Selected Health Centers Research Articles

Survival and Its Predictors among Tuberculosis Patients on Treatment in Selected Health Centers of Addis Ababa, Ethiopia: A Retrospective Cohort Study

Tuberculosis is one of the leading causes of morbidity and mortality globally. Although different strategies have been designed and implemented to combat it, it has continuously increased in the past five years, resulting in 10 million new cases and 1.6 million deaths. This study aims to estimate survival and predictors among tuberculosis patients on treatment in selected health centers in Addis Ababa, Ethiopia. The study employed a retrospective cohort design where data were collected by reviewing medical records of tuberculosis patients who were registered from May 2016 to May 2017 on treatment in 20 selected health centers in Addis Ababa. Independent predictors were identified, and the strength of association between dependent and independent predictors was determined using the Weibull regression model. Before computing Weibull regression analysis, Cox proportional assumption, model diagnosis, and fitness were checked. The hazard ratio was calculated to indicate the strength of association. Of 371 TB patients, about 136 (36.7%) died during the treatment period. Most TB deaths occurred during the intensive phase, and the overall estimated median survival time was 157 days. In the multivariable Weibull model, age (HR = 0.98), baseline weight (HR = 0.96, P = 0.03), tuberculosis treatment phase (continuation phase, HR = 0.48), and tuberculosis type (pulmonary negative TB, HR = 19.92) were found to be independent predictors of time to death of tuberculosis patients. Finally, the study concluded that the survival time to death of the patients is high. The health care providers should give special attention and follow up for pulmonary negative and underweight TB patients.

The relationship between sexual function and emotional intelligence and its components based on fertility status in women referring to health centers in Yazd.

BACKGROUND:Sexual function is affected by many psychological factors and emotions. The impact of emotion management varies in different fertility situationsThis can affect women's sexual function. Therefore, the aim of this study was to investigate the relationship between sexual function and emotional intelligence and its components based on fertility status in women referring to health centers in Yazd.MATERIALS AND METHODS:The present study is a correlational study that was performed on 165 women with inclusion criteria and referred to 4 selected health centers in Yazd in 2017. The study tools include demographic questionnaire, Female Sexual Function Index sexual function, and Bar-On emotional intelligence. The fertility status of women in the present study included a history of infertility, number of children, and history of abortion. The analysis was performed using descriptive statistical methods and analytical tests with SPSS software version 18.RESULTS:The mean score of all components of emotional intelligence except the components of self-expression, independence, and emotional self-awareness and also the total score of emotional intelligence infertile people was significantly higher than infertile people (P < 0.05). Regarding the relationship between emotional intelligence and sexual function in terms of fertility variables, a significant correlation was observed between the mean scores of all components of emotional intelligence except interpersonal relationships, flexibility, responsibility, empathy, and self-expression with sexual performance score in fertile individuals.(P = 0.000).Conclusion:As a result, it is suggested that the institutions in charge of women's affairs try to increase emotional intelligence and improve women's sexual function by holding workshops and classes for women, especially in women with infertility, childlessness, and history of abortion.

Primary health care workers perspective towards cancer in Fiji: a qualitative study.

