Introduction. Cardiovascular disease (CVD) is the leading cause of mortality in Kyrgyzstan. The study aimed at exploring the CVD prevalence depending on various risk factors across diverse ethnic groups in Kyrgyzstan Materials and Methods.A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used a questionnaire with 47 questions to explore the health status, behaviour and lifestyle determinants and prevalence of CVD. We used Chi-Square Test to investigate differences between groups, and ANCOVA to determine differences between mean scores on analysed variable. Logistic regression was used to analyse the relationship between independent and dependent variables. Confounding variables were only included if they correlated with both the independent and dependent variables. Interaction analyses were conducted with logistic regression to investigate if there were any differences between the nationalities in the relationships between the independent and dependent variables. Results. Our study confirmed that the CVD prevalence across diverse ethnic groups can be significantly different: In Kyrgyzstan, the most disadvantaged group in this context were East European and the least – Western Asian. There was no difference between studied groups found in the ethnicity-stratified prevalence of such CVD risk factors as low fruit and vegetable consumption, alcohol intake, smoking, and BMI. There was no statistically significant association between educational attainment and CVD risk markers within the studied ethnic groups. The analysis of ethnicity-stratified prevalence of CVD risk markers resulted in a significant difference in physical activity across ethnicity groups. Conclusion. The study results provided an understanding of the ethnicity-stratified prevalence of CVD risk markers in the population in Kyrgyzstan. They could serve as instrumental in tailoring targeted public health interventions to address the burden of CVDs in specific subpopulations.

Molecular diagnostics have revolutionized viral disease diagnosis in clinical settings, offering rapidity, sensitivity, and specificity. Nigeria’s diverse burden of viral diseases, coupled with resource limitations and underreporting, underscores the critical need for efficient molecular diagnostics. The article traces the progressive trajectory of molecular diagnostics in Nigeria, including the establishment of Lassa virus detection, containment of the Ebola virus outbreak, and the pivotal role of the Nigeria Center for Disease Control (NCDC). It also highlights the impact of the COVID-19 pandemic on expanding molecular diagnostics infrastructure. Despite these advancements, challenges such as limited testing capacity, skilled personnel shortages, and inadequate funding persist. The article recommends measures to address these challenges, emphasizing the transformative potential of molecular diagnostics in viral surveillance and management. Overall, it underscores the importance of strategic planning and concerted efforts to enhance the utilization of molecular diagnostics in Nigeria’s healthcare system.

A document by Kenneth Egwu. Click on the document to view its contents.

Background Estimating malnutrition risk among hospitalized patients is challenging, yet critical due to its association with adverse outcomes such as prolonged hospital stays, increased mortality, impaired wound healing, depression, and increased hospital costs. This research study aims to evaluate the risk of malnutrition among type 2 diabetic hospitalized patients and its impact on the patient’s length of stay in two tertiary hospitals based in Kigali. Method In this retrospective cross-sectional study, 300 adult hospitalized type 2 diabetic patients from Kigali’s tertiary hospital and King Faisal Hospital were enrolled between January 2021 and October 2022. Data collected includes demographics, anthropometrics, serum albumin, and length of hospital stay. The Nutrition Risk Index was used to determine malnutrition risk. Results 55.3% of hospitalized type 2 diabetes patients were found to be at risk of malnutrition based on the Nutrition Risk Index. Gender distribution showed no significant difference (p = 0.724), with 56.6% females and 54.5% males at risk. Significant associations were found with age (r=0.018, p= 0.017), hypertension as comorbidity (r=-0.169, p = 0.004), hospital stay duration (r=0.139, p= 0.016), and blood glucose levels (r=-0.087, p = 0.001). Conclusion A study finds high malnutrition risk in hospitalized type 2 diabetes patients, linked to longer stays and poor outcomes. Early malnutrition screening, proper nutrition support, and a multidisciplinary care team are crucial for improved clinical care and cost-effectiveness.

