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A. Vd L. A. Vithanage, P. V. De Silva, J. D. V. C. Lekamwasam
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.11

Abstract:
Introduction: Burnout is a word used to assess the level of exhaustion or disengagement of a person involve in any particular profession. This topic has come to the light in recent years after the results of several studies showing that there are significant number of professionals is in the “Burnout” category. There are no published study results on this topic in Sri Lanka and it is high time to evaluate the issue in the Country. Method: We included all the professionals employed in the teaching hospitals both Karapitiya and Mahamodara. Data was collected using a self-administered questionnaire called Oldenburg Burnout Inventory (OLBI), well accepted and free to study tool. Results: 155 doctors had completed the questionnaire. Out of this the majority were males; 53.5%. Majority of the doctors were grade medical officers; 63.2%. Among them there were 24.8% doctors who were having more than 10 years’ experience. 24.2% doctors were engaged in private practice. A large number of doctors had satisfactory relationship with their Consultant; 94.7%, and with their colleagues; 98.6%. Most of the doctors had never consumed alcohol and never smoked. Out of all 36.1% found exhausted and 34.2% were disengaged with their work. The overall “Burnout” was 20.6%. Doctors involved in private practice are significantly burnout; P=0.04, compared to doctors not doing private practice. In addition the use of alcohol also showed the significant association; P=0.04 with the Burnout”. Conclusion: This study highlighted that there is a significant proportion of doctors; 20.6%, who are “Burnout”. Therefor further studies are recommended to identify the causes in detail.
Seneviratne R. W., Kumara M. M. A. J., Abewickrama R., Kumarasinghe J. P. M., Somasiri K. G., De Silva P. V.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.18

Abstract:
Introduction: Quality of life (QOL) is one measure of how much a disease has affected the life of a patient from his or her perspective. WHOQL 100 assesses QOL under six domains and 24 facets along with overall quality of life. It was translated to Sinhala and was validated. QOL of hydrocele patients as well as inguinal hernia patients is expected to be lower than normal. Method: Ethical clearance was obtained from the ethical review committee of the Faculty of Medicine, University of Ruhuna, WHOQOL 100 was self administered to patients admitted for hydrocelectomy or herniotomy before surgery and by-standers in surgical ward as the control. Results: There were 23 males subjects in each category. The mean ages and SDs were 43.8±12.9 (Hydrocele), 44.4±14.0 (Control) and 43.7±11.9 (Hernia). QOL score of physical capacity (66.4±9.7 and 78.0±12.1; p=0.001), psychological (65.5±15.4 and 78.0±9.5; p=0.002) and level of independence (67.7±14.3 and 76.5±12.7; p=0.033) domains of hydrocele patients were significantly lower than those of the control. QOL scores of social relation were significantly lower in hydrocele patients than in hernia patients (60.1±15.5 and 71.5±14.4; p=0.014). Conclusions: QOL of hydrocele patients were lower than normal. Physical, psychological and level of independence are more affected than the other aspects of QOL. Psychological aspects of the QOL are lower in hydrocele patients than in patients with hernia. Assessment of QOL using WHOQOL 100 can be considered as a valid tool to find out the impact of hydrocele on different aspects health.
Chandrasiri P. A. A., , Karunarathne A. D. U., Ruban R., Madiwaka M. W. M. K., Suveendran T.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.15

Abstract:
Psychiatric illnesses has emerged as an important disease category as prevalence of mental disorders is being rising sharply. The disease burden due to mental illnesses is rising in Sri Lanka as well. Provision of care for those who are psychiatrically ill poses a significant challenge to health care systems. In this circumstances a community based our reach program becomes an important and effective strategy to improve psychiatric services provided for patients. Community support officers (CSO) program was launched in 2006 in district of Hambantota, Southern Sri Lanka to serve this purpose. Objective of this article is to describe the program in relation to its objectives, initiation, main activities, coordination, technical guidance, funding, monitoring and evaluation. Then we intended to evaluate the success by analyzing performance data and impact made. Finally we critically analyzed the program to discuss strengths and weaknesses in view of providing a guidance to replicate it in other settings. Program documents were reviewed and key informant interviews were done with leading characters of the program. Periodical progress reports and reports on performance review meetings also retrieved. Recruitment of CSO’s was done according to set criteria. They were given a special training and skills were developed on identification of common psychiatric illnesses at field level, communication skills and crisis intervention. Lecture discussions and role plays were used as teaching methods and consultant psychiatrists conducted the program. Organizational structure of the program was laid down within the existing administrative framework of primary health care system in the country. Main functions of CSO’s were Surveying the community to detect mentally ill people, Guiding and directing patients to seek psychiatric care, following up those patients, Conducting, contributing and participating in community mental health promotion programs. Supervision and monitoring was done at various levels and periodical progress review meetings were held. It was based on inbuilt information system. This program was concluded by the end of 2010. Follow up responsibilities were handed over to primary health staff at MOH offices. CSO program is a classic example for how community level workers can be empowered and utilized as an effective workforce to deliver mental health services at grass root level where existing system can’t penetrate. Carefully planned recruitment criteria, training given by technical experts, linking with existing primary health care system and monitoring done by regional health authorities were responsible for the success of this program.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.17

Abstract:
Amblyopia is reduction of vision with the proper optical correction either in one or both eyes.. The diagnosis of Amblyopia requires both the demonstration of visual acuity loss and the absence of an organic cause. A visual defect screening program was conducted on children aged 3-14 years of Bope-Poddala health unit area of the city of Galle Sri Lanka. Children aged 5-14 years were examined at each respective school. Children aged 3-5 years were examined at the pre schools .Children not attending to pre schools were examined in the community. All possitives and difficult to handle cases with a 10% of normal were referred to the ophthalmology clinic for secondary screening, investigation and diagnosis. Cases of diagnosed Amblyopia were called after one year for re-assessment. A total of 6685 school children and 934 preschool children were enrolled for this study. After exclusion, 5649 children were screened.Out of the total of 5649 children who were screened 439 (7.8%) were found to have eye diseases with or without visual defects giving a prevalence of 78/1000 children. Of those with such diseases, 88.8% had visual defects. The prevalence of visual defect was 6.9% (69/1000 children). Of the children with visual defects 90.0% (351) were due to refractive errors. The prevalence of refractive errors was 6.2% (62/1000 children).The analysis of the prevalence of different types of refractive errors showed that the prevalence of myopic astigmatism was 52.3%, Simple myopia was 24.6%, simple hypermetropia was 12.5%. Myopic astigmatism was the commonest type of refractive error in unilateral or bilateral involvement. The second commonest was simple myopia. It was found that out of 223 children with bilateral refractive errors 11.6% had unilateral Amblyopia and 17.5% had bilateral Amblyopia giving a total of 29.1%. Of all children with unilateral refractive errors 39.8% had Amblyopia. The development of Amblyopia among unilateral refractive errors was higher than bilateral refractive errors (p<0.05).The total prevalence of refractive Amblyopia was 2.1% of the population. Of them 1.4% had unilateral Amblyopia and 0.7% had bilateral Amblyopia. This difference was statistically significant. (P<0.05) Highest prevalence was observed in the age group of six and seven years (3.4% and 3.0%.). Distribution of Amblyopia among males and females were almost equal. The total prevalence of Amblyopia among children was 2.3%. Refractive Amblyopia calculated was 2.1% that consisted of 1.9% of Anisometropic Amblyopia.The strabismic Amblyopia was 0.2%. Deprivation Amblyopia was 0.2%. There were no Amblyopes found in the group of strabismic Amblyopia without refractive errors.
Kumara M. M. A. J., Seneviratne R. W., Abewickrama R., Kumarasingha J. P. M., De Silva P. V.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.19

Abstract:
Introduction: Faculty of Medicine University of Ruhuna, Located in southern coastal town of Galle is one of 10 state owned medical faculties in Sri Lanka. . Surgical curriculum consist of lectures, Tutorials, ward classes as well as clinical appointments scattered through last 3 years. The Final year two-month professorial surgical appointment is meant to ensure that Graduates have acquired rounded knowledge and key skills in surgery to pass out to become safe and competent intern house officers. No formal study has been conducted to assess the student perspectives regarding this appointment. Methodology: Purpose of this study is to evaluate the student component of the 360 degree assessment regarding the effectiveness of teaching programme of professorial surgical clinical appointment using a questionnaire consist of five components. Results: Vast majority of students answered the questionnaire (range 130-136 except concerning requirement to modify end appointment assessment method when responding number fell to 118). Components A is aimed to evaluate students view of professorial appointment and its usefulness for different components of final MBBS examination .Over 84% marked generally useful and above for all the components of final MBBS examination. Highest was for short cases at 96.1% while lowest figures were for long cases (84.4%). Component B is to assess view of different modalities of clinical teaching encounters during professorial appointment and its usefulness for improving surgical knowledge and a good pass at final mbbs. 97.8% thought elective ward rounds were generally useful or above while lowest was obtained by emergency theatre teaching (84%). Component C has six questions aimed to assess student satisfaction of quantity of particular sessions. 89.3% were satisfied about number of clinic teaching sessions which fell towards short case practice sessions (73.8%), theatre teaching sessions (59.2%) and endoscopy sessions (58.9%). D is a single question about their satisfaction of end appointment assessment method and any modifications required.46.5% thought continuous assessment method require modifications. Component E assesses the overall effectiveness of the surgery appointment in functioning as an intern medical officer effectively. 81.8% marked generally useful and above. Conclusions: Significant majority of students were satisfied in most of the components of final year professorial appointment while certain drawbacks became apparent such as insufficient number of endoscopic and Operating Theatre sessions. The designed Performa appears to be a satisfactory tool to assess student satisfaction about a final year professorial clinical appointment and more studies and further modifications may result in its validation even for other clinical appointments.
Chandrasekara Karunamuni Pushpika Sudarshini De Silva, De Silva Hiranthi, Indrapala Waldeniyage Kolitha Prasanna
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.16

