American Journal of Public Health Research

Health policy changes in Nepal displayed struggles against a poor political, geographical, and economic setting; Millennium Development Goal #4 demanded improved infant and child mortality, as well as adequate measles vaccine coverage by the year 2015. Research in this report presents progress and direction of child health care policy across more than a decade of time in attempts of attaining MDG #4 and general child health care advancements. Subsequent observations and suggestions were delineated and offered. Progress since the 1990’s up to 2012 was analyzed by review of serial national survey and report data. Trends and variations between regions were mostly analyzed amongst various child health care determinants. Results indicated many improved factors; Nepal will likely achieve MDG regarding child under-5 mortality, but may not achieve measles vaccine coverage or infant mortality goals. Furthermore, severe regional disparities were evident within Nepal, particularly in the Mid and Far-Western regions. A call for integrated community-based primary health care (CB-PHC) for infants and children became an ultimate ideal. A comprehensive, multidisciplinary, and community based primary care delivery service would address many of the deficits identified as well as reach rural and remote areas that still suffered. Risk and data-based resource allocation promise improved utilization, but also demands more frequent and better data reporting. Coordinated, multi-sector health policy initiatives have been underway; this demonstrated a strong direction in improving child health care from urban to every village.

American Journal of Public Health Research. 2015, 3(2), 74-80. DOI: 10.12691/ajphr-3-2-7
Pub. Date: March 29, 2015

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Assessment of Factors Affecting Art Adherence among People Living with Human Immune Virus in Bale Robe Hospital, South East Ethiopia

by Ahmed Yasin Mohammed, Muktar Beshir Ahmed and Tomas Benti Tefera

Original Research

Human Immune Virus now a day is one of the devastating illnesses witnessed worldwide. It becomes a prevalent disease and presents a global public health concern without a cure. Among East Africa countries, Ethiopia is one of which Human Immune Virus becomes major public health emergency. Antiretroviral Treatment (ART) services are important and effective in prevention and palliative treatment of the virus. Non adherence is the risk for the development of drug resistance and failurity of therapy. The objective of this study is to assess factors affecting ART adherence among People Living With Human immune virus. A facility based cross sectional study was conducted on 245 subjects on ART follow up at Bale Robe Hospital selected using systematic random sampling from March 18 to April 13/2013. A structured and pre- tested interviewer administered questionnaires were used for data collection. The item consists of socio demographic variables, psychosocial, Clinical, Behavioral factors and items measure level of ART adherence. Data were analyzed using SPSS version 20. Frequency and percentages were calculated. The x2 (chi – square) test and P values determined and associations were assessed. P < 0.05 considered statistically significant association with ART adherence status. The rate ART dose adherence of the study subjects were 83.1%. The finding emphasize that important multiple psychosocial factors: patients disclosure status, types of social support, stigma, depression, social isolation and active substance use were significantly associated (P < 0.05) with adherence level. Additionally other barriers like being too busy and attitude towards the drug has been significantly associated (P < 0.05) with adherence. The adherence rate found in this study seems to be encouraging. However, focusing on strengthening psychosocial aspects affecting ART adherence behavior and appropriate monitoring of patients could potentially help them to maintain adherence and therefore improve the outcome.

American Journal of Public Health Research. 2015, 3(2), 60-67. DOI: 10.12691/ajphr-3-2-5
Pub. Date: March 26, 2015

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Maxillofacial Fractures in Makka City in Saudi Arabia; an 8-year Review of Practice

by Mazen Almasri, Dina Amin, Anas F AboOla and Jamil Shargawi

Original Research

Objective: to review the practice of maxillofacial trauma surgery in Makka city, Saudi Arabia, as road traffic accidents is considered a major cause of morbidity and mortality in the kingdom. Materials and methods: a chart review of all the maxillofacial trauma cases that visited the major hospital in the city, Alnoor specialist hospital (NSH), from October 2005 to October 2013 was collected. A total of 1132 patients’ records were retrieved. Amongst, 965 maxillofacial injuries were included in the study as completed information was found. Charts of incomplete records, soft tissue injuries only, or solitary dental injury were excluded. Then, pertinent information such as age, gender, residence status, and fracture pattern were extracted, tabulated, and correlated. Results: it was presented that males were affected four times more than females (ratio of 4.4:1), of an age ranged from 3 years old to 97 with a mean of 51 years old, and patients of 1 to 16 years old counting 135 cases (11.9%), while the age between 17 – 45 years counting 856 (75.7%), and the age 46 – 97 counting 139 (12.3%). The majority of injuries was involving the lower facial third (mandible) by 523 cases (54.19%), then the middle third that include Zygomatic maxillary complex (ZMC) by 399 cases (41.3%; p=0.006), orbital floor by 25 cases (2.5%), and upper third (nasal, ethmoid, orbital, and frontal bar) fractures of 18 cases (1.8%). The ratio of Saudi patients to non Saudi was found to be 1.89:1. Conclusion: The maxillofacial injuries in Makka city are mainly affecting male patients aged between 17-45 years old with the mandible and middle face fractures being most commonly injured respectively.

