Mitigating the Prevalence of Diabetic Retinopathy in the United States: Utilization of the Chronic Care Model as a Public Health Framework

As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.

Postpartum Eclampsia in the Department of Obstetrics Gynecology and Reproductive Medicine of the Souro Sanou University Hospital;Burkina Faso: About 76 Cases

Background: Postpartum eclampsia is a life-threatening obstetric emergency. Its management is multidisciplinary. Despite measures taken to accelerate the reduction of maternal, fetal and infant mortality in Burkina Faso, maternal deaths related to postpartum eclampsia persist. The aim of the study was to investigate the epidemiological, clinical and prognostic aspects of postpartum eclampsia in the obstetrics department of the Sourô Sanou University Hospital in Bobo-Dioulasso. Method: This was a descriptive cross-sectional study with retrospective data collection covering the period from June 1, 2018 to May 31, 2019. We included 76 patients in the study;the variables studied were the epidemiological, clinical and prognostic aspects. The data collected were entered on a microcomputer and analyzed with the EPI info version 7.2 software. Results: The prevalence of postpartum eclampsia was 0.87% compared to admissions to the obstetrics department. The average age of the patients was 23 years old with the extremes of 15 and 39 years old. Primiparas accounted for 39.47%, housewives 53%, and home births accounted for 15.79%. Seizures accounted for 55% of the reasons for admission, the average time to onset of these seizures postpartum was 3.8 days with extremes of 1 and 30 days with 45% of seizures occurring postpartum immediately. Maternal complications were noted in 42.10% of cases with 5 cases of Hellp syndrome, 3 cases of renal failure, and 3 cases of acute pulmonary edema. We recorded 4 cases of maternal death, representing a case fatality rate of 5.2%. Conclusion: Postpartum eclampsia is common in the obstetrics department of the Souro Sanou University Hospital Center with a significant case fatality rate. Emphasis should be placed on monitoring and prevention, especially women at risk of developing postpartum eclampsia for better maternal prognosis.

Prevalence and Factors Associated with Anemia among People Living with Human Immunodeficiency Virus Followed at the Outpatient Treatment Centre of Panzi General Referral Hospital in Eastern Democratic Republic of Congo

Introduction: Anemia in people living with human immunodeficiency virus (PLHIV) is a major health problem. Although anemia often responds to combination antiretroviral therapy, many patients remain anemic despite treatment, and such persistent anemia continues to adversely affect prognosis, regardless of drug response. Scientists have identified some of the factors involved. However, the mechanisms put in place have not been effective in overcoming them. Examples include the withdrawal of zidovudine from antiretroviral treatment lines, iron and folate supplementation, etc. Anemia is still a major concern in HIV-positive patients. The aim of this study is to assess the prevalence of anemia and its associated factors among PLHIV followed up at the outpatient treatment centre (CTA) of the Panzi General Reference Hospital (HGR) in South Kivu, Democratic Republic of Congo (DRC). Method: We conducted a cross-sectional, comparative study of 276 HIV-infected adults on antiretroviral therapy (ART) followed up at the CTA of Panzi HGR. Socio-demographic and nutritional parameters were collected using a survey questionnaire, and clinical assessment and nutritional status were performed at the centre. Hemoglobin, seric albumin and viral load determinations were performed at the HGRP laboratory. We constructed univariate and multivariate logistic regression models to assess factors associated with anemia in people living with HIV/AIDS. Results: We found a prevalence of anemia of 39.4%, including 4.1% severe anemia, 17.7% moderate anemia and 17.5% mild anemia. After multivariate adjustment, the factors associated with anemia in our PLHIV were: moderate undernutrition (aOR = 1.26;95% CI: 1.50 - 4.20;p = 0.001), severe undernutrition (aOR = 115.4;95% CI: 2.04 - 164.52;p = 0.021), hypoalbuminemia (aOR = 2.11;95% CI: 1.87 - 5.10;p = 0.004) and the lower degree of dietary diversity (aOR = 1.56;95% CI: 1.10 - 4.32;p = 0.034). Conclusion: The prevalence of anemia in PLHIV on ART is high. This greatly affects quality of life and increases the need for care. Early detection tools and management algorithms are essential in the follow-up of PLWHIV.

