Self-Collected Specimens Revealed a Higher Vaccine- and Non-Vaccine-Type Human Papillomavirus Prevalences in a Cross-Sectional Study in AkuseRead the full article
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Compliance to Iron-Folic Acid Supplementation and Its Association with the Number of ANC Visits in Ethiopia: Systematic Review and Meta-Analysis
Background. The World Health Organization recommended that 80% of communities in all countries should receive the standard dose of iron folic acid. But, in Ethiopia, this target was not yet achieved. The compliance of iron folic acid was also variable across each district. Therefore, the aim of this study was to assess women compliance with iron-folic acid supplementation and its association with a number of antenatal care visits in Ethiopia using systematic review and meta-analysis, 2018. Methods. In the current meta-analysis, the target variables were searched from different electronic database system like PubMed, Google Scholar, Science Direct, and Cochrane Library. To predict the pooled prevalence of compliance with iron-folic acid supplementation in Ethiopia, all original studies were considered. All necessary data were extracted by using a standardized data extraction format. The data were analyzed by using STATA 14 statistical software. Heterogeneity between the studies was assessed by Cochrane and tests. A random effect model was computed to estimate the pooled compliance with iron-folic acid supplementation. Results. Twelve full-text studies were included in the meta-analysis. The findings of this meta-analysis revealed that the pooled prevalence of compliance with iron-folic acid supplementation in Ethiopia was 43.63% (CI: 28.00, 59.25%). The women from the city administration had a high rate of compliance as compared with other regions of Ethiopia. The odds of having four or more antenatal care visit were the independent pooled predictor of compliance with iron-folic acid supplementation. Conclusion. Current compliance with iron-folic supplementation was lower than the World health organization recommendation. Mothers from the city administration who utilized the antenatal care four and above times, had high level compliance with iron-folic acid supplementation. Therefore, we recommended that women should visit the antenatal clinic four times to compliance with the iron folic acid supplementation.
Nephrolepis exaltata Herbal Mask Increases Nasal IgA Levels and Pulmonary Function in Textile Factory Workers
Background. Chronic occupational exposure in textile workers lowers the pulmonary function and levels of sinonasal IgA. A Nephrolepis exaltata herbal mask can protect the respiratory tract. This study aims to understand the effect of this herbal mask on the IgA levels and pulmonary function in textile workers. Thirty employees were selected for this study. Methods. The pre- and post-test randomized experimental control trials were conducted in a garment industry of Bawen, Semarang, Indonesia. The subjects that qualified to participate (n = 30) fulfilled the inclusion criteria i.e., 20–35 years old, healthy, and willing to be a research subject; and exclusion criteria i.e., having history of alcohol consumption, smoking, history of liver disease, autoimmune disease, cancer, pulmonary and heart disease and/or being pregnant. The subjects were then divided randomly into control group (n = 15), who used regular mask that was rewashed and changed every month for eight weeks, and treatment group (n = 15), who used Nephrolepis exaltata mask that was changed every two days for eight weeks. Pulmonary function tests were carried out using MIR Spirolab III before and after the experiment. IgA levels were measured by nasal wash method using ELISA. Results. IgA levels of the treatment group before and after usage of mask were significantly different () compared to the control group. There were significant difference in FVC of the control group, but no significant difference was observed for FEV1 () and PEF (). In the treatment group, all three parameters showed significant differences [FVC (), FEV1 (), and PEF ()]. The means of ΔFVC, ΔFEV1, and ΔPEF were significantly () higher in the treatment group with OR = 5.1 for higher IgA levels. Conclusions. The herbal mask is better in increasing IgA and improving the pulmonary function compared to the regular mask.
Effective Vaccine Management: The Case of a Rural District in Ghana
Background. The Effective Vaccine Management (EVM) initiative provides the platform needed to monitor and assess the vaccine supply chain system to identify strengths and weaknesses of the system at all levels to enhance the development of improvement plan to strengthen the system. This valuation was carried out in the Tolon District of the Northern Region, Ghana. Methods. A descriptive valuation of vaccine management was carried out in six vaccine stores in the Tolon District of Northern Ghana. We employed World Health Organization (WHO) assessment tools and procedures which consisted of desk reviews and interviews of cold chain managers to assess vaccine management practices in the district. Five out of the nine global assessment criteria were assessed and a minimum target level required for all criteria to meet the WHO standard was 80%. Results. None of the facilities assessed met the WHO benchmark of 80% for all but one criteria assessed. With regards to temperature control, the scores ranged from 42% at Kasuliyili CHPS Centre to 77% at the district store with an average district score of 60%. Stock management ranged between 11% at Wantugu Health Centre and 75% at Nyankpala Health Centre with district average score of 32%. Effective vaccine distribution scores ranged between 13% at Kasuliyili CHPS and 46% at Nyankpala Health Centre with an average district score of 27%. Only Nyankpala Health Centre had an acceptable score of 84% for vaccine management, whereas the lowest score for this indicator was 5% at Tolon Health Centre store with district average score of 53%. Information management and supportive functions scores ranged from 0% at Tolon Health Centre to 26% at the district store with the district average score of 16%. Nineteen (90.5%) of vaccine users had poor knowledge regarding temperature control and vaccine distribution. Conclusion. Effective vaccine management knowledge and practices are poor at Tonlon district and calls for urgent and pragmatic approaches such as training and re-training of vaccine users at all levels.
