by N. Kunene, M. Gella and T. Gala
Original Research
More than 2/3 of global HIV/AIDS epidemics, as well as seven in ten of all HIV/AIDs death, are reported in Africa. The economic burden of the disease in terms of treatment and prevention for an already impoverished continent is enormous. Several international organizations are engaging Africa to alleviate the disease epidemics and its economic impacts. This study attempted to determine the geographical controls of HIV/AIDS prevalence rates and established a relationship with demographic, social and economic determinants. Accordingly, significant (I = 0.71; α = 0.5) geographical clustering of adult HIV/AIDS prevalence rates were detected, such that the higher rates are clustered in the southern African countries, while the west African countries have the clustering of the lowest rates. The demographic, social and economic factors such as literacy (female) rate, life expectancy at birth, contraceptive prevalence rate, education expenditure and percent Muslim population, significantly explained the variability of the Adult HIV/AIDS prevalence rates (R2 = 0.81 – 0.84; α = 0.05) in Africa. This result highlights the need for geographically-resolved resource allocation, particularly in the areas of primary education and gender participation for the fight against HIV/AIDS.
American Journal of Public Health Research. 2017, 5(4), 130-137. DOI: 10.12691/ajphr-5-4-6
Pub. Date: September 12, 2017
10740 Views2573 Downloads
by Toni M. Rudisill
Original Research
Background: Narcotics usage is associated with an increased risk of motor vehicle collision and opioid overdose deaths are elevated in West Virginia compared to other states in the United States. This analysis sought to determine the prevalence of narcotics among drivers fatally injured in motor vehicle collisions in West Virginia and to determine if these collisions were clustered in areas of the state where opioid use/abuse is high. Methodology/Principal Findings: Fatal crash data from 2011-2015 were obtained from the Fatality Analysis Reporting System and the locations of the collisions were plotted with spatial software. Spatial analyses, including nearest neighbor indexes, heat maps and hot-spots, were conducted to determine if and where clusters of opioid-positive crashes existed. The results of the spatial analyses were visually compared to the rates of opioid overdose deaths by county, which served as a proxy of opioid use/abuse. Of the 486 drivers, 19% (n=94) tested positive for opioids. A clustering of opioid positive crashes was detected in the state overall (nearest neighbor index=0.89, p-value=0.055). Hot-spots were detected in the lower regions of the state, which overlapped counties with the highest rates of opioid overdose deaths, and cold-spots were detected in areas with lower opioid overdose death rates. Conclusions/Significance:Individuals using narcotics may still operate motor vehicles, which may pose a threat to all road users in West Virginia. Public health interventions, education, or enforcement may be needed in areas of high opioid use/abuse to raise awareness of driving under the influence of drugs.
American Journal of Public Health Research. 2017, 5(4), 124-129. DOI: 10.12691/ajphr-5-4-5
Pub. Date: September 08, 2017
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by James Ouma and Collins Otieno Asweto
Original Research
Background: ANC provides the opportunity to detect and treat anomalies of pregnancy and access to preventive maternal and child healthcare. However, detailed information about the actual quality and content of ANC in practice is scanty, especially in developing countries. We analyzed the pattern and content of antenatal care service in Kenya in order to assess the quality of ANC. Methods: We used data from the 2008/9 KDHS, a nationally representative survey of women aged 15-49 years in Kenya. Proportion was used for description purpose while association was determined by bivariate and multivariate analysis in which odds ratio with a 95% confidence interval values were calculated. Results:About 50.9% of women sought ANC services either in health centers or dispensaries but these lower level health facilities had more content gaps. Multivariate analysis indicated that maternal age, regional residence, urban residence, wealth index, education and the media influenced ANC initiation and at least 4 ANC visits. There was a coverage gap existing in terms of iron-folate supplementation (66.1%), tetanus toxoid (66.5%), presumptive/preventive treatment for malaria with SP (38.7%) and education on pregnancy complication (44.3%). Nearly a third of women missed the screening for complication during pregnancy. Conclusion: Disparities exist in provision of ANC components, by type of facility attended, rural-urban and low versus higher income biases. Consequently vulnerable women attending ANC miss important care including screening for complication during pregnancy and labor. Efforts should be designed to improve on supplies to government health centers and dispensaries. Well stocked outreach village clinics with the requirements of a comprehensive antenatal care resource allocation should be used to eliminate service disparities. Government policy should help to increase media penetration amongst the masses and sensitize mothers on the importance of ANC.
American Journal of Public Health Research. 2017, 5(4), 115-123. DOI: 10.12691/ajphr-5-4-4
Pub. Date: September 08, 2017
11243 Views3228 Downloads
by Hernández J.D. and Gómez R.D.
