World Health Organization Estimates Research Articles

Application of the K-Nearest Neighbor Method for Classification of Hypertension Diseases (Case Study: Stabat Health Center)

Globally, the WHO (World Health Organization) estimates that non-communicable diseases cause about 60% of deaths and 43% of diseases worldwide. Hypertension is a disease that occurs due to an increase in blood pressure in humans. It is difficult to know if a person has hypertension, without measuring the patient's blood pressure. According to the American Heart Association (AHA), the number of Americans over the age of 20 suffering from hypertension has reached 74.5 million, but nearly 90-95% of cases have no known cause. It is estimated that about 80% of the increase in hypertension cases will occur mainly in developing countries by 2025, from 639 million cases in 2000. This number is expected to increase to 1.15 billion cases in 2023. This study uses a quantitative approach with experimental methods to test the application of K-Nearest Neighbor (KNN) in the classification of hypertension diseases at the Stabat Health Center. The description of the results obtained is to make the right decision regarding when and how to treat the disease to prevent the worst possibility for patients by classifying the severity of hypertension both in normal circumstances, prehypertension, stage 1 hypertension, and stage 2 hypertension. The results of the trial show that the KNN model is able to provide accurate predictions based on patient history data available at Stabat Health Center.

Occupational biological risk in healthcare workers

Biohazardous occupational accidents represent a significant challenge in the healthcare field due to the constant exposure of healthcare workers to pathogens. These accidents, which include needle sticks, cuts, splashes of body fluids, and contact with contaminated materials, can lead to serious infections, such as hepatitis B (HBV), hepatitis C (HCV), and HIV. World Health Organization (WHO) estimates that approximately two million healthcare workers experience sharps injuries annually, resulting in a significant risk of exposure to blood-borne pathogens [1]. A study conducted in hospitals in Europe revealed that the prevalence rate of needlestick injuries ranges from 10% to 30% per year, with the highest rates in areas such as surgery and intensive care [2]. The high frequency of these incidents underscores the importance of implementing effective preventive strategies to protect these workers.

Sexually Transmitted Infections Surveillance in Pakistan

Sexually transmitted infections (STIs) are transferred fromperson to person by unsafe sexual contact. Some STIs canalso be transmitted through transfusion of unscreenedblood during pregnancy, childbirth, and breastfeeding.1 Untreated STIs can lead to serious health consequences,including human immunodeficiency virus (HIV) andinfertility, and can complicate pregnancy.1 The World Health Organization (WHO) estimates thatmore than one million infections are transmitted everyday worldwide, and the majority of them areasymptomatic.2 Every year, approximately 400 millionnew STI infections are detected, including the fourtreatable STIs, each of which is curable. These arechlamydia, gonorrhoea, syphilis, and trichomoniasis.2 Asignificant proportion of people between 15-49 years ageare estimated to have herpes simplex virus (HSV orherpes) infection of the genital area.3 STIs can also lead tolifelong stigma.2 Hepatitis B virus (HBV) can also betransmitted through unsafe sexual contact and lead tocirrhosis and hepatocellular carcinoma.2 Continued...

Chikungunya Virus Vaccines: A Review of IXCHIQ and PXVX0317 from Pre-Clinical Evaluation to Licensure.

Chikungunya virus is an emerging mosquito-borne alphavirus that causes febrile illness and arthritic disease. Chikungunya virus is endemic in 110 countries and the World Health Organization estimates that it has caused more than 2 million cases of crippling acute and chronic arthritis globally since it re-emerged in 2005. Chikungunya virus outbreaks have occurred in Africa, Asia, Indian Ocean islands, South Pacific islands, Europe, and the Americas. Until recently, no specific countermeasures to prevent or treat chikungunya disease were available. To address this need, multiple vaccines are in human trials. These vaccines use messenger RNA-lipid nanoparticles, inactivated virus, and viral vector approaches, with a live-attenuated vaccine VLA1553 and a virus-like particle PXVX0317 in phase III testing. In November 2023, the US Food and Drug Administration (FDA)approved the VLA1553 live-attenuated vaccine, which is marketed as IXCHIQ. In June 2024, Health Canada approved IXCHIQ, and in July 2024, IXCHIQ was approved by the European Commission. On August 13, 2024, the US FDA granted priority review for PXVX0317. The European Medicine Agency is considering accelerated assessment review of PXVX0317, with potential for approval by both agencies in 2025.In this review, we summarize published data from pre-clinical and clinical trials for the IXCHIQ and PXVX0317 vaccines. We also discuss unanswered questions including potential impacts of pre-existing chikungunya virus immunity on vaccine safety and immunogenicity, whether long-term immunity can be achieved, safety in children, pregnant, and immunocompromised individuals, and vaccine efficacy in people with previous exposure to other emerging alphaviruses in addition to chikungunya virus.

