Assessing healthcare workers’knowledge and confidence in the diagnosis,management and prevention of Monkeypox

BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of Mpox.METHODS We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July 2023.The questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and management.The data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical significance.RESULTS The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a vaccine.The confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among HCWs.The confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent it.There is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi HCWs.We encourage future researchers to assess potential hesitancy toward Mpox vaccination and its associated factors.

Practice and Determinants of Infection Prevention and Control Measures among Health Care Workers at Benjamin Mkapa Hospital, Dodoma-Tanzania

Introduction: Infection Prevention and Control are scientific approaches and practical solutions designed to prevent harm caused by infection to patients and health workers. The study aimed to assess Infection prevention and control practices and determinants. Method: The hospital-based analytical cross-sectional study design was employed through a convenience approach. The SPSS version 26 was used for data analysis. Results: 72.5% of healthcare workers at Benjamin Mkapa Hospital observed not performing hand hygiene before direct contact with the patient or before the procedure and 60.3% observed performing hand hygiene after direct contact with the patient or after removing gloves. Professionals (Doctors, Medical attendants, and Nurses) were significantly practiced more in infection prevention and control by 2.860, 2.923, and 3.237 units respectively compared to pharmacy personnel. Conclusion: The sustainable availability of Infection Prevention and Control resources is important to enhance a healthy working environment. The current study has shown that the availability of Equipment and Supplies was 100% for gloves, face masks, and sanitizer. The multivariate results showed a statistically significant relationship between those trained in IPC and those more likely to practice IPC than those not trained.

Burnout and mental distress among community health workers in low- and middle-income countries: a scoping review of studies during the COVID-19 pandemic

Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and increased the workload for CHWs.The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic.We searched PubMed for published literature,from January 1,2020 to December 31,2022 that focused on documenting the experiences of burnout,distress,and mental health symptoms among CHWs in LMICs.The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool.Included studies were grouped into the follow-ing broad thematic categories:(1)symptoms experienced;(2)drivers of different mental health symptoms;and(3)strategies for coping with different symptoms.We identified 10 cross-sectional,qualitative,and observational studies from 11 LMICs in South and Southeast Asia,South America,and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic.The studies identified disorders and symptoms such as depression,anxiety,fear,burnout,worsened stress,and fatigue.Contributing factors included increased work-load,financial constraints,and an understaffed and underequipped workplace.CHWs reported using different adaptive responses like humor,support from family and colleagues,denial,and substance use,and asked for recommended regular mental health checkups and counseling.More research and policies should be targeted to-wards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.

What Does Research Say for Improving the Efficiency of Lady Healthcare Workers in Pakistan? Review Article

Background: In Pakistan, the crucial role of Lady Health Workers (LHWs) cannot be over looked and must be supported. Their alliance position between the community and health system allows them to provide services to the most marginalised groups. However, LHWs face numerous challenges and issues resulting in reduced efficiency and effectiveness of LHW program. Aims: The study aims to identify the challenges highlighted in various studies that undermine the performance of LHWs and attempts to combine the recommendations of the studies for addressing these challenges. Methods: Literature search included articles from 2000 to 2024. PubMed and Google Scholar were the main search engines utilized. Initial search resulted in 1380 articles, out of which only those showing a link to the study title were included in the study. From the total articles searched, 55 were selected for writing this article. Results: Literature highlighted the importance of community selection, monitoring, monetary as well as non-financial incentives;trainings;availability of supervision, workload balance, monitoring;recognition, clarity on roles, resources and uninterrupted supply of logistics, support and embedment of LHWs in community and health system. Lack or poor quality of these aspects may lead to low performance of LHWs. Conclusions: This paper explores the extent of issues and challenges faced by LHWs in Pakistan. A number of interventions appear to be effective in improving the efficiency of LHWs in Pakistan. The review may serve as an essential resource for program planners and decision-makers in improving the effectiveness and efficiency of LHW programs.