Hepatitis C virus resistance to new specifically-targeted antiviral therapy: A public health perspective

Until very recently, treatment for chronic hepatitis C virus(HCV) infection has been based on the combination of two non-viral specific drugs: pegylated interferon-α and ribavirin, which is effective in, overall, about 40%-50% of cases. To improve the response to treatment, novel drugs have been designed to specifically block viral proteins. Multiple compounds are under development, and the approval for clinical use of the first of such direct-acting antivirals in 2011(Telaprevir and Boceprevir), represents a milestone in HCV treatment. HCV therapeutics is entering a new expanding era, and a highly-effective cure is envisioned for the first timesince the discovery of the virus in 1989. However, any antiviral treatment may be limited by the capacity of the virus to overcome the selective pressure of new drugs, generating antiviral resistance. Here, we try to provide a basic overview of new treatments, HCV resistance to new antivirals and some considerations derived from a Public Health perspective, using HCV resistance to protease and polymerase inhibitors as examples.

Prelacteal Feeding Practice and Associated Factors among Mothers Attending Immunization Clinic in Harari Region Public Health Facilities, Eastern Ethiopia

Background: Breast feeding will have the intended outcome when it is initiated timely and exclusive for the first six months. Introducing prelacteal feeding and inadequate amount of breast milk contributes to over a million avoidable infant deaths each year in developing countries. The purpose of this study was to assess prelacteal feeding practice and associated factors among mothers attending immunization clinic in Harari region government health institutions. Methods: An institutional based cross-sectional study design was conducted among 634 mothers and infants dyads attending ten public health facilities. Systematic random sampling method was used to select the study participants. An exit interview using pretested structured questionnaire was conducted about their experience on prelacteal feeding and related experience. Logistic regressions with OR and 95% confidence interval were computed. Result: Two hundred seventy eight (45.4%) of mothers gave prelacteal liquids for their infants. The common pre-lacteal food includes sugar or glucose water 121 (43.5%) followed by milk other than breast milk 70 (25.1%). Home delivery, failure to attend ANC, late breastfeeding initiation and influence by friends were significantly associated with prelacteal feeding. Conclusion: The prevalence of prelacteal feeding was relatively high in the area. Failure to attend ANC, giving birth at home, late initiation of breast feeding and influence of friends and relatives to give prelacteal feeds for their new born infants were found to be positively associated with prelacteal feeding.

Corneal collagen cross-linking in patients with keratoconus from the Dresden protocol to customized solutions:theoretical basis

Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.

APOBEC3G Role on HIV Infection in Africa: A Systematic Review

The highly active antiretroviral treatment (HAART) has allowed people living with HIV to live longer with a better quality of life. However, toxicity and the emergence of drug resistance arise from HAART use. Therefore, new antiretroviral therapy is needed since no cure or vaccine is available against HIV. Virus-host interaction has been proven to be important in the last decade. Host factors such as the C-C chemokine receptor type 5 (CCR5), a receptor used by HIV to penetrate host cells, have led to the discovery of the Maraviroc, which is an antiretroviral medication used in the United States. In contrast, other factors like C-X-C Motif Chemokine Receptor 4 (CXCR4) and the Apolipoprotein B mRNA editing enzyme catalytic polypeptide-like 3G (APOBEC3G), a potent host defense factor against HIV, is under investigation. APOBEC3G antiviral activity remains a possible therapeutic target against HIV. This systematic review aimed to synthesize the available evidence on the role of APOBEC3G polymorphisms and their expression on HIV infection disease progression in Africa. We used Web of Science, PubMed, Embase, and Google Scholar and searched for relevant publications in French or English reporting on APOBEC3G polymorphisms association with HIV infection in African populations from January 2009 to May 2023. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyzes) was used to process for reporting systematic review. Fifteen studies were included, of which seven were on APOBEC3G polymorphisms and eight were on APOBEC3G expression. Among the APOBEC3G polymorphisms, the most studied was H186R or rs8177832. The average of the minor allele frequency of H186R of APOBEC3G available for the studies included in this study was 0.29 with a 95% CI (0.172;0.401) and varied from 0.108 reported in Uganda to 0.47 recorded from Burkina Faso. The polymorphism H186R was not associated with HIV status in Southern Africa. However, the referent allele of H186R was protective against HIV infection in Western Central Africa, while in West Africa, it was the minor allele (G) of H186R which was protective against HIV. This review warrants a need to increase research on APOBEC3G, from its variants to its hypermutations on the continent with an essential variety of HIV-1 subtypes, to impact the research on A3G-based anti-HIV strategies.