Depression, Loneliness and Quality of Life in Institutionalised and Non-Institutionalised Older Adults in Portugal: A Cross-Sectional Study.

The World Health Organisation estimates that by 2050, the world's population over 60 will number two billion people, which poses complex challenges in terms of maintaining the mental health of older adults. The COVID-19 pandemic has increased the prevalence of depressive symptoms in this population, but the post-pandemic phase has not yet been studied much. A cross-sectional survey was carried out in 2023 among institutionalised and non-institutionalised older adults (total n = 525; institutionalised = 458; non-institutionalised = 67) who were selected by convenience sampling. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of depressive symptoms, the WHOQOL-BREF to assess perceived quality of life and the Loneliness Scale (UCLA) to assess negative feelings of loneliness. Unconditional logistic regression models were fitted to compute crude adjusted odds ratios (ORs) and the respective 95% confidence intervals (95%CIs) for the association between sociodemographic, clinical and psychosocial characteristics and depressive symptomatology, according to institutionalisation status. The final model was adjusted for sex, age, QoL and feelings of loneliness. Of the 525 participants, 74.6% of the non-institutionalised participants had no or minimal depressive symptoms, while 55.4% of the institutionalised participants fell into this category. Mild to moderately severe depressive symptoms were present in 25.4% of the non-institutionalised participants. 26.9% of the institutionalised participants had mild symptoms, 11.8% had moderate symptoms, 3.9% had moderately severe symptoms, and 2.0% had severe depressive symptoms. Overall, a higher quality of life was associated with lower levels of depressive symptoms. Participants describing feelings of loneliness were more likely also to present depressive symptoms (OR = 78.10; 95%CI 2.90-2106.08 and OR = 3.53; 95%CI 1.72-6.91 for non-institutionalised and institutionalised older adults, respectively), independently of institutionalisation status. The prevalence of depressive symptoms is high in older adults, which means that it has not decreased after the increase seen due to the COVID-19 pandemic. A lower perception of quality of life and the presence of negative feelings of loneliness are associated with the presence of depressive symptoms. These conclusions suggest that plans should be developed to intervene in the dimensions of depressive symptoms, perceived quality of life and negative feelings of loneliness.

Service Designing Together for Better International Employee Experiences : An example from health and social care services in Finland

The World Health Organization (WHO) estimates that the world needs 4.5 million new nurses by 2030.1 Nurses are a critical touchpoint of health and social care services. Without them, the services could not exist as we know them. The nurse shortage is a vicious service design problem.

The Occurrence of Chlamydia felis in Cats and Dogs in Hungary.

The World Health Organization (WHO) estimates that many human infections are zoonoses, creating a worldwide public health challenge. Among Chlamydia species, Chlamydia felis is the leading cause of conjunctivitis in cats and is a prominent zoonotic species. This study aimed to determine the occurrence and risk of chlamydiosis in cats and dogs in Szeged, Hungary, and surrounding areas. The total nucleic acids from conjunctival swab samples of symptomatic and asymptomatic animals were extracted using an automated nucleic acid extraction system. After that, DNA was amplified by pan-chlamydia PCR. Bacterial and fungal cultures were also performed to detect other microorganisms. Of the 93 animals, 32 (34.4%) were positive for pan-chlamydia PCR. The positivity rates were 33.3% (26/78) in cats and 40.0% (6/15) in dogs. Furthermore, the positivity rates were 37.2% (16/43) in the cat shelter, 42.4% (14/33) in the veterinary clinic, and 11.7% (2/17) in household pets. In total, 103 species were identified through culture-based examinations, including 97 (94.2%) bacterial and 6 fungal (5.8%) species. From both human and animal health perspectives, it is essential to have a detailed understanding of the circumstances of chlamydiosis, given the global impact of zoonotic diseases.

