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1.
Anna H Oesterlund Jane F Thomsen Deogratias K Sekimpi James Maziina Apio Racheal Erik J?rs 《African health sciences》2014,14(2):420-433
Background
Over the past years there has been an increase in the use of pesticides in developing countries. This study describes pesticide use among small-scale farmers in Uganda and analyses predictors of pesticide poisoning (intoxication) symptoms.Method
A cross-sectional study was conducted using a standardized questionnaire. Some 317 small-scale farmers in two districts in Uganda were interviewed about pesticide use, knowledge and attitude, symptoms of intoxication, personal protective equipment (PPE) and hygiene. The risk of reporting symptoms was analysed using logistic regression analysis.Results
The most frequently used pesticides belonged to WHO class II. The farmers had poor knowledge about pesticide toxicity, and the majority did not use appropriate PPE nor good hygiene when handling pesticides. There was no significant association between the number of times of spraying with pesticides and self-reported symptoms of pesticide poisoning. The only significant association was between blowing and sucking the nozzle of the knapsack sprayer and self-reported symptoms of pesticide intoxication (OR: 2.13. 95% CI: 1.09 – 4.18).Conclusion
Unlike the practice in several other developing countries, small-scale farmers in Uganda do not use the most hazardous pesticides (WHO class 1a and 1b). However use of WHO class II pesticides and those of lower toxicity is seen in combination with inadequate knowledge and practice among the farmers. This poses a danger of acute intoxications, chronic health problems and environmental pollution. Training of farmers in Integrated Pest Management (IPM) methods, use of proper hygiene and personal protective equipment when handling pesticides should be promoted. 相似文献2.
N Malangu 《African journal of traditional, complementary, and alternative medicines》2014,11(2):425-438
Background
Acute poisoning incidents are one of the leading causes of morbidity and hospitalization in several countries. The purpose of this analysis was to compare the patterns of acute poisoning in three countries namely, Botswana, South Africa and Uganda; and examine the similarities and disparities in the patterns of occurrence of acute poisoning based on the sociodemographic factors of the victims, the toxic agents involved, the circumstances surrounding the incidents and their outcomes.Materials and methods
This paper is based on the re-analysis of data that were collected from January to June 2005 by some Master of Public Health students using a similar data collection tool. A single dataset made of the original individual datasheets was constituted and analysed.Results
Overall, it was found that the mean age of victims of acute poisoning was 20.9 ± 14.5 years; the youngest victim was a 3 months old boy from South Africa; and the oldest was a 75 years old man from Uganda. In descending order, the most common toxic agents involved in poisoning incidents were household products (46.1%), agrochemicals (18.8%), pharmaceuticals (14.0%), animal and insect bites (13.0%), food poisoning (4.5%), as well as plants and traditional medicines (3.6%). Across the three countries, acute poisoning occurred mainly by accident, but the contextual factors of each country led to a pattern of acute poisoning that showed some similarities with regard to the distribution of deliberate self-poisoning among females, teenagers, and young adult victims. There were disparities related to the differential access to toxic agents, based on the age and gender of the victims. Of the 17 deaths reported, 2 (11.7%) were due to traditional medicines; household products were implicated in fatal outcomes in all three countries, though the extent of their involvement varied from country to country.Conclusion
Although plant and traditional medicines caused fewer cases of acute poisoning incidents, they contributed considerably to fatal outcomes. 相似文献3.
Elizabeth Peel Margaret Douglas Odette Parry Julia Lawton 《The British journal of general practice》2010,60(577):570-577
Background
Physical activity is particularly important for people with type 2 diabetes, as evidence suggests that any reduction in sedentary time is good for metabolic health.Aim
To explore type 2 diabetes patients'' talk about implementing and sustaining physical activity.Design of study
Longitudinal, qualitative study using repeat in-depth interviews with 20 patients over 4 years following clinical diagnosis.Setting
Patients were recruited from 16 general practices and three hospitals across Lothian, Scotland.Results
Discussion, and salience, of physical activity was marginal in patient accounts of their diabetes management. Patients claimed to have only received vague and non-specific guidance about physical activity from health professionals, and emphasised a perceived lack of interest and encouragement. Aside from walking, physical activities which were adopted tended to attenuate over time. Patients'' accounts revealed how walking a dog assisted this kind of activity maintenance over time. Three main themes are highlighted in the analysis: 1) incidental walking; 2) incremental physical activity gains; and 3) augmenting physical activity maintenance. The problems arising from walking without a dog (for example, lack of motivation) are also examined.Conclusion
Asking patients about pet preferences might seem tangential to medical interactions. However, encouraging dog walking or identifying another interest that promotes a regular commitment to undertake physical activity may yield long-term health benefits. 相似文献4.
