Visiting Health Centers Research Articles

The Predictive Power of the Mother’s Neck Circumference in the Early Diagnosis of Gestational Diabetes Mellitus

Background: Gestational diabetes mellitus (GDM) is a risk factor for the health of both the mother and fetus, responsible for a significant number of maternal, perinatal, and neonatal complications. Timely diagnosis and effective treatment can reduce the burden of the disease on the health of women and their infants during and after pregnancy. Objectives: The present study aimed to examine the predictive power of the mother’s neck circumference in the early diagnosis of gestational diabetes mellitus. Methods: This prospective cohort study was conducted on 782 pregnant women with a gestational age of 16 weeks who visited health centers in Jiroft between 2020 and 2021. Neck circumference was measured in the 16th week of pregnancy. Gestational diabetes mellitus was diagnosed using an oral glucose tolerance test (OGTT) with 75 grams of glucose at 24-28 weeks of pregnancy. Participants were selected using convenience sampling, and data were collected through interviews with the participants. Results: Among the 782 pregnant women, 179 were diagnosed with GDM, while 603 did not have GDM. The best cut-off point for neck size was determined to be 35.45 cm using the ROC curve. For the neck circumference test, sensitivity was 71.5%, specificity was 60%, positive predictive value was 34.8%, and negative predictive value was 87.7%. Conclusions: The findings indicate that a neck circumference greater than 35.45 cm in early pregnancy (16 weeks) can be considered a new diagnostic test for GDM. Early identification of women at risk should prompt necessary measures to reduce the complications associated with gestational diabetes mellitus.

Predictors of Fertility Desire During COVID-19 Pandemic: A Cross Sectional Study

Background: Fertility, the most important factor in population growth, is affected by various factors, including pandemics. COVID-19 (CV) was a global challenge that spread rapidly around the world. Objective: This study aimed to investigate predictors of fertility desire during the covid virus pandemic. Methods: In this cross-sectional study, 315 women who visited health centers in northern Iran for vaccination against covid virus were recruited using convenient sampling. The participants completed the sociodemographic information, Fertility Desire Scale, and Fear of covid virus scale. Logistic regression analysis was employed to assess the predictive factors of fertility desire. Results: The participants' mean age and marriage duration were 34.4 ± 6.7, and 7.3±11.5 years, respectively. It showed fertility desire among household women was about twofold more compared to employed ones [Odds Ratio (OR) = 1.96, p = 0.009)]. The fertility desire was decreased among more educated women (OR = 0.43, p= 0.035), women with one child (OR = 0.44, p= 0.030), and women with no infant gender preferences (OR = 0.53, p= 0.032). Fear of covid virus and any history of covid virus infection in the participants or their close relatives did not change fertility desire (P > 0.05). Conclusion: In conclusion, health policymakers should pay more attention to the potential effects of women's employment, their educational status, and their attitude toward infant gender preferences on fertility desire during the development of programs. Further research is needed to examine this empirical association on a global scale and its effect on trying to conceive.

Visits to Health Centers Among Adults, by Selected Characteristics: United States, 2022.

This report describes care received at health centers in the United States in 2022. Estimates are presented for selected characteristics. The data presented in this report are from the 2022 National Ambulatory Medical Care Survey Health Center Component. Data were collected from federally qualified health centers and federally qualified health center look-alikes and weighted to produce nationally representative estimates of visits to health centers from all 50 U.S. states and the District of Columbia. During 2022, an estimated 89.5 million visits were made by adults to health centers in the United States, an overall rate of 349.4 visits per 1,000 adults. The visit rate among women was higher than for men. Differences in visit rates by age were not significant. Adults who were not married accounted for 48.2% of visits, and adults who were married accounted for 37.6% of visits. More than one-half of health center visits were disease-related (61.4%). Symptoms-related diagnoses accounted for 22.0% of visits. Screenings (12.6%) and examinations (10.2%) were also frequent reasons for health center visits. Social determinants of health were listed as a reason for the visit at 2.0% of health center visits. Endocrine diseases represented the most frequently mentioned disease category (29.1%), overall and among adults age 45 and older. Mental disorders represented the most common disease category among adults ages 18-44. Women visited health centers at a higher rate than men. In addition, patient and visit characteristics, including marital status and diagnoses, differed by age.

