scholarly journals Epidemiology of Esophageal Cancer (EC) In Oromia Region, Ethiopia 2016: A 4-Year Medical Record Review

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 14s-14s ◽  
Author(s):  
G.G. Bulcha ◽  
M.E. Leon ◽  
M. Gwen ◽  
C.C. Abnet ◽  
A. Sime ◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
Teaching Hospital ◽  
Addis Ababa ◽  
Previous History ◽  
Case Series ◽  
Health Priorities ◽  
Treatment Center ◽  
Medical Teaching ◽  
Incident Cases

Background: It is difficult to determine the prevalence/incidence of EC without an established functional national cancer registry, which helps to demarcate the population at-risk and monitor cancer trends over time. The review of medical records can help to identify areas in a country with high number of diagnosed EC cases and help set public health priorities. Aim: To describe EC hospital case series during a period of 4 years at the main cancer treatment center in Ethiopia and two hospitals in the EC high-risk zones in the Oromia region, concentrating on residents of Oromia region and to offer recommendations for public health officials. Methods: All EC malignancy data from the period 2013-2016 were collected by reviewing patient charts at the selected hospitals: Tikur Anbessa Teaching hospital (TATH) in Addis Ababa, Adama General and Medical Teaching Hospital (AGMTH) and Adama Referral and Medical Teaching Hospital (ARMTH). Cases with insufficient residence information and residents of other regions were excluded from the summary. The number of EC cases is presented by age, sex and site as well as method of diagnosis. Data were expressed as percentages (%). Statistical analysis was done using SPSS 20 software. Results: Over the study period, a total of 669 EC cases who resided in Oromia region were identified in the selected hospitals out of 2211 registered in the referral surgical departments of hospitals in the study, with insignificant difference by sex. A total of 457 (68%) were residents from high risk Arsi/Bale zones and the rest 212 (32%) from other zones of the region. The mean age at diagnosis was 52.4 years with the majority of cases in the age range 45-69 years. A total of 34 (5%) EC cases were younger at diagnosis (15-29 years). A total of 258 (38.5%) cases were identified at TATH, 305 (46%) from AGHMT/ARHMT and 106 (16%) cases from both TATH/AGHMT. Data were gathered from patient charts at endoscopy departments 227 (34%), endoscopy and pathology departments 246 (37%) and all other sources (ie surgical department) 196 (29%). Most patients complained dysphagia for solids 664 (99%) and weight loss 352 (53%). Cases were histopathology proven (256, 38%), identified through endoscopy investigation (385, 58%) or radiology (28, 4%). Squamous cell carcinoma was the predominant histology type with 160 cases (62.5%) of those histologically proven. Among the total of 420 cases whose risk factor history was recorded, 401 (97%) had a previous history of digestive disease, 49% reported hot beverage consumption and 34% persistent heart burn. Conclusion: Two thirds of EC incident cases came from Arsi and Bale zones with decreasing trends over the period considered. Such trends warrant in depth investigation for possible reasons and future study to investigate local based risk factors associated with the disease.

scholarly journals Prevalence and Factors Associated with Postpartum Depression Among Mothers Attending Public Health Centers of Addis Ababa, Ethiopia, 2016

2018 ◽  
Vol 14 (1) ◽  
pp. 196-206 ◽  
Author(s):  
Addishiwet Fantahun ◽  
Amsale Cherie ◽  
Leul Deribe
Keyword(s):  
Public Health ◽  
Postpartum Depression ◽  
Low Income ◽  
Random Sampling ◽  
Addis Ababa ◽  
Previous History ◽  
Health Centers ◽  
Factors Associated ◽  
History Of ◽  
Health Institutions

Objectives:Postpartum Depression (PPD) is a serious public health problem that leads to high maternal morbidity and mortality, enormously affecting the infant, family and society. Thus, the aim of this study was to assess the prevalence and factors associated with postpartum depression among postpartum mothers attending public health centers in Addis Ababa, Ethiopia, 2016.Methods:Facility-based cross-sectional study was conducted from March 2016-April 2016 among 633 postpartum women. Four sub cities were identified through simple random sampling technique among 10 sub cities in Addis Ababa, Ethiopia. Furthermore, the study participants were determined by systematic random sampling after 10 health centers were selected by lottery method and the number of participants in each health center was proportionally allocated. In order to determine postpartum depression, participants were rated using the Edinburgh Postnatal Depression Scale (EPDS) and the findings were analyzed using bivariate and multivariate logistic regression. P-value less than 0.05 with 95% confidence interval was used to state the association.Results:The study revealed prevalence of postpartum depression among mothers was 23.3%. Moreover, women who were unmarried, had unplanned pregnancy, delivered without presence of any relatives in health institutions, had previous history of child health, had history of substance use and had low income were found to more often display postpartum depression.Conclusion:For optimal maternal health care provision in regards to postpartum depression, integration of mental health service in addition to inter sectoral collaboration of women’s affair with health institutions is crucial.

