184 research outputs found
Sort by
Estimating Case Fatality and Case Recovery Rates of COVID-19: is this the right thing to do?
Get PDFIntroduction: Case fatality rates (CFRs) and case recovery rates (CRRs) are frequently used to define health consequences related to specific disease epidemics, including the COVID-19 pandemic. This study aimed to compare various methods and models for calculating CFR and CRR related to COVID-19 based on the global and national data available as of April 2020.Methods: This analytical epidemiologic study was conducted based on detailed data from 210 countries and territories worldwide in April 2020. We used three different formulas to measure CFR and CRR, considering all possible scenarios.Results: We included information for 72 countries with more than 1,000 cases of COVID-19. Overall, using first, second, and third estimation models, the CFR were 6.22%, 21.20%, and 8.67%, respectively; similarly, the CRR was estimated as 23.21%, 78.86%, 32.23%, respectively. We have shown that CFRs vary so much spatially and depend on the estimation method and timing of case reports, likely resulting in overestimation.Conclusion: Even with the more precise method of CFRs estimation, the value is overestimated. Case fatality and recovery rates should not be the only measures used to evaluate disease severity, and the better assessment measures need to be developed as indicators of countries’ performance during COVID-19 pandemic
Work Preferences in Rural Health Job Posting Among Medical Interns in a Lower Middle-Income Country— a Discrete Choice Experiment
Get PDFIntroduction: Timely empirical evidence is important in the success of health systems, and such evidence is necessary for informed policy making to address inequity in the health workforce. Literature is ripe with incentives that affect recruitment and retention of physicians in rural and remote areas, but such data in still lacking in the Philippine setting. Discrete choice experiment is one methodology utilized by the World Health Organization which provides both qualitative and quantitative information to aid policy makers in health human resource management.Methods: The study utilized a discrete choice experiment involving three phases: 1) identification of incentives and levels using key informant interviews and focus group discussions, 2) selection of scenarios utilizing an experimental design, and 3) administration of survey based on WHO guidelines. Conditional logistic regression, point estimates, and correlational analyses were done using Stata.Results: There is significant association between type of background and considerations for rural practice among the respondents based on Pearson’s correlation (p < 0.01). The respondents put more value into non-wage rural job posting incentives than small to modest base salary increases. The high willingness to pay for the presence of supervision, relative location of work areas from families, and status of workplace infrastructure/equipment or supplies suggest the importance of workplace conditions to attract rural health physicians. Combinations of wage and non-wage incentives may be necessary to provide for the most cost-efficient increases in rural job post uptake rates based on post-estimate calculations.Conclusion: Philippine medical interns and young doctors value non-wage incentives in considering rural health job postings. Rural health job postings with these incentives are predicted to significantly increase recruitment in rural health job posts, particularly when combinations of wage and high-impact non-wage incentives are considered
Online Game Addiction and the Level of Depression Among Adolescents in Manila, Philippines
Get PDFIntroduction: World Health Organization recognizes online game addiction as a mental health condition. The rise of excessive online gaming is emerging in the Philippines, with 29.9 million gamers recorded in the country. The incidence of depression is also increasing in the country. The current correlational analysis evaluated the association between online game addiction and depression in Filipino adolescents. Methods: A paper-and-pencil self-administered questionnaire assessing depression and online game addiction was distributed from August to November, 2018. The questionnaire included socio-demographic profiles of the respondents, and the 14-item Video Game Addiction Test (VAT) (Cronbach\u27s ?=0.91) and the Patient Health Questionnaire-9 (Cronbach\u27s ?=0.88) to determine levels of online game addiction and depression, respectively. Multiple regression analyses were used to test the association between depression and online game addiction. Results: Three hundred adolescents (59% males, 41% females) participated in the study. Fifty-three out of 300 respondents (12.0% males, 5.7% females) had high level of online game addiction as reflected in their high VAT scores. In this study, 37 respondents (6.7% males, 5.7% females) had moderately severe depression and 6 (2.0%) females had severe depression. Online game addiction was positively correlated with depression in this study (r=0.31; p<0.001). When multiple regression analysis was computed, depression was found to be a predictor of online game addiction (Coefficient=0.0121; 95% CI-8.1924 - 0.0242; p=0.05). Conclusion: Depression, as associated with online game addiction, is a serious threat that needs to be addressed. High level of online game addiction, as positively correlated to the rate of depression among adolescents in Manila, could potentially be attributed to the booming internet industry and lack of suffiicent mental health interventions in the country. Recommended interventions include strengthening depression management among adolescents and improving mental health services for this vulnerable population groups in schools and within the communities
