Abstract:

 BACKGROUND

Although, birth defects are one of the leading causes of infant deaths and long term disabilities and have contributed significantly to the global burden of diseases, extensive researches have not been carried out in Guyana.

METHODS

A retrospective study, of 138 patients, diagnosed with Congenital Malformations at Georgetown Public Hospital Cooperation, between January 2007- December 2007was carried out. These patients’ medical records; inclusive of infant, neonatal intensive care and postnatal; were located and information was recorded in the form of a questionnaire which had structured and detailed parameters. Exclusion criteria were records for all stillborns, pregnanciesterminated at or after 20 weeks of gestation, out- patients and or patients in specialized clinics / institutions. Analysis on various variables (demographic distribution, clinical outcomes, clinical presentation, Apgar score, birth weight, maternal age, sex, ethnicity, previous infant with a birth defect, family history of a birth defect, known teratogenic exposure, maternal medical history, lack of folic acid supplementation and average length of hospital stay) was done using Microsoft Office Excel version 2003 for information on the epidemiology, management and clinical outcomes of the condition in the Guyanese population.

RESULTS

I found an estimate incidence 2240 cases of birth defects occurring annually in Guyana. The majority of cases were from Regions 4 (46.8%) and 3 (10.9%). The majority (73.9 %) of cases was seen in the age group birth-5 months, followed by (9.4%) > 50 months (>12 years old), 6-10 month (5 %) and 21-25 month (4.4 %). There was a male to female ratio of 1.3: 1 of having a birth defect. Afro-Guyanese accounted for almost one half (48%) of the cases followed by Indo-Guyanese, Mixed and Amerindians. The most common types of birth defects were congenital heart disease, Hirshsprung disease, hypospadia, cryptorchidism, accessory breast, club feet and syndactyl. The average length of stay was 6.5 days. One mother used alcohol and another used an abortificient during the current pregnancy. 82% of patients underwent surgery while 18% had medical interventions. Few patients had laboratory testing done. Patients generally had excellent clinical outcomes given a mortality rate of 0 %.

CONCLUSION

My findings highlight the clinical and public health importance that should be placed on Congenital Malformations in Guyana and to re-evaluate our approach to the condition and to introduce nation-wide screening practices.

References:

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Abstract:

Global burden of TB (1 Frequently asked questions about TB and HIV - http://data.unaids.org/pub/FactSheet/2006/TB_HIV_QA

References:

[1.] Community TB care :A concept framework . presented at the WHO-GFATM round 5 preparatory workshop geneva, 221 – 25 February, 2005

[2.] Concept paper for rapid assessment of a community – based HAST program in Nigeria

[3.] FHI/GHAIN. Proposal for community-based TB care project, March 2007.

[4.] FHI/GHAIN community – TB care (CTBC) program – and Update, March, 2008

[5.] FHI/GHAIN. Proposal for expansion of the community-based TB care project to 5 new states (in Nigeria)

[6.] National Tuberculosis and Leprosy control programme (NTBLCP). Department of public health, federal ministry of Health. Guidelines for community TB care in Nigeria.

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Abstract:

The purpose of this study is to investigate the Knowledge, Awareness, Perceptions and Beliefs (KAPB) of teenagers aged between 15 and 19 living on the Lower East Coast of Demerara (Cummings Lodge to Mon Repos) on HIV/AIDS. Randomly selected sixty Lower East Coast of Demerara teenagers were interviewed using a four page questionnaire and twenty one questions. The questionnaire was selected from the module on HIV/AIDS in the UNICEF End Decade Multiple Indicator Cluster Survey (MICS).

In response to a planned 2000 World Summit for Children, the United Nations Children Fund (UNICEF) developed the Multiple Indicator Cluster Survey as a useful tool for collecting data on primarily women and children. The following organizations worked together to develop the first MICS - UNICEF, World Health Organization (WHO), the United Nations Statistics Division, the London School of Hygiene and Tropical Medicine and the United States Centers for Disease Control and Prevention (CDC). Five rounds of MICS were done globally in 1995, 2000, 2006, 2009 and 2012 – 2014.