Study on Influencing Factors of Mental Health of Mobile Young White-Collar Workers in China

Mobile young white-collar workers not only have the characteristics of mobile young people,but also have the characteristics of general white-collar workers.Under the influence of both,their mental health may be suffering from“double disadvantage”.So,based on an ecological model of the stress process,this paper tries to use the data of the questionnaire on the mental health of mobile young white-collar workers in Zhejiang Province to explore the influence of some factors in the middle workplace and residence place on the mental health of micro individuals.The results show that:(1)The working environment with high control and low freedom and the workplace discrimination against the mobile status will have a negative impact on the mental health of mobile young white-collar workers;(2)Financial anxiety in daily life will lead to a decline in the mental health level of mobile young white-collar workers;(3)Good organizational support and neighborhood social relations can significantly relieve life pressure,so as to effectively improve the mental health of mobile young white-collar workers.It can be seen that we also need to pay more attention to the mental health of mobile young white-collar workers in order to improve their situation.

An Evaluation of STD/AIDS Health Education among Female Sex Workers in Entertainment Establishments in Jingjiang City

Objective: To explore effective ways of conducting STD/AIDS health education among female commercial sex workers in entertainment establishments and to promote implementation of an 100% condom use programme. Methods: In-depth interviews were carried out to collect qualitative information about demographic characteristics, STD/AIDS knowledge, attitude and risk behaviors of female sex workers. Female sex workers were selected by sampling and were given baseline survey and assessment after intervention. Based on the results of the interviews, a questionnaire was developed, and intervention measures were determined. These measures included face-to-face interviewing, counseling, and distribution of STD/AIDS information and condoms. Results: 196 and 182 female sex workers of the same population were interviewed separately before and after intervention. STDs/AIDS knowledge had significantly increased after one year's intervention (P <0.01). Knowledge increased in both the intervention group and the non-intervention group but the increase was more significant among sex workers who received the intervention. Risk behaviors remained at baseline levels in both groups. Conclusion: STD/AIDS health education among female sex workers in entertainment establishments was effective and may benefit society, but the strategies need to be adjusted to the female sex workers' lifestyles, particularly their high rates of mobility and high-risk behaviors.

Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China:a Cross-sectional Survey 3 Years after the Healthcare Reform

The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.

Efficacy of Shanvac-B recombinant DNA hepatitis B vaccine in health care workers of Northern India

BACKGROUND: Health care workers (HCWs) constitute a high-risk population of HBV infection. There are limited data on the efficacy of vaccination in HCWs in India. This study was to evaluate the efficacy of indigenous recombinant hepatitis B vaccine, Shanvac-B, in HCWs. METHODS: In 597 HCWs screened before the vaccination, 216 (36.2%) showed the presence of at least one of the markers of HBV/HCV infection. Of the remaining 381 (63.8%) HCWs who were considered for vaccination, only 153 (age 18-45 years; 48 males and 105 females) were available for final assessment. These HCWs received 20 μg of vaccine at 0, 1 and 6 months. They were asked for the reactogenicity and monitored for the seroprotective efficacy of the vaccination. Anti-HBs titres were measured after vaccination at 1, 2 and 7 months. The presence of anti-HBs titers equal to 1 MIU/ml was considered as seroconversion and that of titres greater than 10 MIU/ml as seroprotection. RESULTS: After vaccination, 32 males (67%) and 76 females (72%) showed seroconvertion; finally 12 (25%) of the males and 47 (45%) of the females were seroprotected. Seroprotection at 2 and 7 months was more dominant in the females than in the males (96% vs. 56%, P=0.001, 100% vs. 85%, P=0.0001), respectively. Geometric mean titres of anti-HBs after vaccination were also higher in the females than in the males (257±19.7 vs. 29±1.88 MIU/ml, P=0.01, 1802±35.2 vs. 306±13.6 MIU/ml, P≤0.05, 6465±72 vs. 2142±73.6 MIU/ml, P<0.05). Seven male HCWs showed unsatisfactory response, non-response (n=3, 6%) and hypo-response (≤10 MIU/ml, n=4, 8%) at the end of vaccination. Smoking and alcoholism were significantly correlated with unsatisfactory response. No significant adverse effects of vaccination were observed in any HCW.CONCLUSIONS: The presence of HBsAg in HCWs indicates that a high proportion of HCWs are infected with HBV and HCV in India. Recombinant indigenous vaccine Shanvac-B is highly efficacious in HCWs, and its immunogenicity is significantly higher in females than in males. However, prevaccination screening of HCWs is strongly recommended in India.

Occupational health protection for health workers during the coronavirus disease 2019(COVID-19)pandemic:6P-approach in China

Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.