Sociodemographic Factors Associated with Bottle Feeding Practices in Infants Under Two Years of Age: A hospital-based study in Woldia, Ethiopia
Get PDFIntroduction: Bottle feeding should be avoided when possible in infants under the age of two to improve health outcomes. The magnitude of bottle feeding practice is currently increasing in Ethiopia, however factors associated with bottle feeding usage are rarely addressed in research. We aimed to fill this gap and assess the magnitude of bottle feeding and its association with sociodemographic factors among infants in Woldia, Ethiopia in 2019.Methods: A hospital-based cross-sectional study was conducted in Woldia General Hospital at the Immunization Clinic. A total of 255 mothers who had infants were selected by systematic random sampling method. Data was collected through face-to-face interview using a structured standardized questionnaire. The data was entered to EpiData version 3.1 and analyzed using SPSS version 20. Binary logistic regression analysis models were used to assess the association between dependent and independent variables. Variables with p-value < 0.2 in bivariable logistic regression analysis were entered to multivariable logistic regression analysis. Finally, variables with p-value < 0.05 with 95% CI in multivariable logistic regression were taken as independent predictors. COR and AOR were used to show the strength of association between the dependent and independent variables.Results: The rate of bottle feeding practice in this study was 42.7% (95%CI: 35.8,48.2). Being an infant age 0-5 months old [AOR=0.16; 95%CI: 0.06,0.4], being a mother age 35-50 years old [AOR=0.43; 95%CI: 0.22, 0.85], having 2-5 children [AOR=6.37; 95%CI: 1.33, 30.44], and being a farmer as reported mother’s occupation [AOR=2.72; 95%CI: 1.30, 5.67] showed significant association with bottle feeding practice.Conclusion: The magnitude of bottle feeding practice was significantly higher in the current study as compared to national prevalence. Several sociodemographic factors showed significant association with bottle feeding practice which need to be explored further in the future research
Community Readiness for Increasing Older Adult Physical Activity Levels in Kazakhstan
Get PDFIntroduction: Physical activity is proven to be a significant element of successful aging, but many seniors worldwide fail to achieve the recommended levels. This study aimed to assess the readiness of the community in Nur-Sultan, Kazakhstan, to act on the issue of physical inactivity among older adults.Methods: In order to achieve this purpose, we conducted qualitative interviews with key informants in the community and applied a validated community readiness tool.Results: The results suggest that the local community is at early stages of readiness to act on the issue of older adult physical inactivity. We identified a number of barriers that prevented seniors from leading active lifestyles, which included community misconceptions about older adult physical activity, family centeredness in older adulthood, scarcity of resources, passive support from the leadership, and lack of efforts in the community. Research findings also highlighted the importance of conducting in-depth analysis of key informant responses in addition to calculating readiness scores, when using the community readiness tool.Conclusion: Community-specific strategies for enhancing the level of physical activity among seniors are required to offset the disease burden associated with aging and to prolong life expectancy in Kazakhstan, and it is of paramount importance to tailor potential efforts as to address the current readiness of the community and its needs
Clinical Data, Comorbidities, and Mortality of COVID-19 in the State of Guanajuato, Mexico until May 20, 2020
Get PDFIntroduction: In December 2019, cases of pneumonia of unknown cause arose in Wuhan, China. The causative agent was subsequently identified as 2019-nCoV and later called SARS-CoV-2. In Mexico, since January 2020 when the first cases were reported, the spread of the infection has occurred throughout the country. The state of Guanajuato, which is located in the center of the country, has taken isolation measures and closed public places in March 2020. The objective of this study was to analyze the evolution, symptoms, co-morbidities and deaths due to confirmed cases of COVID-19.Methods: An ecological study was designed from the database of confirmed cases of COVID-19 in the state of Guanajuato. Odds ratios and 95% confidence intervals were calculated for symptoms and co-morbidities in deaths of confirmed cases. Logistic regression models were generated adjusting for age group and gender.Results: Among the 838 confirmed cases in the state, cases with dyspnea and cyanosis showed more significant effect on death. Age group and gender had little involvement as confounders. For practically all comorbidities (including diabetes, hypertension, cardiovascular disease, chronic kidney disease, and immunosuppression), there was a significant effect (odds ratio greater than 2) on mortality from COVID-19. Age group showed a confounding effect on comorbidities and death, but not gender.Conclusion: The confirmed cases had more than twice the possibility of having comorbidities, compared with those who did not die
