World Health Organization Standards Research Articles

An Evidence-Based Case Series of Male Infertility (OAT Syndrome Associated with Hypospermia) Treated with Constitutional Medicine

AbstractA major clinical problem that still affects 8 to 12% of couples globally, infertility and issues with diminished fecundity have long been a cause for worry. Approximately 35% of the cases of infertility result from deficiencies associated with male factor and as many as 2% of all men will exhibit suboptimal sperm parameters. Medical therapy includes the treatment of reversible endocrine or infectious causes of subfertility that may cause a variety of adverse effects. This study aimed to highlight the importance of employing homoeopathic constitutional medicine in the cases, caused by suboptimal seminal parameters (oligospermia, asthenospermia, teratospermia associated with hypospermia) due to non-specific causes. In this study, three males who had a poor seminal parameter visited the outpatient clinic. Their cases were recorded, appraised and analysed according to homoeopathic principles and repertorised using a complete repertory. Finally, each case received a constitutional medicine for prescription. Causal attribution of changes in their condition to the homoeopathic treatment was assessed by Modified Naranjo Criteria for Homoeopathy (MONARCH) inventory score. After a couple of months of medical care, a second semen analysis of the patients was performed. The reports revealed the improvement in the seminal variables. At the end, the values obtained were according to the 2010 World Health Organization standards. The outcome of the case series supports the clinical potency of constitutional treatment in homoeopathy in idiopathic infertile men. In future, randomised control trials with large sample sizes may be undertaken for validation of results.

How do socioeconomic indicators and fiscal decentralization affect stunting? Evidence from Indonesia

Purpose Stunting has emerged as a prominent concern on a global scale. Over the past seven years, the average prevalence has consistently exceeded the World Health Organization standards. This study aims to investigate the roots and model of stunting. Design/methodology/approach The samples were collected from 406 regencies (counties) and municipalities across 34 provinces in Indonesia from 2017 to 2022 and used the dynamic panel data analysis. Findings The findings showed that the food security index, poverty line, women’s years of schooling, the specific allocation of funds and hopeful family program negatively influenced stunting. Otherwise, village funds and fiscal decentralisation positively affect stunting. The results also confirmed that stunting had a dynamic impact. In addition, the effect of income per capita, the poverty severity index and government funds for education and health on stunting rates were inconclusive. Practical implications The policy implication of the study suggests that the government must consider the budgetary concerns of each region and focus on the regions that exhibit different needs. Originality/value This paper will contribute to the literature about the modelling of determinants of Stunting in Indonesia.

WHO/INRUD prescribing indicators with a focus on antibiotics utilization patterns at outpatient department of Adigrat general hospital, Tigrai, Ethiopia: a retrospective cross-sectional study

BackgroundThe World Health Organization (WHO) defines rational use of drug as a state in which medications are received by patients appropriately according to their clinical needs and individual requirement, for adequate period and at the right cost. More than 50% of all medicines are prescribed, dispensed, or sold inappropriately worldwide. This study aimed to evaluate the prescribing patterns in Adigrat general hospital, Tigrai, Ethiopia.MethodsA retrospective cross-sectional study was done to evaluate prescription patterns. A systematic random sampling technique was used to select 600 prescriptions and the prescriptions were reviewed using WHO/International Network of Rational Use of Drugs prescribing indicators. Data was collected from prescriptions dispensed from 01 March 2023 to 30 March 2024 at outpatient pharmacy of Adigrat general hospital. Data was analyzed using SPSS version 21 and a p-value < 0.05 was declared statistically significant.ResultsA total of 1088 medicines were prescribed in 600 prescription encounters, giving an average number of 1.8 (± 0.83) medicines per encounter. The percentage of medicines prescribed by generic name was 91.5% while 98.7% of the medicines were prescribed from essential medicine list (EML). Besides, the percentages of encounters containing at least one antibiotic and one injection were 44.5% and 7.2%, respectively. A total of 340 antibiotics were prescribed in 267 encounters. Penicillins (34.4%), macrolides (23.8%) and fluoroquinolones (17.1%) were the most prevalent antibiotics classes. The “Access” and “Watch” groups covered 54.4% and 45.6% of the total antibiotics prescribed, respectively. Being under 18 years old [Adjusted Odds Ratio (AOR): 9.830, CI: 4.062–23.786], being prescribed with three medicines (AOR: 3.247, CI: 1.571–6.708) and certain diagnosis like diseases of the respiratory system (AOR: 3.750, CI: 2.136–6.584) were significantly associated with antibiotic prescribing.ConclusionThis study showed deviations of prescribing patterns from WHO standards. The percentage of prescriptions with antibiotic was far from WHO optimal value. The use of antibiotics from “Access” group was below WHO standard. The percentage of medicines prescribed by generic name and the percentage of encounters with injection also deviated from WHO standard. Antibiotics prescribing showed significantly association with age, number of medicines and certain diseases.