Mercury Levels Assessment in the Population of Aby and Frambo Villages in the Vinicity of Aby Lagoon in Côte d’Ivoire (West Africa)

The Minamata Convention in the aim to protect human life and the environment, seeks to reduce mercury (Hg) by monitoring it concentrations in the environment. Artisanal and Small-scale Gold Mining (ASGM) has been identified as the most important anthropogenic source of human exposure to Hg. In this context, the main goal of this study was to assess the level of mercury in hair of two (2) populations living along two lagoons respectively Aby and Tendo, in Ivory Coast. To reach this goal, hair samples of 138 residents were collected and analyzed by using Cold Vapor Atomic Fluorescence Spectrophotometry (CV-AFS) technique for mercury concentration. Results showed that for the entire population the Hg mean was 2.34 μg/g. Also, they were ranged between 0.15 to 8.53 μg/g and presented substantial differences amongst the villages. In Aby village, we observed the highest Hg concentrations (Mean = 2.62 μg/g). Our findings showed that almost the entire sample group (82%) exceed the USEPA recommended limit, furthermore 56% of them exceed the normal level of WHO and 2% of the respondent has the unhealthy levels of mercury (≥6 μg Hg/g) of hair by WHO standards. Gender differences in hair mercury varies greatly among reports. Lower levels in women’s hair compared to men were reported in the both village. Considering age, the lowest concentrations were observed with children. However, when we take in account the age groups, data suggested that the most exposed sub-population of [18-29] years old is from Aby village in opposite at Frambo village, the same case those who were ≥ 40 years old. It’s convenient to note that, the proportion of Mercury levels would not to be neglected among studied population especially with the resident from Aby village. So, some measures need to be taken at the political level to control mercury contamination.

Prevalence and Individual-Level Determinants of Uptake of Three or More Doses of Sulphadoxine-Pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy in Busia County, Kenya

Background: Malaria in pregnancy causes maternal anemia, low birth weight, intrauterine growth retardation, and preterm deliveries. In malaria-endemic regions in Kenya, percentage of pregnant women hospitalized with malaria reach up to 60%. WHO recommends at least three doses of sulphadoxine pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) antenatally. This study sought to ascertain the prevalence and individual-level factors influencing the uptake of IPTp-SP3+. Methods: A facility-based cross-sectional study at Busia County Referral Hospital. 384 mothers were consecutively sampled at the maternity unit during delivery. Semi-structured questionnaires were used to collect data. Odds ratio (OR) and adjusted OR were used to determine statistical significance of individual factors influencing uptake of three or more IPTp-SP. Results: 43.0% of participants took IPTp-SP3+. Individual factors that affected the uptake of IPTp-SP3+ included starting ANC visits in the first trimester (adjusted odds ratio (aOR) = 2.1, 95% CI: 1.23 – 3.67, p = 0.046), having more than four ANC visits (aOR = 3.1, 95% CI: 1.49 – 6.50, p = 0.002), having a higher monthly income (aOR = 2.6, 95% CI: 1.24 – 5.36, p = 0.012), being aware of the advantages of IPTp-SP medications (aOR = 3.7, 95% CI: 1.40 – 9.74, p = 0.008), and having a positive attitude toward ANC services (aOR = 3.2, 95% CI: 1.61 – 6.31, p = 0.001). Conclusion: Less than half of the pregnant mothers are complyingIPTp-SP3+. There should be aggressive efforts by the County and National Ministries of Health promoting initiation of ANC attendance early and attendance of all the recommended eight visits together with ensuring availability of the drugs.