Rapid Emergence of Multidrug-Resistance among Gram Negative Isolates at a Tertiary Pediatric and Maternity Hospital in Ulaanbaatar, Mongolia
Get PDFIntroduction: Information on microbiological and susceptibility profiles of clinical isolates in Mongolia is scarce, hampering infection control and clinical care.Methods: Species and resistance profiles of 6334 clinical gram negative isolates, collected at Mongolia’s National Center for Maternal and Child Health between 2014 and 2017 were analyzed.Results: Annual proportion of multidrug-resistance among E. coli and Enterobacter isolates increased from 2.8% to 16.6% and 3.5% to 22.6% respectively; Klebsiella isolates exhibiting susceptibilities suggestive of extended spectrum beta-lactamase (ESBL) production from 73% to 94%. By 2017, 60.6% of Klebsiella isolates were multidrug-resistant, most originated from intensive care wards. Enterobacteriaceae exhibiting susceptibility patterns suggestive of ESBL production and multidrug-resistant organisms were common and their incidence increased rapidly.Conclusion: These findings will serve to build strategies to strengthen microbiological surveillance, diagnostics and infection control; and to develop empiric therapy and stewardship recommendations for Mongolia’s largest Children’s and Maternity hospital
COVID-19: An International Public Health Concern
Get PDFThis review presents a synopsis on the current COVID-19 pandemic, with focus on preventive measures. COVID-19 is a new viral infection, and is in form of a positive-sense, single-stranded RNA Coronavirus which belongs to an expanded group of viruses which were identified six decades ago. Importantly, the new COVID-19 belongs to the group of SARS-CoV, and it originated in bats but infected humans through smuggled pangolins. At first, the mode of transmission of infection was animal-to-person, but person-to-person and community transmission of the virus has been confirmed in many parts of the world. With an incubation period of between two-fourteen days, signs and symptoms of infection are mild to high respiratory illness; characterized with cough, breathing problems (shortness of breath), high temperature (Fever), tiredness (Fatigue) and nausea. Presently, no vaccines or specific treatment is available for COVID-19, in light of the aforementioned; prevention is the only substantial and less expensive option. With the envisaged explosive community transmission of COVID-19 in the coming weeks in places with limited daily testing, especially in African countries, it is recommended among many that social distancing which includes avoiding any form of contact with people; either through greetings, hugging or shaking of hands and large gatherings, avoid contact with animal items, dead or alive animals, sick and dead people from areas experiencing COVID-19 epidemic, and basic hygienic practices like thorough washing of hands with clean water and antiseptic soap for the duration of at least twenty seconds should be practiced always. However, in the absence of the aforementioned, an alcohol-based hand gel should be used on the hands frequently. Furthermore, health care workers should adhere strictly to the standard preventive measures in areas of heightened COVID-19 epidemic
Role of ‘One Stop Crisis Centre’ in Identifying and Assisting Victims of Violence in an Indian Health Care Setup
Get PDFIntroduction: Cases of female targeted violence often go uncounted in India. To identify the unreported cases of violence, Sukoon was established in 2014 as a hospital-based ‘One Stop Crisis Centre’ (OSCC). Sukoon provides counselling, police assistance and legal aid to the victims. The aim of the present study was to recognize the role of Sukoon in preventing violence against women (VAW) in the region.Methods: Secondary data was extracted from 430 victims who approached Sukoon from August 2014 through January 2017. Data was collected on different variables: age, marital status, nature of violence, medium through which victims approached Sukoon and type of assistance provided. Significance of association of studied factors with the type of assault was investigated using ?2 test.Results: Age of study-victims ranged from 4 to 75 years with a median age of 26 years and mean age of 27.61 years with standard deviation of 10.56 years. Major types of VAW (96.51%) were domestic violence, sexual assault, physical assault and poisoning. The types of violences were significantly associated with victims’ age (?2 =5.76, d.f.=1, p<0.05) and marital status (?2 = 98.23, d.f=4, p<0.001). About 78% of victims were identified from Sukoon through screening and counseling. Around 69% of the cases were resolved directly by Sukoon or through police assistance.Conclusion: The above results indicate a significant role of Sukoon in screening victims of violence and providing them required assistance within the hospital environment in one location. Such centers should be further promoted by the government to address the issues of VAW