Fleas are small wingless hematophagous insect that are frequently infesting on rodents and other small mammals while acting as vectors of many zoonotic diseases including plague, a disease challenging public health in many part of the world including Tanzania. 291 rodents from nine species were captured with Sherman traps in farm land, peridomestic areas, bush and forest buffer zone across wet and dry season in plague and non-plague foci villages. Captured rodents were anaesthetized and 190 fleas comprising four species were collected and morphologically identified with available dichotomous key. Dinopsyllus lypusus were (46.32%) , Ctenophthalmus spp (26.84%), Xenopsylla brasiliensis (16.32%) and Xenopsylla cheopis (10.53%). 38.42% of fleas were collected from Mastomy natalensis, 22.63% from Lemniscomys striatus and 18.42% from Rattus rattus. Highest flea infestation prevalence was found on R.rattus and was strongly associated with X.cheopis and X.brasiliensis. Specific flea index of X.cheopis on R.rattus was (01) in plague foci and (<0.5) in non-plague foci. Result of GLM final model indicated that flea abundance was significant influenced by rodent species ( p < .001), season ( p= .031), habitats ( p= .02), rodent weight ( p < .001), rodent sex ( p < .001) and plague locations ( p= .02). There was significance difference in variation of flea abundance between rodent sexes (W = 9158.5, p = .009) and weak positive correlation between rodent’s weight and fleas abundance ( R= 0.17, p< 0.05). Despite that, specific flea index of X.cheopis on rats in both plague foci and non-plague foci villages were not indicating alarming condition that would require urgent control of fleas, still society should consistently adhere to rodent and fleas control methods especially in farm land and peridomestic areas where flea abundance is high and human activities are customarily implemented.

Background For over 70 years the addition of fluoride to public water with intent to prevent dental caries continues to be controversial and risks are seldom included in monetary evaluations. Objectives To estimate an economic cost-benefit-risk of Community Water Fluoridation (CWF) using 2021 USA dollars Per Person Per Year (PPPY), with the inclusion of two risks: dental fluorosis and lower income resulting from developmental neurotoxicity as measured with lower IQ. Methods Published operational costs and benefits of CWF are used. Published and clinical experience treating dental fluorosis are utilized to estimate treatment costs of patient perceived dental fluorosis, and lost wages from lower IQ. Patients of record provided consent for photographs. Results: Published estimated caries averted, less operational costs, were calculated at $8 PPPY and estimates of compensation for functional and cosmetic dental fluorosis were $126 PPPY. Lower earnings from presumed harm of developmental neurotoxicity $438 PPPY. Net loss from CWF is estimated at $556 PPPY. Conclusions Previous economic evaluations of CWF have estimated caries averted and costs of operations. Few evaluations include the costs of treating harm. CWF is not cost effective if the cost of harm is included. Policy Implications Alternatives for the prevention of dental caries should be promoted and the cessation of CWF is indicated.

Background: Asthma and wheezing are significant health concerns for children in Africa. There is a dearth of prior research examining the occurrence of asthma and wheezing in both preschool and school-aged children within the African environment. Therefore, this meta-analysis aimed to estimate the prevalence of asthma and wheezing in African infants from zero months to children eight years of age. Methods: An electronic search was conducted in July 2023 in Scopus, Web of Science, PubMed, MEDLINE, CINAHL, and Academic Search Complete for studies published from January 2012 to July 2023 using the following subject-specific terms: 1. “Risk factors” OR “Contributing factors” OR “Predisposing factors” OR “Predictor” OR “Cause” OR “Prevalence” OR “Trends” 2. “Asthma” OR “Wheeze” OR “Wheezing” OR “Asthma symptoms”, 3. “Preschool” OR “early childhood” OR “kindergarten” OR “0 to 8 years” OR “School children”, 4. Africa/ or, 5. limit to (English language and year=“2012 -Current” and children). STATA 17 software and a fixed effects model were utilized. Heterogeneity was assessed using I2. Results: The study revealed a prevalence of asthma in preschool and school-aged children of 4.41%, with no heterogeneity observed ( I2 <0). Wheezing in the past prevalence rate was 22.91%, also without heterogeneity ( I2 <0), with no significant differences observed among the studies. This indicates a lack of heterogeneity in studies for asthma and wheezing prevalence rates. Conclusions: Asthma and wheezing are prevalent among African preschool and school-aged children, highlighting the need for comprehensive and localized research to address this public health issue.

This study examined how time and handwashing impact the inferential process related to infectious disease transmission among adults and preschoolers. Thirty-eight Japanese adults aged 18–23 years (8 men; 30 women) and 36 Japanese children aged 5–6 years (15 boys; 21 girls) reported their certainty regarding protagonists’ subsequent infection and whether handwashing affects infection risk across three scenarios (same-time, immediately-after, and next-day). Both age groups perceived a significantly higher likelihood of infection in the same-time condition than in the other conditions. Preschoolers estimated a lower likelihood of infection than adults (η p 2 = .25). Thus, preschoolers inferred infectious disease transmission more optimistically than adults. Amidst infectious disease outbreaks, adults must provide guidance regarding preventive measures, while being mindful of preschooler’s propensity to optimistically speculate about contagion.

