The COVID-19-Effect on Social Life of Dentist Working in Specialist Dental Centers for Adult: Sample Al-Resafa Health Directorate

Background: While causing a financial and economic loss in many countries in a few months, COVID 19 was of great impact on public health. The Iraqi government took several measures since the first Iraqi case was discovered in February 2020. One of the fundamental measures to control this pandemic is social isolation, which depends greatly on people’s awareness to decrease the incidence of COVID-19. Objectives: To study the COVID-19-effect on dentists’ social life and their future plan, and to find the relation between that effect and some dentists’ demographic variables. Methods: A cross-sectional study was conducted from 2nd January to 7th May 2021, by an electronic version of the questionnaire through Google form. With facilitating orders delivered to all the specialist dental centers for adults of Al-Resafa health directorate;any dentists working in specialist dental centers for adults of Al-Resafa health directorate, and accept to participate in this study. Results: A total of 10 specialist dental centers for adults of the Al-Resafa health directorate represent 566/628 dentists enrolled in this study with a response rate of 88.99%. Most of them aged less than 30 years old (62.2%), female (60.6%), married status (50.4%), had 1 - 3 children (71.91%), Rotator (51.1%), with less than five years of experience (61.3%). Conclusion: COVID-19 affected so many aspects of health workers’ lives including dentists. About two-thirds of dentists had negative feelings, of which almost all had anxiety. Younger ages, females, married and having children are factors that contribute to the affection of dental social lives more than other categories.

The Prevalence of Obesity and Overweight in Children Aged 6 in Iran

Obesity is one of the most prominent problems imminent among all societies particularly in developing countries. WHO reported in the latest report that obesity was among the 5 causes of death in the world. In 2010, about 43 million under 5 years children were found to be overweight. At present about 35 million kids suffering from obesity live in developing countries and about 7 million overweight kids live in developed countries. Studies in Iran show that the prevalence of obesity is between 7 - 16 percent. According to this study, from 514,963 examined children (261,633 male and 253,330 female), 2.6 percent of children had severe obesity, 60 percent and 40 percent in males and females respectively. This study showed that 3.6 percent were obese, 57.5 and 42.5 in males and females respectively. Also overweight was 8.4 percent, 49.3 and 50.7 percent in males and females respectively. Overweight was found to be more common among female participants with 50.7 percent as opposed to 49.3 percent for males. However, obesity and severe obesity were found to be more common among males. Life style change is the best way to prevent obesity and also is the best way to control and treat it by increased activity and low food consumption. Because of the importance of nutrition in childhood growth and development and also the effect of childhood malnutrition on adult health, special notice to this issue is necessary.

Effect of Urbanization on Child Safety

Background: The world’s population living in urban areas has grown up from 14% to over 50%. This study was designed aiming to compare injuries related mortality and morbidity in Urban vs Rural settings among children in Iran. Methods: Data were gathered from a household survey. A t-test was used to analyze the relationship between outcomes. Achievements: Injury in all ages accounts for 17% of all deaths in Iran. 20% of death in children is due to injuries. Children in urban settings sustain injuries due to traffic accident, airway blockage and fall from height more than rural children. About 63.5% of morbidity related to injuries occurs in private homes or in residential areas e.g. yards and compounds. In these injuries, no significant statistically difference was found between rural vs. urban setting (p ≤ 0.05). Conclusion: Beside area level measures as an index for considering urbanization, other elements including quality of roads, distances from markets and so on should be considered as well. Safety for children is an important element to be provided prior to planning cities by urban developers. Expansion of the International Safe Community program is a potential solution.

The Association of World Health Organisation (WHO) Safe Community Programme with Death Rate from Motorcycle Accidents in Iran

Background: Many developing countries are facing the problem of rapidly rising death rate from fatal accidents involving motorcycles. Objective: To determine the effect of participation and implementation of the World Health Organization (WHO) Safe Community Programme on death rate from fatal motorcycle accidents. Methods: Motorcycle’ fatal accident data were obtained from forensic medicine departments and hospital records in 11 cities located in three provinces in Iran during 2006-2007. Data were analyzed using chi-square and ANOVA tests. Fidelity of the data was safeguarded by using national security coding for each individual involved in the accident. Results: The highest death rate was found in the Fars province followed by Khorasan and Bushehr provinces. In Fars province, the highest mortality rate was found in Niriz city, which did not implement the Safe Community Programme and the lowest death rate was reported from Arsanjan city participating in Safe Community. Similar results were found in the Khorasan province. In Busher province, the highest death rate was found in Busher city participating in the program and the lowest in Genaveh city—not participating in the program. Among sex and age groups, males aged 19 - 39 years old had a highest death rate. Half of the death occurred at the accident scene—25% during a transfer to the hospital and 25% of death occurred at the hospital. Conclusions: The Safe Community Programme is a promising model to prevent death from fatal motorcycle accidents in urban areas in Iran.