Socio-Demographic and Economic Factors Associated with Uptake of COVID-19 Vaccine among Pregnant Women at Pumwani Maternity Hospital in Nairobi County, Kenya

Introduction: Pregnant women are a highly vulnerable population for COVID-19 with increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and mortality. Objective: This study determined the socio-demographic and economic factors associated with the uptake of COVID-19 vaccine among pregnant women utilizing antenatal care services in Pumwani Maternity Hospital, Nairobi County-Kenya. Methods: The study was carried out from 15 June to 23 July 2023. Systematic sampling was used to select 302 women from whom data was collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Data was analyzed using SPSS software in which bivariate and multivariate logistic regression analyses were done at a significance level of p Results: A total of 302 pregnant women participated in the study. Of these, 105 (34.8%) were aged between twenty-six (26) and thirty (30) years. The mean age of the women was 28.60 ± (SD = 5.297). The uptake of the COVID-19 vaccine was 41.1%. The common side effects reported to be associated with the vaccines were fever, headache, joint pain, vomiting and skin rash. Uptake of the COVID-19 vaccine was significantly associated with being married (AOR = 3.65, 95% CI: 0.62 - 1.80, p = 0.001), having a secondary level of education (AOR = 3.78, 95% CI: 0.99 - 2.88, p = 0.001) and being employed (COR = 2.66, 95% CI: 1.31 - 3.06, p = 0.001). Conclusion: COVID-19 vaccination uptake remains low among pregnant women in seeking ANC in Nairobi. The individual factors associated with the uptake of COVID-19 vaccine among pregnant Women at Pumwani maternity hospital in Nairobi County were being married, having secondary level of education and being employed. Integration of the COVID-19 vaccine with other routine vaccinations as per the national immunization program in Kenya and the enhancement of education regarding the safety and efficacy of the COVID-19 vaccine in pregnancy and breastfeeding and economic empowerment of women are recommended.

Periodontal disease:A silent factor in the development and progression of diabetic retinopathy

The global increase in the prevalence of type 2 diabetes mellitus(T2DM)and its complications presents significant challenges to public health.Recently,periodontal disease(PD)was recognized as a factor that is likely to influence the progression of T2DM and its complications due to its potential to exacerbate systemic inflammation and oxidative stress.In this editorial,we comment on the article published by Thazhe Poyil et al in the very recent issue of the World Journal of Diabetes in 2024,which investigated the correlation between PD and diabetic retinopathy(DR)in T2DM patients,with emphasis on the association between periodontal swollen surface area,glycated hemoglobin(HbA1c),interleukin-6(IL-6),and lipoprotein(a).The findings by Thazhe Poyil et al are significant as they demonstrate a strong link between PD and DR in T2DM patients.This correlation highlights the importance of addressing periodontal health in diabetes management to potentially reduce the risk and severity of DR,a complication of diabetes.The integration of periodontal evaluation and treatment into diabetes care protocols may lead to improved glycemic control and better overall outcomes for T2DM patients.A few studies have established an interconnection between PD and diabetic complication,specifically DR,in T2DM patients,which we aim to highlight in this editorial.Emphasis was placed on the different mechanisms that suggest a bidirectional relationship between PD and T2DM,where the presence of periodontal inflammation negatively influenced glycemic control and contributed to the development and progression of DR through shared inflammatory and vascular mechanisms.This article highlights the importance of collaboration amongst diabetes specialists,ophthalmologists,periodontists,and public health professionals to advance the prevention,early detection,and treatment of PD and DR.This will improve the health and quality of life of T2DM patients.Moreover,the editorial highlights the need for further research on the specific molecular and immunological mechanisms that underlie the link between periodontitis and DR,with identification of common inflammatory biomarkers and signaling pathways.This is expected to facilitate effective direction of therapeutic objectives,thereby improving the management of diabetes and its complications through integrated care that incorporates oral health.