Abstract:
Introduction: Childhood malnutrition remains one of the most challenging global public health problems. To combat this problem, it is essential to reveal the magnitude of malnutrition and underlying socio- cultural factors influencing child feeding and raring. Despite satisfactory income levels, fishing families have low standards of living due to their different life styles and behavioral attitudes which can contribute to poor nutritional status among their children. Methodology: A cross sectional study was conducted among a group of marine fishing families in MOH area Ambalangoda. Study population consisted of all children (189) aged 1-5 years. Height and weight and nutritional status were assessed. Pre tested interviewer administered questionnaire was used to evaluate the selected socio-demographic and cultural factors of these families affecting the nutritional status. Results: Prevalence of different forms of malnutrition reported was underweight-31%, stunting-23% and wasting-11.2%. Prevalence of alcoholism was 37.9% while smoking was 45.5%. Parental level of education, mother’s employment status was not significantly related to the nutritional status. Significant association was found between maternal literacy with underweight and wasting while literacy of father with stunting. Father being an alcoholic was significantly related to wasting, stunting and underweight. Father’s state of smoking has also being identified as a significant associate of underweight and stunting. Method adopted to dispose excreta of children also found to be significantly associated factor with underweight of their preschool children. Conclusions and recommendations: Parental literacy, father’s substance abuse was identified as associated factors for malnutrition in this community and health educational and promotional programmes should be targeted towards these factors using audio visual aids considering the levels of literacy of parents.
, Renuka Jayathissa, Champa J. Wijesinghe
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.14

Abstract:
Background: In Sri Lanka, nutritional indicators are static compared to other health indicators. Under nutrition among children less than five years remains a common public health problem. Poor nutritional status of children is associated with various factors which are preventable. Purpose of this study was to determine the nutritional status of children aged 6-24 months in a selected health unit area and to describe the associated feeding practices. Methods and materials: A cross sectional study was conducted among mothers of 428 children attending 24 randomly selected field weighing posts in Akuressa health division, for routine growth monitoring. Nutritional status of the children was assessed with anthropometric measurements and WHO growth charts. Other data were collected using an interviewer-administered questionnaire. Results: Prevalence of stunting, wasting and underweight in the sample was 17%, 17.1% and 21.3% respectively. Mean age of exclusive breast feeding was 5.8 months and prevalence of exclusive breast feeding for 6 months was 88.8%. Mean age of starting complimentary feeding was 6 months and majority (75.5%) started semisolids as the first food. A majority (75.8%) of the mothers practiced proper feeding during infections. Wasting was significantly associated with male gender (p<0.01), increasing age of the child (p<0.05) and late introduction of fat and oils into the diet (after 8 months of age) (p<0.001). Underweight was associated with male gender (p<0.001), increasing age (p<0.05) and late introduction of fat and oils into diet (after 8 months of age) (p<0.05). Stunting was only associated with male gender (p<0.05). Conclusion: Under nutrition among children is common in this age group. Some of the feeding practices are associated with poor nutritional status and these practices should be improved with effective interventions.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.12

Abstract:
Diabetic Retinopathy (DR) refers to a group of pathologies found in the retina ofdiabetics that can lead to visual complications. Screening for DR is immensely useful in preventing blindness.Diabetic patients who were registered in the diabetic clinic of a leading hospital in the private sector over a period of one year were selected for this study. Total of 2603 diabetics were examined majority (97.0%) were Sinhala. They represented three districts of Southern province. Males were 64.3%. Majority belonged to the diabetic duration of 5 – 15 years. (72.9%). Total prevalence of DR was 7.53%. (Bilateral 5.5% and Unilateral 2.0%). Lowest prevalence value was shown in the age category of below 30yrs and the highest value of 10.9% in 51 – 60yrs group. The total prevalence of maculopathy was 0.6% with a higher age specific value in 51 – 60 group. Prevalence of pre proliferative and proliferative DR was only 0.12%. A steady increase was shown in the appearance of DR with the duration of diabetes. An obvious association with the occurrence of retinopathy and hypertension was shown than non hypertension patients.
, Cg Hewage, P. Fonseka
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.s.2015030201.13

Abstract:
Introduction: Teaching is considered as one of the most important profession in the world today. In the past it was considered as a rather routine job without hard or hazardous work. However the present day school teachers have to play multiple roles in their day-to-day work with children, colleagues and administrators. Therefore teaching is now considered as a high stress profession. As a result there was a growing concern among researchers about teachers' mental health during last few decades. Several researchers have identified number of mental health problems of teachers including burnout. Burnout has not studied among teachers in Sri Lanka. Objective: The present study was planned to determine the prevalence and risk factors of burnout among female primary school teachers in the Southern Province of Sri Lanka. Methodology: Out of the female primary school teachers employed in the southern province of Sri Lanka, 660 teachers were selected using multi stage cluster sampling method. A self-administered questionnaire was used for the data collection. It consists with three broad sections: Socio-demographic characteristics, Occupational and life style factors and validated Sinhala version of Maslach Burnout Inventory- Educators Survey (MBI-ES-Sin). For identification of correlates of burnout, all the teachers identified as having burnout were selected as cases and double the number of cases was randomly selected from the teachers who were identified as not having burnout as controls. Results: Overall prevalence of burnout among female primary school teachers in the Southern Province was 115.6 per 1000 population. The prevalence rate for burnout was highest (157.8/1000 population) in the Hambanthota district. A stepwise increase in prevalence of burnout was observed from Galle (96/1000 population), Matara (105/1000 population) to Hambanthota district. Following the logistic regression analysis female primary school teachers more than 20 years in teaching profession, female primary school teachers who travel more than 10 kilometers daily to school, teachers doing home work more than 5 hours per week, teachers who participating in school activities during weekend, teachers who sleep less than 7 hours per day and teachers who are having one hour or less leisure time per day were identified as having significantly higher level of burnout. Conclusions: Burnout is a problem among female primary school teachers in Sri Lanka. Therefore, it is recommended that relevant authorities take necessary steps to address the factors contributing to the teacher burnout.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160406.12

Abstract:
Background: Ischemic stroke is more commonly occurs in smokersObjective: The purpose of the present study was to estimate the risk of smoking with ischemic stroke in Bangladesh. Methodology: This case control study was carried out in the Department of Biochemistry at Dhaka Medical College, Dhaka, Bangladesh from January 2014 to December 2014. Thepatients presented with ischemic stroke, age ranges from 18 to 65 years of both sexes were taken as cases. Age and sex matched healthy individuals were selected as controls. History was taken from both cases and controls regarding smoking habit and duration of smoking. Results: Inthis study 42% of case group and 11% control group were smoker (p=0.032) and the mean duration of smoking was 22.14±10.58 years and 4.45±2.58 years for those groups respectively. The odd ratio (OR) was 2.56(95%.0718 to 6.1501). Conclusions: Smoking is significantly associated with ischemic stroke.
Uzzal Haque, Most. Sumonara Khatun, Nuzhat Tasnim Amin, Tania Afrin, Anjira Ohomina Jannat, Samaun Rashid, Khadiza Sultana, Nuruna Lovely Nishuti, Trisha Sarker, Sadiur Rahman Sajon
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160406.11

Abstract:
The phenomenon of self-medication is a significant problem in a developing country due to easy availability of drugs. It is important in pregnancy as these agents may be teratogenic; pregnant women may be exposed to drugs that have serious harmful effects on their fetus. The present study was conducted to determine the prevalence and nature of self-medication in pregnant women in Rajshahi city, Bangladesh. The study was carried out using a self-designed standard structured questionnaire following WHO guidelines from January 2015 to April 2015. In this study, 650 pregnant women were considered as randomly selected sample from women attending for maternity care from one public hospital and five private clinics in Rajshahi City. 79 (12.2%) women use self-medication. The conditions which prompted women to obtain self-medication of drugs were gastric acidity (32.9%), infection (24.1%), cold & fever (21.5%), pain (12.7%), vomiting (8.9%) and disorders related to pregnancy (7.6%). The drugs most commonly used were antacids (27.8%) followed by non-steroidal anti-inflammatory drugs (26.6%), iron (15.2%), vitamins and minerals (12.7%), ayurvedic preparations (5.1%), antiemetic (5.1%) and antibiotics (3.8%) respectively. Most common reasons of self-medication were availability of drugs (42%), prior experience (20.8%), emergency usage (11.2%), knowledge about drugs (10.0%) and advice from traditional healers (8.0%). Moreover, 44.3% of women did not complete the course of antibiotics. Due to the adverse effects of self-medication, particularly during pregnancy, which can lead to teratogenicity or fetotoxicity, it is necessary to take some measures to preventing self-medication in pregnant women.
Nyavanga Eunice Jemalel, Mourice Barasa, ,
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160405.13