Background: In Rwanda, Community Health Workers (CHWs) serve a crucial function in providing community-based maternal and neonatal health (CBMNH) services. However, limited access to refresher training contributes to knowledge gaps among CHWs, affecting their confidence and ability to execute their roles effectively. This study aimed to evaluate the impact of eLearning on enhancing and maintaining CHWs’ knowledge of CBMNH. Methods: This prospective cohort study, conducted from April-October 2021 in two Rwandan districts, evaluated knowledge acquisition and retention among 36 Community Health Workers (CHWs) participating in an eLearning course. Knowledge scores were measured using a structured questionnaire administered pre-training, post-training, and at a six-month follow-up. Descriptive analysis and paired t-tests were used to assess mean score differences, exploring the effectiveness of this eLearning approach. Results: This study demonstrated an improvement in Community Health Workers’ (CHWs) performance scores following eLearning training, with an average rise from 86.5% to 98.2%. The improvement was sustained at a six-month follow-up. Statistical significance was found between age category and CHWs’ pre and post-test performance (p=0.01, p=0.04 respectively), and between years of experience and pre-test scores (p=0.02), highlighting demographic influences on training outcomes. Conclusions: The results of this study suggest that eLearning is an effective method for enhancing and retaining CHWs’ knowledge of CBMNH. The findings support the use of eLearning as a valuable strategy for strengthening the capacity of CHWs in Rwanda and other countries with similar contexts.

Deeply rooted in its developmental philosophy of gross national happiness (GNH), Bhutan’s healthcare system strives towards achieving a shared goal of universal health coverage (UHC). Despite being primarily financed by the government, the healthcare system faces a plethora of challenges. To overcome these hurdles and achieve UHC goals, expanding the fiscal space for health and improving operational efficiency is crucial. This policy brief aims to address Bhutan’s evolving healthcare landscape and advance the achievement of UHC through two policy options. The first policy option focuses on dual objective of improving health outcomes and promoting financial sustainability by leveraging heath taxes, while the second option emphasises reinforcing a systematic Health Technology Assessment (HTA) in the healthcare system. First, to promote financial sustainability, the proposal suggests introducing earmarked taxes on alcohol and tobacco products for the health sector. Global evidence suggests that earmarked taxes are a reliable source of revenue for health, and Bhutan’s high prevalence of tobacco and alcohol consumers assures a reliable revenue base. The Goods and Services Tax (GST) will be implemented in 2024, and it will be a good opportunity for the Ministry of Health to advocate and negotiate with Ministry of Finance (MoF) for the earmarked taxes to the health sector. Second, integration of HTA into policymaking and decision-making processes is essential for effective resource allocation in UHC. Nurturing and strengthening the existing HTA structure under MoH and establishing a dedicated multidisciplinary HTA Committee will ensure informed decision-making and resource optimization. HTA evidence should abided to revise health service standards, develop clinical guidelines, make procurement decisions, and set healthcare priorities. These policy options can assist the country in improving ensure financial sustainability, enhance effective resource allocation and utilisation, and improve healthcare delivery, aligning with its vision of GNH and ultimately accelerating progress towards achieving UHC.

Background: Research indicates a relationship between nutrition, physiological characteristics, and mental health. It was already reported that Israeli-Arab adolescents consume more fast food, sweets, and candies than Jews. Higher energy drink consumption by Israeli-Arab adolescents emerged. Though, data on the topic still needs to be updated. The current study examined possible associations between energy drink consumption, anxiety, and well-being in Israeli-Arab adolescents. We also investigated these associations concerning fast food consumption, physical activity, and sleep hours. Methods: One hundred and fourteen adolescents (59 females) aged 12–18 from several cities & villages in northern Israel were recruited to study. A cross-sectional exploratory study assessed adolescents’ energy drink consumption, nutritional and lifestyle habits, well-being, and anxiety using self-reported questionnaires. Anthropometric measurements - weight, height, and waist circumference were also assessed. Results: Gender and energy drink consumption were associated with psychological status. Energy drink consumers reported a lower well-being index and a higher anxiety index than non-consumers. Energy drink consumers ate significantly more fast food per week than non-consumers. In addition, sleep hours were correlated with anxiety levels. These results differed between genders. Conclusions: Our study shows complex associations between energy drink consumption and mental health indices. These associations can serve as a basis for further research into this topic.