By 2040, the predicted global cancer burden is expected to be more than 27 million new cancer cases per year. Understanding primary health care workers' (HCWs) perception on cancer can highlight new ways in which cancer advocacy can be increased. This study aimed to explore the perceptions of primary HCWs in Lautoka, Fiji, towards common cancers with focus on knowledge, risk perceptions, barriers and preventive approaches. The study used a qualitative method approach. The study was conducted among primary HCWs at four purposively selected health centres in Lautoka Subdivision, Fiji, from 1 March 2021 to 1 April 2021. Focus group discussions (FGDs) were conducted with primary HCWs. A semi-structured open-ended questionnaire was used to collect data, and the FGDs were audio-recorded. These audio recordings were transcribed and analysed using thematic analysis. The responses from the four FGDs with six primary HCWs in each group emerged four major themes. These themes were cancer knowledge, health professional training, barriers and challenges and awareness strategies. Primary HCWs were not fully aware about common cancers and were not confident to discuss about cancer with their patients which is an important role of primary HCWs in cancer management. This lack of knowledge was attributed to less training received in primary care setting. Barriers to accessing cancer screening included misconceptions about cancer, negative attitudes from patients, stigmatization, lack of resources at health facility and less informed health staff. Community outreach programmes, opportunistic screening, community HCWs and the concept of a cancer hub centre were awareness strategies highlighted by primary HCWs. Lack of knowledge about common cancers among primary HCWs is a concern that is depicted well in this study. This low knowledge was attributed to lack of training on cancers received by primary HCWs. Guidelines on cancer screening and diagnosis can be developed by the health ministry to assist primary HCWs in detecting patients at pre-cancerous stage.

Evaluation of Epidemiological Investigation 1 -2-5 Implementation Program in Sukabumi

Epidemiological investigations as part of the malaria surveillance system in Indonesia are carried out through the 1-2-5 method. Assessing the 1-2-5 strategy compliance level at the district level is the first step towards determining whether the surveillance and response strategy is working as planned or not. This study was conducted in order to determine whether PE 1-2-5 had been implemented in health centers (puskesmas) in malaria receptive areas according to the technical guidelines issued by the Indonesian Ministry of Health. Health centers were determined through purposive sampling technique. The sampling is determined by selecting health centers that have been doing malaria vector control service in 2018 and 2019. Ten Puskesmas in malaria receptive areas in Sukabumi District were selected. The informants in this study were the key players in the malaria program at the health centers: the head of the health centers, the manager of the malaria program, and the village malaria officer (JMD) who were involved in the vector control process in 2018 and 2019 at the selected health centers. Data collection was conducted through in-depth interviews done by researcher with informants. The interview showed that the malaria program personnel in Sukabumi are doing the strategy as best as possible in order to achieve malaria elimination. 1-2-5 surveillance program in Sukabumi district has been implemented even though the implementation is not as ideal as the technical guidelines suggested by the Indonesian Ministry of Health, Sukabumi district still applied the strategy based on it by adjusting various aspects (resource situation and the availability of facilities) to the suitable condition in Sukabumi.

Evaluating Inventory Management Practice of Antiretroviral Drugs in Public Health Facilities of Addis Ababa, Ethiopia.

BackgroundThe right to safe and effective treatment is an exclusive right that depends on the robustness of the domestic health care system.MethodsA facility-based cross-sectional study was conducted from January 01 to February 01, 2020. Ten eligible hospitals and 12 randomly selected health centers were parts of this study. A total of 66 RRFs and 308 bin cards were reviewed. Data were collected through observation, record and report review, and physical count using an observational checklist. In addition, 44 semi structured interviews were conducted. The collected data were entered to MS Excel sheet and analysed using SPSS (version 20) software. The correlation test result was determined statistically significant at p<0.05.ResultsTwenty-two public health facilities were included in the study of which 16 (72.72%) health facilities had at least one stock out. Availability of ARVs had very strong positive correlation ship with bin card updating practice (r=0.9 1, P<0.01), inventory accuracy rate (r=0.912, P<0.015) and very strong negative correlation ship with wastage rate (r = −0.66, P<0.001). The wastage rate due to expiration and loss was 3.9%. The mean bin card accuracy was 90.6%. RRF reports were accurate 17 (77.3%), complete 7(32%) and reported on time 14 (63.64%). Only 8 (36.36%) health facilities met acceptable storage conditions.ConclusionThe availability of bin cards and reports and resupply forms was promising, but the data quality remains low. The majority of health facilities did not meet acceptable storage conditions and had frequent stock-outs.

Data quality assessment and associated factors in the health management information system among health centers of Southern Ethiopia.

