Epidemiological Investigation of A Goat Rabies Outbreak and Assessment of Knowledge, Attitudes, and Practices of Communities Regarding Rabies in the Rural Commune of Sabou, Burkina Faso

Background: Dog-mediated human rabies is one of the top five priority zoonotic diseases identified for the One Health multisectoral engagement in Burkina Faso. Integrated approaches are required in endemic areas for reliable data collection and improved management of bite victims. This study aimed to assess the knowledge, attitudes, and practices of communities regarding rabies and preventive methods.Subjects and Method: A cross-sectional household survey was conducted in the Commune of Sabou after a goat rabies confirmation. A structured questionnaire was administered to 305 house-hold members to capture data. The dependent variables in this study were the knowledge of rabies and animal vectors, the action to be taken regarding the biting animal, the main challenges to PEP coverage, the knowledge of preventive measures, and the minimum age recommended for primo-vaccination. The independent variables in this study were gender, level of education, professional status, and dog-owning status. The study was analyzed using the Chi-Square test.Results: The results provided that the suspected goat was infected by the rabies virus. Subsequently, the outbreak joint investigation initiated involved key local stakeholders. Data collected during the investigation raised the need for counter-measures such as identification of awareness gaps, organization of a dog rabies vaccination, and awareness-raising campaigns in the local communities. The household survey revealed low awareness about animals involved in human rabies transmission, the common routes of transmission, and the postexposure prophylaxis. Moreover, hindrances to postexposure prophylaxis access cited by the participants were related to frequent vaccine shortage (39.7%) as well as financial inaccessibility (60.3%). In addition, 40% of participants were not well aware of pet rabies prevention and reported only 67.6% of owned dogs were vaccinated.Conclusion: According to the study results, there is a need to strengthen rabies surveillance, promoting outbreak joint investigation, and integrated bite case management. Moreover, key messages on animal and human rabies prevention should be developed and shared with the communities. Keywords: Canine rabies, zoonoses, joint investigation, community awareness, public health, household surve

An Epidemiological Study Incidence Rates of Risk Factors for Colorectal Cancer's Early Symptoms in the Community in Gondanglegi District, Malang, East Java, Indonesia: An Epidemiological Study

Background: Colorectal cancer (CRC) is one of the most common types of cancer worldwide. CRC is most typical symptom is hematochezia while the risk factors encompass sex, age, genetic predispositions, history of colorectal polyps or cancer, chronic inflammatory bowel diseases, physical exercise, and specific dietary choices, including high red meat intake, fried food, and low fiber consumption. This study aims to screen the risk factors of colorectal cancer.Subjects and Method: This research was conducted on residents in the Sepanjang village, Malang Regency, involved in community service by the Internist Association of Malang. Community service was carried out in July 2023 and 148 residents were involved in collecting data on risk factors for colorectal carcinoma. Data collection was carried out using a questionnaire with a cross-sectional approach. The questionnaire assesses the presence of symptoms of bloody stools and several habits related to colorectal carcinoma risk factors, including age, gender, exercise routine, and dietary history. Data presentation and analysis were carried out as in the table.Results: Among the risk factors listed assessed using the questionnaire, Men (p=0.021), lack of exercise (p= 0.008), consumption of fried food (p= 0.021), and consumption of instant noodles (p= 0.013) significantly affect the prevalence of hematochezia.Conclusion: Men, lack of exercise, consumption of fried food, and consumption of instant noodles significantly affect the hematochezia indicating CRC

Incidence of Tuberculosis in Primary Health Care during the COVID-19 Pandemic: A Longitudinal Study and Perspective from Eastern Indonesia