Psychological and mental health impacts of COVID-19 pandemic on healthcare workers in China: A review

The coronavirus disease-19(COVID-19)pandemic has put healthcare workers in an unprecedented situation,increasing their psychological and mental health distress.Much research has focused on the issues surrounding anxiety,depression,and stress among healthcare workers.The consequences of mental health problems on healthcare workers’physical health,health-compromising behaviours,suicide ideation,family relationships,and job satisfaction during the COVID-19 pandemic are not well studied.Enhanced psychological stress has known effects on an individual’s physical health.In healthcare workers with preexisting comorbidities,psychological stressors may exacerbate their current health problems.Healthcare professionals are known to have a high risk of substance use,hence they may be at risk of development of substance use addiction or vulnerable to addiction relapse.Frontline COVID-19 healthcare workers are being pushed above and beyond their limits,possibly resulting in suicidal tendencies.Furthermore,the burden of high workload and burnout may also have serious manifestations in relationships with family and an intention to quit their jobs.Future studies should explore the above-mentioned deleterious consequences to provide insight into the development of mental healthcare strategies to combat the psychological impact of COVID-19 on healthcare workers during the COVID-19 emergency.It is imperative to employ strategies to care for and policies to protect the psychological well-being of healthcare workers.

The Influence of Socio-Demographic, Health and Work-Related Factors on Health-Related Quality of Life among Iranian Industrial Workers

Health-related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present paper aimed to study the influence of the socio-demographic, health and work-related factors on HRQOL among Iranian industrial workers. In this cross-sectional study, participants were 280 workers of two factories. The Persian version of World Health Organization Quality of Life-Brief (WHOQOL-BREF) was used to assess the HRQOL. A questionnaire was developed to assess the socio-demographic, health and work-related factors. Results showed that the means (SD) of physical health, psychological health, social relationships, and environment domains of HRQOL were 13.2 (2.7), 13.3 (2.6), 14.2 (3.5) and 12.6 (2.5), respectively. A multiple linear regression showed that types of job, exercise activity, working schedule, sleep quality, smoking, and conflict between work and social life were significantly associated with physical health domain;whereas, working schedule, marital status, working demand, sleep quality, BMI, and conflict between work and individual life were significantly associated with psychological health domain. Working schedule, working demand, sleep quality, conflict between work and individual life, and having children over two years were significantly associated with social relationship domain;however, working demand, working schedule, smoking, sleep quality, working hour, job satisfaction, marital status and exercise activity were significantly associated with environment domain. Collectively, work-related factors including unhealthy working conditions, unsafe working environments, long working hours, irregular working schedules, and the lack of occupational training may negatively influence the HRQOL of workers. To improve workers’ HRQOL, intervention programs should focus on improving work environment, working schedule, occupational training and restricting working hours.

Knowledge and Attitude of Health Care Workers toward Human Immunodeficiency Virus Infection in King Abdulaziz Medical City

Background: Worldwide data shows that the stigma and discrimination for AIDS patients by health care providers have a negative impact on its epidemic. It discourages people from seeking care or being tested for HIV, thus reducing access to HIV/AIDS prevention. The study aims to evaluate the knowledge of the HCWs (health care workers) in King Abdulaziz Medical City about human immunodeficiency virus infection and their attitudes when?they encounter HIV/AIDS patients. Methodology: A cross-sectional study was designed to collect data using self-administered structured questionnaire from 90 health care workers. It was distributed among HCWs in different wards in King Abdulaziz Medical City in Riyadh in August 2014. Results: The study included a total number of 90 heath care workers, of which 31 were physicians and 59 were nurses. Around 81 (90%) of HCWs knew the causative agent for AIDS. Only 22 (24%) of HCWs knew the level of risk of HIV transmission following needle stick injury. Most of HCWs 66 (73%) knew that sexual practice was the most common mode of transmission. Around 27 (87%) of physicians and 33 (56%) of nurses were able to answer that antiretroviral therapy had the ability to control HIV-infection. In addition, 9 (10%) of HCWs believed that AIDS was curable. Conclusion: It was obvious from our study that there was some amount of general information and knowledge with our HCWs. However, an educational campaign will try to increase the level of awareness and clear any misconception or misleading theories about HIV infection with our health care workers.

