPLAINTS IN A SECONDARY CARE HEALTH INSTITUTION IN THE CITY OF CAMPINAS, SÃO PAULO STATE

Objective: We report data of the profile of patients who sought our outpatient clinic for sleep disorders of the Faculty of Medicine of São Leopoldo Mandic Medical School, during the Week of Sleep, that took place in March, 2022. Methods: All participants responded to a form designed by the researcher, as well as to commonly used questionnaires in Sleep Research, such as the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale, the STOP-BANG questionnaire for screening of apnea, and the WHO Quality of Life abbreviated questionnaire (WHOQOL-BREF). Results: 30 patients were evaluated, mean age 51.8 (± 14), 63% women. Main complaints were insomnia (63%), snore/apnea (23%) and excessive daytime sleepiness (10%). ESS scores were significantly higher among men, daytime nappers and alarm clock users. ISI scores were importantly associated with those who woke 2 or more times per night, while physically active, non-obese, normotensive people and those with Modified Mallampatti (MM) classes I and II scored significantly less in STOP-BANG. Obese, MM classes III-IV and people with abnormal cervical and abdominal circumferences performed markedly worse in Domain 1, while women, older people and alarm clock users went worse in Domain 4 of WHOQOL-BREF. Discussion: One or more sleep disturbances were detected in all seekers of Sleep Care, emphasizing the importance of these types of action.

Health care seeking behaviour of patients reporting to a dental health Institution- A cross sectional study

This study aimed to assess the factors influencing healthcare-seeking behaviour among patients presenting to a dental institution. Oral diseases, such as dental caries and periodontal diseases are prevalent global health concerns, particularly in developed countries, whereas oral cancers are more common in developing countries. In India, there is observed lower utilization of dental care services and higher rates of dental problems. This descriptive study involved 220 patients who visited a dental college and hospital in India. Patients were interviewed to gather information on their chief complaint, history of previous treatment for the complaint, and reasons for delaying dental treatment. The study identified several key factors contributing to delays in seeking dental treatment. Negligence was cited by 27.1% of patients, absence of symptoms by 14.5%, and financial constraints by 9%. Gender, occupation, and education level of patients also showed varying impacts on healthcare-seeking behaviour. Negligence, lack of symptom awareness, and financial constraints, particularly in rural and suburban areas were the significant barriers to timely dental treatment among patients in a dental institution in India.