Abstract:
This study was aimed at determining the efficacy of psychoeducation in improving attitudes towards professional psychological help seeking among young adults in Kenya. Four out of twenty teacher training colleges were sampled. Two colleges made up the control group while the other two made up the experimental group. Both groups were assessed at baseline, before the experimental group was presented with an intervention in form of two, two-hour each psychoeducation modules using power point while sited in their normal classrooms. The second assessment was done a day after the psychoeducation, while the control group received no intervention but were assessed again two days after the baseline assessment. The control group had no improvement in the summative scores of attitudes towards help seeking, while the experimental group increased positively in their attitudes towards seeking help for a mental illness, which is in line with other studies. Globally. We conclude that with education on opinions about mental illness and expectations about counseling, the youth could improve their attitudes towards seeking help for a mental illness problem. This study recommends that young adults and college students should be given education in order to improve their attitudes to seeking help for a mental illness. Collage students should have this education in their curriculum to assist them identify mental illness and seek help for the same.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160404.12

Abstract:
Hypertension is a common chronic disease amenable to control by adopting relevant lifestyle modifications and/or appropriate medication. The aim of the study was to assess the effect of patient centered approach on self-reported health related quality of life (HRQoL) in patients with essential hypertension attending Internal Medicine outpatient clinic in Zagazig University hospital. This single blinded randomized controlled clinical trial was conducted in Zagazig university internal medicine outpatient clinic on 112 non complicated apparently healthy essential hypertensive patients without comorbidities from 45 to 65 years old randomly allocated into two groups (intervention and control 1:1). Data for this study was collected by social, biological and SF-12v2 questionnaire for both groups. Then management of the intervention group according to the patient centered approach for nine months while patients within control group received classic disease centered approach. The patients within intervention group were given an individualized medical care and tailored patient education program about essential hypertension. The outcome of disease was assessed by measuring change in blood pressure control and health related quality of life within the two groups. It has been found that patients with essential hypertension within both groups reported deteriorated HRQoL yet there was no statistically significant difference between both groups regarding HRQoL at the start of the study. By the end of the study, there was a statistically significant difference between the two study groups regarding blood pressure control and self reported health related quality of life where patients within intervention group reported statistically significant improvement in both variables. In conclusion, the patient centered approach is better than the disease centered approach in management of patients with essential hypertension.
Mohammad M. Alkot, Reda A. Goweda, Mokhtar M. Shatla, Enas H. Alfalogy
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160404.11

Abstract:
Pilgrims who are exposed to hot environments may be at risk of heat-related illnesses (HRIs) such as heat cramps, heat exhaustion, or heat stroke. Mutawifeen (pilgrims’ guides) should understand how HRIs affect pilgrims’ health and safety, how they can be prevented, and what the initial treatment options are. The study Objectives is to assess and improve knowledge and practices of Mutawifeen towards HRIs. An intervention study was conducted before the pilgrimage of the year 1437 Hijri calendar (2015) on a group of Mutawifeen (No.200) in Makkah Al-Mukaramh, KSA. The participants were invited after their consent to fill a self-administrated questionnaire before and 3 months after their exposure to an education program (academic and clinical). At the end of the study, the score of knowledge and practices were significantly improved (52.68±14.92 and 49.6±12.84 to 74.54±10.97 and 65.78±7.83; respectively). There was statistically moderate positive correlation between knowledge and practices (r=0.426; p<0.01). The percentage of participants with correct knowledge and appropriate practices has significantly increased from 46%, and 39.5% before education to 89%, and 72.5% after education, respectively (P< 0.05). The study conclude that, academic and clinical education of Mutawifeen is a cornerstone in improving their Knowledge and Practices towards HRIs.
, Joshua Marcella Tari
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160403.15

Abstract:
Diabetes mellitus (DM) is characterized by hyperglycaemia and glycosuria due to defects in insulin secretion from the Islets of Langerhans and associated with cardiovascular disease (CVD). The imperativeness to assess effectiveness of various cardiovascular risk tools is critical with increasing rate of people with diabetes type 2. Study was aimed at the assessment and evaluation of the diagnostic relevance of homocysteine, Cystatin C, cardiovascular risk indices in the risk profile of cardiovascular diseases in Type 2 diabetes mellitus patients. A total of 165 patients were involved in the study, of which 100 were diabetic (test) and 65 non-diabetics (control). The diabetic subjects were those whose glycated haemoglobin (HbA1C) levels were ≥ 6.5%. HbA1C was estimated quantitatively by immunochemical method, Homocysteine (Hcy), Cystatin C, Lipoprotein (a) (Lp (a) were measured by Enzyme Linked Immunosorbent assay (ELISA) method; Glucose oxidase method was used for the determination of fasting plasma glucose (FBS). The results showed elevated serum homocysteine (Hcy), Lp (a) among the diabetics as compared to the non-diabetic subjects (p<0.05). The diabetic subjects also depicted higher Cystatin C (Cys C) levels, in the diabetic type 2 patients compared to the non-diabetic patients. The lipid profile levels in the diabetic subjects showed higher mean values of total cholesterol and triglycerides, (p < 0.05) as compared with the non-diabetic. The percentage risk predictive values of cardiovascular disease in the diabetic sub-population with these risk indices showed Hcy with a sensitivity of 96%, specificity of 96.9% and an accuracy of 96.5% as compared to Cys C with a sensitivity of 95%, specificity of 96.9%, accuracy of 95.9% also compared with that of Lp (a) with a sensitivity of 91%, specificity of 100% and an accuracy of 95.5%. The level of accuracy of Hcy, Cys C and then Lp (a) amongst other indices showed that these diagnostic tools could provide better platform in cardiovascular risk profiling of T2DM patients and should be encouraged.
, Nwabueze Simeon Achunam, Adinma Echendu Dolly, Udedibia Ifeanyi Ndubuisi, Onyemachi Prince Ezenwa, Igwebike Uchenna Nwanneka, Aniemena Reginald Chidozie, Ezenyeaku Chijioke Amara, Emerenini Ikenna
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160403.11

Abstract:
Introduction: Diarrhoea is the 10th most common cause of infant morbidity and mortality in the developing countries, though it is regarded as a minor illness in developed countries. The burden of diarrhoea in the developing world has been estimated by the world health organisation (WHO) to be about 1.7x109 episodes of diarrhoea with 4.4 million children per year. This accounts for 15 to 30% of total outpatient visits in many paediatrics clinics. Aim: To determine the prevalence of diarrhoea disease among infants and compare the risk factors for diarrhoea in infants in the two Local Government Areas (LGAs). Methodology: This was a comparative cross-sectional study. An interviewer-administered, pre-tested, semi-structured questionnaire was utilized. Data was analysed using SPSS Version 20. Frequencies and percentages were presented in tables. Chi square test of independence was used to determine association between qualitative variables. Level of statistical significance was set at p < 0.05. Result: Two hundred and ninety one respondents participated in this study. There were 143 respondents in the urban LGA and 148 respondents in the rural LGA. In the urban LGA, Out of the 143 infants, 73 (51.0%) were males while 70 (49.0%) were females. Also in the rural LGA there were more males (50.7%). This difference was not statistically significant. Out of 143 respondents in the urban LGA 65 (45.5%) has had diarrhoea but in the rural LGA, out of 148 respondents, 95 (64.2%) have had diarrhoea. This difference was statistically significant. In the urban LGA 46.2% of the mothers whose infants have had diarrhoea practiced exclusive breast feeding, while in the rural LGA only 26.3% of the mothers whose infants have had diarrhoea practiced exclusive breast feeding. This difference was not statistically significant. Among the mothers of the urban infants that have had diarrhoea, 93.8% reported that they practice hand washing after handling child’s faeces, but in the rural LGA, only 80.0% reported that they practice hand washing. This difference was statistically significant. Among the urban mothers whose infants had diarrhoea, 92.3% wash their hands before meals, but among the rural mothers, only 89% wash their hands before meals. This difference was statistically significant. Conclusion: Diarrhoea prevalence was higher among infants in the rural LGA. Exclusive breastfeeding was practiced more in the urban than in the rural LGA. We recommended that health education should be intensified in the rural areas.
Olorunfemi Akinbode Ogundele
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160403.14

