scholarly journals Assessment of Anti-TB Drug Nonadherence and Associated Factors among TB Patients Attending TB Clinics in Arba Minch Governmental Health Institutions, Southern Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Addisu Alemayehu Gube ◽  
Megbaru Debalkie ◽  
Kalid Seid ◽  
Kiberalem Bisete ◽  
Asfaw Mengesha ◽  
...  
Keyword(s):  
Associated Factors ◽  
Treatment Success ◽  
Sampling Technique ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Systematic Sampling ◽  
Cross Sectional ◽  
Adherence Scale ◽  
Health Institutions

Background. Tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium tuberculosis. Nonadherence to anti-TB treatment may result in the emergence of multidrug-resistant TB, prolonged infectiousness, and poor tuberculosis treatment outcomes. Ethiopia is one of the seven countries that reported lower rates of treatment success (84%). This study assessed anti-TB drug nonadherence and associated factors among TB patients in Arba Minch governmental health institutions. Methods. An institution based cross-sectional study design was conducted from April 15 to May 30, 2017. A systematic sampling technique was employed to select the study subjects. Data was collected using a semistructured questionnaire with Morisky Medication Adherence Scale-8 (MMAS-8) and was entered, cleaned, and analyzed in SPSS version 20. Results. The study included 271 TB patients with a response rate of 96.4%; 58.3% were males and 64.9% were Gamo by ethnicity. The overall nonadherence was 67 (24.7%) (CI = 20.0–30.4). Nonadherence was high if the patients experienced side effects (AOR = 13.332; 95% CI = 2.282–77.905), were far from the health facility (AOR = 21.830; 95% CI = 0.054–77.500), and experienced prolonged waiting time to get medical services (AOR = 14.260; 95% CI = 2.135–95.241). Conclusions. The proportion of TB patients that did not adhere to anti-TB drugs was high in Arba Minch governmental health institutions.

Prevalence of alcohol use and associated factors among Dilla University Students, Dilla Town, Southern Ethiopia. 2018

2020 ◽  
Author(s):  
Yigrem Ali Chekole
Keyword(s):  
Alcohol Use ◽  
Undergraduate Students ◽  
Associated Factors ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
P Value ◽  
Cross Sectional ◽  
Level Of Significance ◽  
The University

Abstract Introduction Compared to other deadly communicable diseases, Psychoactive Substance use is among the leading cause of death. Repeated use linked to addiction, dependence and predisposition for criminal and antisocial behaviors. Even though drug use in Africa relatively is short; however the abuse of drug in Africa is escalating rapidly. Substances use is also one of the most burning and growing public health problems in Ethiopia, as in many developing countries; alcohol is the most frequently used substance. Objective To Assess the Prevalence of alcohol Use and Associated factors among Dilla University undergraduate students in Southern Ethiopia. 2018. Methods An Institution based cross -sectional study was conducted at Dilla University among undergraduate regular students from January-February. Systematic random sampling technique was used to get a total of 803 samples of students from each year and department of the university. The collected data was coded, entered in to EPI-INFO version7.1 and analyzed by using SPSS version 20. Crude and adjusted OR were analyzed using logistic regression and the level of significance of association was determined at P- value <0.05. Result A total of 803 participants were interviewed with a response rate of 91.7%. Among the Participants, alcohol use was found to be 67.6%. (41.8%; n=336). Being 4 th year students (AOR =2.66, 95% CI: 1.64, 4.31), having friends who use substance (AOR=1.53, 95% CI: 1.09, 2.1), being Khat user (AOR= 1.48, 95% CI: 1.05, 2.09) and being Cigarette smoker (AOR=1.76, 95% CI: 1.09, 2.84) were found to be significantly associated with alcohol use. Conclusion Half of the participants found to have alcohol use. Therefore, early prevention, detection and alleviating of alcohol use should be implemented among students in the university.

