Missed opportunities for tetanus immunization of 15-49 year oldwomen

Tetanoz ülkemizde ve dünyada insan saglıgını tehdit eden ası ile korunabilir hastalıklardan biridir. Kadınların tetanoza karsı bagısıklanması, hem anneyi hem de bebegi tetanozdan koruması nedeniyle son derece önemlidir. Ancak ülkemizde dogurganlık tetanoz asılama oranları, birinci basamakta bagısıklama hizmetlerindeki yetersizliklerin yanı sıra, bu konudaki bilgi ve motivasyon eksikligi nedeniyle istenen düzeyde degildir. Bu çalısmanın amacı 15-49 yas arası kadınların tetanoz bagısıklamasında, kaçırılmıs fırsat durumunun belirlenmesidir. Arastırma kesitsel tipte olup, Aydın Il Merkezi'ndeki 2 saglık ocagında gerçeklestirilmistir. Saglık ocagına herhangi bir sebeple basvuran ve arastırmaya katılmayı kabul eden 15-49 yas arası kadınlar (n=245) çalısmaya dahil edilmistir. Veri Saglık Yüksekokulu ögrencileri tarafından yüz yüze anket yöntemiyle elde edilmistir. Kadınların bagısıklama durumları ası kartı yanında olanların ası kartlarından, yanında olmayanların ise anamnezlerine göre yapılmıstır.Veri analizinde ki-kare, Fisher'in kesin testi ile Student's t testi kullanılmıstır. Bu arastırmada 15-49 yas grubu kadınlarda tetanoz asısı için kaçırılmıs fırsat oranı %24,5 olarak bulunmustur. Kaçırılmıs fırsat tespit edilen kadınların %73,3'ünde kaçırılmıs doz 3.'sü, %25,0'inde 2.'si, %1,7'sinde 1.'sidir. Kadının gebe olmaması veya ası kartı bulunmaması kaçırılmıs fırsat görülme durumunu etkilemektedir. Arastırma bölgesinde her dört kadından birinde kaçırılmıs fırsat oldugu, en fazla kaçırılmıs fırsatın 3. dozda görüldügü tespit edilmistir. Fırsatların yakalanması asılama oranlarını yükseltecegi gibi, anne ve bebek saglıgının korunması bakımından son derece önemlidir. Bu nedenle saglık ocaklarında saglık personelinin egitilerek, tetanoz bagısıklaması ile ilgili farkındalıgın ve duyarlılıgın artırılması önemlidir.Tetanus is a vaccine-preventable disease that threatens health both globally and in Turkey. Tetanus immunization of women is very important as it protects both the mother and the baby. In Turkey however, tetanus immunization coverage is not at the desired level due to insufficiencies in immunization services at health centers and lack of knowledge and motivation. The aim of this study is to determine missed opportunities in tetanus immunization among 15-49 year-old women. This is a cross-sectional study performed at 2 health centers in the city center ofAydin Province. 15-49 year-old women (n=245) were included in the study who came to the health center for any reason and accepted to participate. Data were collected by face to face interviews performed by High School of Health students. Immunization coverage was assessed by examining vaccination cards if women had one, or according to the information they gave if they did not have any. Data were analysed by chi-square, Fisher's exact test and Student's t- test. Ratio of missed opportunities for tetanus vaccination among women at reproductive age were found to be 24.5%. In 73.3% of women in whom missed opportunities were detected, the missed dose of tetanus vaccine was the third, in 25.0% the second, in 1.7% the first dose. No pregnancy or not having a vaccination card affected the rate of missed opportunities. It was found that there was a missed opportunity for 1 in 4 women in the study area and the biggest proportion of the missing vaccination is the 3rd dose. Catching opportunities is important not only in raising the immunization coverage but also good for mother and baby health. Thus, it is important to increase awareness and sensitivity about tetanus vaccination in health centers by training health personnel

