Exploring Diabetes Mellitus' Impact on Tuberculosis Outcomes: A Comprehensive Comparative Study

Background: Tuberculosis (TB) remains among the top ten global causes of mortality, with approximately 1.3 million deaths annually. Diabetes elevates the risk of active TB and treatment failure, potentially increasing drug-resistant TB (DR-TB). This study aimed to compare treatment success rates between TB patients with and without diabetes mellitus (DM) at Dr. Ramelan Central Naval Hospital, Surabaya.Subjects and Method: This cross-sectional study was conducted from January 2019 to December 2023 at Dr. Ramelan Central Naval Hospital Surabaya. A total of 158 patients with TB-DM and TB-NonDM were selected using total sampling. The independent variables were the Presence of Diabetes Mellitus in TB patients (TB-DM vs. Non-TB-DM). The dependent variable was the treatment success rate. The data were collected from patient medical records and analyzed using a chi-square test to compare treatment outcomes between TB-DM and TB-Non-DM patients.Results: The analysis included 158 medical records. Predominantly affecting those over 45 years, both TB-DM and TB-Non-DM patients commonly underwent six months of treatment, with success rates of 78% in TB-DM and 82.4% in TB-Non-DM cases. The chi-square test yielded a p-value of 0.511, indicating no significant difference in treatment success between the groups. However, older age and HIV-positive status were associated with lower odds of treatment success.Conclusion: Success rates were similar between the groups, showing no significant difference based on DM status. Despite similar success rates, older age and HIV-positive status were associated with lower odds of treatment success

Integration of Indonesian National Trauma Guideline into the Emergency Room System (Cipto Code Trauma System)

Background: Indonesia has enacted the national trauma guideline since 2017 and Cipto Mangun-kusumo Hospital (CMH) has applied it since 2019 through the establishment of Cipto Code Trauma. This study aimed to describe the compliance, system adherence, performance and outcome associated with the Cipto Code Trauma system.Subjects and Method: This cross-sectional study was conducted at CMH Emergency Room (ER) using direct observations and data from electronic health records (EHRs). Observations were performed on 106 trauma cases by convenience sampling to map clinical and non-clinical components using a checklist. We compared the implemented ER components against the 2017 national trauma guidelines, assessing the system compliance. Total sampling from EHRs was performed on 4,317 trauma patients to assess performance and outcome of Cipto Code Trauma system. The data were analyzed descriptively.Results: Observations from 106 trauma cases indicate that the Cipto Code Trauma meets all criteria from the national trauma guidelines. Performance indicators from 840 patients were achieved, including trauma team activation (87.6%), on-site multidisciplinary consultation (87.6%), time to physician assessment within five minutes (84.4%), except for length of stay under 4 hours (18.5%) and time to operating theatre within two hours (45.5%). Among the 4,317 trauma cases, the mortality rate for patients in the resuscitation category was 0.4%, while 39% of these patients were discharged directly from the ER.Conclusion: The Cipto Code Trauma at CMH has successfully integrated the Indonesian national trauma guidelines, meeting all required standards. However, further improvements are needed to enhance system adherence and performance

Knowledge and Attitude of Nigerian Women Aged 15-49 Years on the Practice of Female Genital Mutilation

Background: Female genital mutilation (FGM) is among the most harmful traditions that persist in many parts of the world, especially in Africa and other developing countries, including Nigeria, where the prevalence of FGM is still above 15%. This study aims to assess the knowledge and attitude of Nigerian women of reproductive age on FGM practice and its obstetric effects.Subjects and Method: This cross-sectional study examined Abujaarea women aged 15–49 in Nyanya General Hospital, Maitama, and Asokoro District Hospital Antenatal Care (ANC). A total of 634 patients who agreed to participate in the study were selected. The assessment examined respondents' knowledge and opinions about Female Genital Mutilation (FGM), sources of information, attitudes and beliefs, prevalence across three generations, and recommendations. Data was collected using Google Forms, and various statistical tests were analyzed using IBM SPSS version 25.Results: This study comprised 634 females, the majority of whom had post-secondary education (62.6%) and were married (96.8%), of which 29.2% were within the age group 30–34. Most of the respondents (86.3%) had previously heard about FGM. Of those interviewed, 49.5% knew FGM was practiced in their community, and 326 (51.4%) affirmed knowledge of health problems associated with FGM. The Major source of information on FGM was from parents (36.1%), followed by the media (26.1%). Two hundred and thirty-two respondents (36.6%) strongly agreed that FGM is a very harmful and inhumane practice, and a majority (91.8%) had no intention to circumcise their daughters. About 56.0% strongly agreed and recommended a campaign against FGM in school, and 53.8% strongly agreed to educate traditional birth attendants on the risk of FGM.Conclusion: This study found that the respondents had good knowledge of FGM and its obstetric effects. However, most respondents had a negative attitude towards FGM. Hence, a need for more innovative interventions towards its eradication