Parasite Contamination of Water Source at Pangkalan Masyhur Sub-district, Medan Johor District

According to World Health Organisation (WHO) estimates, at least 1,8 billion people consume contaminated water worldwide, hence most of the diarrheal disease in the world is attributable to unsafe water, and the lack of sanitation and hygiene. Water utilization by humans and animals can generate biological pollutants which may contaminate the water. These contaminants come from waste products that may contain bacteria, protozoa, and other parasites. This was a descriptive study with cross sectional design and simple random sampling to determine the contamination of water source by pathogens, particularly parasites at Region V Pangkalan Masyhur sub-district, Medan Johor district, Medan, North Sumatera in 2012. Samples were obtained from each house, depending on the main water source used, either from tap water, open wells, or the nearby river streams. Modified Caldwell’s sedimentation technique was applied to examine the samples under light microscope. Out of the 103 water samples collected, most were from tap water (78 samples), followed by open wells (19 samples), and only six were from the nearby river streams. We found Paramecium caudatum from nine samples (8,7%) collected from the open wells and the nearby river streams, followed by hookworm larva in one tap water sample (1%). No protozoa such as Entamoeba spp., Cryptosporidium spp., and Giardia spp. found in any of the samples. Based on this data, the abundant presence of P.caudatum represented the condition of high organic debris in the open wells and the nearby river streams. Additionally, the presence of hookworm larva in the tap water indicated the distribution system was contaminated with the surrounding soil. Hence it is imperative to provide counseling about optimal environmental sanitation and clean water management, including proper maintenance for water source and its distribution system. Tap water distribution, including its network of pipe deliverance system, must be checked and maintained regularly.

A Study To Assess The Level Of Anxiety, Coping Strategies And Financial Burden Among The Spouses Of Alcoholics Attending De-Addiction Centre At Selected Hospital In Kolkata, West Bengal

Background: Alcoholism is one of the significant problems in India. It is a chronic progressive and often fatal disease but it has not a symptom like other diseases or emotional problems. Prolonged heavy use of alcohol is the cause of addiction. For this addiction higher anxiety level, depression, low self-esteem and communication apprehension have been reported in spouses of alcoholics and attributed to intense, stress and traumas experiences. [1] The World Health Organization (WHO) estimates (9th May 2022) that there are about Worldwide, 3 million deaths every year result from harmful use of alcohol. This represents 5.3% of all deaths. The excessive use of alcohol is one of the main causes of more than 200 disease and injury conditions. Overall, 5.1% of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (DALYs). A cause of death and disability relatively early in life is alcohol consumption. In people aged 20–39 years, approximately 13.5% of total deaths are attributable to alcohol. [9] Materials and Methods: A descriptive survey research design was adopted in this study. Non-probability Convenience sampling technique was used to select 100 spouses of alcoholics attending de-addiction centre of R. G. Kar M. C. H. Kolkata and de-addiction centre of N. R. S. M. C. H., Kolkata. Result: The findings revealed that majority of the subject 70% experiencing moderate level of anxiety, majority of the subject 76% adapted moderate coping strategies and majority of the subject 87% experiencing moderate financial burden. There was no relation between the level of anxiety and coping strategies among the spouses of alcoholics. There was a statistical significant association between anxiety with the selected socio demographic variables as educational qualification (χ2= 4.842 df =1, p>0.05), duration of marriage (χ2=4.762, df=1, p>0.05). Conclusion: Alcoholism had the negative effects towards the individual, family and also the nations. Lower education, loss of job, unemployment, unsocial behaves were also the effect of alcoholism. Awareness about the adverse effect of alcohol can prevent the alcoholism, thus reduce the level of anxiety of the spouses

About the global strategy for the prevention of influenza in 2019–2030

The development of modern methods of epidemiological control, on the one hand, and the creation of modern methods of diagnosis, prevention, and treatment, which will be available to all strata of society, on the other hand, is the key to preventing the pandemic spread of influenza in the world. Today, influenza is a serious threat to human health globally, which covers all countries of the world. Thus, according to the World Health Organization estimates, about 1 billion cases of influenza are registered annually worldwide, of which 3–5 million are severe cases and 290,000–650,000 are cases of death due to severe complications of respiratory dysfunction caused by influenza. Children are more susceptible to acute respiratory viral infections and influenza in the general population due to the physiological instability of the immune system, being mostly in crowded places and in large social groups (kindergartens, schools, entertainment centers), which increases the probability of infection. The risk group consists of patients with chronic pathology, particularly affecting the heart and lungs, who have problems with the immune system.