Cost effectiveness and return on investment analysis for surgical care in a conflict-affected region of Sudan.

The delivery of healthcare in conflict-affected regions places tremendous strains to health systems, and the economic value of surgical care in conflict settings remains poorly understood. Our aims were to evaluate the cost-effectiveness, societal economic benefits, and return on investment (ROI) for surgical care in a conflict-affected region in Sudan. We conducted a retrospective study of surgical care from January to December 2022 at the Mother of Mercy-Gidel Hospital (MMH) in the Nuba Mountains of Sudan, a semi-autonomous region characterized by chronic and cyclical conflict. We collected data on all patients undergoing surgical procedures (n = 3016), including age, condition, and procedure. We used the MMH budget and financial statements to measure direct medical and non-medical expenditures (costs) for care. We estimated the proportion of expenditures for surgical care through a survey of surgical vs non-surgical beds. The benefits of care were calculated as averted disability-adjusted life-years (DALYa) based on predicted outcomes for the most common 81% of procedures, and then extrapolated to the overall cohort. We calculated the average cost-effectiveness ratio (CER) of care. The societal economic benefits of surgical care were modeled using a human capital approach, and we performed a ROI analysis. Uncertainty was estimated using sensitivity analysis. We found that the CER for all surgical care was $72.54/DALYa. This CER is far less than the gross domestic product per capita in the comparator economy of South Sudan ($585), qualifying it as very cost-effective by World Health Organization standards. The total societal economic impact of surgical care was $9,124,686, yielding a greater than 14:1 ROI ratio. Sensitivity analysis confirmed confidence in all output models. Surgical care in this conflict-affected region of Sudan is very cost-effective, provides substantial societal economic benefits, and a high return on investment.

Urogenital schistosomiasis among school children in northwestern Tanzania: Prevalence, intensity of infection, associated factors, and pattern of urinary tract morbidities

BackgroundThe planning and implementation of intervention measures against schistosomiasis, particularly mass administration, require knowledge of the current status of the infection. This is important for monitoring the impact of the intervention on disease indicators such as a decline in infection prevalence, intensity of infection, and urogenital morbidities. Following repeated rounds of mass treatment in northwestern Tanzania, the epidemiology of urogenital schistosomiasis has changed; thus, for the effective planning and allocation of resources, it is important to understand the current status of the disease in the targeted groups. Therefore, the objective of the current study was to determine the prevalence, intensity, and associated factors of Schistosoma haematobium infection and urinary tract morbidities in school-aged children from northwestern Tanzania. Materials and methodsAn analytical cross-sectional study was conducted among schoolchildren aged 5–17 years between November and December 2022. A single urine sample was collected from each child and examined for the presence of S. haematobium eggs and microhaematuria using a urine filtration technique and a urine reagent dipstick. Each child underwent an ultrasonographic examination of the urinary tract according to the World Health Organization standards (Niamey protocol) to detect S. haematobium-related morbidities. ResultsOf the 3225 participants, 54.2 % were female, and the mean age was 10.9 (±1.89) years. The overall prevalence of S. haematobium was 17.7 % (95 % CI: 16.4–19.1, 572/3225). Of the 572 infected children, 81.8 % (95 % CI: 78.4–84.9, 468/572) had light-intensity infections, and 18.2 % (95 % CI: 14.9–21.4, 104/572) had heavy-intensity infections. The prevalence of macro- and microhaematuria was 2.4 % (95 % CI: 1.9–3) and 18.5 % (95 % CI: 17.2–19.8), respectively. Age (aOR: 1.2, 95 % CI: 1.0–1.5), district of residence (aOR: 2.1, 95 % CI: 1.7–2.7) and history of schistosomiasis (aOR: 2.5, 95 % CI: 1.9–3.2) were significantly associated with urinary schistosomiasis infection. However, swallowing praziquantel during the last mass drug administration was protective (aOR 0.6, 95 % CI: 0.4–0.8). The overall prevalence of ultrasound-detectable urinary tract abnormalities was 9.9 % (95 % CI: 8.9–11.1, 299/2994) and included urinary bladder abnormalities in 9.9 % (95 % CI: 8.8–11, 297/2994), ureter abnormalities in 0.2 % (95 % CI: 0.07–0.4, 6/2994), and kidney abnormalities in 0.2 % (95 % CI: 0.09–0.4, 7/2994). Calcification of the urinary bladder was observed in 0.9 % (95 % CI: 0.6–1.3, 29/2994) of the examined children. ConclusionsSchistosoma haematobium infection is still prevalent among schoolchildren in the study setting, and it causes substantial morbidity at an early age. Transmission is driven by the age of the child, district of residence, and history of schistosomiasis. However, swallowing praziquantel in rounds of mass drug administration reduces transmission. Urogenital schistosomiasis infection is associated with haematuria and ultrasound-detectable morbidities. In S. haematobium endemic areas, routine ultrasound screening for urinary tract morbidities could be considered in annual mass treatment programmes for early management. Special attention should be given to children with proteinuria, microhaematuria, and heavy infection intensities.