Assessment of Nitrates and Nitrites in Borehole Water from the Southern and the Northern Region of Côte d’Ivoire (West Africa)

This study aimed to evaluate the quality of water from village boreholes by measuring physicochemical parameters such as nitrates, nitrites, and total organic carbon (TOC). Forty-five (45) village pumps from the Southern (Basse Côte) and the Northern (Korhogo) region of Cte d’Ivoire (west Africa) were sampled. Physicochemical parameters such as temperature, pH, conductivity at 25˚C, and turbidity were determined in situ, while nitrite and nitrate were analyzed according to ISO 10304-1 (2007) standard and total organic carbon (TOC) by NF EN 1484 (1997) standard. The results showed that the borehole waters of the Basse Côte and Korhogo analyzed are acidic, with an average temperature of 27.51˚C ± 0.16˚C and 29.95˚C ± 0.51˚C respectively for the Basse Côte and Korhogo regions. The borehole waters of the Basse Côtedo not contain nitrites, while those of Korhogo have average nitrite contents of 0.32 mg/l. The average nitrate rate in the waters of the Basse Côte and Korhogo are 12.08 ± 2.11 mg/l and 11.03 ± 3.18 mg/l respectively. The average TOC concentration of the waters of the Basse Côte is 1.28 ± 0.32 mg/l and that of Korhogo is 0.56 ± 0.09 mg/L. The study showed that the borehole waters of the Basse Côte and Korhogo have average temperatures between 27.4˚C and 29.95˚C with a slightly acidic pH value and acceptable salinity. The TOC concentrations obtained at the different sampling points were all below the French standard (2 mg/L) except for certains pumps of the Basse Côte. The water samples from the Basse Côte were devoid of nitrite. On the other hand, those from Korhogo revealed the presence of nitrite. Also, the borehole waters of the regions of the Basse Côte and Korhogo contain relatively high nitrate contents, presumably due to anthropometric activity. Overall, our study on the quality of drinking water showed that the waters analyzed are in compliance with international standards and safe for consumption.

Assessment of Selenium Contamination in Sediments of the Aby and Tendo Lagoons in Côte d’Ivoire

Selenium is a trace element that can have both beneficial and harmful effects on aquatic life. The Aby Lagoon is a coastal environment in Côte d’Ivoire that receives selenium inputs from various natural and anthropogenic sources. The aim of this study was to assess the levels of selenium in the sediments of the Aby Lagoon and its tributaries, the Tanoe River and the Tendo Lagoon, and to examine the spatial and seasonal variations of selenium concentrations. Sediment samples were collected from different sites and seasons, and selenium concentrations were measured by atomic fluorescence spectrometry. The results showed that the average concentration of selenium in the sediments of the Aby Lagoon was 0.82 mg/kg, indicating moderate contamination. The concentration of selenium varied between sites and seasons, with higher values in the channel of the Tendo Lagoon and during the dry season. The study highlighted the complexity of selenium dynamics in aquatic ecosystems, and the need to take into account seasonal and spatial variability as well as interactions between environmental factors. The study also suggested potential ecotoxicological risks for some sensitive organisms in certain areas of the lagoon. This study contributes to the knowledge of the dynamics of selenium in lagoon ecosystems and to the assessment of the environmental risks associated with its presence.