Antibiotic use by clinical presentation across all healthcare providers in rural Burkina Faso: a healthcare visit exit survey.

To guide antibiotic stewardship interventions, understanding for what indications antibiotics are used is essential. In rural Burkina Faso, we measured antibiotic dispensing across all healthcare providers. From October 2021 to February 2022, we surveyed patients in Nanoro district, Burkina Faso, following visits to health centres (3), pharmacies (2), informal medicine vendors (5) and inpatients in health centres. We estimated prevalence of antibiotic use and the proportion of Watch group antibiotics by provider type and by clinical presentation, assessing compliance with WHO's AWaRe Antibiotic Book. We estimated per capita antibiotic use by multiplying prevalence of antibiotic use, mean DDD per adult treatment course, and the rate of healthcare visits per 1000 inhabitants per day, estimated from a prior household survey. Outpatient antibiotic use was more frequent after health centre visits (54.8%, of which 16.5% Watch, n = 1249) than after visits to pharmacies (26.2%, 16.3% Watch, n = 328) and informal medicine vendors (26.9%, 50.0% Watch, n = 349). The frequency of antibiotic use was highest for bronchitis (79.9% antibiotic use, of which 12.6% Watch), malaria (31.9%, 23.1% Watch), gastroenteritis (76.0%, 31.7% Watch), rhinopharyngitis (40.4%, 8.3% Watch) and undifferentiated fever (77.0%, 44.8% Watch). Compliance with WHO AWaRe guidance could have averted at least 68.4% of all Watch antibiotic use in outpatients at health centres. Community-wide, 2.9 DDD (95% CI 1.9-3.9) were used per 1000 adult inhabitants per day. Most Watch antibiotic use at community level or primary care deviated from WHO guidance. Antibiotic stewardship should focus on key clinical presentations and include primary care and self-medication.

Quality of the digital gp visits and characteristics of the users: retrospective observational study

Objectives This study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting. Design The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits. Setting Primary health care. Participants The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services. Main Outcome Measures The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization. Results Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments. Conclusion Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations.

Breast cancer screening patterns and associated factors in Iranian women over 40 years

Screening is a key component of breast cancer early detection programs that canconsiderably reduce relevant mortality rates. The purpose of this study was to determinethe breast cancer screening behavioral patterns and associated factors in women over40 years of age. In this descriptive‑analytical cross‑sectional study, 372 over 40 years of agewomen visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling.The data were collected using the sociodemographic characteristics questionnaire, breastcancer perception scale, health literacy for Iranian adults scale, and the Breast CancerScreening Behavior Checklist. The obtained data were analyzed in SPSS version 16 usingdescriptive statistics (frequency, percentage, mean, and standard deviation) and inferentialstatistics (univariate and multivariate logistic regression analyses). In total, 68.3% of allparticipants performed breast self‑examination (BSE) (9.9% regularly, once per month),60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year),51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwentsonography (3.8% regularly, twice per year). The findings also showed that women withbenign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21;P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography(OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderatebreast cancer perception scores were more likely to perform BSE than women with highbreast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women whohad a history of benign breast disease were more likely to perform screening behaviors thanothers (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 weremore likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE(OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participationof women in regular breast cancer screening, it is suggested that health care providershighlight the need for screening at the specified intervals in their training programs. Inaddition, health authorities are recommended to use reminder systems to remind women,especially those over 40 years of age, of the best time for breast screening. Moreover, healthcare providers must seek to improve breast cancer knowledge, attitudes, and perceptionsof women who visit health centers, which are the first level of contact with the healthcaresystem for the general population.