A well designed Health management information system is necessary for improving health service effectiveness and efficiency. It also helps to produce quality information and conduct evidence based monitoring, adjusting policy implementation and resource use. However, evidences show that data quality is poor and is not utilized for program decisions in Ethiopia especially at lower levels of the health care and it remains as a major challenge. Facility based cross sectional study design was employed. A total of 18 health centers and 302 health professionals were selected by simple random sampling using lottery method from each selected health center. Data was collected by health professionals who were experienced and had training on HMIS tasks after the tools were pretested. Data quality was assessed using accuracy, completeness and timeliness dimensions. Seven indicators from national priority area were selected to assess data accuracy and monthly reports were used to assess completeness and timeliness. Statistical software SPSS version 20 for descriptive statistics and binary logistic regression was used for quantitative data analysis to identify candidate variable. A total of 291 respondents were participated in the study with response rate of 96%. Overall average data quality was 82.5%. Accuracy, completeness and timeliness dimensions were 76%, 83.3 and 88.4 respectively which was lower than the national target. About 52.2% respondents were trained on HMIS, 62.5% had supervisory visits as per standard and only 55.3% got written feedback. Only 11% of facilities assigned health information technicians. Level of confidence [AOR = 1.75, 95% CI (0.99, 3.11)], filling registration or tally completely [AOR = 3.4, 95% CI (1.3, 8.7)], data quality check, supervision AOR = 1.7 95% CI (0.92, 2.63) and training [AOR = 1.89 95% CI (1.03, 3.45)] were significantly associated with data quality. This study found that the overall data quality was lower than the national target. Over reporting of all indicators were observed in all facilities. It needs major improvement on supervision quality, training status to increase confidence of individuals to do HMIS activities.

Assessing the Performance of CareStart™ Malaria Rapid Diagnostic Tests in Northwest Ethiopia: A Cross-Sectional Study.

Background While rapid diagnostic tests are an alternative diagnostic tests for microscopy in the diagnosis of malaria in rural settings, their performance has been inconsistent. Performance of rapid diagnostic tests might be affected by manufacturing process, transportation and storage, parasitemia level, and skill of personnel who perform the tests. Therefore, periodic evaluation of the local field performance of rapid diagnostic tests is mandatory in order to make early corrections in case of decreased performance. Methods A facility-based cross-sectional study was conducted from January to May 2020 among 257 malaria-suspected patients attending selected health centers in Bahir Dar Zuria district. Capillary blood was collected from each participant and tested for Plasmodium infection by CareStart™ rapid diagnostic test kit and thin and thick blood film microscopy. Data were analyzed using statistical software for social sciences version 20 and MedCalc software version 19.3. Sensitivity, specificity, positive and negative predictive values, and kappa value were calculated to evaluate the performance of rapid diagnostic tests against microscopy. Results Among 257 study participants, 47 (18.3%) were tested positive for Plasmodium infection by at least one of the diagnostic methods. Rapid diagnostic tests revealed 3 false positive and 3 false negative results. The sensitivity and specificity of CareStart Malaria Pf/Pv Combo test were 93.2% and 98.6%, respectively (kappa = 0.918). Conclusion CareStart™ rapid diagnostic test has comparable performance with microscopy for malaria diagnosis. We recommend continued use of CareStart Malaria Pf/Pv Combo test at health posts in Ethiopia where microscopy is not available.

Prevalence of Malaria and Associated Knowledge, Attitude, and Practice among Suspected Patients in Bahir Dar Zuria District, Northwest Ethiopia.