Determinants of survival time for HIV/AIDS patients in the pastoralist region of Borena: a study at Yabelo General Hospital, South East Ethiopia

IntroductionHIV/AIDS is one of the most dangerous diseases globally, impacting public health, economics, society, political issues, and communities. As of 2023, the World Health Organization estimates that 40.4 million people are living with HIV/AIDS. This study aimed to identify the determinants of survival time for HIV/AIDS patients in the pastoralist region of Borena at Yabelo General Hospital.MethodThe study design was a retrospective cohort study, with a sample size of 293 individuals living with HIV/AIDS, based on recorded data. This research utilized survival model analysis, employing Kaplan-Meier plots, the log-rank test, and Cox proportional hazard model analysis.ResultOut of the total sample size, 179 (61.1%) were female and 114 (38.1%) were male. Among these males, 36 (31.6%) were deceased. The analysis using the Cox proportional hazard model revealed that the following variables were significantly associated with the survival time of HIV/AIDS patients: gender, educational status, area of residence, tuberculosis (TB), and opportunistic infections.ConclusionsWe concluded that individuals living with HIV/AIDS in urban areas have a lower risk of death compared to those in rural areas, indicating that rural residents have a reduced survival probability. Therefore, the Borena zone administration should focus on adult patients to enhance life expectancy.

Geospatial patterns, and individual and community levels factors of cesarean section deliveries in Ethiopia: A spatial and multilevel analysis.

Cesarean Section (CS) is the most popular surgery worldwide in obstetric care to save a mother's or the fetus's life. The prevalence of CS delivery in Ethiopia was 0.7% and 1.9% in 2000 and 2016 respectively and its spatial distribution and variation in Ethiopia are limited. This study provides evidence for healthcare providers and pregnant women on the national CS geospatial distribution and variation to promote evidence-based decision-making and improve maternal and neonatal outcomes. Therefore, this study aimed to determine geospatial patterns and individual and community-level factors of CS deliveries in Ethiopia. A secondary data analysis of 5,527 weighted samples of mothers using the 2019 Ethiopian mini demographic and health survey was conducted. The spatial hotspot analysis using Getis-Ord Gi* hot spot analysis of ArcGIS version 10.7.1 was used to show the spatial cluster of CS and multilevel mixed effect logistic regression analyses were employed. Statistical significance was declared at p-value <0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported. The prevalence of CS delivery in Ethiopia was 5.4% with 95%CI (4.6%, 6.4%). The spatial autocorrelation shows CS was clustered in Ethiopia (global Moran's index = 1.009, and p-value<0.001). Spatial hotspot indicates CS was prevalent in Addis Ababa, Diredewa, Oromo, and Somali regions. The odds of CS delivery were higher among mothers aged 24-35: AOR = 1.98, 95% CI (1.3, 3.1), and 35-49: AOR = 3.7, 95% CI(2.2, 6.1), live with female household heads: AOR = 1.9, 95% CI (1.2, 3.1), mothers with primary AOR = 1.6, 95% CI (1.07, 2.7), secondary: AOR = 2.4, 95% CI (1.3, 4.25) and higher education: AOR = 2.06, 95% CI (1.03, 4.2), multiple births: AOR = 8.1, 95% CI (3.4, 19.74), mothers in Addis Ababa: AOR = 3.4, 95% CI (1.1, 11.9) and Diredewa: AOR = 7, 95% CI (1.23, 40.7) as compared to their counterparts. In Ethiopia, CS deliveries remain below the World Health Organization estimate with distinct geospatial variation. Geographically, CS delivery is concentrated in urban areas like Addis Ababa and Diredewa, as well as in parts of the Somali and Oromia regions. Maternal age, female household head, Muslim religion, higher educational status, and multiple births at the individual level, and region at the community level were factors of CS delivery in Ethiopia. Therefore, efforts should be geared towards strategies and interventions to ensure fair access to CS delivery in line with WHO recommendations, especially in the regions where the CS delivery rate is below WHO estimates in Tigray, Amhara, Afar, and Benishangul Gumze regions.