The results are presented in a manner that is consistent with UNICEF End Decade MICS Model Report. The results of the study will summarize key findings associated with teenagers aged between 15 and 19 living on the Lower East Coast of Demerara knowledge of the modes transmission of HIV/AIDS from mother to child, discriminatory attitudes towards people living with HIV/AIDS, knowledge on three means of preventing HIV transmission, their beliefs/misconceptions about HIV transmission. This study will calculate the percentage of teenagers who have ‘sufficient knowledge’ of HIV/AIDS transmission.

Given that Guyana has a high rate of teenage pregnancy. It is important that these issues be examined. This study is particularly relevant at this time when HIV/AIDS has emerged as an important health issue. 

References:

[1.] Bureau of Statistics and UNICEF. 2008. Guyana Multiple Indicator Cluster Survey 2006.

[2.] End Decade Multiple Indicator Cluster Survey Manual, Division of Evaluation, Policy and Planning, Programme Division, UNICEF, 2000

[3.] Guyana Multiple Indicator Cluster Survey Report, Bureau of Statistics (Guyana), July 2001

[4.] State of the World Population, 2013, United Nations Population Fund (UNFPA), 2013

Abstract:

Zimbabwe is ranked 17^th among the 22 high burden TB countries (HBC) in the world and has the second highest TB mortality rate in the world. Tuberculosis is one of the top 10 causes of infant and maternal mortality, and top five causes of death in children 1 – 4 years old (Zimbabwe National Health Profile, 2008). In 2008 pulmonary tuberculosis was the leading cause of death in the age group 5 years and above and the second most common cause of death in hospitals in all ages, after acute respiratory infection (National Health Profile). The crude death rate is 20 per 1000 and is mainly attributed to the high co-morbidity with HIV. 

References:

Abstract:

Background: This study is set to assess individual, enviromental and medication factors associated with Cd4 cell count in patients attending HIV/AIDS treatment and care clinic in Gulu Regional Referral Hospital. Gulu Regional referral hospital is located in the northern district of Gulu in Uganda. Gulu regional referal hospital performs CD4 cell counts to monitor HIV +ve patients Methodology: A cross sectional study, with study population of Gulu and target population being HIV +ve Patients attending HIV clinic in Gulu regional referal hospital. Systematic random sampling will be used. Questionaires will be administered to patients after informed consent. Results: will be presented in Texts, Tables, Graphs.

References:

Abstract:

In areas of low rainfall or high altitude, rain water harvesting (RWH) becomes an important source of water supply for domestic use. The study assessed the practice of rain water harvesting in a rural community in Edo state Nigeria. Using a cross sectional study design , a pre-tested structured interviewer administered questionnaire was administered to selected households. A structured observational checklist was used for assessment of quality of rainwater harvesting system.

Data was analysed using SPSS version 20, results were presented as frequencies, with statistical test applied where appropriate. Ethical clearance was obtained from the Ethical review board of the Irrua Specialist Teaching Hospital, Irrua.

Findings show that RWH was practiced by over 80% of households, with the roof top as the catchment area. Stored water was most commonly used for personal hygiene purposed. RWH practice was found to be unsatisfactory in the majority of households. Health education should focus on informing households on appropriate design and maintenance of RWH systems.

References:

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Abstract:

Salmonella infection is the one of the most common foodborne diseases in the world and is caused by a bacterial infection. There are many serotypes of Salmonella bacteria which may cause salmonellosis in animals and human. The two most commonly found types of Salmonella are S. typhimurium and S. enteritidis, however, the frequency of Salmonella serotypes varies between countries. ¹Approximately 40,000 cases of salmonellosis are reported annually in the U.S., 400 of these end in death, often as a result of dehydration from chronic diarrhea. ¹ It is also estimated that the actual number may be at least 30 times the number reported by the CDC since milder cases of salmonella are not diagnosed or reported.¹ Any person can contract salmonellosis, however, it is most often found in children below the age of ten years old. Those with impaired immune systems such as young children and old adults, as well as people with illnesses are most likely to have severe infections.