American Journal of Public Health Research. 2015, 3(2), 56-59. DOI: 10.12691/ajphr-3-2-4
Pub. Date: March 23, 2015

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Sexual History, Behaviour and Practice of HIV/AIDS Prevention among Recruits of Depot Nigeria Army, Zaria-Nigeria

by ChineduJohn-Camillus IGBOANUSI, IstifanusAnekoson JOSHUA and Tukur DAHIRU

Original Research

Background: Among Nigerian Military Personnel (NMP), HIV prevalence has been reported to be higher than in the general population due to several factors. Data on HIV among the military are difficult to obtain and comprehensive program for the military in Sub-Saharan Africa were not well coordinated. This study assessed sexual history, behavior and practice of HIV/AIDS prevention among military recruits at Depot Nigeria Army in Zaria Nigeria. Materials and Methods: It was a cross sectional descriptive study carried out on February, 2011 with a sample of 300 army recruits selected by a stratified random sampling technique. Information on socio-demographic characteristics, sexual history, behavior and practice of HIV/AIDS prevention were collected using structured, self–administered questionnaire, and blood samples collected were screened using Determine^® and and Uni-gold^® test kits for HIV antibodies. Stat pak^® test kit was used as a tie-breaker. The data collected were cleaned and entered into SPSS version 15.0 and results presented in tables and statistical significance was set at p <0.05. Results: The age range of the respondents was 17 – 29 years, with mean age of 29 ±1.9 years and male: female ratio of 2.8:1. Majority (93.0%) were single with mean age at sexual debut of 15 years and 40.0% had coitus a month prior to the time of the study. About 21.0% satisfied their sexual urge by having sex with their partners. Two-thirds had used male condom before out of which 29.7% had problems such as reduced sexual urge (16.7%), burst condom (11.3%) among others. The results of the HIV screening for all the respondents were negative for both HIV-1 and HIV-2. Conclusion: The sexual history, behavior and HIV/AIDS prevention among the military recruits showed mixed picture and the HIV screening results were negative for HIV 1 and HIV 2. There is need to have a well-coordinated HIV/AIDS prevention program that is multi-disciplinary and innovative among others to ensure the recruits remain negative for HIV.

American Journal of Public Health Research. 2015, 3(2), 51-55. DOI: 10.12691/ajphr-3-2-3
Pub. Date: March 09, 2015

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Systemic Lupus Erythematosus: some Epidemiological and Clinical Aspects

by Angel Justiz-Vaillant, Patrick E. Akpaka and Peter Poonking

Original Research

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with a wide array of clinical manifestations including rash, photosensitivity, oral ulcers, arthritis, serositis, glomerulonephritis among others clinical findings. In this paper we globally summarized the most important epidemiological and clinical aspects to bear in mind, when the time comes to make the diagnosis of this rheumatic disorder and its management. Factor that are involved in the SLE pathogenesis and novel treatment options are mentioned.

American Journal of Public Health Research. 2015, 3(2), 46-50. DOI: 10.12691/ajphr-3-2-2
Pub. Date: March 08, 2015

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Perceived Sexual and Reproductive Health Needs and Service Utilization among Higher Secondary School Students in Urban Nepal

by Kiran Bam, Fariha Haseen, Rajendra Kumar BC, M. Sophia Newman, Asiful Haider Chaudhary, Rajshree Thapa and Ismat Bhuyia

Original Research

Introduction: Adolescent sexual and reproductive health (ASRH) is best addressed through the promotion of responsible, healthy behavior and the provision of age-appropriate services. This study aimed to assess Nepali adolescents’ perceived ASRH service needs and factors influencing their utilization of ASRH services. Methodology: This descriptive cross-sectional quantitative study was based on a structured, self-administered questionnaire of adolescents aged 15-19 (n = 338) in three government-run higher secondary schools in Bhaktapur, Nepal. Descriptive data was used to summarize socio demographics, sexual activity, and awareness and usage of SRH services. Chi-square and Fisher’s exact tests and binary logistical regression modeling were used to identify factors influencing ASRH service utilization. Results: ASRH service utilization was 9.2% among all respondents. Service utilization was lower among female (4.3%) than males (12.5%). Fifteen percent of students had ever felt a need to access ASRH services, a larger percentage than those who had accessed ASRH services (9.2%). Almost 37% intend to utilize ASRH services in the future. Students attending secondary schools that included ASRH in the school’s health services were 15 times more likely to utilize ASRH services(Adjusted OR: 14.85). The distance from health facility (Adjusted OR: 12.80) and being sexually active within 12 months (Adjusted OR: 10.31) were found to be associated with ASRH service utilization. Those who perceived barriers to services were more likely to utilize the services (Adjusted OR: 7.05).Lack of confidential services was the biggest barrier (71.4%),while friend and peer group influence (86.7%) was a major motivator to access ASRH services. Conclusion: ASRH service utilization among the adolescents is very low, with a gap between perceived needs and service utilization. Students who have accessed ASRH services are more likely to report that they perceived barriers, demonstrating that logistical difficulties may be considerable. Accessibility should be expanded.

American Journal of Public Health Research. 2015, 3(2), 36-45. DOI: 10.12691/ajphr-3-2-1
Pub. Date: March 08, 2015

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