Perceived Physical, Emotional and Monetary Burden among Caregivers of Thalassemia Patients: An Evidence-based Study from District Gujrat, Pakistan

Thalassemia is among the most challenging hereditary blood disorders with no permanent cure. The patients of thalassemia have to face multidimensional complications that may lead to physical, emotional, social, and monetary burdens, among others, that negatively affect the patients, their families, and especially the caregivers. The caregivers feel the burden owing to the long-standing character of the diseases and the struggling process for curing patients, and the caregivers have to face numerous burdens that lead them towards anxiety, depression, social withdrawal, aggression, poor relationships, lower productivity, and many others. The prime objective of this study is to understand the physical, emotional, and monetary burdens faced by caregivers, and primary data for this quantitative study were collected from caregivers of thalassemia patients of district Gujrat. Researchers applied the purposive sampling technique and a structured questionnaire to approach the study participants. The findings highlighted that the caregivers of thalassemia patients face a large number of physical (continued attachment, tiredness, isolation, lower productivity), emotional (aggression, depression, fear of losing a loved one life), and monetary (visiting health centers, arranging blood donors, travel and transportation, personal obligations) burdens that have significant impacts on their socio-economic, psychological and physical health.

Awareness: the Golden Key to Understanding Healthcare Seeking Behavior among Elderly Hypertensive Patients in Taft, Iran

Introduction: Healthcare seeking behavior is crucial for early detection and proper management of hypertension in the elderly. This study investigated the factors influencing healthcare seeking behavior among elderly hypertensive patients residing in Taft, Iran. Methods: This cross-sectional study recruited 230 hypertensive individuals aged 60 and above residing in Taft, Yazd Province, Iran. Participants were randomly selected and completed a questionnaire through face-to-face interviews. The questionnaire assessed their healthcare seeking behaviors and potential influencing factors. Data analysis was performed using SPSS software. Correlation tests and linear regression analysis were employed to identify significant relationships (p &lt; 0.05). Results: A significant majority (70%) of participants reported always paying attention to symptoms of high blood pressure. When experiencing symptoms, over half (53.9%) of the participants indicated a preference for visiting health centers, general practitioners' offices, or emergency departments. Among the factors studied, awareness (B = 0.228) emerged as the most significant positive predictor of healthcare seeking behavior (p &lt; 0.05). Other positive influences included decision-making autonomy (B = 0.177), prior experience with healthcare services (B = 0.131), and social support (B = 0.131) – all statistically significant at p &lt; 0.05. Conversely, barriers to healthcare seeking had a negative and significant impact (B = - 0.064, p &lt; 0.05). Collectively, the investigated factors explained 23% of the variation observed in healthcare seeking behavior among the elderly participants (R2 = 0.23). Conclusion: This study identified awareness of hypertension as the strongest predictor of healthcare seeking behavior in elderly patients. Additionally, providing accessible and supportive healthcare services can further encourage elderly hypertensive patients to seek necessary care.

Hubungan Motivasi dan Dukungan Keluarga dalam Pengendalian Hipertensi dengan Tekanan Darah pada Pasien Hipertensi