Knowledge, Attitudes, and Practices of Dog Owners Regarding Dog-Related Diseases in Mvomero and Morogoro Districts, Tanzania

Background: Dogs were the earliest animals domesticated by humans for various purposes, but receive little attention from the community and may be sources of diseases in humans and other animals. In Tanzania, most dogs are Mongrels and are primarily found in rural areas where they receive limited veterinary care. Therefore, the study aimed to assess the knowledge, attitudes, and practices of dog keepers regarding dog management, and their awareness of zoonoses, to develop effective disease prevention and control programs.Subjects and Method: A cross-sectional study was conducted between October 2017 and January 2018 in the Mvomero and Morogoro districts of Tanzania. The study used a simple random sampling method, whereas a structured questionnaire was administered to 200 dog keepers. Statistical Package for Social Sciences (SPSS) version 20 was used for data analysis. The independent variables were demographic characteristics of dog keepers (age, gender, education, and location), while dependent variables included knowledge of dog management, attitudes toward dogs, and practices.Results: The study found that 59% of respondents had fair to good knowledge of dog management, though practices were generally poor, with most dog keepers owning dogs for security purposes. While 87% were aware of zoonotic diseases, particularly rabies, vaccination rates were higher in Morogoro than in Mvomero (p<0.05). Negative experiences with dogs were reported by 78% of respondents, and attitudes towards dogs were more negative in Mvomero than in Morogoro (p=0.007).Conclusion: The study concludes that dogs in Morogoro are poorly managed, live-in unhygienic conditions, rarely receive veterinary services, and experiences suffering of different kinds, which is contrary to animal welfare principles. Therefore, integrative approaches to raising public awareness about dog management practices in the study areas and other regions of Tanzania are recommended to safeguard the health of both dogs and humans

Detection of Change Patterns in COVID-19 Deaths and the Implementation of Public Health Policies in Botswana

Background: At the earlier stages of COVID-19 disease, there were no pharmaceutical measures such as vaccines and medications available that could be used to either treat or reduce the spread of the virus. Countries worldwide reverted to implementing several non-pharmaceutical measures to end or at least reduce the spread of the COVID-19 pandemic. These included maintaining the physical distance of 1-2 meters in all gatherings, washing hands with soap and clean water, sanitizing hands, and wearing face masks especially when physical distancing cannot be certain. In this study, we aim to determine the change patterns or turning points in COVID-19 deaths, particularly those that occurred in Botswana.Subjects and Method: The study used a retrospective cohort study conducted in Botswana for a period ranging from the 14th May 2020 up to the 3rd March 2022. The population covered for this study comprised of all persons who were susceptible to COVID-19 in Botswana. The researcher used secondary data sourced from Botswana’s Ministry of Health and Wellness. Data for this study were statistically analysed using R software version 4.1.3 to apply the simulation methods.Results: High numbers of COVID-19 deaths in Botswana were recorded starting from week 59 to week 69 and the numbers declined from week 70 to week 75. Altogether, COVID-19 deaths in Botswana have been rising since 14th May 2020 until 3rd March 2022.Conclusion: It is important for the Government of Botswana through Ministry of Health and Well-ness to ensure that COVID-19 restrictions are slowly relaxed to avoid the recurrence of the disease. COVID-19 adherence protocols should be strictly enforced by the Ministry more especially during winter seasons as well as public holidays

Effect of Short Sleep Duration on the Risk of Cardiovascular Diseases: A Meta-Analysis