Bacterial Infections and Their Antibiotic Resistance Pattern in Ethiopia: A Systematic Review
Background. Antibiotic resistance is a global challenge in the public health sector and also a major challenge in Ethiopia. It is truly difficult to report bacterial antibiotic resistance pattern in Ethiopia due to the absence of a review which is done comprehensively. The aim of this systematic review was to provide an overview of the works of literature on the antibiotic resistance pattern of the specific bacterial isolates that can be obtained from different clinical samples in the context of Ethiopia. Materials and Methods. A web-based search using PubMed, Google Scholar, Hinari, Sci Hub, Scopus and the Directory of Open Access Journals was conducted from April to May 2018 for published studies without restriction in the year of publication. Works of literature potentially relevant to the study were identified by Boolean search technique using various keywords: Bacterial infection, antimicrobial resistance, antibiotic resistance, drug resistance, drug susceptibility, anti-bacterial resistance, Ethiopia. Study that perform susceptibility test from animal or healthy source using <10 isolates and methods other than prospective cross-sectional were excluded. Results. The database search delivered a total of 3459 studies. After amendment for duplicates and inclusion and exclusion criteria, 39 articles were found suitable for the systematic review. All studies were prospective cross-sectional in nature. The review encompasses 12 gram-positive and 15 gram-negative bacteria with their resistance pattern for around 12 antibiotics. It covers most of the regions which are found in Ethiopia. The resistance pattern of the isolates ranged from 0% up to 100%. The overall resistance of M. tuberculosis for antituberculosis drugs ranges from 0% up to 32.6%. The percentage of resistance increases among previously treated tuberculosis cases. Neisseria gonorrhea, S. typhimurium, S. Virchow, Group A Streptococci (GAS), and Group B Streptococci (GBS) were highly susceptible for most of the tested antibiotics. Methicillin-Resistant Staphylococcus aureus was highly resistant to most of the antibiotics with a slightly increased susceptibility to gentamycin. Conclusions. Total bacterial isolates obtained from a different source of sample and geographic areas were 28, including M. tuberculosis. Majority of the bacterial isolates were resistant to commonly used antibiotics. A continuous monitoring and studies on the multidrug-resistant bacterial isolates are important measures.
Prevalence Study of Dermatologic Manifestations among Diabetic Patients
Background. Diabetes mellitus (DM) is an interdisciplinary disorder that needs many different specialties’ attention; however, the importance of dermatologists’ knowledge has not been highlighted regarding this issue. As a result, we aim to assess the prevalence and variety of DM skin and nail manifestations in an effort to further acquaint dermatologists and other clinicians with diabetic dermatologic manifestations. Methods. This was a cross-sectional study; subjects who had a diagnosis of DM, attending to the outpatient endocrinology clinics of Rassoul Akram Hospital, Tehran, Iran, were evaluated by one dermatologist for diabetic dermopathy. The results were recorded in prepared data sheets, and general descriptions of DM duration, DM type, DM control, and drug history as well as the demographic data were gathered. Results. Among a total of 255 subjects, the prevalence of one or more identifiable skin conditions was 88.4%. 15.7% of the subjects had nail manifestations. Among cutaneous manifestations, acanthosis nigricans, acral erythema, and onychoschizia showed a significant relationship with the age and disease duration (p<0.05); and knuckle pebbles, eczema, facial erythema, and koilonychias had a meaningful relationship with FBS level and glycated hemoglobin, HbA1c (p<0.05). Conclusion. This study provides an overview that facilitates earlier detection and treatment of DM. Also, this data can help physicians and endocrinologists to visualize DM control level.
Vitamin D as an Adjunctive Treatment to Standard Drugs in Pulmonary Tuberculosis Patients: An Evidence-Based Case Report
Background. Vitamin D has a prominent role in the body’s innate immunity as it is important in the maintenance of macrophages and monocytes and its function in defending against infections. In-vitro studies have established vitamin D’s potential role in tuberculosis (TB) infection, in that it restricts Mycobacterium tuberculosis growth, thus implying the potential benefit of vitamin D as an adjunctive treatment for TB. However, clinical trials and reviews have contradicting findings regarding the true clinical efficacy of adjunctive vitamin D, particularly in reducing the sputum conversion rate (SCR). Objective. This study aims to update the current evidence regarding vitamin D supplementation as an adjunctive treatment in achieving the smear sputum conversion rate (SCR) among pulmonary TB patients. Method. A comprehensive search was conducted in October 2018 in PubMed-NCBI, MEDLINE-OVID, SCOPUS-Elsevier, and Cochrane. The selection of studies was done as per the predetermined inclusion and exclusion criteria of this EBCR and resulted in the inclusion of 11 eligible studies (8 RCTs and 3 systematic reviews). The selected studies were then critically appraised for their validity, importance, and applicability according to the CEBM (Centre for Evidence-Based Medicine) appraisal tools. Results. Overall, most of the trials showed no statistically significant changes in terms of the proportion of TB patients with a negative sputum smear conversion in the group treated with an adjunctive therapy vs. the group treated with standard antituberculosis therapy alone. Only one trial showed significant results, which was conducted in a population of TB patients with vitamin D deficiency. Furthermore, overall the reviews showed no significant change in the 8-week sputum smear conversion after treatment within the group given vitamin D in comparison to those who were not. Conclusion. Vitamin D as adjunctive therapy in TB patients shows no clinical improvement in terms of sputum conversion to antituberculosis management.