Directing diarrhoeal disease research towards disease-burden reduction

Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research questions, the efficacy and effectiveness of the intervention resulting from the research, the maximal potential for disease-burden reduction of the interventions derived from the research, the affordability, deliverability, and sustainability of the intervention supported by the research, and the overall effect of the research-derived intervention on equity. Experts scored each research option independently to delineate the best investments for diarrhoeal disease control in the developing world to reduce the burden of disease by 2015. Priority scores obtained for health policy and systems research obtained eight of the top 10 rankings in overall scores, indicating that current investments in health research are significantly different from those estimated to be the most effective in reducing the global burden of diarrhoeal disease by 2015

Investigation of relationship between particulate matter (PM2.5 and PM10) and meteorological parameters at roadside area of first Penang bridge

Present study was focusing to characterize the particulate matter (PM2.5 and PM10) at the roadside of First Penang Bridge and the associated meteorological parameters influence such as precipitation, temperature, and relative humidity. The study was conducted by focusing on the roadside area of First Penang Bridge (N05°21.375’; E100°23.584’). A total of 12 samples thrice per month for each particulate matter sizes were collected starting from June 2015 to September 2015. Meteorological data were obtained from the Meteorological Department of Penang on daily basis and 24-hours averages. Descriptive statistical analysis was conducted in characterizing the relationship between particulate matter concentrations and the target meteorological parameters. Result showed that PM2.5 and PM10 concentrations ranged between 18.06 – 79.51 µg/m³ and 22.38 – 130.90 µg/m³ with the overall mean concentration of 39.35 µg/m³ for PM2.5 and 45.24 µg/m³ for PM10. For the PM2.5, weak negative correlation was obtained between PM and precipitation (r = -0.462), strong negative correlation with relative humidity (r = -0.799) and weak positive correlation between temperature (r = 0.456). PM10 showed weak negative correlation between PM with temperature (r = -0.061) and precipitation (r = -0.022), and strong positive correlation between PM and relative humidity (r = 0.130)

Antimicrobial resistance: a growing serious threat for global public health

Antibiotics are among the most important discoveries of the 20th century, having saved millions of lives from infectious diseases. Microbes have developed acquired antimicrobial resistance (AMR) to many drugs due to high selection pressure from increasing use and misuse of antibiotics over the years. The transmission and acquisition of AMR occur primarily via a human–human interface both within and outside of healthcare facilities. A huge number of interdependent factors related to healthcare and agriculture govern the development of AMR through various drug-resistance mechanisms. The emergence and spread of AMR from the unrestricted use of antimicrobials in livestock feed has been a major contributing factor. The prevalence of antimicrobial-resistant bacteria has attained an incongruous level worldwide and threatens global public health as a silent pandemic, necessitating urgent intervention. Therapeutic options of infections caused by antimicrobial-resistant bacteria are limited, resulting in significant morbidity and mortality with high financial impact. The paucity in discovery and supply of new novel antimicrobials to treat life-threatening infections by resistant pathogens stands in sharp contrast to demand. Immediate interventions to contain AMR include surveillance and monitoring, minimizing over-the-counter antibiotics and antibiotics in food animals, access to quality and affordable medicines, vaccines and diagnostics, and enforcement of legislation. An orchestrated collaborative action within and between multiple national and international organizations is required urgently, otherwise, a postantibiotic era can be a more real possibility than an apocalyptic fantasy for the 21st century. This narrative review highlights on this basis, mechanisms and factors in microbial resistance, and key strategies to combat antimicrobial resistance

Measurement on Properties of Empty Fruit Bunch Oil Palm Composite Boards at Different Density and Resin Contents

Background: The objective of this study is to measures on the properties of composite boards made from oil palm empty fruit bunch (OPEFB) at different density and resin contents. The oil palm empty fruit bunches were obtained from an oil palm plantation and refined using fibre cutter and particle crusher. Hardeners and wax added at 1% and 3% during the mixing process. Boards of densities 500, 600 and 700 kg m-³ produced with resin urea formaldehyde at 10, 12 and 14% respectively. The boards stored in a conditioning chamber set at 20±2°C and 65% relative humidity before undergoing subsequent testing. The testing procedure followed the EN Standard of specifications. The results indicated increases across the board physical and mechanical properties. The highest modulus of rupture (MOR) and modulus of elasticity (MOE) value achieved in this study were 22.91 N mm-² and 2059.56 N mm-². The highest value for internal bonding (IB) was 0.98 N mm-², for edge and face screw withdrawal the IB were 467.47 N mm-² and 512.37 N mm-². Boards with 700 kg m-² density and 14% resin contents met the requirement in accordance to the established standard. Board with 500 k gm-³ density and 10% resin content observed microscopy showe voids in some of the resin-fibre bonding areas at the cross-section of the board. This suggested that moisture somehow penetrated into the board via the open spaces and attacked the linkages existed causing in the low property. Thermogravimetric analysis conducted in the thermal stability of the boar ds showed maximum rate of decomposition for the OPEFB boards at 380.83°C. In conclusion, the boar d’s dens ity and resin content applied influenced on the boar ds overall properties