Hypertension is a non-communicable disease which is the main factor causing various diseases such as stroke, heart and kidney. Based on data from the Andalas Health Center, it was found that there were 203 hypertension patients in April 2023. A survey conducted on hypertensive patients aged 40-60 years found 4 people with uncontrolled blood pressure (&gt; 140/80 mmHg) and 2 people with controlled blood pressure (≤140/80 mmHg), 4 people who still consume fatty foods regularly excessive daily and 2 respondents who have reduced consumption of fatty foods, 4 people who consume excessive sodium and 2 people who have reduced sodium consumption, 4 people who diligently eat vegetables 4-5 times a week and 2 people who rarely eat vegetables in a week , 5 people who have no desire to exercise in a week and 1 respondent who has a desire to exercise every week. Furthermore, 3 hypertensive patients who are always reminded by their families in controlling hypertension and 3 people who are rarely reminded to control their hypertension, such as taking regular medication and managing their diet. The research objective was to determine the relationship between motivation and family support in controlling hypertension and blood pressure in hypertensive patients in the Andalas sub-district, the Andalas Health Center in 2023. The research design was a cross-sectional study. The study was conducted from October 2022 to July 2023. The study population was all hypertension patients who were registered at the Andalas Health Center visit in the Andalas sub-district, consisting of 68 people. All populations are used as research subjects. Data collection was carried out by interviewing questionnaires and direct measurements. Univariate data analysis using descriptive statistics in the form of frequency and percentage distributions, bivariate analysis using the chi-square test.

DOMINANT RISK FACTORS FOR THE INCIDENCE OF “ACUTE RESPIRATORY INFECTION” “ARI” IN TODDLERS

Background: Acute Respiratory Infection (ARI) is a contagious illness affecting diverse age groups, including toddlers, and is among the top ten reasons for Community Health Center visits. Purpose: This study aims to analyze the influence of dominant risk factors on the incidence of ARI in toddlers. Methods: This study used an observational, analytic-cross sectional approach, at Puskesmas Kampung Lalang, Medan, in 2023. The total population was 394 toddlers (aged 0-59 months). In the determination of the number of samples using the sample size estimation formula, 198 samples were obtained by purposive sampling. Data analysis used Chi-Square test and Multiple Logistic Regression Enter Methods, with a significance level of 95%. Results: The results showed that the variables of Vitamin A administration (OR = 0.27, 95% CI: 0.10-0.77) and immunization status (OR = 0.36, 95% CI: 0.14-0.93) were associated with a decreased risk of ARI in toddlers. In contrast, exclusive breastfeeding (OR = 2.35, 95% CI: 1.11-5.01) was associated with increased risk, while the physical environment of the house (OR = 2.92, 95% CI: 1.28-6.64) was associated with increased risk of ARI. Conclusion: Vitamin A administration and immunization reduce the risk of respiratory tract infection among under-fives at Puskesmas Kampung Lalang. Exclusive breastfeeding and home conditions increased the same risk. Improving these risk factors is essential to reduce the prevalence of childhood respiratory infections in the area.

Determinants of severe acute malnutrition among children less than five years visiting health centers in Leqa Dulacha District, East Wallaga Zone, Oromia Region, Ethiopia: A case control study.

In underdeveloped nations like Ethiopia, severe acute malnutrition (SAM) is one of the most pressing public health issues. Despite efforts to pinpoint the causes of SAM, the impact of parents' drug usage on their children's nutritional status remains unclear and unresolved. The purpose of this research was to determine the risk factors for SAM in children under five who were attending medical facilities in the Leqa Dulacha district. A health facility-based case-control study was carried out from March 1 to July 30, 2022, with 256 children under the age of five. Random sampling was used to identify study participants in a methodical manner. Mothers and other child caretakers were interviewed using a structured questionnaire and anthropometric measurements were performed using standardized, calibrated equipment. Epi-data version 3.1 was used to code and enter the data, and it was then exported to IBM SPSS for analysis. An analysis of multivariable binary logistic regression was conducted, and the measure of association employed was the adjusted odds ratio (AOR), with a 95% confidence interval (CI). A total of 96.5% of respondents responded. SAM in children was significantly correlated with the following factors: parent alcohol consumption [AOR = 3.142; 95% CI = (1.104, 8.945)]; child illness in the previous 15 days [AOR = 4.122; 95% CI = (1.686, 10.07)]; poor dietary diversity [AOR = 3.044; 95% CI = (1.189, 7.788)]; household food insecurity [AOR = 4.024; 95% CI = (1.544, 10.490)]; and parent chewing chat [AOR = 3.484; 95% CI = (1.329, 9.134)]. A number of factors have been linked to SAM in children, including the use of health services, the child's illness within the previous 15 days, food security, child feeding practices, and parent substance use. Therefore, it is important to emphasize the value of health education programs on child feeding habits, particularly the significance of dietary diversity, and to work together to modify the way that parents raise their children.