Spatio-Temporal Trend and Geographic Disparity of Infertility Prevalence in Burkina Faso, 2011 to 2020

Background: Infertility affected 10% to 25% of couples globally, and about half of the infertility cases were reported in sub-Saharan Africa. Infertility poses significant social, cultural, and health challenges, particularly for women who often face stigmatization. However, comprehensive and nationally representative data, including prevalence, temporal trends, and risk factors, are lacking, prompting a study in Burkina Faso to address the need for informed policies and programs in infertility care and management. Objectives: This study aims to better understand the spatiotemporal trend of infertility prevalence in Burkina Faso. Methodology: This is a retrospective population-based study of women infertility from healthcare facilities in Burkina Faso, during January 2011 to December 2020. We calculated the prevalence rates of infertility and two disparity measures, and examined the spatiotemporal trend of infertility. Results: Over the 10-year period (2011 to 2020), 143,421 infertility cases were recorded in Burkina Faso healthcare facilities, resulting of a mean prevalence rate of 3.61‰ among childbearing age women and 17.87‰ among women who consulted healthcare facilities for reproductive issues (except contraception). The findings revealed a significant increase of infertility, with the prevalence rate varied from 2.75‰ in 2011 to 4.62‰ in 2020 among childbearing age women and from 13.38‰ in 2011 to 26.28‰ in 2020 among women who consulted healthcare facilities for reproductive issues, corresponding to an estimate annual percentage change of 8.31% and 9.80% respectively. There were significant temporal and geographic variations in the prevalence of infertility. While relative geographic disparity decreased, absolute geographic disparity showed an increasing trend over time. Conclusion: The study highlights an increasing trend of infertility prevalence and significant geographic variation in Burkina Faso, underscoring the urgent necessity for etiologic research on risk factors, psychosocial implications, and economic consequences to inform effective interventions and mitigate the socioeconomic impact of infertility.

Microsurgical management of radicular cyst using guided tissue regeneration technique:A case report

BACKGROUND Radicular cyst is a lesion of odontogenic origin that arises from epithelial remains due to periapical periodontitis caused by inflammatory reactions generated at the apex of affected teeth with infected or necrotic pulps.The therapeutic mana gement of radicular cysts is controversial.There is only one case report of enucleation of a radicular cyst managed with microsurgery and apicoectomy,but without the use of the guided tissue regeneration(GTR)technique in the same surgical procedure.The present clinical case describes the management of a radicular cyst with microsurgical approach,performance of an apicoectomy of the tooth associated with the entity,application of GTR technique,use of a resorbable membrane of type I bovine collagen,and bovine xenograft.CASE SUMMARY A 68-year-old patient presented with a radicular cyst from an upper lateral incisor.The microsurgical management used was aimed at enucleating the chemical membrane,performing apicoectomy of the tooth along with careful and precise retrograde filling,and implementing GTR technique using a resorbable collagen membrane and bovine xenograft.The diagnosis of radicular cyst was confirmed using histopathological analysis.The patient underwent follow-up evaluations at 10 and 30 d postoperatively.At 4 months postoperative evaluation,she remained asymptomatic,and radiographs showed significant periapical healing with adequate bone formation.CONCLUSION These results suggest that microsurgical management using the GTR technique with collagen membrane and xenograft,contributes to bone regeneration.

Predictors of Low Birth Weight in Newborn Delivered in Public Hospital of Gurage Zone, Southern Ethiopia: A Case-Control Study