Background Control and prevention activities have brought substantial decline of malaria incidence in the last two decades in Ethiopia. However, lack of local data on the disease transmission and community knowledge, attitude, and practice about malaria are thought to reverse the trend of malaria in certain areas. Therefore, assessment of the prevalence and community awareness towards malaria plays pivotal role for the success of malaria control and prevention. Objective To assess malaria prevalence and knowledge, attitude, and practice about malaria among febrile patients in Bahir Dar Zuria district, Northwest Ethiopia. Methods A facility based crosssectional study was conducted from January to March 2020 among 149 febrile patients attending selected health centers in Bahir Dar Zuria district. Data about knowledge, attitude, and practice about malaria were collected using semistructured questionnaire. Blood sample from each participant was tested for Plasmodium species through malaria rapid diagnostic tests and blood film microscopy. Data were analyzed using statistical software for social sciences version 20. Results Among 149 participants, 22 (14.8%) were positive for Plasmodium infection at least by one diagnostic methods. Prevalence of P. falciparum and P. vivax was 3.4% and 10.1%, respectively, while that of mixed infection was 1.3%. From the total study participants, 29.5% have good knowledge, 77.2% have positive attitude, and 34.9% have good practice towards malaria. Statistically significant associations were observed on knowledge with age group (X2 = 10.377, P = 0.035), educational level (X2 = 15.075, P = 0.001), family size (X2 = 7.601, P = 0.022), attitude level and practice level. Participants with family size < 5 were 6.841 (95% CI: 2.570-18.206, P ≤ 0.001) times more likely to have negative attitude as compared to those with family size ≥ 5. Conclusions Prevalence of malaria in the study area was relatively high. Study participants had encouraging attitude; however, their knowledge and practice towards malaria were poor. Therefore, the existing malaria control activities should be supplemented with continuous health educations, aware the community, and ensure participation in the control and prevention activities.

Prevalence and associated factors of intimate partner violence amongst women attending prevention of mother to child transmission services in Blantyre, Malawi

BackgroundIntimate partner violence (IPV) during the perinatal period and when one is HIV-positive is a great concern because of the physical and mental impacts it has on health and on adherence to prevention of mother to child transmission (PMTCT) services. However, factors associated with IPV amongst perinatal women on PMTCT services are not adequately explored in Malawi. The aim of this study was to estimate the various types of IPV and the associated factors amongst HIV-positive pregnant and postnatal women in selected health centres in Blantyre district.MethodsIn this cross-sectional study, we recruited 200 HIV-positive women from antenatal, postnatal and antiretroviral therapy (ART) clinics from four selected primary care facilities of Blantyre district. Data were collected between March and May 2018.ResultsA total of 50% of the participants reported to have experienced either physical, psychological or sexual violence from their partner in the last 12 months. The multivariate logistic regression model showed that feelings about safety of the relationship and depression were the only factors that were consistently associated with IPV in the last 12 months (p = 0.001, Pseudo R2 = 0.20).ConclusionThe presence of depression and safety concerns amongst our study participants calls for serious prioritisation of psychological interventions and risk assessment in the management of HIV-positive perinatal mothers who report IPV cases.

The Value Transformation Framework: Applied to Diabetes Control in Federally Qualified Health Centers.

IntroductionDiabetes and pre-diabetes impact more than 114 million Americans. Federally qualified health centers (FQHCs) provide care to some of the most high-risk and underinsured individuals throughout the US, twenty-one percent of whom report being told they have diabetes, compared to 11% of the general adult population. It is widely agreed our health care system requires a transformation to effectively address diabetes and its complications.ObjectiveBy applying the Value Transformation Framework (VTF) in health centers, the National Association of Community Health Centers (NACHC) aims to show improvements in diabetes control. This systematic strategy to transform the way health centers operate can lead to improvements in health outcomes, patient and staff experiences, costs, and equity (Quintuple Aim). Special attention is paid to the health centers’ infrastructure, people systems and care delivery systems.MethodsEvidence-based diabetes interventions, the learning community model, and the VTF were used together to drive system improvements and activate proven diabetes control practices within eight health centers. Multidisciplinary teams at select health centers in Georgia and Iowa, with their partner primary care associations, participated in this NACHC-led quality improvement project.ResultsDuring the one-year intervention (January 2017–December 2017), the mean raw percentage of patients with HbA1c Poor Control decreased from 50.9% (range, 23.7–70.4%) in January to 27.5% (range, 13.6–37.4%) in December. This represents a relative improvement in diabetes control of 46%. The 1-year-intervention data also showed trends in the desired direction with statistically significant improvements related to the following interventions: a formal written clinical policy, standing orders, patient recall/outreach, performance data shared at the provider/team-level, and performance data shared at the site/organization level.ConclusionA conceptual model focused on transforming health center systems, organized by the NACHC Value Transformation Framework and supported by a strong learning community, can lead to better diabetes control outcomes among patients seen at health centers.