Access to Mental Health and Substance Use Treatment in Comprehensive Primary Care Plus

To meet increasing demand for mental health and substance use services, the Centers for Medicare & Medicaid Services launched the 5-year Comprehensive Primary Care Plus (CPC+) demonstration in 2017, requiring primary care practices to integrate behavioral health services. To examine the association of CPC+ with access to mental health and substance use treatment before and during the COVID-19 pandemic. Using difference-in-differences analyses, this retrospective cohort study compared adults attributed to CPC+ and non-CPC+ practices, from January 1, 2018, to June 30, 2022. The study included adults aged 19 to 64 years who had depression, anxiety, or opioid use disorder (OUD) and were enrolled with a private health insurer in Pennsylvania. Data were analyzed from January to June 2023. Receipt of care at a practice participating in CPC+. Total cost of care and the number of primary care visits for evaluation and management, community mental health center visits, psychiatric hospitalizations, substance use treatment visits (residential and nonresidential), and prescriptions filled for antidepressants, anxiolytics, buprenorphine, naltrexone, or methadone. The 188 770 individuals in the sample included 102 733 adults (mean [SD] age, 49.5 [5.6] years; 57 531 women [56.4%]) attributed to 152 CPC+ practices and 86 037 adults (mean [SD] age, 51.6 [6.6] years; 47 321 women [54.9%]) attributed to 317 non-CPC+ practices. Among patients diagnosed with OUD, compared with patients attributed to non-CPC+ practices, attribution to a CPC+ practice was associated with filling more prescriptions for buprenorphine (0.117 [95% CI, 0.037 to 0.196] prescriptions per patient per quarter) and anxiolytics (0.162 [95% CI, 0.005 to 0.319] prescriptions per patient per quarter). Among patients diagnosed with depression or anxiety, attribution to a CPC+ practice was associated with more prescriptions for buprenorphine (0.024 [95% CI, 0.006 to 0.041] prescriptions per patient per quarter). Findings of this cohort study suggest that individuals with an OUD who received care at a CPC+ practice filled more buprenorphine and anxiolytics prescriptions compared with patients who received care at a non-CPC+ practice. As the Centers for Medicare & Medicaid Innovation invests in advanced primary care demonstrations, it is critical to understand whether these models are associated with indicators of high-quality primary care.

Association of healthy eating index and self-rated health in adults living in Tehran: a cross-sectional study

BackgroundSelf-rated health (SRH) has been identified in many studies as a valid predictor of mortality and healthcare utilization. There is limited research on SRH and dietary intake. This study aimed to investigate the association between healthy eating index (HEI) and SRH in adults living in Tehran.MethodsThis cross-sectional study was carried out among 850 adult men and women aged 20–59 years who visited health centers in Tehran from 2021 to 2022. Dietary intake was assessed using a validated and reliable semiquantitative food frequency questionnaire with 168 food items, and SRH was assessed with one question: “In general, how do you rate your health?“. We categorized SRH into excellent/very good, good, and fair/poor. In the descriptive statistics part, we used mean ± standard deviation or number (ratio) for quantitative and qualitative variables, respectively. The chi-squared test and one-way analysis of variance were used to calculate the percentage and mean for demographic characteristics across tertiles of SRH. An analysis of covariance was used to compare the means of energy, macronutrients, the HEI, and its component variables across the tertiles of SRH.ResultsThe final sample included 795 participants (68.2% female; mean ± standard deviation age: 44.81 ± 10.62 years) whose 40% reported excellent/very good SRH, and 30% reported good and fair/poor SRH separately. There was no association between body mass index, physical activity, education, health status, smoking, and sleep duration with SRH. After adjustment, the total HEI score and its component scores did not differ across the tertiles of SRH status. However, participants with good SRH had a higher intake of total energy (mean difference (MD): 180.33 Kcal, P value < 0.001), total fat (MD: 8.15 gr, P value = 0.002), and total carbohydrates (MD: 20.18 gr, P value = 0.004) than those with fair/poor SRH.ConclusionAccording to our findings, fair/poor SRH was associated with a lower consumption of total energy, total fat, and total carbohydrates in Iranian adults. Additional observational studies would be necessary to clarify these findings.