scholarly journals PROPORTION OF EARLY ANTENATAL CARE BOOKING AND ASSOCIATED FACTORS IN MEKELLE CITY, PUBLIC HEALTH INSTITUTIONS, NORTHERN ETHIOPIA, 2015

2018 ◽  
Vol 11 (4) ◽  
pp. 409
Author(s):  
Gebreamlak Gidey ◽  
Desta Abraha
Keyword(s):  
Antenatal Care ◽  
Associated Factors ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Early Initiation ◽  
World Health ◽  
Systematic Sampling ◽  
Northern Ethiopia ◽  
Cross Sectional ◽  
Mekelle City

 Objective: The objective of this study was to assess the proportion and associated factors for early initiation of antenatal care visit in Mekelle City, Tigray, Northern Ethiopia, 2015.Method: An institution-based cross-sectional study was employed among 391 pregnant women’s in Mekelle special zone. A systematic sampling technique was used to select study participants. Pretested structured questionnaire was used to collect the data through interview. Data were entered into EPI info version 7 and analyzed using SPSS version 20, respectively. Bivariate and multivariate logistic regression was done to see significant variables with p<0.05 at 95% confidence interval (CI).Result: The proportion of pregnant women who initiate early antenatal care (ANC) visit was found to be 41.1%. Perceived correct time of initiation before 4 months (adjusted odds ratio [AOR]=3.261, 95% CI 1.391–7.645) and correct time told by others before 4 months with (AOR=6.617, 95% CI 2.580, 16.971) were found to have statistically significant positive outcomes association with early initiation of antenatal care visit.Conclusion: The proportion of early ANC initiation in Mekelle is lower than the World Health Organization recommendation which is <16 weeks gestation. Therefore, providing information to the community, initiation counseling, and providing health education on the benefits early ANC is crucial to improving maternal, neonatal, and child health outcomes.

scholarly journals Under Nutrition and associated factors among lactating mothers in Southern Ethiopia: Institution Based Cross-sectional study

2019 ◽  
Author(s):  
Gemechu Kejela ◽  
Feleke Gebremeskel ◽  
Hadiya Hassen ◽  
Misgun Shewangizaw ◽  
Markos Desalegn
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Systematic Sampling ◽  
P Value ◽  
Sectional Study ◽  
Quality Of Data ◽  
Cross Sectional ◽  
Under Nutrition ◽  
Lactating Mothers

Abstract Background Maternal Nutrition contributes significantly to the long term health of mothers and their children. Despite this importance, globally, about 795 million people are undernourished and women and their children are the most vulnerable groups.Objective the main aim of this study was to assess under nutrition and associated factors among lactating mothers in Arba Minch zuria district, Southern Ethiopia.Methods institution based cross-sectional study was used. Data was collected using interview administered questionnaire from a total of 441 lactating mothers. To get the required respondents, first health centers in Arba Minch zuria district were selected by using lottery method and probability to population size was performed for each health center. Finally, eligible respondents were selected using systematic sampling method. The questionnaire was pretested and close supervision was undertaken during data collection to assure the quality of data. The collected data was entered using Epi data version 3.02 and exported to SPSS version 20.0 for analysis. Binary and multivariable logistic regression were conducted, and finally variables with p-value of <0.05 were considered as statistically significant predictors.Results Prevalence of under nutrition in this study was 26.1%. Under nutrition is higher among mothers who are unable to read and write (AOR[95%CI]= 3.931[1.700,9.091]), mothers who experienced more than five numbers of pregnancies (AOR[95%CI]= 2.453[1.051, 5.728]), those with more than four members of family size (AOR[95%CI]= 2.289[1.171, 4.472]), those who live in the household with no toilet (AOR [95%CI] = 6.407[3.556, 11.545]) and those who have less than 4 antenatal care visits (AOR[95%CI]= 2.053[1.185, 3.559]).Conclusions and Recommendations In this study, the magnitude of under nutrition among lactating women was high. So, nutrition based health information, education and communication is needed for mothers especially during pregnancy and lactation in the study area.