Prevalence of Post-traumatic Stress Disorder in Women with Normal Vaginal Delivery and Those with Caesarian Section

: Childbirth causes intense emotional arousal that may cause traumatic psychological symptoms in some women. This study investigated the prevalence of post-traumatic stress disorder (PTSD) in women with normal vaginal delivery and those with caesarian section. This was a cross-sectional study conducted in selected health centers affiliated to Shiraz University of Medical Sciences in 2018. The samples included 714 patients (328 vaginal deliveries and 386 cesarean deliveries). Sampling was performed using the convenience sampling method in two cluster stages after selecting the clinic. Mothers were determined to be traumatic in their delivery according to criterion A in the Diagnostic and Statistical Manual of Mental Disorders Version DSM-IV (with four questions). Then, a demographics checklist and a stress disorder questionnaire were filled out for all the mothers after a traumatic delivery through interviews. The prevalence of postpartum stress disorder was higher in the cesarean section group (10.8%) than in the normal vaginal delivery group (10%), but this difference was not significant (P = 0.275). Although the prevalence of PTSD between the two groups was not significant, the prevalence of PTSD was significantly higher in this study than in reports from other countries. This highlights the need for targeted interventions to reduce this disorder.

High-Prevalence Stunting in Preschool Children (1-5 Years) Attending Selected Health Centers in a Food Rich Area-Bushenyi District Southwestern Uganda.

The prevalence of stunting among children in Uganda and Sub-Saharan Africa is still high, and if Uganda is to achieve the food-related Sustainable Development Goals (SDGs), it must urgently invest in improving nutrition and sanitation. In a food rich area like Bushenyi, chronic undernutrition could be due to several other factors than mere scarcity of food. The Objective(s). This study was carried out to determine the prevalence and socioclinical factors responsible for chronic undernutrition (stunting) among preschool children aged 1–5 years in selected Health facilities in Bushenyi district. Methodology. This was a cross-sectional study assessing the prevalence of stunting and its associated factors among children aged 1–5 years attending selected health centers in Bushenyi District. Data was collected using a pretested questionnaire, taking anthropometric measurements (height/length), and stool analysis for eggs of soil-transmitted helminthes. Prevalence of stunting was presented as percentages. Logistic regression with adjusted prevalence ratio was performed to test the association between the sociodemographic and clinical factors and stunting at bivariate levels of analysis. Results. Most of the children were female, with a median age of 2.1 years and resided in semiurban areas of Bushenyi with their parents. Prevalence of stunting was 89.3%. Only 10.7% of the children were infested with soil-transmitted helminthes. Children likely to be stunted were those who drank unboiled water and were exclusively breastfed. Conclusion. There is a high prevalence of chronic malnutrition in Bushenyi district associated with parents'/care takers' low level of knowledge.