Back ground
Iodine deficiency disorders (IDD) cover a variety of pathological conditions including goitre, mental retardation and perinatal mortality in millions of individuals globally. IDD was initially identified as a problem in 1970 and was confirmed in 1991. In 1993, the Uganda government introduced a policy of Universal Salt Iodization (USI) requiring all household salt to be iodized. After 5 years this study evaluates the USI programme.Objectives
To determine goitre prevalence rate, establish the proportion of household consuming iodized salt and determine the levels of iodine intake in the sample districts.Methods
A sample of 2880 school children aged 6–12 years from 72 Primary schools in 6 districts of Uganda was studied in October 1999. Goitre was established by palpation, salt iodine was analysed by thiosulphate titration, while urinary iodine was analyzed using ICCIDD recommended method F in which iodine is detected colorimetrically at 410nm.Results
The over all total goitre rate was 60.2% down from 74.3 in 1991 and visible goitre was 30% down from 39.2% in 1991. The propotion of households taking adequately iodized salt was 63.8% and the median urinary iodine was 310µg/L. Whereas 36% of 95 urine samples analysed in 1991 had urinary iodine below 50µg/L, only 5% of the 293 urine samples studied in 1999 had the same urine levels. This represents a considerable improvement in iodine intake which is confirmed by the fact that 63.8% of the study households consume adequately iodized salt. If maintained and evenly spread, this will enable Uganda to control IDD.Conclusion
USI has improved iodine intake in Uganda. However, iodine malnutrition is still a severe public health problem because some communities in this study such as in Kisoro still have low iodine consumption, while others such as Luwero now have iodine excess. The latter is likely to predispose to hyperthyroidism.Recommendation
The national set standard of household salt iodine of 100ppm be revised. Locally produced salt be iodized, and a national iodine monitoring programme be instituted to ensure evenly spread consumption of adequately iodized salt by all communities in the country. 相似文献5.
Background
During the 2001 election campaign, President Yoweri Museveni announced he was abolishing user fees for health services in Uganda. No analysis has been carried out to explain how he was able to initiate such an important policy decision without encountering any immediate barriers.Objective
To explain this outcome through in-depth policy analysis driven by the application of key analytical frameworks.Methods
An explanatory case study informed by analytical frameworks from the institutionalism literature was undertaken. Multiple data sources were used including: academic literature, key government documents, grey literature, and a variety of print media.Results
According to the analytical frameworks employed, several formal institutional constraints existed that would have reduced the prospects for the abolition of user fees. However, prevalent informal institutions such as “Big Man” presidentialism and clientelism that were both ‘competing’ and ‘complementary’ can be used to explain the policy outcome. The analysis suggests that these factors trumped the impact of more formal institutional structures in the Ugandan context.Conclusion
Consideration should be given to the interactions between formal and informal institutions in the analysis of health policy processes in Uganda, as they provide a more nuanced understanding of how each set of factors influence policy outcomes. 相似文献6.
Kang MK Kim BK Kim TW Kim SH Kang HR Park HW Chang YS Kim SS Min KU Kim YY Cho SH 《Allergy, asthma & immunology research》2010,2(4):247-253
Purpose
Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians'' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace.Methods
We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile.Results
A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4±9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records.Conclusions
This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians'' preferences would encourage their implementation in clinical practice. 相似文献7.
