Table of Contents
Editorial in Global Health and COVID-19
Role of the workplace in implementing mental health interventions for high-risk groups among the working age population after the COVID-19 pandemic
Authors: Francesco CHIRICO1, Giuseppe FERRARI2
1 M.D., Contract Professor, Health Service Department, State Police, Ministry of Interior, Italy. Post-Graduate Specialization School of Occupational Health, Università Cattolica del Sacro Cuore, Roma, Italy.
2 Psychologist, Society for Integrative Psychotherapy and Social Development, Milan, Italy
COVID-19; healthcare professionals; mental health; occupational health; workplace.
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Viewpoint in Global Health and Spirituality
Spirituality to cope with COVID-19 pandemic, climate change and future global challenges
Author: Francesco CHIRICO1
1 M.D., Contract Professor, Health Service Department, State Police, Ministry of Interior, Italy. Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Roma, Italy.
Spirituality refers to a set of values of connectedness with the self, others and the entire universe that is guided by a connection with the Transcendent and Superior. In today’s times of the COVID-19 pandemic, spiritual skills can be a resource to address mental health issues, both among the general population, especially the most vulnerable, including the elderly, sick, marginalised and those affected by psychiatric conditions, and certain categories of workers, including healthcare professionals. All of these mentioned are at a high risk of mental health disorders, such as anxiety, depression, burnout and post-traumatic stress disorders.
During the current pandemic, higher levels of spiritual distress have been associated with lower mental health levels in the population. Therefore, to address the spiritual needs and religious beliefs of patients and families, public health stakeholders should ensure the continuity of spiritual and religious activities during the pandemic as well as the training of healthcare professionals on this topic. At the global level, spiritual resources and values could be decisive skills for coping with the negative consequences of the COVID-19 pandemic in the short and long term, for example, the socioeconomic inequalities generated by the current pandemic. However, they could also be important in addressing post-COVID-19 pandemic climate change and other emerging challenges, such as advancing global health security and reaching sustainable development goals.
Keywords: Climate change; COVID-19; global health; mental well-being; spirituality; holistic health; religiosity.
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Viewpoint in Social and Behavioural Health
Social media, stress and sleep deprivation: A triple “S” among adolescents
Authors: Micajah DANIELS1*, Manoj SHARMA2, Kavita BATRA3
1 Graduate Research Assistant, Department of Environmental & Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA.
2 MBBS, Ph.D., MCHES, Professor, Department of Environmental & Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA.
3 Ph.D., MPH, BDS, Biomedical Statistician, Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA.
This commentary is aimed to discuss the impact of social media or the internet and engagement on youth development and comprehend these complex interrelationships. The discussion will serve as an important basis for designing targeted interventions to promote the judicious use of social media and meaningful engagement among youth. Problematic social media use (SMU) among adolescents may be associated with sleep deprivation, emotional distress, and adoption of maladaptive behaviors. Depression and stress are most notably connected to online harassment from SMU or cyberbullying. Degradation, threats, fake profiles, cyberstalking and unwanted comments are some examples of cyberbullying. Given the critical developmental stage of adolescents, online social rejection triggers a response with higher emotional intensity. The growing use of social media (SM) among youth warrants further investigation to identify its impact on mental health. The influence of SM or the internet on the emotional and social development of adolescents is undergoing a continuous transformation. While digital platforms help to promote social inclusion among adolescents, the risk associated with their excessive or problematic use cannot be overlooked. Understanding relationships between social media use, psychological health, and sleep deprivation among adolescents is essential in deciphering the intricate mechanisms or factors surrounding the youth development cycle.
Keywords: Adolescent; cyberbullying; internet; psychology; sleep; social media; social inclusion.