Compliance with WHO Standards in Monitoring and Evaluating the COVID- 19 Pandemic in the Philippines and Vietnam

This research is concerned with the compliance of the Philippines and Vietnam with World Health Organization (WHO) standards in the monitoring and evaluation (M&amp;E) of COVID-19 policies. Document analysis helps to explore the M&amp;E plan for implementing the set of standards from WHO for COVID-19 prevention in the Philippines and Vietnam while surveys define the perception of the local health authorities on the compliance of the Philippines and Vietnam authorities with the WHO standards. Comparing the situation report shared with WHO by those countries would clarify the valuable information. As a result, compliance levels in the Philippines are perceived to be moderately high to high. Respondents in Vietnam rated compliance at a very high level. However, the two countries still have gaps in their COVID-19 M&amp;E systems. Therefore, recommendations are then proposed for the enhancement of the M&amp;E of COVID-19 policies and compliance with WHO.

The evaluation of bottled water quality compliance association formal and informal retailers in Gauteng municipality. South Africa

The quality of bottled water (BW) can vary based on factors such as handling, processing, transportation, hygiene practices, and the retail shop from which it is purchased. This study aimed to compare the microbiological quality of BW (Heterotrophic plate count (HPC), E.coli, and total coliforms (TC)) purchased from both formal and informal retail shops. The study used a convenience sampling approach and categorized the shops into formal and informal. A total of 117 samples were obtained, with 16 from informal shops and 101 from formal shops. The data was analysed using SPSS version 29, and the water quality compliance was assessed based on SANS 241, 1657, and World Health Organization standards for drinking water. The findings indicated a significant link between compliance with bottled water (BW) standards and the specific shop from which the BW was purchased (p 0.001). These results highlight shop compliance's crucial role in influencing BW's microbiological quality, especially in relation to total coliforms (TC) and E.coli presence. Bottled water obtained from informal shops did not meet the standards, whereas BW from formal shops adhered to the standards for TC and E.coli.