Workplace Wellness,Mental Health Literacy,and Usage Intention of E-Mental Health amongst Digital Workers during the COVID-19

The prevalence of mental health problems in both Malaysian and global workplaces has significantly increased due to the presence of the coronavirus disease(COVID-19)pandemic,globalization,technology advancement in Industry 4.0,and other contributing factors.The pervasiveness of the issue poses a huge challenge to improving the occupational safety and health(OSH)of workers in various industries,especially in the digital industry.The emergence of the innovative industry is evident mainly due to the rapid development of Industry 4.0 and the rele-vant demands of multiple businesses in the digital transformation.Nonetheless,limited studies and academic dis-cussions were conducted on the OSH topic of digital employees.Hence,the current study serves tofill the existing gap and provide academic contributions by scrutinising the perceptions of digital workers regarding their work-place well-being,mental health literacy,and the impression of employing e-mental health.The objectives of this study are:1)To examine the mental health literacy and workplace wellness of digital workers,2)to explore the e-mental health usage intention and actual e-mental health utilization,and 3)to identify digital workers’feedback on e-mental health.In the current context,e-mental health focuses on three dimensions,namely,1)“health in our hand(HIOH)”,2)“interacting for health(IFH)”,and 3)“data enabling health(DEH)”.The present study employed an online cross-sectional survey and received 326 digital workers’completed responses.Variables,such as“mental health literacy(MHL)”,“workplace wellness(WW)”,and e-mental health intention and usage were explicated by analysing the data through descriptive statistics.The study results indicated a moderate to a high level of the MHL and the WW.More than half of the workers possessed a high intention level to employ e-mental health,with the HIOH dimension being the most prevalent domain.Nevertheless,the actual e-mental health usage was very low,owing to the online resources being a new concept amongst digital employees.Numerous confounding factors also existed in affecting the low usage,such as privacy concerns,data security levels,and health verification issues.In addition,the mental health issue has not been openly and widely discussed in Malay-sian workplaces due to stigmatisation.As such,the currentfindings could provide additional insights into the OSH literature;it could serve as a guideline for the OSH decision-makers,employers,and eHealth developers when establishing a feasible framework for the practical adoption of e-mental health services by digital workers.

Assessment of Health Workers’ Concern about COVID-19 Pandemic: Implication for Surveillance Activities among Primary Health Care Workers in Oyo State, South-Western Nigeria

Background: The outbreak of COVID-19 has continued to threaten the existence of the human race. The novelty and unstable epidemiologic pattern of the virus had generated so much concern among the global health experts. These concerns were found to be escalated among the frontline health care workers to the extent of impeding the timeliness of the response activities. To slow down the spread of the already established community transmission through the surveillance activities, the concern of the health workers at the community level needs to be addressed. Therefore, this study assessed the concern about COVID-19 pandemic among primary health workers in Oyo State, Nigeria. Methods: This was an online cross-sectional survey conducted among primary health care workers in Oyo State between March and April 2020. Using a two-stage sampling technique, we recruited 284 respondents. A semi-structured questionnaire linked to the Google form was used to collect data. Data were analyzed using IBM SPSS version 25;bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of health workers’ concern at 5% level of significance. Results: The mean age of respondents was 45.0 ± 9.0 years. The proportion of the respondents who had good knowledge of COVID-19 was 52.5%. In the domains of concern, 66.9%, 53.2%, 51.4%, and 46.5% of the respondents expressed government-related, self-satisfaction related, work-related and social-status related concerns respectively. Male respondents were less likely to express concern about COVID-19 compared with their female counterparts (aOR = 0.39, 95% CI = 0.20 - 0.76). Nurses/midwives (aOR = 0.21, 95% CI = 0.05 - 0.85) had lesser likelihood of expressing concern about COVID-19 while middle staff (aOR = 2.5, 95% CI = 1.18 - 5.39) and income earner of ≥N200,000 (aOR = 2.3, 95% CI = 1.34 - 3.92) had higher likelihood of expressing concern about COVID-19. Conclusion: The study highlights an average knowledge of COVID-19 among the respondents. Government-related and self-satisfaction related concerns were expressed by the majority of the Primary Health Care (PHC) workers. Now that the second wave of COVID-19 is moving with much more fatality across much of Africa, including Nigeria, it is therefore imperative to address these concerns through a holistic policy that addresses the welfare, safety and capacity building of the health care workers (HCWs).