The comparison of spatial patterns and factors associated with healthcare provider knowledge in palliative care in various regions of China

As an integral part of the overall life cycle, it is crucial to ensure equity and accessibility to palliative care services at the end of life. The knowledge of healthcare providers has a significant beneficial impact on the quality of palliative care services. This study aimed to compare the nationwide geographic distribution of healthcare providers’ knowledge of palliative care at the provincial level in China and identify the possible factors associated with its geographic disparities. A descriptive cross-sectional study was conducted in all provinces (n = 29) that implemented palliative care pilot programs in China. Data were collected online using a structured questionnaire. The possible factors associated with healthcare providers’ knowledge including economy, demographics, and health, were explored by using exploratory regression and ordinary least squares. In addition, spatial autocorrelation was also examined with Moran’s I, LISA, and Geographically Weighted Regression. A total of 18,272 participants from 903 health institutions in 87 palliative care pilot cities were included across 29 out of 31 provinces in China. The average knowledge score (mean ± standard deviation [SD]) was 8.61 ± 2.85. A positive spatial correlation was observed in healthcare providers’ palliative care knowledge level in China. The high level of knowledge was significantly associated with fewer hospitals per 10,000 population (β = −0.384, 95% CI: −0.601 to −0.168, p = 0.001), more primary healthcare institutions per 10,000 population (β = 0.220, 95% CI: 0.032–0.407, p = 0.024), and more community health center visits (β = 0.259, 95% CI: 0.054–0.465, p = 0.016), with higher coefficients being observed in the northwest and northeast regions. This study suggested that the knowledge level of palliative care among healthcare providers nationwide was relatively low, indicating the existence of a disparity between the supply and demand of palliative care services. There may be regional disparities in palliative care services based on the substantial geographical variation in healthcare provider knowledge, emphasizing the necessity of tailored interventions targeting areas with the greatest need.

Faktor Risiko Katarak di Wilayah Kerja Puskesmas Astambul, Kabupaten Banjar, Kalimantan Selatan, Indonesia

Background. Indonesia has the highest prevalence of blindness in Southeast Asia; 81.2% are caused by cataracts. The prevalence of cataract blindness in South Kalimantan was 87.9%. Risk factors for cataracts include age, sex, comorbidities, such as diabetes mellitus and hypertension, steroid use, history of smoking, and exposure to ultraviolet radiation. This study aims to determine the risk factors and incidence of cataracts in the area of Astambul Community Health Center. Method. An observational analytical study with a cross-sectional approach. Primary data from January-February 2023 was collected from health center, posbindu and elderly posyandu visits. The data was analyzed with a chi square test. Results. p-value for age was p=0,046, gender p=0,251, occupation p=0,027, diabetes mellitus p=0,028, and hypertension p=0,023. Conclusion. A significant relationship between cataract incidence and age, diabetes mellitus, hypertension, and occupation. There is no significant relationship between cataract incidence and gender.