scholarly journals Thrombolysis in acute pulmonary embolism

2020 ◽  
Vol 66 (3) ◽  
pp. 263-267
Author(s):  
Tiago Spiazzi Bottega ◽  
Marcele Gnata Vier ◽  
Hugo Baldiaserotto ◽  
Ellen Pierre de Oliveira ◽  
Claudia Liliana Moreno Diaz ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Right Ventricular ◽  
Acute Pulmonary Embolism ◽  
Previous History ◽  
Clinical Manifestations ◽  
Case Series ◽  
Right Ventricular Failure ◽  
Severe Bleeding ◽  
Ventricular Failure

SUMMARY OBJECTIVES Acute pulmonary embolism (APE) is an important cause of cardiovascular mortality, due mainly to hemodynamic instability. In these cases, the recommendation is to perform some reperfusion procedure, with systemic thrombolysis being the main therapy used. However, national data evaluating the efficacy and safety of thrombolysis are scarce. METHODS Retrospective analysis of a case series. We included 13 patients diagnosed with high-risk APE and 4 patients with intermediate-high risk from a single-center, who were treated with alteplase 100mg. RESULTS The mean age of the patients was 55 years, most of them female (76.4%). Among the risk factors for VTE were immobilization (41.17%), contraceptive use (35.29%), cancer (17.63%), and previous history of DVT (11.76%). The most frequent clinical manifestations of APE were dyspnea (88.23%), hypoxia (82.35%), hypotension (82.35%), and tachycardia (64.70%). 82.35% of the patients had echocardiographic signs of right ventricular dysfunction, and 52.94% had increased troponin and BNP. Severe bleeding associated with thrombolysis occurred in 17.54% of cases. No patient died due to bleeding. There were 8 deaths from right ventricular failure (47%), 6 in the cases of patients presenting as high-risk APE (35.3%), and 2 in the cases of intermediate-high risk (11.8%). CONCLUSION Thrombolysis in patients with high-risk APE or intermediate-high risk had a severe bleeding rate of 17.6%. However, the high mortality of this population (47%) due to right ventricular failure justifies the use of this therapeutic modality.

The Influence of Behavior Factors on The Incidence of Syphilis in High-Risk Men in Public Health Centers, Medan, North Sumatera

2020 ◽  
Author(s):  
Vicky Arfeni Warongan ◽  
◽  
Fazidah Aguslina Siregar ◽  
Etti Sudaryati ◽  
◽  
...  
Keyword(s):  
Public Health ◽  
High Risk ◽  
Sexually Transmitted Diseases ◽  
Previous History ◽  
Case Control ◽  
Health Centers ◽  
Hiv Status ◽  
Sexually Transmitted ◽  
History Of ◽  
Dominant Influence