Background: The feeding practices of the mothers, particularly responsive feeding, are critical determinants of acceptance of food, dietary intake as well as the growth of infants and young children (IYC). Responsive feeding refers to the interactions between mother and child that lead to a positive feeding experience, adequate dietary intake and enhanced developmental opportunities. Little is known about mothers responsive feeding practices in Rwanda. Therefore, this study sought to explore mothers’ responsive feeding practices as well as the factors that hinder the implementation of recommended practices among mothers from rural Muhanga District. Method: This qualitative, longitudinal study, recruited a purposive sample of 29 pregnant women attending prenatal consultations in two rural health centers. They were interviewed and mother-child interactions during mealtime were further observed during one lunch meal feeding episode at 6, 9 and 12 months postpartum. The interviews were recorded, transcribed and thematically analyzed using qualitative software, Atlas.ti. Frequency distribution was generated for each practice observed. Results: At 6 months, most mothers reported to verbally encourage their children to eat during feeding and the numbers increased over the age at 9 and 12 months respectively. Less than a half, at all 3 time points, reported to allow their child to self-feed, to smile and talking during feeding. During the observation, the practices were even less than the reported at all 3 time points of the observations. The burden of other responsibilities and poverty were perceived as the major barriers that made mother child- interactions during feeding difficult. Conclusion: Findings indicate that what mothers report may not always reflect the responsive feeding practices performed during feeding . Nutrition interventions in the study community should consider promoting responsive feeding practices as well as addressing the issue of poverty and the burden of other responsibilities that hinder mother-child interactions.

This research explores the experience of people living with leprosy at leprosy settlements in Nigeria. This is a concurrent mixed methods design whereby questionnaires, focus groups and interviews are conducted simultaneously. Seven leprosy communities were visited, one from Nigeria’s six geographical zones and the Federal capital area. This study included 35 leprosy patients, 21 family members, seven community leaders, and seven officers in charge of the leprosy settlements. Also questioned were two heads of organisations involved with leprosy control in Nigeria. Majority (93.7%) of the respondents have access to healthcare in the health centres. Majority (95.2%) are interested in learning self-care practices for skin-related neglected diseases. About three-fourths (74.6%) receive free healthcare and accent that PLWL are admitted into the same ward as other patients. Whilst funding is a growing concern for leprosy control, the data from the interview confirmed that there is little support from the government but more from non-governmental organisations and implementing partners in Nigeria for people living with leprosy. Experts demonstrated that leprosy now ranks high among neglected diseases. The Nigerian government must work with partners to ensure the improvement and sustainability of leprosy control programs.

This study analyzes how national intersectoral public policy experiences have been adopted and implemented using a Health in All Policies (HiAP) approach in the past two decades. It seeks to provide evidence on enabling factors that triggered three effective intersectoral public policies to improve population health in Mexico by improving nutritional, educational, and healthcare access conditions, reducing road traffic injuries, and addressing obesogenic feeding practices. We followed a qualitative approach to analyze the three intersectoral public policies selected as case studies. First, we designed an analytical framework to assess how intersectoral public policies are adopted, implemented, and sustained. The proposed framework is based on peer-reviewed articles and grey public policy literature. Second, we used information from eleven semi-structured interviews to key stakeholders conducted in previous research to identify more specific enablers and barriers of the three intersectoral policies selected according to predefined analytical categories used in the questionnaire. The analysis showed three overall key findings. First, sound empirical evidence is essential for adopting a HiAP approach. Second effective intersectoral mechanisms enhance implementation feasibility. Third, results-based monitoring and evaluation contribute to the continuity of the analyzed intersectoral public policies. Finally, political support is needed throughout the policy process to maintain governance capacity and deliver results. Finally, we drew five global policy lessons that may be applicable in similar public policy settings in other countries. First, both technical and political enablers help set the intersectoral agenda. Second, effective communication is instrumental in convincing all stakeholders to address public health-related policy issues. Third, political support at the highest level possible and the federal government’s capacity are essential to implement sound policies. Fourth, several enablers exist for enhancing collaboration between ministries during implementation. Finally, monitoring and evaluation results are necessary for sustaining intersectoral policies beyond administrations.

Background: As adolescent suicide rates have increased, there has been a nationwide focus on legislation requiring school districts to create suicide prevention policies. There is a lack of tools to make a quantitative assessment of the quality and breadth of school-district suicide prevention policies. Thus, we developed a proof-of-concept instrument, the School District Suicide Policy Evaluation Tool (SDSPET). Methods: The SDSPET is derived from the “Model School District Policy on Suicide Prevention,” a document compiled by four nationally recognized suicide organizations. As a preliminary validation of the SDSPET, four independent raters used the SDSPET in a systematic analysis of suicide prevention policies for all school districts in Utah. Results: Inter-rater reliability was calculated to be 98.8% with intraclass correlation analysis. Analysis revealed a right-skewed distribution of policy scores, and a median total score was 2.25 out of 36 possible criteria. Conclusion: This proof-of-concept study demonstrates the utility of the SDSPET in quantifying the shortcomings of school-district policies on suicide while generating specific recommendations for improvement. With further validity testing, we expect this tool to be beneficial to school district administrators, education policymakers, and those studying suicide interventions and outcomes in school-aged children and adolescents.