Amuge B Wabwire-Mangen F Puta C Pariyo GW Bakyaita N Staedke S Kamya M Olico-Okui 《African health sciences》2004,4(2):119-124
Background
The number of orphans in Rakai district, Uganda is estimated to be 34,902 (OCBO, 2000) which translates into 28% of children under the age of 18 years. Young people who have been orphaned and as a result became heads of households must look after themselves and their siblings. These children are likely to be faced with several health problems and have to take crucial life decisions without parental/adult guidance.Objectives
This study was conducted in order to understand how child-headed households, Rakai district in Uganda recognize malaria, their health-seeking behavior when malaria is suspected and reasons for the type of behavior compared to the adult-headed households.Methods
A comparative cross-sectional study was conducted in 300 households in Rakai district, Uganda, in which 8/23 (35%) of subcounties and 150 child-headed households were included. The closest neighborhood adult-headed household to each childheaded household was selected for comparison. Individual interview was carried out with the respondents using semi-structure questionnaire. Key informant interview and focus group discussions were also conducted.Results
The main findings were that the respondents in child-headed households had less knowledge on signs and symptoms of simple and severe malaria compared to adult heads of households. Respondents in child-headed households were less likely to seek health care from health facilities (OR=0.59, CI=0.36-0.97, p-value=0.028). There was no significant difference in the time lag before taking first action in the two types of households (OR=0.72, CI=0.42-1.22, p-value=0.194). The respondents in child-headed households were six times (OR=5.70,CI=2.75-11.91, p-value<0.001) more likely to use local herb for treatment of malaria than the adult heads households. Major reasons stated by the respondents for choosing where health care is sought included distance to source of health care, cheap or free treatment, availability of drugs, and quick services to patients.Conclusion
The respondents in child-headed households had less knowledge on signs and symptoms of simple and severe malaria and receive too little or late health care from health professionals compared to the adult heads of households probably due to lack of knowledge and money. Information Communication and Education programs should be designed and target the child-headed households and supply home packs. 相似文献8.
Zahid Shakoor Adel Almogren Rana Mohammed Waleed Hasanato Bushra Zahid 《African health sciences》2014,14(3):634-640
Background
Allergy to hen''s egg and meat contributes significantly to the manifestations of food allergy all over the world.Objectives
This study was performed to assess the presence of hen''s egg and meat specific IgE antibodies among patients investigated for various allergic disorders.Methods
This is a retrospective study performed at King Khalid University Hosptial, Riyadh. Data from 421 patients with allergic disorders screened for food specific IgE antibodies between January 2009 and March 2011 were analyzed. Sixty (14.25%) patients including 42 males and 18 females with the mean age (sd) of 7.5 (7.4) years were found to have specific IgE antibodies against hen''s egg and chicken meat. There were 56 (93.3%) children and 4 (6.7%) adult patients. Specific IgE antibodies were measured by radioallergosorbent test (RAST) using Pharmacia ImmunoCAP 250 analyzer.Results
Atopic dermatitis was the most common (55%) clinical condition. Out of the total 60 patients harboring hen''s egg and chicken meat specific IgE antibodies high levels of egg white, yolk and chicken meat specific IgEs were detected in 58 (96.6%), 37 (61.6%) and 6 (10%) patients respectively. Both the egg white and yolk antibodies coexisted in 35 (58.3%) patients.Conclusion
Sensitization against hen''s egg was higher compared to the chicken meat. Egg white sensitization higher than the egg yolk particularly in Saudi children with food related allergic disorders. 相似文献9.
Background
Schistosoma mansoni was observed and reported in Kuluva hospital Arua District in north western Uganda as early as 1902. S. mansoni is widely distributed in Uganda along permanent water bodies.Objective
To review the litreture on scistosomiasis in Uganda, since 1902.Method
The core literature for this short review was searched from reports and publications by the British colonial Ministry of Health Districts Medical officers and Entomologists. Additional information was obtained from Makerere University Medical School library archives, London School of Hygiene and Tropical Medicine library archives, University of Antrwap, and post independence publications on schistosomiasis in Uganda in various journals.Results
Since it was first detected in 1902 Schistosoma (S) mansoni is more widely distributed in Uganda than S. haematobium. However Schistosoma mansoni and S. haematobium are of public health importance in Uganda and the importance of migrants and fishermen in disseminating infections into non-infested areas and intensifying infection in areas already infested have been reported.Conclusion
S. mansoni has been on the increase in Uganda whereas S. haematobium is localized in sporadic foci in the north of Uganda. Treatment with praziquantel the drug of choice in Uganda used in schistosomiasis control programme has reduced development of severe schistosomiasis. 相似文献10.