Original Research
To establish the relationship between preterm birth and some biological, psychological and social conditions in pregnant women between the ages of 15 and 19. Materials and Methods: A non-matched case-control study was carried out on a random sample of postpartum adolescents’ ages 15 to 19 years old from the metropolitan area of Medellin, Colombia, who received care in public and private hospitals in the city. A total of 126 postpartum adolescents with preterm birth and 114 controls with term birth were studied. The sample size was calculated based on the prevalence of family dysfunction, estimated at 15% for controls, with an OR (Odds Ratio) of 3.0, reliability of 95%, an error of 0.05 and a power of 80%. A semi-structured assisted and unbound interview that included family Apgar was applied to postpartum adolescents that agreed to participate in the study; additionally, the clinical record was reviewed. Results: The incidence of preterm birth was significantly associated with a greater exposure to family dysfunction during pregnancy (OR = 2.39 CI (Confidence Interval) 95% 1.10-5.20), economic pressures (OR = 2.43 CI 95% 1.16-5.10), as well as social pressures (OR = 1.39 CI 95% 1.07-1.813). The proportion of pregnant adolescents who considered themselves Caucasian was significantly higher in the group with term birth compared to other ethnic groups (OR = 0.219 CI 95%: 0.071-0.672). Recommendations: The findings suggest the importance of monitoring, evaluating and intervening with social support received by the pregnant adolescents from their partner as well as their social and family environment.The fact that most pregnant teenagers did not want their current pregnancy and considered it as an obstacle to their future endevours suggests the importance of defining policies and interventions to provide options that allow them to establish life plans according to their expectations.
American Journal of Public Health Research. 2017, 5(4), 105-114. DOI: 10.12691/ajphr-5-4-3
Pub. Date: August 17, 2017
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by Hailu Chare Koyra, Mende Mensa Sorato, Yohannes Shiferaw Unasho and Zewde Zema Kanche
Original Research
The use of sanitation facilities is known to interrupt the transmission of fecal-to-oral related disease. Health improvement comes from the proper use of sanitation facilities, not simply their physical presence. This is best achieved through regular use of clean and well maintained latrines. A community based cross-sectional study was conducted to assess latrine utilization and associated factors in the rural community of Chencha district, Gamo Goffa Zone in February 2013. Sample population of 420 households with latrine facilities were selected from 5 sub districts (Kebeles). Multistage systematic random sampling method was used. The structured questionnaire was used for data collection. All types of available latrines were pit latrines. Of which 67.4% latrines were functional and from which 46.4% required maintenance. Among 415 households, overall latrine use was 60% and the remaining 40% households were not using latrine. However, over all persistent utilization was 31.08%. Main reasons for non-use or non-persistent use of latrine were lack of functional latrine, stay out for farming and lack of supra structure of latrine. self-initiation (AOR (95% CI) = 6.480(2.772-15.379), p<0.001), peer influence (AOR (95% CI)= 3.111(1.470-6.584), p= 0.003), length of years since latrine was constructed ((AOR (95% CI) = 0.219(0.133-0.362)P<0.001), and educational status of the heads of households ((AOR (95% CI) = 3.293 (1.969-5.506) P<0.001) were the major predictors affecting utilization of latrines. In conclusion, Latrine status and utilization in rural community of Chencha district was found to be very low and needed attention to promote hygiene and sanitation behavior in the community.
American Journal of Public Health Research. 2017, 5(4), 98-104. DOI: 10.12691/ajphr-5-4-2
Pub. Date: August 15, 2017
18830 Views5584 Downloads2 Likes
by Temesgen Lera, Bitiya Admasu and Anteneh Dirar
Original Research
Background: - Ensuring institutional delivery for each child birth is the most critical intervention in reducing maternal and neonatal mortality and morbidity. In Ethiopia the proportions of births delivered in health institutions is very low and even for women who have access to the services. The proportion of birth occurring in health facilities is only 16%.Objective: - To investigate intention of pregnant women to use institutional delivery and associated factors from March to April 2016. Methods: - A Community based cross-sectional study was conducted in Wollaita Soddo town. Theory of Planned Behavior was employed to evaluate intention of pregnant women for delivery utilization. Data was collected by using pre-tested, structured questionnaire. The data collected was checked for its completeness and consistency, coded, entered and cleaned by using Epi data 3.5.1 and exported to SPSS version 20.00 statistical software. Data analysis was done for proximal and distal variables differently based on their presence in the model.Result:-A total of 326 pregnant women who had ANC follow up were included in the study. On multiple logistic regression husband’s occupational status and informed about delivery places were statistically significantly associated with intention to use institutional delivery among ANC attendants from distal variables and Attitude and subjective norms were statistically significantly associated with intention from proximal variables. The odds of intention to use institutional delivery among pregnant women who were informed about delivery places was 2.658 times more likely than those who were not informed about delivery places AOR=2.658(1.357, 5.207) at P-value 0.005.Those women whose husbands’ were employed were 2.2 times more likely to intend to use institutional delivery than women whose husbands’ were not employed (AOR=2.2(1.308, 3.7) at P-value 0.003. Conclusion:-The study concluded that the intention of giving birth at health institution increased with positive attitude towards institutional delivery, being informed by health professionals about the place of delivery and husband’s occupational status being employed and decreased with subjective norms.
American Journal of Public Health Research. 2017, 5(4), 89-97. DOI: 10.12691/ajphr-5-4-1
Pub. Date: August 10, 2017
14921 Views3488 Downloads2 Likes