Introduction: Against the challenging socio-political backdrop of the country, this research examines the periodontal health of pregnant women in Sri Lanka. Methods: This analytical cross-sectional study was conducted among 576 pregnant women, attending community Antenatal Clinics in a selected Medical Officer of Health area, in Sri Lanka. A two-stage cluster sampling method with a probability proportionate to size technique was used to select the clinics. Systematic sampling was used to recruit pregnant women from each clinic. An interviewer-administered questionnaire and oral health examination form were used for data collection. Results: Over 60% exhibited poor oral hygiene. Moderate to severe gingivitis was seen among 23.3%. Approximately 67% of participants demonstrated poor knowledge about periodontal diseases. About 67% of the study participants were unemployed and 32.47% had a monthly income of less than 40,000 rupees. Regression analysis identified the trimester of pregnancy, socioeconomic indicators, frequency of dental visits, recent full mouth scaling, and knowledge about periodontal diseases as significant predictors of oral hygiene status. Age, trimester, brushing frequency, recent full mouth scaling, and knowledge about periodontal diseases predicted the gingival status. Participants with a lower socioeconomic status demonstrated poorer oral hygiene and gingival health. Conclusion: There was suboptimal oral hygiene and gingival health coupled with limited access to dental care and inadequate knowledge about periodontal health that demands urgent interventions. The high prevalence of unemployment combined with the association between low socioeconomic indicators and poor periodontal health outcomes, underscores the importance of empowering young women through education and employment.

The World Health Organization's definition of oral health frames the discussion, highlighting its holistic nature encompassing physiological, psychosocial, and functional dimensions. The current estimates of oral diseases in Tanzania and around the world underscore the urgency of intervention, particularly in light of rising sugar consumption trends. The unique challenges facing Tanzania, including inadequate knowledge, limited infrastructure, and disparities in oral healthcare access, are analyzed within the broader context of sub-Saharan Africa's health priorities. This perspective addresses the multifaceted challenges of oral health neglect in Tanzania, emphasizing the imperative for a comprehensive and integrated approach. The commentary offers a detailed exploration of determinants contributing to oral health neglect, spanning socioeconomic, behavioral, and commercial factors, with a focus on their implications for Tanzanian communities. Recommendations are presented as a strategic roadmap, encompassing public health education, integrated healthcare services, government intervention, educational programs, community engagement, financial accessibility, and research initiatives. By synthesizing these recommendations into a cohesive framework, a proactive and collaborative approach to mitigate the consequences of oral health neglect in Tanzania, emphasizing the need for transformative policies 3and cultural sensitivity are therefore envisioned.

Introduction: Scrub typhus is a neglected life threatening acute febrile illness caused by bacteria Orientia tsutsugamushi and it is a vector-borne zoonotic disease. In 2009, scrub typhus outbreak at Gedu has awakened Bhutan on the awareness and testing of the disease.Information and data of the study highlights the need for in depth surveillance, awareness among prescribers and initiate preventive measures in the country. Methods: We used retrospective descriptive study through review of laboratory registers across three health centres in Zhemgang district, south central Bhutan. The laboratories registers have been transcribed into CSV file using Microsoft excel. Variables of interest were collected from the registers and then analysed using open statistical software R, (R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria.) And use of mStats package, (MyoMinnOo (2020). mStats: Epidemiological DataAnalysis. R package version 3.4.0.) Results: Of the total 922 tests prescribed for suspected scrub typhus in the three health centers in Zhemgang, only 8.2 % (n=76) were tested positive. Of these, Panbang Hospital had highest reported positive for scrub typhus with 56.6 %( n=43) followed by Yebilaptsa Hospital 35.5 %( n=27) and Zhemgang Hospital with 7.9 %( n=6). The female gender is comparably more affected as opposed to male with 57.9% (n=44) of the positive cases being female. The prevalence of scrub typhus seems to be affected by the seasonal variation as the months of Spring, Summer and Autumn together accounts for 98.7%(n=75) of total positive cases. The year 2019 noted significant scrub typhus cases accounting to 89.5 %(n=68) of the total positive cases over the two years. Conclusions:The overall tests tested positive of the scrub typhus infection within two years was 8.2%.