Belson Rugwizangoga Theresia Mwabili Trishia Scanlan Peter Meyer James Kitinya 《African health sciences》2014,14(3):763-768
Background
Coats'' disease is an exudative retinal detachment with vascular telangiectasis occurring mostly in male children, the age group most affected by retinoblastoma.Objectives
Compare the differential diagnoses of Coats'' diseaseEstablish recommendation to early disease detection.Materials and Methods
A 3-year-old female child was referred to Muhimbili National Hospital (MNH), Tanzania, in September 2011. She had presented at the peripheral hospital with gradual onset of left eye leukocoria for 1 year and pain for 2 months. B-scan showed a mass in the left eye. A clinical diagnosis of retinoblastoma was made. Left eye enucleation was performed; the patient was referred to MNH, with the enucleated specimen.Results
Brain and orbits scan revealed no residual tumour. The globe measured 2x1.8 cm, the optic nerve stump measured 3 mm. A whitish mass filled the vitreous, with complete retinal detachment. Microscopy showed retinal gliosis, detachment with sub retinal PAS positive exudates, vacuolation and cholesterol clefts. Foreign body giant cells were present; telangiectatic thin-walled blood vessels were identified. Clinico-pathological findings were of stage 4 Coats'' disease.Conclusion
Coats'' disease is an important differential diagnosis of retinoblastoma. Delay to detect Coats'' disease leads to vision loss which necessitates eye enucleation as was in this child. 相似文献11.
Background
Suicide was investigated in the urban setting of Kampala, Uganda.Objectives
Firstly, to explore the use of two research methodologies, a retrospective review of patient records and the psychological autopsy methodology in suicide research in Uganda. Secondly to investigate the characteristics and correlates of urban suicide in Uganda.Results
A male to female ratio of suicide of 3.4:1 and a peak age of suicide in the 20–39 years age group were found. The main methods of suicide were hanging and ingestion of poison (organophosphates). Problems with social networks, negative life events, higher psychological distress and lower quality of life were associated with suicide at univariate analysis. It was only psychological distress that retained significance at multivariate analysis.Conclusion
The retrospective review of records at Mulago hospital was beset by incomplete records whereas a pilot psychological autopsy study was well accepted and might contribute valuable data in African settings. 相似文献12.
Background
There is growing evidence that emotional distress expressed in terms of anxiety and depression is very high among tuberculosis (TB) patients.Objectives
This study aims to determine levels of anxiety, depression and emotional distress in patients with several types of TB and to determine the association between social-demographic and economical factors, clinical variables and anxiety, depression and emotional distress.Methods
A cross-sectional study was performed in a sample of 81 TB patients. A social-demographic and economical questionnaire was used, followed by the hospital anxiety and depression scale.Results
38.3% and 49.4% of our sample presented significant levels of anxiety and depression. 44.4% of patients had significant levels of emotional distress.Married subjects, a diagnosis of extra-pulmonary TB and multidrug resistant TB were related to higher risk for anxiety. Gender, extra-pulmonary and multidrug resistant TB were associated to depression. Female gender and cases of extra-pulmonary TB presented a 1.5 times risk for emotional distress.Conclusions
Our study found high rates of anxiety, depression and emotional distress among TB patients. Marital status, gender, type and treatment of TB were related to higher levels of emotional disorder. Mental health services should be an integral part of programs against tuberculosis. 相似文献13.
