International Journal of Public Health and Epidemiology

International Journal of Public Health and Epidemiology (ISSN: 2169-303X) Vol. 2 (3), pp. 067-071, March, 2013. © International Scholars Journals

Full Length Research Paper                        

Perceived social support among the spouses of men living with HIV infection

Mohanarani Suhadev ¹, Udaya Mahadevan², Beena E Thomas¹ & Soumya Swaminathan¹

¹National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India.

²Loyola College, Chennai, India.

Accepted 13 February, 2013

Abstract

Social support is an important buffer for the spouses of HIV infected men. This paper aims to find out the support systems from three different sources namely relational, friends and professional for the women who are the family caregivers. The study included 201 women who accompanied their spouses and children to 3 hospitals at Chennai and Vellore, Tamilnadu, India, during January to June 2007. Social Support was measured by a 9 item scale used in the RAND Medical Outcome Study (Sherbourne & Stewart, 1991). Majority of the respondents were sero-positive (69%) and marriage was the only risk factor for them. Of 201 women, 122 (61%) reported that they disclosed their diagnosis of HIV to others and the scale measured different kinds of support namely companionship, intimacy and understanding and physical assistance. One fifth of the respondents did not get any support from others. About 59% of the respondents had someone to show love and affection and 46% had some persons to listen to them most or all of the time. But, they lacked persons to give them good advice and guide properly (41%). Most women caregivers of HIV infected men received social support mostly from their natal families and urban women enjoyed better social support.

Key words: Social Support, Spouses of HIV infected men, RAND Medical Outcome Study, Tamilnadu.

International Journal of Public Health and Epidemiology Vol. 2 (1), pp. 042-049, January, 2013 © International Scholars Journals

Full Length Research Paper

Stroke rehabilitation: Demographic profile and rehabilitation therapy costs of outpatients with stroke in Greece

Angelo V. Vasiliadis

Laboratory of Exercise Physiology and Biochemistry, Laboratory of Adapted Physical Activity, Department of Physical Education and Sport Science at Serres, Medical School at Thessaloniki, Aristotle University of Thessaloniki, Greece.

E-mail: [email protected]. Tel: +30 2310 537926.

Received 31 October, 2012; Accepted 04 January, 2013

Abstract

Stroke is one of the most expensive medical illnesses. In Greece, information on rehabilitation costs after hospital discharge and type of treatment sessions have not been reported. This study provided the demographic profile, the rehabilitation training program and the direct rehabilitation costs of stroke outpatients. A retrospective study, based on a sample of 18 outpatients with stroke, who were all local residents of the prefecture of Thessaloniki and had their first documented rehabilitation session between June 2008 and May 2010. The mean age was 58.8 ± 14 years and 83.3% had ischemic stroke. The direct rehabilitation cost for all stroke cases was €99,960 for a total of 169 months (591.5 € per month for rehabilitation). Pool therapy (52.4%) was the most utilized during rehabilitation. The mean length of rehabilitation period was 9.4 ± 5.9, months. At the end of rehabilitation training program, over half of the outpatients had the need for a walking stick (61.1%). Stroke onset was higher in the evening hours (44.4%) and the spring season was noted with the most cases (38.9%). Stroke patients without any type of insurance continue to incur considerable costs for their rehabilitation therapy program after their discharge from a hospital setting.

Key words: Stroke, rehabilitation, outpatient, cost, incidence, Greece. 

International Journal of Public Health and Epidemiology Vol. 2 (1) pp. 050-055, January, 2013 © International Scholars Journals

Full Length Research Paper

Determinants of helmet wearing behavior among motorcyclists in the Dominican Republic

Amy C. Dennis¹, Nichole Bosson², Jose Elias Collado Peralta³, Cesar Castillo⁴, Mark Foran⁵ and Stephen P. Wall⁵*

¹Department of Emergency Medicine, Kaiser Permanente Hospital, Oakland, California, USA.

²Department of Emergency Medicine, Los Angeles Medical Center, Harbor-University of California, Torrance,

California, USA.