scholarly journals Patients’ satisfaction with outpatient pharmacy services and associated factors in Debre Tabor comprehensive specialized hospital, Northwest Ethiopia: A cross-sectional study

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262300
Author(s):  
Mulugeta Molla ◽  
Woretaw Sisay ◽  
Yared Andargie ◽  
Belayneh Kefale ◽  
Pradeep Singh
Keyword(s):  
Associated Factors ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Public Hospitals ◽  
Systematic Sampling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Negatively Associated ◽  
Patients Satisfaction

Introduction By measuring patients’ satisfaction, providers can gain insight into several elements of health care services, including the effectiveness of their care and the level of empathy they exhibit. The aim of this study was to assess patient satisfaction with pharmaceutical services and associated factors in public hospitals located in Northwestern Ethiopia. Methods An institution-based quantitative cross-sectional study was used. The study was carried out in an outpatient pharmacy from January 1–June 30, 2021. Participants were selected by a systematic sampling technique. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The findings were presented using descriptive statistical methods. To find factors linked to satisfaction, binary logistic regression was used. Results The final analysis included a total of 401 samples. More than half of the participants (229, or 55.1%) were female. The overall mean score of satisfaction was 30.6 out of a maximum of 100 scores. By taking this mean score as a cut-off point, 204 (50.9%) of the study participants had satisfaction with the outpatient pharmacists’ service. Participants’ responses scored on the uncomfortable and inconvenient waiting areas [AOR = 0.31; 95%CI, (0.13, 0.49)] were found to be negatively associated with the level of patients’ satisfaction. Also, the unavailability of medications [AOR = 0.12; 95%CI, (0.02, 0.37)] was negatively associated with the respondent satisfaction. Uncomfortable and inconvenient private counseling areas [AOR = 1.37; 95%CI, (0.79, 4.42)] showed a negative association with their satisfaction. Conclusion Patients’ satisfaction levels with pharmacy service were found to be greater than 50%. The socio-demographic characteristics of patients have no association with their level of satisfaction, but their perception of uncomfortable private counseling areas and waiting areas was negatively associated with their satisfaction.

scholarly journals Foot Care Practice and Associated Factors among Patients with Lymphoedema in Boreda District, Gamo Zone, SNNPR, Ethiopia, 2020. Implications for Elimination of Podoconiosis and Lymphatic Filariasis

2021 ◽  
Author(s):  
Chuchu Churko ◽  
Tsegaye Yohanes ◽  
Alemayehu Bekele Kassahun ◽  
Nathan Desalign ◽  
Gisila Endashaw ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Associated Factors ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Care Practice ◽  
Foot Care ◽  
Cross Sectional ◽  
Negatively Associated

Abstract Background: Lymphatic filariasis is ranked as the second leading cause of disability world-wide. The current global programme to eliminate lymphatic filariasis is based on the interruption of transmission and the alleviation of disability and suffering. Objective: to assess foot care practice and associated factors among lymphoedema patients in Boreda district, Gamo zone Southern Ethiopia.Methods: a community based cross sectional study was employed from December 2020 to June 2021 in Boreda district. Simple random sampling technique was used for selecting participants. Pretested structured interviewer administered questionnaire was prepared in English and translated to local language. Findings: a total of 280 lymphedema patients were involved in this study. More than half 153 (54.6%) had poor practice towards foot care practice with 95% CI (48.7%, 60.4%). Patients who fetched 50 litres or below and wore shoes at the age above 20 years were negatively associated with foot care practice, (AOR=0.383, 95%CI: 0.155, 0.945) and (AOR=0.261, 95%CI: 0.107, 0.63), respectively. Patients who owned only one pair and two pairs were negatively associated with foot care practice (AOR=0.04, 95%CI: 0.009, 0.182) and (AOR=0.27, 95%CI: 0.087, 0.85), respectively. On the other hand, attending LMMDP service and frequency of adenolymphangitis once and twice or more per month were positively associated with foot care practice (AOR= 3.339, 95%CI: 1.53, 7.285) and (AOR=8.15, 95% CI: 3.157, 21.058) and (AOR=9.35, 95% CI: 3.118, 28.059), respectively.Conclusion: this study indicated foot care practice among lymphedema patients in Boreda district was poor. Number of litre of water fetched per day, age at which shoes first worn, number of shoes owned, attending LMMDP and frequency of adenolymphangitis were significantly associated with foot care practice. Standard foot care practice should be emphasized to control progression of lymphedema.