A Computational Model for Water Quality Analysis and Assessment in Tanzania

Research on water quality has received much attention in both developing and developed countries. This is because of the fact that, the effects of poor quality of water are detrimental to human beings, animals and the environment. This study is about a computational model for water quality analysis and assessment in Tanzania. Water quality can be understood as the measure of suitability of water based on physical, chemical and biological attributes. Water quality analysis and assessment face several challenges due to population growth, urban land use, agricultural activities, and industrialization. Besides, attempts have been made by the scholars to address the challenges. However, the tools used like titrimetric, electrometric, pH-meter, thermometer and turbidity meter are yet to come up with effective solutions. Because of these, the researcher was compelled to adopt computational model which uses Statistical Analysis System (SAS) software in order to come up with effective solutions concerning water quality analysis and assessment. In this study therefore, the secondary data were collected from Lake Victoria littoral stations under the auspices of the Ministry of Water in Tanzania with the objective to get sufficient information concerning water quality analysis and assessment. Additionally, the collected data were coded in SAS software to analyse independent and dependent variables. SAS software therefore, was employed to obtain central tendency and dispersion as benchmarks in determining quality of water. Also, the Multivariate Linear Regression Model was run to obtain coefficients of estimation, 95% confident limits and p-value. Statistical findings from central tendency and dispersion indicate that, the mean for potential of Hydrogen (pH) was 8.165; for total suspended solids was 3.065 mg/l; chloride displayed a mean of 6.494 mg/l; calcium displayed a mean of 6.421 mg/l; iron had a mean of 0.188 mg/l; magnesium displayed a mean of 3.331 mg/l and sulphate had mean of 2.326 mg/l. Looking closely at all of the above-mentioned water quality parameters, they all align with a Tanzania Bureau of Standards (TBS) and World Health Organization (WHO) as shown on table 1. Findings from the Multivariate linear regression model shows that: First, iron had a p-value of 0.0153, magnesium 0.0347 and total hardness had a p-value of 0.001. All of these were statistically significant in the analysis and assessment of water quality as shown on table 2. The study concludes that, the water quality in Lake Victoria complies with both TBS and WHO standards as explained above.

Impact of Adverse Childhood Experiences on Child Development in South America: A Systematic Review

Abstract Background Adverse Childhood Experiences (ACEs) have garnered attention globally for their detrimental effects on children’s development, such as lower communication, gross and fine motor, and personal-social domains. While extensively studied in high-income countries, there remains a gap in understanding their prevalence and impact in low- and middle-income countries (LMICs). This review aimed to identify, evaluate, and summarize the findings of an association between ACEs and children’s developmental and mental health outcomes in South America Methods A systematic review was conducted to investigate the association between ACEs and childhood development in South America. Databases MEDLINE, PsycINFO, Web of Science, Applied Social Sciences Index and Abstracts, Literatura Latino Americana em Ciências da Saúde, IBECS and CINAHL were searched. Selection criteria encompassed studies from Brazil, Colombia, Argentina, Peru, Venezuela, Chile, Ecuador, Bolivia, Paraguay, Uruguay, Guyana and Suriname examining the effects of ACEs on developmental outcomes and mental health disorders in children under 18 years old. Quality assessment aligned with World Health Organization standards was employed. Results Twenty-four studies met the inclusion criteria, with most categorized as low or very low quality. While the majority demonstrated a significant association between ACEs and developmental or mental health outcomes, a few studies reported null findings. Challenges in study quality, such as small sample sizes and selection bias, were identified. Conclusions Despite limitations in study quality, findings underscore the impact of ACEs on child development and mental health in South America. Because of the low quality of the existent studies the next steps should be to grasp a greater understanding of the issue. This review also highlights the urgency for further research and targeted interventions to mitigate the long-term consequences of ACEs in this region. Key messages • ACEs profoundly affect child development and mental health in South America, necessitating urgent attention and intervention. • Addressing the impact of ACEs in South America is critical for fostering healthier developmental trajectories and enhancing public health outcomes.

Comparative Analysis of 24-h Movement Behaviours in Non-Overweight and Overweight/Obese Children: Findings from the FAMIly Physical Activity, Sedentary Behaviour, and Sleep (FAMIPASS)

Background: Childhood overweight and obesity are global health concerns associated with insufficient physical activity (PA), excessive sedentary behaviour (SB), and inadequate sleep. This study aimed to determine whether differences exist in 24 h movement behaviours between Czech non-overweight children and children with overweight/obesity aged 3–10 years, with respect to their gender, age, or family socioeconomic status (SES). Methods: A total of 381 children (49.9% girls), aged 3–10 years, participated. Their PA, SB, and sleep were continuously monitored over a regular week using wrist-worn accelerometers. Weight status was determined by BMI z-scores, according to World Health Organization standards. SES was assessed using the Family Affluence Scale. Results: Non-overweight children had averages of 414 min of PA, 472 min of SB, and 554 min of sleep per day, while children with overweight/obesity had averages of 392 min of PA, 503 min of SB, and 545 min of sleep. Non-overweight children engaged in significantly more PA (22 min per day; p = 0.014) and significantly less SB (31 min per day; p = 0.002) than children with overweight/obesity. No significant differences were found between the weight groups in gender distribution, age, family SES, or maternal and paternal obesity. Conclusions: Non-overweight children exhibited higher levels of PA and lower levels of SB compared to their counterparts with overweight/obesity, independent of gender, age, or family SES. These findings highlight an association between daily movement behaviours and weight status in young children. Further research is needed to explore the impact of modifying PA and SB on weight outcomes.

