Pandit Deen Dayal Upadhayaya University of Health Sciences, Karnal is a university specialised in health sciences in Karnal, Haryana, India. It was established by Haryana Act No. 27 of 2016 and named University of Health Sciences, Karnal which was changed into Pandit Deen Dayal Upadhayaya University of Health Sciences, Karnal by an amendment act passed in 2018.
This study examined the impact of a self-monitoring intervention on physical activity, health literacy, and health-related quality of life (HRQOL) in older adults receiving long-term care (LTC) in a non-randomized controlled trial (non-RCT). This non-RCT included participants undergoing rehabilitation at a daycare center between January and April 2024. Inclusion criteria were age ≥ 65 years, ambulatory status, and consent to participate. Those who did not meet LTC levels and those with dementia were excluded. Two-group comparisons at baseline were conducted using unpaired t-test, Mann–Whitney U test, or χ2 test. The effects of the intervention on step count, sedentary behavior, physical activity intensity, health literacy, and HRQOL were analyzed using a two-way mixed effects model with repeated measures with two factors: group (control, intervention) and time (baseline, 12-week follow-up), with 95
BackgroundPersistent human-to-mosquito parasite transmission hinders malaria control in high burden settings. Understanding the human transmission reservoir can support the design of targeted interventions to reduce transmission.MethodsIn a year-long cohort study in rural Malawi, we used molecular methods to detect all Plasmodium falciparum (Pf) infections and those containing gametocytes, the parasite stage required for transmission, longitudinally at routine surveillance and sick visits. Using population-level analyses, we determined the demographic, temporal, and spatial clustering of infections containing gametocytes and gametocyte density, which predicts transmission.ResultsHere we show that gametocytes are not randomly distributed among the population or among individuals with Pf infections; gametocytes are detected in only 23% of the population. Among all participants, school-age children have significantly higher incidence of gametocyte-containing infections and high-density gametocyte infections compared to other groups. The presence of school-age children is a key driver of gametocyte frequencies and densities within households, even after adjusting for Pf infection levels. Based on the total gametocyte abundance in the population, we estimate that clearing infections from asymptomatic school-age children in the rainy season would decrease gametocyte abundance by 67% in the population.ConclusionsSchool-age children are the primary driver of ongoing Pf transmission in Malawi and interventions targeting school-age children are needed to effectively reduce Pf infection risk at a population level.
INTRODUCTION:Cardiovascular diseases (CVDs) are responsible for nearly a third of deaths globally. We conducted this study to understand the prevalence of history of CVDs, their prevention and treatment in twelve African countries using the World Health Organization STEPwise Approach to Surveillance (WHO STEPS) data. METHODS:We used secondary STEPS data extracted from 12 African countries between 2014 and 2019. CVD was defined as a self-reported history of heart attack, angina, or stroke. Weighted percentages, counts, weighted odds ratios (OR), and the corresponding 95% confidence intervals (95%CI) were computed using the R software. We fitted logistic regression models to select the predictor variables from a regression model for CVD prevalence, CVD prevention and CVD treatment binary endpoints. RESULTS:Amongst 60,294 individuals, the prevalence of CVD was 5%. The CVD prevalence was higher in older individuals, females, individuals with hypertension, smokers, people with high salt intake, and in certain countries. Eleven percent of the 23,630 individuals at high risk of CVD (≥40 years) but without a history of the disease received CVD prevention treatment. Amongst the 2,895 persons with CVDs, 22% received treatment and counselling for CVD: 34% (n = 215) receiving aspirin, 32% (n = 202) counselling for CVD risk factors, 11% (n = 66) statins, and 24% (n = 148) both statins and aspirin. The uptake of CVD treatment varied by hypertension status, sex, age and country. CONCLUSION:The prevalence of CVD was relatively low and CVD treatment uptake was sub-optimal. Concerted efforts must be made to accelerate the diagnosis and expand treatment for CVDs in Africa if to curtail untimely deaths attributable to CVDs.
Control of malaria and schistosomiasis among school children poses a key public health challenge in Chikwawa District, Malawi. Furthermore, anticipated environmental changes from the Shire Valley Transformation Programme (SVTP), a large-scale irrigation scheme, are expected to both alter transmission of malaria and schistosomiasis. To later inform future disease surveillance and appropriate control interventions, our study sought to establish comprehensive seasonal and spatial baseline epidemiological data. Four cross-sectional surveys were undertaken in 21 primary schools, covering two wet and two dry seasons. A total of 4176 children aged 7-13 years were examined using rapid diagnostic tests for malaria, urine reagent strips with egg-filtration microscopy for urogenital schistosomiasis, and urine-Circulating Cathodic Antigen (CCA) dipsticks for intestinal schistosomiasis. The overall prevalence was 10.8% (95% CI: 9.8-11.7%) for malaria, 36.5% (95% CI: 35.1-38.0%) for urogenital schistosomiasis, and 1.9% (95% CI: 1.5-2.4%) for intestinal schistosomiasis. Co-infection prevalence of malaria and urogenital schistosomiasis was 5.2% (95% CI: 4.5-5.9%). Macrohematuria was at 5.5% (95% CI: 4.8-6.2%) while microhematuria was at 26.2% (95% CI: 24.9-27.6%). Seasonal fluctuations were noted for malaria, whereas schistosomiasis was limited, although both diseases exhibited strong spatial heterogeneity. Alarmingly, malaria exceeded 25% and urogenital schistosomiasis surpassed 50% in certain schools, thus clearly demonstrating currently unmet public health needs. These are set to become further exacerbated by forthcoming SVTP-driven environmental change; hence, we provide critical evidence to guide the Malawi Ministry of Health in strengthening surveillance and preparing integrated disease control.
Cancer has become a major public health problem in Cameroon. In 2020, 20,000 new cases and 14,000 deaths were registered. Despite its high burden, access to quality medications for this condition continues to be a persistent challenge in the country. This study assessed the perceptions and practices of key stakeholders on barriers to accessing quality anticancer medicines in Cameroon. The overall goal was to generate data on key challenges related to the quality of anticancer medications and their impact on cancer care and treatment in Cameroon. This is to inform policy and interventions aimed at addressing the problem. In a cross-sectional qualitative study, a document review of key reports and documents, and 57 stakeholders were purposively identified and interviewed. The choice of these respondents was informed by their engagements in one of the areas of the chemotherapy supply chain in Cameroon, including regulation, procurement, quality control, and use. Data from document notes and interviews were analyzed using a thematic approach. Several factors were identified as affecting the quality of chemotherapy medications, including weak regulatory systems, inadequate funding for regulatory activities, and a lack of core competencies among staff responsible for regulatory functions. Other factors included the high cost of anticancer medications, which influenced accessibility to quality products, as well as the quality of care offered to patients who could not afford high-priced products. These weaknesses, coupled with a lack of point-of-care tools, appear to encourage the proliferation of substandard medicines in our setting and the use of substandard therapies or protocols to treat patients. Our study sheds light on the multifaceted problems that plague Cameroon's chemotherapy supply chain and how these impact access to optimal care and treatment for cancer patients. Urgent actions are needed to enhance the regulatory landscape and improve the affordability of quality anticancer medications in Cameroon.