Additionally, people with AIDS are especially vulnerable, not only suffering from the most severe infections but also from episodes that are likely to recur. In the last decade salmonella infections have been shown to be decreasing in the United States, however, some types are still increasing. Although this disease can be found across the world, cases occurring in North America and Europe are most often reported by health experts. ² A number of Salmonella serotypes have developed resistance to several antibiotics most often used in salmonella treatment, this presents a potentially serious public health threat.¹

The purpose of this review is to examine the effectiveness of environmental control measures and laboratory diagnostic techniques in controlling the spread of salmonella worldwide. This is an important question to address because of the high frequency of infections of salmonella globally as well as the nature and vulnerability of the populations most at risk. This literature review format is appropriate in answering this question because it deals with the comparative evidence of antimicrobial resistance from different points of transmission and geographical locations and will address factors that promote progress in salmonella treatment and may provide insight into preventive actions that can be employed.

References:

[1.] "Salmonellosis Cause - National Institutes of Health (NIH).” N.p., n.d. Web. 24 July 2013 <http://www.niaid.nih.gov/topics/salmonellosis/pages/cause.aspx>.

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[12.]   Le Hello S et. Al. “Highly drug-resistant Salmonella enterica serotype Kentucky ST198-X1: a microbiological study.” Lancet Infect Disease Journal. 2013 Aug;13(8):672-9. doi: 10.1016/S1473-3099(13)70124-5. Epub 2013 May 28. Web Jul 24, 2013.

[13.]   S.L. Foley*, A. M. Lynne* and R. Nayak†, “Salmonella challenges: Prevalence in swine and poultry and potential pathogenicity of such isolates1, 2.” Journal of Animal Science. April 2008 vol. 86 no. 14 suppl E149-E162.Highwire.Web accessed Jul 24, 2013.

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Abstract:

Health services are intangible products, which need marketing strategies to optimize benefits to the individuals, families and the community. Like every product, tangible or intangible, an optimum marketing mix involving pricing, product quality, product promotion and product packaging or merchandising, can improve consumer satisfaction and their patronage of health products and services. Apart from training of trainers’ programs and specialized health education programs, the audience for a health service is generally heterogeneous, uncontrolled and diverse. There is a need for marketing research in order to select or segment an audience so that health services and products can be, designed in such a way that they are, affordable, accessible, comprehensible, user-friendly and attractive to consumers. Research must be targeted at defining community needs and perspectives while messages concerning health services and products must have clearly defined objectives. In addition, expected benefits from the health products and services must be clearly stated to the target audience. However, marketing policies should be implemented against the background of the humanitarian nature of health services and fundamental human rights.

References:

[1.] Araoye, M.O. (2004): Formulation of Research Objectives. Research Method Statistics for Health and social sciences. First edition. Ilorin. Nathadex Publishers. 33-36

[2.] Biswas, G., Sankara, D.P., Agua- Agum, J. and Maiga, A. (2013): Dracunculiasis (Guinea worm disease): eradication without a drug or a vaccine. Phil. Trans. R. Soc. B. 368(1623): 20120146

[3.] Boslaugh S. E., Kreuter M. W , Nicholson R. A., and Naleid, K. (2007): Comparing demographic, health status and psychosocial strategies of audience segmentation to promote physical activity. Health Education Research. 20(4): 430-438

[4.] Cheng, H., Kotler, P., and Lee, N. R. (2009): Developing Marketing Mix Strategies. Social Marketing for Public Health: An Introduction. Jones and Barlett Publishers. LLC. 21

[5.] Gordon, R., McDermott, L., Stead, M., and Angus, K. (2006): The effectiveness of social marketing interventions for health improvement: what’s the evidence? Public Health, 120(12):1133–1139.