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Viewpoint in Global Health and COVID-19
COVID-19 vaccination inequity in the United States: An intersectional issue
Authors: Rafat H. SOLAIMAN1, Shelly MARETTE2
1 BA, Medical Student, University of Minnesota Medical School, Minneapolis, MN, USA.
2 MD, Associate Professor, University of Minnesota Medical School, Minneapolis, MN, USA.
Disparities in healthcare access have been ever-present in the United States. The COVID-19 crisis has highlighted these nationwide disparities, as early vaccine scarcity has led to inequitable access to this key resource. This paper explores the background of four key barriers that have promoted vaccination inequities in the United States: Race, socioeconomic status, age, and geography. Mistrust between healthcare systems and minority communities have unveiled the need for greater collaboration between the two parties. Groups of higher socioeconomic status are able to utilize their network to acquire a vaccine and are less susceptible to vaccine misinformation. A lack of technological competency has left several members of the elderly population unable to use online appointment systems. Additionally, rural populations without high-speed internet are not able to sign up for online appointments during the limited time windows. Contrarily, urban vaccination pop-up sites are oftentimes overcrowded by outsiders. These barriers have resulted in lagging vaccination rates among several minority groups who tend to be more vulnerable to severe infection. In this viewpoint, I propose four recommendations to increase future equitability of vaccinations in the United States, including greater collaboration of community institutions, development of educational programming, online appointment system assistance programs, and safeguarded pop-up vaccination sites. This paper aims to serve as a starting point for analyzing current barriers to healthcare resource access in the United States, and improvements in programs and policies that can diminish these nationwide disparities.
Keywords: Vaccination; crisis resource allocation; COVID-19; health disparity; racial barriers; socio-economic barriers.
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Viewpoint in Psychiatry and Health Inequity
Racism and inequity in mental healthcare: A call for recalibration of healthcare policies in Europe
Author: Abiola BAMIJOKO-OKUNGBAYE1
1 PhD Sofia University, Sofia, Bulgaria.
Inequitable mental healthcare is becoming an issue that needs urgent attention. Minority groups, especially Afro-Europeans or people of African origin, are likely to feel the impact in light of the increased level of mental disorders recorded amongst the group. In Europe, the institutional response to this problem is inadequate, and it demands a call for change in policies and direction. The inequities observed in mental healthcare might be explicated in terms of discrimination, unfair policies, and racism. It is known that social groups are likely to be affected by structural racism and unfair policies. Recent studies show that those who experience minority stress, discrimination, cultural stress and racism have a greater risk level to develop illnesses. In the literature, there is paucity of studies on the structural links between racism and unfair policies and their relationship to mental healthcare inequities. This viewpoint focuses on how unfair policies and structural racism may contribute to mental healthcare inequities in Europe, in order to give some recommendations to policymakers, scholars and other stakeholders. A pragmatic shift towards equitable care requires policymakers to address unfair policies and structural racism, which are elemental causes of health inequities and mental disorders.
Keywords: Europe; ethnicity; health inequity; healthcare policy; migrant health; minorities; racism; mental health; public health; unfair policies.
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Systematic Review in Occupational Health Psychology
Association between workplace violence and burnout syndrome among schoolteachers: A systematic review
Authors: Francesco CHIRICO1,2, Ilaria CAPITANELLI3, Martina BOLLO4, Giuseppe FERRARI5, Daniela ACQUADRO MARAN6
1 MD, Contract Professor, Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy.
2 MD, Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy.
3 MD, Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy.
4 Psychologist, Department of Psychology, Università di Torino, Turin, Italy.
5 Psychologist, SIPISS, Milan, Italy.
6 Assistant Professor, Work and Organizational Psychology, Department of Psychology, Università di Torino,
Introduction: This review aimed to examine systematically the epidemiological evidence linking occupational exposure to violence with risk of burnout syndrome (BOS) among schoolteachers.
Methods: A systematic review of literature used five primary databases: PsycINFO; Web of Science; PubMed Medline; Scopus; Cochrane; and keywords related to (a) workplace violence (WV), bullying, harassment, lateral violence, pupil misconduct, physical assault, teacher victimization; (b) schoolteachers, teachers, schools, pre-primary, kindergarten, primary, secondary; (c) burnout, emotional exhaustion, depersonalization, to identify relevant articles. Articles included featured occupational violence and burnout among schoolteachers. Results of the studies were analysed qualitatively.
