The Role of Fructose in Public Health and Obesity

We are in the so-called nutritional transition, in which obesity and its comorbidities have emerged as an important research topic, and the information on food composition is fundamental to promote nutritional safety. Fructose is the sweetest carbohydrate, and this sweetness, along with its low cost, is the key factor for its use in commercial drinks and sweets. The global average consumption of fructose per capita has increased from 56 g/day in 1986 to 65 g/day in 2007. Experimental models associate high fructose intake with the development of obesity and induced insulin resistance. In recent studies, diabetic patients have been reported to use fructose more frequently than glucose. Fructose acts differently in the hypothalamus and generates less satiety than glucose;thus, fructose has a high lipogenic potential. Replacing fructose with another isocaloric carbohydrate is associated with better glycemic control.

Attitudes of Undergraduate Public Health and Health Science Students towards Interprofessional Education (IPE) at a California University

Introduction: The study revealed that many healthcare professional students begin their academic studies with positive and high expectations towards interprofessional collaborative studies. Unfortunately, students lose interest if their initial expectations are not met with consistent opportunities to enhance their communication skills and better understand the different healthcare professions. The study aimed to explore health science and public health students’ attitudes toward IPE. The participants’ backgrounds and demographics were used as the variations for the study. Methods: A pre-post semi-quantitative anonymous survey was designed to assess health science and public health undergraduate students’ attitudes toward IPE. The reason for this design was to capture the participants’ attitudes toward IPE at the start of a semester when they had no academic exposure to IPE. Qualtrics was used to collect the research data. A valid and reliable scale was used to measure attitudes toward IPE. A post-survey was included to measure the participants’ change in attitude toward IPE during the semester. The goal was to measure the IPE curriculum effectiveness. There were 21 survey questions. The questions were divided into four validated subscales. The first seven questions (Questions 1 - 7) pertained to the participants’ demographics s, such as gender, age, race, ethnicity, major field of study, and prior education. Questions 8, 9, 16, & 20 were designed to determine how the participants perceived their roles and responsibilities in their future healthcare careers. Each IPE attitude question’s central tendency and demographic variations were measured. The correlation between demographics and IPE attitudes was measured. Results: The pre-survey had 192 participants, and the post-survey had 97 participants. The pre-survey had 87% of participants in the age group 17 - 25 years, while the post-survey had 82.5% in the same age group. Only 5.7% of the participants were 36 years or older in the pre-survey and 9.3% in the post-survey. The participants were 80.70% female in the pre-survey and 85.6% in the post-survey. The largest healthcare career field concentration was nursing, with 42.7% and 45.4% in the pre- and post-surveys. The other three larger career fields were healthcare administration, community health education, and physician assistant. The participants’ attitudes toward learning with different healthcare career students and becoming more effective members of a healthcare team increased from 4.36 (SD = 0.13) to 4.40 (SD = 0.17). Two negative IPE attitude questions showed an increased value: 1) The function of nursing therapists is mainly to provide support for doctors (3.51, SD = 0.19 to 3.12, SD = 0.24, p-value ≤ 0.004) and 2) Clinical and healthcare problem-solving skills could only be learned with students from the same career field (3.73, SD = 0.13 to 3.31, SD = 0.24, p-value ≤ 0.001). Conclusion: Interprofessional Education in an academic setting is essential to help healthcare students prepare and succeed in their future healthcare careers. The study results show that health science and public health students understand IPE and value academic exposure to the IPE process during their studies. Academic healthcare programs should continue integrating the IPE learning model and content throughout the student’s academic journey. The variations in IPE attitude do not significantly vary based on demographics and healthcare career fields. This study only represents a sample size of the many healthcare careers. Interprofessional communication and collaboration are essential to the future healthcare delivery challenges we face. For this reason, IPE should be integrated into healthcare education for all health science and public health students. It is recommended that more research should be done on creative curriculum design to get students more engaged in various healthcare IPE learning activities.

Building the Capacity of Health Professionals in Monitoring and Evaluation in a Public Health Institution: Experience of the National Institute of Public Health (NIPH) of Côte d’Ivoire

Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.