Worldwide, low birth weight is one of the most common causes of neonatal morbidity and mortality. Though factors associated with low birth weight vary from one region to another, in Gurage Zone, there is no sound analytical study done to examine the local determinants of low birth weight. Because of this, the study aimed to elucidate the predictors of low birth weight in public hospital of Gurage zone. Methods: A facility based unmatched case-control study design was employed to detect the existing exposure difference between cases and controls. The study included a total of 270 controls (normal weight) and 134 cases (low birth weight baby). Control and case participants were selected through consecutively. To collect the data, structured interviewer administered questionnaires and anthropometric measurement were used. The data were entered through Epi-data 3.1 computer program and analyzed through Statistical package for Social Sciences version 21 (SPSS v. 21). Univariate, Bivariate and Multivariate analysis were done. Result: Multiple logistic regression model analysis indicated that low birth weight was independently associated with maternal mid upper arm circumference less than 23 cm (AOR 1.79 (95% CI = 1.01 - 3.16)), gestational age less than 37 weeks (AOR 24.94 (95% CI = 12.38 - 50.27)), presence of malaria infection during period of pregnancy (AOR 3.02 (95% CI = 1.39 - 6.51)), presence of preclampsia, multiparity (AOR 2.19 (95% CI = 1.21 - 3.96)) and twining (AOR 5.42 95% CI = 2.01 - 14.59). Conclusion: Gestational age < 37 weeks, twining, malaria infection during pregnancy and maternal undernutrition were a significant predictor of LBW in the region of Gurage zone. Hence, to effectively prevent low birth weight, Gurage zone health departments should work on promotion of maternal nutrition during pregnancy, prevention of malaria during pregnancy.

Infection Control Measures among Healthcare Workers: Knowledge, Attitude and Practice

Background: Nosocomial infections are some of public health problems globally and continue to be increased regardless of the hospital’s efforts on infection control measures and are contributing significantly to morbidity, mortality and cost. The absence of infection control policies, guidelines and trained professionals also contributes to the magnitude of the problem. The aim of this study was to assess the Knowledge, attitude and practices towards infection control measures among healthcare workers at Old Mutare Hospital. Methods: A cross-sectional survey design was used to acquire information. A purposive sampling method was used to select 22 nurses, 15 nurse Aids and 2 laboratory technicians (Lab Tech). A self-administered questionnaire with four components addressing demographic data, knowledge, attitudes and practices was used to collect data that was completed by a checklist. Results: The study findings revealed a poor knowledge of infection control measures among the nurse’s aide. The attitude and practices among participants were impartially good in all variables. The participants had scored over 50% towards their attitude and their practices on infection control. A significant statistical difference was found between the professional status of the participants and the ability to explain how one can get Hospital Acquired Infections (HAIs) and awareness of infection control programs in their hospital (rs = 0.640, 0.645) with P < 0.05 (0.01, 0.01) respectively. Conclusion: Despite of having a fair attitude and practice towards infection control, the participants had presented poor knowledge;therefore, it had been recommended that in service training and workshop should be planned by the administration to update their knowledge and attain full compliance towards their practice.

Health literacy,behavioral and psychosocial characteristics in coronary artery patients:A hospital-based study in Turkey

Objective:To investigate health literacy,behavioral and psychosocial characteristics in coronary artery patients.Methods:Between March 2019 and 2020 years,275 coronary artery patients aged≥50 years were included in the study.Turkish Health Literacy Scale-32 and Beck Depression Inventory were used to collect the data.Results:General health literacy index score was 31.7 and the prevalence of limited health literacy was 59.3%.Adequate health literacy was 2.8 fold higher in the 50-64 age group,3.1 fold higher among men,3.4 fold higher among married and 5.3 fold higher among those who believed in the necessity of individual protective practices(P<0.05).Significant differences were also found in different working status,living places,perceived economic situation,perceived general health status,comorbidities,family history of coronary artery disease,angiography history,material skills on reading and understanding,level of depressive syptom,commitment to individual protective practices health check-ups,utilizing health services,cigarette and alcohol use,and exercise and nutrition between limited and adequate health literacy(P<0.05).Logistic regression analysis showed that adequate health literacy was significantly higher among younger patients(OR:2.81;95%CI:1.46-5.62),male gender(OR:3.10;95%CI:1.46-6.58),married(OR:3.42;95%CI:1.39-8.44)and those with belief in individual protective practices(OR:5.3;95%CI:1.93-14.96).Conclusions:Health literacy is poor among coronary artery patients and behavioral and psychosocial variables differ with health literacy levels.To keep cardiovascular health among these patients,health literacy-based interventions should be adopted in coronary artery clinics,especially for risky population.