Results: Of 1,472 peer-reviewed articles initially identified, 13 articles were included. All of them were published from 2005 to 2021 and had a quantitative approach. Type of violence against teachers ranged from workplace bullying or mobbing (n = 4), psychological violence (n = 4), to a combination of physical and psychological violence (n = 5). Most of the (verbal and physical) violence was perpetrated by students (n = 9). All grade and levels of schoolteachers were involved. In all cross-sectional studies (n = 10), WV was found to be correlated or associated with BOS (n = 5), the dimensions of EE and DP (n = 4) or the only dimension of EE (n = 2). Longitudinal studies showed that depersonalization was a significant predictor of workplace bullying (n = 1) and WV was indirectly a predictor of BOS (n = 2).
Discussion and Conclusions: The reviewed studies consistently indicate an association between WV and BOS in schoolteachers. Further longitudinal studies are needed to provide most evidence on this relationship. There is need of legislative interventions for implementing mandatory occupational health programs and voluntary workplace health promotion programs. These solutions may protect and promote teachers’ mental well-being and give more education and emotional support to students and their families.
Keywords: Burnout syndrome; harassment; psychosocial risk factors; systematic review; teachers; workplace violence.
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Systematic Review in Occupational Health Psychology and COVID-19
Prevalence of anxiety, depression, burnout syndrome, and mental health disorders among healthcare workers during the COVID-19 pandemic: A rapid umbrella review of systematic reviews
Authors: Francesco CHIRICO1,2, Giuseppe FERRARI3, Gabriella NUCERA4, Lukasz SZARPAK5, Pietro CRESCENZO6, Olayinka ILESANMI7,8
1 MD, Contract Professor, Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy.
2 MD, Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy.
3 Psychologist, SIPISS, Milan, Italy.
4 Medical Doctor, Contract Professor, Department of Emergency, Fatebenefratelli Hospital, ASST Fatabenefratelli and Sacco, Milan, Italy.
5 Medical Doctor, Associate Professor, Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
4 Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
6 Psychologist, PhD, Domus Misericordiae, Associazione Migranti senza Frontiere, Salerno, Italy.
7 Lecturer, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
8 Honorary Consultant, Department of Community Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
Introduction: The Coronavirus-19 (COVID-19) pandemic puts a severe strain on all healthcare systems. This study aimed to describe the prevalence of mental health disorders among healthcare workers (HCWs) during the COVID-19 pandemic.
Methods: An umbrella review of systematic reviews and meta-analyses concerning the prevalence of mental health disorders was conducted on PubMed Central/Medline, Cochrane Library, PROSPERO and Epistemonikos databases. The mental health disorders included anxiety, depression, burnout syndrome (BOS), sleep disorders, and post-traumatic stress disorders (PTSD) among HCWs during the COVID-19 pandemic.
Results: A total of 14 studies met the full inclusion criteria and were included. Among them, there were 8 systematic reviews with meta-analysis, 3 systematic reviews, 1 rapid systematic review, 1 rapid systematic review with meta-analysis, and 1 umbrella review of meta-analyses. The prevalence of mental health disorders was high among HCWs. Anxiety and depression or depressive symptoms were included in 10 reviews, followed by sleep disorders (n = 5), BOS (n = 3), PTSD (n = 3), acute stress (n =3), distress (n =3), and psychotraumatic disorders (n =1) and fear (n =1).
Discussion: The COVID-19 pandemic has had profound effects on the mental health states of HCWs, and resulted in high levels of anxiety, depression, sleep disorders, PTSD, and BOS. Therefore, psychological intervention for HCWs need to be commenced. This will help alleviate long-term distress, prevent chronic PTSD after COVID-19 and future outbreaks.