Kematangan Emosi Pada Pria Dan Wanita Yang Menikah Muda

Penelitian ini bertujuan untuk menguji secara empiris perbedaan kematangan emosi pada pria dan wanita yang menikah muda. Penelitian ini dilakukan terhadap 25 orang pria dan 25 orang wanita yang berusia antara 18 sampai dengan 24 tahun yang menikah muda. Dari 56 item disebarkan diperoleh 34 item yang valid. Nilai korelasi yang didapat berkisar antara 0.307 sampai 0.752 sedangkan koefisien reliabilitas sebesar 0.884. Uji hipotesis menggunakan uji beda U Mann-Whitney, karena tidak terpenuhinya kriteria uji statistik parametrik. Berdasarkan analisis data diperoleh skor t sebesar -3.061 (p < 0.01). Hasil tersebut menunjukkan adanya perbedaan kematangan emosi yang sangat signifikan pada pria dan wanita yang menikah muda

Pulmonary Tuberculosis in Severely-malnourished or HIV-infected Children with Pneumonia: A Review

Presentation of pulmonary tuberculosis (PTB) as acute pneumonia in severely-malnourished and HIVpositive children has received very little attention, although this is very important in the management of pneumonia in children living in communities where TB is highly endemic. Our aim was to identify confirmed TB in children with acute pneumonia and HIV infection and/or severe acute malnutrition (SAM) (weight-for-length/height or weight-for-age z score &lt;-3 of the WHO median, or presence of nutritional oedema). We conducted a literature search, using PubMed and Web of Science in April 2013 for the period from January 1974 through April 2013. We included only those studies that reported confirmed TB identified by acid fast bacilli (AFB) through smear microscopy, or by culture-positive specimens from children with acute pneumonia and SAM and/or HIV infection. The specimens were collected either from induced sputum (IS), or gastric lavage (GL), or broncho-alveolar lavage (BAL), or percutaneous lung aspirates (LA). Pneumonia was defined as the radiological evidence of lobar or patchy consolidation and/or clinical evidence of severe/ very severe pneumonia according to the WHO criteria of acute respiratory infection. A total of 17 studies met our search criteria but 6 were relevant for our review. Eleven studies were excluded as those did not assess the HIV status of the children or specify the nutritional status of the children with acute pneumonia and TB. We identified only 747 under-five children from the six relevant studies that determined a tubercular aetiology of acute pneumonia in children with SAM and/or positive HIV status. Three studies were reported from South Africa and one each from the Gambia, Ethiopia, and Thailand where 610, 90, 35, and 12 children were enrolled and 64 (10%), 23 (26%), 5 (14%), and 1 (8%) children were identified with active TB respectively, with a total of 93 (12%) children with active TB. Among 610 HIV-infected children in three studies from South Africa and 137 SAM children from other studies, 64 (10%) and 29 (21%) isolates of M. tuberculosis were identified respectively. Children from South Africa were infected with HIV without specification of their nutritional status whereas children from other countries had SAM but without indication of their HIV status. Our review of the existing data suggests that pulmonary tuberculosis may be more common than it is generally suspected in children with acute pneumonia and SAM, or HIV infection. Because of the scarcity of data, there is an urgent need to investigate PTB as one of the potential aetiologies of acute pneumonia in these children in a carefully-conducted larger study, especially outside Africa

A descriptive study of Forcefully Displaced Myanmar Nationals (FDMN) presenting for care at public health sector hospitals in Bangladesh

Background In 2017 hundreds of thousands of ‘Rohingya’ fled to camps for Forcefully Displaced Myanmar Nationals (FDMN) in Cox’s Bazar, Bangladesh. Objective To describe the FDMNs presenting for care at public health facilities in Bangladesh so as to understand the health problems faced by the FDMNs and the burden on these public health facilities. Methods This study combined a retrospective review of existing hospital and clinic data with prospective surveillance in government health care centres. Findings The retrospective data showed a 26% increase in the number of consultations at the Kutupalong community clinic, the primary health facility closest to the camps, from 19,567 in 2015 to 26,309 in 2019. There was a corresponding 11% increase in admissions to health facilities in the area, from 80,991 in 2017 to 91,424 in 2019. Prospective surveillance of 9,421 FDMNs seeking health care from July 2018 to December 2019 showed that 29% had an infectious disease, 20% nutritional problems, 12% pregnancy-related conditions and 7% trauma or injury. Conclusions Great uncertainty remains regarding the return of FDMN to their home country of Myanmar. The current on-going protests following the military coup adds further insecurity to the status of the Rohingya. The presence of a large migrant population relative to a smaller host community burdens the limited facilities and resources of the public health sector. Continued support by the international public health community and civil society organizations is needed