Infant deaths and stillbirths in Aydın province in 2004

Amaç: Bu çalısmanın amacı, Aydın Ilinde 2004 yılında meydana gelen bebek ölümleri ve ölü dogumların bildirimlerine iliskin farklı bildirim kaynaklarının karsılastırmasını yaparak veri kalitesini degerlendirmek, ve bebek ölümleri ile ölü dogumların kisi-yer-zaman bakımından temel tanımlayıcı özellikleri ile nedenlerini saptamaktır. Yöntem: Bu çalısma, tanımlayıcı bir yöneylem arastırmasıdır. Ölü dogum ve bebek ölümlerine iliskin bir degerlendirme formu (Bebek Ölümü ve Ölü Dogum Olgu Bildirim Formu) hazırlanmıstır. Formlar, saglık ocagında bölgeden sorumlu ebe tarafından doldurulmus ve ocak hekimi tarafından kontrol edilerek Saglık Müdürlügüne gönderilmistir. Formlar, 2004 yılında ilçelerden gönderilen Birinci Basamak Saglık Kurumları Aylık ÇalısmaBildirilerinin (Form 023) yıllık dökümüyle karsılastırılmıstır. Bulgular: Çalısmada 139 bebek ölümü ve 107 ölü dogum incelenmistir. Bildirim formlarının%65,0'i tek seferde ve düzgün olarak gönderilmistir. Bebek ölümlerinin 58'i erken neonatal, 19'u geç neonatal, 57'si postneonatal dönemde meydana gelmistir. Ölü dogum hızı binde 9,6 ve perinatal ölüm hızı binde 14,8 olarak bulunmustur. Aydın'da 2004 yılı neonatal ölüm hızı binde 7,0, postneonatal ölüm hızı binde 5,2, bebek ölüm hızı binde 12,2 olarak bulunmustur. Bebek ölümlerinin nedenleri degerlendirildiginde, sırasıyla prematürite (%18,6), konjenital malformasyonlar, deformasyonlar, ve kromozom anomalileri (%10,6) ile solunum yetmezligi (% 9,7) ilk üç sırayı almıstır. Sonuç: Bebek ölümleri ve ölü dogumların birinci basamak saglık kurulusları tarafından detaylı olarak incelenmesi çok önemlidir. Bu çalısma ile, gebelikle iliskili risklerin arttıgı son trimester, dogum eylemi ile erken neonatal dönem,Aydın için bebek ölüm ve ölü dogumların azaltılmasında öncelikli alanlar olarak saptanmıstır. Bebek ölümleri ve ölü dogumların degerlendirilmesine yönelik standart bir form ve nedenler için de ICD-10'dan türetilen daha kısa bir listenin kullanılması uygun olacaktır.Objective: The aim of this study is to assess data quality by comparing different notification sources of infant deaths and stillbirths and to determine their basic descriptive characteristics in terms of person, place, time and causes. Materials and Methods: This is a descriptive operational study. An assessment form for infant deaths and stillbirths was prepared. Forms were filled in at health centers by midwives responsible of the regions where infant deaths and stillbirths occurred and sent to Provincial Directorate of Health after they were checked by physicians. They were compared with the yearly total of 'Monthly Notification of Work of Primary Health Care Institutions' (Form 023). Results: 139 infant deaths and 107 stillbirths were assessed. 58 infant deaths occurred in early-neonatal, 19 in late-neonatal and 57 in postneonatal period. Stillbirth rate was %0.96 and perinatal mortality rate %1.48. Neonatal mortality rate was %0.7, postneonatal mortality rate was % 0.2, infant mortality rate was %1.22. When causes of infant deaths were assessed, prematurity (18.6%), congenital malformations, deformations and chromosome abnormalities (10.6%) and respiratory deficiency (9.7%) were the first three causes, respectively. Conclusion: Detailed assessment of infant deaths and stillbirths by primary health care institutions is very important. Last trimester, delivery and early neonatal periods were detected as areas of priority for infant deaths and stillbirths in Aydın. For this purpose, it will be appropriate to use a standard form with a shorter list derived from ICD-10 for the assessment of infant deaths and stillbirths and their causes

ARTICLE IN PRESS How is Quality of Life Affected in Women in The Presence of Anxiety and Depression Symptoms? 2

SUMMARY Objective: To assess how quality of life is affected among reproductive age women from the presence of anxiety and depression symptoms and the risk factors related to both. Method: A cross sectional analytic study was performed in person with 461 women. General Health Questionnarie-12 and WHOQOL-BREF were used. Results: 35.5% of the women displayed symptoms of anxiety and depression and those who had experienced domestic violence had a 2.61-fold increase in symptom frequency and those with an income below 500 YTL had a 2.49-fold more frequent occurrence of symptoms compared to others. General health quality mean score was 3.33 ± 0.804, the mean overall quality of life was 3.62 ± 0.791; Physical Health Domain: 15.95 ± 2.422; Psychological Health Domain: 14.70 ± 2.337; Social Relations Domain 14.64 ± 3,027; Environmental Domain 14:27 ± 2.20; National Domain 14:29 ± 2.144l. The total score of GHQ-12 and the first two questions of WHOQOL-BREF had a negative, moderate and highly significant correlation, whereas the Psychological HD score had a a negative,, strong and significant correlation All other domains and the total score of GHQ-12 had negative, moderate and significant correlations. Conclusion: Screening with GHQ-12 as well as offering the possibility of early diagnosis and treatment, is also important to prevent impairment in all areas of quality of life among women. Early diagnosis and treatment of psychological problems of women with risk factors such as exposure to domestic violence and low socio-economic status are the intervention areas with priority

Hepatitis B Seroprevalence and the Relationship Between Being Hepatitis B Vaccinated and Infected with Social Determinants of Health: Manisa, 2014

Background: In Turkey, newborns have been vaccinated for hepatitis B at birth, one, and six months of age since 1998

Seroprevalence of West Nile virus, Crimean-Congo hemorrhagic fever virus, Francisella tularensis and Borrelia burgdorferi in rural population of Manisa, western Turkey

Background & objectives: Zoonotic diseases are well recognised threat to public health globally. The information of regional prevalence and associated risk factors allow the national programmes to determine and frame better strategies for their control, as they also provide the actual status of zoonosis in the region. The aim of this study was to determine the seroprevalence of West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus (CCHFV), Francisella tularensis and Borrelia burgdorferi among the rural residents of Manisa region, Turkey and to identify the associated risk factors. Methods: Cross sectional study was conducted in rural parts of Manisa, Aegean region of western Turkey in 2012. Blood samples from 324 randomly selected subjects were screened for the presence of IgG antibodies to WNV, CCHFV, F. tularensis and B. burgdorferi with commercially available kits. The demographic structure of the rural residents and risk factors related to lifestyle such as outdoor agriculture activities, animal husbandry, hunting and history of tick bite were questioned and their relationships with positive results were analyzed statistically. Results: It was observed that 49 subjects (15%) had IgG antibodies to at least one of the zoonotic agents studied. The seroprevalence of F. tularensis was highest with a percentage of 7.1% (n = 23). Distribution of the positive results for WNV, CCHFV and B. burgdorferi were 4.3% (n = 14), 3.7% (n = 12) and 0.9% (n = 3), respectively. Older age and uncompleted secondary education were the statistically significant risk factors for seropositivity to at least one zoonotic agent investigated. Logistic regression analyses confirmed that older age (over 50) increased the risk of WNV and CCHFV seropositivity. Interpretation & conclusion: Seropositivity rates were not found to be higher than the expected rates. Further, studies are needed to evaluate the threat of vector borne zoonoses and associated risk factors in the study area