Comparison and review of international guidelines for treating asthma in children.

Asthma, the most common chronic disease, is characterized by airway inflammation and airflow obstruction. The World Health Organization estimates that approximately 300 million people worldwide have asthma, 30% of whom are pediatric patients. Asthma is a major cause of morbidity that can lead to hospitalization or death in severe pediatric cases. Therefore, it is necessary to provide children with objective and reliable treatment according to consistent guidelines. Several institutes, such as the Global Institute for Asthma, National Heart, Lung, and Blood Institute, British Thoracic Society, Japanese Society of Pediatric Allergy and Clinical Immunology, and Korean Academy of Asthma, Allergy, and Clinical Immunology have published and revised asthma guidelines. However, since recommendations differ among them, confusion persists regarding drug therapy for pediatric asthma patients. Additionally, some guidelines have changed significantly in recent years. This review investigated the latest changes in each guideline, compared and analyzed the recommendations, and identified the international trends in pediatric asthma drug therapy. The findings of this review may aid determinations of the future direction of the Korean guidelines for childhood asthma.

Incorporating basic periodontal screening into antenatal care services provided in Rwanda: A policy brief.

Preterm birth, which is child delivery before 37 weeks of pregnancy, is the primary cause of perinatal mortality worldwide. Preterm birth remains a major public health challenge in Rwanda, affecting approximately 13.8% of birth. The World Health Organization estimates that 15 million babies are born prematurely each year. While the association between periodontitis and preterm deliveries is increasingly recognized, little is known about this link in Rwanda. This policy brief aims to bridge this knowledge gap by presenting the findings of a recent study investigating the prevalence of periodontitis among pregnant women in Rwanda and its association with preterm deliveries. This policy brief also aims to inform and guide decision making towards incorporating periodontal screening into the antenatal care package in Rwanda. This has the potential to improve pregnancy outcomes and contribute to improved oral health in the future. Contemporary evidence has shown a six-fold increased risk of preterm delivery for women with periodontitis in Rwanda, with a concerningly high prevalence (60%) among pregnant women. Additionally, nurses working in antenatal clinics displayed insufficient knowledge about gum disease. The adoption of basic periodontal screening within existing antenatal care packages is recommended. This, coupled with nurse training and public awareness campaigns, can empower women and healthcare professionals to prioritize oral health for better pregnancy outcomes. Integrating periodontal screening into antenatal care has the potential to significantly reduce preterm deliveries and contribute to a healthier future generation in Rwanda.

Global prevalence of non-partner sexual violence against women.

Sexual violence against women is a human rights violation and public health concern, with serious implications for women's physical and mental health. Reducing non-partner sexual violence, including rape, sexual assault and other forms of non-contact sexual abuse, is one of the main indicators of the sustainable development goals. World Health Organization estimates, based on available prevalence data from 137 countries between 2000 and 2018, showed that, globally, 6% of women aged 15-49years reported experiencing sexual violence in their lifetime from someone other than an intimate partner, with prevalence rates varying across regions. However, the reporting, measurement and documentation of the global extent of non-partner sexual violence against women is methodologically challenging, resulting in a gross underestimation of its magnitude and impact. To prevent and respond to this issue, policy-makers must consider interventions on education, access to relevant health-care services, public awareness, and effective and comprehensive legislation. To better estimate the prevalence of both sexual violence overall and non-partner sexual violence, it is essential to continue to strengthen the measurement of non-partner sexual violence, including the types of acts asked about and the mode of interviewing. Further research is needed to understand the cumulative impact of different forms of sexual violence on the lives of women and girls, including sexual violence during childhood and its associated risk with further exposure. Funding is required for more research and implementation of interventions to prevent and reduce all forms of violence against women and girls, including sexual violence.

Exploring the Determinants of Tobacco Usage Among Adolescents: A Cross-Sectional Study in Western Maharashtra.