Background: Efforts to fight tuberculosis (TB) infection requires a deep understanding of disease control trends to consistently sustain and enhance the identification and treatment of at-risk populations. Indonesia is the third highest globally in TB cases, followed by India and China, accounting for about 10% of all cases. Over the past ten years, Indonesia has witnessed significant TB case reporting and treatment coverage growth. This study aimed to analyze TB case occurrences in a primary health-care setting during the COVID-19 pandemic.Subjects and Method: A cross-sectional study, which included data from the Puskesmas Lau reports from July 2021 to July 2022. A total of 71 patients were conducted using the total sampling method. The collected data were processed descriptively to summarize participants' demographic characteristics and clinical profiles and various important indicators from WHO were analyzed to determine its effectiveness.Results: The center's tuberculosis screening efforts have not reached their optimal level, falling below the national standard of ≥70% for the Case Detection Rate (CDR). However, the treatment success rate (SR) exceeds 90%.Conclusion: The evaluation of the TB control program at Puskesmas Lau reveals achievements in some areas but also highlights challenges posed by the pandemic and the need for strengthened strategies to improve case detection and management. Perceived vulnerability, seriousness, benefit, and barrier, as well as the availability of DOTS treatment, affect treatment adherence. Partnership between patients and health care personnel is recommended to increase the success of TB treatment. Keywords: Tuberculosis, primary health care, COVID-19, longitudinal study, health service

Factors Determining The Delay in Access to Appropriate Emergency Obstetric Care During The Lockdown Period of The COVID-19 Pandemic: An Observational Study at A Tertiary Referral Centre

Background: The WHO declared the COVID-19 pandemic as a public health emergency of inter-national concern following which many governments around the world adopted the most radical social distancing procedure, referred to as “lockdown”, to prevent the spread of the virus. As a result, unsupervised pregnancies and the absence of routine antenatal visits lead to dreaded maternal and fetal complications. This study determines the barriers to accessing emergency care by pregnant women during the lockdown period.Subjects and Method: This prospective study was conducted during the lockdown period in Delhi from 1 May 2021 to 31 May 2021. A total of 666 pregnant and postpartum patients admitted from casualty during this period were included. The variable of the study was various factors causing delays of more than 4 hours in accessing emergency care services by these patients after the onset of symptoms was assessed. This study used the conceptual model of Three Delays. The data was collected as per predesigned proforma. The demography, Obstetric profile, and various levels of delays were noted. The data was analyzed by frequencies and percentages using SPSS version 21.Results: Among 666 enrolled participants, about 55.7% were multigravida and 48.04% belonged to the upper-lower class. Nearly 43% of patients were illiterate. Antenatal delay of > 4 hours was observed in 590 patients (88.6%). In Level 1 delay, the main reasons for the delay were unawareness of danger signs (45.8%) and lockdown (30.93%). The major reason for the Level 2 delay was care declined at the previous center (33.93%). Reasons for the Level 3 delay were due to either unavailability of beds or overcrowding after reaching the facility.Conclusion: The unawareness of danger signs was the most common cause of delay. Hence, effective communication and counseling during the antenatal period have to be improved upon

Multilevel Analysis: Factors Related with Quality Service of Elderly Community Health Post in Sukoharjo Central Java

Background: The quality of health services is the difference between patient expectations and their perceptions of the services they receive, thus the quality of health services shows the success of a health service. This study aims to analyze the factors that influence the quality of at the elderly community health post.Subjects and Method: This research was a cross-sectional study conducted at 25 at the elderly community health post in Sukoharjo Regency, Central Java in November 2023. The sample consisted of 200 elderly people using random sampling. The dependent variable is the quality of health services at the elderly community health post, while the independent variables are gender, age, number of visits, level of education, and income. Data collection was carried out using a questionnaire. Data were analyzed using multilevel linear regression analysis.Results: The results of multilevel analysis show that the assessment of the quality of health services decreases in elderly women (b= -0.82; CI95%= -1.65 to -0.01; p= 0.049), aged ≥66 years (b= -1.22, CI95%= -2.01 to -0.44; p=0.002), number of visits 6 times (b= -3.03; CI95%= -3.89 to -2.61; p <0.001), education ≥0.699, and income (b= -2.09; CI95%= -3.20 to 0.97; p<0.001). Posyandu has a contextual effect on assessing the quality of health services with ICC = 52.76%).Conclusion: The assessment of the quality of the elderly community health post service decreased in the elderly type, age ≥66 years, number of visits 6 times, education ≥high school, and income ≥Rp 2,000,000. at the elderly community health post shows quite large contextual effects on assessing the quality of health services. Keywords: Quality of health services, multilevel analysis, elderl

Mental Health Screening for University Students in the Special Region of Yogyakarta