scholarly journals Foot care practice and associated factors among patients with lymphoedema in Boreda district, Gamo zone, southern Ethiopia, 2020. Implications for elimination of podoconiosis and lymphatic filariasis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Chuchu Churko ◽  
Tsegaye Yohanes ◽  
Alemayehu Bekele Kassahun ◽  
Nathan Desalegn ◽  
Gesila Endashaw ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Associated Factors ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Care Practice ◽  
Foot Care ◽  
Cross Sectional ◽  
Negatively Associated

Abstract Background Lymphatic filariasis is ranked as the second leading cause of disability world-wide. The current global programme to eliminate lymphatic filariasis is based on the interruption of transmission and the alleviation of disability and suffering. Objective to assess foot care practice and associated factors among lymphoedema patients in Boreda district, Gamo zone Southern Ethiopia. Methods a community based cross sectional study was employed from December 2020 to June 2021 in Boreda district. Simple random sampling technique was used for selecting participants. Pretested structured interviewer administered questionnaire was prepared in English and translated to local language. Findings a total of 280 lymphedema patients were involved in this study. More than half 153 (54.6%) had poor practice towards foot care practice with 95% CI (48.7, 60.4%). Patients who fetched 50 l of water or below and wore shoes at the age above 20 years were negatively associated with foot care practice, (AOR = 0.383, 95%CI: 0.155, 0.945) and (AOR = 0.261, 95%CI: 0.107, 0.63), respectively. Patients who owned only one pair and two pairs were negatively associated with foot care practice (AOR = 0.04, 95%CI: 0.009, 0.182) and (AOR = 0.27, 95%CI: 0.087, 0.85), respectively. On the other hand, attending LMMDP service and frequency of adenolymphangitis once and twice or more per month were positively associated with foot care practice (AOR = 3.339, 95%CI: 1.53, 7.285) and (AOR = 8.15, 95% CI: 3.157, 21.058) and (AOR = 9.35, 95% CI: 3.118, 28.059), respectively. Conclusion this study indicated foot care practice among lymphedema patients in Boreda district was poor. Number of litre of water collected per day, age at which footwear first worn, number of shoes owned, attending LMMDP and frequency of adenolymphangitis were significantly associated with foot care practice. Standard foot care practice should be emphasized to control progression of lymphedema. Foot care practices like skin care, exercise and elevation, washing legs, bandaging and massaging are important factors that influence in reduction of lymphedema volume and acute attacks among people who are suffering from the diseases.

scholarly journals Visual impairment and associated factors among primary school children in Gurage Zone, Southern Ethiopia

2020 ◽  
Vol 20 (1) ◽  
pp. 533-542
Author(s):  
Gashaw Garedew Woldeamanuel ◽  
Mohammed Derese Biru ◽  
Teshome Gensa Geta ◽  
Birhan Abera Areru
Keyword(s):  
Primary School ◽  
Visual Impairment ◽  
School Children ◽  
Primary Schools ◽  
Associated Factors ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Primary School Children ◽  
Southern Ethiopia ◽  
Cross Sectional

