International Journal of Public Health and Epidemiology

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 8 (11), pp. 001-004, November, 2019. © International Scholars Journals

Full Length Research Paper

Some emerging issues in medical admission pattern in the tropics

O.O. Okunola, *A.A Akintunde, P. O. Akinwusi

Department of Medicine, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria

Accepted 05 July, 2019

Abstract

Infectious diseases are an important cause of morbidity and mortality in Sub-Saharan Africa. However, there is a changing pattern in terms of medical admissions worldwide with an alarming increase in the prevalence of non-communicable diseases (NCDs) especially in the tropics over the last decade. A regular review and audit of medical admissions is necessary for health policy formulation and resource allocation. The aim of this study was to describe the pattern of medical admission in a Nigerian University Teaching Hospital and highlight the emerging trend.A retrospective review of medical admission at the LAUTECH Teaching Hospital, Osogbo, South Western Nigeria over a 3 year period (January 2005 to December 2007). 1786 patients were admitted into the medical wards during the period of study. This consisted of 1089 males (61.0%) and 697 females (39.0%) with age range 14-96 years, mean of 51years (±16.89) and a male to female ratio of 1.5:1. Elderly subjects (≥ 60 years of age) were the largest age group accounting for 27.3% and 29.8% of male and female admissions respectively. The indications for admission in order of frequency were cerebrovascular disease 239 (27.5%), Diabetes mellitus 194 (22.2%), Chronic Kidney Disease 116 (12.4%) and Tuberculosis 151 (16.6%). NCDs accounted for a significant number of admissions in this study. The elderly constitued the major age group. Non communicable diseases are the commonest indication for medical admission. There is therefore an urgent need for intensification of existing preventive strategies to combat the insurgence of NCDs.

Keywords: Tropics, Medical, Tuberculosis, Infectious diseases

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 8 (11), pp. 001-004, November, 2019. © International Scholars Journals

Case Report

Immune reconstitution inflammatory syndrome:  Case series from Abuja

*Okechukwu AA and **Mamuna CC

*Department of Paediatrics, University of Abuja Teaching Hospital,Gwagwalada.

** Institute of Human Virology, Nigeria.

Accepted 16 July, 2019

Abstract

There is paucity of information on immune reconstitution inflammatory syndrome in children in Nigeria. We reported two cases of IRIS in a 7 and 14 years HIV infected Nigerian boys managed at the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. Immune reconstitution inflammatory syndrome was diagnosed and managed in 4 out of 1,027 (0.38%) HIV positive paediatric patients started on antiretroviral therapy at the health institution over a 6 years period.

Keywords: Immune reconstitution inflammatory syndrome, highly active antiretroviral therapy, Nigeria.

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 8 (10), pp. 001-013, October, 2019. © International Scholars Journals

Full Length Research Paper

Prevalence and risk factors of postpartum depression and barriers to treatment: A literature review

Saleh Rahman,¹ MD, Ph.D., MPH and Erin Manglardi,² MPH

¹University of Central Florida, College of Medicine, United States

²St. George’sUniversity School of Medicine, Grenada, W.I.

Accepted 18 June, 2019

Abstract

Objective:  To assess the prevalence of postpartum depression, the risk factors affecting the onset in men and women, consequences of postpartum depression on raising a child and the barriers which lie in the way of effective treatment. Methods: A systematic literature review written using online databases. PubMed Medline, DynaMed Plus and EBSCOhost were the preferred search engines for this review. Articles were found using the key words below the search was narrowed down based on the main topic of the study, specifically, postpartum depression. All studies were peer reviewed and published between 2007-2018. Results: Prevalence of PPD varies dramatically between low income (so called developing) and high income (so called developed) countries and although rates have decreased over the years, it still affects a significant portion of postpartum men and women. In the developed world, the incidence of postpartum depression ranges from 7-12% while the incidence in developing countries may be as high as 50%.² Common risk factors were identified in both the developing and developed world. These include low socioeconomic status, poor marital quality, having an African American or Mexican American background and a previous history of depression.¹¹

Keywords:Depression, Postpartum, Pregnancy, Psychosocial Factors, Barriers, Consequences, Hormones, Treatment.

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 8 (10), pp. 001-002, October, 2019. © International Scholars Journals

Review

Chikungunia outbreaks in new regions as a sign of ecological ill health: Re-examining vector borne disease in the context of climate change

R. Rajan Patil

School of Public Health, SRM University, Potheri, Kattankulathur – 603203, Greater Chennai, India. E-mail: [email protected]. Tel:  9600110872.