Effect of In-Service Training Program on the Practice of Healthcare Workers toward Malaria Prevention and Treatment Guidelines during Pregnancy in Health Facilities in Jowhar District, Somalia

Malaria is generally considered a major public health problem in Somalia. Providing early diagnosis and effective treatment is the key element of malaria control strategies in malaria-endemic countries, including Somalia. This required to advocate and ensure health worker’s adherence to the national malaria guidelines at all levels of health care service. A well-designed in-service training program may improve the level of health worker’s adherence to national malaria treatment guidelines, although results have been inconsistent. This is an interventional health facility-based pre and post comparative study aimed to assess the effect of an in-service training program on the practice of healthcare workers toward malaria prevention and treatment guidelines, during in pregnancy in health facilities in Jowhar district, Middle Shabelle region of Somalia. The study was implemented in three phases: pre-intervention phase, intervention phase and post-intervention phase. The sample size consisted of (n = 150) health workers who were selected from ten public health facilities using proportional to size sampling;the data collection adopted in this research is composed of a structured interview questionnaire and observational checklist. Data was analyzed through the application of descriptive statistical analysis that includes frequency and percentage and the Chi-square (x2) test was used to test the associations among variables using SPSS software version 25. The study showed that the level of health workers’ awareness of the national malaria guidelines in the treatment and prevention of malaria in pregnancy was found to be good before the intervention 89 (59.3%) and this proportion increased to 150 (100%) post-intervention of the training program. A significance difference has been observed between health workers’ awareness and their adherence to the malarial guidelines at pre-test and post-test with a p-value 0.000. The proportion of health workers who attended previous training on national malaria guidelines in the treatment and prevention of malaria in pregnancy increased from 46 (30.7%) at the pre-test to 150 (100%) after the post-test. A significant difference was observed in the training status among different categories of health worker and their adherence to the guidelines during the pre- and post-intervention of the training program, with a p-value of 0.000. The result showed that health workers were adhering to the guidelines at the pre-test 33 (22%), this increased after the post-test to 87 (58%). The knowledge of the need to adhere led to an increase in the adherence rate after the training program intervention. The study reveals that inadequate awareness was most reason for the non-adherence in the majority of the health workers as indicated by 89 (59.3%) at the pre-test and 56 (37.3%) in the post-test. However, difference was not significant between the availability of anti-malaria drugs in the facilities and the health workers’ adherence to the guidelines p-value 0.355 at the pretest and p-value 0.258 at post-test. The study concluded that the in-service training program significantly improved health workers’ knowledge and practice to the national malaria guidelines in the treatment, and prevention of malaria in pregnancy. The researcher recommends that the national malaria control programme (NMCP) of the Federal Ministry of Health should provide continuous regular in-service training to frontline healthcare workers at (facility and Community-based) to upgrade their skills and knowledge towards the malaria guidelines, disseminate job aids to the health facilities and undertake regular monitoring to ensure effective implementation of the national malaria treatment guidelines in the treatment and prevention of malaria in pregnancy in achieving desired proper case-management practices of malaria in pregnancy at all levels of health care service.