Background: Understanding the impact of short sleep duration on cardiovascular disease incidence is crucial for comprehending its potential health implications. This study aimed to analyze and estimate the magnitude of the effect of short sleep duration on the risk of cardiovascular disease incidence based on similar previous primary studies.Subjects and Method: This research is a systematic review and meta-analysis conducted by following the PRISMA flow diagram and PICO model. Population: general population without prior cardiovascular diseases, Intervention: short sleep duration, Comparison: adequate sleep duration, and Outcome: the Incidence of cardiovascular diseases. The process of searching for articles through Google Scholar, ProQuest, and PubMed journal databases by selecting articles published from 2010 to 2024. The keywords used include: "Cardiovascular Diseases," AND "Incidence," AND "Sleep Duration," AND "cohort Studies. The inclusion criteria were full paper articles, open access with a cohort study design, and articles in English. Data were analyzed using RevMan 5.3.Results: A total of 9 cohort studies involving 564,287 respondents from Africa, Europe, and Asia were selected for a systematic review and meta-analysis. The results of the meta-analysis showed that people with short sleep duration had a 1.20 times risk of experiencing cardiovascular disease compared to people with adequate sleep duration (aHR = 1.20; 95% Cl = 1.14 to 1.25; p<0.001). This meta-analysis has heterogeneity I2= 39%, so it uses a fixed effect model.Conclusion: Insufficient sleep duration could elevate the likelihood of cardiovascular disease occurrence

Assessing the Effect of Social Capital on Depression in Adults

Background: Depression is a mental health problem that affects an individual's quality of life. Previous studies have shown that individuals with high social capital are less likely to experience depression. Understanding the dynamics of social capital and its impact on depression is essential for developing interventions and policies that can improve mental well-being at both the individual and community levels. This study aims to analyze the influence of structural, cognitive, and relational social capital on depression in adults.Subjects and Method: This study is a cross-sectional study carried out in Klaten, Central Java in September-October 2024. Population of 726,839 adults and a sample of 200 adults aged 19-59 years were selected using multistage random sampling. The dependent variable was depression. The independent variables were structural social capital, cognitive social capital, and relational social capital. Depression data was measured using Patient Health Questionnaire-9 (PHQ-9) and other data using questionnaires. Data was analyzed using the Structural Equation Model run on STATA 13.Results: Strong social capital lowered adults' risk of depression (b= -0.39; CI 95%= -0.56 to -0.23; p= 0.001). The older you get, the lower the depression score (b= -0.17; CI 95%= -0.31 to -0.03; p= 0.018). The social capital construct in this study is positively and statistically significant by the structural social capital component (b= 0.75; CI 95%= 0.58 to 0.92; p= 0.001), cognitive social capital component (b= 0.56; CI 95%= 0.39 to 0.73; p= 0.001), and the relational social capital component (b= 0.62; CI 95%= 0.48 to 0.76; p= 0.001). The SEM model showed a good fit (Chi-square p= 0.113; RMSEA= 0.070; CFI= 0.98; TLI= 0.93; SRMR= 0.03).Conclusion: Strong social capital and increasing age lower the risk of depression in adults. The social capital construct is positively and statistically significant by the components of structural social capital, cognitive social capital, and relational social capital. This SEM model shows a good fit

Hazard Quotient Association of SO2 Exposure to Respiratory Symptoms: Study on Scavengers in Sarimukti Landfill, West Bandung Regency, East Java, Indonesia

Background: The WHO reported that airborne diseases were responsible for 39 million deaths, accounting for 57% of the total 68 million deaths worldwide in 2021. Landfills are a significant source of air pollution, producing sulfur dioxide (SO2) gas, which is harmful to respiratory health, particularly the lungs. This study aims to examine the relationship between the hazard quotient of SO2 exposure and respiratory symptoms among scavengers at the Sarimukti landfill in West Bandung Regency, using an environmental health risk analysis approach.Subjects and Method: The research contributes to exposure risk management by establishing safe thresholds for SO2 concentration, exposure time, and frequency for scavengers. This study adopts a correlation design with a longitudinal approach. The sample consisted of 101 scavengers selected through accidental sampling. Pollutant measurements were taken at two locations within the Sarimukti landfill. The independent variable in this study is the hazard quotient value of SO2 expo-sure, while the dependent variable is respiratory symptoms in scavengers.Results: The results indicated a (OR= 15.83; 95% CI= 1.10 to 226.67; p= 0.008). Risk management is based on a safe SO2 concentration limit of 14.18 µg/m³, an exposure time of 15 hours, and an exposure frequency of 637 days over 30 years.Conclusion: The measurement result of SO2 concentration of 7.38 µg/m³ is still below the specified quality standard of 150 µg/m³. However, through the calculation of the hazard quotient, the concentration exceeds the safe limit (HQ >= 1). The implication of this study in preventing the occurrence of respiratory symptoms in waste pickers is the use of PPE, limiting working hours and days in the landfill