Background: Mental health disorders occur a lot among students. Failure to overcome mental health conditions during this period can have a serious impact on their academic condition even on their physical and mental health in adulthood. This study aims to screen mental health in students at Muhammadiyah and Aisyiyah Universities located in the Special Region of Yogyakarta.Subjects and Method: This was a cross-sectional study. A sample of 251 students of Muhammadiyah and Aisyiyah Universities in the Special Region of Yogyakarta were selected by accidental sampling. The study variable was emotional mental disorders which were measured using the Self Rating Questionnaire-20 instrument. Respondents who experienced more than seven symptoms were indicated to have a mental-emotional disorder and needed psychological help. The data were analyzed descriptively.Results: The screening results revealed that 104 students (41.43%) were experiencing mental and emotional disorders and required psychological assistance. In terms of the underlying factors of these disorders, 87.50% of students reported feeling easily fatigued (low energy), 70.19% had difficulty making decisions (cognitive), 52.88% felt unhappy (depression), 55.77% experienced abdominal discomfort (physiological), and 79.81% reported feeling nervous, tense, and worried (anxiety).Conclusion: it is recommended that schools provide accessible psychological counseling and implement stress management programs to help students cope with fatigue, anxiety, and decision-making difficultie

Effect of Tertiary Preventive Behavior on HbA1c Level, Quality of Life, and Complication Risk in Diabetes Mellitus Patients

Background: Type 2 diabetes mellitus (DM) is a non-communicable disease which is a source of additional severity for other diseases. This study aims to determine the effect of tertiary preventive behavior on hba1c level, quality of life (QoL), and complication risk in diabetes mellitus patients.Subjects and Method: This was a cross-sectional study conducted in Sukoharjo, Central Java, Indonesia, from October to November 2023. A total sample of 200 patients with type 2 diabetes mellitus (DM), registered in the Prolanis program, was selected through multistage random sampling. The independent variables were HbA1c levels, risk of complications, and QoL. The inde-pendent variable was tertiary preventive behavior. HbA1c levels were measured using spectrophotometer. QoL was measured using the WHOQOL questionnaire, and risk of complications using a questionnaire. Data were analyzed using the SEM model.Results: Tertiary prevention behavior significantly increased HbA1c level (b= 0.31; CI 95%= -0.45 to 0.15; p<0.001) and quality of life (b= 0.15; 95% CI= -0.15 to 0.38; p<0.001). Tertiary prevention behavior significantly reduced the risk of complications (b= -0.22; CI 95%= -0.42 to 0.02; p= 0.026). The goodness-of-fit values suggest that the structural equation model (SEM) is acceptable (p= 0.188; RMSEA=0.04; CFI=0.97, TLI=0.95; SRMR=0.05; CD= 0.07).Conclusion: Tertiary prevention behavior significantly increased HbA1c level and quality of life. Tertiary prevention behavior reduces the risk of complications in type 2 DM patients. Keywords: Diabetes mellitus, HbA1c, complications, quality of lif

The The Impact of Exercise on Quality of Life, Physical Health, and Mental Health in Type 2 Diabetes Mellitus Patients: Meta-Analysis

Background: Type 2 Diabetes Mellitus (T2DM) is a prevalent metabolic disorder that is common on a global scale. Effective management in addition to medication involves implementing lifestyle modifications, including regular exercise. This study aimed to analyze and estimate the impact of exercise on improving quality of life, physical health, and mental health in type 2 diabetes mellitus patients.Subjects and Method: This was a meta-analysis study using the PICO model which includes; P= type 2 diabetes mellitus patients; I= exercise; C= no exercise; and O= quality of life, physical health, and mental health. The articles obtained were from 2 databases, namely PubMed and ScienceDirect. Keywords used include “exercise” OR “physical activity” AND “quality of life” OR “physical health” OR “mental health” AND “type 2 diabetes mellitus” AND “randomized control trial”. The inclusion criteria of articles were a randomized control trial study design, publication year from 2018 to 2023, full-text, English language, and reported mean and standard deviation values. Data was analyzed using the PRISMA diagram and the Review Manager 5.3 application.Results: This meta-analysis consisted of 13 articles originating from Canada, Denmark, Egypt, Ghana, Iran, Saudi Arabia, Spain, Taiwan, Turkey, and USA. The total sample size was 755 type 2 diabetes mellitus patients. Exercises improved the quality of life (SMD= 0.66; CI 95%= 0.20 to 1.11; p= 0.005); physical health (SMD= 0.91; CI 95%= 0.53 to 1.29; p= 0.001) and mental health (SMD= 0.82; CI 95%= 0.25 to 1.39; p= 0.005) in type 2 diabetes mellitus patients.Conclusion: Exercise carried out regularly and measurably improves the quality of life, physical health, and mental health in type 2 diabetes mellitus patients. Keywords: Exercise, quality of life, physical health, mental health, type 2 diabetes mellitus