Determining Health Literacy Level and Its Related Factors Among Pregnant Women Referred to Medical and Health Centers of Tehran in 2019: A Cross-sectional Study

Background: The ability to acquire, process, and understand health information to make informed decisions about health is defined as health literacy. A low level of health literacy disrupts women’s ability to understand and use health information in order to take appropriate and timely measures during pregnancy. Objectives: Due to the importance of health literacy during pregnancy and its direct impact on fetal health, this study was conducted to determine the level of health literacy and its related items among the pregnant women referred to medical and health centers in Tehran. Methods: This descriptive-analytical study was conducted on 270 pregnant women referred to the medical and health centers of Tehran in 2019. The participants in this study were selected by the mixed sampling method (cluster and random methods to select health centers and the convenience method to select participants). Data collection tools included a questionnaire for demographic and midwifery characteristics and a specialized questionnaire for maternal health literacy in pregnancy (MHELIP). Data analysis was performed by SPSS-19 software. Results: The mean age of the participants was 28.16 ± 5.70 years, and the mean gestational age was 24.50 ± 9.25 weeks. The mean score of health literacy among pregnant women was 63.14 ± 9.63, and 48.9% of them had limited (inadequate and insufficient) health literacy. The results showed positive correlations between the total score of health literacy and the demographic variables of age (P = 0.025), education (P = 0.003), and income (0.008), but no significant relationship was found between the mean total score of health literacy and employment status (P = 0.614) or parity (P = 0.614). Conclusions: It was found that limited health literacy had a high prevalence among pregnant women. Given the importance of pregnancy, it seems necessary for healthcare policymakers to design programs to promote women’s health literacy during pregnancy.

Doctor–Patient Communication in Primary Health Care: A Mixed-Method Study in Fiji

From a clinical perspective, effective and efficient communication is part of a strategy to ensure doctors are providing high-quality care to their patients. Despite the positive impact of effective doctor–patient communication on health outcomes, limited information is available on this in Fiji. This study was carried out to determine the current patients’ perception of doctors’ communication behaviour and identify factors affecting the doctor–patient communication in Fiji. This mixed-method study was conducted in the outpatient setting of three randomly selected health centres in the Suva Subdivision, Fiji. For the quantitative phase, systematic random sampling was used to select the 375 participants who completed the structured questionnaire; of those, 20 participants were selected for the qualitative interview. From the patients’ perception, 45.6% of them perceived doctors’ communication behaviour as good, 53.6% as fair, and 0.8% as poor communication behaviour. Qualitative findings highlight factors such as the attitude of the doctors, their approach, their interaction with the patients, and them providing an explanation as important factors during doctor–patient communication. In Fiji, the majority of patients perceived doctors’ communication behaviour as fair to good and the doctors’ skills were important for effective doctor–patient communication. This study highlighted the importance of doctor–patient communication and suggested that doctors might not be practicing patient-centred care and communication; thus, they need to upgrade their patient-centred communication skills.

Cold Chain Maintenance and Vaccine Stock Management Practices at Public Health Centers Providing Child Immunization Services in Jimma Zone, Oromia Regional State, Ethiopia: Multi-Centered, Mixed Method Approach.

BackgroundCold chain maintenance is the spine of an immunization program.ObjectiveTo examine the status of cold chain maintenance and evaluate knowledge of cold chain handlers and practices of vaccine management at public health centers providing immunization services in Jimma zone.MethodsAn institutional-based cross-sectional study supplemented with a qualitative method was conducted in 41 randomly selected health centers providing immunization service in districts of Jimma zone from October 31 to November 30, 2019. Pre-tested self-administered questionnaires and observation checklists developed from an effective vaccine management assessment tool (EVMAT) were used to collect quantitative data. Key informants were selected using the purposive sampling technique and an in-depth interview was conducted. Quantifiable data were analyzed using SPSS version 20 and chi-square was used to test the presence of association (p-value <0.05). Qualitative data were analyzed by thematic analysis and triangulated with quantitative findings.ResultsAll public health centers had at least functional ice-lined refrigerators while 28 (68.3%) public health centers had functional deep freezers. Of the cold chain handlers, 120 (82.9%) had fair knowledge. Vaccine storage was appropriate per the World Health Organization's vaccine storage code in ice-lined refrigerators in 11 (24.4%) public health centers. Cold chain handlers’ years of service, types of training, availability of funds for cold chain maintenance, and availability of cold chain equipment at public health centers showed the presence of significant association with vaccine cold chain management practice.ConclusionThe majority of cold chain handlers showed inadequate knowledge while a significant number showed poor practice of preserving the vaccines’ cold chain. Cold chain maintenance was not adequate in public health centers, necessitating attentive efforts of providing proper management of vaccine cold chains at immunization delivery points.