Long D Perry C Unruh SA Lewis N Stanek-Krogstrand K 《Journal of Athletic Training》2011,46(6):688-695
Context:
Factors that affect food choices include the physical and social environments, quality, quantity, perceived healthfulness, and convenience. The personal food choice process was defined as the procedures used by athletes for making food choices, including the weighing and balancing of activities of daily life, physical well-being, convenience, monetary resources, and social relationships.Objective:
To develop a theoretical model explaining the personal food choice processes of collegiate football players.Design:
Qualitative study.Setting:
National Collegiate Athletic Association Division II football program.Patients or Other Participants:
Fifteen football players were purposefully sampled to represent various positions, years of athletic eligibility, and ethnic backgrounds.Data Collection and Analysis:
For text data collection, we used predetermined, open-ended questions. Data were analyzed using the constant comparison method. The athletes'' words were used to label and describe their interactions and experiences with the food choice process. Member checks and an external audit were conducted by a qualitative methodologist and a nutrition specialist, and the findings were triangulated with the current literature to ensure trustworthiness of the text data.Results:
Time was the core category and yielded a cyclic graphic of a theoretical model for the food choice system. Planning hydration, macronutrient strategies, snacks, and healthful food choices emerged as themes.Conclusions:
The athletes planned meals and snacks around their academic and athletic schedules while attempting to consume foods identified as healthful. Healthful foods were generally lower in fat but high in preferred macronutrients. High-protein foods were the players'' primary goal; carbohydrate consumption was secondary. The athletes had established plans to maintain hydration. Professionals may use these findings to implement educational programs on food choices for football players. 相似文献14.
Background
In Uganda, the main stay for provision of human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) has been at health facilities. Home based VCT on the other hand, was initiated in the country to improve service coverage.Objective
To evaluate the cost effectiveness of facility- and home-based HIV VCT strategies in rural southwestern Uganda.Methods
Data on costs and effectiveness of facility- and home-based HIV VCT intervention strategies was collected in two sub-Counties in rural southwestern Uganda. Costing was performed using the ingredients approach. Effectiveness was measured as the number of HIV sero-positive clients identified. Incremental Cost-Effectiveness Ratios (ICERs) were calculated from the provider perspective.Results
The cost per client tested were US$6.4 for facility based VCT and US$5.0 for home based VCT. The corresponding costs per positive case identified were US$86.5 and US$54.7 respectively. The incremental cost to providers per additional positive case identified by facility based VCT was US$3.5.Conclusion
Home based VCT was the least costly strategy per client tested and was also cost effective in identifying HIV sero-positive clients in rural areas. This strategy should therefore be promoted to improve service coverage and thereby facilitate early and extensive detection of clients eligible for treatment. 相似文献15.
David Musoke George Karani John C Ssempebwa Samuel Etajak David Guwatudde Miph B Musoke 《African health sciences》2015,15(2):401-412
Background
Malaria is the leading cause of morbidity and mortality in Uganda particularly among children under 5 years of age.Objectives
The study assessed the knowledge and practices on malaria prevention in 2 rural communities in Wakiso District, Uganda with emphasis on the various prevention methods.Methods
The study was a cross-sectional survey carried out among 376 households using both quantitative and qualitative methods. Log-binomial regression, chi square and Spearman''s rank order correlation were used to test for associations.Results
The majority of participants (64.6%) had low knowledge on malaria prevention methods, with untreated mosquito nets (81.7%), mosquito coils (36.9%) and insecticide treated nets (29.6%) being the most known methods. Knowledge on malaria prevention methods was associated with age (χ2 = 32.1; p < 0.01), employment status (χ2 = 18.1; p < 0.01), education (χ2 = 20.3; p = 0.01), income (χ2 = 14.5; p = 0.01) and having heard a malaria message in the previous 12 months (χ2 = 92.3; p < 0.01). Households that had at least one mosquito net were 45.5% and net ownership increased with household income. Only 0.5% of the houses had undergone indoor residual spraying in the previous 12 months, while 2.1% had complete mosquito proofing in windows and ventilators to prevent mosquito entry.Conclusion
There is potential to improve practices on malaria prevention by targeting other methods beyond mosquito nets such as installing proofing in windows and ventilators. The integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner should be explored for this purpose. 相似文献16.