[6.] International Conference on Primary Health Care (1978): Declaration of Alma Ata. www.who.int/publications/almaata_declaration_en. Accessed on 15/08/13

[7.] Kotler, P and N. R. Lee (2008): Social Marketing: Influencing behaviors for good 3rd Edition. Thousand Oaks. California. Sage Publications. I-2

[8.] Kreuter M., Lukwago S, Bucholtz D., Clark E. (2003): Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Educ. Behav. 30:133–46

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[12.]   Park, K. (2007): Communication for Health Education. Park’s Textbook of Preventive and Social Medicine. 19th Edition. Prem Nagar Jabalpur. M/s banarsidas Bhanot Publishers. 707-720. ↵

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[14.]   Ruiz-Tiben E. and Hopkins, D. R. (2006): Dracunculiasis (Guinea worm disease) eradication. Adv Parasitol. 61:275-309.

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[17.]   Vienna Declaration and Program of Action (1993): Article 5. World Conference on Human Rights. 20.

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Abstract:

Diabetes is one of the chronic diseases that affect both the young and old in our society. According to World Health Organization (2006), at least 171 million people worldwide suffer from diabetes and it is more prevalent in developed countries. According to American Diabetes Association (2006), there were about 20.8 million people with diabetes in United States alone, while in developing countries, increase in prevalence is expected to occur especially in Africa, where most patients will likely be found by 2030. This increase in incidence of diabetes in developing countries follows the trend of urbanization and lifestyle changes perhaps most importantly a “Western – Style” diet (World Health Organization, 2006). In Nigeria though no estimate of the individuals suffering from diabetes has been made, in a recent screening exercise carried out in Warri and Sapele (south east, Nigeria) where 787 people attended, 65% were diabetic and hyper-tensive (Urhobo National Association of North America, 2004). Also at University of Nigeria Teaching Hospital Enugu the number of patients that attend Wednesday diabetic clinic is alarming.

Diabetes is characterized by a disorder in metabolism of carbohydrate and subsequent derangement of fat and protein metabolism. Disturbance in production and action of insulin, a hormone secreted by the islets of langerhans in the pancreas is implicated in the disease (Shafer,2000). In addition to insulin, aging, over weight and several other hormones affect blood glucose level there-by preventing glucose from entering the cells (Clavell, 2005).This leads to hyperglycemia, which may result in acute and chronic complications such as diabetic keto-acidosis, coronary artery disease, cerebrovascular disease, kidney and eye diseases, disorders of the nerves and others (Iwueze, 2007).The management of diabetes poses a challenge to medical and nursing staff as well as to the patients themselves. Since diabetes is a chronic disease, most diabetic patients need to continue their treatment for the rest of their lives. The emphasis is usually therefore, on the control of the condition through a tight schedule of blood glucose and urine sugar monitoring, medication and adjustment to dietary modification (American Diabetes Association, 2003; Iwueze, 2007). Such a chronic condition requires competent self-care, which can be developed from a thorough under-standing of the disease process and the management challenges by the patient and family members. This pre-supposes a need for some form of diabetes education and counseling for the patient and family members. According to Colbert (2007) educating and supporting diabetic patients in managing their daily lives are important goals of diabetic patients care today. Unfortunately, about a third of the people suffering from diabetes may not be aware of it early considering the insidious onset and development (Iwueze, 2007). Regrettably too, many who are diagnosed with the condition demonstrate fears about the future and a general distaste because of the predominant misconceptions about the disease. This is heightened by the superstitious explanation of causation of diseases dominant in Africa where most diseases are caused by “poison” and/or “evil spirits”. Some of these problems highlighted can be taken care of if patients and indeed the general public are exposed to diabetes education (Iwueze, 2007).

References:

[1.] American Diabetes Association (2003). Guide to Medicine, Nutrition Therapy of Diabetes. wwwaadenetorg retrieved on July 18th 2007

[2.] American Diabetes Association (2004). Implication of The Diabetes Control, Complication Trials and Diabetic Care. wwwdiabetesorgretrieved on July 2nd, 2007.

