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Multiple Micronutrients Versus Iron Folic Acid on Neonatal Breastfeeding Intervals and Period in Kenya
Betsy Chebet Rono,
Yeri Kombe,
Anselimo Makokha
Issue:
Volume 3, Issue 4, December 2018
Pages:
105-110
Received:
6 July 2018
Accepted:
26 July 2018
Published:
19 October 2018
DOI:
10.11648/j.wjph.20180304.11
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Abstract: Exclusive breastfeeding within the first six months of life, provides sufficient infant nutrients, but remains a challenge for the postnatal women. Maternal pregnancy nutrient deficiency has long-term infant complications: heart disease; heart attacks; deaths; and irreversible cognitive challenges. Half of under five morbidity and mortality are associated with under nourishment. The study introduced multiple micronutrients to promote maternal nutrition to try and influence sustained exclusive breastfeeding to support neonatal and infant health. The study defined sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on breastfeeding outcomes up to six weeks (42 days) post delivery. The study determined variations on breastfeeding intervals and period among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a Block Randomized Controlled study; treatment arm was administered with MMs while the control arm continued with the usual standard care of IFA. A structured Questionnaire with open and closed ended questions was employed to answer the research questions. Focus group discussions were conducted to collect qualitative data on impact of prenatal multiple micronutrients among the infants. The study demonstrated a significant difference in breast milk amounts and substitution between the treatment and control arm and assumed non-equal variances with a Levene’s test <0.10 (f=7.379, p=0.009): breast feeding was initiated immediately at 100% for MMs and 68.8% for IFA; breast milk was available within 30 minutes post delivery in 86.3% of MMs and 25% for IFA (t, -4.8 p =0.000); breast milk amount was sufficient at 100% for MMs and 60.7% for IFA (-3.697, p=0.001); and no breast milk substitution was effected at 100% for the MMs, while breast milk was substituted in 18.5% of the IFAs within 42 days post delivery (t,-2.190, p=0.033). The study demonstrated significant benefits in micronutrient supplementation to promote infant health compared to the Iron folic acid use by enhancing exclusive breastfeeding practice.
Abstract: Exclusive breastfeeding within the first six months of life, provides sufficient infant nutrients, but remains a challenge for the postnatal women. Maternal pregnancy nutrient deficiency has long-term infant complications: heart disease; heart attacks; deaths; and irreversible cognitive challenges. Half of under five morbidity and mortality are ass...
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Family History and BMI Correlate with Blood Pressure: A Cross-Section Study
An-le Li,
Yue-qin Shao,
Hong Yuan,
Yi-ying Zhang
Issue:
Volume 3, Issue 4, December 2018
Pages:
111-117
Received:
21 August 2018
Accepted:
9 October 2018
Published:
7 November 2018
DOI:
10.11648/j.wjph.20180304.12
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Abstract: Hypertension is a general disease which is caused by complex polygenic inheritance, environment and multiple risk factors. The specific proportion of genes and the environment, however, was different in the previous published studies. The objective of this study is to identify the correlation between family history of hypertension (FH) and body mass index(BMI) with blood pressure based on cross section data. The correlation and interaction of FH and BMI on blood pressure is measured of 96646 patients with complete data which is selected from the database of screening in hypertension registry and follow-up management system by statistical analysis. 46.52% of patients with high blood pressure had FH, and 43.52% of patients with high blood pressure are overweight or obese. The average onset age of hypertension in cases without hypertension family history is 65.11 years old, and the average onset age in cases with hypertension family history is 60.17 years old. The average onset age of hypertension in cases in normal weight subjects is 64.01 years old, while the average age in overweight and obese subjects are respectively 61.55 and 61.11 years old. The independent effect of FH and BMI on SBP are OR=1.01 (95%CI:0.98～1.06) and OR=1.26 (95%CI:1.04～1.54) respectively, and the joint effect is OR=1.43 (95%CI:1.11～1.83); the independent effect on DBP are OR=1.75 (95%CI:1.66～1.85) and OR=1.99 (95%CI:1.89～2.09) respectively, and the joint effect is OR=2.37 (95%CI:2.25～2.50). The pure attributable proportion of interaction of FH and BMI on SBP is 37.21%, and that on DBP is 27.01%. FH and BMI have positive interaction with blood pressure. FH and BMI have positive correlation with blood pressure. Both of them (FH and BMI) can simultaneously increase the risk of hypertension, and lead to earlier age of onset.
Abstract: Hypertension is a general disease which is caused by complex polygenic inheritance, environment and multiple risk factors. The specific proportion of genes and the environment, however, was different in the previous published studies. The objective of this study is to identify the correlation between family history of hypertension (FH) and body mas...