Determinants of postpartum depression among women in Kampong Chhnang Province, Cambodia

ObjectiveThis study aimed to identify the prevalence of postpartum depression (PPD) and the factors associated with PPD in Kampong Chhnang Province, Cambodia. Study designA cross-sectional study. ParticipantsThis study included 440 Cambodian women at 6–8 weeks postpartum who visited health centers between July and September 2021. Materials and methodsData were collected through face-to-face interviews by midwives and nurses using a structured questionnaire. The Edinburgh Postnatal Depression Scale (EPDS) in the Khmer language was used to screen for PPD, and suspected PPD was defined as a total EPDS score ≥ 10. Logistic regression analyses were performed to identify the factors associated with suspected PPD. FindingsThe average age of participants was 28.6 years old. The prevalence of suspected-PPD was 30.2 % (n = 133). Factors associated with suspected PPD were income dissatisfaction (adjusted odds ratio (AOR) = 2.66, 95 % confidence interval (CI) 1.27–5.56, P = 0.010), unintended pregnancy (AOR = 1.99, 95 % CI 1.10–3.61, P = 0.023), and a partner employed as a manual laborer (AOR = 3.85, 95 % CI 1.11–13.33, P = 0.034), farmer (AOR = 3.69, 95 % CI 1.11–12.31, P = 0.034), and factory worker (AOR = 5.43, 95 % CI 1.38–21.41, P = 0.016). In addition, poor relationship with partners (AOR = 2.14, 95 % CI 1.17–3.94, P = 0.014), poor relationship with mother-in-law (AOR = 3.51, 95 % CI 1.70–7.21, P < 0.001), and a history of depression before pregnancy (AOR = 6.34, 95 % CI 1.59–25.34, P = 0.009) were significantly associated with suspected-PPD. Key conclusions and implications for practiceThis study highlighted the need for mental health services in primary healthcare settings. Mental health training for healthcare workers, particularly primary-level nurses, should be prioritized and strengthened. Further clinical study on EPDS validation should be carried out to justify the appropriate cut-off EPDS score for Cambodian women. The EPDS should be integrated into routine PNC services to identify women with suspected-PPD. Education on PPD should be provided not only to the nurses and midwives, but also to the women and their families to support the mental health of pregnant and postpartum women.

Healthcare utilization for asthma exacerbation among children of migrant and seasonal farmworkers

Latino children of Migrant and Seasonal Farmworkers (MSFWs) with asthma are at risk for poor health outcomes due to medical access barriers. We compared differences in acute care utilization for asthma exacerbations among migrant and non-migrant Latino and non-Hispanic white (NHW) children at U.S. community health centers.A retrospective observational study utilizing electronic health record data from the ADVANCE Clinical Research Network of United States community health centers included 13,423 children ages 3–17 with a primary care visit between 2005 and 2017 from eight states. Emergency department (ED) and hospitalization data came from Oregon Medicaid claims. Outcomes included acute clinic visits, ED visits, and hospitalizations for asthma exacerbation. Regression analyses adjusted for patient-level covariates.Latino children had higher odds of acute clinic visits for asthma exacerbation compared to NHW children (MSFW odds ratio [OR] = 1.17, 95 % CI = 1.03–1.33; without migrant status OR = 1.13, 95 % CI = 1.03–1.23). MSFW children using Oregon Medicaid had fewer ED visits (rate ratio [RR] = 0.72, 95 % CI = 0.52–0.99) and hospitalizations (RR = 0.47, 95 % CI = 0.26–0.86) compared to NHW children.Increased community health center visits may help mitigate disparities in acute asthma care for MSFW children.

Prevalence of urinary tract infections in pregnancy in rural Andean communities of Peru.