Abstract:
In spite of breastfeeding being almost universal in Nigeria, exclusive breastfeeding rate is low. Poor practices remain a major cause of neonatal and infant mortality. Community Integrated Management of Childhood illness (CIMCI) is a programme that employs the use of community based counsellors to address these challenges. The study assessed the effect of community based counsellor on breastfeeding practices of mothers and factors associated with exclusive breastfeeding in Ile-Ife, South-west, Nigeria. A comparative cross sectional study was conducted in two Local Government Areas (LGA) of Osun State, Nigeria. The study enrolled 722 mothers of index under five children through a multi stage cluster sampling techniques. Data was collected using structured questionnaire and analyzed using SPSS version 16.0. Approximately 94% of children in the CIMCI implementing LGA were exclusively breastfed compared to 76.1% in the non-implementing LGA (p<0.001). Maternal age, maternal education level, family size, Initiation of breastfeeding within an hour of birth and residence in CIMCI-implementing LGA were significantly associated with exclusive breastfeeding. It was concluded that community based counselling has a positive effect on breastfeeding practices. Community based ‘baby friendly’ breastfeeding initiative is suggested.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160402.11

Abstract:
Introduction A study compared rates of measles transmission and force of infection in pre-vaccination era (1967), and at measles vaccine coverage rates of 50-80% (1978-84) and > 90% (1989). Using measles surveillance data cumulative proportions of measles cases by age were determined for the years 1967, 1978-89 (pooled) and 1989. From the cumulative curves estimates of the age dependent rate of infection with measles (force of infection) was determined for the years 1967, 1978-84 and 1989. Results In 1967 and 1978-84 some 75% of all measles cases occurred by age group 36-47 months while in 1989 this occurred by age group 72-83 months thus measles transmission was most rapid in 1967 and least rapid in 1989. Variation of force of infection between years 1967, 1978-84 and 1967 showed that force of infection was not significantly different between the years for age groups 24-35, 36-47 and 48-59 months. Meanwhile, the force of infection varied between the years in the rest of the age groups, with a significant reduction in force of infection over the years for age groups < 11, and 12-23 months; and significant increases in force of infection were observed in the age groups 60-71, 72-83, 84-95, 96-107 and 108-119 months. Conclusion Measles transmission rates in the community were highest in pre-vaccination era and least at vaccination coverage rates of > 90% most likely due to effect of herd immunity. From pre-vaccination era (1967) to vaccine coverage rates of > 90% (1989) there was a shift in force of infection from young age groups < 23 months to older age groups of 60-119 months most likely due to accumulation of susceptibles in these older age groups. Shift in force of infection to older age groups would have been responsible for the shift in age at infection to these older age groups.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160402.15

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Helicobacter pylori (H. pylori) infection is associated with high prevalence of iron deficiency anemia (IDA). Eradication of H. pylori is associated with improvement of IDA. The objective of this study was to assess the effect of H. pylori eradication with and without the use of iron supplementation on IDA among patients with H. pylori infection. It was a prospective therapeutic study on 36 patients tested positive 14C-urea breath test on screening for H. pylori infection, and had chronic mild to moderate IDA. Patients were divided randomly into two groups each of 18 patients. Groups A patients were given anti-H. pylori eradication therapy plus oral iron supplementation for 2 months. Group B patients were given the same anti-H. pylori therapy but without the iron supplement. Hemoglobin, serum iron and serum ferritin were assessed and compared between the two groups at baseline, 1 month, and 2 months of therapy. Results were expressed as mean ± SD. Paired t-test was used to compare quantitative values. P value significant if < 0.05. It has been found that both groups showed significant increase in mean levels of hemoglobin, serum iron and serum ferritin at 1, and 2 months after successful H. pylori eradication (p<0.001), However, the increase was more significant in Group A patients compared with group B patients (p<0.05). At the end of the study, both groups showed normal mean levels of all these parameters. This study concluded that eradication of H. pylori infection plus simultaneous iron supplementation was associated with a faster and greater recovery from IDA as compared with eradication without iron supplement. However, H. pylori eradication without iron supplementation was also associated with significantly increased iron absorption and recovery from IDA.
Abel Girmay Mekuaninte, Alemayehu Worku, Dawit Jember Tesfaye
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160402.12

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Maternal mortality is a substantial public health burden in developing countries. Birth preparedness and complication readiness is a safe motherhood strategy which addresses delays that could increase the risk of dying in pregnancy, child birth and the immediate postpartum period. The main aim of this study was to assess magnitude and factors associated with birth preparedness and complication readiness among pregnant women attending antenatal care clinic in Adama town government health facilities, central Ethiopia, 2015. A facility based cross-sectional study was conducted by interviewing 642 pregnant mothers from December 2014 to January 2015 in ANC clinic of Adama town government health facilities. Systematic random sampling was employed to select the study subject. Data were collected using structured questionnaire. Descriptive statistics were used to describe the study variables. Multivariate logistic regression analysis was used to identify factors associated with birth preparedness and complication readiness practice. P-value < 0.05 was used as cut of value for statistical significance. Out of 642 mothers only 29.1% (95% C/I: 25.9, 32.7) of the respondents were prepared for birth and its complications. Preparation for birth and its complication was associated with respondent who attended secondary and above educational level (AOR=2.76, 95%C/I: 1.41, 5.41). Women who had experience of one still birth (AOR=2.3, 95%C/I: 1.20, 4.63) and those pregnant women who heard the term birth preparedness (AOR=1.56, 95%C/I: 1.03, 2.38) were found to be factors associated with birth preparedness and complication readiness practice. The magnitude of birth preparedness and complication readiness was low in the study area. Knowledge on birth preparedness and complication readiness was identified as low as danger sign. Counseling related to knowledge on birth preparedness and complication readiness with especial emphasis to danger sign during pregnancy, labour and delivery needs due attention.
Anyaka Charles, Ocheke Amaka, Oyebode Tinuade, Isichei Mercy, Anyaka Ifechi, Isichei Christian
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160403.12

Abstract:
Objective: HIV prevalence data from pregnant women who attended Antenatal Care Clinic over a five year period were used in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV programmes and remain useful for Prevention, Care, Treatment and Support of pregnant women and ensuring that the goal of zero transmission is met. It also helped policy makers to take appropriate action in HIV/AIDS programmes. Methodology: A descriptive study of pregnant women presenting for the first time at the antenatal clinic of Faith Alive Foundation and Hospital, Jos from 1st January 2010 to 31st December 2014 was carried out. Information regarding age, gestational age at booking, parity and HIV sero status of the clients were analyzed. Screening test was carried out in a serial two step approach using determine and UNIGOLD as the confirmatory test while stat pack was the tie-breaker with discordant result. Positive samples were confirmed by western blot method. Result: A total of 1720 pregnant women were registered in the antenatal unit of Faith Alive Foundation and Hospital, Jos from 1st January 2010 to 31st December 2014. 120 were sero positive. The overall HIV prevalence rate was 6.9%. High prevalence rate were observed in those aged 20-39 years. There was a decline in HIV prevalence from 10.7% in 2010 to 6.8% in 2013 and 5.8% in 2014. Majority of the sero positive women booked early in pregnancy, within the 1st and 2nd trimesters from 77.8% in 2010 to 80% in 2014. Conclusion: A decline in HIV prevalence was observed during the five year period. The study also revealed that significant number of HIV positive antenatal women registered for antenatal care early. The overall HIV sero prevalence is still high. There is need to astronomically scale up our intervention approach against HIV infection.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160403.13

Abstract:
A study was carried out in Gweru urban district (population-158233) in Zimbabwe to determine the impact of measles vaccine applied at 9 months of age on measles transmission patterns. A retrospective observational study that used data from measles vaccination records and measles disease surveillance was conducted. Linear regression analysis and the chi-squared test for linear trend (χ2) were used to investigate linear relationships at a 5% significance level. Vaccine coverage rates were 0% in pre-vaccination era in 1960-70 and 2-92% in 1971-89 (median=65, Q1=34, Q3=88) when they significantly linearly increased (p90% incidence rates significantly linearly declined (p80% (1984-89), proportion of vaccine failures among cases aged 60-119 months was significantly higher than at vaccine coverage rates of 80%. In age group 60-119 months incidence rates significantly linearly increased as vaccine coverage rates increased (Slope: +29.88, 95 CI [13.95, 45.82]). In pre-vaccination era, and at vaccine coverage rates of 80% some 75% of all reported measles cases occurred by age 36-47 months, 48-59 months and 72-83 months respectively. In conclusion, measles incidence rates declined at vaccine coverage rates of >90%, while measles vaccine failures significantly increased as vaccine coverage rates increased. Increasing measles vaccination coverage led to shift of age at infection from age group <59 months to age group 60-119 months and decline in rates of measles transmission.
, Daze Xie, Xiangrong Shu, You Tang, Nanjin Zhou, Ge Dai
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160402.14

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This study to investigate predominant anaerobic bacteria and their sensitivity spectrum to antibiotics in female patients with genital tract infections from the local and thus to provide scientific basis for the appropriate use of antibiotics. Anaerobic culture method was used to culture and isolate anaerobes in female patients with genital tract infections. Anaerobes were identified by using micro-biochemistry reacting technique and antibiotic-disc susceptibility test. Antibacterial activity of antibiotics to anaerobes was analyzed by means of Kirby-Bauer testing and broth micro-dilution method. The experiment results showed that 72 strains of obligate anaerobes were isolated from 103 samples, positive rate of 69.90%. The predominant anaerobic bacterial were Gram-negative non-spore bacteroides (28 strains, 38.89%) and anaerobic peptostreptococcus (18 strains, 25%). Sensitivity rate of anaerobic cocci, bacteroides and veillonella to metronidazole was 90.91%, 85.71% and 80% respectively. The drug resistance rates of the three isolated anaerobes were all higher than 60% to amikacin, erythromycin and clindamycin. Comparing the MIC50 and MIC90 values of metronidazole (MTZ), penicillin G (PCG) and lincomycin (LCM) on the isolated anaerobes, MTZ had the lowest MIC50 and MIC90 value. The study suggested that anaerobic infection has become a major pathogenic bacterium of infectious diseases in obstetrics and gynecology. Although MTZ has shown strong antibacterial activity in vitro, a few drug resistant strains appeared in the clinically isolated anaerobes and there is an upward trend of the MIC values of MTZ at different rates.
Sola Odu, Samson Ayo Deji, Eyitope Amu, Victor Aduayi
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160402.13