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Survival and Mortality Analysis for HIV Patients in Khartoum State, Sudan 2017
Rania Hassan Abdelgafour Hassan,
Asma Abdellah Abdelaal,
Haidar Abuahmed Mohammed,
Malaz Ahmed Elbashir,
Khalid Badereldien Khalid
Issue:
Volume 3, Issue 4, December 2018
Pages:
118-124
Received:
8 October 2018
Accepted:
1 November 2018
Published:
29 November 2018
DOI:
10.11648/j.wjph.20180304.13
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Abstract: HIV epidemic in Sudan is low with prevalence of 0.3% among general population. The prevalence is higher among key population such as female sex workers and men having sex with men. Thirty percent of the estimated people living with HIV know their status, and 50% were on care by the end of 2016. Attrition rate in Sudan was highest in first 6 months, it was around 60% in 2014. This paper intends to conduct survival analysis for HIV/AIDS and investigate factors determining it, in Khartoum state, 2017. The study is retrospective cohort, facility based using data from the clinical records of adult HIV/AIDS patients who were enrolled in anti-retroviral therapy in Khartoum state between January and December 2015. Cox regression and Kaplan-Meier analyses were performed to examine factors that influence time to death and survival over time. Total of 547 people living with HIV on antiretroviral therapy- ART from all ART centres in Khartoum states during 2015 were included in the study, data collection and compilation was conducted in October 2017. The retention rate was (45.3%), AIDS related mortality rate was (9.9%), and lost to follow up rate was (37.1%). Cox regression model for mortality indicated significant association between survival and the following parameters: the functional status at start of ART (Hazard ratio - HR 4.765), alcohol use has (HR: 4.392), and world health organisation clinical stage at start of ART (HR: 1.859), all had negative impact on survival and increased risks for mortality. Literacy level status reduces mortality and increases survival time, as (HR: 0.338) and adherence to CTX (HR: 0.013). The study concluded that average survival time is significantly associated literacy level, duration between diagnosis and initiation of ART, functional status at start of ART, WHO stage at start of ART, and adherence to CTX. It is recommended that care providers showed modify existing follow up mechanisms to ensure provision of needed care to the patients with the identified determinants. In addition, the National HIV Guidelines should emphasize shortening the duration between diagnosis and linkage to care and early initiation of ART.
Abstract: HIV epidemic in Sudan is low with prevalence of 0.3% among general population. The prevalence is higher among key population such as female sex workers and men having sex with men. Thirty percent of the estimated people living with HIV know their status, and 50% were on care by the end of 2016. Attrition rate in Sudan was highest in first 6 months,...
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Healthcare Spending on the Quality of the Nation’s Health: An Analysis of Public Perceptions
Ray Martell Merrill,
Gordon Bangerter Lindsay,
Chelsi Alexander
Issue:
Volume 3, Issue 4, December 2018
Pages:
125-130
Received:
15 October 2018
Accepted:
26 October 2018
Published:
21 December 2018
DOI:
10.11648/j.wjph.20180304.14
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Abstract: This study evaluated the public’s perception of how increasing levels of GDP spending on healthcare impact average life expectancy, according to a representative sample of adults in the United States. Statistical analyses correlated the responses with selected demographic variables. The results show that the sample placed greater importance on advances in healthcare than on public health efforts for explaining improved life expectancy over the past century. The sample perceived that increased spending on healthcare through 100% of GDP would continue to promote higher life expectancy. As to why life expectancy has improved, 72% of men and 68% of women (p = 0.0004) attributed it to healthcare. The second most common reason given was lifestyle (10%), followed by diet (9%), education (2%), sanitation (2%), and other (6%). A positive linear relationship was observed between percent of GDP spent on healthcare and perceived life expectancy for all education groups, but the estimated slope showing the relationship decreased with increasing education. In addition, estimated life expectancy when 0% of the GDP was spent on healthcare increased from 30.4 for those with some high school to 40.4 for those with some college, to 45.8 for those with a college degree, to 48.8 for those with a doctoral or professional degree. With greater importance placed on healthcare than public health, over spending on healthcare as opposed to public health will likely result in declining health outcomes and life expectancy in the future.
Abstract: This study evaluated the public’s perception of how increasing levels of GDP spending on healthcare impact average life expectancy, according to a representative sample of adults in the United States. Statistical analyses correlated the responses with selected demographic variables. The results show that the sample placed greater importance on adva...
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Managerial Factors Affecting the Provision of Quality Sexually Transmitted Infections Primary Health Care Service in El-Damazin, Sudan 2015-2016
Khalid Fadl Alla Khalid,
Nada Jafar Osman,
Malaz Elbashir Ahmed,
Rania Hassan Abdelgfour
Issue:
Volume 3, Issue 4, December 2018
Pages:
131-135
Received:
22 September 2018
Accepted:
25 December 2018
Published:
18 January 2019
DOI:
10.11648/j.wjph.20180304.15
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Abstract: Provision of quality health care service is the product of cooperation between the patient and the healthcare provider (HCP) in a supportive environment. The efficiency of STIs health program requires proper management and efficient use of resources. In Sudan the STIs services are provided as part of PHC service package. The management and responsibility for PHC centers is decentralized to state and locality levels. This study investigated the managerial factors at health care system , and care provision levels that affect the provision of quality STIs service, and consequently the utilization of STIs health service, in El-Damazin locality at Blue Nile state (BNS), 2015- 2016. The study design was descriptive cross-sectional facility-based applying qualitative research method. Purposive sampling technique was applied for health program managers at state ministry of health (SAP coordinator, RH coordinator and the manager of curative medicine department) and the care providers at all primary health centers in El-damazin locality (total of eight centers and ten care providers). Both content and framework analysis was performed. The following findings were identified by the program managers as barriers to the provision of STI services: the verticality state AIDS program (SAP) and reproductive health program (RH), ineffective coordination between both SAP, RH, and the curative medicine department, and inadequate financial & technical resources. The STIs were reflected in the annual plans, however not prioritized and budgeted. The care providers were not following the standard STI syndromic management protocols, they identified the lack of treatment protocol tools, and no recent trainings on STIs were the main barriers to provide quality services. In addition, the care providers indicated low health seeking of the surrounding communities for STI. It is recommended that proper advocacy on the importance of STI, in addition to effective coordination between the relevant programs at ministry of health should be activated, and are mandatory to ensure proper technical and financial resource mobilization which consequently will yield into provision of quality management of STI program. Moreover, care providers are required to be equipped with the necessary skills and tools in order to provide high quality syndromic management of STIs.
Abstract: Provision of quality health care service is the product of cooperation between the patient and the healthcare provider (HCP) in a supportive environment. The efficiency of STIs health program requires proper management and efficient use of resources. In Sudan the STIs services are provided as part of PHC service package. The management and responsi...
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