Background: Visual impairment is one of the major public health problems worldwide, especially in developing countries. Objective: To determine the prevalence of visual impairment and its associated factors among school children in Gurage Zone, Southern Ethiopia. Methods: A cross sectional study was conducted in eight primary schools of Gurage Zone. A total of 1064 pupils, of whom589 boys and 475 girls were selected using multistage sampling technique. Socio-demographic characteristics of the participants were collected using structured questionnaires and visual acuity was measured using Snellen’s chart. Logistic regression analysis was used to determine the associated factors of visual impairment. Results: The prevalence of visual impairment was 5.2%. Factors significantly associated with visual impairment were age group of 13-18 years (AOR = 9.44, 95% CI = 3.83 – 23.25), school grade level of 5- 8 (AOR = 2.97, 95% CI = 1.23 – 7.17), rural residents (AOR = 2.59, 95% CI = 1.22 – 5.54), family’s monthly income of less than 2000 Ethiopian Birr (AOR = 2.87, 95% CI = 1.08 – 7.61) and visually impaired parents (AOR = 2.16, 95% CI = 1.06 – 4.39). Conclusion: This study found that the prevalence of visual impairment was 5.2%. Keywords: Visual impairment; primary school children; Gurage Zone; Southern Ethiopia. 

scholarly journals Magnitude of Episiotomy and Associated Factors among Mothers Who Give Birth in Arba Minch General Hospital, Southern Ethiopia: Observation-Based Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Kassahun Fikadu ◽  
Negussie Boti ◽  
Birtukan Tadesse ◽  
Dureti Mesele ◽  
Emenet Aschenaki ◽  
...  
Keyword(s):  
General Hospital ◽  
Associated Factors ◽  
Occupational Status ◽  
Sampling Technique ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Participants

Background. Episiotomy is the most common obstetric procedure, performed when the clinical circumstances place the patient at a high risk of high-degree laceration. However, episiotomy should be done with judicious indication to lower perineal laceration with fewer complications. Despite its adverse effects, the magnitude of episiotomy is increasing due to different factors. Therefore, this study is aimed at determining the recent magnitude of episiotomy and at identifying associated factors among women who gave delivery in Arba Minch General Hospital, Southern Ethiopia. Methods. An institution-based cross-sectional study was conducted from December 15, 2018, to January 30, 2019. A systematic random sampling technique was used to select study participants. A semistructured questionnaire was used to collect data. This was supplemented with a review of the labor and delivery records. Binary and multivariable logistic regression analyses were performed to identify factors associated with the magnitude of episiotomy. P value ≤ 0.05 was used to determine the level of statistically significant variables. Results. The magnitude of episiotomy was found to be 272 (68.0%) with 95%CI=64.0‐72.5. Women who attended secondary education [AOR=10.24, 95%CI=2.81‐37.34], women who attended college and above [AOR=4.61, 95%CI=1.27‐16.71], birth weight≥3000 g [AOR=4.84, 95%CI=2.66‐8.82], primipara [AOR=4.13, 95%CI=2.40‐7.12], being housewife occupants [AOR=3.43, 95%CI=1.20‐9.98], married women [AOR=2.86, 95%CI=1.40‐5.84], and body mass index<25 kg/m2 [AOR=2.85, 95%CI=1.50‐5.44] were independent variables found to have significant association with episiotomy. Conclusion. The magnitude of episiotomy was 68.0% which is higher than the recommended practice by WHO (10%). The study participants’ occupational status, marital status, educational status, parity, birth weight, and BMI were significantly associated with the magnitude of episiotomy in the study area. Therefore, to reduce the rate of episiotomy, it is better to have periodic training for birth attendants regarding the indication of episiotomy.

scholarly journals Prevalence of Erectile Dysfunction and Associated Factors among Hypertensive Patients Attending Governmental Health Institutions in Gondar City, Northwest Ethiopia: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Deribew Abebaw Abuhay ◽  
Yibeltal Yismaw Gela ◽  
Ayechew Adera Getu
Keyword(s):  
Erectile Dysfunction ◽  
Associated Factors ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Health Institutions ◽  
Study Participants