Keywords: Anxiety; burnout syndrome; COVID-19; depression; healthcare workers; mental health; sleep disorders; post-traumatic stress disorders; occupational health; systematic review.
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Original Article in COVID-19 and Sport Medicine
Ski world cup in safety in the context of coronavirus disease 2019 (COVID-19) pandemic
Authors: Antonio VILLA1, Mauro BOCCARDI2, Mara FIOCCHI1, Lukasz SZARPAK3,4, Olayinka ILESANMI5
1 M.D., ASST Fatebenefratelli-Sacco, Milano, Italy.
2 M.D., ATS Montagna, Sondrio, Italy.
3 Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
4 Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland. ROLES: Writing – review & editing. E-mail: Lukasz.firstname.lastname@example.org.
5 Department of Community Medicine, College of Medicine, University of Ibadan, and University College Hospital, Ibadan, Oyo State, Nigeria.
Introduction: In the current pandemic scenario, it is necessary to ensure the health and safety of athletes, teams, and participants of competitive skiing events. This paper aimed to report a health and safety protocol for the Ski World Cup races experimented in Italy during the second wave of the COVID-19 pandemic.
Methods: A protocol was developed for the prevention of COVID-19 infection among participants at skiing competitive races conducted at Santa Caterina and Bormio cities, Lombardy region, Italy in December 2020. The protocol was based on the recommended preventive measures issued from the public health community and indications reported by the Italian Sports Medical Federation (FMSI) protocol. A self-reported questionnaire was administered to participants. Antigenic swab tests were carried out ‘on-site’. Medical examinations were performed, when required. Descriptive analyses were carried out.
Results: One thousand three hundred and ninety (91.6%) out of 1,518 participants were accredited. Only one of the 694 swab tests performed on-site for accreditation turned positive in an asymptomatic subject and was confirmed by molecular swab test. During the events no suspected case of COVID-19 was reported to the LOC. At the end of the two sporting events, antigen swabs were performed on 50 participants, and these yielded negative results. No COVID-19 positive case was reported in the next 14 days after the end of the games.
Discussion and Conclusion: In Italy, the application of a protocol based on a self-administered questionnaire with a combination of antigen tests was effective for the reopening of elite skiing activity in Santa Caterina and Bormio during the second wave of the COVID-19 pandemic in Italy.
Keywords: COVID-19; Italy; health protocol; rapid antigen swab; ski; sport medicine.
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Original Article in Health Economics and Childcare Services
Performance-based economic evaluation of child and family care interventions in two Finnish regional family centers
Authors: Jan KLAVUS1, Arja HASTRUP2, Tiina JARVALA3, Anna-Kaisa PUSA4, Pekka RISSANEN5
1 Ph.D. Health Economics Consultant at PUNNUS3, Helsinki, Finland.
2 M.Sc.(Health Care) Finnish Institute for Health and Welfare, Helsinki, Finland.
3 M.Sc. Fimlab Laboratories, Tampere, Finland.
4 Mayor, City of Kurikka, Finland.
5 Professor, Finnish Institute for Health and Welfare, Helsinki, Finland.
Introduction: In Finland, the recent development of child and family care services has involved a move from curative services to promotive and preventive services provided by family centers. The aim of this study was to compare the effectiveness, costs, and cost-effectiveness of a multidisciplinary family center model and a decentralized child and family care services model. In addition, the study examined whether information included in client and patient information registers could be applied to the regular monitoring of performance in child and family care services.
Methods: A quasi-experimental case-control framework was conducted in two demographically similar Finnish municipal federations. Performance-based effectiveness was assessed by three indicators: 1) change in the number of psychiatric referrals 2) change in the number of corrective family work episodes and 3) enrolled duration of the intervention. Performance-based cost-effectiveness was analyzed by means of the incremental cost-effectiveness ratio (ICER) and graphical cost-effectiveness planes and cost-acceptability curves.
