American Journal of Public Health Research

Climate change can be seen as a threat to sustainable development by undermining global poverty alleviation efforts and seriously impacting on successfully achieving the outcomes as envisaged by the Millennium Development Goals. There also exists severe implications for food security, clean water, environmental health and human settlements as the potential impacts of climate change bears much significance especially for the sustainable development of developing countries, such as South Africa. Therefore the role of the Environmental Health sector which is a key component in the protection of public health in South Africa, needs re-addressing as regards the potential impacts of climate change on Environmental Health Services. These potential impacts necessitates forward thinking on what adaptation measures should be considered by this sector, staffed primarily by Environmental Health Practitioners (EHPs), and how can these then be implemented proactively – given that in the South African context, EHPs have a Government regulated scope of practice that covers fourteen key job functions. Therefore, this article for each key job function, considers potential impacts of climate change followed by a discussion of possible solutions and challenges. However, despite adequate awareness on climate change and its impacts, it is evident that there are many challenges, inclusive of immense financial, technical and human resource constraints, still ahead. Therefore, a systematic approach by EHPs to assess, prevent and control climate change impacts and other interacting public health issues is vital and will be crucial to protect the health of affected populations in the future.

American Journal of Public Health Research. 2014, 2(3), 113-118. DOI: 10.12691/ajphr-2-3-9
Pub. Date: June 18, 2014

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Quality of Life at Work and Working Conditions in Sterilization Assistant

by Diemen Delgado, María de los Ángeles Aguilera, Fabián Delgado, Irma Cano, María de Lourdes Preciado and Oscar Ramírez

Original Research

Assessing all the factors relating to working conditions that may impact on health and quality of life at work for Auxiliary sterilization. We performed a cross-sectional analytical study, we applied the CVT-GOHISALO instrument, which measures quality of life at work and the overall evaluation method LEST ergonomic working conditions for the analysis of the data was used the statistical program SPSS 18 software and online work ergonomics of the Polytechnic University of Valencia. In dimension institutional support for work, sterilization assistants, displayed no opportunities for advancement in position or role in the security dimension at work, feel injustice in promotion opportunities within the institution, in the integration dimension to the job, are motivated to overcome challenges and very willing to be leaders in job satisfaction dimension, are usually committed to the mission of the institution, in the dimension of being achieved through work, they risk physical health and mental health, personal development dimension, are optimistic and friendly service, in free time management dimension, fully comply with your schedule and the tasks without compromising their personal and social commitments. The working conditions in terms of posture, handling surgical equipment and tools presents imminent risk of fatigue. The sterilization assistants show a series of subjective perceptions that reflect the reality of their work environment, which should lead to the leadership in decision making towards improving work processes and thus reduce the risk factors that are evident in this study, which may cause physical and mental illness if not corrected early.

American Journal of Public Health Research. 2014, 2(3), 108-112. DOI: 10.12691/ajphr-2-3-8
Pub. Date: June 18, 2014

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Mortality among Burned Colonized/Infected by Staphylococcus aureus Sensitive and Resistant to Methicillin: Meta-Analysis

by Lilian Albregard Peripato, Monica Taminato, Antonio Francisco Peripato Filho and Ana Laura Remédio Zeni Beretta

Meta-Analysis

Staphylococcus aureus is a Gram-positive bacterium that colonizes the skin of 30% of healthy individuals. Although considered as a part of the human microbiota, in some conditions, especially in burned patients, Staphylococcus aureus can become pathogenic and cause a wide variety of infections, such as respiratory infections and skin and is responsible for several Infections Related to Health Care (HAI) and community. Therefore, it is necessary to identify the occurrence of methicillin-resistant/sensitive Staphylococcus aureus in burned patients, assessing the mortality related to cases of burn patients infected / colonized. Results: After bibliographic search of the literature presented in the databases 1519 studies were found. In the pre-selection 13 relevant studies were identified, which were discussed with the group of reviewers. Only two met the inclusion criteria of the study. The studies by Kaiser et al (2011) and Reardon et al (1998) were included in this review, addressing the colonization / infection by methicillin-resistant/sensitive Staphylococcus aureus and the mortality for each group. Conclusion: We found that colonization by methicillin-resistant Staphylococcus aureus is associated with burned body surface, so the higher the percentage burned, the greater the risk / colonization by oxacillin- resistant Staphylococcus aureus. Most patients who died were colonized by methicillin-resistant Staphylococcus aureus. The evidence obtained in this study suggests that the burns, especially those infected with methicillin- resistant Staphylococcus aureus, fall into a serious public health problem because of the difficult, and often unsuccessful treatment, which confirms an increase in morbidity and mortality in these patients. We emphasize the importance of this systematic review and meta-analysis of these data to allow the implementation of treatment protocols, improving the quality of preventive measures and reducing mortality rates by methicillin-resistant Staphylococcus aureus.