Nitrate Content in Root, Tuber, and Leafy Vegetables in Wet Markets in Hanoi: A Health Risk Assessment

Nitrate (NO3–) is a natural compound occurring in foods, especially plant produces, and are also used as additives in industrially processed foods. This study aims to assessing the nitrate contents and health risk in root, tuber, and leafy vegetables in several wet markets in Hanoi. The results showed that the mean nitrate concentration in root and tuber vegetables, herbs and leafy vegetables ranged from 59 to 1118 mg/kg, from 580 to 1204 mg/kg, and from 122 to 3600 mg/kg, respectively. NO3– content in some vegetables at the local market and supermarket were from 1.2 (green beans) to 2.4 times (cucumber) and from 1.4 (long wax gourd) to 3.7 times (radish) higher than World Health Organization (WHO) standards, respectively. The risk assessment of the Estimated Daily Intake (EDI) results shows that the vegetable samples was 23% and 61% in the acceptable value according to WHO for children and adults, respectively. The Hazard Index (HI) shows that, the HI values of nitrate for all samples except for celery were &lt; 1, indicating that health risks for adults associated with nitrate exposure were not significant. On the contrary, 70% of vegetable samples had HI &gt; 1, suggesting adverse effects on children health that consume these vegetables.

Evaluation of water quality and heavy metal contamination in Cauvery River: Tamil Nadu region India

Abstract Comprehensive water quality control is a fundamental requirement for environmental preservation and the sustainable development of communities around the globe. To showcase the importance of local quality controls in identifying the sources of pollution, a case study was conducted to analyze the quality of drinking water from different locations along the Cauvery River from Mettur to Trichy (200 km) in Tamil Nadu, India. The quality of water samples from different locations was indexed and compared with the World Health Organization and Indian Standards of water quality. The results indicate some high local values of TDS, hardness, and chloride content. These high values may be due to effluents from industries, dying factories, and sewage from the urban areas on the banks of the Cauvery River. This is most prevalent near Mohanur, where industrial waste and effluents were directly linked into the river. The results emphasize the importance of local quality control for accurately pinpointing the factors affecting the environment.

Improving communication during damage control surgery: a survey of adult major trauma centres in England.

Deficiencies in non-technical skills can severely impede the functioning of teams in high-intensity scenarios, such as in damage control surgery for the critically injured trauma patient. Truncated preoperative checklists, modified from the standard World Health Organization preoperative checklist, and situational reporting at intervals during surgery are long-established practices in the military, and are recommended in the National Health Service guidelines on major incidents. These tools allow the multiprofessional team to create a shared mental model of the anaesthetic and operative plan, thereby improving team efficiency. Our aim was to establish whether adult major trauma centres in England are using truncated preoperative checklists and situational reporting for damage control surgery. An online survey was devised and distributed via the national programme of care for trauma in November 2020. Responses were received from all 23 adult major trauma centres in England. Nine centres (39.1%) reported using a truncated preoperative checklist for damage control surgery albeit in a variety of formats. Common components were blood products received and/or available, presence of allergies, tranexamic acid and antibiotic administration, availability of viscoelastic tests, equipment required, availability of cell saver, role allocation and reference to other personnel needed, and discussion of the plan. Twelve centres (52.2%) have formal policies in place for situational reporting. Again, these were in multiple formats but all focused on patient physiology to direct surgical planning. We have identified key components to advanced communication aids for damage control surgery, providing a foundation on which other major trauma centres can build their own versions of these potentially lifesaving tools.