ABSTRACT Background: Sexually Transmitted Infection is still a public health problem globally, because the pattern of the disease almost occurs in all countries until now, especially syphilis. Homosexual behavior, sexual promiscuity, and migration from one place to another can be potential to be transmitted by syphilis. This study aimed to analyze the influence of behavioral factors towards the incidence of syphilis in the work area of the Public Health Centers in Medan, 2019. Subjects and Method: A case control study was conducted in Teladan, Helvetia and Padang Bulan Public health centre. A sample of 80 consisting of 40 cases and 40 control was selected by purposive sampling. The dependent variable was syphilis. The independent variables were HIV status, history of sexually transmitted diseases, previous history of syphilis, history of circumcision, use of condoms, use of drugs, number of sex partners and the average frequency of sex. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Variables that influence syphilis are the history of syphilis (OR= 28.52; 95% CI= 7.55 to 107.78; p= 0.0001) and drug use (OR= 15.12; 95% CI= 2.57 to 89.24; p= 0.003). Meanwhile, HIV status (OR = 1.55; 95% CI= 0.41 to 5.87; p= 0.520), use of condoms (OR= 0.2 01; 95% CI= 0.63 to 8.90; p= 0.201) and sexually transmitted diseases (OR= 1.53; 95%CI= 0.23 to 10.18; p= 0.660). The previous history of syphilis was the dominant influence of the incidence of syphilis (OR=28.52; 95% CI= 7.55 to 107.78; p=0.001). Conclusion: Variables that influence syphilis are the history of syphilis (OR= 28.52; 95% CI= 7.55 to 107.78; p= 0.0001) and drug use (OR= 15.12; 95% CI= 2.57 to 89.24; p= 0.003). Meanwhile, HIV status (OR = 1.55; 95% CI= 0.41 to 5.87; p= 0.520), use of condoms (OR= 0.2 01; 95% CI= 0.63 to 8.90; p= 0.201) and sexually transmitted diseases (OR= 1.53; 95%CI= 0.23 to 10.18; p= 0.660). The previous history of syphilis was the dominant influence of the incidence of syphilis (OR=28.52; 95% CI= 7.55 to 107.78; p=0.001). Conclusion: It is recommended that the Health Service of Medan can give inputs for developing health intervention program, including the evaluation of STI intervention programs. The management of Teladan, Helvetia and Padang Bulan Public Health Centers should increase counseling, medication, and prevention programs towards syphilis for the high risk male population. Keywords: Influence, Syphilis, Case Control Correspondence: Vicky Arfeni Warongan, SKM. Fakultas Kesehatan Masyarakat, Universitas Sumatera Utara. Jl. Universitas No.32, Padang Bulan, Kecamatan Medan Baru, Kota Medan, Sumatera Utara 20222. Email: [email protected]. Mobile: 081263197791 DOI: https://doi.org/10.26911/the7thicph.01.22

Epidemiology of pediatric hydrocephalus in Haiti: analysis of a surgical case series

2019 ◽  
Vol 23 (5) ◽  
pp. 568-576
Author(s):  
Michael Ragheb ◽  
Ashish H. Shah ◽  
Sarah Jernigan ◽  
Tulay Koru-Sengul ◽  
John Ragheb
Keyword(s):  
Public Health ◽  
Logistic Regression ◽  
Head Circumference ◽  
Rainy Season ◽  
Statistical Tests ◽  
Multivariate Logistic Regression Analysis ◽  
Case Series ◽  
Multivariate Logistic Regression ◽  
Surgical Case ◽  
Operative Notes

OBJECTIVEHydrocephalus is recognized as a common disabling pediatric disease afflicting infants and children disproportionately in the developing world, where access to neurosurgical care is limited and risk of perinatal infection is high. This surgical case series describes the Project Medishare Hydrocephalus Specialty Surgery (PMHSS) program experience treating hydrocephalus in Haiti between 2008 and 2015.METHODSThe authors conducted a retrospective review of all cases involving children treated for hydrocephalus within the PMHSS program in Port-au-Prince, Haiti, from 2008 through 2015. All relevant epidemiological information of children treated were prospectively collected including relevant demographics, birth history, hydrocephalus etiology, head circumference, and operative notes. All appropriate associations and statistical tests were performed using univariate and multivariate logistic regression analyses.RESULTSAmong the 401 children treated within PMHSS, postinfectious hydrocephalus (PIH) accounted for 39.4% (n = 158) of cases based on clinical, radiographic, and endoscopic findings. The majority of children with hydrocephalus in Haiti were male (54.8%, n = 197), born in the rainy season (59.7%, n = 233), and born in a coastal/inland location (43.3%, n = 61). The most common surgical intervention was endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) (45.7%, n = 175). Multivariate logistic regression analysis yielded coastal birth location (OR 3.76, 95% CI 1.16–12.18) as a statistically significant predictor of PIH. Increasing head circumference (adjusted OR 1.06, 95% CI 0.99–1.13) demonstrated a slight trend toward significance with the incidence of PIH.CONCLUSIONSThis information will provide the foundation for future clinical and public health studies to better understand hydrocephalus in Haiti. The 39.4% prevalence of PIH falls within observed rates in Africa as does the apparently higher prevalence for those born during the rainy season. Although PIH was the most frequent etiology seen in almost all birth locations, the potential relationship with geography noted in this series will be the focus of further research in an effort to understand the link between climate and PIH in Haiti. The ultimate goal will be to develop an appropriate public health strategy to reduce the burden of PIH on the children of Haiti.

