by Sharfun Ara and Collette M. Brown
Original Research
Sickle Cell Disease (SCD) is a genetic disease and a major global public health concern. The transition process from pediatric to adult care is complicated and frustrating for many patients and physicians. This qualitative, phenomenological study explored the perceptions and experiences of Physicians-In-Training (PIT) and young adult patients regarding the transition process from pediatric to adult care. A total of 12 participants (four pediatric PIT and eight young adult patients with SCD) from a hospital in New York City participated in the study. Data were collected through semi-structured interviews, which were audio-recorded, transcribed, and hand-coded into themes. The findings revealed that young adults with SCD had negative experiences and perceptions throughout the transition process. Inadequate information about the transition, poor relationships with adult providers, and long waiting times in the ER reduced the quality of care of patients with SCD. Social support during the transition process came mainly from their parents. Young adults believed that there should be a better relationship with the adult providers, and that patients with SCD and the adult clinical team should be educated about the transition process. Seventy-five percent (75%) of the PIT mentioned that transition to adult care usually starts at age 21; however, they believed that the transition process should start at age 15. They lacked knowledge about the transition process and support services for patients with SCD. They also reported hesitation of pediatric patients to transfer to adult care. They expressed concern that young adults might not be adherent to their medications and schedule their appointments when needed. The transition process should include adequate preparation, patient education, social support, communication between pediatric and adult settings, and a relationship between patients and adult providers.
American Journal of Public Health Research. 2021, 9(5), 222-228. DOI: 10.12691/ajphr-9-5-6
Pub. Date: August 26, 2021
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by Collette M. Brown, Latoya Callender, Peter C. Nwakeze, Donna M. Dyke, Dexter C. Forde, Ronette A. Campbell, Joy Wilcox, Phronie Jackson and Su-yan L. Barrow
Original Research
The novel Coronavirus Disease 2019 (COVID-19) is a pandemic of great public health and clinical concern due to its high rate of infectivity, and subsequent morbidity and mortality. The objectives of the study were to 1) assess individual experiences with testing and symptoms of COVID-19 infection; 2) determine the extent to which individuals experienced COVID-19 post-exposure symptoms; and 3) determine if an association exists between pre-existing conditions and severity of COVID-19 symptoms with post-exposure symptoms. One hundred and twenty-one (N= 121) New York State residents who had COVID-19 symptoms and were tested positive for the virus participated in this study. The survey was created in Qualtrics, and the link was posted online (Facebook, Twitter, Snap Chat), and sent to New Yorkers via email and WhatsApp to gather data. Data were exported from Excel spreadsheet to Statistical Package for the Social Sciences (SPSS), version 25, where Chi-Square tests were conducted. Results indicated that most of the participants were between ages 18-35 (54.5%), African Americans (50.4%), non- Hispanic (65%), female (69.4%), had less than a college degree (51%), and made an income in 2019 of less than $55,000 per year (62%). Eighty-seven (approximately 73%) of the participants reported that getting access to testing was easy/very easy. More than one-half reported that they experienced fatigue (66.9%), lack of energy (61.2%), headache (57.9%), muscle ache (53.7%), cough (50.4%), and loss of smell (50.4%) while infected with COVID-19. Participants who experienced symptoms described their most bothersome symptom as severe (37%), followed by mild (33%), and moderate (27%). There was a statistically significant relationship between severity of symptoms and post-exposure problems experienced by participants (X2 = 13.69; df = 2; p = .001); as well as between pre-existing conditions and post-exposure problems experienced by participants (X2 = 10.53; df = 1; p = .001). Information from this study could benefit public health practitioners and clinicians by improving their knowledge about COVID-19 and its impacts on survivors.
American Journal of Public Health Research. 2021, 9(5), 215-221. DOI: 10.12691/ajphr-9-5-5
Pub. Date: August 25, 2021
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by Monday Daniel Olodu, Adeleye Abiodun Adeomi, Abdulkareem Babalola Murtala, Joy Adurapemi Odedele and Eunice Othuke Oboreh
Original Research
Background: Evidence shows that independent of the pandemic, the university students already exhibit poor sleep patterns, low physical activity and sub-optimal dietary intake. The restrictive measures imposed to curb the disease spread are likely to influence these modifiable factors. This study seeks to assess the influence of COVID-19 on sleep patterns, physical activity level and dietary intake of university students in Southwestern Nigeria. Methods: A total sample size of 396 undergraduates were selected using a multi-stage sampling technique. A semi-structured self-administered questionnaire, which had three sections, was used to elicit information. Sleep patterns were assessed with questions adapted from Pittsburgh Sleep Quality Index (PSQI). Physical activity was assessed using items from the International Physical Activity Questionnaire (IPAQ)-Short Forms (SF), and dietary intake was assessed using items from the PLife COVID-19 questionnaire. Results: Most of the students had increased sleep-wake time (60.4%), Sleep duration (62%) and at least eight hours of sleep/day (55.1%). A majority (85.3%) had a low physical activity level, and their diet remains unchanged except for water (48.7%), fruit (43%) and dietary supplements (32.6%), which increased slightly. A majority (84.8%) had a worsened dietary intake. Statistically significant relationships exist between sleep quantity, physical activity and dietary intake (p<0.05). Conclusion: The COVID-19 pandemic positively influences the sleep quantity of university students. However, it further compounded the low physical activity and unhealthy dietary intake. A sustainable measure to curtail the spread of a virus, with minimal interference in physical activity and dietary intake of this vulnerable group, should be considered in future pandemics.