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There is much concerns that despite the “Innocenti Declaration” and all efforts to promote Exclusive Breastfeeding in Nigeria, the prevalence of malnutrition and infant mortality is high. The study determined the knowledge, attitudes and practices (KAP) of nursing mothers in Osogbo, Nigeria. The study design was cross sectional. A total of 328 nursing mothers attending infant welfare clinics were recruited from selected four health centres in Osogbo Local Government Area by convenience sampling method. Semi-structured questionnaires were used to collect data on the Knowledge, Attitudes and Practices of respondents. Data were analyzed using Statistics Package for Social Scientists (SPSS) version 16. About 97.6% of the respondents were aware of EBF, but only 64.6% had adequate knowledge. Majority of the respondents (92.7%) learnt about EBF from health workers. Attitude to EBF was good as reported by 75.6% of respondents who practiced EBF on demand. About 73.8% of respondents practiced EBF. The respondents have good knowledge and attitude of EBF. The practice of EBF was equally good however less than one third used either water or herbs during EBF before six months.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160403.16

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This study assessed the effectiveness of a clinician client centered counseling on HIV knowledge and attitudes towards HIV/AIDS of adult HIV positive patients enrolled in care in Yola, Nigeria. The study was a 3 arm randomized single blind clinical trial involving 386 randomly selected and allocated adult HIV patients who were enrolled into ART at the 4 comprehensive ART sites in Yola. A clinician client centered training module was developed based on the Information Behavior and Motivation (IBM) Model. Nine Clinicians involved in ART care were trained with this module to deliver a 10 to 15 minutes clinic based intervention (Clinician Client Centered counseling). Intervention group 1 received two counseling sessions; at baseline and at 2 months. Intervention group 2 received one counseling session at baseline and the control group received routine care. An interviewer administered validated and structured questionnaire was used for data collection. Data was collected at baseline, 2 months and 6 months. Outcome measures were knowledge on HIV transmission and prevention and attitude towards HIVAIDS. Significant main effects for groups (F (2, 331) = 17.410, p = 0.0001), time (F (2) = 49.826, p = 0.0001, partial ἠ2 = 0.134) and group-time interaction (F (2, 331) = 4.239, p = 0.015, partial ἠ2 = 0.026) were seen for HIV knowledge scores. Significant main effects were seen for groups (F (2) =11.107, p = 0.021, partial ἠ2 = 0.065) and time (F (2) = 34.088, p = 0.0001, partial ἠ2 = 0.096) for HIV attitudes scores. Clinician client centered counseling is effective in improving knowledge on HIV transmission and prevention and attitudes towards HIV/AIDS.
Nagwa Gad Mohamed, Shamina Begum, Mohamed Hamed El-Batanony, Sawsan Mohammed Al Blewi, Walaa Mahmood,
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160401.11

Abstract:
Neonatal sepsis is defined as a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 28 days of life. Of newborns with early-onset sepsis, 85% present within 24 hours, 5% present at 24-48 hours, and a smaller percentage present within 48-72 hours. The present study included 38 septic neonates. They were divided into two groups: Group with early onset neonatal sepsis (29) and another group with late onset neonatal sepsis (9). The study group with early-onset sepsis showed 18 (62.1%) males, 11 (37.9%) females, mean gestational age (weeks) 34.28±4.7, mean body weight (gm) 2.1±0.8, mean Apgar score at 1 min. 6.7±1.8. 21 (72.4%) delivered by CS, 8 (27.6%) delivered by NVD. E. coli was the commonest organism identified in blood culture of septic neonates. Maternal anemia, PROM, and fever were significant risk factors for neonatal sepsis. Prematurity and low birth weights were among the most common neonatal risk factors. Respiratory manifestations were the commonest manifestations of neonatal sepsis in both groups. Treating maternal anemia during pregnancy will help to reduce the incidence of neonatal sepsis E. coli is still an important cause of early-onset neonatal sepsis. Blood cultures need to be done strictly before the start of the first dose of antibiotic.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160401.12

Abstract:
Diabetes Mellitus is a disease that affects almost every aspect of patients' life. Socio-medical importance and continuously increasing financial costs of diabetes require a thorough research on the quality of life in these patients to optimize clinical management and increase the effectiveness of health interventions. The aim of the study is to assess the quality of life in patients with type 2 diabetes mellitus. Materials and A cross-sectional study was conducted in 90 patients with type 2 diabetes mellitus (T2DM) in Bulgaria. Health-related quality of life was measured using the 36-item Short-Form Health Survey (SF-36). The study result showed that the participants’ age ranged from 32 to 88 years old, with mean of 63.0 years (standard deviation (SD) 0.96). Less than half were females (52.9%), married (74.3%) and living in urban areas (61.4%). Diabetes negative impact is observed on all life aspects. The duration of disease (diabetes duration) and diabetes complication seem to be the most influential factors which negatively and statistically significant affect all the SF-36 subscales. It concluded that better quality of life of patients with diabetes mellitus type 2 is achieved by preventing complications and effective management of chronic underlying diseases.
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160401.13

Abstract:
It is important to examine teacher’s knowledge on malnutrition since they are at the vanguard of the implementation of the school based malnutrition prevention programs and therefore has the vital role to influence nutrition information and behaviour in children. It is only teachers with accurate and substantial information that can orientate the children rightly. This study set out to assess the knowledge levels of teachers on malnutrition in childhood and to explore resources used for information on nutrition. This cross sectional study was conducted among 387 male and female teachers who agreed to participate from 26 public and 13 private primary schools in 3 semi-urban communities in Ido Local Government, Ibadan, Nigeria. A structured and pretested questionnaire was self- administered and collected immediately. Data collected was analysed using SPSS version 16 statistical software. The Mean knowledge score was 49.9; 214(55.3%), 145(37.5%), 28(7.2%) teachers had good, fair and poor levels of knowledge respectively. Handbook (80.4%), television (70.5%) and radio (62.5%) were the major resources reported for use on nutrition information. Based on the findings of this study, percentage of teacher’s with adequate knowledge on childhood malnutrition is not sufficient. In-service training focusing on the causes, effects, symptoms and prevention of malnutrition in childhood would be invaluable; teachers should also be provided with relevant text books that can enhance their knowledge on nutrition issues.
, Amal Khalil Sarsour, Hatem Jamil Alharazin
European Journal of Preventive Medicine, Volume 4; https://doi.org/10.11648/j.ejpm.20160401.14

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University/college period is one of the stressful stage of life, and depressive symptoms and stress are health problems among students worldwide. Understanding nutrition-mood associations may enable students to make healthier food choices that lead to a healthier life style. The present study investigated the relationship between food consumption and stress and depressive symptoms among university/college students in Gaza strip, Palestine. A cross-sectional survey was undertaken among undergraduates enrolled across 5 universities and 3 colleges in Gaza Strip (n=1409). Self-administered questionnaires included a 12-item food frequency questionnaire; Cohen’s Perceived Stress Scale and modified Beck Depression Inventory. Gender and university comparisons were performed. Univariable and multivariable regression analyses were computed for each of the two outcomes; perceived stress and depressive symptoms. In general, females consumed sweets, snacks, fresh fruits and salad/raw vegetables and cooked vegetables more commonly than males, whereas males generally consumed fast food/canned food and cake/cookies, meat/sausage products, fish/sea food, cereal/cereal products and dairy/dairy products more commonly than females with differences across various universities/colleges. Perceived stress and depressive symptoms scores were generally higher among females than males. The univariable analysis showed that significant associations between various food groups and perceived stress and depressive symptoms were more evident for males. In addition, for males, all food groups were negatively associated with perceived stress as well as with depressive symptoms. For females, the exceptions of such negative associations were observed with meat/sausage products, fish/sea food and cereal/cereal products for perceived stress, and only with cereal/cereal products for depressive symptoms. The multivariable analysis indicated that frequent consumption of ‘unhealthy’ food such as sweets/cookies/snacks/fast food was significantly associated with lower perceived stress among males only. In addition, frequent consumption of ‘healthy’ foods such as fruits/vegetables was significantly associated with lower depressive symptoms, but for both sexes. In conclusion, university/college students used food whether ‘unhealthy’ or/and ‘healthy’ as a coping strategy to reduce tremendous and continuous stress due to the imposed Israeli siege since the year 2006 which affects all aspects of life in Gaza strip.
, Ghada Mahmoud Khafajy, Nagwa Eid Saad
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.17