Enhancing Global Poliomyelitis Surveillance Performance is Crucial for Eradication Efforts

Background: Poliomyelitis remains a significant public health challenge, with global efforts focused on its eradication. One critical strategy in this endeavor is the implementation of an acute flaccid paralysis (AFP) surveillance system, which is essential for early detection and response to poliovirus transmission. Specific Background: Despite the system's importance, there is limited evaluation of its performance, particularly in regions like Diyala province, Iraq. Knowledge Gap: Previous studies have not adequately assessed the AFP surveillance performance indicators specific to this region, necessitating a comprehensive analysis. Aims: This study aimed to evaluate the performance indicators of the AFP surveillance system in Diyala province during 2021, utilizing established World Health Organization (WHO) standards. Results: The cross-sectional study analyzed data from seven primary health care centers. Key findings revealed a Non-Polio Acute Flaccid Paralysis rate of 5.11 per 100,000 children under 15 years. Performance indicators included 100% reporting completeness, 95% timeliness of notification and investigation, and 97% stool quality for laboratory analysis. Furthermore, 97.3% of specimens reached the national laboratory within three days, demonstrating high operational efficiency. Novelty: This study is one of the first to provide a detailed evaluation of the AFP surveillance system in Diyala province, highlighting areas of strength and compliance with WHO targets. Implications: The findings underscore the effectiveness of the AFP surveillance system in this region, suggesting that its continued implementation can significantly contribute to the global eradication efforts of poliomyelitis while also serving as a model for similar evaluations in other regions. Highlights: High reporting completeness and timeliness in AFP surveillance. Non-Polio AFP rate exceeds WHO targets, indicating effective monitoring. Study supports global efforts toward poliomyelitis eradication. Keywords: Poliomyelitis, Acute Flaccid Paralysis, Surveillance System, Performance Indicators, Iraq

A prescription audit in the ear, nose and throat outpatient department, in a tertiary care hospital: a descriptive cross-sectional study

Background: Prescription audit is a quality improvement process aimed at enhancing patient care and outcomes by reviewing prescriptions. It provides feedback to healthcare providers, (HCPs) to identify areas for improvement and ensure the quality of prescriptions. This study aims to analyse the prescription patterns and prescribing behaviour of doctors using world health organization (WHO) recommended core prescribing indicators and prescription audit guidelines from national health mission (NHM), India and implement action plan accordingly. Methods: A descriptive observational cross-sectional study was conducted for one month in the ear, nose and throat outpatient department (ENT OPD) of KMC-RI, Hubballi. A total of 96 prescriptions were analysed using WHO-recommended core indicators and additional indicators from a prescription audit template. An action plan was created to enhance prescription quality. Results: All the prescriptions contained complete demographic details of the patients, OPD registration name and date of consultation. Handwriting was legible in all 96 prescriptions with a score of 100%. Two lowest performing attributes were identified using prescription audit tool namely, allergy status and generic name with a score of 7% and 37.9% respectively. The study revealed that average number of drugs encountered was 1.9, the percentage of drugs prescribed by generic name was 37.9%, percentage of encounters with an injection prescribed was 2.08% and percentage of drugs prescribed from NLEM was 37.9%. Conclusions: The prescription audit revealed that most prescriptions adhered to WHO standards. However, improvements are needed in documenting allergy status and prescribing by generic name. An action plan with a defined timeline has been prepared to provide feedback, aiming to enhance prescription quality and ensure better healthcare outcomes.

Indoor air quality assessment of an existing apartment located in Indian tropical city, Bhubaneswar

Introduction: A proper investigation on indoor pollution level in economical apartments is important, where the provision for ventilation is limited. A series of experiments were conducted in the houses within an existing economical apartment in Bhubaneswar, India to evaluate various pollutant levels. Materials and methods: Temperature, relative humidity, CO, CO2, Particulate Matter (PM10 and PM2.5), Formaldehyde and Total volatile organic compounds in the bedrooms and kitchens are measured by pollution meters. The experiments were conducted with doors and windows closed conditions. The readings were taken on a four consecutive working day in February 2023 at an interval of 3 h (9:00 am to 9:00 pm). Results: The day wise temperature and humidity variations inside the bedroom and kitchen shows a reverse trend. At the afternoon, the indoor temperature becomes high, while during the night time humidity becomes the highest. The day wise indoor CO2 and CO variation trend is pretty similar. Both CO2 and CO concentrations in bedrooms are the highest in the evening. In contrast to that CO2 and CO concentrations in kitchens becomes maximum during noon time. High particulate matter concentration at outdoor and indoor is observed at the evening time. Higher formaldehyde (HCHO) and Total Volatile Organic Compounds (TVOCs) concentration at the indoor is observed at noon and afternoon time. Conclusion: The results obtained were compared with the recommended values of World Health Organization (WHO) and National Ambient Air Quality Standards (NAQIS). The results revealed that all measured parameters are at a higher level than the recommended values except the indoor CO2 concentrations.

