Tuberculosis notification: An inquiry among private practitioners in Pimpri-Chinchwad municipal corporation area of Maharashtra,India

BackgroundThe Government of India implemented mandatory TB notification policy since 2012. After that India's TB notifications from the private sector steadily increased; however, less is known about private practitioners' (PP's) experiences with TB notification. The present study aims to fulfil this gap.MethodsWe conducted a cross-sectional study during November 2019 to March 2020 in Pimpri-Chinchwad Municipal Corporation (PCMC) area of Maharashtra State. We used a mixed methods approach which involved a survey of 200 PPs and in-depth interviews (IDIs) with 7 PPs and 8 National TB Elimination Program (NTEP) staff. The data were presented in the form of frequencies and percentages and thematic analysis was performed on the qualitative data.ResultsThe study revealed that most PPs (194 of 200; 97%) were aware of TB notification and 75% reported that they notify TB cases to the NTEP. Of those who notify, majority (129 of 145; 89%) reported that they use paper-based notification being the convenient method due to in-person visit and help by the NTEP staff. Only a third of PPs were aware of electronic notification methods. The main reasons behind low utilization of web based and mobile application were unfamiliarity and technical issues such as poor network connectivity. A third of PPs were aware about monetary incentives for notification and only 17% reported actual receipt of incentive at some point.ConclusionsOur study identifies several areas where the NTEP can undertake interventions to strengthen the implementation of mandatory TB notification policy. Low awareness about electronic notification methods and preference for paper-based notification in this Study area suggest that more efforts are necessary for successful transitioning from paper-based to electronic notification system.     

The experience of spousal caregivers of patients recently diagnosed with cancer in Taiwan

BackgroundMost qualitative studies on caregivers of cancer patients have explored the experiences of family members and friends in Western or European countries. Little is known about the experience of spousal caregivers of patients recently diagnosed with cancer in a Chinese population.AimThe aim of this study was to explore the lived experience of spouses of patients recently diagnosed with cancer in Taiwan.MethodsThis qualitative study analysed focus groups interview data using thematic analysis. Participants were purposively sampled from a medical hospital in central Taiwan. Four focus group interviews were conducted; 15 spousal caregivers participated.FindingsResearch findings from the spouses, seven husbands and eight wives, included four main themes: handling emotions to make decisions quickly, experiencing meaningful support from a right and good physician, struggling with changes in daily life, and placing a peaceful mindset at the centre of life.DiscussionChinese collectivistic culture expects family members to make medical decisions and filter information a patient receives. Spousal caregivers informed patients about their cancer in order to avoid or reduce the amount of psychological harm. Spouses’ strong commitments to caregiving provided them with power and motivation to continue caregiving. A peaceful mindset, influenced by the traditional Chinese philosophy of Buddhism, was considered critical for prolonging the patient’s life and maintaining the caregiver’s emotional health.ConclusionsIt is important for healthcare professionals to understand Chinese cultural influences and concerns of spousal caregivers when caring for Chinese patients to manage patients and caregivers effectively.     

Evaluation of dengue fever reports during an epidemic,Colombia

OBJECTIVE

To assess the validity of dengue fever reports and how they relate to the definition of case and severity.

METHODS

Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics.

RESULTS

We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%.

CONCLUSIONS

Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.     

The association between depression and widowhood and nutritional status in older adults

This study aimed to investigate the association of depression and widowhood on the nutritional status of older adults. A cross-sectional study of community-dwelling older adults in the rural United States was conducted. Dietary intake was measured via questionnaires. Depression status was classified by asking participants if they have ever been diagnosed with the condition, or by review of medical records. The final sample consisted of 1065 participants with 141 (13.2%) depressed, 384 (36.1%) widowed, and 67 (6.3%) both depressed and widowed. Mean caloric intake for total study population was low; widows and widowers had the lowest energy consumption among all groups. Greater intake of several nutrients was observed in depressed and/or widowed subjects. Nutritional services, such as congregate and home delivered meal programs, were not identified as significant contributors to the nutritional intake in older adults who were depressed, widowed, or both. Health care professionals may contribute to meal-based nutrition programs by offering their assistance in aspects of nutritional education and counseling for the promotion of healthy aging.     

2006年1～6月北京市外来短期流动人口传染病流行概况

目的了解北京市2006年1～6月外来短期流动人口中传染病的流行病学特征。方法根据北京市常规传染病报告系统记录的2006年1～6月传染病发病数据,对外来短期流动人口的传染病病例的分布进行描述和分析,并估计发病率。结果 2006年1～6月北京市外来短期流动人口的传染病总发病率为189.91/10万低于北京市一般人群的发病率水平。45.54%的病例分布在城市功能拓展区,43.79%发生在城市发展新区。病例集中在儿童和从事服务行业的青年中。病例数最多的病种为感染性腹泻、痢疾、病毒性肝炎、麻疹和肺结核,这与常住人口情况相似。结论健全疾病信息系统、加强传染病监测和计划免疫工作、提高卫生服务的可及性,是北京市外来流动人口传染病防控工作中亟待解决的问题。     

配偶参与模式对妊娠糖尿病孕产妇孕期血糖波动及伤口美观性的影响

目的 探讨配偶参与模式下对妊娠糖尿病孕产妇孕期血糖波动及伤口美观性的影响。方法 选 择2021年4月-2022年2月在南京市妇幼保健院健康建卡并且分娩的妊娠糖尿病孕产妇90例，随机分为对照 组（ n ＝45）及观察组（ n ＝45）。对照组按照产科护理常规流程进行护理，观察组在对照组基础上对孕产 妇的护理增加了配偶参与模式，比较两组伤口疤痕情况、孕期空腹及餐后2 h血糖、生活质量。结果 观察 组疤痕评分低于对照组（ P ＜0.05）；观察组空腹血糖及产后2 h血糖低于对照组（ P ＜0.05）；观察组生活 质量评分高于对照组（ P ＜0.05）。结论 配偶参与模式下妊娠糖尿病孕产妇孕期的血糖情况得到控制， 提升产妇生活质量，同时能够促进伤口美观性。     

Blood donor notification rate in a blood bank in Veracruz,Mexico

Blood banks are primarily responsible for providing safe blood, but they also indirectly act to prevent the spread of infectious diseases by notifying blood donors of positive screening results. The notification process differs between countries and notifications rates are generally low. This study sought to analyze the notification rate of healthy and infection-positive donors who donated blood at CETS-Veracruz. A total of 41790 donors were analyzed, 1585 (3.79%) were positive for one or more of the screened infection markers. Only 4163 (9.96% of the total) were notified about their serology results. Of the positive donors, 157 were contacted by phone call; of them, 91 (57%) returned to the blood bank for their results. The average notification rate for positive donors was only 17.48%. The highest notification rate was for anti-HBc (26.63%), while the lowest was for HBsAg (4.17%). Age significantly influenced the return of donors: Those aged 18–24 and 25–39 years were 4.71 and 1.64 times less likely, respectively, to return for their results compared to the rate for all ages. The advice received in the pre-donation stage about the risks of transfusion-transmitted infections and the relevance of returning for results did not appear to impact donors, since the rate of notification was lower than those reported internationally. These data indicate that CETS-Veracruz should improve donor data registration and communication mechanisms to increase the notification rate, and that donor notification studies should be carried out in other Mexican blood banks to analyze the return rate at the national level.