Results: Our results showed that during the interventions the multidisciplinary family center had less corrective family work episodes and established higher performance-based effectiveness in comparison to the provider of decentralized family care services. Cost-acceptability analysis suggested that performance-based cost-effectiveness in corrective family work was attained at a willingness to pay of EUR 300-350 per outcome unit. Despite of the lower amount of corrective family work, the duration of the interventions in the multidisciplinary family center was on the average 48 days longer than in the comparative organization.
Discussion and Conclusion: A model of service delivery focusing on preventive measures, responsiveness, duration of care episodes and clearly defined service processes supported the attainment of higher effectiveness and improved overall performance. It was also shown that existing client register data were applicable for monitoring cost-performance outcomes, and by inclusion of quality-of-life information would also be extendable to cost-effectiveness analysis of social services, such as family center services.
Keywords: Child and family care; early identification; family center services; performance-based cost-effectiveness; social and welfare services.
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Original Article in COVID-19 and Mental Health
One year after the first cases of COVID-19: Factors influencing the anxiety among Kosovar university students
Authors: Merita SHALA1, Pranvera JETISHI ÇOLLAKU2, Fatbardha HOXHA3, Samire BLLACA BALAJ4, Diellza PRETENI5
1 Assistant Professor, Faculty of Education, University “Isa Boletini”, Mitrovice, Kosovo. E-mail; email@example.com
2 Assistant Professor, University “Ukshin Hoti”, Prizren, Kosovo. E-mail: firstname.lastname@example.org
3 PhD c, Faculty of Education, University “Isa Boletini”, Mitrovice, Kosovo. E-mail: email@example.com
4 Assistant Professor, Faculty of Education, University “Isa Boletini”, Mitrovice, Kosovo. E-mail: firstname.lastname@example.org
5 Faculty of Education, University “Isa Boletini”, Mitrovice, Kosovo. E-mail: email@example.com
Introduction: One year after the first COVID-19 cases in Kosovo, we aimed to discover the anxiety level of university students and explore factors influencing their anxiety.
Methods: This is a cross-sectional study. 897 students (M = 21.06, SD = 4.41), from six universities in Kosovo completed the 7-item Generalized Anxiety Disorder Scale and a sociodemographic survey through a web-based Google form. Descriptive, Pearson chi-square, t-Test, ANOVA, linear and multiple regressions were used.
Results: We found that 73.5% of the full sample experience anxiety, respectively 12.9 % of them severe anxiety, 22.2 % moderate, and 38.4 % mild anxiety, with female students showing higher levels of anxiety symptoms. Moreover, students in master studies (20%), students who have been infected with COVID-19 (18.9%), students having a relative (14.8%) or having an acquaintance infected with COVID-19 (15.7%), were more likely to be severely anxious (P < 0.05). Students from Medical Faculty, Law and Arts also showed higher level of severe anxiety than the students of Technical faculties and Faculty of Education (P = 0.001). Students with history of infection with COVID-19 showed higher severe anxiety for their family members (14.8%), friends (15.7%) and themselves (18.9%) than the full sample. Anxiety was predicted by being infected with COVID-19 (P =0.000), having friends infected (P = 0.000) and by gender (P = 0.000).
Conclusion: The current study found that most of the students are experiencing anxiety at some levels. Continuous observation of students’ psychological health and other deeper studies is recommended. In the meantime, psychological services for students should be provided.
Keywords: Anxiety; COVID-19; mental health; Kosovo; university students.
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Original Article in COVID-19 and Public Health System
Association between knowledge and attitude towards COVID-19 and utilization of emergency department care in Texas, United States: A hospital-based study
Authors: Stephen GREEN1, Connor BARRY1, Brian PAYNE2, Justin HOLMES3, K Tom XU3
1 M.D., School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
2 M.D., Division of Emergency Medicine, Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
3 M.D., Ph.D, Division of Emergency Medicine, Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Objective: To examine whether patients’ COVID-19 knowledge and concern of contracting COVID-19 in healthcare facilities were associated with decreased utilization of and attitude towards ED care during the initial months of the pandemic.
