BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires l...BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.展开更多
Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors lin...Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors linked to mortality. Methods: We conducted a descriptive and analytical retrospective study from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar, we reviewed all the medical records of patients from 15 to 60 years old who died while admitted in the cardiology department. Data collected were socioeconomic status, clinical history, type of cardiovascular disaese, length of hospitalization, circumstances and timing of death. The data were analyzed with R. Studio version 2022.12.0 + 353 and Excel 2019, with a P-value Results: The study included 73 patients, indicating a specific mortality rate of 8.8% and a proportional mortality of 39%. Predominantly male (sex ratio 1.2), the average age was 44. Key cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). The leading cause for consultation was dyspnea (72.6%). Notable findings included a majority of patients presenting with general condition deterioration (90%) and cardiovascular collapse upon admission (23.3%). Physical exam revealed signs of heart failure in 63%. Echocardiography showed left ventricular ejection fraction impairment (81%) and pulmonary hypertension (78%). Immediate causes of death were primarily cardiogenic shock (45.2%) and septic shock (37%). The analytical study indicates that the data most closely associated with mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvulopathies, pulmonary embolism (p = 0.034), hypertension (HTA) (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemias, prolonged bedrest (p = 0.001), morbid obesity (p = 0.001), and COVID-19 infection (p = 0.017). Conclusion: The prevalence of ischemic heart diseases, pulmonary embolisms, and valvulopathies in premature mortality statistics underscores the need for enhanced cardiovascular prevention efforts.展开更多
Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/A...Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.展开更多
Background: This study assessed the effect of a nutrition education intervention. This intervention aimed to improve the knowledge, attitudes, and practices of mothers on food safety in the peri-urban areas of Bobo-Di...Background: This study assessed the effect of a nutrition education intervention. This intervention aimed to improve the knowledge, attitudes, and practices of mothers on food safety in the peri-urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were administered the FAO questionnaire for food safety knowledge, attitudes, and practices assessment during two cross-sectional surveys, before and after the intervention, in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on food safety KAP of mothers of children under 5 years. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of them were between 20 and 29 years old. One for knowledge (cooking thoroughly with, p-value = 0.0001) and another for attitudes (perceived benefits of reheating leftovers before eating them, p-value = 0.0001), significantly increased after the intervention. In terms of food safety practices, all the indicators (cleaning of dirty surfaces, plates and utensils and storage of perishable foods) significantly increased (all p = 0.0001 Conclusion: This study provided some evidence of an effective nutrition education intervention for improving maternal KAP on food safety for their child’s feeding.展开更多
The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristic...The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.展开更多
Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in chi...Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.展开更多
BACKGROUND The quality-adjusted life year(QALY)is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures.Surgical waiting lists(S...BACKGROUND The quality-adjusted life year(QALY)is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures.Surgical waiting lists(SWLs)represent a pressing problem in public healthcare.The QALY measure has rarely been used in the context of surgery.It would be interesting to know how many QALYs are lost by patients on SWLs.AIM To investigate the relationship between QALYs and SWLs in a systematic review of the scientific literature.METHODS The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.An unlimited search was carried out in PubMed,updated on January 19,2024.Data on the following variables were investigated and analyzed:Specialty,country of study,procedure under study,scale used to measure QALYs,the use of a theoretical or real-life model,objectives of the study and items measured,the economic value assigned to the QALY in the country in question,and the results and conclusions published.RESULTS Forty-eight articles were selected for the study.No data were found regarding QALYs lost on SWLs.The specialties in which QALYs were studied the most in relation to the waiting list were urology and general surgery,with 15 articles each.The country in which the most studies of QALYs