Demographic and parasitic infection status of schoolchildren and sanitary conditions of schools in Sanliurfa, Turkey

BACKGROUND: The design and development of school health programmes will require information at demographic characteristics of schoolchildren and the major health burdens of the school-age group, the opportunities for intervention and the appropriateness of the available infrastructure. This study aims to analyse demographic and parasitic infections status of schoolchildren and sanitary conditions of schools in Sanliurfa province of south-eastern Turkey. METHOD: Three primary schools were randomly selected in the shantytown, apartment and rural districts. A total of 1820 schoolchildren between 7–14 years age were took part to the survey of whom 1120 (61.5%) were boys and 700 (38.4%) were girls. A child form (including child's name, sex, age, school grade and parasitic infections) and school survey form (including condition of water supply, condition of latrines, presence of soaps on the basins and presence of garbage piles around to the schools) were used for demographic, parasitic and sanitary surveys. Stool samples were examined by cellophane thick smear technique for the eggs of intestinal helminths. RESULTS: The demographic survey showed that number of schoolchildren was gradually decreased as their age's increase in shantytown school. The sex ratio was proportional until the second grade, after which the number of females gradually decreased in children in shantytown and rural schools while, in apartment area, schoolchildren was proportionally distributed between age groups and gender even the high-grade students. The prevalence of helminthic infections was %77.1 of the schoolchildren in shantytown, 53.2% in apartment district and 53.1% of rural area. Ascaris lumbricoides was the most prevalent species and followed by Trichuris trichiura, Hymenolepis nana and Taenia species in three schools. Sanitation survey indicated that the tap water was limited in shantytown school, toilet's sanitation was poor, available no soaps on lavatories and garbage piles were accumulated around the schools in shantytown and rural area, while, the school in apartment area was well sanitised. CONCLUSIONS: These results indicated that burden of parasitic infections and poor sanitation conditions constituted public health importance among to the shantytown schoolchildren. School health programmes including deworming and sanitation activities through the health education and improvement of sanitation conditions in the schools have a potential to better health and education for schoolchildren. These programmes also offer the potential to reach significant numbers of population in the shantytown schools with high level of absenteeism

Treatment for Schistosoma japonicum, Reduction of Intestinal Parasite Load, and Cognitive Test Score Improvements in School-Aged Children

Parasitic worm infections are associated with cognitive impairment and lower academic achievement for infected relative to uninfected children. However, it is unclear whether curing or reducing worm infection intensity improves child cognitive function. We examined the independent associations between: (i) Schistosoma japonicum infection-free duration, (ii) declines in single helminth species, and (iii) joint declines of ≥2 soil-transmitted helminth (STH) infections and improvements in four cognitive tests during18 months of follow-up. Enrolled were schistosome-infected school-aged children among whom coinfection with STH was common. All children were treated for schistosome infection only at enrolment with praziquantel. Children cured or schistosome-free for >12 months scored higher in memory and verbal fluency tests compared to persistently infected children. Likewise, declines of single and polyparasitic STH infections predicted higher scores in three of four tests. We conclude that reducing the intensity of certain helminth species and the frequency of multi-species STH infections may have long-term benefits for affected children's cognitive performance. The rapidity of schistosome re-infection and the ubiquity of concurrent multi-species infection highlight the importance of sustained deworming for both schistosome and STH infections to enhance the learning and educational attainment of children in helminth-endemic settings

Neglected diseases of neglected populations: Thinking to reshape the determinants of health in Latin America and the Caribbean

BACKGROUND: People living in poverty throughout the developing world are heavily burdened with neglected communicable diseases and often marginalized by the health sector. These diseases are currently referred to as Neglected Diseases of Neglected Populations. The neglected diseases create social and financial burdens to the individual, the family, the community, and the nation. DISCUSSION: Numerous studies of successful individual interventions to manage communicable disease determinants in various types of communities have been published, but few have applied multiple interventions in an integrated, coordinated manner. We have identified a series of successful interventions and developed three hypothetical scenarios where such interventions could be applied in an integrated, multi-disease, inter-programmatic, and/or inter-sectoral approach for prevention and control of neglected diseases in three different populations: a slum, an indigenous community, and a city with a mix of populations. SUMMARY: The objective of this paper is to identify new opportunities to address neglected diseases, improve community health and promote sustainable development in neglected populations by highlighting examples of key risk and protective factors for neglected diseases which can be managed and implemented through multi-disease-based, integrated, inter-programmatic, and/or inter-sectoral approaches. Based on a literature review, analysis and development of scenarios we visualize how multiple interventions could manage multiple disease problems and propose these as possible strategies to be tested. We seek to stimulate intra- and inter-sectoral dialogue which will help in the construction of new strategies for neglected diseases (particularly for the parasitic diseases) which could benefit the poor and marginalized based on the principle of sustainability and understanding of key determinants of health, and lead to the establishment of pilot projects and activities which can contribute to the achievement of the Millennium Development Goals

Health risk behaviours among adolescents in the English-speaking Caribbean: a review