American Journal of Public Health Research. 2014, 2(3), 103-107. DOI: 10.12691/ajphr-2-3-7
Pub. Date: May 15, 2014

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Ethical Issues in Treating Self and Family Members

by E. B. Anyanwu, Harrison O. Abedi and Efe A. Onohwakpor

Review Article

A trained health care provider principally offers care to ill-patients, offers advocacy to groups of persons, could be a passionate counsellor when needed, and may offer preventive services to individuals and communities at large. He is trained to alleviate the problem of sickness from patients. Therefore, a patient may just as well be the physician himself or may be his immediate family members who can fall ill and so needs the expertise of a doctor. The patient maybe a colleague, friend or employee who all maybe intimate with the physician but may need his services when they are ill. The challenge therefore, is when does the doctor stop doctoring a patient and transfer care to another doctor. What risks may show up if a doctor treats himself and close family members? Is it ethical for a doctor not to offer treatment solely on the ground that the patient is a close relation?

American Journal of Public Health Research. 2014, 2(3), 99-102. DOI: 10.12691/ajphr-2-3-6
Pub. Date: May 14, 2014

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Knowledge, Attitudes, and Practices of Leptospirosis in Catbalogan City, Samar, Philippines

by Charmaine R. Quina, Joseph U. Almazan and Juniel B. Tagarino

Original Research

Leptospirosis is a global bacterial infection that can kill millions of people through contact of mucous membranes or broken skin with water moist soil contaminated with the urine of infected animals. This study determines Knowledge, Attitudes, and Practices of Leptospirosis among barangay residents, health workers, and barangay officials in Catbalogan, City Samar. The study employed the analytical research design, analysis as to any differences in the level of knowledge and extent of practice of prevention and control strategies were made with the use of T-test. There were 187 respondents of the study which included the health workers, barangay officials, and selected residents of six barangays in Catbalogan City. Findings revealed that information dissemination through mass media (TV) is the number one preventive and control strategy to avoid leptospirosis and this could be one of the information that they could share to members of the family and friends. The common prevention and control strategies practiced by the three groups of respondents were to maintain cleanliness on the surrounding and to keep good hygiene. The health workers and barangay officials “frequently practiced” them while the barangay residents “always practiced” them. The Barangay health workers in the RHU and local government unit must have proper information dissemination regarding Leptospirosis, it emphasized environmental sanitation, teaching about the proper safety precautions and develops the interest of the respondents. Moreover, another study is conducted in other city/municipality to ascertain the level of awareness and knowledge of the community residents, thereby validating the findings of this study.

American Journal of Public Health Research. 2014, 2(3), 91-98. DOI: 10.12691/ajphr-2-3-5
Pub. Date: May 10, 2014

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Predicting Obesity among Adolescents in the United States Using Modified Logistic Model

by Eleanor K. Jator

Original Research

Obesity among adolescents is still on the rise and various reasons have been attributed to this increase. Obesity has been associated with many diseases, as well as, increase in healthcare costs. Concentration index and logistic regression have been extensively used to measure inequalities in health, including obesity, but these methods require each parameter to be calculated discretely. In this study, the logistic regression model is modified to predict the degree of obesity distribution that might be associated with multiple variables including income and race among adolescents in the United States. Unlike the methods currently used, the modified logistic model (MLM) can capture all variables at the same time in a single equation. The results produced by the model are comparable with those obtained when concentration index is used in a shorter time. It is hoped that this study will shorten the time to estimate or predict obesity rates among various races using existing Medical Expenditure Panel Survey (MEPS) data based on socioeconomic status. The ultimate goal is to develop targeted intervention strategies. Using existing data yields faster, reliable results since the sampling and collection utilize standard procedures. Results can easily be generalized due to random sampling and the MLM has the potential to predict the rate of obesity without performing further statistical analysis.

American Journal of Public Health Research. 2014, 2(3), 86-90. DOI: 10.12691/ajphr-2-3-4
Pub. Date: May 01, 2014