An epidemiological survey of visual impairment in rural populations aged 30 and above: the Handan Eye Study

Objective: To investigate the changes in prevalence and causes of blindness and visual impairment over six years among rural populations aged 30 and above in Yongnian County, Handan City, Hebei Province, a pilot area in northern China for blindness prevention and treatment, and to study the incidence of common blinding eye diseases. Methods: This population-based prospective cohort study included a baseline survey conducted from 2006 to 2007 using stratified cluster sampling, targeting 6 830 Han Chinese individuals aged 30 and above, with a response rate of 90.4%, and a follow-up survey conducted from 2012 to 2013 with 5 394 participants, maintaining a response rate of 85.3%. Visual impairment was defined according to World Health Organization standards as visual acuity<20/60 but ≥20/400, and blindness as visual acuity<20/400. Age-and gender-standardized prevalence rates of blindness and visual impairment, along with their 95% confidence intervals (CI), were estimated. The six-year incidence rates of primary glaucoma, age-related macular degeneration, and myopic maculopathy, along with their 95%CI, were reported. Results: At baseline, the standardized prevalence of bilateral blindness in individuals aged 30 and above was 0.6% (41/6 799) for presenting visual acuity and 0.5% (31/6 799) for best-corrected visual acuity. These rates were higher than those found in the follow-up survey, 0.5% (27/5 293) and 0.3% (17/5 276). Conversely, the standardized prevalence of bilateral visual impairment increased from 4.7% (361/6 799) and 1.0% (85/6 799) at baseline to 6.5% (355/5 293) and 1.4% (74/5 276) at follow-up, respectively. The leading cause of bilateral blindness was cataract in both baseline (13/31, 41.9%) and follow-up (7/17) surveys. Other major causes included myopic retinal degeneration (5/31, 16.1% at baseline; 2/17 at follow-up), glaucoma (3/31, 9.7% at baseline; 2/17 at follow-up), and corneal opacity (3/31, 9.7% at baseline; 2/17 at follow-up). Over six years, the incidence rates for primary glaucoma, early and late age-related macular degeneration, and myopic maculopathy in individuals aged 35 and above were 1.6% (95%CI: 1.2%-1.9%), 4.2% (95%CI: 3.8%-4.7%), 0.2% (95%CI: 0.2%-0.3%), and 0.1% (95%CI: 0.0%-0.2%), respectively. Conclusions: The prevalence of bilateral blindness in the rural population of Yongnian County, Handan City, Hebei Province, decreased over six years due to blindness prevention and treatment efforts but remained higher than in urban areas. Meanwhile, the prevalence of bilateral visual impairment increased since the baseline survey. Cataracts continued to be the primary cause of blindness, followed by myopic retinal degeneration, glaucoma, and corneal opacity.

Trend analysis, gender-specific patterns, and age dynamics of childhood and adolescent obesity: insights from the Tehran lipid and glucose study