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Background: Videoconferencing technology reduces time and costs between remote locations, fill gaps in teaching services, enables meetings that would not be possible due to prohibitive travel costs, and improves access to learning Aim: To explore the effectiveness of the theoretical module of PDFM (Professional Diploma of Family Medicine) in Sudan delivered via distant learning compared to that of PDFM in Egypt delivered via conventional learning by comparing the achievement level in the post-theoretical-module exam and the results of the exam analysis. Methods: This comparative study was conducted from November 2014 to April 2015. In PDFM Egypt and Sudan, the theoretical part was delivered via face-to face learning and synchronous videoconference respectively. The same exam was used to assess candidates' knowledge in PDFM in Egypt and Sudan at the same time. Item analysis was done to obtain item and test statistics. Also, candidates' feedback was assessed using a Web-based questionnaire Results: Thirty-two candidates (84.2%) passed the exam of PDFM in Egypt while 77 candidates (86.5%) passed it in Sudan. The reliability co-efficient of the exam in Egypt and Sudan were 0.9188 and 0.8140 respectively. There was no significant difference between the discrimination index of the exam (p value=0.074), while there was significant difference between the difficulty index; 70% of the exam questions were considered easy in PDFM Sudan compared to 40% in PDFM Egypt. Conclusion: Synchronous videoconferencing can be used to expand educational capacity and international cooperation between academic institutions in developing countries, a particular priority in the growing field of Family Medicine.
, Seter Siziya, Willard Tinago
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.19

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A study was carried out to determine secular changes in all-cause mortality rates for children aged < 5 years in 1960-1989 and their association with measles and malnutrition mortality rates in the same age group in the same period in city of Gweru, Zimbabwe. The study utilized under-fives mortality data from births and deaths registration office and measles and malnutrition surveillance data obtained from Gweru city’s public health department. Data was analysed in SPSS version 20 for windows and linear regression analysis was used to determine whether measles and malnutrition mortality rates were independent predictors of all-cause underfives mortality rates. It was found that in 1960-1989 underfives mortality rates from all causes were 10.2-63.7/1000 live births (median: 28.7, Q1 = 16.2, Q3 = 42.6) and these rates significantly and linearly declined in this period (χ2 for linear trend=165.74, p < 0.001). Measles mortality rates among underfives significantly and linearly declined (χ2 for linear trend = 812.49, p2 for linear trend = 2411.54, p2 = 0.7048) with malnutrition mortality rates uniquely explaining 21% of the variance in all-cause mortality (semipartial correlation squared = 0.21) while measles mortality rates uniquely explained 7% of the variance in all-cause mortality rates (semipartial correlation squared =0.068). It was concluded that decline in malnutrition and measles mortality rates among underfives significantly contributed to decline in all-cause underfives mortality rates in 1960-89 in Gweru city, Zimbabwe. On account of these findings, it is critical that efforts directed at controlling malnutrition and measles be intensified in areas and populations of similar settings.
Mahendra Kumar Trivedi, Alice Branton, Dahryn Trivedi, Gopal Nayak, Mayank Gangwar,
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.18

Abstract:
Serratia marcescens (S. marcescens) has become an important nosocomial pathogens and increased resistant isolates were reported. The current study evaluates the impact of an alternate energy medicine i.e. Mr. Trivedi’s biofield energy treatment on S. marcescens for changes in sensitivity pattern of antimicrobial, biochemical characteristics, and biotype number. S. marcescens cells were procured from MicroBioLogics Inc., USA in sealed pack bearing the American Type Culture Collection (ATCC 13880) number and divided into two groups, Group (Gr.) I: control and Gr. II: treated. Gr. II was further subdivided into two sub-groups, Gr. IIA and Gr. IIB. Gr. IIA was analyzed on day 10, while Gr. IIB was stored and analyzed on day 159 (Study I). After retreatment on day 159, the sample (Study II) was divided into three separate tubes as first, second and third tube, which were analyzed on day 5, 10 and 15 respectively. All experimental parameters were studied using the automated MicroScan Walk-Away® system. Antimicrobial susceptibility results showed that 42.85% of tested antimicrobials results in altered sensitivity pattern, while decreased minimum inhibitory concentration values in 40.62% tested antimicrobials as compared to the control after biofield treatment on S. marcescens. The biochemical study showed that 12 out of 33 tested biochemicals (36.36%) were reported for alteration of biochemical reactions pattern as compared to the control. Biotype study showed an alteration in biotype number in all the experimental treated groups as compared to the control. These results suggested that biofield energy treatment has a significant impact on S. marcescens. Overall, it is expected that Mr. Trivedi’s biofield energy treatment as an integrative medicine could be better therapy approach in near future.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.16

Abstract:
The study was conducted to assess iodine status of Shendi area inhabitants by determination of urinary iodine excretion of Shendi basic school children. Shendi area was divided into four geographical zones according to the difference in water sources.353pupils were included in the study. Most of cases (68.6%) showed a urine iodine concentration between 10 - 30 µg/dl (normal). 7.9% of cases had urinary iodine excretion more than 30 µg/dl (above normal) and 23.5% of children were suffering from iodine deficiency; 16.4% of them had mild iodine deficiency, 4.5% of pupils showed moderate iodine deficiency and 2.6 % had severe iodine deficiency according to WHO, 2001 standard. The high urinary iodine excretion was in the east of Shendi (23.40 ± 30.64 µg/dl) and the low urinary iodine excretion was in the north of Shendi (13.86 ± 3.88 µg/dl).Analysis of water samples from study zones showed some minerals which are goitrogenic such as fluoride and nitrate.
, Nagwaa Eid Saad
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.14

Abstract:
Background: Infertility can have an extravagated impact on the psychological wellbeing of the couple and subsequently affect the marital relationship and the quality of life. Objective: To screen for depression in infertile female attending infertility clinic and to determine the severity of depression in relation to duration of infertility and other socio-demographic characteristics in an Egyptian setting. Methods: This cross-sectional descriptive study was conducted from June 2014 to December 2014 in the infertility clinic in Kasr Al-Ainy hospital. Three hundred infertile females were screened for depression using the Arabic version of the Patient Heath Questionnaire (PHQ-9). Results: According to (PHQ-9), 62.3% of the studied infertile females suffer from moderate to severe depression. The score of PHQ-9 was inversely proportionate to both the duration of marriage (P value=0.038, person correlation:-0.12) and duration of infertility (P value=0.025, person correlation: -0.13) and was directly proportionate to age of studied females (P value =0.032, person correlation: 0.124), their educational level (P value =0.000, person correlation: 0.312) and number of trial of assisted reproductive technique (P value=0.001, person correlation: 0.189), and these data were statistically significant. Conclusion: A large percentage of Egyptian infertile females suffer from depression. And this highlights the challenging need for providing individualized bio-psychosocial care for all infertile Egyptian females.
, Austin Itohan Ojugo, Gloria Omolegho Omi-Ujuanbi
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.12

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Persons in senior administrative positions (SAP) in public universities are an important segment of the workforce, which could play an important role in the control of HIV/AIDS through their impact on the attitude to people living with HIV/AIDS (PLWHA) both within and outside the university community. However, there is a gross dearth of information on their perception of HIV/AIDS and the corresponding attitude to PLWHA. This is unlike the profusion of data on the perception of students in tertiary institutions of higher learning. The objective of this study was thus to determine the level of awareness and perception of HIV/AIDS, and the workplace attitude to PLWHA, of persons in SAP in public universities and the association with the demographic factors of age, gender and religion. A self-administered questionnaire, ‘Awareness and Attitude towards PLWHA scale’ was used to elicit responses from 250 persons, representing 91.6% of those eligible, in a cross-sectional survey of Deans of Faculties, Directors and Heads of Departments in two public universities in Edo State, Nigeria. Mean scores and mean percentage responses were compared between groups using Student’s t-test and one-way ANOVA. The level of significance was set at P <0.05. The mean (standard deviation, SD) of Respondents with correct answers to the questions on perception was 72.7 (12.8)% on perception of the nature of HIV/AIDS, 45.1 (38.6)% on transmission, 90.9 (7.4)% on diagnosis and 85.8 (10.8)% on perception of its prevention (P = 0.034). The mean (SD) of the responses on general attitude was 96.8 (2.9)% and that on workplace attitude 85.2 (7.5)% (P = 0.036). There was no statistically significant difference between the mean overall scores on perception and attitude in relation to age, gender and religion. We conclude that the perception of HIV/AIDS and workplace attitude to PLWHA among persons in SAP in public universities in Nigeria are quite favourable, except in relation to the transmission of infection. We also conclude that the perception is unrelated to the demographic factors of age, gender and religion. These findings are relevant to the development of HIV/AIDS control messages, particularly those targeted at the reduction of stigmatization and discrimination, important attitudinal problems fueling the transmission of HIV/AIDS in resource-poor countries.
, Mayssa Ebrahim Ali
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.13