Socio-economic, Environmental and Health Aspects of Farm Workers Engaged in Mango Plantations

A cross-sectional survey of 489 male subjects in the age group 15 to 65 years engageddirectly or indirectly in mango cultivation along with 208 control subjects was carried out to find their socio-economic, environmental and health conditions. The conditions like high illiteracy rate (49.5%), poverty (PCI less than Rs 100 per month, 52.2%), poor housing (mud houses, 66.7%) unsafe water supply (78.6%) were prevailing in the surveyed population. The high respiratory morbidity may be attributed to high prevalence of smoking andprolonged inhalation of organic dusts during farming operation associated with illiteracyand poor socio-economic status. Gastrointestinal disorders were related to poor hygienic conditions, smoking and consumption of contaminated water. The symptoms pertaining to CNS, skin and eyes were found to be associated with exposure to pesticides

A Study of Health Prescribing for Children with Tourette’s Disorders in Children’s Health Education Specialty Care Clinics

Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.

Healthcare workers' knowledge towards Zika virus infection in Indonesia:A survey in Aceh

Objective:To assess the knowledge on Zika virus(ZIKV) infection among healthcare providers(doctors) in Aceh province,Indonesia.Methods:A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province.A set of validated,pre-tested questionnaire was used to measure knowledge regarding ZIKV infection and to collect a range of explanatory variables.A two-steps logistic regression analysis was employed to assess the association of participants' demographic,workplace characteristics and other explanatory variables with the knowledge.Results:A total of 442 participants included in the final analysis and 35.9% of them(159) had a good knowledge on ZIKV infection.Multivariate model revealed that type of occupation,type of workplace,availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on ZIKV infection.In addition,three significant source of information regarding ZIKV were online media(60%),medical article or medical news(16.2%) and television(13.2%).Conclusion:The knowledge of the doctors in Aceh regarding ZIKV infection is relatively low.Doctors who have a good knowledge on ZIKV infection are more confident to established ZIKV disease as differential diagnosis in their clinical setting.Therefore,such program to increase healthcare providers' knowledge regarding ZIKV infection is needed to screen potential carriers of ZIKV infection.

Mandatory meningococcal vaccine, and other recommended immunisations: Uptake, barriers, and facilitators among health care workers and trainees at Hajj

AIM To evaluate the uptake of a mandatory meningococcal, a highly recommended influenza, and an optional pneumococcal vaccine, and to explore the key factors affecting vaccination rate among health care workers(HCWs) during the Hajj.METHODS An anonymous cross-sectional online survey was distributed among HCWs and trainees who worked or volunteered at the Hajj 2015-2017 through their line managers, or by visiting their hospitals and healthcare centres in Makkah and Mina. Overseas HCWs who accompanied the pilgrims or those who work in foreign Hajj medical missions were excluded. Pearson's χ2 test was used to compare categorical variables and odds ratio(OR) was calculated by "risk estimate" statistics along with 95% confidence interval(95%CI).RESULTS A total of 138 respondents aged 20 to 59(median 25.6) years with a male to female ratio of 2.5:1 participated in the survey. Only 11.6%(16/138) participants reported receiving all three vaccines, 15.2%(21/138) did not receive any vaccine, 76.1%(105/138) received meningococcal, 68.1%(94/138) influenza and 13.8%(19/138) pneumococcal vaccine. Females were more likely to receive a vaccine than males(OR 3.6, 95%CI: 1.0-12.7, P < 0.05). Willingness to follow health authority's recommendation was the main reason for receipt of vaccine(78.8%) while believing that they were up-to-date with vaccination(39.8%) was the prime reason for non-receipt. CONCLUSION Some HCWs at Hajj miss out the compulsory and highly recommended vaccines; lack of awareness is a key barrier and authority's advice is an important motivator. Health education followed by stringent measures may be required to improve their vaccination rate.

Decoding molecular mechanisms:brain aging and Alzheimer's disease

The complex morphological,anatomical,physiological,and chemical mechanisms within the aging brain have been the hot topic of research for centuries.The aging process alters the brain structure that affects functions and cognitions,but the worsening of such processes contributes to the pathogenesis of neurodegenerative disorders,such as Alzheimer's disease.Beyond these observable,mild morphological shifts,significant functional modifications in neurotransmission and neuronal activity critically influence the aging brain.Understanding these changes is important for maintaining cognitive health,especially given the increasing prevalence of age-related conditions that affect cognition.This review aims to explore the age-induced changes in brain plasticity and molecular processes,differentiating normal aging from the pathogenesis of Alzheimer's disease,thereby providing insights into predicting the risk of dementia,particularly Alzheimer's disease.