<p>Abstract</p> <p>Background</p> <p>The aim of this paper was to review and summarize research on prevalence of health risk behaviours, their outcomes as well as risk and protective factors among adolescents in the English-speaking Caribbean.</p> <p>Methods</p> <p>Searching of online databases and the World Wide Web as well as hand searching of the <it>West Indian Medical Journal </it>were conducted. Papers on research done on adolescents aged 10 – 19 years old and published during the period 1980 – 2005 were included.</p> <p>Results</p> <p>Ninety-five relevant papers were located. Five papers were published in the 1980s, 47 in the 1990s, and from 2000–2005, 43 papers. Health risk behaviours and outcomes were divided into seven themes. Prevalence data obtained for these, included lifetime prevalence of <b>substance use</b>: cigarettes-24% and marijuana-17%; <b>high risk sexual behaviour</b>: initiation of sexual activity ≤ 10 years old-19% and those having more than six partners-19%; <b>teenage pregnancy</b>: teens account for 15–20% of all pregnancies and one-fifth of these teens were in their second pregnancy; <b>Sexually-Transmitted Infections (STIs)</b>: population prevalence of gonorrhoea and/or chlamydia in 18–21 year-olds was 26%; <b>mental health</b>: severe depression in the adolescent age group was 9%, and attempted suicide-12%; <b>violence and juvenile delinquency</b>: carrying a weapon to school in the last 30 days-10% and almost always wanting to kill or injure someone-5%; <b>eating disorders and obesity</b>: overweight-11%, and obesity-7%. Many of the risk behaviours in adolescents were shown to be related to the adolescent's family of origin, home environment and parent-child relationships. Also, the protective effects of family and school connectedness as well as increased religiosity noted in studies from the United States were also applicable in the Caribbean.</p> <p>Conclusion</p> <p>There is a substantial body of literature on Caribbean adolescents documenting prevalence and correlates of health risk behaviours. Future research should emphasize the designing and testing of interventions to alleviate this burden.</p

Adherence to Antiretroviral Therapy by People Accessing Services from Non-governmental HIV Support Organisations in Three Caribbean Countries

Objective: To identify factors associated with antiretroviral therapy (ART) adherence in order to guide the development of strategies to improve the situation. Design and Methods: A cross-sectional survey was conducted with people living with HIV (PLHIV) who receive services from non-governmental organisations affiliated to the Caribbean Regional Network of People Living with HIV/AIDS (CRN+) in Antigua and Barbuda, Grenada and Trinidad and Tobago. PLHIV, from CRN+, traced potential participants, administered informed consent procedures and carried out structured interviews. The main outcome measure was 95% to 100% adherence over the previous seven days. Multiple logistic regression was conducted to identify associations with demo-graphic characteristics, psychological status, health and support service use, sexual behaviour and substance abuse. Results: Of 394 respondents, 69.5% were currently taking ART. Of these, 70.1% took 95% to 100% of their prescribed pills. One in 20 took more pills than prescribed, all of whom were prescribed fewer or equal to the median pill number. Factors independently associated with adherence were use of a counselling service (OR 3.20; 95% CI 1.55, 6.61), revelation of HIV status without consent (OR 2.31; 95% CI 1.13, 4.74), alcohol consumption (OR 0.47; 95% CI 0.23, 0.96) and side effects (OR 0.32; 95% CI 0.15, 0.68). Drug resistance to ART was reported by 6% of users. Conclusion: Improvements in ART adherence may be achieved by counselling, focussed attention to alcohol users and developing drugs with reduced side effects. Such measures are critical to maintain PLHIV quality of life gains and prevent the proliferation of drug resistant HIV strains. Keywords: Adherence, antiretroviral therapy, counselling, HIV "La Adhesión a la Terapia Antiretroviral por Personas que Acuden a los Servicios de Organizaciones no Gubernamentales de Apoyo a la Lucha Contra el VIH en tres Países del Caribe" RESUMEN Objetivo: Identificar los factores asociados con la adhesión a la terapia antiretroviral (TAR) para guiar el desarrollo de estrategias encaminadas a mejorar la situación. Diseño y Métodos: Se llevó a cabo un estudio transversal con personas que viven con VIH (PVVIH), y que reciben los servicios de organizaciones no gubernamentales afiliadas a la Red Regional del Caribe de Personas que Viven con VID/SIDA (CRN+) en Antigua y Barbuda, Granada, y Trinidad y Tobago. La PVVIH de CRN+ se dio a la búsqueda de participantes potenciales, aplicó los procedimientos de consentimiento informado, y llevó a cabo entrevistas estructuradas. La principal medida de resultado fue de 95% a 100% de adhesión durante los últimos siete días. Se llevó cabo una regresión logística múltiple con el propósito de identificar las asociaciones con características demográficas, estado psicológico, salud y uso del servicio de apoyo, conducta sexual y abuso de sustancia. Resultados: De 394 encuestados, el 69.5% se hallaban tomando TAR actualmente. De éstos, 70.1% tomaron de 95% a 100% de las píldoras prescritas. Uno de cada 20 tomó más píldoras que las prescritas, a todos los cuales se les prescribió un número menor o igual a la mediana de las píldoras. Los factores independientemente asociados con la adhesión fueron: uso de un servicio de aconsejamiento (OR 3.20; 95% CI 1.55, 6.61), revelación de la condición de VIH sin consentimiento (OR 2.31; 95% CI 1.13, 4.74), consumo de alcohol (OR 0.47; 95% CI 0.23, 0.96) y efectos colaterales (OR 0.32; 95% CI 0.15, 0.68). Resistencia al medicamento con relación a TAR fue reportada por 6% de usuarios. Conclusión: Las mejoras en la adhesión a la TAR pueden lograrse mediante aconsejamiento, atención focal a los consumidores de alcohol y desarrollo de medicamentos con efectos colaterales reducidos. Tales medidas son de importancia fundamental si se quiere mantener ganancias para la calidad vida de las PVVIH y prevenir la proliferación de cepas de VIH resistentes a los medicamentos. Palabras claves: Adhesión, terapia antiretroviral, aconsejamiento, VI