Ancylostoma ceylanicum and other zoonotic canine hookworms:neglected public and animal health risks in the Asia-Pacific region

Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 milion cases globally and approximately four million disability-adjusted life years lost annually.More than one-fth of these cases are attrib-uted to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hook-worm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmis-sion dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identifica-tion in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),includ-ing hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occur-rence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can under-mine current MDA and proposed animal deworming-based control efforts.

REDISSE in Benin and Lessons Learned for the Management of Public Health Emergencies after Five Years of Implementation

Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.

Toilet Availability and Use in Public Places in Buea: Implications for Public Health

Toilet facilities in public places are a necessity and are supposed to be present in any public place where people visit. Despite the importance of toilet facilities in public places, there is limited access to toilet facilities in public places in Sub-Saharan Africa and this has been a persistent issue. Given that limited studies have been done on availability and use of toilets in public places, this study aimed to fill this research gap. To achieve the objective of the study, a cross-sectional study was used to select participants from the study site. The sample size was 400 after adjustment for non-response. Results from the study showed promising as 95% of public places had a toilet and water for hand washing. However, most of the toilet facilities lacked soap. Toilets in offices and hospitals were perceived to be cleaner and of good quality compared to those in markets and travel agencies. Results also showed that participants hardly used toilets in markets and travel agencies. Toilet facilities in offices and churches were most used, as office toilets were rated clean and of good quality by the participants. The study recommends the need for routine checks by the council to ensure the presence of toilet facilities in public places and the need to sensitise business owners on the importance of having and maintaining toilet facilities in their business establishments.

Antibiotic Resistance Profile of Salmonella Strains Isolated at the National Clinical Biology and Public Health Laboratory in Bangui, Central African Republic

In Africa, each year, there are estimated to be more than 91 million cases of salmonellosis and 137,000 cases of death. The problem of antibiotic resistance in Salmonella strains is a threat to public health. The objective of this study is to evaluate the antibiotic resistance profile of Salmonella strains isolated in biological products analyzed at the National Laboratory of Clinical Biology and Public Health (NLCBPH) in Bangui. This is, therefore, a cross-sectional study with a descriptive aim, running from January to December 2022. It focused on the strains of Salmonella isolated and identified in stools, urines, and blood samples. For each strain of Salmonella isolated, an antibiogram was carried out following the recommendations of the French Society of Microbiology (CASFM, 2022). A total of 93 strains of Salmonella have been recorded. The age group 0 - 9 years was 29% and that of >50 years was 11%. The median age of patients was 30 years with a minimum of 1 and a maximum of 78 years. The female gender was more represented at 52.69% than the male gender at 47.31%, i.e. a sex ratio of 0.89 (M/F). Salmonella strains were much more isolated in stools at 62% followed by urines at 29% and blood at 6%. Salmonella arizonae strains were more represented with 52%. Salmonella strains have a resistance rate to Tetracycline of 62.37% followed by Penicillins of 50%. The rate of multi-antibiotic resistance of the Salmonella strains isolated represented 48.38%. Salmonella spp. strains were multi-resistant at 58.69% followed by Salmonella arizonae strains at 47.91%. There is a significant association between the different families of antibiotics and Salmonella strains (p < 0.05). According to the results obtained, Penicillins, Phenicoles, and Cyclins had a high rate of resistance on Salmonella strains. No strain-producing Broad Spectrum Beta-lactamase has been isolated. Salmonella strains represent a zoonotic health danger, constitute a public health problem and remain a current subject. This germ is resistant to the antibiotics used. It is, therefore, essential to emphasize monitoring the resistance of these germs in the Central African Republic (CAR) to improve the health of the population.