Identifying Public Health Problems

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Problems ◽  
Health Priorities ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Study Designs ◽  
Quality Adjusted Life

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

scholarly journals Are children with SARS‐CoV‐2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients

2020 ◽  
Vol 67 (12) ◽  
Author(s):  
Maha Al‐Ghafry ◽  
Banu Aygun ◽  
Abena Appiah‐Kubi ◽  
Adrianna Vlachos ◽  
Gholamabbas Ostovar ◽  
...  
Keyword(s):  
High Risk ◽  
Pediatric Patients ◽  
Case Series ◽  
Risk For Thrombosis

scholarly journals Anti-HPV16 Antibody Titers Prior to an Incident Cervical HPV16/31 Infection

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1548
Author(s):  
Ana Gradissimo ◽  
Viswanathan Shankar ◽  
Fanua Wiek ◽  
Lauren St. Peter ◽  
Yevgeniy Studentsov ◽  
...  
Keyword(s):  
High Risk ◽  
Hpv Vaccine ◽  
Enzyme Linked Immunosorbent Assay ◽  
Incident Detection ◽  
Antibody Titers ◽  
Circulating Antibodies ◽  
Prospective Association ◽  
Nested Case Control ◽  
Incident Cases

The goal of this study was to investigate the serological titers of circulating antibodies against human papillomavirus (HPV) type 16 (anti-HPV16) prior to the detection of an incident HPV16 or HPV31 infection amongst vaccinated participants. Patients were selected from a prospective post-HPV vaccine longitudinal cohort at Mount Sinai Adolescent Health Center in Manhattan, NY. We performed a nested case–control study of 43 cases with incident detection of cervical HPV16 (n = 26) or HPV31 (n = 17) DNA who had completed the full set of immunizations of the quadrivalent HPV vaccine (4vHPV). Two control individuals whom had received three doses of the vaccine (HPV16/31-negative) were selected per case, matched on age at the first dose of vaccination and follow-up time in the study: a random control, and a high-risk control that was in the upper quartile of a sexual risk behavior score. We conducted an enzyme-linked immunosorbent assay (ELISA) for the detection of immunoglobulin G (IgG) antibodies specific to anti-HPV16 virus-like particles (VLPs). The results suggest that the average log antibody titers were higher among high-risk controls than the HPV16/31 incident cases and the randomly selected controls. We show a prospective association between anti-HPV16 VLP titers and the acquisition of an HPV16/31 incident infection post-receiving three doses of 4vHPV vaccine.

Screening at ports of entry for Ebola Virus Disease in England—a descriptive analysis of screening assessment data, 2014–2015

2020 ◽  
Author(s):  
Nicki L Boddington ◽  
Sophia Steinberger ◽  
Richard G Pebody
Keyword(s):  
Public Health ◽  
High Risk ◽  
Secondary Care ◽  
Ebola Virus ◽  
Virus Disease ◽  
Descriptive Analysis ◽  
Health Assessment ◽  
Ebola Virus Disease ◽  
Screening Assessment

Abstract Background In response to the outbreak of Ebola Virus Disease (EVD) in West Africa in 2014 and evidence of spread to other countries, pre-entry screening was introduced by PHE at five major ports of entry in the England. Methods All passengers that entered the England via the five ports returning from Liberia, Guinea and Sierra Leonne were required to complete a Health Assessment Form and have their temperature taken. The numbers, characteristics and outcomes of these passengers were analysed. Results Between 14 October 2014 and 13 October 2015, a total of 12 648 passengers from affected countries had been screened. The majority of passengers were assessed as having no direct contact with EVD cases or high-risk events (12 069, 95.4%), although 535 (4.2%) passengers were assessed as requiring public health follow-up. In total, 39 passengers were referred directly to secondary care, although none were diagnosed with EVD. One high-risk passenger was later referred to secondary care and diagnosed with EVD. Conclusions Collection of these screening data enabled timely monitoring of the numbers and characteristics of passengers screened for EVD, facilitated resourcing decisions and acted as a mechanism to inform passengers of the necessary public health actions.

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