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Knowledge and Attitude of a Semi Urban Community in the South-South Region of Nigeria towards Diabetes Mellitus

by Faith Osaretin Alele and Olayinka Stephen Ilesanmi

Original Research

Adequate knowledge of Diabetes Mellitus empowers the community about good health seeking behavior, drug compliance and follow up care. Studies on the knowledge and attitude of the community dwellers are therefore important. This study seeks to access the knowledge and attitude towards Diabetes Mellitus. A descriptive cross sectional study of 384 adults was carried out at Okada in Edo State. Questionnaire was used to collect information and analyzed with SPSS version 15. Descriptive statistics were done and presented as bar charts and tables. Attitude was scored using a Likert scale of 10 questions with maximum attainable mark of 50 points. Respondents with mean score and above were classified as having good attitude. Association between categorical variables were explored using chi square, Level of significance was set at 5%. The mean age of respondents was 34±11years, 206 (53.6%) were males and half of the respondents were married. In all, 243(63.5%) of the respondents had a good attitude towards diabetes treatment. Lack of health care facilities and attitude of health care providers were the commoner factor preventing respondents from seeking screening for Diabetes. A larger proportion 82.7% of respondents with tertiary education and 53.2% of those with primary education had good attitude towards Diabetes treatment. P = 0.003. The majority of the respondents have heard about Diabetes but only few of them had a good attitude towards the treatment of the disease. It is therefore important that awareness programs about diabetes should be provided in the community.

American Journal of Public Health Research. 2014, 2(3), 81-85. DOI: 10.12691/ajphr-2-3-3
Pub. Date: April 22, 2014

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Does Socio-demographic Factors Influence Women’s Choice of Place of Delivery in Rural Areas of Tamilnadu State in India

by Rejoice Puthuchira Ravi and Ravishankar Athimulam Kulasekaran

Original Research

Every day, approximately 1000 women die from preventable causes related to pregnancy and childbirth. Of which, 99% of all maternal deaths occur in developing countries. The aim of this study was to assess the socio-demographic factors influence women’s choice of place of delivery in rural areas of Thiruvarur district of Tamilnadu state in India. A community based cross-sectional study was conducted in 28 villages selected using multistage sampling technique for selecting 605 women in the age group of 15-24 years during July 2010-April 2011. Data analysis was by use of Statistical Package for Social Sciences version-17, with statistical significance set at p-value of 0.05. The study reveals that education, age at marriage, birth order, standard of living index and exposure to mass media appeared strong influencing factors for the choice of place of delivery among women in rural areas. The result shows that 69% of home deliveries were monitored by Traditional Birth Attendants (TBAs/Dais). Bivariate analysis indicates that all women who had completed higher secondary education were preferred the health institution for their delivery whereas 18.8% of home deliveries have been taken place among illiterates. The proportion of home deliveries (7.3%) was higher among women in households in the less standard of living index. Home deliveries were higher among women who were less exposed to mass media (7.1%) than more exposed to mass media (1.6%). Birth order was significantly influence on the place of delivery among women. First birth order deliveries were less likely to take place at home (2.5%) than second (8.2%) and third birth order deliveries (9.1%). It concludes that family tradition and poor socioeconomic condition of the family appear to be the main reasons for choosing to deliver at home. It recommends that Government should be taken a comprehensive strategy to increase the availability, accessibility and affordability of delivery care services in rural areas. Public health strategies involving traditional birth attendants will be beneficial particularly rural/remote areas where their services are highly utilized.

American Journal of Public Health Research. 2014, 2(3), 75-80. DOI: 10.12691/ajphr-2-3-2
Pub. Date: April 22, 2014

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Effect of Highly Active Antiretroviral Therapy (HAART) on Human Immunodeficiency Virus Disease Pathogenesis and Progression

by K V Ramana

Review Article

Human immunodeficiency virus (HIV), the causative agent of Acquired Immunodeficiency Syndrome (AIDS) was discovered way back in 1983. More than three decades since its discovery, HIV infection diagnosis, treatment and management has been a big challenge to the medical field. HIV infection is attributed to cause compromised T-cell and B-cell immunity, promote different malignancies and the infected individuals are at risk of acquiring other viral, bacterial, fungal and parasitic infections. HIV disease progression was found different in infected population, where few HIV infected patients develop AIDS in less than 5 years and are called as early progressors, HIV infected population in whom development of AIDS is slow and may remain normal up to 10 years are termed as late progressors and patients in whom the symptoms of AIDS are not seen even after 10-15 years are labeled as long term non-progressors. The variability in disease progression is not completely understood. After the discovery of HAART, the mortality of the HIV infected population has significantly reduced but the morbidity attributed to HAART has remained as a serious concern. From being a life threatening infection HIV has now become a chronic infection, where patients live their natural life years with the HAART therapy. Among the most significant changes in HIV infection and pathogenesis is the development of non-infectious complications attributed to the HIV infection, HAART therapy, other demographic factors and co-morbidities. Other factors that influence the disease pathogenesis and progression include chronic immune activation, drug resistance and toxic side effects of HAART therapy. Among this Immune activation plays a key role in the pathogenesis and progression of HIV infection.

American Journal of Public Health Research. 2014, 2(3), 68-74. DOI: 10.12691/ajphr-2-3-1
Pub. Date: April 20, 2014

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