Introduction The widespread use of tobacco is a major global health threat, causing significant morbidity and mortality. The World Health Organization (WHO) estimates that annually, millions of people die prematurely due to tobacco use, with this number projected to increase significantly in the future. Developing countries, including India, bear a substantial burden of tobacco-related deaths, often beginning during adolescence. This study estimated the prevalence of tobacco use among adolescents in the 13-19 years age group, identified the types of tobacco products used, explored the reasons for initiation, and examined the influence of family, peers, and socio-demographic factors on tobacco use. Methods A community-based cross-sectional study was conducted from August 2022 to June 2024 in a medical college's urban and rural field practice areas in Pune district, Maharashtra. A total of 310 adolescents were surveyed using convenience sampling. Data were collected using a pre-designed, pre-tested questionnaire, and statistical analysis was performed using Jamovi software version 2.3.28. Chi-square and Fisher's exact tests were applied to assess associations between variables. Results Out of 310 participants, 94 (30.32%, 95% CI: 25.25%-35.77%) reported using tobacco. Among these 94 participants, 82 (87.23%) used smokeless tobacco, 19 (20.21%) used the smoked form of tobacco, and seven (7.45%) used both forms. The mean age of initiation was 15.94 years for smoking and 15.59 years for smokeless tobacco. The data indicate a higher percentage of tobacco use among females (50%) compared to males (24.8%). However, in terms of absolute numbers, more males (60) than females (34) reported using tobacco due to the larger number of males in the study sample. The most common reasons for initiation included curiosity (43.74%) and peer pressure (53.99%). Specifically, 49 individuals (42.6%) aged 13-15 were using tobacco, compared to 23 individuals (30.3%) aged 16-17, and only 22 individuals (18.5%) aged 18-19. Participants from urban areas reported higher tobacco use (48%) compared to those from rural areas (46.7%). Among those from joint families, about 24 (31.6%) reported tobacco use, while in nuclear families, it was slightly lower at about 70 (29.9%). Conclusion Factors such as peer pressure and curiosity played significant roles in the initiation of tobacco use, with more than half of the participants citing peer influence as the primary reason for starting. This study revealed differences in tobacco usage patterns across age groups, with younger participants showing higher usage rates. The findings highlight the need for targeted interventions, such as health education and anti-tobacco media campaigns, to reduce tobacco use among adolescents.

EVALUATION OF WOUND HEALING IN POST-SURGICAL PATIENTS CAESAR THOSE USING ANTIBIOTIC DRUGS AT TANJUNG PURA HOSPITAL

Introduction The World Health Organization (WHO) estimates that 5-15% of births globally are surgical cesarean section. Indonesian Health 2017 shows that 17.02% of deliveries in Indonesia are cesarean sections. Surgical wound infections are infections from wounds obtained after surgery. This infection can occur 30-90 days after surgery. Appropriate use of prophylactic antibiotics intraoperatively can reduce Surgical wound infections. Antibiotics are the most widely used class of drugs related to bacterial infectious diseases. Types of research used is prospective survey research with an approach of studying and testing hypotheses related to ongoing experience. Sample studies were 20 respondents. This research uses quantitative descriptive data analysis with a prospective research design. Research results At the Pharmacy Installation at the Tanjung Pura Regional General Hospital, surgical wounds began to close/dry as much as 70% (14 patients) for compliance with the use of antibiotics according to the right indication, right dose, right patient, right drug. Conclusion of this research is that administering antibiotics affects wound healing in patients and can ensure accuracy in suitability. It is recommended that the hospital review the cleanliness of the surgical area in order to improve the quality of the hospital.

Iron Deficiency Anemia (IDA) in Pregnancy : Prevalence and Management

Abstract: - Anemia is a significant public health problem worldwide, particularly among pregnant women. The World Health Organization (WHO) estimates that 18% of pregnant women in developed countries and 56% in developing countries are anemic. In India, anemia during pregnancy affects 45.7% of women in urban areas and 54.3% in rural areas. This review aims to provide an overview of the prevalence, causes, and management strategies of Iron Deficiency Anemia (IDA) during pregnancy, with a focus on the Indian context. The review highlights that anemia during pregnancy leads to significant health risks, including low birth weight and impaired cognitive and physical development in children. Key factors contributing to anemia include inadequate dietary intake, increased iron demands during pregnancy, and traditional cooking practices that do not promote adequate iron absorption. Management strategies for IDA include dietary modifications to increase iron intake and bioavailability, oral iron supplements, and intravenous iron therapy in severe cases. The review underscores the importance of early and regular antenatal care to monitor and address anemia. Notably, oral iron supplements are recommended to start early in pregnancy and continue with adjusted doses throughout gestation.