Urinary tract infections (UTIs) can adversely affect pregnancy, yet their prevalence in rural communities remains poorly understood. For an initial evaluation of the UTI burden among pregnant women in the San Marcos province of rural Andean Peru, we aimed to determine the UTI prevalence in the region. A cross-sectional study was conducted in a subsample of 250 pregnant women enrolled in the Peruvian Andes Multigenerational High Altitude Cohort (ALTO) from 2021 to 2022. Structured questionnaires were administered to collect demographic, socioeconomic, maternal health and behavioural data. Urine samples were obtained for dipstick analyses. Descriptive and logistic regression analyses were performed to investigate the association between risk factors and UTI. The study participants had a median age of 28 years (IQR: 22-33). A UTI prevalence of 27.6% (CI: 22.4%-33.5%) was observed, surpassing estimates from other regions of Peru. Notably, nearly all pregnant women (96%) utilised antenatal care (ANC) services at least once, primarily visiting health centres and community health posts where doctors and obstetricians were the main care providers. In this population, none of the risk factors exhibited statistically significant associations with UTIs. Our study highlights the prevalence of UTIs among Andean pregnant women in San Marcos and underscores the critical need for routine UTI screening and treatment during ANC visits as recommended by national guidelines. While accessibility to ANC services is not a barrier in this region, enhancing the availability and quality of UTI screening services is crucial.

A study to assess knowledge and attitude regarding vitamin A deficiency among mothers of under five children in selected pediatric OPD, WB

Aim: This study intends to focus on assessment of knowledge and attitude regarding vitamin A deficiency among mothers of under five children in selected Paediatric OPD, West Bengal. 100 participants were selected through purposive sampling technique. Materials and Methods: Data were selected through interviewing technique using structured interview schedule. Results: It revealed that most of the mothers (55%) had average knowledge, (28%) mothers had good knowledge, and (17%) mothers had poor knowledge. Knowledge score ranged from 1-12 with mean 7.1 and median 7.5 and calculated SD was 2.4. It also revealed that most of the mothers (60%) of under five children had good attitude, (34%) mothers had average attitude and (6%) mothers had poor attitude. Attitude score ranged from 1-10 with mean 7.6 and median 7.1 and calculated SD was 1.8. There was significant association with knowledge score and selected demographic variables, like- age of mothers, educational qualification, distance of health centre from home and any missed dose of baby. There was also significant association between attitude score with selected demographic variables like- educational qualification, habitant, distance of health centre and visited health centre along with children. The study findings have significant implications for nursing administration and research.

Arbovirus surveillance in febrile patients attending selected health facilities in Rwanda

ABSTRACTArthropod-borne (arbo) viruses cause emerging diseases that affect the livelihoods of people around the world. They are linked to disease outbreaks resulting in high morbidity, mortality, and economic loss. In sub-Saharan Africa, numerous arbovirus outbreaks have been documented, but the circulation and magnitude of illness caused by these viruses during inter-epidemic periods remains unknown in many regions. In Rwanda, there is limited knowledge on the presence and distribution of arboviruses. This study aimed at determining the occurrence and distribution of selected arboviruses, i.e., chikungunya virus (CHIKV), o’nyong-nyong virus (ONNV), dengue virus (DENV), West Nile virus (WNV), Zika virus (ZIKV), Rift Valley fever virus (RVFV) and Crimean-Congo haemorrhagic fever virus (CCHFV), among febrile patients visiting health centres in Rwanda. A total of 2294 dry blood spots (DBS) were collected on filter papers during August 2019 – December 2020. Reverse-transcription polymerase chain reaction (RT-PCR) was performed on samples in pools of ten, using both quantitative (DENV, ZIKV, RVFV) and conventional PCR (CHIKV, ONNV, WNV, CCHFV) with virus specific primers, followed by sequencing. Demographic data and clinical manifestations of illness were analysed. ONNV infection was detected in 12 of 230 pools (5.2%) and ZIKV in three pools (1.3%). The other arboviruses were not detected. All ONNV cases were found in the Rwaniro health centre, while ZIKV infection was found among patients visiting the Kirinda and Zaza health centres. There was temporal variability in ONNV infections with most cases being recorded during the long dry season, while ZIKV infection occurred during both dry and wet seasons. Patients with ONNV were older and more were females. In conclusion, ONNV and ZIKV infection were detected in acute patients and can explain some of the feverish diseases in Rwanda.