SARS-CoV-2 infection among primary healthcare workers: a cross-sectional study

Healthcare workers (HCWs) are critical to the healthcare system and are at an increased risk of SARS-CoV-2 infection.1 They may acquire infections from the community and their work settings. To date, the majority of the studies reporting on the epidemiology of SARS-CoV-2 infections in HCWs, including serology testing, are from hospital settings.2 Primary care provides a platform and plays a critical role in prevention, testing, triaging and treating patients, but a smaller number of studies focus on primary care settings.3 In a recent systematic review, primary care physicians were at increased risk of worse outcomes and were the highest risk specialty for deaths among doctors.2 This short report provides an objective assessment of infection risk among frontline primary care HCWs utilizing RT-PCR results and serology testing. The study aims to establish the point and the period prevalence of SARS-CoV-2 infection among HCWs and their characteristics, exposure risks and infection control practices for SARS-CoV-2 in primary care settings. Overview A cross-sectional study design was employed for the study. The study settings were Primary Health Care Corporation (PHCC) – the largest primary health care provider in Qatar. It has 27 health centers across the country with approximately 1.4 million registered individuals. The study was conducted in July 2020 during the first SARS-CoV-2 pandemic wave with approximately 163 new cases daily per million population. Five health centers were randomly selected for the study – Rawdat Al Khail, Gharrafat Al Rayyan, Al Wajbah, Qatar University and Al Wakrah. Suspected or confirmed SARS-CoV-2 individuals presented in all health centers at the time. All frontline physicians and nurses working in the five selected health centers were invited to participate in the study. Overall, 291 of the 720 invited participants consented to participate. HCWs were booked an appointment where they completed a self-administered questionnaire on sociodemographic, RT-PCR test results, SARS-CoV-2 exposure risk and provided a blood sample to test for antibodies (IgM and IgG) against SARS-CoV-2.

Risk Factors, Knowledge, Attitudes and Practices of Type 2 Diabetics Attending Industry, Campbellville Health Centers and West Demerara Hospital, Guyana

The objective of this study was to examine the risk factors, knowledge, attitudes, and practices of type 2 diabetic patients attending three health care facilities (Industry and Campbellville Health Centers and the West Demerara Regional Hospital) in Guyana, May and June 2019. This study utilized a quantitative, descriptive and cross-sectional approach. The sampling technique used was non-probability and purposive sampling. The participants included 114 diabetic patients attending three selected health centers in Guyana. The study used a pretested questionnaire to collect survey data. Data were analyzed using SPSS version 20.0. Statistical analysis methods were mean, median, standard deviation, percentages, cross-tabulation, p-value, chi-square, ANOVA and Friedman test. Study results indicated that risk factors such as age, ethnicity, family history, BMI had no significant relationship with the onset of diabetes among the study population. Findings revealed that the mean average of participants' RBS, BP, fasting blood sugar, HbA1C and lipid profile were high. Participants demonstrated an inadequate level of knowledge and practices. Some of the participants had challenges accessing specific laboratory tests and Insulin. Findings concluded that there is a critical need for improving diabetic knowledge and healthy practices among diabetic patients. Establishing culturally oriented and multi-sectoral diabetic self-care management programs is imperative to manage diabetes effectively.

A study to assess the knowledge and practice related to maintenance of cold chain among health workers in selected health centre at, Lucknow, U.P

A study to assess the knowledge and practice related to maintenance of cold chain among health workers in selected health centre at, Lucknow, U.P - IJNMHS- Print ISSN No: - 2582-6301 Online ISSN No:- 2582-628X Article DOI No:- 10.18231/j.ijnmhs.2021.002, IP Journal of Nutrition, Metabolism and Health Science-J Nutr Met

Knowledge, Attitude, Practice and Food Poisoning Associated Factors Among Parents in Bench-Sheko Zone, Southwest Ethiopia.