Abstract:
Background: The metabolic syndrome is a clustering of metabolic abnormalities and cardiovascular risk factors. It is vital to start the lifestyle interventions and treatment early in patients with metabolic syndrome to prevent the twin global epidemics of type 2diabetes and CVD. Objective: to investigate the overall effects of omega-3 fatty acids supplementation In addition to Dietary Approaches to Stop Hypertension (DASH) nutritional intervention on the lipid profile in patients with metabolic syndrome and to study if the addition of DASH diet will alleviate the rise in LDL- C that occurs with ω-3 fatty acid supplementation. Research design and methods: This was a prospective interventional outpatient trial conducted on 42 patients with the metabolic syndrome. They received ω-3 fatty acid supplementation 1 g/d in addition to DASH nutritional education for 12 weeks: the DASH diet with increased consumption of fruit, vegetables, low-fat dairy and whole grains and lower in saturated fat, total fat, and cholesterol. The main outcome measures were the lipid profile of the patients with metabolic syndrome. Results: ω-3 fatty acid together with The DASH diet significantly changed the mean of all parameters of lipid profile in metabolic syndrome patients. After 12 weeks, there was a significant increase in HDL-C (14%), significant reductions in TG (37.7%), LDL (29.4%) and a significant reduction in Non HDL-C (24.7%). Conclusion: this study demonstrated that the DASH diet optimizes and complements the effect of ω-3 fatty acid on the lipid profile of patients with metabolic syndrome by alleviating the rise in LDL- C that occurs with omega supplementation.
Alem Deksisa Abebe, , Seblewengel Lema
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.15

Abstract:
Back ground: Low back pain (LBP) is one of the most common work–related health problems among hospital workers. Work–related activities such as twisting, bending, sustained posture, repeated movements are regarded as associated risk factors for low back pain. The aim of this study is to assess the prevalence and associated risk factors of Low Back Pain among hospital workers. Methodology: An institution based cross sectional survey design was conducted among employees in Adama Hospital Medical College (AHMC), Adama Ethiopia. Descriptive statistics, bivariate, and multiple regression analyses were performed. p<0.1 in univariate is considered for multivariate analysis and p<0.05 was used to define statistical significance. Result: Of 263, 137(52.1%) were males and 126(47.9%) were females. The result indicated that the mean and median age of the respondents were 33.5 and 33 years respectively. The life time prevalence of LBP was found to be 50.6% and the 12 month LBP prevalence was 41.4%. Staff not participating in any physical activity (exercise) were more likely to report presence of low back pain (AOR (Adjusted Odd Ratio)=1.75, CI, 1.02-3.02). On the other hand, staff who worked sitting more than 6 hours were associated with increased risk of low back pain(AOR=2.78, CI, 1.09-7.07). Perceived stress often increased risk of low back pain (AOR=2.60, CI, 1.06-6.36). Conclusion: LBP was significantly associated with the obesity, stressed often, those worked in seated position more than six hours and those with long year experience; but doing physical exercise has rather a preventive effect. The findings of this study suggest that primary prevention of LBP should be considered.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150306.11

Abstract:
Background and purpose: The prevalence of behavioral problems in children with mentally ill parents may be higher compared to children with mentally healthy parents. This study was carried out to assess the behavioral problems in children with bipolar mothers. Material and methods: This case-control study was conducted between 50 children (6-11 years) of mothers with bipolar I disorder as a case group and 50 children of healthy mothers as control group in Sari, Iran, during 2011-13. With psychiatric interview based on DSM-IV-R and Minnesota Multiphasic Personality Inventory (MMPI), bipolar disorder in mothers was confirmed and other prominent psychiatric disorders were ruled out. The psychological health of control mothers was confirmed using psychiatric interview and general health questionnaire (GHQ). The behavioral problems of children in two groups were compared using Achenbach child behavior questionnaire. Data were analyzed using SPSS-19, Chi- Square and Student’s t-test. Results: Somatic complaints, anxiety and depression, social problems, externalization and internalization scores and also behavioral problems total scores were significantly higher in case group compared to control group (P< 0.05). No significant differences between case group and control group were mentioned with respect to isolation, attention problems, thought problems, antisocial behaviors. Conclusion: Psychiatric and behavioral problems in children with bipolar mothers were higher, compared to children of healthy mothers. Child psychological counseling and psychiatric management in along to mothers’ treatment is advisable.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150305.15

Abstract:
Barré-Liéou syndrome, or posterior cervical sympathetic syndrome, has symptomatology related to underlying cervical instability. While classified as a rare disease, Barré-Liéou syndrome is likely underdiagnosed. Vertebral instability, occurring after neck ligament injury, affects the function of cervical sympathetic ganglia (located anterior to vertebral bodies). Symptomatology includes neck pain, migraines/headache, vertigo, tinnitus, dizziness, visual/auditory disturbances, and other symptoms of the head/neck region. Treatment for Barré-Liéou syndrome is suboptimal and often involves long-term use of pain medications, chiropractic care, or surgical fusion. Prolotherapy offers a noninvasive treatment option to ameliorate symptoms while treating the underlying cause of the disorder—cervical instability. In this case series, the results of eight patients from 2011 to 2013 who received prolotherapy for Barré-Liéou syndrome following longstanding symptoms after trauma are reported. All patients reported improvement of neck pain and associated symptoms and increased physical activity. Prolotherapy should be considered as treatment for Barré-Liéou syndrome.
Fahad Alamri, , Yousef Al-Saleh, Mohammed Yehia Saeedi, Mussa Hussein Almalki, Nasser Al-Daghri, AbdulAllah Alzahrani, , Ahmed Khair Ibrahim
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150305.14

Abstract:
Vitamin deficiency is considered to be a major public health problem in Saudi Arabia, especially during summer. The major source of vitamin D is sun exposure. In this study, we aimed to determine the optimum time for sun exposure in four different cities (North, South, West and East regions) in the Kingdom of Saudi Arabia. In the current study ampoules containing 7-dehydrocholesterol in ethanol were exposed to sunlight every hour starting from sunrise until sunset in June 2013. Results indicated that the geographical location and the time of the day have a major influence in vitamin D production. In summer, conversion of pre-vitamin D3 was observed to be elevated between 8.00-9.00 AM to 3:30-4:30 PM, with peak hours between 11:30 AM to 12:30 PM. Moreover in the east region (Dammam), conversion of pre-vitamin D3 showed significant reduction by around 50%. In conclusion, the optimum sun exposure time for vitamin D3 production in the north, south and west regions of Saudi Arabia during summer is from 8:30 AM to 10:30 AM, as well as 2:00 PM to 4:00 PM.Air pollution might be the cause for the decreased conversion of 7-dehydrocholesterol to pre-vitamin D3 in the east region. Conservatively, the optimum time for sun exposure therefore in Dammam city is from 8:30 AM to 10:00 AM, as well as 1:00 PM to 2:30 PM. Knowledge of the optimum sun exposure times during summer can be highly effective in preventing vitamin D deficiency in Saudi Arabia.
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150305.13

Abstract:
Camel brucellosis represents a major public health hazard, which affects social and economic development in various developing countries including the pastoral areas of Ethiopia. A cross-sectional study was conducted to determine public awareness, attitude and practices of the pastoralists, agro pastoralists, animal health assistants and human health professionals towards zoonotic Brucella infection in the region using a questionnaire. A total of 168 respondents (56 individuals from each district) were interviewed. According to the logistic regression analysis, Literacy was found statistically significant (PBrucella infection. Moreover, out of the 112 human health professionals included in the study, only 14 (12.5%) had knowledge on zoonotic Brucella infection. But none of them had ever diagnosed the disease in humans and the reason for the diagnosis problem was lack of facility and no attention was given to the disease. The questionnaire survey revealed that there was a knowledge gap not only in the community but also in the human health professionals about zoonotic Brucella infection in the study areas. Even though the animal health assistants had better awareness about the disease, they did not collaborate with human health professionals to create awareness to the community and to prevent the disease. Therefore, Public education on modern animal husbandry, disease prevention and risk of zoonotic Brucella infection should be imparted continuously.
, Kenneth Enwerem, Jean Njab, Charles Anyaka, Ngozi Okoro, Tinuade Oyebode, Prosper Okonkwo
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150305.12

Abstract:
Background: Despite the multisectoral response to HIV epidemic and the promotion of combination prevention with HIV Counseling and Testing (HCT) as an entry into Treatment, Care and Support, coverage has remained low and certain HIV positive persons continue to witness stigmatization and discrimination.Though strategies to scale up HCT services have largely promoted provider initiated mobile HCT including home testing, we investigated the outcome of a provider initiated faith based organization, Faith Alive Foundation and Hospital located in Jos and its facility based HCT among pre-surgical patients in Jos Plateau state, North Central Nigeria.Methods: We conducted a cross sectional survey among pre-surgical patients at Faith Alive Foundation and Hospital in Jos Plateau state from 16-20th December 2013. Participants were selected by simple random as they presented at the hospital after vital signs and clinical diagnosis. HIV Counseling and Testing was provided according to the National guidelines and standards with the “opt out” algorithm.Data were captured and analyzed on Epi Info 6.04. Cross tabulations were used to generate descriptive statistics including frequency distribution, percentages and Fisher’s exact odds ratios at 95% confidence limits with 5% probability level of significance. Results:More than half (56%) of participants were males, 44% were females with a median age of 39 years. HIV seropositive rate was at least two fold higher in females than in male participants and overall HIV positive estimate was 12.2% ( 95%CI , 9.6 – 16.3). In addition, majority (84%) of surgical presentations identified during the outreach were hernia cases (33%), and the rest lipoma (25%), appendicitis (12%) and other forms of lumps (12%). Response rate during the provider initiated pre-surgical HCT “opt-out” design was 100%.Conclusion: Though strategies to scale up HCT services have largely promoted provider initiated mobile HCT, we found high rate of HIV in a provider initiated facility based HCT among pre-surgical patients in Jos, Plateau state of North Central Nigeria with 100% response rate in an “opt-out” design.Therefore, pre-surgical Patient Initiated HIV Testing and Counseling (PITC) is a viable strategy that may significantly contribute towards Universal Access to HIV/AIDS prevention services
Osuchukwu Nelson Chukwudi, Inde Margaret Uyilewhoma, Eko Jimmy Ebi, O’Neill Mary Emmanuel, Osonwa Okorie Kalu, Ekpo Ekpo Iyamba
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150305.11