American Journal of Public Health Research. 2021, 9(5), 207-214. DOI: 10.12691/ajphr-9-5-4
Pub. Date: August 22, 2021
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by Malliga Jambulingam, Margaret Alston, Ariel Hunt, David Thomas and Yvonne Bronner
Original Research
Background: After the 1994 national “Safe Sleep Campaign,” acceptance of infant sleep practices was followed by a significant reduction in the national SIDS death rate. Interestingly, SIDS deaths of African American (AA) infants has remained comparatively high --creating an incidence rate disparity. The elusive question is “why?” Understanding the basis of infant safe sleep practices by given AA caregivers is therefore important to effectively address inconsistency surrounding the “ABCs” of safe sleep practices. Objective: To understand the knowledge base, attitudes, circumstances, and current behavioral patterns surrounding infant safe sleep practices among given AA caregivers. Methods: A purposive sampling strategy, including 31 participants from three targeted Baltimore communities, was employed. Knowledge and attitudes of caregivers were assessed using a Focus Group questionnaire to draw participant responses about why ABC strategies for safe sleep were not consistently followed. Caregivers’ practices of infant placement for sleep were first assessed by having them demonstrate their routine using a life-size doll in a crib which purposefully contained other items. All group conversations were audio-recorded and transcribed. Collected data were analyzed using Atlasti and by two researchers. Results: A substantial percentage of the AA caregivers of these communities did not fully understand safety-based and anatomical rationale for placing infants alone and on their backs for sleep. Many expressed fears that the baby might choke, the goal of getting maximum sleep for baby and caretaker, while some sought easy monitoring ability. Conclusion: Understanding the misgivings, circumstances, and fears are instrumental for imagining and supplementing existing safe sleep practice recommendations. Continued Town Hall forums that include practical demonstrations, along with meaningful discussions with educational tools, inclusive of Q & A follow-up should be developed to reduce fears and misconceptions to best increase consistent practice of placing infants alone in supine reduce the risk of SRID.
American Journal of Public Health Research. 2021, 9(5), 201-206. DOI: 10.12691/ajphr-9-5-3
Pub. Date: August 06, 2021
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by Kenneth Yongabi Anchang, Uwakwe Promise Chinedu, Bernadette Ateghang and Obasi Chidera
Original Research
Background: Individual responses to health are influenced by an array of issues, ranging from personal traits, such as beliefs, to elements acquired through education and the socioeconomic environment. Individual responses to health became intensified during the COVID 19 pandemic in Cameroon. Health-seeking behavior is an important indicator of how health services are used and how they can modify the health outcomes of populations. This study aimed to evaluate the perception of illness and health-seeking behavior amongst the indigenous Kom people in Njinikom Sub Division, Cameroon within the COVID 19 pandemic era Cameroon to help facilitate this process of making health care choices within a brewing COVID 19 pandemic. Methods: A cross-sectional study was carried out by trained interviewers (five nurses), during which a total of 400 people (55.7% female) aged 18-60 years were chosen using multistage random sampling and interviewed after obtaining their informed consent. Data on the respondent's socio-demographic structures and patterns of illness and health-seeking behaviors in their last illness were collected using structured questionnaires. The study statistic used was Chi-square (X2), with a significant level (α) set at 0.05. Four components of community engagement were considered in the study, namely; (1) social support, (2) individual motivation, (3) service utilization, and (4) community acceptance. Results: The study revealed malaria as the most common disease (51%), followed by typhoid fever (21%). Results showed that women are more likely to seek health than males. The differences explained above were significant (X2 = 8.771, P = 0.003). A significant relationship was also observed between gender and health-seeking with an effect size of 0.148 (P = 0.003), as well as between level of education and health-seeking (X2 = 49.422, P < 0.001). There was no significant relationship between religion and health-seeking (X2 = 6.383, P = 0.076), as well as between occupation and health-seeking (X2 = 44.476, P < 0.001). Conclusion: Health-seeking behavior in Njinikom includes a high rate of self-medication and use of traditional medicine, due to the misconception of disease and the costs of health services. Even among respondents who prefer orthodox medicine, the principal reasons for its use were comparisons to traditional medicine, usually with a bad perceptional concept of it. Better health outcomes will be achieved if practical health literacy and promotional programs are developed that take into account the special needs of the community members and their living environment.
American Journal of Public Health Research. 2021, 9(5), 189-200. DOI: 10.12691/ajphr-9-5-2
Pub. Date: August 04, 2021
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by Shakeel Mahmood
Commentary
The world is currently experiencing a devastating pandemic of an infectious disease called coronavirus disease 2019, or COVID-19. Many countries around the globe are now enforcing lockdowns to try to slow down the spread of the killer disease. Such restrictions and measures differ from country to country however usually involve cancelling public events, closing borders, closing schools and encouraging people to work from home. In Feb 2021, WHO said that there was still insufficient evidence to determine how the virus entered Wuhan, but that it was clear it was circulating elsewhere in Wuhan at the same time. In July 2020, an Oxford University expert believes that the novel coronavirus may not have originated from China, rather it stayed dormant across the world and turned up when the environment conditions were friendly for it to flourish. In 1999, Dr. M R Choudhury from Bangladesh indicated the infectious diseases are being controlled and are fading away has evidently been found to be incorrect. Further he maintained that it is quite obvious that microbes can strike us back whenever the delicate ecological balance is disturbed. Dr. Choudhury’s prediction in June 1999, Oxford Professor’s observation in July 2020 and recent WHO findings in Wuhan Feb 2021- all are similar. When the ecological balance is disturbed, humans must figure out a way to restore the ecological balance. It is crucial to eventually determine the origin. It will help us maintain ecological balance with future viruses.
American Journal of Public Health Research. 2021, 9(5), 184-188. DOI: 10.12691/ajphr-9-5-1
Pub. Date: July 14, 2021
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