Food Prohibitions and Other Traditional Practices in Pregnancy: A Qualitative Study in Western Region of Ghana

Women all over the world are confronted with many difficult choices during pregnancy and child birth. Wrong choices often result in unfavorable outcomes for expectant mothers and their babies, a situation which is common in developing countries. Cultural practices, beliefs and taboos are often implicated in determining the care received by mothers during pregnancy and child birth which is an important determinant of maternal mortality. This study explored the traditional practices associated with pregnancy and childbirth in Shama District of the Western Region, Ghana. A qualitative study consisting of six focus group discussions of between eight and ten participants per group and eight in-depth interviews were held over a period of one month. The purpose was to explore local foods that are forbidden for pregnant women and why, herbal medicine use during pregnancy and child birth and reasons for choosing home or hospital delivery. The findings show that pregnant women are forbidden from taking nutritious foods such as snails, ripe plantain, okra and many others for fear of complications during pregnancy and child birth. Herbal medicines are frequently used by pregnant women and traditional birth attendants to induce labour, augment and control bleeding during labour. Traditional beliefs and practices as well as negative attitude of health workers are found to reduce health utilization by pregnant women. Health education concerning traditional practices that are detrimental to the health of pregnant women should be emphasized during ANC visits.

The Influence of Social Desirability on Self-Reported Sexual Behavior in HIV Survey in Rural Ethiopia

Objective: It is in order to examine associations between social desirability (SD) and self-reports of abstinence among youths in rural Ethiopia. Methods: Youths of ages 15-24 (114 participants) were administered questionnaire to assess HIV knowledge and primary abstinence and a modified Marlowe-Crowne Social Desirability Scale to assess SD bias. The relationships between SD groups (dichotomized into high and low) and abstinence by various characteristics were assessed by using Fisher’s exact p-values. Results: The odds of individuals reporting abstinence were 13.2 times greater in the high SD group compared to the low SD group (p-value 0.002) when adjusted for education, gender, age group, and HIV knowledge. The differences in abstinence between the high and low SD score groups were also examined for selected variables. Conclusions: Individuals who exhibited more SD bias were more likely to report primary abstinence. SD bias should be considered when conducting self-reported surveys to measure the effectiveness of HIV prevention programs.

Pharmaceutical innovation and advancement of Clinical therapy and public health:enlightenment from artemisinin development

The discovery of artemisinin is significant because not only it is an innovative new drug,but also its treatment of malaria has saved millions of lives worldwide,especially in(tropical)developing countries.The 2015 Nobel Prize in Physiology or Medicine was awarded to Professor Tu You-You,a scientist from China,who made this seminal discovery.Malaria is one of the most prevalent

Management of dog bites by frontline service providers in primary healthcare facilities in the Greater Accra Region of Ghana,2014-2015

Background:Dog bites are common in developing countries including Ghana,with the victims often being children.Although some breeds of dogs have been identified as being more aggressive than others,all dog bites carry a risk of infection.Immediate and initial assessment of the risk for tetanus and rabies infection with appropriate interventions such as wound management and subsequent selection of prophylactic antibiotics are essential in the management of dog bites.This study examined the management of patients with dog bites by frontline service providers at primary healthcare facilities in the Greater Accra Region,Ghana.Methods:We conducted a cross-sectional study in 66 public health facilities in the Greater Accra Region from July 2014 to April 2015.Up to four frontline service providers were randomly selected to participate from each facility.A structured questionnaire was administered to all consenting participants.Continuous variables were presented as means and standard deviations.The frontline service providers’knowledge was assessed as a discrete variable and values obtained presented as percentages and proportions.The chi-square test of proportions was used to determine any significant associations between the various categories of the frontline service providers and their knowledge about the management of rabies.Results:Regarding the frontline service providers’knowledge about rabies,57.8%(134/232)were correct in that the rabies virus is the causative agent of rabies,39.2%(91/232)attributed it to a dog bite,2.6%(6/232)did not know the cause,and one person(0.4%)attributed it to the herpes virus.Only 15.5%(36/232)knew the incubation period in dogs and the period required to observe for signs of a rabies infection.With respect to the administration of rabies immunoglobulin,42.2%(98/232)of the frontline service providers did not know how to administer it.Of the facilities visited,76%(50/66)did not have the rabies vaccines and 44%(102/232)of frontline service providers did not know where to get the rabies vaccines from.Most of the service providers(87.9%;204/232)had never reported either a dog bite or a suspected case of rabies.Overall,there was gross underreporting of dog bites and suspected rabies cases at public healthcare facilities in the Greater Accra Region of Ghana.Conclusions:In view of the high morbidity and mortality associated with bites from rabid dogs and the poor knowledge and practices of frontline service providers,there is an urgent need for capacity-building such as training in the management of dog bites and subsequent potential rabies infection.