A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world

Background:The period following pregnancy is a critical time window when future habits with respect to physical activity(PA) and sedentary behavior(SB) are established;therefore,it warrants guidance.The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide.Methods:To identity guidelines published since 2010,we performed a(a) systematic search of 4 databases(CINAHL,Global Health,PubMed,and SPORTDiscus),(b) structured repeatable web-based search separately for 194 countries,and(c) separate web-based search.Only the most recent guideline was included for each country.Results:We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines.The continents with guidelines included Europe(n=12),Asia(n=5),Oceania(n=2),Africa(n=1),North America(n=1),and South America(n=1).The most common benefits recorded for PA included weight control/management(n=10),reducing the risk of postpartum depression or depressive symptoms(n=9),and improving mood/well-being(n=8).Postpartum guidelines specified exercises to engage in,including pelvic floor exercises(n=17);muscle strengthening,weight training,or resistance exercises(n=13);aerobics/general aerobic activity(n=13);walking(n=11);cycling(n=9);and swimming(n=9).Eleven guidelines remarked on the interaction between PA and breastfeeding;several guidelines stated that PA did not impact breast milk quantity(n=7),breast milk quality(n=6),or infant growth(n=3).For SB,suggestions included limiting long-term sitting and interrupting sitting with PA.Conclusion:Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.

Exploring the modulatory role of bovine lactoferrin on the microbiome and the immune response in healthy and Shiga toxin‑producing E.coli challenged weaned piglets

Background Post-weaned piglets suffer from F18+Escherichia coli(E.coli)infections resulting in post-weaning diar-rhoea or oedema disease.Frequently used management strategies,including colistin and zinc oxide,have contrib-uted to the emergence and spread of antimicrobial resistance.Novel antimicrobials capable of directly interacting with pathogens and modulating the host immune responses are being investigated.Lactoferrin has shown promising results against porcine enterotoxigenic E.coli strains,both in vitro and in vivo.Results We investigated the influence of bovine lactoferrin(bLF)on the microbiome of healthy and infected weaned piglets.Additionally,we assessed whether bLF influenced the immune responses upon Shiga toxin-producing E.coli(STEC)infection.Therefore,2 in vivo trials were conducted:a microbiome trial and a challenge infection trial,using an F18+STEC strain.BLF did not affect theα-andβ-diversity.However,bLF groups showed a higher relative abundance(RA)for the Actinobacteria phylum and the Bifidobacterium genus in the ileal mucosa.When analysing the immune response upon infection,the STEC group exhibited a significant increase in F18-specific IgG serum levels,whereas this response was absent in the bLF group.Conclusion Taken together,the oral administration of bLF did not have a notable impact on theα-andβ-diversity of the gut microbiome in weaned piglets.Nevertheless,it did increase the RA of the Actinobacteria phylum and Bifi-dobacterium genus,which have previously been shown to play an important role in maintaining gut homeostasis.Furthermore,bLF administration during STEC infection resulted in the absence of F18-specific serum IgG responses.

Promotion of sexual and reproductive health in Pakistan-The role of technology and online awareness

Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in developed countries in the West;however,little research has been conducted in low-income countries,especially in Pakistan.The socioeconomic instability and the government's lack of awareness and knowledge have resulted in no regulations being placed to incorporate telehealth in medicine.The healthcare departments must take into consideration the lifechanging impact of telehealth and the barriers that prevent it in becoming known,to reduce the incidence of unsafe abortions and sexual health practices that prove to be a stigma in society.

The Risk Role of Defeat on the Mental Health of College Students:A Moderated Mediation Effect of Academic Stress and Interpersonal Relationships

Background:College students face significant academic and physiological changes,making them more susceptible to psychological issues such as depression,self-injury,and suicidal ideation.Feelings of defeat can exacerbate these risks by increasing academic stress.However,interpersonal relationships can moderate the impact of academic stress on students’mental health.Utilizing the presage–process–product model,this study aims to empirically investigate how feelings of defeat influence depression,self-injury,and suicidal ideation among college students.Additionally,it explores the mediating role of academic stress and the moderating role of various types of interpersonal relationships.Methods:A total of 1612 college students(750 females,862 males,mean age=19.64±0.62 years)were recruited through cluster sampling.Data were collected via offline questionnaires administered by a trained psychology teacher and a postgraduate student,ensuring high reliability with two examiners per class.Latent profile analysis(LPA)was used to examine the impact of defeat on mental health outcomes,while mediation analysis was conducted to assess the roles of academic stress and interpersonal relationships.Results:1.Defeat is identified as a significant risk factor for mental health issues among college students;2.Four distinct patterns of interpersonal relationships were identified:the interpersonal-relationship risk group,the father–child-relationship high-risk group,the general interpersonal-relationship group,and the superior interpersonal-relationship group;3.Academic stress partially mediates the relationship between defeat and mental health issues such as depression,self-injury,and suicidal ideation;4.Different interpersonal relationship models moderate the impact of academic stress on depression and suicidal ideation.Conclusion:Defeat is a significant risk factor for mental health problems in college students.Academic stress partially mediates the negative impact of defeat on mental health,while patterns of interpersonal relationships moderate this impact.Effective early prevention and intervention should focus on monitoring students’stress levels and fostering warm,positive parent–child relationships.

Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of health.This approach is especially relevant for patients with chronic disorders.Chronic gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ systems.The impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ systems.AIM To describe and quantify the dimensions of PH in patients with chronic GI-HPB disorders.METHODS Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient Department of the Maastricht University Medical Center.Validated questionnaires and data from patient files were used to quantify the six dimensions of PH.Internal consistency was tested with McDonald’s Omega.Zero-order Pearson correlations and t-tests were used to assess associations and differences.A P value<0.05 was considered significant.RESULTS The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general population.Regarding quality of life,participation and daily functioning,GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB disorders.Intercorrelation scores between the six dimensions were only very weak to weak,forcing us to quantify each domain separately.CONCLUSION All six dimensions of PH are impaired in the GI-HPB patients.Malnutrition and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

J-shaped association between dietary thiamine intake and the risk of cognitive decline in cognitively healthy,older Chinese individuals

Background The prospective association of dietary thiamine intake with the risk of cognitive decline among the general older adults remains uncertain.Aims To investigate the association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals.Methods The study included a total of 3106 participants capable of completing repeated cognitive function tests.Dietary nutrient intake information was collected through 3-day dietary recalls and using a 3-day food-weighed method to assess cooking oil and condiment consumption.Cognitive decline was defined as the 5-year decline rate in global or composite cognitive scores based on a subset of items from the Telephone Interview for Cognitive Status-modified.Results The median follow-up duration was 5.9 years.There was a J-shaped relationship between dietary thiamine intake and the 5-year decline rate in global and composite cognitive scores,with an inflection point of 0.68 mg/day(95%confidence interval(Cl):0.56 to 0.80)and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.Before the inflection point,thiamine intake was not significantly associated with cognitive decline.Beyond the inflection point,each unit increase in thiamine intake(mg/day)was associated with a significant decrease of 4.24(95%Cl:2.22 to 6.27)points in the global score and 0.49(95%Cl:0.23 to 0.76)standard units in the composite score within 5 years.A stronger positive association between thiamine intake and cognitive decline was observed in those with hypertension,obesity and those who were non-smokers(all p<0.05).Conclusions This study revealed a J-shaped association between dietary thiamine intake and cognitive decline in cognitively healthy,older Chinese individuals,with an inflection point at 0.68 mg/day and a minimal risk at 0.60-1.00 mg/day of dietary thiamine intake.

Effectiveness of mindfulness-based interventions on the well-being of healthcare workers:a systematic review and meta-analysis

Background Growing evidence attests to the efficacy of mindfulness-based interventions(MBIs),but their effectiveness for healthcare workers remains uncertain.Aims To evaluate the evidence for MBIs in improving healthcare workers’psychological well-being.Methods A systematic literature search was conducted on Medline,Embase,Cumulative Index for Nursing and Allied Health Literature,PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords‘healthcare worker’,‘doctor’,‘nurse’,‘allied health’,‘mindfulness’,‘wellness’,‘workshop’and‘program’.Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion.R V.4.0.3 was used for data analysis,with the standardised mean difference as the primary outcome,employing DerSimonian and Laird’s random effects model.Grading of Recommendations,Assessment,Development and Evaluation framework was used to evaluate the quality of evidence.Cochrane’s Risk of Bias 2 tool was used to assess the risk of bias in the included studies.Results A total of 27 studies with 2506 participants were included,mostly from the USA,involving various healthcare professions.MBIs such as stress reduction programmes,apps,meditation and training showed small to large effects on anxiety,burnout,stress,depression,psychological distress and job strain outcomes of the participants.Positive effects were also seen in self-compassion,empathy,mindfulness and well-being.However,long-term outcomes(1 month or longer postintervention)varied,and the effects were not consistently sustained.Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers.The review also highlights limitations such as intervention heterogeneity,reduced power in specific subgroup analyses and variable study quality.