[3.] American Diabetes Association (2006). Nutrition Recommendation and Intervention for Diabetes. Diabetes Care Journal. Vol 12:161-5

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[6.] Clavel CM (2005). Mayo Clinic on Managing Diabetes. New York: Kensington Publishing Corporation.

[7.] Colbert D (2007). The Bible Cure for Diabetes. New York: Siloam, A strang Company.

[8.] Dyuff RL (2006). Complete Food And Nutrition Guide for Diabetes Patients. California: John Wiley and Sons Inc.

[9.] Iwueze JO (2007). Managing your Diabetes: Assessment and Management of Patients with Diabetes Mellitus. Owerri: Skillmark Media Ltd. p. 42

[10.]   John ME (2007). Handbook of Diabetes Self Management Uyo: Bon Books Publishers p. 11

[11.]   Ngwu EK (2005). Knowledge, Attitude an Practice of Diabetic Patients on Diabetes care. Nsukka.

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[14.]   Strand R D (2007). Oxidative Stress.http://www.bionutrition.org/oxidative-stress.asp

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Abstract:

A descriptive study has been conducted between March and August 2013 on 196 patients consulting the oral clinic at Motebang Hospital aimed at to determine their epidemiological patterns. The findings are as follow:

·         The dental cavity is the most common oral disease with 40.0% and 34,8 % of which in severe clinical form;

·         the range of age between 6-10 years is consulting more than all others ranges the oral clinic with 17,7 %;

·         The dental care (brushing) is performed once a day with 72.2% and horizontally with 64.1%. The children less than 5 years and between 6-10 years do not perform any dental care per day in 28, 6 %( CI=28,6±3,9)

·         The intake of sugar (especially free sugar) is highest than any with 80.8% and the patients with high intake of sugar developed dental cavity in 81,8%;

·         The odds ratio between the sugars’ intake and the development of the dental cavity is 2,19 (OR 2,19; CI=44,3±6,7)

·         The frequency of jobless was 42.4%

·         The facial trauma especially fractures and dislocations of teeth represent 22.7% and are highly more frequent than periodontal diseases which represent 9.5%.

·         The frequency of congenital malformations was 4.0%

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Abstract:

BACKGROUND:

In this study, the factors affecting level of disclosure of HIV staus to sexual partners was studied among HIV positive women in Ikere Ekiti.

PATIENTS AND METHODS:

An interviewer administered questionnnaire was administered to 50 female respondent attending care and support group meeting. The degree of correlation between disclosure of HIV status to sexual partner and level of education was studied using chi square method at level of significance of α = 0.05. other factors were also compared e.g. stigmatisation, fear of divorce etc.

RESULT:

Despite effort and resources available for HIV care including counselling service, 76% of patient who have not disclosed their status are not ready for disclosure. The study also shows that there is no relationship between level of education and significance. Stigmatization is still a big challenge in the fight against the scourge as majority attached non disclosure to fear of stigma.

CONCLUSION:

Much effort is still required in the aspect of disclosure of HIV status among sexual partners through improvement of counselling section, legislation against non disclosure that is harmful to others and adoption of contract referal system into our health policy.

References:

[1.] Women, girls and HIV in Nigeria. National Agency for the Control of AIDS

http://naca.gov.ng/index2.php

[2.] Vu L. et al. Disclosure of HIV status to sex partners among HIV infected men and women in Cape Town, South Africa. HIV and AIDS program, population council, Washington DC 2008, USA.

[3.] Seid M. et al. Disclosure of HIV positive to sexual partner among adult clinical service users in Kemissie district, north east Ethiopia. Afrj Reprod Health,2012 Mar ; 16(1): 97-104

[4.] Gender difference in HIV status disclosure among HIV positive service user. Deribe K et al . East Afrj Public Health 2009 DEC: 6(3): 248- 55.

[5.] Talking about your HIV status, Institute of Human Virology, Nigeria .

www.ihvnigeria.org .