Introduction. Erectile dysfunction is a common sexual problem affecting men with hypertension. It may result in withdrawal from sexual engagement, decreased work productivity, psychosocial problems including poor self-esteem and depression, and reduction in quality of life for both the affected men and their female partners. Objective. This study was aimed to determine the prevalence of erectile dysfunction and associated factors among hypertensive patients attending governmental health institutions in Gondar city, Northwest Ethiopia. Materials and Methods. An institutional-based cross-sectional study was conducted on 423 hypertensive men randomly selected using a systematic random sampling technique. Erectile dysfunction was assessed using the International Index of Erectile Function-5 tool. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data were entered into EpiData version 4.6 and analyzed using Stata-14. Binary logistic regression was performed to identify factors associated with erectile dysfunction. The level of significance was computed at a p value ≤ 0.05. Results. The mean age of the study participants was 58.84 ± 13.52 years. The prevalence of erectile dysfunction among hypertensive men was 46.34% (95% CI: 41.61, 51.12). About 28% of them had a mild form of erectile dysfunction while nearly 6% had severe forms. Age above 60 years (AOR = 3.8, 95% CI: 1.62, 6.55), stage II hypertension (AOR = 3.5, 95% CI: 1.63, 5.74), hypertension duration >10 years (AOR = 2.5, 95% CI:1.12, 4.19), comorbidity (AOR = 1.7, 95% CI: 1.04, 3.15), depression (AOR = 2.35, 95% CI: 1.31, 4.21), and being physically active (AOR = 0.48, 95% CI: 0.28, 0.83) were factors significantly associated with erectile dysfunction. Conclusion. Nearly half of the study participants had some form of erectile dysfunction, indicating the presence of a high burden of the problem. Assessment of hypertensive men for erectile dysfunction should be part of routine medical care.

scholarly journals The Prevalence and Associated Factors of Hypertension among Adults in Southern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Belachew Kebede ◽  
Gistane Ayele ◽  
Desta Haftu ◽  
Gebrekiros Gebremichael
Keyword(s):  
Associated Factors ◽  
Adult Population ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Systematic Sampling ◽  
Cross Sectional ◽  
Screening Programs ◽  
Systematic Sampling Method ◽  
Study Participants

Background. Hypertension is a growing public health problem in many developing countries including Ethiopia. Determining the prevalence of hypertension and identifying the associated factors is crucial. Objective. To assess the prevalence of hypertension and associated factors, among adult population of Arba Minch town, Gamo Zone, Southern Nations, Nationalities and Peoples Region, Ethiopia. Methods. A cross-sectional study design was conducted from December 1 to 30, 2017 among adults. Study participants were selected using a multistage systematic sampling method. Data were collected by face-to-face interview after getting written informed consent by using a structured questionnaire. Additionally, weight, height, and blood pressure of participants were measured following standard procedures. Data were entered into a computer using EPI INFO 7 and exported into SPSS version 20 for analysis. Bivariate and multivariable analyses were performed to explore the association between hypertension and associated factors. Multivariable logistic regressions were fitted to control the effect of confounders. Results. A total of 784 study participants were included in this study. The overall prevalence of hypertension in Arba Minch Town was 35.2%, (95% CI: 32.4%, 38.4%). Nearly 90% of hypertensive patients were screened for the first time. Age ≥55 years [AOR=7.74; 95% CI: 2.19, 27.23], income level which is greater than 2501 Ethiopian Birr [AOR=9.5; 95% CI: 4.5, 20.20], working hour less than seven hours per day [AOR=12.5; 95% CI: 4.3, 36.1], and chewing “khat” [AOR=11.06: 95% CI: 4.3, 27.7] were the independently associated factors with hypertension. Conclusion. The prevalence of hypertension is found to be high. Increasing awareness on control use of “khat,” increasing physical activity, and strengthening community-based periodic screening programs of high-risk populations are recommended.

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