Factors Affecting Adherence to National Malaria Treatment Guidelines in the Diagnosis, Treatment and Prevention of Malaria in Pregnancy among Healthcare Workers in Public Health Facilities in Jowhar District, Somalia

Introduction: Early diagnosis and effective treatment remain critical elements of a malaria control strategy in preventing mortality and reducing the incidence of severe malaria illness in Somalia. In Sub-Saharan African countries showed different levels of adherence to their national malaria guidelines for malaria treatment and prevention in pregnancy, while experiences from many countries indicated several challenges and constraints that may make the implementation of the guidelines difficult. Objective: The study aimed to assess factors affecting adherence to revised national malaria treatment guidelines in the diagnosis, treatment and prevention of malaria in pregnancy among health care workers in public health facilities in Jowhar District, Somalia. Methodology: A cross-sectional health facility-based study conducted in Jowhar district. A structured interview questionnaire was used for data collection from (n = 150). Healthcare workers selected from ten public health facilities using proportional to size sampling and an observational checklist was used to assess patient’s medical prescriptions to review their conformity to the guidelines and the availability of antimalarial drug, malaria diagnostic tests (mRDTs and microscopy) and job aids, such as the national malaria treatment guidelines, clinical algorithm (flow chart), malaria rapid diagnosis tests mRDTs’ use of wall charts, and drug dose wall charts at the facilities. Data was analyzed through the application of descriptive statistical analysis that includes frequency, and percentages by using Statistical Package for Social Sciences (SPSS) Version 25. Results: Healthcare workers interviewed were 89 (59.3%) aware of the existence of the revised national malaria treatment guidelines. However, 61 (40.7%) were not aware of the guidelines and only 46 (30.7%) had been trained for the national malaria guidelines in the treatment and prevention of malaria in pregnancy. Overall, 33 (22%) of the workers reported to adhere to guidelines, with 117 (78.0%) reported non-adherence. A significant difference was observed in the training status among different categories of health workers with (p-value of 0.022). Conclusion and Recommendation: In conclusion, the study showed that adherence to the national malaria guidelines for Malaria diagnosis, treatment and prevention in pregnancy among health care workers are associated with inadequate awareness of the revised national malaria guidelines among healthcare workers, inadequate supply of diagnostic tests (mRDTs and microscopy) at the health facilities and lack of access to revised national guidelines for malaria diagnosis and treatment, a lack of regular supervision and monitoring and lack of in-service training respectively. The national malaria control program should intensify efforts to strengthen the readiness of the public health facilities in the district to handle malaria in pregnancy cases, diagnosis, treatment and prevention, improve the availability of antimalarial drugs and malaria diagnostic tests (mRDTs and microscopy), job-aids at the health facilities and undertake regular monitoring and on job training to ensure the proper use of the guidelines at all levels of health care service delivery points across the country.

Low Birth Weight in Neonates of Iran 2015

Background: Low birth weight has been defined by the World Health Organization (WHO) as weight at birth of less than 2500 grams. Any baby born prematurely is more likely to be small. However there are other factors that can also contribute to the risk of low birth weight, these include: race, mothers’ age, multiple births, mothers’ health and mothers of lower socioeconomic status. The incidence of low birth weight is monitored through both health system surveillance and household surveys. Among regions, South Asia has the highest incidence of low birth weight, with one in four newborns weighing less than 2500 grams. In a study in Iran the prevalence of LBW was estimated 7 percent (SD 95%), prevalence of LBW is different according to the geographical region. Methods: Demographic data got from mothers and children height and weight measured by trained staffs in and out of hospital and health facilities. Results: Total number of births in Iran in 2015 is 1,509,081 that from this 777,351 are male, 731,014 are female and 716 ambiguous. The percentage of LBW in male, female and ambiguous is 6.5, 7.7 and 53.9 respectively. The highest percent of LBW in female was related to Sistan Blochestan province with 12.6 and the lowest percent to Lorestan province with 5.6 percent. Discussion: According to the guidelines published by World Health Organization (WHO), any neonate with a birth weight less than 2500 grams is considered to be LBW. LBW and PTM are leading causes of adverse perinatal outcomes and are closely related to neonatal diseases and deaths. In the world, there are more than 20 million LBW infants born each year that 95.6% are born in developing countries. In the present study, the number of LBW neonate in male, female and ambiguous was 50,569, 55,972 and 386;the percentage of LBW in male, female and ambiguous was 6.5, 7.7 and 53.9 respectively. Regarding the prognosis of LBW, with development of perinatology, the survival rate of LBW infants has substantially increased. However, some adverse outcomes are still relatively common, especially long-term complications such as cerebral palsy, delayed neurodevelopment and visual and hearing impairments. Conclusions: The incidence of LBW in Iran is higher in deprived provinces such as Sistan Blochestan in southeast of Iran.