Methods: This was a cross-sectional study of patients from an urban academic ED in Texas, the United States. Patient-level data were collected for the number of ED visits during the initial pandemic months, the likelihoods to seek care for respiratory symptoms vs. pain-related conditions, changes in perceived need for ED care measured by changes in pain threshold to seek ED care, COVID-19 knowledge and concern of contracting COVID-19 in healthcare facilities. Bivariate and multivariate analyses were performed.
Results: In March, April and May, the ED volume decreased by 11%, 42%, and 26%, respectively. The average number of ED visits in these 3 months was 1.25. About 45% indicated that they were less likely to visit ED for respiratory symptoms and 32% were less likely to visit ED for any pain-related symptoms. Only about 19% reported that they thought it was more likely to contract COVID-19 in healthcare facilities than in crowded public places. A better COVID-19 knowledge, but not the concern of contracting COVID-19, was found to be significantly associated with fewer ED visits. Heavy users continued to be heavy users despite the presence of COVID-19, controlling for other factors.
Discussion and Conclusion: Patients’ knowledge of COVID-19 was a contributing factor to their utilization of ED care during the initial COVID-19 pandemic months. However, its effect may not be as prominent as previously thought. Stay-at-home orders likely had an unintended negative impact on the missed critical ED care. Heavy users continued to be heavy users despite the presence of the pandemic.
Keywords: Attitude; COVID-19; knowledge; emergency department utilization.
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Original Article in Public Health
Factors associated with diarrheal disease among under five children in Godawari Municipality of Nepal: A cross-sectional study
Authors: Marina Vaidya SHRESTHA1,2, Bishnu P CHOULAGAI1, Tista Prasai JOSHI3, Shiva Raj ADHIKARI4, Bandana PRADHAN1
1 Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
2 Kathmandu Medical College, Department of Community Medicine, Kathmandu University, Kathmandu, Nepal.
3 Faculty of Science, Nepal Academy of Science and Technology (NAST), Lalitpur, Nepal.
4 Central Department of Economics, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
Introduction: Water, Sanitation and Hygiene (WASH) are the basic need for all, especially for children. The WASH related matter is still burning issue in the context of developing countries like Nepal. This article is aimed to assess the factors associated with diarrheal diseases among under five children in Godawari Municipality of Nepal.
Methods: A cross-sectional study was conducted in a sample of 742 households from Godawari Municipality. A random sampling technique was applied for data collection. Households with at least one under-five year child were included in the study. Data was analyzed using SPSS Statistics version 20. Univariate and multivariate analysis were carried to determine the relationships between the potential associated factors and diarrheal diseases.
Results: Households with piped water supply for drinking purpose were 98.2%, with improved sanitation 99.5%, no open defecation 100% and 95.1% of households used soap and water for hand-washing. The prevalence of diarrhea among children under the age of 5 years was 50%. Family type (aOR= 0.62, P = 0.008), number of children in household (aOR= 0.13, P = 0.003], occupation as housewife (aOR=1.69, P = 0.02), ethnicity (aOR= 0.23, P = 0.004), location of water source (aOR= 1.95, P = 0.04), sharing of toilet (aOR= 0.56, P = 0.001), critical hand washing before feeding child (aOR= 2.46, P = 0.05) and location of hand washing facility (aOR= 0.26, P = 0.008) were significantly associated factors with the occurrence of childhood diarrheal diseases.
Discussion and Conclusion: Childhood diarrhea remains the most common health problem in the study area despite the good WASH situation of Godawari Municipality as compared to national indicators. This study implies the policymakers and local government authority to investigate and launch more awareness program for the reduction of children’s diarrheal disease in the study area.
Keywords: Diarrhea, hygiene; Nepal; sanitation; under five children; water.