Study of Clinical Spectrum of Neurological Manifestations in HIV/AIDS Seen at Tertiary Referral Hospital in India

Objectives: The pandemic caused by human immunodeficiency virus (HIV) is one of the fastest growing health problems in the world today. Neurological manifestations of HIV infection and acquired immunodeficiency syndrome (AIDS) are being seen in a frequency that is parallel to the increasing number of new cases seen the world over. The World Health Organisation (WHO) estimates that 36.7 million people in the world are infected with HIV. Neurological manifestations of HIV disease can be seen in 20% of outpatients in HIV clinics and almost half of HIV patients being treated as in-patients. Of the various subtypes of HIV, subtype C is responsible for more than 50% of HIV1 infections causing rapidly growing epidemics in India. The objectives of this study were as follows: (1) To evaluate the prevalence of neurological manifestation in HIV-positive patients admitted to a tertiary referral Hospital in India. (2) To describe the neurological manifestations documented. (3) To find the possible predictors of neurological manifestations. Material and Methods: This study was a single centre prospective cross-sectional study in which out of 200 HIV/AIDS patients, 40 patients with neurological manifestations were analysed over a period of 18 months. They were interviewed and evaluated with particular reference to neurological manifestations, and were classified using the WHO staging system. Results: Amongst the studied population of 40 patients, 16 patients (40%) manifested as tuberculous meningitis (TBM) with or without brain tuberculomas, followed by seven patients (18%) presented with peripheral neuropathy and six patients (15%) presented with central nervous system (CNS) vasculitic or multi-infarct state. Cryptococcal meningitis was seen in five patients (12%), efavirenz-induced psychosis/seizure seen in one patient, while HIV-induced polymyositis, progressive multifocal leukoencephalopathy progressive multifocal leukoencephalopathy, acute inflammatory demylinating polyradiculoneuropathy, AIDS dementia complex and CNS toxoplasmosis were seen in one patient each respectively. One patient presented with dual opportunistic infection with coexistence of cryptococcal and tuberculous meningitis. Conclusion: Headache with or without vomiting, seizures and altered sensorium were the most common neurological symptoms. Fundus abnormalities, meningeal signs, gait abnormalities, cranial nerve dysfunction and hemiplegia were the most common neurological signs. New-onset headache was a significant predictor of the occurrence of neurological complications. Opportunistic infections such as TBM and Cryptococcal meningitis were most commonly observed.

Prevention of vertical transmission of hepatitis B: A retrospective review of a 5-year maternal-infant cohort in London.

The World Health Organization (WHO) estimates that 3.5% of the population live with hepatitis B virus (HBV); migrants to Europe are disproportionately affected. UK birth dose HBV vaccination is limited to infants born to those living with HBV (LWHBV). High-risk infants (high maternal infectivity, low birthweight) also receive HBV immunoglobulin (HBIG). The Family Hepatitis Clinic follows infants and those LWHBV working towards WHO goals of combating viral hepatitis by 2030. A trust-wide electronic note review of outcomes for infants born to those LWHBV (2016-2020). Two hundred and eighty-three infants, 134 (47%) females, born to those LWHBV were referred. Two hundred and thirty-one (82%) attended follow-up with a vertical transmission rate of 0%. Twenty (7%) individuals LWHBV received tenofovir disoproxil fumerate in pregnancy; median viral load (VL) at initiation 125 416 376 DNA IU/mL, one having birth VL. Twenty-eight (10%) infants were stratified as high risk and all received HBIG and birth dose vaccination with 9 (32%) subsequently lost to follow-up, compared to 48 (19%) low-risk infants. 267/283 (94%) had birth dose vaccination documented and 206/283 (73%) received at least four vaccine doses. 215/283 (76%) infants had serology by 24 months; 17 (6%) with suboptimal vaccine responses: hepatitis B surface antibody <100 IU/mL. Serology before 18 months resulted in higher rates of maternal hepatitis B core antibody detection (15% vs. 3%). Prevention of vertical transmission of HBV was universal in those attending, although high-risk infants were more likely lost to follow up. HBV post-vaccine serological protection was comparable with national data from 2021 (77% >4 doses, 77% HBsAb >100).