Identification and Antifungal Susceptibility Pattern of Candida Isolates Recovered from Urine and Blood Specimens from Patients Admitted in Wards of a Tertiary Care Hospital, North Delhi

Background: Candida species are responsible for various clinical infections ranging from mucocutaneous infection to life-threatening invasive diseases. Increased resistance to antifungal drugs during the last decade has become a serious concern. Therefore, identification of Candida up to species level and its antifungal susceptibility testing is very important in the management of Candida infections. This study aimed to identify these organisms and study their susceptibility patterns.Subjects and Method: A retrospective study was conducted over 9 months (July 2022 to March 2023) from urine and blood samples collected from 80 IPD patients admitted to various wards of Hindu Rao Hospital. The samples were selected based on their growth on blood agar. The variables of interest are the different species of Candida and susceptibility to antibiotics. Identification of Candida species was done by Gram stain, Germ tube formation test, color on HiCrome Candida agar medium, chlamydospore formation on corn meal agar, and VITEK 2 Compact System. The MICs were interpreted according to the CLSI guidelines 2022.Results: 47 and 33 of urine and blood cultures were positive for Candida species respectively. Most of the isolates were from the Paediatric ward (28.75%), followed by the Medicine ward (27.5%). The most common species was C. tropicalis (56.25%) followed by C. albicans (23.75%). Most species of Candida were sensitive to amphotericin B, fluconazole, voriconazole, caspofungin, micafungin, and flucytosine except Candida albicans which showed 100% resistance to amphotericin B and Candida krusei which showed 66% sensitivity to voriconazole and 33% to caspofungin.Conclusion: Candida colonization has a considerable prevalence among patients hospitalized in our hospital. The species identification of Candida isolates along with their antifungal susceptibility pattern can help the clinician in better treatment of patients with candiduria and candidemia. Keywords: Candida, bloodstream infection, minimum inhibitory concentratio

Meta-Analysis: Effects of Smoking, Alcohol Consumption, and Low Physical Activity on Osteoporosis in Adults

Background: Osteoporosis is a systemic skeletal disease characterized by low mineral bone mass and microarchitectural deterioration of bone tissue. This study aims to analyze the effect of smoking, alcohol consumption, and low physical activity on osteoporosis in adults.Subjects and Method: This was a meta-analysis study using the PICO format. Population: Adults, Intervention: Smoking, Alcohol Consumption, Low Physical Activity, Comparison: No Smoking, No Alcohol Consumption, High Physical Activity, Outcome: Osteoporosis. Articles were searched using online databases such as PubMed, Google Scholar, Science Direct. The search for articles using the keywords "Smoking" OR "Tobacco" AND "Alcohol consumption" OR "Drinking" AND "Physical activity" OR "Exercise" AND "Osteoporosis" OR "Bone mineral density" AND "Cross-sectional". The inclusion criteria for articles used were articles published in 2013-2023. Articles were filtered using PRISMA flow diagrams and analysis was conducted using RevMan 5.4.Results: The meta-analysis used 15 articles with cross-sectional studies from Ireland, Nepal, Taiwan, South Korea, China, Iran, America, Brazil, India, Congo, and Thailand with a total sample of 111,478 samples. The risk of osteoporosis increased with smoking (aOR= 1.49; CI 95%= 1.04 to 2.16; p= 0.030), alcohol consumption (aOR= 1.04; CI 95%= 0.84 to 1.30; p = 0.690), and low physical activity (aOR= 1.17; CI 95%= 0.92 to 1.48; p= 0.210).Conclusion: Smoking, alcohol consumption, and low physical activity increase the risk of osteoporosis in adults. Keywords: smoking, alcohol consumption, physical inactivity, osteoporosis