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Original Article in Global Health and Infectious Diseases
Factors associated with typhoid fever in Western Nepal: A cross-sectional study
Authors: Uttam PAUDEL1*, Krishna Prasad PANT2, Shiva Raj ADHIKARI3, Sashi SILWAL1, Bihungam BISTA1, Bimala BARAL4, Meghnath DHIMAL1
1 Nepal Health Research Council, Kathmandu, Nepal.
2 Visiting Faculty, Kathmandu University, Kathmandu Nepal
3 Central Department of Economics, Tribhuvan University, Kathmandu Nepal.
4 Research Fellow, Padhma Kanya Multiple Campus, Tribhuvan University.
Introduction: Typhoid fever is one of the major public health problems in Nepal. This study aims to generate evidence for policy formulation for typhoid prevention and control by analyzing the role of some environmental and household characteristics as risk factors for typhoid fever in Western Nepal.
Methods: This was a cross-sectional study design using a household survey data of Western Nepal. In-depth in-person interviews were conducted using semi-structured questionnaires for data collection. Probit/logistic regression models were used to gauge the factors affecting typhoid occurrence.
Results: Probit/logistic regression results indicated that extreme winter temperatures (aOR = 2.22; 95% Confidential Interval (CI) 1.15 to 4.28), river water pollution (aOR = 2.11; 95% CI 1.18 to 3.78), decreased shrub cover including medicinal plants (aOR = 2.32; 95% CI 1.32 to 4.06) and less exposure to heat waves (aOR = 0.36; 95% CI 0.16-0.81) are the major environmental factors likely to influence typhoid fever occurrence in Western Nepal. Besides, community awareness programs (aOR = 3.59; 95% CI 1.54 to 8.34) and hand washing with water and soap (aOR = 0.75; 95% CI 0.10 to 0.95) can influence the typhoid occurrence.
Discussion and Conclusion: An appropriate adaptation packages against the inextricable environmental factors at the community level is required together with replantation of medicinal and other shrubs surrounding the community. This research recommends formulation of policies and program for control of waterborne diseases addressing environmental factors with considering personal hygiene maintenance for the control of typhoid fever in Western Nepal.
Keywords: Typhoid fever; environmental factors; household characteristics; Logistic regression; Western Nepal.
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Case Report in Public Health and COVID-19
Two case reports of acute ST-elevation myocardial infarction after COVID-19 vaccination: Co-incidence or causal-association?
Authors: Barun KUMAR1*, Vikas SABBARWAL2, Abhimanyu NIGAM3, Pranay GORE4, Gaurav CHAUHAN5, Anshuman DARBARI6
1 M.D., D.M., Associate Professor, Department of Cardiology, All India Institute of Medical Sciences – Rishikesh, Uttarakhand, India.
2 M.D., Senior Resident, Department of Cardiology, All India Institute of Medical Sciences – Rishikesh, Uttarakhand, India.
3 M.D., Senior Resident, Department of Cardiology, All India Institute of Medical Sciences – Rishikesh, Uttarakhand, India.
4 M.D., Senior Resident, Department of Cardiology, All India Institute of Medical Sciences – Rishikesh, Uttarakhand, India.
5 M.D., Senior Resident, Department of Cardiology, All India Institute of Medical Sciences – Rishikesh, Uttarakhand, India.
6 M.S., M.Ch., Associate Professor, Department of CTVS, All India Institute of Medical Sciences – Rishikesh, Uttarakhand, India.
We describe two cases of presumed inflammatory and thrombotic response to vaccination with the AstraZeneca vaccine, COVISHIELD (ChAdOx1 nCoV- 19 Corona Virus Vaccine). The first case explained here is of a 76 old male who developed cardiac symptoms within 20 hours of receiving the vaccination. The second case is of a 60-year-old male admitted with retrosternal chest pain developing within 30 minutes of receiving the vaccine. The literature search was conducted to review reports of COVID-19 vaccination-related cardiac ischaemic events and thus emphasize the need for awareness of vaccine providers for such co-incidence to provide timely support to the patient.
Keywords: COVID-19; Astrazeneca; myocardial infarction; side effects; vaccination.
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