were carried out was the United States(n=21),followed by the United Kingdom(n=9)and Canada(n=7).The most studied procedure was organ transplantation(n=39),including 15 kidney,14 liver,5 heart,4 lung,and 1 intestinal.Arthroplasty(n=4),cataract surgery(n=2),bariatric surgery(n=1),mosaicplasty(n=1),and septoplasty(n=1)completed the surgical interventions included.Thirty-nine of the models used were theoretical(the most frequently applied being the Markov model,n=34),and nine were real-life.The survey used to measure quality of life in 11 articles was the European Quality of Life-5 dimensions,but in 32 articles the survey was not specified.The willingness-to-pay per QALY gained ranged from$100000 in the United States to€20000 in Spain.CONCLUSION The relationship between QALYs and SWLs has only rarely been studied in the literature.The rate of QALYs lost on SWLs has not been determined.Future research is warranted to address this issue.展开更多
In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and quali...In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.展开更多
Crop rotation periodicity has always been one of the research focuses currently. In this study, the physicochemical properties, nutrient contents and enzyme activities were investigated in soils from rice-cherry tomat...Crop rotation periodicity has always been one of the research focuses currently. In this study, the physicochemical properties, nutrient contents and enzyme activities were investigated in soils from rice-cherry tomato rotation for one year (1a), three years (3a), five years (5a), seven years (7a) and ten years (10a), respectively. The major objective was to analyze the optimal rotation years of rice-cherry tomato from soil perspective, so as to provide theoretical basis for effectively avoiding continuous cropping obstacles of cherry tomato via studying the response characteristics of soil physicochemical properties, nutrient contents and enzyme activities to planting years of rice-cherry tomato rotation system. The results were as follows: 1) Soil pH value was increased year by year during 1a to 5a, reached the highest value 5.32 at 5a. However, soil acidity was sharply enhanced during 7a to 10a (P P •kg<sup>-1</sup> at 5a. 3) The content of soil available phosphorus was increased year by year with increasing of crop rotation years, and increased by 110% to 173% during 3a to 10a (P P P < 0.05). In conclusion, long-term single rotation pattern of rice-cherry tomato would aggravate soil acidification, prompt soil nutrient imbalance and reduce soil enzyme activity. 5a to 7a would be the appropriate rotation period for rice-cherry tomato, or else it would reduce soil quality, resulting in a new continuous cropping obstacle of cherry tomato.展开更多
Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (Mo...Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.展开更多
Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based c...Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based cross-sectional studies have been conducted in East African countries to assess the prevalence of OM;however, no similar studies have been conducted in Somalia. Therefore, we conducted a hospital-based cross-sectional study to identify the prevalence and the underlying risk factors of OM among children under the age of five in Mogadishu, Somalia. Methodology: A hospital-based cross-sectional study was conducted from July 2022 to November 2022 at three main hospitals in Mogadishu, Somalia. A total of 384 children aged less than 5 years were included. Parents of these children were interviewed with a questionnaire and a clinical examination was performed for each child. The Statistical Package for Social Sciences, SPSS (Version 22, IBM, Inc.), was used for the statistical analysis. Result: The prevalence of otitis media among the 384 children recruited was 31.25% (120/384). Otitis media was significantly associated with age less than one year (P = 0.006), malnutrition (P Conclusion: In summary, the present study found that otitis media was highly prevalent (31.25%) in Mogadishu, Somalia. The majority of the affected children were younger than one year. Age of the child, malnutrition, upper respiratory tract infections, feeding in lying position, and dripping something into a child’s ear were found to significantly increase the risk of developing otitis media in children. In contrast, breastfeeding for more than one year has been found to reduce the risk of developing otitis media in children.展开更多
为研究撂荒年限对农田土壤的影响,本试验于8月植物生长旺季进行,选取未撂荒农田(CK)、撂荒7年(7a)、15年(15a)和30年(30a)的农田采集土壤样品,室内计算分析土壤理化特征的变化规律,结果表明,撂荒显著提高了土壤容重,降低了土壤孔隙度和...为研究撂荒年限对农田土壤的影响,本试验于8月植物生长旺季进行,选取未撂荒农田(CK)、撂荒7年(7a)、15年(15a)和30年(30a)的农田采集土壤样品,室内计算分析土壤理化特征的变化规律,结果表明,撂荒显著提高了土壤容重,降低了土壤孔隙度和土壤pH。与未撂荒地对比,撂荒显著提高了土壤有机碳(Soil organic carbon,SOC)、全氮(Soil total nitrogen,TN)和全磷(Soil total phosphorus,TP)的含量。因此,长期撂荒对土壤养分状况具有显著改善作用。不同撂荒年限土壤含水量与土壤养分指标均呈显著正相关,长期撂荒下更少的蒸散耗水量减少了土壤水分的损失,使土壤养分得到了积累。本研究可为坝上农牧交错带撂荒地的合理规划提供理论支撑。展开更多
基金The study was approved by the Ethics Committee of Beijing Tongren Hospital Affiliated to Capital Medical University(Approval No.TRECKY2021-227).