BackgroundFood poisoning is a food borne disease, mainly resulting from ingestion of food that contains a toxin, chemical or infectious microorganisms like bacteria, virus, parasite, or prion. On the other hand, avoiding food contamination during preparing and feeding is a key factor for reducing the prevalence of food poisoning. This study aimed to assess the knowledge, attitude, self-reported practice and food poisoning associated factors among parents in the selected health centers of Bench-Sheko Zone in Ethiopia.MethodsAn institution-based cross-sectional study was conducted among 408 systematically selected parents in Bench-Sheko zone, Ethiopia. The data were collected through face to face interview using a structured questionnaire.ResultsThe median knowledge score was 8.0 with an interquartile range (IQR) of 8.0–10.0. The median attitude score was 9.0 with an IQR of 6.0–9.0. The median practice score was 12.0 with an IQR of 10.0–13.0. A positive correlation was seen between knowledge and attitudes of parents with food poisoning (r= 0.321, P < 0.026), between knowledge and practices of parents towards food poisoning (r= 0.312, P < 0.001) and between attitude and practices result towards food poisoning (r= 0.224, p < 0.031). The parents with a higher education level, employed and who live in a city were the factors significantly associated with higher knowledge scores (p < 0.05). The improved attitude was seen as educational level increased (p <0.05). The parents with female gender, employed and who live in a city were significantly associated with higher hygienic practices towards the prevention of food poisoning (p <0.05).ConclusionThe knowledge, attitude, and self-reported practices of parents regarding food poisoning prevention are associated with each other and are affected by socio-demographic variables. Therefore, adequate emphasis should be given by health sectors to designing strong strategies which address the specific contributing factors for the problem.

Low intake of essential amino acids and other risk factors of stunting among under-five children in Malang City, East Java, Indonesia.

Background: The lack of energy-protein intake has been shown to increase the risk of stunting in under-five children. The quality of protein in food is assessed by the completeness of amino acid content. This study aims to determine the amount of essential amino acid (EAAs) intake and other risk factors of stunting among under-five children.Design and methods: A descriptive, case-control study was performed in the work area of Kedungkandang Health Center Malang. The subjects were 24–59-month-old children with a total of 23 stunted (height-for-age Z-score (HAZ) <-2 SD) and 57 normal children (HAZ ≥-2 SD). Furthermore, the data were collected using anthropometric measurement, validated and pre-tested questionnaires, which were analyzed using multiple logistic regression.Results: The intake of all the nine EAAs in stunted children was lower than that of non-stunted children. However, only histidine, isoleucine, and methionine were significantly different (p<0.05). The significant risk factors of stunting include a family income per month fewer than the Regional Minimum Wages [OR=12.06, 95% CI 1.83-79.53], being underweight [OR=7.11, 95% CI 1.49-33.93], breastfeeding of less than 6 months [OR=5.34, 95% CI 1.28-22.20], and the lack of EAA methionine intake [OR=0.14, 95% CI 0.03-0.67].Conclusions: Stunted children may not receive sufficient dietary intake of EAAs in their diet. Furthermore, the lack of EAAs intake, especially methionine, alongside low family income, underweight, lack of breastfeeding and variety in food consumption were the risk factors of stunting among under-five children in a selected Health Center in Malang City, Indonesia.Significance for public healthStunting is a linear growth failure in children due to poor nutrition and recurrent infection. It is considered a public health problem worldwide. Furthermore, the quality of nutrition, not just quantity, is very important for child development. Protein quality is assessed by the presence of essential amino acids in food. However, research on the quality of protein intake in children is presently very limited. This study describes the importance of essential amino acid intake among other risk factors of stunting in under-five children.