17.
Maternal and fetal outcome of gestational diabetes mellitus in Mulago Hospital, Uganda 总被引:2,自引:0,他引:2
Objective
To determine the maternal and foetal outcomes in mothers with gestational diabetes mellitus attending antenatal clinics in Mulago Hospital Kampala Uganda.Design
This was a cohort study.Setting
Mulago Hospital antenatal clinics.Participants
Ninety mothers with gestational ages between 24–32 weeks were recruited from April to September 2001.They were followed up to the time of delivery. The WHO criterion for the diagnosis of gestational diabetes was used. Thirty mothers with a 2 hrs post prandial capillary blood sugar more than 140 mg/dl were the exposed group and 60 mothers with less than 140 mg/dl were the unexposed group. Blood sugar was measured using a one touch glucometer.Outcome variables
Socio demographic characteristics, maternal complications, mode of delivery and the foetal outcomes.Results
The mean age of mothers in both groups was similar: 28.6 years vs 27.5 years. Both groups had similar body mass index more than 26. The mothers with gestational diabetes mellitus (GDM) were four times more likely to have hypertensive disease(p=0.04) and nine times more likely to have vaginal candidiasis(p=0.002).The modes of delivery were similar in both groups but genital injuries were more common among mothers with GDM. The indications of Caesarian section in mothers with GDM were two times more likely to be due to big babies and obstructed labour. The babies for mothers with GDM were more likely to be macrocosmic, still born, and have shoulder dystocia than those of normal mothers.Conclusion
Gestational diabetes mellitus exists in Uganda and is associated with adverse maternal and foetal outcomes. There is need to routinely screen mothers for gestational diabetes in this environment. 相似文献18.
Background
Nodding Syndrome is a debilitating disorder of yet unknown etiology that has affected children and adolescents aged 3 – 18 years in parts of sub Saharan African countries including Uganda, South Sudan, Tanzania and Liberia.Objective
To identify stereotypes and negative attitudes held by primary care health workers about nodding syndrome.Method
Of one hundred health workers invited by the Uganda Ministry of Health for training on nodding syndrome from the three most affected districts of Pader, Lamwo and Kitgum forty were interviewed using a predesigned tool. Content and thematic analysis was applied.Results
There were 22 females. The median age was 33 years (range 23–54 years). The participants included Psychiatric Clinical Officers, Medical Clinical Officers, Laboratory Technicians, Midwives, Registered and Enrolled Nurses. Overall, four broad categories of negative stereotypes were identified; Nodding syndrome is 1) an incurable disease, 2) is associated with evil spirits and curses, 3) is disabling, making the patient a burden to society and 4) is a fatal illness.Conclusion
Primary health care workers who lead the care of patients with nodding syndrome have several negative stereotypes that may potentially impact negatively on the quality of care they provide. 相似文献19.
Nansera D Bajunirwe F Kabakyenga J Asiimwe PK Mayanja-Kizza H 《African health sciences》2010,10(4):312-319
Background
As countries with a high burden of TB and HIV roll out integrated TB/HIV care, there is need to assess possibility of lower level health units treating TB to provide integrated TB/HIV care.Objective
To determine barriers and opportunities for provision of integrated TB/HIV care in lower level health units offering TB treatment in Mbarara district, Uganda.Methods
Conducted key informant interviews, interviewed health workers and observed services offered.Results
22 health units were assessed and 88 health workers were interviewed. Of the 18 health units mandated to offer laboratory services, 55.6% and 38.9% were able to offer rapid HIV-testing and ZN staining respectively. Understaffing, lack of capacity to diagnose HIV and TB, lack of guidelines to inform care options of TB/HIV co-infected patients and insufficient knowledge and skills among health workers towards provision of integrated TB/HIV care were mentioned as barriers to provision of integrated TB/HIV services.Conclusion
To offer integrated TB/HIV services at lower level health units currently offering TB stand alone services, there is need to address gaps in knowledge and skills among health workers, laboratory diagnostics, staffing levels, medical supplies and infrastructure. 相似文献20.