文摘BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.
文摘Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors linked to mortality. Methods: We conducted a descriptive and analytical retrospective study from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar, we reviewed all the medical records of patients from 15 to 60 years old who died while admitted in the cardiology department. Data collected were socioeconomic status, clinical history, type of cardiovascular disaese, length of hospitalization, circumstances and timing of death. The data were analyzed with R. Studio version 2022.12.0 + 353 and Excel 2019, with a P-value Results: The study included 73 patients, indicating a specific mortality rate of 8.8% and a proportional mortality of 39%. Predominantly male (sex ratio 1.2), the average age was 44. Key cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). The leading cause for consultation was dyspnea (72.6%). Notable findings included a majority of patients presenting with general condition deterioration (90%) and cardiovascular collapse upon admission (23.3%). Physical exam revealed signs of heart failure in 63%. Echocardiography showed left ventricular ejection fraction impairment (81%) and pulmonary hypertension (78%). Immediate causes of death were primarily cardiogenic shock (45.2%) and septic shock (37%). The analytical study indicates that the data most closely associated with mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvulopathies, pulmonary embolism (p = 0.034), hypertension (HTA) (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemias, prolonged bedrest (p = 0.001), morbid obesity (p = 0.001), and COVID-19 infection (p = 0.017). Conclusion: The prevalence of ischemic heart diseases, pulmonary embolisms, and valvulopathies in premature mortality statistics underscores the need for enhanced cardiovascular prevention efforts.
文摘Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.
文摘Background: This study assessed the effect of a nutrition education intervention. This intervention aimed to improve the knowledge, attitudes, and practices of mothers on food safety in the peri-urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were administered the FAO questionnaire for food safety knowledge, attitudes, and practices assessment during two cross-sectional surveys, before and after the intervention, in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on food safety KAP of mothers of children under 5 years. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of them were between 20 and 29 years old. One for knowledge (cooking thoroughly with, p-value = 0.0001) and another for attitudes (perceived benefits of reheating leftovers before eating them, p-value = 0.0001), significantly increased after the intervention. In terms of food safety practices, all the indicators (cleaning of dirty surfaces, plates and utensils and storage of perishable foods) significantly increased (all p = 0.0001 Conclusion: This study provided some evidence of an effective nutrition education intervention for improving maternal KAP on food safety for their child’s feeding.
文摘The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.
文摘Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.
文摘BACKGROUND The quality-adjusted life year(QALY)is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures.Surgical waiting lists(SWLs)represent a pressing problem in public healthcare.The QALY measure has rarely been used in the context of surgery.It would be interesting to know how many QALYs are lost by patients on SWLs.AIM To investigate the relationship between QALYs and SWLs in a systematic review of the scientific literature.METHODS The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.An unlimited search was carried out in PubMed,updated on January 19,2024.Data on the following variables were investigated and analyzed:Specialty,country of study,procedure under study,scale used to measure QALYs,the use of a theoretical or real-life model,objectives of the study and items measured,the economic value assigned to the QALY in the country in question,and the results and conclusions published.RESULTS Forty-eight articles were selected for the study.No data were found regarding QALYs lost on SWLs.The specialties in which QALYs were studied the most in relation to the waiting list were urology and general surgery,with 15 articles each.The country in which the most studies of QALYs were carried out was the United States(n=21),followed by the United Kingdom(n=9)and Canada(n=7).The most studied procedure was organ transplantation(n=39),including 15 kidney,14 liver,5 heart,4 lung,and 1 intestinal.Arthroplasty(n=4),cataract surgery(n=2),bariatric surgery(n=1),mosaicplasty(n=1),and septoplasty(n=1)completed the surgical interventions included.Thirty-nine of the models used were theoretical(the most frequently applied being the Markov model,n=34),and nine were real-life.The survey used to measure quality of life in 11 articles was the European Quality of Life-5 dimensions,but in 32 articles the survey was not specified.The willingness-to-pay per QALY gained ranged from$100000 in the United States to€20000 in Spain.CONCLUSION The relationship between QALYs and SWLs has only rarely been studied in the literature.The rate of QALYs lost on SWLs has not been determined.Future research is warranted to address this issue.