³Department of Internal Medicine, Cleveland Clinic, Weston, Florida, USA.

⁴Department of General Surgery, Hospital Regional Universitario José Cabral y Báez and Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic.

⁵Department of Emergency Medicine, NYU School of Medicine, Bellevue Hospital Center, New York, New York, USA.

 *Corresponding author. E-mail: [email protected]

Received 26 October, 2012; Accepted 14 January, 2013

Abstract

Motorcycle-related traumatic brain injuries are a leading cause of morbidity and mortality in the Dominican Republic. Although rates of helmet use by motorcycle riders are low, little is known regarding the specific factors that drive this behavior. In this study, 26 adults in an urban Dominican hospital who self-reported riding motorcycles often without wearing a helmet participated in semi-structured qualitative interviews about their motorcycle use, collision history, and beliefs regarding helmets. A theoretical construct was created based on iterative coding of the resulting interview transcripts. Most participants understood helmets protect against head injury, yet stated that helmets are not needed for short distances, in rural areas, or when riding as the passenger. Perceived barriers to helmet use include cost, lack of access for passengers, and unattractiveness.  Participants revealed that the national law mandating driver helmet use did not apply to passengers and was not effectively enforced. Findings are discussed in relation to the Health Belief Model. Specific policy recommendations are proposed, including changes in national legislation to apply to motorcycle passengers, increased law enforcement in rural areas and with less predictability in urban areas, financial interventions to reduce the consumer cost of helmets, and cultural interventions to popularize motorcycle helmet use.

Key words: Behavior, helmets, motorcycles, trauma, attitudes, perceptions, Dominican Republic, qualitative. 

International Journal of Public Health and Epidemiology Vol. 2 (1) pp. 056-059,  January, 2013 © International Scholars Journals

Full Length Research Paper

Seroprevalence of rubella among women of childbearing age in Algeria. Is there a need for a rubella vaccination?

A. Ouyahia¹*, A. Segueni², S. Laouamri³, A. Touabti⁴ and A. Lacheheb¹

¹Division of Infectious Diseases Teaching Hospital, Faculty of Medicine, University Ferhat Abbes Setif.

²Division of Infectious Diseases Teaching Hospital, Faculty of Medicine, University of Constantine.

³Division of Epidemiology Teaching Hospital, Faculty of Medicine, University Ferhat Abbes Setif.

⁴Division of Microbiology Teaching Hospital, Faculty of Medicine, University Ferhat Abbes Setif.

*Corresponding author. [email protected].

Received 17 November, 2012; Accepted 14 January, 2013

Abstract

Controlling congenital rubella is one of the targets of the World Health Organization. Most countries currently include rubella vaccine in their national immunization programmes, but not yet in Algeria. The aim of this study was to determine the sero susceptibility of rubella infection among women of childbearing age and the feasibility of establishing an organized prevention program in Algeria. This prospective, cross-sectional study was examined in healthy women of childbearing age (who gave informed consent) living in both an urban and a rural region of the eastern of Algeria. 834 sera were collected between March 2005 and March 2007, and were screened for rubella immunoglobulins G (IgG) using the ethylene diamine tetra-acetic acid (ELISA)-based quantitative assay in the Microbiology Laboratory at the Teaching Hospital of Setif. The mean age of the women was 32 years (range: 18 to 48) and 39.2% were pregnant. None of the women ever had previous rubella vaccination. The global seroprevalence determined with a commercial enzyme immunoassay among 834 WCBA was 68.6% (95% CI: 65.3 to 71.7% ), leaving a high proportion of susceptibility (31.4%).The distribution of this prevalence appeared stable with no significant difference between the years of study, age groups, and residence . The lack of data on rubella and congenital rubella syndrome in Algeria should encourage medical authorities to establish a national rubella surveillance network in order to develop a strategy to survey and control congenital rubella syndrome (CRS) in the country. The present study which is the first national level data on seroprevalence of rubella among women of childbearing age, suggests the need for a policy to immunize all adolescent girls and/or women of childbearing age group against rubella before conception to control CRS.