The practice of essential nutrition actions in healthcare deliveries of Shebedino District, South Ethiopia

The essential nutrition actions explain nutrition through life cycle approach addressing women’s nutrition during pregnancy and lactation, optimal infant and young children feeding, nutritional care for sick children and control of anemia, iodine and vitamin A deficiencies. Essential nutrition action has been implemented and resulted in positive outcome in less developed countries. However, the status of practice and associated factors were not studied in Ethiopia. Thus, institution-based cross-sectional study was conducted to assess the practice of essential nutrition actions in healthcare deliveries of Shebedino District, South Ethiopia. Quantitative data were collected though face-to-face interview with health workers and triangulated with data obtained through in-depth interview with health managers in the district and non-participatory observation of client-provider interaction in health facilities. Data were analyzed using SPSS16.0 software. Descriptive and logistic regression analyses were undertaken. The study revealed that 61 (56.0%) health workers practiced essential nutrition actions. Seventy one (65.1%) health workers were trained on essential nutrition actions. The practice of essential nutrition actions was associated with career structure of the health workers (AOR = 6.79, 95%CI: 2.31, 19.98), essential nutrition actions knowledge of health workers (AOR = 6.87, 95%CI: 2.11, 21.51) and availability of monthly nutrition related report form (AOR = 4.95, 95%CI: 1.46, 16.81). The practice of essential nutrition actions was low. The factors affecting the practice were inadequate training and knowledge of essential nutrition actions, career structure of the health workers and availability of monthly report form. Training should be provided for health workers on essential nutrition actions;moreover, essential nutrition actions indicators should be included in monthly report forms of the health institutions.

Study of HIV Prevalence and Behaviors in Rural Areas of Goudomp Health District (Senegal)

This study aims to determine the factors related to HIV-positive status in people aged 15 to 49 years of age in the commune of Niagha in Goudomp. The study was descriptive and analytically cross-cutting and had taken place in a release of 2018. The data was collected on anonymous questionnaires and then analyzed using R software after entering with Epi 7 software. Bivariate analyses and logistical modelling have been used to investigate the factors associated with HIV status. The sample included 400 people, and a participation rate of 100% was obtained in relation to the administration of the questionnaire. For the detection of HIV infection, 318 people agreed to do so, a proportion of 79.7%. The average age of the respondents was 27.8 years with a standard deviation of 9.1 and extremes of 15 to 49 years. 21.5% of respondents were under 20 years of age, the median was 26 years. With 58.8% of women, the sex ratio (M/F) was 0.7. In this study, 11.5% of respondents did not believe in the existence of HIV infection, 92.0% were sexually active, and 40.5% had sex with casual partners. The main places for casual sex were cultural events (84.0%), weekly markets (53.1%), religious events (27.8%) and during travel (22.8%). Among them, only 20 respondents, or 12.3%, declared that they systematically protect themselves with a condom during these occasional sexual relations. This wearing of condoms was found in 20.7% of singles and 10.7% of married couples having casual sex. In this study, 60.0% of the respondents declared that they had paid for sex, although this practice is not cited in income-generating activities. Non-consensual sex was found in 6.5% of the respondents. In this study, 319 people agreed to be tested for HIV, or 79.7% of the sample. HIV infection was found in 19 people, 6.0% seroprevalence, with 16 cases of HIV 1 infection and three cases of HIV 2 infection. Several risk behaviors were found in this study. However, none of them had a statistically significant link to HIV seropositivity. The prevalence of HIV infection in Niagha common is very high compared to data from the Sedhiou region and national level. Risky sexual behaviors are found in this population with no statistically significant link to HIV. Studies with a mixed approach would be more appropriate to study these relationships.