文摘In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.
文摘Crop rotation periodicity has always been one of the research focuses currently. In this study, the physicochemical properties, nutrient contents and enzyme activities were investigated in soils from rice-cherry tomato rotation for one year (1a), three years (3a), five years (5a), seven years (7a) and ten years (10a), respectively. The major objective was to analyze the optimal rotation years of rice-cherry tomato from soil perspective, so as to provide theoretical basis for effectively avoiding continuous cropping obstacles of cherry tomato via studying the response characteristics of soil physicochemical properties, nutrient contents and enzyme activities to planting years of rice-cherry tomato rotation system. The results were as follows: 1) Soil pH value was increased year by year during 1a to 5a, reached the highest value 5.32 at 5a. However, soil acidity was sharply enhanced during 7a to 10a (P P •kg<sup>-1</sup> at 5a. 3) The content of soil available phosphorus was increased year by year with increasing of crop rotation years, and increased by 110% to 173% during 3a to 10a (P P P < 0.05). In conclusion, long-term single rotation pattern of rice-cherry tomato would aggravate soil acidification, prompt soil nutrient imbalance and reduce soil enzyme activity. 5a to 7a would be the appropriate rotation period for rice-cherry tomato, or else it would reduce soil quality, resulting in a new continuous cropping obstacle of cherry tomato.
文摘Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.
文摘Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based cross-sectional studies have been conducted in East African countries to assess the prevalence of OM;however, no similar studies have been conducted in Somalia. Therefore, we conducted a hospital-based cross-sectional study to identify the prevalence and the underlying risk factors of OM among children under the age of five in Mogadishu, Somalia. Methodology: A hospital-based cross-sectional study was conducted from July 2022 to November 2022 at three main hospitals in Mogadishu, Somalia. A total of 384 children aged less than 5 years were included. Parents of these children were interviewed with a questionnaire and a clinical examination was performed for each child. The Statistical Package for Social Sciences, SPSS (Version 22, IBM, Inc.), was used for the statistical analysis. Result: The prevalence of otitis media among the 384 children recruited was 31.25% (120/384). Otitis media was significantly associated with age less than one year (P = 0.006), malnutrition (P Conclusion: In summary, the present study found that otitis media was highly prevalent (31.25%) in Mogadishu, Somalia. The majority of the affected children were younger than one year. Age of the child, malnutrition, upper respiratory tract infections, feeding in lying position, and dripping something into a child’s ear were found to significantly increase the risk of developing otitis media in children. In contrast, breastfeeding for more than one year has been found to reduce the risk of developing otitis media in children.
文摘为研究撂荒年限对农田土壤的影响,本试验于8月植物生长旺季进行,选取未撂荒农田(CK)、撂荒7年(7a)、15年(15a)和30年(30a)的农田采集土壤样品,室内计算分析土壤理化特征的变化规律,结果表明,撂荒显著提高了土壤容重,降低了土壤孔隙度和土壤pH。与未撂荒地对比,撂荒显著提高了土壤有机碳(Soil organic carbon,SOC)、全氮(Soil total nitrogen,TN)和全磷(Soil total phosphorus,TP)的含量。因此,长期撂荒对土壤养分状况具有显著改善作用。不同撂荒年限土壤含水量与土壤养分指标均呈显著正相关,长期撂荒下更少的蒸散耗水量减少了土壤水分的损失,使土壤养分得到了积累。本研究可为坝上农牧交错带撂荒地的合理规划提供理论支撑。