BackgroundChildhood and adolescent obesity pose significant challenges to global health, with escalating prevalence and associated short- and long-term health consequences. This longitudinal study leveraged data from the Tehran Lipid and Glucose Study (TLGS) to investigate the trends of obesity among Tehranian children and adolescents over a 21-year period.MethodsUtilizing data from TLGS phases I to VII (1999–2021), we included 3845 participants aged 3–18 years at the beginning of phase I. Anthropometric measures, including height and weight, were collected, and body mass index (BMI) was calculated. Childhood obesity (2–19 years) was defined as BMI-for-age > 2SD based on World Health Organization (WHO) standards, and adult obesity was defined as BMI ≥ 30. Descriptive statistics, trend analysis, prevalence calculations, odds ratios, and interaction analyses were employed for data interpretation.ResultsThe mean BMI increased from 18.46 ± 4.37 kg/m² at Phase I to 26.36 ± 5.03 kg/m² at Phase VII. Boys exhibited a greater increase in BMI than girls, and age at study entry influenced BMI trajectories. The prevalence of obesity rose from 6.4% at Phase I to 21.5% at Phase VII, with a more pronounced increase in boys. Odds ratios for obesity steadily increased across phases, indicating a growing risk. Interaction analyses revealed age-specific dynamics, with older participants demonstrating lower odds ratios initially but higher odds ratios in later phases.ConclusionOur study shows a worrisome increase in childhood obesity among Tehranian children and adolescents over 21 years. Sex- and age-specific trends emphasize the necessity for targeted interventions, informing policymakers, healthcare practitioners, and educators regarding public health strategies and interventions against the obesity epidemic.

Groundwater fluoride contamination, sources, hotspots, health hazards, and sustainable containment measures: A systematic review of the Ghanaian context

Groundwater quality is globally threatened by geogenic and human activities. These activities release high levels of potentially toxic elements, such as fluoride (F−), which pose significant threats to human health. This has become a global issue, especially in developing countries such as Ghana. Despite efforts to address this issue, knowledge gaps still need to be addressed to ensure safe and healthy drinking water for all Ghanaians. Moreover, Ghana has been reported to be a fluorosis-endemic country but the sources and exact hotspots of F− enrichment in the aquifers on a countrywide scale are lacking in the available literature. Understanding the quality of water used for diverse purposes in Ghana is necessary to achieve the United Nations Sustainable Development Goals like good health and well-being (SDG 3) and clean water and sanitation (SDG 6), among others. Therefore, this study synthesized all previous studies on groundwater F− contamination in Ghana, to identify the sources of F− enrichment in groundwater, delineate the hotspots for fluorosis, assess the associated human health risks, identify the best sustainable defluoridation methods, and recommend policy intervention for high groundwater F− threat to aquifers in Ghana. In the Ghanaian context, F− contamination in groundwater is largely from geogenic sources like the weathering of fluoride-bearing rocks (granitoids and carbonate sedimentary lithologies) from the Birimian and Voltaian Supergroups and the dissolution of fluoride-rich minerals (fluorapatite, amphiboles, fluorite, biotite, and muscovite). Hotspots for high groundwater F− in Ghana are mainly restricted to the Upper East Region (0.10–5.00 mg/L), North East Region (0.01–13.29 mg/L), Northern Region (0.1–11.6 mg/L), and the White Volta River Basin (0.04–3.79 mg/L). The mean and maximum values of F− in these hotspots exceed the maximum permissible level (1.5 mg/L) set by the World Health Organization and Ghana Standards Authority. Most people in these areas suffer from dental fluorosis. Therefore, affordable and sustainable defluoridation technologies as well as community-based initiatives are recommended to deal with this menace.

Insecticide Resistance in Aedes aegypti from the National Capital Region of the Philippines.

Human arboviral diseases such as dengue, chikungunya, and Zika can be transmitted by the mosquito Aedes aegypti. The insecticide-based vector control strategy is critical in reducing transmission of these Aedes-borne diseases but is threatened mainly by the emergence of insecticide resistance. Adult Ae. aegypti from the National Capital Region (NCR), Philippines, were subjected to bioassays to determine their susceptibility to diagnostic doses of pyrethroid, organochlorine, and organophosphate insecticides following the standard World Health Organization insecticide susceptibility test. This study reports the detection of insecticide resistance to pyrethroids and organochlorine in Ae. aegypti from the Philippines for the first time. Most of the Ae. aegypti populations from NCR exhibited phenotypic resistance to permethrin, etofenprox, and DDT. Varying resistance levels to deltamethrin, cyfluthrin, and lambda-cyhalothrin were observed in the different mosquito populations, while all populations tested to malathion were susceptible to this organophosphate. This finding should alert public health authorities to consider modifying the existing vector management package for greater control efficacy. Best practices proven to prevent or delay the development of insecticide resistance, such as insecticide rotation, should also be implemented, while alternative chemicals with a different mode of action should be explored to ensure the continuing efficacy of program interventions.