Spatial Analysis of Determinants of Hypertension Incidence in Kota Lama Subdistrict, Kupang, Indonesia

Background: Cardiovascular diseases such as hypertension, heart attack, and stroke are chronic non-communicable diseases influenced by genetic, physiological, environmental, and behavioral factors. Geographic Information Systems (GIS) can be utilized for spatial analysis to identify risk factors, distribution patterns, and determinants of diseases, including hypertension. This study aims to examine the determinants of hypertension using a spatial analysis approach in Kota Lama Subdistrict, Kupang City.Subjects and Method: This study employed an ecological study design using an observational analytic method with a cross-sectional approach. The population consisted of residents aged ≥18 years in Kota Lama Subdistrict. A total of 400 individuals diagnosed with hypertension were selected using simple random sampling. The variables examined were age, overweight, lack of physical activity, high-salt diet, alcohol consumption, medication adherence, economic level, and distance to health facilities. Instruments used included a sphygmomanometer, microtoise, weight scale, and questionnaire. Spatial analysis was conducted using the GeoDa application with Regression, Bivariate Local Moran’s Index, Multivariate Local Geary, and Spatial Empirical Bayes tests.Results: The results showed significant associations and clustered spatial autocorrelation with low-to-high relative risk (RR) observed in the subdistricts of LLBK, Bonipoi, Solor, Fatubesi, Oeba, Nefonaek, and Pasir Panjang for the variables: age (p=0.001, I=0.70), overweight (p<0.001, I=0.64), lack of physical activity (p=0.00, I=0.63), high-salt diet (p=0.00, I=0.63), and alcohol consumption (p<0.001, I=0.69). There were no significant associations for variables such as irregular medication intake, economic level, and distance to health facilities, with p-values of 1.000 > α (0.050).Conclusion: Age, overweight, physical inactivity, high-salt diet, and alcohol consumption are significant determinants and show positive clustered spatial autocorrelation with hypertension. It is recommended that individuals over 40 years of age regularly monitor their blood pressure, maintain a healthy diet, engage in sufficient physical activity, and for those with hypertension, adhere to regular medication intake

Determinants of Breast Milk Donation and Use among Postpartum Women at a City Hospital in Nairobi, Kenya

Background: The World Health Organization advocates donor human milk as a superior substitute for newborns unable to obtain their mother’s milk. Calls have been made to scale up human milk banks to provide infants without access to mother’s milk safe donor human milk. This research sought to assess determinants of breast milk donation and the use of donor human milk among postpartum women.Subjects and Method: This cross-sectional study was conducted in May 2023 at a government hospital with human milk banking facilities. A consecutive sampling technique was used to recruit a sample of 370 postpartum women admitted to the postnatal wards. A pretested interview-based questionnaire was used to obtain participants’ sociodemographic data, breastfeeding history, peri-natal characteristics, awareness of human milk banking, and other general factors that might influence acceptance to donate breast milk and the use of donated human milk. Data was analyzed using R-4.3.0 software and descriptive statistics were done for all variables. Further inferential statistics including the Chi-Square test and multivariate logistics regression were computed with a significance level set at α=0.050.Results: The mother’s willingness to donate breast milk and use donor human milk was 78.1% and 70.8% respectively. The respondent’s age (OR=0.42; 95% CI=0.19 to 0.94; p=0.035) was significantly associated with willingness to donate breast milk. Religion (OR=0.27; 95% CI=0.10 to 0.72; p =0.009) and awareness of human milk banking (OR=0.89; 95%CI= 1.07 to 3.36; p= 0.029) were significant predictors of willingness to use donor human milk.Conclusion: Human milk banking awareness was low among the study population; however, mothers are willing to donate and use donated breast milk. Age in years is significantly associated with willingness to donate while religion and awareness of human milk banking are significant predictors of use