AIWW:a new nutrition-screening tool for the oncologic population

Malnutrition is a common comorbidity among patients with cancer.However,no nutrition-screening tool has been recognized in this population.A quick and easy screening tool for nutrition with high sensitivity and easy-to-use is needed.Based on the previous 25 nutrition-screening tools,the Delphi method was made by the members of the Chinese Society of Nutritional Oncology to choose the most useful item from each category.According to these results,we built a nutrition-screening tool named age,intake,weight,and walking(AIWW).Malnutrition was defined based on the scored patient-generated subjective global assessment(PG-SGA).Concurrent validity was evaluated using the Kendall tau coefficient and kappa consistency between the malnutrition risks of AIWW,nutritional risk screening 2002(NRS-2002),and malnutrition screening tool(MST).Clinical benefit was calculated by the decision curve analysis(DCA),integrated discrimination improvement(IDI),and continuous net reclassification improvement(c NRI).A total of 11,360 patients(male,n=6,024(53.0%)were included in the final study cohort,and 6,363 patients had malnutrition based on PG-SGA.Based on AIWW,NRS-2002,and MST,7,545,3,469,and1,840 patients were at risk of malnutrition,respectively.The sensitivities of AIWW,NRS-2002,and MST risks were 0.910,0.531,and 0.285,and the specificities were 0.768,0.946,and 0.975.The Kendall tau coefficients of AIWW,NRS-2002,and MST risks were 0.588,0.501,and 0.326,respectively.The area under the curve of AIWW,NRS-2002,and MST risks were0.785,0.739,and 0.630,respectively.The IDI,c NRI,and DCA showed that AIWW is non-inferior to NRS-2002(IDI:0.002(-0.009,0.013),c NRI:-0.015(-0.049,0.020)).AIWW scores can also predict the survival of patients with cancer.The missed diagnosis rates of AIWW,NRS-2002,and MST were 0.09%,49.0%,and 73.2%,respectively.AIWW showed a better nutritionscreening effect than NRS-2002 and MST for patients with cancer and could be recommended as an alternative nutritionscreening tool for this population.

Twin peaks of in-hospital mortality among patients with STEMI across five phases of COVID-19 outbreak in China:a nation-wide study

Lockdown and re-opening may become cyclical due to the recurrent waves of the COVID-19 epidemic.Few studies have examined temporal trends and determinants of in-hospital mortality among patients with ST-segment elevation myocardial infarction(STEMI),a life-threatening condition that requires emergency medical care.Using nation-wide data before,during and after the Wuhan lockdown,we aimed to depict temporal patterns and major determinants of STEMI in-hospital mortality in China across five time periods of the COVID-19 epidemic.We analyzed the data of 283,661 STEMI patients who were admitted to 4,487 chest-pain-centers across China,from January 1,2019 to May 31,2020.Compared with the period before the lockdown,STEMI in-hospital mortality increased by 25%(OR 1.25,95%CI 1.16–1.34)during Early Lockdown,by 12%(OR 1.12,95%CI 1.03–1.22)during Later Lockdown,by 35%(OR 1.35,95%CI 1.21–1.50)during Early Lift,and returned to pre-COVID risk(OR 1.04,95%CI 0.95–1.14)during Later Lift.For each time-period,we observed a clear mortality gradient by timing and types of revascularization procedure.In conclusion,the COVID-19 epidemic had a significant adverse impact on STEMI in-hospital mortality,with bimodal peaks during early lockdown and early lift periods and clear mortality gradients by timing and types of revascularization procedure,independent of the time periods.