Abstract:
Background: Geriatric healthcare is increasingly becoming a component of the healthcare delivery system as the reality of healthcare for the elderly varies dramatically from one society to another. Objective: The general objective of this study was to identify the determinants of healthcare services utilization among the elderly in Calabar Municipality, Cross River State, Nigeria. Methods: A semi-structured questionnaire was used to generate data from 200 respondents using multi-stage sampling technique. Data generated were analyzed using statistical package for social sciences (SPSS version 20.0) and results were presented in tables and charts. Chi-square was used to test for association between variables at 5% level of significance. Results: The result of this study showed that most respondents were aged 65-69years 74(37.0%) followed by those aged 70-74years 56(28.0%) and 75-79years 42(21.0%). More females 110(55%) than males 90(45%) participated in the study. More than half of the respondents 34(67%) reported to have visited the hospital in the last 12 months mainly for general body checkup 51(25.5%) and treatment 31(15.5%). Barriers to utilization of healthcare services identified in this study include; long waiting time 10(22.2%), drug prescribed not available 10(22.2%) and health workers not friendly 10(22.2%). Factors associated with health services utilisation among the elderly were gender, residential status, educational status, occupational status and income level (P<0.05). Conclusion: Proffering solutions to barriers to health services utilization highlighted in this study would promote optimal use of health services thereby improving the quality of life of the aged population.
Precious Kalamba Gbeneol, Seiyefa Funakpa Brisibe, Best Ordinioha
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150303.13

Abstract:
More than 24% of Nigerians are carriers of the sickle cell gene, while about 2% of all the newborns in Nigeria are born with the sickle cell disease. The disease is a lifelong cause of severe morbidity that often require prolonged hospital admission; even as the patients have 92% excess mortality. The prevention of the disease is therefore very important, especially in Nigeria whose contribution to the global total has been projected to increase. Premarital screening for the sickle cell gene is considered one of the best ways of preventing the sickle cell disease. This study assessed the knowledge, attitude and uptake of the premarital screening among married couples in Choba, a semi-urban community in south-south Nigeria. A descriptive cross-sectional study design was used, with the data collected using structured, interviewer-administered questionnaire that was administered on married male members of the study community. A total of 290 questionnaires were administered and retrieved. The respondents had an average age of 30.55 ±4.1 years; majority (65.86%) had a tertiary education and they were all Christians. All the respondents knew about the sickle cell disease, while 84.83% were aware of the premarital screening for the disease. All had positive attitude towards the premarital screening, with 88.97% recommending that the screening be made compulsory for all intending couples. Most (72.76%) of the respondents carried out the premarital screening when they got married. The age, educational attainment and the religious denomination of the respondents significantly influenced the uptake of the screening (p-value > 0.001). A total of 9.00% of the respondents were of the same HbAS genotype as their intended spouses; out of which 21.05% went ahead and got married, citing as reasons the difficulty of jettisoning their spouses (25.00%); and the power of God to prevent a child with sickle cell disease (75.00%). The knowledge, attitude and uptake of premarital screening for sickle cell disease are high in the study, even as the screening programme is not driven by the government. The input of the government is however required in providing health education, genetic counselling and prenatal diagnosis.
Ibiyemi Olasunbo Olayiwola, Samson Ayo Deji, Daniel O. Adesope, Olawale O. Ajayi, Adebayo F. Adisa, Adeola S. Akinola, Folarin P. Akinlo
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150303.17

Abstract:
Nutritional status of pregnant women is very crucial to the wellbeing of the unborn child. Good dietary pattern among pregnant women reduces the rate of maternal and infant mortality which is still a big problem in developing countries. The study assessed food and dietary pattern, energy intake and awareness of the importance of taking adequate micronutrients during pregnancy. A total of 400 pregnant women attending a routine antenatal clinic of the Obafemi Awolowo University Teaching Hospital Ile Ife, Nigeria were recruited into the study by simple random sampling method on different clinic days. Structured interviewer administered questionnaires were used to elicit data on socio-demographic characteristics, anthropometric indices and 24 hour dietary recall which were used to assess the dietary pattern and nutritional status of the respondents. Seventy two per cent of the respondents were between the ages 25-34years, 91% were from monogamy family structure, 72 % had tertiary education and 83% were aware of micronutrients intake. About 98% of respondents consumed on a daily basis, food rich in carbohydrate, vegetable and fruits but 39% reported consuming protein rich diet such as fish and meat . Conclusively, the research confirmed that the dietary pattern of pregnant women showed they consumed more of carbohydrate diet compared to protein diet which is most important especially during pregnancy to improve their nutritional status and that of the unborn baby. More attention should be paid to nutritional education on the choice of food pregnant women eat, especially the less educated women and those with low income status.
, Khaled Abdelrahim
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150304.13

Abstract:
To achieve the global maternal and neonatal tetanus (MNT) elimination, it is vital to develop an ideal theoretical framework that can be used for the disease elimination. The theoretical framework for this review is the Theory of Planned Behaviour (TPB), a modified model of the Theory of Reasoned Action (TRA). The TPB was meant to be applied to the prediction of purely volitional behaviors, and to help understand the psychological determinants of individuals. The TPB shows that the intention of human beings to perform a particular behavior and the conduct of that behavior are based on belief structures and determined by three independent constructs: attitude toward the behavior, perceived behavioral control, and subjective norms to perform the behavior. In relating TPB to the predictive model of NNT, there are various determinants of preventive behavioral intention among the women towards NNT. The beliefs of pregnant women on the outcomes of their pregnancies after they attend antenatal care, receiving tetanus toxoid (TT) vaccination and delivering in a hospital setting are all dependent on how the women value these which likewise determine their attitudes toward receiving a TT to prevent their unborn child from NNT.
, John Nemecek, Chester Jones
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150303.16

Abstract:
Background: Neonatal tetanus (NNT) is a deadly vaccine preventable disease and one of the most underreported diseases in the developing countries seen in the newborn within the first 28 days of life. NNT remains one of the leading causes of deaths among neonates in the developing countries with about 130,000 neonatal deaths recorded in 2004. Despite the global success recorded in the NNT elimination strategy, Nigeria remains among the 25 remaining countries that record NNT cases. Study Design: Retrospective study Methods: This quantitative cross-sectional study involved mothers who gave birth to children with NNT within their first 28 days of life. The study used secondary data collected between January 2008 and December 2013 from northeast region of Nigeria. Results: The results revealed that 58% had male children (n =182) and the remaining 42% had female children (n = 130). The predominance of the male neonates could partly be as a result of the socio-cultural preference given to the male child in Nigerian. Conclusion: There is the need for parents to promptly seek urgent medical attention for all suspected NNT cases irrespective of the gender of the child to reduce neonatal mortality rates.
Anwar Islam,
European Journal of Preventive Medicine, Volume 3; https://doi.org/10.11648/j.ejpm.20150303.15

Abstract:
The timeline set by the United Nations in achieving the Millennium Development Goals (MDGs) pronounced in the year 2000 is coming to end in 2015. While the United Nations has already came up with a new set of 17 Sustainable Development Goals (SDGs) to follow the MDGs, efforts are underway to assess the success and failures of countries in achieving the MDGs. Bangladesh has made tremendous progress in achieving most of the MDGs including those related to maternal and child health. The maternal mortality ratio and the infant mortality rate in Bangladesh declined from 507 and 149 in 1990 to 209 and 53 in 2010 respectively. However, district level review suggests that numerous constraints and challenges confront the health system in sustaining these achievements. Moreover, desegregated data strongly indicate that the progress is even across different regions of the country. Most importantly, significant gaps still persist between the rich and the poor. For example, while the overall IMR is 43 per 1,000 live births among the highest income quintile, the figure is 84 among the lowest income quintile. In other words, Bangladesh must forcefully address regional disparity and rich-poor gap to ensure sustainable and equitable development in all aspects of health. The study identified a few strategic policy directions for this purpose including aggressive pro-poor and sub-national development planning. To ensure availability of and accessibility to primary health care for all, the study strongly argues for the establishment of community clinics throughout the country equipped with skilled midwives and adequate number of community health workers.
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