Accepted 16 May, 2019

Abstract

The Indian capital city of Delhi reported its first ever case of Chikungunya in June 2007. However, the way this case was detected, and reported raises serious issues related to general epidemiology and disease surveillance. This incident being the first reported case of Chikungunya from the resident of Delhi also raises much larger concern of changing infectious disease dynamics. The objectives of this study are: 1) Occurrence of new disease in new area should be treated as of sign of ecological ill health. Increase in frequency of outbreaks vector borne disease like Chikungunya in India could be manifestation of consequence of global warming.

Key words: Climate change, Chikungunya, global warming.

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 8 (10), pp. 001-004, October, 2019. © International Scholars Journals

Full Length Research Paper

Asymptomatic intestinal protozoan infections among inhabitants in Mexico City, Mexico

Takeshi Yoda^1,2*, Takeshi Suzue ², Tomohiro Hirao², Akira Yoshioka², Jarot Jazek Escobar Jimenes³, Tetsuo Yanagi⁴, Kazuo Minematsu⁴, Kensuke Goto⁴, Jephtha Christopher Nmor^4,5, Hiroshi Tachibana⁶, Yasuyuki Rakue⁷, Noriko Sakano⁸, and Nobuyuki Miyatake⁸

¹Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.

²Department of Public Health, Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan.

³Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.

⁴Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.

⁵Department of Animal and Environmental Biology, Delta State University, Abraka, Nigeria.

⁶Department of Infectious Diseases, Tokai University School of Medicine, Isehara, Japan.

⁷School of Tropical Medicine and Public Health, Tulane University Medical Center, New Orleans, LA, USA.

⁸Department of Hygiene, Faculty of Medicine, Kagawa University Miki, Kagawa, Japan.

Accepted 12 July, 2019

Abstract

Intestinal protozoan is still an important public health problem. We aimed to gain insight into the dynamics of intestinal protozoan infection with a view to describing the prevalence of intestinal protozoan in asymptomatic individuals in Mexico City, Mexico. The study population was primarily both in and out patients from four different hospitals who were referred for routine stool examination. Faecal specimens (510) were collected over a 3-weeks period from asymptomatic individuals. Specimens were tested for a range of protozoan infection using microscopic and partly Enzyme-Linked ImmunoSorbent Assay (ELISA) method. Seven known intestinal protozoan were identified from 54 faecal specimens, a total carriage rate of 10.6%. Blastocystis hominis were present in 22 specimens (4.31%), Entamoeba coli in 18(3.53%), Entamoeba disper in 8(1.57%), Entamoeba hartomanni in 2(0.39%), Giargia lambia in 2(0.39%), Iodoamoeba in 2(0.39%), and Endolimax nana in 1(0.2%). 10(2%) person were infected with two or more protozoa concurrently. These protozoa were all non-pathogenic, but are capable of discharging their cysts thus placing these asymptomatic carriers as potential distributors of intestinal protozoan infection. Considering the public health implication of asymptomatic carriers of intestinal protozoan infection, establishment of sustainable and regular de-worming programme in Mexico City coupled with health education messages on good hygienic practices are strongly recommend.

Key words: Blastocystis hominis, Mexico, Entamoeba, protozoan fecal.

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 8 (10), pp. 001-009, October, 2019. © International Scholars Journals

Full Length Research paper

Enhancing quality of healthcare under the national health insurance system: Identification of factors reducing quality of care in Taiwan

Li Chang

Department of Business Administration, Shih Hsin University, No. 111, Mu-cha Rd., Sec. 1, Taipei 116, Taiwan. E-mail: [email protected]. Tel: +886-2-2236-8225/63929. Fax: +886-2-2236-8669.

Accepted 11 July, 2019

Abstract

This study examines whether the quality of community health in Taiwan has improved after the establishment of the National Health Insurance (NHI); to identify what the related factors are that affect the quality, and to find the possible ways to improve key drivers of healthcare quality. Data were collected from the National Health Insurance Annual Statistics Information Database and the Taipei Health Information Indices Database in the form of unbalanced panel of 153 hospital-years from 1989 to 2002 in 13 Taipei public hospitals within different districts. In addition, panel data analysis with fixed effects model was conducted to identify what factors affected the quality of healthcare before and after the advent of the NHI. After the NHI, quality of care improved insignificantly. The elderly, market competition, new technology, average length of stay (LOS), scale, physician density and nurse to patient ratio were all major factors affecting quality. Moreover, lower doctor density, longer LOS and increased in the number of elderly led to deterioration in the quality of care. The government could improve quality of elder-care by encouraging the re-building of three-generation family values. Policymakers should also permit public hospitals to institute the incentive programs for their professional staffs. In addition, quality could be improved by having hospital managers who enhance efficiency by decreasing the LOS.

Key words: Quality, drivers of quality, national health insurance.