Key words: Rubella, seroprevalence, women childbearing age, vaccination, Setif, Algeria.

International Journal of public health and Epidemiology Vol. 1 (3), pp. 035-039, December, 2012. © International Scholars Journals

Full Length Research Paper

Barriers to timely health seeking behaviour for children among care givers in an urban slum in Uganda

Nabukeera-Barungi Nicolette¹* and Stefan Peterson²

¹School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

²School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.

*Corresponding author. E-mail: [email protected]    

Received 4 October, 2012; Accepted 7 November, 2012

Abstract

Current population trends show increasing rural-urban migration, with majority living in urban slums. Studies show higher disease burden and childhood mortality in the slums than rural areas. Late reporting to hospital is the main contributor to the reported 50 to 70% of hospital deaths in the first 24 h of admission in resource limited settings. Providing a free health unit within 5 km radius of every community is assumed to bridge the access gap. We set out to describe barriers to timely health seeking behaviour among caregivers of children under- 5 years in an urban slum community with geographical access free healthcare. This qualitative research used focus group discussions and key informant interviews. Subjects were caretakers of children under- 5 years living in Makerere Kivvulu slum. Their perceived risks of death during illness, options when children get sick, preferences, determinants of their choices and barriers to health care were assessed. Our study found that the caretakers could identify the signs of serious illness which needed hospitalization. The availability of money was the main determinant of their healthcare choices. They had several options for health care but they preferred Mulago Hospital, a free national referral hospital which also serves as their first level health unit. They appreciated the quality of services and the close proximity but are overwhelmed by barriers to its utilization. These barriers included long waiting hours, bribery in the waiting lines, rudeness of the health workers, lack of drugs in these free facilities among others. Although the community in this urban slum seem to have geographical access to free medical services, financial access still remains the main barrier to its utilization. For communities which depend on a daily income, a day spent in hospital translates into financial loss. 

Key words: Urban slums, health seeking behaviour, free health services. 

International Journal of Public Health and Epidemiology Vol. 1 (3), pp. 040-041, December, 2012. © International Scholars Journals

Full Length Research Paper

Standard serological tests for diagnosis of bovine brucellosis in Mathura district of Western Uttar Pradesh, India

Indu Sharma¹* and B. Bist²

¹Department of Microbiology, Assam University, Silchar-788011, India.

²Department of Veterinary Public Health, U.P. Pt. Deen Dayal Upadhaya, Pashu Chiktsa, Vigyan Vishwa Vidhalaya, Ewam Go-Anusandhan, Sansthan, Mathura-281001, India.

*Corresponding author. E-mail: [email protected]  

Received 12 October, 2012; Accepted 26 November, 2012

Abstract

A total of 56 serum samples from suspected cattles and 5 from brucellosis-free non- vaccinated cattle herd were collected from various livestock farms in Mathura district of Western Uttar Pradesh, of which 16 serum samples found to be positive were subjected to all the three serological tests that is Rose Bengal plate test (RBPT), Standard tube agglutination test (STAT) and Dot- enzyme linked immunosorbant assay (ELISA) respectively. The isolation of Brucella abortus from cervical swab samples was vital in the confirmation of Brucella infection and epidemiological evaluation of the herd. High titer of 1:320 and 1:640 was observed in the present investigation. Two (12.5%) isolates out of 16 samples were positive by STAT and all the 6 RBPT positive samples (100%) exhibited negative results by STAT. However, it was observed that all the 16 samples (100%) which earlier revealed to be negative for RBPT and STAT exhibited positive results with Dot- ELISA. In the present study though Dot-ELISA proved to be the most sensitive of the 3 tests used, it can, however be suggested that a combination of RBPT and Dot ELISA should be used, especially in case of  those samples that are found to be negative by either RBPT or STAT used alone or in combination.

Key words: Brucellosis, Rose Bengal plate test (RBPT), Standard tube agglutination test (STAT), Dot enzyme linked immunosorbant assay (ELISA).