Investigating Non-Compliance with COVID-19 Vaccination through Hesitancy, Refusal, and Access Limitation: A Community-Based Survey from the Democratic Republic of the Congo

Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.

Prevalence and Factors Associated with Overweight and Obesity among Public Secondary School Teachers in Parakou, Benin, in 2021

Introduction: Overweight and obesity represent a public health problem in Africa due to the epidemiological transition. The objectives of this work were to determine the prevalence of overweight and obesity and to identify associated factors among public secondary school teachers in Parakou, Benin in 2021. Methods: We conducted a descriptive and analytical cross-sectional study. Teachers working in public secondary schools in Parakou during the 2020-2021 academic year, present at work and who gave their written informed consent, were included. A two-stage random sampling was carried out. Data were collected during an individual interview using a questionnaire followed by the measurement of anthropometric parameters and blood pressure. Overweight and obesity were defined by a body mass index ≥ 25 kg/m2. Multivariable logistic regression was performed to identify associated factors. Results: A sample of 325 teachers, including 88.6% of men, was recruited with an average age of 36.2 ± 6.8 years. The prevalence of overweight and obesity was 43.7% (95% CI [38.1%-44.8%]). It increased significantly with income (p Conclusion: The results show a high prevalence of overweight and obesity. Actions are necessary to prevent overweight and obesity among secondary school teachers in Parakou, in Benin.

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.

Seroprevalence of SARS-COV-2 Exposure among “High-Risk” Populations (Healthcare Workers, People Who Attend Markets, and School Children) in Zanzibar

In Zanzibar, from the start of the pandemic in March 2020 to the time of sampling in December 2020, SARS-CoV-2 seroprevalence data was limited. We conducted a seroprevalence study to evaluate the magnitude of SARS-CoV-2 exposure among healthcare workers, school children, and people who attended general markets in Zanzibar. The objectives of the study were to analyse the total antibodies from selected higher-risk population groups in order to determine magnitude in SARS CoV-2 exposure. Blood samples were collected from eligible and consented participants (adults and children), and their serum was analyzed for total antibodies against SARS-CoV-2 using ELISA. A questionnaire was used to collect participants’ demographic and clinical data. The overall SARS-CoV-2 seroprevalence across all age groups was 33%, and a higher seroprevalence was observed in the 40 - 49 years’ age group relative to other ages as well as in those who attended markets. A runny nose (18.8% of participants) was the most frequently reported SARS-CoV-2 infection-related symptom. Multivariable analysis showed significantly higher odds of infection in people living in urban districts. The findings provide insight into SARS-CoV-2 infection among school children, health workers, and people who attended markets in Zanzibar in the early stages of the pandemic. Exposure in these groups might have been influenced by infection and prevention strategies taken by the government, as well as shopping behavior, school overcrowding, and population density in urban settings. The study had methodological limitations, including cross-sectional design. Further, well-designed, longitudinal studies are recommended to understand exposure and transmission at a population level.

Assessing Community Health Interventions in Reducing Infant and Child Mortality in the Southeastern Benin

Background: To reduce infant and child mortality in Benin, a package of high-impact interventions per healthcare level was implemented in 2009. This study aimed to assess the quality of community-based health interventions in reducing infant and child mortality within the municipality of Pobè in southeastern Benin. Methods: This was a cross-sectional evaluative study carried out in November 2021 focused on children aged 0 - 59 months, their mothers, health workers, community facilitators, community health workers and the Town Hall health focal point. Mothers and their children were targeted by cluster sampling, and exhaustive selection was used to recruit all other participants. Predetermined scores based on rating criteria were used to assess the quality of community health interventions using the “input, process and outcome” of Donabedian approach. Results: Over 300 mother-child couples, 46 community health workers, 7 health agents, 1 community facilitator and 1 health focal point from Pobè town hall were surveyed. Intervention quality was judged as “average”, with a score of 73.80%. The “inputs” and “outcomes” components were the weakest links. Conclusion: Improving access to the inputs needed by community health workers can enhance the quality of PIHI interventions.